bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of the Correlation between Gaze Avoidance and Schizophrenia Psychopathology with Deep Learning-based Emotional Recognition
Authors: Choi H.S. , Jung D.-U. , Jeon D.-W. , Kim S.-J. , Moon J.-J.
Published: September 2022

Introduction

Direct gaze is the most important mediator of social interaction and communication. Existing studies have evaluated eye movements of patients with schizophrenia by presenting stimuli using photographs or pre-recorded videos, but few directly investigated gaze avoidance in real-world situations.

Objectives

To investigate the correlation between gaze avoidance and psychopathology in patients with schizophrenia through eye movement measurements in real-life interpersonal situations.

Methods

We enrolled 52 clinically stable patients with schizophrenia. Psychopathology was evaluated using the Positive and Negative Syndrome Scale (PANSS), Hamilton Depression Rating Scale, and Hamilton Anxiety Rating Scale. After presenting a visual stimulus, eye movements were measured with Tobii Pro Wearable Glasses 2, and deep learning-based emotional recognition using the residual masking network was used for neutral stimulus verification. Statistical analyses were performed using Pearson’s correlation and regression analyses.

Results

Data of 45 participants with verified stimulus neutrality by deep learning image recognition were used for analysis. The first dwelling time was negatively correlated with the PANSS positive syndrome subscale (p=0.028), general psychopathology subscale (p=0.008), total score (p=0.008), 5-factor positive symptoms (p=0.035), and 5-factor depression/anxiety symptoms (p=0.008). The baseline-area of interest (AOI) pupil diameter change was positively correlated with PANSS 5-factor positive symptom scores (p=0.039). After adjusting for additional variables, the same items had a significant effect on the first dwelling time and baseline-AOI pupil diameter change.

Conclusions

Psychopathology, particularly positive symptoms, was associated with gaze avoidance and pupil diameter in patients with schizophrenia. Evaluating the characteristics of eye movements in patients with schizophrenia will enable better understanding of their symptoms.

Disclosure

No significant relationships.
Dissemination of sport-based psychosocial interventions in Europe: results from the EASMH project
Authors: Sampogna G. , Borgi M. , Cirulli F. , Collacchi B. , Cerino S. , Di Tommaso V. , Moliterni S. , Bichi A. , Barat C. , Pringle A. , Kivisto S. , Melenco I. , Oltean A. , Garside J. , Fiorillo A.
Published: September 2022

Introduction

Among psychosocial interventions, recent studies have highlighted that sport-based interventions can positively impact on the long-term outcomes of patients with severe mental disorders, in terms of improving their quality of life and promoting social inclusion. Although sport-based interventions should be considered an effective strategy for promoting patients’ recovery, few data are available on their dissemination in the clinical routine care in Europe.

Objectives

to evaluate the availability of sport-based psychosocial interventions in European countries.

Methods

In the framework of the EU-Erasmus+, the European Alliance for Sport and Mental Health (EASMH) project has been funded. In order to evaluate the availability of sport-based interventions, an ad-hoc online survey, sent to national mental health centres, has been developed.

Results

103 responses were obtained (49 from Italy, 31 from UK, 17 from Finland and 12 from Romania). The respondents were mainly psychiatrists working in community mental health centers. Sport-based interventions were frequently provided by mental health services, in particular in Italy, UK and Finland. While in UK and Finland sport-based interventions are commonly offered to all patients, in the other countries these are provided only by patient’s request. The most frequent types of sport practised were: running, football, volleyball, tennis and table tennis and basketball. Almost all respondents reported to not use a dedicated monitoring tool for evaluating the efficacy of those interventions.

Conclusions

Sport-based interventions are not frequently provided in the routine clinical settings, although no monitoring tools are routinely adopted. The EASMHaims to fill this gap by disseminating good clinical practice related to sport-based interventions.

Disclosure

No significant relationships.
Depression in men with testosterone deficiency (Preliminary results of the study)
Authors: Osadshiy Y. , Soldatkin V.
Published: September 2022

Introduction

Clinical practice in psychiatry is shifting toward personalized approach. In other words, clinicians aim to help patients based on their individual characteristics. It’s known that testosterone play a crucial role in the regulation of the emotions specially in men. The problems of hypogonadism and its possible role as an etiological factor in the development of depression in men are available in detail. But there is no solid date about the features of depression in men with testosteron defficency and theraputic approach including testosterone replacement therapy and antidepressants.

Objectives

Аssessment of efficiency of different pharmacological approaches in the treatment of depression in men with testosterone deficiency

Methods

The main group included 37 men with a depressive episode that arose against the background of a decrease in testosterone levels (≤12.1 nmol / L). A depressive episode was diagnosed based on the ICD-10 criteria for a depressive episode (F32). Patients were randomized into 3 treatment groups, depending on the received treatment: 1) sertraline; 2) testosterone gel; 3) sertraline + testosterone gel. The control group consisted of men (n = 40) aged 18 to 65 years, suffering from depression in accordance with the ICD-10 criteria with normal testosterone levels

Results

An insufficient effectiveness of antidepressant monotherapy in relation to sexual dysfunction was found in main group, while testosterone monotherapy did not give statistically significant improvements in depression indicators.

Conclusions

Combination therapy was most effective for the main symptoms and can be regarded as the most appropriate algorithm for the treatment of depression in men with low testosterone levels

Disclosure

No significant relationships.
Multiple barriers for accessing mental health service among women attending shelters for women experiencing intimate partner violence
Authors: Daoud N. , Ali Saleh-Darawshy N.
Published: September 2022

Introduction

While women victims of intimate partner violence (IPV) suffer the burden of mental health issues (MHI), they face many challenges accessing mental health services (MHS).

Objectives

We draw on the socioecological model and explore different level barriers for accessing MHS among women experiencing IPV.

Methods

We conducted a qualitative study in 2020-2021 at three levels: policy, practice and women’s experience. This included in-depth interviews with 19 policymakers from the Ministry of Health (MoH) and the Ministry of Social Welfare (MSW); four directors of shelters for women victims of IPV; 35 women (26 Arabs, 9 Jewish) attending shelters for women victims of IPV (age 22-50), and six focus groups with 26 social workers. Participants were asked about the barriers for utilizing MHS.

Results

We identified complex multifaced barriers regarding the accessibility and quality of MHS among women victims of IPV. At the policy level, we identified structural organizational barriers related to the division of responsibilities between the two offices (MoH and MSW). These included lack of collaboration, funding and information transmission and insufficient communication mechanisms. At the practice level, shelters’ directors and social workers raised barriers, most of which were related to divisions in knowledge, terminology, and treatment approaches among mental healthcare providers and social welfare therapists. The women themselves raised issues related to stigma, lack of family support and continuity of MHS.

Conclusions

To improve MHS access, it is crucial to overcome the multiple barriers (individual, family, therapeutic and organizational) that are faced by women who are experiencing IPV.

Disclosure

No significant relationships.
Successful clozapine rechallenge after neutropenia using lithium carbonate : a case report
Authors: Khattech D. , Ouali U. , Dridi N.E.H. , Aissa A. , Ouertani A. , Jomli R.
Published: September 2022

Introduction

Clozapine is widely known as the drug of choice in treating refractory schizophrenia. However, clozapine prescription requires close clinical and biological monitoring to prevent harmful side effects like agranulocytosis, neutropenia and myocarditis.

Objectives

To show the benefits of lithium carbonate in the clozapine rechallenge of a patient with neutropenia under clozapine.

Methods

We present the clinical case of a patient who developed neutropenia under clozapine, we rechallenged with clozapine after lithium treatment to stimulate hematopoietic functions.

Results

A 42-year-old man diagnosed with refractory schizophrenia, under clozapine for 11 years with a good clinical response at a dosage of 500mg per day (clozapine serum level 328ng/ml), developed a neutropenia (BCC at 840/mm3) within an interval of 2 months. Clozapine treatment was suspended and the patient presented a severe psychotic relapse requiring hospitalization. During hospitalization the patient remained symptomatic under haloperidol 15mg daily. At week 3 of clozapine cessation, neutrophil count reached 1510/mm3. After week 4 we introduced lithium carbonate and while reaching 500mg per day we observed an increase in the neutrophil count to 4850/mm3. We rechallenged with clozapine at week 12 after a poor clinical response, with incremental dosage to 150mg per day in 17 weeks. The blood cell count did not show any abnormalities and the patient had a good clinical response up to 11 months after the clozapine rechallenge.

Conclusions

Despite the lack of guidelines assessing clozapine rechallenge after neutropenia, the use of lithium carbonate may be considered to stimulate hematopoietic functions.

Disclosure

No significant relationships.
Neurocognitive Functioning of Adolescents with Clinical High Risk for Psychosis, other Psychiatric Symptoms, and Psychosis
Authors: Orlandi M. , Iorio M. , Rogantini C. , Vecchio A. , Coci C. , Casini E. , Borgatti R. , Mensi M.
Published: September 2022

Introduction

Clinical High Risk of Psychosis (CHR-P) condition and the clinical validity of at-risk criteria are still little studied in child and adolescent population.

Objectives

This study aimed to discover neurocognitive profiles of adolescents with CHR-P, compared with adolescents with psychosis and youth with other psychiatric symptoms that do not meet CHR-P criteria.

Methods

We divided 116 adolescents (12-18 years old) in three groups according to the semi-structured interview Comprehensive Assessment of At-Risk Mental States (CAARMS): psychosis, attenuated psychosis syndrome (APS), non-APS. Moreover, we administered Wechsler scales to assess the IQ, Wisconsin Card Sorting Test to assess abstract reasoning and flexibility, Rey-Osterrieth complex figure to assess planning and attention, and Trail Making Test to assess psychomotor speed, visual attention and task switching. We administered BVN 12-18 subtests to assess lexical denomination, verbal and nonverbal working memory, selective auditory, visual attention, phonemic and categorial fluency, reasoning and problem solving.

Results

Nineteen adolescents met criteria for psychosis, 47 for APS, and 50 did not meet criteria neither for psychosis nor for APS. APS group performed better than psychosis group and similar to non-APS group in processing speed, planning, visual attention, and categorial fluency. APS did not show a significant difference from the other groups in working memory and backward digit span, showing an intermediate profile; non-APS and psychosis groups still differed significantly in these functions.

Conclusions

Identifying typical neurocognitive profiles leads to more accurate diagnoses and early intervention that can lead to better patient outcomes.

Disclosure

The authors declare that they do not have a significant financial interest, consultancy or other relationship with products, manufacturer(s) of products or providers of services related to this abstrac.
Analysis of Oral versus Long-acting Injectable Antipsychotics in the Maintenance of Schizophrenia
Authors: Vasiliu O.
Published: September 2022

Introduction

A debate regarding the comparative efficacy and tolerability of oral and long-acting injectable antipsychotics (LAIs) in patients diagnosed with schizophrenia is still open in the mind of clinicians. While the adherence is intuitively improved by the LAIs, the acceptance of this treatment is not always good.

Objectives

To conduct a literature review in order to find the data about the comparative efficacy of oral and LAI antipsychotics in schizophrenia, during the maintenance phase.

Methods

A literature review was performed through the main electronic databases (PubMed, CINAHL, SCOPUS, EMBASE) using the search paradigm “schizophrenia” AND “maintenance treatment” AND “oral antipsychotics” OR “long-acting injectable antipsychotics”. All papers published between January 2000 and August 2021 were included.

Results

Based on the reviewed clinical trials (n=37), LAI antipsychotics are associated with an efficacy and tolerability profile similar to or slightly superior to the oral formulation. This is confirmed for both typical and atypical antipsychotics that have been detected by this review. The main advantage of the LAIs is their superior therapeutic compliance and the possibility of early detection for non-adherent patients. However, not all data are unanimously supporting this perspective: while observational trials favor LAI antipsychotics, randomized trials included in the meta-analyses do not detect significant differences between the two types of formulations.

Conclusions

LAIs are associated with superior adherence, but their overall efficacy and tolerability are only slightly superior to those of the oral equivalents. Moreover, there are differences in the results related to the methodology of the trials, therefore data should be interpreted with care.

Disclosure

No significant relationships.
The efficacy of cariprazine in chronic schizophrenia – post hoc analyses of phase II/III clinical trials
Authors: Falkai P. , Dombi Z. , Acsai K. , Barabássy Á. , Németh G.
Published: September 2022

Introduction

Chronic schizophrenia patients are experiencing persistent and severe illness for more than 15-20 years and are usually suffering from long-term negative symptoms. Cariprazine, a novel D3-D2 partial agonist has been proven to be effective in the treatment of acute schizophrenia, however its ability to treat chronic patients has not been assessed yet.

Objectives

The primary aim of the present post-hoc analysis is to assess the efficacy of cariprazine in treating patients with chronic schizophrenia (late-stage and residual schizophrenia patients).

Methods

Data from 3 phase II/III 6-week, randomized, double-blind, placebo-controlled trials with similar design in patients with acute exacerbation of schizophrenia were pooled and patients with more than 15 years of schizophrenia were analysed (late-stage patients). Furthermore, schizophrenia patients experiencing predominantly negative symptoms from a 26-week, randomized, double-blind, active-controlled, fixed-flexible-dose trial with an ICD-10 code of F20.5 were analysed post-hoc (residual patients).

Results

Altogether, 414 late stage (286 cariprazine and 128 placebo) and 35 residual (23 cariprazine and 12 risperidone) patients were identified. The pooled analysis evaluating mean change from baseline to week 6 in the PANSS total score indicated statistically significant difference in favour of cariprazine in the late stage (LSMD -6.7, p<0.01) subpopulation compared to placebo. The mean change from baseline in patients with residual schizophrenia in the cariprazine arm was -9.6 on the PANSS-FSNS scale, while -7.9 in the risperidone arm.

Conclusions

Based on the results, it seems that cariprazine might be a good treatment option for patients with chronic schizophrenia. Nonetheless, further studies are needed to confirm this.

Disclosure

I am an employee of Gedeon Richter Plc.
Risk of suicide attempt and suicide in young adult refugees compared to their Swedish-born peers: a register-based cohort study
Authors: Geirsdottir G. , Mittendorfer-Rutz E. , Amin R.
Published: September 2022

Introduction

Refugees, especially minors, who often have experienced traumatic events, are a vulnerable group regarding poor mental health. Little is known, however, of their risk of suicidal behaviour as young adults.

Objectives

We aimed to investigate the risk of suicidal behaviour for young adult refugees who migrated as minors. The moderating role of education and history of mental disorders in this association was also investigated.

Methods

In this register linkage study, all 19-30-year-old Swedish-born (n = 1,149,855) and refugees (n = 51,098) residing in Sweden on December 31st, 2009 were included. The follow-up period covered 2010-2016. Cox models were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). The multivariate models were adjusted for socio-demographic, labour market marginalisation and health-related factors.

Results

Compared to Swedish-born, the risk of suicide attempt was lower for all refugees (HR 0.78, 95% CI 0.70-0.87), and accompanied refugee minors (HR 0.77, 95% CI 0.69-0.87), but estimates did not differ for unaccompanied refugee minors (HR 0.83, 95% CI 0.62-1.10). Low education and previous mental disorders increased the risk of suicide attempt in both refugees and Swedish-born, with lower excess risks in refugees. Findings for suicide were similar to those of suicide attempt.

Conclusions

Young adult refugees have a lower risk of suicidal behaviour than their Swedish-born peers, even if they have low educational level or have mental disorders. Young refugees who entered Sweden unaccompanied do not seem to be equally protected and need specific attention.

Disclosure

No significant relationships.
Long-term suicide risk of children and adolescents with attention deficit and hyperactivity disorder – a systematic review
Authors: Garas P. , Balazs J.
Published: September 2022

Introduction

Several studies showed the high suicide risk of patients with attention deficit and hyperactivity disorder (ADHD), however most of these studies had cross-sectional design.

Objectives

The aim of the current study was to review systematically those studies which investigated the suicide risk among ADHD patients with longitudinal design.

Methods

The systematic search was made on OVID Medline, PsychInfo, PubMed, Scopus, and Web of Science. The search terms were (ADHD OR attention deficit hyperactivity disorder) AND (suicide OR suicidal OR suicidality) AND (follow-up OR longitudinal study OR prospective study). Inclusion criteria were: written in English; participants under 18 years at the baseline; longitudinal, prospective studies; ADHD population at the baseline and at the follow-up; suicide behavior as primary outcome. Exclusion criteria were: the study did not contain empirical data, and reviews/meta-analyses and studies which aimed to investigate the drug treatment efficacy of ADHD.

Results

18 papers were included in the systematic review. 10 articles were published in the last 5 years. 9 studies enrolled children aged under 12 at baseline. The follow-up periods varied between 2 and 17 years. 17 studies found a significant positive association between ADHD diagnosis at baseline and the future suicidal behavior and/or attempts at the follow-up. The affective comorbidity showed an association with the future suicide risk.

Conclusions

These results highlight the importance of screening suicidality in patient with ADHD and consider it during treatment. Further studies are needed to clarify the role of the treatment and comorbidities of ADHD in the increased suicide risk.

Disclosure

No significant relationships.
Fears, Fun and Voices – an update on VR Treatments for Psychosis
Authors: Veling W.
Published: September 2022

Background: Virtual Reality (VR) is increasingly used for treatment of psychiatric disorders. With immersive VR, people can be gradually exposed to situations they fear, they can practice new behaviour in a safe and controlled way. The threshold for engaging in therapy is lower in VR than in real life. VR applications for psychosis have been introduced fifteen years ago, and are rapidly expanding. Methods: In our VR mental health lab, several VR therapies for psychotic disorders have been developed and investigated. Results of recent randomized controlled trials (RCT) will be presented, and ongoing and future projects will be discussed, including VR cognitive behavioral therapy (VRcbt) for paranoid delusions, social cognition training, stress management and avatar therapy for auditory hallucinations Results: The RCT of VRcbt for paranoid delusions (N=116) had strong and statistically significant effects on paranoid ideations, anxiety and safety behavior. Facial emotion recognition was improved by VR social cognition training (RCT N=81), but other domains of social cognition proved more difficult to improve. A VR relaxation tool (RCT N=50) had strong immediate effects on perceived stress and emotional states. Ongoing VR intervention studies are a modular VR intervention aimed at improving social functioning (VR SOAP) and an empowering intervention for patients with auditory hallucinations (VR VOICES). Discussion: VR is a powerful tool for treatment of psychotic disorders, offering interventions for multiple symptom domains and functioning. Next generation VR studies hold the promise to expand and substantially improve psychosocial treatment of psychotic disorders.

Disclosure

I am co-founder and have shares of VRelax, a company providing VR relaxation software.
Association of Psilocybin Use in Adolescents with Major Depressive Episode
Authors: Shah K. , Trivedi C. , Kamrai D. , Akbar M. , Tankersley W.
Published: September 2022

Introduction

Psilocybin is a psychedelic drug found in mushrooms, often referred to as magic mushrooms due to its visual and auditory hallucinations effects upon ingestion. It is a Schedule I drug per DEA, and the FDA has not approved psilocybin for medicinal purposes. However, recent studies have shown promising therapeutic use to treat depression.

Objectives

To identify current use, prevalence, and its association with depression in adolescents.

Methods

The National Survey on Drug Use and Health survey data from 2008-18 studied adolescent data (12-17 years), who responded, “ever used psilocybin (mushrooms)” and “lifetime major depressive episode (MDE).” The association between the psilocybin use and MDE status was analyzed in SAS 9.4 through multivariate logistic regression for odds ratio (OR) and 95% confidence interval (CI).

Results

A total of 172745 adolescents were included in this study, of which 2469 ever used psilocybin in their lifetime, and 170276 responded no lifetime use. The psilocybin ever lifetime users were 17 years old (42%vs.17%,p<0.001), male (60%vs.51%,p<0.001), and non-Hispanic White (71%vs.55%,p<0.001) in comparison to non-users. Among psilocybin user group, 31% of respondents had lifetime MDE, compared to 16% of the lifetime psilocybin non-user group participants (p<0.001). The odds of association of psilocybin use among participants with MDE were 2.17 times compared to those without MDE (CI: 1.93-2.44,p<0.001).

Conclusions

We identified a significant association between psilocybin use and MDE among adolescents, which raises public health concerns about its illegal use, abuse, and toxicity potential. Future clinical studies should assess its clinical safety, efficacy, and addictive properties.

Disclosure

No significant relationships.
Case series: Psychosocial challenges of female youth within the Irish travelling community
Authors: O’ Neill E. , Abdul-Razak N. , Anastasova Z. , O’ Callaghan C.
Published: September 2022

Introduction

The Irish traveller community are an ethnic minority group known for their distinct identity. Although this group has its roots in Ireland, they are marginalised and discriminated against by every part of Irish society. Adolescent females encounter particular difficulties within the expectations of this community. They encounter specific issues including mental illness, sexual stigma and limitations to the role of women.

Objectives

Explore the vulnerabilities of young women within the irish travelling community.

Methods

Literature review and case series using three cases.

Results

Patient A is a nineteen-year-old girl known with a history of overdose and depression. Significant triggers for her mental illness are linked to familial disharmony and sexual assault. Patient B is seventeen years old and was referred for CAMHS inpatient admission following overdose. She has a background of sexual assault and drug misuse. Patient C is fifteen years old and was admitted to a CAMHS unit following a hanging attempt. Her suicide attempt was triggered by chronic bullying, grief and sexual assault.

Conclusions

Young women in the travelling community are estimated to be twice as likely to suffer mental health issues as compared to men. They are primed to follow a culture where the main events in life are centred around training for marriage and child rearing. In this world of ethical practice and focus on women’s rights, females in such communities can feel conflicted between their identity, heritage and their position in the world. Adolescents within the travelling community should be monitored with consciousness given to their particular risk factors.

Disclosure

No significant relationships.
Unplanned Pregnancy in women with mental disorder
Authors: Roca Lecumberri A. , Gelabert E. , Torres Giménez A. , Solé E. , Andrés-Perpiñá S. , Roda E. , Lopez C. , Naranjo C. , Garcia-Esteve L.
Published: September 2022

Introduction

Few studies have investigated the level of planning of pregnancy among women with mental disorder and associated risk factors.

Objectives

The purpose of this study was to determine the associated factors to UP and psychopathological consequences.

Methods

A cross sectional study was conducted at the Perinatal Mental Health Unit of the Hospital Clínic in Barcelona. The total sample comprised 675 consecutive pregnant women with diagnosis of mental disorder (DSM-IV criteria), seen between January 2006 and December 2018. Clinical, psychometric and socio-demographic variables were collected at the first visit. Pregnancy planning was assessed by a question “Was this pregnancy planned?” with three possible answers: 1) Yes, it was planned and has been well received; 2) No, it was not planned but it has been well received; and 3) No, it was an accident. Response 1 was coded as “planned pregnancy” and responses 2 and 3 as “Unplanned Pregnancy”.

Results

38.4% of the sample had an UP. Younger age, lower levels of education, Latin-American population, multiparity, financials problems and poor relationship with the partner were associated with UP in women with mental disorder. The mean EPDS and STAI scores and the presence of self-harming thoughts were significantly higher in women with UP.

Conclusions

UP was associated with more depressive and anxious symptoms and more self-harming thoughts. It is necessary to promote reproductive health care for women with mental disorders and to take into account their reproductive life plan, especially in those with risk factors described.

Disclosure

No significant relationships.
Non-pharmacological treatment of psychiatric disorders in a nationwide population
Authors: Elkrog S. , Ernst M. , Rasmussen L. , Wesselhoeft R.
Published: September 2022

Introduction

Non-pharmacological treatment like psychotherapy is associated with less side effects than pharmacological treatment and is often considered first-line treatment towards psychiatric disorders. The extent and variation of psychotherapy treatment offered in Danish psychiatric clinics over time has not previously been studied.

Objectives

To examine the nationwide use of psychotherapy treatment during 2001-2020 in individuals assigned with a psychiatric disorder diagnosis at Danish psychiatric clinics.

Methods

All Danish individuals aged ≥ 3 years, who were registered with 1) a psychiatric disorder diagnosis (F10-F99) or 2) had a first psychotherapy treatment during the study period 1 January 2001 to 31 December 2020, were identified in the Danish National Patient Registry.

Results

A total of 120,916 (27 %) study participants received psychotherapy treatment during the study period, most commonly individual psychotherapy (65 %) followed by group therapy (25 %). Adults (≥18 years) were more likely to receive therapy (34 %) than children and adolescents aged 3-17 years (15 %). The proportion of treated patients was highest among women (67 %) compared with men (33 %). The median age at first psychotherapy was 25 years (ranging from 19 to 33). 59 % of patients receiving psychotherapy had filled a psychotropic prescription within one year prior to therapy onset, particularly antidepressants (44 %) and antipsychotics (22 %).

Conclusions

The use of psychotherapy for treatment of psychiatric disorders is limited among Danish patients, although national clinical guidelines recommend it as first-line treatment of common conditions such as depressive, anxiety and obsessive-compulsive disorders.

Disclosure

No significant relationships.
Streptococcal infections, autoimmunity, and innate immune system in adult ADHD: A preliminary study
Authors: Di Girolamo G. , Peracchia S. , Boero M. , Bracco I.F. , Oliva F.
Published: September 2022

Introduction

High rate of streptococcus-like infections and related titers has been found in adult ADHD patients. No studies have expressively investigated innate immune system in ADHD patients.

Objectives

To evaluate the relationship between streptococcal infections, autoimmunity and innate immune system in adult ADHD patients.

Methods

The study sample consisted of adult DSM-5 ADHD outpatients referring to the adult ADHD center of “San Luigi Gonzaga” University Hospital and non-clinical adult controls recruited among general population (screened using Adult ADHD Self-Report Scale - ASRS-v.1). All titers were determined in patients’ plasma by specific microwell ELISA kits, whereas genetic polymorphisms were determined by PCR methodology. We compared anti-streptolysin O (ASO), anti-deoxyribonuclease B (anti-DNase B), and anti-basal ganglia antibodies (ABGA) titers of patients with those of controls. Data about history of previous streptococcus/ streptococcus-like infections were collected by ad-hoc form. Furthermore, to investigate the susceptibility to Gram+-borne infections of adult ADHD patients, due to innate immune system impairment, we also evaluated the polymorphism of Toll-like receptors 2, 4, and 9.

Results

Although ADHD patients did not show higher rate of both previous infections (52.7% vs. 66.7%, p=.678) and ASO titers (18.2% vs. 0.0%, p=.577), they had really higher levels of anti-DNase B (85.5% vs. 16.7%, p=.001) and ABGA titers (78.2% vs. 33.3%, p=.036). Genetic analysis did not underline differences in polymorphism compared to general population (GENOME browser).

Conclusions

The high association between previous streptococcal infections, basal ganglia autoimmunity among ADHD patients was confirmed. TLR polymorphism does not seem to be involved in this type of vulnerability.

Disclosure

No significant relationships.
Attitude towards death in family members of adolescents who applied to the crisis care room of a child psychiatric clinic due to suicidal thoughts
Authors: Bebchuk M. , Dovbysh D. , Timoshenko S. , Talmach M. , Zhorina Y. , Diachenko A. , Rabadanova R.
Published: September 2022

Introduction

The study of ideas about death and the mechanisms of their formation in adolescents with suicidal behavior is an important task for both diagnosis and psychotherapy. The parents’ notions of death, and the prohibition on discussing the topic of death in the family, can significantly distort the adolescent’s relationship with death.

Objectives

Investigate differences in attitudes towards death in parents and adolescents who apply to the crisis care room of a child psychiatric clinic.

Methods

The study involved 90 adolescents with their parents who applied to the crisis outpatient care system. The following questionnaires were offered: Death Attitude Profile-Revised, Death Anxiety Scale, Experiences in Close Relationships-Revised, Multidimensional Scale of Perceived Social Support, GAD-7.

Results

Significant differences were found for most of the scales in the samples of adults and adolescents, of particular interest to us were the scales “death avoidance” (W=317,500,z=3,089,p=0,002) and “perception of family support» (W=288,500,z=3,393,p=0,001). For the group of adolescents, there are higher indicators on the scales of anxiety (W=61,000,z=-2,546,p=0,011), anxiety in close relationships (W=83,000,z=-2,549,p=0,011), avoidance of close relationships (W=28,000,z=-3,870,p=0,000), and death as a means of escape (W=54,500,z=-3,076,p=0,002).

Conclusions

In families of adolescents with suicidal behavior, the severity of dysfunctional patterns of building close relationships and the presence of sharply opposite positions in relation to death in children and parents are observed without the possibility of discussing this topic.

Disclosure

No significant relationships.
The psychological impact of the COVID-19 pandemic on secondary school teachers in Sfax, Tunisia : anxiety disorders
Authors: Regaieg N. , Zouari L. , Mejdoub Y. , Omri S. , Gassara I. , Feki R. , Smaoui N. , Maalej M. , Ben Thabet J. , Charfi N. , Maalej M.
Published: September 2022

Introduction

During the COVID-19 pandemic time, teachers have to adapt to many changes that could potentially make them more vulnerable to psychological distress.

Objectives

To determine the prevalence and the factors for anxiety during the COVID-19 epidemic among the high school teachers in Sfax, Tunisia.

Methods

This was a cross-sectional study, for descriptive and analytical purposes, conducted on google drive in May 2021.We involved 97 junior and secondary school teachers from Sfax, Tunisia, practicing in public high schools. Anxiety was assessed by using Generalized Anxiety Disorder tool (GAD-7).

Results

The average age of the participants was 44.23 years old with a sex-ratio (M/F) of 0.32. Since the advent of COVID-19, 54.2% had presented sleep disturbances while 10.4% had suicidal thoughts. Among all participants, 77.8% were afraid of the virus transmission within the classroom or the school and 81.3% reported regular mask wear at work. The median score on the GAD-7 was 6.5 (Q1=3, Q3=11). Scores’ distribution indicated that 68% of the participants had no to mild symptoms of anxiety while 32% had moderate to severe anxiety. Furthermore, the presence of anxiety was associated to the female gender (p=0.01), sleep disturbances (p<0.001), suicidal thoughts (p=0.006), and to the conviction that wearing masks blocks the transmission of voice, information or emotions between teacher and student (p=0.025).

Conclusions

During the COVID-19 outbreak, high school teachers in Sfax, Tunisia have high levels of anxiety.This can lead to a decreased effectiveness of their complex work.

Disclosure

No significant relationships.
The impact of Covid-19 on the well-being of young people with conduct disorder and their families
Authors: Bull M. , Livanou M. , Ball R.
Published: September 2022

Introduction

The Covid-19 pandemic has significantly changed family dynamics and parents experience greater psychological distress. Conduct problems in young people have increased by 35%. However, it is not known how Covid-19 associated stresses have affected parenting practice, conduct problems, and comorbidities and what additional support is needed for families at risk.

Objectives

This study uses self-report measures and semi-structured interviews to examine and explore the impact of Covid-19 on the families of young people with conduct problems and comorbid mental health conditions.

Methods

This is a sequential mixed-methods study. Eligible families with children aged between 11-18 years have participated. One-hundred-and-eighty-two families have completed eight online questionnaires and 12 have participated in semi-structured follow-up interviews.

Results

Analyses indicate that parental harshness, warmth, educational background, and employment have a significant impact on Covid-19 exposure and worries, as well as significantly higher scores of conduct disorder symptoms. Interview codes reveal that young peoples’ behaviour became more severe during the pandemic, and this was associated with reduced in-person support services, reduced personal space at home, and parents taking on the additional role of educator.

Conclusions

The findings suggest that Covid-19 is a significant risk factor to young people with conduct problems and their families. For example, reduced parental warmth and increased parental harshness increased conduct problems for young people during the lockdown. This study highlights that policies and services should work to better support such families. Future online psychosocial interventions are needed to empower families and improve parenting practice at home during the lockdown period and in general.

Disclosure

No significant relationships.
Mental disorders due to Covid-19 in the Turkish population
Authors: Mykhaylov B. , Kudinova O. , Kavak E.
Published: September 2022

Introduction

The COVID-19 pandemic grabs attention to the study and solution of this global problem around the world.

Objectives

The aim of the study is to link the level of anxiety and fear that emerged in Turkey during the epidemic.

Methods

A survey was conducted, which contains 10 questions. 433 people took part, 5-
15 - 18 (1.2%), 168 - 19 - 29 years (38.8%), 202 - 30 - 39 (46.7%), 47 - 40-49 (10, 9%) 11 from 50 years (2.5%).

Results

Men with panic attack criteria - 11.3% (11 people), women - 9.8% (35 people). Symptoms of GTR were found in 31% (25) men and 18% (66) women. 328 participants - university graduates: 29% believe that the information of the Ministry of Health is correct. No significant difference between the percentages of compliance with the criteria for diagnosing panic attacks and anxiety was found depending on educational status. 8.3% of participants, 36 people, were diagnosed with Covid. The share of those who did not have a code, but thought they had, is 42%, and among those who had a code (before the disease) - 72%. There is a direct relationship between the level of education and personal protection against epidemics.

Conclusions

From a community mental health perspective, it is important that all covid-positive patients receive psychiatric support, whether or not they meet the DSM-V and ISD 10 diagnostic criteria.

Disclosure

No significant relationships.
Parallel latent trajectories of mental health and employment earnings among 16- to 20-year-olds entering the US labor force: A 20-year longitudinal study
Authors: Dobson K. , Vigod S. , Mustard C. , Smith P.
Published: September 2022

Introduction

Depression and anxiety-related mental health and employment earnings are complexly intertwined but have rarely been studied as parallel processes.

Objectives

Determine the number of latent parallel trajectories of mental health and employment earnings over two decades among a cohort of American youth entering the labor force, and estimate the association between baseline sociodemographic/health factors and latent trajectory class membership.

Methods

This study included 8,173 participants from the American National Longitudinal Survey of Youth 1997, who were 13–17 years old in 1997. The survey occurred annually until 2011 then biennially until 2017. Mental health was measured eight times using the Mental Health Inventory-5 between 2000–2017. Employment earnings were measured annually between 1998–2017, where participants were 33–37 years old. Latent parallel trajectories were estimated using latent growth modeling. The association between baseline predictors and trajectory membership was explored using multinomial logistic regression.

Results

Four latent trajectory classes were identified: good mental health, high earnings (3% of sample, average 2017 earnings ˜$196,000 USD); good mental health, medium earnings (23%, average 2017 earnings ˜$78,100); good mental health, low earnings (50%, average 2017 earnings ˜$39,500); and poor mental, low earnings (24%, average 2017 earnings ˜$32,000). Multinomial models revealed participants who were younger, female, Black, Hispanic, who had lower socioeconomic status, and had used marijuana at baseline had higher odds of belonging to the poor mental health, low earnings class.

Conclusions

Findings highlight the stagnated, parallel course of poor mental health and earnings, and the influence of gender, race, adolescent socioeconomic status, and health behaviors on these trajectories.

Disclosure

No significant relationships.
The role of academic factors on the development of mental illness stigma
Authors: Brahmi L. , Amemou B. , Adouni A. , Mhalla A. , Gaha L.
Published: September 2022

Introduction

Stigma and discrimination can disrupt the lives of individuals with a mental illness, preventing their opportunities to become productive citizens. These Individuals must also face either an avoidant attitude by healthcare professionals or prejudices about their adherence to medications and the psychological nature of their physical symptoms.

Objectives

Assess stigma in terms of explicit and implicit attitudes among medical school students and junior doctors. Evaluate academic factors and interfering with these attitudes.

Methods

A cross-sectional study was conducted among students from medical schools in Tunisia.

All participants were invited to complete a brief anonymous electronic survey administered on the google forms online platform.

Data were collected using self-administered questionnaires, Stigma Measurement, Mental Illness: Clinicians’ Attitudes (MICA).

Results

The sample consisted of 1028 respondents. The respondents’ mean age was 24.54 years (SD=3.7). Post-clinical students scored higher than pre-clinical students in questions 2, 6, and 12 on the rating scale. A positive significant relationship was identified with specialization in psychiatry. Residents who were specialized in family medicine, emergency, and intensive care had a higher stigma level compared to other residents (Mean score>0.51). The completion of a psychiatry clerkship did not significantly reduce the level of stigma toward people with a mental illness ( p=0.8).

Conclusions

A combination of medical school experiences of psychiatry’s theoretical learning and clerkship are important factors that shape students. Awareness of this will enable educators to develop locally relevant anti-stigma teaching resources throughout the psychiatry curriculum to improve students’ attitudes towards psychiatry as a discipline and mental illness in general.

Disclosure

No significant relationships.
Clozapine induced oesophagitis: A case report
Authors: Herch N. , Lansari R. , Larnaout A. , Achref D. , Melki W.
Published: September 2022

Introduction

There are several case reports describing clozapine side effects such as agranulocytosis, constipation,tachycardia but rarely cases describing oesophagitis caused by clozapine were reported.

Objectives

To report the first case in our country about clozapine induced oesophagitis.

Methods

We describe a case in which a patient who has no gastrointestinal past history,has developed an oesophagitis stage 2 of Savary and Miller Classification without any gastroesophageal reflux disease, few weeks after introducing clozapine at therapeutic dose.

Results

A 25 years old male patient with resistant schizophrenia managed with clozapine,was admitted to reinitiate his treatment after weeks of stopping his medication.During hospitalization, our patient developed a sudden haematemesis in 10 days after commencement of clozapine. The patient had no history of gastrointestinal symptoms or disease. The clinical examination and blood tests did not find any signs of bleeding severity.A gastroscopy was performed, revealing esophagitis stage 2 of Savary and Miller classification and a cardiac polyp removed with biopsy forceps that showed no malignant lesions .The patient was treated with acid suppressant therapy.There was no further episode of haematemesis and our patient healed uneventfully within a week.As for clozapine, it wasn’t interrupted and we continued increasing doses very carefully with no further incident.

Conclusions

Although it is a rare side effect, oesophagitis may appear at therapeutic doses of clozapine, and this possibility should be taken into account when treating patients with resistant psychiatric disorders.

Disclosure

No significant relationships.
Psychotropic drugs cross-reactivity with amphetamines in a FAERS sample: an international pharmacovigilance study
Authors: Giacovelli L. , Battini V. , Boscacci M. , Carnovale C. , Dell’Osso B.
Published: September 2022

Introduction

Urine Drug Screening (USD) is one of the most used techniques for drug testing. However, one of the main issues related to USD is the high frequency of cross-reactivity with other molecules. Amphetamines, because of their simple structures, are highly subjected to cross-reactivity with other molecules.

Objectives

Our aim was to investigate and characterize the role of psychopharmacological drugs in the occurrence of false-positive amphetamine drug screening, by performing an international pharmacovigilance study through the Food and Drug Administration Adverse Event Reporting System (FAERS), in which user’s medication errors for drugs are reported in the form of Individual Case Safety Reports (ICSRs).

Methods

All ICSRs recorded between 2010 and 2020 with a positive screening for amphetamine reported as adverse reaction in patients with a psychiatric diagnosis were included in the study. Duplicated records and ICSRs with missing values for age and gender, were excluded from the study.

Results

Among 249 ICSRs involving false-positive amphetamine drug screening, 109 ICSRs reported psychiatric disorders and/or psychiatric drugs. In 83 (76%) cases, drugs were known for cross-react. 66 cases reported drugs known as “suspect”. 24% of cases reported unknown false-positive reactions: acetaminophen (5%), duloxetine (5%) and oxycodone (5%).

Conclusions

The high cross-reactivity of psychotropic drugs with amphetamine testing in USDs may be linked to the neuromodulatory effect of these drugs, suggesting a similar molecular structure. In this perspective, antidepressants and amphetamines share a similar mechanism of action, maybe partially explaining why the most reported cross-reactions are with antidepressant (59%).

Disclosure

No significant relationships.