bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence and severity of Anxiety and Depression among Primary caregivers with correlation to their Psychiatric outpatients diagnostic entity according to ICD-10
Authors: Afridi I.
Published: September 2022

Introduction

The impact of psychiatric patients on their primary caregivers is important. Outcome of different psychiatric disorders may also depends open the mental health of their caregivers. Therefore assessment of the prevalence and severity of Anxiety and depressive disorders may help to improve the wellbeing the caregivers as well as their sufferers.

Objectives

To assess the prevalence and severity of Anxiety and Depression among primary caregivers of psychiatric outpatients. To correlate the psychiatric diagnosis according to ICD-10, of the patients with their caregivers anxiety and depression.

Methods

The study was carried out in private Psychiatric Hospital with primary caregivers of psychiatric outpatients. One hundred and eighty consecutive and consenting participants were selected. Besides, applying semi-structured preform, designed for this purpose, anxiety and depression levels of these individuals were assessed using the locally validated version of HOSPITAL ANXIETY AND DEPRESSION SCALE (HADS). For the diagnostic categorization ICD-10 of WHO was used. Data was tabulated and analyzed using SPPS 17 version.

Results

Among the 180 caregivers, between the age range of 18 to 92 years, 44% were found to be suffering from anxiety, and 68.56% were suffering from depressive disorders. Anxiety and Depression (combined) existed among 74.85% of the caregivers of psychiatric outpatients. Frequency of depressive disorder was found higher among the brothers (19.08%) as caregivers, followed by mother (18.32%), relatives (16.03%), and in spouses (15.26%).

Conclusions

Caregivers of psychiatric patients, especially females, are more vulnerable to anxiety and depression irrespective of the type of their patients’ illness.

Disclosure

No significant relationships.
Neuropsychological functions as trait markers in OCD: a long term follow-up
Authors: Puialto M. , Segalàs J.
Published: September 2022

Introduction

There is suggestive evidence that Obssesive Compulsive Disorder (OCD) is characterized by impaired neuropsychological functions that are also influenced by clinical variables. Several studies show that these neuropsychological deficits could be potential endophenotype markers.

Objectives

The present study aimed to examine neuropsychological patterns in OCD patients and several clinical variables before and after a follow-up of 10 years.

Methods

This study examined 44 outpatients with OCD. Cognitive performance and clinical data of these patients were documented before and after a follow-up of 10 years. A neuropsychological battery was administered and scored to them including Rey Osterrieth Complex Figure, the Digit-span test, and the State-Trait Anxiety Inventory. As well, several clinical variables were also assessed including sociodemographic variables, general intelligence measured by Progressive Raven’s matrices, Yale Brown Obsessive Compulsive Scale and Hamilton Depression Rating Scale. Finally, data was analyzed using t-Student and Pearson’s correlation.

Results

In general, the pattern of neuropsychological dysfunction in patients with OCD remains unchanged during the follow-up period, except for some specific variables. Low scores on some verbal memory tasks were associated with severity of OCD, and nonverbal memory was influenced by depressive symptoms in the first evaluation, while, after the follow-up, as obsessive and affective symptoms improve, there’s no significant change in the neuropsychological pattern.

Conclusions

Despite the influence of some clinical and sociodemographic variables on the neuropsychological performance in OCD patients, cognitive dysfunction remains unchanged after a follow-up period of 10 year. These results suggest that cognitive deficits could be considered as a trait marker for the disorder.

Disclosure

No significant relationships.
“Family Burnout” of psychiatric patients: its role during the COVID-19 pandemic
Authors: Franza F. , Vacca A. , Minò M.V. , Solomita B. , Papa F. , De Paola A. , Franza A.
Published: September 2022

Introduction

Family members caregivers (FMCs) of patients with severe psychiatric disorders (SMPD) are subjected to a complex system of fatigue and stress. FMCs can be subjected to a care burden defined as “Family Burnout”. Caring of family members of patients affected by psychiatric disorder suffered an additional burden during the pandemic period.

Objectives

To investigate the stress, burnout and compassion fatigue in FMCs during the pandemic vs non-pandemic period.

Methods

In our observational study we recruited family members (FMCs) of SMPDs (DSM-5). The severity was assessed with BPRS > 31; from March 2021 to July 2021 (T1), in 66 FMCs (38 females, 28 men) that completed following questionnaires: CBI (Caregiver Burden Inventory), ProQOL (compassion satisfaction and compassion fatigue (burnout and secondary trauma) subscales]. These data (T1) were compared with the scores obtained in the same family members in 2019 (T0) in a pre-pandemic period.

Results

ProQOL data /T1) have a higher total score than those observed in a previous study (T0). They show a lower main score in Compassion Satisfaction (CS) subscale [T1 vs T0; 34.27 vs 38.89 (p < .00.5). CS subscale T0 vs T1= 34.84% vs 12.12%). High levels of burnout were found in 28.79% (T1) vs 13.64% (T0) of FMCs group. Similar results showed in the Secondary Trauma subscale and CBI with higher scores in T1 vs T0.

Conclusions

The comparative mean results (2019 vs 2021) showed that in the same group of FMCs, the mean values obtained with same scales were higher during the lockdown. During health crisis, FMCs of psychiatric patients are subjected to high levels of stress.

Disclosure

No significant relationships.
How can resilience moderate the effects of the COVID-19 pandemic on mental health?
Authors: Ciampi C. , Carfagno M. , Raia M. , Giallonardo V. , Del Vecchio V. , Luciano M. , Sampogna G. , Fiorillo A.
Published: September 2022

Introduction

The COVID-19 pandemic represents a new form of trauma, which is impacting on the mental health of the general population. However, the effects of this new trauma are variable, being mediated by individual factors such as the levels of resilience and the coping strategies.

Objectives

The aims of the present study are: 1) describe the levels of resilience and the type of coping strategies adopted by the Italian general adult population during the first wave of the pandemic; 2) evaluate the protective role of coping strategies and resilience on the levels of depressive, anxiety and stress symptoms.

Methods

An online survey has been developed, which includes several validated self-reported questionnaires for the evaluation of participants’ mental health condition, coping strategies and levels of resilience. The main outcome measure is the Depression Anxiety and Stress Scale-21 (DASS-21).

Results

The finale sample consists of 20,720 participants, more than half reported low levels of resilience, which were not associated with age or gender. The levels of resilience did not differ among the general population, patients with pre-existing mental disorders and those infected by COVID-19. People with low levels of resilience rarely used adaptive coping strategies. The levels of resilience did not have any influence on stress, depressive or anxiety symptoms.

Conclusions

The presence of low levels of resilience in the general population may be the missing link between the pandemic and increasing concerns on mental health problems. This could be important for the development of ad-hoc supportive and preventive psychosocial interventions.

Disclosure

No significant relationships.
Resilience And Coping: The Chicken and The Egg Paradox
Authors: El Ouni N. , Braham A. , Charaa O. , Kalboussi H. , Maatoug J. , Mrizak N.
Published: September 2022

Introduction

Since the outbreak of the 2019 coronavirus, healthcare workers found themselves on the front lines of an unprecedented battle. Being characterized by adversity, this experience represents a fertile ground for the study of resilience.

Objectives

Our study aims to clarify the phenomenon of resilience through its influence on perceived stress level and its connection with coping strategies.

Methods

A cross-sectional study was conducted involving 254 healthcare professionals in the region of Sousse during the pandemic. In addition to socio-demographic and professional characteristics, Resilience, perceived stress, and coping strategies were assessed using the Connor-Davidson Resilience Scale (CD-RISC), the PSS10 scale, and the Brief Cope questionnaire, respectively.

Results

The overall mean [±standard deviation (SD)] age of the participants was 32.9 ± 8.76 years with a sex ratio (M / F) of 0.51. The assessment of resilience among participants revealed a mean score of 64.99 ± 14.72. The majority of participants evinced a score> 50 (82.68%) and 39.76% had a score >70. Our results revealed that, on the one hand, problem-focused coping strategies were positive predictors of resilience (p<10-3), accounting for 3.6% of its variance. On the other hand, coping strategies (problem-focused strategies and avoidance strategies) are also an integral part of the process by which resilience significantly influences the level of perceived stress (mediating factor).

Conclusions

Despite its complexity, the relationship between resilience and coping strategies is undeniable and it is a part of an important line of intervention opening the way to better identifications and care.

Disclosure

No significant relationships.
Menstrual psychosis diagnosis: Does it still hold?
Authors: Adão C. , Donas-Boto I. , Velosa A. , Trindade P. , Caetano R.
Published: September 2022

Introduction

Menstrual psychosis was first described in the 18th century. Brockington defined its characteristics: acute onset; brief duration with full recovery; confusion, stupor and mutism, delusions, hallucinations, or a manic syndrome and periodicity in temporal association with the menstrual cycle.

Objectives

Description of a clinical case of menstrual psychosis and review of the literature.

Methods

Description of a clinical case. Non systematic review of the literature, searching the terms “psychosis”; “menstrual”; “catamenial” in the databases Pubmed, Medline and Cochrane.

Results

Female, 39-year-old patient. No psychiatric history until the postpartum period of a traumatic vaginal birth, when she developed stupor and mutism which lasted for two days. During the following 2 years, she progressively presented with sadness, asthenia, anhedonia, insomnia and incapacity for self-care. She was prescribed paroxetine and olanzapine, with partial recovery. Subsequently, she had at least 6 episodes with about 3-day duration of asthenia, food refusal, insomnia, incapacity for self-care, disorganization of thought and behavior and mystical and persecutory delusions, coincident with the beginning of menstruation. She was hospitalized in two of them and received treatment with venlafaxine 75mg and paliperidone 6mg, with psychotic symptoms remission after a week.

Conclusions

This case presents the characteristics of menstrual psychosis. This is a rare condition, with only 30 reported cases worldwide. According to current classification systems, this condition fulfills diagnostic criteria for brief psychotic disorder. Nonetheless, studying in more detail this disorder could be interesting, with the goal of deepening the knowledge of the neurobiology of psychosis, particularly the effects of estrogen on this disorder.

Disclosure

No significant relationships.
Brain controllability and clinical relevance in schizophrenia
Authors: Li Q. , Luo L. , You W. , Wang Y. , Wang Y. , Gong Q. , Li F.
Published: September 2022

Introduction

Apart from the psychiatric symptoms, cognitive deficits are also the core symptoms of schizophrenia. Brain network control theory provided information on the role of a specific brain region in the cognitive control process, helping understand the neural mechanism of cognitive impairment in schizophrenia.

Objectives

To characterize the control properties of functional brain network in first-episode untreated patients with schizophrenia and the relationships between controllability and psychiatric symptoms, as well as exploring the predictive value of controllability in differentiating patients from healthy controls (HCs).

Methods

Average and modal controllability of brain networks were calculated and compared between 133 first-episode untreated patients with schizophrenia and 135 HCs. The associations between controllability and clinical symptoms were evaluated using sparse canonical correlation analysis. Support vector machine (SVM) and SVM-recursive feature elimination combined with the controllability were performed to establish the individual prediction model.

Results

Compared to HCs, the patients with schizophrenia showed increased average controllability and decreased modal controllability in dorsal anterior cingulate cortex (dACC). Brain controllability predominantly in somatomotor, default mode, and visual networks was associated with the positive symptomatology of schizophrenia. The established model could identify patients with an accuracy of 0.68. Furthermore, the most discriminative features were located in dACC, medial prefrontal lobe, precuneus and superior temporal gyrus.

Conclusions

Altered controllability in dACC may play a critical role in the neuropathological mechanisms of cognitive deficit in schizophrenia, which could drive the brain function to different states to cope with varied cognitive tasks. As symptom-related biomarkers, controllability could be also beneficial to individual prediction in schizophrenia.

Disclosure

No significant relationships.
From Akute Primäre Verruckheit to Bouffée Delirante: The background of Acute Transient Psychosis
Authors: Romão J. , Gonçalves M. , André R. , Félix F. , Saraiva R. , Abreu M.
Published: September 2022

Introduction

Ever since the end of the 19th century that descriptions of acute and transient psychosis (ATP) have been found in the literature. Psychiatrists from different countries gave different names for these types of episodes, throughout the ages. Those early descriptions were an important part of the development of the concept of acute and transient psychotic disorders (F23: ICD-10).

Objectives

This review aims to provide historical background of the development of different concepts to describe ATP.

Methods

Non-systematic review of literature on acute and transient psychotic disorders, bouffee delirante, brief psychotic disorder, atypical psychosis.

Results

In 1876, K.Westphal introduced the term akute primäre Verruckheit, refering to a sudden paranoia associated with delusion ideas and hallucinations. In 1895, Magnan described Bouffée delirante, characterized by a recorrent, sudden psychosis with polymorphic symptoms. Later (1924), the term cycloid psychosis was introduced by K.Kleist: phasic psychosis with good prognosis. Different concepts appeared throughout history: psychogenic psychosis (Wimmer,1916); atypical psychosis (Mitsuda,1942), holodisfrenia (Barahona,1957). Nowadays, the classification systems include many of these concepts in the same categories: Schizophreniform disorder, Brief psychotic disorder (DSM-5), and ATP (F23 in ICD-10).

Conclusions

All throughout the History of Psychiatry, there was an evolution of concepts associated to ATP. They were strongly influenced by different time epochs. It is important to have context on the historical background of the concepts used in the contemporaneous Psychiatry. Diagnosis is challenging due to their heterogeneous presentation. There are not many studies available, because of ATP’s low diagnostic stability.

Disclosure

No significant relationships.
Therapeutic drug monitoring of LAI antipsychotics as a predictor of clinical relapse: a one-year follow-up
Authors: D’Anna G. , Rotella F. , Ballerini A. , Ricca V.
Published: September 2022

Introduction

Clinical relapses in schizophrenia remain a frequent event. Long-acting injectable (LAI) antipsychotics enhance adherence, but low blood levels can sometimes be observed despite an adequate posology. Nonetheless, the evaluation of this parameter is uncommon in clinical practice.

Objectives

To explore the potential advantages of therapeutic drug monitoring (TDM) of LAIs as a predictor of relapse in clinically stable outpatients with schizophrenia.

Methods

44 individuals who had reached the pharmacokinetic steady state of LAI treatment (paliperidone, olanzapine, aripiprazole) underwent an anamnestic and psychopathological assessment. LAI blood levels were measured using liquid chromatography-mass spectrometry and classified as “in range” or “under range” according to the Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP) guideline values. Individuals who relapsed during the one-year follow-up were compared to non-relapsers (Fisher’s exact test, χ2 or Mann-Whitney U). An exploratory binary logistic regression tested the role of other possible relevant predictors of relapse.

Results

No differences were observed in baseline use of mood stabilisers (p=0.211), antidepressants (p=0.530), or prescribed LAI (p=0.563). Other comparisons are presented in the table: among these variables, in-range LAI levels were the only significant predictor of relapse (F=5.95, p=0.015; OR 0.04, 95%CI 0.02-0.56).Relapse (n=6)No relapse (n=38)pAge (years)41.33±10.7843.95±12.980.667Male4 (66.7%)21 (55.3%)0.600Illness duration (years)21.83±2.6419.13±11.820.289Previous acute episodes3.50±1.053.29±1.470.652PANSS-total49.33±14.8342.74±14.140.231In-range LAI2 (33.3%)32 (84.2%)0.006

Conclusions

TDM of LAIs may optimise the clinical management of schizophrenia by highlighting a suboptimal dosage and a consequent higher relapse risk. Large-scale, drug-specific assessments are needed to confirm these findings.

Disclosure

No significant relationships.
Screen to Intervene; establishing a dedicated metabolic clinic for patients with chronic mental illness in an Irish Metal Health Service
Authors: Usman M. , Saleem F. , Mccafferty B. , Tan J.H.P. , Zubir M. , Adamis D.
Published: September 2022

Introduction

People with serious mental illness exhibit higher morbidity and mortality rates of chronic diseases than the general population.

Objectives

The aim of this study was to establish a dedicated clinic for patients with chronic mental illness to monitor physical health in accordance with best practice guidelines.

Methods

Patients were invited to attend the metabolic clinic. The following areas were examined: Personal and family history of cardiovascular disease, diet, exercise, smoking. Mental state examination, waist circumference, BP, pulse, ECG and BMI. Laboratory tests including U+E, LFTs, HbA1c, Lipid profile and other tests as appropriate such as serum lithium. AIMS scale, HoNOS and WHOQOL-BREF scales as additional indicators of global health.

Results

A total of 80 patients attended during 3.5 years of clinic. Mean age was 54.9 years (SD:13.81) at first contact and 45% were females. Mean years in the service was 19.66 (SD:11.54) and mean number of previous hospital admissions was 4.4 (SD:5.63). Metabolic syndrome was present in 42% at first assessment and 20% had at least one new physical abnormality identified during the clinic. A statistically significant difference was found for the psychological domain of the WHOQOL-BREF and the HoNOs particularly at third assessment. (β=4.64, Wald x2=7.38, df:1, p=0.007, CI:1.3-8.1, β
=-.889, Wald x2=4.08, df:1, p=0.043, CI: -1.752 to-.026) respectively.

Conclusions

The results show a high prevalence of physical health conditions in this cohort, some of which represent a new diagnosis. This implicates better allocation of existing resources for screening and early detection, and potential to run joint clinics with primary care.

Disclosure

No significant relationships.
Age and gender differences in coping and mental health during and post COVID-19 lockdown
Authors: Romano O. , Stout D. , Mendrek A.
Published: September 2022

Introduction

As a reaction to growing number of COVID-19 cases in Quebec, the government issued a lockdown to prevent further spread of the virus in March 2020. The novelty of the imposed restrictions warranted an assessment of adult coping and potential effects on anxiety and depressive symptoms.

Objectives

The purpose of the present study was to evaluate methods of coping employed during Quebec’s lockdown and their potential ramifications on anxiety and depressive symptoms post-lockdown in Quebec.

Methods

In a retrospective longitudinal design, two-hundred and twenty-three (n = 223) adults (65.5% female; 34.5% male) completed the study online. They were asked to fill out several questionnaires and provide demographic information.

Results

Analysis revealed significant improvement in anxiety symptoms post-lockdown relative to during lockdown across the entire sample. Depressive symptoms also improved significantly across the sample, but the difference was less pronounced among 18–34-year-olds than those 35 and above. Male adults aged 18-34 utilized maladaptive coping strategies to the greatest extent. Moreover, maladaptive coping was significantly associated with anxiety and depressive symptoms and predicted depressive symptoms post-lockdown. Further investigation revealed that young adult males differed from females in their use of substances and self-blame to cope.

Conclusions

Overall, the data suggest that the lockdown adversely affected anxiety and depressive symptoms among the general population. Furthermore, young adults, particularly males, were most susceptible to depressive symptomatology due in part to their methods of coping with the novel context. A follow-up study is warranted. Future studies should also seek to recruit individuals whose self-identified gender is non-traditional (e.g., non-binary).

Disclosure

No significant relationships.
Treatment outcomes of COVID-19 infection in PSYCHIATRIC HOSPITAL
Authors: Borkovic V. , Župan K. , Šuša D.
Published: September 2022

Introduction

The ongoing pandemic of coronavirus disease 2019 (COVID-19) has made a serious public threat worldwide. The first case in the Republic Croatia was reported on 25th February 2020 and the first case in Psychiatric hospital Ugljan was diagnosed on 3rd December 2020. To maximize protection and prevent spreading to other patients, COVID-infected-individuals were isolated. This poster will describe treatment outcomes of COVID 19 in Psychiatric hospital Ugljan.

Objectives

This rapid review summarizes outcomes of COVID-19 infected psychiatric patients with mild disease severity to provide synthesized evidence to support policy decision making.

Methods

PubMed, Medline, PsychINFO were systematically searched from January 2021 for COVID-19, with studies describing epidemiology, treatment and outcomes in various long-term care facilities. Studies were excluded if they did not report clinical evidence.

Results

In the time of COVID-19 breakthrough in psychiatric hospital, in December 2020 328 patients were hospitalized of whom 44 tested positive for SARS-CoV-2 infection: of 307 hospitalized patients in January 2021 36 tested positive for SARS CoV-2. By that time, there were no treatment options available, so we focused on repurposing efficacy of the currently used drugs. Five patients needed admission to ICU, we reported one death from coronavirus disease 2019 in that period.

Conclusions

The COViD-19 pandemic has highlighted extreme vulnerability of psychiatric patients who reside in long-term care psychiatric hospitals and there is an urgent need for evidence-based policy that can protect adequately psychiatric patients.

Disclosure

No significant relationships.
Inpatient psychiatric care of COVID-19 infected patients in a Hungarian general hospital
Authors: Gazdag G. , Grenda Z. , Takács R.
Published: September 2022

Introduction

during the study period (08/02/2021 – 11/05/2021) the Centre of Psychiatry in the Jahn Ferenc South-pest Hospital (CP-JFSH) was one of the two psychiatric wards in Budapest, specialized for the treatment of COVID-19 infected psychiatric patients.

Objectives

the aim of the study was to survey the characteristics and evaluate the outcome of the COVID-19 infected psychiatric patients treated in the CP-JFSH.

Methods

retrospective analysis of the files of COVID-19 infected psychiatric patients admitted to the CP-JFSH in a 3 month period. In addition to demographic data, diagnostic distribution, co-morbidities, date of infection, method of detection of the virus, presence of pneumonia, severity of infection, outcome, treatment, vaccination data were evaluated.

Results

in the study period 124 COVID-19 infected psychiaric patients were admitted to the CP-JFSH. The gender distribution was aproximately equal, the mean age of the patients was 62.8+/-15.7 years. Majority of the patients suffered from major neurocognitive disorder followed by schizophrenia spectrum disorder. Most common co-morbidities were cardiovascular diseases and diabetes. Pneumonia was present in 41% of the patients. Majority of the patients were already infected at the time of admission, detected with the first PCR examination and haven’t been vaccinated yet. Thirty-one percent of the patients suffered from moderate to severe COVID-19 illness. COVID-19 specific therapy (favipiravir, remdesivir, fluvoxamin) was introduced in 57%. Mortality was 12% while the relaps rate 4%.

Conclusions

comparing with inpatient mortality rate published in the literature, mortality rate was higher among psychiatric patients, underlining the need for special attention of this population.

Disclosure

No significant relationships.
Cognitive biases in first psychotic episode with Attention deficit and hyperactivity disorder: a controlled study
Authors: Manzanares Tesón N. , Solé M. , Algora M.J. , Cabezas A. , Sánchez-Gistau V.
Published: September 2022

Introduction

Cognitive biases are a core feature of psychotic disorders. Moreover, people with first episode of psychosis (FEP) have more difficulties in social cognition, in particular in theory of mind. On the other hand, deficits in processing speed and distractibility appear to be core features of attention deficit hyperactivity disorder (ADHD) and impairment in these basic processes can lead to deficits in more complex functions, that could induced to cognitive biases.

Objectives

To evaluate whether FEP with and without ADHD differ in the rate and type of cognitive biases.

Methods

Participants 121 FEP treated at the Early Intervention Service of Reus and aged between 14 and 28 years. Instruments : The Diagnostic Interview for ADHD (DIVA) and the Cognitive Biases Questionnaire for Psychosis (CBQp) measuring 2 themes : anomalous perception (AP) and threatening events (TE) and 5 cognitive biases: Intentionalising (Int) , Catastrophising (Cat), Dichotomous thinking (DT), Jumping to conclusions (JTC) and Emotional reasoning (ER)

Results

31 out 121 (25.6%) met criteria for childhood ADHD. Compared with FEP ADHD- , FEP-ADHD+ presented significant higher scores in the CBQp total score (U= 2.538 ; p=0.001), the AP theme (U=2.262; p=0.02) , the TE theme (U= 2.242 ; p=0.02) and DT bias ((U= 2.188 ; p=0.03)

Conclusions

Our findings support the fact that subjects with FEP-ADHD+ presented more cognitive biases than those ADHD-. So, FEP-ADHD+ subjects could represent a clinical subgroup with a worse prognosis than FEP-ADHD
- subjects, presenting more delusions, distress and a worse cognitive insight.

Disclosure

No significant relationships.
Working Memory Deficit and Attentional Distractibility in Schizophrenia
Authors: Becske M. , Marosi C. , Molnár H. , Fodor Z. , Tombor L. , Csukly G.
Published: September 2022

Introduction

Meta-analyses suggest that patients with schizophrenia show deficit in working memory – both verbal and visual – and are more distractible. Working memory disturbances are even regarded as the central deficit in schizophrenia by some researchers. Theta synchronization (especially over fronto-central areas) is related to cognitive control and executive functioning during working memory encoding and retention.

Objectives

The main goal of the study was to gain more understanding of the nature of working memory deficit and attentional distractibility in schizophrenia.

Methods

35 patients with schizophrenia and 39 matched controls were enrolled in our study. Participants performed a modified Sternberg working memory task that contained salient and non-salient distractor items in the retention period. A high-density 128 channel EEG was recorded during the task. Event-related theta (4-7 Hz) synchronization was analyzed during working memory encoding (learning) and retention (distractor filtering) in a later time window (350-550 ms).

Results

Patients with schizophrenia showed weaker working memory performance and increased attentional distractibility compared to the control group: patients had significantly lower hit rates (p < 0.0001) and higher distractor-related commission error rates (p < 0.0001). Theta synchronization was modulated by condition (learning < distractor) in both groups but it was modulated by salience only in controls (salient distractor > non-salient distractor, p[patients] = 0.95, p[controls] < 0.001).

Conclusions

Our results suggest that patients with schizophrenia show diminished cognitive control compared to controls in response to salient distractors. Difficulties in cognitive control allocation may contribute to the behavioral results observed in this study.

Disclosure

No significant relationships.
Feasibility and Acceptability of Transcranial Direct Current Stimulation in Obsessive Compulsive Disorder
Authors: Fineberg N.
Published: September 2022

Background Transcranial direct current stimulation (tDCS) has shown promise as a treatment for obsessive compulsive disorder (OCD) in a small number of trials. We performed a feasibility study to inform the development of a definitive trial, focussing on acceptability, safety, feasibility of recruitment, adherence and tolerability of tDCS and the size of any treatment-effect. Methods FEATSOCS was a randomised, double-blind, sham-controlled, cross-over multicentre study. Twenty adults with OCD received three courses of tDCS targeting the two most favourable stimulation targets; supplementary motor area (SMA), orbitofrontal cortex (OFC) and sham-stimulation, randomly allocated and delivered in counterbalanced order. Each course comprised four 20 minute-stimulations, over two consecutive days, separated by a four weeks washout period. Clinical outcomes were assessed by ‘blinded’ raters before, during and four weeks after stimulation. Results: tDCS was acceptable, well tolerated and safe; adherence was good, with few dropouts, there were no serious adverse events, and adverse effects were mostly mild. Recruitment to target was feasible. Yale-Brown Obsessive-Compulsive Scale scores numerically improved from baseline to 24 hours after final stimulation (primary outcome) across all interventional groups. The greatest effect was seen in the OFC arm. Additional significant within-group improvements in secondary outcomes occurred in the OFC, and to a lesser extent in the sham arms, but not with SMA. Discussion tDCS appears a promising potential treatment for OCD. The OFC represents the optimal target. A full-scale trial to determine optimal stimulation protocols (current, frequency, duration), longer-term effectiveness and feasibility of home delivery is indicated.

Disclosure

No significant relationships.
When mental health care is stigmatizing: experience of users and families and associated factors
Authors: Valery K.-M. , Prouteau A. , Guionnet S. , Violeau L. , Fournier T.
Published: September 2022

Introduction

Mental health care is considered to be one of the main sources of mental illness stigmatization. Detailed information about these stigmatization experiences is needed to reduce stigma in mental health practices.

Objectives

The study aimed i) to identify the most relevant stigmatizing situations in mental health care encountered by users and families, ii) to characterize the relative importance of these situations in terms of frequency, experienced stigmatization and suffering, and iii) to identify individual and contextual factors associated with these experiences.

Methods

In a focus group, users were asked to select the 15 most relevant stigmatization situations among those they elicited and those that were taken from the literature. An online survey was then conducted among users and family members to characterize these situations and identify predictors.

Results

A total of 235 participants were included: 59 participants with schizophrenia diagnosis, 96 with other psychiatric diagnoses and 80 family members. The results revealed 15 situations with different levels of frequency, stigmatization and suffering. Participants with a diagnosis of schizophrenia experienced more situations of stigmatization and with a higher frequency. Moreover, factors such as recovery-oriented practices and measures without consent were the best predictors of experienced stigmatization.

Conclusions

These original stigmatization situations could be targeted to reduce stigmatization and associated suffering in mental health practices. Results strongly suggest that recovery-oriented practice should be fostered to fight stigma in mental health care.

Disclosure

No significant relationships.
Clinical characteristics of lurasidone-treated patients in Spain using Natural Language Processing – A real-world data study with Electronic Health Records
Authors: De La Pinta C. , Gabarda I.
Published: September 2022

Introduction

Schizophrenia is a chronic neuropsychiatric disorder which affects over 20 million people worldwide. Atypical antipsychotics are the first-line choice for the treatment of schizophrenia due to improved tolerability and diminished risk of extrapyramidal symptoms. Lurasidone is an atypical antipsychotic approved in Spain for the treatment of schizophrenia in September 2019. An RWD-based picture of lurasidone use is necessary to better understand its impact in routine clinical practice.

Objectives

To set up a methodology based on Natural Language Processing (NLP) and machine learning for the analysis of the free-text information contained in the EHRs of patients treated with lurasidone in Spain.

Methods

A multicenter, retrospective study based on RWD collected in EHRs of lurasidone users will be conducted in hospitals from the Spanish National Healthcare System. Information extracted from the free text in EHRs using NLP will be treated and analyzed as big data.

Results

A study database for lurasidone-treated patients in Spain has been instituted using the EHRead® technology (
Figure 1), which applies machine learning and deep learning to extract, analyze, and interpret the free-text information written in their de-identified EHRs. Sociodemographic and clinical variables in EHRs from September 2019 until the most recent data available are being collected to describe the target patient population and address treatment-related outcomes.

Conclusions

NLP of free text in EHRs of lurasidone-treated patients renders a real-world picture of lurasidone usage in Spain. Studies using artificial intelligence techniques represent a novel source of information regarding psychiatric disorders and their clinical management.

Disclosure

I. Gabarda is employee at Angelini Pharma España, S.L.U. and C. de la Pinta is employee at Medsavana.
Impact of the COVID-19 pandemic on maternal mental health during pregnancy: The CONCEPTION study – Phase I
Authors: Berard A. , Lacasse A. , Gomez Y.-H. , Gorgui J. , Côté S. , King S. , Tchuente V. , Muanda F. , Lumu Y. , Boucoiran I. , Nuyt A.-M. , Quach C. , Ferreira E. , Kaul P. , Winquist B. , O’Donnell K. , Eltonsy S. , Château D. , Zhao J.-P. , Hanley G. , Oberlander T. , Kassai B. , Mainbourg S. , Bernatsky S. , Vinet É. , Brodeur-Doucet A. , Demers J. , Richebé P. , Zaphiratos V. , Wang C. , Wang X.
Published: September 2022

Introduction

Mental health regional differences during pregnancy through the COVID-19 pandemic is understudied.

Objectives

We aimed to quantify the impact of the COVID-19 pandemic on maternal mental health during pregnancy.

Methods

A cohort study with a web-based recruitment strategy and electronic data collection was initiated in 06/2020. Although Canadian women, >18 years were primarily targeted, pregnant women worldwide were eligible. The current analysis includes data on women enrolled 06/2020-11/2020. Self-reported data included mental health measures (Edinburgh Perinatal Depression Scale (EPDS), Generalized Anxiety Disorders (GAD-7)), stress. We compared maternal mental health stratifying on country/continents of residence, and identified determinants of mental health using multivariable regression models.

Results

Of 2,109 pregnant women recruited, 1,932 were from Canada, 48 the United States (US), 73 Europe, 35 Africa, and 21 Asia/Oceania. Mean depressive symptom scores were lower in Canada (EPDS 8.2, SD 5.2) compared to the US (EPDS 10.5, SD 4.8) and Europe (EPDS 10.4, SD 6.5) (p<0.05), regardless of being infected or not. Maternal anxiety, stress, decreased income and access to health care due to the pandemic were increasing maternal depression. The prevalence of severe anxiety was similar across country/continents. Maternal depression, stress, and earlier recruitment during the pandemic (June/July) were associated with increased maternal anxiety.

Conclusions

In this first international study on the impact of the COVID-19 pandemic, CONCEPTION has shown significant country/continent-specific variations in depressive symptoms during pregnancy, whereas severe anxiety was similar regardless of place of residence. Strategies are needed to reduce COVID-19’s mental health burden in pregnancy.

Disclosure

No significant relationships.
CLINICAL CASE “I finally woke up, it seems like a miracle”
Authors: Min H.J.
Published: September 2022

Introduction

Clinical case about a 62 year old patient, diagnosed with mixed anxiety-depressive disorder. In current treatment with Paroxetine, Clorazepate and Trazodone. She presents low spirits secondary to a neurological process (stroke + amyloid angiopathy+ epilepsy+ cognitive impairment) and difficulties in performing daily activities. Her daughter reports that she is totally dependent, she spends the whole day in bed. On examination we observe a dull mood, without emotional reactivity. Lack of motivation. Psychomotor slowness.Significant cognitive impairment with difficulties in performing daily activities. Mnesic faults.

Objectives

Clinical case shows radiological and cognitive improvement with vortioxetine

Methods

Last diagnoses: August 2020: HSA OF THE FRONTAL AND PARIETAL GROOVES RIGHTS September 2020:SYMPTOMATIC FOCAL EPILEPSY SECONDARY TO LEFT FRONTOPARIETAL INTRAPARENCHIMATOSUS HEMATOMA December 2020:MYELOID ANGIOPATIA February 2021:SUBARACHNOID HEMORRHAGE March 2021:DEPRESSIVE DISORDER SECONDARY TO MEDICAL ILLNESS - MODERATE COGNITIVE IMPAIRMENT

Results

Spectacular improvement in mood and cognitive deficit. The family reports that after 5 days they noticed the change. They find her more lively, she has returned to doing housework and is autonomous for day-to-day life. She has regained her memory and performed calculation exercises on a daily. The patient says that she has returned to being her usual self, “before I felt like a mummy and now I have finally woken up, it seems like a miracle”.

Conclusions

It has improved much with change of antidepressant, from paroxetine to vortioxetine in patient who show in cranial MRI: New-onset lesion in the right frontal lobe attributable and subarachnoid hemorrhage located in convex furrows ,radiological findings in favor of amyloid angiopathy

Disclosure

No significant relationships.
Depression among Endometrial Cancer hospitalizations - Preliminary results of a nationwide retrospective study
Authors: Vieito P. , Ferreira A.R. , Gonçalves-Pinho M. , Costa F. , Coelho M. , Freitas A. , Fernandes L.
Published: September 2022

Introduction

Uterine cancer is the most common gynecologic malignant neoplasm in developed countries. While depression is up to 3-5 times more common in patients with cancer than in the general population, literature is still limited regarding the relation between Endometrial Cancer and depression.

Objectives

To analyze Depression among Endometrial Cancer hospitalizations in mainland Portuguese public hospitals (2008-2015).

Methods

A retrospective observational study was conducted using administrative data from all hospitalizations in Portuguese mainland public hospitals between 2008-2015. All women’s hospitalizations(≥18 years) with a primary diagnosis of Endometrial Cancer (ICD-9-CM 182.x) were selected. Secondary diagnosis of depression was identified with ICD-9-CM 296.2x, 296.3x and 311x codes. Surgical procedures codes 68.4x, 65.6x, 40.3x, 40.5x, 68.6x, 68.9x and 68.8x were used to divide the hospitalizations into surgical vs non-surgical. Groups were compared with Pearson Chi-square test and crude odds ratio(OR) was used to estimate the association between surgery and depression.

Results

From 10227 hospitalizations with a primary diagnosis of Endometrial Cancer, 533 had a registry of depression(5.2%). Annual depression frequency rose from 2.0% (2008) to 8.3% (2015). Among patients with a record of depression, 73.2% had surgery. Women who had surgery were significantly more likely to have registered depression (p<0.001). The OR for depression in surgical vs non-surgical patients was 1.73 (95%IC:1.42-2.10).

Conclusions

Patients hospitalized due to Endometrial Cancer and submitted to surgery had almost two-fold more risk of having a registry of depression. This trend reinforces the importance of early depression screening of these patients, enabling the implementation of timely therapeutic strategies before and after surgery.

Disclosure

No significant relationships.
Manic episode secondary to single right cerebellar metastasis in context of ovarian tumor: report of clinical case
Authors: Téllez Gómez A. , Rubio Granero M.T.
Published: September 2022

Introduction

The cerebellum is often overlooked when evaluating neuropsychiatric disorders. Lately, evidence has increased for the existence of cerebellar connections -generally in relation to vermis and posterior lobe- with cortical areas related to pathophysiology of psychiatric disorders. The cerebellar affective cognitive syndrome, also known as Schmahmann syndrome, has even been described with an evaluation scale.

Objectives

Case report of a patient suffering a manic episode in context of single right cerebellar metastasis derived from ovarian tumor.

Methods

A non-systematic literature review was conducted on PubMed database on cerebellum pathology related to psychiatrics disorders. The clinical case report was prepared through the review of the patient´s clinical record.

Results

The authors introduce the case of a 50-year-old woman, diagnosed with high-grade serous ovarian tumor, with single right cerebellar metastasis of 42mm, who was admitted to oncology due to behavioral alteration, with no prior psychiatric history. The patient showed hyperthymic mood, with speech scanned but fluid, manifesting intense well-being and ideation of mystical-religious and megalomaniac content. Haloperidol up to 7.5mg/8 hours and clonazepam 2 mg/8 hours were prescribed, switching haloperidol to olanzapine up to 25mg/day after several days, since the symptoms did not improve. Valproic acid 500 mg/24 hours was also added. Progressive improvement was seen, without worsening of motor symptoms or instability. The CCAS scale (Cerebellar Cognitive Affective/Schmahmann syndrome) was performed, with a positive result (10/10) being> 3 definitive CCAS.

Conclusions

The relationship between cerebellum and neuropsychiatric disorders is still partly unknown, requiring more research to be able to carry out specific diagnoses and treatments for patients.

Disclosure

No significant relationships.
Lost in Translation – What is Alexithymia
Authors: Morais A.S. , Gomes R. , Descalço N.
Published: September 2022

Introduction

Alexithymia is considered a personality trait characterized by difficulties in identifying and expressing emotions, impoverished fantasy life and tendency toward action-oriented or ‘operational’ Thinking. There are alterations in cognitive processing and regulation of emotions, and tendency to somatization.

Objectives

The authors examine literature regarding the concept of alexithymia, exploring the current definition and role in the clinic, research findings and proposed management.

Methods

A brief non-systematized review is presented, using the literature available on PubMed and Google Scholar.

Results

Alexithymia is not a discrete psychiatric diagnosis. It has been reported in 9-10% of the general population. It is related to numerous psychiatric disorders (substance use disorders, anxiety disorders, depression and eating disorders), but also to somatic illnesses (essential hypertension, functional gastrointestinal disorders, diabetes mellitus, psoriasis, fibromyalgia and cancer pain). Neuroimaging and neurobiological studies found evidence for morphological and functional brain alterations that integrate the classification introduced by Bermond. Affective type I is characterized by the absence of emotional experience and, consequently, by the absence of cognition accompanying the emotion (associated to right unilateral cortical lesions). Cognitive Type II is characterized by a selective deficit of emotional cognition with sparing of emotional experience (associated to a right-to-left unidirectional deficit in interhemispheric transfer).

Conclusions

There is little consensus on the subject. Clarification of the mechanisms underlying alexithymia can improve our management of these individuals. Identification of effective strategies could improve the patients’ capacities for adaptive emotional processing and enhance other aspects of functioning.

Disclosure

No significant relationships.
Is Praecox Feeling at risk of extinction?
Authors: Duarte A. , Laginhas C. , Lourenço A. , Simões I. , Martins P.
Published: September 2022

Introduction

Praecox feeling (PF) is a characteristic feeling of bizarreness or unease that a psychiatrist experiences when facing a patient with schizophrenia. This term, proposed by Rumke in 1941, was considered an important feature of a schizophrenia diagnosis. However, since the movement toward operational diagnostic methods in the late 1970s, it has fallen out of use.

Objectives

This work aims to discuss the role of Praecox Feeling in the clinical approach to schizophrenia diagnosis.

Methods

PubMed database was searched using combinations of the terms “praecox”, combined with “feeling” and “schizophrenia”.

Results

PF is sometimes experienced silently before the patient participates verbally. An experienced and attentive clinician can intuitively feels changes in the body posture, facial expression, the tone of the voice, motor behavior, and attitude that could look insignificant, but as a whole they present the patient as “definitely un-understandable.” Although there is lacking evidence to sustain the rehabilitation of the PF as a reliable and valid clinical criterion consistent with the operational approach, a broader scientific approach is called for. PF should not be trivialized, as is sometimes the case, into a quick diagnosis but could be a real determinant of medical decision.

Conclusions

Even though there may not be sufficient evidence to consider it valid clinical diagnostic criteria, it still appears to play an important role in the clinical decision-making process and should not be underestimated or stigmatized. This concept is not completely subjective and does rely on objective information, such as the patient’s behaviour and body language.

Disclosure

No significant relationships.