bluuebunny/crossref_metadata_2025 huggingface dataset:
Cannabis use in different mental disorders: a descriptive study in a psychiatric hospital
Authors: Samso B. , López Fariña A. , González Navarro C. , Morado San Segundo L. , Bilbao Idarraga A. , López Puentes U. , Lopez Brokate R. F. , Ruiz de Azua Aspizua T. , Ortega Pozas U. , Arán Cisneros C. , Garnica de Cos E. , Alonso Salas I.
Published: August 2023

Introduction

In the last decade, the prevalence of THC use is increasing among adolescents and adults. There is also strong evidence to suggest that cannabis use is associated with psychiatric comorbidities. The strongest evidence is found between cannabis use and psychotic disorder. However, the literature shows that those who have used cannabis in the past or for a large part of their lives are at higher risk of mood disorders, anxiety, personality disorder or other drug use than those who do not use cannabis in a harmful way.

Objectives

To provide an overview of the association between cannabis use and the different mental pathologies presented by the patients admitted during the study period. To describe the prevalence of THC use in the study according to the mental pathology presented by the patient.

Methods

A retrospective observational descriptive study was developed for 3 months, of all patients admitted to the acute unit of the psychiatric hospital. No exclusion criteria were included.

Results

During the period of study 172 patients were admitted to the hospital, classified according to the main diagnosis we have: 49 patients suffer from schizophrenia, 26 bipolar affective disorder, 20 with depressive disorder, 20 with personality disorder, 19 with substance use disorder, 18 with other unspecified disorders and 20 patients with no known previous diagnosis. The prevalence of THC use in the study sample according to diagnosis, would be schizophrenia 16%, Bipolar affective disorder 19%, Depressive disorder 5%, Personality disorder 45%, Substance use disorder 21%, Unspecified disorders 11% and patients with no known previous diagnosis 10%.

Conclusions

The results obtained in the study in terms of THC use are in agreement with those obtained in the literature. In our study, we observed that cannabis use is associated with psychotic disorders as well as with mood, personality and substance abuse disorders. Given that the frequency of use has increased and there is a strong association with different comorbid psychiatric diagnoses, guidance on modifications in medication strategies might be necessary.

Disclosure of Interest

None Declared
The impact of the COVID-19 pandemic on children and adolescent mental health inpatient service use in England: An interrupted time-series analysis of national patient records
Authors: Tsiachristas A. , Holland J. , Guo B. , Sayal K. , Pari A.
Published: August 2023

Introduction

During the COVID 19 pandemic children and young people (CYP) faced significant restrictions. The virus and restrictions also affected how health services could function, including mental health. Research analysing the COVID 19 pandemic is important to ensure dynamic and resilient service design in case of future national emergencies.

Objectives

To investigate the impact of COVID-19 lockdowns on CYP psychiatric admission trends during lockdowns 1 (started 26 March 2020) and 2 (started 20 November 2020) of the COVID 19 pandemic in England.

Methods

Routinely collected, retrospective, English, administrative data looking at the CYP hospital admissions, length of stay and patient demographics were analysed using an interrupted time series analysis to compare pre-pandemic service use with service use during COVID 19 lockdowns 1 and 2. The analysis used an ordinary least squares (OLS) approach with Newey–West standard errors to handle autocorrelation and heteroscedasticity.

Results

Table 1.

Patient characteristics in the entire sample (n=6,250)

VariablePre-pandemicPost-pandemicTotal sample(n=1,156)(n=94)(n=6,250)Mean age at admission (SD) [Median; IQR]15.3 (1.7) [16;3]15.6 (1.6) [16;2]15.3 (1.7) [16;3]GenderFemale70%72%70%Missing1%2%1%BAME backgroundYes18%18%18%Missing7%6%7%Looked afterYes11%8%11%Missing14%13%14%In full educationYes43%34%43%Missing35%47%35%Mean number of admissions per patient (SD) [Median; IQR]1.7 (1.2) [1;1]1.2 (0.6) [1;0]1.7 (1.2) [1;1]Mean length of stay (SD) [Median; IQR] n93 (94) [68;94] 6,06565 (65) [43;77] 7193 (94) [67;94] 6,136Mean number of out-of-area admissions per patient (SD) [Median; IQR]0.48 (0.8) [0;1]0.33 (0.6) [0;1]0.48 (0.80) [0;1]

SD: standard deviation; IQR: Interquartile range

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Conclusions

During lockdown 1 and 2, psychiatric admissions for CYP were fewer and shorter. The rise in admissions for more deprived CYP and looked after children suggests these CYP may have been disproportionately affected by the pandemic.

Disclosure of Interest

None Declared
A psychiatric mobile clinic in rural Ghana as a model to deliver professional services to a huge catchment area, review of 12 years experience
Authors: Shwarzman O. , Budde-Schwartzman B.
Published: August 2023

Introduction

The population in remote areas in Ghana as in other low- and middle- income countries (LMIC’s) are known to suffer from limited access to quality mental health services. The challenges include limited inpatient and outpatient mental health services at the regional and district levels, shortage of well-trained professionals, poor funding by the government and difficulties for the patients to pay for medical costs, poor telecommunication services and the lack of adequate infrastructure.

Objectives

We present a novel model of professional psychiatric mobile clinic, Gye Nyame Mobile Clinics, in remote areas in Ghana. This comprehensive service package connects the current loose ends of existing structural efforts in the subdistricts, trains regularly district hospital teams and bridges the gap between district hospital, primary health posts down to every patient.

Methods

In this retrospective descriptive study we collected demographic data of all the patients who visited the Gye Nyame professional mobile clinic in Psychiatry (GNMC) from November 1, 2008 to October 31, 2019 in the ten health posts of Ghana’s Ashanti Region

Results

Between November 2008 and October 2019, we counted 16.370 visits of patients with psychiatric/ neurological diagnosis. The patients suffered mostly from schizophrenia in 24,1%, general convulsions in 40,8 % and other psychotic disorders in 5,9% of the visits. 78,5% returned to our mobile clinic for follow-up, 100% could be treated on outreach.

Conclusions

This community-based approach delivers psychiatric services to subdistrict and district levels and to patients who have no other access to these professional services. According to the results, a wide spectrum of pathologies and quantity of patients are seen – especially patients with no former treatment- the most common diagnosis in the rural area are schizophrenia, other psychotic disorders and generalized convulsions, followed by intellectual disabilities/autism spectrum disorder and cerebral malaria neuropsychiatric complications.

This is the first study to evaluate the implemented impact of integrated psychiatric services into existing structures in remote areas of LMIC`s.

Disclosure of Interest

None Declared
Mycobiota, neuro-cognitif disorders and behavioural impairments: is there a relationship?
Authors: Abdelmoula B. , Sellami H. , Neji S. , Torjmen M. , Bouayed Abdelmoula N.
Published: August 2023

Introduction

The human body carries large and diverse communities of symbiotic microbes that are important for human health and development. While the impact of the bacterial microbiota, which are mostly found in the human gut, on host physiology is relatively well described, much less is known about the interactions between the mycobiota and the host and the resulting effects on human health. At the level of the nervous system, there is increasing evidence implicating the gut microbiota in a variety of neurological disorders. Similar demonstrations of a causal or supportive role of the mycobioma in neurological disorders are still rare, but several studies linking fungal dysbiosis to disease in humans suggest a contribution of symbiotic fungi to neurocognitive and behavioral disorders.

Objectives

We aim through this review to show the role of mycobiota in neurocognitive and behavioral disorders.

Methods

We comprehensively review the scientific literature using Pubmed database and other search platforms such as Google scholar to state the role of mycobiota in neurocognitive and behavioral disorders.

Results

Our bibliographic review revealed that, according to recent studies, Candida species are overrepresented in the stool of individuals with autism spectrum disorders and Rett syndrome compared to healthy controls. Other studies revealed mycobiome signatures specific to cognitive impairment and demonstrated that different diets modulate the mycobiome in association with Alzheimer’s disease markers and fungal-bacterial co-regulatory networks in patients with cognitive impairment.

Conclusions

Our understanding of the role of the mycobiota in the biology of neurocognitive disorders-whether causal, consequential, or predisposing-could open up new hypotheses in this area and inspire further research on potential mycobiotic signatures, associated dysbiosis and dysfunction in the neurocognitive developmental-homeostasis spectrum that may contribute to neurocognitive and behavioral developmental disorders and predisposition to cognitive decline, dementia, and progression of neurodegenerative diseases including Parkinson’s and Alzheimer’s disease in high-risk subjects.

Disclosure of Interest

None Declared
Schizophrenia may be considered as a member of the spectrum of PBAFopathies
Authors: Abdelmoula B. , Sellami S. , Smaoui W. , Bouayed Abdelmoula N.
Published: August 2023

Introduction

Chromatin modifications and epigenetics are important pathogenesis mechanisms leading to various neurologic and psychiatric disorders including epilepsy, drug addictions, depression, autistic spectrum, learning disabilities and schizophrenia. Recently, the disruption of the chromatin remodeling BAF complex has been linked to several neurodevelopmental syndromes, commonly referred to as PBAFopathies.

Objectives

Here, we review the implication of PBAF complex genes in schizophrenia and we outline syndromes caused by mutations in these chromatin-modifying enzymes labelled as PBAFopathies to discuss the functional consequences of reported mutations in the literature.

Methods

We comprehensively review the scientific literature using Pubmed database and other search platforms such as Google scholar to state the role of PBAF complex genes in schizophrenia and to reveal the most frequent genes mutations reported in literature.

Results

Our review revealed that the human analogs of the subfamily of ATP-dependent chromatin remodeling complexes, which are known in eukaryotes as the mammalian SWI/SNF complex (counting a group of proteins that associate and possess a DNA-stimulated ATPase activity that can destabilize histone-DNA interactions in reconstituted nucleosomes providing crucial nucleosome rearrangement and allowing the activation/repression of genes) are crucial for the regulation of genes expression and cells differentiation. They involve two well-known complexes which are SWI/SNF-A (known as BAF complex) and SWI/SNF-B (known as Polybromo-associated BAF or PBAF complex). SWI/SNF is a multisubunit chromatin-remodeling complex that performs fundamental roles in gene regulation, cell lineage specification, and organismal development and mutations that inactivate SWI/SNF subunits are found in nearly 20% of human cancers and in various developmental disorders, forming a continuum or spectrum of diseases. Since the first description of BRG1/BRM mutations in schizophrenia, other mutations of the SWI/SNF subunits have been reported: SMARCA1, SMARCA2, SMARCA4/BRG1, etc. Single nucleotide polymorphisms (SNPs) in these and other genes of PBAF have been also associated with schizophrenia.

Conclusions

This review focuses on the PBAF SWI/SNF subunits to find out if schizophrenia may be considered as a member of the spectrum of PBAFopathies.

Disclosure of Interest

None Declared
Donepezil-induced psychosis: a cautionary report of a rare adverse reaction
Authors: Hutchings K. R. , Hutchings B. K. , Ratnakaran B. , Kablinger A. S.
Published: August 2023

Introduction

Donepezil is an acetylcholinesterase inhibitor approved by the Food and Drug Administration for the treatment of dementia in Alzheimer’s disease. While it is not curative for Alzheimer’s disease, donepezil has been shown to improve symptoms and slow disease progression; however, cases of rare psychiatric adverse effects, including hallucinations, mania, and increased confusion, have been reported. This report presents a case of donepezil-induced psychosis, which quickly resolved following cessation of the offending medication.

Objectives

To illustrate a unique case of donepezil-induced psychosis

Methods

The patient is an 81-year-old male with a history of late-onset Alzheimer’s disease, mild depression, hypertension, hyperlipidemia, gastroesophageal reflux disease, and myocardial infarction. The patient was prescribed oral donepezil 10mg twice daily to manage his late-onset Alzheimer’s disease. Subsequently, he began developing persecutory delusions, increased agitation toward his family, and auditory hallucinations. His symptoms were worse at night after taking the donepezil, and he regularly requested to have a firearm for self-defense in the late hours of the night. His symptoms progressed for several weeks before his family brought him into the geriatric psychiatry clinic to address his psychosis. The family recognized that these new symptoms started shortly after the patient began taking donepezil and had already started decreasing the dose to half of what was originally prescribed.

Results

This patient experienced symptom remission from psychosis immediately upon discontinuation of donepezil. The patient and his family reported significant improvement with no continuation of hallucinations or paranoia. There was also reported improvement in mood and irritability, and the patient appeared significantly better upon follow-up with geriatric psychiatry. Due to this immediate improvement, the suspected causative factor in the precipitation of psychosis in this patient is the anticholinesterase activity of the donepezil. Although the prescribing information of donepezil details inadequate data proving an association between donepezil and psychotic symptoms, two other published case reports (Yorston GA et al. J Psychopharmacol 2000;14:303-4, Pozzi FE et al. Case Rep Neurol 2022; 14:359-365), along with this one, provide evidence of a causal relationship between the two. The patient was switched to memantine therapy and has remained free of psychotic symptoms thus far.

Conclusions

This case demonstrates the caution required among clinicians when prescribing donepezil for the treatment of Alzheimer’s disease. There needs to be a more focused risk evaluation of potential psychiatric adverse effects in patients treated with donepezil.

Disclosure of Interest

None Declared
Negative symptoms and associated factors in older people with schizophrenia
Authors: Karoui M. , kammoun I. , Kammoun R. , Nefzi H. , Ellouze F.
Published: August 2023

Introduction

The evolution of schizophrenia with age remains poorly studied. The prevalence of negative symptoms in elderly people with schizophrenia is even less described in the literature.

Objectives

to evaluate the prevalence of remission of negative symptoms in the elderly and to study the sociodemographic and clinical variables associated with this remission.

Methods

The sample consisted of 83 subjects aged 55 years and over, followed at the psychiatry department "G" of the Razi hospital in Tunis and suffering from schizophrenia according to the DSM5 criteria. Global remission was defined as a score below 4 on the seven negative symptom items of the PANSS. A questionnaire was administered to each patient to collect epidemiological and anamnestic data.

Results

59% of the sample showed remission of global negative symptoms. 84% and 60% were in remission on the emotional and cognitive subscales, respectively. The existence of remission was correlated with lower PANSS global score, more preserved cognitive functioning, later age of onset, more family and social support, and the absence of a concomitant somatic illness.

Conclusions

This study showed that measures to optimize treatment of positive symptoms and cognitive functioning may have an impact on negative symptoms. Similarly, quality of social network in later life impacts the level of negative symptoms.

Disclosure of Interest

None Declared
Case presentation: Very early combined first-line immunotherapy and surgery in tumor-associated anti N-methyl-d-aspartate (NMDA) receptor encephalitis associated with improved outcome
Authors: Witzel S. , Zeiss R.
Published: August 2023

Introduction

Anti N-methyl-d-aspartate receptor (anti-NMDA-R) encephalitis is a potentially reversible cause of psychosis. Nearly all patients (>95.5%) quickly develop additional neurological symptoms, and only about 50 percent fully recover, often with latency. At symptom onset, patients commonly present with isolated psychosis, making it challenging to distinguish the disease from a primary psychiatric disorder: The median time from symptom onset to immunotherapy in adults is 28 days (IQR 14–49), and from symptom onset to surgery in tumor-associated cases 1.4 months (IQR 0.7–2.6). Steroids, intravenous immunoglobulins (IVIG), or plasmapheresis are recommended as first-line immunotherapies.

Objectives

To highlight a case with improved outcome after very early combined first-line immunotherapy (steroids plus IVIG) and surgery in tumor-associated anti-NMDA-R encephalitis.

Methods

Workup of the clinical case followed by a review of the literature.

Results

We present the case of a 33-year-old woman with sudden onset of anxiety and jealousy ideas, which within a few days, developed a manifest psychosis with formal thought disorders, paranoid and guilt delusions, distrust, and orientation disorders in the absence of additional neurological deficits. A lower abdominal tumor suspicious of an ovarian tumor was detected sonographically five days before the onset of the first symptoms. Lumbar puncture and abdominal computer tomography were performed within 30 hours after hospital admission, confirming the diagnosis of tumor-associated anti-NMDA-R encephalitis with autoantibodies in CSF and serum at a very early clinical stage. First-line immunotherapy with steroids (methylprednisolone 1000mg, day 6 to 10 after symptom onset) was started immediately and combined with IVIG therapy (0.35g/kg, day 9 to 13 after symptom onset). Surgery of the ovarian tumor was performed on day 14 after admission, with histology revealing an immature teratoma. The neuropsychatric examination on day 1 after surgery showed complete remission of clinical symptoms, which persisted during clinical follow-up after 1 and 4 months.

Conclusions

The present case highlights the role of early CSF diagnostic and tumor assessment if autoimmune encephalitis is suspected. Very early first-line immunotherapy with steroids and IVIG, complemented by tumor surgery, was associated with improved outcome in this case with anti-NMDA-R encephalitis. Further studies are warranted to evaluate the generalizability of the finding.

Disclosure of Interest

None Declared
New insights into cerebellar dysfunction in patients with delusional disorder: A systematic review
Authors: González- Rodríguez A. , Guàrdia A. , Alvarez A. , Natividad M. , Pagés C. , Ghigliazza C. , Román E. , Sánchez B. , Monreal J. A.
Published: August 2023

Introduction

The cerebellum has been implicated in cognitive, affective and motor functions, including emotion regulation, executive control and sensorimotor processing. In schizophrenia, cerebellar dysfunction has been associated with treatment resistance and clinical features. However, few studies have been focused on delusional disorder (DD).

Objectives

Our main purpose was to review the evidence available on cerebellum abnormalities and dysfunctions in patients with DD.

Methods

A systematic review was conducted through PubMed, Scopus and ClinicalTrials.gov (inception-June 2022) according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) directives. The following search terms were used: cerebellum OR cerebellar AND (“delusional disorder” AND paranoia). Reference lists from included studies were hand-checked to find other potential relevant papers.

Results

Six studies were included from a total of 119 retrieved records (PubMed: 52, Scopus: 66, ClinicalTrials.gov: 1). Study 1:Patients with DD somatic type (n=14) presented a decreased gray matter volume in cerebellar lobules compared to healthy controls (HC) (n=32, left lobule VIIIa) and non-somatic DD (n=18, lobule V). Cerebellar volumes did not seem to differ between HC and non-somatic DD. Study 2:Abnormalities of voluntary saccadic eye movements, linking frontal and cerebellar functions, were found in DD patients (n=34) compared to HC (n=40). Study 3: Abnormal smooth pursuit eye movements in DD (n=15) compared with HC (n=40) and similar to schizophrenia (n=40). Case reports (n=3): DD associated with Dandy-Walker variant (partial vermian hypoplasia), unruptured intracerebral aneurysm of basilar artery, and megacisterna magna.

Conclusions

Cerebellar deficits in patients with DD has been reported, particularly in those presenting somatic delusional contents.

Disclosure of Interest

None Declared
Psychological Issues among Adult Patients with Untreated Clef Lip and Palate: Algerian Survey-based study
Authors: Rais M. A. , Moussa A.
Published: August 2023

Introduction

Cleft lip and palate are birth defects that occur when a baby’s lip or mouth do not form properly during pregnancy. Individuals with a cleft of the lip and/or palate (CL/P) differ from their peers due to their facial appearance, hearing and speech problems, in addition, it causes psychosocial impacts among affected children. However, among untreated adults, it seems that psychological sequelae can be major and life limiting.

Objectives

The purpose of this study is to assess Algerian untreated young CL/P patients psychological and lifestyle issues.

Methods

This is a survey-based cross-sectional study conducted during August- October 2022 in Algeria through an online survey which is a self-administered questionnaire ( SAQ). The study target population were young individuals ( age between 17 and 30) with untreated or partially treated clef lip and palate confitions. The questionnaire consisted of 10 multiple questions including a demographic section, evaluating patients satisfaction, lifestyle, psychological problems related to their conditions and limitations due to it. All participants provided their informed consent prior to their participation. The Statistical Package for the Social Sciences (SPSS) version 22.0 was used to analyse the collected data.

Results

Final sample size consisted in 207 responses. The mean age of the participants was 24.3± 3 years. Findings showed that slightly more that three fourths (75,9%) of participants reported that they are unsatisfied of their life because of their CL/P condition. Among 120 uneducated participants, (67%) of them reported thay they abandoned school because of their appearance. For P <0.001, suicide thoughts were higher among female participants (38%) than male participants (9%). Almost half of respondents (49.4%) presented strong immigration desires due to their education, relationships and psychosocial health issues.

Conclusions

The psychological impact of cleft lip and palate in adults appears to be disturbing, chronic and life-limiting. Urgent approaches to ensure the early management of cleft lip and palate in Algeria remain mandatory. Increasing the number of specialized maxillofacial services seems to be a good first step.

Disclosure of Interest

None Declared
Mental Health Home Intensive Care during Spanish national lockdown due to COVID-19 Pandemic
Authors: Alba L. , Alonso L. , Pérez H. , Saez S. , Coll C. , Palma S. , Ortiz S.
Published: August 2023

Introduction

The SARS-CoV-2 pandemic situation forced the Spanish Government to declare a home confinement that was prolonged for three months. The Health System had to focus almost entirely on the treatment of patients with Covid-19 infection and vulnerable populations such as people with severe mental illness were overlooked. In this context, mental health home care as an alternative to hospitalization became a first-line approachment for patients with an acute mental health disorder.

Objectives

The aim of this study is to describe the professional practice and the patients characteristics attended by a mental health team in Catalonia during the home confinement due to the SARS-CoV-2 pandemic.

Methods

This study includes the period between March 15, 2020 and June 21, 2020. Sociodemographic, clinical and team functioning variables were described. The patient data was obtained from medical history whereas the rest of information was collected through the creation of a database by the members of the assistencial team.

Results

Team’s structure was changed with the creation of two mirror teams. Psychological attention was expanded and the weekend coverage was reorganized.During that period 40 patients were treated with a mean age of 47 years. There were no differences regarding the gender (50% were men and 50% were women). 87% of the patients lived with their family. 75% of referrals were made by the hospital and 90% were referred to community services upon discharge. Regarding diagnoses, 57.5% of the patients were diagnosed with a psychotic disorder (10% being reactive to Covid-19). A total of 482 visits were made, of which 51% were conducted in a telematic form. The mean time between the referral and the admission was 37.98h. The team accepted 97% of the referred patients with an occupancy rate of 112.4%.

Conclusions

The re-organisation of a home treatment team during the domiciliary lockdown allowed to increase the occupancy rate and offered a rapid response to patients, avoiding the need of conventional hospitalization and providing a proper care plan.

Disclosure of Interest

None Declared
Universal protective and risk factors of mental health during the COVID-19 pandemic: The role of compassion and fears of compassion
Authors: Matos M. ,   C. A. C.-1. Consortium
Published: August 2023

Introduction

The COVID-19 pandemic has had an unprecedented detrimental impact on mental health in people around the world. It is therefore important to examine factors that may buffer or heighten the risk of mental health problems in this context.

Objectives

The current study explores the buffering effects of different flows of compassion (for self, for others, from others) and the magnifying effects of fears of compassion on the impact of perceived threat of COVID-19 on indicators of mental health and psychosocial wellbeing.

Methods

4057 adult participants collected from the general community population across 21 countries from Europe, Middle East, North America, South America, Asia and Oceania, completed self-report measures of perceived threat of COVID-19, compassion, fears of compassion, social safeness, loneliness, depression, anxiety, stress, posttraumatic stress and growth.

Results

Self-compassion moderated the impact of perceived threat of COVID-19 on depression, anxiety and stress, whereas compassion from others moderated the effects of fears of COVID-19 on social safeness. Fears of compassion moderated the impact of perceived threat of COVID-19 on psychological distress. Only fears of compassion from others moderated the effects of fears of COVID-19 on social safeness. Furthermore, social connection (compassion and social safeness) predicted higher post-traumatic growth and traumatic stress, whereas social disconnection (fears of compassion and loneliness) predicted increased traumatic symptoms only. Social connection heightened the impact of perceived threat of COVID-19 on post-traumatic growth, while social disconnection weakened this impact. Social disconnection magnified the impact of the perceived threat of COVID-19 on traumatic stress. The effects were consistent across countries.

Conclusions

Our findings highlight the universal protective role of compassion and social connection in promoting resilience and buffering against the harmful effects of the COVID-19 pandemic on mental health and psychosocial wellbeing. Furthermore, our results reveal that fears of compassion have a magnifying effect on the damaging impact of the COVID-19 pandemic on mental health.

Disclosure of Interest

None Declared
The impact of COVID-19 pandemic on the healthcare workers mental health
Authors: Ferrandino M. , Sollo V. , Di Vincenzo M. , Marafioti N. , Della Rocca B. , Brandi C. , Giallonardo V. , Luciano M. , Sampogna G. , Fiorillo A.
Published: August 2023

Introduction

The COVID-19 pandemic represents an unprecedented in health events that has had a negative impact on the mental health of the population in general as well as on specific categories, including patients with mental and physical disorders, and healthcare professionals. In particular, COVID-19 pandemic has produced extraordinary stress in healthcare workers, especially frontline physicians, nurses and healthcare professionals.

Objectives

In the present study we aimed to evaluate levels of burnout, a clinical condition characterized by emotional, psychological and physical exhaustion, in a sample of health workers from the Campania region, Italy, during the first phase of the COVID-19 pandemic. Secondary objectives of the study include the assessment, in the same group, of levels of anxiety-depressive symptoms, insomnia, suicidal ideation and symptoms on the post-traumatic spectrum.

Methods

An online survey was released through the official website of the University of Campania “L. Vanvitelli” and social media. The Maslach Burnout Inventory was used to assess burnout in the healthcare professionals; Depression Anxiety Stress Scale-21 Short Version to measure levels of anxiety, depression and stress; the Insomnia Severity Index was used to identify insomnia-related symptoms; the Suicidal Ideation Attributes Scale was adopted to select individuals based on the presence of suicidal thoughts while the Impact of Event Scale-Revised was administered to evaluate trauma-related dimensions.

Results

A total of 389 health workers was recruited. They were predominantly female, with an average age of 39.06 (± 11.85) years, working mainly in the second line hospitals during the COVID-19 emergency. During the pandemic, first- or second-line health workers reporting significant levels of emotional exhaustion are on average 23,89 (±4.22), those reporting feelings of depersonalization are on average 7.58 (±2.73), while those who report a good level of professional efficiency are on average 21.12 (±3.48).

Predictors of increased levels of depersonalization are being a first-line worker and the presence of traumatic event avoidance symptoms. Furthermore, levels of professional fulfillment are negatively affected by age, the presence of intrusive symptoms, the presence of sleep disorders, and being a frontline worker.

Conclusions

The impact of the COVID-19 pandemic on the mental health of healthcare professionals involved in the first and/or second line COVID hospitals is indisputable. Although burnout syndrome is not a new clinical condition, the COVID-19 pandemic may further worsen the magnitude of the problem. However, our results could be a starting point to promote a change in the way we perceive the mental health of healthcare professionals.

Disclosure of Interest

None Declared
Music therapy and depression : the alternative approach
Authors: Zbidi M. , Bouali W. , Hnia M. , Kacem M. , Bensoussia R. , Zarrouk L.
Published: August 2023

Introduction

Depression is a highly prevalent disorder associated with reduced social functioning, impaired quality of life, and increased mortality. This disease is one of the most common reasons for the use of complementary and alternative therapies. Music therapy is a therapeutic approach that uses musical interaction as a means of communication and expression.

Objectives

To assess, through a systematic review, the effectiveness of music therapy in patients with depression disorder, and to design a research protocol for a randomised controlled trial of group music therapy for depressed patients in a Psychiatry Department.

Methods

We conducted a systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA).We systematically searched 3 databases (Pubmed, Google Scholar and SciElo) and reviewed randomized controlled trials. The evaluation of the trials was made using the CONsolidated Standards of Reporting Trials (CONSORT) guidelines.The review included studies of 16-to-80-year-old impatients and outpatients of both genders with clinical depression using any diagnostic criteria such as ICD 10 (WHO 1992) or DSM 5 Research Diagnostic Criteria. Change in depressive symptoms was measured with various scales. An experimental protocol was then designed to conduct a randomized controlled trial for depressed patients in the Psychiatry Department at the University Hospital of Mahdia, seeking to supplement scientific knowledge in the field of music therapy that has not yet been explored.

Results

A total of 13 articles were included in the study: The analysis of these articles highlighted a predominance of Anglo-Saxon papers and an increasing rate of publication over time.The duration of treatment varied between 2 weeks and 10 weeks and the number of music therapy sessions varied between 4 sessions and 20 sessions.Two major music therapy approach were identified, active method where patients are the ones making music and receptive or passive methods where patients will receive the music.12 researches included in our review reached the conclusion that music therapy had a significant positive effect on patients as the score scales were significantly lower after the end of the therapy. Only one included research found no significant difference between music therapy group and treatment as usual.In addition the results of all studies came on the conclusion that music therapy improved symptoms of anxiety and scores were significantly lower.

Conclusions

This systematic review and meta-analysis suggests that music therapy has an effect on reducing depressive symptoms to some extent. However, high-quality trials evaluating the effects of music therapy on depression are required. Thus,the aim of our study protocol is to contribute to the development of this therapy

Disclosure of Interest

None Declared
Linked patterns of symptoms and cognition with brain controllability in major depressive disorder
Authors: Li Q. , Zhao Y. , Wang Y. , Long F. , Gong Q. , Li F.
Published: August 2023

Introduction

Major depressive disorder (MDD) is characterized by both clinical symptoms and cognitive deficits. Prior studies have typically examined either symptoms or cognition correlated with brain measures, thus causing a notable paucity of stable brain markers that capture the full characteristics of MDD. Brain controllability derived from newly proposed brain model integrating both metabolism (energy cost) and dynamics from a control perspective has been considered as a sensitive biomarker for characterizing brain function. Thus, identifying such a biomarker of controllability related to both symptoms and cognition may provide a promising state monitor of MDD.

Objectives

To assess the associations between two multi-dimensional clinical (symptoms and cognition) and brain controllability data of MDD in an integrative model.

Methods

Sparse canonical correlation analysis (sCCA) was used to investigate the association between brain controllability at a network level and both clinical symptoms and cognition in 99 first-episode medication-naïve patients with MDD. The potential mediation effect of cognition on relationship between controllability and symptoms was also tested.

Results

Average controllability was significantly correlated with both symptoms and cognition (rmean=0.54, PBonferroni=0.03). Average controllability of dorsal attention network (DAN) (r=0.46) and visual network (r=0.29) had the highest correlation with both symptoms and cognition. Among clinical variables, depressed mood (r
=-0.23) , suicide(r
=-0.25), work and activities(r
=-0.27), gastrointestinal symptoms (r
=-0.25) were significantly negatively associated with average controllability, while cognitive flexibility (r=0.29) was most strongly positively correlated with average controllability. Additionally, cognitive flexibility fully mediated the association between average controllability of DAN and depressed mood (indirect effect=-0.11, 95% CI [-0.18, -0.04], P=0.001) in MDD.

Conclusions

Brain average controllability was correlated with both clinical symptoms and cognition in first-episode medication-naïve patients with MDD. The results suggest that average controllability of DAN and visual network reached high associations with clinical variates in MDD, thus these brain features may serve as stable biomarkers to control the brain functional states transitions to be relevant to cognitions deficits and clinical symptoms of MDD. Additionally, altered average controllability of DAN in patients could induce impairment of cognitive flexibility, and thus cause severe depressed mood, indicating that controllability of DAN may be a potential intervention target for alleviating depressed mood through improving cognitive flexibility in MDD.

Disclosure of Interest

None Declared
The medical consequences of eating disorders: the correlation between the severity of the disease and the degree of the cardiological changes in paediatric patients with anorexia nervosa
Authors: Adamo E. , Pisano T.
Published: August 2023

Introduction

Anorexia nervosa (AN) is associated with several medical complications. The cardiac changes represent the most severe complications and are associated with higher mortality. For this reason, periodic evaluation is necessary, by ECG and echocardiography. Moreover, there is not a protocol that defines the timelines or how to select higher risk patients that must be evaluated more frequently.

Objectives

This single-center, retrospective, observational and epidemiological study aims to analyze the prevalence of cardiac changes and their correlation with disease severity, in patients admitted to the Child and Adolescent Psychiatry Unit, AOU Meyer, Florence.

Methods

The study population consisted of 123 children between the ages of 7 and 18 years old admitted to inpatient or intensive day hospital, with a diagnosis of AN, between January 1, 2019, to March 31, 2022. Data were collected by retrospectively consulting clinical reports. The correlation between BMI, percentage of weight loss since the onset of symptoms and HR, QTc interval values and pericardial effusion was evaluated. Furthermore, the correlation between cardiac changes and the intake of antidepressant and antipsychotic medications was analyzed.

Results

The overall prevalence of cardiac changes was 57.7%. In our analysis BMI showed a significant positive correlation whit HR. QTc prolongation was significantly related only to psychotropic drug intake. Pericardial effusion was evidenced exclusively in patients diagnosed with severe or extreme AN. After six months from the hospitalization and the beginning of treatment the prevalence of cardiovascular complications was reduced.

Conclusions

The present study identifies criteria able to select patients with AN at higher risk of developing cardiac changes and underlines the importance of performing more frequent and targeted cardiologic evaluations in this subgroup of patients. This suggests the importance of establishing a common protocol for all clinicians.

Disclosure of Interest

None Declared
Stratified therapeutic security and understanding backwards care pathway moves. A 5-year retrospective cohort analysis from the Dundrum Forensic Redevelopment Evaluation (D-FOREST) study in Dublin, Ireland
Authors: Jordan L. , Crudden G. , Mohan D. , Kennedy H. , Davoren M.
Published: August 2023

Introduction

Secure forensic hospital settings provide care and treatment to mentally disordered offenders with a history of serious violence. Most modern forensic hospitals operate a system of stratified therapeutic security, where patients are placed on the internal care pathway according to individual risks and needs. Unfortunately, at times patients move ‘backwards’ from a unit of lower to a unit with higher therapeutic security. This is a challenge to manage from an individual patient and service perspective.

Objectives

The aim of this study was to analyse backwards moves along the care-pathway within a complete national cohort of forensic in-patients in Ireland over a five-year period. We aimed to clarify the reasons for these moves and ascertain if they were linked to mental illness, security or other issues.

Methods

A naturalistic retrospective five-year observational cohort study was completed. All in-patients in the Central Mental Hospital, Dundrum, Ireland or associated high support hostels between January 2016 and January 2021 were included (60 months). Demographic data, data pertaining to diagnosis, data pertaining to backwards moves and reasons for those moves were gathered. Data was gathered as part of the Dundrum Forensic Redevelopment Evaluation study (D-FOREST study).

Results

A total of n=231 patients were included; the majority (n= 203; 87.9%) were male. The most common diagnosis was schizophrenia (64.1%), followed by schizoaffective disorder (12.6%), bipolar affective disorder (4.8%) and autistic spectrum disorder (3.5%). Mean age at admission was 35.9 years, SD 9.5.

Over the 60-month period, a total of 93 backwards moves relating to 50 patients occurred. Reasons for backward moves included deteriorating mental state (8.7%), assaults (4.3%), challenging behaviour (4.3%), security (1%) and others. Binary logistic regression demonstrated that lacking capacity to consent to medication (Odds ratio 0.352, 95%CI 0.198-0.627, p<0.001) and higher (worse) scores on HCR-20 Historical scale (Odds ratio 1.13, 95%CI 1.01-1.27, p=0.035) were associated with backwards moves, when adjusting for age and Dundrum-1 need for therapeutic security scores.

Conclusions

Backwards care pathway moves are a major issue in forensic hospitals both nationally and internationally. We were surprised at the strength of association between lacking capacity to consent and backwards moves. Understanding backwards moves will assist in supporting patients and minimising length of stay.

Disclosure of Interest

L. Jordan Grant / Research support from: This study was funded by the Health Service Executive for the Republic of Ireland as part of the Dundrum Forensic Redevelopment Evaluation (D-FOREST) study, G. Crudden: None Declared, D. Mohan: None Declared, H. Kennedy: None Declared, M. Davoren: None Declared
How to measure autobiographical amnesia: time to upgrade the CUAMI?
Authors: Isidoor B.
Published: August 2023

Autobiographical memory loss is a common complaint of patients treated with electroconvulsive therapy (ECT). However, reliable measurement of autobiographical memory loss after ECT is still a subject of debate. In the 1990s, the Colombia University Autobiographical Memory Interview (CUAMI) was developed specifically to monitor changes in autobiographical memory during a course of ECT. However, this instrument has been criticized due to the lack of psychometric data. In this talk, we will discuss the experiences of administrators and preliminary results of a study into the psychometric properties of the CUAMI. Is the CUAMI useful to test autobiographical memory after ECT or could it use an upgrade?

Disclosure of Interest

B. Isidoor Grant / Research support from: Isidoor Bergfeld works on a clinical trial of DBS for depression sponsored by Boston Scientific (in kind). He also received grants from ZonMw and Amsterdam Brain and Cognition for studies on DBS and ECT
Evaluation of self-stigma in patients with mental illness from hospitalization in the Mental Health Acute Unit
Authors: Valverde Barea M. , España Osuna A. , Solis Correa M. O.
Published: August 2023

Introduction

Stigma is a complex process and a universal phenomenon that is part of all social groups and that is maintained by its functions related to the establishment of one’s own identity and the facilitation of socialization processes. The stigma of the patient is important to evaluate since it is a subjective experience that can have negative correlations in relation to self-esteem, empowerment and recovery orientation of the patient with mental illness. Hospitalization in mental health takes place at times of mental illness decompensation and is an intervention closely related to the stigma towards mental illness.

Objectives

The objective of the study is to evaluate the stigma perceived by patients with mental illness hospitalized in an acute mental health unit.

Methods

Observational study with 53 patients hospitalized in an acute mental health unit.

Variables collected: Sociodemographic variables (age, sex), clinical diagnosis and stigma is evaluated with the Illness Self-stigma Scale (ISMI).

Results

Sample of 53 patients, 55% women and 44% men, the most frequent diagnoses among those admitted are psychosis spectrum 26.42%, depressive disorders 24.53%, personality disorders 22.64% and bipolar disorders 11.33%. The average age is 41.96 years, between 18 and 72 years. The self-stigma according to the scale (ISMI) we obtain as a total score the patient with the highest stigma scores 100 points and the one with the least scores 44 points. Regarding diagnoses, depressive disorders score 33-72 points, while psychotic disorders score 36-85 points. The highest scores in self-stigma in our study are in personality disorders 49-100 and borderline personality disorder stands out (100 points). In the 5 subscales such as alienation, self-stigma, perceived discrimination, social isolation and resistance to stigma. Higher scores in alienation stand out in all patients.

Conclusions

Patients with personality disorders, especially borderline personality disorder, followed by psychotic disorders, present greater perceived self-stigma in our study than the rest of the patients; it is a very important factor that can affect the evolution of the clinical picture. This factor is important to establish the therapeutic plan and the different interventions, it would be recommended to assess the stigma together with the measures to reduce symptoms.

Disclosure of Interest

None Declared