bluuebunny/crossref_metadata_2025 huggingface dataset:
Ketamine enhanced ECT in refractory recurrent depression.
Authors: Arribas-Simon B. , Martinez.Gimeno P. , Calvo-Valcarcel M. , Alario-Ruiz C. , Martin-Santiago O.
Published: August 2024

Introduction

Recurrent Depressive Disorder is a chronic condition that significantly impacts the quality of life. Despite various treatment options, some patients face severe and treatment-resistant relapses. This case is related to research on ketamine in Electroconvulsive Therapy (ECT) for RDD. One study highlighted the efficacy and safety of ketamine compared to other anaesthetic agents in ECT for major depression. Additionally, another study explored subanesthetic doses of ketamine before each ECT session to improve therapeutic outcomes and sleep quality in patients with major depressive disorder.

Objectives

To present a clinical case of a patient with Recurrent Depressive Disorder (RDD) who improved following a change in the Electroconvulsive Therapy (ECT) protocol using ketamine as an anaesthetic inducer.

Methods

We examined the patient’s medical records, including her medical history, previous treatments, and therapeutic responses.

Results

A 65-year-old childless woman with a history of stroke, bilateral carotid atheromatosis, and hypothyroidism suffered from RDD. Despite multiple prior treatments and ECT, she experienced a severe depressive relapse. Eight intensive ECT sessions were administered, with observed memory lapses. Due to the lack of response, the anaesthetic inducer etomidate was replaced with ketamine, resulting in a positive response. The patient continued pharmacological treatment with improved mood, but recent and evident memory alterations persisted, possibly related to anterograde amnesia.

Conclusions

This case highlights the complexity of RDD in patients with comorbidities and treatment-resistant relapses. The change in the ECT protocol using ketamine was effective, emphasizing the importance of alternative therapeutic approaches in refractory cases. The successful treatment of RDD in this patient using ketamine in ECT underscores the need for personalized therapeutic options in treatment-resistant patients. These scientific resources reinforce the relevance of exploring therapeutic alternatives in contemporary clinical practice. We need more research to understand the underlying mechanisms and how this approach could be enhanced in similar cases.

Disclosure of Interest

None Declared
From Loss to Healing: Navigating Perinatal Grief with Enhanced Psychological Care
Authors: Razki K. , Zgueb Y. , Ben Aissa S. , Najar C. , Ouali U.
Published: August 2024

Introduction

Several factors can influence the journey of perinatal grief in mothers, including the quality of care during this experience. The objective of our study was to investigate the factors influencing the perception of grieving women during the perinatal period and identify the role of medical and paramedical healthcare professionals in psychological support.

Objectives

To determine the factors influencing the perception of fetal loss in grieving mothers.

Methods

This was a descriptive, longitudinal, retrospective study conducted between july 2021 and march 2022 at the Fetal Pathology Department of the Center for Maternity and Neonatology in Tunis, Tunisia. The study included women who experienced perinatal loss and underwent fetal pathology examination.

The study was conducted in two stages: Initial consultation at the Fetal Pathology Department, five weeks after the date of expulsion, for perinatal grief counseling. Follow-up interview one year after the date of expulsion: The participants were contacted via telephone for an average duration of twenty minutes .The assessment of perinatal grief during both interviews was conducted using the shortened version of the Perinatal Grief Scale (PGS)

Results

The mean age of the patients was 31.41 years (± 5.15). The average gravidity was 2.47 (± 1.43). More than half of the patients had no living children (n=41). The majority of patients had no notable pathological history. Six patients had been followed in psychiatry, and five had a history of subfertility. The majority of patients (n=61) reported having good marital relationships.

Among the participants, 20% (n=14) had a high Perinatal Grief Scale (PGS) score (PGS >= 91) at five weeks post-loss and were subsequently referred for psychiatric consultation.

At one year, all participants had a PGS score > 91, demonstrating the effectiveness of psychiatric management. Multivariate analysis identified four independent factors associated with a high PGS score at five weeks: absence of living children (OR=0.59; 95% CI [0.36-0.98]; p=0.04), quality of marital relationship (OR=1.2; 95% CI [1.1-3.9]; p=0.02), family support (OR=2.52; 95% CI [1.55-4.12]; p<0.001), and quality of loss disclosure (OR=2.52; 95% CI [1.32-3.77]; p=0.003).

Conclusions

To identify patients at high risk of developing complicated grief and improve the quality of psychological care, it is necessary to implement appropriate protocols, provide training to healthcare personnel, and establish well-equipped healthcare facilities.

Disclosure of Interest

None Declared
Preliminary results of “Choose Life!” - a county-wide programme for suicide prevention and mental health awareness
Authors: Wernigg R.
Published: August 2024

Introduction

Suicidality and depression awareness still remains a concern in Hungary. This programme, based on the principles of the European Union Against Depression, implemented its five steps, such as: 1. improving family doctors’ readiness to diagnose and treat depression, 2. increasing public awareness, 3. training stakeholders and community facilitators, 4. offering special help for risk groups, 5. facilitating self-help by the online tool “ifightdepression” in five of seven districts of Heves county from November 2014 until May 2016.

Objectives

We aimed to look at some clinical outcome measures of the programme, like diagnosis density of depression in primary care before and after the intervention; diagnosis density of depression in outpatient services; suicide attempts in specialised care; and completed suicide rates.

Methods

We extracted patient turnover data from the joint database of the National Healthcare Fund and the National Directorate-General for Hospitals. Raw patient turnover data were divided by the total patient turnover in order to obtain diagnosis density. For the diagnosis of depression, we used the sum of the ICD-10 diagnoses of F32 (depressive episode) to F33 (recurrent depression) plus F4120 (mixed anxiety-depressive disorder), as family doctors tend to use these diagnoses interchangeably. For suicide attempts, we used the diagnoses X60 to X84, plus Y8700. For completed suicides we used the same diagnoses with the “deceased” flag. Diagnosis densities were compared with concurrent national data and were standardised to the long-term average. In the case of outpatient services, we only could retrieve monthly data, which we smoothed out with threemonthly moving averages.

Results

Baseline diagnosis density of depression in primary care was already 44% above the national average when the program started and after the kickoff, it shortly went up to 53,3% and remained over the baseline for as long as until 2019. Also, the recognition rates of depression with no comorbidities in primary care increased by 6%, and steadily remained over the national average until 2019. For outpatient psychiatry, there was an 8% increase in depression turnover throughout the duration of the programme. As regards to suicide attempts treated in hospital, the rates went 20% below the national averages for the duration of the programme, and mostly remained there until 2020. Fatal suicidal events accounted for five to seven deaths a year per county, therefore, simple statistical methods could not uncover significant differences.

Conclusions

These early results indicate that the programme may have been effective in terms of reinforcing the diagnostic and treatment capacities of primary care for recognising a treating depression adequately, thereby eliminating suicide risk. Further statistical exploration of the data is still needed to confirm the magnitude and the validity of these results.

Disclosure of Interest

None Declared
Real-world effectiveness and safety of esketamine intranasal spray combined with treatment-as-usual in psychiatric inpatients
Authors: Kavakbasi E. , Yilmaz M. , Bulut Ö. , Berndt H. , Baune B. T.
Published: August 2024

Introduction

Esketamine intranasal spray has been approved in both the USA and EU as a novel treatment in patients with treatment-resistant major depression (TRD) and for the management of acute depressive emergencies during the course of major depressive disorder (MDD). Real-world data on the effectiveness and safety of esketamine nasal spray in clinical use are limited.

Objectives

To investigate the clinical effects and safety of esketamine nasal spray on depression severity and suicidal ideation during inpatient treatment in n=76 patients in a German university hospital.

Methods

In this retrospective chart review, we analyzed the change in depression severity and safety after a treatment series with esketamine nasal spray combined with treatment-as-usual in patients with treatment-resistant depression (TRD) in inpatient treatment setting of a University Hospital. Depression severity has been rated with the Montgomery–Åsberg Depression Rating Scale (MADRS) as well as with the BDI-II (Beck Depression Inventory-Second Edition) before and after the treatment series. The intensity of suicidal ideation has been evaluated using MADRS item 10 on suicidal thoughts.

Results

A total of 76 patients have been included (women 55.3, n=42) in this analysis. Mean BDI-II pre-treatment was 37.6 and mean MADRS was 33.6 corresponding to severe depression. Mean score on item-10 pre-treatment was 2.4 (median 2.0). On average patients received 10.9 sessions (standard deviation 4.2, median 11.0) of esketamine nasal spray (min 1, max. 19 sessions). There was clear improvement after the treatment series in both the BDI-II (mean change -10.1, p < 0.001) as well as in MADRS score (mean reduction -10.0, p < 0.001). Suicidal ideation on item-10 also decreased significantly (-0.9, p < 0.001). The effect sizes were large for all three measures: Cohen’s d 1.050 for BDI-II; 0.986 for MADRS and 0.742 for changes in suicidal ideation. Overall, esketamine treatment was well tolerated. In five cases esketamine treatment has been terminated early (after a mean of 3.4 sessions) due to dissociations (n=4; 5.3%) or due to non-response (n=1).

Conclusions

Esketamine nasal spray is a novel effective and safe treatment option, which leads to significant decrease in depression severity as well as in suicidal ideation. More data from real-world patients are needed to position esketamine in the algorithm of depression treatment. Rate of treatment discontinuation due to side-effects in this study was comparable to those in other esketamine studies (4.2% in Reif et al, NEJM, 2023).

Disclosure of Interest

None Declared
Suicide risk in patient with diabetes varies by the duration of diabetes: The Korea National Health and Nutrition Examination Survey
Authors: Kim Y.-C. , Um Y.-H. , Seo H.-J. , Jeong J.-H.
Published: August 2024

Introduction

Suicide has a complex relationship with several factors, and it is known that identifying high-risk groups of suicide and managing crisis in advance can help prevent suicide. Moreover in a previous study, it showed that people with chronic diseases often suffer from psychological difficulties such as depression and anxiety, which can influence one to commit suicide. Based on many studies about the relationship between diabetes and depression, 10% of diabetic patients experience major depression, and diabetic patients experience twice as much depression as the general population. But, there are few studies examining the relationship between diabetes and suicide risk, and most of them were targeted for type 1 diabetes only.

Objectives

The objectives of this study were to investigate the suicide risk in diabetic patients, and evaluate the suicide risk varies by the duration of diabetes, using a large population sample in South Korea

Methods

Using the 2019 Korea National Health and Nutrition Examination Survey data, 6,296 adults (aged 19 years or older) were included. Suicidal ideation, suicidal plan, and suicidal behavior of diabetic patients were compared with the general population. After classifying the patients into ≤ 1 year, 2 to 9 years, and 10 years ≤ for the duration of diabetes, we evaluated the relationship between the duration of diabetes and the risk of suicide.

Results

Diabetic patients had higher prevalence of suicidal ideation (9.1%, P<0.001) and suicidal plan (3.6%, P<0.001) than general population. After adjusting for potential confounding factors, suicidal plan (aOR = 3.011, 95% CI = 1.392-6.512) was significantly associated with diabetes. In the 2 to 9 year group of diabetes, we found an increase in risk of suicidal ideation (aOR=2.068, 95% CI=1.219-3.510), suicidal plan (aOR=3.640, 95% CI=1.592-8.320), and suicidal behavior (aOR=6.222, 95% CI=1.759-22.008) after adjusting covariates. However, increase in suicide risk was not observed in the ≤1 year and 10 years ≤ groups after diagnosis of diabetes.

Conclusions

In adults, diabetes is associated with increase in suicide risk. Suicide risk in diabetic patients shows an ‘inverted U-shaped’ depending on the duration of diabetes.

Disclosure of Interest

None Declared
Divergent risk of SARS-CoV-2 infection, severe COVID-19 and mortality across psychiatric disorders: analysis from electronic health records in Catalonia
Authors: Monistrol-Mula A. , Félez-Nobrega M. , Giné-Vázquez I. , Haro J. M.
Published: August 2024

Introduction

People with psychiatric disorders are particularly vulnerable to SARS-CoV-2 infection and its associated complications. However, current literature show that not all psychiatric disorders are equally vulnerable to COVID-19.

Objectives

This study aimed to assess whether individuals with distinct psychiatric disorders exhibit different risk of SARS-CoV-2 infection, COVID-19 hospitalization, and mortality.

Methods

We conducted a case-control study using data of electronic health records from Catalonia. Cases included adults with a hospital admission between 2017 and 2019 for non-affective psychosis, bipolar disorder, depressive disorder, stress-related disorders, neurotic/somatoform disorders, and substance misuse. These were matched to patients without a diagnosis by sex, 5-year age band, and living area. Outcomes included SARS-CoV-2 infection, hospitalization, and COVID-19-related death up to December 2021. Logistic regression analysis were employed to test the association between the six groups of psychiatric disorders and COVID-19 outcomes, controlling for age, sex, smoking, being in a nursing home, and physical comorbidities.

Results

785,378 subjects were included. Preliminary findings showed that patients diagnosed with psychosis and bipolar disorder had lower risk of infection [OR: 0.85 (95% CI: 0.79-0.92), p<0.001; OR: 0.84 (95% CI: 0.76-0.92), p<0.001], whereas individuals with stress-related and neurotic/somatoform disorders had higher risk of infection [OR: 1.08 (95% CI: 1.04-1.14), p<0.001; OR: 1.06 (95% CI: 1.03-1.10), p<0.001]. People with depressive, stress-related, and neurotic/somatoform disorders had lower risk of COVID-19 hospitalization [OR: 0.87 (95% CI: 0.78-0.97), p = 0.01; OR: 0.71 (95% CI: 0.61-0.84), p<0.001; OR: 0.67 (95% CI: 0.60-0.76), p<0.001]. In line with these results, individuals with stress-related disorders also experienced lower mortality [0.49 (95% CI: 0.33-0.70), p<0.001]. Conversely, people with psychosis, bipolar disorder, and substance misuse exhibited higher risk of COVID-19-related death [OR: 2.9 (95% CI: 1.68-3.1), p<0.001; OR: 1.95 (95% CI: 1.30-2.81), p<0.001; OR: 1.82 (95% CI: 1.49-2.20), p<0.001].

Conclusions

We found different risks of SARS-CoV-2 infection, COVID-19 hospitalization, and COVID-19 mortality for psychiatric disorder groups. Differences in vulnerability to COVID-19 among people with psychiatric disorders might be explained by factors such as shared living facilities, physical comorbidities, psychotropic medications, and difficulties in accessing high-intensity medical care. Special attention should be directed towards individuals with psychosis, bipolar disorder, and substance misuse.

Disclosure of Interest

None Declared
Risks of mental health of foreign medical residents who study in Ukraine
Authors: Markova M. , Kaafarani A. , Aliieva T.
Published: August 2024

Introduction

The high level of psycho-emotional stress today significantly increases the moral burden on the mental health of medical workers. One of the most vulnerable groups of medical specialists in Ukraine are foreign resident doctors. Since in Ukraine this contingent of doctors is faced with extraordinary problems of high psycho-emotional stress, such as COVID-19 around the world and the russian war against Ukraine. Raising the issue of resident doctors, the main issue becomes not only their professional identity, but also the formation of the necessary stress resistance in different conditions of professional activity.

Objectives

To study the level of tolerance to stress and uncertainty among foreign resident doctors in unusual conditions of performing professional duties.

Methods

The examination included the use of clinical-psychological, psychodiagnostic and psychometric research methods.

Results

As of the beginning of 2020, 395 foreigners were studying. During the first phase of the pandemic, 118 foreigners left Ukraine. By the beginning of 2022 (before the full-scale war), 302 medical residents were trained. As of the beginning of 2023, 167 doctors are studying, of which only 61 people are on the territory of Ukraine.

The primary analysis of the clinical-psychological study showed that the most common complaints among foreign resident doctors are: increased levels of feelings of tension (in 75,4%), decreased motivation for activity (73,2%), anxious (72,7%) and depressive symptoms (69,3%), frequent headaches (68.6%), constant feelings of irritation (65,4%), manifestations of aggression in relation to colleagues (63,9%) and patients(61,4%), a feeling of fear for the future (60,1%), conflicts in the family (59,5%).

The study of factors that influence the increase in the level of stress among foreign resident doctors were sorted according to the principle of ordinary and extraordinary. Ordinary stress factors include: the nature of the specialty, the conditions of professional activity, a foreign country, relationships in the team. Extraordinary factors include new working conditions (professional challenges of COVID-19, war on the territory of Ukraine), increased risks of responsibility for the patient’s life (search for a treatment solution against the background of COVID-19), nature of assistance (providing assistance due to combat injuries).

Conclusions

At the end of the study, a comprehensive program will be created for the early detection of signs of adaptation disorder, which will be aimed at reducing emotional distress, tension in the learning process, support in the first years of training for medical residents.

Disclosure of Interest

None Declared
Antioxidant and metabolic adjunctive treatment in late onset psychosis
Authors: Prokhorova T. , Boksha I. , Savushkina O. , Tereshkina E. , Vorobyeva E. , Burbaeva G.
Published: August 2024

Introduction

Basing on our previous findings of significant additional gain obtained from usage of adjunctive antioxidant medicine added to antipsychotic+antidepressant therapy in late-onset schizophrenia-like psychoses (LOP), the group often suffering of comorbid pathologies and experiencing substantial side-effects of drugs, we spred our approach to try “metabolic” medicines as adjunctives in LOP.

Objectives

To reveal biochemical parameters of the blood cells which might be used for distinguishing subgroups of patients suffering with LOP for whom various adjunctive therapy (antioxidant, metabolic) would be advantageous.

Methods

The study included 59 patients 50-89 years old, with LOP (onset after 40 years), and 38 healthy peoples 51 – 84 years old. The activities of glutamate dehydrogenase (GDH), glutathione reductase (GR), and glutathione S-transferase (GST) were determined spectrophotometrically in erythrocytes and platelets. Scores by PANSS were evaluated twice: before and on the 28-th day of antipsychotic treatment.

Results

Samples from control group were used for determination of the control ranges for levels of studied enzymatic activities. Enzymatic activity levels were analyzed in three groups of patients: group Gr1 (n=16) treated without adjunctive therapy, and two other groups (Gr2 and Gr3) treated with adjunctive medicines: antioxidant 2-ethyl-6-methyl-3-hydroxypyridine succinate (Gr2, n=20), or “metabolic” medicines citicoline/cerebrolysin/cortexin/actovegin/gliatilin (Gr3, n=23).

As compared with controls, activity of erythrocyte GR was decreased at baseline and after the treatment course in all patients’ groups (p<0.01); in Gr2 significant decreases in baseline platelet GDH and GST activities were observed (p=0.005). Different significant links between biochemical parameters and scores by clinical scales before treatment were observed: in Gr1, erythrocyte GST activity positively correlated with scores by PANSS-Neg (R=0.61, p=0.012), by PANSS-Psy (R=0.54, p=0.032), and by PANSS (R=0.62, p=0.010), in Gr2, erythrocyte GST activity positively correlated with scores by PANSS-Pos (R=0.53, p=0.016), by PANSS-Psy (R=0.52, p=0.015), and by PANSS (R=0.60, p=0.005), in Gr3, platelet GR activity positively correlated with PANSS-Pos (R=0.50, p=0.014).

Conclusions

We have confirmed the additional favor (decrease in side-effect severity) obtained by distinct patient groups when treated with adjunctive antioxidant or “metabolic” therapy. Moreover, correlations revealed in the patient subgroups between enzymatic activities and scores by psychometric scales enable revealing those biochemical markers measurement of which facilitate differentiating the patients for whom the adjunctive medicines to antipsychotic+antioxidant treatment can positively influence the treatment outcome.

Disclosure of Interest

None Declared
Comparative Financial Implications of Outpatient and Inpatient Service of the Psychiatric Department in General Hospital during the COVID-19 Pandemic in Taiwan: Case Report
Authors: Su W.-Y. , Wang S.-C.
Published: August 2024

Introduction

The COVID-19 pandemic has stressed global healthcare systems, with Taiwan’s National Health Insurance (NHI) playing a crucial role in prevention and treatment. Like other countries, Taiwan grappled with managing the virus alongside regular healthcare services, resulting in notable financial strain on hospitals after COVID-19 pandemic.

Objectives

This study explores the financial implications of the psychiatric department at a medical center in Taiwan, highlighting the changing dynamics of healthcare costs and revenue during this period.

Methods

Data were collected monthly between January 2020 and September 2022, including the number of outpatient visits, inpatient patient-days, medical revenue, medical costs, and gross medical profit. Multivariate linear regression analysis confirmed the assumptions of the model and validated the findings.

Results

Regression analysis revealed a significant correlation between the number of patients and financial indicators (USD1). Medical revenue (Table. 1), grew by 82 USD for each outpatient visit(p<0.001, 95% CI:41–122), and grew by 70 USD for each inpatient-days(p=0.001, 95% CI:31–108). Medical costs (Table. 2), increased by 59 USD for every inpatient-days (p=0.01, 95% CI:15–102). Finally, the gross medical profits (Table. 3) increased by 72 USD for each outpatient visit (p=0.003, 95% CI:27–117).Table 1.

Multiple linear regression analysis of the impact of medical service on medical revenue.

RevenueCoef.SEtp[95% Conf. Interval]Outpatient (Visits)82204.136.00041122Inpatient (Patient Days)70193.664.00131108
Table 2.

Multiple linear regression analysis of the impact of medical service on medical cost.

CostCoef.SEtp[95% Conf. Interval]Outpatient (Visits)9220.422.676-3655Inpatient (Patient Days)59212.757.01015102
Table 3.

Multiple linear regression analysis of the impact of medical service on medical gross profit.

Gross ProfitCoef.SEtp[95% Conf. Interval]Outpatient (Visits)72223.261.00327117Inpatient (Patient Days)11210.501.620-3354

1All values were converted from TWD to USD using the rate as of 2023/08/15.

In summary, outpatient visits significantly augmented revenue and gross profit, whereas inpatient days led to heightened revenue and costs.

Conclusions

During the COVID-19 outbreak, healthcare systems, including those in Taiwan, were tested for unparalleled service challenges. This study found that while outpatient services boosted profits, rising inpatient admissions strained finances, given their higher costs and staffing needs. After the pandemic, psychiatric departments should reconsider resource allocation to balance expenses and revenues. Effective management is crucial for patient outcomes, emphasizing the need for quality care and fiscal control. Future research must focus on fortifying healthcare resilience.

Disclosure of Interest

None Declared
How good is the clinical diagnosis in schizophrenia? Reliability and validity
Authors: Falkai P.
Published: August 2024

Several changes to the classification of mental disorders have been made during the past half century to increase the reliability, clinical use and validity of the diagnostic classification. Despite the high expansion of knowledge about mental disorders, understanding of their components and processes still requires fine-tuning. This symposium identifies key issues on different classification systems with different purposes relevant to understanding and classifying mental disorders. We discuss how key issues such as ICD-11, RDoC or Biomarkers correspond or diverge because of their different purposes, and constituencies. Although these approaches have varying degrees of overlap and distinguishing features, they share the goal of reducing the burden of suffering due to mental disorder.

Disclosure of Interest

None Declared
Clinical, psychological and brain imaging investigation of first episode psychosis patients treated at Semmelweis University, Department of Psychiatry and Psychotherapy, Budapest, Hungary
Authors: Zsigmond R. I. , Hermán L. , Simon V. , Csukly G. , Vass E. , Baradits M. , Réthelyi J.
Published: August 2024

Introduction

First episode psychosis (FEP) is the first manifestation of psychotic disorders lasting at least one week, but not longer than 2 years, causing personal suffering and decreased functional outcome of patients. The early intervention in FEP is crucial. Published results on early intervention programmes indicate that during the first 5-10 years relapse prevention and functional outcomes can be improved and mental health care costs can be reduced, compared to treatment as usual.

Objectives

Our objective was to examine FEP patients at the Department of Psychiatry and Psychotherapy. Our aim was to create a homogeneous sample and identify factors that can help in early differential diagnosis and therapy. Our goal was to compare the neuropsychological performance and MRI results of patients and healthy controls.

Methods

Male and female inpatients hospitalized at our department due to a first psychotic episode and consenting to participate were included, since 2019 October. Cases with drug induced psychosis and organic background in the etiology of the psychotic episode were excluded. Male and female healthy controls were matched by age and education. Including healthy controls is still in progress. The duration of the project is 36 months, 24 months for recruiting patients and healthy controls, 12 month for analyzing data. The investigation includes detailed clinical, neuropsychological examination (baseline, 6th, 12th, 18th, 24th month) and MRI (baseline and in the 24th month).

Results

Forty patients and sixteen healthy controls were included. 60% of the patients were rehospitalized due to relapses. Neuropsychological tests (RBANS, faux pas, Baron-Cohen eyes test) indicate cognitive dysfunction compared to healthy subjects. Using resting state fMRI second level analysis we found alterations in thalamo-cortical connectivity. We found significant differences in the connectivity of the thalamus and frontal lobe, postcentral gyrus, insula and cerebellum.

Conclusions

Our FEP research, although limited by the COVID-19 pandemic, shows promising results that can help in better understanding of the underlying factors of psychotic disorders.

Disclosure of Interest

None Declared
Cannabis use in first episode psychosis in Tunisia
Authors: Bergaoui E. , Lansari R. , Chehaider O. , Ben Flah W. , Larnaout A. , Melki W.
Published: August 2024

Introduction

The use of cannabis is associated with developing psychotic disorders, especially for those with a pre-existing vulnerability and elevated familial risk for psychosis.

Objectives

To assess cannabis use during first episode psychosis and its relationship with patients’ clinical symptoms and functioning.

Methods

We assessed 50 patients hospitalized for first episode psychosis using three scales: CAST test (Cannabis Abuse Screening Test), Positive and Negative Syndrome Scale (PANSS) and Global Assessment of Functioning (GAF).

Results

The sex ratio of our population was 4 men to 1 woman. The average age was 25.6±6.16 years. About 60% of the patients used cannabis. The average duration of untreated psychosis was 10 months, with extremes ranging from one week to 24 months. Forty-four patients were antipsychotic-naïve (88%). For patients who used cannabis, the mean score of CAST test was 11.3±4.16, with extremes between 4 and 18. The risk of dependence was high in 81% of cannabis users. The PANSS total scale showed a mean score of 58.29±12.90 with extremes between 35 and 91. The average score at GAF scale was 30 with extremes between 20 and 70. Duration of untreated psychosis was significantly correlated to negative scale of PANSS (p=0,012 ; r=0,420), PANSS total score (p=0,011 ; r=0,424) and GAF levels (p=0,012 ; r=-0,420).

There was no association between age of onset of psychosis and cannabis use (p=0,181) nor CAST scores (p=0,747). There was no correlation between CAST and GAF scores (p=0,641).

However, there was a significant and positive correlation between CAST scores and positive scale of PANSS (p=0,04 ; r=0,432).

Conclusions

Cannabis use is neither necessary nor sufficient to cause psychosis on its own. However, it has an influence on the prognosis. Early intervention programs should address cannabis and substance use problems early in the course of illness.

Disclosure of Interest

None Declared
Gamma activity in Autism Spectrum Disorder: Enhanced response to visual input
Authors: Kakuszi B. , Szuromi B. , Tóth M. , Bitter I. , Czobor P.
Published: August 2024

Introduction

Autism spectrum disorder (ASD) is a childhood onset neurodevelopmental condition, that leads to permanent disability in a high proportion of cases. ASD is associated with a heterogeneous symptom presentation, which - besides social interaction and communication difficulties - encompasses altered sensory reactivity, including excessive hyper-sensitivity to stimuli, especially in the visual domain. Meta-analyses of fMRI studies revealed increased reactivity in visual task conditions in the temporal and occipital brain regions. Neural oscillations in the EEG gamma band are viewed as a candidate neurobiological marker for higher order sensory and perceptual processes, and social interactions.

Objectives

We investigated changes in gamma activity in the EEG in the eyes open (EO) vs. eyes closed (EC) condition in order to identify the neurobiological underpinning of the enhanced sensitivity to visual input in ASD as compared to typically developing (TD) subjects.

Methods

EEGs were obtained in EC and EO condition in ASD (N=23) and TD subjects (N=24) in an ongoing study. For EEG recording we used a high-density 128-channel BioSemi system, with 0.5 Hz frequency resolution. The spectral power in the gamma band (30-100Hz) was quantified by the power spectral density. To investigate whether changes in the gamma band were linked to changes in arousal instead of enhanced visual processing, we also examined alterations in the alpha band (8-13Hz) in the EO condition. Spectral power changes were determined for each EEG channel by computing the difference between the EC and EO conditions (EO-EC).

Results

Spectral power in the gamma band showed changes in the opposite direction in the two study groups: ASD subjects manifested significant (p<0.05) increase, while TD subjects had a decrease in the EO vs. EC condition in the temporal and occipital brain regions. By contrast, the changes in the alpha band were similar, with both groups exhibiting a spectral power decrease in the EO compared to the EC condition.

Conclusions

In ASD, an enhancement of gamma activity is present in the EO as compared to the EC condition in the posterior brain areas. These brain areas are involved in the processing of visual information, and gamma activity is considered as a measure of perceptual processes. Thus, the gamma alterations in the EO vs. EC condition may underlie the hyper-sensitivity symptoms to visual stimuli in ASD, and EEG can offer a simple to use tool to delineate the neurobiological foundation of the symptom presentation.

Funding statement: Hungarian Brain Research program,#NAP2022-I-4/2022

Disclosure of Interest

None Declared
Is gaming disorder related to psychological trauma? A scoping review
Authors: Fung H. W. , Cheung C. T. Y. , Lam P. , Yuan G. F. , Wong M. Y. C. , Ling H. W.-H. , Lam S. K. K. , Chau A. K. C. , Lee V. W. P.
Published: August 2024

Introduction

Gaming disorder has become a global concern and it could have a variety of health and social consequences. The trauma model has been applied to the understanding of different types of addictions as behavioral addictions can sometimes be conceptualized as self-soothing strategies to avoid trauma-related stressors or triggers. However, much less is known about the relationship between trauma exposure and gaming disorder.

Objectives

To inform prevention and intervention strategies and to facilitate further research, we conducted the first scoping review to explore and summarize the literature on the relationship between trauma and gaming disorder.

Methods

A systematic search was conducted on the Web of Science, Scopus and ProQuest. We looked for original studies published in English that included a measure of trauma exposure and a measure of gaming disorder symptoms, as well as quantitative data regarding the relationship between trauma exposure and gaming disorder.

Results

The initial search generated 412 articles, of which 15 met the inclusion criteria. All of them were cross-sectional studies, recruiting participants from both clinical and non-clinical populations. Twelve of them (80%) reported significant correlations between trauma exposure and the severity of gaming disorder symptoms (r = 0.18 to 0.46, p < 0.010). Several potential mediators, including depressive symptoms and dissociative experiences, have been identified. One study found that parental monitoring moderated the relationship between trauma and gaming disorder symptoms. No studies reported the prevalence of trauma or trauma-related symptoms among people with gaming disorder.

Conclusions

There is some evidence supporting the association between trauma and gaming disorder, at small to medium effect sizes. Future studies should investigate the mediators and moderators underlying the relationship between trauma and gaming disorder. The longitudinal relationship between trauma exposure and the development of gaming disorder should be clarified. A trauma-informed approach may be a helpful strategy to alleviate gaming disorder symptoms.

Disclosure of Interest

None Declared
Assessing the dimensions of psychological (in)flexibility in adolescence: Validation of the Portuguese Version of the Multidimensional Psychological Flexibility Inventory - short form
Authors: Cunha M. , Flórido S. , Pinto-Gouveia C. , Galhardo A.
Published: August 2024

Introduction

Psychological Flexibility (PF) is a complex and extensively studied concept within the Acceptance and Commitment Therapy (ACT) framework. PF denotes one’s capacity to effectively navigate psychological distress and challenges while aligning one’s actions with deeply held values. Given its association with mental health and overall well-being, it is crucial to develop assessment tools able to capture the various facets of flexible behaviour and design strategies for its enhancement.

Objectives

To adapt the Portuguese version of the Multidimensional Psychological Flexibility Inventory (MPFI-24; Grégoire et al., 2020) for the adolescent population.

Methods

The study involved 269 adolescents aged 12 to 18 years old. Participants completed a set of self-report instruments, including the MPFI24-A, the Depression, Anxiety, and Stress Scales-21 (DASS-21), Mental Health Continuum - Short Form (MHC-SF), and the PsyFlex-A, which also assesses PF. A subsample also completed the MPFI24-A four weeks later to assess test-retest reliability.

Results

Two models, specifically the six-factor correlated model and the bifactor model, emerged as presenting the best fit when analysing data separately for the Flexibility and Inflexibility indices. The MPFI24-A demonstrated good reliability for both overall scores (α = .90 and α = .85, respectively) and good test-retest reliability. The PF index showed significant positive associations with PsyFlex-A scores, perceived mental health, and a moderate negative association with depression and anxiety. Conversely, the Psychological Inflexibility (PI) index presented the opposite association pattern with these variables and showed no significant correlation with PF as measured by the PsyFlex-A. The two indices of the MPFI24-A demonstrated a weak positive correlation. Significant differences between boys and girls were found for the PF index, with boys showing higher scores. No significant differences were found between boys and girls concerning the PI index.

Conclusions

Results suggest that the MPFI24-A is a reliable and valid instrument for assessing adolescents’ psychological flexibility and inflexibility competencies. Although further clarification of the MPFI24-A factor structure and the utility of different factors is warranted, the findings support its overall applicability.

Disclosure of Interest

None Declared
Self-harm among Brazilian teenagers: scoping review
Authors: Da Silva J. L. , sobrinho J. E. D. L. , Heimer M. V. , Oliveira L. D. A. , Malheiros L. S.
Published: August 2024

Introduction

Non-suicidal self-injury among adolescents has grown in recent years, becoming a significant public health issue. The high social and psychological impacts related to it are often characterized by substance abuse and the development of anxiety and depression. Furthermore, emotional dysregulation and heightened reactivity are associated psychological characteristics.

Objectives

The aim of this paper was to do a scoping review, mapping the existing literature on self-harming behaviors among Brazilian adolescents, considering their sociodemographic and clinical characteristics.

Methods

We followed the adapted PRISMA checklist for scoping reviews. We searched eight databases: APA PsycNet, LILACS, MEDLINE, PubMed, Embase, Web of Science, The Cochrane Library, and Scopus. The selection of studies was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, where three independent researchers examined all titles and abstracts, applying the eligibility criteria. Accordingly, six studies were selected for descriptive analysis due to the variety of study types.

Results

A total of 2,032 youngsters were studied in the age range of 10 to 19 years-old, among over 15,000 reported cases of self-harming behaviors. Females accounted for 51.3% of the cases and had higher scores of impulsivity and loneliness to self-harming behavior (P ≤ 0.05). Alcohol use was evident across both genders but showed higher measures for males in both age groups (10 to 14 and 15 to 19 years, p < 0.001).

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Conclusions

The study pointed to a diversity of clinical and sociodemographic characteristics; however further research is needed on this topic on Brazilian adolescents. In addition, a broader standardization of data is necessary for more specific statistical analyses.

Disclosure of Interest

None Declared
Anxiety and depression among patients with chronic sciatica
Authors: Feki A. , Sellami I. , Bejaoui H. , Abbes A. , Gassara Z. , Ben jemaa S. , Ezzeddine M. , Kallel M. H. , Fourati H. , Akrout R. , Baklouti S.
Published: August 2024

Introduction

Spinal radicular syndromes are currently a significant healthcare concern in society. A common manifestation of these syndromes is sciatic pain, characterized by severe pain radiating along the course of the sciatic nerve. In many patients, chronic pain can lead to psychological problems.

Objectives

The aim of this study was to assess the frequency of anxiety and depression disorders in patients with sciatica and their impact on functional capacity.

Methods

We conducted a cross-sectional study, including patients suffering from documented common sciatic pain evolving for more than 3 months. The study was conducted in a rheumatology department over a period of 3 years. We used the Hospital Anxiety and Depression Scale (HADS) questionnaire, supplemented with information about the study group, pain location, and patients’ occupations. Additionally, the Oswestry Disability Index (ODI) and the Visual Analog Scale (VAS) were applied.

Results

The study included 104 patients (71 women and 33 men, with a male-to-female sex ratio of 0.46). The mean age of our patients ranged from 23 to 74 years. The most frequent etiology of sciatic pain was a herniated disc, followed by lumbar spinal stenosis and spondylolisthesis. The root path was L5 in 74 cases and S1 in 30 cases. The average duration of sciatic pain was 6.4 months. The mean Oswestry score was 25 (ranging from 15 to 38). The mean VAS score was 7.4 (ranging from 4 to 9). The mean Work Ability Index (WAI) was 25.2 (ranging from 15 to 38).

Depression was noted in 53 patients (50.9%) with a mean HADS depression score of 10.8 (ranging from 4 to 16). Anxiety was noted in 8 patients (7.6%) with a mean HADS anxiety score of 6.40 (ranging from 3 to 16). In univariate analysis, anxiety was associated with the low educational level of patients and with the duration of sciatic pain (p < 0.05). There was a significant association between depression and anxiety (p = 0.000). However, there was no relationship between these psychiatric disorders and functional status (p > 0.05).

Conclusions

Among patients with sciatic pain, there is a high prevalence of psychiatric disorders, including anxiety and depression. Regular screening for these disorders should be conducted by healthcare providers.

Disclosure of Interest

None Declared
The association between depressive symptoms and medication adherence among polypharmacy older adults
Authors: Alhashem G. , Alyasery R. , Al-Hassan S.
Published: August 2024

Introduction

Among many polypharmacy term definitions, the most common definition refers to the concurrent use of five or more medications. Multiple medication administration is highly prevalent in older populations with multimorbidity. Apart from polypharmacy impacts on physical health, it might be detrimental to mental health.

Objectives

The present study aims to evaluate the association between depression and poor adherence in multimorbidity Iraqi older population using five or more medications.

Methods

This cross-sectional study was conducted in Iraq during July and August 2023, involving a sample of 196 older adults recruited from private clinics and hospital clinical medicine wards, all of whom had polypharmacy regimens. The questionnaire includes age, gender, medication regimen adherence and Patient Health Questionnaire-8 (PHQ-8) using a cutoff score of 10. Chi-square and binary logistic regression were performed to determine the association between poor adherence and the presence of depressive symptoms.

Results

A total of 196 respondents, mean age = (61±11.4), 49 (25%) male and 147 (75%) female, 178 (90.8%) good adherence and 18 (9.2%) poor compliance, 81 (41.3%) participants have PHQ-8 score was equal or less than ten while 115 (58.7%) have PHQ-8 score was more than 10. Depressive symptoms and patient adherence showed a significant association (p = 0.02). Moreover, poor adherence polypharmacy participants were more likely to have depression odd ratio (OR) = 3.9, 95% confidence interval (CI = 1.09 – 13.9; p = 0.036).

Conclusions

Our findings suggest that depressive symptoms are associated with poor adherence polypharmacy older adults and, highlighting the importance of addressing medication management and mental health in this population.

Disclosure of Interest

None Declared
Psychosomatic relationships between the state of mental health and the level of vital threat of dermatological disease
Authors: Markova M. , Abdriakhimova T. , Skrebtsova H. , Chemerys M.
Published: August 2024

Introduction

According to the literature, 25-60% of dermatological patients have mental disorders. In the case of oncodermatological disease, the patient is under the influence of two stressogenic factors – existential experiences and social discomfort from the manifestations of the disease, which imprints on the patient’s mental health and promotes the development of mental maladaptation (MM).

Objectives

To study the features of mental state in patients with dermatological diseases with different levels of vital threat.

Methods

The examination included the use of clinical-psychological, psychodiagnostic and psychometric research methods.

Results

120 dermatological patients were examined: 60 patients with non-vital dermatological diseases (L82, A63.0, D18.0, L80), and 60 patients with dermatological diseases posing a vital threat (C43, C44, D04).

The identification of clinical signs of MM proved their presence in 70 (58.4%) people in the total sample. Among patients with non-vital diseases, the signs of MM were established in 33 (55.0%), among the patients with vital diseases – in 37 (61.7%). So, among patients with dermatological diseases, there are both psychologically adapted and maladapted individuals, regardless of the vitality/non-vitality of the pathological process.

In dermatological patients with signs of MM, the clinical picture is dominated by anxious (mainly in patients with non-vital diseases) and depressive (mainly in patients with vital diseases) radicals. Auxiliary psychopathological constructs are represented by manifestations of somatization, obsessive-compulsive symptoms, interpersonal sensitivity, and phobic anxiety. Affective symptoms are most pronounced in patients with MM and vital diseases, it is less pronounced in patients with non-vital pathology.

The presence and intensity of maladaptive pathopsychological-affective reactions in patients with dermatological pathology are not clearly associated with the vitality of the dermatological process, but are based on mechanisms of the mutual influence of biological predisposition and psychological and psychosocial factors, the mosaic combination of which determines the individual’s resource capabilities for constructive acceptance the fact of the presence of a dermatological disease and the development of an adequate strategy for its mastery, regardless of the severity of the disease.

Conclusions

These patterns should be considered when developing treatment measures and rehabilitation for patients with dermatological pathology.

Disclosure of Interest

None Declared