bluuebunny/crossref_metadata_2025 huggingface dataset:
Cancer Survivors in Delaware: Impact of Comorbidity
Authors: Gupta S.
Published: August 2024

Introduction

Delaware’s recent longevity and aging trends predict a continual increase in the number of cancer survivors. As the cancer survivors live longer and age, the prevalence of comorbid chronic conditions tends to increase. Dual burden of cancer and comorbid chronic conditions can have significant and wide-ranging ramifications for cancer survivors. Comorbidity potentially affects the development, stage at diagnosis, treatment options, recurrence and long-term survival of people with cancer. Detailed delineation of Delaware adult cancer survivors including an exploration of comorbidity is critical.

Objectives

The primary objective was to characterize selected chronic conditions among Delaware adults with cancer in order to present: (i) disparities amongst cancer survivors by select sociodemographic and survivorship characteristics, and (ii) compare the prevalence of chronic conditions among cancer survivors and adult Delawareans without a cancer diagnosis.

Methods

Combined data (2018, 2020 and 2021) for Delaware were obtained from the Behavioral Risk Factor Surveillance System. The final data set included 927 Delawareans with at least one type of cancer (excluding skin cancers other than melanoma) and 11,917 participants without a cancer diagnosis. Descriptive statistics examined sociodemographic characteristics and chronic conditions in Delawareans with and without a cancer diagnosis.

Results

Amongst adult Delawareans, 5.1% (CI: 4.6–5.5) were cancer survivors. Across the state, the majority of cancer survivors (76.8%) reported having only one cancer diagnosis. In this sample of Delaware cancer survivors, 83.5% identified as White. Majority were female (57.4%), aged 65 or older (58.9%), had some college or more education (63.7%), and with an income of $50,000 or more (51.1%). Arthritis (46.3%), diabetes (21.5%), depression (18.7%), asthma (14.1%), chronic obstructive pulmonary disease (13.7%) angina (11.9%) and heart attack (11.6%) were the most prevalent comorbid conditions. Prevalence of certain chronic conditions was 2-3 times higher among cancer survivors. Nearly 23% reported not receiving instructions regarding cancer follow-up
care.

Conclusions

Cancer survivors have unique concerns. Results aim to facilitate targeted interventions aimed at coordinated managed care among cancer survivors in Delaware. This study bolsters the ongoing public health effort towards the Healthy People 2030 goal of increasing the proportion of cancer survivors.

Disclosure of Interest

None Declared
Digital treatments for affective disorders: an integrated overview
Authors: Volpe U.
Published: August 2024

Affective disorders represent a category of psychiatric syndromes with high prevalence and associated disability. While effective, both pharmacological and psychosocial, treatments are available for depression and bipolar disorder, the many therapeutic needs of affected patients are far from being properly addressed under routine conditions. Along the past decade, several digital treatments, tools and approaches have been developed and tested in clinical settings, showing an highly promising potential to fill the treatment gap of affective psychopathology. In more detail, reviewed here will be telepsychiatry solutions for affective disorders, also encompassing the available officially approved digital therapies for major depression and bipolar disorder. Furthermore, the impact of artificial intelligence, serious gaming, social media and virtual/augmented reality in the treatment of mood disorders will be also discussed, in the light of the most recent research evidence on these topics.

Disclosure of Interest

None Declared
Comparison of inpatient psychiatric care for SARS-CoV-2 positive and negative adults in Vienna
Authors: Erfurth A.
Published: August 2024

Introduction

The structure of psychiatric care has undergone many changes in recent decades. In addition, the SARS-CoV-2 pandemic has posed specific challenges for inpatient psychiatric care. In Vienna, the admission of SARS-CoV-2 positive psychiatric patients has been centralised in one department, the 1st Department of Psychiatry and Psychotherapeutic Medicine, Klinik Hietzing.

Objectives

It will be investigated to what extent the admissions of SARS-CoV-2 positive and negative patients differ with regard to age, gender, diagnosis, need for involuntary admission, medication, duration of treatment, country of birth and the question of where the patients come from and where they are discharged to.

Methods

Between 15 March 2020 and 21 May 2022 (start and end of cohorting of all Vienna SARS-CoV-2 positive inpatient psychiatric patients in one department), 338 SARS-CoV-2 positive and 1312 SARS-CoV-2 negative patients were treated as inpatients at the 1st Department of Psychiatry and Psychotherapeutic Medicine of the Klinik Hietzing.

Results

The results of the study will be shown.

Conclusions

The SARS-CoV-2 pandemic has presented an outstanding challenge to inpatient psychiatry. An accurate portrayal of differences in the treatment of positive and negative patients is of importance for assessing the impact of the pandemic.

Disclosure of Interest

None Declared
Understanding the Traumatic Impact of Serious Chronic Illness
Authors: Theodoratou M. , Diamanti H.
Published: August 2024

Introduction

The diagnosis of a severe chronic illness represents a deeply impactful traumatic event, frequently giving rise to initial adverse consequences that can manifest as post-traumatic stress. The duration and characteristics of these effects exhibit considerable variation among individuals.

Objectives

This study aims to explore the levels of post-traumatic stress, post-traumatic growth, and psychosocial adaptation among individuals coping with chronic diseases.

Methods

This cross-sectional study involved 92 participants with chronic illnesses, recruited through convenience and snowball sampling. Data collection utilized an online questionnaire that included both demographic questions to provide a comprehensive understanding of participants’ experiences, as well as psychometric scales for measuring post-traumatic stress, post-traumatic growth, and psychosocial adaptation.

Instruments used :

1.PTSD Checklist for DSM-5 (PCL-5)

2.Posttraumatic Growth Inventory (PTGI) and Tedeschi and Calhoun Posttraumatic Growth Inventory (TCGI).

3.Psychosocial Adjustment to Illness Scale (PAIS).

Analysis included descriptive statistics and inductive analysis using SPSS (p < 0.05). Ethical considerations were observed, with informed consent and data confidentiality.

Results

The study revealed the presence of low to moderate levels of post-traumatic stress (M= 2.45), moderate levels of post-traumatic growth (M= 2.90), and moderate levels of psychosocial adaptation in various aspects of participants’ lives, including work (M= 2.36), sexuality (M= 2.11), sociability (M= 2.28), relationships with partners and family members (M= 1.92), and perception of their health (M= 1.94). Furthermore, the overall psychosocial situation of the participants was found to range from low to moderate (M= 2.48). Notably, individuals with fewer chronic illnesses tended to experience lower levels of post-traumatic stress and exhibited less adaptation in their work. Additionally, higher levels of post-traumatic growth were observed in women and patients with higher educational backgrounds. The analysis revealed a positive and statistically significant correlation (sig.<0.05) between post-traumatic stress, post-traumatic growth, and various dimensions of psychosocial adjustment among the participants.

Conclusions

A chronic illness diagnosis can be deeply traumatic, potentially causing post-traumatic stress. However, it’s crucial to understand that this doesn’t diminish the possibility of post-traumatic growth and effective psychosocial adaptation. To foster this positive path, individuals must receive holistic psychological and emotional support, along with essential social assistance as they navigate life with chronic diseases.

Disclosure of Interest

None Declared
Who moderate the relationship between executive functions and quality of life among adults with and without adhd: structural equation model
Authors: Grinblat N. , Rosenblum S.
Published: August 2024

Introduction

Literature evidences indicates that adults with attention-deficit/hyperactivity disorder (ADHD) are struggling with executive functions deficiencies, organization in time deficits, low sleep quality, and poor quality of life (QoL). However, it is not clear how those factors associate and interact with each other.

Objectives

This study aims to compare those factors as well as the relationships between them, among adults with and without ADHD using structural equations modeling (SEM).

Methods

Sixty-nine adults with ADHD and 52 matched controls (ages 20-46) completed the Behavior Rating Inventory of Executive Function-adult version (for executive functions), Time Organisation and Participation Scale (for organization-in-time), Mini Sleep Questionnaire (for sleep quality), and Adult ADHD Quality of Life questionnaire (for QoL).

Results

Compared to adults without ADHD, adults with ADHD showed significantly poorer executive functions, organization-in-time, sleep quality and QoL. The SEM indicated that sleep quality and organization-in-time domains mediated the relationship between executive functions abilities and QoL. This SEM explained 79% of the QoL variance for adults with and without ADHD.

Conclusions

Understanding the role of organization-in-time and sleep quality as mediators between executive functions and quality of life emphasize the unique challenges of adults with ADHD, which deals with deficiencies at those factors. Those findings call for including these factors in evaluation and intervention processes to improve QoL and this population’s global health.

Disclosure of Interest

None Declared
Attention deficit hyperactivity disorder in adults : prevalence and association with addictive disorders
Authors: Bader S. , Karkni A. , Abbes W.
Published: August 2024

Introduction

Attention deficit hyperactivity disorder (ADHD) is a neurobehavioral disorder witch assumed to be a disorder of childhoood but recently has been shown to persist into adulthood. As in children, core features of adult ADHD include inattention, impulsivity, and/or hyperactivity.Despite growing interest in adult ADHD, little is known about its prevalence or correlates.

Objectives

We aimed to estimate the prevalence of ADHD in adult outpatient psychiatric care at the university hospital of Gabes (southern Tunisia) and to explore its association with addictive disorders.

Methods

We conducted a cross-sectional, descriptive, and analytical observation study,in the outpatient psychiatry department of the Gabes university hospital, during the period ranging from 1/1/2023 to 30/06/2023. We used an anonymous pre-established information sheet exploring the socio-demographic, clinical, therapeutic data of the patients, lifestyle habits and substance use, the DSM-5 to classify diagnoses, CGI-S to rate the severity of overall mental illness, Fagerström test to assess the nicotine dependence, Adult ADHD Self-Report Scale (ASRS) in its validated Arabic version to screen ADHD and the Diagnostic Interview for ADHD in Adults (DIVA) to confirm the ADHD diagnosis. Data entry and analysis were performed using Statistical Package for Social Sciences (SPSS) version 21.0.

Results

The response rate in our study was around 64.5%, 205 patients were included.The mean age of the patients was 48years ±14.9, the male/female ratio was 1.The estimated prevalence of adult ADHD according to the DIVA was 5.9% (male/female ratio=1/2). At the uni-variate study, significant associations were found between ADHD and the age category (p=0), the marital status (OR=0.14; CI [0.03- 0.55], p=0.003), theFagestrom score (p=0.01), cannabis consumption (OR=19; CI [1.8-201], p=0.018), psychotropic drugs consumption (OR=39; CI[3-196], p=0.02), self-harm behavior (OR=6.9, CI[1.9-26], p=0.01), excessive use of internet and screens (OR=38, CI[7-179],p=0). At the multivariate study, two determining factors were found: cannabis consumption(OR=8 [1- 58]; p=0.031), and the excessive use of internet and screens (OR=25 [4-144]; p=0).

Conclusions

Regarding our findings and the important prevalence of the adult ADHD,more efforts are needed to increase the detection and treatment of this disorder, in order to set up an early intervention before major impairments and complications become irreversible.

Disclosure of Interest

None Declared
The Detached Mindfulness approach to anxiety disorders in an Italian mental health service
Authors: Raffone F. , Pessina E. , Martini A. , Giunnelli P. , Massa A. , Carbone E. , Russo M. , Martiadis V.
Published: August 2024

Introduction

Anxiety disorders are one of the most common mental illnesses, and a consistent increase was observed after the COVID-19 pandemic. Mindfulness refers to a process that leads to a mental state characterized by nonjudgmental awareness of the present experience. Mindfulness can be considered both a skill and a practice. The stronger is the ability to adopt a mindful state, the less suffering one will experience. While Mindfulness-based Psychotherapies have shown efficacy in their treatment, they have not yet been thoroughly studied in Italian public mental health services. In Detached Mindfulness, negative thoughts are acknowledged and avoided by turning them into actions using a standardized, time-limited, metacognitive intervention.

Objectives

The purpose of this study is to examine the efficacy and cost-effectiveness of Detachment Mindfulness for twelve patients with Generalized Anxiety Disorder (GAD) not being treated pharmacologically.

Methods

We enrolled 12 patients diagnosed with GAD according to DSM-V in an 8-session program of Detached Mindfulness Psychotherapy (once a week). The Generalized Anxiety Disorder - 7 Scale (GAD-7) and the Kellner Symptom Questionnaire (SQ) were used to assess anxiety symptoms at baseline (T0), after 4 sessions (T1), and at the end of treatment (T2). The Client Satisfaction Questionnaire (CSQ-8) was used to assess treatment satisfaction.

Results

The GAD-7 score showed consistent reductions in generalized anxiety symptoms after Detached Mindfulness treatment (mean decrease of -42% at the end of the program). As measured by SQ, patients also reported improvement in physical well-being, relaxation, and somatic symptoms significantly respect to baseline. As for treatment satisfaction, ten out of twelve patients rated their treatment as satisfactory. As reported by patients, mindfulness can become a powerful and effective means to relate to one’s own internal experiences such as anxiety or fear, learning to recognize them, staying with them and avoiding their consequences.

Conclusions

These results showed that detached mindfulness was an effective and cost-effective intervention for GAD, given the short amount of time it requires and the ease with which it can be implemented. For its extensive use in the public mental health system to be further supported, studies on larger populations are needed.

Disclosure of Interest

None Declared
Attention-deficit/hyperactivity symptoms and personal strengths in adults
Authors: Miklósi M. , Vajsz K. , Oláh S. , Nagy V. , Szabó B.
Published: August 2024

Introduction

Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent chronic neuropsychiatric disorders in children and adolescents; however, it continues into adulthood in 4-77% of the cases. Due to executive dysfunction, adults with ADHD may have deficits in personal strengths, as well as difficulties utilizing existing strengths in challenging situations, which may add to the functional impairments associated with ADHD in adults.

Objectives

Therefore, we aimed to explore the association between personal strengths and ADHD symptoms in a community sample of adults.

Methods

Five hundred and twenty-eight adults (mean age = 21.41 years, SD = 2.29, range: 18 ̶ 28, female: N = 488, 92.4%) filled out an online questionnaire after giving their informed consent. Personal strengths were assessed using Bernstein’s Strengths Scale (BSS) which measures sixteen positive attributes grouped into four higher-order factors: self-directedness (Identity, Self-reflection, Self-confidence, Self-assertion, Imagination/Creativity), self-regulation (Emotional balance, Resilience, Self-control, Self-care, Reality testing), connection (Empathy, Compassion, Humour, Responsibility), and transcendence (Gratitude and Wisdom). ADHD symptoms were measured by the screening version (Part A) of the Adult ADHD Self-Report Scale (ASRS).

Results

Participants who were screened positive in ASRS (N = 247, 46.7%) scored lower in all but four BSS subscales than participants who were screened negative (N = 280, 53.3%). Effect sizes reached the medium level (Cohen’s d > .5) for Self-confidence, Self-care, Responsibility and Wisdom, and were small (Cohen’s d > .2) for Identity, Self-assertion, Imagination, Resilience, Reality-testing, Emotional balance, and Gratitude. However, no group differences were found in the Self-reflection, Empathy, Compassion, and Humour subscales of the BSS.

Conclusions

Our results suggest that ADHD symptoms in adults may be associated with deficits in personal strengths; that is, adults with ADHD may have difficulties, especially in trusting in their abilities, qualities, and judgements, in taking care of their own emotional and physical well-being, in taking responsibilities and in being open to learning from their experiences. Addressing personal strengths in psychosocial interventions for adult ADHD may improve patients’ functioning.

This research has been supported by the National Research, Development, and Innovation Office, OTKA-PD-134849 and ÚNKP-22-2-I-ELTE-854 grants.

Disclosure of Interest

None Declared
Psychiatric brain gain in Switzerland. Competency-based onboarding.
Authors: Gurrea Salas D. , Palma Álvarez R. F.
Published: August 2024

Introduction

In the last 30 years, Switzerland has been established as a destination country for psychiatric trainees. The needed competences for the work as a trainee deviate regarding colleagues from foreign countries though, hindering a viable solid development professional without specific on-boarding program. A similar approach to the figure of tutor anchored in the Spanish postgraduate medical training is still missing in the Swiss medical System. Hereby we performed a survey in the new colleagues who are part from the medical team in an observer status before beginning with the responsibilities as a trainee.

Objectives

Recognizing competences and needs of the onboarding in current trainees that are still allocating because of the work conditions as stated in the following paper, (Bischof et al. Swiss Arch Neurol Psychiatr Psychother. 2021;172:w03198)

Methods

Survey with open questions collecting needs and competences expected to fulfil in Switzerland were distributed in 5 different medical colleagues in an observer status between August 2022 and September 2023.

Results

Response rate was 62,5 %. Main reasons for the migration were considering better perspectives in education and professional development in the goal country, coming push factors as the current work situation in the original country to the fore. Support regarding the local language and an overview of the interprofessional communication were outlined as the advantage of the internship prior to the duties as a psychiatric trainee.

Conclusions

An structured on-boarding program is a demand for the newcomers - majority of trainees from foreign countries - to step in better in the Swiss health system. Elements of the Spanish trainee system could be adapted for a suitable allocation and integration process in the goal country.

Disclosure of Interest

None Declared
Post-traumatic stress disorder in crack/cocaine users
Authors: Ait Bensaid N. , Bensalah Y. , Sabir M. , El Omari F.
Published: August 2024

Introduction

Cocaine use has become popular in the form of crack and has spread throughout the world. Crack/cocaine use is often linked to serious social and psychiatric disorders, including post-traumatic stress disorder, and users appear to be at increased risk of physical and mental illness and social harm.

Objectives

To determine the prevalence of post-traumatic stress disorder in patients followed and hospitalized in the addictology department at the Arrazi psychiatric hospital in Salé for management of crack/cocaine use disorder.

Methods

This is a descriptive cross-sectional study using a questionnaire including sociodemographic and clinical criteria and a post-traumatic stress scale (PCLS) to investigate the existence of post-traumatic stress disorder in patients monitored and hospitalized for crack/cocaine use disorder in the addictology department at the Arrazi psychiatric hospital in Salé.

Results

We collected 77 participants. The majority of patients were born in the city The average age of the participants was 27, with a male predominance (67%). The majority were unemployed at the time of the study, single, separated or divorced. For more than 50%, the start of drug use was more than 4 years ago. The smoked route (crack) is the most predominant, followed by the inhaled route and 1% for the injectable route. Some 37% were hospitalized in an addictology unit. Almost 65% of participants had a history of post-traumatic stress disorder.

Conclusions

Co-morbidity between crack/cocaine use disorder and post-traumatic stress disorder is frequent among patients monitored and hospitalized in the addictology department at the Arrazi psychiatric hospital in Salé. There seems to be a need to develop new therapeutic strategies and to adapt existing programs to patients’ needs. In addition, understanding the profiles of patients suffering from this comorbidity in mental health facilities could help clinical staff to better accept their problems and behaviours, thus promoting treatment adherence and better outcomes.

Disclosure of Interest

None Declared
Ekbom síndrome (Parasitosis delirium): Cocaine Use vs. Psychotic Depression. A case report
Authors: Arroyo Sánchez E. , Gimillo Bonaque J. , Setién Preciados P. , Díaz Mayoral C.
Published: August 2024

Introduction

Parasitosis delirium represents a rare mono-symptomatic psychosis characterized by the delirious firm belief of the patient, against all evidence, of being infested by cutaneous parasites. The syndrome affects in particular middle-aged women, and can be the single manifestation of psychological uneasiness or represent one of the aspects of a more complex psychiatric case, compromising almost totally any normal daily work and/or social activity. It is often accompanied by a refusal to seek psychiatric care. This condition can be associated with various underlying causes, including substance use disorders and psychotic depression. Understanding the differences and similarities between delirium of infestation in the context of cocaine use and psychotic depression is crucial for accurate diagnosis and effective treatment.

Objectives

This study aims to compare and contrast the clinical features, etiology, and treatment approaches of delirium of infestation in individuals with cocaine use and those with psychotic depression. By examining these two distinct populations, we can gain insights into the unique challenges and considerations associated with each condition.

Methods

A case report of a 44-year-old woman with delirium of parasitosis, depressive symptoms and cocaine use in the last three days. Also a comprehensive literature review using the PubMed database to identify relevant clinical articles on delirium of infestation, cocaine use, and psychotic depression.

Results

Cocaine use and psychotic depression can both cause delirium of infestation. Cocaine-induced delirium is characterized by agitation, paranoia, and delusions of infestation. Psychotic depression is characterized by a depressed mood, delusions, and hallucinations. Delusions of infestation are a common feature of bothconditions. However, the underlying mechanisms and treatment approaches differ. Cocaine-induced delirium is primarily associated with the acute effects of cocaine on the central nervous system, while psychotic depression involves a complex interplay of biological, psychological, and environmental factors. Treatment for cocaine-induced delirium involves addressing the underlying cocaine use, while treatment for psychotic depression involves antidepressant and antipsychotic medications. Otherwise, Anti-Parkinson drugs were most frequently associated with delusional infestation

Conclusions

Delirium of infestation can occur in individuals with cocaine use and those with psychotic depression, albeit with different etiologies. Clinicians should consider the underlying cause when diagnosing and treating patients with this condition. Further research is needed to explore the specific neurobiological mechanisms and optimal treatment strategies for delirium of infestation in these distinct populations.

Disclosure of Interest

None Declared
The awareness of behavioral addictions in general practitioners- An epidemiological report
Authors: Vasiliu O.
Published: August 2024

Introduction

Although the research on behavioral addictions (BAs) is continuously developing, the awareness about this category of disorders and their important negative consequences still remains a problem for many physicians. This phenomenon is associated with delayed diagnosis and treatment initiation, lack of valid epidemiological data about these pathologies, and overall lower quality of life in these patients.

Objectives

The main objective of this study was to explore the awareness of GPs on the general diagnosis criteria of BAs.

Methods

An online questionnaire addressed to general practitioners (GPs) investigated the level of their knowledge regarding the main criteria for diagnosis in five more commonly reported BAs, i.e., gambling disorder, problematic Internet use, cell phone addiction, food addiction, and shopping addiction. The questionnaire included 50 items and required 20-25 minutes to complete. The answers were anonymized.

Results

Answers from 12 GPs were analyzed, with an 80% completion rate. Gambling disorder was the only diagnosis recognized by all the respondents, followed by shopping addiction (50%) and abusive Internet use (33.3%). Lack of time to screen for these disorders was the most frequently invoked reason for not including instruments dedicated to BAs in the regular visits to the GPs. The Internet was admitted by all the respondents as their source of information about BAs.

Conclusions

There is an acute need to improve the knowledge of GPs about the existence and consequences of BAs in order to increase the probability of early detection and treatment initiation for these patients. It is expected that Internet-based campaigns for increasing GPs will benefit BAs patients in the long term.

Disclosure of Interest

None Declared
Corticosteroid-induced mania, review and case report
Authors: García Moreno M. , De Cos Milas A. , Beatobe Carreño L. , Izquierdo De La Puente A. , Del Sol Calderon P.
Published: August 2024

Introduction

Corticosteroid treatment has been associated with the appearance of psychiatric symptoms such as depression, mania or psychosis. It is believed that manic symptoms appear with lower doses than psychotic ones. Furthermore, manic symptoms are usually associated with brief treatments against depressive ones that often appear with chronic administration of corticosteroids. The symptoms can persist for to 2 months, with an average duration of 3 weeks. The prognosis is favorable with a complete remission of symptoms in more than 90% of patients. Treatment initially consists in reducing or removing corticosteroids. However, sometimes symptomatic treatment with antipsychotics or mood stabilizers is necessary.

Objectives

To review about corticosteroid-induced mania

Methods

We carry out a literature review about corticosteroid-induced mania, accompanied by a clinical description of one patient previously diagnosed of bipolar disorder who presents a manic episode after corticosteroids treatment.

Results

A 25-year-old male was admitted to the short-term hospitalization unit from the emergency department due to manic symptoms. He had a previous diagnosis of attention deficit hyperactivity disorder sin adolescence and also a diagnosis of bipolar disorder established 7 years ago. During the last year he had received treatment with asenapine 10 mg and lamotrigine 200 mg, with good response. Several weeks before his admission he received corticosteroid treatment during several days, due to an respiratory infection. In this context he appeared more nervous, dysphoric, hyperthymic, impulsive, with increased speech pressure, insomnia and tachypsychia. Despite the withdrawal of corticosteroid treatment, manic symptoms persisted. During admission, asenapine´s dose was increased with a complete remission of the manic symptoms.

Conclusions

Corticosteroids are associated in a high percentage with the appearance of manic symptoms. The prognosis is usually favorable after the withdrawal of corticosteroid treatment. However, sometimes the symptoms do not disappear despite withdrawal - mainly due to individual vulnerability - or this one is not possible. In these cases, treatment with antipsychotics or mood stabilizers is indicated.

Disclosure of Interest

None Declared
Clinical and electroencephalographic particularities of children and adolescents with behavioral disorders
Authors: Bouchech R. , Fki A. , Kammoun I. , Masmoudi K.
Published: August 2024

Introduction

Behavioral disorders are a frequent reason for consultation in child psychiatry. Children and adolescents with epilepsy are at risk of behavioral disorders that can affect their quality of life.

Objectives

The aim of this study was to investigate the electroencephalographic aspects of children with behavioral disorders and to determine the prevalence of comorbidity with epilepsy.

Methods

This was a retrospective descriptive study conducted from January 2019 to May 2022. We included all children and adolescents referred to the functional explorations department at Habib Bourguiba hospital, Tunisia for Electroencephalogram (EEG) as part of a workup to explore a behavioral disorder.

Results

A total of 117 patients were included in the study. The mean age was 14 ±4.2 years. The sex ratio was 1.29. Agitation was reported in 66.7% of patients. One case of attempted suicide was noted. Among these patients, 29.9% reported audiovisual hallucinations. Concentration difficulties were associated with 59% of cases. Ten patients had a history of epileptic seizures. Of the 117 EEGs performed, 59.8% were pathological. The abnormalities observed were paroxysms in 67.1% of cases and focal slowing in 25.7%. Five patients had a rapid rhythm on the EEG. An absence-type electro-clinical seizure was recorded in one patient. Patients with visual hallucinations had epileptiform abnormalities of occipital location in 41.7% of cases, and slow waves of anterior location in 50% of cases. Patients with auditory hallucinations had parietal epileptiform abnormalities in 89% of cases.

Conclusions

Ictal and interictal manifestations seem to play a part in the genesis of behavioral disorders in children and adolescents. An EEG would therefore be preferable in this age group, for better management.

Disclosure of Interest

None Declared
Early Onset Schizo-Obsessive Disorder: A Case Series of 7 Inpatient Children
Authors: Yerlikaya Oral E. , Karaçetin G.
Published: August 2024

Introduction

Schizo-obsessive disorder (SOD) is a complex psychiatric condition characterized by exhibiting symptoms of schizophrenia and obsessive-compulsive disorder (OCD)(Schirmbeck et al. Front Pharmacol. 2013 Aug 9;4:99). Some researchers prefer to describe this condition as a spectrum called “schizo-obsessive spectrum” and state that clinical represantations such as OCD with poor insight, OCD with schizotypal personality disorder, schizophrenia with obsessive-compulsive symptoms and schizophrenia with OCD are included in this spectrum(Poyurovsky et al. J Psychiatr Res. 2005 Jul;39(4):399-408). There is limited literature available on early on-set schizo-obsessive disorder in child and adolescent sample.

Objectives

This case series aimed to describe the clinical characteristics, phenomenology, diagnostic process and treatment response of SOD in a sample of inpatient adolescents and illuminate the intricate symptomatology between schizophrenic and obsessive-compulsive features.

Methods

A retrospective review was conducted of 7 adolescent patients who met DSM-V criteria for both schizophrenia and OCD in our inpatient clinic over the past year. Data were collected from medical records, including demographic information, clinical presentation, treatment history and response to treatment. All data were anonymized to maintain patient confidentiality.

Results

The sample consisted of 5 females and 2 males, with a mean age of 15,4 years. All patients presented with a mixed symptomatology of hallucinations, delusions and obsessive-compulsive symptoms. Many common points observed about clinical characteristics and psychiatric history of the patients. In most of the patients, the first psychiatric complaints started with obsessive-compulsive symptoms. It was observed that obsessions evolved into over-valued ideas and delusions in the course of time. Patients responded late and inadequately to pharmacological treatment, multiple drug use was necessary. Hospitalization lasted longer, the average time was 53 days. Most of the patients required augmentation with cognitive-behavioral therapy due to partial response or intolerable side effects. Unfortunately, no patient experienced full remission or returned to premorbid functioning.

Conclusions

This case series underscores the complexity of diagnosing and treating schizo-obsessive disorder in a pediatric population. It appears that a combined approach using both pharmacotherapy and psychotherapy may yield the most beneficial results. However, given the small sample size and retrospective design, these findings need to be interpreted with caution. Further research are crucial to corroborate our findings and refine treatment strategies.

Disclosure of Interest

None Declared
Exploring Early Autism Markers in High-Risk Infants: Implications for Timely Intervention
Authors: Negm M. , Khoweiled N.
Published: August 2024

Introduction

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by challenges in social communication and behaviour. Timely identification of ASD is pivotal for effective intervention. However, significant gaps persist in our understanding of early signs and biomarkers, particularly among infants with older siblings already diagnosed with ASD. Furthermore, factors during the perinatal and neonatal period remain underexplored.

Objectives

This systematic review aims to investigate early autism markers within this specific cohort and assess their potential impact on intervention strategies.

Methods

A thorough search of electronic databases, including PubMed, PsycINFO, and Scopus, was conducted, initially identifying 161 relevant papers related to ASD and resilience published from 2013 to 2023. After excluding studies focused on environmental determinants of resilience in ASD, 75 papers remained. We concentrated on studies examining early identification of autism, especially in infants with older siblings with ASD, biomarker discovery, or predictive factors within this unique population. The search strategy employed a diverse set of keywords encompassing ASD, genetics, neurobiology, and the perinatal period to ensure comprehensive coverage of pertinent studies. Quality assessment of each study followed standardized criteria, and data synthesis utilized a thematic analysis approach.

Results

Our systematic exploration revealed a spectrum of early markers associated with ASD in high-risk infants, spanning behavioural, neurodevelopmental, genetic, and perinatal domains. Recognizing these early indicators offers promise for timely and potent intervention strategies, potentially refining long-term outcomes for children at risk of ASD.

Discussion

The synthesis of existing research in this systematic review underscores the significance of studying early markers within high-risk populations. Early intervention, guided by these markers, holds the potential to enhance the quality of life for at-risk children with ASD and their families. This review contributes to our understanding of the early identification of autism and emphasizes the imperative need for continued research in this critical area.

Conclusions

This systematic review sheds light on the current state of research on early signs and biomarkers of autism in infants with older siblings diagnosed with ASD. The findings carry significant implications for the development of targeted interventions that can be implemented at an earlier stage of development. Future research should further investigate these markers and their potential role in guiding early and effective intervention strategies.

Keywords: Autism Spectrum Disorder, early signs, biomarkers, infants, older siblings, early intervention, high-risk population.

Disclosure of Interest

None Declared
Attentional Bias to Angry Faces: Contrasting Responses in Typically Developing Children and Children with Autism Spectrum Disorder
Authors: Kim S.-Y. , Choi Y.
Published: August 2024

Introduction

Human faces generally attract immediate attention. However, it has been found that children with autism spectrum disorder (ASD) tend to allocate relatively less attention to faces. Previous research showed that typically developing children (TD) exhibited an attentional bias to angry faces, regardless of their anxiety levels, but it’s unclear if this applies to children with ASD. Therefore, the present study aims to investigate attentional bias induced by angry and/or happy faces in children with ASD.

Objectives

We explored attentional bias toward angry faces in both TD children and children with ASD. We hypothesize that while TD children will show attentional capture effects in response to angry faces, children with ASD will not exhibit such attentional bias to facial stimuli, irrespective of their emotional content.

Methods

By now, five ASD participants (all male) and 34 TD participants (17 male), aged 6-12, have completed a continuous performance task. In this task, irrelevant distractors (angry or happy faces) appeared and disappeared abruptly, while the orientation of the target changed every 1,250 ms. Participants were asked to respond as quickly and accurately as possible to the orientaiton of the target. We designated the time when the distractor first appeared as T1, and subsequent time intervals at 1,250 ms increments were labeled as T2, T3, and T4. The time intervals when no distractor was present were labeled as TB (baseline). If the reaction time (RT) at T1 was significantly slower compared to TB, it indicated attentional bias by the distractor.

Results

For the RT data, separate repeated measures ANOVAs with 2 (emotion) * 5 (time) factors were conducted for each group. The results revealed a significant main effect of time (F(4, 132) = 17.59, p < .01) and a significant interaction between emotion and time (F(3.27, 107.74) = 4.92, p < .01) only in TD. Post hoc t-tests indicated that TD children exhibited significantly slower RT at T1 compared to TB, but this difference was observed only for angry faces (t(33) = 4.84, p < .01). In contrast, no significant effect was found in children with ASD. In other words, TD demonstrated attentional bias only when exposed to angry faces, while ASD children did not exhibit attentional bias to either emotion.

Conclusions

This study aimed to investigate attentional bias to angry faces in both TD and ASD children. The results indicate that TD children exhibited an attentional bias when exposed to angry faces, whereas ASD children did not display such bias. These findings are consistent with previous research suggesting that TD children tend to show attentional bias towards angry faces, regardless of their anxiety levels. Furthermore, the absence of attentional bias to angry faces in ASD suggests that their characteristic of reduced attention to faces may contribute to the lack of attentional bias towards angry faces.

Disclosure of Interest

None Declared
The effect of Self-Regulation Based Cognitive Psychoeducation Program on emotion regulation and self-efficacy in children diagnosed with attention deficit hyperactivity disorder
Authors: Sökmen Z. , Karaca S.
Published: August 2024

Introduction

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder with early onset (Christiansen, H., et al. CPR 2019, 1–11), which is characterized by several symptoms, including lack of attention, hyperactivity, and impulsivity that are incompatible with age and developmental level (Caye, A., et al. 2020 JAACAP, 990–997)

Objectives

This study aimed to determine the effect of Self-Regulation Based Cognitive Psychoeducation Program on emotion regulation and self-efficacy in children diagnosed with attention deficit hyperactivity disorder (ADHD) and receiving medication.

Methods

The sample of this study with control group and pre-test, post-test and follow-up randomized experimental design consisted of children followed in the child and adolescent mental health outpatient clinic of a state hospital. The data were evaluated by parametric and non-parametric analyses.

Results

A statistically significant increase was determined in the internal functional emotion regulation mean scores of children, who participated in the Self-Regulation Based Cognitive Psychoeducation Program, measured before, immediately after, and 6 months after the intervention (p < 0.05). A statistically significant increase was also found in their external functional emotion regulation mean scores measured before and 6 months after the intervention (p < 0.05). In addition, a statistically significant difference was found between their internal dysfunctional and external dysfunctional emotion regulation mean scores measured before and 6 months after the intervention; however the mean scores of those in the control group 6 months after the intervention were higher than those in the intervention group (p < 0.05). Furthermore, there was a statistically significant increase in their self-efficacy mean scores measured before and 6 months after the intervention (p < 0.05).

Conclusions

The Self-Regulation Based Cognitive Psychoeducation Program was found be effective in increasing the levels of emotion regulation and self-efficacy in children with ADHD.

Disclosure of Interest

None Declared
Clinical Outcomes and Histologic Findings of Patients With Hepatocellular Carcinoma With Durable Partial Response or Durable Stable Disease After Receiving Atezolizumab Plus Bevacizumab
Authors: Shen Ying-Chun , Liu Tsung-Hao , Nicholas Alan , Soyama Akihiko , Yuan Chang-Tsu , Chen Tse-Ching , Eguchi Susumu , Yoshizumi Tomoharu , Itoh Shinji , Nakamura Noriaki , Kosaka Hisashi , Kaibori Masaki , Ishii Takamichi , Hatano Etsuro , Ogawa Chikara , Naganuma Atsushi , Kakizaki Satoru , Cheng Chih-Hsien , Lin Po-Ting , Su Yung-Yeh , Chuang Chien-Huai , Lu Li-Chun , Wu Chi-Jung , Wang Hung-Wei , Rau Kun-Ming , Hsu Chih-Hung , Lin Shi-Ming , Huang Yi-Hsiang , Hernandez Sairy , Finn Richard S. , Kudo Masatoshi , Cheng Ann-Lii
Published: August 2024

PURPOSE

Durable partial response (PR) and durable stable disease (SD) are often seen in patients with hepatocellular carcinoma (HCC) receiving atezolizumab plus bevacizumab (atezo-bev). This study investigates the outcome of these patients and the histopathology of the residual tumors.

PATIENTS AND METHODS

The IMbrave150 study's atezo-bev group was analyzed. PR or SD per RECIST v1.1 lasting more than 6 months was defined as durable. For histologic analysis, a comparable real-world group of patients from Japan and Taiwan who had undergone resection of residual tumors after atezo-bev was investigated.

RESULTS

In the IMbrave150 study, 56 (77.8%) of the 72 PRs and 41 (28.5%) of the 144 SDs were considered durable. The median overall survival was not estimable for patients with durable PR and 23.7 months for those with durable SD. The median progression-free survival was 23.2 months for patients with durable PR and 13.2 months for those with durable SD. In the real-world setting, a total of 38 tumors were resected from 32 patients (23 PRs and nine SDs) receiving atezo-bev. Pathologic complete responses (PCRs) were more frequent in PR tumors than SD tumors (57.7%
v
16.7%,
P
= .034). PCR rate correlated with time from atezo-bev initiation to resection and was 55.6% (5 of 9) for PR tumors resected beyond 8 months after starting atezo-bev, a time practically corresponding to the durable PR definition used for IMbrave150. We found no reliable radiologic features to predict PCR of the residual tumors.

CONCLUSION

Durable PR patients from the atezo-bev group showed a favorable outcome, which may be partly explained by the high rate of PCR lesions. Early recognition of PCR lesions may help subsequent treatment decision.
Exploiting automatic differentiation for quantum optimal control of driven dissipative two-level systems
Authors: Jirari H. , Rabitz H.
Published: August 2024

In principle one can use Pontryagin's minimum principle to treat an optimal control problem and derive the gradient for the cost functional. However, for the driven spin-boson model studied here, the response of the system to the variation of the control is determined by the master equation and the equation of motion for the propagator of the coherent system dynamics. As a result, the application of Pontryagin's minimum principle is less straightforward. An alternative to this approach is the technique of automatic differentiation which in principle amounts to doing calculus on the fully discretized form of the optimal control problem. Automatic differentiation tools can be viewed as black boxes taking as input a program computing the cost functional and giving as output another program computing its gradient. First we derive for the polaron transformed Hamiltonian a Born-Markov master equation using the Bloch-Redfield formalism. By combining the latter with automatic differentiation we are able to implement Z-gate and coherent destruction of tunnelling with high fidelity. Optimization of a dissipative quantum gate poses a more complex numerical problem, since it should occur independent of the input state. To overcome this difficulty, we apply optimal control to the concept of resolvent of the master equation which is the generalisation of quantum unitary evolution operator in the case of dissipative dynamics.
Directional cues affect the collective behaviour of self-propelled particles in one dimension
Authors: Mishra Pawan Kumar , Puitandy Abhra , Mishra Shradha
Published: August 2024

This study explores the effect of quenched disorder on the characteristics of self-propelled particles in one dimension. Here, particles interact with disorder which serve as directional cues. The study investigates how the density of the directional cues influences the emergence of ordering and clustering in the collection of the self-propelled particles. We introduce the microscopic model as well as corresponding coarse-grained equations of motion for the local density and the orientation of particles. Directional cues affect the macroscopic ordering in the system, the size of the ordered clusters decays algebraically with density of cues. Further, in the presence of directional cues, a big macroscopic cluster breaks into small clusters, leading to the localization of particles around it and resulting in high density around the cues.