bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Staging Methods for Treatment-Resistant Depression: Chart Review
Authors: Avanoğlu K. B. , Oktar Erdoğan N. , Ağaoğlu E. , Başar K.
Published: August 2024

Introduction

Treatment-resistant depression (TRD) lacks a universally consistent definition due to varied interpretations despite attempts to define it based on inadequate response or remission despite sufficient antidepressant treatment. There’s a crucial demand for a uniform definition and staging to streamline its effective management amid diverse treatment options and the complex nature of resistance. Five methods have emerged to define and classify treatment resistance reliably.

Objectives

The aim of this study is to compare the five staging methods (Thase&Rush SM (T&R), European Staging Method (ESM), Maudsley Staging Method (MSM), Massachusetts General Hospital Staging Method (MHG-s), Conway Staging Method(Conway)) in assessing treatment resistance within a single sample.

Methods

Retrospective analysis involved medical records of inpatient psychiatry clinic admissions at Hacettepe University between October 2012 and October 2014. Patients with a primary diagnosis of bipolar affective disorder, schizophrenia, other chronic psychotic disorders, dementia or cognitive disorders, alcohol and substance use disorders, and those with missing data were excluded.

Results

Initial screening yielded a total of 115 patients. 64 patients were included in the study, 13 patients were excluded due to missing data, and 38 patients were excluded due to comorbidity.CharacteristicTotal (N=64)
Last Episode CharacteristicsTotal (N=64)Female - N(%)44 (69)Episode duration – month (mean ± SD)13.75 ± 16.09Age – yr (mean ± SD)48.39 ± 18.81Psychotic symptoms – N(%)20 (31)Married – N(%)41 (64)Anxiety symptoms – N(%)24 (38)Secondary school and over – N(%)38 (59)Suicidal attempt – N(%)19 (30)Employed – N(%)16 (25)TRD definition and staging method (N=55)
T&R
ESM
MSM
MGH-S

ConwayNot resistant by this method26 (47.3)45 (81.8)0 (0)27 (49.1)43 (78.2)Identified by this method29 (52.7)10 (18.2)55 (100)28 (50.9)12 (21.8)Exclusively identified by this method0 (0)0 (0)21 (38.2)0 (0)0 (0)By this and one other method27 (49.1)0 (0)11 (20)5 (9.1)0 (0)By all methods10 (18.2)10 (18.2)10 (18.2)10 (18.2)10 (18.2)Identified as TRDAge of onset
(mean ± SD)40.28 ± 17.4235.6 ± 18.2740.44 ±18.3840.07 ± 17.938.17 ± 17.71ATHF score
(mean ± SD)7.55 ± 5.4612.1 ± 6.514.93 ± 4.987.43 ± 5.6911.08 ± 6.47Last episode duration (month)
(mean ± SD)17.11 ± 17.2522.10 ± 20.9614.22 ± 17.0816.33 ± 17.6620.83 ± 19.25

Conclusions

There is no universally agreed-upon definition for treatment resistance. In this sample, different definition and staging methods were employed to examine the similarities and differences in the clinical and treatment related characteristics of groups with TRD identified with each. The reasons and possible implication of concurrence and discordance between the methods will be discussed.

Disclosure of Interest

None Declared
Personality Traits in Patients with Depression: Association with Symptoms of Depression and Anxiety
Authors: Galnaitytė S. , Adomaitienė V.
Published: August 2024

Introduction

The symptoms of depression and anxiety, which are frequently comorbid, may be significantly impacted by the individual’s personality, even considering the complex etiology of depression. Several studies have shown that while certain personality traits may act as protective factors, others may increase vulnerability to depression and anxiety. Understanding these relationships may be important since personality traits have gained attention as potential determinants of symptom severity and treatment outcomes.

Objectives

To identify and evaluate the association of personality traits with symptoms of depression and anxiety in patients with depression.

Methods

The study involved 80 inpatients (≥ 18 years), hospitalised in University psychiatry department with depression diagnosis based on the ICD-10-AM classification. Subjects were asked to fill the Overall Anxiety Severity and Impairment Scale (“OASIS”), the Big Five Personality Dimensions scale and the Patient Health Questionnaire-9 (PHQ-9). Data analysis included descriptive data, Shapiro-Wilk test, Spearman correlation, Kruskal–Wallis test and Chi-Square test, with a significance threshold of p<0.05.

Results

Severe (26.3%) and very severe (41.3%) depressive symptoms were the most prevalent. Extraversion was associated with minimal (p=0.002), conscientiousness with mild (p<0.001), neuroticism with very severe depressive symptoms (p=0.003). The majority of depressed patients had severe (33,75 %) or very severe (32,5 %) anxiety symptoms. Anxiety symptoms were associated with more severe depressive symptoms (r=0.704, p<0.001). The association of conscientiousness and moderate anxiety symptoms was found (p=0.004). In the presence of expressed neuroticism, most of the respondents showed very severe anxiety symptoms, in the absence of neuroticism – moderate anxiety symptoms (p<0.001).

Conclusions

The results showed that personality traits were associated with severity of depression and anxiety symptoms in psychiatry inpatient with depression. Therefore, recognition of predominant personality traits in patients with depression may be helpful in selecting treatment and predicting treatment outcomes.

Disclosure of Interest

None Declared
Exploring the Interplay of Humor and Quality of Life in Adults Confronting Chronic Diseases: A Comprehensive Systematic Review
Authors: Bartzou E. , Tsiloni E. , Mantzoukas S. , Dragioti E. , Gouva M.
Published: August 2024

Introduction

Chronic diseases, often referred to as non-communicable diseases (NCDs), stand as the leading global cause of mortality. Individuals grappling with chronic ailments frequently experience a decline in their overall quality of life (QoL), encompassing psychological, social, and physical dimensions of well-being.

Objectives

Recognizing that humor has demonstrated the potential to engender favorable effects on QoL, this systematic review seeks to explore the correlation between humor and QoL among adults contending with chronic health conditions.

Methods

A thorough examination of quantitative data was conducted in strict adherence to the PRISMA 2020 guidelines. PubMed/MEDLINE, PsycINFO, and CINAHL were comprehensively searched from their inception until June 22, 2023. Furthermore, the reference lists of the included datasets and relevant review articles were exhaustively scrutinized (Figure 1). The Newcastle-Ottawa Scale (NOS) was employed to assess the quality of eligible studies.

Results

A total of eighteen studies met the inclusion criteria, encompassing a diverse spectrum of chronic disease categories, including cardiovascular diseases and various types of cancer, among others. Collectively, these studies involved a participant cohort comprising 4,325 individuals. Noteworthy findings emerged, indicating a substantial association between distinct facets of humor—such as one’s sense of humor, coping humor, humor styles, and laughter—and psychological QoL. Nevertheless, the relationship between humor and physical QoL exhibited a more intricate pattern, characterized by mixed outcomes (Figure 2).

Image:

Image 2:

Conclusions

Despite the limited and inconsistent evidence across studies, humor appears to exhibit a positive association with QoL.

Disclosure of Interest

None Declared
The Effect of the COVID-19 Pandemic on Suicide Attempts and Self-Harm in Teenagers and Young Adults: An Analysis of Regional Emergency Medical Center Data of a Metropolitan City in South Korea
Authors: Bae S. M. , Ku N.
Published: August 2024

Introduction

The COVID-19 pandemic has had a wide-ranging impact on economic and social phenomena worldwide, particularly affecting mental health. However, these impacts have varied significantly across countries. Previous studies have shown that the groups more vulnerable to mental health problems also differ across countries and societies(Gunnel et al. Lancet Psy 2020; 7(6) 468-471, Pirkis et al. Lancet Psy 2021; 8(7) 579-588, Nomura et al. Psy Res 2021; 295 113622). Therefore, by examining changes in self-harm and suicide attempts, which constitute mental health emergencies, at the community level, we can explore the COVID-19 pandemic’s impact on the deterioration of mental health in various age groups within the region and identify the groups most vulnerable to mental health problems.

Objectives

The aim of this study is to examine the relationship between the COVID-19 pandemic and changes in the number of emergency room visits due to suicide attempts or self-harm in teenagers and young adults in Incheon, a metropolitan city in the capital area of South Korea.

Methods

We conducted a retrospective data analysis on the medical records of patients who visited the regional emergency center of Incheon Medical Institution from January 2018 to December 2022 due to suicide attempts or self-harm. As our statistical method, we employed interrupted time series analysis to determine whether the COVID-19 pandemic has a statistically significant correlation with the trend changes in the number of emergency room visits related to suicide attempts or self-harm. This study was approved by the Institutional Review Board of Gil Medical Center, Gachon University of Korea(IRB approval number GFIRB2022-335).

Results

The data of 4,030 subjects(35.8% male; n=1,443) who visited the regional emergency center during the study period were analyzed. A total of 556 (13.79%) of the study participants were minors under the age of 19, and a total of 1,789 (44.39%) were young adults aged 20-39. The analysis revealed an increasing trend in the number of emergency room visits due to elevated suicidality in teenagers and young adults (20-39 years old) following the COVID-19 pandemic(figure 1 & figure 2).

Image:

Image 2:

Conclusions

While suicide attempts and visits to the emergency room due to self-harm increased both before and after COVID-19, it is noteworthy that past suicide attempts are the most significant risk factor for future suicide attempts. Therefore, the data on vulnerable groups presented in this study can be instrumental for effective prevention and follow-up management of suicide attempts within the field of community psychiatry.

Disclosure of Interest

None Declared
Comparing Psychiatric Admission Following Suicidal Presentations to the Emergency Department pre-COVID and During the COVID era
Authors: Crowley S. , Cassidy E.
Published: August 2024

Introduction

Suicide is one of the leading causes of death worldwide, (Centiti et al. 2020). Presentations to the emergency department (ED) with suicidal ideation (SI) or deliberate self-harm (DSH), and admissions following same, are a major part of unscheduled adult mental health service activity.

Objectives

To evaluate how suicidal presentations to the emergency department (ED), and admission following same have been affected by the COVID era thus far. To evaluate how key patient characteristics affect admission during the COVID era and pre-COVID, namely whether presentations were with suicidal ideation (SI) or deliberate self-harm (DSH), whether the patient was previously known to a community mental health team (CMHT), and whether the patient was intoxicated at the time of presentation.

Methods

Data is routinely collected on all adults presenting with SI/DSH to the ED. We looked at presentations, admissions and key patient characteristics over the 12 months of the COVID era thus far (March 2020-February 2021) and compared them to the preceding 12 months.

Results

Presentations over the two 12 month periods were similar (pre-COVID n=819, COVID era n=823). However, admission increased by 27% (139 to 177) over the COVID era as a whole. For nine months of the COVID era monthly numbers of admissions were higher than their pre COVID comparison. Admission rates during the COVID era were found to be increased across all patient groups examined, but were particularly increased in those presenting sober or with SI. Admission rates rose equivalently for those known or unknown to a CMHT.

Image:

Image 2:

Conclusions

The number of admissions following suicidal presentations to the ED has risen significantly in the COVID era. This may be due to more severe presentations in terms of risk of suicide without admission or increased psychiatric morbidity requiring admission. Limitations of service provision in the community due to COVID era restrictions may also partially explain these findings.

Disclosure of Interest

None Declared
Anxiety and subjective assessment of cognitive functions after COVID-19.
Authors: Medvedeva T. I. , Boyko O. M. , Enikolopov S. N. , Vorontsova O. U.
Published: August 2024

Introduction

Wide circulation of the COVID-19 has led to the high occurrence of a longcovid in which the complaints of violations of cognitive functions and affective disorders often occur.

Objectives

The aim of this study was to assess the relation of anxiety and subjective appraisal of the states of cognitive functions.

Methods

The data of 1233 respondents of internet-research who were divided into the four groups according to their COVID-19 status and the level of anxiety. Group 1 (didn’t have COVID before, low level of anxiety) – 689 people (mean age 40,6), group 2 (didn’t have COVID before, High level of anxiety) – 364 people (mean age 39,8), group 3 (had been ill COVID-19, low level of anxiety) – 102 people (mean age 41,2), group 4 (had been ill COVID-19, High level of anxiety) -130 people (mean age 35,5). Methods include the questions about the states of their cognitive functions (attention, memory, working capacity), a question about COVID-19 status. There are the results of comparing the groups that was carried out using the Kruskal-Wallis test. A pairwise comparison was carried out using the Mann-Whitney test for two groups of people who were not ill; two groups who were ill; two groups with a low level of anxiety; two groups with a high level of anxiety. To correct multiple comparisons, the adjusted significance level calculated by the formula (p = 1 - 0,9511/n) was used, which was p=0,017 for 4 pairwise comparisons.

Results

Results are shown in table.Group 1Group 2Group 3Group 4Trouble remembering things0,500,990,771,30(*2)(*1,*4)(*1,*4)(*2,*3)Feeling low in energy or slowed down0,741,771,232,34(*2,*3)(*1,*4)(*1,*4)(*2,*3)Having to do things very slowly to insure correctness0,270,880,311,00(*2)(*1)(*4)(*3)Difficulty making decisions0,631,630,821,67(*2)(*1)(*4)(*3)Your mind going blank0,341,120,641,36(*2,*3)(*1)(*1,*4)(*3)Trouble concentrating0,581,550,721,86(*2)(*1,*4)(*4)(*2,*3)Feeling everything is an effort0,431,470,561,81(*2)(*1,*4)(*4)(*2,*3)

An entry in parentheses such as (2*) means that this group for this parameter statistically significant differs from group 2.

As indicated in the table, respondents with the high level of anxiety have higher levels of the subjective assessment of cognitive functions regardless of their COVID-19 status.

Conclusions

A possible explanation may be the disorganizing effect of anxiety on the cognitive functions. When combined with possible organic disorders caused by the transferred COVID-19, the most marked indicators of cognitive decline are observed. An effective rehabilitation of cognitive functions after COVID-19 requires to diagnose the level of anxiety and to seek psychological and psychiatric assistance for people with a high level of anxiety.

Disclosure of Interest

None Declared
The influence of the COVID-19 pandemic on the occurrence of depressive symptoms in the Croatian adult population
Authors: Dumic J. , Miskulin I. , Kristic M. , Kovacevic J. , Vukoja I. , Dumic L. , Miskulin M.
Published: August 2024

Introduction

The COVID-19 pandemic has led to a worsening of mental health among the Croatian general population. However, the overall prevalence of population depressive symptoms in Croatia over the COVID-19 pandemic is still unknown.

Objectives

This study aimed to investigate the influence of the COVID-19 pandemic on the occurrence of depressive symptoms among Croatian adults.

Methods

This cross-sectional questionnaire study was conducted from mid-February to mid-May 2022 period. A validated, anonymous questionnaire that contained questions regarding demographic data, as well as the Zung Self-Rating Depression Scale was self-administered to a convenient sample of adults from the city of Osijek in eastern Croatia.

Results

The study sample included 500 subjects with a median age of 34 years (interquartile range 26-53), 42.4% males, and 57.6% females. According to the Zung Self-Rating Depression Scale, there were 16.2% of subjects with mild or moderate depressive symptoms. Depressive symptoms were more frequent among older subjects (61 years or older) (p=0.001), among subjects with a lower level of education (subjects with or without elementary school) (p<0.001), among subjects who were retired (p=0.005), among subjects who considered their socioeconomic status as under average (p<0.001), and among subjects who experienced death of close family member caused by COVID-19 infection (p=0.004).

Conclusions

The COVID-19 pandemic increased the prevalence of depression in the Croatian general population where some sociodemographic characteristics of study subjects seem to put those subjects at greater risk considering the occurrence of depressive symptoms. Development of appropriate supportive programs that enhance the mental health of the Croatian general population during pandemics is needed to potentially prevent the occurrence of depressive symptoms and to help the general population successfully overcome this important mental health challenge.

Disclosure of Interest

None Declared
DefiGame, a serious game to discover neurodevelopmental disorders
Authors: Bonnet C. , Immesoete C. ,   Specialists and parents affiliated to the french rare disease network DéfiScience - Professeur Vincent des Portes, Mme Marie-Pierre Reymond, Mme Caroline Immesoete, Mme Fanny Forel, Mme ANTOINE Odile, Mme AUPETIT Laure, Mme BENOIT Céline, Docteur BROSSEA
Published: August 2024

Défigame is a training tool designed in collaboration with parents and specialists from the French Rare Diseases Network DéfiScience.

In this serious game, you take on the role of a general practitioner treating four young patients whose developmental trajectories raise questions. Interactively and with the help of concrete tools, you’ll learn about the recommendations for coordinating an appropriate course of prescription, care and support for a family, from the search for a diagnosis to early management of a Neurodevelopmental Disorder (NDD).

WHO IS DEFIGAME FOR?

–

Any European doctor questioning the etiology of a neurodevelopmental disorder, prescribing genetic tests or wishing to update their knowledge in the field of NDD, particularly in relation to a rare disease.

–

Any other healthcare professional concerned with etiological diagnosis or support for people with NDD and their families.

Disclosure of Interest

None Declared
Developing a support intervention for family members of people treated under the Mental Health Act
Authors: Wells I. , Wintsch K. , Giacco D.
Published: August 2024

Introduction

In England, a national Mental Health Act (MHA) review was carried out, providing recommendation for policy and practice changes. One of these recommendations was to provide support to family members (FMs) of patients who have been involuntarily hospitalised. In response to this review, the National Institute for Health and Care Research (NIHR) provided funding for research to address policy questions, for example what support may be most relevant to FMs during their patients’ treatment. The study presented here was funded as part of this initiative and has explored what support FMs wish to receive.

Objectives

To explore FMs’ experiences and views around support they would have liked during their patients’ involuntary hospitalisation and wider stakeholder views on what a family support programme in England should involve. This information can be used to develop a support programme for FMs.

Methods

One-to-one interviews were conducted online as part of two work packages. The first work package explored FMs’ experiences and views of support. The second work package explored views on what should be included in a family support programme in England from FMs, patients and professionals. Interviews took place at three sites across England. Audio recordings of the interviews were transcribed, and data were analysed using thematic analysis.

Results

22 FMs were recruited to the first work package, where four key themes were identified: (1) heterogeneity in the current support for families; (2) information about mental health and mental health services; (3) continuous support; and (4) peer support and guidance. FMs reported receiving support from professionals, peers and relatives, but the extent of this support varied. FMs consistently reported wanting a named contact to provide information and personal continuity of support. 5 FMs, 4 patients and 10 professionals took part in the second work package, where four main themes were also identified: (1) development of a support programme; (2) delivery of a support programme; (3) factors limiting accessibility or engagement; and (4) benefits of a support programme. Information about the MHA and strategies to promote effective communication between FMs and professionals were identified as important to include in the programme and its delivery should include a combination of face-to-face, written and online methods. Potential benefits of the programme include improved FM knowledge and wellbeing.

Conclusions

FMs of involuntarily hospitalised patients should receive information around the MHA and strategies to promote effective communication with professionals. FMs should also be allocated a named contact person to offer information and personal continuity of support through various methods, for example through online, face-to-face or written contact.

Disclosure of Interest

None Declared
Palestine-Israel War Coping Strategies of Tunisian People
Authors: Messedi N. , Guermazi F. , Samet A. , Chaari I. , Sehli M. , Charfeddine F. , Aribi L. , Aloulou J.
Published: August 2024

Introduction

The war in Gaza is a stressful life event. Due to its significant human and financial losses, it affected the mental health of people around the world including the middle east citizens.

Objectives

To study the coping strategies of Tunisian people toward Palestine-Israel war in its first month and the factors associated with them.

Methods

It was a cross-sectional, descriptive and analytical study, conducted among Tunisians. Data were collected during October and November 2023, through an anonymous online questionnaire, spread throughout social media (Facebook/Instagram), using the Google Forms® platform. We used a socio-demographic and clinical data sheet and the “Brief-COPE” to assess coping strategies.

Results

A total of 1091 participants completed the questionnaire. Their mean age was 32,7± 9.8 years, with a sex-ratio (F/M) of 3.5. Among participants, 46,1% are married, 42,5% have children and 19,5% have a psychiatric follow history. Sport’s practitioners represent 23,3% of the participants and 10,6% increased their use of sports after the war news.

In terms of coping strategies: problem focused coping was the most used strategy (mean= 2,02) followed by emotional focused coping (mean= 1,98) and avoidant coping (mean= 1,63). Tunisians rely the most on religion, accepting reality and planning as coping mechanisms (score= 2,85; 2,4 and 2,23 respectively). Substance use was the last resort option (score= 1,11).

Our survey revealed significant associations between coping mechanisms and several factors: Venting, humor and behavioral disengagement were significantly correlated with sex gender (p=0,000 ; 0,000 ; 0,000 respectively); Substance use coping mechanism was significantly correlated with participants having a psychiatric follow history (p=0,001); Avoidant coping subscale was significantly correlated with having children (p=0,000); Self distraction was significantly correlated with the increase use of sport among Tunisians (p=0,000).

Conclusions

These findings underscore the need for healthcare and productive coping strategies for Tunisians and middle east people during the Palestine-Israel
war.

Disclosure of Interest

None Declared
Effects of a transition care program on depression, self-efficacy, and self-care behaviors in heart failure patients
Authors: Yeh H.-S. , Tsai Y.-F.
Published: August 2024

Introduction

Heart failure is a progressive and unpredictable heart disease. How to work with these patients to decrease their psychological distress and promote their self-care behaviors is important. Transition care is the continuity of medical care for heart failure patients returning home from the hospital. Intervention through transition care may improve the continuity of medical care for patients with heart failure but it has not been examined in clinical settings in Taiwan.

Objectives

The aims of this study were to explore the effects of a newly developed transition care program on depression, self-efficacy, and self-care behavior of heart failure patients.

Methods

Using an experimental research design and block randomization, participants were divided into the experimental group (received transition care and routine care) and the control group (received routine care only). The Patient Health Questionnaire-9 (PHQ-9), the General Self-Efficacy Scale (GSES), and the Self-Care of Heart Failure Index (SCHFI version 6.2) were used to collect data before discharge and the first month after discharge.

Results

A total of 20 patients with heart failure were recruited. No significant differences were found between the experimental (n=10) and control groups (n=10) in the degree of depression (Z=-.077, p=.938), self-efficacy (Z=-1.214, p=.225), and three self-care behaviors subscales (self-care maintenance Z= -1.214, p=.225; self-care management Z= -.401, p=.689; self-care confidence Z=-.436, p=.663) at discharge. After the one-month posttest, only self-efficacy (Z=-2.545, p=.011) and three self-care behaviors subscales (self-care maintenance Z=-3.097, p=.002; self-care management Z= -2.595, p=.009; self-care confidence Z=-3.671, p<.001) reached a statistical difference between the two groups.

Conclusions

Based on the preliminary results, heart failure patients can improve their self-care behavior and self-efficacy but not depression through transitional care intervention.

Disclosure of Interest

None Declared
Older Adults’ Knowledge of Geriatric Depression and Its Related Factors
Authors: Tsai Y.-F. , Lee S.-H.
Published: August 2024

Introduction

Even though depression is a severe health issue among older adults, few studies have explored their knowledge of geriatric depression.

Objectives

This study aimed to explore older adults’ knowledge of geriatric depression and its related factors.

Methods

A cross-sectional survey was conducted. Older adults were recruited by convenience from outpatient clinics of three hospitals in Taiwan.

Results

A total of 327 older adults participated in this study. Their mean score of knowledge was 7.73 (SD=2.12, Range=2-12) on an 18-item knowledge scale, indicating poor knowledge of geriatric depression. Females had significantly higher geriatric depression knowledge scores than males (t=2.50, p=0.01). Junior and senior high school graduates had significantly higher geriatric depression knowledge scores than illiterate and primary school graduates (F=10.23, p<0.01). In addition, their geriatric depression knowledge scores also differed by religious belief (F=4.91, p<0.01), living status (F=8.64, p<0.01), and perceived health condition (F=8.81, p<0.01). Buddhists had significantly higher geriatric depression knowledge scores than Taoists. Living with partners and perceiving their health status as fair and good tended to have higher geriatric knowledge scores than their counterparts. However, their geriatric depression knowledge scores did not significantly correlate with their mean scores of social distance toward older adults with depression.

Conclusions

Older adults tended to have poor geriatric depression knowledge. Improving their knowledge shall be an urgent task. Our results may serve as references for developing further depression prevention.

Disclosure of Interest

None Declared
Features of the spectrum of immune markers in patients with juvenile depression with clinically high risk of psychosis
Authors: Zozulya S. A. , Omelchenko M. A. , Otman I. N. , Sarmanova Z. V. , Migalina V. V. , Kaleda V. G. , Klyushnik T. P.
Published: August 2024

Introduction

Identification of biomarkers associated with the risk of psychosis manifestation in juvenile patients with depression may contribute to a better understanding of the pathogenesis of mental disorders and early diagnosis.

Objectives

To determine the level of pro-inflammatory and anti-inflammatory cytokines and other inflammatory indicators in the plasma of juvenile patients with depression and clinically high risk of psychosis, and to study the correlation of these markers with the severity of psychopathologic symptoms.

Methods

80 young men aged 16-24 years with the first depressive episode (F32.1-2, F32.38, F32.8) were examined. Based on the severity of attenuated psychotic symptoms (APS) in the structure of depression according to the SOPS scale, all patients were divided into two groups - with clinically high risk of psychosis (n=58) and with depression without APS (n=22). The HDRS-21 and SANS scales were also used for psychometric assessment. Serum level of cytokines TNF-α, IL-6, IL-8, IL-10, TNF-α/IL-6 ratio, TNF-α/IL-10 ratio, leukocyte elastase (LE) and α1-proteinase inhibitor (α1-PI) activity, C-reactive protein (CRP) concentration, and the level of autoantibodies to S-100B protein were determined.

Results

Both groups of patients showed a high level of inflammation assessed by LE and α1-PI activity (p>0.05). Significantly higher level of IL-6 (p=0.03), CRP concentration (p=0.026) and TNF-α/IL-10 ratio (p=0.032) were found in patients with clinically high risk of psychosis. This group was also characterised by high level of autoantibodies to the S-100B protein compared to patients with depression without APS (p=0.048).

In the high clinical risk group, correlations were found between the SOPS positive subscale score and the level of TNF-α (R=0.32, p=0.017), IL-8 (R=-0.3, p=0.034), TNF-α/IL-6 ratio (R=0.30, p=0.021) and TNF-α/IL-10 ratio (R=0.32, p=0.014). The SOPS negative subscale score correlated with CRP concentration (R=0.3, p=0.043). The SOPS total score correlated with TNF-α/IL-10 ratio (R=0.31, p=0.021). In this group of patients, the level of IL-10 was found to correlate with the duration of the disease (R=0.48, p<0.001). In patients with depression without APS, the level of IL-6 was correlated with the severity of depression according to the HDRS scale, and the level of TNF-α was associated with the duration of the depressive episode (R=0.51, p=0.029).

Conclusions

The obtained results confirm the involvement of inflammation in the development of juvenile depression. Qualitative and quantitative characteristics of the spectrum of immune markers and the cytokine profile, and correlations with the severity of psychopathologic symptoms were revealed in patients with clinically high risk of psychosis.

Disclosure of Interest

None Declared
Logistic regression model for the prediction of asthenia development in schizophrenia based on inflammatory blood markers
Authors: Zozulya S. A. , Simonov A. N. , Klyushnik T. P.
Published: August 2024

Introduction

According to a number of authors, inflammation is involved in the development of asthenic syndrome in different diseases. The results of our own studies indicate that the main feature of the spectrum of inflammatory markers in patients with asthenic syndrome in schizophrenia is low enzymatic activity of leukocyte elastase against the background of high levels of other inflammatory markers. Presumably, the decrease in LE activity may be associated with functional exhaustion of neutrophils and/or their transmigration to the brain through the disrupted blood-brain barrier due to a long-term chronic inflammatory process.

Objectives

To create a logistic regression model for predicting the development of asthenia in schizophrenia based on the analysis of the association between leukocyte elastase (LE) and α1-proteinase inhibitor (α1-PI) activity in blood plasma.

Methods

A database including clinical and demographic parameters (ICD-10 diagnosis, duration of the disease, psychometric evaluation according to the PANSS and MFI-20 scales, sex and age) and immunological parameters (enzymatic activity of LE and functional activity of α1-PI in blood plasma) of 95 patients from 22 to 55 years old with paroxysmal-progressive (F20.x1) and paranoid (F20.00) schizophrenia was used to construct the model. An asthenic symptom complex was diagnosed in 61 patients.

Results

A binary logistic regression model linking the probability of developing asthenia to LE and α1-PI activity was constructed by analyzing a database of patients with schizophrenia.

P=1/(1+exp [-(11.71-0.057-LE+0.027-α1-PI)] (2), where

P is the probability of asthenia development; exp is the base of the natural logarithm; 11.71 is the regression constant; 0.057 is the coefficient for LE; 0.027 is the coefficient for α1-PI.

This model adequately describes the clinical data and has good predictive ability (sensitivity - 93.44%, specificity - 76.47%, AUC - 0.89).

Conclusions

A binary logistic regression model was created to predict the development of asthenia in schizophrenia using immunological parameters LE and α1-PI. The model is highly effective and can complement clinical examination of patients with schizophrenia, contributing to the objective diagnosis of asthenic syndrome and, consequently, timely therapeutic correction.

Disclosure of Interest

None Declared
A study exploring regional level predictors of suicide rates across time in Sweden
Authors: Eliasson E. T. , Carli V.
Published: August 2024

Introduction

In Sweden, four lives are lost to suicide each day. Hence, identifying relevant risk factors to inform effective prevention strategies is key. Such strategies can range from individual (‘micro’) -level prevention methods, to broader national suicide prevention policies.

Objectives

Whilst a range of studies have explored individual-level risk factors, highlighting municipal, regional, or national-level predictors can be valuable to identify broader social and contextual determinants. This study will therefore aim to go beyond proximal predictors of suicide by looking through a wider national- and regional-level lens in Sweden.

Methods

This project will be conducted utilizing routinely collected and publicly available data and applying longitudinal modelling to investigate potential predictors of changes in suicide rates across time in Sweden. More specifically, the study will explore whether regional data on economic (e.g. proportion of state benefit recipients), socio-demographic (e.g. educational level) and healthcare related variables (e.g. trust in the healthcare system) are associated with suicide rates over time.

Results

This is an ongoing project and results will be available and presented at the time of the conference.

Conclusions

Utilizing publicly available data to explore potential predictors of suicide rates is not only cost-effective, but adding such findings to existing knowledge of individual-level risk factors can also be important when targeting wider policy and ensuring effective coordination and implementation of regional suicide prevention strategies.

Disclosure of Interest

None Declared
Introducing the construct of risky cannabis use: designing and piloting a co-created educational intervention on cannabis health literacy among adolescents and young adults. The CAHLY (CAnabis Health LiteracY) study.
Authors: Caballeria E. , Oliveras C. , Guzmán P. , Ballbé M. , Fleur B. , Pol B. , Ilzarbe D. , López-Pelayo H. , Matrai S. , Artigas M. , Pons-Cabrera M. T. , Folch D. , Nuño L. , Balcells-Oliveró M.
Published: August 2024

Introduction

Cannabis use poses a significant risk to the psychological wellbeing of youth, affecting academic performance and potentially triggering the onset of mental health issues. Providing young people with comprehensive information about patterns of cannabis use and specific factors that increase an individual’s health risks is crucial. The ability to critically assimilate this information is known as health literacy (HL).

Objectives

To design a psychoeducational intervention to increase HL on risky cannabis use among students aged 16-25, and to assess its usability and feasibility.

Methods

We designed a psychoeducational intervention based on the outcomes of a 3-hour co-creation session involving healthcare professionals and students. 29 university students and 25 high-school students completed this intervention and assessed its usability and feasibility with the SUS (System Usability Scale), PSSUQ (Post-Study System Usability Questionnaire) and additional open questions regarding the most and less-liked aspects of the intervention.

Results

The design phase resulted in an informative website (http://www.cahlyclinic.cat/) and a 1-hour structured onsite educator-facilitated session, comprising 3 group activities (completed on paper or online) addressing three dimensions of cannabis HL: searching for, interpreting and applying reliable information. Usability of the intervention was rated as excellent (SUS mean score>80). PSSUQ results indicate that students were satisfied with the intervention; found the HL information clear, relevant, and adequate for their needs; found the interface of the digital version pleasant and usable without support; and would recommend it to other students.

Conclusions

We propose an innovative structured and usable intervention, designed using a participatory approach, which aims to disseminate information on risky cannabis use to a key target population, namely young people.

Disclosure of Interest

None Declared
The polymorphism ZNF804A rs1344706 is differentially associated with negative symptoms domains in schizophrenia
Authors: Lezheiko T. , Kolesina N. , Golimbet V.
Published: August 2024

Introduction

Negative symptoms (NS) are an important clinical characteristic of schizophrenia. In recent years, clinical research on NS has focused on their clinical heterogeneity. Based on two-factor analysis, it has been proposed to divide NS into abulia-apathy (AA) and expressive deficit (ED) domains. A number of studies have shown that these domains have different effects on the clinical features of schizophrenia, which suggests different pathophysiological mechanisms of their development. Neurobiological differences between AA and DE have been identified in neuroimaging and immunological studies but there is less research on the genetic background of NS.

Objectives

To search for an association between the rs1344706 polymorphism of the zinc finger protein gene (ZNF804A) and the AA and ED subdomains. The rs1344706 polymorphism is one of the best-supported risk variants for schizophrenia. The risk genotype AA has been shown to be associated with clinical presentations of the disease.

Methods

The study included 1116 (741 (66.3% women) patients with schizophrenia. The diagnosis was made according to ICD-10 criteria (item F20). The average age of the patients was 38.4 (13.6) years, age at disease onset was 26.1 (10.6) years. NS were assessed with the PANSS. The PANSS-derived AA domain consisted of Emotional withdrawal (PANSS item N2), Apathetic social withdrawal (N4), Active social avoidance (G16). The DE domain included Blunted affect (N1), Poor rapport (N3), Lack of spontaneity (N6), Mannerism and posturing (G5), Motor retardation (G7), Disturbance of volition (G13). Genotyping of the ZNF804A rs1344706 polymorphism was carried out using HRM-PCR. ANOVA with genotype and sex as independent variables, and age at the time of disease manifestation and its duration as covariates was used. Post hoc tests were performed using Bonferroni correction.

Results

A significant effect of the rs1344706 polymorphism on the severity of symptoms in the AA domain was revealed (F=5.88, df=2, p=0.002). In carriers of the CC genotype, the severity of symptoms was significantly lower than in carriers of the AA genotype and the AC genotype (8.4(3.5), 9.4(7.4) and 8.8(3.5) points, respectively). This effect was independent of sex and was not mediated by age at onset or duration of disease. There was no effect of the rs1344706 polymorphism on the severity of symptoms in the ED domain.

Conclusions

The association of the ZNF804A rs1344706 (A/C) polymorphism with NS of schizophrenia has not been reported so far though some studies have found the effect of this polymorphism on  PANSS positive symptoms and PANSS total score. The finding of the association with NS can be explained by the fact that the NS heterogeneity was taken into account in the present study.

Disclosure of Interest

None Declared
Rates of perinatal environment risk factors in schizophrenia patients with higher and lower schizophrenia polygenic risk scores
Authors: Alfimova M. , Gabaeva M. , Lezheiko T. , Plakunova V. , Golimbet V.
Published: August 2024

Introduction

Understanding the relations between genetic (G) and environmental (E) factors in the development of schizophrenia is important for psychosis prevention. These relations may vary from G x E correlations to G x E interactions and independent additive effects of genetic load and environment. The G x E interactions mean that genetic variants associated with schizophrenia make an individual vulnerable to specific environmental exposures thus enhancing the risk of disease manifestation in those who possess such genetic variants. In the case of independent effects, environmental exposure might serve as the main cause or an additional to genetic load external trigger which is needed for the illness development. Thus, the rate of independent environmental risk factors is expected to be higher in patients with a lower genetic liability to schizophrenia.

Objectives

The study aimed to confirm this hypothesis by comparing schizophrenia patients with higher and lower polygenic risk scores for schizophrenia (SZ-PRS) on the rate of urbanicity, winter birth and obstetric complications (OC), as previous data suggested their independence from the genetic burden of the disease.

Methods

SZ-PRS were calculated for 861 patients with schizophrenia spectrum diagnoses (ICD-10, F2), predominantly of Slavic decent, based on the latest GWAS. For patients comprising the highest and lowest SZ-PRS deciles, information on the environmental risk factors was extracted from medical records. Each environmental factor was coded as present/absent. The presence were defined as being born in the most urban environment (a city’s population > 5 million), in winter months and having at least one OC from a predefined list (Alfimova et al. Int J Mol Sci 2022; 23: 12629). In addition, hypoxia/asphyxia, and low birth weight were analyzed separately. Polyenvirommental risk scores (PERS) aggregating the three factors were calculated using natural logarithms of the odds ratios (OR) from an umbrella review (Radua et al. World Psychiatry 2018; 17: 49-66). Logistic regression adjusted for ancestry-related principal components, demographic, and technical variables was applied to compare the SZ-PRS deciles on each factor and PERS.

Results

None of the factors alone or PERS predicted SZ-PRS decile membership.

Conclusions

The results did not support the hypothesis. Future research needs reliable data on the frequency of the studied factors in the general population where the patients come from.The study was supported by the Russian Science Foundation, grant no. 21-15-00124.

Disclosure of Interest

None Declared
Exercise addiction: is it linked to eating disorders? A cross-sectional study in a sample of Tunisian athlete students
Authors: Smaoui N. , Bouattour O. , Feki R. , Gassara I. , Maalej M. , Charfi N. , Ben Thabet J. , Maalej M. , Omri S. , Zouari L.
Published: August 2024

Introduction

Eating disorders and sports addiction are becoming increasingly common among athletes.It’s important to be aware of these disorders in order to improve their overall prevention.

Objectives

The aim of our study was to determine the links between exercise addiction (EA) and eating disorders in Tunisian students at the Institute of Physical Education and to examine the factors associated with these disorders.

Methods

An anonymous self-administered questionnaire was distributed to students in the Sfax and Gafsa sports sections during March 2023. The Exercise Addiction Inventory (EAI) was used to study exercise addiction. It is a scale whose purpose is to separate individuals into 3 groups: those at risk of exercise addiction (score ≥ 24), those non-addicts with symptoms (score 13 to 23) and those non-addicts without symptoms (score 0 to 12).

Eating disorders were assessed using the SCOFF-F questionnaire ( Sick, Control, One stone, Fat, Food), with a score of 2 or more indicating possible eating disorders.

Results

We collected 240 participants. The mean SCOFF-F and EAI scores were 1.7±1.3 and 16.6 ± 4.1 respectively. Among the participants, 52.9% of students were at risk of developing eating disorders and 2.5% of students were at risk of exercise addiction. In our study, 82.5% of students took part in regular physical activity in a gym. The main reasons for going to the gym were muscle strengthening (57.9%) and preparation for a sporting competition (37%).

Among students exercising outside the institute, the mean SCOFF score was significantly higher for those doing so to prepare for a sports competition (p=0.001), for professional obligations (p=0.005) or for weight loss (p=0.001). Participants at risk of exercise addiction had a higher mean SCOFF score, but the difference was not significant (p=0.051).

Conclusions

Our study shows that eating disorders were widespread among Tunisian athlete students, and were higher among students at risk of exercise addiction.

Disclosure of Interest

None Declared
Suicidal behaviour and intravenous drug use in chemsex context
Authors: Curto Ramos J. , Rodríguez Laguna A. , Barrio P. , Ibarguchi L. , García A. , Azqueta I. , Dolengevich Segal H.
Published: August 2024

Introduction

Several studies have called atention to the mental health disorders associated with chemsex --the intentional use of drugs before or during sexual intercourse GBMSM (gay, bisexual and men who have sex with men) population-. Sexualized intravenous drug use is also known as slam or slamsex. There are few studies that analyze the mental health differences between intravenous drug users compared to non-intravenous drug users in chemsex context.

Objectives

To describe the suicidal behaviour in a sample of users with sexualized drug use (chemsex) attended by the non-governmental organization Apoyo Positivo in the program “Sex, Drugs and You” and to compare the suicidal behaviour between intravenous drug users compared to non-intravenous drug users.

Methods

A cross-sectional descriptive analysis of a sample of users attended by the non-governmental organization Apoyo Positivo in the program “Sex, Drugs and You” between 2016-2019 was performed.

Results

We included 217 participants. 37 had attempted suicide at least once. The percentage of chemsex users who have attempted suicide were significantly higher in the intravenous drug use group compared to the non-intravenous drug use group (p<0.05).

Conclusions

Possible risk factors for suicidal behaviour among chemsex users include slamsex. Other possible risk factors previously described in other studies include adversities experienced due to one’s sexual orientation and an increased risk for HIV and other STI infections. Further studies analyzing the relationship between chemsex, slamsex and suicidal behaviour are needed.

Disclosure of Interest

None Declared