bluuebunny/crossref_metadata_2025 huggingface dataset:
Drug attitude inventory is relevant to LAI treatment persistence in schizophrenia: Preliminary results
Authors: D’Anna G. , Tatini L. , Pietrini F. , Ballerini A. , Ricca V.
Published: February 2022

Introduction

Patients’ attitudes and subjective experience are crucial in the management of severe mental illness, but their practical value is overlooked.

Objectives

To identify predictors of future adherence to LAI antipsychotic maintenance treatment of schizophrenia among socio-demographic, clinical, and psychometric characteristics – including Drug Attitude Inventory-10 (DAI-10) and Subjective Well-being under Neuroleptics short form (SWN-K) scores.

Methods

Retrospective baseline data from 53 clinically stable outpatients with schizophrenia switched from oral to LAI therapy were collected. Patients continuing treatment at the time of analysis (n=29) were compared to those who had discontinued it (n=24). Selected variables were further evaluated in survival analyses.

Results

Between-group differences are presented in Table 1 (**: p<0.01; *: p<0.05).Continued treatmentDiscontinued treatmentχ2 or tTreatment persistence (months)63.79±21.0123.88±25.806.21**Age (years)39.17±10.1135.58±13.391.11Male15 (51.7%)13 (54.1%)0.03Single20 (69.0%)15 (62.5%)0.25Instruction (years)13.28±3.3111.83±3.561.53Employed20 (69.0%)7 (29.2%)8.32**Illness duration (years)17.69±10.5313.42±11.361.42Previous hospitalisations2.10±1.322.67±1.86-1.29MADRS13.59±9.0614.67±8.99-0.43YMRS5.52±5.576.00±9.94-0.22p-PANSS12.17±5.2014.38±6.13-1.41n-PANSS10.90±5.3915.63±7.93-2.48*g-PANSS29.38±10.3333.63±10.26-1.49PANSS52.66±17.5763.96±20.61-2.15*DAI-103.86±4.96-1.13±5.803.38**SWN-K74.93±23.0781.00±15.60-1.09

Cox regression analysis included instruction, employment, hospitalisations, PANSS subscales and DAI-10 scores: a protective role against treatment discontinuation was outlined only for employment (HR 0.16; 95%CI 0.05-0.50) and higher DAI-10 scores (HR 0.85; 95%CI 0.78-0.94). DAI-10 scores delineated distinct adherence trajectories (Figure 1).

Conclusions

Baseline DAI-10 scores may identify patients at risk of dropout after switching to LAI.

Disclosure

No significant relationships.
Assessment of risk factors of treatment discontinuation among patients on paliperidone palmitate and risperidone microspheres in france, germany and belgium – a retrospective database study
Authors: Cai R. , Decuypere F. , Chevalier P. , Wimmer A. , Guillon P. , Pype S. , Godet A. , Timtschenko V.
Published: February 2022

Introduction

Long-acting antipsychotics (e.g. 1-monthly (PP1M) / 3-monthly (PP3M) injection forms of paliperidone palmitate) have been developed to improve treatment continuation in schizophrenia patients.

Objectives

To assess risk factors of treatment discontinuation in patients on paliperidone palmitate and risperidone microsphere. Additionally, treatment continuation between patients with PP1M and PP3M was compared.

Methods

The IQVIA Longitudinal Prescription databases were used. Risk factors of treatment discontinuation were identified by a multilevel survival regression using Cox proportional hazards model. Kaplan Meier analyses were performed by identified significant risk factors.

Results

25,361 patients (France: 9,720; Germany: 14,461; Belgium: 1,180) were included. Over a one-year follow-up period, a significant higher treatment continuation was observed for patients newly initiated on paliperidone palmitate (46.2%) than those initiated on risperidone microspheres (14.6%). Additionally, a significantly higher treatment continuation was found for ‘stable’ PP3M patients (81.8%) than ‘stable’ PP1M patients (62.9%). Patients were more likely to discontinue when drugs prescribed by GP only (HR = 1.68, p < 0.001 vs. psychiatrist only) or being females (HR = 1.07, p < 0.001), whereas discontinuation rate decreased with age (31-50 years: HR = 0.95, p = 0.006 and > 50 years: HR = 0.91, p < 0.001 vs. 18-30 years).

Conclusions

Paliperidone palmitate was associated with a significantly higher treatment continuation than risperidone microspheres. Treatment continuation is likely to be improved by targeting young patients (18-30 years), empowering GPs with mental health knowledge and managing patients by a collaborative primary care-mental health model. Further research is needed to understand why females have more treatment discontinuation.

Disclosure

Rui Cai, Flore Decuypere and Pierre Chevalier are IQVIA employees and served as paid consultants to Janssen during the conduct of this study. Antonie Wimmer, Pascal Guillon, Stefan Pype, Annabelle Godet, Valeria Timtschenko are Janssen employees.
Conversation analysis, psychopathology and subjective experience in patients with schizophrenia
Authors: Lucarini V. , Cangemi F. , Paraboschi F. , Lucchese J. , Daniel B. , Marchesi C. , Tonna M.
Published: February 2022

Introduction

Patients with schizophrenia show severe difficulties in interpersonal communication, including impairments in conversation skills, like the turn-taking. To our knowledge, very few studies to date have taken into account conversation analysis in order to investigate turn-taking in schizophrenia patients.

Objectives

To investigate the conversational patterns in schizophrenia patients; to assess possible associations between dialogic features, abnormal subjective experiences and symptom dimensions.

Methods

Thirty-six patients with Schizophrenia underwent an interview, subsequently analyzed with an innovative semi-automatic analysis. Positive and Negative Syndrome Scale (PANSS) was adopted for the investigation of psychopathology and Examination of Anomalous Self Experience (EASE) for Self-Disorders.

Results

Dialogic exchanges are graphically represented in Figure 1. An inverse correlation was found between participant speaking time and PANSS negative symptoms score (r = -0.44, p value < 0.05; Figure 2), whereas no associations were found between conversational variables and PANSS positive or disorganization dimensions. Finally, a positive correlation was found between the EASE item “spazialization of thought” and average pause duration (r = 0.42, p value < 0.05).

Conclusions

The finding of a relationship between negative symptoms and conversational patterns suggest that conversational features in schizophrenia are expression of the “core” negative dimension of the disorder. The association with the phenomenon of thought spatialization seems to suggest that the disturbances of the stream of consciousness impact on natural dialogic interactions. Ultimately, conversation analysis seems a promising tool to study dialogic exchanges of patients with schizophrenia.

Disclosure

No significant relationships.
Hebephrenic schizophrenia as a variant of frontotemporal dementia – the true dementia praecox?
Authors: Medeiros A.B. , Descalço N. , Santos C. Fernandes , Gomes R. , Pereira M. Veiga
Published: February 2022

Introduction

Frontotemporal Demential (FTD) is a neurodegenerative disorder evolving the frontal or temporal brain lobes. They have been described six variants. Behaviour variant (BvFTD) is the most common, and is characterized by changes in social behaviour and conduct, with loss of social awareness and poor impulse control. Hebephrenic schizophrenia (HSz), or disorganized schizophrenia, was recognized as a schizophrenia subtype, characterized by desorganized behaviour and a cognitive deteriorization. Subtypes of schizophrenia are no longer recognized as separate conditions neither in the Diagnostic and Statistical Manual of Mental Disorders, nor in the new International Statistical Classification of Diseases.

Objectives

To review the literature about the concepts of hebephrenic schizophrenia and their similarities with the concept of frontotemporal dementia

Methods

Narrative review of the literature on PubMed/MEDLINE, using the keywords “hebephrenic szchizophrenia” AND “frontotemporal dementia”. Only articles in English were included.

Results

Some authors described dificulty in establish a diferential diagnosis between HSz and BvFTD. HSz has an earlier onset. However, BvFTD is an early age dementia. The fenomenology of both diseases is similar, and schizophrenia was historical conceptualized as praecox dementia. Frontotemporal abnormalities are common neuroimagiological findings in schizophrenia. Clinically, FTD shows a profound alteration in personality and social conduct, emotional blunting and loss of insight. Memory, intellectual functions, executive and attentional abilities may be disturbed in both.

Conclusions

A diferential diagnosis between HSz and BvFTD is dificult to establish (clinically and imagiologically). The response to treatment is weak in both. It should be investigated the possibility they could be the same syndrome, onseting in diferent ages.

Disclosure

No significant relationships.
Influenza and schizophrenia: How can we shed a light in the new virus from an old association?
Authors: Magalhães D. , Ferreira F. , Ferreira T. , Figueiredo I. , Martinho F. , Felício R. , Santos N.
Published: February 2022

Introduction

COVID-19 raises serious concerns regarding its unknown consequences for health, including psychiatric long term outcomes. Historically, influenza virus has been responsible for pandemics associated with schizophrenia. Epidemiological studies showed increased risk for schizophrenia in children of mothers exposed to the 1957 influenza A2 pandemic. Controversy remains concerning the mechanisms of pathogenesis underlying this risk.

Objectives

We aim to review the evidence for the association between influenza infection and schizophrenia risk, the possible pathogenic mechanisms underlying and correlate these findings with the schizophrenia hypothesis of neurodevelopment.

Methods

We reviewed literature regarding evidence from epidemiological, translational animal models and serological studies using medline database.

Results

The biological mechanisms likely to be relevant account to the effects of infection-induced maternal immune activation, microglial activation, infection-induced neuronal autoimmunity, molecular mimicry of the influenza virus, neuronal surface autoantibodies and psychosis with potential infectious antecedents. Influenza infection may fit into the theory of the neurodevelopment of schizophrenia as a factor that alters the normal maturation processes of the brain (possible second or third hit).

Conclusions

Influenza infection has multiple pathogenic pathways in both pre and post natal processes that might increase the risk of schizophrenia or psychosis. The existing evidence regarding the relationship between influenza virus and psychosis might help us draw similar long-term concerns of COVID-19.

Disclosure

No significant relationships.
The role of professionals' associations under extraordinary situations: Contingency, capacity, and collaboration
Authors: Başar K.
Published: February 2022

COVID-19 pandemic, with its profound effects on almost every sphere of individual and social life, is a significant challenge and threat to mental well-being. Although mass disasters with similar traumatic effects are not exceptional incidents globally, the rate of the spread of infection, the scale of the effects of the disease and precautions, and uncertainty concerning the nature, prevention from, and treatment of the disease render the psychosocial effects unique. As it is the case for the individual’s response to the stressful events, the psychiatric communities initially addressed this challenge by adapting their usual responses to mass trauma, through their capacity acquired from earlier experiences and training. Although the response to the pandemic is expected to be orchestrated by the public authorities, in many countries, either the administration was not sufficiently cognizant of the psychosocial consequences of the pandemic, or the health-care system was unable to function properly due to the excessive burden. Therefore, the associations of mental health professionals, with varying degrees of preparedness to cope with such a challenge, had to recruit their full resources. As many associations worldwide did, the Psychiatric Association of Turkey prepared written and audiovisual resources for psychiatrists, health professionals, and the general population related to the mental health effects of the pandemic and precautions, often including strategies to cope with stress-related difficulties. Many associations, also provided distant-access psychological support to health-care workers on the frontlines and the general population. These were achieved through a fast-organized collaboration among its members and between associations worldwide.

Disclosure

No significant relationships.
The relationship between sleep disorders and psychotic-like symptoms in the general population
Authors: Fusar-Poli L. , Surace T. , Aguglia A. , Aguglia E.
Published: February 2022

Introduction

Abnormalities of sleep patterns are common in people with psychiatric disorders and often represent a source of distress, worsening the outcome. However, little is knwon about the relationship between psychotic-like symptoms and sleep disorders in the general population.

Objectives

1. Whether there is a relationship between sleep disorders and psychotic-like experiences in a sample of individuals belonging to the general population. 2. Which sleep disorders are more commonly associated with psychotic-like experiences.

Methods

A web survey was spread thorugh social networks. We administered the SLEEP-50 to investigate the presence of sleep disorders and the Community Assessment of Psychic Experience (CAPE) for psychotic-like symptoms. Moreover, socio-demographic characteristics of participants were collected.

Results

The web-survey was completed by 824 participants. Six people refused to give consent and 95 were excluded because they declared to suffer from psychiatric disorder sor other medical conditions potentially infleuncing on sleep. Therefore, 729 subjects were included in the analysis. Pearson correlation coefficients showed strong correlations between the scale regarding SLEEP-50 “All sleep disorders” scale and CAPE Total and Depressive scales (r = 0.52, p < 0.001). A moderate correlation was found between “All sleep disorders” and CAPE Negative (r = 0.49) and Positive (r = 0.32) scales. Correlations with specific SLEEP-50 subscales were also found.

Conclusions

There seems to be a strong relationship between psychotic-like symptoms and sleep problems in the general population. Our findings might indicate that some sleep abnormalities may represent earlier symptoms of a psychiatric condition and need to be always monitored even in the non-psychiatric population.

Disclosure

No significant relationships.
Are demoralization and insight involved in suicide risk? An observational study on psychiatric inpatients
Authors: Berardelli I. , Innamorati M. , Sarubbi S. , Rogante E. , Erbuto D. , Costanza A. , Casale A. Del , Pasquini M. , Lester D. , Pompili M.
Published: February 2022

Introduction

Although several authors have investigated the relationship between demoralization, insight, and suicide risk, the role of these factors in determining suicide risk in patients with psychiatric disorders is still unclear [Berardelli et al., 2019; Costanza et al., 2020].

Objectives

The main aim of this study was therefore to determine whether suicide risk was associated with better insight and worse demoralization in a sample of 100 adult psychiatric inpatients.

Methods

The study was performed on 100 psychiatric hospitalized adult patients consecutively enrolled between January 2019 and April 2020 at psychiatric units of Sant’Andrea Medical Center, Sapienza University of Rome. The Columbia Suicide Severity Rating Scale (C-SSRS) was used to assess suicide risk, Demoralization was assessed using the Demoralization Scale (DS) [Kissane et al., 2004] and for the assessment of insight we used the The Insight Scale (IS).

Results

Only age was significantly associated with higher suicide risk (χ2=9.07, p<0.01). The variable mood disorder was significantly associated with higher suicide risk (χ22=7.50, p<0.05). Non-suicidal self-harm behaviors in the last 3 months (χ2=5.89, p<0.05) and lifetime suicide attempts (χ2=21.80, p<0.001) were significantly associated with higher suicide risk. Only the insight-high dimension (χ2=8.01, p<0.01) and lifetime suicide attempts (χ2=12.33, p<0.001) were significantly associated with higher suicide risk.

Conclusions

Our results don’t confirm the role of demoralization in suicide risk. In our sample of patients, only high insigth of illness and other psychological variables are involved in suicide risk.

Disclosure

No significant relationships.
Sociodemographic, personality and symptomatologic profiles associated with an increased likelihood of suicidal risk in patients hospitalized for recurrent depressive disorders
Authors: Kalinovic R. , Vlad G. , Neda-Stepan O. , Dinescu M. , Giurgi-Oncu C. , Enatescu I. , Enatescu V.R.
Published: February 2022

Introduction

According to WHO statistics, 800,000 suicides occur annually, representing the second leading cause of death in people aged 15 to 29. The contributing factors for suicidal risk are multifactorial and multileveled.

Objectives

We aimed to analyze the predictive value of distinct sociodemographic, personality and symptomatology characteristics in predicting the presence of suicidal risk in patients hospitalized for the analyzed mood disorder.

Methods

A longitudinal retrospective case-control study was performed on medical data records of 90 patients admitted in the Timisoara Psychiatric Clinic during 2018 – 2020. Besides the parametric and non-parametric statistical analyses, logistic binary regression analyses were done.

Results

Patients with suicide risk tended to be younger (p = 0.039), without intimate partnership (p < 0.001), current smoker (p = 0.038) and to present psychotic symptoms at some moments during the psychiatric disorder. 51 (56.7%) of the total patients have presented different degrees of suicidal risk (from suicidal ideation to suicide attempt). Patients with suicide risk tended to be younger (p = 0.039), without intimate partnership (p < 0.001), current smoker (p = 0.038) and to present psychotic symptoms at some moments during the psychiatric disorder. Personality traits has not influenced suicidal risk. Presence of intimate partner (OR = 0.135; p < 0.001) and the presence of psychotic symptoms during recurrent depression (OR = 7.309; p = 0.004) have presented predictive value on suicide risk.

Conclusions

Psychiatrist practitioners should be aware of the clinical and sociodemographic characteristics that put recurrent depressive patients at risk of suicidal behaviors.

Disclosure

No significant relationships.
Personality traits and disorders among adult adhd patients: Do they vary between males and females?
Authors: Bracco I.F. , Boero M. , Mangiapane C. , Oliva F.
Published: February 2022

Introduction

Patients with Attention Deficit/Hyperactivity Disorder (ADHD) have shown an increased risk of developing a DSM Cluster B (i.e., Borderline, OR=13.16; Antisocial, OR=3.03; Narcissistic, OR=8.69) and DSM Avoidant Personality Disorder (PD; OR=9.77; Miller et al., 2008). Although different comorbidities affect males and females with ADHD (Kooij et al., 2013), gender differences in personality traits and disorders have not yet been investigated.

Objectives

To describe gender differences in personality traits and disorders among a sample of adult outpatients with ADHD.

Methods

A consecutive sample of DSM-5 ADHD outpatients was recruited at the Adult ADHD Center of the “San Luigi” University Hospital (Orbassano (TO), Italy) between Jan 2017 and Jan 2018. Patients’ personality was assessed by Millon Clinical Multiaxial Inventory (MCMI-III; Zennaro et al, 2008).

Results

The study sample consisted of 82 males and 31 females. Sixty percent of men vs. 77% of women had a personality disorder (

Conclusions

Women with ADHD showed a higher frequency of personality disorders and higher rate of Masochistic PD than men. Moreover, the two most important clusters detected in women included severe personality components (i.e., Borderline and Paranoid) when compared with men. Further studies on larger samples should be conducted to confirm more severe personality profiles in women than in men.

Disclosure

No significant relationships.
Is resilience a protective factor against the effects of the COVID-19 pandemic on mental health? Results from a national multicentric study
Authors: Fiorillo A.
Published: February 2022

The COVID-19 pandemic is impacting on the mental health of the general population and its consequences will be long lasting. As already noted in previous epidemics, different factors can moderate the detrimental impact of a traumatogenic event on mental health. In particular, it has been found that people using problem-solving coping strategies, with an adequate social network and supported by family members, have good long-term outcomes and are able to adjust to the detrimental impact of the traumatic event. The COvid Mental hEalth Trial (COMET) network, including ten university Italian sites and the National Institute of Health, has promoted a national online survey in order to evaluate the impact of COVID-19 pandemic on the mental health of the Italian general population. In particular, the use of Internet and social media, the duration of the exposure to COVID-19 related containment measures, the different levels of post-traumatic growth and the variety of coping strategies adopted have been considered as possible mediators of the resilience styles adopted. In our sample, participants from the general population reported a good level of resilience compared with people with pre-existing mental or physical disorders. This data should be taken seriously in consideration in order to develop appropriate psychosocial interventions for supporting resilience in people at high-risk in order to mitigate the detrimental impact of the pandemic.

Disclosure

No significant relationships.
The role of dysfunctional attitudes towards motherhood in postpartum depressive symptoms and disorder
Authors: Pereira D. , Cabaços C. , Azevedo J. , Xavier S. , Soares M.J. , Madeira N. , Macedo A. , Pereira A.T.
Published: February 2022

Introduction

Postpartum depression (PPD) is the commonest postpartum psychiatric condition, with prevalence rates around 20%1. PPD is associated with a range of adverse outcomes for both the mother and infant2. Therefore, identifying modifiable risk factors for perinatal depression is an important public health issue3.

Objectives

To explore the role of dysfunctional attitudes towards motherhood in postpartum depressive symptoms and disorder.

Methods

247 women were evaluated in the third (12.08±4.25 weeks) and sixth months (31.52± 7.16 weeks) postpartum with the Attitudes Towards Motherhood Scale4, the Postpartum Depression Screening Scale5 and the Diagnostic Interview for Psychological Distress-Postpartum6. Correlation analysis was performed followed by linear/logistic regression analysis when the coefficients proved significant (p<.05), using SPSS.

Results

Dysfunctional beliefs towards motherhood concerning judgement by others and maternal responsibility positively correlated with depressive symptoms at the third (.528; .406) and the sixth months (.506; .492) postpartum. Those dysfunctional beliefs were predictors of depressive symptoms at the third (ß=.440; ß=.151) and sixth months (ß=.322; ß.241) explaining 29.4% and 30.2% of its variance, respectively. Having dysfunctional beliefs at the third month significantly increase the likelihood of being diagnosed with Major Depression (DSM5) both in the third (Wald=9.992, OR=1.169; Wald=16.729, OR=1.231) and sixth months (Wald=5.638, OR=1.203; Wald=7.638, OR=1.301) (all p<.01).

Conclusions

Cognitive distortions should be included in the assessment of risk factors for PPD. Early identification of women presenting motherhood-specific cognitive biases may be crucial for implementing preventive interventions favoring a more positive and healthier motherhood experience.

Disclosure

No significant relationships.
Psychosocial risk factors for dysfunctional beliefs towards motherhood
Authors: Cabaços C. , Pereira D. , Azevedo J. , Soares M.J. , Araujo A. , Macedo A. , Pereira A.T.
Published: February 2022

Introduction

Motherhood-related beliefs are characterized by themes of failure and maternal role idealization. Recent studies found that postpartum depression/PPD is both predicted and a predictor by/for dysfunctional beliefs/DB. Additionally, it is possible that when contextual factors (eg. lack of social support) are present, women may anticipate the parenting experience as being of isolation, which in turn can lead to more dysfunctional attitudes.

Objectives

To explore psychosocial risk factors for motherhood-DB.

Methods

233 women were evaluated in the second trimester (17.05±4.82 weeks) of pregnancy and in the third month (12.08±4.25 weeks) postpartum sociodemographically and psychosocially (years of education, previous children and social support) and the Portuguese validated self-report questionnaires to assess: perinatal depression; perinatal anxiety; perfectionism; negative affect; self-compassion; and repetitive negative thinking (all in T0). The Attitudes Towards Motherhood Scale was administered in the postpartum. When Pearson/Spearmen correlation coefficients proved significant (p<.05), linear/logistic (hierarchic) regression analysis were performed.

Results

Motherhood-DB correlated significantly with all the variables, except for years of education, Other-oriented-Perfectionism and Common-Humanity. Motherhood-DB were significantly higher in women without previous children (p<.05). The final regression model was statistically significant (p<.001) explaining 15% of the Motherhood-DB variance, with Socially-Prescribed-Perfectionism and social support being the only statistically significant predictors. Hierarchic regression showed that even after controlling for social support, SSP significantly incremented the variance in 9%.

Conclusions

Our results highlight the need for preventive approaches to help women understand the origins of their dysfunctional beliefs (perfectionism, the myths of perfect motherhood) and for the promotion of positive cognitions.

Disclosure

No significant relationships.
Associations between social anxiety and avoidance, attachment styles and parental marital status, in late adolescence
Authors: Maia B. Rodrigues , Coelho C. , Marques M. , Carvalho F.
Published: February 2022

Introduction

The relation between insecure general attachment and social anxiety has long been established.

Objectives

To explore the associations between social interaction and performance anxiety and avoidance, attachment styles, and parental marital status.

Methods

146 Portuguese adolescents, with a mean age of 18.99 years old (SD = .848; range: 18-20), filled in the Social Interaction and Performance Anxiety and Avoidance Scale and the Experiences in Close Relationships-Relationship Structures Questionnaire.

Results

Distress/Anxiety was correlated with avoidance attachment to mother and father (rs = .17*, p = .04; rs = .18*, p = .03), to anxious attachment to romantic partner (rs = .21*, p = .01), and to anxious and avoidance attachment to best friend (rs = .25**, p = .00; (rs = .17*, p = .035). Avoidance was significantly correlated with avoidance to father and to romantic partner (rs = .18*, p = .03), and to anxious and avoidance attachment to best friend (rs = .21**, p = .009; rs = .18*, p = .03). A significant difference was found in avoidance attachment to father X2 = 10.246 (4, n = 146), p = .036, by parental marital status, with the adolescents with single/divorced parents presenting a higher mean score (Md = 111.10; Md = 82.93) than the other groups.

Conclusions

Distress/anxiety seems to be associated with more close relationships, and a single/divorced status with Avoidance. Longitudinal studies are needed to explore if insecure attachment to parents predicts insecure extra-familiar attachment, and to explore the long-term effects of parental marital status.
Anxious driving behavior among taxi drivers
Authors: Bejar M. , Regaieg N. , Gdoura D. , Aloulou J. , Amami O.
Published: February 2022

Introduction

The data suggest that anxious drivers may engage in problem behaviors that expose them and others to an increased risk of negative traffic events.

Objectives

To study the problematic behavior taxi drivers related to anxiety in three areas exaggerated safety/caution, performance deficits, and hostile/aggressive behaviors and to determine the factors who are associated with them.

Methods

This is a cross-sectional descriptive and analytical study of 58 taxi drivers in the city of Sfax, Tunisia. We used an anonymous questionnaire that included a socio-demographic fact sheet, and a driver behavior rating scale: Driver Behavior Survey (DBS) with 21 items.

Results

The mean age of the drivers was 40.8 ± 10.2 years. The sex ratio was 0.98. 75.9% were married. 6.9% lived alone. 53.4% were smokers and 25.9% drank alcohol. Coffee and tea consumption were 59% and 33% respectively. 67% had a pathological personal history, including osteoarticular pathologies. 17.2% had a history of serious accidents. The behavior related to anxiety among taxi drivers was 74.66 ± 13.35. The hostile behavior was 18.88 ± 8, the exaggerated safety behavior was 38.31 ± 7.3 and the deficit performance related to anxiety was 17.47 ± 7.1. The problematic behavior in our population was significantly associated with lifestyle alone, coffee consumption and with serious accidents.

Conclusions

The results of our study identified some risk factors that could lead to poorly adaptive driving behaviors among Taxi drivers. These elements reinforce us in the idea that this population requires special care with a meeting with the doctor.
The effects of sleep and wakefulness on human fear conditioning
Authors: Pavlov Y. , Kotchoubey B.
Published: February 2022

Introduction

Studies on fear conditioning have made important contributions to the understanding of affective learning mechanisms as well as its applications (e.g., anxiety disorders, post-traumatic stress disorder). However, central mechanisms of sleep related consolidation of fear memory in humans have been almost neglected by previous studies.

Objectives

In the current study we aimed to test effects of sleep and a period wakefulness on fear conditioned responses.

Methods

In our experiment in a group 18 healthy volunteers event-related brain potentials (ERP), heart rate variability (HRV) and behavioral responses were recorded during a fear conditioning procedure presented twice, before daytime sleep (2h) or control intervention (a period of wakefulness) and after. The conditioning procedure involved pairing of a neutral tone (CS+) with a highly unpleasant sound (UCS+).

Results

Differential conditioning manifested itself in the contingent negative variance (CNV)-like slow ERP component. Both period of sleep and wakefulness resulted in an increased amplitude of the CNV to CS+. But we did not find an interaction effect of Time (Pre-Post) by Intervention (Sleep-Wake), suggesting that sleep did not affect the conditioned response differently as compared to a period of wakefulness. An apparent increase in HRV after a period of wakefulness did not affect fear conditioned responses (CNV and valence ratings).

Conclusions

To summarize, the data indicate that fear memories are consolidated with the course of time with no beneficial effect of sleep; relearning of fear causes stronger differential responses as measured by slow wave amplitude but not behavior; increase of HRV does not affect fear learning.
Is perfectionism associated to dental anxiety?
Authors: Pereira A.T. , Cabaços C. , Araujo A. , Soares M.J. , Macedo A.
Published: February 2022

Introduction

Personality traits like neuroticism and trait-anxiety, as well as the predisposition to a greater sensitivity to pain, are risk factors for dental anxiety. Although perfectionism has been associated with both anxiety and pain, particularly when mediated by repetitive negative thinking/RNT (Macedo et al. 2015; Albuquerque et al. 2013), its role in dental anxiety has not yet been studied.

Objectives

To analyze the role of perfectionism and RNT in dental anxiety.

Methods

A community sample of 552 adults (68.2% women; mean age=35.15±15.79 years) completed the Portuguese versions of:Hewit and Flett Multidimensional Perfectionism Scale–13, State-Trait Anxiety Inventory, Sensitivity to Pain Traumatization/SPT Scale, Fear of Dental Pain/FDP Questionnaire, Perseverative Thinking Questionnaire and Dental Fear Survey/DFS.

Results

Trait-anxiety (r=.225), socially prescribed perfectionism/SPP (r=.177), SPT (r=.286), FDP (r=.509) and RNT (r=.274) were significantly (p<.01) correlated with dental anxiety (DFS total score). Serial mediation analysis using the PROCESS-macro 3.5 for SPSS (Hayes, 2020; Model 6) showed that even controlling for trait-anxiety and gender (as SPT, FDP and RNT mean scores were significantly higher in women, p<.01) SPP plays a significant indirect effect through SDT, FDP and RNT on dental anxiety, which are (isolated or sequentially) full mediators of this relationship (Total effect: .553, p<.001).

Conclusions

This study shows for the first time that negative perfectionism is a predictor of dental anxiety; its influence operates through the increase in levels of sensitivity to pain, DPA and RNT. We suggest that when intervening in this health problem it is important to evaluate perfectionism and try to mitigate its negative impact, namely diminishing RNT and the focus on pain and fear.
Climate change and mental health: An overview
Authors: Erfurth A. , Sachs G.
Published: February 2022

According to the UN Environment Programme “climate change is one of the most pervasive and threatening issues of our time”. “In many places, temperature changes and sea-level rise are already putting ecosystems under stress and affecting human well-being” (1). The presentation wants to give an overview on how climate change can affect mental health. A search was performed on PubMed for the combination of “climate change” and “mental health”. 281 publications were identified, the first being from 2007 (the only one in that year). In 2020, until Dec 22nd, 76 publications were found. The somehow prophetic 2007 publication reviews “natural disasters, climate change and mental health considerations for rural Australia” (2) and pinpoints central aspects of today’s debate, namely anxiety and depression, vulnerability and resilience. In addition to problems of rural areas (2), the impact of urbanicity (3) will be discussed as well as the role of air pollution on psychiatric disorders (4). (1) UN Environment Programme. https://www.unenvironment.org/explore-topics/climate-change/about-climate-change Dec 22nd, 2020. (2) Morissey SA, Reser JP. Aust J Rural Health. 2007 Apr;15(2):120-5. doi: 10.1111/j.1440-1584.2007.00865.x. (3) Krabbendam L et al. Psychol Med. 2020 Mar 11:1-12. doi: 10.1017/S0033291720000355. (4) Kim SY et al. Sci Total Environ. 2020 Dec 8;757:143960. doi: 10.1016/j.scitotenv.2020.143960.

Disclosure

No significant relationships.
Prevalence of health anxiety in indian ophthalmologists during COVID-19: a survey
Authors: K C.
Published: February 2022

Introduction

Mental health concerns are common in health care workers during pandemic. There are no studies of the prevalence of health anxiety in ophthalmologists in India.

Objectives

To estimate the prevalence of health anxiety in ophthalmologists practicing in India during the ongoing pandemic.

Methods

A questionnaire-based online survey on the “changes and challenges during COVID-19” using Google forms was sent to all members of the All India Ophthalmological Society. Besides demographics, the survey had questions to assess the general mental and medical health status of the ophthalmologists. Short Health Anxiety Inventory (SHAI) was used to assess health anxiety.

Results

1027 ophthalmologists responded to the study. Higher stress was experience by 83.1% compared to pre-COVID while examining patients closely (35.9%) or during surgery due to the risk of aerosol generation (29.3%). SHAI score >20 was observed in 5.6%. Only emergency services were being provided by 50% and 17% in the SHAI > 20 group were not working as compared to overall 14%.

Conclusions

Our findings indicate that a majority of the ophthalmologists were under stress during the COVID-19 pandemic but only a small proportion experienced health anxiety. It is likely that mental health issues may arise among ophthalmologists in the foreseeable future.
The effect of childhood trauma and trauma-focused psychotherapy on blood expression in patients with major depressive disorder
Authors: Minelli A. , Maffioletti E. , Sacco C. , Magri C. , Zampieri E. , Cattaneo A. , Perusi G. , Mazzelli M. , Bortolomasi M. , Gennarelli M.
Published: February 2022

The only available genome-wide study (Minelli et al., 2018) indicated an association between the neglect CT and MED22, a transcriptional factor gene. To verify how the dysregulation of MED22 could be affected by environmental and genetic factors, we carried out an analysis on these components and a longitudinal study concerning the effect of trauma-focused psychotherapy in MDD patients that experienced CT. On a large mRNA sequencing dataset including 368 MDD patients we computed the genetic (GReX) and the environmental (EReX) components affecting gene expression in relation to CT. Furthermore, we measured the expression of MED22 in 22 MDD patients treated with trauma-focused psychotherapy. The dissection of MED22 expression profiles revealed an association of neglect with environmental and genetic components (p=6x10-3 p=2.6x10-4). Furthermore, in an independent cohort of 177 controls, we also observed a significant association between cis-eSNPs of MED22 and higher neuroticism scores (best p-value: 0.00848) that are usually associated with a decreased amount of resilience to stress events. Finally, the results of psychotherapy revealed a reduction of depressive symptomatology (p<0.001) and 73% of patients resulted responders at the follow-up visit. MED22 expression during psychotherapy showed a change trend (p=0.057) with an interaction effect with response (p=0.035). Responder and non-responder patients showed MED22 expression differences at different trauma-focused psychotherapy timepoints (p=0.15; p=0.012) and at the follow-up (p=0.021). Our results provide insights suggesting that some biological and clinical consequences of CT depend on genetic background and environmental factors that could induce vulnerability or resilience to stressful life events.

Disclosure

No significant relationships.
Barriers and facilitators associated with pharmacological treatment in bipolar disorder patients
Authors: Partera J.Á. Alcalá , Navas A. Fontalba , Morales M. Company , Guillena S.L. Romero , Higueras T. Gutiérrez , Cortés F. Calera , Forés S. Vicent , Rojas L. Gutiérrez
Published: February 2022

Introduction

The main factors that are involved in a correct adherence to the therapeutic recommendations in Bipolar Disorder includes aspects related to age, sex, ethnicity, socioeconomic level and characteristics of the illness associated with the severity, comorbidity and adverse effects related to previous medicine.

Objectives

To analyse the individual perception that the patient with Bipolar Disorder has regarding the positive and negative aspects of taking the recommended medication.

Methods

Descriptive and interpretative observational study under the qualitative paradigm of research, extracting the data through the completion of four focus groups with ten patients everyone. To complete the codification of the content of the participant’s discourses, we rely on the QRS NVivo 10 computer program.

Results

In the participant’s discourse concerning the main barriers to pharmacological treatment, for example “It’s because we live in a society and, because of that, we don’t go without medicine; if we didn’t live in society, we wouldn’t take medicine because we wouldn’t bother anyone”. Some examples of patient’s discourse, about perceived facilitators were: “I have to take medicine for my bipolar disorder, that’s it, I have a treatment, my illness has a name”.

Conclusions

The main facilitators regarding the use of pharmacological treatment in Bipolar Disorder are the perceived need for treatment in the acute phase and the recognition of the illness, the shared clinical decision and the causal biological attribution in the chronic phase. About perceived barriers, social control is identified in both phases, adverse effects in the acute cases and the absence of effective treatment in the chronic state.
Telomere attrition and inflammatory load in major depressive disorder
Authors: Squassina A.
Published: February 2022

Patients with major depressive disorder (MDD) present features that suggest the involvement of accelerated aging, such as increased circulating inflammatory markers and shorter telomere length (TL). Here we measured T-lymphocytes TL with quantitative fluorescent in situ hybridization (Q-FISH) and plasma levels of inflammatory markers in a cohort of 37 patients with MDD and 36 non-psychiatric controls (C). TL was shorter in MDD compared to C (F=8.52, p=0.005). Patients with treatment resistant (TR) MDD showed higher levels of TNFα compared to non-TR (adjusted p= 0.034) and C (adjusted p=0.025), suggesting that treatment resistance might be associated with increased inflammation compared to non-TR.

Disclosure

No significant relationships.
Circadian rhythm dysfunction in bipolar affective disorder
Authors: Valadas M.T. , Freitas R. Mota
Published: February 2022

Introduction

Sleep is paramount in bipolar affective disorder and sleep disturbance can be a trigger or initial manifestation of an episode of illness. Changes in the circadian rhythm in bipolar affective disorder have consistently been recognized and reported, however, this feature can be overlooked in daily clinical practice.

Objectives

We aim to review and summarize the literature regarding changes in circadian rhythm in patients with bipolar affective disorder.

Methods

We performed an updated review in the PubMed database using the terms “circadian rhythm” and “bipolar affective disorder”.

Results

Irregularity of the sleep–wake rhythm, eveningness chronotype, abnormality of melatonin secretion, vulnerability of clock genes, and the irregularity of social time cues are circadian rhythm markers disrupted in bipolar affective disorder. Circadian rhythm dysfunction might be a trait marker of this illness and can act as a predictor for the first onset of bipolar affective disorder and the relapse of mood episodes. Achieving normalization of circadian rhythm in combination with pharmacological, psychosocial and chronobiological treatments can be a tool for managing bipolar affective disorder.

Conclusions

Recognizing patterns of changes in circadian rhythms is important to detect and diagnose bipolar disorder in clinical practice, also affecting treatment. These alterations are often overlooked and can lead to inadequate treatment and management.
Spirituality and quality of life among bipolar disorder patients
Authors: Ajmi S. , Sellami R. , Najjar S. , Masmoudi R. , Feki I. , Masmoudi J.
Published: February 2022

Introduction

Quality of life is a broad and complex concept, but essentially refers to an individual’s well-being in a spectrum of life domains.

Objectives

The aim of the present study was to investigate the relationship between spirituality, religiosity (S/R) and quality of life (QOL) among bipolar disorder (BD) patients.

Methods

Data were collected between July and December 2017.Participants were enrolled from the Mood Consultation of the Psychiatry (A) Department of the University Hospital HediChaker. We assessed symptoms of mania [Young Mania Rating Scale (YMRS)], depression [Beck scale], quality of life [World Health Organization Quality of Life-Brief Version (WHOQOL-BREF)]andquality of life aspects related to spirituality, religiousness and personal beliefs [World Health Organization Quality Of Life –Spirituality, Religiousness and Personal Beliefs (WHOQOL-SRPB)]

Results

Our sample included 60 patients. It consisted of 55% of female and the mean age was 44.94 (SD=12.76). The sample included 68% of participant diagnosed with BDI and 32% with BDII The median score of quality of live was 3 (minimum=1; maximum=5).The median of physic, psychic, social and environmental quality of life was respectively (25, 31, 81 and 19) (Minimum=0; Maximum=100). The mean score of WHOQOL-SPRB was 14.82 (Minimum=4, Maximum=20). S/R were correlated to psychic, social and environmental quality of life (p=0.006, p=0.011, p=0.016). We did not find a significant association between physic quality of life and S/R (p=0.234).

Conclusions

Our study suggests that spirituality, religiosity have an important influence on most aspects of the quality of life among bipolar patients.
Lithium placental passage at delivery and neonatal outcomes: A retrospective observational study
Authors: Imaz M.L. , Torra M. , Soy D. , Langorh K. , Garcia-Esteve L. , Martin-Santos R.
Published: February 2022

Introduction

Lithium is an effective mood stabilizer and is widely used as a first-line treatment for bipolar disorder in the perinatal period. Several guidelines have provided clinical advice on dosing strategy (dose reduction versus stop lithium) in the peripartum period to minimize the risk of neonatal complications. An association has been observed between high neonatal lithium concentrations (> 0.64 mEq/L) and lower 1-min Apgar scores, longer hospital stays, and central nervous system and neuromuscular complications.

Objectives

To quantify the rate of lithium placental passage at delivery. To assess any association between plasma concentration of lithium at delivery and neonatal outcome.

Methods

In this retrospective observational cohort study, we included women treated with llithium at least in late pregnancy. Maternal (MB) and umbilical cord (UC) lithium blood level measurement were collected at delivery. Lithium serum concentrations were determined by means of an AVL 9180 electrolyte analyzer. The limit of quantification (LoQ) was 0.20 mEq/L and detection limit was 0.10 mEq/L. From the medical records, we extracted information on neonatal outcomes (preterm birth, birth weight, Apgar scores, pH-values, and admision to NICU) and complications categoriced by organ system: respiratory, circulatory, hematological, gastro-intestinal, metabolic, neurological, and immune system (infections).

Results

Umbilical cord and maternal lithium blood levels were strongly correlated: mean (SD) range UC/MR ratio 1.15 (0.24). Umbilical cord lithium levels ranged between 0.20 to 1.42 mEq/L. We observed no associations between umbilical cord lithium blood levels at delivery and neonatal outcomes.

Conclusions

In our study, newborns tolerated well a wide range of lithemias, between 0.20 and 1.42 mEq/L.