bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of Gender Identity Clinic waiting times on the mental health of transitioning individuals
Authors: Henderson N. , Selwyn V. , Beezhold J. , Howard R. , Gilmore R. , Bartolome I.
Published: September 2022

Introduction

Waiting times for gender identity services, even before the Covid-19 pandemic, have been a cause of concern. Despite the waiting time standard for planned elective care in the NHS being a maximum of 18 weeks, the average waiting time for a first appointment with a gender identity clinic is 18 months. This study aims to analyse the effect that these timings have on the transgender community, and whether they impact the risk of developing mental health conditions such as depression or anxiety.

Objectives

This study’s main aim is to analyse the correlation between waiting times and mental health burden in the transgender community.

Methods

A literature review and analysis on a transgender individual’s mental health and waiting times for Gender Identity Clinics; looking at any key themes and conclusions. Research papers were taken from MEDLINE, The International Journal of Transgender Health, Oxford Academic, SpringerLink and Emerald Insight, with studies publishing date ranging from 2014 – 2021.

Results

The transgender population were found to have higher rates of suicidal ideation, depression and self harm compared to the general population. Longer waiting times were found to contribute to feelings of low mood and suicidal ideation, as well as decreasing overall quality of life.

Conclusions

Longer waiting times can decrease a transgender individual’s quality of life and impact their overall mental wellbeing: especially with the impact of COVID-19 and the rise in referrals.

Disclosure

No significant relationships.
comparisation of ABO blood groups between female patiens diagnosed with depressive disorders an bipolar affective disorders
Authors: Vuk Pisk S. , Matic K. , Ivezic E. , Geres N. , Filipcic I.
Published: September 2022

Introduction

The prevalence of ABO alleles in population is different. Many studies confirmed the correlation between the occurrences of some diseases with different genotypes of ABO blood groups. Studies had shown possible differencese between patients with depressive dissorder and bipolar affective disorders according to ABO blood groups. There are contradictory results; some studies had shown significant association between blood group O and BAP, other showed relationship between unipolar depression and blood type O. Others shoedn association between involuntary depression and blood group A and negative association between blood group A and BAP.

Objectives

The purpose of this study was to reassess the potential diferences between patients with depressive dissorder and bipolar affective disorders according to ABO blood groups.

Methods

A total of 97 adult female psychiatric inpatients participated in this study. 57,7% were diagnosed with depressive disorder and 42,3% were diagnosed with bipolar affective disorder. Type of ABO group were measured from the blood samples taken in the morning after 30 min rest. From whole blood, genomic DNA was isolated on QIAcube device (Qiagen, Germany) using QIAamp DNA Blood mini QIAcube kit (Qiagen, Germany). ABO genotyping on 5 basic ABO alleles was performed using allele-specific
PCR.

Results

Comparing ABO blood groups between female patients who are suffering from depressive disorders and bipolar affective disorders, we didn’t found any differences. In both examination groups, higher proportion of A blood group was significant.

Conclusions

The results of this study didn’t support the hypothesis of diferences in ABO blood group between depressive disorders and bipolar affective disorders.

Disclosure

No significant relationships.
Quality of Life Among Women With Breast Cancer
Authors: Chouchane A. , Kacem I. , Bannour I. , Kahloul M. , Maoua M. , Naija W. , Mrizak N.
Published: September 2022

Introduction

Breast cancer (BC) is the most common cancer in women all over the world. Its physical consequences and psychosocial distress had adverse effect on quality of life (QOL).

Objectives

Evaluate the QOL among women with BC.

Methods

Descriptive cross-sectional study of BC patients, carried out during a period of 5 years. Socio-demographic and medical data was collected based on a pre-established synoptic sheet. The European Organization for Research and Treatment Quality of Life Questionnaires (EORTC QLQ-C30) and EORTC QLQ-BR23 were used to assess the QOL.

Results

A total of 100 patients were included. The mean age was 52 ± 8 years. The mean overall health score was 77.5 ± 25.5. The mean scores of physical and emotional functioning were 82 ± 25.1 and 90 ± 19.5 respectively. The QLQ-BR23 objectified a body image score of 63 ± 23.9, an average score for sexual functioning of 87.3 ± 22 with loss of sexual enjoyment in 75% of cases. The increase in mean overall health score and physical functioning was significantly associated with type of treatment (p = 0.01). The mean score of emotional functioning was correlated with the feeling of support (p = 0.04). The increase in the patient’s body image score was significantly associated with age (p <10-3), marital status (p = 0.01) and having had a mastectomy (p <10-3).

Conclusions

Our results underline the importance of psychosocial care, which must be an integral part of oncological care in women with BC, in order to improve their quality of life.

Disclosure

No significant relationships.
“It’s not only the bad side” - Experiences reported by health professionals working with women victims of sexual violence in a Brazilian university specialized outpatient service: A qualitative study
Authors: Turato E. , Cavalcante J. , Silva F. , Guerra L. , Azevedo R.
Published: September 2022

Introduction

Health Psychology is a scientific branch that studies interpersonal relationships in the field of emotions and behavior in clinical settings. Violence against women is a gender-based action that alarmingly affects the population, with sexual violence (SV) being one of its main phenomena. The complexity of the care offered to SV patients by clinical professionals impacts themselves, affecting their personal lives and the quality of their work.

Objectives

To explore symbolic emotional meanings attributed by health professionals to care and follow-up of women victims of SV in state service of reference of the Unified Health System.

Methods

Clinical-Qualitative design was used to guide semi-directed interviews with open-ended questions in-depth. Clinical-Qualitative Content Analysis was employed to treat data. Five participants make up the multi-professional team at the Hospital of the Woman of the State University of Campinas. Theoretical framework chosen to interpret categories was Balintian Medical Psychology.

Results

Three categories were selected for this presentation: The human anguishes as the main challenge and handling of working with sexual violence; “To see things progressing”: to the patient and together with the team, a facilitator of the work; and “I try to leave it on the three’s leaves”: the difficult attempt to separate work from personal life.

Conclusions

Taking care of SV is a very emotionally demanding task. Working with the team and see expected outcomes help clinical professionals deal with negative feelings, avoiding, for example, compensatory traumas. New research about social-cultural impacts of working with SV is important to develop institutional approaches of coping for health teams.

Disclosure

No significant relationships.
The impact of burnout syndrome among medical students - meta-analysis
Authors: Hogea L. , Corsaro L.
Published: September 2022

Introduction

The medical profession is associated with high requirements and responsibilities, and high rates of burnout have been reported in the medical literature.

Objectives

The aim of this study was to provide a detailed systematic review, focused on the impact of occupational burnout syndrome among medical students. A detailed perspective of existing instruments which are the psychometric properties and a meta-analysis of the average values of those three subscales of the most commonly applied tool - Maslach Burnout Inventory (MBI-HSS).

Methods

The meta-analysis was performed based on the available data on burnout rates in medical students measured by the Maslach Burnout Inventory (MBI-HSS) method. In order to define the eligibility criteria for finding the relevant literature, the PICO method - the “population-intervention-comparison-result” approach was used.

Results

The sample sizes included ranged from n = 73 to 4050 students. Mean values (M) ranged from 12.94 to 28.26 for emotional exhaustion and from 7.30 to 13.43 for depersonalization. M for personal achievement ranged from 31.3 to 38.07. Weighted averages and standard deviations were M = 22.93 (SD = 10.25) for emotional exhaustion, M = 8.88 (SD = 5.64) for depersonalization, and M = 35.11 (SD = 8.03) for self-accomplishment. The included studies reported different prevalence rates with burnout rates ranging from 7.0% to 75.2%. The prevalence rate of burnout measured by MBI-HSS varied between 10.0% and 63.4%.

Conclusions

The meta-analytical aggregation of eligible studies showed high values of “emotional exhaustion”, “depersonalization” and “self-accomplishment”.

Disclosure

No significant relationships.
Main substance of consumption of patients in follow-up in the hospital consultation. Have there been changes in the current pandemic context? And what about women?
Authors: Pérez Oms A. , Dinamarca F. , Casanovas F. , Llimona Sánchez C. , García Hernández D. , Calls Samora M. , Ginés J.M. , Mayans J. , Pérez-Solà V. , Fonseca F. , Torrens M.
Published: September 2022

Introduction

Gender is a factor influencing characteristics of substance use disorders. The Covid-19 pandemic has had a great impact in all areas of society, meaning a context of exceptionality in this population. Usually the male population represents a greater number of patients in general samples, so the descriptive characteristics of a global sample may not be representative in the case of women.

Objectives

- Identify if there are changes in the main substance of psychoactive substance use during the Covid-19 pandemic. - Identify possible divergences in characteristics of the general sample with respect to the sample made up of women.

Methods

It will be used data collected in the database of patients in follow-up with the addiction consultation service in two periods of 6 months, one prior to the pandemic situation due to Covid-19 and another corresponding to same period in 2020. A descriptive analysis is carried out by applying chi-square statistic, performing the analysis by subgroups according to gender.

Results

84.8% of total sample are men. Results show that there are no statistically significant differences between periods in main substance of consumption. Despite this, differential trends can be observed in the sample that correspond to women with respect to the global sample and that of men.

Conclusions

Taking into account the low number of women that make up the sample, the fact that differential trends are observed could indicate possible differences, which in case of increasing the sample size could acquire statistical significance and that this it would be specific to women subgroup.

Disclosure

No significant relationships.
Cannabis use in early ADHD, a 3-years follow-up study in relations to clinical characteristics
Authors: Kvitland L.R. , Moa H. , Schei J. , Lydersen S. , Thomsen P. , Mundal I.
Published: September 2022

Introduction

ADHD is known to increase the risk of substance use, and is associated with lower degrees of education, criminal behavior and neuropsychic difficulties. Previous research is limited by small samples, variable findings, and short follow-up time. Earlier research tends to be limited to substance use above the threshold for abuse or dependency.

Objectives

This study aims at looking at the effects of cannabis use both over and under threshold for abuse or dependency in relations to clinical characteristics over a 3-year follow-up period.

Methods

At follow up a total of 203 patients were diagnosed with ADHD either as primary of as secondary diagnosis, of those 57 (28,1%) had lifetime use of cannabis (LUC), mean age at inclusion was 15 and half years old and 40% were of female sex. SPSS (v.29) were used to perform independent sample t-tests to test for effects and Hierarchical block-wise regressions were done to check for confounding variables.

Results

Lifetime cannabis use was associated with lower global functioning (p=0.000), increased risk of suicidal ideation (p=0.007), more suicide attempts (p=0.049), more self-reported symptoms (p=0.001), more school drop-out (p=0.000) and with psychotic features (p=0.024). Even after testing for know confounders such as female sex and age LUC explained significant variance.

Conclusions

LUC is associated with increased functional and clinical characteristics. The findings are discussed in relationship with clinical practice and limitations of the study.

Disclosure

No significant relationships.
Bipolar disorder and maternity
Authors: Palomo Monge M. , López Rodrigo M.V. , García Montero C. , Osca Oliver A. , Tascón Guerra M.F. , Pérez Fominaya M. , Ros Font V.
Published: September 2022

Introduction

Bipolar disorder can be a severe psychiatric disorder. The combined prevalence of bipolar I, bipolar II, and unspecified bipolar disorders according to DSM-IV is 1.8%. Mean age at first affective episode has been estimated to 20 years among out-patients in the United States (2).

Objectives

We present the case of a 40-year-old patient, diagnosed with type I bipolar disorder. In her story, multiple admissions are recorded for both manic and depressive episodes. The patient showed a desire to be a mother and multiple therapeutic interventions were performed, de-escalation of stabilizers until she was withdrawn, which triggered generally manic episodes that required hospital admission.

Methods

Given the controversy in the decision to maintain or not drug treatment during pregnancy and the lack of clear criteria, in this case it was decided to try to gradually withdraw the treatment, which triggered several serious relapses. It was then decided to maintain the treatment at lower doses than usual or complete withdrawal, which in all cases precipitated relapses. Finally the patient reconsidered her wishes and abandoned the possibility of pregnancy.

Results

Bipolar I Disorder

Conclusions

Although most studies have found similar lifetime prevalence rates of bipolar disorder between men and women, gender differences may be evident in the impact of reproductive life events on affected women. In addition to the controversy regarding the decision to maintain or not treatment during pregnancy, there is also the certainty that childbirth can be the specific trigger for a manic or hypomanic episode.

Disclosure

No significant relationships.
Postpartum psychosis treatment: review of mother-baby units
Authors: Costa M.L. , Elduayen Vila A.
Published: September 2022

Introduction

Postpartum Psychosis is an underdiagnosticated psychiatric condition that may be suffered by mothers within a year since delivery. It is a severe syndrome in which symptoms such as delusions, hallucinations and disorganized thinking may appear. The traditional approach of admitting the mothers separated from their children has shown harmful consequences. This has led to the creation of Mother-Baby Units (MBU), psychiatric admission units dedicated to full-time housing mothers and their babies.

Objectives

To evaluate the evidence available regarding the potential benefits of MBU not only for the mothers, the babies, but for the mother-baby bond. To analyse postpartum psychosis risk factors and prognosis.

Methods

A thorough review of scientific literature and databases regarding postpartum psychosis and MBU has been carried out. Additionally, international mental health care guidelines for perinatal mental disorders were analysed.

Results

A wide range of related aspects were studied for the present work, including characteristics of the patients, differences in the
self- assessment scales of depression, anxiety, postpartum attachment of the mother to the baby at admission and at discharge and the work and social adaptation. Other studies analysed the percentage of mother-baby separation at discharge, as well as the most frequent delusions, and the potential effect of childhood trauma on these patients.

Conclusions

The available evidence suggest that MBU may be helpful for the improvement of the mental health in women suffering perinatal mental disorders and for the building of a secure attachment style in the baby. The results of the interventions included in MBU programs also show promotion of a positive mother-baby relationship.

Disclosure

No significant relationships.
Rates of Post-Partum Psychosis in women with risk factors cared for by a specialist community perinatal mental health service in London
Authors: Tsoumpris T. , Tang K. , Miele M. , Acosta C.
Published: September 2022

Introduction

Community Perinatal Mental Health Services
(CPMHS) have been established in the UK, however, there is limited research around their real-world effectiveness. Post-Partum Psychosis (PPP), a severe episode of affective psychosis usually occurring soon after birth, has known risk factors. CPMHS offer assessment and interventions for women with risk factors for PPP, with a view to reducing the risk of its occurrence, as well as, where necessary, to proactively manage the illness to minimise the impact on the mother-infant dyad, as well as associated risks to self and/or others.

Objectives

To review the rate of PPP in women with established risk factors, who were referred and managed by our CPMHS between September 2019-September 2021. This rate will be compared with the known rates of PPP reported in the literature. Rates of non-psychotic relapse, acute hospitalisation, children social care supervision and mother-infant separation as a result of postnatal relapse will be (amongst others) secondary outcomes. Perinatal interventions offered to reduce the risk of PPP and contingency planning will also be reviewed.

Methods

This will be a retrospective case review study involving women referred and cared for by our CPMHS from October 2019 to October 2021, with known risk factors for PPP. Women identified as high risk for PPP receive consultant led-care in our service, therefore cases will be identified via the individual caseloads. Subsequently, electronic case notes will be reviewed to determine the primary and secondary outcomes, as well as the perinatal interventions that were offered.

Results

To be reported.

Conclusions

To be reported.

Disclosure

No significant relationships.
Effectiveness and implementation of a MUltidisciplinary Lifestyle focused approach in the Treatment of Inpatients with mental illness (MULTI+): a stepped wedge study protocol
Authors: Van Schothorst M. , Den Bleijker N. , Hendriksen I. , Cahn W. , De Vries N. , Van Harten P. , Deenik J.
Published: September 2022

Introduction

People with mental illness (MI) have a reduced life expectancy compared to the general population, mostly attributable to somatic diseases caused by poor physical health. Modifiable lifestyle factors are increasingly associated with the onset of somatic diseases in people with MI. Despite the increasing evidence for the efficacy of lifestyle interventions there is little change in routine clinical care. This discrepancy is referred to as the implementation gap and has caused a need for effectiveness and implementation research in real-world settings.

Objectives

This study investigates the health outcomes and implementation of a multidisciplinary lifestyle focused approach in treatment of inpatients with mental illness (MULTI+).

Methods

This is an open cohort stepped wedge cluster randomized trial in inpatients psychiatric wards of GGz Centraal. Three clusters are randomly allocated to one of the three pre-defined steps to integrate MULTI+. MULTI+ can be tailored to fit individual psychiatric wards and includes 10 core components aimed at improving lifestyle factors. The primary outcome is to investigate whether there is a greater decrease in the QRISK3 cardiovascular risk score after receiving MULTI+ as compared to treatment as usual. Secondary outcomes include somatic and mental health outcomes, lifestyle factors, and implementation factors.

Results

First results expected in 2022.

Conclusions

To our knowledge, this will be the first large-scale study evaluating the long-term effects of a multidisciplinary, multicomponent approach aimed at improving lifestyle factors. We expect that this approach will increase long-term sustainability and can serve as a potential blueprint for future implementation of lifestyle interventions to improve routine clinical care.

Disclosure

No significant relationships.
Incidence and risk factors of cognitive disorders after urologic endoscopic surgery
Authors: Dahmen M. , Chrigui R. , Loghmari A. , Soussi M. , Mansour S. , Bouassida K. , Kahloul M. , Naija W.
Published: September 2022

Introduction

Postoperative cognitive disorders are an emerging public health problem because of its related socio-economic impact.: Postoperative cognitive disorders are an emerging public health problem because of its related socio-economic impact.

Objectives

To determine the incidence and risk factors of cognitive disorders after endoscopic resection in urology.

Methods

This is an observational, descriptive and analytical study carried out in the urology department of Sahloul University Hospital during a 3 month period, and enrolling patients scheduled for endoscopic resections. Collected data included socio-demographic characteristics and parameters related to the operative management. Cognitive disorders were assessed by the MOCA Test one day before the intervention, then, during the first postoperative day. Patients developing TURP syndrome were excluded.

Results

During the study period, 104 patients were enrolled with a mean age of 67.76 years. The sex ratio was 33.6. Main interventions were transurethral resection of bladder tumor and transurethral resection of the prostate.The incidence of cognitive disorders was 45.2% after endoscopic resection. Main Risk factors in multivariate analysis were age (p <10-3), low educational level (p <0.001), sedentary (p <0.001), smoking (p = 0.029), an age gap with spouse> 10 years (p <0.001), high blood pressure (p <0.001), myocardial infarction (p = 0.005); chronic bronchitis (p = 0.002), sleep disorders (p <0.001), preoperative concentration disturbances (p = 0.005), poor quality of patient information (p <0.05), and the type of anesthesia (p = 0.012).

Conclusions

The incidence of cognitive disorders after urologic endoscopic surgery is considerable. Patients with risk factors require preventive measures, regular screening and optimal management.

Disclosure

No significant relationships.
Psychiatric Misdiagnosis in Frontotemporal Dementia
Authors: Yay Pençe A. , Ekmekçi Ertek İ. , Coşar B.
Published: September 2022

Introduction

Frontotemporal dementia(FTD) is the prevalent type of primary progressive dementia. Psychiatric symptoms can be seen in FTD. So it can imitate psychiatric disorders and be misdiagnosed. However, few studies have investigated the underlying cause of misdiagnosis.

Objectives

The primary aim of this study was to identify the prior psychiatric diagnoses of patients before receiving a definitive diagnosis of FTD and the main reasons to cause diagnostic delay.

Methods

We screened through the records of patients who were admitted to our psychiatry outpatient or inpatient clinic from January 1st, 2018 to June 30th, 2021. The patients with FTD were included in our study.

Results

Our sample consisted of 13 patients with FTD(mean age= 54.77 ± 12.22, 7 females). Psychiatric misdiagnoses were depression(n=6), psychosis(n=5), bipolar affective disorder (n=5), conversion disorder(n=4), and malingering(n=1). As we looked at the first symptoms of the patients, it was revealed that 9 of 12 patients presented with depressive symptoms or at least experienced a short depressive period at the beginning of their behavioral changes. Interestingly, 8 of 12 patients had given a history of stressful life events just before their complaints emerged, which was thought the main misdirector for physicians. The average delays in diagnosis were 14.58(±16.93) months in the psychiatry clinic, 5.66(±11.02) months in the neurology clinic in our hospital.

Conclusions

Our study suggests that the depressive episode preceding behavioral changes may be the prodromal stage for fully developed FTD. Moreover, the depressive episode and the history of stressful life events appear to mislead clinicians in diagnosing FTD.

Disclosure

No significant relationships.
When Attention-Deficit/Hyperactivity Disorder reaches adulthood
Authors: Morais A.S. , Gomes R. , Descalço N.
Published: September 2022

Introduction

Attention-Deficit/Hyperactivity Disorder (ADHD) was classically considered a childhood-onset neurodevelopmental condition. Over the past 40 years, it became evident that it can persist during adulthood.

Objectives

The purpose of the authors is to describe the characteristics of ADHD in adults and the specific comorbidities, proposing an approach to these patients.

Methods

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

Results

Only 40-50% of children and adolescents with ADHD will have symptoms that persist into adulthood (estimated adult prevalence of 2.8% across 20 countries; 25% in prisons). A more subtle presentation in adults and the difficulty to access past medical history, lead to diagnosis and treatment rates of lower than 20% (versus 50% in children). Well-characterized core symptoms in children evolve into a predominance of inattention symptoms. They became adults with marked disorganization, difficulties in completing tasks and managing time. Emotional dysregulation is a very prevalent symptom in this population. The comorbidities rate increase over time (reaching 75% of patients).

Conclusions

Adults (or even older subjects) with cognitive and/or behavioural complaints should be submitted to systematic screening for ADHD. Non-treated ADHD symptoms in adulthood are associated with severe impairment, therefore adjustments in the health care system to support the transition from child to adult services are needed.

Disclosure

No significant relationships.
Unique treatment principles in the service of speech treatment – The VML method
Authors: Vashdi E.
Published: September 2022

Introduction

Childhood Apraxia of Speech (CAS) was declared as a motor speech disorder by ASHA (2007). The prevalence of CAS is yet to determined due to difficulties in reliable diagnosis, however 63.6% of children with ASD were found to Apraxic (Tierney et al, 2015), hence prevalence would be at least 1/100 (ASD prevalence is 1/54).

Objectives

The consequences of inability to speak in early and advanced developmental age are many and might include frustration, anger, depression, communication deficit, language delay, poor social skills and behavioural problems. Not only treating motor speech disorder is challenging enough, the external consequences make it far more difficult.

Methods

The VML method (Verbal Motor Learning) was designed to treat the motor aspect of speech. It uses manual techniques and motor learning principles in order to directly teach the basic milestones of speech for children with CAS. In addition, the importance of the manner of the practice was established over the years, extracting 16 unique treatment principles. These principles guide the therapist regarding HOW to perform the practice, while giving an answer to the external CAS consequences.

Results

The principles are the platform, managing energy levels, relationship, attention, goal-oriented thinking, emotional safety, treatment structure, rhythm, timing, threshold point, support, dynamic thinking, ecological treatment, proactivity, clarity and commitment.

Conclusions

The lecture will introduce the 16 principles briefly, and demonstrate the use of them via treatment videos.

Disclosure

I am the founder of the VML method and I teach it in various countries.
Concomitant diagnosis of bipolar disorder and tuberous sclerosis - a case report
Authors: Santos M. , Ferreira T. , Neves P. , Peres J.
Published: September 2022

Introduction

Tuberous sclerosis is a multisystem genetic disorder. It is associated with significant psychiatric comorbidity mainly autistic disorders, hyperkinetic disorders, depression and anxiety. It is rarely associated with psychosis and bipolar disorder.

Objectives

To describe the case of a 34-year-old male with concomitant diagnosis of bipolar disorder and tuberous sclerosis.

Methods

Case report based on clinical records. Brief literature review using articles searched in the PubMed/MEDLINE database using the terms “tuberous sclerosis”, “bipolar disorder” and “neuropsychiatric”.

Results

The patient presented at our Emergency Department 3 years ago with a mixed episode with psychotic symptoms with 1 month of duration. Prior history of two hypomanic episodes, but no depressive episodes. High baseline functionality. Sporadic use of alcohol and cannabis. No family history of psychiatric or neurological diseases. Diagnostic work-up showed no relevant results, aside from small calcifications in brain CT. He was admitted to our ward and medicated with aripiprazol (titrated up to 30 mg), leading to full remission of the clinical picture. The patient was referred to our outpatient clinic and stayed with medication for 1,5 years. One year after, he presented a sudden episode of mutism and perplexity with quick remission. The EEG wielded no relevant results. New brain CT showed signs of tuberous sclerosis. He was referred to Neurology and subsequent assessments, including brain MRI, led to the fulfilment of clinical criteria for tuberous sclerosis.

Conclusions

This case illustrates the possibility of concomitant diagnosis of bipolar disorder and tuberous sclerosis. The possible association between these disorders is discussed.

Disclosure

No significant relationships.
A Review of Aeruginascin and Potential Entourage Effect in Hallucinogenic Mushrooms
Authors: Chue P. , Andreiev A. , Bucuci E. , Els C. , Chue J.
Published: September 2022

Introduction

The 5-HT2A agonist classic psychedelic, psilocybin (O-phosphoryl-4-hydroxy-N,N-dimethyltryptamine) is a tryptophan, indole-based alkaloid present in up to 2% of certain hallucinogenic “magic” mushroom species; typically Psilocybe azurescens, semilanceata, and cyanescens,. In addition, mushrooms may contain psilocin (4-hydroxy-N,N-dimethyltryptamine). Both are indolylalkylamines (tryptamines); other naturally occurring tryptamine compounds include norbaeocystin, baeocystin, norpsilocin, and aeruginascin. A putative synergistic contribution of these compounds has been referred to as the “entourage” effect. Aeruginascin (N,N,N-trimethyl-4-phosphoryloxytryptamine) is found naturally in Inocybe aeruginascens and Pholiotina cyanopus mushroom species and ingestion reportedly invokes elevation in mood without accompanying hallucinogenic effects:

Objectives

To review the pharmacology of aeruginascin and putative entourage effect.

Methods

The extant literature on aeruginascin was reviewed and discussed.

Results

Methylation of aeruginascin results in an active metabolite, 4-hydroxy-N,N,N-trimethyltryptamine (4-HO-TMT) which has been shown to bind at 5-HT1A, 5-HT2A, and 5-HT2B receptors with Inhibition Constants (Ki) of 4400, 670, and 120 nM respectively; compared with psilocybin’s binding of 567.4, 107.2 and 4.6 nM respectively. Further, 4-HO-TMT does not bind at the 5-HT3 receptor, and as a quaternary trimethylammonium compound it is less likely to be able to cross the blood-brain-barrier (BBB).

Conclusions

There are very limited data with respect to the pharmacology of aeruginascin. Its activity at serotonin receptors is less by several orders of magnitude than psilocybin and it has potentially less brain penetrance. Given that it is found in different mushrooms species the data would suggest that its direct contribution to any entourage effect is limited. Further research in needed into other naturally occurring tryptamine compounds.

Disclosure

PC is a member of the Scientific Advisory Board of Zylorion. AA, EB, JC, CE have no disclosures to report.
How Covid-19 changed emergency department access: observational study comparison of patient stage of the day access in the psychiatric emergency department over three years
Authors: Santini R. , Barlattani T. , Jannini T. , Mariano A. , Bianchi F. , Niolu C. , Siracusano A.
Published: September 2022

Introduction

A few studies have analyzed the impact of COVID-19 pandemic on psychiatric Emergency Department (ED) accesses. The pandemic may indeed have influenced the phase of day accesses for patients with psychiatric disorders.

Objectives

Aim of this cross-sectional study is to analyze how COVID-19 weighed on psychiatric patients daily accesses over the course of three years.

Methods

Data on 219 patients were retrospectively collected from the ED in the Policlinico Tor Vergata, Rome. According to the stage of the day, accesses were divided into 4 groups: between 00:00 and 6:00; between 6:00 a.m. and 12:00 a.m.; between 12:00 a.m. and 18:00 p.m.; between 18:00 p.m. and 00:00 p.m.

Results

Performing a regression analysis, a relation was found between psychiatric symptoms, stage of the day admission and year. In 2019 the admissions seem to be homogeneously distributed, however during 2021 and 2020 the admissions rates have a delayed evening trend.

Conclusions

Despite the low number of accesses considered, the Covid-19 pandemic appears to exert an effect that still lasts in terms of both accesses and worsening or new onset of psychiatric symptoms. Measures taken to prevent the spread of infections may have affected access in the ED of patients in various ways. However, the trend of increasing evening accesses could be related to a saturation of territorial psychiatric services that work mainly until the afternoon. Thus, an enhancement of territorial psychiatric services seems highly necessary to cope with what could be an increase in psychopathology in patients without previous diagnosis.

Disclosure

No significant relationships.
White matter changes following electroconvulsive therapy for depression: a mega-analysis
Authors: Belge J.-B. , Mulders P. , Van Diermen L. , Dols A. , Oudega M. , Tendolkar I. , Van Eijndhoven P.
Published: September 2022

Introduction

Electroconvulsive therapy (ECT) is proposed to exert an effect on white matter (WM) microstructure, but the limited power of previous studies made it difficult to highlight consistent patterns of change in diffusion metrics.

Objectives

We initiated a multi-site mega-analysis and sought to address whether changes in WM microstructure occur following ECT.

Methods

To this end, diffusion tensor imaging (DTI) data (n=58) from 4 different sites were harmonized before pooling them by using ComBat, a batch-effect correction tool that removes inter-site technical variability, preserves inter-site biological variability and maximizes statistical power. Downstream statistical analyses aimed to quantify changes in Fractional anisotropy (FA), Mean Diffusivity (MD), Radial Diffusivity (RD) and Axial Diffusivity (AD), by employing whole-brain, tract-based spatial statistics (TBSS).

Results

ECT increases FA in the right splenium of the corpus callosum and the left cortico-spinal tract. Both the left superior longitudinal fasciculus and the right inferior fronto-occipital fasciculus showed increases in AD. Increases in MD and RD could be observed in overlapping white matter structures of both hemispheres. Finally, responders showed significantly smaller FA values in the left forceps major and smaller AD values in the right uncinate fasciculus compared with non-responders.

Conclusions

This is the first and largest multi-site mega-analysis to demonstrate that ECT normalizes altered WM microstructure in important brain circuits that are implicated in the pathophysiology of depression. Furthermore, responders appear to present a more decreased WM integrity at baseline, which if replicated could serve as a biomarker for ECT response.

Disclosure

No significant relationships.
The thalamus and its subregions – a gateway to obsessive-compulsive disorder
Authors: Weeland C. , Vriend C. , Van Der Werf Y. , Huyser C. , Hillegers M. , Tiemeier H. , White T. , De Joode N. , Thompson P. , Stein D. , Van Den Heuvel O. , Kasprzak S.
Published: September 2022

Introduction

Higher thalamic volume has been found in children with obsessive-compulsive disorder (OCD) and children with clinical-level symptoms within the general population (Boedhoe et al. 2017, Weeland et al. 2021a). Functionally distinct thalamic nuclei are an integral part of OCD-relevant brain circuitry.

Objectives

We aimed to study the thalamic nuclei volume in relation to subclinical and clinical OCD across different age ranges. Understanding the role of thalamic nuclei and their associated circuits in pediatric OCD could lead towards treatment strategies specifically targeting these circuits.

Methods

We studied the relationship between thalamic nuclei and obsessive-compulsive symptoms (OCS) in a large sample of school-aged children from the Generation R Study (N = 2500) (Weeland et al. 2021b). Using the data from the ENIGMA-OCD working group we conducted mega-analyses to study thalamic subregional volume in OCD across the lifespan in 2,649 OCD patients and 2,774 healthy controls across 29 sites (Weeland et al. 2021c). Thalamic nuclei were grouped into five subregions: anterior, ventral, intralaminar/medial, lateral and pulvinar (Figure 1).

Results

Both children with subclinical and clinical OCD compared with controls show increased volume across multiple thalamic subregions. Adult OCD patients have decreased volume across all subregions (Figure 2), which was mostly driven by medicated and adult-onset patients.

Conclusions

Our results suggests that OCD-related thalamic volume differences are global and not driven by particular subregions and that the direction of effects are driven by both age and medication status.

Disclosure

No significant relationships.
Atypical working hours are associated with substance use, especially in women: longitudinal analyses from the CONSTANCES cohort
Authors: Hamieh N. , Airagnes G. , Descatha A. , Goldberg M. , Limosin F. , Roquelaure Y. , Lemogne C. , Zins M. , Matta J.
Published: September 2022

Introduction

Difficult working conditions could be associated with addictive behaviors.

Objectives

To examine the prospective associations between atypical working hours and substance use, including sugar and fat consumption.

Methods

In the CONSTANCES cohort, a total of 47,288 men and 53,324 women currently employed were included from 2012-2017 for tobacco and cannabis outcomes, and 35,647 and 39,767, respectively from 2012-2016 for alcohol and sugar and fat outcomes, and they were then followed up annually. Atypical working hours were self-reported at baseline and considered three different indicators: night shifts, weekend work and non-fixed working hours. Generalized linear models computed odds of substance use and sugar and fat consumption at follow-up according to baseline atypical working hours while adjusting for sociodemographic factors, baseline depression and baseline level of consumption.

Results

Night shifts increased significantly the odds of using tobacco in women (Odds ratios, ORs varying from 1.55 to 1.62) and cannabis in men (ORs varying from 1.80 to 1.95). Weekend work increased the odds of using tobacco (ORs varying from 1.51 to 1.67) and alcohol (OR of 1.16) in women. Non-fixed working hours increased the odds of using tobacco and alcohol in men and women (ORs varying from 1.15 to 1.19 and 1.12 to 1.14, respectively). Dose-dependent relationships were found for tobacco use in women (P for trends<0.0001). No significant associations were found for sugar and fat consumption.

Conclusions

The role of atypical working hours on substance use should be taken into account by public health policy makers and clinicians for information and prevention strategies, especially among women.

Disclosure

Nadine Hamieh was supported by a grant from “Direction de la recherche, des études, de l’évaluation et des statistiques”, DREES, Ministry of Labour, France.
The moderating role of mental health on the association between gaming time and gaming disorder symtoms
Authors: Koncz P. , Demetrovics Z. , Paksi B. , Magi A. , Eisinger A. , Király O.
Published: September 2022

Introduction

Video games are among the most popular leisure time activities. While majority of gamers play in a healthy manner, a minority shows gaming disorder (GD) symptoms and experiences detrimenting effects in their lives. Even though gaming time is moderately associated with gaming disorder symtoms, research suggests that it is not a reliable predictor by itself.

Objectives

The aim of the present study is to explore whether depression symptoms, self-esteem, attention-deficit/hyperactivity disorder (ADHD) and escapism (when gaming is motivated by the avoidance of everyday problems) moderate the association between gaming time and GD symptoms and whether this is different for boys and girls.

Methods

Data was collected from a representative sample of 5th grade students of public education institutions in Budapest. Sample selection was carried out by one-step sampling stratified for school type, district, and maintainer; the sampling unit was the class. Data from 2126 students were analyzed (49.3% male, mean age 10.7 years, SD=0.54).

Results

Depression symptoms moderated the association between gaming time and GD symtoms in both genders. For those with higher depression symptoms the aforementioned association was stronger. Furthermore, self-esteem had a moderator effect only among girls, while escapism motivation and ADHD only among boys. In these cases, the association between gaming time and GD symptoms was stronger among those with lower self-esteem, and higher ADHD and escapism scores.

Conclusions

Results suggest that gaming time is more strongly connected to GD symptoms in certain conditions, but its predictive value is limited even in those cases.

Disclosure

Funding statement: This study was supported by the Hungarian National Research, Development and Innovation Office (KKP126835). Orsolya Király was supported by the János Bolyai Research Scholarship of the Hungarian Academy of Sciences and by the ÚNKP-21-5
White matter microstructure associated with the range of attentional and impulsive performance in school-aged children
Authors: Gagnon A. , Descoteaux M. , Bocti C. , Grenier G. , Gillet V. , Posner J. , Baccarelli A. , Takser L.
Published: September 2022

Introduction

Inhibition capabilities have been shown to be a strong predictor of social and educational life outcomes (Mischel & Ebbesen, 1970; Shoda et al., 1990). Inhibition capabilities have an enormous impact on attention and impulsivity (Bari & Robbins, 2013). These two executive functions are associated with numerous psychiatric disorders but are not well understood in terms of white matter (WM) connectivity (Puiu et al., 2018). Novel techniques and statistical approaches in neuroimaging bring us closer to a biologically sustained model.

Objectives

This research aims to: 1) identify WM connections associated with attention/impulsivity performance and 2) characterize the differences in WM microstructure associated with the variation of the performance.

Methods

157 children (GESTE cohort, 8-12 years, 27 Dx ADHD, 2 Dx ASD) with b=1500mm2/s, 2mm isotropic dMRI acquisitions were included. Tractography was performed with TractoFlow pipeline (Theaud et al., 2020). Dimensionality reduction of diffusion metrics yielded two components : microstructural complexity (DTI Metrics, AFD & NuFo) and axonal density (AFD_fixel) (Chamberland et al., 2019). Attention/impulsivity were evaluated with the CPT3. Multivariate linear regression was performed in python.

Results

Lower microstructural complexity was associated with poorer attentional performance on regions of the parietal lobe to the occipital gyrus (P-O, p=0.044, R2=0.14, Figure 1.) and the Broadman’s area 8 to area 6 (SF8-SF6, p=0.002, R2=0.12, Figure 1.). Lower axonal density was associated with a less impulsive pattern on SF8-SF6 (p=0.001, R2=0.13, Figure 1.). Results remained significant when removing children with an ADHD or ASD diagnosis.

Conclusions

We identified underlying difference in WM microstructure that may be associated with the variation in attention/impulsivity performance in school-aged children.

Disclosure

No significant relationships.
The effect of emotion recognition and mindfulness on depression symptoms: A case-control study
Authors: Aydın O. , Tvrtkovic S. , Çakıroğlu E. , Ünal-Aydın P. , Esen-Danacı A.
Published: September 2022

Introduction

Abnormalities in emotion recognition (ER) are frequently reported in depression, with lowered recognition accuracy in patients with major depressive disorder (MDD) when compared to healthy individuals. Mindfulness was found to directly impact the severity of depressive symptoms, by negative cognition and dysfunctional reaction recognition.

Objectives

The aims of this study were to compare ER and mindfulness levels between MDD patients and healthy controls (HC), as well as to examine whether ER and mindfulness are related to symptom severity in MDD patients.

Methods

68 patients with MDD and 93 HC participated in the study. A sociodemographic form, Reading the Mind in the Eyes Test (RMET), Five Facet Mindfulness Questionnaire-Short Form (FFMQ-S) and the Montgomery Asperg Depression Scale (MADRS) were administered. Group comparison in ER and mindfulness was assessed using the Multivariate analysis of covariance (MANCOVA). Bivariate correlations and multiple linear regression analyses were performed to assess the associations between depression severity, ER and mindfulness in the patient group.

Results

Better ER and higher levels of mindfulness were found in HCs relative to the MDD group. A positive association between depression severity and the non-reactivity facet of mindfulness was found, indicating that in the MDD group non-reactivity was a significant predictor for depression severity. On the other hand, ER was not significant in predicting symptom severity.

Conclusions

Non-reactivity, unlike other dimensions of mindfulness, seems to increase with the severity of depressive symptoms among MDD patients. To particularly focus on this subdimension in mindfulness techniques may yield better outcomes in alleviation of depressive symptoms.

Disclosure

No significant relationships.