bluuebunny/crossref_metadata_2025 huggingface dataset:
The link between personality dimensions, impulsivity, decision and coping style, and suicide attempts in affective patients.
Authors: Pawlak J. M. , Bilska K. , Skibińska M. , Narożna B. , Zakowicz P. , Rajewska-Rager A. , Kapelski P. , Dmitrzak-Węglarz M.
Published: August 2024

Introduction

Introduction: Affective patients, especially depressive, have an increased risk of suicidal behavior. Identifying individuals at increased risk remains a challenge. Among the correlates that may be crucial, the impact of personality is emphasized. Attention is paid to impulsivity, measured by subjective or objective tests.

Objectives

Objectives: Comparative analyses were carried out to capture the differences and relationship between personality dimensions, impulsivity, and the decision-making style and coping with stress strategies in suicide attempters and non-attempters in the course of an affective disorder.

Methods

Methods: Data were obtained from 276 individuals diagnosed with unipolar and bipolar affective disorder, both sexes. The study group was disaggregated into a subgroup of patients with (N=95) and without (N=181) suicide attempts in an individual’s history. The Temperament and Character Inventory (TCI) was used to assess personality dimensions. The Barratt Impulsiveness Scale version 11 (BIS-11) was used to measure impulsivity subjectively, and the Simple Reaction Time (SRT) test and the Continuous Performance Test (CPT) were objective assessment methods. The Coping Orientation to Problems Experienced (COPE) and Iowa Gambling Task (IGT) were applied to investigate coping and decision-making styles. Statistical analyses were performed in Statistica 13.3 StatSoft, Krakow, Poland.

Results

Results: In TCI, significant differences between suicide attempters and non-attempters concerned the following dimensions: harm avoidance (HA) (p=<0.0000), self-directedness (SD) (p=0.0001), and cooperativeness (C) (p=0.0186). In the CPT test, significant differences concerned correctly responded trials (p=0.0179) and Bias response (p=0.0230). In IGT, significant differences occurred in IGT block1_sum (p=0.0496) only (Table 1). We did not observe any significant differences in other tests applied. In the Spearman rank correlation analysis in the group of suicide attempters, the following correlations (p>0.05) with at least moderate strength rs>0.4 were revealed: Novelty seeking (NS), SD, and C correlated with several CPT parameters; Persistence (P) correlated with SRT variables; NS, HA and SD with BIS-11 variables.

Conclusions

Conclusions: Objective computerized tests (SRT; CPT; IGT) did not differentiate suicide attempters and non-attempters more clearly than self-reporting personality inventory TCI. Personality traits correlated with SRT and CPT variables. BIS-11 and COPE parameters did not enable to distinguish suicide attempters and non-attempters in the investigated group. This suggests that tests used complement each other, and using a single tool may be insufficient to indicate patients at increased risk of suicidal behavior.

Disclosure of Interest

None Declared
12-Month Outcome Data for Buprenorphine-Naloxone Maintenance Treatment in Individuals with Opioid Use Disorder
Authors: Taylan Y. , Sönmez M. B.
Published: August 2024

Introduction

Buprenorphine/Naloxone (B/N) is a safe and effective treatment for the long-term stabilization of individuals with opioid use disorder (OUD). Patients undergoing opioid maintenance treatment experience reduced mortality rates, decreased substance use, and an overall improvement in their quality of life. Premature discontinuation of maintenance treatment increases the risk of relapse.

Objectives

Our primary objective was to assess patient compliance with maintenance treatment and to identify potential factors associated with treatment discontinuation and relapse.

Methods

The study involved 206 patients with OUD who initially enrolled in a 28-day abstinence-based inpatient program at our hospital. Following their inpatient treatment, they were subsequently admitted as outpatients for B/N maintenance treatment at the Alcohol and Substance Addiction Treatment Center in Trakya University School of Medicine (Edirne, Türkiye). The addiction profiles of patients were assessed using the Addiction Profile Index (API) Clinical Form during the baseline evaluation. Sociodemographic and clinical data were collected from the patients’ records.

Results

After 3 months, 114 patients (55.3%) remained in treatment, and 52 patients (25.2%) were still in treatment at the end of 1 year. Factors associated with a higher likelihood of remaining in treatment for one year included older age (z=-2.257, p=0.024), longer length of education (z=-2.270, p=0.023), later onset of smoking (z=-2.704, p=0.007), later onset of substance use (z=-3.597, p<0.001), and a higher rate of completing the inpatient treatment program (χ²=4.016, p=0.045). Patients in the 1-year retention group had lower scores on the API anxiety (z=2.767, p=0.009), anger management problems (z=2.754, p=0.011), and novelty-seeking behavior (z=2.634, p=0.043) subscales. They also had a lower rate of having a criminal history (χ²=5.349, p=0.021). The duration of treatment retention was positively correlated with age (r=0.160, p=0.021), length of education (r=0.158, p=0.023), age of onset of smoking (r=0.228, p=0.001), and age of onset of substance use (r=0.268, p<0.001). It was negatively correlated with the duration of substance use (r=-0.138, p=0.048), the number of inpatient treatments (r=-0.142, p=0.042), and scores on the API anxiety (r=-0.167, p=0.040), anger management problems (r=-0.173, p=0.033), and novelty-seeking behavior (r=-0.209, p=0.010) subscales.

Conclusions

Identifying the specific factors associated with treatment retention and dropout/relapse can be valuable in developing more effective and personalized treatment plans for individuals with OUD.

Disclosure of Interest

None Declared
Serum Lithium Concentration and the Risk of Chronic Kidney Disease
Authors: Gislason G. , Indriðason Ó. S. , Pálsson R. , Sigurðsson E.
Published: August 2024

Introduction

Lithium is an important treatment option for individuals with mood disorders, but its use has been linked to the development of chronic kidney disease (CKD). Existing studies on this association have reported conflicting results.

Objectives

The aim of this study was to examine the risk of developing CKD with lithium use adjusting for common comorbidities.

Methods

This was a retrospective cohort study that included all individuals in Iceland receiving lithium therapy between 2008 and 2018. Lithium use was defined as at least one dispensed prescription for Lithium or at least one serum lithium concentration above the detection limit. Patients with affective disorders (ICD-10 codes F30-F39) attending the outpatient clinics of Landspitali–The National University Hospital Mental Health Services in 2014-2016, without lithium exposure, served as controls. CKD stages 3-5 were defined according to the Kidney Disease Improving Global Outcomes (KDIGO) guidelines for CKD as estimated glomerular filtration rate (eGFR) less than 60 mL/min/1.73 m2. The eGFR was calculated using the serum creatinine (SCr) based on the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Acute kidney injury (AKI) was defined according to the SCr component of the KDIGO criteria for AKI, and other comorbid diseases were defined based on ICD-9 and ICD-10 codes. Individuals with fewer than 2 SCr measurements during the study period and those with CKD stages 3-5 prior to 2008 were excluded. Cox regression analysis with time dependent variables was performed to assess the risk of CKD.

Results

The study included 2046 individuals exposed to lithium, of whom 221 (10.9%) developed CKD in the study period. Among the 1220 control subjects, 39 (3.2%) developed CKD. Lithium use was associated with CKD (hazard ratio [HR] 1.93, 95% confidence interval [CI] 1.37–2.74) after adjusting for sex, age, and comorbid diseases. Other significant risk factors were age (per year, HR 1.03, 95% CI 1.02–1.04), initial eGFR (per mL/min/1.73 m2, HR 0.92-0.96, 95% CI 0.90–0.99), presence of diabetes (HR 1.73, 95% CI 1.15–2.48) and history of AKI (HR 1.89, 95% CI 1.32–2.70). When compared to the control group not exposed to lithium, the risk (HR) of CKD was 1.24 (95% CI 0.81–1.89), 2.88 (95% CI 1.97–4.20) and 5.23 (95% CI 3.31-8.26) for groups with a mean lithium concentration of 0.3-0.59, 0.6-0.79 and 0.8-0.99 mmol/L, respectively.

Conclusions

Long-term lithium therapy seems to increase the risk of CKD in a concentration-dependent manner in individuals with bipolar and unipolar mood disorders. To mitigate this risk, it is essential to monitor blood levels carefully and use doses of lithium as low as possible for adequate mood stabilization and treatment.

Disclosure of Interest

None Declared
Affective temperament and emotional dysregulation in cyclothymia and adult ADHD: differential characteristics and clinical implications.
Authors: Moriconi M. , Bartolini D. , De Rosa U. , Barbuti M. , Schiavi E. , Perugi G.
Published: August 2024

Introduction

Emotional dysregulation is central to the problem of the overlap between attention‐deficit/hyperactivity disorder (ADHD) and cyclothymia.

Objectives

We aimed to compare clinical characteristics, psychiatric comorbidity, affective temperament, and emotional dysregulation among subjects with attention-deficit/hyperactivity disorder (ADHD) and cyclothymia.

Methods

In this cross-sectional study, 187 participants were consecutively recruited between January 2018 and December 2019 at the outpatient clinic of the 2nd Psychiatry Unit of the University Hospital of Pisa. Eighty-one subjects were diagnosed with ADHD, 62 with cyclothymic disorder, and 44 with both conditions. Participating psychiatrists collected socio-demographic and clinical data, psychiatric comorbidities according to DSM-5 criteria, familiarity for psychiatric disorders, and any previous responses to antidepressant drug therapy. To study the temperamental characteristics of the participants, the short version of the Memphis, Pisa, Paris and San Diego Temperament Assessment (Brief-TEMPS-M) was administered, while emotional dysregulation was measured through the Reactivity, Intensity, Polarity, Stability questionnaire (RIPoSt-40).

Results

Cyclothymic subjects, both with and without ADHD, were more often female (p<0.001) than subjects with ADHD. Participants with ADHD showed significantly lower educational attainment than subjects without ADHD (p<0.001). In addition, participants with ADHD alone showed comorbid substance use disorder more frequently (p<0.001) than subjects with cyclothymia alone. On the other hand, the latter showed higher rates of eating disorders (p=0.033) and familiarity for major depressive disorder (p=0.009) and panic disorder (p=0.029). Depressive and anxious temperament was significantly more represented in cyclothymic subjects without ADHD, as was negative emotionality, while hyperthymic temperament showed an opposite trend. No significant differences were observed between groups for cyclothymic temperament and overall negative emotional dysregulation, but patients comorbid with both conditions had the highest scores in these subscales.

Conclusions

ADHD and cyclothymia show high and overall similar levels of emotional dysregulation. However, cyclothymic patients may be more prone to negative emotionality (“dark cyclothymia”). It is possible that individuals with “sunny” cyclothymic features may escape clinical attention if ADHD is not present in comorbidity.

Disclosure of Interest

None Declared
Sexual exploitation of male youth: background characteristics and needs from a life-course perspective
Authors: Mercera G. , Leijdesdorff S. , Heynen E. , van Amelsvoort T.
Published: August 2024

Introduction

Sexual exploitation is a human rights violation that has a detrimental impact on the psychological-, physical- and social well-being of victims. Sexually exploited male youth are prevalent, yet underrepresented in clinical practice, policy and research. There are multiple barriers that often prevent male youth to disclose and to seek or receive support, such as gender norms, limited awareness of victimization and feelings of guilt and shame.

Objectives

By gaining more insight into the background and clinical characteristics of male victims and their care and support needs, this study aims to raise awareness and to better inform policymakers, care- and educational professionals on adequate prevention and intervention efforts.

Methods

Twenty-six male youth at high-risk or victims of sexual exploitation participated in this qualitative study. By means of semi-structured interviews and case-file analyses, data was collected by to identify risk and protective factors in their life-course and care and support needs.

Results

Results indicate that several vulnerabilities (e.g. previous experiences of abuse and neglect, mental health problems, household dysfunction, social rejection, running away, substance use) and a lack of positive and supportive relationships led male youth into high-risk situations. Among these were involvement in pay dates, survival sex and criminality, which contributed to victimization. Experiences of stigmatization were often a barrier to express vulnerabilities and to disclose victimization. There was a wide variety in care and support needs, including peer-to-peer support, therapy, support with day-to-day practices and anonymous support.

Conclusions

These results will contribute to adequate prevention and intervention strategies and meet the unique needs of male youth at risk for, or victim of sexual exploitation.

Disclosure of Interest

G. Mercera Grant / Research support from: This research was funded by the Dutch Ministry of Health, Welfare and Sports (grant number: 328604)., S. Leijdesdorff: None Declared, E. Heynen: None Declared, T. van Amelsvoort: None Declared
Teleassistance Telerehabilitation Services for urgent mental health needs of people with Intellectual and Developmental disabilities
Authors: Bertelli M. O.
Published: August 2024

Persons with intellectual disability (PwID) and/or and autism spectrum disorder with high support needs (ASD-HSN) have resulted to be among the most vulnerable populations to COVID-19 and distress factors associated to the measures for containing its spread. Many health, rehabilitation, and assistance needs were managed through the use of telemedicine, specifically teleassistance (TA) and telerehabilitation (TR), with regard to the prevention and treatment of the epidemic illness as well as the continuity of care required for the condition of developmental disability and co-occurring physical or mental disorders. TA and TR can function either directly or indirectly with the PwID/ASD; in the latter case, a family member, a regular caregiver, or a technician provides local mediation. This paper examines the most common TA and TR activities, along with their requirements, applications, and goals. All of these activities should be in line with the overarching goal of each customized therapy and rehabilitation plan, which is to enhance and support the quality of life for people with intellectual and developmental disabilities.

Studies on TA and TR efficacy for PwID/ASD are limited, especially concerning adulthood. The scant research that is currently available demonstrates efficacy in maintaining or marginally enhancing cognitive, adaptive, and vocational skills. In addition to managing both routine and unusual activities as well as critical episodes, family members and other caregivers reported feeling more empowered about their educational and interpersonal abilities with the PwID/ASD. The primary benefits over traditional in-person services have been found to be greater accessibility and availability as well as a reduction in both physical and psychological distance. The primary limits include the absence of all elements of the therapeutic alliance pertaining to face-to-face communication, possible poor ability to use technology, accessibility of the technology itself, concerns regarding privacy, and variables that divert attention connected to the household setting.

Even while telemedicine has proven to be feasible and beneficial thus far, it is doubtful that traditional techniques will be able to be replaced, at least not anytime soon. Telemedicine could, nonetheless, serve as a useful addition, integration, or short-term substitute. Future studies should provide light on the indications, contextual deployment, efficacy evaluation, and operational stability over time of certain TA and TR activities in addition to the use of artificial intelligence, machine learning, and interactive avatars.

Disclosure of Interest

None Declared
Perceived vulnerability, fear of covid-19, and psychological distress of military hospital healthcare workers
Authors: Papathanasiou C. , Christodoulias D.
Published: August 2024

Introduction

The healthcare workers of military hospitals are actively involved in the fight against covid-19, as part of the national healthcare systems. Therefore, these health professionals may experience symptoms of psychological distress.

Objectives

The study of sociodemographic characteristics and pandemic-related psychosocial factors that affect the psychological distress of healthcare professionals in a military hospital.

Methods

134 health professionals participated (- 34.3% doctors, 53% nurses and 12.7% other staff
). A cross-sectional study was conducted using the DASS-21, PVDS, and FCV-19S questionnaires. Demographic variables were also collected. The data was analyzed using student’s t-test and Mann-Whitney test, analysis of variance and Kruskal-Wallis test, Pearson’s correlation coefficient and Spearman’s correlation coefficient, as well as multivariate linear regression.

Results

21.64%, 17.91%, and 16.42% of the sample showed symptoms of depression, anxiety, and stress respectively. A significant correlation emerged between all three dimensions with perceived infectibility and fear of covid-19. Contact with a possible covid-19 patient, female gender, marriage, underlying diseases, increased working hours were found as stressors. The mean values of perceived infectibility and germs aversion were 3.4 and 4.9, respectively. A significant correlation was found between the two subscales with fear of covid-19 (p=0.001 and <0.001 respectively). Participants who had undergone psychotherapy in the past had a higher score of perceived infectibility (p=0.024). Women and staff in the pathological sector showed greater aversion to germs (p=0.040 and 0.001 respectively). Educational level and working hours were negatively correlated with germs aversion (p=0.037 and 0.044 respectively). The mean of fear of covid-19 was 14.5, with 14.2% of the population being above the scale average. Fear of covid-19 showed a positive correlation with female gender, age, family, contact with a possible positive case. It was negatively correlated with the medical staff, the educational level, and the employees in a covid-19 clinic. According to the results of the multivariate linear regression analyses: (i) The increase in educational level was associated with a decrease in the fear for covid-19 score (p=0.026); (ii) The increase in perceived infectibility score was associated with an increase in the fear for covid-19 score (p<0.001); (iii) The increase in germs aversion score was associated with an increase in fear for covid-19 score (p=0.014).

Conclusions

The findings confirm the presence of psychological distress on the healthcare workers of the hospital and its dependence on perceived infectibility and fear of covid-19.

Disclosure of Interest

None Declared
Patients’ perceptions and preferences regarding telemedicine for addictive disorders
Authors: Achab S.
Published: August 2024

Telemedicine is an emerging treatment option having been heaviliy used during covid lockdowns, in order to maintain traetment access including for ddictive disorders.

In the present talk, we first present data published on the challmenges met at ReConnecte the treatment facility for Addictive behaviors during pandemic.

We second, present results of a survey we conducted on preferences of telemedicine use in patients and doctors in our Geneva University Hospitals.

We finaly illustrate findings by clinical cases of patients suffering form addictive behaviors and their specific meeds and preferences in terms of telemedicine (phone or Visioconsultation).

Preferences and ehealth tools elicited depended of their psychosocial profiles, their specific needs and expected benefits from online sessions of psychotherapy.

One of the ingredients of successful psychotherapy for addictive behaviors, is teh purposeful use of telemedicine as an inztegarted treatment modality.

Disclosure of Interest

None Declared
Humanitarian Love in Values-Based Practice and Health Professionals’ Psychosocial Outcomes: Systematic Review
Authors: Batiridou A. L. , Dragioti E. , Mantzoukas S. , Gouva M.
Published: August 2024

Introduction

The literature on Values-Based Practice often neglects the significance of love in therapeutic interactions, sometimes treating it as taboo or crossing professional boundaries.

Objectives

This systematic review investigates the role of humanitarian love in the lives of healthcare professionals and its psychosocial impact, aiming to establish it as a core value in values-based practice.

Methods

We conducted a PRISMA 2020-compliant systematic review, searching databases (CINAHL, PubMed, Scopus) from inception to April 3, 2023, using PEO elements: health professionals (P), love (E), psychosocial impact (O). Two independent reviewers conducted screening, data extraction, and bias assessment. A narrative synthesis of the data was applied. The selection process is presented in Figure 1.

Results

Eight articles met the inclusion criteria, comprising 1,948 participants (median age: 28.55). Humanitarian love encompassed compassionate love, self-compassion, and affection. Humanitarian love showed a negative correlation with burnout, compassion fatigue, self-judgment, and secure attachment, while positively correlating with professional well-being, professional commitment, self-care, patience, diversity acceptance, spirituality, self-kindness, and ethical values. Humanitarian love significantly influenced healthcare professionals’ psychosocial well-being. The main outcomes are presented in Figure 2.

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Image 2:

Conclusions

This review highlights humanitarian love’s potential to enhance the psychosocial well-being of healthcare professionals and emphasizes its significance as a core value in values-based practice. Cultivating humanitarian love among healthcare professionals through research and interventions could bolster their resilience, job satisfaction, and overall fulfillment in their roles.

Disclosure of Interest

None Declared
Plasma concentrations of IL-8, IFN-γ and IL-1β in schizophrenia patients with subgroup analysis of first episode drug naïve patients
Authors: Markovic M. , Stasevic M. , Stojkovic M. , Velimirović Bogosavljević M. , Stojkovic T. , Zivkovic M. , Stasevic Karlicic I. , Nikolic T. , Totic Poznanovic S. , Petronijevic N.
Published: August 2024

Introduction

Increased plasma concentrations of proinflammatory cytokines are found in chronic schizophrenia patients, patients with first episode and in individuals with high risk for psychosis. The most replicated findings are increased concentrations of IL-6, TNF-α and IL-1β through different phases of the disorder while the results for two important proinflammatory cytokines IL8 and IFN-γ were not consistent.

Objectives

Primary objective of this study was to assess differences in concentrations of IL-8, IFN-γ and IL-1β between schizophrenia patients and healthy controls, Secondary objective was to explore differences in first episode drug naïve patients.

Methods

We measured plasma concentrations of IL-8, IFN-γ and IL-1β in 64 healthy controls and 64 schizophrenia patients during acute exacerbation and remission phase. 25% were drug naive first episode schizophrenia patients. The patients were matched by age, sex and body mass index and exclusion criteria included obesity class 2 or higher, any concomitant organic mental or neurological disorder, acute or chronic inflammatory disease, and use of immunomodulatory drugs or psychoactive substances.

Results

Levels of IL-8 were significantly lower in patients with schizophrenia in acute phase and remission compared to healthy controls (p=0,009 for acute phase and p=0,020 for remission). There was no significant difference in the levels of INF-γ and IL-β between schizophrenia in acute phase and remission and healthy controls (p>0,05). In schizophrenia patients there was no difference in the levels of INF-γ, IL-β and IL-8 between acute phase, remission and healthy controls (p>0,05). There was no difference in plasma levels of IL-8, IFN-γ and IL-1β between first episode drug naïve and previously treated schizophrenia patients.

Conclusions

Our research did not find disturbance of plasma levels of IFN-γ and IL-1β in schizophrenia patients, although the increase of IL-1β was the most replicated finding up to date. Interestingly and contrary to expected the finding of significantly decreased levels of IL-8 in schizophrenia patients requires further research since IL-8 plays a vital role in the inflammatory pathway and may be implicated in cognitive dysfunction.

Disclosure of Interest

None Declared
A specialized unit for women with schizophrenia: Results from the healthcare model Observatories-Monitoring Stations and Interventions.
Authors: Paolini San Miguel J. P. , Natividad M. , Seeman M. V. , Román E. , Balagué A. , Palacios B. , Bagué N. , Izquierdo E. , Rial E. , Monreal J. A. , González Rodríguez A.
Published: August 2024

Introduction

There are many theoretical reasons to implement gender-specific care for schizophrenia. For all these reasons, the Mutua Terrassa-Functional Unit for Women with Schizophrenia was inaugurated in January 2023 in the context of a community mental health service.

Objectives

Our aim today is to describe the health care model applied in this newly initiated unit.

Methods

We created a healthcare model in our new unit consisting of A)Five observatories of Health (somatic morbi-mortality, hyperprolactinemia-HPRL, substance use disorders, social exclusion/discrimination, and drug safety); B)Monitoring stations or vigilance teams (reflecting the 5 observatories); and C)resulting actions (specific interventions). The observatory teams each meet monthly. In this presentation, according to the healthcare model we implemented, we first describe data about the original patient recruitment and then focus on the observatories of somatic morbi-mortality and hyperprolactinemia.

Results

From 265 potentially eligible women, 42 were included in the 5 observatories. (A) of the 11 women in the observatory of somatic morbi-mortality, 10 women had died within the last 24 months. Causes of Death: (1)respiratory tract disease (n=5,45.4%), (2)cancer (n=3;27.3%): lung cancer (n=1), pancreatic cancer (n=1), kidney cancer (n=1), (3)ischemic colitis (n=1;9%), (4)Alzheimer disease (n=1;9%). 2) Morbidity. One woman had an ongoing glioblastoma. (B)Observatory of HPRL. Eight women with moderate/severe HPRL were included. Strategies for lowering prolactin levels were discussed with neuroendocrinologists. Interventions:adjunctive aripiprazole (n=3), switch to aripiprazole (n=2), lowering antipsychotic doses (n=2), and adjunctive cabergoline (n=1).

Conclusions

Designating special teams to focus on specific problems of women with schizophrenia will reduce morbidity and improve outcomes in this vulnerable population.

Disclosure of Interest

None Declared
Cardiovascular Risk Assessment in Psychotic Disorders: A Comparative Analysis of Plasma Atherogenic Index between Remitted Patients and Healthy Control
Authors: Ergün M. T. , Sağlıyan B. , Bayırlı Ö. , Kaya S. , Aydın M.
Published: August 2024

Introduction

Psychiatric patients have a higher risk of premature mortality primarily due to cardiovascular diseases (CVD). One significant contributing factor is the presence of dyslipidemias . Current studies are shifting focus towards lipoprotein ratios, believed to better reflect cardiovascular risk. These studies have demonstrated that ratios associated with high-density lipoprotein (HDL) are stronger predictors for CVD compared to traditional lipid parameters. One of these ratios is the logarithmic transformation of the triglyceride (TG) to HDL ratio, known as the plasma atherogenic index (PAI).

Objectives

Our study aimed to compare the PAI between patients diagnosed with psychotic disorders who presented to our outpatient clinic and healthy control groups.

Methods

Fifty patients diagnosed with psychotic disorders, including 50 residing in a nursing home and 50 outpatient in such facilities, presented to our psychiatric outpatient clinic and were included in our study. Additionally, a healthy control group consisting of 49 individuals was recruited. A socio-demographic data form was administered to all groups. Peripheral blood levels of HDL, Triglycerides (TG), and LDL were recorded for each participant included in the study. Ethical approval for the study was obtained from the local ethics committee.

Results

The patient groups were compared in terms of age and gender. While there was no statistically significant difference in gender between the groups, a significant difference was observed in terms of age (p=0.099, p=0.004). When examining the age distribution of the groups, it was observed that the care facility group was older compared to the other groups. The age and gender distributions of the groups are shown in Table 1 and Table 2.

Psychotic patients in the outpatient group and the nursing home group were compared in terms of age and atherogenic index. Age was statistically significant, indicating that thenursing home group was significantly older (p=0.001, p=0.478). In the comparison of the control group with psychotic patients, there was no statistical difference in age, but a significant difference was found in terms of the atherogenic index (p=0.510, p=0.001). The statistical analysis and data between psychotic patients and the control group are presented in Table 3.

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Conclusions

This study, examining the comparison of Plasma Atherogenic Index (PAI) in patients diagnosed with psychosis with healthy controls, represents a significant step in understanding the cardiovascular health profile of this population and developing appropriate treatment strategies. Future research will further contribute to a deeper understanding of the impact of psychiatric disorders on cardiovascular health and aid in the development of effective interventions to minimize these effects.

Disclosure of Interest: None Declared.

Disclosure of Interest

None Declared
New drugs in the treatment of dual psychosis: use of cariprazine in schizophrenia, other psychotic disorders and use of cocaine. A case series in a specific outpatient psychiatric clinic for substance use disorders.
Authors: Montero-Hernandez G. , Alberdi-Páramo I. , Pérez-Lombardo M. , Rodríguez-Quijano J. , Pemán-Rodríguez J. , Ibáñez-Vizoso J. E.
Published: August 2024

Introduction

New drugs in the treatment of dual psychosis: use of cariprazine in schizophrenia, other psychotic disorders and use of cocaine. A case series in a specific outpatient psychiatric clinic for substance use disorders.

Objectives

The main objective of this case series is to observe and describe the tolerability and clinical response to different doses of cariprazine in a series of patients with dual psychosis, especifically cocaine users; with a special attention upon psychotic symptoms, disruptive behaviour, affective symptoms and cocaine use pattern.

Methods

This series consists of an observation of a total of 20 patients treated on an outpatient basis. All of them had a either a diagnosis of Schizophrenia or Other Non Specified Psychotic Disorder meeting the DSM-5 criteria, as well as a Cocaine Use Related Disorder meeting the DSM-5 criteria. All of them received treatment with cariprazine in different doses from 1,5mg to 6mg per day, as a solo treatment or as an adjuvant to another previous antipsychotic treatment when antipsychotic augmentation was justified. We observed patients that had started cariprazine in the past three months and that had active drug use or had had one in the past three months.

We monitored the tolerance to the treatment, the clinical response in terms of positive and negative symptoms of schizophrenia, affective symptoms, disruptive behavior, and the response in terms of substance use; for a period of six months of follow-up, with psychiatric consultation at least every month and nurse consultation every two weeks in our clinic.

Results

95% of the patients did not present any side effect related to cariprazine. In one patient (5%) the treatment had to be stopped due to akathisia that did not disappear after two weeks and symptomatic treatment with benzodiacepines. 60% of patients either stopped using (50%) or reduced their use frequency (50%). 70% of the patients presented an improvement in positive symptoms and behavior. Also, one third of them presented a slight improvement in negative symptoms. 20% of patients referred a significant improve in depressive symptoms.

Conclusions

The main conclusion of this case series is that cariprazine at any dosis between 3mg and 6mg per day has a positive outcome, both in the psychotic domain and the substance use disorder. We hope this case series will help our colleagues treat their patients suffering from these pathologies in an optimal way. This could also set a basis to encourage a proper clinical trial to assess if new antipsychotics such as cariprazine could be a new standard for the treatment of Dual Disorders.

Disclosure of Interest

None Declared
Concentration of HSPA1A and transthyretin proteins in the blood serum of patients with bipolar disorder
Authors: Smirnova L. , Epimakhova E. , Seregin A. , Ryzhkova A. , Simutkin G.
Published: August 2024

Introduction

Insufficient knowledge about the pathophysiological processes in bipolar disorder (BD) leads to difficulties in differentiating this disorder from other affective disorders. Quantitative analysis of serum protein profiles in BD expands our understanding of the pathophysiology of the disease and may aid in subsequent diagnosis. As a result of a previously conducted comparative mass spectrometric study of serum proteins in patients with depression, bipolar disorder and healthy donors, increased expression of Heat Shock 70kDa Protein1A (HSPA1A) and transthyretin was identified.

Objectives

Determination of HSPA1A and transthyretin concentrations in the blood serum of patients with mental disorders.

Methods

Blood serum of 28 patients with bipolar disorder aged 49 years [33;52], 30 patients with recurrent depressive disorder aged 40 years [31; 51] and 130 patients with schizophrenia aged 38 years [31;49], as well as 20 mentally and somatically healthy individuals aged 35 years [31;40] was studied. The amount of Heat shock protein 1A (HSPA1A) and Transthyretin (thyroxine and retinol transport protein) was determined using a Enzyme-linked Immunosorbent Assay Kit from Homo sapiens (Cloud-Clone Corp). Statistical data processing was carried out in the Statistica 12.0 program.

Results

A statistically significant (p = 0.016) increase in the level of HSPA1A was found in patients with BD (0.84 [0.59; 1.09] ng/ml), compared with healthy individuals (0.61 [0.51; 0.77] ng/ml). HSPA1A plays a pivotal role in the protein quality control system, ensuring the correct folding of proteins. It is known that this protein is involved in the embryonic development of the central nervous system, as well as in neuroprotection by preventing the death of neurons due to its anti-apoptotic properties. A statistically significant (p = 0.047) increase in the level of transthyretin was found in patients with BD 21.8 рg/ml, compared with healthy individuals 19.4 pg/ml. Transthyretin plays an important role in ensuring the normal state of the central nervous system and is involved in cognitive processes.

Conclusions

Thus, the HSPA1A and transthyretin are probably involved in the pathogenesis of BD and can be proposed as be proposed as an additional paraclinical criterion for differential diagnosis.

Support by RSF №23-75-00023.

Disclosure of Interest

None Declared
Clinical features of suicidal behaviouг in youth with borderline personality disorder
Authors: Kaleda V. , Kuleshov A. , Krylova E.
Published: August 2024

Introduction

Borderline personality disorder (BPD) in youth has the greatest spectrum of psychopathology and is strictly associated with nonsuicidal self-injury (NSSI) and suicidal behaviour [Guile et al. Adolesc Health Med Ther 2018; 9 199-210; Paris Med. 2019; 55(6):223]. The formation of autoaggressive behaviour and suicidal activity is due to the psychopathological features of BPD, which include affective instability, impulsivity and impaired self-identity.

Objectives

The aim of the study was to investigate the psychopathological features of suicidal behaviour in BPD in youth.

Methods

Clinical and psychopathological examination with assessment of suicidal behaviour at the time of, 6 and 12 months later. For additional psychometric examination of patients we used: SCID-II questionnaires, Barratt Impulsiveness Scale (BIS-11), Toronto Alexithymic Scale (TAS), Columbia Suicide Severity Rating Scale (C-SSRS). Sample: N=62 male and female youth males and females in two equal groups of 31, respectively, with an established diagnosis of BPD and the presence of suicidal behaviour. The mean age of first referral in both groups was 19.1±2.2 years.

Results

This study defined 2 variants of suicidal behaviour in patients with BPD in youth: 1) Expansive - with predominance of impulsiveness (BIS-11 70±3), affective instability, associated with psychosocial factors as a trigger of suicidal activity. Suicidal attempts were made at the height of psychoemotional stress. These patients were characterised by moderately high scores of the C-SSRS scale 2±1, in which patients noted the absence of a plan and specific intentions before the attempt, and a lower incidence of repeated attempts after 6 ((N=6 (19.4%) and 12 months N=10 (32.2%). 2) Rationalistic variant of suicidal behaviour was found in patients with predominance of self-identification disorders, dissociative disorders and high level of alexithymia TAS 81±4.2 in the clinical picture. Suicidal ideation was revealed in all patients, often throughout the entire youth period, and attempts were characterised by thoughtfulness and led to severe consequences, including fatal outcome. Patients with rationalistic variant of suicidal activity had higher C-SSRS scale scores of 4±1, with the presence of suicidal intentions and high frequency of attempt recurrence after 6 (N=11 (35.5%) and 12 months (N=17 (54.8%)).

Conclusions

The variant of suicidal behaviour depended on the degree of severity and correlation of the psychopathological structure of BPD in youth. Less favourable prognosis was characteristic of the rationalistic variant due to the high frequency of repeated attempts. The results obtained require further analysis and contribute to the development of differentiated therapeutic strategies.

Disclosure of Interest

None Declared
Recovery in schizophrenia: the role of antipsychotic treatment
Authors: Bitter I.
Published: August 2024

Introduction

Comprehensive care programs, which include individually planned pharmacotherapy are associated with higher rates of recovery1 and better long-term prognosis2. However, there are barriers to individually optimised antipsychotic treatment both from both the patients and treatment teams perspectives.

Objectives

To summarize the potential contribution of adequate long-term antipsychotic treatment to recovery or better outcomes in schizophrenia.

Method

Review of research data.

Results A shorter duration of untreated psychosis, a lower number of relapses, and the absence of a chronic course of psychosis are associated with higher rates of recovery and a better prognosis. The OPUS early intervention program was associated with better outcomes for up to 10 years, but not for more than 20 years3. Second generation antipsychotics are associated with lower mortality rates, including suicides in young people with schizophrenia.4

Higher doses of antipsychotics are associated with poorer outcomes and with potential structural brain changes, while adequate (lower) doses of antipsychotics are associated with lower side effect burden and better overall outcomes5. A significant proportion of patient may benefit from polypharmacy (combination of 2 antipsychotics)6. Antipsychotic treatment discontinuation strategies are associated with the development of treatment resistance.7

Conclusions

Adequate (low dose) antipsychotic treatment is part of the complex early intervention programs and long term treatment of schizophrenia, which are associated with higher rates of recovery and good outcomes. The role of polypharmacy (combination of 2 antipsychotics) may need a reconsideration in the treatment guidelines of schizophrenia.

1.

Kane JM et al. The Journal of clinical psychiatry. 2015 Mar 25;76(3):16590.

2.

Posselt CM et al. 2021. American Journal of Psychiatry, 2021, 178(10):941-951

3.

Hansen HG et al. 2023. JAMA Psychiatry, 2023, 80(4): 371-379.

4.

Correll CU et al. World Psychiatry. 2022 Jun;21(2):248-71.

5.

Andreasen NC et al. 2013 Jun;170(6):609-15.

6.

Katona L et al. 2014 Jan 1;152(1):246-54.

7.

Emsley R et al2013 Feb 1;33(1):80-3.

Disclosure of Interest

None Declared
Women’s emotional dependence on men and its relationship to intimate partner violence
Authors: Tabib F. , Guermazi F. , Mnif D. , Cherif F. , Feki I. , Baati I. , Masmoudi J.
Published: August 2024

Introduction

A woman’s emotional dependence on a man refers to a marked need for care, protection, and support, even in situations where the woman is able to function autonomously. This dependence fosters a fusional bond that makes it difficult for the woman to leave the relationship, however unhealthy it may be. This puts the victim at greater risk of suffering and tolerating violence, in particular intimate partner violence (IPV).

Objectives

To study the emotional dependence of women who are victims of IPV, and to determine the factors associated with this dependence.

Methods

We conducted a descriptive and analytical cross-sectional observational study, carried out over a 10-month period from March 2021 to December 2021, among female victims of IPV consulting psychiatric emergencies at UHC Hedi Chaker, Sfax, Tunisia for medical expertise at the request of the court.

Emotional dependence was assessed using the Emotional Dependence Questionnaire (EDQ) which contains 20 items. Responses are given on a seven-point Likert-type scale which is recoded so that a high score reflects a high level of emotional dependence in relationships.

Results

The total number of participants was 120 with an average age of 37.27 years. The majority had secondary education or less (62.5%), were professionally active (53.3%), and were financially dependent on their partners (26.7%). As for the women’s clinical characteristics, 19.2% were under psychiatric care, 15% had attempted suicide and 10% had a history of childhood abuse. Tobacco was the only psychoactive substance consumed by 12.5% of the women. The average length of marriage was 12.34 years, exceeding 10 years in 44.2% of cases. Marital conflicts had existed since the very beginning of the relationship in 91.7% of cases.

The mean total score of the EDQ was 79.38, indicating a slight emotional dependence of these women on their spouses. It was correlated with childhood violence (p=0.028), smoking (p=0.049), early conflict (p<10-3), and personal psychiatric history (p=0.02).

Conclusions

A link, probably bidirectional, may occur between emotional dependence and IPV, particularly a link with maintaining the relationship in an IPV context. However, the slight emotional dependence of our victims may explain why they seek help from the police and report the violence.

Disclosure of Interest

None Declared
Similar cognitive characteristics between gaming disorder and other psychiatric disorders
Authors: Tei S. , Fujino J.
Published: August 2024

Introduction

Cognitive characteristics that differentiate normal from problematic gaming need to be identified, owing to the growing popularity of internet games and the rapid rise in mental health problems. Gaming disorder (GD) involves playing games despite their negative effects and is often related to unsuccessful attempts to reduce gaming. GD frequently results in adverse outcomes related to education, employment, and social responsibilities, thereby significantly influencing daily life.

Objectives

We aimed to elucidate the neurocognitive features underlying GD development and preservation, and possible overlapping features between GD and other psychiatric disorders.

Methods

We performed a literature search to identify GD-related studies. We focused on two key aspects: (a) altered executive functions (EFs) and (b) gaming urge. We mainly searched the PubMed and Web of Science databases using relevant keywords. All retrieved literature were assessed for eligibility to reduce selection biases.

Results

Our preliminary review identified that GD features prominent deficits in EFs, including cognitive inflexibility, poor response inhibition, altered decision-making, and intensified susceptibility to game-related stimuli. These deficits were found to be associated with abnormal neural activity in brain regions subserving EFs and reward-based learning. Hence, excessive gaming may maladaptively suppress controlled and conscious processing, which can amplify automatic and implicit processes to develop gaming urges. In addition, many of these neuropsychological deficits have been observed in other addictions and seemingly unrelated disorders such as autism spectrum disorder (ASD). Similar EF deficits have been identified in ASD, which involve reduced cognitive flexibility and related dysfunction, including excessive attention focus, restricted interest, maladaptive reward processing, and reduced self-control. However, there is considerable variation among individuals and study methods, which requires more comprehensive research strategies.

Conclusions

We elucidated comparable cognitive features among individuals with GD, addiction disorders, and ASD. These similarities provide clues regarding GD etiology, ideas for improving preventative therapies, and markers for risk evaluation. Additional investigations on how GD and other disorders possess similar and distinctive cognitive functions are worth pursuing. It is also crucial to further examine the extent of shared cognitive features in the general population, wherein the peripheral pathological characteristics lie on a continuum with typical and atypical populations.

Disclosure of Interest

None Declared