bluuebunny/crossref_metadata_2025 huggingface dataset:
Characteristics of Single vs. Multiple Suicide Attempters Among Adult Population: A Systematic Review and Meta‑Analysis
Authors: Abascal-Peiró S. , Herrera-Sánchez J. , Izaguirre-Gamir L. , Aznar-Carboné J. , Alacreu-Crespo A. , Porras-Segovia A.
Published: August 2024

Introduction

Suicide is one of the leading causes of unnatural death worldwide. There might be meaningful differences between those individuals that attempt suicide once in their lifespan and those who make multiple attempts in terms of sociodemographic and clinical characteristics. There are no previous meta-analysis addressing this topic in the adult population.

Objectives

We aimed to examine the factors that differentiate single and multiple suicide attempters in adult population.

Methods

We followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines to conduct this review and meta-analysis. The review protocol was registered in PROSPERO. We carried out a systematic literature search in three databases to identify original studies that explored the differences between single and multiple suicide attempters among adult population. A total of 75 studies were included in the review and 69 were included in the meta-analysis.

Results

Multiple attempters were more likely to present certain disorders such as mood and psychotic disorders, as well as personality or substance use disorders. Higher suicide ideation and suicide intent scores also characterized this group. Childhood trauma experiences, stressful life events, and higher rates of hopelessness were statistically significant in multiple attempters.

Conclusions

Identifying the factors predicting multiple suicide attempts helps to delineate a high-risk suicidal profile that should be taken into account in the clinical and suicide prevention scenario.

Disclosure of Interest

None Declared
Traumatic symptoms and institutional support expectations among psychiatry residents dealing with patient suicide
Authors: Yaich I. , Ben Said C. , Ben Hamida T. , Bram N.
Published: August 2024

Introduction

Adult and child psychiatry residents encounter unique stressors in their training distinct from those in other medical specialties. Patient suicide has been identified as one of the most distressing experiences during psychiatric training.

Objectives

This study represents the first Tunisian investigation aiming to assess (1) the impact of patient suicide on psychiatry residents and (2) the limitations of the institutional support system in dealing with such cases.

Methods

A Google Forms questionnaire was distributed via email to all residents, gathering socio-demographic data, assessing traumatic impact using the PTSD Checklist for DSM-5 (PCL-5), and soliciting open-ended responses regarding personal experiences and expectations of the institutional support system.

Results

Fifty-three residents participated in the study. Among them, 29 residents had encountered patient suicide, with 12 directly involved. Symptoms of PTSD were detected in three residents. The physician directly involved in treating the suicidal patient reported the highest PCL-5 score. The majority of residents (27 out of 29) expressed the need for a structured support and training program tailored to healthcare professionals dealing with suicide.

Conclusions

The findings suggest that psychiatric residents may require additional training and support to effectively address the complex issue of patient suicide. Implementing specific training programs could significantly enhance their ability to manage such situations.

Disclosure of Interest

None Declared
From legislation to reality: Understanding gender-based violence in Tunisia
Authors: Mahfoudh K. , Hamzaoui S. , Walha S. , Mezri D. , Ouertani A. , Ouali U. , Aissa A. , Jomli R.
Published: August 2024

Introduction

Tunisia marked a significant milestone in the fight against gender-based violence with the adoption of Organic Law No. 2017-58. This pioneering law in the region enhanced the protection of women and girls’ rights and introduced harsher penalties for perpetrators of sexist violence. However, the journey toward eradicating violence against women is complex and multifaceted.

Objectives

Our aim is to explore how tunisian women perceive gender-based violence and their attitudes towards it.

Methods

A cross sectional online survey designed using Google Forms and distributed on social media platforms (Facebook, Instagram) was conducted from August 30th to September 25th 2023. The questionnaire, presented in the tunisian dialect, included questions about personal experiences with violence, knowledge of gender-based violence laws as well as their perceptions and attitudes towards gender-based violence. The sample consisted of women from various regions of Tunisia.

Results

In our study, we analyzed a sample comprising 110 tunisian women, with 46.4% falling within the 20 to 30 age bracket and 36.4% belonging to the 30 to 40 age range. Half of the survey participants were unmarried, and the majority of them (97.3%) had attained a university-level education.

Our research revealed that 45.5% of the surveyed women reported instances of gender-based violence in Tunisia. However, only a minority of these individuals (22.2%) initiated legal proceedings, primarily citing a lack of confidence in the judicial system and fear of potential reprisals as their reasons.

A majority of the participating women expressed deep concern regarding the issue of violence against women in Tunisia.

When asked about their perceptions of the most prevalent types of violence in Tunisia, 76.36% believed that psychological violence was the most common, followed by sexual violence (21.3%). Economic and physical violence were perceived as less frequent (9.9%; 12.6%). These women attributed the primary factors contributing to violence against women in Tunisia to cultural norms and laws that they considered inadequately stringent. Indeed, 83.3% of them believed that the current legislation was not stringent enough to deter potential perpetrators, and 37.3% indicated that they were unaware of the existing legal framework.

Conclusions

Despite legislative advancements, gender-based violence remains a pressing concern in Tunisia. These findings underscore the importance of increasing awareness about available resources for victims, educating individuals about women’s rights and mental health, and building trust in the judicial system.

Disclosure of Interest

None Declared
Pros and cons of alternative therapy omega-3 fatty acids during pregnancy and lactation for mental problems
Authors: Boronin L. , Nastas I.
Published: August 2024

Introduction

Fatty acids omega-3 are irreplaceable. They stabilize cell membranes, nerve impulses, homeostasis, immune reactions, the birth process, the psycho-emotional state of the fetus-mother dyad. Correlations between adequate dietary intake of omega-3 and cognitive health have been described in detail. According to the literature, docosahexaenoic acid is associated with the synthesis of serotonin, dopamine, acetylcholine, glutamate, neuroprotective and anti-apoptotic action, has antidepressant effect. Omega-3 makes up 60% of neuronal membrane phospholipids. Under clinical aspect,according to publications, fish oil reduces the risk of preterm birth by 44%.

Objectives

The aim is to study the risks and benefits of using omega-3 during pregnancy and lactation in patients with mental disorders.

Methods

Comparative analysis of evidence-based scientific publications for the use of omega-3 fatty acids in pregnancy and lactation.

Results

The body level of omega-3 depends on the quantitative intake from food, as well as gene polymorphism and age. For pregnant and lactating women are recommended 200-300 mg per day or about 300 g per week from food. Deficiency of omega-3 (protectins) affects the processes of myelination, neurogenesis, synaptogenesis, the metabolism of neurotransmitters, cell differentiation, neuronal migration and inflammatory responses.

Conclusions

There are many probably mechanisms of action of omega-3, namely: Enhances peroxisomal oxidation, reduces the synthesis of triglycerides in the liver; inhibits plasma acyltransfrerase. Omega-3 acts on phospholipids of the cell membranes of the nervous system and retina, their adequate functioning, improve psychomotor development of newborns. It was found the effect of decreasing the levels of cytokines and depressive symptoms, as well the risk of food allergies and depression. In conclusion, in adequate doses, omega-3 fatty acids seems to be useful in deficiencies and for prophylactic purposes in pregnancy and lactation.

Keywords

omega- 3 fatty acids, pregnancy, lactation, mental disorders.

Disclosure of Interest

None Declared
What link between violence against women and self-esteem?
Authors: Abdelkefi M. , Feki R. , Turki A. , Gassara I. , Smaoui N. , Omri S. , Charfi N. , Zouari L. , Ben Thabet J. , Maalej Bouali M. , Maalej M.
Published: August 2024

Introduction

Violence against women is a public health problem worldwide and a violation of human rights. It affects women’s lives due to its potential short-, medium- or long-term physical and psychological consequences.

Objectives

The aim of our study is to explore the link between violence against women and self-esteem.

Methods

A descriptive cross-sectional study was conducted from March to August 2023 among Tunisian women consulting in three health care centers in Sfax, Tunisia. We have included women victims of violence (psychological, physical, sexual, and economic). We have used a semi-structured interview and the Rosenberg scale to determine the quality of self-esteem.

Results

Among one hundred interviewed women, fifty-four women who had reported being violence victims were included in our study. The mean age of the participants was 44 years with the majority being married (87 %). Only 29.6% had a high school level and 51.9% had a profession. A total of 29.6% had a low socioeconomic status.

We found that 79.6% are victims of domestic violence (57.4% being victims of spousal violence). Psychological violence seemed to be the most frequent type (59.3%).

Almost all those who were abused (90.6%) experienced psychological (emotional) violence.

The mean score of the Rosenberg self-esteem scale was 31.54.

Self-esteem was very low in 16.7%, low in 37%, medium in 18.5%, and high in 27.8% of the women.

A statistically significant association was found between being a victim of spousal violence and low self-esteem (p=0.032). The semi-structured interview demonstrates that women with low self-esteem are more likely to accept violence.

Conclusions

These results justify the implementation of screening and support programs for women victims of violence to improve their self-esteem.

Disclosure of Interest

None Declared
Differences in the perception of stigma in schizophrenia between men and women: a brief qualitative approach
Authors: Andres-Olivera P. , Arribas-Simon B. , Alvarez E. D. , Bote B. , Martin-Gomez C. , Payo C. , Munaiz C. , Brito R. , Ligero-Argudo M.
Published: August 2024

Introduction

Men and women with psychosis have different courses and presentations of symptoms. Men with psychosis have an earlier onset of illness, more negative symptoms, and worse premorbid functioning. Women, on the other hand, have better social functioning and less substance abuse. Despite these evident differences, there are few studies that delve into these distinctions, especially from a subjective perspective.

Objectives

The aim of this study is to understand the differences in the perception of psychosis between men and women.

Methods

Five women and five men diagnosed with schizophrenia participated in the study. They were matched so that the age difference between them was no more than 5 years, with ages ranging from 40 to 56 years. Participants had not experienced acute decompensation of their underlying illness and had not required admission to an Acute Care Unit in the 6 months prior to inclusion in the study. Data collection was conducted through the Spanish translation of the Indiana Psychiatric Illness Interview, consisting of five parts: a narrative about their life, a narrative about the illness, questions related to how the illness has changed their life and what has not changed, the overall influence of the illness on their life, and lastly, expectations for the future.

Results

Men expressed more concerns about work (4 men versus 2 women), while women expressed more concerns about not having become mothers (3 out of 5 women, compared to one man). All participants shared experiences of isolation in intimate relationships, including romantic relationships. Regarding stigma, three women believed that people treated them like children and dismissed their opinions. However, two of them viewed this behavior from their loved ones positively. Two women discussed the impact that psychosis and medications had on their bodies and how others had reacted to these changes

Conclusions

The concerns and stigma associated with mental illness differ between genders. These differences should be taken into account when developing specific biopsychosocial treatment plans.

Disclosure of Interest

None Declared
Postpartum Depression: Plaguing the Joy of New Mothers
Authors: Sonkar G. , Sonkar M.
Published: August 2024

Introduction

Depression is a significant global mental health problem and is very common compared to how it is perceived. In 2020 alone, 264 million people globally suffered from depression and its different forms as per the World Health Organisation. It is a leading cause of disability in individuals, affecting their ability to perform their daily chores, work, study, and even maintain relationships. The impact of depression is deeper and affects families, the economy, health care systems, and so on.

In India, the problem is grave and leads to serious consequences, thanks to the stigma and unawareness attached to mental health disorders. It is estimated that India has one of the highest rates of depression in the world, but it is hardly acknowledged.

Post-Partum Depression (PPD) is the most neglected and unreported subtype of depression in India. Globally, 1 in every 7 women suffers from Post Partum Depression. India is such a diverse country in terms of prevalence varies from 15% to 25% based on region, population, cultural and social expectations, economic status, living standard, climate factors, and others.

Objectives

The objective of the study is to spread awareness, identify the risk factors, root cause analysis of risk factors, possible solutions, and treatments.

Methods

This study is conducted to capture the awareness level of PPD in females across different ages, regions, income classes, cultures, working statuses, and societies. This is carried out using a detailed yet anonymous survey, it captures the demography, knowledge of signs and symptoms of PPD, personal experiences, attitudes, expected support for PPD, and awareness of possible healthcare options. The result of the study tries to understand and conclude the most common risk factors, groups at highest risk, a root cause analysis of the risk factors, and possible solutions and treatments.

Results

PPD occurs in the postnatal period, typically within the first year after childbirth. This condition can have a significant impact on the new mother and the infant’s well-being. The mother’s ability to take care of the child and herself is hugely impacted, impacting the child’s development and family dynamics negatively. Pushing to the limits, certain communities that believe in superstition and taboo often take PPD as an excuse to blame the mother resulting in the extremities like suicides.

Conclusions

PPD occurs in the postnatal period, typically within the first year after childbirth. This condition can have a significant impact on the new mother and the infant’s well-being. The mother’s ability to take care of the child and herself is hugely impacted, impacting the child’s development and family dynamics negatively. Pushing to the limits, certain communities that believe in superstition and taboo often take PPD as an excuse to blame the mother resulting in the extremities like suicides.

Disclosure of Interest

None Declared
Dissociative Identity Unveiled: A Case Report of 17 Distinct Identities Emerging in a Clear Timeline Following Trauma Events
Authors: Li J. , Childs N. M. , Raai H.
Published: August 2024

Introduction

Dissociative Identity Disorder (DID) is a complex and enigmatic mental disorder in which an individual maintains two or more distinct identities or personality states. We present a rare and captivating case report of a 27-year-old female patient who exhibited a remarkable 17 distinct identities, developed in a clear and unprecedented timeline following a series of specific traumatic events. The novelty of this case lies in the comprehensive documentation and analysis of the sequential emergence of these identities, offering valuable insights into the development and progression of DID.

Objectives

Our aim in presenting this case study is to offer a unique presentation to the constantly evolving understanding of DID. This case offers insight and provokes the need for research into the traumagenic nature of DID. This case showcases the influence on the chronological evolution of the patient’s 17 identities following a multitude of traumatic events.

Methods

Structured interviews, psychiatric assessments, and psychological measurements, including self-reported measures of the Dissociative Experiences Scale, were employed to assess the identities and their individual experiences of the traumatic events. The patient was diagnosed with DID and received treatment including pharmacotherapy, psychoeducation, and trauma-focused psychotherapy. As a result of the therapeutic process, the patient was able to develop a higher sense of self-awareness and thus was able to integrate their 17 fragmented identities into a single host identity, demonstrating improvement in the functioning of interpersonal relationships.

Results

The patient’s history reveals that the onset of her DID was linked to a traumatic event that occurred during early childhood, triggering the emergence of her first alternate identity. Over time, additional identities manifested, each appearing to serve as a coping mechanism to contend with the psychological distress stemming from subsequent significant trauma episodes. This case report meticulously outlines the chronological development of these identities and explores the distinct characteristics, behaviors, and roles assumed by each personality.

Conclusions

This case report offers valuable information on the complex development and pathogenesis of DID with a trauma influence. The presentation of this patient may lead to further research and more tailored therapeutic interventions for individuals suffering from DID.

Disclosure of Interest

None Declared
Exploration of dreams in Charaka Samhita – an Ayurveda text and their content analysis of prodromal dreams in various conditions
Authors: Iyer A. K. , Upadhyaya W.
Published: August 2024

Introduction

Research into dreams, have shown the association between increased frequency of distressing dreams, specific content themes (analysed using the Hall Van de Castle system) and greater incidence of progression of neurological conditions and dementia. The history of predicting illnesses by the content of dreams, in the western world is popularly traced backed to the ancient Greek medicine. This stimulates the curiosity if any such practices existed in the ancient medical practises of the eastern world. Ayurveda is one such traditional system of medicine, that is native to the Indian subcontinent. Charaka Samhita is one of the oldest texts on Ayurveda consisting of 8 sections and 120 chapters totally. This text was selected for the purpose of this review, with the line of enquiry such as what does Ayurveda say about dreams associated with illnesses? What are the contents of such dreams? Furthermore, the dream content analysis was done using the Hall Van de Castle system, which is probably the first time being done on an Ayurveda text content.

Objectives

1) To explore if, Charaka Samhita mentions, describes dreams in relation to illnesses, stages of illnesses and their prognosis. 2) To analyse content of the dreams seen in prodromal stage of illnesses.

Methods

1-The Charaka Samhita text was scanned chapter by chapter, to answer the questions- a) What are the types of dreams? b) Are any associated with illnesses? c)Are any dreams mentioned in the prodromal stage of illnesses? d)What do they imply? e)What are their contents? 2-
The contents of prodromal dreams were analysed against the categories of Hall Van de Castle system.

Results

As per Charaka Samhita, the types of dreams are, i) those based on what was seen ii) heard iii) reflected upon iv) desired v) imagined vi) those of prophetic type and vii) those caused by illnesses. Specific dreams in the prodromal stage, predict manifestation of specific illnesses (mild or fatal). In the diverse dream contents (18 themes mentioned) ranging from things animals to gods and demons, except the elements of the past, rest of the general categories occur, at least once. The categories characters, objects, activities and social interactions were more common than the rest.

Conclusions

Thus akin to the ancient Greek medicine, Ayurveda too had the practice of predicting illnesses based on the dream contents.

Disclosure of Interest

None Declared
Updating the WHO Model Lists of Essential Medicines to promote global access to the most cost-effective and safe medicines for mental disorders
Authors: Papola D. , Ostuzzi G. , Gastaldon C. , Barbui C.
Published: August 2024

Introduction

Since its first publication in 1977, the World Health Organization’s (WHO) Model List of Essential Medicines (EML) has guided the national procurement of medicines deemed essential to inform public health policy worldwide. Aiming to include the most effective, safe, and cost-effective medicines for priority conditions, WHO updates the EML every two years. However, over the past 45 years, updates to the mental health section of the EML have been infrequent, mostly involving the addition of individual medicines. A comprehensive revision of the entire section was never attempted.

Objectives

The aim of this project was to update the mental health section of the EML to identify the most effective and safest medicines for mental disorders in the light of the most up-to-date evidence base.

Methods

A series of nine evidence-based applications were submitted to the WHO Expert Committee on the Selection and Use of Essential Medicines in December 2022, recommending a substantial revision of the entire mental health section.

Results

All of our applications were accepted by the WHO Expert Committee. For psychotic disorders, aripiprazole, olanzapine, paliperidone, and quetiapine were added as therapeutic alternatives to risperidone; short-acting intramuscular chlorpromazine was replaced by short-acting intramuscular olanzapine; first-generation antipsychotics were limited to oral haloperidol and chlorpromazine. For bipolar disorder, the list now includes second-generation antipsychotics such as quetiapine, aripiprazole, olanzapine, and paliperidone. Tricyclic antidepressants for depressive disorders were limited to amitriptyline alone. Treatment options for anxiety and obsessive-compulsive disorder are now expanded to include SSRIs. For anxiety disorders, diazepam and lorazepam became the only benzodiazepines recommended, with the specific caveat that they should only be used for short-term emergency treatment of acute and severe anxiety symptoms. Finally, chlorpromazine and haloperidol are no longer considered essential medications for psychotic disorders in children under 13 years of age.

Conclusions

The WHO released the 23rd EML in July 2023. After decades of minimal and inconsistent updates, groundbreaking changes have been made to its mental health section. The updated mental health section provides a compelling opportunity to improve the quality of medicine selection at the country level, with the goal of increasing the availability of the safest and most effective psychotropic medicines worldwide.

Disclosure of Interest

None Declared
A Meta-Analysis of fMRI Activation Studies of Ketamine in Healthy Participants
Authors: Shepherd J. H. , Hickman A. , Baten C. , Klassen A. M. , Zamora G. , Johnson-Venegas E. , Madugula S. S. , Woo E. , Miller J. A. , Sacchet M. D. , Hedges D. W. , Miller C. H.
Published: August 2024

Introduction

There has been rapidly growing interest in understanding the pharmaceutical and clinical properties of psychedelic and dissociative drugs, with a particular focus on ketamine. This compound, long known for its anesthetic and dissociative properties, has garnered attention due to its potential to rapidly alleviate symptoms of depression, especially in individuals with treatment-resistant depression (TRD) or acute suicidal ideation or behavior. However, while ketamine’s psychopharmacological effects are increasingly well-documented, the specific patterns of its neural impact remain a subject of exploration and basic questions remain about its effects on functional activation in both clinical and healthy populations.

Objectives

This meta-analysis seeks to contribute to the evolving landscape of neuroscience research on dissociative drugs such as ketamine by comprehensively examining the effects of acute ketamine administration on neural activation, as measured by functional magnetic resonance imaging (fMRI), in healthy participants.

Methods

We conducted a meta-analysis of existing fMRI activation studies of ketamine using multilevel kernel density analysis (MKDA). Following a comprehensive PubMed search, we quantitatively synthesized all published primary fMRI whole-brain activation studies of the effects of ketamine in healthy subjects with no overlapping samples (N=18). This approach also incorporated ensemble thresholding (α=0.05-0.0001) to minimize cluster-size detection bias and Monte Carlo simulations to correct for multiple comparisons.

Results

Our meta-analysis revealed statistically significant (p<0.05-0.0001; FWE-corrected) alterations in neural activation in multiple cortical and subcortical regions following the administration of ketamine to healthy participants (N=306).

Conclusions

These results offer valuable insights into the functional neuroanatomical effects caused by acute ketamine administration. These findings may also inform development of therapeutic applications of ketamine for various psychiatric and neurological conditions. Future studies should investigate the neural effects of ketamine administration, including both short-term and long-term effects, in clinical populations and their relation to clinical and functional improvements.

Disclosure of Interest

None Declared
A longitudinal study of child and adolescent psychopathology in conditions of the war in Ukraine
Authors: Skrypnyk T. , Martsenkovsky I. , Martsenkovska I.
Published: August 2024

Introduction

According to UNICEF, 2 million children have left the country since the beginning of the war. 2.5 million Ukrainian children are internally displaced persons. Minors often become victims or witnesses of violence.

The events of 2022-2023 are the largest military conflict in the world since World War II. The impact on the mental health of the population is characterized by the variety and mass of traumatizing factors.

Mental trauma causes PTSD, depressive disorders (DD), anxiety disorders (AD), behavioral disorders (CD), attention deficit hyperactivity disorder (ADHD).

Objectives

The aim of the study was to determine the prevalence of PTSD and its comorbidities at different stages of experiencing a traumatic experience.

Methods

785 teen`s displaced from the zone of military operations, occupied territories were surveyed. Examinations included: K-SADS-PL, PSC-17, SCARED, CATS. 260 teen`s were examined during - 6, 400 – 6–12 months after traumatization.

Results

After 6 months of trauma, PTSD was diagnosed in 9.8%, ADHD – 10.2%, DD-22.3%, AD-30.8%, CD – 15.4%, 28.8%; examined 6 to 12 months after the injury, respectively: 21.9%, 12.6, 33.3%, 11.5%, 18.0%.

Conclusions

In war-affected children, PTSD is a risk factor for the subsequent development of comorbid depression, anxiety, conduct disorders, and ADHD. Female sex, secondary traumatization after displacement increase the risk of developing depression, signs of pervasive development and ADHD - the risk of destructive and self-injurious behavior. The prevalence of PTSD, DD, ADHD increases within 6-12 months after the trauma, the sensitivity of children with PTSD to secondary traumatic events increases.

Disclosure of Interest

None Declared
An Umbrella Review of Effectiveness of Intravenous Ketamine in Treatment-Resistant Depression
Authors: Klassen A. M. , Baten C. , Shepherd J. H. , Zamora G. , Johnson-Venegas E. , Madugula S. S. , Woo E. , Miller J. A. , Sacchet M. D. , Hedges D. W. , Miller C. H.
Published: August 2024

Introduction

Major depressive disorder (MDD) is a tremendous global disease burden and the leading cause of disability worldwide. Unfortunately, individuals diagnosed with MDD typically experience a delayed response to traditional antidepressants and many do not adequately respond to pharmacotherapy, even after multiple trials. The critical need for novel antidepressant treatments has led to a recent resurgence in the clinical application of psychedelics, and intravenous ketamine, which has been investigated as a rapid-acting treatment for treatment resistant depression (TRD) as well acute suicidal ideation and behavior. However, variations in the type and quality of experimental design as well as a range of treatment outcomes in clinical trials of ketamine make interpretation of this large body of literature challenging.

Objectives

This umbrella review aims to advance our understanding of the effectiveness of intravenous ketamine as a pharmacotherapy for TRD by providing a systematic, quantitative, large-scale synthesis of the empirical literature.

Methods

We performed a comprehensive PubMed search for peer-reviewed meta-analyses of primary studies of intravenous ketamine used in the treatment of TRD. Meta-analysis and primary studies were then screened by two independent coding teams according to pre-established inclusion criteria as well as PRISMA and METRICS guidelines. We then employed metaumbrella, a statistical package developed in R, to perform effect size calculations and conversions as well as statistical tests.

Results

In a large-scale analysis of 1,182 participants across 51 primary studies, repeated-dose administration of intravenous ketamine demonstrated statistically significant effects (p<0.05) compared to placebo-controlled as well as other experimental conditions in patients with TRD, as measured by standardized clinician-administered and self-report depression symptom severity scales.

Conclusions

This study provides large-scale, quantitative support for the effectiveness of intravenous, repeated-dose ketamine as a therapy for TRD and a report of the relative effectiveness of several treatment parameters across a large and rapidly growing literature. Future investigations should use similar analytic tools to examine evidence-stratified conditions and the comparative effectiveness of other routes of administration and treatment schedules as well as the moderating influence of other clinical and demographic variables on the effectiveness of ketamine on TRD and suicidal ideation and behavior.

Disclosure of Interest

None Declared
Evaluation of Psychiatric High and Intensive Care (EPHIC-study): monitoring innovative care from a value-based approach
Authors: Demunter H. , Jossa H. , Vandenhout K. , Claes S. , Bruffaerts R.
Published: August 2024

Introduction

Systematic monitoring and evaluation of innovative healthcare programs are essential to develop sustainable solutions to health needs in the population (Porter & Teisberg, 2006). Development of Psychiatric High and Intensive Care Units (HIC’s) in Belgium, following the Dutch Model (van Mierlo et al., 2013), is an innovative model for patients with acute and severe psychiatric illness, resulting in potential danger. HIC aims to provide intensive, need-adapted care with interventions that reduce (perceived) coercion, focusing on participative processes and continuity of care.

Objectives

(1) What are the clinical characteristics of admitted patients? (2) How does clinical symptomatology evolve during admission? (3) How do patients, relatives and caregivers experience the process of care and recovery? (4) What is the role of HIC’s in the reformed mental health care?

Methods

This is an explorative, hypothesis-generating study, using a mixed-method approach, consisting of qualitative and quantitative methods against a value-based framework. Data collection lasted 18 months in the first 9 HIC’s in Belgium. Results are based on validated questionnaires completed by adult patients and their HIC caregivers at admission and discharge (N=472).

Results

We provide the first, preliminary results. Suicidality, psychotic and substance-related symptoms are the most important primary symptoms. Almost 70% have 2 or more symptoms, with psychiatric comorbidity of 50%. Substance-related- and psychotic disorders are the two most common diagnoses, followed by personality disorder cluster B and depressive disorder. 83% have been in residential care in the past, of whom 87% twice or more. The median age is 36 years, but the median age of onset of mental disorders is 21 years, which equals to 15 years in mental disorder progress and comorbidity development. Over 50% meet the criteria for Severe Mental Illness and 56% are involuntary admitted. There is a high degree of unmet needs: no outpatient care is provided for one out of five prior to admission and there is a low follow-up by mobile teams prior to and after admission (around 12% each). We found significant improvements after an average stay of 22 days for aggression, suicidality and crisis (respectively decrease of 68%, 25% and 9%); readiness to change and motivation for treatment (respectively increase of 5% and 14%) The Client Satisfaction Questionnaire scores range from 1 to 4, with an average score 3.15 out of 4.

Conclusions

Based on these preliminary results we can conclude that aggression, suicidality, crisis, readiness to change and motivation for treatment all improve significantly after a short stay of 3 weeks. Despite a vulnerable, severely distressed population, patients are generally satisfied with received care. There is a high degree of unmet needs: insufficient provided outpatient care and low follow up by mobile teams.

Disclosure of Interest

None Declared
Opioid Use Disorder in Three Samples of the Lebanese Population: Correlation with Clinical and Genetic Factors
Authors: Chamoun K. , Hajj Moussa Lteif F. , Salameh P. , Sacre H. , Haddad R. , Rabbaa L. , Megarbane B. , Hajj A.
Published: August 2024

Introduction

Opioid Use Disorder (OUD) is a severe and recurrent condition that contributes to a global prevalence of disabilities. Accumulating evidence suggests a potential convergence of clinical and genetic factors underlying OUD.

Objectives

This study explores the clinical and genetic factors associated with OUD in the Lebanese population.

Methods

A cross-sectional study in the Lebanese population included three different groups of participants stratified according to the cut-off of the revised Opioid Risk Tool (ORT-OUD): (1) Low-risk group for OUD (n=513; general population; ORT-OUD score <2.5); (2) High-risk group for OUD (n=87; general population; ORT-OUD score ≥3); (3) a third group consisting of patients clinically diagnosed with OUD according to the DSM-5 (n=46). The survey included sociodemographic information and used validated scales to assess other substance use disorders, sleep disturbances, depression, and anxiety. Genotyping for the COMT, MTHFR, and CRY2 genes was conducted for 91 patients using a real-time PCR (Roche®). Bivariate and multivariate analyses were conducted to identify the associations between OUD risk and sociodemographic, clinical, and genetic factors.

Results

This study enrolled 646 participants. Multivariate analysis showed significant associations between risk of developing an OUD and cigarette smoking (B=0.583), worse insomnia scores (B=0.074) and Alcohol, Smoking and Substance Involvement Screening Test-alcohol (B=0.053) scores, male gender (B=13.351), lack of education (B=4.159), unemployment (B=7.235), low income (B=11.285), lack of healthcare coverage (B=4.190), neuropsychiatric disorders (B=7.966). Conversely, OUD risk was negatively correlated with the morning chronotype (B=-0.372). Bivariate analysis showed that the CRY2 AA genotype was significantly associated with a higher risk of OUD; nevertheless, none of the genetic factors remained significant in the multivariable model.

Conclusions

This study identified several sociodemographic, clinical, and genetic factors that could potentially increase the risk of developing OUD in the Lebanese population. Further research is needed to clarify risk factors and underlying mechanisms, enabling the development of more effective prevention strategies.

Disclosure of Interest

None Declared
Extent of substance abuse among patients with psychiatric disorders in Amman, Jordan
Authors: Abbasi L. N. , Daradkeh T. K. , ElWasify M. , Abassy S.
Published: August 2024

Introduction

The issue of substance abuse is increasingly being recogniszed as a significant global public health concern. In relation to its influence on the Arab world, scholarly investigation continues to be regarded as relatively constrained in scope.

Objectives

The primary goal of the present study was to investigate the extent of substance abuse in a sample of patients with psychiatric disorders who attended a psychiatric clinic in Amman and analyse this in relation to demographic and clinical variables.

Methods

In this prospective study, we investigated the prevalence, sociodemographic, and clinical characteristics of substance abuse among patients with psychiatric disorders who attended an outpatient private psychiatric clinic in Amman, Jordan between January and May 2023. Overall, 671 patients were enrolled. We compared demographic and clinical parameters of drug abuse and non-drug abuse patients.

Results

Among the 671 patients included in the study, 48.0% (n=322) reported substance use, while 52.0% (n=349) did not. The mean age of the patients was 32.45±10.18 years. The sample included 546 male patients (81.4%). Among the participants, 388 (57.8%) were single, 360 (53.7%) held a bachelor’s degree or higher, 394 (58.7%) were employed, and 545 (81.2%) lived with their families. 506 (75.4%) were smokers, 110 (16.4%) reported having a medical illness, and 25% reported engaging in self-harm. The most prevalent psychiatric diagnosis was major depressive disorder, accounting for 30.6% of cases, followed by anxiety disorders. Additionally, 148 patients (22.1%) reported emotional abuse, 40 (6.0%) reported physical abuse, 57 (8.8%) reported sexual abuse, and 47 (7.0%) had a family history of substance use.

Conclusions

Our research findings indicate that substance abuse is more prevalent among certain demographic groups, specifically young, unemployed, male patients with a low level of education and a family history of substance use. These findings highlight the need for further research in diverse settings and populations to better understand the scope and underlying factors contributing to substance abuse in Arab countries. Additionally, targeted interventions and prevention strategies should be developed to address the specific needs of these high-risk groups and reduce the burden of substance abuse in these communities.

Disclosure of Interest

None Declared
Descriptive study of adolescents hospitalized in the Psychiatric Unit of a hospital in Madrid, Spain
Authors: Del Sol Calderon P. , Izquierdo de la Puente A. , Fernández R. , García Moreno M. , Mallol L. , Palanca I.
Published: August 2024

Introduction

An increase in suicidal behavior among the adolescent population is reflected in the literature and in clinical practice. According to a study of suicidal behavior and mental health by the Spanish ANAR Foundation, the number of cases with suicidal behavior has experienced an accentuated growth in the period 2012-2022 (1,921.3%), highlighting the increase produced in the post-COVID-19 period, between 2020 and 2022 (128%)

Objectives

To analyze the reasons for admission to the short hospitalization unit. To describe the sociodemographic characteristics of hospitalized adolescents.

Methods

Descriptive observational study of the sample of adolescents admitted to the inpatient psychiatric unit of the Hospital Universitario Puerta de Hierro between January 1, 2023 and June 30, 2023. It is carried out through the information obtained in the clinical history of the patients.

Results

During this period of time 113 adolescents were admitted, 80.2% were female. The mean age was 15.16 years. The main reason for admission was autolytic ideation, occurring in 33.3% of the patients. The second most frequent reason for admission was suicide attempt (29.7%) and behavioral disturbance (17.1%) was the third most frequent. Of the methods used in suicide attempts, drug overeating stands out among the methods used in suicide attempts. (75.8%), followed by attempted hanging (12.1%) or cutting (12.1%).

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Conclusions

The results corroborate what is reported in the scientific literature, where self-harm and self-injury attempts have increased and are the most frequent reasons for admission. This shows that suicide is a public health problem of the first order, where prevention and early intervention programs are necessary.

Disclosure of Interest

None Declared
Sleep quality mediates the relationship between problematic social media use and attention-deficit/hyperactivity symptoms
Authors: Paulina L. R. , Csejtei I. , Miklósi M.
Published: August 2024

Introduction

Commencing in 2019, the onset of the COVID-19 pandemic prompted an upsurge in online engagement, drawing attention to the advantages and perils associated with the use of social media. Existing research emphasizes that elevated symptom levels of attention deficit/hyperactivity disorder (ADHD) are linked not to the extent (time) of usage but to its addictive nature. However, scant research has explored its relationship with sleep quality.

Objectives

In this study, we scrutinized the correlation between problematic social media usage, sleep quality, and ADHD symptoms in a non-clinical sample of young individuals during the third wave of the pandemic.

Methods

We administered an online survey to 139 participants (mean age: 21.37 years, standard deviation: 2.68 years, range: 15-27). The survey encompassed various assessments, including the Bergen Social Media Addiction Scale (BSMAS), the Athens Insomnia Scale (AIS), and the self-report version of the SWAN scale (Strengths and Weaknesses of ADHD Symptoms and Normal Behavior). Participants also reported on the extent of their social media use.

Results

Significant distinctions emerged in the extent of social media usage between online (M=3.12; SD=1.08) and in-person educational settings (M=2.47; SD=0.78) (t(73)=6.01; p<0.001; d=0.70). While ADHD symptom levels exhibited no correlation with the extent of social media engagement, they did exhibit a significant positive correlation with problematic usage (r=0.32; p<0.001). Likewise, the extent of social media usage displayed no correlation with sleep quality; however, problematic usage was linked to poorer sleep quality (r=0.27; p=0.002). In our mediation analysis, problematic usage correlated both directly (c’=-0.61; p=0.02) and indirectly (ab=-0.36; 95% CI: -0.60 - -0.10) with heightened ADHD symptoms through diminished sleep quality (F(1,120)=21.94; p<0.001; R2=0.27).

Conclusions

Our findings affirm that it is not the extent but rather the problematic nature of social media usage that assumes significance. Moreover, our results propose that problematic usage may exacerbate ADHD symptoms, not only directly but also by influencing sleep quality.

Disclosure of Interest

None Declared
Clinical suitability of intranasal delivery of M2 macrophage soluble factors in patients with post-COVID olfactory disorders
Authors: Markova E. , Shevela E. , Davydova M. , Meledina I. , Ostanin A. , Kozlov V. , Chernykh E.
Published: August 2024

Introduction

SARS-CoV virus showed transneuronal penetration through the olfactory bulb resulting in the rapid intracranial spread. So, olfactory dysfunction is an early marker of COVID-19 infection. However, individuals may develop chronic olfactory impairment for more than six months in 1–10% of cases.

Objectives

The study’s objective was to evaluate the efficacy and safety of intranasal immunotherapy using bioactive substances produced by M2 macrophages for the treatment of people with long-term post-COVID-19 hyposmia.

Methods

Seven individuals with long-term persistent hyposmia (7 to 24 months), associated with PCR-confirmed coronavirus infection were evaluated for olfactory function at baseline, one, and six to twelve months after therapy.

Results

The intranasal inhalation of M2 macrophage conditioned medium (one time per day for 28-30 days) was well tolerated. Furthermore, olfactometry demonstrated that the patients restored their capacity to perceive (Kruskal-Wallis H test 14.123, p = 0.0009) and recognize odors (H = 11.674, p = 0.0029). In addition, the subjective evaluation of smell significantly improved (H = 11.935, p = 0.0026). At the 6-
to 12-month follow-up, the majority of patients (5/7) reported extremely high levels of satisfaction with the outcomes, and the remaining two patients also felt generally positive about the therapy’s success.

Conclusions

Overall, our study showed that the use of intranasal inhalations as a method of delivering bioactive factors and the conditioned medium of M2 macrophages as a therapeutic agent are both safe, well tolerated and, according to preliminary data, clinically effective in the treatment of patients with long-term post-COVID-19 hyposmia.

Disclosure of Interest

None Declared