bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of peripheral markers of inflammation in cognitive dysfunction in schizophrenic patients: a systematic review
Authors: Ben Othman F. , Aissa A. , Adouni A. , Yosra Z. , Ouali U. , Jomli R.
Published: August 2023

Introduction

Schizophrenia (SCZ) is a chronic mental illness characterized by a rich and diverse symptomatology. A generalized cognitive deficit has been widely recognized among the symptoms of this disease. Several authors have studied the relationship between peripheral markers of inflammation and cognitive dysfunctions in order to explain the etiopathogeny of these disorders.

Objectives

The aim of our study is to better comprehend the nature of the relation between peripheral markers of inflammation and cognitive dysfunctions.

Methods

A systematic review of the literature was conducted following the guidelines provided by the PRISMA method. We performed a systematic search focused on two automated bibliographic databases: Pubmed and Google Scholar including the following keywords: “inflammation”, “schizophrenia”, “cognition”

Results

A total of 17 articles were included.

Significant relations with cognitive function were reported with IL-6, IL-18, IL-2, IL-8, tumor necrosis factor α (TNF-α ) and chemokines. Memory was the cognitive domain where the most significant relations with cytokines were objectified.

BDNF levels were correlated with cognitive tests in 5 studies of SCZ populations. The domains concerned were inhibition, flexibility, verbal fluency, verbal memory, attention, and processing speed.

Elevated CRP in patients with SCZ was reported by all studies and a significant relation with cognition in 3 studies. This relations is objectified in the areas of memory, executive functions and processing speed.

The relations between CRP, BDNF, cytokines and cognitive functions was inconsistent across studies.

Conclusions

The majority of the results observed during the review were in favor of a significant relation between CRP, BDNF and cytokines. Nevertheless, these results were not constant and heterogeneous. It would be interesting to better explore the nature of this relation through prospective studies in order to establish therapeutic perspectives.

Disclosure of Interest

None Declared
Fate of the first Brief Psychotic Disorder in hospitalised patients
Authors: Bouguerra I. , Homri W. , Lagha M. , Ben Romdhan I. , Bram N. , Labben R.
Published: August 2023

Introduction

Brief Psychotic Disorder (BPD), defined according to the DSM-5 by the presence of delusions and/or hallucinations and/or disorganised speech persisting for at least one day and less than one month, the disturbance not being due to a bipolar disorder or a schizophrenia spectrum disorder or to the effect of a substance. Classically, the prognosis of a BPD is considered to be divided between restitution ad integrum (30%), progression to bipolar disorder (30%), progression to schizophrenia (30%) or repetition of the same form (10%).

Objectives

The objectives of our study were to evaluate the evolutionary modalities after the first hospitalization for BPD after a follow-up of at least one year and to compare them with the data in the literature.

Methods

Our study was retrospective and descriptive. We reviewed the records of patients hospitalised in our department from 1 January 2014 to 31 December 2018 for a first BPD and assessed the subsequent course over a minimum period of one year.

Results

We included 70 records of patients hospitalized. Twenty-five patients (35.71%) were lost to follow-up after their first hospitalisation. The remaining patients (64.29%) were divided into 3 groups according to the above-mentioned evolutionary modalities (recovery, recurrence of BPD, progression to schizophrenia, progression to bipolarity). Results were in favour of an evolution towards bipolar disorder (35.55%), towards schizophrenia (44.44%), a relapse of the BPD (4.44%), while 13.33% of the BPDs had no future after an aftercare of at least one year. In addition, one case of evolution towards a chronic delusional disorder of the persecution type was observed.

Conclusions

In the present study, our results tend to be in line with the law of one-third described by some authors despite a slight discrepancy partly explained by the limitations of our study. Although, the outcome of BPD remains unpredictable. The minimum five years of evolution are decisive in assessing the subsequent prognosis.

Disclosure of Interest

None Declared
A phenomenological approach to the affective core of Delusional Disorder.
Authors: Pellegrini R. , Muñoz Negro J. E. , Ottoni R. , Tonna M. , Cervilla J. A.
Published: August 2023

Introduction

According to current diagnostic systems, affective symptoms do not represent a fundamental criterion for the diagnosis of DD. However, numerous studies have highlighted frequent comorbidity between DD and Mood Disorders and have elucidated the importance of the affective state in the development and persistence of delusions. Thus, some factor analysis studies have identified the existence of a depressive dimension in DD, suggesting a substantial psychopathological heterogeneity in DD. However, these important affective features have not evaluated from a phenomenological point of view and in their relationship with delusions.

Objectives

The aim of the present study is to investigate the relationship between personality, trait affectivity and severity of delusions in patients with Delusional Disorder (DD).

Methods

Thirty-two outpatients affected by DD were administered the Structured Interview for DSM-IV-TR Personality Disorders (SIDP-IV), the Pathological Narcissism Inventory (NPI), the Positive and Negative Affect Schedule (PANAS) and the Psychotic Symptom Rating Scale (PSYRATS). Next, we analysed the prevalence of personality disorder in our sample of patients with DD and studied the correlations between the severity of delusions and the different affective variables. Finally, we obtained a multivariate explanatory model of the severity of the delusions.

Results

The severity of delusions was directly associated with “Grandiose Fantasy” item of narcissistic personality and inversely related with the feelings of shame, fear and guilt. In the multivariate model, the feeling of shame was the only independent variable capable of accounting for the severity of the delusions, that, in in DD patients, would lie on an affective core of shame.Table 2.

Pearson correlation coefficient

VARIABLESDRS total scoreGRANDIOSE FANTASYp = 0.045SHAMEp = 0.048GUILTp = 0.016AGITATIONp = 0.049FEARp = 0.041Table 3.

Standardized coefficients in linear standard regression (DRS)

DRS: total scoreR²βtpStep 10.157---GRANDIOSE FANTASY-0.3961.890.048Step 20.460---GRANDIOSE FANTASY-0.2911.650.116SHAME--0.560-3.170.005

Conclusions

The severity of delusional beliefs in DD patients would lie on an affective core of shame upon predisposing personality traits. These findings could help to develop a psychotherapeutic approach for delusional patients focused in the feeling of shame.

Disclosure of Interest

None Declared
Combined Foot and Eye Dominance Scale as a useful tool for the assessment of lateralization
Authors: Akabalieva K. V.
Published: August 2023

Introduction

Lateralization is the functional dominance of one of the dual organs of the body: eyes, arms, legs and even ears, during their spontaneous or purposeful actions. The handedness is influenced by many factors like geographic region, genetic and cultural factors as well as sex. The most used assessment for functional lateralization is hand dominance. When assessing foot and eye dominance, however, we find significantly higher left foot dominance as well as very strong left eye dominance in schizophrenic patients versus controls. We consider the explanation of this results is because in Bulgaria, during the communist regime (before 1990) left hand writing was under cultural pressure. Also handedness itself is influenced by other cultural factors as mentioned already. All of the above made us conclude that foot and eye dominance may assess much better the lateralization than hand dominance.

Objectives

The aim of the study was to investigate the relaibility (internal consistency) of a combined Foot and Eye Dominance Scale in women- patients with schizophrenia and healthy subjects.

Methods

A sample of 94 women- scizophrenia patients and healthy controls were assessed with a Combined afaoot and Eye Dominance Scale. It consisted of two subscales Foot Dominance Subscale and Eye Dominance Subscale. The Foot Dominance Subscale included a modified Chapman & Chapman Foot Dominance Scale and a new Complex Task Scales with four foot tests, reflecting on complex tasks. The Eye Dominance Subscale included three eye tests. Scale reliability statistics (item-scale statistics, summary statistics for the items, Cronbach’s alpha), non-parametric Mann-Whitney test and Spearman’s rank correlation coefficient were used.

Results

Considerable differences were found in the contribution of the single items to the Combined Foot and Eye Dominance Scale. Some items show greater means than other items (from 0,14 to 0,80), which suggested greater phenogenetic component and consequently greater contribution of these items to the total scale mean. The mean correlation between the items of the Combined Foot and Eye Dominance Scale was positive (0,32), indicating good internal consistency of the scale.

Conclusions

The Combined Foot and Eye Dominance Scale more strongly and objectively reflect leftedness and could be a more useful tool for the assessment of lateralization irrespectively of culture and nation. The Combined Scale allows cross-cultural worldwide equivalence to the different studies in different neuroontogenetic diagnoses with presumed abnormal cerebral asymmetry.

Disclosure of Interest

None Declared
The correlation beteen lifestyle and risk of metabolic syndrome in schizophrenia
Authors: Krysta K. , Tredzbor B. , Martyniak E. , Piekarska-Bugiel K. , Koźmin-Burzyńska A. , Cieślik A. , Krzystanek M.
Published: August 2023

Introduction

Patients suffering from schizophrenia have a higher risk of premature death. An unhealthy lifestyle contributes to increased risk of cardiovascular diseases, metabolic syndromes, suicides among them. In addition to the use of selected therapy with a restriction metabolic risk has become important to influence non-pharmacological factors such as proper diet, introducing the principles of a healthy lifestyle. A diet rich in fiber, the DASH diet, the Mediterranean diet may become beneficial in terms of lowering parameters metabolic, cardiovascular and immune related to premature mortality in schizophrenia.

Patients suffering from schizophrenia have a higher risk of premature death. An unhealthy lifestyle contributes to increased risk of cardiovascular diseases, metabolic syndromes, suicides among them. In addition to the use of selected therapy with a restriction metabolic risk has become important to influence non-pharmacological factors such as proper diet, introducing the principles of a healthy lifestyle. A diet rich in fiber, the DASH diet, the Mediterranean diet may become beneficial in terms of lowering parameters metabolic, cardiovascular and immune related to premature mortality in schizophrenia.

Objectives

The objective of this study was to evaluate the influence of the lifestyle on the metabolic parameters in schizophrenia

Methods

In our study, we assessed the influence of diet, nutritional knowledge and lifestyle on parameters of metabolic syndrome (cholesterol, triglicerydes, glucose) in patients with schizophrenia.

Results

In the results we have found positive co-relations between unhealthy diet and lifestyle and lack of knowledge on proper nutrition and increased parameters of metabolic syndrome.
Groups
BMI (Std. Dev)
Cholesterol HDL mg/dl
Triglicerides mg/dl
Insuline resistaneceInsuline uU/mlStudy group30,58(4,44)45,63(7,34)177,32(108,76)4,68(4,64)19.77(17,35)Control Group26,00(3,39)54,32(14,07)111,47(57,48)2,1(!,21)9,01(4,97)

Conclusions

Dietary intervention may become one of the therapeutic goals in schizophrenia.

Disclosure of Interest

None Declared
Amantadine augmentation in electroconvulsive therapy-resistant catatonia: a case report.
Authors: Bueno Sanya L. , Andreu Gracia H. , De Juan Viladegut O. , Olivier Mayorga L.
Published: August 2023

Introduction

Catatonia is a syndrome characterized by physical symptoms ranging from immobility to excessive motor activity. Besides being historically associated mainly with schizophrenia, it is widely known that it can be the expression of different psychiatric, neurological or medical conditions. The treatment of choice is benzodiazepines, indicating electroconvulsive therapy in refractory cases. Amantadine is considered a second-line therapy in setting when electroconvulsive therapy is not available.

Objectives

To describe the case of a patient with treatment-resistant catatonic schizophrenia. Not having responded to benzodiazepines or electroconvulsive therapy, potentiation with amantadine was subsequently started.

Methods

Our patient presented at a psychopathological level; psychomotor inhibition, a perplexing attitude, and mute speech. At the motor level; ambitendency, indecision, automatic obedience, motor stereotypes, and facial grimaces. He did not present other alterations at the neurological level. Regarding complementary explorations, we performed neuroimaging and blood tests, which resulted all anodyne. With an alternative diagnosis, we considered that sequelae of a neuroleptic malignant syndrome could have produced the symptoms that he had suffered. Due to the persistence of the symptoms and their typical characteristics, catatonia was our first diagnostical impression. As treatment with benzodiazepines was ineffective, electroconvulsive therapy was started. No clinical improvement was observed. Given the refractoriness of the case, a review of the existing literature was carried out. We found reports of a good response to amantadine in similar cases. Amantadine was introduced up to a dose of 200mg.

Results

After four weeks of treatment with amantadine at a dose of 200mg, the patient showed meager improvement at both psychopathological and motor level.

Conclusions

We find the case of a patient with long-term schizophrenia who is nowadays dependent on all daily living activities and requires sustained care.

Disclosure of Interest

None Declared
Factors attributed to violent behaviour by primary caregivers toward their relative with schizophrenia
Authors: Stambouli M. , Fekih Romdhane F. , Ghrissi F. , Cherif W. , Cheour M.
Published: August 2023

Introduction

There is a modest but consistent association between violent behavior and schizophrenia. Persons with schizophrenia are at a modestly increased risk of committing violence ,with approximately half of victims being relatives

Objectives

Our study examined the factors attributed to violent behaviour within the relationship patient-caregiver in schizophrenia according to caregivers.

Methods

This is a cross-sectional study among caregivers of patients with schizophrenia during the period from June to August 2022.Patients who attended our department of psychiatry at the Razi.

The questionnaire was divided into three sections. The first section contained items regarding patient- and caregiver-related information.

In the second section, caregivers were asked questions about their experience of violence perpetration and victimization involving their relative with schizophrenia in the past 12 months.

Beyond frequency, caregivers were also asked to specify, the causes of the violence perpetrated and suffered

The third section contained two measures, i.e. the Depression Anxiety and Stress Scales (DASS-21) and the abridged version of the Zarit Burden Interview (ZBI), assessing psychological distress and caregiving burden, respectively. The protocol of the study was approved by the ethics committee of the Razi Psychiatric Hospital.

Results

The majority of caregivers were females (63.6%), and consisted of patients’ parents (50.9%).

The most endorsed causes of violence victimization were symptoms of illness (57.3%), followed by refusal to adhere to treatment (49.1%), drug reaction (23.6%), and negative events; while the most reported causes of violence perpetration were refusal to adhere to treatment (42.7%), Symptoms of illness (37.3%), and limitation of patients’ activities and/or liberty (32.7%).

Bivariate analysis showed that lower patients’ economic status (p=.042), tobacco (p=.015) and alcohol use (p=.014) as well as taking Trihexyphenidyl (p=.001) were significantly and positively associated with violence perpetration by caregivers against their relatives with schizophrenia.

Multivariable analysis (Logistic regression) revealed that caregivers’ levels of burden remained significantly associated with violence victimization occurrence (p=.026; OR=1.48), while only having other person in charge of caring represented a significant factor associated with perpetration of any form of violence against patients (p=.007; OR=.17).

Conclusions

It is important for medical staffs to provide caregivers with professional knowledge about patients’ real motivation for violence in order to improve their skills of problem-solving.

Disclosure of Interest

None Declared
Clinical presentation of late-onset psychosis (LOP) and differential diagnosis with dementia: a case report
Authors: Oller S. , Esteve Vila R. , Pérez Machado M.
Published: August 2023

Introduction

Late-onset psychosis appears in people over the age of 40. Some preliminary studies show that LOP has fewer severe positive symptoms, more systematic persecutory delusions, more bizarre-type delusions, less affective flattening, and more social withdrawal than early onset psychosis.

There are some studies that consider late-onset and very late-onset psychosis as prodromes of neurodegenerative disease. There are some differences in neuropsychological profiles and specific cognitive function alterations discovered. More evidence, however, is required to make an accurate diagnosis.

Objectives

The objective of this study was to reflect the difficulties in differentiating between late-onset psychosis and dementia by reporting the case of a 77-year-old woman who presented with mystical-religious delusions and hallucinations during her hospitalization.

Methods

We present the case of a 77-year-old woman who was hospitalized because of a stroke. During her stay, she began receiving follow-up from the mental health team because she verbalized some mystical-religious delusional ideas. During the psychiatric interview, the patient verbalized mystical-religious ideas and oscillated between coherent, organized, and disaggregated speech. No problems were detected with orientation, or florid affective symptoms that could point to a delirium or affective disorder. The premorbid personality was extravagant, with interpersonal difficulties and magical thinking. Nonetheless, she had no prior contact with the mental health system or hospitalization. We could approximate the beginning of the symptomatology at around 60 years old, thanks to her relatives. Prior to this age, she maintained good function by working as a chef on a regular basis. She gradually isolated herself due to her lack of mobility. Similarly, she decreases her self-care activities, begins hoarding items around the house, and gradually develops more psychotic symptoms.A brain scan was performed, and no acute pathology was found. A neuropsychological test was not executed due to a lack of collaboration from the patient.

Results

-

Conclusions

This case reflects the complexity of differentiating between dementia and late-onset psychosis. Supplementary testing and follow-up are essential for establishing a diagnosis. Related to that, more research is needed to identify the differential characteristics between the two disorders and the temporal correlation between them.

Disclosure of Interest

None Declared
Early detection and intervention of psychosis in children and adolescents in Zurich, Switzerland: Clinical Data from 2017-2022
Authors: Franscini M. , Traber-Walker N. , Probst F. , Gerstenberg M. , Walitza S.
Published: August 2023

Introduction

The construct of a clinical high-risk (CHR) state of psychosis has been established to describe potentially prodromal symptoms which typically appear during adolescence and young adulthood. This is a very sensitive developmental period and the clinical high risk (CHR) is associated with increased functional impairment. To address the specialities in the care for this patient population a specialized outpatient care unit for early intervention in psychosis at the Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital, of the University Zürich (CAPS) is established. The interdisciplinary team (psychiatrists and psychologists) supports children and adolescents with psychotic disorders or at clinical high risk for developing psychosis. The early intervention service offers specialized assessment, treatment and case management for minors with a first psychosis or CHR-state in an outpatient or inpatient setting as well as by day clinic care.

Objectives

The evaluation main objective was to get a better understanding about this vulnerable patient group. Therefore we analysed the clinical data about CHR-state, comorbid diagnosis, treatment, medication and hospitalisation of the patients who entered the service for early intervention in psychosis.

Methods

Participants who entered the service for early intervention in psychosis were followed up in the years 2017-2021 and descriptive analysis was used to summarize the data. For the evaluation of the risk construct the participants have been classified in “no increased risk”, “CHR” or “early onset psychosis” (EOP). Additionally, ICD diagnosis, demographics and treatment (medication, psychotherapy, treatment setting) were assessed. Therapy was either psychotherapy and/or group training called DBT2P (Dialectical behavioral group training for adolescents, to prevent psychiatric disorders). Additionally, the use of a smartphone application “Robin Z”(add-on treatment tool to support the patients between the sessions) was assessed.

Results

In the last five years we saw 300 patients (112 female, mean age 15.7) who sought the care unit for early intervention. The evaluation of the risk showed that 44 patients had no increased risk, 205 were classified with a CHR and 51 fulfilled the criteria of an early onset psychosis (18.5%). Most of the patients showed comorbid diagnosis, mainly depressive disorders (42%). The data about the treatment will be analyzed for the congress.

Conclusions

Despite clinical implications, there is little data about early detection and early intervention in psychosis for children and adolescent. Therefore, the evaluation of the clinical data of the CAPS is of clinical importance and expected to add essential information in the fields of prevention and early intervention in psychosis.

Disclosure of Interest

None Declared
Moroccan suicidal schizophrenics: Case study in arrazi hospital of sale
Authors: El Moussaoui N. , Bahetta S.
Published: August 2023

Introduction

Schizophrenia is a severe, common, chronic mental disorder with a prolonged and disabling course, having a high social impact.

Mortality is two to three times higher in schizophrenic patients than in the general population.

Suicide is the main cause of death in patients with schizophrenia. In spite of great efforts in preventing such deaths, suicide rates have remained alarmingly high, highlighting the need for a better understanding of the phenomenon.

Objectives

The objective of this work is to determine the prevalence of suicide in schizophrenic patients, to investigate the main risk factors in these patients and the characteristics of suicide and the therapeutic management of the patients.

Methods

This is a retrospective study on medical records about 43 patients (32 men / 11 women) who were admitted to the Arrazi Hospital in Salé, from september 2021 to september 2022, using an operating form grouping socio-demographic criteria of the patients, personal and family history, characteristics of the suicide attempt and management.

Results

In this study, 75% were male and 25% were female with an average age of 34.5 years. The existence of a personal history of suicidal ideation, plans and attempts is a major risk factor for suicide. The lethality of the means used reflects a higher degree of suicidal intentionality. Clozapine, in particular, plays a protective role by reducing the rate of suicides and suicide attempts.

Conclusions

Despite therapeutic progress, the prevalence of suicide among patients suffering from schizophrenia is still high.

The prevention of suicide in these patients remains fundamental, as does the reduction of positive or negative symptoms, the improvement of quality of life, the reduction of the handicap caused by this illness and the fight against the stigmatization of patients.

Disclosure of Interest

None Declared
Suicidal risk in Latino patients with schizophrenia
Authors: Olive O. , Ontiveros J. A. , Perez A. A. , Serna M. F.
Published: August 2023

Introduction

Schizophrenia is a highly debilitating disorder afflicting more than 24 million individuals worldwide. In Mexico, the Ministry of Health estimates that it affects more than 1 million people. Suicide is one of the main causes of death among people diagnosed with schizophrenia, their risk is 12 times higher than in. the general population

Objectives

To evaluate the clinical characteristics of schizophrenic patients at risk of suicide in the Latino population.

Methods

We included 130 patients recruited from genetics studies in Latino patients with schizophrenia from the outpatient and inpatient psychiatric ward of the University Hospital “Dr José E. González” in Monterrey, Nuevo Leon, Mexico. Beck Depression Inventory (BDI-II), the Convergent Functional Information for Suicidality (CFI-S) were applied to all participants. We compared the sociodemographic and clinical characteristics of patients with suicidal risk (measured by history of suicidal attempt or current suicidal risk) and present depressive episode.

Results

Of the 130 participants, 66.9% were male, the median age was 38 years. We found 11(14.3%) patients with suicidal risk and 119 (91.5%) without suicidal risk. Sociodemographic and clinical characteristics of the study population at risk of suicide are described in graphic 1. Patients with a history of suicide attempt scored higher on the CFI-S scale with a median of 0.5 (q1=0.45; q3=0.54) vs. 0.31 (q1=0.22; q3=0.45) (p= 0.004)(Graphic 2). Based on the BDI-II we found 2.30% patients showed a mild depression, 20.0% moderate depression and 4.61% severe depression (graphic 3). Schizophrenic patients with a previous suicide attempt and depressive episode had higher score range in CFI-S, median .65 (q1=.65; q2=.59, p=0.000). Also, 63.60% were severely depressive (p=0.000) when they compared with patients with low risk of suicide. Schizophrenic patients with suicidal risk were characterized by: age >=60 years old, unemployment, no children, single, without religion, family history of suicide, previous suicide attempt, depressive episodes, substance abuse, auditory hallucinations and referential delusions.

Image:

Image 2:

Image 3:

Conclusions

In our study with Latino population, we observed similar clinical characteristics predictive of suicide risk described in the international studies. Our study is relevant to applied preventive measures in groups of schizophrenic patients with risk factors and their relatives.

Disclosure of Interest

None Declared
The impact of substance misuse in patients with first-episode psychosis: a retrospective study
Authors: Moreira R. A. , Gomes H. J. , Correia J. P. , Maldonado E. , Justo J. M.
Published: August 2023

Introduction

Substance misuse increases the risk of developing psychosis in vulnerable people. However, patients with substance use disorders’ attributes and their effect on first-episode psychosis (FEP) are still unclear.

Objectives

To describe and compare inpatient admissions for FEP with substance misuse and its impact on clinical outcomes.

Methods

We conducted an observational and retrospective study, analyzing sociodemographic determinants and clinical data regarding the patients hospitalized for FEP, between January 2019 and June 2022, in the psychiatric unit at our hospital in Bragança, Portugal. We used logistic regression to estimate the effect of social determinants and other clinical data regarding the patients hospitalized for FEP with substance abuse.

Results

We included 78 patients in this study. Of these patients, 30% (n=23) reported substance (drugs or alcohol) misuse prior to hospital admission. Regarding only the patients with substance misuse, 96% were male and the median age was 31 years. Cannabis was the most often reported substance of abuse (83%). Most of these patients were unmarried (OR:10.794; 95%CI:2.855-40.805;P=0.001), lived in a rural setting (OR:0.263; 95%CI:0.094-0.731;P=0.009) and had no previous psychiatric history (OR:1.022; 95%CI:0.386-2.709;P=0.964).Regarding hospital admission, 70% were involuntary admitted (OR:4;95%CI:1.408-11.366;P=0.007) and the median time of hospitalization was 17 days. At the time of discharge, 48% of these set of patients still didn’t have insight into their mental illness (OR:1.737;95%CI:0.646-4.679;P=0.272). During the evaluation period of this study, 13% of the patients were readmitted to the hospital (OR:1.029;95%CI:0.241-4.383;P=0.970) and 35% missed outpatient appointments (OR:3.133;95%CI:1.003-9.791;P=0.044). The diagnoses at the time of discharge were: substance-induced psychosis (52%), schizophrenia (22%), affective psychosis (17%), and acute and transient psychotic disorder (9%).

Conclusions

This analysis indicates substance misuse predates and is prevalent in FEP. Many of these patients fail to recognize and accept that they are suffering from a mental illness and drop out of outpatient psychiatric care. Further, substance-induced psychoses are associated with a significant risk for transition to schizophrenia particularly following cannabis-induced psychosis. Thus, it is crucial to optimize adherence to the therapeutic regimen and outpatient follow-up.

Disclosure of Interest

None Declared
FAMILY-CENTERED COLLABORATIVE CARE FOR PATIENTS WITH CHRONIC MENTAL ILLNESS: A NARRATIVE LITERATURE REVIEW
Authors: Dehbozorgi R. , Fereidooni-Moghadam M. , Shahriari M. , Moghimi-Sarani E.
Published: August 2023

Introduction

Chronic mental illnesses are long-lasting and recurring, require continuous care as well as an integrated and collaborative approach to organize the care. This study sought to examine whether family center collaborative care is an acceptable treatment option for individuals with chronic mental illness.

Objectives

Is the family-centered collaborative care suitable for patients with chronic mental illness?

Methods

From the years 2000 to 2021, ten electronic databases relating to family-centered collaborative care for mental illness were searched adopting PRISMA’s checklist

Results

After systematic search, 27 articles and a thesis were found. According to moderate to high quality qualitative research, family-centered collaborative care was considered acceptable intervention, though a few studies supporting it.

Conclusions

This study examines theoretical, methodological, and practical considerations as a basis for more robust data collection based on individual experiences and evidence-based practice.

Reference(s)

1.

Wittchen, H.-U., et al., The size and burden of mental disorders and other disorders of the brain in Europe 2010. European neuropsychopharmacology, 2011. 21(9): p. 655-679.

2.

CUTLER, J.L., Kaplan and Sadock’s synopsis of psychiatry. 2016, LWW.

3.

Thornicroft, G., et al., The personal impact of schizophrenia in Europe. Schizophrenia research, 2004. 69(2-3): p. 125-132.

4.

Vigo, D., G. Thornicroft, and R. Atun, Estimating the true global burden of mental illness. The Lancet Psychiatry, 2016. 3(2): p. 171-178.

Disclosure of Interest

None Declared
A diet rich in polyunsaturated fatty acids as supportive therapy in the treatment and prevention of psychotic disorders
Authors: Sitarz R. , Juchnowicz D. , Karakuła K. , Forma A. , Baj J. , Rog J. , Karpiński R. , Machrowska A. , Karakuła-Juchnowicz H.
Published: August 2023

Introduction

Proper nutrition with fats has a protective effect on the functioning of the nervous system. However, a disturbed ratio of essential polyunsaturated fatty acids supply is nowadays a common phenomenon. A diet overloaded with saturated fats and a shortage of those essential ones in the company with possibly some unfavorable genetic endowment could lead to the release of psychosis from the framework of diet defined by nature for thousands of years.

Objectives

The study aims to review the literature to assess the influence of supplementation with polyunsaturated fatty acids in the occurrence of psychotic disorders prevention, as well as their impact on remission prolongation.

Methods

Literature review in PubMed, Google Scholar, and Web of Science using the keywords [psychosis] OR [psychotic] OR [schizophrenia] OR [unipolar] OR [bipolar] OR [schizoaffective] OR [depression] OR [manic] OR [hypomanic] OR [mania] OR [hypomania] OR [first episode psychosis] OR [ultra-high risk] OR [UHR] AND [polyunsaturated fatty acids] OR [PUFA] OR [prostaglandin] OR [phospholipid] OR [phospholipase A2] OR [arachidonic acid] OR [linoleic acid] OR [alpha-linolenic acid] OR [omega-3] OR [omega-6] OR [nutrition] OR [diet]. The review included original articles, reviews, systematic reviews, meta-analyses, and case reports from 1977-2022 in Polish and English.

Results

86 articles devoted to diet and nutrition in psychotic disorders were analyzed. Patients with schizophrenia, bipolar disorder, and schizoaffective disorders exhibit deficiencies in polyunsaturated fatty acids. Such results may indicate compliance with David Horrobin’s theory of the psychotic disorders development in predisposed individuals.

Conclusions

Supplementation with polyunsaturated fatty acids may be a chance for a selected group of patients to prolong remission but also hope to prevent the occurrence of psychotic disorders in particularly vulnerable individuals.

Disclosure of Interest

None Declared
Course of untreated depression in people with tuberculosis in Ethiopia: a cohort study
Authors: Getahun F. A.
Published: August 2023

Introduction

Co-morbid depression is common in people with tuberculosis (TB) but little is known about the course over time.

Objectives

Our objectives were to determine the level of remission and factors associated with failure to remit in depressive symptom scores in people with TB undergoing treatment in primary care facilities in Ethiopia.

Methods

We assessed 648 people with newly diagnosed TB for depressive symptoms using Patient Health Questionnaire (PHQ-9) at the time of starting anti-TB medication, and again at two and six months. Remission was defined as more than 50% reduction in baseline depressive symptom scores. We analyzed factors associated with failure of depressive symptom score to remit at the end of the follow up using multilevel mixed-effects logistic regression by taking individuals as nested within 14 health institutions. Adjustment was made for socio-demographic characteristics, baseline depression score, stigma, type of TB, outcome of TB treatment, perceived severity of TB, substance use, perceived social support, substance use, and HIV status.

Results

Compared to the baseline, the mean PHQ-9 scores declined at two months (Hedge’s G: 0.82; 95%CI: 0.71, 0.94) and six months (Hedge’s G: 1.20; 95%CI: 1.08, 1.33). However, depressive symptom scores failed to remit in 176 (33.1%) of the 532 people with TB who completed the follow up. . Stigma (AOR: 2.23; 95%CI: 1.09, 4.55), older age (AOR: 2.2; 95%CI: 1.13, 4.29), and treatment completion without a bacteriological proof of cure (treatment complete as compared to treatment cure) (AOR: 2.47; 95%CI: 1.37, 4.48) were independent predictors of failure of depressive symptom score to remit. Surprisingly, baseline lower depressive symptom score was more persistent than higher baseline depressive symptom score (AOR: 2.93; 95%CI: 1.56, 5.47).

Conclusions

In one-third of people with newly diagnosed TB, baseline depressive symptom scores did not remit after full course of TB treatment. TB treatment guidelines require in-built mental health component. Studies are required to understand course of depression beyond six months and effective interventions in this population.

Disclosure of Interest

None Declared
Association between thermal balance of the brain, inflammation and response to therapy in patients with schizophrenia.
Authors: Kaleda V. , Zozulya S. , Klyushnik T. , Tikhonov D. , Simonov A. , Shevelev O. , Petrova M. , Mengistu E.
Published: August 2023

Introduction

Disruption of cerebral thermal homeostasis accompanies various CNS diseases. Presumably, (neuro)inflammation and the changes of temperature heterogeneity of the cerebral cortex may be interrelated links in the pathogenesis of schizophrenia.

Objectives

to study the association between the brain thermal balance indicators, inflammatory markers and clinical features of the disease in patients with schizophrenia during therapy.

Methods

37 patients aged 16 to 46 years with schizophrenia (F20, ICD-10) were examined. Clinical examination included psychometric assessment using PANSS, HDRS, and YMRS scales. Cortical temperature was determined by microwave radiometry. Temperature heterogeneity was assessed by calculating the Pearson correlation coefficient between temperature indicators in 9 symmetrical areas of the cerebral cortex. The activity of the proteolytic system of inflammation (ratio of leukocyte elastase (LE) and α1-proteinase inhibitor (α1-PI) activity) and the level of autoantibodies to S100B and MBP antigens were determined in patients’ blood.

Results

Low temperature heterogeneity is related to an increase in the activity of the proteolytic system of inflammation and a good response to therapy in most patients. High temperature heterogeneity is associated with insufficient activity of the proteolytic system of inflammation and the development of autoimmune reactions, which is accompanied by a more severe course of the pathological process and, in most cases, treatment resistance.

Conclusions

The association between the features of the thermal balance of the brain and inflammatory markers confirms the hypothesis of their role in the pathogenesis of schizophrenia. Temperature heterogeneity of the brain can serve as a criterion for predicting of therapeutic response in patients with schizophrenia.

Disclosure of Interest

None Declared
Being mindful of our insomnia can get us to sleep? - Mindfulness aproach to sleep disorders
Authors: Cohen R. B. , Pereira I. M. , Marguilho M. G. , Sousa M. C. , Ferreira B. V.
Published: August 2023

Introduction

Sleep disorders (e.g., insomnia) are extremely prevalent in our population and are intimately associated with distress and productivity impairment. It is estimated that between 40 to 60% of people suffering from a sleep disorder have an underlying psychiatric diagnosis.

Mindfulness, which is described as the quality or state of being self-conscious or aware of something, has shown to be a potential helpful therapy in insomnia.

Objectives

Therefore, and due to the lack of new and effective treatment approaches, we did a non-systematic review of the positive impact of mindfulness in quality of sleep.

Methods

Bibliographic research through PubMed, Web of Science and Springer Link.

Results

The mindfulness tools that may be linked to its therapeutic effects include the awareness state and conscious posture to respond when perceiving insomnia symptoms, as well as the modulation of sleep-related arousal courses. These can be primary when directly related to the inability to sleep, or secondary if considering the relationship with thoughts about sleep (such as the tendency to create bias in the attention and perception of sleep related thoughts).

Formerly, mindfulness-based cognitive therapy (MTPC) was designed for the treatment of chronic depression and has shown to be efficacious. It was hypothesized that interoceptive dysfunction in the insula, commonly observed in anxiety and depression, may respond to MTPC by the gained interoceptive awareness, which provides advantage to adapt to life challenges and ongoing adjustments.

Conclusions

Based on the currently available literature, mindfulness-based strategies may be a valuable treatment option in sleep disorders, especially for patients with concomitant mental illness. Therefore, it is necessary further research to standardize in terms of type of approach, duration, and outcome measures since it seems promising as an intervention for insomnia.

Disclosure of Interest

None Declared
The impact of the OPRM1, OPRK1, DCC genes polymorphisms on the motivation for non-suicidal self-injury in young adults: a pilot study
Authors: Kibitov A. A. , Mazo G. E.
Published: August 2023

Introduction

Non-suicidal self-injury (NSSI) – the deliberate, self-directed damage of body tissue without suicidal intent and for purposes not socially or culturally sanctioned – is a highly prevalent phenomenon in adolescents and young adults. Motivation for the NSSI is known to be heterogenous in different patients. However, biological and especially genetic markers associated with different motivation for the NSSI have not been studied to date. One of the possible candidates are mu- (OPRM1) and kappa-opioid receptor (OPRK1) genes, since opioid system is known to be involved in the NSSI. Another perspective candidate is the DCC gene, encoding the netrin 1 receptor, which plays vital part in the formation of the prefrontal cortex.

Objectives

We conducted a pilot cross-sectional study to test the impact of the rs1779971 OPRM1, rs6473797 OPRK1 and rs8084280 DCC gene polymorphisms on the characteristics and motivations for the NSSI in young adults.

Methods

28 patients of European ancestry with NSSI (89,3%; n=25) women, median age (Q1-Q3) – 23 (21,25-25) years) were included in the pilot sample. The majority of the sample had a diagnosis of bipolar disorder (78,6%; n=20). Characteristics and motivation for the NSSI were measured by the Inventory of Statements about Self-Injury (ISAS). The Childhood Trauma Questionnaire (CTQ) was used to control for adverse childhood experiences, a potent environmental factor, associated with NSSI. Genotyping was performed using RT-PCR. The genetic effect was evaluated using the dominant model. For statistical analysis multiple linear regression with the presence of minor alleles, different types of childhood trauma, diagnosis, age and sex as factors and ISAS scores as dependent variables were used.

Results

Multiple linear regression showed that minor C allele of rs6473796 OPRK1 gene polymorphism was associated with an increase of the “Affect regulation” (B=2,23; CI95% [0,39–4,06]; p=0,022), “Anti-dissociation” (B=3,31; CI95% [0,18–6,44]; p=0,039) subscales of ISAS scores. Moreover, the minor T allele of the rs8082480 DCC gene polymorphism was associated with a decrease of the “Affect regulation” subscale score (B=-1,74; CI95% [-3,30 – -0,18]; p=0,032).

Conclusions

To our knowledge, this is the first study on the genetic markers of motivations for NSSI. Our pilot results showed that, controlling for diagnosis, age, sex and childhood trauma, OPRK1 and DCC gene polymorphisms may be associated with the heterogeneity of motivations for NSSI. However, these results require confirmation on the larger samples.

Disclosure of Interest

None Declared
Relieving pandemic-related psychological distress: Key protective factors against mental health impairment
Authors: Alonzo D. , Popescu M. , Zubaroglu P.
Published: August 2023

Introduction

Despite studies pointing to the important role of relational and community factors in influencing mental health during times of crises such as the current pandemic, little research has examined protective factors at the relational/community level that serve protective factors against mental health impairment in response to the current pandemic.

Objectives

This study aims to address this gap and examines protective factors against adverse mental health consequences related to the pandemic at the relational and community levels among individuals residing in high-risk marginalized low-resourced settings in Guatemala at one and a half years post onset of the pandemic

Methods

Telephone surveys were administered to 100 participants to assess sociodemographic characteristics, psychosocial functioning, and protective factors (interpersonal support, psychoeducation, community resources, and adaptive coping) against psychological distress. (anxiety, depression, stress, burnout). Multiple linear regressions were used to examine predictors of mental health impairment.

Results

Our findings demonstrate that only psychoeducation serves a protective factor against psychological distress.Interpersonal support was found to predict increased levels of anxiety and depression and adaptive coping was found to predict increased levels of anxiety, depression, and burnout. No significant relationship between community resources and any type of mental health impairment was found.

Conclusions

Public mental health efforts should capitalize on the effectiveness of psychoeducation to promote strategies for managing symptoms of psychological distress as well as providing information regarding resources and services. In the context of complex emergencies that have an immediate effect on already scarce resources at a personal, community, and institutional levels, psychoeducation has the advantage of a low-cost intervention, easily transferable between communities, providing immediate support as well as sustainability over time.

Disclosure of Interest

None Declared
Suicide in Schizophrenia: A literature review
Authors: Huete Naval M. , Galerón Guzmán R. , Herrero Pellón E. , Albarracín Marcos P. , Serván Rendoluna B.
Published: August 2023

Introduction

More than 90 percent of patients who attempt suicide have a psychiatric disorder. The diagnosis of schizophrenia is associated with a decrease in life expectancy of about 10 years, with suicide being the most important related factor. Literature suggests that the risk of suicide death in this population has been found to be 10 to 20 times higher than that in the general population

Objectives

To present a case report of a patient with a first psychotic episode and suicide attempt focusing on clinical features and risk factors.

Methods

Presentation of a clinical case supported by a non-systematic review of literature containing the key-words “suicide”, “Suicidal ideation”, “psychosis” and “schizophrenia”.

Results

This is a case report of a male 28-year-old patient, with no known psychiatric history, admitted to our inpatient service after a suicide attempt by precipitation. In a first evaluation, the patient presented psychotic symptoms consisting of paranoid delusions, auditory hallucinations, tendency to social isolation and the appearance of self-harming ideation in the days prior to the episode. After initiation of antipsychotic medication, a significant improvement in positive symptoms was observed. The patient has since had no delusions or hallucinations and is living independently at home.

Contemporary research studies indicate that the lifetime rate of completed suicide in individuals with schizophrenia is between 4% and 13%. Several specific risk factors have been described in the schizophrenia population, such as early stage of the illness, lack of adherence to treatment, recurrent relapses, comorbid depression and the paranoid subtype. The antipsychotic treatments with the most scientific evidence are clozapine, risperidone, olanzapine and quetiapine. Within psychotherapy, cognitive behavioral therapy appears to be the most effective.

Conclusions

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It is important to know the risk factors that are associated with an increased risk of suicide in patients diagnosed with schizophrenia.

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An early intervention and specific treatment can improve prognosis of this population.

Disclosure of Interest

None Declared