bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of the COVID-19 pandemic on mental health and service use of people with severe mental illness
Authors: Mueller-Stierlin A. , Meixner F. , Lehle J. , Kilian R.
Published: September 2022

Introduction

The COVID-19 pandemic has a huge impact on the provision of mental health care. Particularly the limitations of face-to-face contacts and the access to treatment facilities can be expected to have significant negative effects on the practice of psychiatric treatment and outcomes. To date the extent and the severity of these effects in people with severe mental illnesses are rarely investigated in Germany.

Objectives

We investigated the impact of the COVID-19 pandemic on mental health and service use of people with severe mental illness in Germany.

Methods

As part of a pragmatic randomized trial on the effectiveness of an integrated community mental health care program that started immediately after the first COVID-19 wave in June 2020, 1000 people with severe mental illness from different regions in Germany have been asked for the effects of the COVID-19 pandemic on their mental health care and on their general living conditions. Multivariate regression models were computed to estimate the effects of the patients’ COVID-19 experiences on the outcome parameters empowerment (EPAS), psychosocial impairment (HoNOS) and unmet needs (CAN).

Results

Using prospective data in a large sample of people with mental illness, we will be able to examine the extent to which the pandemic has affected participants’ mental health, their social lives, but also the use of mental health care services.

Conclusions

The data will help to examine the impact of the pandemic on people with severe mental illness in a comprehensive way and will provide evidence where immediate action is needed to reduce further burdens and inequities.

Disclosure

No significant relationships.
Psycho-Covid
Authors: Gordillo Montaño M.J. , Boned Torres S.V. , Rodriguez L.
Published: September 2022

Introduction

The COVID-19 pandemic generated a health emergency and led to the adoption of different measures, including home quarantine and social isolation, which, as we have seen, has had an impact on the mental health of the majority of citizens, with the possibility of psychiatric disorders appearing. in people without prior mental illness, such as acute decompensations in patients with known disorders, more vulnerable to environmental stressors.

Objectives

Learn and rethink alarm signals in extreme situations such as the one experienced in recent months, as well as observe the impact, negative in many cases, but positive in others, of the patients we treat daily.

Methods

Description through brief clinical cases of the impact of the COVID-19 pandemic on psychotic patients and the decompensation that it has entailed, including due to confinement measures and social isolation, associated with over-information through the media, chaos initial and the uncertainty that it caused and the associated fear.

Results

Restrictions as a result of COVID-19 have played a very relevant role as an external stressor for the appearance of psychopathological alterations, including psychotic symptoms. In addition, people who suffer from psychosis or at risk of psychotic disorder can be especially affected and trigger acute psychopathology with social isolation, loss of daily routines, unemployment, homelessness.

Conclusions

These cases are an example that shows the need for an early and effective approach to the rise in mental illnesses in circumstances of this caliber.

Disclosure

No significant relationships.
Covid-19: knowledge, risk perception, trust and vaccination readiness among German medical students
Authors: Baessler F.
Published: September 2022

Introduction

The Covid-19 pandemic has highlighted the urgency for innovative vaccine strategies since the best of vaccines cannot be useful if people do not accept vaccinations. The current situation suggests that vaccinology has been ignored in the medical curriculum and needs more representation in teaching.

Objectives

What, where and how vaccinology is taught during medical studies in Heidelberg and development of an interdisciplinary revised syllabus and practice-oriented teaching methods.

Methods

Curricular mapping of courses on the topic of “vaccination”, defining new learning objectives for designing innovative teaching units in consultation with teachers and students, redevelopment and updating of teaching materials.

Results

In preliminary work, an OSCE has been created by students. Initial findings on the status of teaching on vaccinations and related communication skills in medical schools of Germany with respect to student needs and the national guidelines on learning goals for future physicians are submitted in journal ‘Vaccine’. In collaboration with the elective track Digital Medicine, two tele-OSCEs, an online knowledge quiz on vaccination education and a corresponding evaluation tool will be developed in WS 2021/22. Students will learn how to create modern teaching methods and evaluate them scientifically, using a concrete and relevant topic as an example, and will gain an insight into teaching.

Conclusions

The findings will be integrated into the Heidelberg medical school curriculum (HeiCuMed) on a long-term basis by developing a comprehensive interdisciplinary module ‘Vaccination and Vaccines’, which can either be integrated into various existing courses (e.g. virology, medical Communication, global health, etc) or as a separate elective interprofessional course.

Disclosure

No significant relationships.
Factors associated with suicidal ideation in the French nationwide EPICOV study
Authors: Davisse-Paturet C. , Orri M. , Florence A.-M. , Hazo J.-B. , Geoffroy M.-C. , Melchior M. , Rouquette A.
Published: September 2022

Introduction

The COVID-19 pandemic seems associated with a worsening in mental health issues as well as a widening of pre-existing social and health inequalities. Assessment of its impact on suicidal behavior might therefore be relevant.

Objectives

To assess factors associated with suicidal ideation in the general population, using data from the French nationwide Epicov study

Methods

In the nationally representative Epicov study, data on occurrence of suicidal ideation from November 2019 to November 2020 were available, including timing with respect to France’s lockdown periods. We studied the incidence of suicidal ideation among participants without a prior history of suicidal behavior, after May 11, 2020, when first COVID-19 related lockdown was suspended. Studied factors assessed sociodemographic and health status, including mental health, as well as COVID-19 related information such as symptom. Associations between selected factors and suicidal ideation were assessed in sex-stratified adjusted logistic regression models.

Results

In the Epicov study, prevalence of suicidal ideation was of 2,9%, as opposed to around 4% pre-pandemic. Among 48 702 female and 41 016 male participants, health or financial issues were associated with a higher incidence of suicidal ideation. Interestingly, Covid19-like symptoms were also associated with higher risk of suicidal ideation. While an impaired mental health has been observed in survivors of past pandemics, given the unprecedented context of the current pandemic, this association needs further investigation.

Conclusions

While the COVID-19 pandemic might have lowered suicidal ideation, it’s aftermaths may reverse the trend. To prevent this rise, identification of vulnerable groups is crucial to promote tailored public health strategies.

Disclosure

No significant relationships.
Clinical Phenotypes Characterization in Pharmacogenetics Testing Trials for Major Depressive Disorder Treatment
Authors: Minelli A.
Published: September 2022

Several data indicate that the success of pharmacological treatment in major depressive disorder (MDD) is still unsatisfactory. The determination of the optimal treatment generally requires multiple trials with different treatments, with the sobering observation that the more treatments tried without success, the less likely a successful outcome, with the result of a long unremitted disease, worse long term prognosis, increased rates of side effects, and important medical, social and economic burden. The reasons for the low response and remission rates are multiple and depend on environmental and biological factors intrinsic to the disease and drug treatments. Pharmacogenetic (PG) tests have the potential to increase efficacy predicting outcome and to reduce antidepressant discontinuation due to side effects. Several studies investigated the utility of PG tests for antidepressants in MDD with interesting but contrasting results. To date most of them are observational studies with no comparator group, and few are randomized controlled trials (RCTs). Several limitations concerning study design, generalization of results, duration of trials, patients group studied, and cost-effectiveness ratio were found, and a number of barriers have been noted in the adoption of PG tests into clinical practice. Despite some preliminary positive results, there is the need for larger and longer‐term RCT studies, with the goal to capture the real impact of PG tests, also with stratified analysis concerning MDD features in terms of severity and antidepressant treatment failures in different ethnicity cohorts.

Disclosure

No significant relationships.
The level of depressive, anxiety and obsessive-compulsive psychopathological dimensions in symptomatic versus asymptomatic SARS-CoV-2 infected pregnant women
Authors: Enatescu V.R. , Dinescu M. , Kalinovic R. , Vlad G.
Published: September 2022

Introduction

The neurotropic valence of SARS-CoV-2 has been revealed in several studies. Depressive and anxiety symptoms are more frequent in the perinatal period leading to maternal and neonatal negative outcomes. Accordingly, depressive and anxiety symptoms are more frequent in the perinatal period leading to negative consequences in both mothers and their neonates.

Objectives

To determine the level of depression, anxiety, and obsessive-compulsive symptoms depending on the severity of SARS-CoV-2 infection of pregnant women.

Methods

Based on the RT-PCR test, thirty-eight pregnant women with SARS-CoV-2 infection, hospitalized in Bega Clinic in Timisoara, were assessed concerning the presence of psychopathology. The severity of infection was dichotomized based on the presence or absence of the symptoms. The Edinburgh Postnatal Depression Scale, State and Trait Anxiety Inventory, and the Obsessive-Compulsive Inventory were administered to all participants.

Results

Of 38 recruited pregnant women, 12 (31,5%) had symptomatic SARS-CoV-2 infection. Symptomatic SARS-CoV-2 infected pregnant women had a higher average score of depression (p = 0.001) and state and trait anxiety (p = 0.002 and p < 0.001, respectively) compared to their asymptomatic counterparts. There were no differences in obsessive-compulsive symptoms (p > 0.05) in relation to the severity of SARS-CoV-2 infection.

Conclusions

The SARS-CoV-2 infection significantly interferes with the psychological status, thus jeopardizing the mental health of pregnant women. Therefore, SARS-CoV-2 infection should be considered an additional risk factor for anxiety and affective disorders during pregnancy.

Disclosure

No significant relationships.
Perceived Stress and risk of infection among Covid-19 frontline Healthcare workers
Authors: Haddar A. , Sellami I. , Abbes A. , Masmoudi R. , Halweni H. , Derbel N. , Hammami K. , Masmoudi J. , Masmoudi M.L. , Hajjaji M.
Published: September 2022

Introduction

Working at Covid-19 frontline may threaten physical and mental health healthcare workers (HCWs). Assessing perceived Stress in HCWs is important to prevent serious mental illness

Objectives

Assess the association between perceived stress and risk perception among healthcare workers working in the Covid-19 unit.

Methods

We conducted a cross-sectional study among healthcare workers working in a COVID-19 unit between March and July 2021 through a self-administered questionnaire. The Perceived Stress Scale (PSS-10) was used to assess perceived stress. The perceived risk of getting infected was assessed by a 5-item Likert Scale. The perceived risk of family members’ infection was evaluated by a Scale from 0 to 10.

Results

A total of 85 participants were included. The mean age was 31±6 years. About 87% of participants lived with their families. Seventy-six per cent of HCWs rated their health status greater than or equal to 8/10. A percentage of 18,8% of HCWs have been infected with the Covid-19. Our population consisted of 44.7% technicians and 24,7% nurses, and 80% of the participants reported direct contact with COVID-19 confirmed patients. The level of the perceived risk of getting infected was high to very high in 95% of the HCWs. The mean score of the perceived risk of family members contracting the virus was 5.7 and 27,1% rated it greater than or equal to 8. The PSS-10 showed moderate and high perceived stress in 82,3% and 7,1% of participants, respectively. Only 10,6% of HCWs presented low-stress perception.

Conclusions

Frontline healthcare providers have high perceived stress and are at risk of mental health disorders

Disclosure

No significant relationships.
Hysteria: history of a conceptual and clinical pathomorphosis
Authors: Sanz Giancola A. , Alvarez Garcia C.
Published: September 2022

Introduction

Transhistorical psychiatry defends that a psychic alteration can be interpreted as a cultural, historical and personal construction, subject to incessant variations.

Objectives

A journey through the history of the disorder and the successive pathomorphoses it has undergone could provide us with a better understanding of it and explain the reason for the epidemiological trend towards a decrease in its diagnosis; and bring us closer to a universal definition of the phenomenon.

Methods

Bibliographic review

Results

The word hysteria and all its subsequent meanings, not only contain a particular conception of the pathology, but also reflect its different forms of presentation in specific periods of time. Hysteria is presented as a voluble material that can take on any form: from the wandering womb theory of classical Greece to the demonic possessions of the Middle Ages; from the neurological degeneration of Charcot (1825-1893) to the conversion and dissociation of Freud (1856-1939). With the entry of the 20th century, its dramatic clinic has been progressively overshadowed by somatoform disorders and emerging functional somatic syndromes. Today, it is practically unrecognisable and very difficult to diagnose, to the point of having disappeared as a term from the official classifications of our time.

Conclusions

Hysteria is an entity that has not always been the same, neither in its conception nor in its manifestations. Depending on the socio-cultural context in which it is framed, it will be interpreted and expressed in different ways.

Disclosure

No significant relationships.
White matter integrity and pro-inflammatory cytokines as predictors of antidepressant response in MDD
Authors: Breit S. , Mazza E. , Poletti S. , Benedetti F.
Published: September 2022

Introduction

Major depressive disorder (MDD) often involves immune dysregulation with high peripheral levels of pro-inflammatory cytokines that might have an impact on the clinical course and treatment response. Moreover, MDD patients show brain volume changes and white matter (WM) alterations that are already existing in the early stage of illness.

Objectives

The aim of the present review is to elucidate the association between inflammation and WM integrity and its impact on the pathophysiology and progression of MDD as well as the role of possible novel biomarkers of treatment response to improve MDD prevention and treatment strategies.

Methods

We conducted an electronic literature search of PubMed on studies that examined the role of inflammation in depression and that focused on WM integrity and pro-inflammatory cytokines as predictors of antidepressant response.

Results

There is evidence for central effects of peripheral inflammation which could activate microglia which, in turn, might trigger a cascade of inflammatory processes leading to neurotransmitter imbalances. Numerous studies indicated that both altered levels of peripheral inflammatory markers, particularly TNF-α, IL-6, and CRP as well as WM integrity might predict antidepressant treatment outcome.

Conclusions

Despite mounting evidence on the impact of the immune system on WM microstructure, no study has yet addressed the interaction between the two factors in influencing antidepressant response. There is a lack of reproducible biomarkers predicting treatment response on an individual basis. The availability of such biomarkers would enable more efficient and personalized treatments with a faster treatment response and better prevention of treatment resistance.

Disclosure

No significant relationships.
Probiotics as a therapeutic strategy in Major Depressive Disorder
Authors: Vargas L.
Published: September 2022

Introduction

Major depressive disorder is a prevalent disease, in which one third of sufferers do not respond to antidepressants. Disturbance in the equilibrium of the gut microbiota has been involved in the pathophysiology of depression. Probiotics have the potential to be well-tolerated and cost-efficient treatment options. However, there is not enough evidence of the impact of probiotics in patients suffering MDD.

Objectives

The main aim of this revision is to assess those clinical trials that evaluate the effects of probiotic treatment in patients with MDD.

Methods

A research on the database PubMed has been done with the terms “probiotics” AND “MDD” and then a systematic review has been performed between those articles meeting the inclusion criteria.

Results

Most of the articles show an improvement of the depressive symptoms in outpatients with mild to moderate TDM after 8 week treatment with probiotics added to the treatment as usual. Those articles assessing inpatients with severe MDD after four weeks of treatment with probiotics added to their usual treatment didn’t find statistical differences between treatment with probiotics from placebo.

Conclusions

Probiotics may be useful in mild to moderate symptoms of MDD after 8 weeks treatment added to usual treatment. Nevertheless, further investigation in larger samples during more time. Moreover, a new awareness is raised about gut- brain axis pathophysiology, that would lead the path to new investigations about this relation so as the difference in depressed patients microbiome, tryptophan metabolism and the pro- inflammatory compounds that reach the blood-brain barrier because of the “leaky-gut”.

Disclosure

No significant relationships.
The effect of Working Alliance on drug attitude in patients with Major Depressive Disorder
Authors: Santarelli G. , Sanfilippo G. , Benvenuti F. , Santoro L. , Nistri A. , Innocenti M. , Ballerini A. , Ricca V.
Published: September 2022

Introduction

Working Alliance is defined as the emotional bond and the agreement on therapeutic goals and tasks between patients and therapists. Despite the wide use of the construct of working alliance in research on psychotherapy, few studies have investigated the role of working alliance in influencing adherence to pharmacotherapy, and drug attitude. A deeper knowledge of the interplay between working alliance and drug attitude could help to challenge low adherence to psychopharmacological treatments in Major Depressive Disorder.

Objectives

This study aimed to investigate the relationship between working alliance and drug attitude in patients with Major Depressive Disorder.

Methods

27 patients admitted in the Psychiatric Unit of Careggi with diagnosis of Major Depressive Disorders were enrolled. Working Alliance Inventory - patient version (WAI-P), Drug Attitude Inventory (DAI) and Beliefs about Medicines (BMQ) were administered. Pearson’s correlation was used to assess relationships between variables.

Results

A significant positive correlation was detected between BMQ total scores, DAI total scores and WAI-P task, bond, and goal subscales.Correlations between WAI-P subscales and BMQ and DAI total scores
DAI total scores
BMQ total scoresrprpWAI-P task0.5510.0030.6130.001WAI-P bond0.4300.0010.5600.004WAI-P goal0.6210.0010.6030.002

Conclusions

Such preliminary data suggest a relationship between Working Alliance and drug attitude. This could contribute to provide tools to challenge low adherence to psychopharmacological treatments in patients with Major Depressive Disorder.

Disclosure

No significant relationships.
Clinical consensus regarding the importance of rapid reduction in depressive symptoms in major depressive disorder with acute suicidal ideation or behavior (MDSI)
Authors: Borentain S. , Nash A. , Daly E. , Joshi K. , O’Hara M. , Zhang Q. , Mathews M. , Haughey S. , Richards S. , Anjo J. , Zante D. , Perry R.
Published: September 2022

Introduction

Patients with major depressive disorder (MDD) with acute suicidal ideation or behavior (MDSI) require immediate intervention. Though oral antidepressants can be effective at reducing depressive symptoms, they can take 4–6 weeks to reach full effect.

Objectives

This study aimed to identify unmet needs in the treatment of patients with MDSI, specifically exploring the potential clinical benefits of rapid reduction of depressive symptoms.

Methods

A Delphi panel consisting of practicing psychiatrists (n=12) from the US, Canada and EU was conducted between December 2020–June 2021. Panelists were screened to ensure they had sufficient experience with managing patients with MDD and MDSI. Panelists completed two survey rounds, and a virtual consensus meeting.

Results

This research confirmed current unmet needs in the treatment of patients with MDSI.

Hopelessness, functional impairment, worsening of MDD symptoms, recurrent hospitalization and higher risk of suicide attempt were considered as key consequences of the slow onset of action of oral antidepressants.

Treatment with rapid acting antidepressant was anticipated by panelists to provide short-term benefit such as rapid reduction of core MDD symptoms which may contribute to shorter hospital stays and improved patient engagement/compliance, allowing for earlier interventions and improved patient outcomes. For long-term benefits, panelists agreed that improved daily functioning and increased trust/confidence in treatment options, constitute key benefits of rapid-acting treatments

Conclusions

There is need for rapid-acting treatments which may help address key unmet needs and provide clinically meaningful benefits driven by the rapid relief of depressive symptoms particularly in patients with MDSI.

Disclosure

SB, ED, KJ, MO’H, QZ, MM, MH, SR, JA and DZ are employees of Janssen and hold stock in Johnson & Johnson Inc. AN is currently employed by Neurocrine Biosciences Inc. RP is an employee of Adelphi Values PROVE hired by Janssen.
Investigating Depression and Anxiety among Turkish Immigrants with Endocrine Disorders Treated at the NPZR
Authors: Cindik-Herbrüggen E.D. , Demirkol R. , Demir Z. , Ilıman Ö.
Published: September 2022

Introduction

Immigrants encounter difficulties in adapting to social life due to cultural and socioeconomic differences which consequently causes psychological and physical problems. Previous studies demonstrated that diabetes, high blood pressure, dyslipidemia and obesity are associated with psychological disorders.

Objectives

This study aimed to investigate the frequency of depression and anxiety and to observe associated sociodemographic among endocrine patients treated at NPZR.

Methods

190 Turkish psychiatric patients with at least one endocrine disorder (45.3% were male (n=86) and 54.7% were female (n=104) between the ages of 30-65, who participated in group therapy session at the NPZR, were recruited. Demographics, prevalence of depression and anxiety as well as current psychological conditions of participants were analyzed through Beck Depression Inventory, Hamilton Anxiety Scale, SCL-90-R and Personal Information Form.

Results

The findings of our study demonstrated that prevalence of depression, anxiety and sleep disorders among Turkish immigrant patients with endocrine diseases is high. The mean scores of depression and anxiety were 31.39 and 32.61 respectively. The most common endocrine diseases were hypertension (51.6 %) and obesity (49.6%). Analysis of our research showed that there was no significant gender differences in the anxiety and depression scores. However, there was a significant relationship between income of participants and prevalence of anxiety, depression (p<0.05).

Conclusions

The results of this research suggest that anxiety and depression disorders are highly prevalent among Turkish psychiatric patients with endocrine diseases Using the data of this study, the frequency of endocrine diseases among immigrant psychiatric patients can be analyzed.

Disclosure

No significant relationships.
Attitudes towards death in adolescents hospitalized with depressive disorder
Authors: Bebchuk M. , Dovbysh D. , Timoshenko S. , Rabadanova R. , Zhorina Y. , Diachenko A. , Talmach M. , Fakhretdinova G.
Published: September 2022

Introduction

The study of attitudes towards death in patients of different nosological groups is an urgent task for modern science. It becomes especially relevant when working with adolescents with severe depressive disorder: for many of them, thoughts about death in various forms become the main reason for contacting specialists and the most subjectively painful symptom.

Objectives

Revealing the characteristics of attitudes towards death in adolescents with severe depressive disorder.

Methods

The study involved 135 adolescents (12-17 years old) with depressive disorder, hospitalized in a psychiatric hospital. Participants completed the following methods: Hamilton Rating Scale for Depression, Columbia Suicide Severity Rating Scale, Death Attitude Profile-Revised, Fear of Personal Death Scale, Death Anxiety Scale.

Results

The severity of depressive symptoms is significantly associated with the “death-as-flight” scale (r = 0.639, p = 0.000). The values on the “fear of death” scale are positively associated with the indicators on the scales “death anxiety” (r = 0.432 p = 0.025), “consequences of death for the individual” (r = 0.658, p = 0.000), “transcendental consequences of death” (r = 0.711, p = 0.000), “the consequences of my death for loved ones” (r = 0.496, p = 0.008). Indicators on the “active death search” scale are negatively associated with indicators on the “neutral acceptance of death” scale (r = -0.503, p = 0.007) and positively with the “fear of oblivion” scale (r = 0.432, p = 0.024).

Conclusions

The attitude towards death in adolescents with depressive disorder has a pronounced specificity, which can become one of the targets of psychotherapeutic work.

Disclosure

No significant relationships.
A comparison between patients who suffer from major depression and are treated with Esketamine – one group participates in group therapy and the other one does not
Authors: Yaniv H. , Savlev V.
Published: September 2022

Introduction

Major depressive disorder is present in approximately 7% of the general population. There are some patients that remain treatment-resistant - patients who were treated with two or more different medications and did not demonstrate any improvement in their mental state. These patients can be treated with a new treatment – Esketamine. The recommended Esketamine treatment protocol includes 8-treatment sessions, each session lasts about two hours. In our clinic, we added a therapy group after each treatment. The therapy group is led by two co-therapist and lasts 30 minutes. The patients are invited to share their experiences from the session, their thoughts and emotions.

Objectives

The study that we will present was conducted in the Esketamine treatment unit at a psychiatric hospital. There were two groups - 1. A group whose treatment included a therapeutic group at the end of each Esketamine treatment (n=30); 2. A group whose treatments did not include a therapeutic group at the end of the Esketamine treatment (n=30).

Methods

The current study examines the role of the therapeutic group. It compares between the standard treatment protocol, with and without a therapeutic group. All participants completed three questionnaires, about their emotions, three times during the treatment (before the first session, after 4 sessions and after 8 sessions).

Results

We will present first results as well as vignette to demonstrate.

Conclusions

The expectation is to find a better patient experience and a better insight about the clinical changes following the Esketamine treatment, in the group which participates in the therapy group

Disclosure

No significant relationships.
Levothyroxine supplementation among individuals with Subclinical Hypothyroidism and Depression | a review
Authors: Ribeiro M. , Lourenço A. , Lemos M. , Duarte A.
Published: September 2022

Introduction

Depression is known to be associated with changes in the hypothalamic-pituitary-thyroid axis and the brain is a major target organ for thyroid hormone. Overt hypothyroidism can cause symptoms compatible with depression. However, its relationship with subclinical hypothyroidism (SCH) is not well established.

Objectives

To review the literature regarding the effect of levothyroxine therapy among patients with SCH and coexistent depression.

Methods

We conducted a MEDLINE search using depression, subclinical hypothyroidism and levothyroxine as keywords, selecting studies written in English.

Results

SCH is defined as an elevated thyroid stimulating hormone with normal peripheric hormone levels. The association between SCH and depression is controversial. Some studies indicate that SCH had the same propensity with overt hypothyroidism, while others report that major affective symptoms are not associated with SCH, but are likely due to independent psychiatric diagnoses, which are common in the general population and occur with similar frequency in patients with SCH. Individuals with SCH are recommended to initiate levothyroxine replacement therapy only when their TSH level is above 10 mIU/L or if symptoms are present. There is a lack of evidence supporting the use of levothyroxine therapy to improve mental health outcomes and the majority of meta-analysis do not show relief of affective symptoms after levothyroxine therapy, among individuals with SCH.

Conclusions

Routine screening for depressive symptoms among individuals with SCH is important to prevent morbidity. Nevertheless, there is no evidence enduring levothyroxine supplementation in these cases. Further studies, with larger sample sizes and longer follow-up periods are needed to enlighten the potential benefit of this therapy.

Disclosure

No significant relationships.
Proposal of a therapeutic algorithm for the psychopharmacological management of treatment-resistant depression
Authors: Sanz Giancola A. , Molina Liétor M.D.C. , Cuevas Iñiguez I. , Alvarez Garcia C. , Blanco Prieto M.
Published: September 2022

Introduction

The lack of a standardised definition for the concept of TRD and an adequate criteria for therapeutic response make difficult the management of patients with MDD who do not achieve remission with one or more courses of treatment. All classifications suggested to define TRD are arbitrary, partially evidence-based, subordinated to the pharmacological findings of the time in which they are written and with serious inconsistencies, making it difficult to construct a universal and enduring diagnostic system.

Objectives

Considering that the most important goal in treating a patient with Major Depressive Disorder (MDD) should be remission and return to previous functionality, the search for a standardised, evidence-based classification system will allow timely and effective interventions leading to the reduction of this devastating condition.

Methods

Bibliographic review

Results

The proposed therapeutic algorithm arises from the combination of several fundamental principles for the management of treatment-resistant depression: the different classification systems of the concept, as well as the concepts of response, relapse, recurrence and remission; the scientific evidence found in the current literature, routine clinical practice, knowledge of switching and augmentation strategies, the new pharmacological targets and neurobiological hypothesis discovered, without forgetting finally the different clinical profiles of depressive symptomatology and the specific indications of each antidepressant.

Conclusions

Resistant depression is difficult to treat successfully and is not a uniform entity. Recently there has been a move to characterise treatment-resistant depression as ‘difficult-to-treat’ depression on the basis that the former description implies that depression treatments are normally effective and that non-response is therefore somehow abnormal.

Disclosure

No significant relationships.
Effectiveness of vortioxetine in real-world clinical practice: French cohort results from the global RELIEVE study
Authors: Polosan M. , Rabbani M. , Simonsen K. , Ren H.
Published: September 2022

Introduction

Major depressive disorder (MDD) affects around 10% of the French population annually and significantly impacts patient functioning. Efficacy of vortioxetine was demonstrated in randomised controlled trials, data on its real-world performance is needed.

Objectives

To describe the effectiveness and safety of vortioxetine in real-world setting from patients enrolled from France in the global RELIEVE study.

Methods

RELIEVE was a prospective, multi-national, observational study of outpatients initiating vortioxetine treatment for MDD at physician’s discretion. Data were collected at routine clinical visits. Here we present the outcomes of treatment of patients in France. The primary outcome was functioning measured by SDS. Secondary outcomes included depressive symptoms measured by PHQ-9, cognitive symptoms measured by PDQ-5 and DSST. Changes from baseline to month 6 were estimated with a linear mixed model of repeated measures approach.

Results

A total of 184 patients (mean age, 50.2 years, 65% female, 67.9% of patients had at least one comorbidity) were enrolled from France and included in the analysis. Mean(SD) SDS total score, PHQ-9, PDQ-5 scores at baseline were 21.1(5.4), 17.5(4.7) and 11.7(4.4), the scores(SE) decreased by 10.9(0.59), 9.3(0.48) and 6.1(0.37) from baseline to month 6. Mean(SD) DSST improved from 41.6(15.2) at baseline to 49.1(19.0) at month 6. Safety and tolerability profile of vortioxetine was in line with previous studies.

Conclusions

Sustained improvements in overall functioning, depressive symptoms, cognitive function were observed in patients treated with vortioxetine in a real-world setting, which provided further evidence of effectiveness and safety of vortioxetine in a broad MDD population in France.

Disclosure

M. Rabbani is an employee of Lundbeck France. K. Simonsen and H. Ren are employees of H. Lundbeck A/S.
Mental Health and Information Reporting Assistant: technological innovation including low- and middle-income countries - an update
Authors: Zimmermann R.
Published: September 2022

Introduction

According to the World Health Organization, addressing the mental health care gap for adolescents, especially in low-resource contexts, is a priority. Evidence-based assessment is crucial for selecting treatment strategies and for quality management.

Objectives

To develop a digital platform for evidence-based assessments and implement it in different low-resource settings.

Methods

The project operates according to the principles of digital development (https://digitalprinciples.org/), including designing with the user, user testing, understanding the ecosystem, resusing software and being open source, think about sustainability and addressing privacy and security.

Results

Different implementation contexts (in Tanzania, Kosovo and Chile) will be presented.

The learned lessons will be presented to the audience.

Conclusions

MHIRA is a promising tool that helps bridge the gap regarding adolescent mental health in low-resource settings. Challenges include the clinicans attitude towards evidence based assessment, sustainability of the project and integration with the existing information technology eco-system and regulations.

Disclosure

No significant relationships.
Developing A Smartphone-Based Application for the Behavioral Cognitive Therapy of Panic Disorder
Authors: Esen E.C. , Baykan H.
Published: September 2022

Introduction

Even though cognitive behavior therapy is proven to be an effective treatment for panic disorder, the scarcity of psychiatrists cause many patients not to get a sufficient therapy. E-mental health applications are being developed to address this shortage, especially after the COVID-19 pandemic. However, none of the e-mental health applications developed so far has offered a structured cognitive behavioral therapy.

Objectives

We are developing a mobile application which will integrate with psychiatric interventions that aims to make cognitive behavioral therapy more accessible.

Methods

Our algorithm consists of multiple choice questions and answers to determine the progression of the algorithm. The first three sessions consist of psycho-education of the application and the cognitive therapy model of panic mostly. During the psycho-education sessions, patients’ symptoms during panic attacks and their catastrophic thoughts will be questioned to be used in following sessions. After the panic log has been introduced in the third session, patients will enter the details of their panic attacks right after they experience it and this information will be investigated in the following sessions. Progress for the cognitive restructuring will be monitored as the sessions proceed. Later session will also include in-session symptom induction exercises.

Results

We are still on the development phase of the mobile application. Hence we do not have any data to present at the moment.

Conclusions

Our main purpose is to develop a mobile application which will integrate with structured cognitive behavioral therapy process, reduce the workload of the therapist and is easily accessible through the smart phones.

Disclosure

No significant relationships.
What can we say about the impact of teleconsultations on preventing psychiatric inpatient treatment during COVID-19 pandemic?
Authors: Figueiredo I. , Cargaleiro I. , Nascimento M.
Published: September 2022

Introduction

Telepsychiatry was proved effective and satisfactory in settings like the emergency department and mental health services, but its use is historically restricted. Although there are several studies about telepsychiatry pros and cons, more is needed to know about its effect on patient’s follow-up and its influence on inpatient treatment rates, specifically during COVID-19 pandemic.

Objectives

The aim is to look for an eventual change on psychiatric inpatient admissions, during COVID-19 pandemic, when psychiatric patients are in follow-up through teleconsultation.

Methods

We compared the number of hospitalizations for 3 different 6 months periods of time: the 2nd semester of 2019 with no teleconsultations, March-August 2020 only with teleconsultations (except some few 1st consultations) and the 1st semester of 2021 with face-to-face and teleconsultations. A one-way repeated measures ANOVA was conducted on a 1050 patients sample.

Results

The statists showed that the type of approach in consultations didn’t lead to statistically significant differences in hospitalizations (F test-statistic = 0.33086, p = 0.718345).

Conclusions

There is a plethora of advantages about telepsychiatry and it was already shown to be as effective as in-person contact. Some articles show an association of telepsychiatry with a decrease in hospitalization rates, but mostly display similar clinical outcomes. In this study, the authors found that the results follow the latter tendency, although we must consider the COVID-19 pandemic as a possible decompensation and worsening clinical factor. More studies on this matter are important to better understand the potential benefits (and risks) of this treatment setting.

Disclosure

No significant relationships.
Attitudes towards body and perception of parental care and close relationships in anorexia nervosa (AN)
Authors: Karpenko P. , Pechnikova L. , Zhuykova E. , Sokolova E. , Ryzhov A. , Ioannisyants O.
Published: September 2022

Introduction

The links between body image disturbances and distorted relationships with parents were supposed since the early conceptualizations of AN by Hilde Bruch. The empirical studies however were concerned with perceptual aspects of body image and much less is known about how the attitudinal aspects and the body-related behaviors are affected.

Objectives

To study the attitudinal and behavioral aspects of body image in adolescents with AN in relation to perceived parental care and the attachments to close people.

Methods

The Body Investment Scale (BSI), Parental Bonding Instrument (PBI) and Attachment Style Questionnaire (ASQ) were used. 53 girls with Anorexia Nervosa were compared to 63 controls (adjusted by age).

Results

Girls with AN scored significantly higher on BIS Body attitude (p<.001) and Protection scales (p<.01), while displayed equal results on Body Care scale. They displayed lower Confidence in relationships (p<.01), higher Need for approval, Discomfort and preoccupation in close relationships (p<.05). No differences were found on PBI, excerpt for AN group perceiving less paternal control (p<.05). The correlation analysis, while showing a number of similar correlations within groups, suggests that in AN group positive Body image was more closely linked to perceived early care, especially from father (r=.6), in contrast with controls. In current relationships negative Body image for AN is stronger related to Discomfort and Need for approval (r>0.6), while Discomfort with Touch is less linked to problems in relationships than in controls.

Conclusions

Results suggest the importance of studying the father’s mediating role in the formation of body attitudes in AN.

Disclosure

No significant relationships.
Eating disorder and suicide attempt
Authors: Chaara A. , Laboudi F. , Ouanass A.
Published: September 2022

Introduction

The quantification of suicidal risk in specific populations is important for the adoption of prevention and risk reduction measures. This risk remains very high in patients with eating disorders compared to the general population.

Objectives

The present study evaluates the prevalence of suicide among patients with eating disorders all seeking different suicidal risk factors in these patients.

Methods

A retrospective study of medical records of all patients with eating disorders, diagnosed according to DSM 5 criteria, at Arrazi hospital of Salé for the past 14 years, by assessing the prevalence of suicide attempts and care.

Results

In our work, all patients are female, 17 years old on average, 18 patients out of 20 have anorexia nervosa, 4 of them have had bouts of bulimia, and only one patient was admitted for management of bulimia nervosa alone. The mean age of onset was 15 years with addictive comorbidity in 5 patients.

Thirteen patients had comorbid depressive disorder, one patient was schizophrenic and six patients had borderline personality disorder.

12 patients have made suicide attempts, planned especially in a depressive environment.

Conclusions

Preventive management of suicidal risk must be taken in order to improve the prognosis in this category of patients.

Disclosure

No significant relationships.
The evaluation of distorted body image in anorexia nervosa
Authors: Ciwoniuk N. , Wayda-Zalewska M. , Kucharska K.
Published: September 2022

Introduction

A distorted body image appears to be a significant factor predisposing an individual to developing anorexia nervosa and its maintaining. Anorexia nervosa presents with the highest mortality rate among all mental disorders.

Objectives

The aim of the research work was to assess the distorted body image in women diagnosed with anorexia nervosa, as well as to analyse the impact of the severity of the symptomatology of eating disorders, level of depression and anxiety on the distorted body image.

Methods

A total of 105 people participated in the study. The clinical group consisted of 36 women diagnosed with anorexia nervosa, while the group of healthy women consisted of 69 participants. Patients completed several psychological and clinical measures such as: EAT-26, BSQ-34, BIDQ, BDD-YBOCS, CDRS, CESDR, and STAI.

Results

Between group comparisons were performed using nonparametric the Mann-Whitney U test. Results revealed statistically significantly greater distorted body image perception in anorexia group. Women diagnosed with anorexia nervosa showed significantly higher levels both depression and anxiety compared to the healthy controls. Based on correlation analyses, it was shown that there are statistically significant relationships between the body image variable and eating disorders, depression, and anxiety (state and trait).

Conclusions

To deepen the problem of distorted body image, further research is required on etiopathogenesis and dynamics of body image in relation to body mass index and illness chronicity.

Disclosure

No significant relationships.
Psychiatric Causes of Bariatric Surgery Exclusion: A Descriptive Study
Authors: Vilella Martín C. , García Vázquez P. , Barrera García Y. , Fernández Perea P. , Serrano García A. , Franch Pato C. , Gómez Martínez R.
Published: September 2022

Introduction

The psychopathological causes that advise against a bariatric surgical procedure include any state that puts at risk the modification of habits and beliefs regarding eating behavior, wich condition weight loss and health improvement.

Objectives

To Study the psychiatric profile of patients rejected for bariatric surgery at the Complejo Hospitalario Asistencial de León (León, Spain).

Methods

Retrospective observational study. All patients for whom bariatric surgery procedure has been contraindicated for psychopathological reasons are included. 145 patients were evaluated in the context of the protocol for bariatric surgery. The following diagnostic scales were used as support: Salamanca Questionnaire, Plutchik Impulsivity Scale, Attitudes towards change in patients with eating disorders (ACTA), Bulimia Investigatory Test Edinburgh e, and European Quality of Life-5 Dimensions.

Results

41 Patients were rejected for psychiatric reasons (28.28%). The most frequent diagnoses are impulse control disorder (39%), followed by eating disorder (27%). Other diagnoses found are: depressive disorder (10%), adjustment disorder (5%), personality disorders, intellectual disability and generalized anxiety disorder (3%) 78% of them are women.

Conclusions

Uncontrolled psychiatric pathology is a contraindication to bariatric surgery. Impulse control disorder and eating disorder are related to overweight and obesity, so a diagnosis and treatment are necessary prior planning surgical procedure. Psychopathological variables determine the success of bariatric surgery procedures and it is mandatory to consider them in the process.

Disclosure

No significant relationships.