bluuebunny/crossref_metadata_2025 huggingface dataset:
Thyroid disorders in psychiatric patients: a descriptive study in a psychiatric hospital
Authors: López U. , Morado San Segundo L. , González Navarro C. , Alonso Salas I. , López Fariña A. , Bilbao Idarraga A. , Samsó Martínez B. , López Brokate R. F. , Garnica de Cos E. M. , Ruiz de Azua Aspizua T. , Ortega Pozas U.
Published: August 2023

Introduction

Thyroid disorders can present with psychiatric symptons similar to depression, and, at the same time, certain treatments, like litio, can cause changes in thyroid function. Given, therefore, the importance for the treatment and care of patients, the study of thyroid function is one of the parametres that should be requested in patients with psychiatric pathology.

Objectives

To study the frequency of thyroid disorders in patients who where admitted to a psychiatric short stay unit.

Methods

Retrospective descriptive observational study is carried out in the acute stay unit of a psychiatric hospital. As a sample, all patients admitted to the unit over a period of three months. During admission, their sociodemographic data, the treatment they receive and their diagnosis are recorded. Secondly, blood test are performed whith differents parameters, including TSH values.

Results

In the total sample of 172 patients, 8 of them have TSH abnormalities. 7 of them, all women, present hypothyroidism values.

A single male patient presented values of hyperthryroidism.

Conclusions

According to the present study, 4,6% of the patients present alterations at the TSH at admission, although except in one case, the values were not markedly altered.

The thyroid study at admission allows detecting cases of altered TSH that are amenable to treatment and monitoring.

Disclosure of Interest

None Declared
Posttraumatic orientation to bodily signals: The engraving of trauma in bodily perceptions
Authors: Tsur N. , Solomon Z.
Published: August 2023

Introduction

Theoretical perspectives emphasize that trauma and complex/posttraumatic stress disorder (C/PTSD) may interrupt with the perception of normal day-to-day bodily sensations, such as hunger, temperature and pain. Yet, a coherent conceptual synthesis of such processes is still lacking.

Objectives

This presentation portrayes two studies that provide empirical grounding for the conceptualization of ‘Posttraumatic Orientation to Bodily Signals’ (posttraumatic-OBS); an umbrella term reflecting the tendency to interpret bodily signals as catastrophic and frightful following trauma.

Methods

Two studies assessing exposure to trauma, C/PTSD, and OBD (Pain catastrophizing scale, PCS; body vigilance scale, BVS; Anxiety sensitivity index-physical), were conducted to test the hypothesized association between exposure to trauma and posttraumatic-OBD, as explained by C/PTSD.

Results

Study 1 included 59 ex-prisoners of war and 44 controls along three time-points, revealing that exposure to trauma was associated with a more catastrophic OBS (t = 2.73, p = .008; Cohen’s d = .57), which was mediated by longitudinal hyperarousal PTSD symptoms (indirect effect = .04 [.009, .11]). Additionally, a long-term chronic trajectory of PTSD was implicated in a more catastrophic OBS (F (2102)=6.91, p = .046).

Study 2 included 194 dyads of mothers and their young adult daughter. Dyadic path analyses demonstrated that OBD was associated with exposure to trauma, through the mediation of CPTSD among mothers (indirect effects between 0.13–0.28; p > 0.021) and daughters (indirect effects between 0.21–0.11; p > 0.032). Mothers’ OBD was associated with daughters’ OBD (effects between 0.19-0.27; p < 0.016). Daughters’ OBD was serially associated with mothers’ trauma exposure through mothers’ CPTSD and mothers’ OBD, (indirect effect = 0.064; p = 0.023). The findings demonstrate that trauma is often implicated in posttraumatic-OBD, which is mediated by C/PTSD, and that these processes may be intergenerationally transmitted.

Conclusions

The findings lay the foundation for the conceptualization of posttraumatic-OBD. The implications of the unified encapsulation of posttraumatic-OBD as an umbrella term reflecting subjective perception of bodily sensations for future research and practice will be presented.

Disclosure of Interest

None Declared
Validation of a theoretically based mental health literacy framework: A meta-analytic structural equation modeling approach
Authors: Lien Y.-J. , Chen L.
Published: August 2023

Introduction

Mental Health Literacy (MHL) includes four distinct but interrelated components: maintenance of positive mental health (MH), recognition of mental disorders (R), mental illness stigma attitudes (S), and help-seeking efficacy (E). A fifth component, help-seeking attitude (A) was included in a MHL model because it is a strong predictor of help-seeking behaviors. The five-factor model of MHL has been validated previously. In the study of multiple mediation model of MHL, it demonstrated the mediation role of help-seeking efficacy between recognition of mental disorders and help-seeking attitude (R-E-A path), but the roles of mental illness stigma attitudes or maintenance of positive mental health remain unknown.

Objectives

The present study aimed to examine the theory-based multifaceted MHL model by utilizing a meta-analytic structural equation modeling analyses (MASEM) method.

Methods

Systematic search of articles from electronic databases, including APA PsycArticles, ERIC, MEDLINE, Psychology and Behavioral Sciences Collection, Pubmed, and Airiti Library (Chinese), from inception up to July 31, 2022, was conducted by raters independently assessed study eligibility, and extracted 127 empirical, quantitative, non-interventional studies with properly reported effect sizes (k=192). MASEM analyses were conducted via a two-stage approach. First, a pooled correlation matrix was obtained for each mediation model by applying a multivariate random-effects model using Comprehensive Meta-Analysis Version 3.3. Second, a structural equation model was fitted on the pooled correlation matrices to test for mediation effects (i.e., indirect effects) using IBM SPSS Amos.

Results

In the single-mediator model analysis, there was a significant partial mediation effect of help-seeking efficacy and Mental illness stigma attitudes on the relationship between recognition of mental disorders and help-seeking attitude (R-E-A path & R-S-A path, p <.05). The multiple-mediator model has showed adequate fit (RMSEA = 0.09, SRMR = 0.04, CFI = 0.93, GFI = .99). It confirmed the help-seeking efficacy served as a mediator. A sequential mediation of maintenance of positive mental health and mental illness stigma attitudes was found (p <.05) between recognition of mental disorders and help-seeking attitude (R-MH-S-A path).

Conclusions

There is a robust mediation effect of Help-seeking efficacy on the relationship between recognition of mental disorders and help-seeking attitude either in the single mediation model or the multiple mediation model. Furthermore, increased recognition of mental disorder was related to increased maintenance of positive mental health, therefore decreased mental illness stigma attitude, and eventually increased help-seeking attitude. Future research directions regarding pathways in the MHL models were discussed.

Disclosure of Interest

None Declared
AGESMind clinical trial: SocialMIND® results at 16 weeks
Authors: Vidal-Villegas M. P. , Abad Pérez A. , Herrero Ortega P. , Oliva Lozano A. , Garde González J. , Andreo-Jover J. , Muñoz-Sanjosé A. , Mediavilla R. , Rodríguez-Vega B. , Lahera G. , Palao-Tarrero Á. , Bayón-Pérez C. , Bravo-Ortiz M. F.
Published: August 2023

Introduction

Early intervention on a first psychotic episode is fundamental for a more favorable prognosis, and it usually combines pharmacological treatment, which mainly affects positive psychotic symptoms, with interventions that can improve the rest of the symptoms and associated problems such as deterioration in social functioning (Harvey & Penn, 2010; Fusar-Poli, McGorry & Kane, 2017). While Mindfulness is gaining more and more prominence in the field of psychotherapy (Chan et al., 2019; Cillesen et al., 2019), social cognition and social functioning are being researched as key targets on which to intervene after a first psychotic episode (Green, Horan & Lee, 2015).

SocialMIND® is a mindfulness-based social cognition training tailor-made to improve social functioning in people who have suffered a first psychotic episode within the last five years. It is currently being compared with a group Psychoeducational Multicomponent Intervention (PMI) in a Randomized Controlled Trial (RCT) (Mediavilla et al., 2019). Both group psychotherapies include 17 sessions delivered over a 9 month period: 8 weekly sessions, 4 biweekly sessions and 5 monthly sessions.

The results of SocialMIND® at 8 weeks showed improvements in social cognition and social functioning, specifically on affective social cognition and self-care (Mediavilla et al., 2021).

Objectives

To evaluate the efficacy of SocialMIND® in improving social functioning, measured by the Personal and Social Functioning (PSP) scale 16 weeks after starting the intervention, in people who have suffered a first psychotic episode in the last 5 years.

Methods

Randomized, controlled pilot trial (use of a psychoeducational multicomponent intervention or PMI as active comparator) of two parallel groups (SocialMIND® and PMI) with a 1:1 ratio using a blind evaluator.

Results

No statistically significant differences were found in the social functioning variable between the two treatment arms. Intragroup differences are observed in other secondary variables studied (social cognition) 16 weeks after starting the interventions.

Conclusions

SocialMIND® has not been shown to be more effective than a PMI in improving social functioning at 16 weeks after starting the intervention in people who have suffered a first psychotic episode in the five years prior to being included in the study.

Disclosure of Interest

None Declared
Posttraumatic growth in psychosis: Symptoms, meaning, and coping
Authors: Mazor Y. , Gelkopf M. , Roe D.
Published: August 2023

Introduction

Research suggested that psychosis and mental illness-related experiences can be extremely traumatic, and that psychosis could theoretically also lead to posttraumatic growth (Mazor et al., 2019; PTG). The promotion of PTG may contribute to the treatment of people who experienced massive traumas such as people with severe mental illness (SMI). Psychotic symptoms are a common feature of SMI, and individuals who have experienced psychosis are also more likely to have been exposed to trauma and are more vulnerable to developing posttraumatic symptomatology (Ng et al., 2021). Negative symptoms such as amotivation could also contribute to the traumatic experiencing of psychosis (Mazor et al., 2016). Amotivation is specifically relevant to the possible traumatic sequelae of psychosis (Mueser et al., 2010). Alongside the adverse consequences of psychopathological symptoms is the unique outcome of coping with adversity (Tedeschi & Calhoun, 1995)- PTG. Two important factors that contribute to PTG is coping self-efficacy (CSE), and meaning making (Mazor et al., 2018). We investigated the possibility of PTG in individuals with SMI, through the mediating effect of CSE and meaning making.

Objectives

Recent research has shown high rates of exposure to trauma among people with SMI, and that psychosis and mental illness-related experiences can be extremely traumatic. While some develop PTSD, it has been noted that some may also experience PTG. However, few studies have examined PTG in this population.

Methods

121 participants were recruited from community mental health centers and administered trauma and psychiatric questionnaires. Study protocol was approved by the University of Haifa ethics board.

Results

High levels of traumatic exposure were found in the sample. Furthermore, we found that people who endured psychosis can experience PTG, which was mediated by meaning making (MLQ) and CSE. Psychotic symptoms were found to be a major obstacle for PTG, whereas negative symptoms were found to have the potential to lead to PTG when mediated by meaning making and CSE.

Mediation analyses for the dimensions of PANSS, MLQ total, CSE total, and PTGI total (N=121)Dependent Variable (DV)Independent variable (IV)MediatorIV to mediator
B (SE)Mediator to DV
B (SE)Mediation effect
B (SE)Z
PTGI totalPANSS
Positive symptoms totalMLQ total-0.46
(0.26)0.99***
(0.10)-0.46
(0.27)1.71CSE total-2.08
(0.89)0.28***
(0.03)-0.58
(0.28)PANSS
Negative symptoms totalMLQ total-0.64***
(.17)0.93***
(0.11)-0.60
(0.17)3.62***-2.06***
(0.58)0.26***
(0.03)-0.53
(0.17)3.13**PANSS
General psychopathology totalMLQ total-0.64***
(.12)0.96***
(0.11)-0.61
(0.13)4.77***-2.32***
(0.43)0.27***
(0.03)-0.62
(0.15)4.08***

Note.

**

p<.01

***

p<.001

Conclusions

The portrayed research provided preliminary evidence for the potential role of meaning making and CSE as mediators of PTG in the clinical, highly traumatized population of people with SMI who have experienced psychosis.

Disclosure of Interest

None Declared
Interactions between dopamine transporter and N-methyl-D-aspartate receptor-related amino acids on cognitive impairments in schizophrenia
Authors: Chou Y.-H.
Published: August 2023

Introduction

Cognitive impairments, the main determinants of functional outcomes in schizophrenia, had limited treatment responses and need a better understanding of the mechanisms. Dysfunctions of the dopamine system and N-methyl-D-aspartate receptor (NMDAR), the primary pathophysiologies of schizophrenia, may impair cognition.

Objectives

This study explored the effects and interactions of striatal dopamine transporter (DAT) and plasma NMDAR-related amino acids on cognitive impairments in schizophrenia.

Methods

We recruited 36 schizophrenia patients and 36 age- and sex-matched healthy controls (HC). All participants underwent cognitive assessments of attention, memory, and executive function. Single-photon emission computed tomography with 99mTc-TRODAT and ultra-performance liquid chromatography were applied to determine DAT availability and plasma concentrations of eight amino acids, respectively.

Results

Compared with HC, schizophrenia patients had lower cognitive performance, higher methionine concentrations, decreased concentrations of glutamic acid, cysteine, aspartic acid, arginine, the ratio of glutamic acid to gamma-aminobutyric acid (Glu/GABA), and DAT availability in the left caudate nucleus (CN) and putamen. Regarding memory scores, Glu/GABA and the DAT availability in left CN and putamen exhibited positive relationships, while methionine concentrations showed negative associations in all participants. The DAT availability in left CN mediated the methionine-memory relationship. An exploratory backward stepwise regression analysis for the four biological markers associated with memory indicated that DAT availability in left CN and Glu/GABA remained in the final model.

Conclusions

This study demonstrated the interactions of striatal DAT and NMDAR-related amino acids on cognitive impairments in schizophrenia. Future studies to comprehensively evaluate their complex interactions and treatment implications are warranted.

Disclosure of Interest

None Declared
Prescription of cannabinoids in psychiatry: (how) do we cross that door?
Authors: Batalla A.
Published: August 2023

Cannabis policy liberalization has increased the availability of cannabis products for medical and recreational purposes, following a growing public demand. The large number of cannabinoid users reporting self-medication for several mental health-related problems and the limited medical indications for cannabis prescription have led to prescription dilemmas and confronted views between patients and clinicians. This discrepancy in perspectives grows together with a huge terminological confusion regarding medical cannabis, as some subjects use recreational products for medical purposes. In this session we will outline the current controversies of cannabis prescription in psychiatry and discuss how to deal with (il)legitimate patient needs and prescription barriers. Finally, we will discuss research approaches that could shed light on this controversial topic.

Disclosure of Interest

None Declared
Treating Trauma- Evaluation of a multi-disciplinary psychiatry service for patients post major trauma
Authors: Crudden G. , Corrigan K. , Smith C. , Richards Á. , Doherty A. M. , Clarke A. M.
Published: August 2023

Introduction

Research has shown 30-40 % of people who have experienced traumatic injury are at risk of developing mental illness. Some injuries may be the result of mental ill-health, including self-inflicted injury. Furthermore, the development of psychopathology after injury appears to be a major determinant of long term disability. Early intervention can reduce symptom severity and prevent development of mental illness.

Ireland’s National Trauma System Implementation Programme, announced in April 2021, highlights the need for screening for mental disorders.

The Mater Misericordiae University Hospital (MMUH) is designated as one of two national Major Trauma Centres in Ireland. Its trauma service will expand with an expectation of an additional 450- 500 major trauma patients over the next three years.

The Consultation Liaison Psychiatry Service (CLP) currently provides expert mental health input to medical and surgical teams, in managing a range of patients with mental illnesses or psychological difficulties, including those with experience of major trauma.

Objectives

To examine the current mental health service provision for trauma patients over a six-month period. We aimed to identify areas of need to inform future development of a psychiatry-led MDT service for trauma patients.

Methods

A review of all patients admitted on the MMUH trauma pathway between January 2021 and June 2021 was performed. The following data were recorded: demographics, mechanism of injury and information on referrals to the liaison psychiatry service.

Results

There were 105 trauma cases over the six-month period; 46 females and 59 males. The mean age was 58.4 years (SD 22.16). Twelve individuals were recorded as ‘No Fixed Abode’ or living in homeless accommodation(11.4%).

In terms of mechanism of injury; 20 were assaulted of which 8 were stabbing/ knife injuries. There were 65 falls and 12 road traffic accidents. In 3 cases (2.8%), the mechanism of injury was self-inflicted. Twenty patients were admitted to critical care (19%).

Of the 105 trauma patients, 19 (18%) were referred to CLP service; 2 (10.5%) were seen in the outpatient setting, the rest as inpatients (89.5%). At least one repeat review was indicated in 10 of the 19 patients (52.6%).

Conclusions

Trauma patients have a high rate of comorbid mental illness. Nearly 1/5 are currently referred to the CLP service, which is likely an underestimation of the actual burden of mental health disorders and could be explained by the lack of dedicated services. The liaison psychiatry team provides valuable input into the multidisciplinary care of trauma patients and the demand for its services is likely to increase with the expansion under the Major Trauma Strategy for Ireland.

Disclosure of Interest

None Declared
Anorexia Nervosa and Autism Spectrum Disorder: what links them?
Authors: Santos C. M. , Quintão A. , Jeremias D. , Fraga M.
Published: August 2023

Introduction

According to the literature, about 35% of patients with Anorexia Nervosa (AN) also have a diagnosis of Autism Spectrum Disorder (ASD), and this comorbidity occurs more frequently in males.

Objectives

With this work, the authors intend to address the characteristics present in this comorbidity and what is the impact of this comorbidity in the diagnosis, approach and prognosis of AN.

Methods

Non-systematic research of the literature through the PubMed database with the terms “autism spectrum disorder” and “anorexia nervosa”. Only surveys conducted in the last 10 years were considered for inclusion.

Results

Although AN and ASD may seem to be quite distinct conditions, the studies found suggest the existence of four characteristics that overlap the two diagnoses: deficits in theory of mind, inability to switch between courses of action fluently, inability to see the whole pictures to the detriment of detail and alexithymia. Studies also point to greater resistance to treatment in AN when an ASD is present in comorbidity.

Conclusions

Scientific evidence suggests that autistic characteristics in people with AN are not a consequence of being underweight, but rather stable characteristics present before and after the onset of AN. The studies thus conclude that comorbidity between the two disorders exists and is frequent enough to warrant greater attention to the diagnosis of ASD in people with AN. However, there are still no specific guidelines for the treatment of AN in people with ASD, which leads to a worse response to treatment, evolution and prognosis of AN in people with ASD.

Disclosure of Interest

None Declared
I-TREAT: Internet-based Cognitive Behavioral Treatment for Other Specified Feeding or Eating Disorders (OSFED) in Danish Adolescents and Adults – Study Protocol for a Randomized Controlled Trial
Authors: Runge E. , Lichtenstein M. B.
Published: August 2023

Introduction

Eating disorders severely impair psychosocial functioning, physical health, and quality of life. In particular, Anorexia Nervosa has the highest mortality rate among all psychiatric diseases. Other Specified Feeding or Eating Disorders have the highest lifetime prevalence with weighted means of 7.64% for women. Eating disorders are considered hard-to-treat, and studies have indicated that people suffering from eating disorders prefer low-threshold interventions compared to traditional mental health care. International studies show promising results of internet-based interventions for Other Specified Feeding or Eating Disorders.

Objectives

To test the effectiveness of an internet-based psychologist-guided cognitive behavioral treatment program (I-TREAT) to reduce eating disorder symptoms in Danish adolescents and adults with Other Specified Feeding or Eating Disorders.

Methods

This study is a randomized controlled trial with two arms: 1) an intervention group and 2) an active control group. Participants are adolescents from the age of 15 or above, as well as adults, diagnosed with Other Specified Feeding or Eating Disorders. The intervention group receives the I-TREAT program while the control group receives self-guided mindfulness exercises. I-TREAT comprises 12 text-based treatment sessions with psychoeducation and treatment-related tasks, based on cognitive behavioral therapy and elements of compassion-focused therapy. The treatment duration is approximately 12 to 36 weeks. Videos, pictures, and animations support the treatment content and the program is accessible by web-browser and app. A specialist in eating disorders guides the patient through treatment with task-related feedback and asynchronous written communication. Patients will answer questionnaires regarding eating disorder symptoms, quality of life, and motivational states before, during, and after treatment, with follow-up measures at 3, 6, and 12 months. We expect to include 63 patients to each group and commence recruitment in August 2023. Preliminary results from a feasibility study on I-TREAT show good evaluations from clinicians and patients (N=30).

Results

No results have yet been obtained. The results will be submitted to international scientific journals and presented at conferences.

Conclusions

The internet-based cognitive behavioral treatment program I-TREAT may be a promising tool for effectively treating adolescents and adults with Other Specified Feeding or Eating Disorders in Denmark.

Disclosure of Interest

None Declared
Cannabis use in Tunisian high school adolescents: MedSPAD 2021
Authors: Mallekh R. , Rejaibi S. , Silini A. , Zid M. , Ben Slema I. , Zoghlami N. , Ben Youssef S. , Zribi M. , Ben Salah N. , Aounallah-Skhiri H.
Published: August 2023

Introduction

Cannabis use is wrongly deemed “safe” by teenagers worldwide, despite its increased tetrahydrocannabinoids content and its psychosocial and cognitive harmful effectts.

Objectives

We aimed to estimate the prevalence of cannabis use, identify associated factors among Tunisian adolescents and assess the risk of problem cannabis use among users.

Methods

The 2021-Mediterranean School Survey Project on Alcohol and Other Drugs (MedSPAD) is a national survey, targeting Tunisian high school adolescents aged 16 to 18 years.

Based on a self-administered questionnaire, adolescents were asked about their engagement in several risky behaviours including cannabis use. The 6-item Cannabis Abuse Screening Test (CAST) was intended for users to assess the risk of problem cannabis use.

Binary logistic regression was performed to identify factors associated to cannabis use and Adjusted Odds Ratios (AORs) were presented with correspondent 95% confidence intervals (CI). Cspro and STATA software were used for data entry and analysis respectively.

Results

Among 6201 participants (girls: 60.4%), lifetime prevalence of cannabis use was 7.9% ,95% CI [7.0, 8.9] significantly higher among boys (16.1 % Vs. 2.5 % in girls, p<10-4). Early onset (at 13 or younger) was reported by 8.6% of users.

Multivariate analysis showed that cannabis use was more prevalent in Tunis district(p=0.04), and significantly associated to alcohol, tobacco and electronic-cigarettes use (AOR of 6.2, 4.2 and 2.6 respectively, p<10-3). Absenteeism for non-medical reasons and nights spent away from home were also independent factors significantly associated with cannabis use (p<10-3).

The CAST indicated a high risk of cannabis-use-related problems in 67.2% of respondents (n=223).

Conclusions

Cannabis use is increasingly common in Tunisian adolescents. Moreover, the alarming risk of problem cannabis use warrant the urgent need for school-based interventions and screening programs to prevent and control cannabis use especially among vulnerable subgroups.

Disclosure of Interest

None Declared
Smoking status trajectories, intergenerational socioeconomic mobility and depression: Preliminary results from 107,734 French adults (18 to 75 years) of the CONSTANCES cohort
Authors: Andersen A. J. , Mary-Krause M. , Melchior M.
Published: August 2023

Introduction

Cigarette smoking prevalence is significantly higher among people with mental health problems than among the general population. Smoking accounts for much of the reduction in life expectancy associated with mental illness, why the high co-occurrence of smoking and mental health illness is a major public health concern. Persons belonging to socioeconomical disadvantaged groups have higher risk of mental health conditions and also higher smoking rates.

Objectives

In this study we aim to examine smoking trajectories among adult smokers between 2012 and 2020. Furthermore, we aim to investigate differences in smoking trajectories by adult depression by taking into consideration participants intergenerational socioeconomic mobility (ISEM).

Methods

Analyses were based on data from CONSTANCES, a French general population cohort conducted from 2012 to 2020. In total were 107,734 participants included after exclusion of never smokers. Depression was measured by the CES-D scale, and depression was classified with a score ≥16. ISEM is based on childhood (maternal and parental occupational grade) and adult socioeconomic position (SEP), and low ISEM includes those with low SEP as child and adult and high ISEM those with consistent high SEP. Group-based trajectories modelling (GBTM) was used to determine smoking status trajectories. To address the association between ISEM and smoking trajectory class we used multinomial logistic regression with former smokers as reference class adjusted for depression, household income, sex and age.

Results

We identified five smoking trajectories 1) Former smokers (56.6%), 2) Long-term smokers (26.4%), 3) Intermediate smokers (3.3%), 4) Early quitters (5.0%) and 5) Late quitters (8.7%). Preliminary results from multinomial logistic regression showed that persons with low ISEM had higher odds of depression (OR [95%CI]=1.91 [1.77;2.06]) than those with high ISEM. Participants with low ISEM had higher odds of being long-term smoking than former smokers compared to those with high ISEM (ORa [95%CI]=1.55 [1.43;1.67]). Furthermore, those with low ISEM had lower odds of being in any of the other smoking trajectory groups vs. former smokers compared to those with high ISEM (ORa [95%CI]=0.82 [0.69;0.97]) for intermediate smokers, ORa [95%CI]=0.75 [0.66;0.85]) for early quitters, and ORa [95%CI]=0.78 [0.70;0.87]) for late quitters).

Conclusions

Preliminary results showed an association between ISEM and smoking trajectories in our study. Persons with low ISEM are more likely to be long-term smokers. Future analysis should consider the effect of depression as a mediating factor on the association between ISEM and smoking trajectories.

Disclosure of Interest

None Declared
What minimal detectable effect size is in your power – An inverted sample size formular for survival data
Authors: Dalgaard M. K. , Christensen A.-E. , Kjeldsen M. K.
Published: August 2023

Introduction

Power calculations are widely used in the conduct of clinical trials and are often required in funding applications and approvals. There is a recent debate on the role of power calculations in observational studies on existing data with (Hernán J Clin Epidemiol 2022; 144 203-205) and (Moris and Smeden J Clin Epidemiol 2022; 142 261-263) emphasizing the need for planning for all study types without risking discarding imprecise but otherwise relevant studies. In the current study, we construct a graph useful in the planning of a wide range of studies with survival data. We map the minimal detectable effect (MDE) for any possible number of events with a dichotome exposure varying the proportion assigned to the exposure groups.

Objectives

To provide a visual tool relating the sample size, more precisely the number of events, and the MDE for survival data in unbalanced designs.

Methods

The visualization is based on the formulas used by Stata’s power logrank function by (Schoenfeld Biometrics 1983; 39 499-503) and (Freedman Statistics in medicine 1982; 1 121-129), and the MDE is mapped as a function of the number of events. Furthermore, we apply this to an ongoing project on data from the Danish national registers, comparing the risk of developing polycystic ovary syndrome (PCOS) associated with treatment with valproic acid in a population with bipolar disorder or epilepsy.

Results

Preliminary results (Fig. 1) show, as expected, that a larger sample size is required to obtain an MDE close to one. Also, the MDE increases when the assignment among groups is skewed. Moreover, we find a relevant minimal detectable HRR of 1.78 for developing PCOS in a population of 13,839 patients with bipolar disorder or epilepsy, exposed to valproic acid versus those not exposed to valproic acid, with a total of 203 cases of PCOS.

Fig. 1 shows the minimal detectable effect size as a function of the number of events, with α = 0.05 and a power of 1 - β = 0.8, for various assignment ratios φ = PT/PC, where PT and PC are the proportions of patients assigned to the treatment group and the control group, respectively.

Image:

Conclusions

The current visualization and corresponding calculation can be used to guide decisions in the design phase of both observational studies as well as in clinical trials. For observational studies, the sample size, or equivalently, the number of events, could well be fixed, and the MDE may help assess the clinical relevance of conducting the study as in the example with PCOS data. The curves can also provide insight into which efforts might lower the MDE, e.g., whether a small increase in sample size or a different assignment proportion would be most beneficial based on a given sample size.

Disclosure of Interest

None Declared
Cognitive functions and their correlates in people with psychosis: are there gender differences?
Authors: Fusar-Poli L.
Published: August 2023

Impairments in social and non-social cognition are common in psychosis and may be sparsely present even before the onset of the disorder. Genetic and environmental influences have been linked to cognitive dysfunctions, which, in turn, may significantly impact the real-world functioning of people with psychosis. The role of gender in determining the interplay between cognitive skills, risk factors, and outcomes has been relatively unexplored. Nevertheless, identifying putative gender differences in cognitive functions and their correlates may favor the identification of individualized prevention and treatment strategies.

Disclosure of Interest

None Declared
Prevention strategies in clinical high-risks states for psychotic disorders: weighing up costs and benefits
Authors: Schultze-Lutter F.
Published: August 2023

Today, the indicated prevention of psychosis prior to its first episode is mainly based on clinical high-risk of psychosis (CHR) criteria, namely ultra-high risk criteria and basic symptom criteria. These are associated with conversion-to-psychosis rates of about 30% within three years. Thus, many patients meeting CHR criteria will not progress to psychosis over a medium-term period, and the cost-benefit evaluation of CHR states is always complicated by the largely unknown individual psychosis risk of CHR patients. In consequence, for the lesser risk of adverse events, treatment recommendations commonly favour non-pharmacological strategies, in particular cognitive-behavioural psychotherapy. Yet, individual risk estimation in identified CHR patients is increasingly done with help of machine learning algorithms, which might help to identify CHR patients who would greatly benefit from an additional pharmacological intervention with low-dose antipsychotics. The presentation will discuss the evidence-base of such a multistep, machine learning informed prevention strategy.

Disclosure of Interest

None Declared
Child and Adolescent Suicide Rates and Economic Crisis in South Korea using Hierarchical Age-Period-Cohort Analysis
Authors: Song J. , Roh B. R. , Hong H. J.
Published: August 2023

Introduction

Suicide is a complex problem in which individual, family social factors are interrelated. The 1997 Asian financial crisis caused a major economic crisis in Korea, and Korea received bailout support from the International Monetary Funds(IMF) from December 23, 1997 to August 23, 1997.

Objectives

This study aimed to investigate the relationship between the suicide rate of children and adolescents who grew up during this economic crisis in Korea.

Methods

Suicide rates are calculated according to gender, region, and age of 5 years (10-14 years old, 15-19 years old, 20-24 years old) using suicide death data from the Korea National Statistical Office from 2000 to 2017. The cohort of interest in the study is the group that was in childhood and early adolescence between 1997-2000 and corresponds to 1986-1995 in terms of birth year. Cohorts are divided into 1986-1989 (G1), 1990-1992 (G2), and 1993-1995 (G3) according to birth year. These groups were 8-14 years old for G1 and 5-10 years old for G2, 2-7 years old for G3 during 1997-2000, during the economic crisis. The Age-Period-Cohort analysis and linear mixed-effects regression models are used and the moderating effect on region and age is also analyzed.

Results

The 10-24 year-old suicide rate was higher in males than females, in older age groups, earlier in birth years in the birth cohort, and in rural than urban areas. Suicide rates between the ages of 20-24 years were particularly high among men living in rural areas. During the national economic crisis, the suicide rate was higher among adolescents than preschoolers (G3 < G1) (p<0.001), and this trend was observed for both men and women. However, the main effect of the cohort was not observed at a statistically significant level.

Conclusions

The national economic crisis has a negative impact on the mental health of children and adolescents, and it is more negative for adolescents than for children, which can increase the suicide rate between the ages of 20-24.

Disclosure of Interest

None Declared
What do we know about lithium associated hypercalcemia?
Authors: Laherrán Cantera N. , Palacios - Garrán R. , Sanchez-Guerra Alonso A. , Gutiérrez Santaló C. , Muñoz-Manchado L. I.
Published: August 2023

Introduction

Lithium associated with hypercalcemia may mimic a psychiatric condition and be confused for a relapse of bipolar disorder. The etiology seems to be due to a reduced sensitivity of the parathyroid cells to calcium, altering the parathyroid hormone (PTH) response. Lithium as an essential monovalent cation has some structural similarity to calcium (Ca) and can interact with protein receptors. This leads to changes in the inhibitory configuration of PTH and increased serum calcium concentrations, rising the threshold necessary to suppress hormone secretion.

Lithium-induced hyperparathyroidism (HIL) is the main cause of hypercalcemia in these patients.

Objectives

Based on a clinical case of lithium-associated hypercalcemia in a patient with bipolar disorder, review the existing literature and state the needs for periodic monitoring protocols.

Methods

Case report and bibliographical review.

Results

A 38-year-old woman, diagnosed with bipolar affective disorder at the age of 18, has been treated with lithium during which she developed secondary tubulointerstitial nephropathy as an adverse effect. Recently, she requested medical evaluation for constitutional syndrome associated with deterioration of general condition with loss of strength and difficulty in walking. Analytically, mild hypercalcemia was detected, and the study was extended to include Ca and PTH.

Chronic lithium therapy often develops mild hypercalcemia (approximately 10 to 20 percent of patients taking lithium), most likely due to increased secretion of PTH. Lithium can also unmask previously unrecognized mild hyperparathyroidism in patients with adenomas within a few years of starting therapy or induce parathyroid hyperplasia with a chronic use.

The hypercalcemia usually, but not always, subsides when the lithium is stopped. Normalization of serum calcium is more likely to occur one to four weeks post-lithium withdrawal in patients with a relatively short duration of lithium use. It is less likely in patients receiving lithium for more than 10 years.

Regarding the case to be presented, a review of the literature is carried out and the need to propose periodic calcium monitoring protocols is exposed.

Conclusions

Recommendations include determination of serum calcium every 6 months, urinary calcium and creatinine every 12 months, and bone mineral density monitoring every 1 to 3 years. Regular analytical monitoring including total calcium, PTH and vitamin D, would identify patients with a tendency to hypercalcemia so that appropriate measures could be taken. So as chronic treatment with lithium can develop mild hypercalcemia, I consider it necessary to develop periodic monitoring protocols for this adverse effect.

Disclosure of Interest

None Declared
Pharmacological treatment of early psychosis: risks and benefits
Authors: Sīle L.
Published: August 2023

Psychiatry has changed a lot during the last decades and lot of effort has been made to ensure that treatment of schizophrenia spectrum disorders is in line with modern science of medicine. Therefore, in everyday practice the psychiatrist is in a constant process of decision making when to start pharmacological treatment of early psychosis and with what dosage. The lecture will include evidence-based treatment options, the aspects of clinical practice and the power of shared decision-making in psychiatry.

Disclosure of Interest

None Declared
Sex differences in antipsychotic efficacy and side effects in psychosis
Authors: Erzin G.
Published: August 2023

There are a lot of studies investigating gender differences in the side effects of first and second-generation antipsychotic drugs. Even though some side effects are seen at higher rates in women, it is not determined yet the influence of gender on the efficacy and side effects of antipsychotic agents is still not well clear. In this review, we give a brief overview of antipsychotic side effects leading probably to distinguished clinical outcomes in both sexes.

Disclosure of Interest

None Declared
Impact of cannabis use on Schizo-affective disorder
Authors: Zbidi M. , Bouali W. , Haouari W. , Kacem M. , Khouadja S. , Zarrouk L.
Published: August 2023

Introduction

Schizoaffective disorder (SAD) is a nosographic entity characterized by an association of schizophrenic symptoms with thymic episodes. Addictive substance abuse behaviours precede or appear concomitantly with thymic and/or schizophrenic symptoms for the majority of patients.

Objectives

The objective of our work was to specify the sociodemographic ,clinical and therapeutic characteristics of this population and to compare them to a group of schizophrenic patients who do not use cannabis.

Methods

This is a retrospective descriptive study of patients with Schizoaffective Disorder (SAD) meeting the criteria of the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association, 5th Version (DSM-5), hospitalized between January 2015 and December 2021 in the psychiatry department of the EPS Tahar Sfar Mahdia.

Results

Our sample was composed of two groups: A first group formed by patients with a positive toxicological assessment to tetra-hydro-cannabinol (n=14) and a second group witha negative toxicological assessment (n=36). In SAD subjects using cannabis, the average age at first hospitalization was younger (27.5 years) than in the other groups, hospitalization was earlier (27.27 vs 33.58; p=0.04), the duration in number of days of hospitalization was greater (29.33 vs. 24.67; p=0.02) and they had required during their hospital stay a higher dosage of antipsychotics in equivalent doses of chlorpromazine (723 vs 603; p=0.04). There was a significant difference (p ≤ 0.04) in the psychometric scales (BPRS, SAPS and SANS) in favour of patients who did not use cannabis.

Conclusions

The deleterious psychic effects of chronic cannabis use have long been suspected for a long time. Patients followed for SAD present more frequently than the reference population addictive behaviours towards cannabis which is associated with many negative events affecting clinical symptomatology, evolution, prognosis and therapeutic response.

Disclosure of Interest

None Declared
The Relationship Between Somatization and Depression and Anxiety Levels of Parents with Children Diagnosed with Spina Bifida
Authors: Ulual P. , Özer V. , Uyar M. , Alatas I. , Özpınar G. , Guclu O.
Published: August 2023

Introduction

Spina Bifida, a congenital neural tube defect causing multi-system dysfunction. The birth of a disabled child in the family inevitably affects the family members, their lives, feelings, behavior and social life negatively. A lifelong challenge with the disease may give rise to severe pathologies to the parents or caregivers; such as somatization disorder which is characterized by various functional somatic symptoms that can not be explained by organic pathology. For the DSM-V, the diagnosis of complex somatic symptom disorder is proposed to replace the current diagnoses of somatization disorder, undifferentiated somatoform disorder, hypochondriasis and pain disorder. The proposed diagnostic criteria for complex somatic symptom disorder require the presence of somatic symptoms, together with misattributions, excessive concern or preoccupation with symptoms and illness and increased healthcare use.

Objectives

We aimed to find out the relationship between somatization, depression and anxiety levels of parents with children diagnosed with SB.

Methods

Interview form, the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and the SCL-90-R (Psychological symptoms screening test) were used. 79 individuals were included.

Results

Severely depresssed and anxietic parents show correlating levels of somatizaton. Depression and anxiety scores were above normal range. SCL-90-R Test the ratio of general somatization level compared to other values was found to be 1.72. Parameters above 1 are considered high. This ratio was found to be 100 % in pie charts, indicating all parents had somatization.

Conclusions

SB is not only physical but also a psychological burden to the child as well as the parents. Families often find themselves in despair and feel powerless while giving care to their child with SB. They have a greater tendency for mood and somatization disorder, long term psychiatric follow-up and more frequent evaluations and interventions should be undertaken.

Disclosure of Interest

None Declared
EPA guidance on treatment of cognitive impairment in schizophrenia
Authors: Vita A.
Published: August 2023

Although cognitive impairment is a core symptom of schizophrenia related to poore outcome in different functional domains, it still remains a major therapeutic challenge. To date, no comprehensive treatment guidelines for cognitive impairment in schizophrenia are implemented.

The aim of the European Psychiatric Association (EPA) guidance paper was to provide a comprehensive meta-review of the current available evidence-based treatments for cognitive impairment in schizophrenia, structured into three sections: pharmacological treatment, psychosocial interventions, and somatic treatments.

Based on the reviewed evidence, the EPA guidance recommends an appropriate pharmacological management as a fundamental starting point in the treatment of cognitive symptoms in schizophrenia. Among psychosocial interventions, cognitive remediation and physical exercise are recommended for the treatment of cognitive impairment in schizophrenia. As for cognitive remediation, some variables have been confirmed as core elements for treatment effectiveness.

The dissemination of the EPA guidance paper may promote the development of shared guidelines concerning the treatment of cognitive functions in schizophrenia, with the purpose to improve the quality of care and to achieve clinical recovery in this population.

Disclosure of Interest

None Declared
Family Members’ Experiences in a Psychiatric Hospital During the COVID-19 Pandemic: Implications for Family-Centered Work in Mental Health Systems
Authors: Shor R. , Shalev A.
Published: August 2023

Introduction

Restricted visitations of family members of persons with mental illness in psychiatric hospitals which may occur during times of public health crises such as the COVID-19 pandemic can have potential adverse consequences on the family members and on their ability to fulfill the caregiving role. Therefore, mental health professionals may encounter difficulties implementing a family centered-care model during such periods.

Objectives

Due to the limited knowledge about the effects of the restrictions during the pandemic a study was conducted in Israel. It examined the difficulties which family members experienced as a result of the restricted visitations and the effects of the restrictions on advancing a family-centered care model,

Methods

A semi-structured questionnaire was distributed via digital means to 75 family members who had a family member who was hospitalized in psychiatric hospitals during the pandemic.

Results

The findings indicate that family members had limited opportunities in the following areas during the COVID-19 area: Developing relationships with the professional staff, being involved in the therapeutic process during the hospitalization, communicating with the hospitalized family member, and receiving help for themselves.

Conclusions

Mental health professionals in psychiatric hospitals should adapt family-centric procedures to circumvent restrictions on physical presence and maintain the involvement of family members during psychiatric hospitalization.

Disclosure of Interest

None Declared