bluuebunny/crossref_metadata_2025 huggingface dataset:
Long–term Neurodevelopment outcomes to Prenatal Antipsychotic Medication Exposure: Systemic Review
Authors: González Campos T.
Published: August 2023

Introduction

Peak incidence for many psychiatric disorders occurs in reproductive years. We don’t have FDA-approved drugs or clinical guidelines. The main cause of pharmacological suspension in pregnancy is the lack of knowledge of their effects on the product. Gathering information on this regard becomes crucial so we can avoid relapses or exacerbation

Objectives

Describe neurodevelopmental effects in children ≥ 6 months exposed to antipsychotics prenatally.

Methods

PROSPERO-CRD42020170314. Using MeSH terms in 5 databases, without language and time restriction, obtaining n=3932. After review and exclusion n=24 were obtained for qualitative review.
(Figure 1).

Results

Of 20 case reports 4 had more ambivalence results
(Table 1). In the cohort studies, exposure may cause short-term delay at 6 months but no significant difference at 12 months
(Table 2).Table 2StudyNAntipsychoticMonthsConclusion using clinical evaluationImaz et al. Front. Pharmacol.2018; 9:2641Risperdal
Clozapine72Abnormal memory, attention/executive, hyperactivity1Clozapine32Normal2Clozapine18AbnormalNormalBurt et al. Am J Psychiatry 2010; 167:892-8971Olanzapine12,18,
22,2918 months Abnormal motor 22 months normal 29 months normalKirchheiner et al. Pharmacopsych 2000; 33:78-801Olanzapine7,117 months Abnormal motor
11 months NormalMendhekar et al. J Neuropsychiatry Clin Neurosci 2007; 19:21Clozapine65 years Abnormal languageTable 3StudyNAntipsychoticMonthsConclusion using clinimetry and clinical evaluationShao et al. Plos ONE, 2015; 10(4),1-963Clozapine
Risperidone
Olanzapine
Quetiapine6,12BSID-III 6 months Adaptive behavior score lower in clozapine group 12 months No differenceJohnson et al. Arch Gen Psychiatry2012; 69(8), 787-79422Haloperidol
SGA*6INFANIB Lower scores with SGA then HaloperidolPeng et al. Psychopharmacology 2013; 228(4), 577-58476Clozapine
Risperidone
Sulpiride
Olanzapine
Quetiapine6,12BSID-III 6 months Lower socio-emotional and adaptive behavior scores
12 months No differencePetersen et al. BMJ 2016; 5(6), 1-9290FGA+SGA**6More neurodevelopmental disorder that those who didn’t take antipsychotics.

Image:

Conclusions

Most are case reports, hence the importance of collecting this information, not ignoring it due to lack of methodological rigor. The intent is not to conclude that prenatal exposure to antipsychotics doesn’t have long-term neurodevelopmental effects, rather documenting the available evidence contributing to an informed clinical decision.

Disclosure of Interest

None Declared
The Role of The Predominant Polarity on Neurocognitive and Social Cognitive Dysfunctions in Patients with Bipolar Disorder
Authors: Atay E. , Ermis C. , Ozmen E.
Published: August 2023

Introduction

Bipolar disorder (BD) is characterized by significant inter-individual variation in terms of course and outcome. The most important factors associated with the outcome are subsyndromal depression and cognitive disability. Predominant polarity (PP), which is a proposed course specifier for BD, can be associated with various clinical differences such as psychotic feature, suicidality, hospitalization, while it is thought to be associated with the severity of cognitive impairment.

Objectives

To elucidate the role of the predominant polarity on cognitive dysfunction in patients with BD.

Methods

Patients with BD in remission (n=84) and healthy control volunteers (HC, n=27) participated in the study. Patients were divided into 3 subgroups according to their PP characteristics: manic (MPP, n=31), depressive (DPP, n=25), and undetermined (UPP, n=28). Structured Clinical Interview for DSM-5 Disorders-Clinician Version (SCID-5/CV), WAIS-R-Vocabulary Subtest, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Young Mania Rating Scale, Rey’s Auditory Verbal Learning Test (RAVLT), Trail Making Test (TMT), Stroop Test (ST), WMS-R Visual Reproduction Subtest, Controlled Oral Word Association Test (COWAT), Auditory Consonant Trigrams Test (ACT), Reading the Mind in the Eyes Test (RMET), Hinting Test (HT), Wisconsin Card Sorting Test (WCST), and Conners Continuous Performance Test (CCPT) were administered. Scores that do not show normal distribution were transformed using the two-step normalization method. Principal component analysis (PCA) with direct oblimin rotation was applied as a dimension reduction technique to identify different neurocognitive domains. Single-factorial PCA was also applied to calculate global cognition scores.

Results

In MPP group compared to HC, worse performance was observed in ACT (d=1.24), COWAT (d=1.16), RMET (d=1.03), HT (d=1.78), WCST correct answers (d=0.99), CCPT correct target section (d=0.99) and a prolongation in TMT-A (d=1.00). Compared to DPP, MPP had a weak performance in COWAT (d=0.89), RMET (d=0.86) and HT (d=1.00). MPP (d=1.18) and UPP (d=1.03) groups showed deterioration in processing speed compared to HC. MPP group showed impairment in working memory (d=1.17) and attention (d=0.70) compared to HC. In problem-solving and reasoning, deterioration was found in MPP compared to HC (d=1.16) and UPP (d=0.67), also in DPP compared to HC (d=0.74).

Conclusions

The MPP group yielded more severe cognitive impairment in verbal fluency and social cognition tests compared to DPP. Predominant polarity may also be related to cognitive impairment patterns seen in BD.

Disclosure of Interest

None Declared
Cyber gaming addiction and impulsivity in adolescents
Authors: Chiha K. , Khemakhem K. , Chaabane M. , Ben Touhemi D. , Kammoun W. , Boudabous J. , HadjKacem I. , Ayadi H. , Moalla Y.
Published: August 2023

Introduction

The relationship between cyber video game addiction and impulsivity is controversial. Some studies have shown a significant link, others have found no association between the two behaviours.

Objectives

To study impulsivity in adolescents with problematic use of internet video games.

Methods

This was a cross-sectional, descriptive and analytical study, conducted among a sample of adolescents randomly collected in 6 schools in the region of Sfax-Tunisia, during the month of February 2022. The rate of addiction to video games was assessed by the 20-item “Internet Gaming Disorder-20” (IGD-20) scale and impulsivity by the 30-item “Barratt Impulsivity Scale” (BIS-11). Both scales are validated in Arabic.

Results

The study involved 360 secondary school students, with a mean age of 16.62 +/- 0.822 years. The sex ratio was 1.09.

A gaming addiction was found in 4.7% of cases.

Similarly, impulse control disorder was noted in 23.6% of adolescents.

Problematic internet game use was significantly related to motor impulsivity (p=0.025).

There was no significant association between cyber video game addiction and cognitive or non-planning impulsivity.

Conclusions

According to the results, impulsiveness is a factor to consider for understanding the development of addiction to internet video games. Thus, impulsiveness should be taken into account to explain problematic gaming behaviour as well as to design preventive and treatment interventions.

Disclosure of Interest

None Declared
Influence of COVID-19 lockdowns on patterns of coercive measures in Austria
Authors: Fellinger M.
Published: August 2023

Abstract: Background and Aim

Coercive measures (CMs), such as involuntary psychiatric admission and mechanical restraint, are considered a last resort in the treatment of people with psychiatric disorders. Although numerous factors influencing its use have been identified, the impact of a pandemic and in particular restrictions like lockdowns on CMs are still unclear. Thus the aim of the present retrospective study was to examine the effects of the COVID-19 pandemic, especially the lockdowns, on CMs in Austria.

Method

This retrospective exploratory study assessed all CMs in Austria, except for the federal state of Vorarlberg, between 01.01.2018 and 31.12.2020. Descriptive statistics and regression models were performed.

Results

During the three-year study period, 40,012 individuals (45.9% females, mean age 51.3 years) had 66,124 involuntary psychiatric admissions for an average of 10.9 days and restraint in 33.9%. In periods of COVID-19 lockdowns (2020 vs. 2018/2019), CMs in form of involuntary admissions were significantly fewer (OR:0.93, p=.0001) but longer (11.6 (SD:16) vs. 10.9 (SD:15.8) days). The likelihood of involuntary admission during lockdowns was only associated with year (2020 vs. 2018/19, p=0.0002), but not with sex (p=0.814), age (p=0.310), use of mechanical restraint (p=0.653) or type of ward (p=0.843).

Conclusions:

Restrictions such as lockdowns are affecting CMs and have resulted in fewer but longer involuntary psychiatric admissions during weeks of lockdown in Austria. The result strengthens previous knowledge that showed the dependence on external factors when using CMs, but requires further clarification with regard to the causality and the association with outcomes that are intended to be prevented, such as suicides.

Disclosure of Interest

None Declared
Alcohol related dementia and Brain Imaging
Authors: Faria I. , Galiano J. , Wildenberg B. , Silva T. , Silva C.
Published: August 2023

Introduction

Alcohol is considered a social evil worldwide owing to its vast array of associated problems and complications, which may manifest in medical, legal or social domains. Excessive and prolonged alcohol use may lead to permanent structural and functional damage to the brain. The evidence from neuroimaging, neuropathological reports and autopsy evaluations suggest some degree of brain pathology in individuals diagnosed with an alcohol related disorder.

Objectives

The aim of this study is to characterize the structural imaging findings on computed tomography (CT) and magnetic resonance (MR) imaging of our sample and provide an overview of the literature on the subject.

Methods

Retrospective observational study with inpatients of Coimbra Hospital and University Centre (CHUC), who had alcohol use disorder diagnosis associated with dementia or cognition deficit. Patients were admitted from 2017 to 2021 and submitted to neuroimaging: CT and MR. Data was collected in May 2021 at informatic system.

Results

Among 38 participants, the median age was 64 years; 86,8% were male. 35 realize CT, 34 with alterations: 23 with microvascular lesions, 17 with cortical atrophy, 8 with white matter hypodensities and 7 with subcortical atrophy. From all patients, only 14 realize MR, 13 with alterations, the most common vascular leukoencephalopathy and cortical atrophy.

Conclusions

Our results support the hypothesis of neuroimaging changes resulting from alcohol consumption. The severity of alcohol dependence also correlates with neuropathophysiological and neuroimaging changes. Volume shrinkage, altered glucose metabolism and perfusion along with evidence of markedly decreased neuron density are commonly reported. The evidence of neuro-circuit disturbances is seen in form of significant loss of white matter (most prominent in the prefrontal cortex, cerebellum and corpus callosum) on functional imaging. Greater cognitive impairment has been associated with multiple and repeated withdrawal due to greater neuronal damage, and can limit the psychotherapeutic intervention, the adherence to pharmacological therapy and abstinence maintenance. The sheer presence of alcohol use disorder should encourage a neuroimaging evaluation.

Disclosure of Interest

None Declared
Moria or Mania? Manic symptoms as the clinical manifestation of glioblastoma recurrence: a case report
Authors: Mayor Sanabria F. , Expósito Durán M. E. , Fernández Fariña M. , Regueiro Martín-Albo C. E. , Paz Otero M. , Alberdi Páramo I. , Rodado León B.
Published: August 2023

Introduction

Up to 50% of patients with brain tumors experience psychiatric symptoms, and rates up to 80% have been reported in malignant neoplasms such as glioblastoma multiforme (GBM). Still, clinical presentation as mania-like syndromes is a rare phenomenon, mainly occurring when frontal structures are compromised.

We present the case of a 42-year-old woman who was admitted to our hospital due to manic symptoms coinciding with a recurrence of a bifrontal GBM, for which she underwent surgery 5 months prior.

Objectives

1) To describe the clinical particularities of this case, focusing on the differential diagnosis.

2) To review the association between manic symptoms and frontal dysfunction caused by brain tumors, with special interest on GBM.

Methods

A review of the patient’s clinical history and complementary tests performed was carried out. Likewise, we reviewed the available literature in relation to manic symptoms related to brain tumors.

Results

The patient’s GBM recurrence presented with late onset symptoms of mania, including euphoric mood, increased spending, ideas of grandiosity and hyper-religiosity. She had no previous psychiatric history but, interestingly, she had an extensive affective burden in her family, with 4 consummated suicides. However, she also presented other clinical signs, such as disorientation, perseveration, mild memory impairment and stereotyped motor behaviors, that pointed to relevant frontal lobe dysfunction, suggesting Moria as a possible contribution for the symptoms described.

Manic symptoms in the context of brain tumors appear in 7-15% of patients with psychiatric symptoms, usually associated with right frontal dysfunction (75% of cases). Bifrontal affectation, such as this patient, is only described in 6% of cases. Although fast growing, malignant tumors have been associated with higher rates of psychiatric symptoms, no correlation has been described between these and brain tumor histology.

Conclusions

- The presence of atypical manic symptoms, such as those presented in this case, should raise clinical concern for secondary mania.

- Moria shares similarities with mania, including mood elevation, tendency to hilarity or hyper-sexuality, that may hinder diagnosis of patients with frontal dysfunction.

- This case outlines the difficulties in making a differential diagnosis in patient with both manic and neurological signs, and highlights the implication of frontal structures in the development of manic symptoms.

Disclosure of Interest

None Declared
Stages of treatment of eating disorders in endogenous depressions
Authors: Barkhatova A. , Smolnikova A. , Bolgov M.
Published: August 2023

Introduction

The problem of eating disorders has become increasingly important in recent years, due to the increase in the number of cases among children and adolescents, as well as the insufficient effectiveness of therapeutic measures. An important role in the course of eating disorders is occupied by the depressive syndrome associated with it, which complicates the process of treatment and rehabilitation in this pathology.

Objectives

Study of the stages of treatment of eating disorders in the structure of depressive states.

Methods

The sample consisted of 63 patients aged from 15 to 25 years old (all female, average age 16.2), who were on outpatient and inpatient observation in the clinic were studied.

Results

In the process of treatment, several stages of treatment of patients were carried out. The first stage was aimed at normalizing the body’s vital functions and management of somatoendocrine impairments (the duration of the stage is about 14 days). The next stage was aimed at the psychotropic treatment of eating disorders and concomitant mental pathologies (the duration of the stage is 3-4 weeks). The final stage included rehabilitation, which consisted of working with a psychotherapist (the duration of the stage was 8 weeks or more). It should be noted that in the process of rehabilitation, patients continued to receive psychopharmacotherapy and underwent a comprehensive examination to assess the dynamics of their condition.

Conclusions

Eating disorders in the structure of endogenous depressions require an integrated approach to treatment, including both ensuring adequate vital activity of the organism and the selection of drug treatment depending on the nosological affiliation of the underlying syndrome. Rehabilitation work aimed at social adaptation and prevention of relapses of the disease also plays an important role.

Disclosure of Interest

None Declared
Anorexia Nervosa and Psychiatric Comorbidities – It’s not all about food
Authors: Morais A. S. , Martins F. , Casimiro P. , Henriques V. , Descalço N. , Diniz Gomes R. , Cruz S. , Costa N.
Published: August 2023

Introduction

Anorexia nervosa (AN) is a severe psychiatric disorder that usually begins during adolescence and is associated with a high risk of mortality and morbidity, its treatment is complex and often ineffective. Psychiatric comorbidity is common in patients with eating disorders (with the prevalence of 20–95%), namely 39% in AN.

Objectives

The purpose of the authors is to review the most common areas of psychiatric comorbidity in AN, how it affects the course of both diseases and the potential treatment approaches.

Methods

A brief non-systematized review is presented, using the literature available on PubMed and Google Scholar.

Results

The most common psychiatric comorbidities in AN are: Affective disorders in 24-38% (mainly unipolar depression which can appear in up to 75% of patients, compared to 11% in bipolar disorder); Anxiety disorders in 25.5% (11% with panic disorder, 20% social phobia/social anxiety disorder, 15% specific phobias, 10% generalized anxiety disorder, 13% post-traumatic stress disorder); Obsessive compulsive disorder in 12%; Substance use disorders at 17%; Personality disorders around 30%. Other pathologies occur less commonly but can have a significant impact on the patient, namely Autism spectrum disorder (predictive factor for unfavourable outcome) or Schizophrenia (there are reports of reciprocal relationships between the two pathologies).

Some of these comorbidities may increase mortality in AN, namely unipolar depression, personality disorders, alcohol and illicit drug use.

The profound impact that starvation has on mood and cognition is well known. It can condition symptoms that are confused with other psychiatric diseases and change their clinical presentation. As such, the specific clinical characteristics and the therapeutic approach will be presented for each of the psychiatric comorbidities.

Conclusions

Early diagnosis and treatment of psychiatric comorbidities in AN are essential to improve the prognosis of this eating disorder. The additional treatment of these pathologies will increase complexity of the already challenging treatment of AN, with the additional symptomatology often being perpetuated by an uncontrolled eating disorder and a poor compliance to treatment.

The limited evidence available for approaching these cases is based on the few studies available, most with insufficient samples.

Disclosure of Interest

None Declared
Ukrainian refugees in Germany – what are the consequences for mental health care services in Germany?
Authors: Graef-Calliess I. T.
Published: August 2023

Since about a year there has been an influx of refugees from Ukraine due to the current war situation.

Data on the mental health condition of Ukrainian refugees will be reviewed and compared to the mental health conditions to refugees from other parts of the world in Germany. Moreover, the psychosocial and socioeconomic situation of refugees from Ukraine will be reflected on the background of the situation of refugees from other countries.

Conclusions from the recent experiences for the mental health care system will be drawn and discussed with the aufience in a European perspective. Special highlight will be given to pilot best practice modells for mental health care of Ukrainian refugees within the German mental health care system.

Disclosure of Interest

None Declared
Epidemiological patterns of new psychoactive substances use in Tunisian school adolescents, 2021
Authors: Silini A. , Rejaibi S. , Zid M. , Ben Slema I. , Mallekh R. , Zoghlami N. , Ben Youssef S. , Zribi M. , Ben Salah N. , Aounallah-Skhiri H.
Published: August 2023

Introduction

The emergence of New Psycho-active Substances (NPS) such as Synthetic cannabinoid and cathinone, represents a challenging issue for drug policy globally. In order to set up new adjusted measures to limit this phenomenon extension, objective epidemiologic indicators are requested.

Objectives

We aimed to determine the prevalence of Synthetic cannabinoid and cathinone consumption in Tunisian adolescents by gender and regional distribution.

Methods

Data from the Mediterranean school survey on alcohol and other drugs (MedSPAD III-2021) were used. Based on three-stage stratification sampling method, high school teenagers in first and second grades of secondary education, were enrolled. Data collection was performed using a self-administered standardized questionnaire. We examined weighted prevalence estimates of NPS use at least once in a lifetime (Synthetic cannabinoid and cathinone) by gender and regional distribution. Epi data software was used for data entry and all statistical analysis were performed with STATA software.

Results

The survey included 6201 adolescents with a mean age of 16.8 years and a sex ratio female/male of 1.5. Synthetic cannabinoid’s use was reported by 1.9%, 95% CI [1.57-2.39] of students, with statistically significant difference between boys (4.1%) and girls (0.6%), p-value<10-4 . This consumption was the highest in Tunis the capital city, the center-east and the north-east (2.7%, 2.2% and 2% respectively). As for synthetic cathinone’s use, it was reported by 0.36% 95%CI [0.24-0.56] of our study sample, with statistically significant difference between boys (0.8%) and girls (0.8%), p-value<10-4 .

Conclusions

Our study highlighted an emerging use of NPS among high school students with significant male predominance. Further research on NPS epidemiology is, hence, needed to reinforce evidence-based management strategies aiming at fighting this phenomenon. Sensitization of decision makers to control accessibility, and increasing awareness among adolescents’ close family / school-staff environment regarding this issue, are strongly recommended.

Disclosure of Interest

None Declared
Adverse incidents and therapy options for opioid use disorders in forensic psychiatry
Authors: Voulgaris A.
Published: August 2023

Introduction

Patients admitted into Forensic Clinics for Dependency Diseases (FCDD) in Germany are diagnosed with at least one substance use disorder. Opioid use disorders is common in this clinical population. Surprisingly, data on the availability and practice of opioid substitution treatment (OST) options in German FCDD according to Sect. 64 of the German Criminal Code (StGB) is scarce. Additionally, important data on the prevalence of adverse incidents such as violent behavior, relapse or escape from the clinic are missing for this highly specific treatment setting.

Objectives

Our aim ewas to describe the clinical practice regarding opioid substitution therapy in forensic psychiatry in Germany and to identify the prevalence of relevant adverse incidents during the therapy process.

Methods

We conducted a observational study including all FCDD units in Germany via a questionnaire. We assessed the clinical practice and total number of patients that received an OST, clinical reasons for beginning and ending the OST, number of treatments terminated without success, number of successful treatments and relevant adverse incidents such as violent behavior, relapse, escape and reoffending. The data was analyzed descriptively.

Results

15 of the existing 46 FCDD participated in our study (33%). In total, 2483 patients were treated in the participating FCDD, 18% of the patients were relocated into prison due to treatment termination and 15% were discharged successfully. 275 adverse incidents were reported: violence against a patient (4%), violence against staff (1,6%), escape (4,7%) and reoffending (0,5%). Merely in seven FCDD treating 1153 patients, an OST was availabe. Available options included buprenorphine/naloxone, buprenorphine, methadone and levomethadone. Regarding adverse incidents and successful discharge, no differences were detected in the clinics with or without an OST. In the clinics that offered an OST, we found a significantly higher rate for treatment termination without success (p<0.007) in comparison to clinics without this program. 99 patients received an OAT and this treatment was ended due to illegal drug abuse (57%), refusal to give an urine drug sample (71%) and in cases were the OAT was given away to other patients (85%).

Conclusions

Surprisingly, opioid substitution therapy is only accessible in a part of the FCDD in Germany. Reasons for this are unclear. Critical incidents such as violent behavior against staff/patients and escape are not uncommon in this forensic psychiatric treatment setting. Further studies are needed to enhance the understanding of the limited OST practice and the risks for patients and staff in this specific forensic treatment setting.

Disclosure of Interest

None Declared
Older adults’ mental health during humanitarian crisis
Authors: De Mendonca Lima C. A.
Published: August 2023

Introduction

A humanitarian crisis is defined as a singular event or a series of events that are threatening in terms of health, safety or wellbeing of a community or group of individuals, and require action that is usually urgent and often non-routine. Examples of such crisis are wars, natural disasters, epidemics and forced immigration. There is an urgent need of an international commitment to planning for humanitarian emergencies that include individual and community psychosocial support for older adults with mental health conditions. The current lack of inclusion for these older adults in humanitarian response is dramatic and constitute a clear violation of their Human Rights.

Objectives

The World Psychiatric Association Section of Old Age Psychiatry and the International Psychogeriatric Association are working together since 2020 to promote the older adults’ Human Rights. Articles, position statements, seminars, sympsoia and congress were produced. The ultimate common goal is to support the adoption of an UN Convention on the Human Rights of the Older Persons that include the promotion and protection of the mental health of these persons.

Methods

Input to the Independ Expert on Older Adults at the OHCHR who prepared official repports presented during the UN General Assembly in 2022.

Publication of articles, organization of seminars, symposia and congress

Results

The main documents pulblished will be presented as well the template of the next Position statement on Older Adult’s mental health during Humanitarian Crisis

Conclusions

Humanitarian actors must provide assistance in accordance with the principles of humanity, neutrality and impartiality. Promoting and ensuring compliance with these principles are essential elements of effective humanitarian coordination, in respect of the Human Rights principles, in particular when vulnerable people such older adults with mental health conditions are involved.

Disclosure of Interest

None Declared
Smoking in an Inpatient Psychiatric Unit in Ireland with a “Tobacco Free Campus” policy: the prevalence, the associated factors, the social consequences and what can be done to address this
Authors: Srikumar K. , Adam A. , Sargaison F. , O’Grady M.
Published: August 2023

Introduction

Smoking is highly prevalent in patients with mental health disorders and although most literature describes the physical health impact of smoking, there is little which addresses the poverty and social consequences associated with nicotine addiction. In 2022, Ireland’s HSE (Health Service Executive) published clinical guidelines, regarding smoking cessation in healthcare settings, with special attention to mental health settings.

Objectives

The aim of this study was to assess the current prevalence of smoking among inpatients in a psychiatric unit with a “Tobacco Free Campus” policy in place, and the associated patient factors. We also assess the efficacy at which mental health professionals are addressing smoking in this setting.

Methods

We performed a cross-sectional analysis of all patients admitted to the inpatient psychiatric unit on a single date. All inpatients were interviewed using a standardised format to ascertain smoking history and employment status. Case records were examined to record diagnoses and assess the patient’s inpatient care plan, nursing admission proforma and medical admission proforma. Medication charts were examined to ascertain whether Nicotine Replacement Therapy (NRT) was prescribed to those identified as smokers. Using Microsoft Excel, we analysed the smoking behaviours data gathered, and the identification of smokers and their orientation to the Tobacco Free Campus policy, on admission.

Results

Of the 51 inpatients, 78% (n=40) had an Axis 1 diagnosis according to the DSM-4, 72% (n=37) were unemployed and 67% (n=34) were receiving Social Welfare. 57% (n=29) of inpatients were current smokers. 63% (n=25) of smokers had an Axis 1 diagnosis, 51% (n=19) were unemployed and 53% (n=18) were receiving Social Welfare. Since admission, 52% (n=15) of smokers have been smoking more, and 48% (n=14) have been spending more money on tobacco. 7% of smokers (n=2) started smoking on the unit. 50% (n=9) of smokers receiving Social Welfare were smoking more, with the majority in receipt of long-term disability allowance (n=7). Only 10% (n=3) of smokers were prescribed NRT, with only 1 patient taking NRT. 90% (n=26) of smokers did not have smoking addressed in their care plan. 38% (n=11) had a fully completed smoking history in the nursing admission, while only 14% (n=4) had one in the medical admission.

Conclusions

Despite a Tobacco Free Campus policy, smoking continues to be highly prevalent in an inpatient psychiatric setting. Smoking was particularly prevalent in patients with Axis 1 diagnoses, and in the unemployed. A large proportion increased their smoking on admission, and their expenditure on tobacco. More can be done to identify smokers on admission so as to promote quitting, and in turn, reduce the social consequences related.

Disclosure of Interest

None Declared
Cannabis and cognitive deficiency: a descriptive study
Authors: Kacem M. , Bouali W. , Henia M. , Brahim S. , Zarrouk L.
Published: August 2023

Introduction

Cannabis is the most widely used illicit drug; 3.8% of the world’s population consumes cannabis on a regular basis. Cannabis use–associated alterations in the domain of cognition have been extensively studied.

Objectives

To research memory deficiency in the young consumers of cannabis in Tunisia.

Methods

This is a transversal descriptive study conducted during two months (January and February 2022). The research involved about 137 participants aged between 18 and 35 years old, exhaustively recruited amid emergency patients of Mahdia Hospital regardless of the reason for their health care seeking. The patients were declared as consumers of cannabis and accepted to be part of this study. Therefore, Data were collected on a pre-determined data sheet that included various information (age, sex, lifestyle, personal and family psychiatric history, age when first used cannabis and the rate of cannabis use …).

Principally, a Functional Impact Assessment (ERF: French abbreviation for échelle d’évaluation des Répercussions Fonctionnelles ) scale was used to assess and review working memory.

Results

In our study population, there was a noticeable male predominance of 71%. Hence, the age structure ranged between 18 years old and 35 years old. Among the latters, 65.9% were single, and 29.7% experienced school failure. In this sample, 23.2% had a psychiatric history like depression, bipolarity, etc. The average age of the first use of cannabis was between 18 and 25 years old in 70% of cases.

Besides, a high percentage of association of other substances was found among cannabis users as follows: use of alcohol 72.5%, tobacco 74.6%, ecstasy 41.3%, and cocaine 25.4%. First and foremost, the use of cannabis was considered as a means of indulgence for 66.7% of the study population, as an anxiolytic for 26.8%, and as a sedative for 23.9%.

Additionally, the effect of cannabis use on working memory deficiency according to the functional impact assessment scale was: no deficiency in 19% of cannabis users, minimal in 34%, mild in 32%, moderate in 9%, fairly severe in 4%, very severe in 1%, and extreme in 1% of cases.

More importantly, the percentage of consumers with significant memory deficiency (moderate to extreme) was 15%.

Conclusions

The assumption of the effect of cannabis on memory and cognitive deficiency remains controversial and leads us to suggest further in-depth study of this subject.

Disclosure of Interest

None Declared
Person-centered approach to work with drug addicts on substitution maintenance therapy
Authors: Halytska-Pasichnyk N. , Moroz S. , Semenikhina V.
Published: August 2023

Introduction

According to the United Nations World Drug Report 2019, there are an estimated 53 million opioid users[1]. Health problems, social problems associated with this abuse are the result of a complex interaction between psychoactive substances, the patient and the environment. There are two main approaches in the treatment - aimed at complete abstinence from the use of a psychoactive substance and substitution maintenance therapy using methadone and buprenorphine [2]. This is due to the pharmacological effects of narcotic substances, the dynamics of physiological processes and the general state of health with the systematic use of psychoactive substances.

Objectives

The problem of the use of narcotic substances must be considered not only as a physiological problem, but also as a problem of a person resorting to drugs in a specific social situation. In this case, curative and rehabilitation work acquires new content and new opportunities. The emergence of addiction depends on two main reasons: on the one hand, these are certain specific personality traits of a person, formed primarily by the family, and on the other hand, external factors such as the influence of friends, curiosity, life difficulties experienced and other personal problems. The greatest danger of the formation of drug addiction occurs in the case of simultaneous exposure to both groups of causes.

Methods

The study interviewed 123 patients aged 23 to 45 years (109 men and 14 women) diagnosed with opioid addiction. Of these, 17 patients with a period of abuse of up to three years and 105 - longer than three years, respectively. Personality disorders were assessed using the 16-factor Cattell Personality Questionnaire for the study of personality traits [3], the multi-aspect MMPI methodology (mini-mult) [4], and the Luscher color choice method [5].

Results

14 drug addicts (82%) with a period of abuse of less than 3 years were characterized by impulsivity, reduced stress resistance, risk appetite; in 83 drug addicts (79%) with a period of abuse longer than 3 years, persistent psychosocial maladjustment, communication difficulties, conflicts were detected, social norms were disregarded, increased readiness for open manifestation of aggression; 14 women (100%) had features of mental rigidity, disregard for social norms, conflict, impulsiveness; 88 men (81%) had emotional instability, excitability, hostility.

Conclusions

The formation of opioid dependence is influenced by both the psychophysiological characteristics and the pathopsychological changes that occurred during the use of a psychoactive substance.

Addiction therapy should include a psychological analysis of risk factors.

Selection of psychological options for social adaptation that contribute to the maximum possible realization of the individual’s potential, will increase the effectiveness of substitution therapy and accelerate the resocialization of drug addicts.

Disclosure of Interest

None Declared
Prospective Study of Prolonged Grief Disorder in Relatives of COVID-19 Deceased
Authors: Martins S. N. , Salgado R. , Nogueira Â. , Guedes I. , Carvalho N. , Ribeiro Â. , Ribeiro B. , Mendes D.
Published: August 2023

Introduction

COVID-19 pandemic along with its social restrictions changed our burial practices and
the way we bury our dead. In consequence, it affected people’s experiences and traditions
which could lead to severe, persistent, or disabling grief.

Thereby, it is relevant to understand how someone may be more susceptible to
developing pathological grief and what can we do to prevent it.

Objectives

To assess the risk of Prolonged Grief Disorder (PGD) in family members of patients who
died from COVID-19 infection and identify possible risk factors.

Methods

Prospectively, we performed follow-up interviews conducted with family members of all
patients who died from COVID-19 infection in 2020 at our hospital. The sample was
characterized, and clinical follow-up was performed for at least 6 months after the date of
death. By that time, the PG-13 scale was applied.

Results

A total of 269 individuals who had some type of relationship with patients who died
from COVID-19 were included, with 68% being female with a mean age of 53.7 years.

After clinical follow-up, 10.8% of the patients met the diagnostic criteria for
PGD.

Regarding the degree of kinship, the only predictor of PGD was “spouse” (OR 11,236,
[4,762; 26,316]; p < 0,001). A closer and more regular interaction with the deceased was
also associated with an increase in PDG (OR 5.682, [1.314; 24.390] p = 0.009).

Feelings of denial and guilt by the time of death notification were also risk
predictors for PGD (OR 2,412, [1,091; 5,332] p = 0,026) and OR 2,888, [1,244; 6,703] p =
0,011, respectively).

The impossibility of being present at the funeral was associated with a risk of about
3 times higher of developing PGD (OR 3,817 [1,727; 8,403] p < 0,001).

Older age (p<0,001) and lower educational qualification (p=0,003) were also
presented as risk factors.

Other characteristics including gender, marital status, previous suicide attempts,
psychiatric or consumption history, previous significant bereavement or the social and family
support of the person contacted were not predictors of PGD.

Conclusions

The present prospective study made it possible to reinforce and support the way in
which the COVID-19 pandemic, associated with significant social modifications, changed the
way people experience grief.

Disclosure of Interest

None Declared
Biomarker Variability, Severity of CORADS and Impact of Psychotropic Medications on Course and Outcome of Neuropsychiatric Sequalae of COVID-19 ICU Patients: A Preliminary Observation from South India
Authors: Kandrakonda S. , Vatte V. R. , Penubarthi S. , Karri S. R. , Kamble A. , Khairkar P. , Pustakaala D. , kanlur A. , Anna S. K. Y. , Penugonda S. S. , Gadde R. , Inakollu V. K. , Soorineedu R.
Published: August 2023

Introduction

There is growing evidence of neuropsychiatric presentations in patients of COVID-19, but literature is scarce on laboratory, clinical and radiological markers as well as impact of psychotropic medications during the course of hospitalization in critically ill patients.

Objectives

The primary outcome measure was variability of clinical biomarkers and CORADS scores with severity of COVID-19 infections and the impact of psychotropic medications like risperidone and aripiprazole.

Methods

We screened 430 ICU patients admitted to our tertiary care hospitals, out of whom 67 were diagnosed positively with definitive neuropsychiatric sequalae and receive psychotropic interventions during their hospital stay. We compared their D-dimer levels, C-reactive proteins, serum ferritin levels, serum procalcitonin and Vitamin D levels and further analyzed CORADS severity score with psychiatric severity and outcome.

Results

The mean age of the patients was 42.38 years, majority (44.8%) of them belonged to 21-34 years with slight (52.2%) male preponderance and none of them were more than 60 years. We observed a 43.3% were having organic mood disorder and 37.3% of individual had significant history of alcohol dependence while hypertension and diabetes mellitus were noted in 34.3% and 29.9% respectively. Only D-dimer levels were found to be significant and positively associated with outcome of psychiatric disorders (p<0.05), accounting for 41% of covariance on linear regression analysis.

Conclusions

Our study has found significant association of elevated levels of D-dimer variability but not the other laboratory biomarkers among various neuropsychiatric comorbid sequalae in ICU admitted COVID 19 patients. This particular observation might have potential for serum D-dimer levels to be possibly used as an early biomarker to screen or suspect for comorbid neuropsychiatric presentations.

Disclosure of Interest

None Declared
Lower thyroid stimulating hormone concentrations linked to suicidal ideations among individuals with anxiety and mood disorders
Authors: Liaugaudaitė V. , Podlipskytė A. , Burkauskas J. , Mickuvienė N. , Adomaitienė V. , Zauka E. , Steiblienė V.
Published: August 2023

Introduction

Suicidal behavior is quite common in individuals with anxiety and mood disorders (AMD). One of the coexistence factors in suicidal behavior is thyroid dysfunction, however the results are still controversial (Shen et al. J Affect Disord 2019;(1)180-185; Zhou et al., Transl Psychiatry. 2021;11(1):97). The role of thyroid function in suicidal ideation among individuals with comorbid AMD have not been thoroughly investigated.

Objectives

The aim of this cross-sectional study was to identify potential associations between thyroid function and suicidal ideation in a sample of individuals with anxiety and mood disorders.

Methods

This exploratory study comprised 77 consecutive individuals with AMD (age range 18-73 years, 76% were females) attending the Psychiatry Day care unit. All individuals have been evaluated for current psychiatric diagnoses, suicidal ideation using the Mini International Neuropsychiatric Interview [M.I.N.I. 7.0.2]) as well as for socio-demographic factors and for current psychotropic medication use. Severity of depression and anxiety symptoms have been evaluated using the Patient Health Questionnaire-9 (PHQ-9) and the General Anxiety Disorder-7 (GAD-7). The biochemical blood tests were performed for the concentrations of thyroxine (FT4), triiodothyronine (FT3) and thyroid stimulating hormone (TSH). The univariate and multivariable logistic regression analyses were used to assess the association between biochemical parameters and suicidal ideation.

Results

Of all study individuals with AMD – 56% have been identified as having current SI. There were not significant differences according to age, gender, education, BMI, smoking, depression and anxiety symptoms and current psychotropics use between SI and non-SI individuals. Serum FT4, FT3 and TSH concentrations were within normal range. However individuals with SI had significantly lower TSH concentrations in comparison to the non-SI (1.54 (0.77) vs. 2.04 (1.22) IU/L, respectively; p = 0.049), without significantly differences in FT4 and FT3 concentrations. A multiple logistic regression, adjusting for sociodemographic factors and severity of mental symptoms revealed, that non-SI individuals with AMD were likely to have higher TSH levels than SI (odds ratio = 2.15 (95% CI 1.10–4.22; p = 0.027).

Conclusions

Among individuals with AMD, lower levels of TSH concentrations have been associated with presence of suicidal ideation, independently of sociodemographic factors and severity of depression and anxiety.

Disclosure of Interest

V. Liaugaudaitė Grant / Research support from: European Union (project No P-PD-22-150) under the agreement with the Research Council of Lithuania (LMTLT)., A. Podlipskytė: None Declared, J. Burkauskas Consultant of: Cronos, N. Mickuvienė: None Declared, V. Adomaitienė: None Declared, E. Zauka: None Declared, V. Steiblienė: None Declared
Resting-state gamma oscillations in adult Autism spectrum disorder: A High-Density EEG study
Authors: Kakuszi B. , Szuromi B. , Tóth M. , Bitter I. , Czobor P.
Published: August 2023

Introduction

Autism is neurodevelopmental disorder with a heterogeneous presentation of symptoms, which include disturbances in sensory, motor and cognitive processes, among which social cognitive impairments and social interaction difficulties play prominent role. Despite the fact that these impairments can lead to lifelong disability and difficulties in everyday functioning, their neurobiological basis remains largely unknown. Neural oscillations in the gamma band have been shown to be an important candidate neurobiological marker of higher order cognitive processes and social interactions. Yet, alterations of gamma oscillations in ASD have received little attention in the literature.

Objectives

The aim of the current study was to investigate resting state gamma oscillations in the EEG in order to delineate alterations in ASD as compared to typically developing (TD) subjects in the intrinsic activity of the neural networks that have been linked to social cognitive functioning.

Methods

Resting-state EEGs were obtained in an ongoing study investigating ASD (N=19) and TD subjects (N=15), based on eyes closed condition. EEGs were recorded using a 128-channel BioSemi system. EEG absolute power was investigated in the gamma 30-48Hz frequency band.

Results

Gamma activity was significantly (p<0.05) diminished in multiple brain regions in ASD as compared TD subjects. The diminished gamma activity had a distinctive topographical distribution, which included the left and right inferior temporal gyrus, the right superior temporal gyrus, the TPJ and the right extrastriate areas. Additionally, we found a hemispheric asymmetry in the occipital brain areas with a decrease of gamma activity on the right and an increase in the left hemisphere as compared to TD.

Conclusions

Diminished gamma activity in the above brain areas may represent a cortical dysfunction which can be present due to a reduced capacity to process socially relevant information and a decreased capacity to omit irrelevant stimuli.

Funding: Hungarian Brain Research program,#NAP2022-I-4/2022

Disclosure of Interest

None Declared