bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Antidepressant Treatment on Fibronectin Levels in Patients with Depression and Chronic Heart Failure
Authors: Sikora A. K. , Fedorov S.
Published: August 2024

Introduction

Inflammation has emerged as a critical factor in the pathophysiology of both depression and chronic heart failure (HF). Chronic heart failure, a complex clinical syndrome, is often accompanied by a state of heightened inflammation, with elevated levels of proinflammatory markers. Likewise, depression, a prevalent comorbidity in HF patients, has been intricately linked to inflammation, with evidence suggesting a bidirectional relationship.

Objectives

This study aimed to evaluate the effect of antidepressant treatment on plasma fibronectin levels in patients with comorbid depression and chronic heart failure.

Methods

We enrolled a total of 113 patients with HF, all of whom had comorbid depression. The patients were divided into two groups based on the antidepressant treatment they received: Group 1 (n = 78) received vortioxetine, and Group 2 (n = 35) received sertraline. Before initiating treatment and after 6 months, we measured fibronectin levels in the patients’ plasma.

Results

The study revealed a significant difference in the effects of the two antidepressants on fibronectin levels. Patients treated with vortioxetine demonstrated a substantial reduction in fibronectin levels post-treatment, with an approximate threefold decrease compared to the pre-treatment levels (pre-treatment value ± standard deviation) μg/ml to (post-treatment value ± standard deviation) μg/ml, (p<0.05). Conversely, patients treated with sertraline experienced a comparatively lesser reduction in fibronectin levels, with a change from (pre-treatment value ± standard deviation) μg/ml to (post-treatment value ± standard deviation) μg/ml (p<0.05).

Conclusions

This study highlights the considerable impact of vortioxetine on fibronectin levels in patients with comorbid depression and chronic heart failure, resulting in a significant reduction. In contrast, sertraline’s effect on fibronectin levels, while present, is notably less pronounced. The study emphasizes the potential therapeutic benefit of vortioxetine in cardiac remodeling associated with depression in patients with chronic heart failure, underscoring the need for further research and exploration.

Disclosure of Interest

None Declared
Anxious-depressive symptoms after a first episode of schizophrenia: Response to treatment and psychopathological considerations from a 2-year follow-up study in Italy
Authors: Pelizza L. , Leuci E. , Quattrone E. , Di Lisi A.
Published: August 2024

Introduction

Depression is common in schizophrenia and is correlated with suicide risk and poor long-term outcomes. However, the presence of depressive symptoms is often underestimated in both research and treatment, particularly at the illness onset.

Objectives

The goals of this study were: (a) to longitudinally observe anxious-depressive symptom levels in patients with First Episode Schizophrenia (FES) during a 24 months of follow-up period, and (b) to examine their associations with other psychopathology and the intervention patients received in an “Early Intervention in Psychosis” (EIP) program during the follow-up period.

Methods

The Global Assessment of Functioning (GAF) and the Positive And Negative Syndrome Scale (PANSS) were completed by 159 FES patients both at baseline and across the follow-up. Data were analyzed by linear regression analysis and Spearman’s coefficients.

Results

Anxious-depressive symptoms had significant longitudinal associations with GAF deterioration and PANSS “Positive Symptoms”, “Negative Symptoms” and “Disorganization” subscores. During the follow-up period, FES participants significantly improved the level of anxious-depressive symptoms. This was significantly associated with the number of case management and individual psychotherapy meetings the patient engaged in, as well as with lower antipsychotic doses prescribed during the follow-up period.

Conclusions

In conclusion, anxious-depressive symptoms are prominent in FES and at the initial entry into EIP programs. Anxious-depressive symptom severity tends to diminish overtime, especially with the provision of specialized EIP treatments. However, since we did not have a control population studied in parallel, we cannot say whether these results are specific to the protocols of EIP programs or just to the intensity of engagement in care.

Disclosure of Interest

None Declared
The impact of climate change on mental health
Authors: Heinz A.
Published: August 2024

Climate change has a profound impact on mental health, supported by meta analytic evidence. For every degree temperature increase, there is a statistical increase in mental health problems by about 0.9%. The direct association between catastrophic events such as hurricanes or flooding and traumatization or negative mood states is evident. However, there are also interactions between pollution or heat islands in urban contexts and stress associated mental disorders, and there are indirect interactions e.g. between loss of agricultural space, poverty, displacement and mental health challenges. We provide an overview regarding direct and indirect effects of climate change on mental health and discuss possible interventions on the health care system.

Disclosure of Interest

None Declared
Relation between biomarkers and suicide attempts in patients with schizophrenia
Authors: Garcia Fernandez A. , Martínez-Cao C. , Couce-Sánchez M. , González-Blanco L. , Sáiz P. , García-Portilla P.
Published: August 2024

Introduction

An increased risk of suicide has been reported by psychiatric patients, including schizophrenia1. Numerous evidence suggests alterations in the grade of pro-inflammatory impact on suicidal behavior2, and this relation has been shown in patients with mood or anxious disorders3,4. However, the grade of inflammation impact suicidal behavior in patients with schizophrenia has hardly been investigated.

Objectives

Identify peripheral blood biomarkers of suicidal behavior in patients with schizophrenia, including inflammatory and lipid profile parameters.

Methods

Secondary analysis of a cross-sectional study. Sample: 254 patients with schizophrenia, aged 18-72. Assessments: ad-hoc demographic and clinical questionnaire, PANSS, CDS, CAINS, PSP. Inflammatory and lipid parameters: C-reactive protein (PCR), interleukin 6 (IL-6); high-density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglyceridaemia (TG). Statistical analysis: Correlations, T Student, U Mann-Withney and lineal regression.

Results

Mean age: 40.49 (13.10). Men: 64.2%.

No statistically significant differences were found between patients with suicide attempts and those without in any of the inflammatory or lipid parameters (p>0.05). However, differences were found in terms of suicide attempts (yes/no) in the PANSS negative (T=-2.217; p=0.028) and PANSS general psychopathy (T=-4.224; p< 0.001), in depressive symptoms (T =-6.967; p< 0.001), and the MAP subscale of the CAINS (T= -3.741; p<0.001).

Among patients with suicide attempts (n=42; 16.52% of the sample) (mean=1.90; sd=1.73; Range:1-7), statistically significant correlations were found with PCR (r=0.309; p=0.046), but not with cytokines and lipid parameters. On the other hand, no correlations were found with age, sex, length of illness, and any of the clinical scales.

A multiple linear regression was performed considering the number of suicide attempts as the dependent variable and as independent variables, age, sex, and those that were significant in the bivariate analysis (PCR).

A predictive model was found that explains 9.60% of the variance of number of suicide attempts (F = 4.224; p < 0.001). The variable that entered the model was PCR (β= 0.309; p=0.046).

Conclusions

The increase in inflammation (manifested by the elevation of PCR) is related to an increase in the number of suicides. On the contrary, no correlations were found with lipid parameters or interleukins.

Disclosure of Interest

None Declared
The association between maternal diabetes and the risk of attention deficit/hyperactivity disorder in offspring: Updated systematic review and meta-analysis.
Authors: Sinishaw Y. D. , Dachew B. A. , Ayano G. , Betts K. , Alati R.
Published: August 2024

Introduction

The existing body of evidence on the association between maternal diabetes and attention deficit/hyperactivity disorder (ADHD) in offspring is inconsistent and inconclusive. Thus, we need to synthesise the available evidence to examine the association between maternal diabetes and risk of ADHD in offspring.

Objectives

The aim of this meta-analysis was to examine the association between maternal diabetes and the risk of ADHD in offspring.

Methods

We conducted a comprehensive search across PubMed, MEDLINE, EMBASE, Scopus, CINAHL and PsychINFO databases from their inception to September 8th, 2023. The methodological quality of the included studies was evaluated using Joanna Briggs Institute (JBI) and Newcastle-Ottawa Scale (NOS). Between-study heterogeneity was assessed using I2 statistic and potential publication bias was checked using both funnel plot and Egger’s test. Randomeffect model was used to calculate the pooled effect estimates and subgroup, sensitivity, and meta-regression were further performed to support our findings

Results

Twenty observational studies (two cross-sectional, five case-control and thirteen cohort studies) were included in this systematic review and meta-analysis. Our meta-analysis indicated that intra-uterine exposure to any type of maternal diabetes was associated with an increased risk ADHD in offspring [RR=1.33: 95 % CI: 1.23–1.43, I2=79.9%]. When we stratified the analysis by maternal diabetes type, we found 17%, and 37% higher risk of ADHD in offspring exposed to maternal gestational [RR=1.17: 95 % CI: 1.07–1.29] and pre-existing diabetes [RR=1.37: 95 % CI: 1.27–1.48] compared to unexposed offspring respectively. Results of subgroup and sensitivity analysis further supported the robustness of our main finding.

Conclusions

Our review suggested that exposure to maternal diabetes increased the risk of ADHD in offspring. These findings underscore the need for early screening and prompt interventions for exposed offspring.

Disclosure of Interest

None Declared
Best of 2023 in psychosomatic medicine: the contribution to the rest of psychiatry
Authors: Ferrari S.
Published: August 2024

The field of psychosomatics has experienced many waves of “celebrity” since its origin. Its historical origin is impossible to precisely locate in time, one may argue that medicine since its very beginning has been psychosomatic in nature. In very recent times, many clinicians and researchers even from different backgrounds than psychosomatic medicine or psychiatry have expressed disappointment and worry about the excessive fragmentation of medical sciences, providing evidence in support and advocating towards the so-called holistic approach and integrated care. The old lesson of psychosomatic medicine, then, appears more contemporary than ever. This is also because it has been able to stay coherent but at the same time integrate the enormous progresses in the understanding of physiology and pathophysiology that medical sciences have witnessed in the last decades.

The presentation will focus on the most striking scientific production of 2023 in the field of psychosomatics, to show the contributions in its three souls of research, training and clinical activities and to outline the stimulating though sometimes difficult dialogue between this area of behavioural sciences and the rest of psychiatry.

Disclosure of Interest

None Declared
Self-stigma and its reduction in patients with bipolar affective disorder
Authors: Mitikhin V. , Oshevsky D. , Alieva L.
Published: August 2024

Introduction

The phenomenon of self-stigma in patients with bipolar affective disorder (BD) has been studied much less than in other mental disorders (Favre, Richard-Lepourie, 2023). However, self-stigma has equally negative psychosocial consequences for them (Shargh et al, 2015). Therefore, identifying the clinical and psychological characteristics of self-stigma in BD patients, especially in the initial stages of the disease, and developing on this basis new directions for their psychosocial rehabilitation to reduce self-stigma is relevant.

Objectives

To identify clinical and psychological characteristics of self-stigma in BD patients, to identify targets for psychosocial rehabilitation.

Methods

«Questionnaire for assessing the phenomenon of self-stigmatization of mentally ill people» (Mikhailova et al., 2005), «Insight Scale for Psychosis» - ISP (Birchwood et al., 1994). We examined 17 patients (12 women and 5 men) with a diagnosis of bipolar affective disorder (F31.xxx according to ICD-10). The average age of the patients was 25.52±4.55 years. The duration of the disorder is 0.5-3 years.

Results

It was shown, that patients with BD had a high level of self-stigma. Indicator «General level of self-stigma» was 1.22±0.73 points, that higher its average values. The main component in the structure of self-stigmatization was an overestimation of possible limitations of one’s own internal activity and self-realization (1.96 ± 0.87 and 1.62 ± 0.82 points, respectively) associated with the disease. Idealization of one’s pre-illness qualities and achievements (1.62±0.82 points) and the formation of misconceptions about the loss of previous opportunities will able to lead to negative personal changes and limit the activity of patients. Correlation analysis revealed significant (p≤0.01) correlations between the «Patient’s ability to recognize painful phenomena as symptoms of mental illness» scale of the ISP scale and individual parameters of the questionnaire for assessing self-stigma: «Imagination of one’s own failure due to illness» - r = 0, 52; «Fear of becoming insolvent due to illness» - r=0.54; «Idealization of the «healthy self», r=0.51. Thus, in BD patients, self-stigma is associated with low awareness of the disease and misconceptions about it and about themselves.

Conclusions

Psychoeducation programs, aimed at formation an adequate perception of mental disorder, the ability to recognize its symptoms, and destigmatization trainings to increase the social activity are needed for BD patients. Such trainings were developed during the research and are currently being tested.

Disclosure of Interest

None Declared
Psychometric Properties of the Depression, Anxiety, Stress Scales-21 (DASS-21) in a Portuguese Sample during the early stage of the COVID-19 pandemic
Authors: Laranjeira C. , Dixe M. A. , Querido A. I.
Published: August 2024

Introduction

The COVID-19 global crisis has resulted in significant disruptions in the lives of students in higher education, leading to negative consequences for their academic achievements and general psychological well-being.

Objectives

In this study, we sought to examine the psychometric properties of the Depression Anxiety Stress Scale-21 (DASS-21) among students in Portuguese higher education institutions during the initial phase of the COVID-19 pandemic and its efficacy in capturing mental health symptoms due to a global health crisis.

Methods

In this cross-sectional study, a convenience sampling method was used to enlist a total of 1522 participants. The sample consisted of 75.1% women and 79.2% undergraduate students. Participants completed an electronic survey that was designed using the Depression Anxiety Stress Scale-21 (DASS-21) — a self-report instrument measuring anxiety, depression, and stress.

Results

The findings of the study indicated a significant occurrence of depressive symptoms [≥10] (N = 434, 28.5%), anxiety symptoms [≥7] (N = 551, 36.2%), and stress symptoms [≥11] (N = 544, 35.7%). Based on the collected data, a Confirmatory Factor Analysis (CFA) was conducted in order to examine the factor structure of the scale. The analysis revealed a three-factor solution that corresponded to the three subscales of the DASS-21. The Heterotrait-Monotrait (HTMT) correlation ratio was then used to assess the discriminant validity, with good results. Results showed that the DASS21 has satisfactory reliability indexes (Cronbach’s α > 0.90).

Conclusions

In light of the notable changes in living conditions brought by the COVID-19 pandemic, the present study has shown that the DASS-21 instrument has maintained its reliability and validity. Consequently, this finding supports the appropriateness of using the DASS-21 as a screening tool for assessing mental health among students in Portugal. Moreover, it is recommended that academics and healthcare practitioners use the DASS-21 as a tool for assessing the levels of psychological distress experienced by students. Additional validation studies of this scale are required, using bigger and more representative populations.

Disclosure of Interest

None Declared
Emergency Department Presentations to the Mental Health Services at Sligo University Hospital during the COVID pandemic
Authors: Gunawardena S. M. , Godavarthi A. , Gethins E.
Published: August 2024

Introduction

In March 2020, the WHO declared the outbreak of SARS-CoV-2 a pandemic and Ireland went into its first lockdown. The Mental Health Liaison team at Sligo University Hospital operate 8 am to 8 pm, 7 days a week, with out of hours covered by the on-call Psychiatry junior doctors. The service has seen an increase in referrals, many of whom are known to community mental health teams.

Objectives

We reviewed the numbers and trends of mental health presentations to the Emergency Department at Sligo University Hospital throughout the pandemic, including the patterns of presentations around the implementation of lockdowns.

Methods

The Liaison Mental Health Service at Sligo University Hospital gathers data relating to numbers and types of presentation to the service. Data was taken from a pre-existing database of psychiatric presentations to the emergency department at Sligo University Hospital including patient demographics, nature of presenting complaint, time period in which they presented and whether they were previously linked in with a community mental health team in the preceding six months. We also looked at the pattern of ED mental health presentations from March 2019 to August 2021. In order to compare psychiatric presentations pre and during covid, data was broken down into two groups: the twelve months preceding March 2020 and the twelve months from March 2020. Categorical data were analysed using the Chi squared test for homogeneity in SPSS.

Results

Overall, there was a 14% increase in mental health presentations during the pandemic. There was a significantly greater proportion of presentations of psychosis during the pandemic period (p<.014) and for medication review (p=.03) and significantly less presenting with addiction (p <0.001). Of those patients seen in the Emergency Department in 2021, 54.3% were known to the CMHT in the previous 6 months. in 2019, mental health presentations made up 1.36% of total ED attendances. This increased to 1.47% in 2020. From January to August 2021, 2.62% of ED attendances were mental health presentations.

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Conclusions

The Covid-19 pandemic led to increased mental health presentations to Sligo University Hospital emergency department, with a significantly greater proportion presenting with psychosis and for medication review. These findings have implications around patient care and service provision. These results show that the prevalence of mental health has increased during the pandemic, particularly severe and enduring mental illnesses. New strategies must be implemented to accommodate to this increase in presentations.

Disclosure of Interest

None Declared
Psychological struggles in tunisian Infertile couples: A gender Perspective
Authors: Mahfoudh K. , Askri F. , Hamzaoui S. , Ouertani A. , Ouali U. , Aissa A. , Jomli R.
Published: August 2024

Introduction

Defined by the World Health Organization (WHO) as the inability to conceive after a year of unprotected sexual intercourse, infertility remains a current and compelling topic of interest for both scientists and the general public.

Over the past few decades, the prevalence of infertility, regardless of its cause, has significantly increased. Furthermore, it affects approximatively 15% of tunisian couples. However, previous studies have primarily assessed the psychological impact on women, leaving a gap in understanding gender differences.

Objectives

Our study aims to compare the psychological impact of infertility between genders in a Tunisian sample.

Methods

We conducted a cross-sectional study in a public hospital specializing in Assisted Reproductive Technology (ART) from August 30th to December 1st, 2022, involving sexually active infertile couples who had been under observation for at least one year. The participants provided information related to socio-demographic data. Additionally, we used the Hospital Anxiety Depression Scale (HADS) to assess anxiety and depression, and the Fertility Quality of Life (FertiQol) questionnaire to evaluate the quality of life. These questionnaires were administered in the Tunisian dialect.

Results

A sample of 60 infertile couples were recruited to this study. Primary infertility was present in 97% of cases and male infertility was the most common cause, accounting for 35%. Our findings revealed that women experienced higher rates of depression (35%) and anxiety (52%) compared to men (15% and 28%), with a statistically significant difference (p ≤ 0.001).

Furthermore, women reported a significantly compromised overall quality of life, particularly in the context of treatment-related aspects (p=0.03).

Notably, anxiety was identified as a significant risk factor for reduced quality of life among women (B = -5.27). In contrast, lower socioeconomic status was associated with diminished overall quality of life in men (B = -7.09).

Conclusions

It is important to consider gender differences in the management of infertility in order to guide and target psychological interventions and to improve the quality of life of infertile couples.

Disclosure of Interest

None Declared
Mental health impact of the Russian-Ukraine war on Canadian residents with or without Ukrainian descent
Authors: Belinda A. , Shalaby R. , Wei Y. , Agyapong V. I. O.
Published: August 2024

Introduction

War tends to produce fear. The devastating and traumatic occurrences of war can have both short- and long-term effects on the mental well-being of populations. Russia’s invasion of Ukraine indirectly affects all populations, especially individuals of Ukrainian descent.

Objectives

To assess the mental health impact of the Russian invasion of Ukraine on Canadian residents who subscribed to ‘Text4Hope Ukraine’ program and to ascertain if there are differences in mental health impacts between those with and without Ukrainian descent.

Methods

Canadians were invited to self-subscribe to the text messaging program. An online survey was used to collect sociodemographic, war-related, and clinical information; stress, resilience, likely anxiety disorder and likely depressive disorder from subscribers. Outcome measures included baseline scores using validated scales. Data were analyzed using SPSS Version 25. To examine the association of psychological problems with the sociodemographic and war-related factors, univariate analysis using the Chi-square/Fishers Exact test was performed with two-tailed significance (p ≤ .05). An independent sample t-test with two-tailed significance (p-value ≤ 0.05) was employed to assess the differences in the respective mean scores of the psychological problems across the two groups. The first group represents the participants who did not have citizenship or ancestors from Ukraine (NUk), while the second group represents the respondents are Ukrainian who either have previously held citizenship or have ancestors/family from Ukraine (Ukr). No imputation of missing data and reported data represents the complete responses

Results

Study findings reflected prevalence of low resilience (59.7%), moderate to high stress (87.5%), likely Generalized Anxiety Disorder (45.8%) and likely Major Depressive Disorder (38.9%). Respondents who identified as female had a higher likelihood of presenting with low resilience (χ2(1) = 5.68, p = .02) and likely Generalized Anxiety Disorder (χ2 (1) = 4.85, p = .03) compared to male respondents. There was no statistically significant difference in the mean scores of the four psychological problems based on any of the variables that suggest Ukrainian descent or not (p>.05).

Conclusions

War can have negative impacts on all populations irrespective of their location, or association of individuals with the impacted country. This study provides valuable insights into the mental health impact of the Russian invasion of Ukraine on a specific sample of Canadian residents who subscribed to the ‘Text4Hope Ukraine’ text messaging program. This information is relevant when planning mental health intervention for this population. Governments should target and provide adequate mental health and psychosocial support or interventions for global populations at risk during war.

Disclosure of Interest

None Declared
Cognitive functioning of patients with borderline personality disorder
Authors: Chumakov E. , Charnaia D. , Petrova N.
Published: August 2024

Introduction

The neurocognitive deficit model as a characteristic of patients with borderline personality disorder (BPD) has been the focus of research for the past 20 years. However, no such studies have been performed in Russia.

Objectives

The aim of the present study was to investigate the neurocognitive profile of patients with BPD.

Methods

Fifty patients with BPD (according to DSM-V criteria) in stable mental state (72% women; mean age 22.44±4.32) were examined. BPD symptom severity was assessed using the Borderline Personality Disorder Questionnaire (PBQ-BPD), which was validated in the Russian population (34 points or more indicated a higher probability of BPD diagnosis). The Brief Assessment of Cognition in Schizophrenia (BACS) was used to assess cognitive function (in order to use these data for differential diagnosis with schizophrenia spectrum disorders). The study was approved by the ethical committee of Saint Petersburg State University.

Results

On the PBQ-BPD results, 38% of patients (n=19) scored over 34 points, despite being stable. BACS subscales T-scores (presented as median [Q1; Q3]) were within normal limits (Verbal memory - 49.81 [46.56; 53,06]; Working memory - 43.73 [38.0; 47.50]; Motor function - 44.08 [41.0; 47.25]; Coding - 45.56 [42.50; 48.63]; Verbal fluency - 48.14 [46.0; 52.0]; Tower of London test - 52.33 [47.0; 57.0]). A number of patients had low scores on the BACS subscales (T-score < 40), particularly working memory (33.3%), coding (20.8%), and verbal memory (18.8%). The BACS Composite T Score (46.02 [43.65; 48.39]) correlated with the PBQ-BPD score (32.00 [27.00; 36.00]; r=-0.316; p=0.028). To better characterize the cognitive functioning of patients with BPD, patients were divided into two groups: those who scored less than 34 on the PBQ-BPD (group 1) and those who scored more than 34 on the PBQ-BPD (group 2). Group 2 patients had a lower BACS Composite T-score (42.32 [38.06; 46.58]; 48.45 [45.87; 51.03]; p=0.009) and nominally lower mean scores on all BACS subscales, compared with Group 1 patients. We found significant differences in T-scores values on the Working Memory subscale (Group 1 - 45.0 [41.0; 49.0]; Group 2 - 38.0 [33.0; 43.5], p=0.003), Verbal Fluency (49.0 [47.25; 53.75]; 48.0 [44.0; 49.0]; p=0.047), Tower of London Test (57.0 [52.0; 57.0]; 48.0 [42.0; 57.0]; p=0.036).

Conclusions

Neurocognitive impairment was detected in 33.3% of patients with BPD. The dominant cognitive impairments in the patients were decreased working and verbal memory and information processing speed. The severity of BPD symptoms has been confirmed to correlate with the neurocognitive functioning of these patients.

Disclosure of Interest

None Declared
Evaluation of the effectiveness of psychosocial rehabilitation: an innovative approach based on the analytic hierarchy process
Authors: Mitikhin V. , Solokhina T.
Published: August 2024

Introduction

In psychosocial rehabilitation (PSR), rank scales are widely used to assess the severity of functional disorders in patients. The main problem of evaluating the effectiveness of PSR is related to the methods of processing data obtained using psychometric scales used to evaluate the effectiveness of interventions within PSR. The proof of the non-numerical nature of ranks was obtained by J. Pfanzagl (1968). Incorrect processing of rank information obtained in the framework of psychosocial research leads to contradictions in the assessment of the patient’s condition. Consequently, rank processing does not allow classical mathematical operations (summation, average), which makes it impossible to correctly estimate the effectiveness of PSR numerically.

Objectives

Development of algorithms for numerical evaluation of PSR efficiency based on rank information processing using the analytic hierarchy process (AHP) [1].

Methods

Clinical, psychometric, AHP algorithms

Results

The analysis of the problems of assessing the patient’s conditions on the basis of categorical and psychometric (rank) scales and subscales shows that these problems can be presented in the form of appropriate hierarchies, the structure of which must be taken into account when processing the initial information.

According to the results of the analysis of the data of preliminary studies, the main areas of impaired functioning of patients affecting the evaluation of the effectiveness of PSR have been identified. Rank estimates of changes in the relevant areas of the patient’s dysfunction after the PSR program compared to the initial level are the basis for the conclusion about the effectiveness of the PSR components. Algorithms of the AHP normative approach were used to translate rank information into numerical information [2]. The weight of the areas of the patient’s functioning disorders was used in the formation of integral estimates of the effectiveness of PSR.

The fundamental difference between AHP-based assessments and rank assessments is due to the fact that numerical estimates of the weight of the criteria and the corresponding changes in the patient’s condition are obtained, which depend on the qualifications of specialists, the characteristics of the scales used to measure violations in the relevant areas and the procedures of the PSR.

Conclusions

Obtaining the results of processing rank information in a numerical scale allows to obtain the correct integration of the patient’s personal characteristics when considering PSR procedures and to obtain correct prognostic models of the patient’s condition. 1. Saaty T. European Journal of Operational Research.1990; 48(1):9-26. https://doi.org/10.1016/0377-2217(90)90057-I 2. Mitikhin V.G., Solokhina T.A. et al. Psychiatry, 2022; 20(2): 51-59. DOI: 10.30629/2618-6667-2022-20-2-51-59

Disclosure of Interest

None Declared
A differentiated approach to the choice of a neuroprotective drugs during complex antidepressant therapy of elderly depressive patients in a hospital setting
Authors: Pochueva V. , Yakovleva O. , Safarova T.
Published: August 2024

Introduction

The complex antidepressant therapy in combination with neuroprotectors increases the overall effectiveness of the treatment of depression in the elderly due to the group of the most difficult patients for therapy with ≥2 predictors of a low therapeutic response (LTRP), as well as in patients with complex (anxious, senesto-hypochondriacal, delusional) and prolonged (≥6 months) depressions.

Objectives

Development of a differentiated approach to the choice of types of neuroprotective drugs in the course of complex antidepressant therapy in depressive elderly patients.

Methods

We studied groups of hospitalized patients aged ≥60 years with mild, moderate and severe depression (according to ICD-10) who received antidepressant monotherapy (comparison group) for 28 days (43 people) or complex antidepressant therapy in combination with carnicetin (20), cerebrolysin (20), citicoline (20), ethylmethylhydroxypyridine succinate (EMHPS) (25) and actovegin (25). Complaints about memory impairment, lonely living, and the presence of leukoaraiosis on brain CT were considered as LTRP. Efficacy of therapy (change in total HAMD-17 scores in %) was compared in subgroups with neuroprotectors and in the comparison group in patients with ≥2 LTRPs, as well as in patients with complex and prolonged depressions. Statistical analysis was performed.

Results

By the 28th day of treatment, all patients with ≥2 LTRPs in the subgroups with the addition of any neuroprotectors were responders (≥50% change) with a significantly higher efficacy of therapy than in the monotherapy group (36.0%, p<0.05). The efficacy of therapy was significantly higher in the subgroup with the addition of actovegin than in the subgroups with cerebrolysin and citicoline (73.7% versus 55.6% and 52.0%, respectively, p<0.05). In complex depression, the effectiveness of therapy in the subgroup with cerebrolysin did not statistically differ from the comparison group. In prolonged depression, no statistically significant difference in efficacy was found between the citicoline-supplemented subgroup and the monotherapy group. The highest efficacy in the treatment of complex and prolonged depression was observed in subgroups with the addition of actovegin and EMHPS (p<0.01).

Conclusions

If there are indications for prescribing complex antidepressant therapy (≥2 LTRPs) in depressive patients of late age, all studied neuroprotective drugs demonstrated high efficiency compared to monotherapy. In complex depressions, the combination of antidepressants with cerebrolysin turned out to be less effective, in protracted depressions - with citicoline. Neuroprotectors actovegin and EMHPS can be considered universal drugs of choice for complex therapy of the most difficult categories of elderly depressive patients in a hospital setting.

Disclosure of Interest

None Declared
Different modalities of measuring life engagement in people living with schizophrenia spectrum disorders: A preliminary analysis
Authors: Cerati C. , Calzavara-Pinton I. , Nibbio G. , Cicale A. , Zardini D. , Italia M. , Altieri L. , Lisoni J. , Deste G. , Barlati S. , Vita A.
Published: August 2024

Introduction

The concept of “life engagement” encompasses several aspects of one’s life, including personal well-being, contentment, purpose, and engagement in meaningful activities. In 2006, the group led by Scheier designed a 6-item scale to measure this concept in the general population: the Life Engagement Test (LET), however, this tool was never validated in clinical populations (Scheier et al. 2006 J Clin Psychiatry 2006; 29 291-298). In subjects living with schizophrenia life engagement can be measured through the Positive and Negative Syndrome Scale-Life Engagement (PANSS-LE), derived by isolating 11 items (i.e., N01, N02, N03, N04, N05, N06, G06, G07, G13, G15, G16) from the PANSS (Correll et al. 2022 J Clin Psychiatry 2022; 83-4) (Correll et al. 2022 J Clin Psychiatry 2022; 83-5).

Objectives

The aim of this study was to investigate the clinical and functional correlates of two different measures of life engagement in a cohort of individuals living with schizophrenia spectrum disorders (SSD).

Methods

Ninety-five subjects living with SSD recruited from the ASST Spedali Civili of Brescia (Italy) were included in the preliminary ad-interim analysis of the present study: for each patient information regarding the clinical presentation were measured with the Clinical Global Impression (CGI) scale, the Health of the Nation Outcome Scales (HoNOS), the Brief Negative Symptoms Scale (BNSS) and the PANSS; additionally, information related to the psychosocial functioning were collected through the Global Assessment of Functioning (GAF) scale; finally, life engagement was evaluated through the LET and the PANSS-LE. Spearman’s correlations were performed using SPSS v28 and p values < 0.05 were considered significant.

Results

Both the LET and the PANSS-LE were correlated with the CGI (p=0.002 and p<0.001 respectively), but only the PANSS-LE was found to be correlated with the GAF (p<0.001), the BNSS (p<0.001) and the HoNOS (p<0.001).

Conclusions

The concept of life engagement is of growing interest for healthcare professionals working in the mental health field, in line with the concept of reaching a full functional recovery and considering patient-reported outcomes. From our study it is evident that life engagement in individuals living with SSD is better characterized through the PANSS-LE rather than the LET, as the former is more specific to define the complexity of the SSD symptomatology.

Disclosure of Interest

None Declared
Deep brain stimulation and psychosis as side effect: A case study
Authors: Selakovic M. , Panetsou C. , Karkatsoulis T. , Tsaklakidou D.
Published: August 2024

Introduction

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a therapeutic method used for decades in neurological diseases such as Parkinson’s disease (PD), Huntington’s disease (HD) or dystonia. HD is a rare, inherited, neurodegenerative condition that causes progressive motor deficits, psychiatric symptoms, and cognitive impairment.

Objectives

Moreover, after DBS as a psychiatric side effect has been marked and the etiology of that side effect is not well- understood.

Methods

A case study of a 51 years old male is presented, who developed involuntary movements, for the first time at the age of 17, being diagnosed with Chorea Huntington, was treated with medication without improvement of the symptoms, such as rigidity and bradykinesia. After ten years, based on guidelines, he was treated with DBS, the outcome of which showed complete improvement of neurological symptomatology. Nevertheless, he started to present delusional ideas of reference with his siblings, sleep disturbance, dysphoria and agitation.

Results

Obviously, DBS improved neurological symptomatology permanently. The medical history of our patient has shown the recurrence of psychiatric symptoms as a few mandatory psychiatric hospitalizations and his condition has improved with olanzapine 20 mg/ daily and L.A.I. of paliperidone (once /monthly).

Conclusions

By far, DBS, as a treatment modality, has great potential to modify disease outcomes and potentially cure the devastating genetic neurodegenerative disorder such as chorea. The cases with psychiatric side effects of DBS have been described so rarely, that it’s difficult to formulate conclusions that can be applied to the whole population of patients treated with DBS. In our opinion, in some cases it is possible to effectively treat the psychotic symptoms without resignation from the benefits of DBS.

Disclosure of Interest

None Declared
“Engaging, interactive, not boring” – A new innovative tutorial programme for medical students with promising longevity at the University of East Anglia.
Authors: Das S. , Beezhold J.
Published: August 2024

Introduction

Medical students at the University of East Anglia (UEA) complete a psychiatry rotation in the fourth year of their MBBS degree. There are four rotations each academic year, in 2022-2023 there were 24 students per rotation. The rotation consists of two weeks of lectures, a four-week clinical placement, and then a further two weeks of lectures. Students are based across Norfolk and Suffolk for their clinical placements. Although case-based discussions occurred every Wednesday morning via Teams, there were no face-to-face small group teaching sessions during placement.

Objectives

To design an interactive set of tutorials for medical students covering a wide range of psychiatric topics which can be easily delivered by other facilitators.

Methods

Three 1.5 hour tutorials were created: 1)” Psychotic Bingo” - Students have a unique card with terms used in descriptive psychopathology to play Bingo, 2) “Medical ethics, mental health and the law” – Explores the case of Kerrie Wooltorton to discuss the mental capacity act, advanced decisions, and the mental health act, 3) “Team Quiz” – Played in groups and covers the different sub-specialties of psychiatry and pharmacology. Tutorials were only mandatory for students in Norwich (average 11 students per tutorial) due to a large geographical area across placements. Tutorials were delivered for three rotations between December 2022 – May 2023, the initial two rotations by the first author and the third rotation by other facilitators. Facilitators were provided with a tutorial guidance document to ensure consistency. The same feedback form was used to obtain qualitative and quantitative feedback from students at all tutorials.

Results

The table below shows that feedback from students was consistently high, and there was little difference in average students rating between tutorials delivered by the first author and other facilitators. The predominant qualitative feedback was that the tutorials were “very interactive”, “engaging” and “fun”.

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Conclusions

This tutorial programme consistently received excellent feedback. The results show that the tutorials can be effectively delivered by other facilitators whilst maintaining a high standard, which ensures the programmes longevity. The tutorial programme is being formally implemented for all medical students at UEA from October 2023.

Disclosure of Interest

None Declared
Electroconvulsive therapy: the perspective of the informal caregiver in the decision-making process
Authors: Geerts P.-J. , Abihi S. , Verhaeghe S.
Published: August 2024

Introduction

Despite the importance of electroconvulsive therapy (ECT) as treatment, it remains one of the most controversial and misunderstood treatments. Negative media representations, primitive practice in the past and fear for electricity results in fear that extends beyond other therapies. Research on the perspective and role of informal caregivers (IC) in the process of ECT is limited. Most research focuses on relatives’ attitude or knowledge of ECT measured with questionnaires. However, profound understanding of their perspective can facilitate the role of physicians (or psychiatrists) in guiding patients and their IC through the decision-making process of ECT.

Objectives

The aim of this study was to describe the perspective of informal caregivers in the decision-making process in ECT treatment.

Methods

A qualitative phenomenological study was set up. Semi-structured interviews were held with IC of patients who are treated with ECT. Purposive sampling was based on maximum variation. All interviews were fully transcribed and thematic analyses took place. Trustworthiness was guaranteed by e.g. researcher triangulation

Results

In nine interviews were held with partners, children and parents of patients. The interviews had a mean duration of 102 minutes and interviewing proceeded until saturation of the most important themes was reached. During the interviews it became clear that the decision-making process of ECT is strongly influenced by the illness-trajectory and context of living with the mental health problems of the patient. IC describe their life and that of the patient as ‘trying to survive’. The proposal of ECT is seen as a way out of this unendurable situation. The perceived responsibility of the IC in the informed consent process to ECT adds to this burden. The IC worry, feel uncertain and fear to do wrong. Nonetheless ECT seems to be a beacon of hope. Trust in the psychiatrist as a competent professional who wants the best for the patient seems more important than having an answer to all of their questions. After the ECT has been started, IC establish a framework to evaluate the side-effects and effectiveness of ECT. This framework is based on how they experience the patient in daily life and on what they define as ‘the patient becoming a bit more himself again’. IC weigh the effects and side-effects to support the continuation of ECT. However, if patients clearly express that they experience side-effects that are too hindering, IC follow the patient if he or she wants to stop ECT.

Conclusions

Our study gives an insight in the perspective of the IC of patients undergoing ECT. It could be helpful for IC if the psychiatric team repeats information stepwise and takes the burden of responsibility perceived by the IC into account. The framework used by IC to evaluate the effects of ECT could be a valuable addition to the clinical evaluation of the ECT treatment.

Disclosure of Interest

None Declared
Mental health front-liners: Police officers’ knowledge and attitudes towards suicide in Malta
Authors: Zammit D. , Bezzina Xuereb M.
Published: August 2024

Introduction

Police-officers are in a strategic position of providing the first immediate response to a crisis as mental health frontliners.

Objectives

In this nation-wide cross-sectional study, we explored knowledge and attitudes towards suicide in the local police force, a crucial first step in the design and implementation of effective suicide prevention programmes.

Methods

An online, anonymous questionnaire was distributed to all local police-officers (n=2600). It contained questions about their demographics and their experience with suicide while on duty, along with 34 statements from the validated tool Attitudes Towards Suicide (ATTS) (Renberg & Jacobsson. Suicide Life Threat Behav. 2003; 33 52-64), scored on a 5-point Likert Scale (1 = Strongly Disagree, 5 = Strongly Agree).

Results

The sub-scale “Suicide as a right” was positively correlated with “Tabooing” (r (201) = .25, p=<.001), “Normal-common
” (r (201) = .29, p=<.001), and “Resignation” (r (201) = .47, p=<.001), but negatively correlated with “Incomprehensibility” (r (201) = -.26, p=<.001), and “Preparedness to Prevent” (r (201) = -.19, p=<.001), meaning such individuals had a more permissive attitude towards suicide. On the other hand, the subscale Preventability was found to be positively correlated with Incomprehensibility (r (201) = .21, p=<.001) and Preparedness to Prevent (r (201) = .30, p=<.001).

Females scored higher in the sub-scale Non-communication
(M=3.40, 95% CI [3.29, 3.51]) while males scored higher in Preventability (M=3.35, 95% CI [3.27, 3.44]). The higher the educational status of police-officers, the more they adopt a pro-prevention attitude to suicide (M=3.67, 95% CI [3.44, 3.89]) and the more likely they are to appreciate that suicidal thoughts and behaviour can be common (M=3.40, 95% CI [3.20, 3.60]). Participants with a mixed/different composition at home (M=4.05, 95% CI [3.86, 4.24]) and/or have experienced only between 0 to 2 situations related to suicide in the past one year alone (M=4.05, 95% CI [3.94, 4.16]), were the most likely to feel prepared to prevent suicide.

Conclusions

This study brings out different attitudes police-officers hold towards different aspects of suicide, influenced by their gender, educational background, personal life at home and total exposure to suicide during their career. Training programmes can help improve their knowledge and attitudes towards suicide, leading to a more positive behavioural response to individuals in crisis and create a safer environment. Malta, through an EU-funded programme, is currently investing its resources on drafting a national suicide prevention strategy, and such educational opportunities for our frontliners will ensure we have the right tools in screening, identifying, treating, and saving more lives.

Abbreviations:M: Mean score; CI: Confidence Interval

Disclosure of Interest

None Declared