Vol 5, No 1 (2024)

BACKGROUND: Suicide cases in Mexico have increased during the last two years and are the second-leading cause of death in the young adult population.

AIM: To describe gender differences in violent suicide attempts as relates to diagnosis and the seeking of psychiatric care.

METHODS: A descriptive retrospective study was conducted. The referral forms of 241 patients who had attempted suicide were analyzed.

RESULTS: The mean age of the patients was 29.1 (SD=10.8) years, n=140 (58.1%) of the sample were women. Affective disorders were the most frequent diagnoses for both sexes. Women were more likely to delay seeking psychiatric care: 60 days versus 30 days of delay for men (p=0.009). Men were shown to more frequently resort to violent suicide methods. Both women and men who used violent suicide methods were shown to delay by more days the seeking of psychiatric care than those who were found to have used non-violent suicide methods.

CONCLUSION: We found that patients who use more violent methods of suicide took longer before seeking psychiatric care. This delay in accessing psychiatric care can be thought to contribute to the fact that completed suicides are more frequent within that category of patients. The majority of suicide attempts occurred in the 17–24 years age group; therefore, it seems reasonable to analyze the existing barriers to seeking psychiatric care, mainly in the young adult population, and to design strategies to bring mental health services closer to this population group.

BACKGROUND: Cannabis Hyperemesis Syndrome (CHS) is a condition characterized by episodic bursts of vomiting and abdominal pain linked to cannabis use. The clinical picture mimics an acute abdomen and is often misdiagnosed, especially when the patient avoids reporting their cannabis use for legal reasons.

CASE REPORT: We report on the case of a 33-year-old man that was brought to the emergency room with a history of 3 days of non-bloody, non-projectile, and non-bilious brownish vomit, coupled with severe epigastric and left hypochondriac pain, and a slight fever. He was a daily cannabis user for several years and had stopped using a week or so before the onset of the symptoms, as he was traveling to a country with more restrictive cannabis laws. His condition deteriorated rapidly, followed by emergency room attendance, thorough diagnostic work-up, and unsuccessful interventions, including intravenous treatment with the anti-emetic Ondansetron. The patient was referred to a psychiatrist after a suspected psychogenic etiology by the medical team. The history was suggestive of CHS and also included anxious, depressed mood with ‘brain fog’. The abdominal pain was the most severe complaint. A combination of tramadol, promethazine, and mirtazapine given on an outpatient basis led to full recovery within 10 days.

CONCLUSION: CHS can occur soon after the interruption of chronic cannabis use and overlap with withdrawal symptom. A combination of anti-histaminergic, opioid-based medication, and antidepressant mirtazapine seemed an effective treatment of CHS, which resulted in a relatively quick recovery.

The Dhat syndrome is a culture-bound syndrome associated with anxiety and somatic and mood symptoms related to semen loss. It sometimes occurs in women, in whom it comes with vaginal discharge. Only a single case has been reported whereby Dhat delusion was associated with schizophrenia. In this case report, we dwell on two individuals suffering from a somatic-type delusional disorder with Dhat-like symptoms who had initially presented classical symptoms of the Dhat syndrome. Further studies are needed to explore the intersections of Dhat syndrome and psychoses, as well as the risk factors involved in mutual predisposition.

Psychiatric care has undergone several cycles of profound changes in the past centuries all over the world. In Hungary, community-based outpatient care has been showing signs of evolution since the 1950s. Initially, the system centered on assertive outreach and family involvement, especially for those with serious mental health problems. Such services remain available throughout the country, but the emphasis in the past decades has shifted towards mass care provision. In many places, community-based services are no longer provided, and where they are the approach is biomedical and less asuming of recovery. In other centers, the services provided are conceived with the eventuality of rehabilitation in mind and in close cooperation with community-based care providers.

Community-based services providers, as part of the social fabric, offer as many psychiatric and rehabilitation services as possible for those with mental disorders within their communities. The main objective of community-based care is to achieve community re-integration and recovery from mental disorders. Today in Hungary, deinstitutionalisation and the introduction of community-based psychiatric care have been adopted even by large inpatient institutions. The replacement of institutional bed space and the provision of subsidised housing further underscore the importance of community-based psychiatric care provision. There is the opinion that, as a further course of development, the emphasis needs to now shift towards the nurturing of a community of experienced experts and creastion of user-led programs. In this new paradigm, the ability of a person with a mental disorder to make decisions and the bolstering of that ability are seen as vital. In order to achieve these objectives, it is essential that health and social seervices professionals cooperate. Hands-on experience is key in the provision and development of such services.

The progress in any field depends, first and foremost, on the people who work in it. Luckily, today the indispensable contribution of women to all areas of knowledge is widely recognized. However, it is crucial to continue advocating, challenging prejudices and promoting empowerment of women worldwide.

International and regional platforms to address gender equality issues, the UN Women initiative and the annual Women's History Month, which is celebrated in March in many countries across the globe, are intended to emphasize the role of women in world history and the development of modern society.

While mental sciences by their very name refer to Psyche, the young heroine of ancient Greek myths, women began to contribute fully to psychology and psychiatry as late as the beginning of the 20^th century. Sabine Spielrein (1885) is known to be the first woman psychoanalyst. She was a student, a friend and a colleague of Freud and Jung. Karen Horney, born in the same year, was one of the key figures of neo-Freudism. At the end of the 19^th century, Ivan Mikhailovich Balinsky gave lectures on psychiatry to the young women attending medical courses.

Why do women increasingly choose the path once dominated by men? What motivates bright young women to pursue this career? Why have some of them dedicated their lives to caring for others’ mental health? We had an opportunity to talk to several female psychiatrists and psychologists, members of the editorial board and authors of Consortium Psychiatricum.

We asked our interviewees, explorers of human mind, a few simple questions so that this time, they could open up their own souls and share. The key features that distinguish our interviewees are the desire to follow their vocation despite stereotypes, a true passion for science, the ability to empathize and to create a safe space for themselves and others wherever they go.

We hope that their memories, reflections and guidance will inspire and support the next generation of women working in the mental health field.