bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence and Associated Factors of Depressive Disorder after Exposed Prolonged Traumatic Event
Authors: Yoon B.-H. , Kim M.-D.
Published: August 2023

Introduction

Depressive disorder is one of the most typical psychiatric disorder that occurs after a traumatic event. However, there has been minimal research regarding the prevalence and associated factors of depression after a traumatic event.

Objectives

Therefore, this study aims to investigate the prevalence of depressive symptoms and associated factors in the residents of the Gangjeong village, who have been exposed to a traumatic event recently for a prolonged period.

Methods

The subjects of this study were the residents of the Gangjeong village, who have been exposed to a traumatic event related to the construction of the Jeju Civilian-Military Complex Port. The questionnaires were used to assess the participants` general characteristics (sex, age, marital status, occupation, self-perceived health, etc.); in addition, for the clinical evaluation, overall stress was assessed through the Global Assessment of Recent Stress Scale (GARS), social support through Functional Social Support Questionnaire (FSSQ) and suicide risk through Mini-International Neuropsychiatric Interview-Plus (M.I.N.I-Plus). In order to evaluate the depressive symtpoms, CES-D (Center for Epidemiologic Studies Depression Scale) was used.

Results

In 713 subjects, the prevalence of depressive symptoms was 18.5% (95% CI=15.66-21.36) (Table 1). Multivariate logistic regression analysis identified the length of residence and marital status as factors associated with depressive symptoms (Table 2). Furthermore, the depression group has a significantly higher score of overall stress (GARS), suicide risk and the lack of social support (FSSQ), in comparison with the non-depression group (Figure 1) group (depression gr. vs non-depression gr. : 28.8±15.0 vs 12.8±10.1, 4.9±8.0 vs 1.1±3.6, 44.8±13.2 vs 34.0±13.9, respectively).

Conclusions

The prevalence of depressive symptoms was higher among the study population compared to the general population. People exposed to the traumatic event, especially after prolonged exposure, should be assessed environment factors, the status of overall stress, social support and the suicidal risk.

Disclosure of Interest

None Declared
Three Months of Text4Hope-Addiction Support Program mitigates substance craving and improves mental health.
Authors: Obuobi-Donkor G. , Shalaby R. , Vuong W. , Agyapong B. , Gusnowski A. , Surood S. , Agyapong V. I. O.
Published: August 2023

Introduction

Problematic substance use is rising, and other mental health conditions like anxiety and depression correlate with substance abuse. Diverse interventions to reduce this effect are emerging. Supportive text messages offer the prospect of improving symptoms of drug misuse and other associated comorbidities.

Objectives

The study aims to evaluate the impact of the Text4Hope-Addiction program in mitigating craving, anxiety, and depression symptoms in subscribers.

Methods

Individuals self-subscribe to Text4Hope Addiction program by texting “Open2Change” to 393939 to receive daily addiction-related text messages for three months. Subscribers are invited via text message to complete online questionnaires which assess cravings, anxiety, and depressive symptoms using the Brief Substance Craving Scale, Generalized Anxiety Disorder-7 Scale, and Patient Health Questionnaire-9 on subscription (baseline), six weeks and three months. Data were analyzed using SPSS version 25 with descriptive and inferential statistics. Satisfaction responses were used to assess various aspects of the Text4Hope- Addiction program.

Results

There was a significant difference in the mean baseline and three-month BSCS scores ( -2.17, 95% CI of -0.62 to -3.72), PHQ-9 scores (-5.08, 95% CI of -1.65 to -8.51), and the GAD-7 scores (-2.93, 95% CI of -0.48 to -5.56). Participants agreed that the supportive text messages helped them cope with addiction-related stress (89%), anxiety (81%) and depression (69%).

Conclusions

The Text4Hope-Addiction program effectively reduced cravings, anxiety, and depression among subscribers, with high satisfaction rates for the program. Healthcare practitioners and policymakers should consider implementing supportive text-based strategies to complement conventional treatments for addiction.

Disclosure of Interest

None Declared
A qualitative investigation of healthcare professionals’ viewpoints of the healthcare process of persons with a serious mental illness in prisons with a traditional model for mental health care provision in Spain
Authors: Calcedo-Barba A. , Paz Ruiz S. , Estévez Closas V. , López López Á. , Barrios L. F. , Antón Basanta J.
Published: August 2023

Introduction

Healthcare delivery in prisons depends on the national Ministry of Interior in 14 of 17 autonomous regions in Spain. A traditional model for health and mental health care provision prevails.

Objectives

To increase understanding of the mental health care process of imprisoned persons with a serious mental illness (SMI) in Spanish prisons with a traditional model of health care provision.

Methods

10 healthcare professionals (6 physicians, 3 nurses, 1 pharmacist) working in small (<450 imprisoners), middle size (450-1,000) and big (>1,000) prisons took part in 3 online focus groups between 31st May and 2nd June 2022. The moderator used open-ended questions to research into the healthcare process (diagnosis, treatment, follow up, prevention) of imprisoners with SMI. Focus groups lasted 2 hours, and were audiotape recorded and transcribed. Transcripts were analysed applying constant comparative method and theoretical saturation.

Results

Mental healthcare provision varies across prisons, but commonalities exist. Healthcare professionals reported that about 60% of SMI are diagnosed by the correctional general practice physician (GP) at incarceration. Severe cases are assessed by an external psychiatrist. Once a week (average) the psychiatrist visits the prison to either confirm diagnoses or adjust treatments. One third of imprisoners who would benefit from a psychiatric assessment has it. Follow up occurs in the prison infirmary for close supervision. If addiction concurs, referral to therapeutic modules happen. Polypharmacy and overmedication are common. Simplification of therapies and slow-release injectable formulations of antipsychotics are desirable. Everyday mental health care and rehabilitation take place throughout a specific, little equipped, psycho-social support programme implemented in most prisons but restricted to the most disabled SMI persons. Acute psychiatric episodes occur due to treatment interruptions or deviations and are managed by the correctional GP. Hospital referrals are problematic without protocols. Prevention of relapses relies on imprisoners supervision and staff observation. Healthcare records are only available to healthcare professionals working in prisons. Outside prisons, continued care needs of mental health and social support in the community. Due to healthcare services modest readiness to respond to needs and poor social networks, SMI persons are prone to relapse and recidivism.

Conclusions

Focus groups found that working in isolation from the public healthcare system, shortage of psychiatrists, poorly implemented therapeutic and rehabilitation programmes, and lack of mental health and social care services in the community negatively affect the care of imprisoners with SMI in Spain.

Disclosure of Interest

None Declared
Lessons from the Impact of War in Ukraine on Combatants’ Mental Health during the Last Decade
Authors: Haydabrus A. , Giménez-Llort L.
Published: August 2023

Introduction

The threat and preservation of the territorial integrity of Ukraine are not new issues. During the last decade, peacetime (Peace, until 2013) was disrupted by active hostility (AH, 2014–2015) and trench warfare (TW, 2016–2021). War exert acute and chronic impacts on mental health, may be a substrate for mental health disorders, especially worrisome since, today, the large-scale conflict has demanded the recruitment of adult civilians to defend and fight alongside armed forces troops.

Objectives

The analysis aimed to unveil the impact of those conflicts on the mental health of the army and help us to anticipate risk factors (ranks, time period) and need for resources (admissions and days of hospitalization per time period, rank and disease).

Methods

A retrospective cross-sectional analysis of an anonymized part of the internal database included 3995 anonymized records.Data are expressed as the frequency (%), fold-increase, or mean ± SEM. Chi-square analysis and ANOVA with Bonferroni post hoc correction were performed with Jamovi.

Results

The temporal distribution of admissions (Figure 1) showed a 6.97 (AH) and 3.62 (TW) [5.02 (TW1, 2016–2017), 3.91 (TW2, 2018–2019), and 1.95 (TW3, 2020–2021)] fold increase per year compared to peacetime. The most frequent mental health problems, accounting for 76.1% of cases, were ‘anxiety, dissociative, stress-related, somatoform and other nonpsychotic disorders’ (F40-F48, ANXd, 40.1%) and ‘mental and behavioral disorders due to psychoactive substance use’ (F10–F19, PSUd, 36.0%). ‘Reaction to severe stress and adjustment disorders (F43, 76.5%) and ‘Alcohol-related disorders (F10, 89.3%) were the predominant mental health disorders, respectively.

The ICD-10 category depended on the war period (Figure 2), with peacetime to TW2 accounting for 90% of cases. ‘ANXd’ were the main mental health problem in any period, with 61.8% of cases occurring in peacetime. PSUd, residual in peacetime 6.1%, reached their peak in active hostility (47.4%), with 97.9% of ‘Alcohol-related disorders’ as the cause of these admissions, which could agree with the use of alcohol serving as a coping mechanism in front traumatic events. In trench warfare, PSUd decreased (TW1, 39.2%; TW2, 25.1%).

Hospital stays for people with ANXd or PSUd lasted at least one month in peacetime but significantly decreased in war periods (Figure 3). This could be explained by a ‘need for free beds effect’ and the distribution of admissions by ranks.

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Conclusions

-

The dominance of ANXd, mainly among professional soldiers and high ranks, points to the need for rank-tailored psychological training in skills to reduce the ANXd burden.

-

The large number of PSUd in nonprofessional soldiers during wartime dictates the need to strengthen the selection of military personnel.

-

Hospitalizations in military operations are heterogeneous and depend on the military rank.

Disclosure of Interest

None Declared
Two-year experience of the implementation of a psychiatric home hospitalization care service for acute mental illness
Authors: Guàrdia A. , Marin L. , González-Rodríguez A. , Bañon V. , Izquierdo E. , Lafuente L. , Martinez-Bio X. , Llors D. , Natividad M. , Ros L. , Monreal J. A.
Published: August 2023

Introduction

Psychiatric home hospitalisation is a service aiming to support people with mental illnesses in their acute stage at their own home. This care model has been recently implemented in our territory with the main objective of avoiding hospital admissions.

Objectives

Our goal is to describe a cohort of patients followed up over 2-years in the context of a pilot mental health program within a community-based model (Mutua Terrassa University Hospital).

Methods

We conducted a prospective longitudinal study including 125 patients attended from 01/11/2020 to 09/11/2022 in our reference area of 250,000 inhabitants. The team was formed by 1 psychiatrist and 1 mental health nurse. DSM-5 diagnoses, socio-demographic variables, mean stay and care trajectories were collected.

Results

One-hundred twenty-five patients were attended (women: 70). Mean age at consultation: 38.3 years-old. Mean stay: 24 days. The most frequent diagnoses: non-affective psychotic disorders (58%), affective disorders (30%), followed by anxiety and personality disorders. Referrals from Community Mental Health Outpatient Services (CMHS) (72%), Acute Inpatient Unit (25%), and Psychiatric Emergency Service (3%). Referrals after discharge: CMHS (83%), Adult Acute Inpatient Unit (13%), others (4%). Individualized mental health plans were carried out in all cases, in coordination with community mental health services. Follow-up adherence after discharge was about 95%. Patients with first-episode of psychosis showed the highest degree of satisfaction (N=46).

Conclusions

Patients with emerging psychosis were the profile of users who showed the highest benefit of our service. Women showed higher adherence, and loss to follow-up was lower than we expected.

Disclosure of Interest

None Declared
What are the fundamental ways that psychiatric services should engage with carers and family?
Authors: Maybery D.
Published: August 2023

Introduction

When mental health service providers, service users and their carers/family are successfully integrated, widespread benefits will flow to all stakeholders. However, mental health services do not commonly engage with carers or family.

Objectives

This presentation describes (a) an extensive review of the literature and (b) empirical research with carers and family about what they received and wanted from engagement with mental health services.

Methods

A mixed method online survey asked 134 family members and carers what they received and what they wanted from mental health services. Participants also quantified the importance of seven hypothesised core practices on a 0-100 point likert scale.

Results

Almost 250 verbatim responses were deductively matched against hypothesised engagement practices from the literature, with additional unaligned responses inductively categorised. The findings triangulate with multiple diverse literatures to confirm seven fundamental engagement practices that carers and family want from health services. Conceptually, these practices are represented by two broad overarching practice themes of (i) meeting the needs of the family member and (ii) addressing the needs of the service user.

Conclusions

Policy, clinical practice, training and future research might encompass these core practices along with consideration of the intertwined relationship of family, carers and the service user suggested by the two broader concepts.

Disclosure of Interest

None Declared
Efficiacy of Pharmacotherapy in Patients with Hypothimic Mental Disorders Suffered from Covid-19 Infection
Authors: Labunskiy D. , Kuzmin D. , Baranov D. , Kiryukhina S. , Pavelkina V.
Published: August 2023

Introduction

In organic mental disorders in people who have undergone COVID-19, it has been established that the complex use of periciazine in combination with paroxetine, diazepam,
3-hydroxypyridine succinate and hyperbaric oxygenation is superior in effectiveness to traditional therapy with an antipsychotic drug, antidepressant and anxiolytic. The inclusion of 3-hydroxypyridine succinate, hyperbaric oxygenation in the complex therapy of this pathology corrects the concentrations of adrenaline, norepinephrine, dopamine, serotonin in the peripheral blood of patients, eliminates hormonal status disorders and humoral immune responses.

Objectives

The aim of the work was to optimize approaches to the treatment of hypothymic disorders in organic mental illness, to substantiate the complex use of periciazine in combination with paroxetine, diazepam, 3-hydroxypyridine succinate and hyperbaric oxygenation in patients who underwent COVID-19.

Methods

The object of the clinical study were patients with organic mental disorders who underwent COVID-19. To assess the condition, laboratory research methods were selected taking into account the etio- and pathogenesis of diseases: determining the level of catecholamines, some indicators of humoral immune responses, and the hormonal profile.

Results

Table 2.3 - Nosological structure of patients included in the studyNosological formAssociated hypothymic disorder
Number of patientsGender
Average age (years)MalesFemalesOrganic mental disorderOrganic anxiety disorder F06.42115628,7±6,3Depressive Episode F3322129Organic mental disorder associated with COVID-19Organic anxiety disorder F06.418153Depressive Episode F331610643,7±7,4

Conclusions

In patients with organic mental disorders, occurring with hypothymic symptoms, compared with healthy donors, there is a complex of disorders in plasma concentrations of catecholamines. Traditional and, to a greater extent, combination therapy increase the levels of serotonin, dopamine, norepinephrine, both in the group of patients who did not have COVID-19, and in those who underwent a new coronovirus infection.

In patients with organic mental disorders, occurring with hypothymic symptoms, compared with healthy donors, there is a complex of disorders in plasma concentrations of catecholamines. Traditional and, to a greater extent, combination therapy increase the levels of serotonin, dopamine, norepinephrine, both in the group of patients who did not have COVID-19, and in those who underwent a new coronovirus infection.Complex therapy with periciazine, paroxetine, diazepam in combination with 3-hydroxypyridine succinate and HBO for organic mental disorders causes a more complete reduction of hypothymic disorders both in the group of patients who did not have COVID-19, and in those who underwent a new coronovirus infection.

Disclosure of Interest

None Declared
Suicide Attempts in Panic Disorder: Clinical Effects on Treatment Response and Link to Fear of Cognitive Dyscontrol
Authors: Kim H. , Jung H.-Y. , Bang M. , Lee S.-H.
Published: August 2023

Introduction

Panic disorders (PD) are associated with suicidality. The link between PD and suicide has been suggested to be depression; however, this remains controversial. Comprehensive research on the history of suicide attempts (SAs) in patients with PD is scarce.

Objectives

This study investigated the characteristics and pharmacological short- and long-term treatment responses of patients with PD, with or without SAs. Moreover, a network analysis was conducted to investigate the central symptoms and their connection to suicidality among SA-related variables with and without SAs.

Methods

We investigated the characteristics of SAs in patients with PD using PD-related scales, magnetic resonance imaging, and network approaches. A total of 1151 subjects were enrolled, including 755 patients with PD (97 with SA and 658 without SA) and 396 healthy controls. Suicide and PD-related scales were also administered.

Results

Our results revealed that the scores of all symptom severities were significantly higher in the PD+SA group than in the PD-SA group. Multiple linear regression analysis revealed that short- and long-term pharmacological treatment responses were significantly poor in the PD+SA group. Network analysis showed that fear of cognitive dyscontrol (FCD) was the strongest central symptom among strength, expected influence (1 and 2 step), randomized shortest path betweenness, and eigenvector centrality measures in PD+SA, whereas depression was the central symptom in PD-SA.Table 1.

Results of multiple regression analysis to predict treatment response for patients with panic disorder.

Treatment response
at 8 weeks
(n = 450)[R2 =0.19]Treatment response
at 6 month
(n = 379)[R2 =0.20]Treatment response
at 1 year
(n = 329)[R2 =0.22]Βp-valueβp-valueβp-valueGender0.100.150.140.090.080.39Age-0.060.440.040.620.010.94Baseline PDSS total score0.46<0.001**0.48<0.001**0.42<0.001**Baseline BDI-II total score0.050.650.090.470.170.19Baseline PSWQ total score-0.070.47-0.110.29-0.180.09Baseline ASI-R total score-0.140.19-0.190.10-0.190.11Baseline ETISR-SF total score0.070.340.040.600.110.24A history of the suicide attempt-0.190.01*-0.200.02*-0.280.002*

Note: Model p-values <0.001.

*

p < 0.05.

**

p < 0.001.

Abbreviations: PD, panic disorder; SA, suicide attempt; PDSS, Panic Disorder Severity Scale; BDI-II, Beck Depression Inventory-II; PSWQ, Penn State Worry Questionnaire; ASI-R, Anxiety Sensitivity Inventory-Revised; ETISR-SF, The Early Trauma Inventory Self Report-Short Form.

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Image 3:

Conclusions

Our results suggest that SA history could be associated with high symptom severity and poor pharmacological treatment response in patients with PD and that FCD is the central symptom in the PD+SA network.

Disclosure of Interest

None Declared
Lamina-specific association between reduced mRNA levels of tyrosine kinase b and glutamate decarboxylase 67 in the orbitofrontal cortex in bipolar disorder: A possible reflective of defective connectivity in bipolar disorder
Authors: Park J. E. , Choi J. , Jung S.-B. , Lee J.-C. , Kim I. B.
Published: August 2023

Introduction

Lamina-specific alterations of inhibitory circuitries have been considered the crucial pathogenesis of perceptual, cognitive and behavioral symptoms presented in schizophrenia and mood disorders. Especially, with emerging evidences indicating the close lamina-specific relationship between synaptic defects and γ-Aminobutyric acid (GABA)-related gene dysfunctions, it has been suggested the mRNA dysregulations of Tyrosine kinase B (TrkB) and Glutamate decarboxylase 67 (GAD67) could particularly be implicated in middle and deep layers of neocortex of patients with major psychiatric disorders.

Objectives

Giving inquiries of whether defects of these mRNA levels in Orbitofrontal cortex (OFC) would be involved as lamina-specific patterns in individuals with schizophrenia and mood disorders.

Methods

We examined mRNA levels of BDNF, TrkB and GAD67 in each OFC layer I through VI. We analyzed data from postmortem brain tissue of the Stanley Neuropathology Consortium Integrative Database (SNCID). SNCID consists of 15 subjects in each of four groups (schizophrenia, bipolar disorder, major depression without psychotic features, and unaffected controls). All groups were matched for age, sex, race, brain pH and post-mortem interval.

Results

We found TrkB mRNA levels to be significantly reduced in layer VI in both groups with schizophrenia (25.8%) and bipolar disorder (35.7%) compared with controls. GAD67 mRNA levels were also significantly reduced in layer III and IV in patients with schizophrenia (23.4% and 22.7%, respectively) and bipolar disorder (31.2% and 24.9%, respectively) compared with controls. Individuals with major depression showed only trends toward decreased mRNA levels of GAD67 in layer III and IV and of TrkB in layer VI compared with controls. TrkB mRNA levels in layer VI were significantly correlated with GAD67 mRNA levels in layer III (ρ=0.581, p=0.037) and IV (ρ=0.857, p<0.001) in subjects with bipolar disorder, but not in those with schizophrenia. When analyzed with partial correlation controlling the effects of pH and PMI, significance of correlation remained only between GAD67 mRNA in layer IV and TrkB mRNA in layer VI in individuals with bipolar disorder (ρ=0.768, p=0.006).

Conclusions

The resulting lamina-specific decreases in inhibitory tone across layers of OFC may contribute to the unrestrained irritability and violent behaviors in common shared by both patients with schizophrenia and bipolar disorder. Nonetheless, our findings indicate the obvious correlations between lamina-specifically altered TrkB and GAD67 mRNA levels in OFC might be a candidate for endophenotype of bipolar disorder.

Disclosure of Interest

None Declared
Relationship of smartphone use severity with sleep quality in bipolar patients
Authors: Kim J. , Kim S.-H.
Published: August 2023

Introduction

Maintaining a good sleep-wake cycle is an important factor for the prognosis and management of bipolar disorder. However, studies on the to various technological advances including smartphoe usage affecting inter-episodic sleep quality are yet relatively less thoroughly investigated.

Objectives

This study aims to identify the association between smartphone usage and inter-episodic sleep quality of bipolar patients.

Methods

A total 52 Bipolar I or II subjects who were euthymic for at lest 6 months were included in this analysis. Pearson correlation analysis was used to examine the association among psychological assessments, including the Pittsburgh Sleep Quality Index (PSQI-K), Smartphone Addiction Scale (SAS), Hamilton Depression Rating Scale (K-HDRS), Young Mania Rating Scale (K-YMRS), and Multidimensional Scale of Perceived Social Support (MDPSS). Significant results were then analyzed using a multiple linear regression analysis with PSQI-K as the dependent variable to assess the impact of clinical variables on sleep quality.

Results

PSQI-K was positively correlated with SAS (r = 0.457, p < 0.001), K-HDRS (r = 0.447, p < 0.001), and negatively correlated with MDPSS (r = -0.336, p < 0.05). Smartphone use, depressive symptoms, and perceived social support seemed to explain 35.7% of sleep quality. After adjusting for confounders, more smartphone use and more severe depressive symptoms were associated with poor sleep quality (SAS: β = 0.383, p = 0.002; K-HDRS: β = 0.339, p = 0.006), but perceived social support did not reach statistical significance (MDPSS: β = -0.204, p = 0.086).

Conclusions

The results of this study show that the more a person uses a smartphone, the worse their sleep is. This effect is significant, even when other factors are taken into account. These results support the possibility that improving the degree of smartphone use could be an essential intervention target for improving sleep quality during the inter-episode period in patients with bipolar disorder.

Disclosure of Interest

None Declared
Symptoms of depression and anxiety in adolescents and their caregivers: A cross-sectional study from North Macedonia
Authors: Kunovski I. , Bolinski F. , Raleva M. , Isjanovska R. , Kalpak G. , Novotni A. , Stefanovski B. , Hadzihamza K. , Bajraktarov S.
Published: August 2023

Introduction

Mental health problems have increased internationally during the COVID-19 pandemic. However, most data stems from Western countries and there is a clear lack of prevalence rates and potential risk factors from Central and Eastern Europe.

Objectives

To investigate the point prevalence and to provide further information on risk factors of depressive and anxiety symptoms in adolescents and their caregivers in North Macedonia after the COVID-19 pandemic.

Methods

A cross-sectional survey study was conducted on adolescents and their caregivers through the school setting in different areas of North Macedonia. Survey items assessed symptoms of depression, anxiety, and respondents’ fear of COVID-19, as well as a number of risk factors, such as gender and living environment.

Results

506 adolescents and 492 caregivers completed the survey. Symptoms of depression and anxiety were mild to moderate in adolescents and their caregivers. Women and girls generally scored higher than men and boys, and adolescents in high school scored higher than those in elementary school. Prevalence rates for depression were 29.2% for adolescents and 10.4% for caregivers, while rates of anxiety were 23.7% for adolescents and 6.1% for caregivers.

Conclusions

This study provides a first insight into the mental health of adolescents and their caregivers after the COVID-19 pandemic in North Macedonia. Further research is required to investigate the relatively low reported rates of caregivers’ mental health problems compared to data from other countries.

Disclosure of Interest

None Declared
Factors associated with insomnia and aggression among healthcare workers during the COVID-19 pandemic
Authors: Schneider-Matyka D. , Cybulska A. M. , Rachubińska K. , Grochans S. , Weymann A.
Published: August 2023

Introduction

Healthcare workers are exposed to increased risks of insomnia and aggression during the COVID-19 pandemic.

Objectives

The aim of the study was to estimate the prevalence rate of insomnia and aggression and identify associated risk factors among healthcare workers during the COVID-19 pandemic

Methods

A total of 264 healthcare workers participated in the study. The study was conducted with the diagnostic survey method, using the Buss-Perry Aggression Questionnaire, the Athens Insomnia Scale, the Pittsburgh Sleep Quality Index, and a questionnaire of our authorship.

Results

The vast majority of the respondents (81.06%) suffered from insomnia and had poor sleep quality (78.03%). Education (p=0.038), marital (p=0.043) and parental status (p=0.004), and contact with patients suffering from COVID-19 (p=0.024) were statistically significant contributors to insomnia. Working time was found to significantly correlate with insomnia (r=0.124 p=0.044) and a physical aggression (r=0.168 p=0.006), anger (r=0.121 p=0.05), a verbal aggression (r=-0.132 p=0.032). Age was found to significantly correlate with total aggression (r=-0.133 p=0.031), verbal aggression (r=-0.138 p=0.025), anger (r=-0.151 p=0.014). Sex was found to be statistically significantly related to physical aggression (p=0.017), anger (p=0.032), and hostility (p=0.002).

Conclusions

A considerable proportion of HCWs experienced sleep disorders during the pandemic, emphasizing the need to establish ways to reduce long-term adverse outcomes associated with chronic insomnia and adjust interventions under pandemic conditions. Our findings confirm that insomnia and poor sleep quality are consistently associated with aggression.

Disclosure of Interest

None Declared
The impact of the COVID-19 pandemic and related measures on people with psychiatric disorders in a small town in Greece
Authors: Kostarelou S. , Argyropoulos K. , Mproumas V. , Avramidis D. , Assimakopoulos K. , Gourzis P. , Jelastopulu E.
Published: August 2023

Introduction

A pandemic can have significant effects on people’s emotional wellbeing. Infection control measures such as social distancing can lead people to feel isolated and to increased feelings of fear, anxiety, anger, and sadness. Recent research showed a worrying increase in depression and anxiety disorders, general distress, and sleep disorders. People who already suffer from a mental illness may be more vulnerable to stress caused by the pandemic and may experience a deterioration of already preexisting symptoms of anxiety and depression.

Objectives

The purpose of the present study was to assess the pandemic’s psychological impact on people with preexisting mental illness, to investigate their COVID-19-related fear, anxiety, and depression in association with various variables and to explore their behavioral responses regarding the measures against the pandemic.

Methods

A cross-sectional study was conducted from March to May 2022 in the outpatient mental health clinic of a provincial hospital in Greece. Participants were patients, who were not fully disorganized and have been diagnosed with a mental illness before the COVID-19 pandemic. Among the 50 adult patients, 11 lived in assisted living facilities. The study included sociodemographic questions, questions about fear of COVID-19, negative feelings, safety measures and behaviors, disease progression, and compliance with their therapists. DASS-21 scale was used to measure the 3 subscales of emotional states.

Results

Sadness was reported as the most unpleasant emotion of the lockdown, following by hopelessness and denial. Several participants (36%) reported high levels of COVID-19-related fear, mainly patients living in the community and not in assisted facilities (40.1% vs 18.2%) and males compared to females (42.1% vs 32.3%). The majority (70%) declared high compliance with the therapy. A moderate to severe deterioration in disease progression during the pandemic was observed in 28%, mainly in females compared to males (38.7% vs 10.6%). Based on DASS-21 the mean scores ranged from moderate to severe symptoms in depression (16.2/42), anxiety (14.3/42), and stress (18.4/42) without a statistically significant correlation with age, gender, and living situation. However, 34%, 22% and 56% screened positive for severe and extreme severe depression, anxiety, and stress, respectively.

Conclusions

The study revealed a substantial proportion of patients with mental disorders to experience unpleasant emotions and increased levels of psychological distress and highlights the need for supportive mental health services to address the increased mental health symptoms in people with pre-existing mental illnesses during a pandemic.

Disclosure of Interest

None Declared
Characteristics of admissions to a Hospitalization Unit in a rural population during the COVID-19 pandemic
Authors: Chauca Chauca G. M. , Galán Armenteros M. R. , Carrión Expósito L.
Published: August 2023

Introduction

On January 7, 2020, the Chinese authorities identified a new type of virus from the Coronaviridae family as the causative agent of an outbreak of pneumonia of unknown etiology, which has been named SARS-CoV-2. The disease caused by this new virus has been named by international consensus COVID-19. The WHO recognized it as a global pandemic on March 11, 2020. The Government of Spain declared the State of Alarm on March 13.

Hospitals have had to reorganize their consultation areas and emergency rooms to carry out security measures and prioritize the care of patients with COVID-19. All this has had repercussions on the closure of Psychiatric Day Hospitals and outpatient consultations, carrying out fundamentally telephone or telematic follow-up.

Objectives

The objective of the study was to analyze the characteristics of admission during the year after the 2020 pandemic compared to the similar period in 2019.

Methods

An observational study of retrospective characteristics of patients admitted to a hospitalization unit during the year 2020 after the pandemic will be carried out compared to the year 2019 of the same period. Demographic and clinical variables are included in the study.

Results

During the period after the 2020 pandemic, a total of 135 patients were admitted, with a mean age of 42.8 years, 65 of them women and 70 men. With a diagnosis at discharge of 48% of Psychotic Disorder, 17% of Bipolar Disorder, 11.1% of other affective disorders (T. depressive, adaptive, dysthymia) 14% of Personality Disorder, and 17% of others. Compared to the same period of the previous year, the number of admissions decreased by 98 patients (42%), including the severity of the clinic, with 36% of the total admissions being psychotic disorders.

Conclusions

It can be concluded that the number of hospitalizations has decreased due to the patients’ fear of being admitted and therefore being subject to infection, and the higher percentage of psychotic and affective pathology because these patients are more serious, making home containment impossible.

Disclosure of Interest

None Declared
Major Depressive Disorder in Youth: A Meta-Analysis of Functional Magnetic Resonance Imaging Studies
Authors: Zamora G. , Baten C. , Klassen A. M. , Shepherd J. H. , Pritchard E. , Saravia S. , Ali Z. , Jordan J. , Kahlon S. K. , Maly G. , Duran M. , Santos S. L. , Nimarko A. F. , Hedges D. W. , Hamilton J. P. , Gotlib I. H. , Sacchet M. D. , Miller C. H.
Published: August 2023

Introduction

Major depressive disorder (MDD) is a highly prevalent mental illness that frequently originates in early development and is pervasive during adolescence. Despite its high prevalence and early age of onset, our understanding of the potentially unique neural basis of MDD in this age group is still not well understood, and the existing primary literature on the topic includes many new and divergent results. This limited understanding of MDD in youth presents a critical need to further investigate its neural basis in youth and presents an opportunity to also improve clinical treatments that target its neural abnormalities.

Objectives

The present study aims to advance our understanding of the neural basis of MDD in youth by identifying abnormal functional activation in various brain regions compared with healthy controls.

Methods

We conducted a meta-analysis of functional magnetic resonance imaging (fMRI) studies of MDD by using a well-established method, multilevel kernel density analysis (MKDA) with ensemble thresholding, to quantitatively combine all existing whole-brain fMRI studies of MDD in youth compared with healthy controls. This method involves a voxel-wise, whole-brain approach, that compares neural activation of patients with MDD to age-matched healthy controls across variations of task-based conditions, which we subcategorize into affective processing, executive functioning, positive valence, negative valence, and symptom provocation tasks.

Results

Youth with MDD exhibited statistically significant (p<0.05; FWE-corrected) hyperactivation and hypoactivation in multiple brain regions compared with age-matched healthy controls. These results include significant effects that are stable across various tasks as well as some that appear to depend on task conditions.

Conclusions

This study strengthens our understanding of the neural basis of MDD in youth and may also be used to help identify possible similarities and differences between youth and adults with depression. It may also help inform the development of new treatment interventions and tools for predicting unique treatment responses in youth with depression.

Disclosure of Interest

None Declared
Infections and obsessive-compulsive disorder - results from a systematic review and meta-analysis
Authors: Descalço N. , Gomes R. D. , Maia A. , Barahona-Corrêa B. , Oliveira-Maia A. , Oliveira J.
Published: August 2023

Introduction

Obsessive-compulsive disorder (OCD) is a psychiatric disorder affecting 1.3% of the population worldwide where both genetic and environmental factors, such as perinatal events and neuroinflammation, are thought to contribute to the etiology of the disorder. In the past, the description of clinical entities such as Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections (PANDAS), in which an acute neuropsychiatric syndrome with prominent obsessive-compulsive features emerges in children infected with group-A beta-hemolytic streptococcus (GABHS), sparked the hypothesis that infections may be a risk-modifying factor for the development of OCD. Along with streptococcal infections, other pathogens such as Toxoplasma gondii have been implicated in the pathophysiological models of the disorder, although causal associations have not been established for any of beforementioned pathogens.

Objectives

To perform a systematic review and meta-analysis about the presence of biological evidence of infection in patients diagnosed with OCD.

Methods

We conducted a systematic review and a meta-analysis (PROSPERO registration CRD42021223415) by performing a standardized electronic database search in MEDLINE/PubMed, Web of Science, Embase and Scopus. Search was conducted on 17/10/2022. Eligible papers included case-control and cohort studies using a comparator group, that tested for specific biomarkers providing evidence of infection in patients diagnosed with OCD; exclusion criteria included studies without quantitative or qualitative measures of infection, case reports, systematic or scope reviews, and animal studies. Selection process was conducted according to PRISMA 2020 statement guidelines. Study quality was assessed through Newcastle-Ottawa Quality Assessment Scale.

Results

We identified 8911 records through the search after duplicate removal. A total of 22 studies met inclusion criteria after selection process, and 15 were eligible for meta-analysis. Most evidence concerned Toxoplasma gondii (10 studies), and patients with OCD appear to have higher odds of being infected compared to controls, with a meta-analytic odds ratio of 2.39 (95% IC 1.60-3.58), when comparing 467 patients with 5411 controls. However, most studies were methodologically heterogeneous, which compromises the interpretation of meta-analytic results. Information regarding other agents, including GABHS, Borna disease virus and Toxocara canis was gathered but due to an insufficient number of papers it was not possible to perform a meta-analysis for each of them.

Conclusions

Our work suggests that albeit exhaustively reported in the literature, there is no strong evidence of the over-representation of biomarkers of infection in patients with OCD compared to control volunteers. Methodologically robust studies are needed to further test this hypothesis.

Disclosure of Interest

None Declared
The role of dysregulated ghrelin/LEAP-2 balance in eating disorder: a translational study in anorexia nervosa.
Authors: Tezenas du Montcel C.
Published: August 2023

The ghrelin system is a key regulator of appetite and food intake across species. LEAP-2, a recently discovered ghrelin antagonist, appears to be up-regulated in obesity and opposes to the orexigenic drive of ghrelin. The evolution of LEAP-2 levels could be an interesting insight to reflect the regulation of appetite in eating disorders such as anorexia nervosa (AN). We provide the first study exploring the ghrelin and LEAP-2 regulation in long-term food restriction followed by refeeding in both mice and patients suffering from AN.

Using a translational strategy, we compared the regulation of ghrelin and LEAP-2 concentrations in blood during food restriction and after refeeding in female mice exposed to a 14 days protocol combining quantitative food restriction and running wheel activity followed by progressive refeeding. We compared these results to clinical data fom in an ongoing longitudinal study of patients with AN evaluated before and after refeeding as well as 6 months after hospital discharge.

Long-term food restriction in mice was associated with increased ghrelin and decreased LEAP-2 concentrations compared to ad libitum fed controls. Refeeding led to an increase in LEAP-2 concentrations. Patients with AN displayed increased ghrelin levels but also higher LEAP-2 concentrations on admission than after refeeding. LEAP-2 decreased with refeeding. On 17 patients re-evaluated 6 months after discharge, patients with unstable weight gain exhibited a greater decrease of LEAP-2 concentrations during refeeding compared to patient with stable weight gain. Decreasing LEAP-2 concentrations was able to predict a negative outcome (i.e. unstable weight gain) in 80% of the cases.

We provide evidence that the ghrelin/LEAP-2 system is not regulated according to the nutritional status in AN as it is in the case of a physiological adaptation to food restriction. Our clinical data suggest that the evolution of LEAP-2 concentrations during refeeding is opposed to data from preclinical model and could give new insights on the outcome of weight gain in AN.

Disclosure of Interest

None Declared
Mortality in older adults with severe mental illness: the role of metabolic syndrome and its components
Authors: Abou Kassm S. , Sánchez Rico M. , Naja W. , Alvarado J. , Halaby A. , Limosin F. , Hoertel N.
Published: August 2023

Introduction

Studies in adult psychiatric patients consistently call attention to premature mortality and its association with metabolic syndrome. However, the utility of the metabolic syndrome construct is controversial in older adults in the general population, since literature shows that some components, such as obesity, can be protective against mortality. In older adults with mental illness, only one study explored the relation between metabolic syndrome and mortality and found no association.

Objectives

To examine whether metabolic syndrome or any of its components predicted mortality in a cohort of older adults with psychiatric disorders, and to determine if this association differs across diagnostic groups.

Methods

We used a multicentric prospective design to follow, over 5 years, a cohort that included 634 in– and outpatients with schizophrenia, bipolar or major depressive disorder (MDD). Metabolic syndrome was assessed at baseline following NCEP-ATPIII criteria. Cause of death was categorized as cardiovascular disorder (CVD) mortality, non-CVD disease-related mortality, suicide and accident.

Results

We found no significant association between metabolic syndrome or any of its components with all-cause, CVD and non-CVD mortality. However, an association with increased all-cause and disease-related mortality was found in the subpopulation of older adults with MDD, even after adjustment for age, sex and smoking status (p=0.032 and p=0.036, respectively). A significant interaction was found between metabolic syndrome and psychiatric diagnoses indicating that in participants with MDD, metabolic syndrome had a significantly greater effect on all-cause mortality (p=0.025) and on disease-related mortality (p=0.008) than in participants with either bipolar disorder or schizophrenia.

Conclusions

In older adults with psychiatric illness, our findings do not support an association between metabolic syndrome and increased mortality, in contrast with the literature findings on their younger counterparts. We discuss several possible explanations, including a survival bias, a lack of sensitivity of the used cut-offs and a ceiling effect of metabolic syndrome on mortality in this very high-risk population. The lack of a ceiling effect in the depressive subgroup, because of a less marked premature mortality, could explain the positive association, in contrast with bipolar disorder or schizophrenia subgroups.

Disclosure of Interest

None Declared
A qualitative study on perceived sexual intimacy and mental health in later life during the COVID-19 pandemic
Authors: von Humboldt S. , Low G. , Leal I.
Published: August 2023

Introduction

The COVID-19 pandemic may affect sexual intimacy and have implications for overall sexual well-being.

Objectives

This study comprised two main objectives: 1) To explore the influence of COVID-19 pandemic on older couples’ sexual intimacy; and 2) To assess how older couples’ sexual intimacy during the COVID-19 pandemic influences mental health.

Methods

The sample of this qualitative study consisted of 391 older participants (between 65 and 87 years of age).

Results

For the first objective, semi-structured interview data yielded five main themes: (1) Less sexual satisfaction (68%); (2) Less sexual desire (67%); (3) Stronger affective relationships (34%); (4) Fear of contracting physical illness (29%); and (5) Less attractiveness (23%). Three main themes concerning mental health were reported by participants: (1) Less anxiety and distress (78%); (2) Greater attention to negative emotional states (55%); and (3) Less emotional outbursts (41%).

Conclusions

The pandemic affected older adults’ sexual intimacy, mostly negatively. Less sexual satisfaction and desire were felt by these older couples. Conversely, stronger affective relationships were reported. In spite of these mostly negative influences, existing sexual intimacy was mostly linked to less perceived anxiety and distress, greater attention to negative emotional states, and less emotional outbursts. Sexual intimacy during COVID-19 has received little attention; however, these results highlight its positive contribution to mental health and therefore a relevant approach to this topic should be taken, especially in later life.

Disclosure of Interest

None Declared