bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychopharmacological treatment in dissociative identity disorder (DID)
Authors: Pinilla R. , Sabaté C. Rodríguez , Méndez B. Ordóñez , Sotillos A. , Mata A. Hernández
Published: February 2022

Introduction

Patients with dissociative identity disorder (DID) present two or more identities. Although it is a widely questioned diagnosis, it is currently found in the main DSM-5 and ICD-10 diagnostic manuals. So far there is no standard psychopharmacological treatment for people with this pathology.

Objectives

Describe the pharmacological treatment associated with the clinical evolution of a patient with DID.

Methods

Follow-up was carried out in a mental health center for a year, undergoing psychopharmacological and psychotherapeutic treatment. The information is taken from the medical history.

Results

The patient presents with anxious and depressive symptoms. She was referred from primary care with 50mg sertraline without response. Dose was increased to 100mg without response. New management started with desvenlafaxine 100mg, associated with lorazepam, partially reducing the symptoms. Later, the patient presented self-referentiality, sounding of thought, began to describe frequent memory losses and a rebound in anxiety-depression symptoms, increasing the dose of desvenlafaxine to 200mg and introducing haloperidol to 1.5mg. Three months later, she presented showing another identity, active, aggressive, pythiatic, without evident anxious symptoms that she previously presented in a marked way. Desvenlafaxine was adjusted to 100mg and haloperidol to 0.5mg every 12 hours. The patient evolved favorably, decreasing anxiety, depressive symptoms and memory loss, in addition to disappearing psychotic symptoms. This treatment was sustained, keeping the patient psychopathological and functional stability and allowing a psychotherapeutic approach.

Conclusions

Treatment with desvenlafaxine and haloperidol was favorable to maintain clinical stability and allow other therapeutic approaches.High dose of antidepressant could favor the expression of another identity of the patient.

Disclosure

No significant relationships.

Keyword

antidepresive antipsicotic disociative memory-loss
Changes in sleep with transcranial magnetic stimulation in adults with treatment resistant depression: Preliminary results from a naturalistic study
Authors: Sonmez A.I. , Kay R. , Schmids S. , Peterson C. , Herman A. , Widge A. , Nahas Z. , Albott C.S.
Published: February 2022

Introduction

Sleep disturbance specifically insomnia, non-restorative sleep, and hypersomnia are common symptoms of major depressive disorder (MDD). As it alleviates major depressive disorder, transcranial magnetic stimulation (TMS) may improve associated sleep disturbances, and may also have inherent sedating or activating properties.

Objectives

To examine the impact of TMS on sleep disturbances in adults with treatment resistant depression in a clinical setting, we retrospectively reviewed de-identified data from naturalistically-treated MDD patients undergoing an initial acute course of TMS therapy at St.Louis Park MinCEP Clinic.

Methods

Adults with treatment-resistant depression received daily TMS treatments. 9-item Patient Health Questionnaire (PHQ-9) total scores were used to calculate % change at endpoint (relative to pretreatment baseline); response on both measures was defined as 50% reduction in scores, with remission defined as a final total score 4 on the PHQ-9. Insomnia was measured with a 3-item subscale of the Inventory of Depressive Symptomatology Self Report (IDS-SR). Hypersomnia was measured with a single IDS-SR item. Pairwise comparisons were performed using Student’s T-test. Categorical variables were compared using Fisher’s Exact test. Continuous outcome measures were tested with an analysis of covariance, using baseline PHQ-9 score as a fixed effect covariate.

Results

TMS appears to have differential modulatory effects on insomnia and hypersomnia in adults with treatment resistant depression.

Conclusions

These results may provide the basis for further investigation into therapeutic applications of TMS in addressing sleep disturbances in treatment-resistant depression. Measures that separate hypersomnia and insomnia should be implemented in future work addressing effects of TMS in treatment-resistant depression.

Disclosure

No significant relationships.
Prediction of quality of life in schizophrenia using machine learning models on data from clinical antipsychotic trials of intervention effectiveness (CATIE) schizophrenia trial
Authors: Beaudoin M. , Potvin S. , Hudon A. , Giguère C.-E. , Dumais A.
Published: February 2022

Introduction

Schizophrenia is a chronic and severe mental disorder. While research focus remains mainly on negative outcomes, it is questionable whether we are placing enough emphasis on improving their sense of well-being and functioning. This could be accessed through the study of the quality of life (QoL). To date, QoL prediction models mainly focused on neurocognition and psychotic symptoms, but their predictive power remained limited.

Objectives

The aim is to accurately predict the QoL within schizophrenia using unsupervised learning methods.

Methods

We computed variables from 952 patients from the CATIE study, a randomized, double-blind clinical trial for schizophrenia treatment. QoL was measured using the Heinrichs-Carpenter Quality of Life Scale and potential predictors included almost all available variables: symptoms, neurocognition, medication adherence, insight, adverse effects, etc. By optimizing parameters to reach optimal models, three linear regressions were calculated: (1) baseline predictors of 12-month QoL, (2) 6-month predictors of 12-month QoL, and (3) baseline predictors of 6-month QoL. Adjustments were made to ensure that included variables were not collinear nor redundant with QoL.

Results

Calculated models had adjusted R-squared of 0.918, 0.922 and 0.913, respectively. Best predictors were medication side effects, sociodemographic and neurocognitive variables. Low psychotic and depressive symptoms were also included, as well as lab values suggesting the absence of problems with chloremia and calcemia.

Conclusions

Calculated predictive models explain almost all subsequent QoL. It appears that physical health variables, generally omitted from mental health-related studies, have an important impact on patients’ QoL. Therefore, interventions should also consider these aspects.

Disclosure

No significant relationships.
Efficacy and tolerability of lurasidone in schizophrenia: A systematic review and meta-analysis of short-term, randomized, placebo controlled trials
Authors: Hagi K. , Nosaka T. , Kane J. , Correll C.
Published: February 2022

Introduction

Lurasidone is an atypical antipsychotic approved for the treatment of patients with schizophrenia. We report on a meta-analysis focusing on both the efficacy and safety/tolerability of lurasidone in the treatment of patients with schizophrenia.

Objectives

To obtain pooled estimates from placebo-controlled clinical trials on the efficacy and safety/tolerability of lurasidone in schizophrenia.

Methods

We selected acute, randomized placebo-controlled trials of lurasidone for schizophrenia. Primary outcome for efficacy was the Positive and Negative Syndrome Scale (PANSS) change and for “acceptability” was all-cause discontinuation. Secondary outcomes included specific adverse events, body weight change, ≥7% weight gain, and glucose and lipid parameter change.

Results

Across 10 RCTs (n=3,963, age=40.5±2.3 years, males=64.7 %, trial duration=6.0 weeks), lurasidone outperformed placebo regarding the PANSS total score (N=10, n=3,354, SMD=-0.34, 95% CI: -0.47−-0.21, p<0.001). Stratifying the analysis by dose, lurasidone significantly outperformed placebo at doses 40-160 mg/day. Lurasidone was associated with significantly lower all-cause discontinuation than placebo (N=10, n=3,410, RR=0.87, 95% CI: 0.78−0.97, p=0.014). Lurasidone had significantly higher body weight change compared with placebo (N=10, n=3,359, SMD=0.17, 95% CI: 0.09−0.24, p<0.001), but without significant differences regarding ≥7% body weight gain (N=9, n=3,186, p=0.112). Lurasidone did not differ from placebo in total cholesterol (N=10, n=3,140, p=0.439), LDL-cholesterol (N=7, n=2,414, p=0.849), triglycerides (N=10, n=3,140, p=0.238), and fasting glucose change (N=10, n=3,112, p=0.633).

Conclusions

In short-term trials, lurasidone was efficacious, acceptable and safe, having minimal effect on body weight gain and glucose and lipid metabolism.

Disclosure

K. Hagi is a full time employee of Sumitomo Dainippon Phrma Co., Ltd.
Altered brain functional dynamics in auditory and visual networks in schizophrenia
Authors: You W.F. , Luo L. , Li F. , Gong Q.
Published: February 2022

Introduction

One of the most perplexing and characteristic symptoms of the schizophrenia (SZ) patients is hallucination. The occurrence of hallucinations to be associated with altered activity in the auditory and visual cortex but is not well understood from the brain functional network dynamics in SZ.

Objectives

To explore the brain abnormal basis of hallucinations in SZ with the dynamic functional connectivity (dFC).

Methods

Using magnetic resonance imaging for 83 SZ patients and 83 matched healthy controls and independent component analysis, 52 independent components (ICs) were identified as nodes and assigned into eight intrinsic connectivity networks (Figure 1A). Subsequently, we established dFC matrices and clustered them into four discrete states (Figure 1B) and three state transition metrics were obtained. To further explore the changes in the centrality of each component, eigenvector centrality (EC) was calculated and its time-varying was evaluated.

Results

Compared to controls with FDR correction, we found that patients had more mean dwell times and fractional time in state 1 (P=0.0081 and P=0.0018), mainly with hypoconnectivity between auditory and visual network and other networks and hyperconnectivity between language and default-mode network (DMN). While, patients had less dwell times and fractional time in state 3 (P=0.0018 and P=0.0009), and decreased FC between visual network and executive control network (ECN) and increased FC between ECN and DMN than controls (Figure 2).

EC statistics showed that SZs displayed increased temporal dynamics in visual-related regions (Figure 3).

Conclusions

SZ was mainly manifested as altered dFC and temporal variability of nodal centrality in auditory and visual networks.

Disclosure

No significant relationships.
Cardiological health in patients with schizophrenia. A prospective cohort study
Authors: Nielsen R. Ernst , Rodrigo-Domingo M. , Jørgensen L. , Hostrup C. Tranekær , Jensen S. Eggert
Published: February 2022

Introduction

Patients with schizophrenia have a four-fold increased all-cause and a doubled cardiovascular mortality rate as compared to the general population.

Objectives

The study overall investigates the point-prevalence and prospective changes in cardiovascular risk factors in patients with schizophrenia, with baseline demographics of participants presented here.

Methods

A prospective study of patients diagnosed with schizophrenia divided into two subpopulations consisting of newly diagnosed (≤2 years from baseline in study (group A)) or chronic (diagnosed ≥10 years from baseline in study (group B)).

Results

A total of 199 patients (57 diagnosed ≤2 years preceding baseline and 142 diagnosed ≥10 years ago) were included. Group A had been diagnosed for an average of 1.13±0.58 years and 21.19±7.62 years in group B. The majority (n=135 (67.8%)) were diagnosed with paranoid schizophrenia. At baseline PANSS total (median[Q1;Q3]) for group A was 61.0[51.0;76.0] and 60.0[48.0;76.0] for group B, with PANNS Positive being 17.0[13.0;20.0] and 15.0[12;19], PANSS Negative being 16.0[11.0;20.0] and 14.5[10.0;20.0], and PANSS General being 28.0[22.0;35.0] and30.0 [25.0;37.0], respectively. No difference in Clinical Global Impression was observed between groups ((median[Q1;Q3): 4.0[3.0;4.0] in both groups). Lastly, global assessment of function was similar between groups ((median[Q1;Q3): group A symptom: 38.5[37.0;46.0] and group B 41.0[37.0;52.0], and with function being 48.0[44.5;53.5] in group A and 45.5[41.0;53.0] in group B).

Conclusions

Prospective studies investigating prevalence of and prospective changes in cardiovascular risk in patients with schizophrenia are essential to understand the increased all-cause and cardiovascular specific mortality. Demographic descriptions of participants are essential to estimate generalizability in different treatment settings.

Disclosure

No significant relationships.
A polydiagnostic approach to cognitive deficits in schizophrenia
Authors: Sánchez-Torres A. , Gil-Berrozpe G. , Lorente-Omeñaca R. , Zandio M. , Moreno-Izco L. , De Jalón E. García , Ribeiro M. , Peralta V. , Cuesta M.
Published: February 2022

Introduction

Cognitive deficits are common, clinically relevant and closely linked to poor functional outcomes in everyday functioning in patients with schizophrenia and other psychoses.

Objectives

To ascertain to which extent a polydiagnostic assessment of schizophrenia is associated with clinically-derived criteria of cognitive impairment and gold-standard neuropsychological assessment.

Methods

We assessed 98 patients with a psychotic disorder. We tested if patients met criteria for schizophrenia according to five diagnostic classifications: Krapelin, Bleuler, Schneider, ICD-10 and DSM-IV. Also, we applied a set of clinically-derived criteria to assess cognitive impairment associated with psychosis (CIAPs). Gold-standard neuropsychological assessment was administered, covering the cognitive domains included in the MATRICS Cognitive Battery: attention, processing speed, verbal memory, visual memory, working memory, executive function and social cognition. MANOVAs were performed to test the association between polydiagnostic and clinically-derived criteria and neuropsychological assessment.

Results

MANOVA profile analyses revealed that patients who met CIAPs criteria showed cognitive impairment in all the cognitive domains except for social cognition. Patients diagnosed with Kraepelin’s criteria showed significant differences in processing speed, visual memory, working memory and GCI. Patients fulfilling Bleuler and DSM-IV criteria showed significant deficits in processing speed and verbal memory, respectively. Schneider and ICD-10 diagnostic criteria did not reveal differences in cognition between patients who fulfilled these criteria.

Conclusions

CIAPs criteria were the most accurate classifying patients with cognitive impairment, followed by Kraepelin’s criteria, which were the ones among diagnostic criteria which better differentiated patients regarding cognitive impairment. These criteria take into consideration the outcome in addition to symptoms.

Disclosure

This work was supported by the Government of Navarra (grants 17/31, 18/41, 87/2014) and the Carlos III Health Institute (FEDER Funds) from the Spanish Ministry of Economy and Competitivity (14/01621 and 16/02148). Both had no further role in the study des
Lurasidone in adolescents with schizophrenia: Sustained remission and recovery during 2 years of open-label treatment
Authors: Tocco M. , Pikalov A. , Deng L. , Goldman R.
Published: February 2022

Introduction

Compared with adult onset, early onset schizophrenia is typically characterized by greater illness severity and less favorable prognosis.

Objectives

To evaluate the proportion of adolescent patients with schizophrenia who achieved sustained remission and recovery during 2 years of treatment with lurasidone.

Methods

Patients aged 13-17 years with a DSM-IV-TR diagnosis of schizophrenia, and a Positive and Negative Symptom Scale (PANSS) total score ≥70 and <120, were randomized to 6 weeks of double-blind (DB), fixed-dose treatment with lurasidone (37 or 74 mg/d) or placebo. Patients who completed 6 weeks of DB treatment were eligible to enroll in a 2-year, open-label (OL), flexible dose extension study of lurasidone (18.5-74 mg/d). Criteria for sustained remission, were the 6-month consensus criteria summarized by Andreasen (Am J Psych 2005;162:441-9). Criteria for sustained recovery consisted of meeting sustained remission criteria with a Children’s Global Assessment Scale (CGAS) score ≥70 for at least 6-months indicating no clinically significant functional impairment.

Results

A total of 271 patients completed the 6-week DB study and entered the extension study, and 186 (68.6%) and 156 (57.6%) completed 52 weeks and 104 weeks of treatment, respectively. During OL treatment with lurasidone, 52.8% met sustained remission criteria, with a Kaplan-Meier (KM) estimate of 64.1 weeks for median time to sustained remission; and 28.8% met sustained recovery criteria, KM estimate of 104.6 weeks for median time to sustained recovery.

Conclusions

For adolescents with schizophrenia, treatment with lurasidone was associated with high rates of sustained remission and sustained recovery over a two-year period.

Disclosure

Employee of Sunovion Pharmaceuticals Inc. The study summarized in this Abstract was supported by funding from Sunovion Pharmaceuticals Inc
The prevalence of anxiety and depression in transgender people living in russia
Authors: Chumakov E. , Ashenbrenner Y. , Petrova N. , Zastrozhin M. , Azarova L. , Limankin O.
Published: February 2022

Introduction

The prevalence rates of mental health issues, particularly anxiety and depression, is high among transgender people. However, the incidence of anxiety and depression in transgender people living in Russia is unclear until now.

Objectives

To examine the frequency of anxiety and depression in transgender people living in Russia.

Methods

The Hospital Anxiety and Depression Scale (HADS) was used for online screening for symptoms of anxiety and depression in transgender people living in Russia throughout November 2019. 588 transgender adults living in all Federal Districts of Russia (mean age 24.0±6.7) were included in the final analysis. 69.6% (n=409) of the survey participants indicated the direction of transition as transmasculine (TM), 23.1% (n=136) – as transfeminine (TW), and 7.3% (n=43) – as other (TO).

Results

It was found that 45.1% (n=265) and 24.0% (n=141) of transgender people had clinically significant levels of anxiety and depression, respectively (HADS score of 11 or higher). The rates of anxiety (TM=10.21±4.68; TW=8.72±3.91; TO=10.72±4.43) and depression (TM=7.53±4.09; TW=7.40±4.19; TO=7.74±4.33) did not have statistically significant differences within the direction of transition. The anxiety and depression mean scores in all subgroups were statistically significantly higher than in the general Russian population (p<0.001; one sample t-test).

Conclusions

Our findings suggest a high prevalence of depression and anxiety disorders in the transgender population as compared to the cisgender population in Russia. The identified frequency of anxiety and depression in transgender people in Russia is worrying and requires immediate action to improve the availability and quality of medical and psychological care for this group of people.

Disclosure

No significant relationships.
Sexual fantasies, subjective satisfaction and quality of sexual life in patients of sexual dysfunction: A comparative study
Authors: Ohri N. , Dubey A. , Vankar G. , Rathi P. , Gill A.
Published: February 2022

Introduction

Exploring the ways in which sexual fantasies may affect sexual experience and satisfaction is of relavence in the clinical setting involving sexual dysfuntion.

Objectives

To observe how the sexual fantasy scores differ in their relationship with sexual satisfaction, experience and quality between sexual dysfunction cases and normal controls.

Methods

Scales included: Wilson’s sex fantasy questionnaire (WSFQ), Arizona Sexual Experience Scale (ASEX), Sexual Quality of life Questionnaire (SQoL), and a subjective sexual satisfaction meter. Differences in resposes of both groups on WSFQ (item-wise and domain-wise) were analysed using T-tests. Two-way ANOVA was applied to see how other scales affected sexual fantasy.

Results

Cases scored significantly higher on ASEX scale, and low on satisfaction, SQoL and WSFQCases N=1OOControls N=100t-testSatisfaction Mean(sd)4.27(1.85)7.82(1.31)t=3.052;df=198,p=0.0026Asex17.52(4.73)8.28(1.34)t=15.24;df=198,p<0.0001SQoL29.41(12.12)49.5(6.67)t=14.52;df=198,p<0.0001WSFQ26.80(17.61)30.59(15.32)t=1.62,df=98,p=0.106

Majority of WSFQ responses, both in cases and controls, fell in the intimate and impersonal domains. Sexual fantasy scores and sexual satisfaction had a strong positive and significant correlation in controls but no linear correlation in the case-subjects. sexual fantasy scores contributed to 5.7% of difference in the scores of SQoL between groups. Major variance in scores of satisfaction in our subjects depended on presence or absence of sexual dysfunction(46.5%)but sexual fantasies also contributed to 8.8% of the variance.

Conclusions

The study showed that fantasies contribute to positive sexual outcomes only in absence of sexual dysfunction. ANOVAanalysis revealed that in case-subjects sexual satisfaction briefly increases initially with increase in fantasy scores but starts to decline as fantasies increase.

Disclosure

No significant relationships.
Reduced sleep time is associated with increases in frontal sleep-like activity and emotion regulation failures
Authors: Avvenuti G. , Bertelloni D. , Lettieri G. , Ricciardi E. , Cecchetti L. , Pietrini P. , Bernardi G.
Published: February 2022

Introduction

Emotion self-regulation relies both on cognitive and behavioral strategies implemented to modulate the subjective experience and/or the behavioral expression of a given emotion.

Objectives

While it is known that a network encompassing fronto-cingulate and parietal brain areas is engaged during successful emotion regulation, the functional mechanisms underlying failures in emotion suppression are still unclear.

Methods

We analyzed facial-view video and high-density EEG recordings of nineteen healthy adult subjects (26±3yrs, 10F) during an emotion suppression (ES) and a free expression (FE) task performed on two consecutive days. An actigraph was worn for 7-days and used to determine sleep-time before each experiment. Changes in facial expression were identified and manually marked on the video recordings. Continuous hd-EEG recordings were preprocessed using standard approaches to reduce artifactual activity and source-modeled using sLORETA.

Results

Changes in facial expression during ES, but not FE, were preceded by local increases in sleep-like activity (1-4Hz) in in brain areas responsible for emotional suppression, including bilateral anterior insula and anterior cingulate cortex, and in right middle/inferior frontal gyrus (p<0.05, corrected; Figures 1 and 2). Moreover, shorter sleep duration the night prior to the ES experiment correlated with the number of behavioral errors (p=0.01; Figure 3) and tended to be associated with higher frontal sleep-like activity during emotion suppression failures (p=0.05).

Conclusions

These results indicate that local sleep-like activity may represent the cause of emotion suppression failures in humans, and may offer a functional explanation for previous observations linking lack of sleep, changes in frontal activity and emotional dysregulation.

Disclosure

No significant relationships.
“I have no disease and weed just relaxes me!”: The therapeutic challenge in young patients with psychosis and cannabis abuse
Authors: Mota P.
Published: February 2022

Introduction

Substance use disorders (SUDs) are estimated to affect around 30 million people worldwide, and are characterized by repeated use of a substance that leads to clinically significant impairment or suffering, making it a serious health problem, with high associated costs.

Objectives

Understand and evaluate the impact of cannabis use on adherence to treatment in young patients with psychosis.

Methods

Narrative literature review by performing a search on MedLine for English-written articles. The query used was “(Cannabis) AND (Schizophrenia OR Psychosis) AND (Adherence)”.

Results

About 70 to 80% of young people with SUDs have at least one concomitant psychiatric disorder and cannabis is involved in approximately 50% of psychosis or schizophrenia of those cases, so there is a growing concern about the deleterious medical and psychiatric consequences of the increase and early initiation of consumption of this substance. It is estimated that about 26% of patients with psychotic conditions do not adhere to the treatment plan established by the psychiatrist; however, especially during the inaugural phases of psychotic disorders, rates of non-adherence to therapy are high (above 50%), and are said to be higher in younger patients.

Conclusions

The risk of relapse after a first psychotic episode is high. As the use of cannabis is a potentially preventable risk factor, interventions aimed at improving therapeutic adherence in psychotic conditions must specifically target the use of this substance, since reducing its consumption can lead to a more favorable course of the disease and at less expensive costs in addressing these pathologies.

Disclosure

No significant relationships.
Ethical issues under the pressure of COVID-19 pandemic
Authors: Carpiniello B.
Published: February 2022

The pandemic has highlighted with particular evidence the vulnerability of people with mental disorders and a series of specific ethical concerns regarding their condition. First of all, the risk of receiving poor medical care due to the double stigma of being affected by a mental disorder and Covid infection, in addition to the many other additional barriers, including poverty, marginal housing, and food insecurity. Moreover, in some countries, in a situation where demands for intensive care exceeded the treatment facilities available, the tragical ethical dilemma regarding the choice of people to be saved was resolved with the option in favor of healthier and/or younger people who have more chances of recovery, thus excluding, among others, aged people with severe mental disorders such as dementias. In other countries, ethical concerns emerged related to the enhanced risk of involuntary hospital admission of individuals with severe mental illness mainly due the high likelihood of these patients violating physical-distancing and other safety rules. Social distancing measures have determined, among others, relevant obstacles for direct access to psychiatric care services, with the consequent adoption of the so called “telepsychiatry” of “tele mental health” by mental health services, a measure which unfortunately has cut off a large amount of patients who have not been able to benefit from these innovative methods of care both because of barriers posed by their own serious mental conditions, and by the impossibility of having the necessary technology.

Disclosure

No significant relationships.
Non-suicidal self-injury and suicide attempt: A continuum or separated identities?
Authors: Cammisa L. , Pacifici S. , Fegatelli D. Alunni , Calderoni D. , Fantini F. , Ferrara M. , Terrinoni A.
Published: February 2022

Introduction

Non-suicidal self-injury (NSSI) has been proposed as diagnostic entity and was added in the section 3 of the DSM 5. However, little is known about the long-term course of the disorder: NSSI and suicide attempt (SA) often lie on a continuum of self-harm, but it’s still unclear if they represent two different nosografical entities. Both these groups are commonly enclosed in the term of Deliberate self-harm (DSH), also including self-harm with suicidal intent conditions.

Objectives

This study aims to explore differences between two clinical samples (NSSI and SA) to highlight the possible connection between these two categories, to better understand the risk of progression from NNSI into suicidal intent conditions.

Methods

102 inpatients with DSH (62 NNSI; 40 SA; age range: 12 to 18 years) were assessed by self-report questionnaires: the Deliberate Self-Harm Inventory (DSHI) and the Repetitive Non-suicidal Self-Injury Questionnaire (R-NSSI-Q) to explore the severity and repetitiveness of self-injurious behaviors and by the Beck Hopelessness Scale (BHS) and Multi-Attitude Suicide Tendency scale (MAST), as indirect measures of suicidal risk.

Results

Preliminary results showed that inpatients with NSSI (62) presented high scores of indirect suicide risk, similar to SA sample (40).

Conclusions

This result highlights the possibility to consider NSSI and SA in a continuum of psychopathology and that repetitive self-harm even in the absence of clear suicidal intentions represent a significant risk factor in the development of suicidality in adolescence.

Disclosure

No significant relationships.
EEG features in depressive female adolescents with suicidal and non-suicidal auto-aggressive behavior
Authors: Iznak E. , Damyanovich E. , Oleichik I. , Levchenko N.
Published: February 2022

Introduction

In adolescents, both non-suicidal self-injuries (NSSI) and previous suicidal attempts (SA) represent significant risk factors for future suicide. Thus, the search for EEG markers of these forms of auto-aggressive behavior seem to be an actual task.

Objectives

The aim of the study was to reveal the differences of baseline EEG features in depressive female adolescents with auto-aggressive behavior such as NSSI or SA.

Methods

The study included 45 depressive female in-patients aged 16–25 years. 21 of them showed only NSSI (NSSI subgroup), 24 patients had a history of SA (SA subgroup). Subgroups did not differ in clinical and social-demographic parameters. Baseline EEG spectral power (SP) and its asymmetry were measured.

Results

SA subgroup had higher parietal-occipital alpha-2 (9-11 Hz) SP than NSSI subgroup. Its focus was located in the right hemisphere, and alpha-3 (11-13 Hz) SP was higher than alpha-1 (8-9 Hz). In contrary, in NSSI subgroup alpha-1 SP was higher than alpha-3; and foci of alpha-2 and alpha-3 SP were localized in the left hemisphere.

Conclusions

Spatial distribution and the ratio of EEG alpha frequency components SP in the SA subgroup reflect greater activation of brain cortex, especially of the left hemisphere that is more typical for EEG of individuals with increased risk of suicide. In NSSI subgroup, the right hemisphere is relatively more activated that is more typical for EEG in depression without SA. The study supported by RBRF grant No.20-013-00129a.

Disclosure

No significant relationships.
Factors associated with same-sex experience in people with non-psychotic mental disorders and suicidal ideation
Authors: Zinchuk M. , Beghi M. , Beghi E. , Kustov G. , Pashnin E. , Voinova N. , Avedisova A. , Guekht A.
Published: February 2022

Introduction

People with mental disorders who had same-sex experience (SSE) are at increased risk of self-injurious behavior probably due to the double stigma phenomenon, which severity varies in different societies. So far, there is a knowledge gap on factors associated with SSE in Russian psychiatric patients.

Objectives

We aimed to investigate variables associated with homosexual experience in Russian patients with non-psychotic mental disorders (NPMD) and suicidal ideation (SI).

Methods

In a case-control study (1:1.5): 92 female patients with NPMD and SI with lifetime SSE were compared with 138 patients without homosexual experience. All patients underwent a psychiatric examination, Self-Injurious Thoughts and Behaviors Interview (Nock MK, 2007) and semi-structured interview to assess demographic, clinical, and behavioral features. Mann-Whitney, Fishers exact test and Pearson’s chi-squared were used as statistical methods.

Results

Groups did not differ in education level, marital status, family history of suicidal behavior, traumatic events exposure and lifetime eating disorders (all:p>0.05). More patients with SSE had family history of non-suicidal self-injuries (NSSI), were dissatisfied with their parenting style, had a higher number of unprotected sexual contacts with unfamiliar persons, practiced group sex, had a history of sexual abuse, illicit drug use experience, were smokers, had piercing and severe body modifications. Lifetime history of suicide plan, attempts and NSSI were significantly more common in people with SSE (all:<0.05).

Conclusions

A number of suicide risk factors were found to be more prevalent in people with SSE. Homosexual experience in people with mental disorders is associated with an increased risk of NSSI, suicide plan development and suicide attempts.

Disclosure

No significant relationships.
Experiences and projections for the future of research, training and other academic activities: Will it be the same?
Authors: Mohr P.
Published: February 2022

The global SARS-CoV-2 pandemic with subsequently imposed restrictions and lockdowns also radically disrupted academic life. Many research projects involving recruitment of human subjects were abruptly put on hold, educational activities have moved into online trainings, scientific meetings have been transformed into virtual events. Social distancing does not restrict only everyday human contact but also limits direct exchange of clinical, educational, and research experiences, professional and academic networking, sharing ideas. Besides all the drawbacks, does the current situation also bring any advantages? Every challenge results in new opportunities. Although the online congresses will most likely never fully replace real-life experience, it was found that many work meetings can be held more efficiently via online communication. Saving time, cutting costs of travel and accommodation, plus other expenses, may help to allocate limited resources where needed. Similarly, while practical medical education and training cannot be substituted for remote broadcasting, many theoretical presentations can. More importantly, epidemic of COVID-19 is a unique opportunity for mental health research, to study individual and population consequences of the virus, its impact on psychiatric patients. It is still early to predict whether and when research, training, meetings, and other academic activities return back to “normal”, but appears that some changes are here to stay.

Disclosure

No significant relationships.
The reciprocal relation between stigma and suicidality in a sample of patients with affective disorders
Authors: Giannelli L. , Cristilli G. , Marone L. , Felice G. De , Carello A. , Vincenzo M. Di , Sollo V. , Cerbo A. Di , Giallonardo V. , Sampogna G. , Vecchio V. Del , Luciano M. , Fiorillo A.
Published: February 2022

Introduction

Suicide is one of the major public health concerns worldwide, currently listed as the 15th most common cause of death. Mental illness stigma may contribute to suicidality and is associated with social isolation and low self-esteem among people with affective disorders.

Objectives

The aim of the present study is to assess, in a sample of people with affective disorders, whether high levels of internalized stigma are associated to suicidal thoughts and behaviours.

Methods

60 outpatients diagnosed with depression or bipolar disorder according to DSM-5 have been recruited. Suicidal behaviours and ideation were assessed through the Columbia Suicide Severity Rating Scale (C-SSRS); internalized stigma through the Internalized Stigma of Mental Illness (ISMI) scale. Socio-demographic characteristics have been collected through an ad hoc schedule.

Results

62.9% of the sample was female, with a mean age of 45.7 (±14) years. About half of the sample had a diagnosis of major depression (54.8%). Patients with suicidal ideation reported higher score at ISMI “alienation” subscale (p<0,05), compared to those without suicidal ideation. Patients with a previous history suicide attempts reported higher score at “alienation” and “social withdrawal” ISMI subscales (p<0,05). Moreover, “alienation” ISMI subscale significantly correlated with suicidal ideation and behaviours (p<0,01).

Conclusions

These results are in line with the available literature, highlighting that stigma and suicidality are strongly correlated. This underline the importance of interventions at addressing internalizing stigma, in particular to those with previous suicidal attempts and with an active suicidal ideation.

Disclosure

No significant relationships.
5 years follow up study on changes of romanian psychiatric residents’ opinion on factors which influence their decision to emigrate
Authors: Mihai A. , Trandafir S. , Duica L. , Mihai A. , Lungu C. , Pirlog C.
Published: February 2022

Introduction

Important changes have been done in economic status of residents in 2018. The impact of these measures in changing opinion was checked.

Objectives

The prioritization exercises of main factors related with psychiatric residents’ decision to emigrate could be a starting point of elaboration of a strategy of reforms.

Methods

The study was cross sectional evaluation at national level on a randomized selected sample of Romanian psychiatric residents’ opinion on factors which influence decision of migration in EU countries in two time points: 2015 and 2020.

Results

38% of residents intend to work abroad comparing with 78% before the economic changes (25.84% versus 71.66% for a limited period of time and 15.73% versus 28.33% intend to emigrate) and 2% versus 5% intend to leave the speciality. The most important factors for decision to emigrate changed from “Better working conditions” (15.73 versus 37.31% residents) to “Better training” 20.25% residents and the factor “respect and appreciation by colleagues” remained important for 19.10% versus 17.91%. “Lack of working place for partner” was considered by 26.96% of responders as an important disadvantage of working abroad. “Being far from family members” which was considered 5 years ago by 64.18% of responders as an important disadvantage of working abroad, nowadays concerns only 6.74%, probably because it seems easier to go abroad together with the family members.

Conclusions

The factors (better training in psychiatry and psychotherapy, better supervision, more involvement in research) which influence the residents’ decision to emigrate represent the starting points on futures reforms in educational and medical system in psychiatry.

Disclosure

No significant relationships.
Infant exposure to lithium through breast milk
Authors: Imaz M.L. , Torra M. , Soy D. , Langorh K. , Garcia-Esteve L. , Martin-Santos R.
Published: February 2022

Introduction

Women who take lithium during pregnancy and continue after delivery may opt to breastfeed, formula feed, or mix these options.

Objectives

To evaluate the neonatal lithium plasma concentrations and nursing infant outcomes based on these three feeding trajectories.

Methods

We followed 24 women with bipolar disorder on lithium monotherapy during late pregnancy and postpartum (8 per trajectory). Lithium serum concentrations were determined by an AVL 9180 electrolyte analyser with a 0.10 mEq/L detection limit and a 0.20 mEq/L limit of quantification (LoQ).

Results

The mean ratio of lithium concentration in the umbilical cord to maternal serum being 1.12 (0.17). We used the Turnbull estimator for interval-censored data to estimate the probability that the LoQ was reached as a function of time. The median times to LoQ was 6–8, 7–8, and 53–60 days for formula, mixed, and breastfeeding, respectively. Generalised log-rank testing indicated that the median times to LoQ differed by feeding trajectory (p = 0.037). Multivariate analysis confirmed that the differences remained after adjusting for serum lithium concentrations at birth (formula, p = 0.015; mixed, p = 0.012). We did not found any acute observable growth or developmental delays in any of the neonates/infants.

Conclusions

Lithium did not accumulate in the infant under either exclusive or mixed-breastfeeding. Lithium concentrations declined in all trayectories. The time needed to reach the LoQ was much longer for those breastfeeding exclusively. Lithium transfer via breastmilk is much less than via the placenta. We did not found any acute observable growth or developmental delays in any infant during follow-up.

Disclosure

No significant relationships.
Anxiety and depressive symptoms in patients with psoriasis
Authors: Sallemi R. , Bouhamed M. , Masmoudi R. , Feki I. , Masmoudi J.
Published: February 2022

Introduction

Psoriasis is a chronic inflammatory skin disease that affects approximately 2% of the population. It seems to have a multifactorial aetiology and it can be considered as a psychosomatic disorder.

Objectives

To determine risk factors for anxiety and depression in psoriasis

Methods

Case-control study including 44 subjects with psoriasis and 50 controls without psoriasis. All participants answered the Hospital Anxiety and Depression Scale (HADS) to measure the severity of anxiety and depression

Results

Descriptive study: We solicited 44 patients and the average age was 45.8 years. The majority of patients were married (70.5%), unemployed (40.5%), without medical heredity (84,6%). Psoriasis was in plaque (65.9%), guttate (20.5%), pustular (13.6.5%).Its severity, assessed by BSA, was mild to moderate in 72.7% of cases and associated arthropathy was noted in 29.5% of patients.the prevalences of anxiety and depression estimated at 29.54% and 18.18% respectively. Analytical study: Subjects with psoriasis, as opposed to controls, showed higher levels of anxiety (29,54% vs 15,9%) and depression (18,18% vs 4,54%) but there was no significant difference (p=0,335, p=0,573) Depression was significantly more important for single (p=0.043), for patients with associated arthropathy (=0.005) and for guttate form (p=0.015) According to the severity of the disease: patients with mild disease are more anxious and patients with severe disease are more depressed

Conclusions

Higher scores in anxiety and depression is common in psoriasis. Dermatologists should give special attention to this subgroup of persons with psoriasis in order to prevent future psychopathology.
Quality of life in patients with psoriasis
Authors: Bouhamed M. , Kolsi S. , Abdallah M. Ben , Feki I.
Published: February 2022

Introduction

Psoriasis is a chronic inflammatory skin condition affecting diverse racial/ethnic groups throughout the world. It has a major impact on the patient’s quality of life, influencing career, social activities, family relationships, and all other aspects of life

Objectives

To evalue the quality of life in patients with psoriasis

Methods

Participants were outpatients of Hedi chaker University Hospital Center in sfax, Tunisia, recruited between January and July of 2017, diagnosed with psoriasis. A Demographic questionnaire and the Quality of life Questionnaire (SF-36) were administered in this study.

Results

44 patients were included in this study. They had with a mean age of 45.8 ±12.1. The majority of patients were married (70.5%), unemployed (40.5%), without medical heredity (84,6%). Psoriasis was in plaque (65.9%), guttate (20.5%) and pustular(13.6.5%). Its severity assessed by BSA, was mild to moderate in 72.7% of cases and associated arthropathy was noted in 29.5% of patients. The overall average SF-36 scale scores for all patients ranged from 4 to 98 with an average of 55.97. The quality of life of patients was impaired in 45.5% of casesQuality of life was significantly more impaired in patients with associated arthropathy (p=0.004). There is no significant differences for the different dimensions of quality of life regarding the clinical form of psoriasis.

Conclusions

Psoriasis certainly has an impact on patients’ quality of life.So, dermatologists should give special attention to this subgroup of persons in order to prevent future psychopathology.
From trauma to pain - a pathway to dental anxiety
Authors: Pereira A.T. , Cabaços C. , Araujo A. , Soares M.J. , Macedo A.
Published: February 2022

Introduction

The main risk factor for dental anxiety is previous traumatic experiences of pain in the dental office. Other consistent etiologic factors are trait-anxiety and preparedness (genetic predisposition to increased sensitivity to pain and aversive stimuli). However, there is a wide inter-individual diversity in the anxiety experience – not all individuals with traumatic experiences at the dentist will develop dental anxiety anxiety

Objectives

To explore potential paths by which a traumatic experience at the dentist (TRAUMA) can lead to dental anxiety.

Methods

A community sample of 552 adults (68.2% women; mean age= 35.15±15.790) completed the Portuguese validated versions of: Dental Fear Survey/DFS, State-Trait Anxiety Inventory, Sensitivity to Pain Traumatization/SPT Scale, Fear of Dental Pain/FDP Questionnaire and Perseverative Thinking Questionnaire–15.

Results

140 participants (25.2%) had TRAUMA; it was significantly (p<.01) correlated with trait-anxiety (Spearman r=.190), SPT (r=.192), FDP (r=.333), RNT (r=.274) and dental anxiety (DFA total score; r=.418). In the mediation analysis (PROCESS macro 3.5 for SPSS; Model 81; Hays, 2020), trait-anxiety and gender were controlled (as RNT, SPT, FDP mean scores were higher in women, p>.01). Our model was significant (R2=17.15%; p<.001) and showed that TRAUMA predicted dental anxiety directely [direct effect: 10.25 (95% CI - 7.10-13.40)] and also through SPT, FDP and RNT (5 significant indirect effects).

Conclusions

This study underlines the importance of avoiding traumatic experiences in the dental office and of good clinical communication in pain management. If trauma still occurs, dentist should learn how to reduce its impact on the sensitivity and fear of pain and on the RNT.
Relationship of cyberchondria to hypochondriac beliefs and internet use
Authors: Kumchenko S. , Rostovzeva N. , Rasskazova E. , Tkhostov A.
Published: February 2022

Introduction

Although cyberchondria was suggested as a separate phenomenon (Starcevic, Berle, 2013, Starcevic, 2017), it is by definition related to both health anxiety, general hypochondriac beliefs and behavior and Internet use (Baumgartner and Hartmann, 2011, Eastin and Guinsler, 2006, Singh and Brown 2014).

Objectives

The aim was to reveal relationship between cyberchondria in adult Internet users, Internet use and hypochondriac beliefs and behavior.

Methods

126 adults (18-70 years old) filled The Cyberchondria Severity Scale (CSS, McElroy, Shevlin, 2014), checklist of activities about health online, Scale for Assessing Illness Behavior (Rief et al., 2001), Cognitions About Body and Health Questionnaire (Rief et al., 1998).

Results

Compulsion, Distress, Excessiveness, Reassuarance Seeking scales are related to various health-related activities online including both specialized (medical web-sites) and non-specialized (Wikipedia) ones (r=.25-.48, p<.01). Compulsion is closely related to surfing in social networks (r=.41, p<.01), excessiveness – to viewing of illnesses-related pictures (r=.48, p<.01) and reassurance seeking – to reading of online reports (r=.47, p<.01). Cyberchondria is related both to health anxiety (r=.37), hypochondriac behavior (r=.19-.41), beliefs about autonomic sensations, bodily weakness, intolerance to sensations and somatosensory ampliphication (r=.25-.31).

Conclusions

In general population, different aspects of cyberchondria seem to reflect health anxiety and hypochondriac beliefs but are differently related to different forms of online behavior including use of more or less specialized web-sites. Research is supported by the Russian Foundation for Basic Research, project No. 20-013-00799.