bluuebunny/crossref_metadata_2025 huggingface dataset:
Potential gastrointestinal Behcet’s disease flare after treatment with anti-interleukin 17a therapy
Authors: Sun Frances Sze Kei , Chiu Nicole Sau Yan , Chung Ho Yin
Published: August 2023

Background

Behcet’s disease (BD) is a systemic disease characterized by recurrent oral and genital ulcers. The underlying disease pathway likely involves interleukin (IL)-17 A, a proinflammatory cytokine that is implicated in Behcet’s uveitis. Secukinumab is an anti-IL-17 A drug that may have an emerging role in the treatment of refractory BD. This is the first known case report of gastrointestinal BD flare up after anti-IL-17 A therapy.

Case presentation

We presented a case of BD with cutaneous and articular features being treated with secukinumab. After the third dose of loading secukinumab, the patient developed acute lower abdominal pain required hospital admission. Urgent computer tomography (CT) abdomen showed fatty stranding of caecum. Colonoscopy with caecal showed increased number of inflammatory cells in lamina propria. Secukinumab was stopped and patient was started on medium dose steroid. His abdominal symptoms resolved after treatment.

Conclusions

This case report illustrates a case of gastrointestinal (GI) BD presenting as acute inflammatory colitis after the use of secukinumab. Therefore, anti-IL-17 A agents should be used cautiously in patients with GI BD, and preferably guided by a phenotype-tailored approach.
Comparison of the different monosodium urate crystals in the preparation process and pro-inflammation
Authors: Yan Fei , Zhang Hui , Yuan Xuan , Wang Xuefeng , Li Maichao , Fan Youlin , He Yuwei , Jia Zhaotong , Han Lin , Liu Zhen
Published: August 2023

Objectives

The deposition of monosodium urate (MSU) crystals within synovial joints and tissues is the initiating factor for gout arthritis. Thus, MSU crystals are a vital tool for studying gout’s molecular mechanism in animal and cellular models. This study mainly compared the excellence and worseness of MSU crystals prepared by different processes and the degree of inflammation induced by MSU crystals.

Methods

MSU crystals were prepared using neutralization, alkali titration, and acid titration methods. The crystals’ shape, length, quality, and uniformity were observed by polarized light microscopy and calculated by the software Image J. The foot pad and air pouch models were used to assess the different degrees of inflammation induced by the MSU crystals prepared by the three different methods at different time points. Paw swelling was evaluated by caliper. In air pouch lavage fluid, inflammatory cell recruitment was measured by hemocytometer, and the level of IL-1β, TNF-α, and IL-18 by ELISA. Inflammatory cell infiltration was assayed by immunohistochemistry of air pouch synovial slices.

Results

For the preparation of MSU crystals with the same uric acid, the quantity acquired by the alkalization method was highest, followed by neutralization, with the acid titration method being the lowest. The crystals prepared by neutralization were the longest. The swelling index of the foot pad induced by MSU crystals prepared by acid titration was significantly lower than that of the other methods at 24 h. The inflammatory cell recruitment and level of IL-1β, TNF-α, and IL-18 in air pouch lavage fluid were lowest in animals with crystals prepared by acid titration. IL-1β secretion induced by MSU crystals prepared by acid titration was significantly lower than that of the other two groups, but there was no significant difference in IL-18 secretion between the three groups in THP-1 macrophages and BMDMs.

Conclusions

All three methods can successfully prepare MSU crystals, but the levels of inflammation induced by the crystals prepared by the three methods were not identical. The degree of inflammation induced by MSU crystals prepared by neutralization and alkalization is greater than by acid titration, but the quantity of MSU crystals obtained by the alkalization method is higher and less time-consuming. Apparently, the window of inflammation triggered by acid titration preparation is shorter compared to other forms of crystal preparation. Overall, MSU crystals prepared by the alkaline method should be recommended for studying the molecular mechanisms of gout in animal and cellular models.
Emerging of artificial intelligence and technology in pharmaceuticals: review
Authors: Sultana Ayesha , Maseera Rahath , Rahamanulla Abdul , Misiriya Alima
Published: August 2023

Background

The review covers a variety of Artificial intelligence (AI) related topics in medication development. Additionally, it gives a quick account of the recent advances made in drug development by the pharmaceutical industry in cooperation with various AI. All facts of science have been impacted by advances in computing and technology. In all fields of science and technology, from fundamental engineering to medicine, AI has become a crucial component. AI has so influenced pharmaceutical chemistry and health care.

Main body

The use of computers to assist in drug creation has overtaken more conventional approaches in recent years. AI is frequently utilised to reduce the amount of time and improve drug design processes. The success rate of the developed medicine is further increased by the ease with which the target proteins may be discovered utilising AI. Every step of the medication design process involves the use of AI technology, which lowers the cost and greatly lowers the health hazards related to preclinical studies. AI is a powerful data mining technique that is based on vast amounts of pharmaceutical data and the machine learning process.

Conclusion

The use of AI in de novo drug design, activity scoring, virtual screening, and In silico evaluation of drug molecule characteristics is the consequence (absorption, distribution, metabolism, excretion, and toxicity). To speed up drug research and the healthcare system, pharmaceutical companies have joined with AI firms.
A systematic review of economic evaluations for opioid misuse, cannabis and illicit drug use prevention
Authors: Faller Jan , Le Long Khanh-Dao , Chatterton Mary Lou , Perez Joahna Kevin , Chiotelis Oxana , Tran Huong Ngoc Quynh , Sultana Marufa , Hall Natasha , Lee Yong Yi , Chapman Cath , Newton Nicola , Slade Tim , Sunderland Matt , Teesson Maree , Mihalopoulos Cathrine
Published: August 2023

Background

Substance use disorders negatively affect global disease burden. Effective preventive interventions are available, but whether they provide value for money is unclear.

Aims

This review looks at the cost-effectiveness evidence of preventive interventions for cannabis use, opioid misuse and illicit drug use.

Method

Literature search was undertaken in Medline, CINAHL, PsycINFO, EconLit through EBSCOhost and EMBASE, up to May 2021. Grey literature search was conducted as supplement. Studies included were full economic evaluations or return-on-investment (ROI) analyses for preventing opioid misuse, cannabis and illicit drug use. English-language restriction was used. Outcomes extracted were incremental cost-effectiveness ratios (ICER) or ROI ratios, with costs presented in 2019 United States dollars. Quality was assessed with the Drummond checklist.

Results

Eleven full economic evaluation studies were identified from 5674 citations, with all studies conducted in high-income countries. Most aimed to prevent opioid misuse (n = 4), cannabis (n = 3) or illicit drug use (n = 5). Modelling was the predominant methodology (n = 7). Five evaluated school-based universal interventions targeting children and adolescents (aged <18 years). Five cost–benefit studies reported cost-savings. One cost-effectiveness and two cost–utility analysis studies supported the cost-effectiveness of interventions, as ICERs fell under prespecified value-for-money thresholds.

Conclusions

There are limited economic evaluations of preventive interventions for opioid misuse, cannabis and illicit drug use. Family-based intervention (ParentCorps), school-based interventions (Social and Emotional Training and Project ALERT) and a doctor's programme to assess patient risk of misusing narcotics (‘the Network System to Prevent Doctor-Shopping for Narcotics’) show promising cost-effectiveness and warrant consideration.
Trajectories of distress and recovery, secondary stressors and social cure processes in people who used the resilience hub after the Manchester Arena bombing
Authors: Stancombe John , Williams Richard , Drury John , Hussey Louise , Gittins Matthew , Barrett Alan , French Paul , Chitsabesan Prathiba
Published: August 2023

Background

Terrorist incidents lead to a range of mental health outcomes for people affected, sometimes extending years after the event. Secondary stressors can exacerbate them, and social support can provide mitigation and aid recovery. There is a need to better understand distress and mitigating factors among survivors of the Manchester Arena attack in 2017.

Aims

We explored three questions. First, what experiences of distress did participants report? Second, how might secondary stressors have influenced participants’ psychosocial recoveries? Third, what part has social support played in the relationships between distress and participants’ recovery trajectories?

Method

We conducted a cross-sectional online survey of a convenience sample of survivors of the Manchester Arena bombing (N = 84) in January 2021 (3 years 8 months post-incident), and a longitudinal study of the same participants’ scores on mental health measures over 3 years from September 2017.

Results

Survivors’ mental well-being scores in early 2021 were significantly lower than general population norms. Longitudinal follow-up provided evidence of enduring distress. Secondary stressors, specifically disruptions to close relationships, were associated with greater post-event distress and slower recovery. We found an indirect relationship between identifying with, and receiving support from, others present at the event and mental well-being >3 years later.

Conclusions

The Arena attack has had an enduring impact on mental health, even in survivors who had a mild response to the event. The quality of close relationships is pivotal to long-term outcome. Constructive support from family and friends, and people with shared experiences, are key to social cure processes that facilitate coping and recovery.
Mental Health literacy: Perspectives from Northern Kenya Turkana adolescents
Authors: Wadende P. , Sodi T.
Published: August 2023

Introduction

Mental illness accounts for high levels of morbidity, mortality, and poor quality of life among young people. Globally, 1 in 7 youth between 10-19 years are mentally ill making up 13% of the global burden of disease; depression, anxiety, conduct disorders, and attention-deficit/hyperactivity disorder lead here. Unaddressed mental illness progresses into adulthood disrupting victims’ lives. In Kenya, school going adolescent mental illness is manifested in violent outbursts such as arson attacks, intimate partner violence and riots in school. Not much is documented of non-school going adolescents and children in Kenya even while it is estimated that they number about 1.8 million. To seek help for mental illness, one has to recognize and understand it causes.

Objectives

An ethnographic study exploring rural based Kenyan adolescents’ conceptualizations, causes and management options for Depression, Schizophrenia and anxiety among the rural Turkana community of Northern Kenya.

Methods

An ethnographic study exploring rural based Kenyan adolescents’ conceptualizations, causes and management options for Depression, Schizophrenia and anxiety among the rural Turkana community of Northern Kenya. We conducted Focus Group Discussions with 32 adolescents between the ages of 13 and 17 divided into four groups; school going girls and non-school going girls and a similar two groups for boys. We first read out scenarios in which the main character exhibited symptoms of one of the three mental health conditions and analyzed the data thematically.

Results

32 participants described the health conditions without referring to the local names we had collected earlier; Depression (Akiyalolong) Schizophrenia (waarit/ Ngikerep) Anxiety (Ngatameta naaronok). Participants conceived the three conditions as resulting from extreme sadness attending loss, traumatic event, curses and rarely as mental illness. They assigned curses, guilt, hunger pangs, evil spells as causes and believed friends and age-mates, parents, teachers, the local chief among other options could help and rarely medical intervention.

Conclusions

Interventions to improve the adolescent’s knowledge of mental illness is needed so they can seek help for themselves and possibly help others.

Disclosure of Interest

None Declared
Experimental models of autism spectrum disorders on the example of the use of brain organelles
Authors: Sidenkova A.
Published: August 2023

Introduction

ASD are heterogeneous pathological conditions characterized by difficulties in establishing social contacts and the manifestation of repetitive behavior. An atypical trajectory of brain maturation, impaired neurogenesis, synaptogenesis, and an imbalance in the excitatory and inhibitory systems of the CNS form the morphofunctional basis of the ASD.

Objectives

To understand the functioning of this complexly organized system in time and space, a three-dimensional model is needed. The closest in vitro model of the human brain from early embryonic stages to aging is brain organoids. Human brain organoids are self-organizing three-dimensional cell aggregates derived from pluripotent stem cells (hiPSCs)

Methods

Organelles generalize neurogenesis, gliogenesis, synaptogenesis, cell migration and cell differentiation, gyrification of the cerebral cortex, and reflect the connections of brain regions.

Results

The use of telencephalon organelles in the RAS model revealed a deficit in neuronal migration, acceleration and disruption of cell cycle synchronization, aberrant cell proliferation, abundant synaptogenesis, temporary deviations in the development of the cortex, increased branching of neurons, unbalanced inhibitory differentiation of neurons, high activity of ion channels is a consequence of a violation of FOXG1 activity. Organelles generalize neurogenesis, gliogenesis, synaptogenesis, cell migration and cell differentiation, gyrification of the cerebral cortex, and reflect the connections of brain regions.The use of telencephalon organelles in the RAS model revealed a deficit in neuronal migration, acceleration and disruption of cell cycle synchronization, aberrant cell proliferation, abundant synaptogenesis, temporary deviations in the development of the cortex, increased branching of neurons, unbalanced inhibitory differentiation of neurons, high activity of ion channels is a consequence of a violation of FOXG1 activity .

Conclusions

hiPSCs can provide insight into the cellular mechanisms underlying ASD as a neuropsychiatric disorder, providing access to the development of platforms for in vitro drug screening and individualized patient therapy.

Disclosure of Interest

None Declared
Alterations in peripheral levels of cytokines and associated inflammatory markers in acute and chronic stages of schizophrenia spectrum disorders: a systematic review and network meta-analysis
Authors: Halstead S. , Siskind D. , Amft M. , Wagner E. , Yakimov V. , Liu Z. , Walder K. , Warren N.
Published: August 2023

Introduction

It has been previously identified that levels of peripheral inflammatory proteins, such as cytokines, are altered in people with schizophrenia spectrum disorders (SSD).

Objectives

As there is considerable inconsistency in the literature with respect to how inflammatory profiles differ between acute and chronic stages of SSD, a systematic review and network meta-analysis was performed.

Methods

Records from CINAHL, the Cochrane Central Register of Controlled Trials, EMBASE, PubMed, and PsycINFO were systematically searched from inception until 31 March 2022 for published studies that had measured levels of inflammatory proteins in cases of SSD and healthy controls. Pairwise and network meta-analyses were performed to determine whether there were significant differences in mean peripheral protein concentrations between acute SSD, chronic SSD, and healthy controls.

Results

After application of the screening process, 215 articles were included for data-analysis. One group of markers were consistently elevated (p<0·05) in both acute and chronic SSD, relative to healthy controls; this group comprised interleukin (IL)-1β, IL-1 receptor antagonist (IL-1RA), soluble interleukin-2 receptor (sIL-2R), IL-6, IL-8, IL-10, tumor necrosis factor (TNF)-α, and high sensitivity C-reactive protein (hsCRP). A second group of markers were inconsistently altered between illness stages: IL-2 and interferon (IFN)-γ were significantly elevated (p<0·05) in acute SSD, whilst IL-4, IL-12 and IFN-γ were significantly decreased (p<0·05) in chronic SSD.

Conclusions

These results indicate that a baseline level of inflammatory protein alteration occurs in SSD throughout the course of illness. This was evident from the group of markers that were consistently elevated in acute and chronic SSD (e.g., IL-6), representing possible trait markers. Moreover, superimposed immune activity may occur in acute SSD, given the group of possible state markers that were increased only in acute illness (e.g., IFN-γ). Further research is required to elucidate whether these peripheral changes are reflected within the central nervous system.

Disclosure of Interest

None Declared
Suicide risk among residents in a cross-sectional study: the role of the Interpersonal Psychological Theory of Suicide
Authors: Magliocca S. , Pontiggia M. , Madeddu F. , Calati R. , Zeppegno P. , Gramaglia C.
Published: August 2023

Introduction

The peculiar requests of postgraduate teaching could affect the students’ lives, predisposing them to mental disorders and suicide risk (e.g. Abreu et al., 2021). The Interpersonal Psychological Theory of Suicide (IPTS) (Joiner, 2005) is a model that has proved useful in explaining this risk.

Objectives

We analyzed risk factors associated with current suicidal ideation (SI) and history of suicidal planning and/or suicide attempt (SP/SA) in a sample of 97 Italian residents in psychological (n= 17, 17.5%) and medical and health care area (n=80, 82.5%) (mean age 29.18±3.25 SD).

Methods

Socio-demographic, psychological (i.e. State-Trait Anxiety Inventory, Beck Depression Inventory – II; BDI-II, Rosenberg Self-Esteem Scale, Reasons For Living Inventory; RFL, Psychache Scale, Mental pain questionnaire; MPQ, Visual Analogue Scale - VAS - on mental pain, Acquired Capability for Suicide Scale-Fearlessness About Death) psychosocial (i.e. Interpersonal Needs Questionnaire; INQ, UCLA Loneliness Scale Version 3, Multidimensional Scale of Perceived Social Support; MSPSS) and somatic pain features (i.e. VAS, Pain Vigilance and Awareness Questionnaire; Self-Awareness Questionnaire; SAQ) were collected through an online questionnaire. We compared residents with SI vs No SI and residents with SP/SA vs No SP/SA and the emerged significant variables, have been inserted in logistic regression models with stepwise method, backward elimination.

Results

The presence of depression (BDI-II), low reasons for living (RFL), psychological pain (Psychache Scale and MPQ), interoceptive awareness (SAQ), Thwarted Belongingness (TB, INQ subscale), loneliness (UCLA) and low perceived social support (MSPSS) were associated with both current SI and history of SP/SA. Concerning regression models, TB (INQ) increased the likelihood of SI while Survival and Coping Beliefs (RFL subscale) reduced it. The model explained 49% of the variance of SI by correctly predicting 88.7% of SI cases. Perceived social support (MSPSS)reduced the likelihood of current SP/SA levels while interoceptive awareness (SAQ) increased it. This model explained 40% of the variance of SP/SA by correctly predicting 82.5% of suicide risk cases.

Conclusions

We have identified risk and protective factors for suicide, consistent with the IPTS, which can orient the prevention, evaluation and clinical treatment of residents.

Disclosure of Interest

None Declared
Chronic obstructive pulmonary disease and comorbid psychiatric disorders: preliminary results of an 8-year retrospective study using real data
Authors: Santos G. , Ferreira A. R. , Gonçalves-Pinho M. , Freitas A. , Fernandes L.
Published: August 2023

Introduction

Chronic obstructive pulmonary disease (COPD) is the third leading cause of mortality worldwide. In Portugal, it is estimated to afflict 14.2% of the population over the age of 45 and is one of the most common causes of morbidity, with a significant social impact and excessive expenses. Moreover, COPD is associated with high levels of psychological distress and diverse psychiatric disorders that heighten the disease burden as they are associated with increased risk of exacerbations and frequent hospitalizations. Despite this overview, psychiatric conditions remain understudied compared to comorbid general medical conditions, and few studies have assessed their effect on COPD hospitalization outcomes.

Objectives

This study aimed to describe the occurrence of a vast array of psychiatric comorbid diagnoses in COPD hospitalizations and to understand their impact on hospitalization outcomes.

Methods

A retrospective observational study was conducted. All inpatient episodes from 2008 to 2015 of patients with at least 40 years and a primary diagnosis of COPD (ICD-9-CM codes 491.x, 492.x and 496) were selected from a national administrative database that included all hospitalizations in mainland public hospitals. From these sampled episodes, secondary psychiatric diagnoses were identified (ICD-9-CM codes 290.x-319.x). Age at hospitalization, sex, psychiatric comorbidities, length of stay (LoS) in days, admission type and date, destination after discharge, in-hospital mortality and hospital charges were analyzed.

Results

From a total of 66,661 COPD hospitalizations, 17,652 (26.5%) corresponded to episodes with a secondary psychiatric diagnosis. Patients with a comorbid psychiatric diagnosis were on average younger at admission (70.3 vs. 75.9 years, p<0.001), had a longer median LoS (9.89 vs. 9.33 days, p<0.001) and higher urgent admission rates (96.2% vs. 95.7%, p=0.009). There was also a significant association between discharge destination and psychiatric diagnoses (p<0.001).

Conclusions

These findings suggest that mental disorders have an adverse and quantifiable impact on COPD hospitalization outcomes. With this in mind, to provide optimal treatment for patients with both conditions, psychiatric disorders should become a matter of routine evaluation and follow-up.

Disclosure of Interest

None Declared
Intergenerational transmission of childhood maltreatment and eating disorder behaviors: Shedding light on the mother-daughter dyad and grandmother-mother-daughter triad
Authors: Talmon A. , Tsur N.
Published: August 2023

Introduction

Previous studies have established a relation between childhood maltreatment and eating disorder behaviors. However, this pattern of relations has not yet been studied within the nuclear family interactions.

Objectives

The aim of this study was to examine a model illuminating the transgenerational mechanism underlying the association between childhood maltreatment and eating disorder behaviors.

Methods

One-hundred-sixty-eight Israeli mothers and their young-adult-daughters (discovery sample) and 143 Israeli grandmother-mother-daughter triads (replication sample) filled out a battery of questionnaires assessing their history of childhood maltreatment and level of eating disorder behaviors.

Results

Results of structural equation modeling (SEM) in the discovery sample indicated that mothers’ childhood maltreatment was associated with daughters’ childhood maltreatment and that mothers’ eating disorder behaviors were also associated with daughters’ eating disorder behaviors. In addition, for both mothers and daughters, childhood maltreatment was associated with eating disorder behaviors. Finally, an indirect effect was found in which the relation between mothers’ childhood maltreatment and daughters’ eating disorders was mediated by mothers’ eating disorders. Partial replication was observed; grandmothers’ childhood maltreatment was significantly associated with mothers’ childhood maltreatment. Grandmothers’ eating disorder behaviors were associated with mothers’ eating disorders and mothers’ eating disorders were associated with daughters’ eating disorders. Finally, an indirect effect was found in which the association between grandmothers’ eating disorders and daughters’ eating disorders were mediated by mothers’ eating disorders.

Conclusions

These findings point to the significant contribution of the mother-daughter relationship in different aspects of the intergenerational transmission of both childhood maltreatment and eating disorder behaviors. These findings highlight the need to include a trauma-informed family-system approach in the treatment of eating disorders.

Disclosure of Interest

None Declared
Addressing Decision-Making Capacity in Application of Involuntary Treatment in Latvia: Case Law Analysis
Authors: Konstantinova K. , Olsena S.
Published: August 2023

Introduction

A well-established principle is that informed consent is an obligatory requirement for any medical intervention; a patient’s decision-making capacity to consent is a requirement for legally valid consent. Some individuals may be unable to give valid informed consent due to their limited mental capacity. In such cases, laws permit substitute decision-making and involvement of the patient as far as possible (Art.6, Oviedo Convention). National laws of European countries allow persons with mental health problems to be deprived of their liberty and undergo involuntary treatment, namely treatment without a patient’s informed consent, in certain circumstances. Procedural safeguards must be secured, and a court must review its lawfulness (FRA, 2012). The legality of involuntary treatment is highly debated by various audiences (CRPD committee, CoE bodies). In Latvia and other countries, the requirement to assess a person’s decision-making capacity in the application of involuntary treatment is not required.

Objectives

This study was conducted to reveal the role of a person’s decision-making capacity to consent to the treatment of mental disorders in cases where involuntary treatment was approved by courts.

Methods

A retrospective case law study method was applied. Anonymised decisions of Latvian courts at www.manas.tiesas.lv in cases of involuntary treatment in Latvian adult psychiatric hospitals since 2010 were collected and analysed. The content of decisions concerning persons’ decision-making capacity and applicable legal regulations were studied.

Results

The case law revealed that the decision-making capacity had not been addressed regularly and in detail. Latvian law does not require an assessment of capacity, and as a result, the courts do also not require any data. Some elements of decision-making abilities, such as the limited ability to comprehend or process information, are mentioned in the decisions of courts.

Conclusions

There is a need to address the significance of decision-making capacity in the application of patients’ rights law in clinical and legal settings when involuntary treatment is suggested or applied. There is a need to amend the laws justifying the limitations of patients’ rights, particularly concerning involuntary treatment.

Acknowledgements

This paper has been prepared within the research project “Towards a human rights approach for mental health patients with a limited capacity: A legal, ethical and clinical perspective”, No. lzp-2020/1-0397 and the project “Strengthening of the capacity of doctoral studies at the University of Latvia within the framework of the new doctoral model, identification No.8.2.2.0/20/I/006”

Disclosure of Interest

None Declared
Establishing Disorder-Specific and Transdiagnostic Neural Features of Psychiatric Disorders Through Large-Scale Functional Magnetic Resonance Imaging Meta-Analyses
Authors: Miller C. H. , Pritchard E. , Saravia S. , Duran M. , Santos S. L. , Hamilton J. P. , Hedges D. W. , Gotlib I. H. , Sacchet M. D.
Published: August 2023

Introduction

Meta-analyses of functional magnetic resonance imaging (fMRI) studies have been used to elucidate the most reliable neural features associated with various psychiatric disorders. However, it has not been well-established whether each of these neural features is linked to a specific disorder or is transdiagnostic across multiple disorders and disorder categories, including mood, anxiety, and anxiety-related disorders.

Objectives

This project aims to advance our understanding of the disorder-specific and transdiagnostic neural features associated with mood, anxiety, and anxiety-related disorders as well as to refine the methodology used to compare multiple disorders.

Methods

We conducted an exhaustive PubMed literature search followed by double-screening, double-extraction, and cross-checking to identify all whole-brain, case-control fMRI activation studies of mood, anxiety, and anxiety-related disorders in order to construct a large-scale meta-analytic database of primary studies of these disorders. We then employed multilevel kernel density analysis (MKDA) with Monte-Carlo simulations to correct for multiple comparisons as well as ensemble thresholding to reduce cluster size bias to analyze primary fMRI studies of mood, anxiety, and anxiety-related disorders followed by application of triple subtraction techniques and a second-order analysis to elucidate the disorder-specificity of the previously identified neural features.

Results

We found that participants diagnosed with mood, anxiety, and anxiety-related disorders exhibited statistically significant (p < .05 – 0.0001; FWE-corrected) differences in neural activation relative to healthy controls throughout the cerebral cortex, limbic system, and basal ganglia. In addition, each of these psychiatric disorders exhibited a particular profile of neural features that ranged from disorder-specific, to category-specific, to transdiagnostic.

Conclusions

These findings indicate that psychiatric disorders exhibit a complex profile of neural features that vary in their disorder-specificity and can be detected with large-scale fMRI meta-analytic techniques. This approach has potential to fundamentally transform neuroimaging investigations of clinical disorders by providing a novel procedure for establishing disorder-specificity of observed results, which can be then used to advance our understanding of individual disorders as well as broader nosological issues related to diagnosis and classification of psychiatric disorders.

Disclosure of Interest

None Declared
Sex differences for antipsychotic dosing and how to guide therapy
Authors: Schoretsanitis G.
Published: August 2023

Over the past decades the role of sex in the antipsychotic treatment type and dose selection has been virtually overseen. In fact, medication approval trials barely stratify for sex differences. Emerging hints from different types of data highlight the need for antipsychotic treatment personalization within the context of sex differences. Varying bioavaibility patterns of the prescribed antipsychotics between female and male patients may be easy to capture measuring plasma or serum levels of the antipsychotics ultimately guiding dose selection in clinical routine. Here we will discuss pitfalls and current evidence regarding sex affecting dose selection to enhance safety and effectiveness outcomes of antipsychotic treatment.

Disclosure of Interest

G. Schoretsanitis Consultant of: HLS Therapeutics and ThermoFisher
Childhood maltreatment and clinical response to mood stabilizers in patients with bipolar disorder
Authors: Attianese N. , Donato S. , Battipaglia M. , Ceres R. , D’Agostino G. , Cascino G.
Published: August 2023

Introduction

Childhood maltreatment (CM) is recognized to be a
non-specific risk factor for the development of psychiatric disorders in adulthood. It has been consistently demonstrated that exposure to CM increases the risk of developing bipolar disorder (BD). In addition, CM has been associated with worse clinical presentation and course of BD. CM has been also linked to poorer responses to psychotropic drug treatments in different psychiatric disorders.

Objectives

The aim of the current study was to explore retrospectively the impact of CM on the response to prophylactic treatment with lithium or anticonvulsants in a cohort of adult BD patients. Based on the reported literature, we hypothesized that BD patients with a history of CM would present a poorer response to both lithium and anticonvulsant treatments.

Methods

Participants were recruited from patients consecutively attending the outpatient facilities of the Psychiatric Unit of the University of Salerno. The following inclusion criteria were adopted: (1) diagnosis of BD type 1 or type 2 according to DSM‐5 criteria; (2) age ≥ 18 years; (3) willingness to participate in the study, expressed by written informed consent; (4) stable adequate treatments with mood stabilizers (at least 1‐year duration and, in the case of lithium, at therapeutic blood levels); (5) being clinically euthymic at the time of inclusion. Retrospective treatment response was evaluated by using the Alda scale. CM history was assessed by means of the short form of the Childhood Trauma Questionnaire (CTQ).

Results

Thirty‐seven patients (24 with a history of CM and 13 without CM) were on stable lithium treatment while sixty (35 with a history of CM and 25 without CM) were on stable anticonvulsant treatment. Clinical response to drug treatment did not differ between BD with CM and those without CM in the whole sample as well as in the anticonvulsant‐treated subgroup. In the lithium‐treated subgroup, a significant negative correlation emerged between physical abuse and treatment response (ρ = −0.38; p = 0.03) and patients with CM showed a significantly reduced Alda score (p = 0.04).

Conclusions

In patients with BD, CM did not influence the clinical response of anticonvulsants, whereas it was associated with a poorer response to lithium with childhood physical abuse playing a major role in this effect.

Disclosure of Interest

None Declared
Coping Strategies and Quality of life: Reaction to the COVID-19 Pandemic Among Romanian physicians
Authors: Stretea R.-M.-A. , Milhem Z. , Forray A.-I. , Crișan C.-A.
Published: August 2023

Introduction

The COVID‑19 pandemic has raised multiple psychological challenges among most healthcare workers, from anxiety to depression, burnout, sleep disorders, and substance use disorders. Thus, the burden caused by this prolonged medical crisis has inevitably drastically lowered the quality of life of the medical staff. In order to mitigate the negative effects of the pandemic, healthcare workers resorted to various coping strategies, with better or worse outcomes.

Objectives

The present study aims to identify Romanian physicians’ main coping mechanisms and evaluate the role of positive and negative stress-reducing strategies on quality of life.

Methods

A cross‑sectional national survey was conducted using a web-based questionnaire among physicians practicing in Romania (n=265). In addition to socio-demographic and professional information, the questionnaire addressed participants’ coping mechanisms using the COPE inventory and quality of life with the WHOQOL-Brief scale. Descriptive statistics, Pearson correlations, and multiple linear regressions were used in the statistical analysis.

Results

In total, 265 physicians consented to their participation in the survey. Of those who responded, 84.5% identified as female, 92.1% had a permanent residence in a urban setting, 63.8% were married and 55.1% attained a master’s degree, a PhD diploma or equivalent level of education. The results showed that optimism was higher in male professionals, while avoidance coping was higher in female health professionals. The mean values of QoL subscales were: 74.7± 18.3 for the general quality of life, 70.8± 20.7 for health satisfaction, 64.0± 14.2 for the physical area, 61.7± 16.2 for the psychological area, 61.2± 20.3 for the social relationships area and 64.7± 12.7 for the environment area. Specific coping mechanisms (emotional venting, behavioral and mental disengagement) were associated with lower quality of life. In contrast, emotion-focused (positive reinterpretation and acceptance), problem-focused strategies (planning, active coping, suppression of competing activities) and humor were associated positively with most QoL subscales scores.

Conclusions

Our data points to specific protective characteristics and some detrimental factors on physicians’ quality of life during the pandemic, with the implication that these factors may be important considerations for mitigating distress and psychiatric disorders for healthcare workers during times of high stress. Concerted initiatives to improve wellness in healthcare workers ought to develop targeted programs to ensure adequate psychological support.

Disclosure of Interest

None Declared
The Pain of Unjust Losing. The feeling of injustice and the perception of pain
Authors: Wojtyna E. , Mucha A.
Published: August 2023

Introduction

Social pain is a phenomenon where you feel pain in response to a social stimulus such as feelings of loss, exclusion, and injustice. In today’s world, people often experience unfair treatment. A special case is a situation in which the individual has aroused commitment, but there is no consequence in the form of the expected gratification.

Objectives

The study aims to determine the impact of losing and unjust losing on the perception of pain.

Methods

The study involved 80 people who were randomly assigned to one of the following groups: win, lose, unfairly lose and control. The first three groups participated in a “paper-scissor-stone” game that was created in which they played against a false opponent. The game was constructed in such a way as to obtain the result provided for each group. The “unfairly lose” group received negative points for both a loss and a draw. The control group was only watching the play of two other players. Pre- and post-game pain thresholds and pain tolerance were tested in each group. Pain severity was also assessed. The pain was generated by a thermal stimulus using the TSA-II neuroanalyzer. Pain severity and involvement in the game were analyzed with the VAS scale.

Results

The level of involvement in the game was identical in all three experimental groups. The lowest pain nuisance was observed after the game in the “win” group. The pain was the most strenuous in the group that was unjustly lost. In the group of “unfairly lose”, the pain tolerance threshold decreased after the game.

Conclusions

Feelings of injustice can increase pain and pain sensitivity in people who, after inducing commitment, do not receive fair gratification.

Disclosure of Interest

E. Wojtyna Grant / Research support from: National Science Centre, A. Mucha: None Declared
Causal relationship between the administration of high-dose corticosteroids and the appearance of maniform-type psychopathology
Authors: Solis Correa M. O. , Valverde Barea M. , Soldado Rodriguez L.
Published: August 2023

Introduction

To present a clinical case that reflects the causal relationship between the administration of high-dose corticosteroids and the appearance of maniform-type psychopathology.

Objectives

Descriptive study of a case report and literature review on the subject.

Methods

32-year-old woman with alcohol abuse detected, added Antabus 250 mg / day to her treatment.

Results

After 2 months of treatment, she was admitted to the Digestive Service due to acute hepatitis. After a liver biopsy and autoimmunity study was diagnosed as Autoimmune Hepatitis. Treatment with Antabus was withdrawn, and Prednisone 60 mg/day was prescribed. Seven days after starting treatment with corticosteroids, she presented maniform symptoms (psychomotor restlessness, expansive mood, dysphoria, megalomanic delusions, alteration of biological rhythms with decreased need for sleep and risk behaviors), and she was admitted in a psychiatric hospitalization unit. After considering various differential diagnoses she is diagnosed with Substance-Induced (corticosteroids) Mood Disorder with manic features. Psychiatry agrees with the Digestive Service to start treatment with Paliperidone and progressively lower the dose of corticosteroids until suspending it and prescribe an immunosuppressant. Finally, the maniform symptoms that led to admission remitted completely and control and outpatient treatment were continued.

Conclusions

Its important to always keep in mind the great risk of the appearance of psychiatric disorders that treatment with high doses of corticosteroids entails, especially in susceptible patients or with a psychiatric history or genetic susceptibility. It is necessary to know the possible appearance of these neuropsychiatric adverse effects in order to prevent them, and if it appear, to assess, if possible, the suspension or reduction of corticosteroid treatment.

Disclosure of Interest

None Declared
Loneliness and the degree of addiction to shopping and work among Polish women: the mediating role of depression
Authors: Rachubińska K. , Cybulska A. M. , Schneider-Matyka D. , Grochans E. , Grochans S.
Published: August 2023

Introduction

The rapid development of civilization is accompanied by many changes affecting human functioning. Technological development, wide access to positive stimuli and the neglect of emotional control and self-awareness in the learning process make it difficult for individuals to control their behavior. Such a loss of control is associated with the development of addictions. Therapists, doctors and researchers more and more often encounter cases of compulsive behavior focused on a specific activity - apart from gambling or playing computer or internet games, more and more often the subjects of preoccupation are compulsive shopping, sexual activities and work (workaholism).

Objectives

The aim of the research was to try to define the mediating role of depression in the relationship between addiction to shopping and work and loneliness, understood in terms of general loneliness among Polish women.

Methods

The study was conducted among 556 women. The research was carried out with the use of the diagnostic survey method, using the questionnaire technique: the De Jong Gierveld Loneliness Scale, the Purchasing Behavior Scale, the Work Addiction Risk Test, Beck Depression Inventory and a questionnaire of our authorship.

Results

Depressiveness is a mediator in the relationship between the feeling of loneliness and the degree of addiction to shopping (β = -0.0246, z = -2.03, p = 0.043) and in the relationship between the feeling of loneliness and the degree of addiction to work (β = -0.0722, z = -4.002, p < 0.001). The direct impact of the feeling of loneliness on the degree of addiction to shopping (p = 0.237) and work (p = 0.576) is statistically insignificant.

Conclusions

In the mediation model adopted, it was shown that depressiveness plays the role of a mediator between the feeling of loneliness and the degree of addiction to shopping and work. The increase in the level of depression increased the degree of addiction to shopping and work. The mediator’s participation lowered the level of the feeling of loneliness. Loneliness was not a significant predictor of addiction to shopping and work. There is a need to include activities aimed at identifying psychological factors influencing the occurrence of addictions to shopping and work among women. It seems important to be able to use psychological help when needed. It is also necessary to take institutional preventive measures to prevent the occurrence of behavioral addictions among women.

Disclosure of Interest

None Declared
Piracetam and Ginkgo biloba in the treatment of residual cognitive symptoms after the discontinuation of benzodiazepines in long-term users; case series and review of the literature
Authors: Sugnet T. , Jonovska S. , Šendula-Jengić V. , Čargonja P.
Published: August 2023

Introduction

Long-term benzodiazepine use is common although not routinely recommended. While their dependence potential is notorious, cognitive problems due to their chronic use have only recently been intensively studied. Residual cognitive symptoms may linger months after successful benzodiazepine discontinuation and significantly limit optimal functional outcome in abstinent individuals.

Objectives

We present a series of cases, a 41-year-old man and a 33-year-old woman who successfully completed a ten-week benzodiazepine-dependence rehabilitation program at our hospital, including successful tapering and post-withdrawal integrative therapy. At subsequent monthly outpatient check-ups, abstinence was confirmed (including toxicology testing) and there was no residual anxiety or mood symptomatology. Still, patients complained of their suboptimal functioning due to residual cognitive problems, especially trouble concentrating and short-memory deficits, which were objectively confirmed via psychometric tests.

Methods

During continuous outpatient treatment (monthly controls), patients were clinically and neurocognitively evaluated. They were reluctant to try conventional psychopharmacology agents but were open to supplement therapy. After thorough literature review, a trial of piracetam and Ginko biloba extract was suggested. Piracetam, a positive allosteric modulator of AMPA-receptors, has been used in the treatment of vascular neurocognitive changes in the elderly. Bilobalides from G. biloba, act as atypical antagonists of GABA-A receptors and were found to exert neuroprotective effects in animal models, without epileptogenic or anxiogenic risks.

Results

Patients were recommended piracetam (2.4 g a day) in divided doses and a once-daily dose of G. biloba extract (240 mg a day), in a standardized form containing 3.2% of bilobalides. No side effects were noticed. At subsequent monthly checkups, patients reported fewer cognitive problems and better everyday functioning. Neurocognitive testing confirmed subjective findings, with positive changes in all areas, but especially so in verbal memory, which may be due to this specific pharmacological combination. At the end of the observation period of sixth months, piracetam was gradually discontinued while patients were given free choice whether to continue with G. biloba supplementation.

Conclusions

According to our findings, piracetam and G. biloba extract may prove beneficial in the treatment of residual cognitive symptoms after benzodiazepine discontinuation, in long-term benzodiazepine users. Other treatments, focusing not only on modulation of glutamate and GABA, but also on other pathways should be evaluated. Further clinical studies are warranted.

Disclosure of Interest

None Declared