bluuebunny/crossref_metadata_2025 huggingface dataset:
COVID-19 Infection and Medicines in Pregnancy in Canada
Authors: Berard A. , Sheehy O. , Kaul P. , Eltonsy S. , Walker M. , Hawken S. , Bernatsky S. , Pugliese M. , Barrett O. , Savu A. , Dragan R.
Published: August 2024

Introduction

Although over 100 million pregnant women worldwide are at risk of infection with SARS-CoV-2, little data exists on the impact of COVID-19 and related treatments on maternal/neonatal health.

Objectives

1) To quantify the prevalence of medication use in pregnancy to treat COVID-19; 2) To quantify and compare the risk of adverse pregnancy/neonatal outcomes in those with and without COVID-19.

Methods

In the Canadian Mother-Child population-based cohort (CAMCCO), two key sub-cohorts were identified using prospective data collection of medical services, prescription drugs, hospitalization archives data, and COVID-19 surveillance testing program (02/28/2020-2021). The first cohort included all pregnant women with at least one completed trimester of pregnancy during the study period regardless of pregnancy status (delivery, induced/planned or spontaneous abortion); this cohort was further stratified on COVID-19 status. The second cohort included all non-pregnant women (aged 15-45) with a positive COVID-19 test. COVID-19 infection in pregnant or non-pregnant women was assessed using COVID-19 test results or ICD-10CM codeU07.1 from hospital data. COVID-19 severity was categorized based on hospital admission. Women were considered exposed to COVID-19 medications if they filled at least one prescription for a medicine included in the WHO list in the 30 days pre- or 30 days post-COVID-19 positive test/diagnosis. Considering potential confounders, association between COVID-19 during pregnancy, treated vs not, and perinatal outcomes were quantified using log-binomial regression models.

Results

150,345 pregnant women (3,464 (2.3%) had COVID-19), and 112,073 non-pregnant women with COVID-19 diagnoses were included. Pregnant women with COVID-19 were more likely to have severe infections compared to non-pregnant women with COVID-19 (11.4% vs 1.6%, p< 0.001). The most frequent medications used in pregnancy to treat COVID-19 were antibacterials (13.96%), psychoanaleptics (7.35%), and medicines for obstructive airway disease (3.20%). In pregnancy COVID-19 was associated with spontaneous abortions (adjRR 1.76, 95%CI 1.3, 2.25), gestational diabetes (adjRR 1.52, 95%CI 1.18, 1.97), prematurity (adjRR 1.30, 95%CI 1.01, 1.67), NICU admissions (adjRR 1.32, 95%CI 1.10, 1.59); COVID-19 severity was increasing these risks but COVID-19 treatment with study medications reduced all risks.

Conclusions

Severity of COVID-19 was greater in pregnancy. Antibacterials, psychoanaleptics, and medicines for obstructive airway disease were the most used overall. Severe COVID-19 in pregnancy was associated with higher risks of adverse maternal, and neonatal outcomes.

Disclosure of Interest

None Declared
Comparing DSM-5 pathological personality traits in eating disorder patients and healthy control subjects using PID-5: results of a pilot study
Authors: Biliczki J. , Bognár J. , Pólya D. B. , Somogyi S. , Sutori S. , Gonda X. , Hamvas S. , Réthelyi J.
Published: August 2024

Introduction

The presence of eating disorders is often associated with serious physical complications, self-destruction, and suicidal tendencies. Furthermore, eating disorders may often present as a symptom of or in comorbidity with personality disorders. In order to treat eating disorder patients successfully we need a more complex and individual approach taking into consideration the specific personality dysfunctions and traits present in the patient underlying symptomatic manifestations. Recently a paradigm shift in conceptualisation of personality disorders led to the introduction of a dimensional concept focusing on severity of dysfunction in both ICD-11 and DSM-5 in its Alternative Model for Personality Disorders (AMPD). IN addition, DSM-5 as part of AMPD also considers the presence of 5 domains of pathological personality traits including 25 facets. This more complex mapping of personality could aid understanding personality contributors to psychopathology not only in personality disorders and could aid treatment by providing targets for psychotherapy.

Objectives

Our aim was to compare pathological personality traits according to DSM-5 AMPD in eating disorder patients, and matched healthy control subjects.

Methods

We are launching a large project focusing on personality disorders. For this analysis we used the adult form of PID-5 to assess pathological personality traits along 5 domains and 25 facets in eating disorder patients and psychiatrically healthy controls. Data were analyzed with the Mann-Whitney test using R.

Results

Preliminary results of a pilot analysis in 14 eating disorder patients and matched psychiatrically health controls are shown. Comparing the data of the two groups, a significant difference was observed in several personality facets, including Anxiousness, Deceitfulness, Grandiosity, Impulsivity, Manipulativeness, Perceptual dysregulation, Rigid perfectionism, Submissiveness, and Unusual beliefs. These differences in the above facets reflect differences in the two groups in all pathological personality domains including Anhedonia, Negative affect, Antagonism, Disinhibition, and Psychoticism.

Conclusions

Our results show complex differences between eating disorder patients and healthy control subjects in several facets, pointing to a unique pattern and the affectedness of all pathological personality domains. Such results could possibly add to identifying personality trait targets for psychotherapy in eating disorders besides increasing our understanding on the etiopsychopathology of this serious psychiatric illness. Our study is ongoing, but more complex analyses involving further measures and variables in larger samples bring the hope for increasing effectiveness of treatment for anorexia.

Disclosure of Interest

None Declared
Bipolar Disorder in Pregnancy: A Challenging Case Managed with Maintenance Electroconvulsive Therapy
Authors: Arribas-Simon B. , Mateos-Sexmero M. J. , Martin-Santiago O. , Andres-Olivera P. , Rodriguez-Rodriguez B. , Martinez-Gimeno P. , Navarro-Barriga N. , Jimenez-Aparicio T. , Fernandez-Pando P. , Andreo-Vidal M.
Published: August 2024

Introduction

Pregnancy is a high-risk period for major affective disorders and can lead to a destabilizing period for our patients. Standard pharmacological strategies must be carefully evaluated due to potential teratogenic or side effects. We present a case of bipolar disorder type I with challenging-to-control maniac episodes during pregnancy, which has required Electroconvulsive Therapy for its management.

Objectives

Presenting maintenance electroconvulsive therapy (ECT) as a safe and effective therapeutic strategy during pregnancy, with the presentation of a case in which it has been administered every 3 weeks from the second trimester until the baby’s birth at 37 weeks

Methods

This concerns a 28-year-old immigrant woman, married, with a 10-year-old child. She was diagnosed with bipolar disorder type I at the age of 16 when she experienced her first manic episode in her country of origin. Subsequently, during her first pregnancy, she required hospitalization for electroconvulsive therapy (ECT) treatment, with a positive response after a single session. She remained stable for several years without maintenance pharmacological treatment or follow-up until the ninth week of her second pregnancy when she experienced a manic episode requiring hospitalization.

Results

She was initially treated with Olanzapine and Lorazepam with a positive response, but three weeks later, she was readmitted with a similar episode. These decompensations occurred almost monthly, leading to the consideration of introducing mood stabilizers after the first trimester. However, due to the patient’s severe hyperemesis gravidarum, this stabilizing treatment was ruled out due to the difficulty in controlling its blood levels and the associated risk of intoxication. During the fifth admission at the 20th week of gestation, the decision was made to initiate ECT treatment, which yielded an excellent response and subsequent maintenance.

Conclusions

The indications for electroconvulsive therapy (ECT) during pregnancy are the same as in the rest of adult patients. In individuals with a psychiatric history, it is possible for a relapse of mental illness to occur during pregnancy, although the risk is considerably higher during the postpartum period. ECT is considered an effective and safe treatment option in all three trimesters of pregnancy and the postpartum period. During the informed consent process, patients should be informed about the potential impact of ECT as well as alternative treatment options.

Disclosure of Interest

None Declared
Pharmacotherapy and psychotherapy interventions in patients with borderline personality disorder in outpatient clinical practice
Authors: Chumakov E. , Charnaia D. , Petrova N.
Published: August 2024

Introduction

Despite the high prevalence of borderline personality disorder (BPD) in the population, the evidence regarding approaches to therapy for BPD is inconsistent. No psychopharmacological medications are approved for the treatment of BPD, yet most patients with BPD are treated with pharmacotherapy. Meanwhile, psychotherapy is the method of choice for the treatment of BPD. Little is known about the clinical practice of BPD treatment in Russia, since most studies have been conducted in Western countries.

Objectives

The aim of the study: analysis of approaches to treatment of BPD in real outpatient clinical practice in Saint-Petersburg, Russia.

Methods

Fifty patients (72% female; n=36; mean age 22.4±4.3) who were treated in an outpatient community care were included in the study. Diagnosis was made according to the ICD-10 criteria (F60.31), as it does in clinical practice in Russia. Research methods included a clinical-catamnestic method.

Results

All examined patients received pharmacotherapy. Twenty-four patients (48.0%) received monotherapy with a selective serotonin reuptake inhibitor antidepressant. The remaining patients (52.0%) received two or more psychotropic medications simultaneously. The most frequent combination of psychopharmacotherapeutic agents was a combination of an antidepressant and a mood stabilizer. Analysis of therapy revealed that antipsychotics (always of the second generation) as well as mood stabilizers were prescribed to target emotional instability and impulsivity as symptoms of BPD, as well as increased self-harming behavior in order to reduce impulsivity. Despite the assumption that the simultaneous prescription of several medications to patients with BPD was due to the presence of a comorbid psychiatric diagnosis, this was not confirmed (p>0.05). Most of the patients (n=42; 84.0%) received individual and group psychotherapy (cognitive-behavioral with elements of dialectical-behavioral therapy). It was found that patients who received psychotherapy had a faster response to pharmacotherapy (p<0.05).

Conclusions

An analysis of approaches to the treatment of BPD in outpatient clinical practice in Saint-Petersburg, Russia, showed a predominance of medication-assisted psychopharmacotherapy (selective serotonin reuptake inhibitors, antipsychotics, mood stabilizers) over the frequency of prescription of psychotherapeutic care. In none of the cases was a first-line psychotherapy method (with proven efficacy for BPD) used. An assessment of the availability of psychotherapeutic care for patients with BPD is required. An earlier initiation of psychotherapeutic care after the BPD diagnosis is recommended, which may lead to an increase in the effectiveness of psychiatric care for patients with BPD in outpatient clinical practice.

Disclosure of Interest

None Declared
Postictal recovery of orientation in person, place and time relates to restoration of cortical activity after electroconvulsive therapy
Authors: Stuiver S. , Pottkämper J. , Verdijk J. , ten Doesschate F. , van Putten M. , Hofmeijer J. , van Waarde J.
Published: August 2024

Introduction

Most patients show temporary impairments in clinical orientation (i.e., orientation in person, place, and time) after electroconvulsive therapy (ECT)-induced seizures. It is unclear whether postictal reorientation is related to electroencephalography (EEG) restoration. This tentative relationship may shed light on mechanistic aspects of reorientation after ECT.

Objectives

To study whether postictal EEG restoration after an ECT-induced seizure is related to recovery of clinical orientation in the cognitive domains person, place and time.

Methods

We performed a longitudinal study in ECT patients and collected continuous postictal EEGs. Postictal EEG restoration was estimated by the evolution of the normalized alpha/delta ratio (ADR). Recovery of orientation in the cognitive domains of person, place, and time was assessed using the Reorientation Time (ROT) questionnaire. In each cognitive domain, a linear mixed model was fitted to investigate the relationship between ROT and postictal EEG restoration. In these models, other (ECT-)parameters including seizure duration, use of benzodiazepines and electrode placement were included.

Results

In total, 272 ictal and postictal EEG recordings of 32 patients were included. In all domains, longer ROT was associated with slower postictal EEG recovery. Longer seizure duration and use of benzodiazepines were related to longer ROT in all domains. Increased total charge of the ECT-stimulus was associated with increased ROT in place and age was positively associated with ROT in time.

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Conclusions

We show a relationship between restoration of the postictal EEG and clinical reorientation in person, place and time after ECT-induced seizures. This indicates that clinical reorientation probably depends on gradual cortical synaptic recovery. Increased seizure duration and the use of benzodiazepines were also related to increased ROT values. Longer seizures and use of benzodiazepines may induce longer postictal synaptic depression.

Disclosure of Interest

None Declared
Prescription practices for antipsychotic medication in an acute inpatient ward: Risks / benefits discussions with patients and performance of baseline investigations as per NICE guidelines
Authors: Elesawy M. , Munday G. J. , Lekka N.
Published: August 2024

Introduction

Antipsychotic medications are essential for managing psychiatric disorders, offering symptom relief and improved functioning. However, their use carries potential risks. Vigilant monitoring and patient engagement are crucial when initiating antipsychotics.

Objectives

To explore whether comprehensive discussions with patients concerning the benefits and risks of antipsychotics are taking place, and whether baseline investigations are performed before initiation of antipsychotics as per NICE guidelines.

Methods

This retrospective study focused on admissions to a male acute ward between March 1 and May 31, 2023. Data from electronic patient records included demographics, Mental Health Act (MHA) status, psychiatric diagnoses, medical co-morbidities, documentation of medication benefits / side effects discussions with patients, medication information provision, as well as baseline investigations involving weight, height, waist/hip circumference, pulse, blood pressure, blood glucose, HbA1c, lipid profile, prolactin levels, movement disorder assessment, nutritional status, diet, physical activity, and ECG.

Results

Among 23 admitted patients, 15 were newly initiated or reintroduced to antipsychotics, with 14(93.3%) admitted under the MHA. Primary diagnoses included Paranoid Schizophrenia (33.33%), Unspecified Non-Organic Psychosis (20%), Bipolar Affective Disorder (20%), and others. Medical comorbidities were observed in 10(66.7%), notably type 2 diabetes (40%). Among initiates, 6(40%) were new to treatment, while in 9(60%) it was re-initiated.

Within the 15-patient group, discussions on treatment benefits engaged 11(73.3%), while 4(26.7%) lacked complete documentation. Only 6(40%) had discussions about side effects. Metabolic side effects were discussed with 3(20%), extrapyramidal effects with 2(13.33%), while 4(26.7%) had general side effect talks. Patient information leaflets were given to 5(33.3%) patients. Baseline measurements: 12(80%) had weight/height, 4(26.7%) waist/hip, and 14(93.3%) pulse/blood pressure assessed. Blood tests were declined by 4(26.7%). Baseline glucose, HbA1c, lipids, and prolactin were assessed in 8(53.3%), 10(66.7%), 9(60%), and 8(53.3%) patients respectively. Nutritional status was assessed in 13(86.7%), movement disorders in 1(6.7%), and physical activity in 1(6.7%). All 15(100%) patients were offered ECGs, although 5(33.3%) declined.

Conclusions

Adherence to NICE guidelines for baseline investigations and risk/benefit discussions prior to antipsychotic initiation was low, apart from ECGs, weight/height, pulse/blood pressure, assessment of nutritional status, and discussions about antipsychotics’ benefits. Implementing effective monitoring and patient engagement to mitigate potential side effects, is crucial to facilitating the safe and efficient utilisation of antipsychotics.

Disclosure of Interest

None Declared
Changes in Parental Reflective Functioning before and after a postpartum depression group therapy
Authors: Erkoreka L. , Alonso Z. , Pérez Cabeza L.
Published: August 2024

Introduction

Parental Reflective Functioning (PRF) refers to parents’ ability to view their children’s and their own behavior by considering internal mental states, such as thoughts, desires, and intentions. Depression has been described as compromising reflective functioning in female samples, whereas other studies have not detected differences in RF between depressed and non-depressed mothers.

Objectives

We aim to study whether a group intervention focused on postpartum depression, which we have already observed to cause significant changes in the mother-child bond and the severity of depressive, also improves parental reflective functioning.

Methods

To that end, we analyzed pre-post data from two different groups (N=12), composed of mothers who had been clinically diagnosed with postpartum depression. They received the 6-week Mothers & Babies Program© and completed the Parental Bonding Questionnaire (PBQ), the Edinburgh Postnatal Depression Scale (EPDS) and the Parental Reflective Functioning Questionnaire (PRFQ) before and after group therapy. Pre-post data from the PRFQ were analyzed using the repeated measures t-test. The correlation between changes in the three questionnaires was also analyzed using Pearson’s correlation test.

Results

Significant changes were observed in the Pre-Mentalization Modes (pre=2.37±.457, post=2.03±.520, t=2.0206, p=0.027) and Certainty About Mental States (pre=2.87±1.141, post=3.68±.908, t=-2.814, p=0.010) subscales of the PRFQ, with no significant changes in the Interest and Curiosity subscale (t=-.516, p=0.309). A significant correlation was also observed between pre-post change in EPDS scores and pre-post change in the Certainty About Mental States subscale of the PRFQ (r=-.640, p<.05), while no significant correlations were observed with the rest of the PRFQ subscales, nor with the PBQ.

Conclusions

A brief cognitive-behavioral group therapy developed specifically to treat postpartum depression improves pre-post scores on the Pre-Mentalization (lower post- than pre- score) and Certainty About Mental States (higher post- than pre- score) subscales of the PRFQ. Although a control group is needed to determine the actual effect of the intervention, as time could also play a role in the observed changes, this is an encouraging result. Moreover, the improvement obtained in Certainty About Mental States is inversely correlated with the pre-post changes observed in the EPDS, meaning that the greater the improvement in depression, the greater the improvement in the aforementioned subscale of the PRFQ. A larger sample is needed to assess a hypothetical mediating effect of depression in the observed change.

Disclosure of Interest

None Declared
The Influence of Nonparental Care on Internalizing and Externalizing Behaviors Across Adolescence: An individual Participant Meta-Analysis
Authors: Barry K. M.
Published: August 2024

Introduction

In Europe, associations between different types of nonparental care and internalizing and externalizing behaviors in children have not been adequately explored (Gialamas, A et al. J Epiemiol Community Health. 2015). Internalizing and externalizing symptoms in childhood can have lifetime repercussions, thus understanding their risk factors and the potentially protective role of family policies is highly relevant.

Objectives

To explore the associations between different types of nonparental care prior to primary school and internalizing and externalizing behaviors across young adolescence.

Methods

Six parent-offspring prospective birth cohort studies across five European countries within the EU Child Cohort Network (EUCCN) were included in the study. A two-stage individual participant data (IPD) meta-analysis on complete cases was performed. Linear regression models (one for each age group: 5-6 years, 7-9 years, 10-13 years) were applied in each cohort separately and then cohort-specific coefficients and standard errors were combined using random-effects (restricted estimate maximum likelihood (REMD) meta-analysis to attain overall effect estimates. Data were then stratified by socioeconomic position and sex.

Results

There were 74 453 parent-offspring dyads to study children’s internalizing difficulties and 72 462 parent-offspring dyads to study children’s externalizing difficulties. Center-based care attendance was associated with lower levels of internalizing difficulties 5-6 years [-1.13 (95%CI:- 2.68, 0.42), p=0.15]; 7-9 years [-1.38 (95%CI:- 2.85, 0.10), p=0.07]; 10-13 years [-1.06 (95%CI:- 1.95, -0.17), p=0.02]. Children who attended other forms of nonparental care appeared to have higher levels of internalizing difficulties: 5-6 years [0.02 (95%CI:- 1.96, 2.01), p=0.98], 7-9 years [0.91 (95%CI:0.23, 1.58), p=0.009]; 10-13 years [0.52 (95%CI:- 0.23, 1.27), p=0.17]. Other forms of nonparental care (not including center-based care) had a positive association with externalizing symptoms : 5-6 years [2.45 (95%CI:0.35, 4.55), p=0.02]: 7-9 years [2.78 (95%CI: 0.60, 4.95), p=0.01];10-13 years [1.93 (95%CI:-0.45, 4.32), p=0.11]. We found some evidence of effect moderation by the child’s sex and socioeconomic position (SEP).

Conclusions

The results suggest that center-based care may protect children from developing internalizing behaviors, but other forms of nonparental care may put children at more risk of developing more internalizing and externalizing behaviors. Also, factors such as sex and SEP may interact with nonparental care in influencing externalizing behaviors.

Disclosure of Interest

None Declared
Clozapine-induced pyoderma gangrenosum. A case report
Authors: Peyioti M. , Argitis P. , Pikou O.
Published: August 2024

Introduction

Clozapine is an atypical antipsychotic medication which is mainly used in cases of treatment-resistant schizophrenia. Although it has several advantages over other typical and atypical antipsychotic medication, such as fewer relapses and lowering the risk of tardive dyskinesia and suicide it also has a range of adverse effects which makes compliance an issue for many patients.

Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis clinically characterized by painful pustules or nodules that rapidly evolve in ulcers with violaceous, undermined borders and raised periphery. The etiopathogenesis of the disease remains unclear, however PG is usually manifested in the setting of an underlying immune-mediated disease, more commonly inflammatory bowel disease, rheumatoid arthritis and haematological malignancies.

Objectives

Nevertheless, in the literature there are scarce reports of drug-induced
PG.

Methods

We present the case of a 56-year-old woman with a diagnosis of refractory schizophrenia on clozapine treatment for 4 months, who was admitted to the emergency department for a skin eruption localized on the trunk, genital area and extremities. The clinical examination revealed numerous, discrete erythematous macules, papules and plaques with central necrosis, and multiple, sharply marginated ulcers with undermined, red to purple border. Further physical examination disclosed no systemic findings and laboratory analyses and skin biopsy were performed.

Results

On work-up, white blood cell count and C-reactive protein (CRP) were elevated, while blood and pustule cultures were negative. Histologic examination revealed dermal necrosis and inflammation, features consistent with the diagnosis of PG. The pathergy test was positive.

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Conclusions

Pyoderma gangrenosum is a rare autoinflammatory skin disorder of unknown etiology. The pathogenesis of the disease is not well understood, but drug-induced PG is considered to result from neutrophil dysfunction and dysregulation of the inflammatory response. Cases of drug-induced PG are rare and attributed to certain drugs. Clozapine is an antipsychotic medication for the treatment of refractory schizophrenia. It is suggested that clozapine alters plasma TNF-α levels and thus can modulate the inflammatory response. To date, a variety of adverse skin reactions (Stevens- Johnson syndrome, DRESS syndrome etc) have been previously described in the literature. However, to the best of our knowledge, this is the first case which strongly indicates the likely association between clozapine and drug-induced
PG.

Disclosure of Interest

None Declared
New ways in delivering services for people with dual diagnosis
Authors: Lien L. , Halvorsen N.
Published: August 2024

Introduction

People with severe mental health disorders and concurrent addiction problems are one of the most challenges patients to treat within mental health and addiction. They often find themselves fallen between different chairs within mental health and addiction services and between spescialist and primary care. There is a need for new ways of delivering services for this group.

Objectives

The objective of this presentation is to present how Flexible assertive outreach teams (FACT) are delivered in a densly populated country and the results on changes in use of spescialist services and detension. We will also present the results of changes in quality of life before and after entering FACT and which factors that might be associated with life quality.

Methods

The establising of FACT in Norway has been extecively evaluated both in the form of official reports to the health authorities and academic research papers. We will do a scoping review of the Norwegian research on the effect of FACT teams with a spesific attention to the results obtained in densly populated areas. The review will cover the years fra 2018 up til to day.

Results

The results so far indicate that it is possible to deliver FACT services in densly populated areas and that there is an increase in qualty of life before and after entering a FACT team. The use of hospitalization days are reduced with about 50 % and the same applies for days in detention.

Conclusions

FACT teams seems to be a viable way of delivering mental health care services to one of the most vulnerable groups in our society.

Disclosure of Interest

None Declared
Special Session Best of 2023: Care of the elderly
Authors: Perneczky R.
Published: August 2024

In the field of Alzheimer’s disease disease-modifying therapy, there has been a shift in diagnosis from the later dementia stages towards the earlier stages, with the potential for pre-symptomatic diagnosis. The development of truly ‘disease-modifying’ therapies that target the underlying mechanisms of Alzheimer’s disease has reached late stages of human clinical trials. The primary targets include beta-amyloid, whose presence and accumulation in the brain is thought to contribute to the development of Alzheimer’s disease, and tau protein which, when hyperphosphorylated, results in the self-assembly of tangles of paired helical filaments also believed to be involved in the pathogenesis of Alzheimer’s disease. Therapeutic strategies aimed at preventing Aβ formation, blocking its aggregation into plaques, lowering its soluble levels in the brain, and disassembling existing amyloid plaques are among the main strategies employed to slow the progression of AD. First anti-amyloid antibody treatments have proven effective in late-stage clinical trials and are now being approved for clinical use in some countries, initiating a new are of treatment. In terms of blood-based early diagnosis, the development of in vivo biomarkers has shifted the diagnosis of Alzheimer’s disease from the later dementia stages of disease towards the earlier stages and has introduced the potential for pre-symptomatic diagnosis. Recent study shows promising results for blood tests that could be used to identify Alzheimer’s changes in the brain before the onset of any symptoms, which could result in preventative treatments being used before any memory loss. This presentation will highlight the most exciting development of the past year in the Alzheimer’s disease therapy and diagnosis arena.

Disclosure of Interest

None Declared
Advancing schizophrenia care: Ongoing Study of a Mobile Application for Personalized Support
Authors: Vass E. , Szőke Á. , Réthelyi J. , Unoka Z. , Hermán L. , Morvai L. , Csukly G. , Strausz G. , Pataki B. , Orbán-Szigeti B. , Blénesi S. , Farkas K.
Published: August 2024

Introduction

Psychiatric care faces a significant challenge in the regular monitoring of patient states, predicting relapses, and ensuring treatment adherence. To address this, we aim to develop a mobile application tailored to individual patient needs. This application will revolutionize mental health care by offering real-time monitoring, education, evidence-based interventions, and enhanced communication between patients and clinicians.

Objectives

This ongoing study seeks to develop and evaluate a mobile application for individuals with schizophrenia spectrum disorders, aiming to transform personalized mental health care by addressing critical challenges in psychiatric care.

Methods

The study follows a multi-phase approach, incorporating prototype development, a proof-of-concept trial, and a Randomized Controlled Efficacy Study (RCT). Each phase is informed by iterative stakeholder feedback, ensuring responsiveness to real-world needs and experiences. The research was approved by the Semmelweis University Regional and Institutional Committee of Science and Research Ethics (SE RKEB: 85/2023).

Results

In the pilot phase, we have effectively tracked the daily well-being of participating patients through interactive activities and structured questionnaires. Our experiences in this phase promise to offer valuable insights for the psychiatric community, shedding light on the potential of personalized mental health care interventions.

Conclusions

This ongoing study represents a pivotal step towards redefining interventions for individuals with schizophrenia spectrum disorders. Early results signal a transformative potential in enhancing symptom management. As the study advances, deeper insights will emerge, emphasizing the profound impact of leveraging mobile technology in personalized mental health care.

Disclosure of Interest

None Declared
Emotion Regulation and Physiological Reactivity in the Parent-Child Relationship: A Preliminary Study of an Online Attachment-Based Program for Parents of Preadolescents with Behavioral Disorders
Authors: Tironi M. , Charpentier Mora S. , Bizzi F.
Published: August 2024

Introduction

Behavioral disorders have been defined as a “health crisis” of modern times that has a significant impact on the parent-child relationship. In this scenario, the emotional regulation (ER) of each partner plays a central role and serves a protective factor, configuring as an area to intervene. The Connect Parent Group, an attachment-based intervention for parents, has shown evidence of effectiveness. However, its online version (e-Connect) has not yet garnered specific evidence related to emotional and physiological regulation in parents and preadolescents.

Objectives

This study aimed to explore changes in the short and medium term regarding ER abilities - both self-reported and measured through physiological indices - in parents and preadolescents with behavioral disorders, building upon initial findings from an online parenting intervention.

Methods

28 parents (82.1% mothers, 17.9% fathers, M_age = 47.48, SD = 4.73) and their 28 preadolescents with behavioral disorders (M_age = 11.22 years, SD = 2.69, 35.7% girls) were recruited from child neuropsychiatry services in Northern Italy and subsequently took part in the pilot study. They were assessed at three time points: before intervention (T1), one months after the intervention (T2) and at 6-months follow-up (T3). ER were assessed with a multimethod approach: parents and children completed a self-report questionnaire (i.e., Difficulties in Emotion Regulation Scale and How I Feel, respectively) and then they interact during a stress-task in which physiological parameters (i.e., Galvanic Skin Response, GSR; Heart Rate/Beat per Minute, BPM) have been measured.

Results

Regarding self-reported ER, mixed-effects regression models showed an improvement in parent emotion dysregulation between T1 and T3 (p=0.004), a decrease in preadolescents’ negative emotions (p=.012) between T1 and T2 and a lower emotion intensity in preadolescents between the three-time points (p=.003). Regarding physiological ER, the two overall models of GSR and BPM were not significant for both parents and children. Yet GSR correlations within three-time points were positive and significant for children (T1-T2: r=.58; T1-T3: r=.68) but not for parents, while BPM correlations between T1 and T2 were significant for parents (r=.49) but not for children.

Conclusions

The online attachment-based parenting program appears to have contributed to a reduction in emotional dysregulation in parents and preadolescents, which seems to persist to some extent in the medium term. The non-significant results at the physiological level may suggest that changes reported by parents and children through self-report questionnaires do not align with changes in the physiological response to interpersonal stress experienced after an online intervention. Clinical and research implications will be discussed.

Disclosure of Interest

None Declared
Aggression management of criminal offenders in prison setting
Authors: Nikolić G. , Stojanović N. M. , Branković J. , Tošić Golubović S. , Žikić O. , Kostić J.
Published: August 2024

Introduction

A new approach of social therapy for criminal offenders was applied in Penalty Facility in Niš, Serbia. It is based on three month peer-training focusing on recognizing of triggers for anger, understanding emotional manifestation and learning socially acceptable ways of anger expression.

Objectives

To estimate how the impact of pear-based training influences the level of agression of criminal offenders in prison settings.

Methods

One hander and six prisoners were randomly assigned to program. The six previously educated inmates trained the participants through 12 work-shops. An independent professional evaluated change in aggression levels after training using Buss&Perry Aggression Scale. We compared subgroups with shorter versus longer sentences pre and post training using Student’s t test. And univariate logistic regression analysis for impacts of sociodemographic variables on aggression scores.

Results

We found a significant higher scores of anger (6.6 ± 4.7 & 11.8 ± 4.2, p=0,043) hostility (15.5 ± 8 & 20.1 ± 6.5, p=0,029) and total aggression (32 ± 14 & 48 ± 21, p=0,023 in subgroup with longer sentences at baseline. After training anger (12.4 ± 4.8 & 15.5 ± 5.6, p= 0,0167), physical aggression (14.6 ± 51. & 17.2 ± 5.6 ,p=0,024) and total aggression score (55.5 ± 14.1 & 68.2 ± 18, p=0,0152) remained higher in the group with sentences more than five years. Lower education level is associated with undesirable outcome-higher level of aggression after training.

Conclusions

Three months training was not sufficient for adopting skills for better control of aggressive behavior in criminal offenders never the less the length of the sentences.

Disclosure of Interest

None Declared
Insight into Illness Among Inpatients in a National Forensic Mental Health Service: A Dundrum Forensic Redevelopment Evaluation Study (D-FOREST)
Authors: Waqar M. U. , Murray S. , O’Reilly A. , Kennedy H. G. , Davoren M.
Published: August 2024

Introduction

Forensic psychiatric services serve a dual purpose: treatment of mental disorders and prevention of associated violent reoffending. Progression along the secure care pathway is often impeded by impaired insight, mainly as a result of treatment-resistant psychoses.

Objectives

We assessed levels of insight among patients in Ireland’s National Forensic Mental Health Service before and after its relocation from the historic 1850 campus in Dundrum to a modern facility in Portrane, Dublin.

Methods

The VAGUS insight scale was used in this repeated measures study before and after the relocation at two time points 42 months apart. All inpatients were invited to participate in completing the self-report (VAGUS-SR) and clinician-rated (VAGUS-CR) versions on both occasions. Total scores of both versions were averaged to obtain a combined VAGUS insight score. Corresponding Positive and Negative Syndrome Scale (PANSS) scores were used to ascertain correlations between the insight and symptomatology scales. This study is part of the Dundrum Forensic Redevelopment Evaluation Study (D-FOREST)

Results

40 pairs of observations were available for legal capacity to consent to medication, combined VAGUS-CR and VAGUS-SR assessments of insight (Cronbach’s alpha=0.927), and PANSS. VAGUS-CR insight and PANSS scores were progressively better from admission and high dependency wards through medium-term medium secure wards to rehabilitation and pre-discharge wards. Mean scores did not change significantly over this time interval. Those legally certified fit to give or withhold consent by their treating consultant psychiatrists scored significantly better on the VAGUS combined insight scale: 8.3 (SD 1.7) v 5.3 (2.2) at baseline, paired t=25.9, p<0.001; and also 42 months later: 8.2 (1.4) v 5.7 (3.9), paired t=5.2, p=0.022. PANSS subscales were all significantly better for those assessed as being capacitous. Change in combined VAGUS score correlated with change in all PANSS subscales. Binary logistic regression with legal capacity as the dependent variable yielded a model in which combined VAGUS score and PANSS positive symptom score were independent determinants of assessed capacity status. Receiver operating characteristic area under the curve was 0.873, 95% CI 0.760-0.986, at baseline and 0.856, 95% CI 0.720-0.991, at 42 months. A score of 7.3 yielded a sensitivity of 0.8 and a specificity of 0.8.

Conclusions

The combined VAGUS score is a reliable and valid measure of insight relevant to functional mental capacity to consent to treatment with sensitivity and specificity sufficient to guide but not bind clinical decision-making. It measures a quality that varies with symptom severity but is also partly independent of symptom severity; the constructive inclusion of self-reported insight is notable.

Disclosure of Interest

None Declared
The forensic assessment of human trafficking víctims in Catalonia (Spain): characteristics and mental health status
Authors: Bertomeu A. , Cano E. , Mateu A. , Xifró A. , Barbería E.
Published: August 2024

Introduction

Systematic reviews show a high prevalence of mental distress among victims of human trafficking. In criminal proceedings in Spain, a forensic expert assessment of survivors may be ordered by the courts. Its aims are mainly, albeit not exclusively, to determine the consequences of trafficking on the physical, mental, and social health of the victims. The Institute of Legal Medicine and Forensic Sciences is the public institution providing psychiatric expert assessments in the autonomous region of Catalonia (Spain). Recently, a unit devoted to the forensic assessment of human trafficking victims has been created at the central headquarters of the Institute in Barcelona.

Objectives

To describe the characteristics and the mental health status of trafficked people identified as victims in criminal proceedings.

Methods

Retrospective study of case records of victims of human trafficking at the Institute of Legal Medicine and Forensic Sciences of Catalonia (2016-2023).

Results

Case records of 50 survivors were identified. 38 (76%) were female; mean age was 30,5 years (SD 10,42; range 17 to 69 years). All of them were foreigners, mainly from Latin America (24; 48%). Most of them were trafficked for sexual exploitation (32; 64%). 11 (22%) were assessed immediately after their rescue (emerging cases). Some of the victims had previous mental health problems, including intellectual disability (3; 6%). Among the non-emerging cases, the most frequently recorded mental disorders at the moment of the psychiatric expert assessment were post-traumatic stress disorder (PTSD; 21; 53,8%) and anxiety (12; 30,8%). Complex PTSD was observed in 1 case.

Conclusions

The majority of human trafficking survivors in the forensic setting suffer from persistent mental health problems as a consequence of their victimisation. A trauma-informed forensic psychiatric assessment is recommended.

Disclosure of Interest

None Declared
Impact of mother’s childhood trauma on development of psychopathological dimensions in patients with peripartum mental disorders
Authors: Bassi de Toni A. , Culicchia G. , Del Casale A. , Tinè M. , Vallerga A. V. , Cutillo L. , Bernardi S. , Bilotta I. , Fattorini A. , D’Alessio R. , De Felici D. , Pompili M. , Angeletti G.
Published: August 2024

Introduction

Peripartum mental disorders (PPMD) are characterized by heterogeneous psychopathological symptoms related to specific personality traits, which are only taken into account by a few preventive and therapeutic strategies. Traumatic experiences during childhood could predispose to develop those disorders during adulthood, especially in more stressful conditions, such as pregnancy and postpartum.

Objectives

Our study aims to evaluate the correlation between mother’s childhood trauma and the development of certain psychopathological dimensions during peripartum and which of these dimensions could be indicative of mother’s childhood trauma.

Methods

The sample included 74 women, recruited from Sant’Andrea Hospital in Rome between 2011 and 2022, diagnosed with a psychiatric disorder during peripartum, according to criteria of DSM-5. All recruited women were administered the Childhood Trauma Questionnaire – Short Form (CTQ-SF) and the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). We performed a linear regression using the total CTQ score as a dependent variable and the MMPI-2 scale’s scores as independent variables.

Results

The linear regression used showed two significant models, of which the most inclusive explained 60% of the variance (R2 = 0.597), resulting significant (F = 31.141; p < 0.001). This model showed that a greater expression of childhood traumatic aspects was associated with greater expression of Pa (paranoia) (t = 4.04; p < 0.001) and Ma (hypomania) (t = 3.873; p < 0.001) in the clinical scales of the MMPI-2, which were indicative of childhood trauma.

Conclusions

Our study shows that paranoiac and hypomanic symptoms in PPMD, assumed by the MMPI-2 scale, are indicative of previous traumatic dimension. Thus, in the presence of a positive history of trauma, clinicians should pay attention especially to these aspects, in order to optimally set both pharmacological and psychotherapeutic treatment.

Disclosure of Interest

None Declared
Scale for Body Image Concerns During the Perinatal Period – Adaptation and validation
Authors: Pereira A. T. , Barbosa B. , Lima R. , Araújo A. I. , Marques C. , Pereira D. , Macedo A. , Pinto Gouveia C.
Published: August 2024

Introduction

The perinatal period may intensify weight and body image concerns. Due to its specifics, the traditional body image scales are inaccurate in the perinatal period (Fuller-Tyszkiewicz et al. 2013). The Body Image Concerns During Pregnancy (Uçar et al. 2018) was developed to measures this cognitive-emotional variable in pregnancy.

Objectives

To analyze the psychometric properties of the Portuguese adapted (both for pregnancy and postpartum) version of the Body Image Concerns during the Perinatal Period (BICPP), namely its construct validity and the internal consistency.

Methods

A sample of 346 women recruited through social media and Family Health Units, assessed in the second trimester of pregnancy (mean gestational age=28.11±7.67 weeks) and after delivery (baby’s age 4.37±2.87 months), completed a survey including the Portuguese BICPP.

The total sample was randomly divided into two sub-samples: sample A (n=173) was used to perform an exploratory factor analysis/EFA; sample B (n=173) to perform a confirmatory factor analysis/CFA.

Results

EFA resulted in four components. CFA revealed that the second-order model with four factors presented good fit indexes (X2/df=2.4141; CFI=.9195; GFI=.948; TLI=.9028; GFI=.8181; RMSEA=.0807). BICPP Cronbach alphas was α=.936; for F1 Concern about future weight and image, F2 Concern with the new body image, F3 Social avoidance and concern and F4 Concern with appearance were .922, .930, .809, .807, respectively.

Conclusions

This psychometric study provides evidence for the validity and reliability of the Portuguese version of BIC-Perinatal Period, which will be used in an ongoing research project on the relationship between eating, depressive and anxiety disorders in the perinatal period.

Disclosure of Interest

None Declared
Screen for Cognitive Impairment in Psychiatry (SCIP): Adaptation and validation for Portuguese Version
Authors: Couto B. , Ortiga R. , Gonçalves A. S. , Monteleone F. , Oliveira S. , Fonseca J. B. , Rodrigues R.
Published: August 2024

Introduction

Cognitive dysfunction has been reported in acute psychiatric patients for a long time and has profound implications for the management of severe mental disorders. The Screen for Cognitive Impairment in Psychiatry (SCIP) is a scale developed for screening cognitive deficits. This tool is simple and easy to administer.

Objectives

To translate and to validate to Portuguese the SCIP.

Methods

The accepted back-translation method is employed for translating from English into Portuguese. One-hundred individuals in good health were characterized using demographic questionnaires and a neuropsychological battery. Subsequently, the new version of the scale was administered on two distinct occasions with a minimum one-week gap between them.

Results

High internal consistencies as well as strong correlations with comparable neuropsychological tests were obtained.

Conclusions

The results obtained from the Portuguese version of SCIP are in line with those from the English version. Effectively, SCIP serves as a key instrument for the initial assessment of cognitive function. Its characteristics, particularly its conciseness and independence from a technological platform, allow it to be integrated into clinical practice. Our aim is to use this version and apply it to different pathologies, comparing patients with controls. This will allow us to study different patients and apply it to our population.

Disclosure of Interest

None Declared
(Ir)reversibility of structural and functional brain alterations in severe anorexia
Authors: Kaufmann L.-K.
Published: August 2024

Anorexia nervosa is characterized by profound structural and functional brain alterations, particularly during the phase of acute underweight. Understanding the reversibility of these changes upon weight normalization is an important question in the pursuit of recovery and relapse prevention. This talk shares findings from recent neuroimaging studies, focussing on the dynamic processes of brain recovery observed during and after inpatient treatment in individuals with severe anorexia nervosa.

Disclosure of Interest

None Declared