bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of invasive VNS on depression severity and the need of concomitant drug and neuromodulatory treatment dose
Authors: Kavakbasi E. , Baune B.
Published: September 2022

Introduction

Invasive vagus nerve stimulation (VNS) is an adjunctive long-term treatment option for chronic and recurrent difficult-to-treat depression (DTD).

Objectives

In this prospective observational open-label case series we report on the effects of invasive VNS on depression severity, medication load and the need of maintenance electroconvulsive therapy (ECT) and esketamine treatment after 12 months.

Methods

Patients were treated with invasive VNS according to clinical indication. All patients were included in the Restore-Life-Study. The assessment of depression severity (MADRS) and concomitant treatment was performed at baseline and in 3-months intervals postoperatively over a 12 months period.

Results

Twelve patients were treated with adjunctive VNS due to unipolar (n=10) and bipolar (n=2) depression. The majority of patients were female (n=9). The mean age at baseline was 53.8 years (range 38-66). Patients were severely affected by a variety of depression symptoms which was reflected in high MADRS Scores (median 29, mean 28) at baseline. All patients received at least 2 or more psychotropic drugs at baseline. After 12 months of VNS a clear reduction of MADRS Scores (41 % on average) was seen (12-months MADRS Score median 17, mean 18). After 12 months, one patient each was discontinued from maintenance ECT and esketamine, respectively. The median of drug load was reduced from 4,56 to 4,06 after 12 months.

Conclusions

Invasive VNS is an effective treatment option in the long-term management of DTD to reduce the need of concomitant drug dose and maintenance treatment.

Disclosure

E Kavakbasi received speaker fees from Livanova. BT Baune received speaker and advisor fees from Livanova. The patients were included in the Restore-Life Study sponsored by LivaNova.
Nucleus accumbens functional connectivity and circulating endocannabinoids levels in anorexia nervosa
Authors: Miranda-Olivos R. , Baenas I. , Pastor A. , Del Pino A. , Codina E. , Sánchez I. , Juaneda-Segui A. , Jimenez-Murcia S. , De La Torre R. , Soriano-Mas C. , Fernandez-Aranda F.
Published: September 2022

Introduction

Neuroimaging findings have reported aberrant functional connectivity in brain regions involved reward system in individuals with anorexia nervosa (AN) altering hedonic processing over food. Likewise, endocannabinoids such as Anandamide (AEA) and 2-Arachidonoylglycerol (2-AG) have been involved in rewarding aspects of food intake.

Objectives

To identify nucleus accumbens (NAcc) functional connectivity with whole-brain comparing between individuals with AN and controls. Furthermore, in a sub-study, to explore the interaction between NAcc functional connectivity and peripheral AEA and 2-AG levels.

Methods

A total of 60 adult women (18 to 56 years of age) took part in the present study. Twenty-six individuals belonged to the AN group (BMI<18) and 34 to the HC group (BMI=18-24.99). All participants underwent functional magnetic resonance in resting-state, and blood samples were obtained in fasting.

Results

Negative functional connectivity was observed in the AN group compared with the control group between the NAcc and the cerebellum (pFWE<.001), between the NAcc and the insula (pFWE<.001), between the NAcc and the supramarginal gyrus (pFWE=.019), and between the NAcc and the postcentral gyrus (pFWE=.010). Analyses exploring the association between NAcc functional connectivity and peripheral endocannabinoids levels displayed altered NAcc-cerebellum functional connectivity was negatively associated with peripheral 2-AG levels in the AN group (r= -.553; p=.011).

Conclusions

Understanding the interaction between the reward system and peripheral endocannabinoids in patients with AN could contribute to better elucidate the pathophysiology of this disorder. Future studies will need to further investigate the clinical and therapeutic implications of these findings in patients with AN.

Disclosure

No significant relationships.
Short-term psychological support to civilians exposed to the January 2015 terrorist attacks in France
Authors: Vuillermoz C. , Pirard P. , Stene L. , Vandentorren S.
Published: September 2022

Introduction

Some projects have described post-disaster psychosocial services and planning across Europe. However, little is known about the real psychosocial disaster responses such as low-intensity initiatives after a terrorist attack

Objectives

This study aims (1) to describe psychological support (PS) in the immediate (<48 hours), post-immediate (48 hours – 1 week) periods and more than one week after a terrorist attack among terror-exposed people, and (2) to identify factors associated with a lack of short-term PS among those who suffered from mental health disorders.

Methods

This study used data from a longitudinal survey of 189 civilians exposed to the January 2015 terrorist attacks conducted 6 months after the attacks. Factors associated with lack of PS after the attacks was identified using a Robust Poisson regression in three separate models (for the 3 periods).

Results

Among participants who suffered from PTSD (n=34), depression (n=74), or anxiety (n=59) 6-9 months after the terrorist attacks, respectively, 9%, 18% and 12% did not received psychological support. The lack of immediate PS was associated with geographical distance, type of exposure, and support in daily life. The lack of post-immediate PS was associated with geographical distance, peri-traumatic reactions and past psychological follow-up. The lack of PS after one week was associated with geographical distance and social isolation.

Conclusions

Characteristics of exposition and social support seem to play an important role in lack of PS after a terrorist attack and highlights the need to use strategies to reach out to people regardless of the type of exposure.

Disclosure

No significant relationships.
Elevated osteopontin and IFNy serum levels and increased neutrophil-to-lymphocyte ratio are associated with the severity of symptoms in schizophrenia
Authors: Kovács M. , Tényi T. , Kugyelka R. , Prenek L. , Herold R. , Balogh P. , Simon D.
Published: September 2022

Introduction

Inflammation and immune dysregulation could contribute to the pathogenesis of schizophrenia. Osteopontin (OPN) is a key cytokine-like molecule in cellular immune response and it can directly modulate the cytokine expression and survival of microglia. Furthermore, its mRNA expression is elevated in first episode psychosis. Imbalance of T-helper subtypes could also represent a vulnerability factor for schizophrenia.

Objectives

The aim of this study was to evaluate the relevance of T-helper subtype associated cytokines, OPN and NLR in the assessment of the severity of schizophrenia.

Methods

22 patients with schizophrenia were assessed for the intensity of their symptoms by PANSS and CGI scores. Serum OPN, IFNy, IL-10 and IL-8 concentrations were measured by ELISA kits and NLR was calculated from blood count. Statistical evaluation was performed using Mann-Whitney U test, Student’s t test and Spearman correlation.

Results

We found significant correlation between the level of OPN and PANSS-total, PANSS-general scores. IFNy level and NLR showed significant correlation with PANSS-total, PANSS-positive, PANSS-general and CGI score. Antipsychotic therapy only had significant effects on NLR and OPN levels, both of which were significantly reduced after long-term antipsychotic treatment.

Conclusions

Our results indicate that elevated OPN and IFNy concentrations, and increased NLR are associated with severe symptoms in schizophrenia and suggest the importance of Th1 subtype in patients with high PANSS-positive and PANSS-general score. Antipsychotic treatment had significant effects on the level of OPN and NLR, but not on the level of IFNy. Overall our results strengthen the inflammation hypothesis of schizophrenia.

Disclosure

No significant relationships.
Predictors of functioning at clinical high-risk for psychosis
Authors: Omelchenko M.
Published: September 2022

Introduction

In addition to the psychosis onset, patients at clinical high-risk (CHR) show a decrease of functioning. This may not be related to the degree and persistence of the attenuated positive symptom (APS). Other clinical factors also predict the level of remission.

Objectives

Revealing the predictors of the functioning in the 5-year follow-up in patients at CHR.

Methods

124 young depressive patients at CHR were examined. Depression symptoms were assessed on the HDRS scale, and the CHR symptoms were assessed on the SOPS scale. The follow-up examination was conducted after 5 years with the determination of functioning on the PSP scale. A correlative analysis of the predictors of the level of remission was conducted.

Results

The functioning level was inversely related to the length of a depressive episode with the CHR symptoms (r=-0,432, p˂0.05), to the negative sub-scale SOPS score (r=0.312, p˂0.05) and to the symptoms of disorganization sub-scale SOPS score (r=0.246, p˂0.05) in the primary assessment. Insufficient reduction of the positive, negative symptoms and symptoms of disorganization on the SOPS during in-patient treatment was also a predictor of the worst outcome at the 5-year follow-up (r=-0,206, p˂0,05; r=-0,309, p˂0,05; r=-0,355, p˂0,05, and r=-0,349, p˂0,05, respectively).

Conclusions

There are some factors, except the severity of APS, that may be considered as the predictors of functioning level in patients at CHR.

Disclosure

No significant relationships.
A family study on first episode of psychosis patients: exploring neuropsychological performance as an endophenotype
Authors: Ayesa-Arriola R. , Murillo-García N. , Díaz-Pons A. , Miguel-Corredera M. , Barrio-Martínez S. , Ortiz-García De La Foz V.
Published: September 2022

Introduction

Family studies provide the opportunity to investigate endophenotypes as a powerful neurobiological platform to better understand the underlying neurobiological mechanisms of schizophrenia spectrum disorders. Shared features between the patients and their first-degree relatives may shed some light on the path to identify potential causes of psychosis, and to implement preventive and therapeutic interventions.

Objectives

This study aimed to explore and compare neuropsychological measures in first episodes of psychosis (FEP) patients, their first-degree relatives and healthy controls (HC), participants on the PAFIP-FAMILIES project.

Methods

Statistical analyses were performed using one-way ANOVA, followed by multiple comparisons test where appropriate. Age, sex and years of education were introduced as covariates.

Results

From 387 eligible FEP patients enrolled in a previous cohort, 133 were included. In addition, 244 of their first-degree relatives (146 parents and 98 siblings) and 202 HC participated in this study (see Figure 1). In general, relatives showed an intermediate neuropsychological performance between the HC and the FEP patients (see Figure 2). Specifically, siblings performed similar to HC in the domains verbal memory, visual memory, working memory, motor dexterity and theory of mind, since their values practically overlap those of HC. The parents presented significant deficits, similar to that of the affected individuals, in executive functions and attention domains.

Conclusions

These findings suggest that executive and attention dysfunction might have a greater family aggregation and could be a relevant cognitive endophenotype for psychotic disorders. The study shows the potential of exploring intra-family neuropsychological performance supporting neurobiological and genetic research in schizophrenia.

Disclosure

No significant relationships.
The Effect of Sleep Disorders on Sexual Function in Bipolar Disorder in the Remission Period
Authors: Ünlü Çilesiz M. , Tomruk N. , Çilesiz N. , Varlık C. , Yıldızhan E.
Published: September 2022

Introduction

Bipolar Disorder(BD) is a common,severe and recurrent disease with significant effects on functionality. Residual symptoms such as sleep disturbance and sexual dysfunction are defined as predictors of poor functioning in remission.

Objectives

The aim of this study was to investigate the correlation between sleep disorder and severity of sexual dysfunction in patients with BD in remission.

Methods

The study was conducted with 100 female and 100 male BD patients in remission. The sociodemographic and clinical characteristics were recorded by interview with the patients and the patients were given the Young Mania Rating Scale(YMRS),Hamilton Depression Rating Scale(HAM-D),Pittsburg Sleep Quality Index(PSQI),Epworth Sleepiness Scale(ESS),Female Sexual Function Scale(FSFI) and International Index of Erectile Function(IIFF-15)for the assesment of symptom severity.

Results

The frequency of “sleep disorder” was 45.5% and the frequency of ’’daytime sleepiness’’ was 5.5%.In women the mean FSFI score was 26.06±5.14 and sexual dysfunction frequency was 48%.In men,the mean IIEF score was 59.63±8.34 and erectile dysfunction frequency was 56%. There was a statistically significant negative correlation between total FSFI score with HAM-D(r=-0.592, p <0.001),ESS (r=-0.330, p=0.001)and PSQI(r=-0.557, p<0.001)and between total IIEF score with HAM-D(r=-0.509, p<0.001),ESS(r=-0.361, p<0.001)and PSQI(r=-0.511,p<0.001). Sexual function scores in both women and men with sleep problems were significantly lower than those without sleep problems(23.56±4.71vs.28.56±4.31and53.88±7.10vs.63.80±6.56 respectively). Multiple linear regression analysis also showed that total sleep quality scores were an effective factor on sexual function in women(OR:2.74,%95CI[0,799-0,127];p=0,007) and men(OR:2.45, %95CI[1.577-0.164];p=0,016) with BD.

Conclusions

There was an increased incidence of sexual dysfunction in bipolar patients with sleep disorders.Treatment of sleep disorders is important for improving sexual function in bipolar patients for both genders.

Disclosure

No significant relationships.
Family aggregation of the Intelligence Quotient: understanding its role in first episode of psychosis
Authors: Murillo-García N. , Soler J. , Fatjó-Vilas M. , Ayesa-Arriola R.
Published: September 2022

Introduction

The familiality of intelligence quotient (IQ), understood as its similarity among family members, might be related to different manifestations in first episode of psychosis (FEP) patients.

Objectives

To estimate the IQ familiality through the intra-family resemblance score (IRS) in FEP patients and their unaffected first-degree relatives; and to analyze if the deviation from the family-IQ is related to the patients’ premorbid, clinical and cognitive characteristics.

Methods

Individuals from 129 families participated in this study (129 patients, 143 parents, 97 siblings). For each family, two values were estimated: the family-IQ, obtained by the mean IQ of the patient and his/her relatives (using the WAIS vocabulary subtest); and the IRS, an index previously reported that indicate intra-family heterogeneity (IRS<0) or homogeneity (IRS>0) for a given trait. According to the IRS and the family-IQ, patients were assigned to 6 groups (Figure 1).

Results

FEP patients in families with heterogeneous IQ (IRS<0) had a significantly lower IQ than their relatives (p<0.001). Also, those with low IQ and from heterogeneous families had poorer childhood adjustment (p=0.001). The patients with high IQ belonging to homogenous families showed less positive symptoms at baseline (p=0.009). FEP patients in homogenous families due to low IQ evidenced the lowest neuropsychological performance (Figure 2).

Conclusions

The analysis of the IQ familiality and the concordance/discordance of the patients’ and relatives’ IQ, offers a new approach for the characterization of different premorbid, clinical and cognitive profiles in FEP patients. The relationship between deviation from the family-IQ and poor premorbid childhood adjustment supports the neurodevelopmental hypothesis of schizophrenia.

Disclosure

No significant relationships.
Alcohol-induced psychotic disorder: a study of hospitalized patients in Lisbon
Authors: Nogueira V. , Pereira I. , Moreno M. , Teixeira J.
Published: September 2022

Introduction

While alcohol-induced psychotic disorder (AIPD) is a well-recognised clinical disorder, relativery little is known about aspects such as epidemiology, course and treatment of the condition. Current evidence suggests AIPD can be clinically distinguised from alcohol-withdrawal delirium and schizophrenia. AIPD is associated with high comorbidity with other psychiatric disorders, high re-hospitalization and mortality rate, namely suicidal behaviour.

Objectives

The objetive of the study was to examine the correlates, clinical features, psycopathology, and short-term response in an inpatient sample with alcohol-induced psychotic disorder, predominant hallucinations (ICD-10 F10.52) admitted to Centro Hospitalar Psiquiátrico de Lisboa.

Methods

We collected retrospectively data from all admitted patients to our Alcohol Unit between January 2010 and January 2020 with the diagnosis of AIPD. The exclusion criteria were: presence of preexisting psychotic disorder, delirium, or other substance use disorders. We characterized our sample in Demographic categories, Clinical categories, Treatment and Short-term course.

Results

A total of 113 subjects were included in the study. The prevalance of alcoholic hallucinosis was found to be 1.3% of all patients who received inpatient treatment. Most individuals reported auditory hallucinations, that iniciated when they decrease their alcohol intake, and 1 in 4 had past episodes of AIPD.

Conclusions

There are specific challenges in studiyng AIPD, such as the relatively rarity of the disorder, its often transient nature and high levels of comorbidity. A high degree of recurrence and morbidity indicates a need to prevent, and intervene early with an abstinent-oriented management goal.

Disclosure

No significant relationships.
CYP2C19 expression modulates affective functioning and brain anatomy – a large single-center community-dwelling cohort study
Authors: Grosu C. , Trofimova O. , Gholam M. , Strippoli M.-P. , Kherif F. , Lutti A. , Preisig M. , Draganski B. , Eap C.
Published: September 2022

Introduction

The association between CYP2C19 poor metabolizer status, depressive symptom severity and hippocampal volume in humans is controversial. Progress in understanding not only the pathophysiology of depression but also potential protective mechanisms is important both for daily clinical practice and for the development of new antidepressant therapies.

Objectives

To test and validate previous findings regarding the impact of CYP2C19 status on depressive symptoms and to examine whether it could influence hippocampus subregions and brain tissue microstructure.

Methods

A total of 4152 individuals from the Longitudinal cohort in the community-dwelling adult population - Colaus|PsyCoLaus in Lausanne, Switzerland were included. They have participated in at least one psychiatric evaluation. Brain anatomy patterns using a comprehensive set of psychometry, water diffusion- and relaxometry-based magnetic resonance imaging data were analysed in a subset of the cohort (BrainLaus, n=1187).

Results

In this population-based cohort study, better lifetime global assessment of functioning scores were observed in poor metabolizers when compared to other metabolizers, this result was mainly driven by female participants (ß=3.9, P=0.01). Examination of brain imaging data revealed that higher right hippocampal subiculum volume was related to poor metabolizer status (ß=0.03, P=0.006). In addition, associations were observed between metabolizer status and white matter microstructure in the left uncinate fasciculus (ß=-0.01, P=0.01) and the left cingulum bundle (ß=-0.01, P=0.01).

Conclusions

CYP2C19 status is associated with modifications in lifetime global functioning, and brain anatomy. Such differences in brain structures can contribute to explain the protective effect of CYP2C19 poor metabolizer status.

Disclosure

No significant relationships.
Psychiatric care following deliberate self-harm and prospective mortality: evidence from a national cohort of patients in routine care
Authors: Qin P.
Published: September 2022

Introduction

Psychiatric care following self-harm treatment is pivotal in patients´ life both in short- and long-terms.

Objectives

To examine follow-up psychiatric care received by patients treated for deliberate self-harm (DSH), and to assess the influence of psychiatric referral and treatment attendance on risk for subsequent mortality.

Methods

Nationwide registries were interlinked to follow all DSH patients for data on personal socioeconomic status, clinical features of DSH, psychiatric treatment and cause of death. Data were analyzed with Logistic regression and cause-specific survival analysis.

Results

The study identified 43153 patients involving 69569 DSH episodes. Of these patients 15.7% were referred or transferred to psychiatric services and 51.0% attended psychiatric treatment within subsequent 3 months. Evidently, prior psychiatric history and psychiatric comorbidities had strong influence on both referral and attendance to psychiatric healthcare, personal socioeconomic status also deviated the likelihoods. During the follow-up, 7041 patients died from suicide (n=911) or other causes (n=6130). While suicide risk was highly associated with male gender, middle age, and particularly, prior and coexisting psychopathologies, other cause mortality was strongly associated with old age and socioeconomic disadvantages. Meanwhile, a referral to psychiatric services was associated with suicide risk, and the risk was particularly high for patients who received the referral but did not attend psychiatric treatment. The observed effect was more pronounced during the early years, and in patients of young or middle age and those with a clear intent of self-harm.

Conclusions

The insightful findings highlight the importance of patients´ attendance and engagement in follow-up psychiatric care on risk for subsequent mortality.

Disclosure

No significant relationships.
Poverty, agency, and suicide: Men and women
Authors: Steyn R.
Published: September 2022

Introduction

Assumptions linking poverty with sex, associating poverty with agency, as well as connecting agency with suicide, are widespread. Women are often seen as being affected more by poverty than men. Men are frequently considered to possess more agency than women, and men are also more prone to suicide than women.

Objectives

The research aims to assess if poverty, agency and suicide differences occur across sexual lines. The study will attempt to establish if a poverty-agency-suicide relationship is supported by data, and how the poverty-agency and the agency-suicide relationships are in turn influenced by sex.

Methods

A cross-sectional survey design was used and interviews were conducted with 3 531 respondents. Chi-squared tests were used to calculate whether differences on poverty, agency and suicide ideation exist across sexual lines. Correlation analysis was implemented to test for the poverty-agency-suicide relationship, and regression analyses were used to test the moderating effects of sex on the poverty-agency and the agency-suicide relationships.

Results

Men and women did not differ significantly on levels of poverty, agency, nor suicide ideation. Poverty did relate to agency (a negligible effect), but agency did not have an effect on suicide ideation. Sex did not moderate the poverty-agency nor the agency-suicide relationship.

Conclusions

The data do not support established stereotypes nor empirical findings regarding sex differences across the poverty, agency and suicide ideation spectrums. The data also do not support the poverty-agency-suicide relationship and sex does not influence this relationship. Healthcare professionals should be aware that (well-founded) stereotypes do not necessarily materialize in all populations.

Disclosure

No significant relationships.
An innovative combination of cypropheptadine and prazosin for the treatment of alcohol use disorder: a double-blind, randomised, parallel-group, three-arm, multicentre, placebo-controlled phase 2 trial
Authors: Aubin H.-J. , Puech A.
Published: September 2022

Introduction

Animal studies have shown that the simultaneous blockade of α1b-noradrenergic receptors and 5HT2A-serotonergic receptors strongly decreases alcohol intake. In addition, recent clinical studies have indicated that the selective α1b antagonist prazosin could be effective on alcohol use reduction in alcohol-dependent subjects.

Objectives

Cocktail is a double-blind, randomised, parallel-group,
three-arm, multicentre, placebo-controlled phase 2 proof-of-concept study aiming at demonstrating the superiority of a 12-week treatment with the KT110 combination of cyproheptadine (8 mg/day or 12 mg/day) and prazosin (5 mg/day or 10 mg/day) over placebo on the reduction of total alcohol consumption.

Methods

The study two main inclusion criteria are a DSM5 diagnosis of severe alcohol use disorder and a WHO high-risk drinking risk level. The primary endpoint is the change from baseline (4 weeks preceding randomization) to the end of treatment (Weeks 9-12) in the mean quantity of alcohol consumed per day in the three groups. Daily alcohol consumption is determined using the Timeline Follow Back, automatically be filled in on the basis electronic patient reported outcomes platform. The 12-week treatment period is followed by a 4-week post-treatment follow-up.

Results

One hundred and eighty patients are planned to be randomized 1:1:1 into the two treatment groups. Enrollment of patients started in November 2019, and will end in July 2021.

Conclusions

In this communication, we will present the rationale for the development of the KT110 combination of cypropheptadine and prazosin for the treatment of alcohol use disorders, as well as the main features of the Coctkail study. ClinicalTrials.gov identifier: NCT04108104.

Disclosure

Member of advisory boards, DSMB, or steering committees, speaker honoraria or consultancy for Bioprojet, D&A Pharma Ethypharm, and Kinnov Pharmaceuticals, Lundbeck, and Pfizer D&A Pharma, Ethypharm, Kinnov Pharmaceuticals, Lundbeck, and Pfizer.
The association between social media use and mental health among adolescents and young adults
Authors: Koronczai B. , Demetrovics Z.
Published: September 2022

Introduction

The associations of problematic social media use, the special use of image-based social media (photo editing, following celebrities) and mental health (body dissatisfaction, self-esteem, depression) have been established (e.g. Yurdagül et al., 2019; Gioia, Griffiths, Boursier, 2020; Lowe-Calverley and Grieve, 2021). The links may be explained with the theory of social comparison and self-objectification.

Objectives

Testing theory-oriented hypotheses related to image-based social media use and body dissatisfaction, gender specifically, among adolescents and young adults.

Methods

Three surveys have been conducted with convenience sampling: (1) 117 Hungarian university students in person (mean age=22.4, SD=2.9, 79% female), (2) 383 high school students in person (mean age=16.5, SD=1.2, 58% female); (3) 124 Israeli adolescents online (mean age=16.8, SD=2.7, 68% female).

Results

(1): The tendency of modifying body image in social media (the frequency of modifying pictures, the use of filters) mediates the association between body shame and problematic social media use. Physical appearance social comparison mediates the association between self-related negative emotions and attitude (low self-esteem+ineffectiveness) and problematic social media use. (2): The technology-based social comparison mediate the association between muscle checking and problematic Instagram use among boys. (3) Physical appearance social comparison mediates the association between the frequency of following celebrities and body dissatisfaction among girls, but not among boys.

Conclusions

During the use of image based social media, social comparison and the exposure to the beauty standards may lead to poorer mental health, which could result in problematic social media use as maladaptive coping.

Disclosure

No significant relationships.
Concurrent use of alcohol and cocaine: which is the best drug choice?
Authors: Darriba H. Becerra
Published: September 2022

Introduction

Patients with comorbid cocaine and alcohol dependence have a worse prognosis with lack of adherence to follow-up and treatment, frequent psychosocial problems, and higher rates of relapse [1]. Concurrent use of both substances produces cocaethylene, which is associated with more toxicity than cocaine alone [2].

Objectives

To determine the efficacy of disulfiram compared to nalmefene in the treatment of comorbid cocaine and alcohol use.

Methods

A quasi-experimental open study was designed on 41 outpatients, with a follow-up of at least 1 year at the Mental Health Unit, aged between 18 and 65 years, diagnosed with cocaine and alcohol dependence (ICD-10). A minimum simultaneous weekly consumption of 2 grams of cocaine and 12 SD (Standard Drink) of alcohol during the month before, described by self-records was established. Treatment with oral disulfiram 250mg/day was assigned to 21 patients, and with oral nalmefene 18mg/day to 20 individuals. Observation period was for 6 months. Urinalysis and alcohol breath test were carried out twice a week. Abstinence was defined by obtaining negative results for at least 4 consecutive weeks. Statistical analysis were performed using SPSS v21.0 (significance p<0.05).

Results

61.9% of patients treated with disulfiram achieved a minimum of 4 consecutive weeks of abstinence from cocaine and alcohol, compared to 40% in the nalmefene group (χ²=1.188; gl=1; p=0.276). There were no significant differences.

Conclusions

Disulfiram or nalmefene monotherapy seems clinically ineffective or insufficient in reducing the combined use of cocaine and alcohol. Further research is needed to assess the effect of both drugs simultaneously.

Disclosure

No significant relationships.
Aripirazole-Long Acting Injectable in Pregnant Women with Schizophrenia: A Case Series
Authors: Fernández-Abascal B. , Recio-Barbero M. , Saenz-Herrero M. , Segarra R.
Published: September 2022

Introduction

Long-acting injectable antipsychotics (LAIs) have emerged as a new therapeutic option to treat patients suffering a psychotic disorder. To date, there is a lack of studies regarding safety and clinical use pattern of LAIs in pregnant women.

Objectives

Provide evidence and real world clinical data of pregnant women with schizophrenia who have been treated with long-acting aripiprazole monohydrate (aripiprazole once monthly [AOM] condition) during their pregnancy.

Methods

Descriptive real-world clinical experiences of pregnant women in treatment with AOM. The information was obtained by reviewing electronic medical records and by direct clinical observation management.

Results

The first six case-series describing the pregnancy course of women with schizophrenia treated with AOM. All of them remained psychopathologically stable through pregnancy, and their infants became healthy with normal developmental milestones (Table 1).

Table 1.

Clinical characteristics of six case-reports.

Mothers
1
2
3
4
56Maternal/Pregnancy outcomesAge(years)352935313830DiagnosisSchizophreniaSchizophreniaSchizophreniaSchizophreniaSchizophreniaSchizophreniaAOM(mg/days)400-300400-300400-300160300400Type of deliveryEutocic.Eutocic, pretermEutocicEutocicEutocicEutocicNeonatal outcomesWeight(grams)330018003140310229403400GenderFemaleFemaleMaleMaleMaleMaleDevelopmental
Abnormalities
(years)No(3)No(2)No( 0.17)No(2)No(2)No(1.5)

Conclusions

The favorable results in this case-series suggest that despite the lack of evidence on reproductive safety and treatment with AOM during pregnancy, this therapeutic option should be considered in pregnant women with schizophrenia. However, further research on the use of long-acting antipsychotics in pregnant women is needed.

Disclosure

No significant relationships.
Suicide in Adolescents with Mood Disorders
Authors: Shah K. , Trivedi C. , Kamrai D. , Srinivas S. , Mansuri Z.
Published: September 2022

Introduction

Adolescents patients presenting with mood disorders, including disruptive mood dysregulation disorder (DMDD), often present with the comorbid disorders such as oppositional defiant disorder (ODD) and attention-deficit hyperactivity disorder (ADHD).

Objectives

1) Evaluate the association between suicide in adolescents and various mood disorders. 2) To study the impact of comorbid conditions in DMDD on suicide ideation and attempt in adolescents.

Methods

We used 2016-2017 National Inpatient Sample dataset to select patients with mood disorders. Rao Scott adjusted Chi-Square test used to compare the groups with SPSS v26.

Results

In this study, 15195 patients were in the DMDD group (Mean age:12.1,F: 38%) and 219205 in the ‘other mood disorders’ group (Mean age:14.4,F:67%). The odds of SI/SA were two times more in patients with the ‘other type of mood disorder’ (OR:2.07, 95%CI: 1.77-2.14). Patients with the primary diagnosis of DMDD sub-classified into four groups (Group 1: DMDD only (n=5160), Group 2: DMDD+ADHD (n=7240), Group 3: DMDD +ODD (n=700), and Group 4: DMDD+ADHD+ODD (n=2095). SI/SA was prevalent in 30.8%, 26.0%, 22.9% and 26.3% in Group 1, 2, 3 and 4 respectively (p: 0.03). SI/SA was more prevalent in females compared to males (31.3% vs. 25.2%). An increase of 1 year in age was associated with a higher SI/SA (OR:1.05, 95%CI:1.01-1.08, 0.01). The SI/SA odds were 5% more in female patients (OR:1.27, p:0.01).

Conclusions

The study reveals that the risk of suicide ideation or suicide attempt is almost twice in the adolescent with mood disorders without DMDD compared to the DMDD group.

Disclosure

No significant relationships.
Parental concerns during COVID-19-related school closures: children’s behaviors and media usage
Authors: Kim S.J. , Cho S. , Kim D.
Published: September 2022

Introduction

Coronavirus Disease 2019 has prompted widespread school closures and physical distancing measures. Concerns regarding COVID-19 school closures often increase stress levels in parents.

Objectives

This study examined whether higher levels of parental concerns were associated with children’s problematic behaviors and other factors during COVID-19-related primary school closures.

Methods

Participants were 217 parents who responded to a web-based questionnaire covering parental concerns, subjective stress, and depression; children’s sleep patterns, behavioral problems, and changes in activity level after COVID-19; previously received mental health services; and media usage during the online-only class period from community center in Suwon city.

Results

The number of parental concerns was associated with children’s behavioral problem index (BPI) score (Pearson correlation 0.211, p < 0.01), sleep problems (0.183, p < 0.01), increased smartphone usage (0.166, p < 0.05), increased TV usage (0.187, p < 0.01), parents’ subjective stress levels (0.168, p < 0.05), and parental depression (0.200, p < 0.01). In families with children who previously received mental health services, the children reportedly suffered from more sleep and behavioral problems but not increased media usage, and parents noted more stress and depression. Parental concerns are related to family factors such as change of caregiver, no available caregiver, decreased household income, and recent adverse life events. Economically vulnerable people also reported higher rates of reported caregiver burden during COVID-19-related primary school closures, thus will require the potential heightened mental health needs.

Conclusions

Ongoing monitoring of mental health at risky group and multiple support systems should be considered for parents having difficulty in caring their children.

Disclosure

No significant relationships.
Prediction of ADHD symptoms from prenatal data in two large population-based cohorts
Authors: Dooley N. , Cannon M. , Cotter D. , Clarke M.
Published: September 2022

Introduction

The association between low birth weight and attention problems in childhood has been replicated many times (e.g. Momany, Kamradt, & Nikolas, 2018). However birth weight is unlikely the aetiological start-point of this association, as birth weight is itself the product of many prenatal factors e.g. gestational complications, maternal toxin exposure during pregnancy and basic demographics.

Objectives

We explore (1) which prenatal factors best predict attention problems in two independant population-based cohorts of children (2) which associations, if any, are moderated by sex and (3) we report accuracy statistics of our prenatal prediction algorithm for attention problems.

Methods

Participants were children aged 9 from ABCD study from the United States (N > 9,000) and the Growing Up in Ireland (GUI) study from Ireland (N > 6,000). Selected variables included familial pscyhiatric history, maternal smoking during gestation, prescription and non-prescription drug-use during gestation and a variety of gestational complications. All interactions with sex were also included. We used 5-fold cross-validation and elastic net regression (glmnet) to identify the optimal predictors of attention problems (measured by CBCL and SDQ).

Results

Strongest predictors of attention problems in the U.S. cohort included male sex, number of drugs used during pregnancy, number of family members with a history of mental illness, and number of gestational complications. Sex interacted with several of these risks. Protective factors included being a twin/triplet, being Asian, having higher household income and higher parental education level.

Conclusions

Several risk factors for childhood attention problems were identified across both cohorts, supporting their generalizabilty. Other findings were cohort-specific.

Disclosure

No significant relationships.
A Once Malignant Malady: the Story of Schizophrenia and the Path to Prevention
Authors: Lieberman J.
Published: September 2022

Schizophrenia is synonymous in the public’s mind with madness. To see someone experiencing a florid psychosis, who has lost the ability to distinguish between the real and the imagined, is to know that you are in the presence of insanity. Schizophrenia has existed for centuries. It’s one of the leading causes of disability in the world, with a lifetime prevalence of about 1 percent of the population. That’s 3.3 million people in the US and 78 million worldwide. Schizophrenia afflicts rich and poor, genders, all races and ethnic groups. Schizophrenia has been subject to many misconceptions, from spiritual affliction to social deviance, psychodynamic conflicts to romanticized notions of iconoclastic creativity. Perhaps, the most significant myth about the disease is that there are no effective treatments or cure. But the reality couldn’t be more different: today’s treatments are effective and often lifesaving. Beginning in the mid-twentieth century, scientific progress has enhanced our understanding of schizophrenia as a brain disorder that disrupts thought, perception, and emotion. Findings of abnormalities in brain structure, biochemical analytes and genetic mutations have revealed its causal mechanisms and have guided the search for effective pharmacologic and psychosocial treatments. This presentation traces the evolution of our social and scientific understanding of Schizophrenia. It will elucidate how science and medicine dispelled the superstition and myth surrounding this ancient malady of the mind and forged a path toward its understanding as a brain disorders and offers affected people, not just humane treatment, but the promise of its ultimate prevention.

Disclosure

No significant relationships.
Heredity as a factor in the formation of recurrent depression
Authors: Maruta N. , Kolyadko S. , Panko T. , Semikina O.
Published: September 2022

Introduction

At the current stage of psychiatry development, special attention is paid to studying the influence of hereditary factors on the occurrence of recurrent depression (RD). The study can be informative in predicting the risk of the RD occurrence RD. Therefore, studies related to this problem are designed to identify the specificity “familial” forms of RD.

Objectives

To study the influence of hereditary factors on the RD formation.

Methods

Clinical-psychopathological, clinical-genealogical, statistical.

Results

Based on the clinical and genealogical data study, a statistically significant excess of the individuals with psychiatric disorders proportion in the main group (108 patients with RDD whose family history included relatives with depression, main group) was found: The percentage of individuals on psychiatric registry (18%, CI: 14.5-22.1) was 15 times higher than the control group (46 individuals without RDR in the pedigree) (p<0.05), individuals with depression (33%, CI: 28.5-37.8) were 7.3 times higher (p < 0.05), suicides (7.9%, CI: 5.6-11.0) were 4.2 times higher (p < 0.05), cases of alcohol dependence (25.6%, CI: 21.6-30.2) were 1.8 times higher (p < 0.05). In the main group family tree examinees, this pathology occurred most frequently in I and II degree of kinship relative. When comparing heredity factors with peculiarities of the RD course, we found a specific weight in correlations of such factors as: depressive disorders predominantly in first-degree relatives (p ≤ 0.005), suicidal behavior in first- and second-degree relatives (p ≤ 0.005).

Conclusions

The findings should be taken into account in diagnostic and preventive measures.

Disclosure

No significant relationships.
Early-Onset Depression Is Associated With Specific Neurovegetative Symptoms
Authors: Kasyanov E. , Rukavishnikov G. , Nikolishin A. , Gareeva A. , Savitskaya K. , Kazantseva A. , Kretsu A. , Soldatkin V. , Lezheyko T. , Golimbet V. , Neznanov N. , Kibitov A. , Mazo G.
Published: September 2022

Introduction

The age at onset of depression is not only an important clinical predictor of the further disease course, but also a robust marker, reflecting the genetic impact on depression risk.

Objectives

This study aimed to find whether early-onset depression had an association with specific clinical symptoms, comorbid psychiatric disorders and family history of mood disorders.

Methods

This pilot cross-sectional, multicenter study was performed under the supervision of the Russian National Consortium for Psychiatric Genetics. Early-onset depression was defined as the first depressive episode before the median age of onset in the sample (Me=29 years). Logistic regression models were used to determine the independent association of early-onset depression, after adjusting for the effects of sex and age, with binary characteristics.

Results

A total of 172 patients with depression were enrolled in the study (64.5% women; age - 40.9 (15.9) years). Early-onset depression was associated with psychomotor retardation (p=0,025; OR=2,3; 95%CI [1,1 - 4,9]), decreased libido (p=0,014; OR=2,8; 95%CI [1,2 - 6,2]), and lower prevalence of weight loss/decreased appetite (p=0,011; OR=0,4; 95%CI [0,2 - 0,8]). No associations were found with the history of comorbid psychiatric disorders and the family history of mood disorders.

Conclusions

Early-onset depression is associated with specific neurovegetative symptoms. Further clinical and genetic studies are needed to evaluate the specific effects of age at onset of depression on its clinical course.

Disclosure

Research is supported by an RSF grant №20-15-00132.
Mentalizing abilities and serum lipid levels in adult MDD patients with childhood maltreatment – preliminary results
Authors: Nyarondi P. , Péterfalvi Á. , Szennai M. , Németh N. , Tényi T. , Czéh B. , Simon M.
Published: September 2022

Introduction

Childhood maltreatment (CM) contributes to negative mental and physical health outcomes including major depressive disorder (MDD), and an elevated risk for cardiovascular disease (CDV) in adults. Also, childhood maltreatment can be related to mentalizing deficits in MDD. Cardio-metabolic diseases often coincide with MDD and worsen its course and outcome. Little is known on the interplay of these factors.

Objectives

We examined MDD patients with and without CM to explore the effects of CM on serum lipid and lipoprotein levels and assessed their mentalizing abilities. Self-oriented mentalizing was operationalized as emotional self-awareness/alexithymia, other-oriented mentalizing was defined as theory of mind (ToM).

Methods

MDD patients (N=42) and healthy controls (n=20) matched in age, sex, and lifestyle were investigated. Total cholesterol, triglycerides, high- and low-density lipoproteins (HDL-C and LDL-C), body mass index, and exercise in a typical week were measured. Beck Depression Inventory, Childhood Trauma Questionnaire, Toronto Alexithymia scale, and the Reading the mind in the Eyes Test were used to assess clinical symptoms, mentalizing abilities and CM.

Results

After controlling for depressive symptom severity, demographic and lifestyle variables, CM was found to be a strong predictor of serum lipid alterations. Mentalizing deficits correlated with CM. Serum triglycerides, HDL-C were significant predictors of ToM performance (P<0.05, and P=0.005) and alexithymia (P< 0.05, and P< 0.05) in the MDD group.

Conclusions

Several, inter-correlated pathways may mediate the undesirable effects of CM on the course and outcome of MDD. According to our preliminary results, diminished self-awareness and ToM can be possible mediating factors.

Disclosure

This work was financially supported by the Hungarian Brain Research Program (2017-1.2.1-NKP-2017-00002)
Cognitive impairment and frailty in depressed elderly
Authors: Arts M. , Petrykiv S. , Jonge L.
Published: September 2022

Introduction

Cognitive frailty has recently been defined as the co-occurrence of physical frailty and cognitive impairment. Late-life depression (LLD) is associated with both physical frailty and cognitive impairment, especially processing speed and executive functioning.

Objectives

The objective of this study was to investigate the association between physical frailty and cognitive functioning in depressed older persons.

Methods

A total of 378 patients (>60 years) with depression according to DSM-IV criteria and a MMSE score of 24 points or higher were included. The physical frailty phenotype was examined as well as its individual criteria (weight loss, weakness, exhaustion, slowness, low activity). Cognitive functioning was examined in 4 domains: verbal memory, working memory, interference control, and processing speed.

Results

Of the 378 depressed patients (range 60-90 years; 66.1% women), 61 were classified as robust (no frailty criteria present), 214 as prefrail (1 or 2 frailty criteria present), and 103 as frail (>3 criteria). Linear regression analyses, adjusted for confounders, showed that the severity of physical frailty was associated with poorer verbal memory, slower processing speed, and decreased working memory, but not with changes in interference control.

Conclusions

Physical frailty in LLD is associated with poorer cognitive functioning, although not consistently for executive functioning. Future studies should examine whether cognitive impairment in the presence of physical frailty belongs to cognitive frailty and is indeed an important concept to identify a specific subgroup of depressed older patients, who need multimodal treatment strategies integrating physical, cognitive, and psychological functioning.

Disclosure

No significant relationships.