bluuebunny/crossref_metadata_2025 huggingface dataset:
The evaluation of IMR in crisis resolution home treatment, a mixed methods study protocol
Authors: Kieft S. , Schaap I.
Published: August 2023

Introduction

In the past years, recovery has become a central concept in psychiatric treatment (Sowers et al. Acad Psychiatry 2016; 40 461-467). However, in acute mental health care the concept of recovery is lacking attention (Rabenschlag et al. Psychiatry Q 2014; 85 225-239; Jaeger et al. Nord J Psychiatry 2015; 69 188-195; Luigi et al. Can. Med. Educ. J. 2010; 11 62-73). In 2021 a short version of Illness Management and Recovery (IMR) was implemented at the Psychiatric Emergency Service Amsterdam-Amstelland (SPAA). IMR is an evidence based group intervention for patients with severe mental illness, based on cognitive-behavioral, psychoeducational and motivational components. The aim of IMR is to support participants to manage their mental illness (Mueser et al. Schizophr Bull 2006; 32 32-43). To our knowledge this the first time that IMR is implemented within an acute mental health care setting Therefore the effects of IMR program on recovery in the acute phase of psychiatric illness are unknown.

Objectives

Insight in effects of IMR in acute mental health care.

Methods

We will carry out a mixed method study. In phase 1 the intervention will be carried out. 25 patients who are admitted to acute mental health care and diagnosed with a severe mental illness (SMI) will take part in the shortened version of IMR. Effects will be measured by the client version of the IMR-scale (Salyers et al. Community Ment. Health J. 2007; 43 459-480).Phase 2 includes qualitative interviews with a subsample from phase 1 (using maximum variety in diagnosis and demographic characteristics) to gain insight in the mechanisms and impact of the program.

Results

The proposed study will investigate the effects of an adjusted evidenced-based treatment within a population of people who receive treatment in a Psychiatric Emergency Service. The original intervention is shortened in time and topics, to match the needs of people in the acute phase of psychiatric illness. The question that arises is if an existing treatment can be translated to a different group of patients.

Conclusions

The proposed project has some important limitations that we feel deserve mentioning. It is questionable if a person can profit from a recovery program during a phase of acute crisis. Also, can we expect the same effects if the new program is a shortened version of the original evidence based intervention?

Disclosure of Interest

None Declared
Medical cannabis use among patients with Post-Traumatic Stress Disorder (PTSD): A nationwide database study
Authors: Yakirevich Amir N. , Treves N. , Davidson E. , Bonne O. , Matok I.
Published: August 2023

Introduction

In recent years, cannabis use among PTSD patients has become more common than ever. However, data available today regarding the effectiveness and safety of medical cannabis in PTSD treatment is limited, based on cross sectional studies, self-report surveys and a few clinical studies with small sample size.

Objectives

To characterize patterns of use and adverse effects over time in patients with PTSD using medical cannabis in real life setting.

Methods

Data were acquired from the Israeli national database of all patients licensed to use medical cannabis from January 2014 to December 2021. A license for medical cannabis is given to patients with PTSD of at least moderate intensity after treatment failure of at least two drugs and two psychological interventions. Comparative statistics were used to evaluate patterns of use and adverse effects.

Results

12,977 patients were licensed to use medical cannabis in the study period for PTSD (8.2% of all users; 70% men) during the above-mentioned time period. PTSD was the 3rd most common indication after chronic pain and symptoms related to oncological disease and chemotherapy treatment. Over time, the relative increase in use of medical cannabis among PTSD patients was higher than that found in non-PTSD patients. In 2021 36.2% of all PTSD patients using medical cannabis had their license issued that year compared to 28.1% of all non-PTSD patients. PTSD patients were significantly younger compared to non-PTSD patients (40.9 years vs. 52.9 years). PTSD patients consume slightly higher monthly amount at the beginning of treatment compared to non-PTSD patients (32.1gr vs. 30.6gr) with higher Tetrahydrocannabinol (THC) concentration (15.2% vs. 12.9%) and lower Cannabidiol (CBD) concentration (4.7% vs. 6.0%). Over two years of use, amount, and composition of cannabis among the two groups were comparable and showed an increase in total amount and THC concentration, reaching the maximal available THC concentration of 20%. Data regarding adverse effects were available for 6,242 PTSD patients (48.1%) and 39,497 non-PTSD patients (26.6%). PTSD patients reported more physical adverse effects (RR 1.45 [95%CI 1.34-1.56]), anxiety (RR 1.47 [95%CI 1.13-1.92]), and derealization (RR 3.44 [95%CI 2.42-4.89]).

Conclusions

PTSD is one of the leading indications for medical cannabis use in Israel, despite scarcity in good quality data supporting its effectiveness and safety. The increased risk of mental adverse effects among PTSD patients emphasizes the need for cautious use in cannabis in this population. Expanding the knowledge regarding patterns of use and risks in medical cannabis use among PTSD patients is important for understanding the role of cannabis in PTSD treatment and to ensure an effective and safe treatment.

Disclosure of Interest

None Declared
““Why shouldn’t I expect things from life?” – what people with lived experience from psychosis highlight as important to their personally defined long-term recovery process”
Authors: Åsbø G. , Haavind H. , Hembre Kruse S. , Fjelnseth Wold K. , Ten Velden Hegelstad W. , Lie Romm K. , Ueland T. , Melle I. , Simonsen C.
Published: August 2023

Introduction

Many people with lived experience from psychosis recover and thrive, contrary to the common stigmatizing belief that they will be chronic “patients”. But there are several ways to understand recovery, one is as a subjective process best explored through qualitative interviews with people who have recovered from psychosis. However, there is a need for more qualitative interview studies exploring what has been important for long-term subjective recovery for people with lived experience from psychosis outside of treatment. Exploring themes that are novel than previous research will have important clinical implications.

Objectives

This study aims to qualitatively explore what people with lived experience from psychosis believe has been the most important to attain and sustain their long-term personally defined recovery.

Methods

Qualitative interviews with 20 individuals participating in two follow-up-studies (TOP and TIPS-study) 10 and years 20 years after first treatment for a psychotic disorder (schizophrenia- or bipolar spectrum), respectively. All participants were in either clinical recovery (symptom remission and adequate functioning) or personal recovery (self-rated questionnaire) or both. Interviews were analyzed with thematic analysis in group meetings between the PhD-candidate, the main supervisor, a professor emerita in qualitative method and a co-researcher with lived experience from bipolar disorder.

Results

Participants defined recovery differently, but: “understanding myself”, “stable symptoms” and “finding the life that is right for you” were of the most common definitions. Tentatively, five main themes appear to be the most salient contributions to recovery: 1. Balance stress management with taking risks and following personal goals. 2. Accepting experience/”owning your story” in order to strategically disclose and manage stigma. 3. Taking agency over own recovery and mastery of everyday life. 4. Social support is crucial, but should change over time depending on need. 5. Feeling a sense of belonging to society does not need to entail “normality”.

Conclusions

Recovery was defined differently by each participant, but common themes across participants highlight that appropriate risk-taking, accepting your experience/owning your story, sense of agency, social support and inclusion are important to long-term recovery in psychosis.

Disclosure of Interest

None Declared
Antidepressant Use and Its Association with 28-Day Mortality in Inpatients with
SARS-CoV-2: Support for the FIASMA Model against COVID-19
Authors: Hoertel N. , Sanchez-Rico M. , Kornhuber J. , Gulbins E. , Reiersen A. , Lenze E. , Fritz B. A. , Jalali F. , Mills E. , Cougoule C. , Carpinteiro A. , Mühle C. , Becker-Flegler K. A. , Boulware D. R. , Blanco C. , Alvarado J. M. , Strub-Wourgaft N. , Lemogne C. , Limosin F.
Published: August 2023

Introduction

To reduce Coronavirus Disease 2019 (COVID-19)-related mortality and morbidity, widely
available oral COVID-19 treatments are urgently needed. Certain antidepressants, such as
fluvoxamine or fluoxetine, may be beneficial against COVID-19.

Objectives

The main objective was two-fold: (i) to test the hypothesis that the prevalence of
antidepressant use in patients hospitalized with COVID-19 would be lower than in patients
with similar characteristics hospitalized without COVID-19, and (ii) to examine, among
patients hospitalized with COVID-19, whether antidepressant use is associated with reduced
28-day mortality. Our secondary aim was to examine whether this potential association could
only concern specific antidepressant classes or molecules, is dose-dependent, and/or only
observed beyond a certain dose threshold.

Methods

We included 388,945 adult inpatients who tested positive for SARS-CoV-2 at 36 AP–HP
(Assistance Publique–Hôpitaux de Paris) hospitals from 2 May 2020 to 2 November 2021. We
compared the prevalence of antidepressant use at admission in a 1:1 ratio matched analytic
sample with and without COVID-19 (N = 82,586), and assessed its association with 28-day
all-cause mortality in a 1:1 ratio matched analytic sample of COVID-19 inpatients with and
without antidepressant use at admission (N = 1482) (Figure 1).

Results

Antidepressant use was significantly less prevalent in inpatients with COVID-19 than
in a matched control group of inpatients without COVID-19 (1.9% versus 4.8%; Odds Ratio (OR)
= 0.38; 95%CI = 0.35–0.41, p < 0.001) (Figure 2). Antidepressant use was significantly
associated with reduced 28-day mortality among COVID-19 inpatients (12.8% versus 21.2%; OR =
0.55; 95%CI = 0.41–0.72, p < 0.001), particularly at daily doses of at least 40 mg
fluoxetine equivalents (Figure 3). Antidepressants with high FIASMA (Functional Inhibitors of
Acid Sphingomyelinase) activity seem to drive both associations.

Image:

Image 2:

Image 3:

Conclusions

Antidepressant use is associated with a reduced likelihood of hospitalization in
patients infected with SARS-CoV-2 and with a reduced risk of death in patients hospitalized
with COVID-19. These associations were stronger for molecules with high FIASMA activity.
These findings posit that prospective interventional studies of antidepressants with the
highest FIASMA activity may be appropriate to help identify variant-agnostic, affordable, and
scalable interventions for outpatient and inpatient therapy of COVID-19.

Disclosure of Interest

None Declared
Changes in UK Pre-Schooler’s Mental Health Symptoms over the first year of the Covid-19 pandemic: data from Co-SPYCE Study
Authors: Dodd H. , Skripkauskaite S. , Shum A. , Waite P. , Lawrence P.
Published: August 2023

Introduction

The COVID-19 pandemic caused significant disruption to the lives of children and their families. Pre-school children may have been particularly vulnerable to the effects of the pandemic, with the closure of childcare facilities, playgrounds, playcentres and parent and toddler groups limiting their opportunities for social interaction at a crucial stage of development. Additionally, for parents working from home, caring for pre-school aged children who require high levels of support and care, was likely challenging

Objectives

We aimed to conduct an intensive longitudinal study to examine trajectories of pre-schoolers’ mental symptoms in the United Kingdom during the first year of the COVID-19 pandemic.

Methods

UK‐based parents and carers (n = 1520) of pre-school‐aged children (2 to 4 years) completed monthly online surveys about their pre-schoolers’ mental health between April 2020 and March 2021. The survey examined changes in children’s emotional symptoms, conduct problems and hyperactivity/inattention.

Results

Pre-schoolers’ emotional problems and hyperactivity/inattention symptoms declined from April through summer 2020 and then increased again during the autumn and winter 2020/2021 as lockdowns were re-introduced. Pre-schoolers who attended childcare showed greater decline in symptom severity than those who did not. Older children, compared to younger, showed greater lability of emotion symptom severity. Attending childcare predicted lower symptom severity across all three domains of conduct problems, emotional symptoms, and hyperactivity/inattention, while the opposite pattern was observed for children whose parent had a mental health problem.

Conclusions

Our findings reinforce the importance of examining pre-schoolers’ mental health in the context of micro and macro-level factors. Interventions focusing on family factors such as parent mental health, as well as continued provision of childcare, may have most potential to mitigate the impact of COVID-19 on young children’s mental health.

Disclosure of Interest

None Declared
Differential Impact of Social Cohesion in the Lens of U.S. College Students with different Sexual and Gender Identities on their Mental Health during the COVID-19 Pandemic
Authors: Lin Y. , Deng W. , Xie H.
Published: August 2023

Introduction

Sexual and gender minority (SGM) college students endorsed higher psychological distress and worsened mental health outcomes than their cisgender heterosexual peers. Such disparity is exacerbated during the COVID-19 pandemic, during which SGM youth may be sent home to unaccepting environments or presented with fewer healthcare options. The “Black lives matter (BLM)” and “Anti-Asian Hate” also exposed college students disproportionally to more witnessed discrimination and poorer social cohesion, which in turn, might negatively affect the mental health outcomes.

Objectives

The present study aims to explore the mental health outcome profile within SGM college students by (1) identify mental health disparities across different sexual and gender identities and (2) evaluating the impacts of discrimination, social cohesion and other factors on mental health outcomes of college students with different sexual and gender identities.

Methods

The study utilizes the 2020-2021 Healthy Minds Study data with 139,470 college students across 60 U.S. campuses. Multivariable regression models are built with minority status to predict mental health outcome (depression, anxiety, and suicidal ideation).

Results

SGM students reported higher symptoms of depression, anxiety, and suicidal ideation. Besides, SGM individuals having experienced or witnessed discrimination or hostile behaviors due to their race/ethnicity also showed worse mental health outcomes. Noted, perceived stronger social cohesion is a protective factor for lower depression (OR: 0.59; 95%CI: 0.45, 0.78) and anxiety (OR: 0.69; 95%CI: 0.51, 0.93) symptoms in SGM, while perceived weaker social cohesion is a risk factor for depression (OR: 1.37; 95%CI: 1.14, 1.64) and anxiety symptoms (OR:1.32; 95%CI:1.09-1.59) in cisgender heterosexual individuals.

Conclusions

These findings acknowledge the negative impact of discrimination on mental health, highlight the importance of recognizing social cohesion affect differently in SGM and their peers, and enhance the understanding of differential impact of social cohesion to inform public policy and early intervention in vulnerable populations during COVID-19 pandemic.

Disclosure of Interest

None Declared
Severe COVID-19 and breakthrough infections in vaccinated schizophrenia patients: A matched controlled cohort study
Authors: Tzur Bitan D.
Published: August 2023

Introduction

Schizophrenia patients are at an increased risk for severe SARS-CoV-2 illness. Recent studies indicate that vaccines reduce morbidity gaps between schizophrenia patients and the general population; nonetheless, the ongoing emergence of COVID-19 variants and the increased frequency of breakthrough infections might lead to changes in these risk profiles.

Objectives

In this study we aimed to bridge this gap by assessing the risk of COVID-19 infection, hospitalization, and mortality among vaccinated individuals with schizophrenia, as compared to vaccinated individuals with no schizophrenia, matched for age, sex, and vaccination coverage (first, second, and booster) throughout the first year of the vaccination plan.

Methods

The study included 50,958 vaccinated individuals: 25,479 individuals with schizophrenia and 25,479 without schizophrenia. Data were derived from the databases of Clalit Health Services, the largest healthcare organization in Israel.

Results

Findings indicated that differences among vaccinated schizophrenia patients and controls were non-significant after adjusting for infection (HR = 0.93, 95%CI 0.84-1.03, p = 0.14) and mortality rates (HR = 2.18, 95%CI 0.80-5.90, p = 0.12). Nonetheless, differences in rates of hospitalization remained significant even after controlling for demographic and clinical factors (HR = 2.68, 95%CI 1.75-4.08, p<0.001). A longitudinal assessment of relative risk indicated that the rate ratio of differences between the groups increased during the fourth infection wave of the B.1.617.2 (delta) variant across all parameters, with schizophrenia patients demonstrating higher relative risk of hospitalization (RR = 4.19, 95%CI 2.41-7.23) and mortality (RR = 7.61, 95%CI 0.93-61.89) during the relevant periods.

Conclusions

These findings suggest that vaccination coverage is effective in narrowing overall morbidity and mortality gaps; nonetheless, individuals with schizophrenia are still at risk for severe COVID-19 outcomes.

Disclosure of Interest

None Declared
Antipsychotic treatment and cognitive function in patients with schizophrenia
Authors: Tumova M. A. , Stepanova A. A. , Yanushko M. G. , Kotsyubinsky A. P. , Ivanov M. V.
Published: August 2023

Introduction

It is known that cognitive impairment is one of the main symptoms of schizophrenia, which determines the functional outcome. The question of the effect of antipsychotics on the cognitive functions of these patients is still unresolved. Cognitive impairment while taking antipsychotics is thought to be mostly related to extrapyramidal abnormalities. In practice, it is difficult to distinguish what causes a patient’s complaints of cognitive decline. Is it related to taking the medication? Or a worsening mental state? Age, lifestyle, etc.?

Objectives

We analyzed the relationship of cognitive impairment with the severity of extrapyramidal symptoms, mental status gravity, age, and dose of antipsychotic and cholinergic medication at weeks 2 and 8 of treatment.

Methods

We examined 37 patients with schizophrenia on stable antipsychotic treatment at weeks 2 and 8 of therapy. Thirty patients received a 2nd-generation antipsychotic, and seven patients received a 1st-generation antipsychotic. The anticholinergic drug was trihexyphenidyl. The antipsychotic dose was estimated in olanzapine equivalent. Extrapyramidal symptoms were assessed by The Scale for Extrapyramidal Symptoms (SAS), severity of mental condition was rated by The Positive and Negative Syndrome Scale (PANSS), cognitive function was measured by The Brief Assessment of Cognition in Schizophrenia (BACS).

Results

As previously described, patients with more severe extrapyramidal symptoms tended to have lower BACS composite scores (rxy = -0.318, p-value = 0.055) at week 8 of therapy. The total score on the SAS scale, as expected, only negatively correlated with scores on the Token Motor Task test (rxy = -0.412, p-value = 0.011) at the 8th week of therapy. There were also negative correlations between Token Motor Task scores and trihexyphenidyl dose (rxy = -0.496, p-value = 0.002). At both weeks 2 and 8, there was a negative relationship between age and Symbol Coding scores (rxy = -0.387, p-value = 0.018; rxy = -0.35, p-value = 0.034, respectively). Verbal Fluency scores were lower in patients with high scores on the PANSS excitement component and at week 2 (rxy = -0.42, p-value = 0.01), this trend continued at week 8 (rxy = -0.31, p-value=0.063) . Tower of London scores were negatively associated at week 8 with cognitive and positive PANSS scores (rxy = -0.46, p-value = 0.004; rxy = -0.336, p-value = 0.042, respectively).

Conclusions

Thus, we have demonstrated that cognitive impairment in patients with schizophrenia is associated with various factors, and not only antipsychotic treatment.

Disclosure of Interest

None Declared
Changes in inflammatory parameters and their impact on clinical symptoms in patients suffering from schizophrenia
Authors: Nycz B. , Krysta K.
Published: August 2023

Introduction

One of the factors influencing the symptoms of schizophrenia, which may indicate changes in the cognitive functioning of patients, is the fluctuating level of inflammatory cytokines.

Objectives

The aim of the review was to analyze the available literature on the importance of selected inflammatory factors [interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10), of tumor necrosis α (TNF-α)] in schizophrenia and the assessment of the impact of changes in cytokine levels on the occurrence of schizophrenia symptoms.

Methods

For this purpose, available scientific publications from following databases: PubMed, Scopus, Google Scholar were used to prove that the levels of selected inflammatory parameters changed in people suffering from schizophrenia. Moreover, fluctuations in cytokine concentrations influenced the occurrence of negative symptoms of schizophrenia, including cognitive disorders, as well as psychotic symptoms.

Results

An increase in the concentration of IL-1β in the cerebrospinal fluid of patients with the first episode of schizophrenia has been described, which may indicate the involvement of the cytokine in the inflammatory process involving the CNS. The increased level of IL-6 is associated with the occurrence of psychotic disorders, it is also noted in stressful conditions. IL-6 is qualified as an indicator of exacerbation of schizophrenia, which normalizes after antipsychotic treatment. In the blood of patients with paranoid schizophrenia, elevated levels of IL-8 and IL-6 were detected compared to healthy individuals, which indicates the development of an inflammatory process in schizophrenia. The relationship between the level of IL-8 in women in the second trimester of pregnancy and the risk of developing schizophrenia spectrum disorder in children has been proven. Untreated patients with acute psychotic symptoms showed an increase in the level of TNF-α in the blood serum (compared to healthy subjects). An increase in the level of TNF-α in the blood serum of patients with an acute relapse of schizophrenia or the first episode of psychosis was also demonstrated. In conclusion, the relationship of IL-6 and TNF-α with the occurrence of psychotic disorders, the relationship of IL-1β with the appearance of changes in mood, behavior, including cognitive dysfunction, the relationship of IL-8 with the risk of developing schizophrenia spectrum disorder in children, the relationship of reduced concentrations of IL-10 with the intensification of negative symptoms, including cognitive deficits.

Conclusions

In conclusion, the analysis showed that patients with schizophrenia fluctuate in the concentration of inflammatory cytokines, which affects the occurrence of clinical symptoms.

Disclosure of Interest

None Declared
The risk of developing diabetes during antipsychotic drug treatment: A nationwide study among 31,856 patients with schizophrenia
Authors: Marker Madsen N. , Köhler-Forsberg O. , Garne Rohde C. , Aalkjær Danielsen A. , Mors O.
Published: August 2023

Introduction

Antipsychotics (AP) are the primary pharmacological treatment for schizophrenia but increase the risk for diabetes, with recent meta-analyses indicating important differences between specific APs. However, these findings are based on randomized clinical trials, which only include 20% of patients seen in everyday clinical settings, and are hence prone to selection bias.

Objectives

We aim to investigate 1) the actual risk of developing diabetes in patients treated with APs using real-world data and 2) whether there are risk differences between specific APs.

Methods

We conducted a retrospective cohort study using Danish nationwide healthcare registers. We identified all individuals receiving a schizophrenia diagnosis from January 1, 1999, to January 1, 2019 and an age- and sex-matched reference population from the general population. The primary outcome was diabetes, identified via hospital discharge diagnoses and redeemed prescriptions for glucose-lowering drugs. First, we compared the risk of developing diabetes between patients with schizophrenia and the age- and sex-matched reference population. Second, among the patients with schizophrenia, the association between AP drug treatment and the risk of diabetes were analyzed. Third, risk differences for developing diabetes between specific AP drugs were investigated. We used cox regression for all analyses, the latter adjusted for age, sex, year of schizophrenia diagnosis, Charlson Comorbidity Index (CCI), occupational status, marital status, education and schizophrenia severity (use of antipsychotics, antidepressants, anxiolytics/hypnotics/sedatives, mood stabilizers and number of psychiatric admissions in the year preceding the diagnosis of schizophrenia).

Results

We identified 31,856 patients with schizophrenia and 159,280 reference individuals. Patients with schizophrenia had an increased risk of developing diabetes compared with the reference individuals (unadjusted HRR: 3.12, 95%CI: 2.98-3.28). Treatment with AP in patients with schizophrenia, compared to periods with no AP use, was associated with an increased risk of developing diabetes (adjusted HRR: 2.04, 95%CI: 1.75-2.38). This risk was particularly increased among individuals treated with lurasidone (HRR: 2.66, 95%CI: 1.10-6.42), sertindole (HRR: 2.10, 95%CI 1.51-2.93), paliperidone (HRR: 1.84, 95%CI 1.47-2.31), clozapine (HRR: 1.74, 95%CI 1.49-2.03) and aripiprazole (HRR: 1.54, 95%CI 1.35-1.75), whereas treatment with zuclopenthixol (HRR: 1.00, 95%CI 0.82-1.23), flupentixol (HRR: 0.71, 95%CI 0.40-1.25) and pimozide (HRR: 0.74, 95%CI 0.31-1.78) were not associated with an increased risk of diabetes.

Conclusions

This real-world study indicates differences in the risk of developing diabetes between specific AP compounds. Further analyses will be presented at the conference.

Disclosure of Interest

None Declared
Ghrelin at the interface of hunger, reward and obesity
Authors: Dickson S. L.
Published: August 2023

Ghrelin, a stomach-derived hunger and appetite signal, drives behaviors that ensure we seek out and consume foods, not only in situations of energy deficit but also when anticipating palatable foods. Key target pathways for ghrelin include the orexigenic agouti-related peptide (AgRP) neurones in the hypothalamic arcuate nucleus (Arc), that appear to confer the unpleasant feelings of hunger. They also include dopamine neurones in the ventral tegmental area, where ghrelin heightens motivation for food rewards. Recently, we have employed a variety of neural circuit mapping techniques in rodents to help clarify the function of populations of ghrelin-responsive targets. We found that 1) chemogenetic activation of ghrelin-responsive cells in the Arc is sufficient to drive a feeding response and to induce food-motivated behaviour and 2) that dopamine neurones in the VTA are activated when mice are exposed to cues that predict a food reward than to its retrieval, as revealed by fiber photometry recordings from these cells. Further studies aim to determine the role of ghrelin-responsive cells in the parabrachial nucleus of the brainstem. Overall, the brain ghrelin signalling system is well positioned to integrate the response to hunger, enhanced by both intrinsic and external cues and in ways that are relevant to curb over-eating in obesity.

Disclosure of Interest

None Declared
Gender differences in response and remission rates among patients receiving esketamine
Authors: Guterman A. T. , Feffer K. , Gershi A. Z.
Published: August 2023

Introduction

Depressive disorders are among the leading causes of disability. The lifetime risk for developing clinically significant depression is estimated around 15%. Multiple studies have found female-male ratio of 2:1 across nations and cultures. The reason for this marked difference is still not clear, although several theories addressing social, biological, and environmental contributors have been suggested. Respond to anti-depressant treatment is considerably similar in both genders. However, several studies have shown worse outcomes among women during menopause.

In 2019, the US Food and Drug Administration (FDA) approved a nasal spray formulation of esketamine for the treatment of resistant depression (TRD) in adults, and the treatment has been approved to use by the ministry of health in Israel since 2020 . Recent studies found more than 50% response and 35% remission rates, when nasal esketamine was given as an add-on therapy.

Objectives

to assess gender differences in response and remission rates among patients receiving esketamine as an add-on therapy for TRD in a real-world setting

Methods

23 female and 22 males received at least 12 weeks of esketamine treatment in a day-care setting. Data collected included depression, dissociation and quality of life scales.

Results

Females tend to experience more severe dissociation during treatment. Average response and remission rates were similar in both groups (48% and 32% respectively), however females were less favorable to show rapid response (during the first 4 weeks). among responders no major differences in time to response has been found.

Conclusions

no major gender differences in response or remission rates have been found among patients receiving esketamine treatment for TRD aside from lower rates of rapid response. Additionally, Females report more severe dissociation during treatment.

Disclosure of Interest

None Declared
Resting-state fMRI markers of conversion to dementia in amnestic MCI: a pilot study
Authors: Abdullina E. , Panikratova Y. , Ponomareva E. , Roshchina I. , Selezneva N. , Lebedeva I. , Gavrilova S.
Published: August 2023

Introduction

Patients with amnestic mild cognitive impairment (aMCI) have a high risk of transition to Alzheimer’s disease. Analysis of potential biomarkers of conversion to dementia in this clinical group is crucial for prognosis and early intervention.

Objectives

The aim of the pilot study was to compare whole-brain functioning characteristics (fMRI, spontaneous activity and local coherence) in aMCI converters and non-converters to dementia.

Methods

Nine aMCI converters to dementia of the Alzheimer’s type (mean age 69.2 ± 8.2; 9 females) and ten aMCI non-converters (mean age 65.9 ± 6.1; 8 females) underwent resting-state fMRI (3T). All patients were followed up for three years. Baseline whole-brain amplitude of low-frequency fluctuations (ALFF) and local coherence (LCOR) were compared between groups (CONN-fMRI toolbox 19.с, https://web.conn-toolbox.org/; p < .001 voxelwise, p(FDR) < .05 clusterwise). Age was included in the analyses as a second-level covariate.

Results

As compared to non-converters, aMCI converters were characterized by higher ALFF and LCOR values in the cluster located in the frontal medial cortex and frontal pole bilaterally.

Conclusions

Frontal medial cortex and frontal pole are involved in a wide range of cognitive functions, including episodic memory and “hot” (motivational) executive control (Rolls. ProgNeurobiol 2022; 217; Friedman, Robbins. Neuropsychopharmacology 2022; 47(1) 72-89). Both increased and decreased LCOR/ALFF values in aMCI converters compared to non-converters were found, although in the other regions (Mondragón et al. Dement Geriatr Cogn Dis Extra 2021; 11(3) 235–249; Khatri, Kwon. Front Aging Neurosci. 2022; 14). It seems reasonable to clarify if the brain functional features revealed in our study are the markers of conversion to dementia in aMCI.

Disclosure of Interest

None Declared
Affective wellbeing moderates the association between polygenic risk score for neuroticism and change in neuroticism
Authors: Bahbouhová J. , Cade M. V. , De Sadeleer A. T. , Dibbets C. , Herrmann L.-Q. , Hovens P. O. F. , Jakson B. M. , Reising R. C. , Menne-Lothmann C. , Decoster J. , van Winkel R. , Collip D. , Delespaul P. , De Hert M. , Derom C. , Thiery E. , Jacobs N. , Wichers M. , van Os J. , Rutten B. P. F. , Gülöksüz S. , Klingenberg B.
Published: August 2023

Introduction

Neuroticism has societal, mental and physical health relevance, with an etiology involving genetic predisposition, psychological influence, and their interaction.

Objectives

To understand whether the association between polygenic risk score for neuroticism (PRS-N) and neuroticism is moderated by affective well-being.

Methods

Data were derived from TwinssCan, a general population twin cohort (age range=15-35 years, 478 monozygotic twins). Self-report questionnaires were used to measure well-being and neuroticism. PRS-N was trained from the Genetics of Personality Consortium (GPC) and United Kingdom Biobank (UKB). Multilevel mixed-effects models were used to test baseline and changes in well-being and neuroticism.

Results

Baseline wellbeing and neuroticism were associated (β=-1.35, p<0.001). PRSs-N were associated with baseline neuroticism (lowest p-value: 0.008 in GPC, 0.01 in UKB). In interaction models (PRS x wellbeing), GPC PRS-N (β=0.38, p=0.04) and UKB PRS-N (β=0.81, p<0.001) had significant interactions.

PRSs-N were associated with changes in neuroticism (lowest p-value: 0.03 in GPC, 0.3 in UKB). Furthermore, changes in wellbeing and neuroticism were associated (β =-0.66, p<0.001). In interaction models (PRS x change in wellbeing), only UKB PRS-N had a significant interaction (β=0.80, p<0.001).

Conclusions

Interaction between polygenic risk, wellbeing and neuroticism, were observed regarding baselines measures and change over time. Depending on the analysis step, the direction of the effect changed.

Disclosure of Interest

None Declared
Psychometric properties of the Greek translation of the Greek Short Dark Triad questionnaire (GSD3Q) in a subclinical sample
Authors: Lyrakos G. N. , Aslani E. , Spinaris V.
Published: August 2023

Introduction

‘Dark Triad’ is a constellation of three conceptually distinct but empirically overlapping personality variables. The three members- Machiavellianism, narcissism and subclinical psychopathy – often show differential correlates but share a common core of callous-manipulation.

Objectives

To validate an easy to use and valid measurement for subclinical populations examining the 3 factors of the dark triad of personality.

Methods

A pool of items designed to circumscribe the classic conceptions of the Dark Triad constructs used for the Short Dark Triad were translated using the multiple forward and backward translation protocol. Participants consisted of 391 adults recruited from social media. Participants were then asked to rate their agreement with each of the 44 items generated for the GSD3Q).

Results

391 adults participated, 51 (13%) male, 340 (87%) female mean age 41.4(SD=10.8). Corrected Item-Total Correlation was used for the first reduction of items and then PCA with eigenvalues >1.5 was used for the reduction of the items loading lower than 0. 400 for each factor independently. Finally, Principal Axis Factoring with Varimax rotation led to 9 items for Machiavellianism (alpha coefficient=0.659), 8 items for Narcissism (alpha coefficient=0.659) and 10 items for Psychopathy (alpha coefficient=0.742). Strong correlations were found as expected between the 3 factors with lower between Machiavellianism and Narcissism r=.487 p=0.001 and higher between Psychopath and Narcissism r=.617 p=0.001.

Conclusions

The results of the current validation led to a 27 item, with 3 factors questionnaire with similar psychometric properties for non-clinical populations. Further validation is needed for clinical samples.

Disclosure of Interest

None Declared
What does the immunometabolic status tell us about depression?
Authors: Lopez-Garcia P.
Published: August 2023

Despite being a clinical identifiable entity, major depressive disorder (MDD) is an heterogenous clinical syndrome, with a variety of clinical presentations which likely reflects different biological underpinnings. The identification of biologically-based depression symptoms profiles would be of great importance to unravel different pathophysiological pathways in MDD and therefore to achieve more precise and personalized therapeutical approaches as well as preventive strategies.

Converging evidence from epidemiological and clinical studies, points to the importance of inflammation in MDD, shown by increased levels of pro-inflammatory proteins and increased inflammation-related comorbidities, including metabolic diseases. In fact, there exists a bidirectional relationship between inflammation and metabolic dysfunction that could be linked to multiple factors, including life style, stress and genetic predisposition. MDD patients exhibit several metabolic disturbances such as overweight, insuline resistance and dyslipidemia, among others, which are not always fully explained by life style factors. These findings have led to the formulation of an immunometabolic hypothesis, which could be present in a subgroup of MDD patients, associated to specific symptoms and clinical features.

In this presentation, data reflecting the complex relationships and interactions between immune and metabolic disturbances in MDD will be shown. In particular, it will be shown how machine learning approaches can be useful to disentangle the clinical and biological heterogeneity of MDD, using immunometabolic biomarkers.

Disclosure of Interest

P. Lopez-Garcia Grant / Research support from: Grant from Carlos III Health Institute ref PI15/00204 and FEDER funding from the EU
Circadian rhythm disturbances in mood disorders: characterisation and clinical impact
Authors: Cappannini G. , Bianchi S. , Menculini G. , Semeraro B. , De Giorgi F. , Amantini K. , Moretti P. , Tortorella A. A. V.
Published: August 2023

Introduction

Circadian rhythms, defined as endogenous oscillations that regulate metabolism, physiology and behaviour, may be frequently disrupted in mood disorders, influencing their clinical presentation and course (Srinivasan V. et al. World J Biol Psychiatry. 2006;7(3):138-151).

Objectives

To characterise circadian rhythm disruptions in a population of patients with mood disorders, analysing clinical and course differences in subjects with and without clinically significant circadian rhythm alterations

Methods

Patients selected for this cross-sectional study were assessed with CGI-BP, HAM-D, MRS, and PANSS. Circadian rhythm disturbances were evaluated with BRIAN. Patients with clinically relevant circadian rhythm disturbances were defined as BRIAN > 36 (Mondin TC et al. J Psychiatr Res. 2017;84:98-104). Bivariate analyses were subsequently performed to compare subgroups of patients.

Results

In our study, 61 subjects with DD or DB were enrolled. The overall mean BRIAN test score was 40.08 ± 10.26. When comparing the BRIAN test scores, both total and subscales, between subjects with DB and DD, social rhythms were significantly more altered in subjects with DB (8.63 ± 2.90 VS 6.80 ± 2.11, p=0.034). Subjects with disruption of circadian rhythms displayed greater severity of depressive symptoms (mean total HAM-D test score 16.06±8.61 VS 8.94±5.85; p<0.003, mean CGI-BP severity of depression test score 3.14±1.68 VS 1.88±1.11; p<0.010) and with a longer duration of untreated illness (6.14±8.64 VS 2.53±6.28; p= 0.040).

Conclusions

Alterations in circadian rhythms should be routinely investigated in all individuals with mood disorders, especially BD, and may represent a transdiagnostic psychopathological construct that defines a more severe disease phenotype.

Disclosure of Interest

None Declared
Factors associated with poor medication adherence in patients with Bipolar Disorders
Authors: Jemli H. , Djelassi M. , Zgueb Y. , Zaibi R.
Published: August 2023

Introduction

Treatment adherence in patients living with Bipolar Disorders can influence prognosis and quality of life. It is associated with an increased morbidity and healthcare costs.

Objectives

The aim of our study was to evaluate treatment adherence in a sample of patients living with Bipolar disorders and to determine factors associated with poor adherence.

Methods

We conducted a cross sectional study where we included bipolar patients being treated in psychiatry department A. We developed a survey containing sociodemographic and clinical features. We used the medical adherence rating scale to evaluate treatment adherence.

Results

Our sample consisted of 100 patients with a mean age of 47,5 years old. Sixty seven patients were being treated for bipolar disorder type 1. Medication adherence rate was 64%.

Factors associated with poor medication adherence were being single, an early age of onset, comorbid substance abuse disorder, severe treatment side effects and poor insight.

Conclusions

Poor medication adherence is a major issue for people living with Bipolar Disorders. Clinicians should pay more attention to sociodemographic and clinical factors to predict and enhance treatment adherence.

Disclosure of Interest

None Declared
Exploring the role of lifetime brain maturation trajectories and their determinants in the onset of psychiatric disorders
Authors: Maggioni E.
Published: August 2023

Recently, the diffusion of sophisticated neuroimaging techniques has tremendously advanced our understanding of brain structure and function. Nevertheless, the current knowledge of the neurobiology of complex mental illnesses - like major psychoses and depression - is limited, hindering the development and validation of biomarkers for diagnosis, prognosis, and prediction of treatment response.

Increasing evidence is suggesting a crucial role of environmental, personal, and behavioral processes, interacting among themselves and with genetics, in shaping mental functioning and psychopathological risk. In this context, the study of brain maturation trajectories and of their association with genetic and environmental factors can provide key insights on the risk for the emergence of mental illnesses over lifetime.

The present lecture will provide an overview of our recent research on the brain underpinnings of psychotic and affective disorders onsetting during either adolescence/young adulthood or late adulthood. Evidence obtained from young samples of twins will be presented to provide useful information on the genetic and environmental determinants of physiological and pathological neurodevelopmental trajectories. The complex relationships among life events, brain morphology and connectivity, and psychopathology will be discussed by showing our recent findings on multicentric transdiagnostic samples of young adults and elders. Special focus will be given to the brain mechanisms affected by social stressors, including discrimination and bullyism, as well as chronic stress, and their possible role in facilitating the onset or in enhancing the severity of psychotic and affective disorders.

Disclosure of Interest

None Declared
Substance use disorders in bipolar patients with a painful expression
Authors: Chabert J. , Icick R. , Cabé J. , Patoz M.-C. , Moisset X. , Godin O. , Gard S. , Loftus J. , Aubin V. , Belzeaux R. , Dubertret C. , Lestrat Y. , Mazer N. , De Premorel A. , Roux P. , Polosan M. , Schwitzer T. , Aouizerate B. , Isabelle B. , Etain B. , Moirand R. , Olié E. , Haffen E. , Leboyer M. , Courtet P. , Llorca P.-M. , Brousse G. , Samalin L.
Published: August 2023

Introduction

Bipolar Disorder (BD) is a common psychiatric disease. It has been demonstrated a long time ago that bipolar patients are more painful than the healthy subjects. Substance use disorder is a frequent comorbidity in BD, but also in painful patients. The aim of our study was to analyze if bipolar patients with a painful expression have more substance use disorder than bipolar patients without pain.

Objectives

The aim of our study was to analyze if bipolar patients with a painful expression have more substance use disorder than bipolar patients without pain

Methods

We included all bipolar patients from the FACE-BD cohort which is a prospective cohort of French outpatients with BD enrolled at the 12 advanced Centers of Expertise in Bipolar Disorder (CEBD). Pain has been evaluated by the “pain item” of the EQ-5D scale and we divided subjects in four categories: “no pain”, “slight pain”, “moderate pain”, “severe or extreme pain”. A multivariate analysis was performed to identify differences between each pain’s groups according to the kind of substance use disorder, psychiatric comorbidities and clinicals data.

Results

The cohort enrolled 1897 bipolar patients, 970 had no pain (51.1%), 507 had slight pain (26.7%), 298 had moderate pain (15.7%) and 122 had severe or extreme pain (6.4%). We found significant differences according to age, comorbidities and clinicals data with older, more anxious, and more severe patients more represented in the more painful groups. Painful bipolar patients had also more frequently lifetime substance use disorders (alcohol, opioid, sedative, marijuana) and we were able to characterize different profiles in bipolar patients.

Conclusions

Bipolar patients with a painful expression had more risks to have a lifetime substance use disorder, an anxiety disorder, and a higher score on MADRS. Interestingly, subjects seemed to prefer substances with anxiolytic or antalgic effects during the acute intoxication as alcohol, marijuana, opioid and sedatives.

Disclosure of Interest

None Declared
Full-time hospitalization in child and adolescent psychiatry: an overlook of the Tunisian situation
Authors: Sahli L. , Abbes Z. , Halayem S. , Bouden A.
Published: August 2023

Introduction

Admissions in a child psychiatry unit can be voluntary or unvoluntary in some cases when the patient meets specific criteria.

Objectives

The aim of our study was to assess the frequency and trend over time of admissions of minors in the child psychiatry department in Razi Hospital between 2011 and 2019, and to examine the psychiatric diagnoses in involuntary admissions of minors.

Methods

We conducted a retrospective study of medical records of inpatients admitted to the hospitalization unit of the child psychiatry department in Razi Hospital in Tunisia between 2011 and 2019.

Results

Over the nine years, the total number of hospitalizations was 924. There is a slight female predominance over the total number of hospitalizations (sex ratio = 0.85). There was no consistent and significant change in the number of hospitalizations between 2011 and 2019. A growing increase in the number of compulsory hospitalizations was noted. From 2011 to 2019, the number of compulsory admissions increased from 03 in 2011 to 22 in 2019.

Regarding compulsory hospitalizations, admission requests came from child protection delegates, public prosecutors or family judges. Conduct disorder was found in 33.3% of the cases followed by a normal psychiatric examination in 11.8% of the cases. Mood disorders were found in 9.8% of the cases.

Conclusions

Our study shows the explosion in the number of compulsory hospitalizations despite a relatively stable total number of hospitalizations. More comprehensive guidance for legal authorities is needed regarding the compulsory admission of minors.

Disclosure of Interest

None Declared