bluuebunny/crossref_metadata_2025 huggingface dataset:
Positive schizotypy is associated with amplified mnemonic discrimination and attenuated generalization
Authors: Vass Á. , Becske M. , Szőllősi Á. , Racsmány M. , Polner B.
Published: September 2022

Introduction

Tendency to experience inaccurate beliefs alongside perceptual anomalies constitutes positive schizotypal traits in the general population and shows continuity with the positive symptoms of schizophrenia. It has been hypothesized that the positive symptomatology of schizophrenia, and by extension, positive schizotypy, are associated with specific alterations in memory functions. Imbalance between memory generalization and episodic memory specificity has been proposed on several counts; however, the direction of the imbalance is currently unclear.

Objectives

We aimed to contrast two competing hypotheses regarding the association between positive schizotypy, and memory alterations in a general population sample (N=71) enriched for positive schizotypy from a larger pool of individuals (N=614).

Methods

Positive schizotypy was measured with the short-version of the O-LIFE questionnaire, and memory specificity and generalization was captured by the well-established Mnemonic Similarity Task.

Results

Distortions in the behavioural memory performance indices were found to correlate with positive schizotypy: individuals prone to unusual experiences demonstrated increased discrimination and reduced generalization (explaining 10% and 17% of variance, respectively). Associations were robust when controlled for the disorganized, negative and impulsive-asocial dimensions of schizotypy and associated psychopathology.

Conclusions

Our findings show that people who are prone to irrational beliefs and unusual experiences also show measurable alterations in memory and likely have difficulty grasping the global picture and rather be overpowered by fragments of information.

Disclosure

No significant relationships.
Resting-state Functional Connectivity within Frontoparietal Network in Schizophrenia Patients and Healthy Individuals with Better and Worse Executive Functions
Authors: Panikratova Y. , Abdullina E. , Tikhonov D. , Kaleda V. , Lebedeva I.
Published: September 2022

Introduction

Patients with schizophrenia spectrum disorders (SP) demonstrate heterogeneity in executive functions (EF) associated with the quality of outcome. However, neurobiological mechanisms of this heterogeneity are understudied.

Objectives

We aimed to identify features of resting-state functional connectivity (FC) within the frontoparietal network (FPN) that discriminate between SP and healthy individuals (HI) with better and worse EF.

Methods

Twenty-five SP (mean age 20.8±3.23, illness duration 1.3±2.1 years, all males) and twenty-six HI (mean age 25.17±3.46, all males) underwent EF assessment (4 verbal fluency tests and a modified Stroop task) as well as resting-state fMRI (3T).

Results

We used k-means clustering based on EF scores to divide all participants into groups with worse (15 SP, 6 HI) and better EF (10 SP, 20 HI). These groups differed in productivity of all verbal fluency tasks and performance time of the Stroop task. Differences between four subgroups (HI/SP with worse/better EF) were revealed in FC between the cingulate and lateral prefrontal cortex in the left hemisphere (ANCOVA, p-uncorrected<.005, p[FDR]<.05; Fig. 1). SP and HI within each group demonstrated a similar FC pattern. SP with poorer EF had increased FC, compared to HI with higher EF. HI with poorer EF demonstrated increased FC, compared to HI and SP with better EF.

Conclusions

FC within FPN may be one of the neurophysiological underpinnings of EF heterogeneity in SP as well as in HI. Further machine learning fMRI studies are needed to clarify whether FC within FPN is a prognostic marker in schizophrenia.

Disclosure

The study was supported by RFBR Grant 20-013-00748.
Psychopathological and temperamental features of Late Onset versus Early Onset Bipolar Disorder
Authors: Orsolini L. , Ferretti L. , Fiorani M. , Rocchetti D. , Salvi V. , Volpe U.
Published: September 2022

Introduction

Age at onset of type-I bipolar disorder (BD-I) typically averages 12-24 years, is older among patients with type-II-BD (BD-II), even though generally before 50-years-old (EOBD). Clinical observation of late-onset BD (LOBD) posed some questions regarding a differential phenotypic/psychopathological manifestations and affective temperaments between LOBD vs EOBD.

Objectives

A case-control pilot-study was carried out to investigate psychopathological, clinical and temperamental features of a psychogeriatric cohort of LOBD and EOBD subjects.

Methods

Out of 74 enrolled patients, 64 patients (31 EOBD, 33 LOBD) were included and administered an ad hoc socio-demographic datasheet, BPRS, CGI, GAF, HAM-D, GDS, MSRS, MRS, MOCA and TEMPS-M.

Results

LOBD is significantly associated with higher rates of BD-II diagnosis (X2 = 26.1, p<.001), depressive (p=0.05) and mixed states (p=0.011), higher comorbid anxiety levels and depressive affective temperament (p<.001); while clinical manifestations of geriatric EOBD is significantly associated with higher endocrinological (X2 = 7.815, p=.005) and metabolic comorbidity (X2 = 6.896, p=.009), a diagnosis of BD-I, manic episodes and hyperthymic (p=.001) affective temperaments. GDS and MSRS total scores were significantly higher in LOBD (respectively, p<.001 and p=.008).

Conclusions

Further studies with larger sample sizes and a control group should verify whether LOBD is a distinct psychopathological entity from EOBD and evaluate differences (if any) in terms of prognosis and treatment between EOBD and LOBD.

Disclosure

No significant relationships.
A multicentric multimodal in vivo microscopy MRI study of bipolar disorder reveals axonal loss and demyelination
Authors: Sarrazin S. , Poupon C. , Uszynski I. , Mangin J.-F. , Polosan M. , Favre P. , Laidi C. , D’Albis M.-A. , Leboyer M. , Lledo P.-M. , Henry C. , Emsell L. , Shakeel M. , Goghari V. , Houenou J.
Published: September 2022

Introduction

Bipolar disorder has been repeatedly associated with abnormalities of white matter. However, DTI is intrinsically limited and the precise cellular mechanisms that underlie these alterations remains unknown.

Objectives

Our aim was to investigate microscopical characteristics of white matter using MRI in patients with bipolar and healthy controls.

Methods

77 patients and 71 controls from 3 sites had a T1 structural MRI, a multi-shell HARDI MRI and at one site with a T1-weighted VFA-SPGR acquisition, and a T2 MSME acquisition. The volume fraction and the orientation dispersion was extracted using NODDI from DW images in each site. Myelin Water Fraction was extracted in 33 patients and 36 controls to probe myelin characteristics. White matter bundles were reconstructed using deterministic tractography. Statistical analyses were performed after harmonization by the ComBat algorithm and controlled for age, gender and handedness.

Results

We found significant lower axonal density in patients along the short fibers of the left cingulum, the left anterior arcuate and the left inferior fronto-occipital fasciculus. We found lower mean MWF in patients along the short fibers of the right cingulum, the left inferior fronto-occipital fasciculus, the left anterior arcuate and the splenium of the corpus callosum. We found higher mean orientation dispersion in patients only along the left uncinate fasciculus.

Conclusions

We report alterations of limbic and inter-hemispheric white matter tracts in patients with bipolar disorder reflecting axonal loss, demyelination and architecture alterations. These results contribute to better capture the plurality of the mechanisms involved in bipolar disorder that cannot be deciphered with classical diffusion MRI.

Disclosure

No significant relationships.
Hyponatremia from oxcarbazepine: A case report
Authors: Coucheiro Limeres P. , Cerame A. , Maldonado Orellana S. , Franco Soler A.
Published: September 2022

Introduction

Oxcarbazepine (OXC) is an antiepileptic drug used as a mood stabilizer in patients diagnosed with bipolar disorder (BD). OXC has been reported as a source of hyponatremia in its use in both epilepsy and BD.

Objectives

We present the case of a 53 year-old male patient diagnosed with Schizoaffective disorder, bipolar type who developed hyponatremia during his treatment with OXC.

Methods

The patient’s treatment was desvelafaxine 100 mg, Paliperidone depot 150 mg, Oxcarbazepine 600 mg which he had maintained for at least one year. He began to manifest headache, asthenia and mild confusion gradually, with morning predominance, without being clearly suggestive of an acute worsening.

Results

In control analysis, the existence of sodium leveles of 127 and low osmolarity was observed. Therefore it was decided to suspend furosemide, close monitoring of water intake in order to rule out primary polydipsia and extra salt was introduced into the diet. Given the persistence of the symptoms, laboratory abnormalities and ruled out the existence of primary polydipsia, it was decided to suspend treatment with oxcarbazepine. After the discontinuation of the aforementioned drug the analytical findings went back to normal ranges and the symptoms disappeared.

Conclusions

Carrying out control tests in patients with psychiatric pathology and multiple psychiatric treatments is essential to be able to rule out analytical alterations which could be asymptomatic or with nonspecific symptoms that could be attributed to the underlying pathology. The easy reversal of symptoms encourages us to emphasize the study and differential diagnosis of each case.

Disclosure

No significant relationships.
Review of gastrointestinal bleeding during use of SSRIs combined with use of NSAID
Authors: Arts M. , Petrykiv S. , De Jonge L.
Published: September 2022

Introduction

In recent years, more and more attention has been paid to the risks of using SSRIs. This group of antidepressants may be associated with an increased risk of gastrointestinal bleeding. This risk would be even further increased with concomitant use of NSAIDs. A number of studies have described this interaction, however they reported conflicting results.

Objectives

Our objective was to investigate the risk of gastrointestinal bleeding with SSRIs, with or without NSAID use.

Methods

We performed a literature search, using Pubmed, EMBASE, and Cochrane library, in order to investigate controlled trials, cohort, case-control and cross-sectional studies that reported the incidence of gastrointestinal bleeding s on SSRIs with or without concurrent NSAID use, compared to placebo or no treatment.

Results

15 case-control studies and 4 cohort studies were included in the analysis. There was an increased risk of gastrointestinal bleeding with SSRIs in the cohort studies and case-control studies. The risk of gastrointestinal bleeding was even further increased with the combined use of both SSRIs and NSAIDs.

Conclusions

SSRIs are associated with a modest increase of gastrointestinal bleeding. However, this risk is significantly increased when SSRIs are used in combination with NSAIDs. Psychiatrists should be aware of the hazards in prescribing these medications together.

Disclosure

No significant relationships.
Development process of artificial intelligence based chatbot to support and promote mental wellbeing in sparsely populated areas of five European countries
Authors: Kuosmanen L. , Vartiainen A.-K. , Nieminen H. , Kostenius C. , Bond R. , Mulvenna M. , Potts C. , Ennis E. , Malcolm M. , Vakaloudis A. , Cahill B. , Dhanapala I.
Published: September 2022

Introduction

In many countries, people face problems regarding access to care, 24/7 support and evidence-based support. Digital interventions and services, such as chatbots, can be one option to tackle these challenges. There is a lack knowledge regarding how mental health chatbots are developed and how to ensure that there is collaboration between mental health and digital technology experts and users.

Objectives

This presentation describes the phases of the development for the ChatPal mental health and wellbeing chatbot.

Methods

Development process was conducted in five and with four different languages. First, using an electronic survey for mental health professionals (n =190) we screened how familiar they are with chatbots and how they evaluated their potential. Second, university students and staff, mental health professionals and service users (n=78) participated in workshops to design the chatbot content. Finally, the content and scripts of chatbot were written in multi-professional and multi-national collaboration.

Results

ChatPal is based on the PERMAH model of positive psychology and on the idea that we all have mental health which needs boosting and support from time to time. ChatPal includes relevant mental health information, exercises, mood diaries and simple monitoring and self-care tools. Based on preliminary evaluations, the ChatPal chatbot offers an option to offer support in areas where other mental health services are lacking or are insufficient.

Conclusions

ChatPal is already freely available in application stores and first scientific trials are have started. Preliminary results of 4-week and subsequent 12-week in-the-wild trials will be in place at the time of EPA 2022 conference.

Disclosure

No significant relationships.
COVID-19 and the emergence of inpatient tele-ward rounds
Authors: Boland X. , Dratcu L.
Published: September 2022

Introduction

Telemedicine has been at the heart of healthcare system’s strategic response to the COVID-19 pandemic. Within psychiatry, there has been a surge of research and guidelines into the use of video-teleconferencing to replace face to face consultations across clinical settings. Clinical ward rounds are central to inpatient psychiatric care yet little guidance is available on how best to integrate telemedicine into the multidisciplinary work of inpatient psychiatry.

Objectives

We report on the introduction of video teleconferencing for psychiatric ward rounds on our acute inner-London psychiatric unit during the outbreak of COVID-19.

Methods

In undertaking the rapid transition to tele-ward rounds, we had to reconcile the multiple functions of psychiatric ward rounds with the technological resources available to us.

Results

Tele-ward rounds helped simplify care delivery, facilitate multidisciplinary collaboration and improve accessibility for patients and relatives in a time of crisis. The transition to tele-ward rounds also brought about technical, operational and communication issues that may impact on the patient experience and quality of care including governance challenges, contextual dissonance and technological limitations.

Conclusions

The routine use of newer technology in psychiatry ward rounds is unlikely to succeed on the basis of improvisation, particularly given the stream of technical innovations in telemedicine, and the multifarious quality of social interactions in our clinical setting. Staff training and the development of an adapted etiquette and code of communication are both essential. Patient participation in future developments will also help ensure tele-ward rounds continue to meet the standards of high quality inpatient psychiatric care beyond the COVID-19 pandemic.

Disclosure

No significant relationships.
Sociodemographic characteristics associated with an eHealth system designed to reduce depressive symptoms among patients with breast or prostate cancer: a prospective study
Authors: Petros N.G. , Hadlaczky G. , Carletto S. , Martínez S.G. , Meyer B. , Ostacoli L. , Ottaviano M. , Scilingo E.P. , Carli V.
Published: September 2022

Introduction

Electronic health (eHealth) interventions integrate different elements of care in treating and preventing mental ill-health in patients with somatic illnesses. Identifying different sociodemographic characteristics that might be associated with higher perceived usability can help in improving the usability of these e-health interventions.

Objectives

This study aimed to identify sociodemographic characteristics that might be associated with the perceived usability of the NEVERMIND e-health system, comprised of a mobile application and a sensorized shirt, developed to reduce co-morbid depressive symptoms in patients with breast or prostate cancer.

Methods

The study included 129 patients with a diagnosis of breast or prostate cancer who received the NEVERMIND system. Sociodemographic data were collected at baseline. Usability outcomes included the System Usability Scale (SUS), the Mobile Application Rating Scale: user version (uMARS), and a usage index.

Results

The analysis was based on 108 patients (68 breast cancer and 40 prostate cancer patients) who used the NEVERMIND system. The overall mean SUS score at 12-weeks was 73.4 with no statistical differences among different sociodemographic characteristics. The global uMARS score was 3.8, and females scored the app higher than males (β coefficient= 0.16; p=.03, 95% CI 0.02 - 0.3). Females had significant lower usage (β coefficient= -0.13; p=.04, 95% CI -0.25 to -0.01) after adjusting for other covariates.

Conclusions

There was a higher favourability of the mobile application among females compared to males. However, males had significantly higher usage of the NEVERMIND system. The NEVERMIND system does not suffer from ‘digital divide’ where certain sociodemographic characteristics are more associated with higher usability.

Disclosure

No significant relationships.
Prevention and Management of Falls in Older Adults admitted to Woodlands Hospital, an inpatient Old Age Psychiatric Unit
Authors: Darod N.
Published: September 2022

Introduction

Falls are a significant cause of injury in older adults who are disproportionately at higher risk due to multiple factors such as, mobility issues, co-morbidities and polypharmacy. There are several evidence-based interventions that can be implemented to reduce the risk of – and manage falls.

Objectives

Assess whether Woodlands Hospital has implemented the standards set by NICE guidelines on the management of Falls in Older People.

Methods

Retrospective audit of patients admitted to Woodlands Hospital from 1st June to 1st December 2018. 113 patient records were analysed to determine; was an falls risk assessment completed on admission, did patients ’at risk of falls’ have individualized interventions in place, was a falls risk assessment completed weekly at MDT, following a fall, were patients checked for signs of fracture before moved, was a medical examination completed and were neurological observations completed in patients with observed head injury or where it could not be excluded?

Results

100% of patients had individualised interventions to reduce risk of falls and 97.3% of patients had an assessment of risks completed on admission. 60.3% of patients were checked for signs of fracture. 78.3% of patients had a physical examination within 12 hours. 75% of patients had neurological observations completed.

Conclusions

Risk assessment for falls and individualized interventions for patients at risk of falls were completed at a high standard. There remains scope for improvement of review of risk of falls during weekly MDT, documentation of checking for signs of fractures and neurological examination. The outcomes were relayed to the unit and plans to re-audit in September 2021.

Disclosure

No significant relationships.
Prodromal stage of late-onset psychosis
Authors: Pochueva V. , Sheshenin V. , Savina M. , Safarova T.
Published: September 2022

Introduction

Prodromal stage of psychosis may be an aim of prevention first episode psychosis. In late-onset psychosis it’s low described.

Objectives

The aim of this investigation is to describe prodromal phase of late-onset psychosis and their connection with psychopathology.

Methods

74 women with late-onset psychosis (age 64,3±6,7) - late-onset schizophrenia (LOS) (n=49, age 63±8,4), schizoaffective disorder (n=17, age 62,4±6,5), late onset delusion disorder (LoDD) (n=8, age 76,6±4,3) underwent clinical assessment (SOPS, PANSS, HAMD-17), cognitive examination (MMSE, MoCA), structured interviewing on life-time pathology. Spearman’s rho statistics was used.

Results

LOP patients have low prodromal symptoms according to the SOPS score. In LOS patients middle score of SOPS is 18±8,5, in schizoaffective patients middle score of SOPS is 12,3±6,8, and for LoDD SOPS is 13,4 ±4,6. Prodromal disturbances are represented mainly by fragmentary paranoid ideas, thoughts of unusual content, acoasms and affective fluctuations. In LOS patients SOPS negative subscale correlate with HAMD (r=0,384, p<0,05), desorganisation subscale correlate with PANSS common psychopathology subscale (r=0,32, p<0,05) and total PANSS (r=0,28, p<0,05), generous subscale and common SOPS correlate with HAMD (r=0,29, r=0,3, p<0,05). For patients with schizoaffective disorder there is no correlations, and in patients with LoDD SOPS desorganisation subscale negative correlate with PANSS negative subscale (r=-0,71, p<0,05).

Conclusions

In patients with late psychoses, the severity of disorders in the prodromal period is minimal. However, prodromal features are associated with the psychopathology.

Disclosure

No significant relationships.
Changes in neuropsychiatric symptoms and caregivers’ distress in behavioral variant frontotemporal dementia and Alzheimer’s disease in 12 months
Authors: Yassuda M. , Lima-Silva T.
Published: September 2022

Introduction

In behavioral variant frontotemporal dementia (bvFTD) neuropsychiatric symptoms are a significant concern as they impact care management and caregiver wellbeing.

Objectives

To describe change in individual neuropsychiatric symptoms and associated caregivers’ distress assessed by the Neuropsychiatry Inventory (NPI) in patients diagnosed with bvFTD and Alzheimer’s disease (AD) from baseline to a 12-month follow-up.

Methods

The sample consisted of 31 patients diagnosed with bvFTD and 28 patients with AD and their caregivers. The NPI and the Addenbrooke´s Cognitive Examination Revised (ACE-R) were applied. Descriptive statistics, Mann-Whitney U test, Wilcoxon test, Chi square (χ2) were used.

Results

At baseline, significantly higher scores were observed for the bvFTD group for: agitation, disinhibition and eating disturbances. The latter two were also higher in the NPI Distress subdomains. At followup, there were significantly higher scores for the bvFTD group in agitation, disinhibition, eating disturbances, hallucination and irritability. For the NPI Distress subdomains, agitation, eating disturbances and hallucination scores were significantly higher for the bvFTD group.

Conclusions

In 12 months, neuropsychiatric symptoms increased in both bvFTD and AD groups. However, NPI subdomain and caregiver distress scores were statistically higher among bvFTD patients at both assessment points. Neuropsychiatric symptoms may be associated with care burden in bvFTD and should be a focal point in care management decisions.

Disclosure

No significant relationships.
Psychiatrist-led treatment of hepatitis C (HCV) at an opioid agonist treatment (OAT) clinic in Stockholm - enhancing the HCV treatment care cascade
Authors: Kåberg M. , Klasa P.-E. , Nordin T.
Published: September 2022

Introduction

People who inject drugs (PWID) and opioid agonist treatment (OAT) patients have an increased hepatitis C (HCV) prevalence. Studies among these populations show promising HCV treatment results, which is essential to reach the WHO goal of eliminating HCV as a major public health threat by 2030.

Objectives

To introduce psychiatrist-led HCV treatment at an OAT clinic and to investigate HCV treatment results, i.e. sustained virological response at 12 weeks post treatment (SVR12) and numbers of reinfections.

Methods

Prima Maria OAT clinic in Stockholm, provides OAT for 450 patients. The majority have a history of injection drug use. Baseline HCV prevalence (January 2018) was retrospectively investigated through medical charts. In January 2018, psychiatrist-led HCV treatment (with consultation support from infectious diseases specialists) was introduced at the clinic. Prospective treatment results, numbers of reinfections and incidence rates between January 2018 and April 2021 were further investigated.

Results

Baseline data (n=418), showed that 46% were not tested for HCV. Of those tested (n=225), 64% had a chronic HCV infection. By January 2021, 104 HCV treatments were initiated. 97/97 (100%) were HCV RNA negative at end-of-treatment. 78/88 (89%) reached SVR12. Overall, 2 reinfections were noted after SVR12 corresponding to a reinfection rate of 3.5/100 PY. Numbers of HCV treatment did not decrease during the COVID-19 pandemic.

Conclusions

To enhance the HCV treatment cascade, targeted HCV diagnosis efforts are needed. Bringing HCV treatment to OAT clinics enhance the HCV care cascade. HCV treatment education for psychiatrists/addiction specialists makes HCV treatment more sustainable, as specifically noted during the COVID-19 pandemic.

Disclosure

This study was partly funded by Gilead Nordic Fellowship 2020. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the poster/manuscript.
Covid-19: Lessons for Mental and Brain Health
Authors: Falkai P.
Published: September 2022

Psychiatry is facing major challenges during times of a pandemic as illustrated by the current COVID-19 pandemic. The challenges involve its actual and perceived role within the medical system, in particular how psychiatric hospitals can maintain their core mission of attending to the mentally ill while at the same time providing relief to general medicine. Since psychiatric disorders are the top leading causes of global burden of disease, we need to strengthen mental health care in the wake of the massive onslaught of the pandemic. While nobody can deny the need to act decisively and swiftly and ramp up intensive care readiness, we believe that the immediate availability of psychiatric care is just as important. In order to provide the best possible treatment conditions for people suffering from mental illness but as well for those suffering from the immediate pandemic’s consequences such as isolation, reduced social interaction etc. instant and comprehensive provision is inevitable.

Disclosure

No significant relationships.
Darier-White disease and Psychiatric disorders: A Case Report
Authors: Esteve R.L. , Sánchez-González R. , Campillo M. , Carrió E.
Published: September 2022

Introduction

Darier-White disease (DD) is a rare genodermatosis of dominant autosomic inheritance characterized by the keratinization of epidermis, nails and mucous membrane. It leads to the formation of papules and brown hyperkeratotic plaques, mainly in seborrheic areas. The disease is associated with a mutation on the ATP2A2 gene, mapped in the 12q23-24 chromosome. There is known a relationship between DD and neuropsychiatric diseases, such as bipolar disorder, depression and schizophrenia.

Objectives

To discuss the relationship between DD and neuropshychiatric disorders.

Methods

We report the case of a patient with diagnosed schizophrenia, alcohol and cannabis dependence who presented skin lesions.

Results

The physical exploration of our patient revealed cutaneous lesions and we pointed the diagnostic towards DD. Afterwards, a cross-consultation was done with the dermatology experts. During the physical exploration, the patient shows confluent hyperkeratotic papules, dominant on the sides and center of back and hands, together with nail injuries (see images). The diagnostic was confirmed through anatomic pathology. The patient was treated with 10 mg/day of Acitretin together with emollients twice a day, which improved the patient clinical status and signs. The patient remained stable at a psychiatric standpoint. After 3 years of treatment, the patient keeps the same medication but with a reduced dose of 5 mg/day, with a 70% decrease of the initial hyperkeratotic lesions.

Conclusions

Previous studies concludes that mutations in the ATP2A2 gene, in addition to causing DD, confer susceptibility to neuropsychiatric features.These case report highlight the need for clinicians to asses and recognize neuropsychiatric symptoms in DD.

Disclosure

No significant relationships.
The effects of a computerized clinical decision aid on clinical decision-making and guideline implementation in psychosis care
Authors: Castelein S. , Roebroek L.O. , Boonstra A. , Veling W. , Jörg F. , Sportel B. , Bruins J. , Delespaul P.A.E.G.
Published: September 2022

Introduction

Clinicians in mental healthcare have few objective tools to identify and analyse their patient’s care needs. Clinical decision aids are tools that can support this process.

Objectives

This study examines whether 1) clinicians working with a clinical decision aid (TREAT) discuss more of their patient’s care needs compared to usual treatment, and 2) agree on more evidence-based treatment decisions.

Methods

Clinicians participated in consultations (n=166) with patients diagnosed with psychotic disorders from four Dutch mental healthcare institutions. Primary outcomes were measured with the modified Clinical Decision-making in Routine Care questionnaire and combined with psychiatric, physical and social wellbeing related care needs. A multilevel analysis compared discussed care needs and evidence-based treatment decisions between treatment as usual (TAU) before, TAU after and the TREAT-condition.

Results

First, a significant increase in discussed care needs for TREAT compared to both TAU conditions (b = 20.2, SE = 5.2, p = 0.00 and b = 15.8, SE = 5.4, p = 0.01) was found. Next, a significant increase in evidence-based treatments decisions for care needs was observed for TREAT compared to both TAU conditions (b = 16.7, SE = 4.8, p = 0.00 and b = 16.0, SE = 5.1, p = 0.01).

Conclusions

TREAT improved the discussion about physical health issues and social wellbeing related topics. It also increased evidence-based treatment decisions for care needs which are sometimes overlooked and difficult to treat. Our findings suggest that TREAT makes sense of ROM data and improves guideline-informed
care.

Disclosure

No significant relationships.
Resilience and Wellbeing in Mental Health Workforce: Why it Matters and How to Develop it
Authors: Steinebach C.
Published: September 2022

Resilience, mental health, and well-being are currently being discussed in general and for healthcare workers. Employees in the mental health workforce are subject to a variety of stresses. There have been long-standing stresses due to structural and discipline-specific conditions. In addition, there are special challenges due to the pandemic.

The systemic perspective of the biopsychosocial model of human development focuses on biochemical, muscular-neuronal, emotional, cognitive, and environmental risk and protective factors. These systemic events are embedded in different environmental systems that represent micro- to macrosystemic conditions. All these factors need to be reflected, evaluated, and positively developed in a profession- and workplace-specific manner. In this sense, “career resilience” can be promoted individually, at team level and organizationally. Corresponding evidence-based programs for prevention and intervention are presented. In the discussion, it becomes clear that expectations of societal requirements can also be derived under the concern of prevention and promotion. It is necessary to complement self-care with the “caring team community” to promote the development of a comprehensive “caring society”. Thus, we contribute to an overarching conception in terms of transdisciplinary consilience of resilience and wellbeing in mental health workforce.

Disclosure

No significant relationships.
Depressive Symptoms and Suicidal Ideation in Spanish Medical Students
Authors: Blanco J.A. , Rodriguez M. , Santos Carrasco I. , Queipo De Llano De La Viuda M. , Gallardo Borge L. , Marqués Cabezas P. , Mateos Sexmero M.J. , Blanco Vilches J.
Published: September 2022

Introduction

Medical students have higher rates of depression, anxiety and suicidal ideation over the general population. The onset of these disorders can be a risk factor with unfavorable impact in both medical care and their lives during the years of clinical specialization

Objectives

To assess the prevalence and factors involved in depression, anxiety and suicidal behavior in medical students of the University of Valladolid (Spain). The results are compared with a previous study conducted 5 years earlier

Methods

We used an online self-administered questionnaire that included demographic variables, academic information, sanitary data, Beck Depression Inventory (BDI), Generalized Anxiety Disorder 7 (GAD7), and MINI International Neuropsychiatric Interview for suicide. Chi-Square Test was used for categorical variables, Student`s t-test for quantitative variables and Spearman’s Coefficient to evaluate correlations between variables

Results

362 students of all courses enrolled in Medicine at the University of Valladolid completed the survey. There were no differences between male and female students, both with high rates of moderate-severe depression (27% vs 30,4%), anxiety (42,9% vs 54,5%), and moderate-severe suicide risk (14,2% vs 10,7%). Previous study (n=584) also showed no differences between sexes but with lower rates of moderate-severe depression (14,3% vs 16,3%). 11% reported suicidal thoughts in the past month (11,6% previous study). There was a significant inverse correlation between medical career satisfaction and BDI scores

Conclusions

Five years later, rates of depression and suicide risk could have increased in medical students at the University of Valladolid. We urgently recommend the implementation of mental health prevention programs in this population

Disclosure

No significant relationships.
Depression and suicidality amongst infertile women: a hidden pandemic?
Authors: Ghosh Dastidar B.
Published: September 2022

Introduction

The psychosocial impact of infertility has been well researched and documented. However very little research has been conducted to assess the causative relationship between infertility and serious psychiatric illness such as suicide.

We conducted a cross-sectional study to investigate suicidal risk ( suicidal ideation/ suicide attempts) amongst 100 infertile women undergoing infertility treatment at an IVF Centre based in Kolkata, India. Allied parameters such as depression, anxiety, quality of life were also studied.

Objectives

The goal of the presence study was to assess the suicidal risk ( suicidal ideation / attempted suicide ) amongst infertile women undergoing infertility/ ART treatment. And to examine the possible etiological factors behind increased levels of suicidal risk amongst infertile women.

Methods

Mini International Neuropsychiatric Interview was administered to 100 female patient’s undergoing IVF treatment and 100 control patient’s , visiting an IVF Centre based in Kolkata. Chi square test, independent t test and Z test used for statistical analysis.

Results

According to the results obtained by assessment of MINI scale , the prevalence of major depressive disorder (50 % ) followed by Dysthymia (25%) was documented among infertile group while suicidality at 15% were significantly higher than other disorder (Z = 3.80, p> .001). No such cases of suicidality or Dysthymia was found among patients of control group. (fertile group).

Conclusions

Routine screening of suicidal risk and depression should be conducted for all patients undergoing IVF treatment. Infertility specialists should recognize psychiatric morbidity amongst infertile patients for subsequent referral and treatment.

Disclosure

No significant relationships.
Living on the edge: a review on potential risk factors for suicide in adult attention-deficit/hyperactivity disorder
Authors: Miranda J. , Barbosa M. , Tarelho A. , Guedes R.
Published: September 2022

Introduction

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by symptoms including inattention, hyperactivity and/or impulsivity that commonly persists into adulthood. Suicide is a major cause of death in adult ADHD (aADHD) patients. Suicidality is higher in these patients, in possible relationship to various clinical and socio-demographic factors.

Objectives

To review the current literature concerning potential risk factors for suicide in aADHD patients.

Methods

A research was made using the Medline database through the Pubmed search engine, with the following keywords: “adhd”, “suicide”, “risk factors”.

Results

Comorbid psychiatric disorders (major depressive disorder, sleep disturbances, behavior disorders and addictive disorders) are powerful predictors of suicidal behavior in aADHD. Depression is the most frequent diagnosis among aADHD patients with previous suicide attempts. Subtype (mostly the combined type) and severity of ADHD were also associated with a higher number of prior suicide attempts. Impulsiveness, poor emotional self-regulation, recklessness, persistent hyperactivity, inability to relax, engagement in risk behavior (often found in ADHD), common personality traits in aADHD like low frustration tolerance, maladaptive coping and poor problem-solving, as well as interpersonal relationship problems, were associated with higher suicidality. Financial distress caused by unemployment is associated with higher suicidal behaviors. The suicidality is higher in females, mostly associated to self-concept, whereas in males is typically related to impulsivity.

Conclusions

Clinicians should be aware of the potential risk factors for suicide in aADHD patients because the early detection of these factors is fundamental to improve the patients’ quality of life and could contribute to the design of more effective treatments.

Disclosure

No significant relationships.
Anxiety disorders and age-related changes in physiology
Authors: Mutz J. , Hoppen T. , Fabbri C. , Lewis C.
Published: September 2022

Introduction

Anxiety disorders are leading contributors to the global disease burden, highly prevalent across the lifespan, and associated with substantially increased morbidity and early mortality.

Objectives

The aim of this study was to examine age-related changes across a wide range of physiological measures in middle-aged and older adults with a lifetime history of anxiety disorders compared to healthy controls.

Methods

The UK Biobank study recruited >500,000 adults, aged 37-73, between 2006-2010. We used generalised additive models to estimate non-linear associations between age and hand-grip strength, cardiovascular function, body composition, lung function and heel bone mineral density in cases vs. controls.

Results

The main dataset included 332,078 adults (mean age = 56.37 years; 52.65% females). In both sexes, individuals with anxiety disorders had lower hand-grip strength and blood pressure than healthy controls, while their pulse rate and body composition measures were higher. Case-control differences were larger when considering individuals with chronic and/or severe anxiety disorders, and differences in body composition were modulated by depression comorbidity status. Differences in age-related physiological changes between female anxiety disorder cases and healthy controls were most evident for blood pressure, pulse rate and body composition, while in males for hand-grip strength, blood pressure and body composition. Most differences in physiological measures between cases and controls tended to decrease with age increase.

Conclusions

Individuals with a lifetime history of anxiety disorders differed from healthy controls across multiple physiological measures, with some evidence of case-control differences by age. The differences observed varied by chronicity/severity and depression comorbidity.

Disclosure

JM receives studentship funding from the Biotechnology and Biological Sciences Research Council (BBSRC) and Eli Lilly and Company Limited. CML is a member of the Scientific Advisory Board of Myriad Neuroscience. CF and THH declare no relevant conflict of
Comparison of Metacognitions in Obsessive-Compulsive Disorder, Generalized Anxiety Disorder, and Healthy Controls
Authors: Gundogmus I. , Tekin S. , Aydin M.B. , Ucar H. , Uzun Ö.
Published: September 2022

Introduction

Generalized anxiety disorder (GAD) and Obsessive compulsive disorder (OCD) are common psychiatric disorders. Researchers studying the pathophysiology of these two disorders evaluated the effect of metacognition. However, there is no research examining the metacognition differences of these two psychiatric conditions.

Objectives

This study was performed to compare the metacognitions in OCD, GAD and healthy controls.

Methods

The sample of this study consisted of 158 GAD and 137 OCD patients aged 18-65 years who presented to outpatient psychiatry clinic and applied to the health committee 168 healthy controls without psychopathology. Sociodemographic data form, Meta-Cognitions Questionnaire-30 scale(MCQ-30), Beck Depression Inventory(BDI) and Beck Anxiety Inventory(BAI) were applied to the volunteer participants who met the criteria for participation in the study. The data obtained were evaluated statistically and subjected to statistical analysis.

Results

The mean age was 31.89 ± 10.86 years and was 60.5% (n = 208) women. There was statistical difference between marital status, occupation and income(p <0.05). In addition, there was a statistically significant difference between MCQ-30 total and subscales, BDI and BAI (p <0.001). According to the comparison of OCD and GAD patients, ’positive belief’, MCQ-30 total and BAI scores were found to be statistically different (p <0.05), ’Uncontrollability and danger’, ’Cognitive Confidence’, ’Beliefs about The Need to Control Thoughts’, ’Cognitive Self-Consciousness’, BDI there was no statistical difference between them (p> 0.05).

Conclusions

Our results are contributing to the understanding of the uncertainty of development and maintenance of OCD and GAD. Additionally, metacognitions could be important for the diagnosis and treatment of OCD and GAD.

Disclosure

No significant relationships.
Preliminary evidence for a Theory of Mind impairment in patients with Anxiety Disorders
Authors: Santarelli G. , Innocenti M. , Faggi V. , Miglietta V. , Colpizzi I. , Galassi F. , Castellini G. , Ricca V.
Published: September 2022

Introduction

Theory of Mind is defined as the ability to understand mental states of other people, and is notoriously impaired in patients with Autism Spectrum Disorder. A growing body of evidence suggests an impairment of Theory of Mind in several other psychopathological disorders. However, only few studies have assessed Theory of Mind in patients with Anxiety Disorders (AD), addressing only patients with Social Anxiety Disorder.

Objectives

We aimed to investigate the differences in Theory of Mind between patients with AD and Healthy Controls (HC).

Methods

We enrolled 35 patients admitted in the Psychiatric Unit of Careggi with diagnosis of AD and 31 HC. We administered them: Zung Anxiety Scale (ZSAS), Empathy Quotient (EQ), Reading the Mind in the Eyes (RMET), and Faux Pas test (FP). A t-test for independent samples was performed to assess between-group differences.

Results

Zung total scores proved to be significantly higher in patients (t(60)=4.375, p<0.001), while Empathy Quotient total scores (t(61)=-3.325, p=0.002), detection of faux pas in Faux Pas test (t(61)=-4.957, p<0.001), RMET total scores (t(63)=-2.269, p=0.031) were significantly higher in healthy controls.

Conclusions

Such preliminary data suggest impairment of Theory of Mind and Empathy in patients with AD as compared to HC. This could be linked to the development and maintenance of anxiety symptoms in patients with AD, making Theory of Mind a potential target in psychotherapy of AD.

Disclosure

No significant relationships.
Anxiety in patients with hyperthyroidism
Authors: Nevzorova S.
Published: September 2022

Introduction

Mental symptoms are the first manifestations of hyperthyroidism. They include anxiety, dysphoria, irritability, emotional lability, sleep disorders, intellectual dysfunction, mania or depression. Anxiety is the main symptom and requires more detailed study.

Objectives

The objective was to determine symptomatology of anxiety in patients with hyperthyroidism and compare with euthyroid patients.

Methods

The study included 56 patients with hyperthyroidism (high free T3 and free T4, suppressed TSH) and 32 euthyroid patients (normal free T3, free T4 and TSH) of the control group. For psychiatric assessment State-Trait Anxiety Inventory [STAI], Hamilton Depression Rating Scale [HAM-D], and Hamilton Anxiety Rating Scale [HAM-A] were used.

Results

Total scores obtained from STAI, HAM-D and HAM-A were significantly greater in the hyperthyroidism group than that of the euthyroid group (p<0.05). The level of state anxiety in patients with hyperthyroidism was 51.39 ± 0.95 (high level) compared with 41.59 ± 2.41 (moderate level) in the control group. The level of trait anxiety in patients with hyperthyroidism was 46.86 ± 0.69 (high level), and 44.16 ± 2.17 (moderate level) in the control group. Psychomotor agitation (HAM-D # 9), psychic anxiety (HAM-D # 10), insomnia (HAM-A # 4) and weight loss (HAM-D # 16) were typical for patients with hyperthyroidism, while in the control group predominate the feelings of fatigue, weakness and loss of interest in working (HAM-D # 7).

Conclusions

The prevalence of anxiety in patients with hyperthyroidism is significantly more frequent compared to euthyroid patients. Anxiety and other psychiatric symptoms should be considered by both endocrinologists and psychiatrists.

Disclosure

No significant relationships.
Comparative effectiveness of group-analysis therapy and psychoeducation in patients with different somatoform disorders
Authors: Tkhostov A. , Rasskazova E. , Belokrylov I.
Published: September 2022

Introduction

Psychological interventions including group analysis (Leichsenring et al., 2015, Beutel et al., 2008) are effective with patients having somatoform disorders.

Objectives

To reveal differences in dynamics of pathological bodily sensations, quality of life, illness representation in patients with somatoform disorders undergoing group analysis and psychoeducation program.

Methods

100 patients with somatoform disorders (undifferentiated somatoform disorder – 42, somatization disorder – 10, somatoform autonomic disfunction – 36, persistent somatoform pain disorder and other SD – 12) were randomly assigned randomized to psychoeducation intervention and to the group analysis psychotherapy. Before and after treatment they filled Screening for somatoforms symptoms (Rief, Hiller, 2003), Illness Perception Questionnaire - Revised (Moss-Morris et al., 2002), Cognitions About Body And Health Questionnaire (Rief et al., 1998), Scale for the Assessment of Illness Behaviour (Rief et al., 2003), Quality of Life Enjoyment and Satisfaction Questionnairie-18 (Ritsner et al., 2005).

Results

In both conditions decrease in complaints was the most in patients with undifferentiated somatoform disorder and the least in somatoform autonomic disfunction (F=6.19, p<.01, η²=.17). In patients with somatization disorder there was the most increase in quality of life in leisure time, beliefs about intolerance to bodily sensations, rechecking the diagnosis (F=3.32-4.87, p<.05, η²=.10-.14). Decrease in beliefs about bodily weakness, illness consequences was the most prominent in patients with somatization disorder undergoing group therapy (F=2.90-4.46, p<.05, η²=.09-.13).

Conclusions

Patients with undifferentiated somatoform disorder demonstrate most clinical improvement in interventions while patients with somatization disorder – the most psychological improvement. Research is supported by the Russian Foundation for Basic Research, project No. 20-013-00799.

Disclosure

Research is supported by the Russian Foundation for Basic Research, project No. 20-013-00799.