bluuebunny/crossref_metadata_2025 huggingface dataset:
Sexual dysfunction and motor disability in Parkinson’s disease: any link?
Authors: Mousli A. A. , Zouari R. , Lahmer A. , zakaria S. , Rachdi A. , Nabli F. , Ben Sassi S.
Published: August 2023

Introduction

Parkinson’s disease (PD) is a chronic, neurodegenerative disorder leading to dopamine deficiency. Phenotypically, there is a wide spectrum of motor and non-motor symptoms (NMS). Among NMS, sexual dysfunction (SD) is one of the most disabling and crippling symptom. However, SD are usually neglected and underdiagnosed in PD patients.

Objectives

Our study aimed to estimate the effect of motor disability and the disease course on sexual dysfunction in PD patients.

Methods

This retrospective study included 42 patients (18 males and 24 females) from the department of neurology of the National Institute of Neurology Mongi Ben Hmida in Tunis, Tunisia, diagnosed with PD between 1999 and 2022. The diagnosis of PD was confirmed according to the Movement Disorder Society (MDS) diagnostic criteria of PD. The MDS Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) motor was used to estimate motor disability and Hoehn and Yahr (H&Y) stage was used to rate disease severity. The SD of PD patients was measured by applying the sexual items of Scales for Outcomes in Parkinson’s Disease - Autonomic Dysfunction (SCOPA-AUT).

Results

SD was observed in only 11 patients (26.2%) with a sex-ratio of M/F = 1.2 and a mean age of 52 (between 40 and 72). The mean age of PD onset was 47. According to the MDS-UPDRS part III, 1 patient had a severe motor disorder (MDS-UPDRS> 59), and according to the H&Y scale, no patient had a severe stage of the disease. Nine patients had motor complications such as motor fluctuations and L-Dopa induced dyskinesia.

The SD described by our patients were: women reported Vaginal Dryness (4 patients), with difficulties reaching an orgasm (3 patients); men reported erectile dysfunction (6 patients), and difficulties in reaching an orgasm (6 patients). Among these patients, 3 were treated for SD with Tadalafil (all males).

In our study, no significant gender-related differences were found in scores related to SD in patients with PD. Neither the disease severity nor the motor disability was significantly associated to sexual disorders (respectively p=0.26 and p=0.12). Also, Motor complications induced by L-Dopa medication, assessed by the part IV of MDS-UPDRS scale, had no significant effect in the occurrence of SD in PD (p=0.78).

Conclusions

Sexual behavior has neuronal and hormonal modulation. Lack of dopamine seems to have an important role in the development of SD. However, it occurs independently of the disease severity and the motor disability. Thus, clinicians should be aware of the importance of assessing and treating such symptoms since the beginning of the disease.

Disclosure of Interest

None Declared
Antipsychotic-induced priapism: case report and review of the literature.
Authors: Machado D. R. , Borges A. C. , Maia J. , Domingues V. , Laureano C.
Published: August 2023

Introduction

Priapism is a painful and prolonged penile erection in the absence of sexual stimulation. It is a urology emergency that, if not treated, may cause erectile dysfunction. Pharmacologically induced priapism is the most common form of priapism and almost half of all cases are caused by antipsychotic (AP) drugs. Considering priapism is a rare but important side effect, it is of major importance that psychiatrists be aware of it. Thus, we herein report the case of a 46-year-old man that developed priapism upon receiving intramuscular APs in a psychiatric emergency setting.

Objectives

To alert for the importance of priapism as a potential side effect of AP drugs and to understand the physiological mechanisms involved in antipsychotic-induced priapism.

Methods

A non-systematic review of the literature was carried out on PubMed. We looked for reviews and case reports published in the last 10 years containing the terms “priapism”, “antipsychotics” and “psychopharmacology priapism”. We also present a clinical case of antipsychotics-induced priapism.

Results

We report the case of a 46-year-old man that was brought to the Psychiatric ER by police authorities due to disruptive and aggressive behaviour, a sense of increased energy and power and delusional speech of grandiose and persecutory content. No clinical records of psychosis or bipolar disorder were known, and the patient had never been medicated with AP drugs. The patient was involuntarily admitted to the psychiatric inward for treatment. Due to the aggravation of his aggressive behaviour, with potential danger for himself, other patients and the nursing staff, he was medicated with 5 mg of haloperidol and 25 mg of chlorpromazine. About an hour later the patient developed a painful erection that lasted at least for 4 hours. He was promptly sent to the Urology ER where an intracavernosal aspiration followed by injection of phenylephrine was needed to reverse priapism. APs are the most common cause of drug-induced priapism. Even though typical APs were pointed as more prone to cause this side effect, it is now known that atypical APs, including third-generation ones such as aripiprazole, may also cause priapism. It is thought that the α1- adrenergic antagonist action of most APs inhibits the contraction of smooth muscle in the corpus cavernosum of the penis, impeding venous outflow and thus causing ischemic priapism. To reduce the risk, the dosage of the AP may be reduced or changed to an AP with lower affinity for α1- adrenergic receptors.

Conclusions

Priapism is a rare but important side effect of APs. Being aware of it and of its physiological mechanism is of major importance when treating patients with APs.

Disclosure of Interest

None Declared
An Explorative Study to Assess the Suicidal Risk Amongst Infertile Patients
Authors: Ghosh Dastidar B.
Published: August 2023

Introduction

This given study was designed to qualitatively and quantitatively examine the Psychosocial – emotional consequences of infertility on female infertile patients . Suicidal risk amongst infertile patients was a incidental yet significant finding with 25 percent of the study population reporting a positive result by the MINI scale. There are very few studies conducted in the Indian context that analyses the psychosocial aspects of infertility and the impact of ART treatment on the quality of life.

The finding in our study indicates that both infertility and stress associated with ART treatment contributes to psychological turmoil namely depression , anxiety, psychopathology and quality of life impairment in addition to suicidal ideation and suicidal risk.

Objectives

Aims

To assess the psychosocial impact of infertility amongst female infertile patients including suicidal risk/ suicidal ideation in the given study population.

Methods

A total of 300 women attending the Obstetrics and Gynecology out patients department of a tertiary hospital in Kolkata, India were selected by simple random sampling. 100 fertile women attending the routine ante natal clinic were selected as cases and 100 infertile women seeking fertility treatment were selected as controls. 100 women didn’t follow up with the study. The following questionnaires were administered to both case and control group- BAI, BDI, SCL-90-R, SF-36, MINI and socio demographic proforma ; by trained clinic psychologist .

The raw scores & adjusted scores were analysed statistically by SPSS using the following tests, independent t test, chi square test and Z test.

Results

The results of the MINI scale indicate that up to 25% of the infertile cohort suffer from suicidal risk/ suicidal ideation which is statistically significant in comparison to the control group.

The other psychosocial parameters are also statistically significant in the case in comparison to the control population.

Conclusions

Although the psychosocial impact of infertility has been well researched and documented. Few studies have been conducted globally which assess suicidal risk amongst infertile patients.

Our results corroborate earlier studies such as the Danish administrative population-based registry study by Trille Kristina Kjaer et al which found a causative link between infertility and suicidal risk.

Further research is needed in this direction

Disclosure of Interest

None Declared
Werther effect in the juvenile population. About a series of cases
Authors: Valverde Barea M. , Alvarado Dafonte A. , Soldado Rodriguez L. , España Osuna A.
Published: August 2023

Introduction

Suicide is currently one of the biggest public health problems, it is the third cause of death in the age group between 15 and 29 years (16.36% of young people who died in 2013). The ‘Werther effect’ refers to the mimetic behavior of the suicidal act, thus making reference to the controversial novel “The Sorrows of Young Werther” by Goethe, in 1774. The population most susceptible to this influence is the most vulnerable and ambivalent, such as they can be adolescents and young people, people with personality disorders and drug use. Durkheim considered that imitation was not due to the contagion effect of making suicides public, but to the social conditions of some places, which were what caused people to commit suicide.

Objectives

The objective of the case is to expose the vulnerability to the imitation of suicidal behaviors of young people suffering from personality disorder and drug use.

Methods

We present the case of 4 young people between 18 and 21 years old (3 women and 1 man) from the same group of friends who, after the death by suicide of a 20-year-old boy, in the following 2 months, carried out suicidal behavior by taking medication they found at home and consumption of different drugs.

Results

The two 21-year-old patients planned for the first month of the anniversary of the friend’s death, the intake of drugs and medication and leave a farewell note explaining the reasons. The patients required hospitalization in an acute mental health unit, one patient developed myocarditis secondary to toxins, during hospitalization they undergo psychotherapeutic treatment and are evaluated, leading to the diagnosis of Borderline Personality Disorder and Multiple Drug Use Disorder. The 20-year-old patient took medication on the anniversary month but did not require hospitalization. He underwent outpatient follow-up at a day hospital. During the therapeutic process, he was diagnosed with schizoid personality disorder. The 18-year-old patient required hospitalization for structured self-injurious ideation with a risk of acting out at 2 months, psychotherapeutic treatment was started and she was diagnosed with borderline personality disorder and harmful drug use. The 4 young people continue outpatient follow-up by both the community mental health unit and the addiction treatment center.

Conclusions

We observe in the series of cases exposed, the vulnerability of young people suffering from personality disorders and drug use to suicidal behavior, so risk factors for their prevention must be identified and continue working on adequate information of suicidal acts, whether completed or not, to avoid imitation phenomena. In all cases, suicide should not be seen as a desirable alternative and strategies to cope with difficulties and emotional management should be offered and promoted, especially in this young population that is still developing and is more vulnerable.

Disclosure of Interest

None Declared
Suicide behaviour after hospitalisation and related factors: a case report.
Authors: Setién Preciados P. , Sanz Giancola A. , Arroyo Sánchez E. , Martín Velasco M. , Romero Gerechter I.
Published: August 2023

Introduction

Suicide is a global epidemic, with the World Health Organization (WHO) estimating that there are roughly 800,000 suicides annually, accounting for 1.4% of all deaths, and making suicide the 18th leading cause of death in 2016 (World Health Organization. There is a pressing need to better understand factors that contribute to suicide risk. One important domain for suicide prevention is inpatient psychiatric treatment, as many patients are admitted precisely in order to reduce their risk of suicide. Although inpatient psychiatric treatment is often used for suicide risk prevention the risk of suicide after inpatient treatment remains high. Patients who have been recently discharged have a greater risk of suicide than non-hospitalised mentally ill people.

Objectives

Review suicidal risk after hospitalisations and the factors that may have an influence on it.

Methods

Presentation of a patient’s case and review of existing literature, in regards to the rate of suicide after a patient is released from psychiatric hospitalisation and the factors that surround it.

Results

The patient in question is admitted into a psychiatric ward with a diagnosis of severe psychotic depression, after a suicide attempt trying to dissect his arms’ blood vessels. Health professionals at the hospital attend to his needs and the patient sees improvement. Not long after his release, there is a second hospital admission, which doesn’t have the same result and after his release he successfully ends his life. What comes to mind with these sorts of patients is: what kind of help would they have needed? Why hospital admission was not enough? And which factors and profile of patient is more prone to develop suicide behaviour?

Conclusions

Admissions at psychiatric wards always have to be thought of as a beneficial resource for patients. There are some cases in which patients do not get the help they need by being hospitalised, increasing the risk of comitting suicide. A lot more studies will have to be carried out to understand what variables play a part in this. Meanwhile an improvement in outpatient care to support patients after hospital release is crucial.

Disclosure of Interest

None Declared
Psychiatry residents’ perceptions of competence acquisition, training programe compliance and clinical supervision in the Spanish psychiatry training system
Authors: Esteve Aznar J. , Carrasco Picazo J. P. , Etxeandía Pradera J. I. , Aguilar García-Iturrospe E. J.
Published: August 2023

Introduction

There are differences in the training curricula of medical specialists in different countries. The opinion of the doctors in training on how they acquire competencies and carry them out is of great importance. In our case, we asked ourselves what were the perceived shortcomings in psychiatric training.

Objectives

The main objective of the study is to describe the opinion of psychiatry residents in Spain on the acquisition of competencies, compliance with the training programme and quality of clinical supervision.

Methods

This is a descriptive, cross-sectional, mixed (quantitative and qualitative) study. Based on previous bibliography and the ministerial order of the official training programme, an online survey was prepared, which was disseminated telematically through the residents’ representatives of the National Commission of the Speciality of Psychiatry of the National Council of Health Sciences Specialities.

Results

A total of 109 responses were obtained, with representation from all the Autonomous Communities of Spain. Graph I shows the opinion of the psychiatry residents as to which competencies they feel are less developed at present, with the competencies related to psychotherapy standing out in first place with great importance. In terms of compliance with the training programme, the parameter most in line with what was established was the average number of shifts, with an average of 4.26 shifts per month. However, 11.7% of residents do not take compensatory rest after on-call duty as required by law. Moreover, the rotation times established by the BOE are not complied with in 38.5% of the hospitals. With regard to the rotations that the residents feel should increase their rotation time, the child and adolescent psychiatry and dual pathology rotations stand out (graph II). Finally, with regard to the supervision process, only 22.90% of first-year residents are always supervised in person during their rotations (graph III).

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Image 2:

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Conclusions

Our study reflects the belief on the part of the resident physicians that further training in psychotherapy (45.7%), psychogeriatrics (10.6%) and dual pathology (8.5%) would be necessary. The fact that only 11.7% of the participants stated that they did not take compensatory rest after on-call duty seems to us to be an improvement over what was initially expected. There are other less reassuring data, such as the fact that only 22.9% of first-year residents report having continuous supervision. We consider that the results found follow the trends observed in studies carried out in residents from other countries. We stress the need to carry out a greater number of studies with a broad population base in which to find the failures that psychiatry residents themselves perceive in their training.

Disclosure of Interest

None Declared
Negative attitudes and lack of Knowledge towards mental health problems
Authors: Bouattour N. , Cherif F. , Abid W. , Guermazi F. , Massmoudi R. , Hentati S. , Sellami R. , Feki I. , Baati I. , Massmoudi J.
Published: August 2023

Introduction

Negative thoughts towards mental illness are a global problem for health care professionals. Mainly it leads to late help seeking which aggravates the prognosis of the problem, denial of this situation, refusing long term medication etc.…

Objectives

We aim to identify the determinants leading to negative attitudes towards psychiatric problems among medical students.

Methods

This is a descriptive and analytical cross-sectional study conducted at the Faculty of Medicine of Sfax through an anonymous questionnaire via google Forms. The degree of stigmatization was evaluated by the score « The Attribution Questionnaires AQ-27 ».

Results

One hundred and seven students completed the questionnaires. The Sex-ratio was 0.30 (M/F). The percentage of first- and second-year students was 24.42%, third to 6th year students was 34.57% and residents was 41.01%. Students with a personal history of psychiatric disorders presented 45.8% of our population and those with a family history of mental health problems 40.2%. Medical students who studied psychiatry as a discipline and students who had internship in the psychiatry department (third to 6th year students and residents) had lower scores of the Attribution Questionnaires AQ-27 (p=0,003 and p=0,002 respectively). Sixty per cent of the students reported that spreading listening cells when needed, media coverage of mental illness and campaigns of awareness can help us reduce mental disease’s related stigma.

Conclusions

To conclude, in order to lower rates of stigmatization of mentally sick people, spreading awareness among medical students can be an important tool in order to understand this situation and to provide a better health care.

Disclosure of Interest

None Declared
Use of psychotropic medications during pregnancy and the postpartum period: Review on Recent Works and Clinical Scenarios
Authors: Román E. , Natividad M. , Cobo J. , Ayesa R. , Cachinero H. , Figueras I. , Izquierdo E. , Martínez E. , Paolini San Miguel J. P. , Monreal J. A. , González-Rodríguez A.
Published: August 2023

Introduction

The effects of antidepressant and antipsychotic medications in the perinatal period in both mothers and children have been a subject of interest for many decades. Risks and benefits should be considered according to the illness stage, trimester of pregnancy/ postpartum period, and neonatal outcomes.

Objectives

Our goal was to summarize the knowledge about the use of antidepressants and antipsychotics in the perinatal period. To illustrate the complexity of treatment decisions with clinical reports.

Methods

Review: A narrative review was carried out using the PubMed database including papers published in 2022. Evidence about the risks and benefits of using antidepressants and antipsychotics in the perinatal period is presented. Search terms: antidepressants OR antipsychotics AND (perinatal OR pregnancy OR postpartum).

Case reports (5 clinical scenarios): (1) pre-pregnancy counselling, (2-4) first-, second- and third-trimester of pregnancy, and (5)postpartum/breastfeeding.

Results

Review: (1)Depression/antidepressants. Treating maternal depressive symptoms is associated with a lower risk of pregnancy complications. Although placental passage of sertraline is low, drug monitoring is recommended. Antidepressant use in pregnancy is associated with preterm delivery and low weight at birth. (2)Psychosis/Antipsychotics. Antipsychotic intrauterine exposure is not significantly associated with increased risk of major congenital malformations. Minimum effective doses are recommended.

Case reports. (1)Pre-pregnancy counselling. Schizoaffective disorder receiving perphenazine, quetiapine and lithium. (2)First-trimester pregnancy. Discontinuation of treatment in major depressive disorder. (3-4)Second/third trimester. Occurrence of anxiety symptoms in posttraumatic stress disorder. (5)Postpartum/Breastfeeding. Discontinuation of antidepressants.

Conclusions

Shared decision-making models for antidepressants and antipsychotics prescription represent patient-centered approaches to be recommended in perinatal period.

Disclosure of Interest

None Declared
Mental and physical health outcomes of war migrants
Authors: Valdimarsdóttir U. A.
Published: August 2023

According to the UN Refugee Agency, around 100 million individuals were estimated to
be forcibly displaced worldwide in 2022 due to violence, war or other human rights
violations. This represents a doubling in the global population of forcibly displaced
individuals during the last decade. War migrants are frequently exposed to multiple traumas,
including direct or indirect exposure to violence, as well as extended periods of
insecurities in access to housing, clothes, food, education and health care. As a corollary,
war migrants face extensive health risks, including elevated risks of psychiatric disorders
with potential implications for the development of other conditions, e.g. autoimmune and
cardiovascular diseases. The most recent evidence of the health risks of war migrants will be
reviewed along with possible mitigating factors of such adverse sequalae.

Disclosure of Interest

None Declared
Suicide Deaths Before and During the COVID 19 Pandemic
Authors: Rossom R. , Penfold R. , Owen-Smith A. , Simon G. , Ahmedani B.
Published: August 2023

Introduction

With stressors that are often associated with suicide increasing during the coronavirus disease 2019 (COVID-19) pandemic, there has been concern that suicide mortality rates may also be increasing. Our objective was to determine whether suicide mortality rates increased during the COVID-19 pandemic.

With stressors that are often associated with suicideincreasing during the coronavirus disease 2019 (COVID-19) pandemic,there has been concern that suicide mortality rates may alsobe increasing.

Objectives

Our objective was to determine whether suicidemortality rates increased during the COVID-19 pandemic.

Methods

We conducted an interrupted time-series study using data from January 2019 through December 2020 from 2 large integrated health care systems. The population at risk included all patients or individuals enrolled in a health plan at HealthPartners in Minnesota or Henry Ford Health in Michigan. The primary outcome was change in suicide mortality rates, expressed as annualized crude rates of suicide death per 100,000 people in 10 months following the start of the pandemic in March 2020 compared with the 14 months prior. We conducted an interrupted time-series study using data fromJanuary 2019 through December 2020 from 2 large integrated health care systems. The population at risk included all patients or individuals enrolledin a health plan at HealthPartners in Minnesota or Henry Ford HealthSystem in Michigan. The primary outcome was change in suicide mortality rates, expressed as annualized crude rates of suicide death per 100,000 people in 10 months following the start of the pandemic in March2020 compared with the 14 months prior.

Results

There were 6,434,675 people at risk in the sample, with 55% women and a diverse sample across ages, race/ethnicity, and insurance type. From January 2019 through February 2020, there was a slow increase in the suicide mortality rate, with rates then decreasing by 0.45 per 100,000 people per month from March 2020 through December 2020 (SE= 0.19, P=0.03). There were 6,434,675 people at risk in the sample, with 55% women and a diverse sample across ages, race/ethnicity, and insurance type. From January 2019 through February 2020, there was a slow increase in the suicide mortality rate, with rates then decreasing by 0.45 per 100,000 people per month from March 2020 through December 2020 (SE= 0.19, P=0.03).

Conclusions

Overall suicide mortality rates did not increase with the pandemic, and in fact slightly declined from March to December 2020. Our findings should be confirmed across other settings and, when available, using final adjudicated state mortality data. Overall suicide mortality rates did not increase with the pandemic, and in fact slightly declined from March to December 2020. Our findings should be confirmed across other settings and,when available, using final adjudicated state mortality data.

Disclosure of Interest

None Declared
2. Predictors of Generalized Anxiety Disorder Symptoms in Residents of Fort McMurray Five Years after the Devastating Wildfires.
Authors: Owusu E. , Shalaby R. , Eboreime E. , Nkire N. , Lawal M. A. , Agyapong B. , Obuobi-Donkor G. , Adu M. K. , Oluwasani F. , Mao W. , Pazderka H. , Agyapong V. I.
Published: August 2023

Introduction

Natural disasters adversely impact individuals living in places where they occur, resulting in emotional distress. The wildfire that occurred in Fort McMurray (FMM), Alberta in 2016 is no different.

Objectives

This study aims to identify the prevalence and predictors of Generalized Anxiety Disorder (GAD) symptoms in residents of FMM five years after the devastating wildfires.

Methods

Data for the study were collected through a cross-sectional survey conducted online from the 24th of April to the 2nd of June 2021. A validated instrument, the GAD-7 scale, was used to collect information on anxiety.

Results

Of the total number of 186 residents who took part in the study, the majority were females (85.5%), employed (94.1%), working at school boards (50.0%), and were either married, cohabiting, or partnered (71.0%). The prevalence of likely GAD among the study sample was 42.5%. Unemployed respondents were seventeen times more likely to develop GAD symptoms (OR = 16.62; 95% C.I. 1.23-223.67) while respondents who would like to receive mental health counseling were five times more likely to experience GAD symptoms (OR = 5.35; 95% C.I. 2.03-14.15). Respondents who suffered a loss of property because of the wildfire were two times more likely to develop GAD symptoms (OR = 2.36; 95% C.I. 1.01-22.62).

Conclusions

Formulators of policy may mitigate GAD symptoms, particularly after natural disasters, by making long-term mental health counseling available and a key component of post-disaster management, and by investing in the social capital of the people to build resilience and support to deal with the post-disaster mental health effects.

Disclosure of Interest

None Declared
Exploring Decision-Making Strategies in the IOWA Gambling Task and Rat Gambling Task
Authors: Hultman C. , Tjernström N. , Vadlin S. , Rehn M. , Nilsson K. W. , Roman E. , Åslund C.
Published: August 2023

Introduction

Impairments in decision-making processes are believed to play an important role in both substance use disorders and behavioral addictions. Clinical and pre-clinical experimental testing provide complimentary insights on the psychobiological mechanisms of decision-making. The IOWA Gambling Task (IGT) assesses decision-making under ambiguity and risk, in which individuals are faced with four card choices associated with varying monetary reinforcer/loss contingencies. The rat Gambling Task is a pre-clinical version using palatable reinforcers as wins and timeouts mimicking losses. However, studies with interspecies comparisons in these tasks are lacking, but important to facilitate translation of information that may help unravel the complex processes of decision-making and generate clinical advances.

Objectives

This study explores decision-making strategies among humans and rats performing the IGT and rGT.

Methods

A total of 270 young human adults performed a computerized version of the IGT, and 72 adult outbread male Lister Hooded rats performed the rGT. Performance was assessed and explored by normative scoring approaches and subgroup formations based on individual choices.

Results

Results showed that most humans and rats learned to favor the advantageous choices, but the overall level of performance differed considerably. Humans displayed both exploration and learning as the task progressed, while rats showed relatively consistent pronounced preferences for the advantageous choices throughout the task. Nevertheless, variability in individual choice preferences during end performance were evident in both species.

Conclusions

Results are discussed in relation to procedural differences impacting performance and potential to study different aspects of decision-making. This is a first attempt to provide formal evaluation of similarities and differences regarding decision-making processes in the IGT and rGT from an explorative perspective.

Disclosure of Interest

None Declared
Avatar Intervention for cannabis use disorder in patients with psychotic and mood disorders
Authors: Giguère S. , Dumais A. , Potvin S.
Published: August 2023

Introduction

Cannabis use disorder (CUD) is a complex issue, even more so when it is comorbid with a psychotic disorder or a mood disorder. Indeed, this population seems more vulnerable to this substance since the incidence of developing CUD is five to six times higher. Psychotherapies have only shown a modest short-term effect that is not maintained in the long term. The emergence of the use of virtual reality (VR) in psychiatry could be the tool that will make it possible to overcome this lack of efficiency. Indeed, VR has shown its considerable potential in a variety of psychiatric conditions. However, this modality has not been investigated for treatment for CUD. The Avatar intervention for substance use disorder allows the creation of an avatar and voice transformation that represents a significant person in relation to the patient’s substance use and is interpreted by the therapist. During the immersive sessions, patients are invited to work with their avatars on self-affirmation and refusal techniques, the management of negative emotions, stress and cravings, conflict resolution, self-esteem and motivation for change.

Objectives

The purpose of this pilot project is to collect preliminary data on a new intervention.

Methods

For the realization of this research project, we intend to recruit 40 participants, aged 18 and over, with a diagnosis of a CUD of at least moderate intensity, with a regular cannabis use and who also has a psychotic and/or mood disorder. The intervention consists of 8 weekly one-hour long sessions. Clinical research interviews were conducted and after therapy, and follow-ups occured at 3, 6 and 12 months. These evaluations will allow us to analyze the quantity of consumption, the severity of CUD measured with the cannabis use problem identification test (CUPIT), as well as objectively the concentration of THC thanks to samples. urinary tests which are carried out at the first and last intervention session as well as at the 3-month follow-up. Also, the psychotic symptoms and the quality of life will be evaluated.

Results

In November 2022, 32 participants had been recruited of which 17 participants had completed the Avatar intervention. Preliminary results from this sample show that a decrease of moderate effect size for amount of cannabis consumed was observed, as well as on severity of the cannabis use problem after the intervention. The quantity of cannabis consumed and the severity of the problem was also significantly reduced at follow-up Quality of life tends to increase and disease symptoms decreased significantly at 3 and 6 month follow-up.

Conclusions

To our knowledge, this intervention is a first in the world to target CUD in this particular population while using innovative technology The Avatar intervention under study in this project presents itself as a new avenue for cannabis use disorders.

Disclosure of Interest

None Declared
Virtual self-conversation to support people living with obesity when starting their change process towards a healthier lifestyle: Preliminary results of a longitudinal study
Authors: Lusilla P. , Anastasiadou D. , Herrero P. , Vazquez J. , Spanlang B. , Slater M. , Ramos J. A. , Parramon G. , Ciudin A. , Comas M.
Published: August 2023

Introduction

People living with obesity (PLWO) often experience ambivalence when starting their change process towards a healthier lifestyle. Psychological treatments for obesity should resolve this ambivalence and help PLWO to explore their own reasons for change in line with their needs and values, as well as promote self-efficacy. Following the Motivational Interviewing (MI) principles, the SOCRATES project proposes a “virtual self-conversation” to help PLWO to address some of the psychological aspects associated with obesity, such as the lack of awareness about their condition, the impact of the internalization of weight stigma, and the lack of self-efficacy.

Objectives

With the current longitudinal study, we aim to explore how the participants’ process of lifestyle change, and how their eating habits and dysfunctional eating patterns change before and after the virtual intervention.

Methods

Forty-eight patients with obesity from the Vall d’Hebron University Hospital (Mean age = 19.7 years) were assigned to 3 groups. The Experimental Group 1 (EG1) (N = 21), after completing an intensive training on MI, received a virtual intervention using the “motivational self-conversation” technique. The Experimental Group 2 (EG2) (N = 17) underwent a virtual intervention with a pre-registered psychoeducational dialogue, and the Control Group (CG) (N = 10) followed treatment-as-usual. All participants completed self-reported questionnaires on their motivation to change lifestyle [(Readiness Rulers (RR), Processes of Change questionnaire in weight management (P-W)], eating habits (Habits questionnaire) and dysfunctional eating patterns (Three Factor Eating Questionnaire-18) at baseline (T0), post-intervention (T1), and 4 weeks follow-up (T2). Repeated measures ANOVA was performed for all the questionnaires.

Results

Statistically significant results were shown regarding motivation to change through the RR and the “evaluation of the consequences of their weight” subscale of P-W across time for the EG1 (p < .05). These results suggest that participants’ motivation to eat healthier and do more exercise, as well as self-awareness about the negative consequences of their condition increased after the virtual intervention.

Conclusions

The present study showed that this novel virtual intervention might be an effective tool in helping PLWO resolve their ambivalence to change lifestyle and acquire self-awareness about their condition. However, the intervention did not lead to significant changes in other psychological variables, such as lifestyle habits or dysfunctional eating patterns; domains that may be less sensitive to changes over the time, and which may take place once motivation is well-established.

Disclosure of Interest

None Declared
Long-term efficacy and safety of paliperidone 6-month formulation: An open-label extension of a double-blind study in adult patients with schizophrenia
Authors: Najarian D. , Turkoz I. , Galderisi S. , Lamaison H. F. , Zalitacz P. , Aravind S. , Richarz U.
Published: August 2023

Introduction

Paliperidone palmitate 6-month (PP6M), administered twice-yearly, demonstrated non-inferiority to paliperidone palmitate 3-month (PP3M) in preventing relapse in patients with schizophrenia in a phase-3 randomized, double-blind (DB) global study.1 We report results of a 2-year single-arm, open-label extension (OLE) of this study (NCT04072575).

Objectives

To assess long-term efficacy and safety of PP6M in patients with schizophrenia.

Methods

Patients who completed DB study without relapse were enrolled and followed up every 3 months for up to 2 years. Patients received 4 PP6M injections (700/1000 mg eq.) at baseline, 6-month, 12-month, and 18-month visits. Efficacy endpoints included relapse rate, Positive and Negative Syndrome Scale (PANSS) total score, Personal and Social Performance (PSP) score, and Clinical Global Impression-Severity (CGI-S) scale change from baseline. Safety was assessed by treatment-emergent adverse events (TEAEs), physical examinations and laboratory tests.

Results

Of 178 patients, 154 (86.5%) completed the study; mean age: 40.4 years; 70.8% were men. Mean duration of PP6M exposure was 682.1 days. Overall, 7/178 (3.9%) patients relapsed between 20 to 703 days after enrolment. Mean (SD) change from baseline to endpoint: PANSS total score, 0.7 (8.22); CGI-S, 0.0 (0.51); PSP Scale, 0.5 (7.47). Overall, 111/178 patients (62.4%) reported ≥1 TEAE; most common (>10%) TEAEs were headache (13.5%) and blood prolactin increased (10.7%). Total, 7/24 patients withdrew due to TEAEs, and 8/178 (4.5%) patients experienced serious TEAEs; no deaths were reported.

Conclusions

Relapse rate with PP6M was very low (<4%). Clinical improvements in PANSS, CGI-S, and PSP scales demonstrated in DB study were maintained during this 2-year OLE study and no new safety concerns were identified.

Reference

1. D. Najarian et al. Int J Neuropsychopharmacol. 2022 Mar 17;25(3):238-251.

Disclosure of Interest

D. Najarian Shareolder of: Johnson & Johnson, Employee of: Janssen Research & Development, LLC, I. Turkoz Shareolder of: Johnson & Johnson, Employee of: Janssen Research & Development, LLC, S. Galderisi Consultant of: Janssen, Gedeon Richter-Recordati, Angelini, Speakers bureau of: Angelini, Gedeon Richter-Recordati, Janssen, Lundbeck, Sunovion, Recordati, H. Lamaison Grant / Research support from: Novartis, Eli Lilly, Lundbeck, Servier, AstraZeneca, Wyeth, Pfizer, Otsuka, Takeda, Sunovion, Roche, Janssen Pharmaceutical, Speakers bureau of: Servier, Abbot, Raymonds, Raffo, Temis Lostalo and Janssen Pharmaceutical, P. Zalitacz: None Declared, S. Aravind Shareolder of: Johnson & Johnson, Employee of: Advarra, Inc. USA, U. Richarz Shareolder of: Johnson & Johnson, Employee of: Janssen Research & Development-Cilag, Switzerland.
Development of a school-based digitalised intervention for ADHD using Intervention Mapping
Authors: Russell A.
Published: August 2023

Introduction

Attention deficit/hyperactivity disorder (ADHD) is a prevalent and impairing neurodevelopmental disorder affecting 2-5% of children. These children are at risk of negative health, social and educational outcomes; ADHD incurs an estimated £670 million annual cost to health, education and social care in the UK. Children with ADHD often experience severe difficulties at school despite drug treatment: effective psychosocial interventions are needed. There is mixed evidence for the effectiveness of existing school-based interventions for ADHD, which are complex and resource-intensive, contradicting the preferences of teachers for short, flexible strategies that suit a range of ADHD-related classroom-based problems.

Objectives

To develop a prototype of a school-based intervention for ADHD.

Methods

Intervention Mapping, a framework for developing theory- and evidence-informed interventions with explicit consideration of implementation context, was used. Logic models were developed of the behaviour change steps required by each agent in the school system to improve outcomes for students with ADHD.

A comprehensive evidence synthesis was conducted for interventions that targeted the key outcomes of relevance (inattention, impulsivity, hyperactivity, peer and teacher relationships, self-esteem, executive functions and organisation skills); findings were integrated alongside behaviour change theory and theories of the underlying aetiology of ADHD, in order to develop a logic model for the intervention. Components of the intervention were then developed in line with the logic model using evidence-based behaviour change methods, with input from people with ADHD, school staff and other key stakeholders at every stage of the development process.

Results

The development process resulted in a prototype digital platform that can be utilised to deliver a personalised behavioural intervention for children with ADHD within primary schools. It contains some core components that all teachers and children will complete, and then is individualised based on the key problems each child is currently facing. There are six optional modules, each containing a range of behavioural strategies for teachers to implement with the student or the whole class. The toolkit includes a symptom tracking graph that teachers can use to visualise the progress a child is making, and is developed to align with the current resources and capacity of primary schools in the UK.

Conclusions

The prototype intervention is designed explicitly to fit with existing school structures and demands, and to be low cost in terms of delivery and training. It focusses on adapting the school environment to better suit children with high levels of ADHD symptoms. It is now being feasibility tested, and in this talk I will describe the development process using Intervention Mapping, and the initial feedback from the first testing of implementation of the prototype.

Disclosure of Interest

None Declared
Taxonomy of psychopathology based on a neurochemical framework
Authors: Trofimova I.
Published: August 2023

Introduction

Temperament and mental illness are considered to be variations along the same continuum of imbalance in the neurophysiological regulation of behaviour.

Objectives

This presentation presents the benefits of constructivism approach to psychiatric taxonomies.

Methods

The presentation reviews findings in neurochemistry that link temperament traits in healthy individuals and symptoms of psychiatric disorders to complex relationships between neurotransmitter systems.

Results

Specialization between neurotransmitter systems underlying temperament traits is analyzed here from a functional ecology perspective that considers the structure of adult temperament corresponding to the functional structure of human activities. In contrast to a more popular search for neuroanatomic biomarkers of psychopathology and temperament traits in healthy individuals, this presentation focuses on neurochemistry-based biomarkers. The roles of monoamine neurotransmitters (serotonin, dopamine, noradrenalin), as well as the roles of acetylcholine, neuropeptides and opioid receptor systems in the regulation of specific dynamical properties of behaviour are summarized within the neurochemical Functional Ensemble of Temperament (FET) model (Table 1) (Trofimova & Robbins, Neurosci Biobehav Rev, 2016, 64, 382-402; Trofimova, Neuropsychobiology, 2021, 80(2), 101-133).

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Conclusions

The FET framework allows having a neurochemistry-based structure of a taxonomy that can classify both, healthy bio-psychological traits and symptoms of psychopathology. The presentation will give examples of how the FET framework can be used in psychiatry and clinical psychology.

Disclosure of Interest

None Declared
Development of a youth version of the Here and Now Aboriginal Assessment (HANAA-Y) tool
Authors: Janca A. , Lyons Z.
Published: August 2023

Introduction

Assessment of social and emotional wellbeing (SEWB) of Aboriginal people is challenging. A The culturally appropriate screening instrument for SEWB in Aboriginal adults entitled Here and Now Aboriginal Assessment (HANAA), has been developed and evaluated. The HANAA explores ten key domains and adopts a yarning process to initiate a semi-structured interview that covers each domain. This is recorded in narrative form and each domain rated as ‘problem’ or ‘no problem’ and a ‘recommended action’ is determined. The HANAA is widely used by Aboriginal mental health service providers around Australia.

Objectives

There have been multiple requests by service providers for a similar instrument to be developed for young Aboriginal people. This study aims to develop a youth version of the instrument abbreviated as HANAA-Y.

Methods

A Working Group comprised of Aboriginal and non-Aboriginal psychiatrists and mental health professionals with expertise of SEWB in Aboriginal youth was established and a draft version of the HANAA-Y has been produced. Evaluation od cultural applicability, reliability and validity of HANAA-Y is underway in metropolitan, rural and remote locations across Australia.

Results

The original HANAA structure, yarning style, and rating has been retained. However, new domains and probe words relevant to young people have been selected. The new domains are as follows: somatic complaints; emotional issues; suicide risk and self-harm; alcohol and drug use; cognition and activity; behavioural and legal issues; strange thoughts and unusual experiences; functioning; stressful life events; and resilience and healing. The HANAA-Y administration guidelines have also been amended to be of relevance to Aboriginal youth.

Conclusions

It is expected that HANAA-Y will be a culturally appropriate and useful instrument which can be used by a range of service providers with differing levels of mental health training to screen for SEWB among young Aboriginal people.

Disclosure of Interest

None Declared