bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of nurses and the nursing assistants in the implementation and monitoring of physical restraint in psychiatry
Authors: Maatouk O. , Larnaout A. , Abassi B. , Lansari R. , Staali N. , Melki W.
Published: September 2022

Introduction

Physical restraint is a therapeutic procedure allowing to immobilize an agitated patient.Although it is an effective method especially in the states of psychomotor instability, its practice is not devoid of risks which imposes a codified technique with particular monitoring.

Objectives

The aim of this work was to evaluate the knowledge of nurses and nursing assistants in the practice and monitoring of physical restraint and to establish a suitble protocol codifing it.

Methods

Our study was a descriptive cross-sectional study based on a questionnaire grouping together a set of questions on general and professional characteristics, the decision of physical restraint, its prescription, its means, its monitoring, informing the patient and his relatives, physical restraint’s risks, the patient’s experience, the caregiver’s experience as well as the relationship between caregiver and patient. Our target population was composed of nurses and orderlies of the psychiatry department <> of the Razi hospital in Manouba.

Results

We collected 30 professinals.90% of them were women. 30% of our sample had less than five years of experience. Only 23.30% of caregivers had mental health training at the beginning of their professional career. 50% of them received training focused on physical restraint.83.30% reported using physical restraint for psychomotor agitation.56.6% ignored the psychological effects of the physical straint on patients. 73.3% of caregivers informed patients before straint.

Conclusions

A physical restraint protocol, codifying the technique of implementation and monitoring parameters is needed in order to improve the relation patient-cargiver and ensure an optimal care .

Disclosure

No significant relationships.
Use of mindfulness-based interventions for parental stress in relation with ASD: A review
Authors: Yesilkaya M. , Mijail Magallon Neri E.
Published: September 2022

Introduction

Children with ASD may present their parents with several challenges, most notably aggressive and destructive behaviors. Parents of children with ASD typically experience more stress, depressive and anxiety symptoms than other parents. Mindfulness-based interventions are reported to be effective in reducing parental stress along with improving the challenging behaviors of their children

Objectives

The current review aimed to investigate if the use of mindfulness-based interventions is beneficial to reduce parental stress when caring for children with ASD.

Methods

The databases of PsycINFO and PubMED were used. The variables studied in this systematic review were Autism, Parental stress, and Mindfulness. Inclusion criteria were that all articles should be academic journals, and with a full text available in English during the last 20 years.

Results

Compared to other behavioral approaches, mindfulness-based interventions showed statistically significant results in reducing the stress levels of parents as well as improving their children’s challenging behaviors.

Conclusions

Most of the studies in the current review indicated that mindfulness-based interventions are beneficial in improving the stress level of parents.

Disclosure

No significant relationships.
Psychiatric manifestations of measles encephalitis: About a case report
Authors: Bouhamed M. , Feki I. , Guermazi A. , Guermazi F. , Sallemi R. , Masmoudi J.
Published: September 2022

Introduction

Acute measles encephalitis is a pathology of the central nervous system. It is most frequent in children but can also be described in adults. Given the rarity of this pathology, we present the case of this patient.

Objectives

present a rare neuropsychiatric complication of measles

Methods

Présentation d’un cas clinique d’encéphalite rougeoleuse et revue de la littérature

Results

Mrs. HJ, 45 years old, without any somatic history, was followed for an antisocial personality with a substance use disorder. She consulted the emergency for psychomotor agitation, a fever of 39, and a rash on the face, thorax, and limbs. At the psychiatric interview, she was disoriented and very unstable. She seemed to be hallucinating.

The brain imaging and the lumbar puncture (CT scan and brain MRI) were without abnormality. The rapid test (HIV) was negative and the biological check-up showed a hyperleukocytosis at 12660 and a crp at 138. The patient was put on double antibiotic therapy.

The evolution was marked by the non-improvement of the symptomatology with the persistence of agitation. Her speech was almost absent with a refusal to answer and to execute orders. She maintained certain postures. The patient was put on 400 mg of amisulpride.

After recovery of the viral serology, the diagnosis of a measles encephalopathy was confirmed (IgM positive) and the patient improved after a few days of hospitalization and was addressed to the psychiatric outpatient clinic.

Conclusions

Measles encephalitis is a rare but serious complication that requires multidisciplinary management

Disclosure

No significant relationships.
Mental disorders among sexual and gender minorities
Authors: Khouadja S. , Zaouali F. , El Echi M. , Najjar C. , Zarrouk L.
Published: September 2022

Introduction

The term “Sexual and Gender Minorities” includes lesbian, gay, bisexual, transgender, queer, intersex and/or asexual populations. It was introduced in the MeSH Database in 2018. Mental health research on sexual and gender minority populations is gaining momentum.

Objectives

To describe mental disorders among sexual and gender minorities.

Methods

This is a review of the literature via Medline. The database was searched using the keyword combination “sexual gender minorities” OR “homosexuality” OR “bisexuality” OR “transgender persons” OR “intersex persons” AND “mental disorders”. The filters applied were Full text, Meta-Analysis, Systematic Review and in the last 5 years.

Results

A total of 59 articles were included. The lowest rates of depression and anxiety were reported among heterosexual people. Depressive symptoms, suicidality, interpersonal trauma exposure, substance use disorders, anxiety, and general distress have been consistently elevated among transgender and gender non-conforming people. Among transgender people, the prevalence of binge drinking ranged from 7%-61%. Depression was the most frequent mental disorder among sexual minority men (43.2%) followed by anxiety (32.2%), suicidal ideation (21.2%), suicide plans (6.2%) and suicide attempts (7.3%). Eating disorders were more frequent among sexual minority women compared with heterosexual peers. Compared with heterosexual youth, sexual minority youth had 123% to 623% higher odds of lifetime substance use, 82% to 317% higher odds of depressive symptoms and suicidality and 20% to 280% higher odds of violence victimization.

Conclusions

The prevalence of mental disorders is high among sexual and gender minorities for whom mental health prevention and treatment programs are needed.

Disclosure

No significant relationships.
Oral health attitudes and behavior among undergraduate students
Authors: Nikolaev E. , Petunova S. , Dakdaki N.
Published: September 2022

Introduction

Oral health behavior is based on an acquired experience and cultural traditions. University education may smooth out cultural differences in oral health practice.

Objectives

Our goal is to study self-reported oral health attitudes and behavior of university students and the cultural basis for it.

Methods

We used the English version of the Hiroshima University Dental Behavioral Inventory to carry out an online survey of 136 university students of Morocco and Russia.

Results

Over half of the students (60.3%) do not feel anxious when visiting a dentist. Most of them take care of their gums (41.2%), teeth color (49.3%) and the degree of their cleanness (38.2%). The overwhelming majority of the students brush their each tooth very thoroughly (62.5%), they regularly examine their teeth in the mirror after brushing them (90.4%). They are well aware that tooth brushing alone cannot prevent a gum disease (63.2%), and they feel concerned about the possibility of having bad breath (73.6%). At the same time, over half of the students (61.7%) put off their visit to a dentist until they have a toothache, which is a negative behavioral factor. We did not reveal any gender or cultural differences between the students of the two countries, which can be regarded as a universalization factor of oral health behavior in young people who get higher education in universities.

Conclusions

The majority of the surveyed Russian and Moroccan university students have similar patterns of oral health attitudes and behavior. This assumption needs verification on a larger sample of students.

Disclosure

No significant relationships.
«The Application of the New Law of Adoption and the Psychological Preparation of Prospective Stepparents»
Authors: Farmakopoulou I. , Stavropoulou K. , Bari N. , Theodoropoulou N. , Theodoratou M.
Published: September 2022

Introduction

The new adoption law, which was introduced in Greece in 2018, brought radical changes in adoption.

Objectives

This presentation aimed to investigate the emotions of the prospective stepparents, based on the changes which were effectuated by the new law of adoption.

Methods

This survey was conducted through mixed methodology. Quantitative research was addressed to investigate the emotions of the to prospective stepparents. Qualitative research was addressed to social workers and its goal was to depict their opinion about the new law and the prospective stepparents’ expressed emotions.

Results

The findings of the survey have demonstrated that the stepparents had a variety of emotions that changed throughout the adoption process. The dominant feelings of parents at the first visit with the social worker were stress and anxiety. However, at the end of the training process, these feelings were replaced by confidence and impatience. This emotional rotation of prospective stepparents was confirmed in the social workers’ interviews. In addition, social workers interviews highlighted the importance of the amendment of the old law of adoption’s process.

Conclusions

To sum up, this research has shown the importance of the new law and therefore the significance of its right application from all children’s placements in Greece. Nevertheless, it seems that due to the recent application of the new law, many placements have not yet complied with it and therefore there is urgent need for reinforcement of its application, according to the guidelines of the European Union that demanded gradual deinstitutionalization using the alternative types of child care.

Disclosure

No significant relationships.
Psychotherapy employed additionally to Psychopharmacotherapy is not related to Better Treatment Outcome in Major Depressive Disorder
Authors: Bartova L. , Fugger G. , Dold M. , Mitschek M. , Zohar J. , Mendlewicz J. , Souery D. , Montgomery S. , Fabbri C. , Serretti A. , Kasper S.
Published: September 2022

Introduction

Although numerous effective antidepressant (AD) strategies are available for the treatment of major depressive disorder (MDD), many patients do not achieve satisfactory treatment response.

Objectives

The aims of the present European, cross-sectional, multicenter, naturalistic study were (1) to determine the proportion of patients suffering from primary MDD who received additional psychotherapy to their ongoing psychopharmacotherapy and (2) to identify the associated socio-demographic and clinical patterns.

Methods

Patients receiving both treatments were compared to those lacking concomitant additional psychotherapy that was manual-driven psychotherapy (MDP) in all cases.

Results

While 68.8% of a total of 1279 MDD patients received exclusively psychopharmacotherapy, 31.2% underwent a psychopharmacotherapy-MDP combination. The latter patient population was rather younger, higher educated, employed, exhibited an earlier mean age of MDD onset, lower severity of current depressive symptoms with lower odds of suicidality and higher rates of melancholic features, and comorbid asthma and migraine, and was generally treated with lower daily doses of their first-line ADs. Whereas agomelatine was more commonly dispensed in these patients, selective serotonin reuptake inhibitors were more often prescribed in MDD patients lacking additional MDP. No significant between-group differences were detected in terms of treatment outcome.

Conclusions

The fact that the employment of additional MDP was not related to better treatment outcome in MDD represents our major and clinically most relevant finding. Generally, MDP was employed in a minority of our patients who experienced rather beneficial socio-demographic and clinical characteristics. This might reflect an inferior accessibility of these psychotherapeutic techniques for patients who are more severely ill and less socio-economically privileged.

Disclosure

References Bartova L, Fugger G, Dold M, Swoboda MMM, Zohar J, Mendlewicz J, Souery D, Montgomery S, Fabbri C, Serretti A, Kasper S. Combining psychopharmacotherapy and psychotherapy is not associated with better treatment outcome in major depressive disor
Clozapine and myopathic dysfunction: is creatinine kinase an important parameter to measure?
Authors: Barbosa P. , Remelhe M. , Venâncio Â. , Ribeiro L.
Published: September 2022

Introduction

There have been reports of myopathic dysfunction with creatinine kinase (CK) elevation associated with neuroleptics, particularly, in clozapine-treated patients. The patients in these reports did not have any other clinical symptoms or signs indicative of neuropleptic malignant syndrome. Myopathic dysfunction was supported by the presence of CK elevations and either proximal limb weakness or fatigue, characteristic electrophysiologic abnormalities, or both. It has also been reported that CK elevation is neither dose nor treatment-duration dependent. The underlying mechanism is still unknown although it has been postulated that it is associated with cytochrome P450 interactions and/or calmodulin antagonism.

Objectives

To report a case of elevation of CK during treatment with clozapine.

Methods

The authors report a case of elevation of CK during treatment with clozapine. A non-systematic review was conducted by searching the PubMed database, using the terms “clozapine”, “myotoxicity”.

Results

A 36-year-old man was admitted after abandoning treatment with clozapine. During the titration of the medication, he developed complaints of muscle fatigue in conjunction with an elevation of CK. CK levels normalized after intravenous hydration and with dose reduction. Furthermore, CK levels would increase with clozapine re-titration.

Conclusions

Clozapine has numerous side effects. Myopathic dysfunction with CK elevation is a possible side effect which could have serious consequences such as renal impairment. In such cases, appropriate treatment should be implemented. Therefore, clinicians should be aware of this potential side effect.

Disclosure

No significant relationships.
Belief in conspiracy theories and esoteric thinking during COVID-19 pandemic
Authors: Medvedeva T. , Enikolopov S. , Boyko O. , Vorontsova O.
Published: September 2022

Introduction

Psychological distress during the SARS-CoV-2 pandemic can manifest itself in interpretations of what is happening.

Objectives

To analyze response to COVID-19 pandemic in people with high level of esoteric thinking.

Methods

Internet survey 23.03.20-29.01.21 (N=621); Constructive Thinking Inventory(CTI); SCL-90R. It was proposed to assess statements: “The authorities are hiding the true scale of the coronavirus pandemic”, “Coronavirus is the result of biological weapons development”, “Coronavirus is a punishment or a sign sent to people from above”, “The emergence of the coronavirus is the Earth’s response to its pollution”. It was offered to express an opinion about pandemic. The answers were coded on the basis of qualitative semantic analysis.

Results

The growth of “esoteric thinking” was revealed (Std.J-T, p=.025). With a high level of esoteric thinking, emotional statements (“fear, anxiety, panic”) are more common (27.8% versus 16.9% for group with high and low level of «esoteric thinking»). Correlations of the level of «esoteric thinking» with level of depression (Spearman’s correlation ,085*), anxiety (,097*), GSI (,130**), «fears for the life» (23.4% versus 14.5%) show high emotional distress. With an increase in the level of «esoteric thinking», belief in various conspiracy theories increases; Spearman’s correlation ,370** with the belief is biological weapons, punishment for sins (,355**), belief in concealing information about the pandemic (,167**).

Conclusions

A high level of esoteric thinking is associated with an increased emotional response to the pandemic and with belief in conspiracy theories, and can increase emotional instability by itself also making constructive decisions difficult in situations related to protecting personal health and safety.

Disclosure

No significant relationships.
Belief in false information regarding the COVID-19 pandemic and a tendency to conspiracy thinking as factors that may exacerbate symptoms of anxiety and depression among Polish citizens
Authors: Dębski P. , Piegza M. , Kapuśniak N. , Boroń A. , Dębska M. , Gorczyca P.
Published: September 2022

Introduction

The COVID-19 pandemic has become the subject of intense discussion on social media platforms. Fake news and conspiracy theories about the SARS-CoV-2 virus, in particular its origin, spread, impact on health and prevention, have become especially popular. The social crisis triggered by the COVID-19 pandemic is associated with a growing tendency to believe in conspiracy theories, which in turn may contribute to an increase in anxiety tension and thus deteriorate the psychological health of citizens.

Objectives

The aim of the study was to determine the relationships between the tendency to believe in false information about the COVID-19 pandemic and the severity of symptoms of anxiety and depression among the surveyed Polish citizens.

Methods

The study included 700 Polish people aged 24.7±6.34 years. We used questionnaires such as: COVID-19 Conspiratorial Beliefs Scale to measure the level of belief in false information regarding the COVID-19 pandemic, Generic Conspiracist Beliefs Scale to measure tendencies to believe in conspiracy theories, and Hospital Anxiety and Depression Scale.

Results

Belief in false information about the COVID-19 pandemic may be associated with a slight increase in the severity of both anxiety symptoms (b=0.044; p=0.021) and depression (b=0.048; p=0.004). A factor known as belief in the criminal activity of government organizations may also contribute to predicting the increase in the severity of symptoms of anxiety (b=0.172; p=0.001) and depression (b=0.169; p=0.000) during the COVID-19 pandemic.

Conclusions

Belief in false information about the COVID-19 pandemic, as well as belief in general conspiracy theories, can contribute to the psychological deterioration of citizens during the COVID-19 pandemic.

Disclosure

No significant relationships.
COVID-19 infection, hospitalisation and mortality rates in people with severe mental illness: findings from two UK cohort studies
Authors: Hassan L. , Firth J.
Published: September 2022

Introduction

Recent systematic reviews have highlighted that people with Severe Mental Illness (SMI) have higher risks of infection, hospitalisation and death from COVID-19, although the full extent of these disparities are not yet established.

Objectives

Utilising electronic health records, we investigated COVID-19 related infection, hospitalisation and mortality among people with schizophrenia/psychosis, bipolar disorder (BD) and/or major depressive disorder (MDD) in two large UK samples: the UK Biobank (UKB) cohort study and GP-registered patients in Greater Manchester (GM).

Methods

We sampled 447,296 adults with and without SMI from UKB (inc. schizophrenia/psychosis=1,925, BD=1,483 and MDD=41,448, non-SMI=402,440) and 1,152,831 adults from GM (inc. schizophrenia/psychosis =46,859, BD=3,461, recurrent MDD=134,661, non-SMI = 922,264). Primary care, hospital and death records were linked to identify COVID-19 related outcomes. Logistic regression models were used to estimate unadjusted and adjusted Odds Ratios (ORs) to compare differences in COVID-19 outcomes by diagnosis, controlling for sociodemographic factors and comorbidities.

Results

We will report the findings of unadjusted and adjusted analyses, comparing ORs for people with and without SMI, by diagnosis. Findings will be compared between the two datasets, with attention to the demographic and clinical profiles of each sample. We will consider the role of demographic characteristics and comorbidities in attenuating outcomes.

Conclusions

Emerging evidence suggests that people with SMI have higher risks of COVID-19 infection, hospitalisation and mortality. Based on two large datasets utilising EHRs, we present findings from the UK on COVID-19 outcomes among people with SMI, a country that has been severely affected by COVID-19.

Disclosure

No significant relationships.
Retinal single-layer analysis with optical coherence tomography (OCT) in schizophrenia spectrum disorder
Authors: Kregel T. , Schönfeldt-Lecuona C. , Schmidt A. , Kassubek J. , Dreyhaupt J. , Freudenmann R. , Connemann B. , Gahr M. , Pinkhardt E.
Published: September 2022

Introduction

Volume reductions in brain structures of patients with schizophrenia spectrum disorder (SSD) have repeatedly been found in voxel-based morphometry MRI studies. Hence, an underlying neurodegenerative etiological component of SSD is currently being discussed. In recent years, the imaging method of optical coherence tomography (OCT) has shown its potential in evaluating structural changes in the retina in patients with confirmed neurodegenerative disorders, providing a window into the brain.

Objectives

To evaluate potential differences in measurements of retinal layers between patients with schizophrenia spectrum disorder and healthy controls with OCT.

Methods

Twenty-six patients with schizophrenia or schizoaffective disorder and 23 age- and sex-matched healthy controls were examined with the Heidelberg Spectralis OCT system to derive a single-layer analysis of both retinas. The segmentation of retinal layers was manually corrected to minimize artifacts and software imprecisions.

Results

Compared to the control group, SSD patients showed reduced thickness and volume measurements for nearly all retinal layers, and these differences reached significance for macular volume, macular thickness, retinal nerve fiber layer (RNFL) and inner nucleiform layer (INL). Furthermore, a significant correlation between the duration of illness and the total volume of the RNFL was found.

Conclusions

Our OCT measurements demonstrate reduced single retinal layer thickness in patients with SSD. In the context of the MRI volume changes, our results provide further evidence that structural changes seen in the brain of patients are also observable in the retina, potentially allowing further insights into the different components of the nervous system that are altered in this highly etiologically complex disorder.

Disclosure

No significant relationships.
N-Methyl-D-Aspartate Receptor availability in First-Episode Psychosis: a multi-modal PET-MR brain imaging study
Authors: Beck K. , Arumuham A. , Brugger S. , Mccutcheon R. , Veronese M. , Kaar S. , Pillinger T. , Stone J. , Howes O.
Published: September 2022

Introduction

N-Methyl-D-Aspartate Receptor (NMDAR) hypofunction is hypothesised to underlie psychosis but this has not been tested early in illness.

Objectives

Our aim was to determine if NMDAR availability was lower in patients with first episode psychosis compared to healthy controls.

Methods

To address this, we studied 40 volunteers (21 patients with first episode psychosis and 19 matched healthy controls) using PET imaging with an NMDAR selective ligand, [18F]GE179, that binds to the ketamine binding site to index its distribution volume ratio (DVR) and volume of distribution (VT). Striatal glutamatergic indices (glutamate and Glx) were measured simultaneously using magnetic resonance spectroscopy imaging (1H-MRS).

Results

Hippocampal DVR, but not VT, was significantly lower in patients relative to controls (p=0.02, Cohen’s d=0.81; p=0.15, Cohen’s d=0.49), and negatively associated with total (rho=-0.47, p= 0.04), depressive (rho=-0.67, p=0.002), and general symptom severity (rho=-0.74, p<0.001). Exploratory analyses found no significant differences in other brain regions (anterior cingulate cortex, thalamus, striatum and temporal cortex). We found an inverse relationship between hippocampal NMDAR availability and striatal glutamate levels in people with first-episode psychosis (rho = -0.74, p <0.001) but not in healthy controls (rho = -0.22, p = 0.44).

Conclusions

These findings are consistent with the NMDAR hypofunction hypothesis and identify the hippocampus as a key locus for relative NMDAR hypofunction, although further studies should test specificity and causality.

Disclosure

No significant relationships.
Increased Risk for Substance Use-Related Problems in Mild Intellectual Disability: A Population-Based Cohort Study
Authors: Påhlsson A. , Liu S. , Tideman M. , Larsson H. , Lichtenstein P. , Butwicka A.
Published: September 2022

Introduction

Intellectual disability (ID) has been linked to substance use-related problems (SUP). However, previous research is limited by the small sample sizes, lack of general population comparison and have not accounted for familial confoundings. The role of other psychiatric comorbidities also remains unknown.

Objectives

To examine the risk of SUP in individuals with mild-ID and assess whether the associations depend on other psychiatric comorbidities, controlling for potential familial confounding.

Methods

Population-based cohort study of individuals born in Sweden 1973-2003. We identified 19,078 individuals with mild-ID, 953,900 reference individuals from the general population, and 20,722 full-siblings of individuals with mild-ID. Conditional logistic regression models were used to compare individuals with mild-ID to the general population and their full-siblings regarding the risk of SUP, including alcohol and substance use disorders, alcohol and substance-related somatic diseases, substance-related crime, and substance-related death. Analyses were repeated stratified by the presence of psychiatric comorbidities.

Results

Individuals with mild-ID had increased risks of any SUP (adjusted OR [95%CI]: 1.41 [1.35, 1.47]), compared to the general population, including alcohol-related somatic diseases (3.27 [1.92, 5.59]), alcohol (2.05 [1.91, 2.22]) and drug-use disorder (1.79 [1.69, 1.91]), and alcohol (1.36 [1.19, 1.49]) and drug-related crime (1.27 [1.19, 1.36]). The risk of SUP for individuals with mild ID was particularly elevated with comorbid mood (3.74 [3.47, 4.04]), anxiety (3.30 [3.09, 3.53]) and attention-deficit/hyperactivity disorders (2.61 [2.44, 2.80]). Increased risk of SUP remained significant when controlling for familial confounding.

Conclusions

Individuals with mild-ID, especially those with other psychiatric comorbidities, are at increased risks of SUP.

Disclosure

No significant relationships.
Psychological impacts of Intentional Non-Medical Fentanyl Use Among People Who Use Drugs: A Systematic Review
Authors: Tsang V.
Published: September 2022

Introduction

The use of non-medical fentanyl and structurally related compounds has changed drastically over the last ten years. Community members working with individuals who use fentanyl intentionally currently struggle with the rapidly evolving drug markets and patterns of use, thereby failing to adapt treatment approaches and harm reduction strategies to individuals with severe opioid use disorder (OUD) and concurrent psychiatric disorders.

Objectives

This systematic review aims to evaluate intentional fentanyl among PWUD by summarizing demographic variance, concurrent disorders, and resulting patterns of use.

Methods

The search strategy in this study was developed with a combination of free text keywords and Mesh and non-Mesh keywords, and adapted with database-specific filters to Ovid MEDLINE, Embase, Web of Science, and PsychINFO (May 2021). The search results resulted in 4437 studies after de-duplication, of which 132 were selected for full-text review. A total of 42 articles were included in this review.

Results

It was found that individuals who use fentanyl intentionally were more likely to be young, male, and Caucasian. Individuals who intentionally use fentanyl were more commonly homeless, unemployed or working illegally, and live-in cities. Independent correlates of any purposeful fentanyl use included moderate/severe depression.

Conclusions

Individuals who intentionally use fentanyl are more likely to report injection drug use and polysubstance use, including cocaine use, heroin use, and methamphetamine use. Among PWUD, individuals who intentionally use fentanyl have the most severe substance use patterns, the most precarious living situation, and the most extensive overdose history and higher proportion of ever having a mental health diagnosis.

Disclosure

No significant relationships.
Distinct behavior in early life stress dams predicts heterogeneity in future stress response in offspring over lifespan
Authors: Mey F. , Treccani G. , Schmitt U. , Müller M.
Published: September 2022

Introduction

Exposure to early life stress (ELS) strongly predicts prevalent, impairing, and costly psychiatric illness throughout life including mental disorders. The reason, some individuals are more vulnerable to ELS whereas others remain resilient, is poorly understood. There is a need for better understanding of early biological changes triggered by ELS with responsibility to negative outcomes in health.

Objectives

We stratify animals after ELS according to corticosterone levels. [1] Re-challenging the animals to a second stressor, chronic social defeat (CSD) [2], in adulthood was performed to understand individual trajectories depending on corticosterone exposure during early adverse conditions.

Methods

We performed ELS as previously reported [1]. Behavior of mothers was observed during ELS. Correlation between level of corticosterone and behavior observed in dams. ELS animals were exposed to a second stress in adulthood. A battery of tests for different behavioral domains was performed. Behavioral analyses was combined with assessment of litter HPA system reactivity and observed behavior in dams.

Results

Stress dams where significantly higher in number of sorties over whole observation period, time dams spent outside the nest differed. We could correlate the number of sorties on p3 with corticosterone plasma level at p9. Control dams spent significantly more time outside in 9pm recordings than stress animals. We could show reduced interaction with social juvenile targets in sociability test for CSD mice. Light dark transition was significantly higher for control mice compared to CSD but lower for control vs ELS animals.

Conclusions

Behavior in dams during ELS correlates with chronic stress coping mechanisms in offspring’s adulthood.

Disclosure

No significant relationships.
Longitudinal effects of antidepressant treatment on resting state functional connectivity in adolescents with major depressive disorder
Authors: Lee K.H. , Shin J. , Lee J. , Yoo J.H. , Kim J.-W.
Published: September 2022

Introduction

Adolescents with major depressive disorder (MDD) often show reduced prefrontal functional connectivity with the subcortical regions than healthy controls (HC) (Tang et al., 2018). However, relatively little is known about longitudinal effects of antidepressant (AD) treatment on resting state functional connectivity (RSFC) in the prefrontal cortex (PFC).

Objectives

This study aimed to investigate abnormal PFC RSFC in MDD adolescents compared to HC and longitudinal effects of AD on PFC RSFC.

Methods

This study included 59 adolescents with MDD and 43 HC. MDD adolescents were treated with escitalopram in an 8 week, open-label trial. The treatment outcome was assessed by Children’s Depression Rating Scale (CDRS-R) and patients showing at least a 40% improvement in CDRS-R scores from baseline to week 8 were defined as “responders”. Functional and T1 images collected before and after treatment were processed using AFNI and Freesurfer. Our seed was the lateral PFC (LPFC, BA46). T-tests and repeated measures ANCOVAs, controlling for age and IQ, were conducted to examine abnormal PFC RSFC and longitudinal effects of AD on LPFC RSFC.

Results

Relative to HC, MDD showed increased LPFC RSFC with the posterior middle temporal gyrus (pMTG) and superior frontal cortex (SFG) involved in attentional networks. Responders showed greater changes in LPFC RSFC with the MTG and SFG after AD treatment compared to non-responders and HC (Figure 1).

Conclusions

Our finding suggests that reduced LPFC RSFC with the pMTG and SFG reflecting decreased attentional network connectivity may serve as a biomarker to predict AD treatment outcome in adolescents with MDD.

Disclosure

No significant relationships.
Integrating services to improve the return-to-work process in depression or anxiety: results from a three-arm parallel randomized trial
Authors: Hoff A.
Published: September 2022

Introduction

Depression and anxiety are very frequent and associated with high societal costs, much suffering and functional impairment. Employment is essential and pivotal recovery after sick-leave. In many countries, health care interventions are delivered separately from vocational rehabilitation services. This fragmented placement of interventions often implies lack of coordination, creating despair among sick-listed persons.

Objectives

The aim of this trial was to investigate an integrated mental health care and vocational rehabilitation intervention to improve and hasten the return-to-work process among people sick-listed with anxiety or depression.

Methods

In this RCT, participants were randomly allocated to A) integrated interventions (INT), B) improved mental health care (MHC) or B) service as usual (SAU). Primary outcome was time to return-to-work during 12-month. Secondary outcomes were time to return-to-work at 6-month follow-up; levels of anxiety, depression, stress symptoms and social and occupational functioning at 6-month follow-up; and return-to-work measured as proportion in work at 12-month follow-up.

Results

631 individuals randomized. INT showed higher proportion in work compared with both SAU and MHC at the 12-month follow-up. We found no differences regarding return-to-work time at either the 6-
or 12-month follow-up. No differences in symptoms between SAU, MCH or INT were detected, but MHC and INT showed lower scores on Cohen’s perceived stress scale compared with SAU at 12-month follow-up.

Conclusions

Although INT did not hasten return-to-work, it yielded higher proportion in work compared with MHC and SAU.

Disclosure

No significant relationships.
Mother and father depression symptoms and child emotional difficulties: a network model
Authors: Martin A. , Konac D. , Maughan B. , Barker E.
Published: September 2022

Introduction

Enhancing understanding of depression symptom interactions between parents and associations with subsequent child emotional difficulties will inform targeted treatment of depression to prevent transmission within families.

Objectives

To use a network approach to identify ‘bridge’ symptoms that reinforce mother and father depression, and whether bridge symptoms, as well as other symptoms, impact subsequent child emotional difficulties.

Methods

Symptoms were examined using two unregularized partial correlation network models. The study included 4,492 mother-father-child trios from a prospective, population-based cohort in the United Kingdom. Mother and father reports of depression symptoms were assessed when the child was twenty-one months old. Child emotional difficulties were reported by the mother at ages nine, eleven and thirteen years.

Results

Bridge symptoms mutually reinforcing mother and father depression symptoms were feelings of guilt and self-harm ideation, whereas anhedonia acted as a bridge from the father to the mother, but not vice-versa (fig.1, network 1). The symptom of feelings of guilt in mothers was the only bridge symptom which directly associated with child emotional difficulties. Other symptoms that directly associated with child emotional difficulties were feeling overwhelmed for fathers and anhedonia, sadness, and panic in mothers (fig.1, network 2).

Conclusions

Specific symptom interactions are central to the co-occurrence of depression symptoms between parents. Of interest, only one of the bridge symptoms associated with later child emotional difficulties. In addition, specific symptom-to-child outcomes were identified, suggesting that different symptoms in mothers and fathers are central for increased vulnerability in children.

Disclosure

No significant relationships.
Cognitive correlates of mixed depression
Authors: Simonetti A. , Bernardi E. , Bartolucci G. , Ferrara O. , Ruggiero S. , Di Nicola M. , Janiri D. , Sani G.
Published: September 2022

Introduction

Mixed depressive states portend greater rates of impulsivity, attempted suicide, treatment resistance, and poorer outcome than non-mixed forms of depression. The neurocognitive bases of such affective states have not been defined yet.

Objectives

This work represents an attempt to clarify the neuropsychology underlying mixed depressive states.

Methods

Thirty subjects with affective disorders with mixed depression (MxD), 54 subjects with non-mixed depression (nonMxD), 73 euthymic subjects (Eu) and 93 healthy comparisons (HC) underwent a neurocognitive battery including the Trail-Making Test (TMT), the Controlled Word Fluency Test (WFT) and the Semantic Fluency Test (SFT), the Wisconsin Card Sorting Test (WCST, the Rey Auditory Verbal Learning Test RAVLT, the Rey-Osterrieth Complex Figure Test ROCFT, the Raven’s Progressive Matrices (RPM), and the Interference Component of the Stroop Test (ST). Between-group differences were performed through multiple one-way analyses of variance. Post-hoc analyses were performed using Tukey post-hoc tests.

Results

HC performed better than the three patient groups in all the aforementioned neurocognitive tests. Eu performed better in RPM, TMT, SFT than nonMxD, and better on ST WCST than both nonMxD and MxD. MxD showed better performances in RPM, TMT-A, WCST than nonMxD, and more errors and less reaction times in the ST than nonMxD.

Conclusions

Mixed depressive states are characterized by enhanced attentional resources and greater set shifting abilities than non-mixed depressive states. On the other hand, they have less cognitive control than non-mixed depression. Such findings might explain some typical features observed in subjects with mixed depression, such impulsivity, suicidality, emotional reactivity and behavioral dyscontrol.

Disclosure

No significant relationships.
Screening Accuracy of the Portuguese version of the Postpartum Depression Screening Scale-7 according to DSM-5 criteria
Authors: Pereira A.T. , Azevedo J. , Soares M.J. , Marques C. , Marques M. , Barros M. , Carvalho F. , Pereira D. , Macedo A.
Published: September 2022

Introduction

The Portuguese shortest version of the Perinatal Depression Screening Scale/PDSS-7 proved to be valid and reliable, in Portugal and Brazil, but it is essential to analyze its operational characteristics before using it for screening purposes.

Objectives

To determine PDSS-7 cut-off points and associated conditional probabilities to screen for major depression, according to the DSM-5.

Methods

he pregnancy sample was composed of 259 women in the second trimester (Mean gestation weeks=17.83±4.750). The postpartum sample consisted of 241 women assessed between the 2nd-6thmonths postpartum(M=17.99±4.689 weeks postpartum). All women completed the PDSS-7 and were interviewed with the Diagnostic Interview for Psychological Distress(Pereira et al., 2017), a semi-structured clinical interview to assess the most prevalent psychiatric disorders in the perinatal period according to the DSM-5 criteria. MedCalc was used to perform ROC analysis.

Results

During pregnancy, the major depression prevalence was of 4.6%(n=12). The cut-off point that maximizes the Youden Index(J=.98, 95%CI: .97-.99; AUC=.99; se=.004; p<.001) was of 18(95%CI:17-19), which resulted in a sensitivity of 100%(71.5%-100%), a specificity of 97.98%(95.3%-99.3%), a positive predictive value/+PP of 68.8%(48.0%-84.0%) and a negative predictive value/-PP of 100%. In the postpartum, the major depression prevalence was of 10.4%(n=25). The cut-off point(J=.79, 95%CI: .63-.82; AUC=.89; se=.036; p<.001) was of 14(95%CI: 12-16), with a sensitivity of 85.0%(69.3%-93.2%), a specificity of 85.0%(69.3%-93.2%), a +PP of 56.5%(46.1%-67.3%) and a -PP of 97.5%(94.6%-98.8%).

Conclusions

The Portuguese version of PDSS-7 presents good combinations of sensitivity and specificity, being accurate and usable to screen for depression during pregnancy and in the postpartum both in research and primary health care.

Disclosure

No significant relationships.
Leadership skills training in Psychiatry: A European-based cross-sectional survey
Authors: Santos M. , Samouco A. , Azvee Z. , Krishnan D. , Zaja N. , Pedro J. , Maitra R. , László A. , Fellinger M. , Halbreich U. , Pinto Da Costa M.
Published: September 2022

Introduction

Leadership in healthcare organisations is crucial to continually improve and provide high quality compassionate care. Leadership development and training enables the psychiatrists in developing these essential skills. Focusing on how to enhance leadership development through leadership skills training and experiential learning should be a priority. However, little is known about the extent to which this leadership skills training is available across Europe in the early stage of the career of psychiatrists.

Objectives

To investigate the access to leadership development opportunities among European psychiatric trainees and early career psychiatrists (ECPs) and their perceptions related to leadership skills training.

Methods

Cross-sectional study, using an online survey consisting of multiple-choice questions and free text responses.

Results

Participants from 33 European countries took part in this survey, where the majority were female. More than half were general adult psychiatric trainees and more than a quarter ECPs. About half indicated having no access to leadership skills training within their training program, with only about 10% being satisfied with the training received. About half sought additional training outside their program. A vast majority requested training in leadership skills to be included in a psychiatric training program.

Conclusions

Our study provides an overview of important gaps in availability and access to leadership skills training amongst psychiatric trainees and ECPs across Europe. We hope that this study will help inform future actions pertaining to development and improvement of leadership skills training for trainees and ECPs across Europe.

Disclosure

No significant relationships.
Associations between COVID-19 pandemic impact, dimensions of behavior and eating disorders: a longitudinal UK-based study
Authors: Ioannidis K.
Published: September 2022

Introduction

There is growing concern about how people with eating disorders are impacted by the widespread societal restructuring during the COVID-19 crisis.

Objectives

We aimed to examine how factors relating to the impact of the pandemic associate with eating disorders and quantify this relationship while adjusting for concurrent and longitudinal parameters of risk.

Methods

We gathered demographic, behavioral and clinical data pre- and mid-pandemic as well as childhood trauma history from a longitudinal online survey of 489 adults (mean age 23.4 years) recruited from the Neuroscience in Psychiatry Network (NSPN). Using pre-pandemic (T1) and concurrent (T2) data we aimed to predict eating disorders at mid-pandemic (T2). We deployed hierarchical generalized logistic regression to ascertain the strength of longitudinal and concurrent associations.

Results

Pre-pandemic eating disorder scores strongly associated with concurrent eating disorder (z=5.93). More conflict at home mid-pandemic (z=2.03), pre- (lower sensation seeking z=-2.58) and mid-pandemic (higher lack of perseverance z=2.33) impulsivity traits also associated with mid-pandemic eating disorder. Significant correlations between pandemic-related disrupted lifestyle and eating disorder psychopathology both pre- and mid-pandemic were observed.

Conclusions

Conflict at home mid-pandemic and specific aspects of impulsiveness significantly associated with concurrent eating disorder when adjusted for pre-pandemic eating disorder symptoms, baseline demographics, behavioral traits, history of traumatic experiences and concurrent psychopathology. These results provide insight into the struggles of those suffering with eating disorders during the COVID-19 pandemic and highlight the importance of impulsiveness traits and the immediate family environment in their experience of illness during the pandemic.

Disclosure

No significant relationships.
Daily affective experiences are associated with daily, but not trait-level rumination
Authors: Kovacs L. , Kocsel N. , Toth Z. , Smahajcsik-Szabo T. , Karsai S. , Kökönyei G.
Published: September 2022

Introduction

Rumination is a transdiagnostic risk factor to psychopathology that has mostly been studied in relation to depression (Nolen-Hoeksema, 1991). However, rumination may also occur in response to positive events and emotions (Feldman et al., 2008), and may be a protective factor as it is associated with higher positive affect (Harding et al., 2017).

Objectives

We aimed to examine ruminative response to positive affect (RPA) in daily life and explore its relationship with daily positive and negative affect. We hypothesized that daily positive and negative affect would be associated with daily RPA even after controlling for trait-level RPA and depressive rumination.

Methods

We carried out a daily diary study with university students (n=178). After filling out the baseline survey assessing trait-level rumination, participants had to answer short surveys online about their daily affect and daily rumination every evening for 10 consecutive days. We analyzed our data with multilevel regression in R.

Results

In line with our expectations, daily RPA was significantly associated with daily positive (β=0.16) and negative affect (β=-0.07), while trait-level rumination scores were not significantly associated with daily positive and negative affect. The within-person relationship was stronger between RPA and positive affect (β=0.17) than the between-person relationship (β=0.09). Daily and trait-level rumination were weakly correlated (r=0.218-0.284).

Conclusions

Under ecologically valid conditions, we found that daily rumination was more important in daily affective experiences than trait-level rumination. Understanding whether one’s current affect is more strongly associated with trait-level, state-level or even contextual factors may yield better intervention strategies for affective disorders.

Disclosure

No significant relationships.