bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychosocial differences in perceived older workers’ work (un)adaptability, effectiveness and workplace age discrimination
Authors: von Humboldt S. , Miguel I. , Valentim J. , Costa A. , Low G. , Leal I.
Published: August 2023

Introduction

The aging population in the developed world has implied increasing age diversity in the workforce of organizations. Consequently, mutual perceptions about one’s co-workers and age discrimination is becoming increasingly important.

Objectives

This study aims to explore how perceptions about older workers’ work (un)adaptability, work effectiveness and workplace age discrimination vary according to participants’ psychosocial factors, such as age group, gender, education level and work sector.

Methods

This study included a sample of 453 workers in Portugal, diverse in terms of age, gender, education level and work sector. Four different instruments were used: (a) a sociodemographic questionnaire; (b) an older workers’ Work Adaptability scale; (c) an older workers’ Work Effectiveness Scale and; (d) the Workplace Age Discrimination Scale (WADS).

Results

Middle-aged and older participants perceive older workers as more adaptable than younger participants. The oldest group of participants perceives older workers to be more work-effective and experience the highest levels of age discrimination in the workplace, when compared to the other age groups. Also, participants with lower levels of education tend to perceive higher levels of workplace age discrimination, when compared to participants with high school and higher education.

Conclusions

Generational perceptions in the workplace are perceived by workers differently, hence organizations should implement age management strategies to address age discrimination, particularly due to the increasing proportion of older workers.

Disclosure of Interest

None Declared
Cerebellar dysfunction and autism spectrum disorders – what do we know?
Authors: Pinheiro Ramos C. , Alves M. , Marta J. , Ribeiro R. , Gamito A.
Published: August 2023

Introduction

Autism spectrum disorders (ASD) are complex neurodevelopmental conditions characterized by impairments in social cognition and repetitive behaviors with onset in early infancy. Deficits in emotion recognition, social perception, and communication have been identified as core symptoms of ASD.

Comorbid disorders are frequent, namely psychiatric illness, epilepsy, sleep disruption, and hyperactivity.

Immune profile changes during early life may contribute to pathogenesis of ASD. Other risk factors include advanced parental age, fetal environment, fertility treatments, medications, and nutritional and toxic factors.

Several brain regions are involved in the pathophysiology of ASD but the cerebellum is the structure most consistently found altered. An increased risk of ASD is associated with cerebellar damage.

Objectives

To highlight the importance of understanding the key processes of cerebellar development and how altered cerebellar function leads to social and cognitive impairments, and consequently ASD.

Methods

Non-systematic review of the literature using Pubmed database. Papers were selected according to their relevance.

Results

From imaging studies, we can understand that cerebellum is not just about motor function. Different tasks like adding working memory, emotional and social processing, and language seem to be part of core functions of the cerebellar circuit.

Adults with lesions in the cerebellum can develop cerebellar cognitive affective syndrome (CCAS), with core symptoms of impaired executive function, difficulties in spatial cognition, blunted affect, or inappropriate behavior. Some children who have tumor resection surgery for medulloblastomas also exhibit symptoms of CCAS, and some experience posterior fossa syndrome (PFS).

The linguistic, cognitive, and behavioral deficits in CCAS and PFS may contribute to explaining how cerebellar alterations are related to ASD, which is a neurodevelopmental disorder characterized by an earlier onset and broader spectrum of these symptoms.

Conclusions

The literature has suggested an important role for cerebellar dysfunction in etiology of ASD, under certain premises: (a) cerebellar expansion temporarily coincides with onset of ASD; (b) cerebellum is prone to lesions during this period; (3) cerebellar lesions contribute to dysfunctional social and language abilities.

Disturbances in cerebellar development lead to alterations in higher cognitive functions, due to changes in Purkinje cells. These dysfunctional neurons, once integrated into a brain circuit that controls complex tasks, lead to these functions becoming aberrant.

It is therefore fair to say that cerebellum is important for development of the so-called “cognitive and social brain” since it is itself part of this network. So, the cerebellum certainly plays a relevant role in pathophysiology of ASD.

Disclosure of Interest

None Declared
Latent classes based on clinical symptoms of military recruits with mental health issues and their distinctive clinical responses to treatment over a 6-month duration
Authors: Jon D.-I. , Park E.-H. , Hong H. J. , Jung M. H. , Hong N.
Published: August 2023

Introduction

In South Korea, all men at the age of 18 or older are required to serve at military for a certain period as an obligation. These recruits should be able to withstand psychological stress and pressures of rapid adaptation of the unique and new environment in military.

Objectives

The current study attempted to identify distinct subgroups of patients referred for military service suitability and further to investigate whether there is a difference in clinical features such as treatment responsiveness and prognosis among those subgroups.

Methods

Subjects were male patients aged 18 to 28 years who visited the department of psychiatry at the University Hospital for evaluating mental health problems related to military service. We conducted a latent profile analysis (LPA) using 10 clinical scales of MMPI-2 as an indicator variable to investigate the subgroups of subjects. The clinical state of subjects was assessed with CGI-S and GAF scale for three time point (0, 3, and 6 month).

Results

The results showed that the best fitting model corresponded to a three-class model: each class was named ‘Class 1: mild maladjustment’, ‘Class 2: neurotic depression and anxiety’, and ‘Class 3: highly vulnerable and hypervigilant’ respectively. Subsequent analysis was also carried out to identify changes in clinical symptoms and functional level across treatment time of each subgroup identified in LPA. We demonstrated that the three subgroups displayed differential characteristics in treatment responsiveness and clinical course evaluated by CGI-S and GAF over a treatment period of 6 months. Three subgroups indicated significant differences in the number of medications prescribed as well. Class 3 had more antidepressants and anxiolytics on use than Class 1 and 2. Antipsychotic agents and a combination of three antidepressants were prescribed more frequently in Class 3 than in Class 1 and 2.

Conclusions

While Class 1 and 2 significantly improved over 6 months, Class 3 showed little or no improvement in our clinical parameters even with more medications. This study has a clinical significance that it has classified qualitatively different subgroups within the sample by conducting LPA with clinical profiles of MMPI-2 and provides a basis for comprehensively understanding their differentiated clinical features. This study suggests clinical implications for treatment plan and intervention of each subgroup classified based on MMPI-2 clinical profiles of military recruits who might show maladjustment to serve.

Disclosure of Interest

None Declared
Vocal music and brain plasticity_a literature review
Authors: Arshad H. , Muhammad G. , Khan A. R. , Arshad A.
Published: August 2023

Introduction

Vocal music has been a way for the expression of beautiful human emotions and gives a consolidated framework to words. Our review is centered on finding neuroplastic changes in exposure to music.

Objectives

Our main Objective is to identify structural brain changes in different brain areas. Identification of motor and sensory changes that are produced in response to vocal music.

Methods

Detailed literature review was conducted using Pubmed and Google Scholar databases. The literature search was narrowed down to cover the research topic with the search terms [plasticity] OR [brain] OR [neurons] OR [music] OR [vocal]. Our Inclusion criteria included studies with effects of vocal music on neuronal plasticity regardless of age, gender, duration of training, type of training, medium of lanuage and profession. Exclusion criteria included instrumental music and forms of music other than vocal music.

Results

Results showed that music impacts areas of the brain that are highly associated with human emotions. Any brain area can undergo neuroplasticity but is most commonly seen in the insular areas, paracortex, putamen, amygdala, and white matter. Music therapy promotes the formation of instant neural networks and the release of neurotransmitters like serotonin and dopamine. These microscopic changes increase depending on the duration of exposure to vocal music. Later, it appears as macroscopic changes visible with the help of neuroimaging. There is also a significant difference in the brain changes of vocalists and non vocalists. Vocal music impacts the left side of the cortex. Music activates reward system in the brain that leads to stimulation of dopaminergic pathways. It helps in neuronal division in post strock and post traumatic brain injury patients.

Conclusions

Music therapy is widely used as the rehabilitative process that combines music with therapeutic medications to promote therapeutic alliance and better results. It is used to direct focus toward the fulfillment of the emotional and cognitive needs of patients with psychiatric ailments. This area is needed to be explored more so that vocal music can be used for integrated therapy.

Keywords: Vocal music; Brain changes; neuroplasticity; therapy.

Disclosure of Interest

None Declared
Choroid plexus volume as a proxy of neuroinflammation in depression
Authors: Bravi B. , Melloni E. , Servidio L. , Agnoletto E. , Paolini M. , Poletti S. , Lorenzi C. , Colombo C. , Benedetti F.
Published: August 2023

Introduction

Choroid plexus (CP) is a physiological barrier, producing cerebrospinal fluid (CSF), neurotrophic, and inflammatory factors. It’s also involved in the neuro-immune axis, facilitating the interplay between central and peripheral inflammation, allowing trafficking of immune cells. Coherently, CP enlargement has been found in psychiatric diseases characterized by inflammatory signature. Although CP volume correlates with central microglia activation in major depressive disorder (MDD), it’s never been directly associated with peripheral markers in mood disorders.

Objectives

Examine CP volume in mood disorders and healthy controls (HC) in relation to clinical features and peripheral inflammatory markers.

Methods

CP volume was extracted with FreeSurfer in 72 HC and 152 age- and sex-matched depressed patients: 79 BD and 73 MDD. Plasma analytes in patients were collected through immunoassay technology (Bioplex). We tested for the effect of age by group on CP volume. Then we focused on the interaction between illness duration and diagnosis in predicting CP volume. After testing the effect of specific analytes by diagnosis, we calculated moderated moderation models (SPSS, PROCESS) setting each analyte as independent variable, CP volume as predicted variable and illness duration and diagnosis as moderators. We get the effects’ significance with the likelihood ratio statistic, always controlling for age, sex, and intracranial volume.

Results

Patients were comparable in illness duration and severity. CP volume is differentially distributed through groups (right: p=0.04; left: p<0.01), with higher volumes in the clinical groups. Age by group significantly predict right CP volume (p=0.01). Also, duration of illness differently predicts right CP volume in MDD and BD (p=0.03) (Figure1). Then, given the significant interaction effect of IL13 (p=0.02) and IL1ra (p=0.01) in predicting right CP, we run the moderated moderation model. Longer illness duration has an effect in strengthening the opposite predicting value of IL1ra (ΔR2=0.03, p<0.01) on right CP volume in MDD and BD (Figure2).

Image:

Image 2:

Conclusions

Our findings propose CP as a proxy of inflammation in depression, being significantly predicted by peripheral immune markers in MDD and BD. In particular, the signature of inflammation in depression, could represent the neurotoxic load of the disease over the illness, with a worse effect in BD, with possible disruption of brain barriers permeability and an opposite effect of tightening and central segregation in MDD. Further analyses are needed to better elucidate this neurobiological mechanisms across mood disorders.

Disclosure of Interest

None Declared
Effect of Neutrophil to Lymphocyte ratio on antidepressant treatment response: moderating effect of sex and mediating effect of Hippocampal volumes.
Authors: Paolini M. , Harrington Y. , Ernst J. , Zanardi R. , Poletti S. , Benedetti F.
Published: August 2023

Introduction

In recent years much focus has been put on the role of immune/inflammatory alterations in affecting Major Depression (MDD) development and antidepressant efficacy. Neutrophil-to-lymphocyte ratio (NLR) is an inexpensive inflammatory marker shown to be elevated in depressed patients, with large population studies reporting this effect only in women. However, its relation to treatment response is much less clear. Reduced hippocampal volumes (HV) are among the few consistent brain structural predictors of poor treatment response, and they have been shown to be influenced by inflammatory status.

Objectives

To investigate the effect of NLR on treatment response in MDD patients, testing a possible moderating role of sex. To investigate the effect of NLR on HV and test a possible mediating role of the latter in the relation between NLR and treatment response.

Methods

Our study was performed on a sample of 120 MDD inpatients suffering from a non psychotic depressive episode (F=78; M=42). Depression severity was assessed via the Hamilton Depression Rating Scale (HDRS), both at admission and discharge; as a measure of treatment response, delta HDRS was calculated subtracting the two scores. NLR was calculated for each subject. Patients underwent 3T MRI acquisition and bilateral HV were estimated.

Results

We found a significant moderating effect of sex on the relationship between NLR and Delta HDRS (p < 0.001): a negative relation was found in women (p < 0.001) and a positive one in men (p = 0.042). NLR was found to negatively affect left HV in the whole sample (p = 0.027) and in women (p = 0.038). A positive effect on Delta HDRS was found for both left (p = 0.038) and right (p = 0.027) HV. Finally, we found a significant indirect effect of NLR values on Delta HDRS through left HV in women (95% BCa CI [- 0.948, -0.017]); the direct effect of NLR on Delta HDRS also remained significant (p = 0.002).

Conclusions

Sex was found to moderate the relation between NLR and treatment response. The detrimental effect in women is in line with previous reports linking inflammation to hampered antidepressant effect; the positive one in men is more surprising: however, the only studies to date on the effect of NLR on antidepressant efficacy report a positive effect in patients with psychotic depression. In women we found NLR to affect treatment response partially through its effect on left HV, providing a possible, albeit incomplete, mechanistic explanation of the effect of inflammatory status on antidepressant efficacy.

Disclosure of Interest

None Declared
Association of α-klotho levels with serum copper and cadmium levels in schizophrenia
Authors: Yadav D. , Birdi A. , Nebhinani N. , Kumar K. , Tomo S.
Published: August 2023

Introduction

Schizophrenia is associated with harmful health effects such as oxidative stress from heavy metal exposure. We considered the relationship between genes and heavy metals in association with oxidative stress and then investigated the association between serum α- klotho and copper and cadmium exposure among schizophrenia patients in western India.

Objectives

To investigated the association between serum α- klotho and copper and cadmium exposure among schizophrenia patients in western India.

Methods

100 individuals participated out of which 50 were diagnosed with schizophrenia, severity was assessed by using PANSS score and 50 were taken as controls using General health questionnaire. Serum Klotho levels were estimated using ELISA. Serum Cadmium (Cd) and Serum Copper (Cu) was estimated using Atomic Absorption Spectrophotometry.

Results

The mean ± SD levels of Serum Cd, Serum Cu and serum Klotho were 1.05 ± 0.55 μg/dl, 135.5 ± 51.25 μg/ml and 62.9 ± 35.1 ng/ml respectively in the patients and 0.23 ± 0.17 μg/dl, 147.9 ± 25.42 μg/ml and 78.6 ± 34.6 ng/ml respectively in controls. The differences in Serum Cd, Serum Cu levels and Klotho levels among the study group were highly significant (p <0.05).

Conclusions

Both Cu and Cd levels were significantly raised in schizophrenic patients compared with controls. Serum klotho levels showed a statistically significant decreasing trend with increasing cadmium levels. These results suggest that cadmium levels may be associated with the serum klotho levels which may be associated with decreased cognition in schizophrenia.

Disclosure of Interest

None Declared
The association between exposome score for schizophrenia and metabolic parameters in individuals with schizophrenia and healthy controls: Findings from the EUGEI study
Authors: Erzin G. , Atbaşoğlu C. , Fusar-Poli L. , Saka M. C. , Üçok A. , Alptekin K. , Os J. V. , Gümüş Akay G. , Gülöksüz S.
Published: August 2023

Introduction

Exposome is all nongenetic exposures from the prenatal period to death. Exposome score for schizophrenia (ES-SCZ) is a cumulative measure of environmental liability for schizophrenia. Our previous studies showed that the ES-SCZ is associated with mental and physical health outcome.

Objectives

The aim of the study is to investigate the association of the ES-SCZ with metabolic parameters in individuals with schizophrenia and healthy controls.

Methods

This study obtained 124 individuals with schizophrenia and 440 healthy controls from the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions, Work Package 6 (Vulnerability and Severity) Turkey dataset. The ES-SCZ was calculated by summing log-odds weighted environmental exposures (childhood adversities, winter birth, hearing impairment and cannabis use). Linear regression analysis was used to investigate the association between ES-SCZ and metabolic parameters. After that analysis age and sex were added as covariates.

Results

There was an association between ES-SCZ and diastolic blood pressure (B = -2.69 [95% CI -4.74; -.65], P-value = 0.010) in schizophrenia. ES-SCZ was associated with the fasting glucose level (B = -6.23 [95% CI -11.59; -.87], P-value = 0.023); high density lipid level (B = 1.77 [95% CI .27; 3.27], P-value = 0.021) in control and these results remained significant after adjusting for age and sex.

Conclusions

ES-SCZ was associated with important metabolic parameters. These findings show that ES-SCZ is not only related to increasing the risk for psychosis development but may also influence comorbidities. This result is important since it may increase our knowledge of ES-SCZ and contribute to the importance and framework of its clinical implementation.

Disclosure of Interest

None Declared
Gender differences in the relationship between sleep and childhood traumas
Authors: Fusco R. , Kulkarni S.
Published: August 2023

Introduction

Sleep is one of the most important factors for well-being. Numerous studies have linked poor sleep to negative consequences such as depression (Guo et al., 2014), substance use (Comasco et al., 2010), obesity (Wu et al., 2015), and suicidality (Liu & Buysse, 2006). Understanding the causes of poor sleep is an important public health concern. Childhood trauma can have a lifelong influence on mental health and development. However, many examinations of childhood trauma focus on the number of experiences and not the impact of specific experiences. Research has shown gender differences in both insomnia and childhood maltreatment outcomes (Lee et al., 2014); however, less attention has been paid to the potential role of gender in the link between other types of childhood trauma and sleep disturbance.

Objectives

The goal of the current study is to understand the role of gender in the relationship between childhood traumas and sleep problems among a community sample of emerging adults. This research aims to build on and extend previous work in three different ways: 1) add to the literature on childhood trauma among emerging adults; 2) examine specific types of childhood traumas; and 3) expand the categories to explore the role of some less studied adversities.

Methods

The study included a sample of 211 young adults from an urban community. Traumas were measured with the Brief Trauma Questionnaire (BTQ; Schnurr et al., 1999) and sleep was measured with the Pittsburgh Sleep Quality Index (Buysse et al., 1989). Logistic regression was used to calculate odds ratios for the relationship between sleep problems and five traumas (involved in a serious accident, experienced serious injury, violent death of a close family member or friend, witnessed someone’s serious injury or death, and natural disaster).

Results

Results showed that males and females experienced similar rates of trauma. Trauma experienced during childhood was associated with an increased prevalence of poor sleep. In the male model, being involved in a serious accident (OR=1.47), experiencing serious injury (OR=1.24), and experiencing a natural disaster (OR=1.11) were all significantly associated with poor sleep. In the female model, the violent death of a close family member or friend (OR=2.02), witnessing someone’s serious injury or death (OR=1.78), and experiencing a natural disaster (OR=1.69) were all significantly associated with poor sleep.

Conclusions

Traumatic events may impact men and women differently. Women in the study showed greater sleep problems in the wake of childhood traumatic events. They also responded more strongly to events that they saw happening to other people, while men were more greatly affected by things that happened directly to them. Natural disasters are a relatively common event that has a strong impact on sleep. Intervention efforts addressing trauma and poor sleep should be aware of gender differences for greater efficacy.

Disclosure of Interest

None Declared
Cariprazine add-on for resistant bipolar depression: preliminary results from an italian real-world experience
Authors: Martiadis V. , Pessina E. , Martini A. , Raffone F. , De Berardis D.
Published: August 2023

Introduction

Depressive episodes represent the most frequent mood alteration in bipolar disorder (BD). Persistent depressive episodes and subsyndromic depressive symptoms often lead to poor quality of life and increase suicide risk. Recent studies have also shown that BD patients with a history of predominant depressive episodes generally show poorer response to pharmacological treatments. Although not specifically approved in Italy for use in bipolar depression, the scientific literature produced so far suggests the possible use of cariprazine in clinical conditions of bipolar depression that do not respond to conventional treatments.

Objectives

The aim of the study was to evaluate, in a real-world multicentric Italian clinical setting, the efficacy and safety of cariprazine augmentation strategy in a sample of patients suffering from treatment-resistant bipolar depression.

Methods

16 resistant bipolar depressed patients, whose resistance was defined according to The CINP Guidelines on the Definition and Evidence-Based Interventions for Treatment-Resistant Bipolar Disorder, were observed for 4 weeks after the add-on to previous mood stabilizing treatment of a cariprazine 1,5 mg fixed dose. Psychopathology at time 0 and at 1, 2, 3, and 4 weeks of treatment was evaluated using the Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale, the Young Mania Rating Scale and the Brief Psychiatric Rating Scale; safety and tolerability of the therapy was measured by the UKU Side Effect Rating Scale.

Results

Clinical improvement induced by 1,5 mg cariprazine add-on was effective and well tolerated in the study sample. Improvement in depression scores started from the first week, reaching about 35% reduction within 15 days and almost 50% in the following weeks (mean HDRS score from 24,7 to 13,2, GLM r.m. p<0,001); global psychopathology improved (mean BPRS score from 29,9 to 15,3 GLM r.m. p<0,001) as well as anxiety symptoms (mean HARS score from 26,5 to 16,5 GLM r.m. p=0,003). No manic shifts were observed during the observation period and the treatment was generally well tolerated.

Conclusions

Despite the small number of patients examined and the short term of observation, cariprazine could represent an effective and safe enhancement strategy for patients with bipolar depression resistant to common pharmacological treatments. Further studies on larger samples are needed to confirm these preliminary findings. In addition, a more prolonged observation would be appropriate to highlight whether the beneficial effect of cariprazine add-on persists over time.

Disclosure of Interest

None Declared
The impact of climate change and natural disasters on the development of post traumatic stress disorder in child and adolescent population
Authors: Ghosh Dastidar B.
Published: August 2023

Introduction

Major traumatic natural disasters have occurred worldwide. Post-traumatic stress disorder (PTSD) has been the most common psychiatric disorder discussed by the studies addressing the psychological sequelae of adolescents after traumatic natural disasters. In this study we have studied the impacts of natural disaster yash cyclone that took place in West Bengal on the development of PTSD; factors related to the development of PTSD; predisposing, precipitating, and perpetuating factors related to the development of PTSD.

Objectives

To assess the incidence and prevalence of ptsd amongst survivors of natural disaster yash cyclone in a rural hamlet of West Bengal.

Methods

In this study ,200 survivors from Yash cyclone who belonged to Child and Adolescent age group were randomly selected .PCL 5 Scale was used to collect data and assess the incidence and prevalence of PTSD , standardized Bengali versions of the questionnaire was used in our study.

Results

There is statistical correlation between post traumatic stress disorder and subjects exposed to climate change events such as cyclone Yash.

Initial research suggests that a PCL-5 cut-off score between 31-33 is indicative of probable PTSD across samples.

In our study the mean pcl 5 value from the data assessment is 70.67 with standard deviation of 4.61.

Further assessment by linear regression analyses shows that female subjects are more prone to post traumatic stress disorder and higher income groups are more susceptible to ptsd.

As shown by higher values as per the pcl 5 scale.

Conclusions

Our study clearly demonstrates the impact of climate change and natural disasters on the mental health status of people living in disaster prone areas especially the child and adolescent population. Our study group was child and adolescent population between 10 to 15 years.

The psychologist and volunteers had to collect data in disaster affected zone , yet they collected data which gave a clear cut findings and a very clear statement on climate change and mental health. The values are very high and consistent in most subjects across all twenty domains.

It is our opinion that Mental health support should be provided for all victims of climate change and natural disaster calamities such as cyclone and earthquake.

Disclosure of Interest

None Declared
Neuropsychiatric presentations of hypocortisolaemia - a literature review
Authors: Ravulapalli K. C. , Sud N.
Published: August 2023

Introduction

Patient populations in psychiatry can have low cortisol for many reasons such as adrenalitis, secondary adrenal insufficiency and poor compliance with glucocorticoid replacement therapies. A literature review in 2005 highlighted the prevalence of neuropsychiatric features in those with low cortisol. Unfortunately, this has received little to no attention in the wider literature and hypocortisolaemia is often overlooked as a cause of neuropsychiatric presentations in clinical practice.

Objectives

Review the literature to understand what psychiatric features hypocortisolaemic patients present with and any themes between cases.

Methods

A literature review on neuropsychiatric presentations of hypocortisolaemia was performed using PUBMED and Google Scholar. English language studies from 2005 to October 2022 were included and searched for using the following term: (Hypocortisolaemia* OR “Low-cortisol” OR Addisons OR Adrenal-crisis OR “Adrenal insufficiency”) AND (Psychiatric OR Hallucination OR Neuropsychiatric OR “Neuropsychiatric symptoms” OR Pyschosis*). Citations in relevant papers were also reviewed.

Results

7 case reports were identified, 5 male (71%) and 2 female (29%) with an average age of 42 (28-63). The cause was identified as Addisons’ disease in 4 patients (57%) and secondary adrenal insufficiency in 3 patients (43%). Hallucination or delusion was the most prevalent symptom with 86% of patients initially presenting with it, followed by depression (43%) and speech abnormality (14%). In all cases, basic blood sets (Full blood count, urea & electrolytes and liver function tests) were done in an initial assessment. 6 patients presented with hyponatraemia, and 4 of these patients had hyponatraemia as their only abnormality within their U&E profile. In one patient this delayed their diagnosis by several years. One patient developed psychosis again when being treated with glucocorticoid therapy. In 4 patients, adrenal pathology was not suspected and cortisol was not tested until initial differentials were investigated and ruled out.

Conclusions

Further case reports highlight psychosis being a key feature of hypocortisolaemia that presents initially with neuropsychiatric symptoms. Cortisol levels should be considered in initial investigations of psychosis if hyponatraemia is discovered even in the absence of hyperkalaemia to help aid an earlier diagnosis. A rebound psychosis may be seen once starting glucocorticoid therapy. Additionally, there should be consideration of neuropsychiatric monitoring in stable psychiatric patients undergoing cortisol treatment.

Disclosure of Interest

None Declared
Recurrence and profile of reconsultants: descriptive study of 162 patients
Authors: Brahim S. , BOUALI W. , Mohamed K. , Sabria K. , Rim B. S. , Samira Y. , Lazhar Z.
Published: August 2023

Introduction

Emergency psychiatric consultation requests present certain specificities both in the situations encountered and in their management, due to a close relationship between the consultant and his environment. They do not only correspond to psychiatric emergencies, in the strict sense of the term, but also to psychological emergencies with their possible social dimension. They require an adapted response that can be decisive for the future

Objectives

To determine the epidemiological and clinical characteristics of patients reconsultants in the emergency medical department.

Methods

This is a cross-sectional study, conducted over a period of 12 months, from 01 April 2020 to 31 March 2021, in the emergency medical department of Mahdia University Hospital.

Results

During the study period, 162 reconsultations for psychiatric emergencies were recorded. the age ranged from 18 to 61 years with an average of 35 years. The level of education was primary or secondary in 78.8% of cases. The majority of reconsultants had single marital status (70%). The absence of professional activity and social security coverage was found in 72.3 and 49% of cases respectively. The presence of family and personal psychiatric history was noted in 29.8% and 91.5% of reconsultants respectively. Heteroaggressiveness followed by instability were the most frequently encountered reasons for consultations with 23.4% and 12.8% of cases respectively. The presence of a triggering factor was found in 63.8% of cases where problems with the main support group followed by those related to the social environment and those related to access to health services were the most reported with 49.23 and 13% respectively. The syndromic psychiatric diagnoses were, in decreasing order of frequency, psychomotor excitement (23.4%), delusional syndrome (17%), dissociative syndrome (12.8%) and somatic conversion (12.8). For reconsultants, relational approach and/or injectable treatment were the most used therapeutic means immediatly (49%). Neuroleptics and benzodiazepines were prescribed in 38% and 13% of cases, respectively. The decision to hospitalize in a psychiatric department concerned 45% of reconsultants.

Conclusions

Referral decisions favored the organization of ambulatory follow-up, with a decrease in the rate of hospitalization. These results make it possible to identify the evolutionary trends of the population consulting in emergency

Disclosure of Interest

None Declared
Measuring the professional social capital of psychiatrists: adaptation and validation of the Resource Generator for Psychiatrists (RG-Psy)
Authors: Lagreula J. , Lorant V. , Dalleur O.
Published: August 2023

Introduction

Psychiatrists need access to professional resources to care for their patients. In mental health settings, clinical innovations such as a new therapeutic approach, clinical guidelines or new drugs can diffuse more or less, depending on the social capital of these clinicians. The Resource Generator developed by Snijders & Van Der Gaag (2004) measures access to resources within a social network for the general population. It may therefore not capture access to social capital in the professional field of psychiatry.

Objectives

We aimed to develop and validate the Resource Generator for Psychiatrists and to detect factors influencing the social capital of clinicians.

Methods

The development of the final 11-item questionnaire followed multiple steps. First, the items were selected and adapted by an expert in the sociology of mental health to match the sector of psychiatry. Content validity and detection of important issues or misunderstandings were ensured by cognitive interviews with a panel of 6 clinicians. Each item has a 6-point response scale, rated from 0 to 6. Answers were coded “0” when the respondent did not need a certain resource or it was not applicable to their situation, while answering the closest resource was coded “6”. The online self-completion questionnaire was administered through a link sent by email to all adult psychiatrists and psychiatric residents licensed to work in Belgium. Additional warm contacts were performed for psychiatrists working in ambulatory care. An exploratory factor analysis was conducted. Internal consistency was ensured with Pearson’s correlation, item-total correlation and Cronbach’s alpha. Test-retest reliability was also measured. Multivariable linear regression analysis assessed the association between psychiatrist demographics and the RG-Psy total score.

Results

The Resource Generator for Psychiatrists questionnaire completed by 152 psychiatrists showed a normal distribution with a mean of 32.5 (SD=12), good test-retest reliability (ICC=0.81), and good total Cronbach’s alpha (0.74). Exploratory factor analysis revealed two main subtypes in psychiatrists’ social capital: “attention and access to advice” and “practical assistance, knowledge and expertise”, with Cronbach’s alpha of 0.62 and 0.7 respectively. Clinicians attending institutional seminars (β=5.5221, p=0.013) and working in multidisciplinary settings such as hospitals (β=4.7448, p=0.023) or a mobile team (β=8.7475, p=0.014) were more likely to have higher social capital.

Conclusions

Psychiatrists’ access to professional resources can be reliably measured by a 11-item questionnaire and can be used to test the influence of their professional social capital on different outcomes.

Disclosure of Interest

None Declared
Disrupted structural brain networks across psychiatric disorders determined using multivariate graph analyses
Authors: Paunova R. K. , Stoyanov D. , Ramponi C. , Latypova A. , Kherif F.
Published: August 2023

Introduction

Identifying the specific brain pattern characterizing psychiatric disorders could lead us to precise diagnostic process, better treatment plan and outcome prediction. Structural covariance is a graph-analysis method with which disruptions in large scale brain network organization can be observed. More studies, employing this method in psychiatry, are still needed.

Objectives

The current study aims to investigate how the main psychiatric disorders – schizophrenia, major depressive disorder, bipolar disorder, affect brain circuitry by means of multivariate graph theory, more specifically – structural covariance. We hypothesized that specific abnormalities in the brain circuits would be found in separate diagnostic entities.

Methods

164 subjects were included with schizophrenia-SCH (n=17), bipolar disorder-BD(n=25), major depressive disorder–MDD(n=68) and a healthy control group-HC(n=54). Each participant provided a written informed consent and the study protocol was approved by the University’s Ethics Committee. High resolution structural MRI was acquired, and preprocessing was performed using SPM 12 toolbox. The structural covariance method was applied consisting of calculation of the correlation across subjects between the different pairs of regions by using the gray matter average volume. We used the threshold statistic to binarize the covariance matrix and transform it into an adjacency matrix. This allows us to compare psychiatric disorders at a network level by calculating measures such as authorities, hubs and outdegree.

Results

61 statistically significant regions were found for the whole sample. The matrices of the four groups were compared according to their ‘authorities’ ,‘hubs’ and ‘outdegree’ as first, second and third ranking variables, respectively. In the group comparison between HC and BD patients the top five significant regions were Planum temporale (PT), Putamen, Precuneus (PreCu), Calcarine cortex (Calc_cor) and Postcentral gyrus medial segment (PostCGms). The MDD group demonstrated the following regions with most significant difference including Precentral gyrus (PreCG), Entorhinal area (EntA), Amygdala (Amy), Anterior cingulate gyrus (ACC), Anterior insula (AI). While SCH grop was charachterized by ACC, PreCG – medial segment, PostCGms, anterior orbital gyrus, and frontal pole.

Conclusions

The results of our study demonstrated that schizophrenia and mood disorders have specific disturbances in brain network structural organization, affecting hubs of default mode network, salience network, motor, sensory and visual cortex, as well as limbic system. These alterations might elucidate the pathophysiological mechanisms of common symptoms of the disorders under investigation including perceptual, affective and cognitive disturbances.

Disclosure of Interest

None Declared
Modulatory effects of Nigella sativa l. oil on the hippocampus of dizocilpine-induced schizophrenia in BALB/c MICE
Authors: Folarin R. O. , Owoeye O. , Malomo A.
Published: August 2023

Introduction

Schizophrenia is a neuropsychiatric disorder characterised by positive, negative and cognitive behavioral symptoms. Despite years of research, the need for suitable therapy remains elusive. Nigella sativa oil (NSO) is a medicinal plant notable for its dietary, neuroprotective and anti-inflammatory properties. However, there is paucity of information on its neuroprotective potentials in schizophrenia.

Objectives

This study was designed to investigate the modulatory effects of NSO on the hippocampus of dizocilpine-induced schizophrenia in mice.

Methods

Sixty 14-weeks old male BALB/c mice (23-25g) were divided into five groups (n=12); control (normal saline, 1 mL/kg), NSO (1 mL/kg), dizocilpine-control (0.5 mg/kg) all for 7 days, while NSO (1 mL/kg for 7 days) + dizocilpine (0.5 mg/kg, for another 7 days) for preventive measure, and dizocilpine (0.5 mg/kg for 7 days) + NSO (1 mL/kg for another 7 days) for reversal. Dizocilpine and NSO were administered intraperitoneally and orally, respectively. Open field box was used for stereotypic popping. Animals were euthanised after behavioral studies, and harvested brains were weighed. Hippocampal glutamate was determined spectrophotometrically. Neuronal arrangement, sizes and densities were determined in perfused brain tissues using haematoxylin and eosin stain. Dendritic arborisations were assessed using Golgi stain. Metabotropic glutamate receptor-II (mGluR-2) and Glia Fibrilliary Acidic Protein (GFAP) were evaluated immunohistochemically. Data were analysed using descriptive statistics and ANOVA at α0.05.

Results

Stereotypic popping was observed in dizocilpine-control but not in the preventive and reversal NSO-treated animals. The NSO increased glutamate levels in the reversal (0.19±0.00 μM/μg tissue) but not in the preventive (0.18±0.00 μM/μg tissue) groups relative to dizocilpine-control (0.18±0.00 μM/μg tissue). Hippocampal neuronal density was significantly increased by dizocilpine (21.25±1.11neurons/100μm2) but modulated by NSO in the preventive (17.25±0.51 neurons/100μm2) and reversal groups (12.00±0.71 neurons/100μm2). Significant neuronal de-arborisation that occurred in the dizocilpine-control (989.90±253.9 μm2/2.5mm2area) was inhibited by NSO in the preventive (1678±370.90 μm2/2.5mm2area) and reversal (1639±314.80 μm2/2.5mm2area) treatments. Compared to dizocilpine-control (4219±127.3 ODU), NSO increased mGluR-2 expression in the preventive (4945±17.00 ODU) and reversal (4116±24.97 ODU) groups. The GFAP expression in NSO-treated animals relative to dizocilpine-control (5510±38.45 ODU) was significantly reduced in the preventive (4945±17.00 ODU) and reversal (4116±24.97 ODU) measures.

Conclusions

Nigella sativa oil mitigated schizophrenic symptoms induced by dizocilpine in mice via modulation of hippocampal glutamate, metabotropic glutamate receptor–II upregulation, astrogliosis inhibition and neuroprotective mechanisms.

Disclosure of Interest

None Declared
Assessment of Fatigue and Quality of Life in Multiple Sclerosis Patients: A Cross-Sectional Study
Authors: Chemingui S. , Mersni M. , Youssef I. , Yousfi I. , Ernez S. , Mechergui N. , Brahim D. , Bahri G. , Ben Said H. , Ladhari N.
Published: August 2023

Introduction

Multiple sclerosis (MS) is a chronic inflammatory disorder of the central nervous system that is associated with a range of devastating symptoms including fatigue. In addition, the accumulation of disability that occurs in most MS patients can have a detrimental effect on their quality of life.

Objectives

To assess fatigue and quality of life in patients with MS.

Methods

Descriptive cross-sectional study that interested MS patients referred to the occupational pathology consultation of Charles Nicolle Hospital, during the period from 1 July 2020 to 30 September 2022. The data collected concerned socio-demographic and occupational characteristics. The impact of MS on quality of life was studied using the SF-12 quality of life scale. Fatigue was assessed by the Fatigue Severity Scale (FSS).

Results

Twenty-six cases of MS were identified. The mean age was 38 ± 9 years with a sex ratio (M/F) of 0.3. The average occupational seniority was 11 ± 8 years. The health sector was the most represented (23%, n= 6) followed by the transport sector (19%, n= 5). The main occupations were manual workers (31%), drivers, and administrative agents (19% each). The occupational constraints were physical in 44% of cases and psychological in 24% of cases. Fourteen patients (87% of the cases) lost their jobs because of the disease. The decision on occupational fitness was definitive incapacity in 44% of cases. The mean FSS score was 4±1.74. Sixteen patients (62%) had moderate fatigue (FSS 36-52), eight patients (31%) had mild fatigue (FSS <36) and two patients (8%) had severe fatigue (FSS >52). In addition, the mean scores for the physical and mental components of perceived health were estimated to be 37.04±7.67 and 44.93±7.23, respectively. The mean global score (SG) of SF12 was 40.98±7.23. The majority of patients (92%, n=24) had an average quality of life (SG- SF12 between 30 and 60) and two patients (8%) had a poor quality of life (SG <30).

Conclusions

The impact of MS on the socio-professional quality of life of patients was noted in the majority of cases. It is therefore imperative to improve the care of our patients on both the physical and psychological levels.

Disclosure of Interest

None Declared
Online Multifamily Systemic Therapy after First Psychotic Episode
Authors: Selakovic M. M. , Pomini V. , Zartaloudi A. , Galanis D.
Published: August 2023

Introduction

In Greece, the Athens Multifamily Group Therapy Project (A- MFGT) provides systemic multifamily therapy to young adults after the first psychotic episode, with a purpose to deliver an early intervention program.

Objectives

Few evidence is available regarding the viability of multifamily systemic therapy in an online setting in purpose of widely developing in e-mental health care (Borcsa et al., 2021). The members of ten families who participated at two online multifamily systemic groups for young adults after the onset of psychosis provided their opinions regarding their experience of 10-month therapeutic program through online platform, with two - hour sessions every 15 days.

Methods

The members of the group described in an online form what they found helpful and/or unhelpful/harmful at three separate times: in the middle of the therapy process, at the end of therapy and at 6 months follow up period. The data collected was analyzed with an inductive, “data – driven”, form of coding based on the methodology of thematic analysis (Braun & Clarke, 2006). Themes represent the prevalence of what the participants found important in relation to the perceived effectiveness of online A-
MFGT.

Results

The members highlighted the impact of the online group process on family communication, reflected on advantages and difficulties offered by the online setting, described their emotions and the effect of diagnosis and hospitalization at individual and family level, valued the problem solving and empathy techniques in the group and identified the obstacles they encountered in the group sessions.

Conclusions

Psychosis can affect all aspects of a person’s life, and without support and appropriate care, it can place considerable weight on the patient’s relatives, as well as the community in general. Our suggestion is that MFGT can be a viable way to support the whole system facing psychosis, with the aim of preventing relapse and implementing quality of life of all the participants.

Disclosure of Interest

None Declared