bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of Cognitive Impairment in Early Intervention Settings
Authors: Nordentoft M. , Glenthøj L. , Medalia A. , Roberts D. , Hjorthoj C.
Published: September 2022

Background. Cognitive impairment in schizophrneia is highly prevalent, the level of impairment range from moderate to severe. It has previously beed stated that cognitive impairment was stable through the course of illness, but newer finding from long-term studies indicate that some patient have improved cognitive function. Cognitive function is marginally reactive to antipsychotic medication, and it is highly predictive of poor social and vocational outcome. Also, it constitute a ‘glass ceiling’ for psychosocial and vocational rehabilitation. Several large batteries have been developed, and internationally, there is an attempt to agree on common measurements of core areas. There is a strong rationale for cognitive remediation, namly that it might improve the ability of patients to function in everyday life and that it has no side effects. Individuals at ultra-high risk (UHR) for psychosis have significant cognitive deficits that can impede functional recovery. Methods. In this randomised, clinical trial 146 individuals at UHR for psychosis were randomly assigned to treatment as usual (TAU) or TAU plus cognitive remediation. The CR targeted neurocognitive and social cognitive remediation. Results. A total of 73 UHR individuals were assigned to TAU and 73 assigned to TAU + cognitive remediation. Cognitive remediation did not result in significant improvement on the primary outcome; the Brief Assessment of Cognition in Schizophrenia composite score at 6-month follow-up (b=-0.125, 95%CI: -0.23 to 0.172, p=0.41). Conclusion. The 20-session treatment protocol was not well received in the UHR group. Possibly situations close to everyday life could be better received and be more motivating

Disclosure

No significant relationships.
Psychiatric-psychotherapeutic and psychosocial care for refugees: effects and future prospects of the refuKey project - perspective of experts
Authors: Wendt N. , Graef-Calliess I. , Loos K. , Finkelstein D. , Mohwinkel V. , Özkan I. , Penteker G. , Trilesnik B.
Published: September 2022

Introduction

Refugees have been shown to be a vulnerable population with increased psychiatric morbidity and lack of access to adequate mental health care. By establishing cooperations between psychosocial centers and psychiatric clinics the state funded project refuKey by NTFN e.V. and DGPPN aims to improve access to and quality of mental health care for traumatized refugees pursuing a stepped-care model.

Objectives

As part of a larger project evaluation study four focus-groups among experts were conducted to explore the impact of refuKey on refugees’ mental health care.

Methods

Data analysis was conducted using Mayring qualitative content analysis as well as an additional quantitative survey with state refugee reception centers’ employees.

Results

The results indicate that refuKey faciliated the access to mental health care for refugees in terms of systematic identification of mental disorders, eased transitions and increased networking between the mental health care institutions and sectors. Planning and implementation of treatment is described as being more coordinated, solution oriented and sustainable due to multiprofessional collaboration and regular use of qualified interpreters. Reduced distress as well as increased transcultural expertise was found for professionals.

Conclusions

The persisting barriers for refugees in access to mental health care, especially to psychotherapeutic treatment and the emotional burden for professionals underlines the need for further support and research. The experts highly endorse the continuance of refuKey. Furthermore, they call for expansion of the project in terms of staff and new sites and changes of health policies to guarantee the access to adequate health care for traumatized refugees.

Disclosure

No significant relationships.
Identifying prodromal biomarkers for schizophrenia and bipolar disorder using magnetoencephalography
Authors: Jefsen O. , Dietz M. , Friston K. , Mors O. , Shtyrov Y.
Published: September 2022

Introduction

Schizophrenia (SZ) and bipolar disorder (BD) are severe mental illnesses with large overlapping heritability. Both disorders are associated with altered neurophysiological responses, as measured with magnetoencephalography (MEG) or electroencephalography (EEG), particularly reduced mismatch negativity (MMN) and 40 Hz auditory steady-state responses (ASSR). These deficits could potentially both serve as early markers of illness and provide insight into the underlying pathophysiology as endophenotypes. First-degree relatives to patients with SZ and BD also show some neurophysiological deficits, however whether these deficits can be detected in adolescent offspring of patients is undetermined.

Objectives

We aim to investigate whether adolescents at familial high risk of schizophrenia and bipolar disorder show aberrant MMN and ASSR compared to population-based controls.

Methods

We will investigate MMN and 40 Hz ASSR in 15 year old adolescents (n ≈ 175) born to parents diagnosed with either SZ (FHR-SZ), BD (FHR-BD), or neither SZ or BD (population-based controls, PBC) using MEG. We will first perform sensor-level analyses and subsequently apply dynamic causal modeling (DCM) to investigate effective connectivity and make inferences about the underlying neurobiological mechanisms. We will investigate whether current psychopathology, cognitive status, and genetic risk for SZ and BD predict neurophysiological responses in the adolescents. Investigations are part of The Danish High Risk and Resilience Study - VIA (VIA15), a population-based longitudinal cohort study integrating social, psychological and biological risk factors and outcomes for SZ and BD.

Results

Final results are expected in 2024

Conclusions

The VIA15 study will allow for unprecedented insight into the neurobiological development of schizophrenia and bipolar disorder.

Disclosure

No significant relationships.
Assessing response, remission and treatment resistance in patients with Obsessive-Compulsive Disorder with and without Tic Disorders: results from a multicenter study
Authors: Conti D. , Girone N. , Benatti B. , Gambini O. , Albert U. , Maina G. , Amore M. , Porta M. , Dell’Osso B.
Published: September 2022

Introduction

Obsessive Compulsive Disorder (OCD) and Tic Disorder (TD) are two highly disabling, comorbid and difficult-to-treat conditions. DSM-5 acknowledged a new “tic-related” specifier for OCD, i.e., Obsessive-Compulsive Tic-related Disorder (OCTD), which may show poor treatment response.

Objectives

The aim of the present study was to evaluate rates and clinical correlates of response, remission and resistance to treatment in a large multicentre sample of OCD patients with versus without tics.

Methods

398 patients with a DSM-5 diagnosis of OCD with and without comorbid TD was assessed from ten psychiatric departments across Italy. Treatment response profiles in the whole sample were analysed comparing the rates of response, remission and treatment-resistance as well as related clinical features. Multivariate logistic regressions were performed to highlight possible treatment response related factors.

Results

Later ages of onset of TD and OCD were found in the remission group. Moreover, significantly higher rates of psychiatric comorbidities, TD, and lifetime suicidal ideation and attempts were associated to the treatment-resistant group, with larger degrees of perceived worsened quality of life and family involvement.

Conclusions

While remission was related to later ages of OCD and TD onset, specific clinical factors, such as early onset and presence of psychiatric comorbidities and concomitant TD, predicted a worse treatment response, with a significant impairment in quality of life for both patients and their caregivers. These findings suggest a worse profile of treatment response for patients with OCTD.

Disclosure

No significant relationships.
Adjunctive therapeutic strategies in Obsessive-Compulsive Disorder resistant to serotonin reuptake inhibitors: a literature review
Authors: Regueira P. , Hall S. , Cerejeira J.
Published: September 2022

Introduction

Obsessive-Compulsive Disorder (OCD) is a common mental disorder and a major cause of disability worldwide. Typically, it has a chronic course, marked by recurrent intrusive thoughts (obsessions) and repetitive behaviors (compulsions). Its pharmacological first line of treatment has been well established for several years now, with the Serotonin Reuptake Inhibitors (SRIs). However, about half of the patients are resistant to this approach, representing a therapeutic challenge for clinicians. Evidence suggests that other medications can augment SRIs, enhancing its effects and achieving a bigger efficacy in these patients’ treatment. Also, there is an increasing interest in neurosurgical interventions in these patients.

Objectives

The main goal of this work was to assess the clinical efficacy of adjunctive therapeutic strategies in patients with OCD resistant to SRIs.

Methods

A literature review was conducted searching PubMed and ScienceDirect databases from the 1st of January 2000 to the 1st of September 2021 to identify clinical trials comparing an active drug/neurosurgical intervention with placebo as an adjunctive therapeutic strategy in SRI-resistant
OCD.

Results

Sixteen studies were selected for data extraction, including a total of 585 patients. Risperidone, aripiprazole, N-acetylcysteine, lamotrigine, pindolol, riluzole, memantine and methylphenidate were efficacious for augmenting SRIs in OCD. Ablative surgery (ABL) and deep brain stimulation (DBS) were equal effective in the treatment of refractory OCD.

Conclusions

Several therapeutic options presented as potentially effective in OCD when it is resistant to SRIs, although this is still an area for further research.

Disclosure

No significant relationships.
Augmentation strategy fluoxetine and lurasidone in the treatment of OCD with comorbid Restrictive Anorexia: a case report
Authors: Orsolini L. , Bellagamba S. , Tempia Valenta S. , Salvi V. , Volpe U.
Published: September 2022

Introduction

Obsessive-Compulsive Disorder (OCD) is characterized by the presence of intrusive thought (obsessions) and ritualistic behaviour (compulsions). First-choice psychopharmacological treatment is based on serotonin reuptake inhibitors (SRIs). However, about half of OCD do not or partially respond to SRIs (TR-OCD) and need an augmentation strategy with second-generation antipsychotics (SGAs).

Objectives

We report a case of severe OCD with comorbid anorexia nervosa, restrictive type (AN-r) treated with fluoxetine (up to 40 mg daily) and lurasidone (37 mg daily bedtime) augmentation.

Methods

At baseline and monthly 4-months-follow-up were administered Y-BOCS-II (Yale-Brown Obsessive Compulsive Scale), CGI-S (Clinical Global Impression-Severity), SCL-90 (Symptom Checklist-90 items) and EDI-3 (Eating Disorder Inventory-3).

Results

Compared to the baseline, a clinically significant clinical response was observed on OC at Y-BOCS-II (≥35% Y-BOCS reduction) and eating symptomatology at EDI-3 after 1 month of augmentation treatment, while a full remission after 3 months (Y-BOCS scoring ≤ 14)(p<0.01). We also noticed, throughout clinical follow up interviews, improvement in patient’s social skills and life satisfaction.

Conclusions

Further longitudinal and real-world effectiveness studies are needed to confirm these preliminary findings and investigate the potential of lurasidone augmentation strategy in attenuating OC symptomatology in TR-OCD and whereas a comorbid AN-r is present.

Disclosure

No significant relationships.
Autism spectrum disorder in older adults: The case study of a 65-year-old man
Authors: Menstell J. , Altunoz U. , Ziegenbein M.
Published: September 2022

Introduction

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized with ritualized behavior, difficulties in communication/ social interaction, restricted interests, and sensitivity to external stimuli. The ASD has gained attention in recent years, however it’s still difficult in geropsychiatric setting to identify high-functioning ASD, especially when patients’ coping mechanisms are successful. Not to determine high-functioning ASD structure in older age can lead to wrong diagnosis and inappropriate treatment trials.

Objectives

The aim of this presentation is to emphasize the importance of the evaluation of ASD-structure in old-age-psychiatry through the case study of a 65-years-old
man.

Methods

One case report from the inpatient unit of a psychiatric clinic in Lower Saxony, Germany will be presented.

Results

Case: The patient was referred to our acute-psychiatric-ward due to delusional thoughts, depressive symptoms and lorazepam dependency. Delusional disorder was diagnosed in the outpatient-setting since he had interpreted some external stimuli in an eccentric way. During the therapeutic process, some features of high-functioning ASD such as social difficulties, dislike of change and repetitive/restrictive habits were prominent. Developmental history of the patient and the Autism-Spectrum-Quotient-50 also supported the clinical diagnosis of the ASD. Delusional disorder was excluded, and the therapy organized according to the structure characteristics of the high-functioning ASD which yielded to significant amelioration of depressive symptoms and increased perceived life quality of the patient.

Conclusions

Although coping mechanisms of the patients can be successful, identifying high-functioning ASD-structure even in an old-age can be quite helpful in diagnostic/therapeutic processes. An elaborate discussion of the subject through contemporary literature will be presented.

Disclosure

No significant relationships.
Evidences of neurodegenerative processes in patients with late-onset schizophrenia and cognitive impairment
Authors: Pochueva V. , Savina M. , Sheshenin V. , Cherkasov N.
Published: September 2022

Introduction

The large proportion of patients with late-onset schizophrenia (LoS) has cognitive impairment. We hypothesized that this group of patients could have more risk factors associated with neurodegeneration.

Objectives

The aimed to compare various clinical and risk factors in LoS patients with low and relatively preserved cognitive status.

Methods

28 LoS patients (ICD-11) with duration of disease less than 10 years from a cohort of patients with late onset psychosis underwent clinical assessment (PANSS, HDRS-17), cognitive examination (MMSE, MoCA, FAB, verbal and symbolic memory, trail making test (part A, B)), structured interviewing on risk factors and CT. Hierarchical cluster analysis of cognitive test results was applied. Nonparametric statistic was used to compare control group (24 subjects with signs of psychosis or depression, age 58,1±10,8, 50% females) and patient`s groups.

Results

Patients were divided on two clusters: Cluster 1 with lower cognitive functions (n=20, age 62,2, 94% of females) and Cluster 2 with preserved cognitive functions (n=8, age 56,8, 100% of females). Patients of Cluster 1 were older, had more negative symptoms, higher atrophy scores, higher rate of leukoaraiosis on CT and more history of mild brain injury than patients of Cluster 2 and controls. There was no group differences in age of manifestation, other PANSS scores, rates of social phobia and number of habitual anxiety reactions between clinical groups.

Conclusions

LoS patients with cognitive deficiency had more factors associated with neurodegeneration, in particular history of mild brain injury.

Disclosure

No significant relationships.
De-prescribing strategy in a case of Delirium in the elderly
Authors: Díez Valle B. , Coucheiro Limeres P. , Roldán Larreta J.
Published: September 2022

Introduction

Iatrogenic factors, such as polypharmacy and prescription cascade, are some of the main causes of delirium in the elderly. We present a case of delirium of months of evolution that improved after applying a pharmacological de-prescription strategy.

Objectives

To report a case and review the available literature on the concepts of prescription cascade and de-prescription in delirium in the elderly.

Methods

A 92-year-old woman with a history of cerebrovascular accidents and no psychiatric history or dementia was admitted to a psychogeriatric clinic due to disorientation, delusions of harm and gait apraxia. Several months earlier she had required admission to the general hospital for agitation. In view of the suspicion of delirium, an exhaustive examination and complementary tests were performed, including a neuropsychological assessment and a brain scan (Image 1).

Results

The patient had previously received multiple high-dose psychotropic drugs (Gabapentin, trazodone, Zolpidem, Quetiapine), which had reduced the agitation but had not resolved the problem. Organic causes were treated in a multidisciplinary team (pressure ulcers), together with a gradual tapering of medication. Although underlying vascular dementia was diagnosed, the patient’s gait and cognitive status improved, with a significant impact on her autonomy and quality of life.

Conclusions

Despite an extensive literature on the subject, delirium in the elderly remains an under-diagnosed medical condition, especially the hypoactive subtype, just as cascade prescribing remains common. It is important to raise awareness among specialists in training to prevent and diagnose it.

Disclosure

No significant relationships.
The specific of development tasks in old age
Authors: Konovalova A. , Maslova K.
Published: September 2022

Introduction

The presentation considers the peculiarities of late adulthood, different views on the periodization of older ages (World health organization, I. Burnside, H.S. Pryazhnikov).

Objectives

The research is aimed at studying the peculiarities of late adulthood.

Methods

The method of work is a bibliographic analysis.

Results

Reveals the structure of psychological age (concept by L.S.Vygotsky), the specificity of the development in late adulthood and features of the social situation of development. Reveals modern ideas of ageing as a process not only of involution and loss, but also a process of continued development. The greatest attention is paid to the peculiarities of development tasks at older ages and the difficulties faced by older people trying to cope with them. There are the brief overview of the positions of C.G.Jung, A.Adler, E.Erikson, R.Peck, G.M.Bryugman, A.G.Liders, N.S.Pryazhnikov, E.E.Sapogova, I.V.Shapovalenko, V.I.Slobodchikov, G.A.Zuckerman, etc. regarding the development tasks in late adulthood. The comparison of the development tasks of early and late age periods by G.M. Bryugman, which shows that the tasks of aging worse defined, at least sequentially ordered, and the results of solution of development tasks is less predictable than in earlier ages.

Conclusions

We can say that in old age is important not only the task of adjusting to different changes of pace of life, quality of life, social circle, etc., and overcome the negative aspects of aging but also issues of self-development. As the primary development task in late adulthood is considered an achievement of his own integrity and finding the meaning of life.

Disclosure

No significant relationships.
Homebased screening for cognitive impairment due to dementia
Authors: Hansen T. , Waldorff F. , Andersen K. , Stenager E.
Published: September 2022

Introduction

Dementia develops slowly and insidiously and causes cognitive impairment. The diagnosis is pivotal for relevant treatment and care. However, 50,000 people are estimated to have undiagnosed dementia in Denmark, while 36,000 are diagnosed.

The municipalities offers a home visit to the population at the ages of 75 and 80 years to assess the need of care and prevent sickness. These home visits are well established and might offer an unused opportunity to detect cognitive impairment and dementia.

Objectives

To assess impaired cognition at home visits in order to initiate clinical examination for dementia.

Methods

A feasibility study with the use of Brief Assessment of Impaired Cognition Questionnaire (BASIC-Q) (sensitivity 0.92, specificity 0.97) at home visits. It is expected to include 1000 participants without a dementia diagnosis at the ages of 75 and 80 years. Participants will be included in a period of 12 moths (in the year of 2022), in a number of municipalities.

If the screening for cognitive impairment is positive, the participant is motivated for clinical examination at the general practitioner. Follow-up through registers and general practitioners.

Results

Preliminary results will be presented at the conference.

Conclusions

Assessment of cognition might give an opportunity to start medication and social support early in the elderly with impaired cognition and undiagnosed dementia.

Disclosure

No significant relationships.
A reflection on the use of Antidepressants to manage agitation in dementia
Authors: Basto M.D.R.D.R.F.D. , Santa Marinha L. , Nombora O. , Horta A.
Published: September 2022

Introduction

Agitated behaviors is a common neuropsychiatric symptom (NPS) in dementia, defined as inappropriate verbal, vocal, or motor activity that is not thought to be caused by an unmet need. It is frequently reported as a major problem, that impairs the quality of life for the elderly themselves and for caregivers. There has been increasing interest in the use of sedative antidepressants to treat NPS due to concerns over the safety and efficacy of antipsychotics in this setting.

Objectives

We aim to review clinical evidence of alternatives to antipsychoticst to manage agitation in dementia.

Methods

We conduct a non-systematic review of recent evidence on dementia and agitation, using PubMed/Medline database.

Results

Although non-pharmacological interventions are the first-line treatment for agitation, it is a legitimate target for therapeutic intervention and according to previous guidelines, antipsychotic are among the most used drugs, albeit restricted because of side-effects. A substitution strategy to avoid antipsychotic prescription was highly considered, however there is limited evidence to support the use of antidepressants as a safe and effective alternative for agitation in dementia. Studies compare Mirtazapine, Selective serotonin reuptake inhibitors (SSRIs) and Trazodone and a reduced benefit in mortality is observed. However, citalopram was more effective were more likely outpatients for moderately agitation and Mirtazapine reveals being potentially harmful, in different studies.

Conclusions

Moving forward, a greater understanding of NPS neurobiology, will help to clarify the efficacy of Antedepressants for the treatment of agitation in dementia. Benefits an also the patient and caregiver preference should be kept in mind.

Disclosure

No significant relationships.
Oncologists’ beliefs about people with psychotic disorders : a qualitative study
Authors: Le Glaz A. , Lemey C. , Walter M. , Lemogne C. , Flahault C.
Published: September 2022

Introduction

Cancer is the second major cause of death among people with psychotic disorders. With the same incidence, mortality in these patients remains higher than in the general population. As stigma has been identified as a risk factor for excess mortality, we focused on oncologists’ beliefs and attitudes towards people with psychotic disorders.

Objectives

The aim of this study was to uncover physicians’ representations about the impact of psychosis on oncological care.

Methods

In this qualitative study, individual semi-structured interviews were conducted with 20 physicians working in oncology in the University Hospital of Brest (France). Transcribed interviews were thematically analyzed. This study meets the COREQ criteria.

Results

Psychosis is described as a broad-spectrum condition whose severity ranges from the “mild” patient with imperceptible abnormality to the “severe” patient with cognitive and affective deficits. Oncologists identified behavioral and emotional symptoms which may modify the patient-physician relationship with difficulties to interact. Some of them consider that these patients are not interested in their health and will not get involved in oncological care. While the psychotic disorder is not considered as a limiting factor per se, oncologists felt concerned about being stigmatizing. They mentioned different aspects (like anticipation of non-compliance or inability to get help) that lead to changes in conventional treatment regimens and may result in a loss of opportunity.

Conclusions

Oncologists’ beliefs may lead to stigmatizing attitudes towards people with psychotic disorders who may not be given the best possible chances. Thus, these specific elements should be the basis for collaboration between psychiatrists and oncologists.

Disclosure

No significant relationships.
Relationship between chronic pain syndrome and anxiety disorders in patients with rheumatoid arthritis
Authors: Chernus N. , Gorenkov R. , Sivkov S. , Sivkov A. , Savina T. , Serdakova A. , Zolotovickaja A.
Published: September 2022

Introduction

Chronic pain syndrome is still one of the leading complaints of patients with rheumatoid arthritis (RA).

Objectives

Study the relationship between chronic pain syndrome of different duration and the level of anxiety disorders.

Methods

Clinical and psychophysiological examination of 76 patients with RA was carried out, the average age was 42.4 ± 7.2 years. The severity of pain syndrome was determined on the VAS scale, the level of anxiety by the Spielberger-Hanin technique

Results

Analysis of pain syndrome according to YOUR revealed higher rates (p < 0, () 1) in patients with shorter periods of disease: up to 12 months and more than 12 months: 66.0 ± 1.5 mm and 61.9 ± 1.5 mm, respectively, than in patients with a longer period of war - more than 3 years (53.7 ± 1.0 mm). Psychophysiological examination of RA patients revealed anxiety spectrum disorders in 53 (69.7%) patients. The severity of anxiety disorders was different depending on the duration of the chronic pain syndrome: the highest indicators of reactive anxiety were detected in patients with a length of pain syndrome of up to 12 months: 45.7 ± 0.6 points, in patients with a disease period of more than 12 months - 42.4 ± 0.5 points, and in patients with a disease period of more than 3 years 37.6 + 0.5 points.

Conclusions

Thus, a direct correlation between the degree of pain severity and the level of anxiety disorders is revealed, which is desirable to consider when selecting pathogenetic therapy

Disclosure

No significant relationships.
Review of the interaction between lifestyle habits and personality disorders
Authors: St-Amour S. , Bérubé F.-A. , Cailhol L. , Le Corff C.
Published: September 2022

Introduction

Individuals with personality disorders have a decreased life expectancy when compared to the general population in particular due to physical illnesses. Many factors can be associated with those physical illnesses such as lack of physical activity and bad nutritional habits. Moreover, physical activity and nutrition (lifestyle) intervention have shown great results in decreasing symptoms and improving condition in affective and anxiety disorders. However, little is known about the relation between lifestyle, and personality disorders.

Objectives

The purpose of this review is to regroup the available information on this topic.

Methods

In February 2021, we searched the literature using 4 databases for articles analyzing the relation between lifestyle and personality disorders. Twenty-one articles were included.

Results

In this review, we found few studies analyzing the relation between lifestyle and personality disorders. Most studies either used lifestyle measures as control variables or did not use such variables at all. Moreover, instruments used to measure lifestyle variables lacked precision at best. Two studies demonstrated a relation between early malnutrition and further development of personality disorders, but those results may be influenced by confounding variables and cannot indicate a clear link between nutrition and personality disorder.

Conclusions

Few evidences are available linking lifestyle to personality disorders in any way. This lack of evidence is surprising considering the multiple benefits individuals with personality disorders could get from it. More studies are needed to thoroughly analyze the impact of lifestyle on personality disorders and vice versa. Those studies need to use validated instruments to provide strong evidence about this relation.

Disclosure

No significant relationships.
PIT study: research into the Protocol Imaginary execuTion of self-injury
Authors: Van Kampen M. , Kool N. , Deen M.
Published: September 2022

Introduction

Self-injury, defined as inflicting damage or pain to one’s own body, is a way to deal with unbearable emotions. Unfortunately, it can become addictive through the rewarding effect, and this makes it also really hard to stop with this destructive behavior. Currently, there is a lack of specific treatments.

Objectives

The aim of the research is to investigate whether the “Protocol imaginary execution of self-damaging behavior” leads to a reduction of self-damaging behavior and the urge to self-damaging behavior.

Methods

We have investigated the “Protocol Imaginary execuTion of self-injury” as a potential treatment for self-injury. In this protocol the patient is asked to imagine he/she is performing the self-injury and at the same time a distracting task is offered. This ensures the working memory is double burdened as is with EMDR. We expected a reduction of patient’s self-injurious behavior. For this study, a single-case experimental design with 11 clinical patients is used, aimed to investigate whether there is a functional relationship between the treatment, the urge to self-injure and the frequency and seriousness of the self-injury. Data are analyzed with a multivariate analysis. The results of this study will contribute to expanding and improving treatment options for self-injury.

Results

At the moment the results are not yet available, but they will be known in April 2022.

Conclusions

Respondents indicate that they experience more control over self-injurious behaviour. We hope to have confirmed this in April 2022 with the analyzed data.

Disclosure

No significant relationships.
Adaptive and maladaptive perfectionism of graduating medical students
Authors: Baranskaya L. , Zhuravskaya K. , Ivanova V.
Published: September 2022

Introduction

Perfectionism, as a multiform trait of character, plays an important role in the formation of motivation of achievements in socially significant activity. Adaptive perfectionism, together with the desire to achieve recognition in one’s professional community and insure the emotional stability. Maladaptive (neurotic) perfectionism is directed towards the achievement of excessively high (non-relevant) standards of activity, a constant anxiety, internal stress and lack of self-confidence

Objectives

To pinpoint the types of perfectionism that graduating medical students at Medical University experience, those who, during all the years of study, showed high academic results

Methods

Forty-nine graduating medical students volunteered to take part in the study, their average mark being not lower than 4.75 (maximum was 5). Their average age was 22.41±0.75. The following scales measured the level of expressiveness of perfectionism: A.A. Zolotareva, Hewitt and Flett, I.I. Gracheva

Results

The results of the study undertaken showed two distinct groups. Students of the first group (79.6%) aimed at high internal standards in their study that would make them very well prepared professionally for their future work as doctors. They consciously accepted the common rules and norms of their society. Students of the other group (20.4%), consciously and subconsciously, estimate their high academic results as a good way of overcoming personal disturbances. They have excessive non-realistic demands towards self and others

Conclusions

The results of our study make it possible for us to suppose that medical students of the second group will experience quite a lot of difficulties in their future professional activity

Disclosure

No significant relationships.
Prevalence of Late Onset Stress Symptomatology (LOSS) in geriatric combat veterans and its relation with dementia: A Pilot Study
Authors: Barman R. , Detweiler M.
Published: September 2022

Introduction

Late onset stress symptomatology (LOSS) is a relatively new concept in combat veterans, which includes repeated but not intrusive thoughts about combat-related experiences, irritability, or nightmares that do not cause impairment of daily functioning.

Objectives

The objectives of this study were to identify the LOSS phenomenon in geriatric combat veterans and to establish a correlation between LOSS and cognitive deficit ± major stressors.

Methods

The electronic database was searched for the last 2 years from starting the study with the hypothesis that the LOSS phenomenon has been diagnosed with sleep, anxiety, trauma-related, or impulse control related disorders. Records were examined for trauma-related symptoms, excluding major symptoms of trauma-related stressors. The veterans were assessed objectively using LOSS, PCL-5 (PTSD checklist for DSM-5), social readjustment rating scales, and MOCA (Montreal Cognitive Assessment scale) for cognitive screening.

Results

We reviewed 1329 patient records and identified 35 potential LOSS subjects. Four veterans were diagnosed with PTSD not otherwise specified, 2 with anxiety disorder unspecified, and 1 veteran with nightmare disorder. The majority (85%) of the veterans scored >40 in PCL-5, and only one veteran fulfilled the criteria for LOSS, who scored 67 on the LOSS scale. All the veterans scored ≤25 on MOCA with a significant deficit in recent recall.

Conclusions

Our study shows new onset stress-related symptoms are strongly associated with significant cognitive deficits and higher individual stress levels. The onset of PTSD symptoms in older combat veterans might have been correlated with the onset of cognitive deficits, as suggested by several other studies.

Disclosure

No significant relationships.
Methylenedioxymethamphetamine-assisted Psychotherapy For Posttraumatic Stress Disorder: A Review
Authors: Sá Couto J. , Da Luz B. , Rodrigues J. , Pão Trigo M. , Ventura Gil T.
Published: September 2022

Introduction

Posttraumatic stress disorder (PTSD) is a psychiatric condition which can be developed following traumatic experience. Treatment guidelines have long considered psychotherapy as a first line treatment. Despite that, PTSD remains an illness with high rates of comorbidity. Therefore, exploring novel therapies is of utmost importance.

Objectives

Clarifying methylenedioxymethamphetamine (MDMA)-assisted psychotherapy efficacy in symptom relief in people with PTSD. Explaining clinical MDMA mechanism of action. Assessing safety of MDMA clinical use.

Methods

PubMed database search, with “MDMA for PTSD” keyword expression. 12 Articles published in the last ten years were selected among the 112 best matches. Reference lists of articles were reviewed to identify additional articles.

Results

Mithoefer et al. (2010) carried out the first controlled clinical study with MDMA-assisted psychotherapy in people with PTSD. Twenty patients with treatment-resistant PTSD were selected. They were given either placebo or two or three sessions of MDMA. 83% of the experimental group no longer met the criteria for PTSD (mean remission lasted 45 months without further MDMA doses) compared with 25% of the placebo group. Further studies were also suggestive of improvements in treatment-resistant PTSD patients undergoing MDMA-assisted psychotherapy. MDMA may increase exposure therapy effectiveness, allowing patients to stay emotionally involved while revisiting past traumas without being overwhelmed by anxiety and fear.

Conclusions

To date, MDMA-assisted psychotherapy studies demonstrated consistently positive results. However, they have been carried out with small groups of individuals. Therefore, larger trials should be conducted to assess MDMA’s efficacy and safety for it to become a licensed medicine.

Disclosure

No significant relationships.
Dealing with Posttraumatic Nightmares
Authors: Alvarez Garcia C. , Nocete Navarro L. , Sanz Giancola A.
Published: September 2022

Introduction

Posttraumatic nightmares are one of the most frequent symptoms in posttraumatic stress disorder. Prevalence can be up to 96%. These nightmares evoke the experienced traumatic event, causing a negative impact. Besides, they are and independent risk for suicide. There are different pharmacological and non-pharmacological options for PTN, despite is no optimal treatment.

Objectives

To analyse the different treatment options for PTN.

Methods

This was a narrative literature review.

Results

The two main treatments for PTN nowadays are the Imagery Rehearsal Therapy (IRT) and prazosin. IRT is a cognitive-behavioral intervention, that helps the patient to change the content of the nightmare to a “happier ending”. Prazosin is an alpha-adrenergic receptor antagonist that blocks the stress response in the central nervous system receptors. Although it was a promising drug, significant differences compared to placebo have not been found. There is growing data that suggests nabilone, a synthetic cannabinoid, could be helpful in PTN treatment. A clinical trial made in Canada revealed that 72% of patients experienced a complete disappearance or at least an important reduction of PTN.

Conclusions

PTN is a very common and distressing symptom in patients presenting PTSD. Nevertheless, there is no treatment with enough evidence for this pathology. On this account, it is fundamental to do more research in order to find and suitable treatment that can improve the quality of life of these patients.

Disclosure

No significant relationships.
Gender Differences after Digital Interventions in the Golden Hours after Traumatic Events
Authors: Lahutina S.
Published: September 2022

Introduction

Digital technologies are used in the prevention of post-traumatic stress disorder (PTSD). There is no clear evidence for effective gender-sensitive preventive measures for PTSD. Using Tetris during the golden hour after trauma can reduce intrusive memories and thus reduce the likelihood of PTSD in the future.

Objectives

Understand the features of gender differences after psychological interventions in patients in the acute period after a traumatic event. Video games that use visual-spatial efforts over a fixed time and frequency (Tetris) may reduce the likelihood of developing PTSD.

Methods

Main inclusion criteria was an exposure to traumatic event (time from traumatic event - 0-24 hours). Respondents were assessed by PTSD symptom scale (PCL-5), peritraumatic distress scale (PDS), peritraumatic dissociative experience scale (PDES) and global functioning scale (GFS), intrusion diary (intervals: week 0, week 4, week 8, week 12).

Results

PTSD symptoms were more severe in female participants (p ≤ 0,05). Participants in the Tetris game group recorded significantly fewer intrusive memories during the first week after the traumatic event than participants in two other groups, with a mean effect size of 57 (M = 8.73 vs. M = 23.26, t (69) = 2.80, P = 0.005, d = 0.67, 95% CI: 0.18, 1, 14). After the first month of follow-up, members of the Tetris game group reported less stress from intrusive symptoms.

Conclusions

Tetris intervention may reduce intrusive memories of real trauma. Women had more severe PTSD symptoms. Due to the small number of samples, the study should be repeated.

Disclosure

No significant relationships.
An International External Validation and Revision of the PsyMetRiC Cardiometabolic Risk Prediction Algorithm for Young People with Psychosis
Authors: Perry B. , Vandenberghe F. , Osimo E.F. , Grosu C. , Piras M. , Jones P. , Mallikarjun P. , Stochl J. , Upthegrove R. , Khandaker G. , Eap C.
Published: September 2022

Introduction

The comorbidity between cardiometabolic and psychotic disorders develops early. This is a crucial window of opportunity to reduce excess morbidity and mortality. Recently, a cardiometabolic risk prediction algorithm for young people with psychosis, the psychosis metabolic risk calculator (PsyMetRiC) was developed and externally validated in the UK. However, its international transportability is unknown.

Objectives

We performed the first international validation study of PsyMetRiC in Lausanne, Switzerland, and examined whether additional variables (clinical and/or genetic) may improve the predictive performance of the algorithm

Methods

We included people aged 16-35y with psychosis from the PsyMetab cohort, who did not have MetS at baseline, and who had 1-6y follow-up data. The PsyMetRiC partial (age, sex, ethnicity, body mass index, smoking status, and prescription of a metabolically-active antipsychotic) and full (also including high-density lipoprotein and triglycerides) algorithms were applied. Predictive performance was assessed using measures of discrimination (C-statistic) and calibration (calibration plots). Recalibration steps included refitting the intercept and/or slope if necessary. Additional variables (e.g. speed of weight gain, polygenic risk scores) were added to the model and predictive performance was reassessed.

Results

We included 545 participants. The discrimination performance of both PsyMetRiC algorithms was good (C>0.75), and calibration plots showed good agreement between observed and predicted risk. Additional analyses to be conducted.

Conclusions

PsyMetRiC is likely to be generalizable for use in Switzerland, suggesting that PsyMetRiC may also be suitable for use in other European populations. While additional international validations are required, these findings are an encouraging step toward an international cardiometabolic risk prediction algorithm for young people with psychosis.

Disclosure

No significant relationships.
Precision Medicine & Pharmacogenomics: Personalized Medication in Neuropsychiatric Disorders using AI and telepsychiatry
Authors: Gkouvas N.
Published: September 2022

Introduction

The term “personalised therapy” refers to the use of genetic data to better treat or determine the predisposition to a specific genetic disease, with the ultimate goal of improving quality of life. Telepsychiatry and AI are key to support it..

Objectives

Determine benefits of pharmacogenomic analysis (PGx) in CNS diseases regarding: - cost effectiveness - adverse drug reactions - reduced hospitalizations -drug interactions - efficacy - quality of life - “trial and error” approach avoidance

Methods

Questionnaires before and after the treatment provided using PGX tests Telepsychiatry for consultation along face to face sessions were conducted. Artificial intelligence in data analyses

Results

Benefits of pharmacogenomic analysis (PGx) in CNS diseases: - cost effective savings - prediction and prevention of adverse drug reactions - reduced hospitalization due to ineffectiveness of medication - reduced risk of drug interactions - more effective treatments - better quality of life for the patient - with the analysis (PGx) the “trial and error” approach is avoided

Conclusions

In a number of studies in patients with mental disorders, pharmacogenomic analysis (PGx) has led to an increase in both clinical response and remission, better tolerated treatments, fewer side effects, and reduced treatment costs. In conclusion, pharmacogenomic analysis is ideal for patients with CNS diseases: a) Not responding to treatment b) Who in their history have many relapses and hospitalizations c) They show serious side effects d) Who do not comply with the treatment e) Taking many medications and suffering from serious illnesses f
) Who are wary of taking psychotropic drugs

Disclosure

No significant relationships.
Does my lifestyle explain my depression? The role of exercise, diet and smoking in the prevention of depression
Authors: Gomes R. , Santos C. , Descalço N. , Moutinho F.
Published: September 2022

Introduction

Depression as a public health concern highlights the importance of prevention. The nature of the disease is complex, linked to numerous biopsychosocial factors. However, it was found that healthiest lifestyle reduced 67% the risk of depressive symptoms.

Objectives

To review evidence on how exercise, diet, and smoking impact on the risk of depression.

Methods

Non-systematic review of literature through search on PubMed/MEDLINE following the terms “Lifestyles”,“risk” and “depression”.

Results

Several studies have shown that exercise reduces the incidence of depressive symptoms and major depressive disorder regardless of intensity, geographic region, age, gender, or follow-up period. Smoking significantly increases the risk of depression, including the ones exposed to second-hand smoking and pregnant women in which prenatal smoking was associated with a three-fold increased risk of postpartum depression. The Mediterranean diet rich in complex carbohydrates, omega-3 fatty acids, B-group vitamins and several amino acids have shown a negative association with the incidence of depression. A high frequency of breakfast consumption, an increased intake of fruits, vegetables, and some specific nutrients (zinc, iron, magnesium, vitamins, and folate) was also inversely correlated with prevalence of depressive symptoms. On the other hand, western dietary patterns, with sweetened beverages, processed food, and foods rich in saturated fatty acids, have been linked to an increased risk. Skipping meals and snacking on unhealthy food also contributes to depressive symptoms.

Conclusions

Relatively modest changes in population diet, tobacco consumption and levels of exercise may have important public mental health benefits preventing a substantial number of new cases of depression.

Disclosure

No significant relationships.
E-tool for mental health prevention: a study of the receptivity and engagement in a large-scale group of subjects
Authors: Maçorano R. , Canais F. , Ferreira H. , Parreira M. , Ribas M.
Published: September 2022

Introduction

Due to the Covid-19 effects, mental health conditions are now, more than ever, affecting our daily lives - both personally and professionally. The average delay between the onset of first symptoms of a mental health disorder and seeking suitable healthcare is 11 years. The WHO states that the only sustainable way to reduce mental healthcare burden is by acting earlier.

Objectives

The aim of this project is to assess the receptivity and engagement of a mobile app for mental health prevention, amongst a large-scale and heterogeneous group of individuals. The main hypothesis under testing is that people are receptive to actively act towards mental health prevention, despite still being a very neglected and stigmatized topic.

Methods

A mobile app for mental health improvement and disease prevention was developed through the digitalization of positive psychology strategies, such as mood tracking, journaling, breathing exercises, among others, which are personalized to the user through biofeedback. The app aims at teaching people how to autonomously cope with mental health conditions, identifying early signs and redirecting them to proper mental health professionals. The app is being released for a population of 35,000 subjects resident in Portugal.

Results

Receptivity and engagement metrics will be assessed on a weekly and monthly basis, for 3 months, segmented by different subject profiles. Mental health metrics will also be assessed, namely anxiety, depression, and burnout levels - using standard psychiatric scales.

Conclusions

We have yet to draw conclusions from the project; however, we aim to achieve first results in due time.

Disclosure

The aim of this research is to assess the receptivity of mental health prevention strategies using technology, namely a mobile app provided by a company.