bluuebunny/crossref_metadata_2025 huggingface dataset:
Familial Autism Spectrum Disorder : A clinical study from South Tunisia
Authors: Boujelben I. , Chaabane M. , Ben ayed I. , Ben Touhemi D. , Gharbi N. , Guirat M. , HajKacem I. , Ayadi H. , Kamoun H. , Moalla Y.
Published: August 2023

Introduction

Autism Spectrum Disorder (ASD) is a multifactorial neurodevelopmental disorder, with both contribution of genetic and non-genetic factors. A collaboration of de novo mutations and prenatal with postnatal environmental factors are likely to play a role. ASD can be syndromic or non-syndromic. The etiology of non-syndromic ASD is still relatively undefined due to its genetic heterogeneity. Contrary to non-syndromic ASD, syndromic ASD is often associated with chromosomal abnormalities or monogenic alterations. Familial cases of ASD support the strong genetic component of ASD.

Objectives

To collect clinical arguments supporting a genetic cause of autism spectrum disorder.

Methods

We present a clinical study of familial cases of ASD. The families were recruited as part of a collaborative project between the department of Medical Genetic and the department of Child Psychiatry in Hedi Chaker Hospital, Sfax, Tunisia. The clinical and paraclinical data were collected retrospectively.

Results

Our study included 11 unrelated families from southern Tunisia, each with two ASD children, among them four couples of twins. Most families (80%) are consanguineous belonging to a middle socioeconomic class. None of the parents suffered from psychiatric disorder and a familial history of autism was reported in one family. Perinatal history, including advanced maternal or paternal age, fetal suffering and/or gestational problems, was found in 35% of cases.

The average age was 9.89 ± 3.787 (3 to 17 years) with a balanced sex-ratio.

ASD was syndromic in seven out of 11 families: facial dysmorphism in half of cases (6/11 families) and/or another comorbidity in 25% of cases (celiac disease, congenital heart disease or idiopathic hydrocephaly). ASD was associated with other(s) neurodevelopmental disorder(s) in all children. Most of cases (14/22) had delayed psychomotor development and all of them had intellectual disability with various degrees. Epilepsy was identified in three cases belonging to unrelated families. Other behavioral problem was identified in 65% of cases.

When the autism spectrum disorder is syndromic and/or associated with other(s) neurodevelopmental(s) disorder(s), this points more towards a genetic origin.

Conclusions

Our study highlights the interest of clinical investigations to determine genetic risk factors of ASD. The identification of a genetic cause in familial cases would contribute not only to better understand the pathological processes of ASD but also to provide an appropriate genetic counseling.

Disclosure of Interest

None Declared
Sensory integration in a department of child and adolescent psychiatry
Authors: Maria Del Carmen M. L. , Nadia B. B. , Irene C. I.
Published: August 2023

Introduction

The area of Sensory Integration has its origin in the 1960s, developed by the neuroscientist and occupational therapist Jean Ayres. Although the first studies focused on the relationship between learning problems and atypical sensory processing, today there are new applications in clinical practice.

Sensory integration is defined as the neurological process responsible for organizing the sensations that one receives from one’s own body and from the environment, in order to respond and function adequately in relation to environmental demands.

Objectives

This work has several objectives. On the one hand, review the concept of sensory integration, the definition and theoretical basis as well as the scientific evidence of this theory. On the other hand, review the use of sensory integration in psychiatric practice from the 1960s to the present day. Also, explain the experience of a child and adolescent psychiatry unit with the use of sensory integration as part of the treatment. Finally, new challenges, approaches and needs of psychiatry services will be considered for the implementation or improvement of this new work tool in a multidisciplinary team.

Methods

A bibliographic search has been carried out in the main sources of medical information such as pubmed, uptodate as well as in national and international journals. Likewise, the knowledge and clinical experience of the team has been reviewed.

Results

In our clinical experience, the child and adolescent psychiatry device for intensive outpatient treatment where patients between 12 and 17 years of age with severe mental disorders attend, initially passed the sensory profile by occupational therapy to patients who presented behavioral or emotional symptoms. not consistent with the psychopathological examination. In view of the results and magnificent progress, this intervention began to be carried out systematically to the boys who joined the device.We present the case of a 15-year-old patient who attended the device due to emotional dysregulation and suicidal risk. During evolution, possible difficulties were seen in sensory integration that made it difficult for the patient to improve with psychiatric or psychological therapy alone. The patient was evaluated and treated by the team’s occupational therapist, specifically trained in sensory integration. It was evaluated with the sensory profile, with the results having a sensory sensitivity profile and auditory and tactile avoidance. The specific measures that were carried out were: sensory diet and environmental modifications.

Conclusions

Sensory integration is a therapy with sufficient clinical evidence to implement it in child and adolescent psychiatry services. Therapy should be performed by suitably trained and validated occupational therapists. This therapy must be included in a multidisciplinary approach to the patient and specific modifications that can be developed at home and at school are provided.

Disclosure of Interest

None Declared
Measurement of Cannabis Consumption to Determine Risk and Promote Public Health
Authors: Budney A. J.
Published: August 2023

With the escalation of cannabis legalization and commercialization, the need to differentiate low- vs. high-risk patterns of cannabis use, especially among frequent consumers, becomes essential for development of prevention and intervention strategies and public health messaging. The diversity of cannabis products and methods of intake make this task complex. In particular, the lack of valid methods for quantifying use of the intoxicating component of cannabis, i.e., THC, poses a difficult challenge. This presentation will describe a series of internet-based, personalized survey studies of adults who consume cannabis frequently. The aims of the studies are to develop methods for quantifying THC from self-reports of use, identify patterns of use, and determine associations between use and risk. In the first study of adult daily cannabis consumers (n>4000), rates of CUD were 35% no disorder, 39% mild, 18% moderate, 8% severe disorder. Higher severity was significantly related to younger age, unemployment, and specific reasons for use. Latent class analyses identified four distinct subgroups and preliminary analyses showed that those more likely to report oral use were less likely to meet CUD criteria, and those more likely to report use of high potency products were more likely to meet moderate/severe criteria. Two studies (n’s >2000) compared different quantitative formulas for estimating daily THC consumption from vaping or smoking cannabis products. Findings demonstrated how quantity (mgTHC) relates to socio-demographics, use patterns, and CUD severity. However, substantial variability in the estimates obtained across quantitation methods indicates the need for additional studies to determine optimal approaches. Overall, findings show that specific characteristics of use can discriminate low- from high-risk consumption among those who use frequently, which is critical for developing cannabis policy and public health messaging.

Disclosure of Interest

None Declared
Eating Disorders across the life span: the role of biology and psychosocial factors
Authors: Micali N.
Published: August 2023

Eating Disorders are common. They onset in adolescence and affect individuals of all ages. Women are more affected than men. I will present evidence on the epidemiology of eating disorders across the lifespan. I will also review risk factors focusing in particular on biological risk factors that might explain onset of these disorders in critical periods of a woman’s life. I will also cover pyschosocial risk factors across life stages. I will present results from a series of cohort studies. I will then summarise the evidence from our own and other existing studies.

Disclosure of Interest

None Declared
Mental Health Responses to Covid and Lock-down in Auckland, New Zealand
Authors: Soosay I.
Published: August 2023

Introduction

The Government of New Zealand closed the borders and introduced a number of restrictions following the first reported case of Covid-19 in February 2020. Comprehensive measures to control the outbreak included a strict managed isolation and quarantine (MIQ) system and rolling lockdowns that restricted movement. There were concerns about the mental health impact on the population. This presentation will outline the approach to maintaining social cohesion and supporting the psycho-social needs of the population through the pandemic.

Objectives

An overview of the Covid-19 response will be presented, including the Covid-19 alert systems and the strategies to support particular populations.

Methods

This will include:

1. The mental health support for the 229,000 people subjected to managed isolation and quarantine in government facilities

2. Psycho-social interventions for our Maori and Pacific populations

3. Specific approaches for people with severe mental disorders, including vaccination strategies and supporting people in the community with Covid-19

4. Interventions for homeless and socially vulnerable populations

Results

Reflections and learnings from our apprach will be shared.

Conclusions

The government ended the Covid-19 Framework in September 2022 and retrurned to fully open borders in October 2022. There have been over 1.8 million cases and 2000 deaths during the period of restrictions.

Disclosure of Interest

None Declared
The psychological impact of Covid on health care professionals during the third wave
Authors: Theodoratou M. , Potoglou A. , Tamiolaki A. , Kalaitzaki A.
Published: August 2023

Introduction

The COVID-19 pandemic is a healthcare crisis, with unprecedented impact on healthcare services, notable morbidity and mortality of the public and healthcare workers, economic impact and significant psychosocial impact. Besides, this pandemic has had a profound negative effect on the mental health of people worldwide, particularly among those who are faced with combating the virus.

Objectives

The aim of this research was to examine the impact of the COVID-19 pandemic on healthcare workers’ mental health (HCWs), as they are on the front line of the pandemic.

Methods

An internet-based questionnaire was created including the following scales: (1)Posttraumatic Stress Disorder Checklist (PCL-5), (2) Secondary Traumatic Stress Scale (STSS) (3) Quality of Professional Life (ProQOL) (4) Post-Traumatic Growth Inventory, (PTGI), (5) Brief Resilience Scale (BRS), (6) Brief Orientation to Problems Experienced Inventory (Brief Cope)], (7) Self-Compassion Scale (SCS-SF). It was distributed to 120 Greek health professionals, including nurses, doctors, midwives and physiotherapists.

Results

Most of the participants were female with an average age of 46 years. HCWs had low levels of both primary and secondary traumatic stress . They presented post-traumatic growth in the dimension of relationship with others. They used predominantly the coping strategies of positive reframing, acceptance of the situation, venting, and instrumental support.

Females had statistically significant higher levels of post-traumatic growth, better quality of life, and used more positive coping strategies compared to males. Humor and acceptance were coping strategies used mainly by physicians. Nurses and midwives had worse quality of professional life potentially due to increased workload. HCWs with more functional ways of coping were more resilient and seemed to have better quality of life, such as higher compassion, satisfaction, lower burnout, and lower post-traumatic stress.

Conclusions

The experience of the COVID-19 pandemic highlights the need to implement some strategies to protect health care workers’ mental health and to take extensive prevention measures in highly stressful situations.Further research is needed to clarify the long-term negative and positive psychological effects of the pandemic on healthcare personnel’s mental health.

Disclosure of Interest

None Declared
The influence of physical activity during sleep deprivation on mood and reaction speed to visual and auditory stimuli
Authors: Sochal M. , Ditmer M. , Turkiewicz S. , Karuga F. , Strzelecki D. , Gabryelska A.
Published: August 2023

Introduction

Sleep deprivation (SD) is being examined in the treatment of depression and other affective disorders for years. However, studies’ outcomes remain ambiguous, with varying levels of clinical improvement and its ephemeral character. Thus, it is necessary to find new factors accounting for the variability of results to develop new therapeutic protocols.

Objectives

The study aimed to assess the influence of physical activity on mood and reaction speed following SD.

Methods

The study group consisted of 71 participants. SD lasted about 24 hours, beginning in the morning hours of the SD day to the morning hours of the following day. Physical activity (PA) was controlled using actigraphy (actigraph GENEActive Original, ActivInsights Ltd.) given to each participant. Participants underwent the reaction speed test (Response Time Test Apparatus, AT Smart Systems, Poland) and filled out a questionnaire assessing depression symptoms- Beck Depression Inventory (BDI), in the evening of the SD day, and the following morning. Based on the percentage of sedentary time (gravity-subtracted sum of vector magnitudes<386, DOI 10.1111/sms.13488) participants were classified as inactive (≥70% of SD duration spent sedentary, n= 43) or active (n= 28).

Results

There were no significant differences between the active and the inactive participants regarding pre/post SD BDI score, reaction speed, and demographic data (age, sex, BMI) (all p>0.05). The inactive group had a significantly lower BDI score following SD in comparison with their baseline parameters (5, IQR 1-12 vs. 3, IQR 0-12, p=0.024) than the active group (3, IQR 1-6 vs. 3, IQR 0-7, p=0.408). Reaction speed after SD was impaired in both active (0.216, IQR 0.206-0.226 vs. 0.231, IQR 0.222-0.46, p<0.001) and inactive group (0.224, IQR 0.216-0.235 vs. 0.238, IQR 0.220-0.251, p<0.001). However, the difference between pre/post SD response time was slightly higher in the active individuals (0.015, IQR 0.011-0.028 vs. 0.012, IQR 0.003-0.022, p=0.047).

Conclusions

This study shows, that a sedentary behavior during SD might improve mood and slightly less impair the response time to auditory or visual stimuli than a higher activity level. Thus, PA could be an important modulator of clinical outcomes observed in individuals with affective disorders subjected to SD. PA should be accounted for in the SD protocols designed for future studies.

Disclosure of Interest

None Declared
The Association between Mood, Inhibitory Control and Depressive Symptoms: An Ecological Momentary Assessment Study
Authors: Nahum M. , Yitzhak N. , Shimony-Mazar O. , Oved N. , Bonne O.
Published: August 2023

Introduction

Cognitive models of depression highlight the role of inhibitory control - the cognitive control ability which supports our goal directed behavior – as key and even causal feature of the disorder. According to these models, deficits in inhibitory control prevent the exclusion of irrelevant negative information, leading to rumination and sustained negative mood which result in depressive episodes. However, the scientific evidence linking deficits in inhibitory control to depression is thus far mixed. Moreover, although one’s inhibitory control ability may fluctuate, it is often assessed using a single-time measurement in the lab.

Objectives

Here we aimed to assess the association between intra-individual fluctuations in inhibitory control measured in ecological settings, daily mood states, and depressive symptoms.

Methods

N=106 participants (Mean age: 38 ± 10 years; range: 19-62 years; 68% female) reported their depressive symptoms (using the PHQ-9 scale) and completed a mobile version of the Go-NoGo inhibition task at baseline. They then completed a 5-day
ecological-momentary-assessment (EMA) protocol, in which they reported their current mood (using the IMS-12 scale) and performed a shortened version of the Go-NoGo task twice/day using a mobile application. Depressive symptoms were assessed again following the 5-day EMA. Hierarchical-linear-modeling (HLM) was applied to examine the association between momentary IC and mood, with post-EMA depressive symptoms as a moderator. Inhibitory control was included as a time-varying predictor for mood in the 1st step, and depressive symptoms post-EMA and their interaction with inhibition were included in the 2nd step.

Results

At baseline, there were no correlations between depressive symptoms and inhibitory control (rp = .035, n.s). However, individuals with elevated depressive symptoms demonstrated worse and more variable inhibition performance over time (rp = .29, p = .002), as captured in the EMA measures. In addition, participants with more variable inhibitory control performance over time also reported more depressive symptoms at the end of the 5-day period (rp = .27, p = .006). Finally, post-EMA depressive symptoms moderated the association between momentary inhibitory control and daily mood, such that reduced inhibition was associated with more negative mood only for those with lower, but not with higher, depressive symptoms (Figure 1).

Image:

Conclusions

Variable, rather than mere reduced inhibitory control is related to depressive symptoms. Moreover, the role of inhibition in modulating mood differs in non-depressed vs. depressed individuals. These findings contribute to our understanding of inhibition and mood in real life and help account for some of the discrepant findings related to cognitive control models of depression. Future investigations should examine the validity of these outcomes in other, clinical samples.

Disclosure of Interest

None Declared
Fathers’ Role in Bulimia Nervosa: A Systematic Review
Authors: Akkese M. N. , Treasure J. , Himmerich H.
Published: August 2023

Introduction

Bulimia Nervosa (BN) is a highly prevalent eating disorder related to multiple risk factors. In this regard, familial variables can play a critical role in the development and maintenance of BN.

Objectives

The existing studies frequently explored mothers and maternal factors, while fathers and paternal variables have been less extensively investigated in this field. Therefore, we aimed to systematically review the studies on the role of paternal factors in BN.

Methods

This systematic review process was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. As a result of the literature search on PubMed, Web of Science TM, and APA PsycINFO, 419 candidate papers were determined and evaluated based on the eligibility criteria. The quality assessment of the final 59 studies was conducted using the JBI Critical Appraisal Tools.

Results

Then, we thematically arranged and narratively reported the qualitative and quantitative research findings. Paternal attitudes (e.g., critical, abusive, aggressive, uncaring, and unaffectionate), family dynamics (e.g., chaotic, rigid, less communicative, and emotionally involved), and father-specific features (e.g., personality traits, eating psychopathology features) were found as three main groups that could be directly or indirectly associated with the development and maintenance of BN symptoms. The eligible qualitative studies also indicated that fathers could positively influence the recovery process of their daughters with BN (e.g., by helping them develop healthy adaptive body image, self-adequacy, and self-esteem).

Conclusions

The contradictory outcomes were discussed for further research and clinical implications.

Disclosure of Interest

None Declared
Resilience for Juvenile Recidivists Versus One‑Time Offenders in Argentina
Authors: Orlando M. S. S.
Published: August 2023

Introduction

Resilient potential of 100 young male offenders (aged 16-17), in Buenos Aires was assessed using a translated and revised version of the Resilience Scale (RS) of 14 items (Wagnild, 2009). Data on family criminality, school achievement and socioeconomic status was also obtained for both groups. The greater the resilient potential the greater the opportunity of not to reoffend irrespective of being controlled by key risk factors.

Objectives

1-Do repeat offenders have lower resilient potential than one-time offenders? 2. If a relationship between resilience and repeat offending does exist, is this explained by family criminality, low school achievement or low socioeconomic status?

Methods

Psychosocial interviews with each participant were conducted by the named author, under strict judicial conditions considering privacy in all cases, based on informed consent, with the condition of maintaining the concealed identity of the participants. In all cases it was clarified that youth participation was voluntary.

Results

Table 1.

M (SD) M (SD) t d p

Age 16.20 (0.41) 16.45 (0.50) 2.70 0.66 0.008

Resilience M (SD) M (SD) t d p

Factor I 29.92 (7.25) 63.45 (4.92) 27.16 5.41 <0.001

Factor II 7.37 (1.95) 16.59 (1.87) 24.13 11.33 <0.001

Total Resilience 37.29 (8.67) 80.09 (6.49) 27.82 5.59 <0.001

Risk Factors % % chi d p

Family Criminality 44.9 3.9 20.81 1.03 <0.001

Low School Achievement 98.0 11.8 71.31 3.15 <0.001

Low Socioeconomic Status 42.9 11.8 10.73 0.69 0.001

Table 2. Independent Predictors of Repeat Offending

Variables β p

Criminality in the family 2.994 <0.001

Low school achievement 5.886 <0.001

Low socioeconomic status (SES) -1.727 <0.001

Note. All comparisons p<.001.

Conclusions

Taking into account the lack of studies on resilience in juvenile offenders in both national and international research the findings of the present study provide an important contribution in the field of juvenile offending, particularly in the view of further interventions aimed at the prevention and rehabilitation in the near and long term of juvenile offenders in Argentina.

Disclosure of Interest

None Declared
Evaluation of mental functioning of patients with rheumatoid arthritis
Authors: Mnif I. , Feki A. , Sellami I. , Gassara Z. , Ben Djemaa S. , Ezzeddine M. , Kallel M. H. , Fourati H. , Baklouti S.
Published: August 2023

Introduction

Rheumatoid arthritis (RA) is a chronic inflammatory degenerative disease whose symptoms are mainly joint with significant functional impact, resulting in a restriction of the activities of the patient and increasing the impact on mental well-being.

Objectives

This study aimed to screen for mental functioning in RA patients, detect anxiety and depression, evaluate self-esteem and study its relation to clinical parameters, as well as disease activity.

Methods

Single-centre cross-sectional study, involving patients with RA using the hospital anxiety and depression scale (HADs). Rosenberg scale was used to evaluate self-esteem. We evaluated the RA severity Disease Activity Severity (DAS 28).

Results

Fifty patients were included. The average age was 54 years [24-72]. The mean duration of the disease was 10 years. Thirty-nine patients had immunopositive RA with a mean Rheumatoid Factor level of 189.1 ± 291.3 U/ml and a mean anti-CCP antibody level of 165 ± 225.3 U/ml. At diagnosis, the mean DAS 28 of the patients was 5.1 ± 1.4. Moderately active and highly active RA were predominant with percentages of 40% and 50% respectively. All patients were treated, and 36% received biological treatment.

Depression was noted in 42% of the patients with a mean score of 10.1 ± 3.7. Anxiety was noted in 50% of the patients with a mean score of 10.3 ± 4.

In this study, we did not find a statistically significant association between disease activity and depression or anxiety scores (p=0.6 and p=0.1 respectively).

The mean Rosenberg scale score was 27± 3. Sixty-eight per cent of patients had low self-esteem, twenty-one per cent had moderate self-esteem and eleven per cent very low self-esteem. Disease activity was associated with low self-esteem.

Conclusions

RA is a chronic inflammatory disease that has a significant impact on the mental health and quality of life of patients. The detection and treatment of psychiatric disorders such as anxiety, depression and low self-esteem; improve the care of patients with RA.

Disclosure of Interest

None Declared
Essential Skills Development Needs of High School Students in Southern Thailand for Work in the 21st Century Labour Market
Authors: Janyam K.
Published: August 2023

Introduction

Presently, the concept of preparing youth for the labor market in the 21st century receives much attention because of the rapidly changing nature of work and the soft skills and hard skills required by employers. Therefore, graduates need to be competent at work skills necessary for the 21st century to be able to face challenges of work in the present age and to have new perspectives for facing challenges and changes of work. According to the Federation of Thai Industries, the estimated number of workers needed by 14 groups of manufacturing industries during 2013-2017 included 58 percent of high school graduates.

Objectives

The current study aims to survey and assess essential skills development in high school students in Southern Thailand for the workforce in the 21st century.

Methods

The cross-sectional study was applied to 1,200 subjects consisting of 400 employers and 800 high school students. Data was analysed using means, standard deviation and t-test

Results

The results revealed that communication, digital literacy, creativity, critical thinking, collaboration, and responsibility were the major skills development needs of high school students in the 21st century labor market. The results indicated that high school students’ levels of skills were lower than those required by employers in four skills: communication, digital literacy, critical thinking, and creativity at the statistical significant level of .001, as presented in table 1.Table 1.

Means different for skills development need by sample group.

SkillsEmployersHigh school studentsΧS.D.χS.D.tCommunication4.08.403.17.8921.385***Digital literacy4.17.413.41.9717.120***Creativity3.97.453.01.7917.113***Critical thinking4.14.433.47.9714.776***Collaboration3.391.043.41.94-4.267***Responsibility3.391.183.611.00-3.877***

P<.001

Conclusions

The high school students possess skills needs for work in the 21st century at lower levels than those needed by employers. This is the issue requiring attention from individuals involved in educational management as they must find ways to develop the teaching and learning methods that can upgrade students’ skills that are needed for work and seen by employers as highly important. These skills are communication, digital literacy, critical thinking, and creativity. The teaching and learning styles should be more active rather than passive to stimulate students to think, to be proactive instead of passively to respond to whatever happens, to propose their ideas or to express differing opinions and using the appropriate language or communicating tools. The fact that these skills are at a moderate level could result in limitations for young people’s development or employment as these skills are required for work in this century where analytical thinking and creativity are necessary for invention both in the workplace and in private life.

Disclosure of Interest

None Declared
Presentation of Trauma Disorder in Adults with Intellectual Disability
Authors: McCarthy J.
Published: August 2023

Abstract: Background

In the 20 years since a review by McCarthy (2001) on the presentation of Post-traumatic stress disorder (PTSD) in people with intellectual disability (ID), the understanding of trauma disorder has increased.

Method & Findings

Diagnostic criteria for ID will be presented to set the context. A brief summary of the key literature over the past twenty years will be discussed focusing on the presentation of PTSD in people with ID including the use of ICD-11 criteria. Evaluated tools available to assess the impact of life events and trauma for use in people with ID will be outlined including treatment options. The presentation of trauma disorder will be illustrated through a case study.

Conclusion

Psychiatrists need to be aware that a history of trauma may be an underlying factor in the presentation of people with ID to psychiatric services.

Reference

McCarthy J (2001). Post-traumatic Stress Disorder in People with Learning Disability. Advances in Psychiatric Treatment; 7, pp. 163-169.

Disclosure of Interest

None Declared
Neural Abnormalities Associated with Generalized Anxiety Disorder: A Meta-Analysis of Functional Magnetic Resonance Imaging Activation Studies
Authors: Kahlon S. K. , Ali Z. , Pritchard E. , Saravia S. , Baten C. , Klassen A. M. , Shepherd J. H. , Zamora G. , Jordan J. , Duran M. , Santos S. L. , Hedges D. W. , Hamilton J. P. , Sacchet M. D. , Miller C. H.
Published: August 2023

Introduction

Generalized anxiety disorder (GAD) is a highly prevalent mental illness that is associated with clinically significant distress, functional impairment, and poor emotional regulation. Primary functional magnetic resonance imaging (fMRI) studies of GAD report neural abnormalities in comparison to healthy controls. However, many of these findings in the primary literature are inconsistent, and it is unclear whether they are specific to GAD or shared transdiagnostically across related disorders.

Objectives

This meta-analysis seeks to establish the most reliable neural abnormalities observed in individuals with GAD, as reported in the primary fMRI activation literature.

Methods

We conducted an exhaustive literature search in PubMed to identify primary studies that met our pre-specified inclusion criteria and then extracted relevant data from primary, whole-brain fMRI activation studies of GAD that reported coordinates in Talairach or MNI space. We then used multilevel kernel density analysis (MKDA) with ensemble thresholding to examine the differences between adults with GAD and healthy controls in order to identify brain regions that reached statistical significance across primary studies.

Results

Patients with GAD showed statistically significant (α=0.05–0.0001; family-wise-error-rate corrected) neural activation in various regions of the cerebral cortex and basal ganglia across a variety of experimental tasks.

Conclusions

These results inform our understanding of the neural basis of GAD and are interpreted using a frontolimbic model of anxiety as well as specific clinical symptoms of this disorder and its relation to other mood and anxiety disorders. These results also suggest possible novel targets for emerging neurostimulation therapies (e.g., transcranial magnetic stimulation) and may be used to advance our understanding of the effects of current pharmaceutical treatments and ways to improve treatment selection and symptom-targeting for patients diagnosed with GAD.

Disclosure of Interest

None Declared
Virtual reality exposure therapy for panic disorder
Authors: Cho S.-E. , Ma H. , Kang S.-G.
Published: August 2023

Introduction

Virtual reality exposure therapy (VRET) is a treatment in a virtual environment based on the representation of a patient’s disease in virtual reality. VRET means getting used to a specific situation by intentionally facing the patient’s fearful situation based on the ‘exposure technique.’ By repeatedly exposing the patient to a fearful situation, in the end, inducing the intensity of fear to decrease without avoiding the situation. Virtual reality exposure therapy (VRET) was initially used to treat phobias, anxiety disorders, and stress. It has been proven to be an effective psychotherapy method mainly focusing on acrophobia, flight phobia, arachnophobia, social phobia, and post-traumatic stress disorder (PTSD).

Objectives

Virtual reality exposure therapy (VRET) is used to treat phobias, anxiety disorders, and stress. The virtual reality treatment system can reproduce virtual scenes with the environment modified or removed, and can familiarize patients with such environments. This study aims to verify the degree of improvement of the symptoms of panic disorder by conducting VRET that we have made considering the degree of gradual exposure to the panic disorder group and the control group.

Methods

A total of 60 subjects were included in this study, including 43 patients with panic disorder and 17 control group. Subjects were systematically exposed to specific situations over five steps. We checked the heart rate, body temperature, EEG and symptoms before and after exposure using the following assessment instruments; Subjective Units of Discomfort (SUD), Anxiety Sensitivity Index (ASI), Panic Disorder Severity Scale. Repeated measures ANOVA was performed separately for presence, SUDS (distress) scores, and PDSS across time points.

Results

In the patient group, the program proved to be effective as the sensitivity to anxiety decreased significantly after the VR program (F=3.570, p<0.05). Among the subcategories of ASI, the fear of anxiety symptoms showed statistical significance between sessions (F=3.883, p<0.05) and in the interaction between group and time (F=4.585, p<0.01). The study confirmed the effectiveness of the VR program in situations that mainly induce panic attacks in patients diagnosed with panic disorder (elevator riding, driving a car, driving a car in a tunnel, driving a car in rain). The program effect was significant through repeated measurement ANOVA for each variable of EEG (Alpha, Beta, Delta, Gamma, Theta) (F=3.249, p<0.01).

Conclusions

VRET is the process of gradually being exposed to fear stimuli, deliberately confronting and experiencing a fear situation, and learning that nothing dangerous will happen. Even if the patient experiences bodily sensations that are the subject of fear, they can reduce their fear of bodily sensations by repeatedly confirming that they are safe and getting used to them.

Disclosure of Interest

None Declared
The effect psychobiotics on anxiety symptoms
Authors: Denysov Y. , Putyatin G. , Moroz S. , Semenikhina V.
Published: August 2023

Introduction

Psychobiotics are a group of probiotics that affect the central nervous system related functions and behaviors mediated by the gut-brain-axis via immune, humoral, neural, and metabolic pathways to improve not only the gastrointestinal function but also the antidepressant and anxiolytic capacity.

Objectives

An assessment of psychobiotic and anti-anxiety effects a probiotic supplement containing Lactobacillus Plantarum CECT7485 and Lactobacillus Brevis CECT7480 (PLANTARUM) in patients with anxiety undergoing treatment with selective serotonin reuptake inhibitors (SSRI) antidepressants.

Methods

Sixty patients with mixed anxiety and depressive disorder (according to ICD-10 diagnostic criteria F41.2) were included in an 8-week open label study. Thirty participants received either SSRI antidepressants with PLANTARUM at a dose of 1.0 × 109 CFU once per day and thirty patients received SSRI antidepressants only. The severity of anxiety symptoms was assessed using Hamilton Anxiety Rating Scale (HAM-A) and General Anxiety Disorder Scale (GAD-7).

Results

After 8 weeks intervention, a significant reduction of HAM-A total score (from 37,8±5,3 to 23,6±4,4) was detected in patients with anxiety who prescribed SSRI antidepressants and PLANTARUM (p˂0,05), compared with participants who didn’t receive probiotics (p>0,05). Also, a significant reduction of GAD-7 total score (from 21,7±3,3 to 12,5±2,4) was detected in patients with anxiety symptoms who received SSRI antidepressants and PLANTARUM (p˂0,01), compared with patients who didn’t intake probiotics (p>0,05).

Conclusions

The present data illustrated that probiotic supplement PLANTARUM is a feasible for adjunctive to SSRI antidepressants intervention for anxiety treatment.

Disclosure of Interest

None Declared
Effects of probiotic supplement Lactobacillus Plantarum CECT7485 and Lactobacillus Brevis CECT7480 on sleep quality in patients with anxiety and depression comorbidity
Authors: Denysov Y. , Putyatin G. , Moroz S. , Semenikhina V.
Published: August 2023

Introduction

Recent studies have supported that Lactobacillus plantarum can reduce the severity of anxiety and depression. However, previous studies did not focus on the sleep quality. This study determines whether Lactobacillus Plantarum CECT7485 and Lactobacillus Brevis CECT7480 reduce the severity of insomnia, and improves sleep quality in patients who comorbidity of depression and anxiety disorders.

Objectives

An assessment of insomniac effects a probiotic supplement containing Lactobacillus Plantarum CECT7485 and Lactobacillus Brevis CECT7480 (PLANTARUM) in patients with anxiety and depression comorbidity undergoing treatment with selective serotonin reuptake inhibitors (SSRI) antidepressants.

Methods

Sixty patients with mixed anxiety and depressive disorder (according to ICD-10 diagnostic criteria F41.2) were included in an 8-week open label study. Thirty participants received either SSRI antidepressants with PLANTARUM at a dose of 1.0 × 109 CFU once per day and thirty patients received SSRI antidepressants only. The severity of insomnia was assessed using Insomnia Severity Index (ISI). The severity of depressive symptoms was rated using Hamilton Depressive Rating Scale (HDRS). The severity of anxiety symptoms was assessed using Hamilton Anxiety Rating Scale (HAM-A) and General Anxiety Disorder Scale (GAD-7).

Results

After 8 weeks intervention, a significant reduction of ISI total score (from 22,1±2,8 to 14,1±2,1) was detected in patients with anxiety and depression who prescribed SSRI antidepressants and PLANTARUM (p˂0,05), compared with participants who didn’t receive probiotics (p>0,05). Also, we detected a significant improve sleep quality of insomniac patients with comorbidity of anxiety and depressive symptoms (p˂0,05) who received SSRI antidepressants and probiotic supplement Lactobacillus Plantarum CECT7485/Lactobacillus Brevis CECT7480.

Conclusions

The present data illustrated that probiotic supplement Lactobacillus Plantarum CECT7485 and Lactobacillus Brevis CECT7480 is a feasible for adjunctive to SSRI antidepressants intervention for insomniac patients with anxiety and depressive comorbidity

Disclosure of Interest

None Declared
Anxiously expecting during a COVID-19: a cross-sectional descriptive inquiry on the effects of the pandemic on pregnant women
Authors: Ionescu T. C. , Zaharia S. , Draganescu M. I. , Tudose C.
Published: August 2023

Introduction

While pregnancy itself is a risk factor in the development of anxiety disorders, the COVID-19 pandemic has brought additional pressure on expecting women. Despite these two independent factors, no study regarding their cumulative effect on anxiety in soon-to-be Romanian mothers exists.

Objectives

This study intends to address this deficiency by measuring the level of anxiety in a sample of pregnant women from the public healthcare sector in Romania.

Methods

Sociodemographic data and Zung Self-reported Anxiety Scores (SAS) were used to look at 121 pregnant women to get a fuller picture of anxiety in pregnant women during the pandemic.

Results

Some of the main findings of the study are as follows: anxiety symptoms are more intense during the first trimester of pregnancy, especially in the psychological domain of the scale, as opposed to the third one. High BMI was weakly correlated with lower Zung Scale scores, while marital status and having other children were moderately correlated with less anxiety symptoms. While no association could be found between history of infection, vaccination and anxiety, surprisingly, unvaccinated women showed less psychological distress than vaccinated ones (moderate correlation), suggesting that less anxiety prone women are also less likely to get adequate protection. Getting one’s information from official sources also proved to be weakly correlated with higher Zung Scale scores.

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Conclusions

In conclusions, the findings of this study can serve as a start for further inquiry regarding the impact of the COVID pandemic on the mental health of pregnant women.

Disclosure of Interest

None Declared
Efficiency of a psychiatric support for PTSD on a cohort of relatives of patients hospitalized in intensive care unit during the French lockdown – the OLAF (Opération Liaison et Aide aux Familles in French) dispositive
Authors: Raymond V. , Salles J. , Aïtout C. , Ducos G. , Silva S. , Arbus C. , Birmes P.
Published: August 2023

Introduction

Having a family member admitted in Intensive Care Unit (ICU) can cause a severe psychological stress, and various psychological disorders gathered into the notion of Post intensive care syndrome-family (PICS-F). In this way, Family-centered care in ICU represents the aim of international accepted recommendations focusing on a partnership approach to health care decision-making between the family and health care provider to prevent PICS-F. During the first SARS-CoV-2 linked lockdown, social restrictions impaired the right application of these recommendations, increasing risk of PICS-F, particularly Post-Traumatic Stress Disorder (PTSD).

Objectives

The main objective was to compare the PTSD prevalence at 6 months in a group of relatives including during OLAF implementation with a control group in a cohort of ICU-patient relatives.

Methods

Considering this, the psychiatric team and the ICU team of the Toulouse University, France, proposed the creation of a temporary device called OLAF (Opération de Liaison et d’Aide aux Familles in French), aiming to bring a psychological phone support to ICU-patient relatives. Besides this operational approach we designed a research approach that aimed to investigate the impact of OLAF device on PICS-F.

Results

We noted that 12 participants (11.5 %) presented a PTSD at 6 months without statistically significant differences between the groups (p=0.8). Considering that OLAF group presented higher PDI (Peritraumatric Distress Inventory) score at screening we also considered a mediation model suggesting that OLAF could have played a role to diminish the PCL-5 score as a covariable. In the multinomial logistic regression analysis, we found that the only factor associated with the PTSD diagnosis was the level of Anxiety and Depression Signs measured with HADS (Hospital Anxiety and Depression Scale) at screening (OR= 1.2, p<0.001).

Conclusions

We found no difference in PTSD prevalence according to OLAF intervention. Nevertheless, our result suggested that the intervention could have play a role in reducing PTSD by acting on anxiety and peri traumatic distress in a mediated model. We found that anxiety score could serve as a risk marker to predict PTSD and should probably be precociously screened and treated in this population.

Disclosure of Interest

None Declared
Burnout Syndrome and its associated factors among anesthesia technicians in a Teaching Hospital in the central region of Tunisia
Authors: Athimni Z. , Chouchen A. , Kalboussi H. , Nsiri L. , Ferhi F. , Aloui A. , Gaddour A. , Bouhoula M. , Maoua M. , Brahem A. , Maalel O. , Chatti S. , Kacem I. , Mrizak N.
Published: August 2023

Introduction

Burnout (BO) is a syndrome combining psychological and somatic symptoms caused by exposure to several years of chronic stress at work. Far from being a theoretical problem, it is a real social problem that has become globalized as societies change. Anesthesiology is among the most stressful medical disciplines which expose to BO in Tunisia and around the world.

Objectives

Identify associated factors to BO among anesthesia technicians.

Methods

We conducted a cross-sectional study during two months, from October 1st, 2015 to December 31th, 2015, among anesthesia technicians affected in the different operating rooms of the Farhat Hached teaching Hospital in Sousse. Data collection was based on a self-administered questionnaire with validated tools assessing BO (Maslach Burnout Inventory) and stress (Siegrist and Karasek)..

Results

Forty-six senior anaesthesia technicians was included in the study. The mean age of our population was 43.76 ±7.74 years with a female predominance (89.1%). According to the Karasek model, 59% of the workers were in job strain, and according to the Siegrist model 23.9% of the participants had an imbalance between high effort and low reward. The BO rate among anaesthesia technicians at the Farhat Hached University Hospital was 39.1%. The results showed a statistically significant association between working at the gynaecology-obstetrics department (p=0.001), the seniority in the department superior or equal to 20 years (p=0.006), the absence of break time at work (p=0.003) and the risk of the occurrence of BO. Furthermore, the last 2 consecutive day rest dates back to more than 15 days (p=0.001), the number of free weekends during the last 3 months less than four (p=0.044) were also significant associated to BO.

Conclusions

Our study confirms that BO is a tangible reality in our country especially among anesthesia technicians, so it must be addressed by adopting effective preventive strategies.

Disclosure of Interest

None Declared