bluuebunny/crossref_metadata_2025 huggingface dataset:
Disentangling the multigenerational transmissions of socioeconomic disadvantages and mental health problems by gender and across lineages: Findings from the Stockholm Birth Cohort Multigenerational Study
Authors: Li B. , Almquist Y. B. , Liu C. , Berg L.
Published: August 2023

Introduction

There is a paucity of research examining the patterning of socioeconomic disadvantages and mental health problems across multiple generations. The significance of research on multigenerational processes is based on a concern with if and how (dis)advantages are generated and sustained across generations, and how socioeconomic, mental health, and gender inequalities evolve over a longer period of time.

Objectives

The current study therefore aimed to investigate the interconnected transmissions of socioeconomic disadvantages and mental health problems from grandparents to grandchildren through the parents, as well as the extent to which these transmissions differ according to lineage (i.e., through matrilineal/patrilineal descent) and grandchild gender.

Methods

Drawing on the Stockholm Birth Cohort Multigenerational Study, the sample included 21,416 unique lineages by grandchild gender centered around cohort members born in 1953 (parental generation) as well as their children (grandchild generation) and their parents (grandparental generation). Based on local and national register data, socioeconomic disadvantages were operationalized as low income, and mental health problems as psychiatric disorders. A series of path models based on structural equation modelling were applied to estimate the associations between low income and psychiatric disorders across generations and for each lineage-G2 gender combination.

Results

We found a multigenerational transmission of low income through the patriline to grandchildren. Psychiatric disorders were transmitted through both the patriline and matriline, but only to grandsons. The patriline-grandson transmission of psychiatric disorders was partially operated via low income of the fathers. Furthermore, grandparents’ psychiatric disorders influenced their children’s and grandchildren’s income.

Conclusions

We conclude that there is evidence of transmissions of socioeconomic disadvantages and mental health problems across three generations, although these transmissions differ by lineage and grandchild gender. Our findings further highlight that grandparents’ mental health problems could cast a long shadow on their children’s and grandchildren’s socioeconomic outcomes, and that socioeconomic disadvantages in the intermediate generation may play an important role for the multigenerational transmission of mental health problems.

Disclosure of Interest

None Declared
Evaluation of Vitamin D in the serum of in-hospital patients with psychosis. Retrospective study.
Authors: Kapiris E. , Laskos E.
Published: August 2023

Introduction

The reduction of vitamin D (VitD) has often been associated with pathological cognitive processes and in general with various mental illnesses2,3. More frequent reports of reduced concentrations of VitD concern patients with schizophrenia, however it has not been clarified whether this concerns the pathology itself of the disorder or if nutritional factors are involved1.

Objectives

The measurement of VitD in the serum of hospitalized patients with mental illness (schizophrenia) compared to the levels of people without mental illness.

Methods

The serum levels of VitD were measured in the serum of 45 psychiatric patients of psychiatric hospital “Dromokaiteion” (22 men and 23 women) mean age 59 ±14 years. The control group consisted of 49 healthy subjects (24 men and 25 women) with a mean age of 57 ±14 years (Table 1). Serum VitD levels were measured on the Architect ci4100 immunobiochemical analyzer, Abbott Laboratories Ltd, by the chemiluminescent microparticle immune assay (CMIA) method and according to the manufacturer’s instructions. The statistical analysis of the data was done with the software program SPSS V.25.

Results

Mean values of Vit D (ng/ml) were 15.8±10.7 and 15.3±12.5 in male and female patients, respectively. For the control group the mean values were 22.4±7.9 in men and 26.4±13.9 in women. Vit D values in the psychiatric patients of both groups compared to the control group were statistically significantly different (men p=0.021 and women p=0.006). (Table2, 3).

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Conclusions

The findings of the study are consistent with those of similar studies confirming low concentrations of VitD in the serum of patients with mental illness. This parameter should be taken into account as its measurement is not included in the routine laboratory control to date. Further future studies should correlate VitD deficiency with specific demographic and clinical characteristics.

1. Belvederi Murri M, Respino M, Masotti M, et al. Vitamin D and psychosis: mini meta-analysis. Schizophr Res. 2013;150(1):235-239. doi:10.1016/j.schres.2013.07.017

2. Kalueff A, Minasyan A, Keisala T, Kuuslahti M, Miettinen S, Tuohimaa P. The vitamin D neuroendocrine system as a target for novel neurotropic drugs. CNS Neurol Disord Drug Targets. (2006) 5:363–71. doi: 10.2174/187152706784111506

3. Oudshoorn C, Mattace-Raso FU, van der Velde N, Colin EM, van der Cammen TJ. Higher serum vitamin D3 levels are associated with better cognitive test performance in patients with Alzheimer’s disease. Dement Geriatr Cogn Disord. (2008) 25:539–43. doi: 10.1159/000134382

Disclosure of Interest

None Declared
Management of comorbid schizophrenia with prolactinome (about a case)
Authors: Chamsi F. Z. , Aberbak H. , Radi S. , El Ammouri A.
Published: August 2023

Introduction

Prolactin adenoma, called “prolactinoma” is a benign neoplasm, it is the most common secreting pituitary tumor, and represents up to 40% of all pituitary adenomas. More than 90% are small intrasellar tumors which rarely increase in size.

Objectives

the problem of management lies in how to stabilize the patient on a psychiatric level without increasing the level of prolactin.

Methods

We report the case of a young woman who presented a comorbid schizophrenia with a prolactinoma. We will try through this clinical vignette to study the different pillars of management of such pathologies.

At the same time, we did a literature review. The main search engines used were Pubmed, medline, and Science Direct. The keywords Prolatinoma schizophrenia olanzapine

Results

This is Mrs. N. Q., 39 years old She is single, an engineer but currently without a profession, from an average socio-economic level of a teacher father and a housewife mother. She is the 3rd of his siblings of 6 . She is currently hospitalized at Ar-razi Tanger hospital for treatment of decompensation of her chronic psychotic disorder. The patient would have been born following a premature delivery of 34 weeks. For her antecedent, she was followed for asthma since her childhood. Her mother and her maternal grandfather would have been psychotic. The history of the disease dates back to 2017. The patient suffered from headaches resistant to any treatment. The patient would have consulted a neurologist. Magnetic resonance brain imaging would have been requested, which objectified at the left latero-pituitary level a lesional process of 7 mm discretely intense in T2, hypo-intense in T1 and not enhanced by Gd reflecting a pituitary micro adenoma. The patient was put on Cabergoline (Dostinex®). So the psychiatric symptomatology dates back to the end of 2019, by behavioral problems, social withdrawal, she will have stopped all professional activity. At the same time, she will have stopped all medication (Cabergoline). In 2020, the patient would have been hospitalized for the first time at the Ar-razi Tangier psychiatric hospital. The diagnosis of schizophrenia was retained according to the DSM 5 criteria. After a stay of 5 weeks, the patient would be stabilized on olanzapine 20mg/d. Currently, and following non-compliance with treatment (because of adverse effects such as amenorrhea and galactorrhea), the patient has returned, suffering from a relapse, justifying her second hospitalization. During his stay, a check-up would have been requested to show hyperprolactinemia 3 times normal. We therefore switched to Aripiprazole.

Conclusions

We have proposed an approach to the management of patients with comorbid schizophrenia and prolactinoma, an approach that balances the benefits and risks of managing the psychiatric stability of the patient on antipsychotics with the management of prolactinoma and symptoms. of hyperprolactinemia.

Disclosure of Interest

None Declared
The role of immune disfunction in schizophrenia pathogenesis
Authors: Azevedo Silva I. , Martins B. , Melo V. , Cardão J. , Matos A. , Agostinho C.
Published: August 2023

Introduction

In the last years there has been increasing evidence that inflammation and autoimmunity may play a role in the pathogenesis of schizophrenia.

Although the brain has been considered an immune-privileged site, we understand now that infections and inflammation interfere with the blood-brain barrier, making the brain vulnerable to antibodies, cytokines and infectious agents.

Objectives

To understand the role of immune disfunction in schizophrenia pathogenesis, as well as the potential role of immunotherapy in its treatment.

Methods

We performed a narrative review of the evidence, using the following terms and their combinations “schizophrenia”, “autoimmunity” and “monoclonal antibodies”.

Results

It is widely known that prenatal, perinatal and childhood exposure to infections, nutritional deficits and other environmental insults, acting on a background of genetic vulnerability, may lead to schizophrenia. In such cases, we can observe potent and enduring inflammatory responses, such as cytokines dysregulations.

State markers, including IL-1β, IL-6 and TGF-β have increased levels during exacerbation of symptoms and stabilized levels when antipsychotics are administrated. Trait markers, such as IL-12, IFN-γ and TNF-α have systematically increased levels in acutely and chronically ill patients, even during clinical stability.

Moreover, patients with schizophrenia have been showing abnormalities of the blood-brain barrier, signs of central nervous system inflammation and elevated autoantibody levels and reactivity.

Several autoimmune diseases are associated with schizophrenia, such as celiac disease, Graves’ disease and psoriasis. On the other hand, it is known since the 1950’s that schizophrenia has a negative association with rheumatoid arthritis.

There are case reports of people with psychosis that were treated with immunosuppressive agents (for concurrent autoimmune diseases) that showed improvement in their psychotic symptoms.

NSAIDs, immunomodulators and several monoclonal antibodies have been tested as potential treatments for schizophrenia. The results were conflicting but promising. It is suggested that not every patient with schizophrenia may benefit from these treatments. Ideally, treatment targeting the immune system should be provided in earlier phases of disease, such as in prodromal psychosis and first episode psychosis, because these are related to irreversible grey matter loss which causes cognitive decline.

Conclusions

Immune dysregulation may have an important etiological role in schizophrenia.

Hence, specific therapeutic approaches targeting the immune system may lead to new ways of treating and even preventing psychotic disorders.

Further investigation is necessary in order to provide more information on how aberrant antibody and cytokine production interferes with neuronal function and how it is expressed at the clinical level.

Disclosure of Interest

None Declared
Folie a Deux in 2 Elderly Sisters - Challenges in Diagnosis and Management
Authors: Suhairi K. H. B.
Published: August 2023

Introduction

Folie a deux is a rare psychiatric disorder where an identical or similar mental disorder affects two or more individuals usually with close emotional ties. Management of patients with folie a deux may require multiple types of treatment including separation, family therapy and antipsychotics.

Objectives

Narrative case of Folie a deux in 2 elderly sisters

Methods

Clinical case presentation through retrospective review of clinical notes

Results

We present a case of 2 sisters living together of 76 and 74 years of age. The elder sister, Sister A, presented to Singapore’s Institute of Mental Health on October 2021 after she was referred from court for disturbed behaviour with more than 10 years history of paranoid delusions against their neighbours, eventually extending to strangers in general. She was admitted and stayed in hospital from October 2021 to February 2022. She was referred to community psychiatric services to perform home visits due to her unwillingness to attend subsequent follow ups after discharge. During these home visits, it was determined that her sister, Sister B, was displaying delusional thinking as well. Sister A was started on antipsychotics while Sister B was managed non-pharmacologically. After commencement of antipsychotics, Sister A showed good response with improvement of symptoms, while Sister B continued to display delusional thinking. Discussion was made with the next-of-kin of both sisters, their nephew, and the decision was made to continue to observe these symptoms and monitor for their resolution with continued treatment of Sister A. A multidisciplinary approach was also used to attempt to reintegrate them into society to rebuild trust in the public. Currently both sisters still report vague paranoia of strangers in general and a multidisciplinary team is involved in improving their symptoms further.

Conclusions

With this case report, we hope to raise awareness of the different methods that are useful in the management of Folie a deux along with the challenges faced when managing these cases.

Disclosure of Interest

None Declared
Neutrocytopenia associated with a lurasidon therapy in a patient with paranoid schizophrenia
Authors: Mielczarek Z. , Trędzbor B. , Krysta K.
Published: August 2023

Introduction

Lurasidon is a relatively new, second-generation antypsychotic drug with an interesting receptor profile. It is considered safe and has a low risk of side effects. This drug is effecitve in reducing the productive symptoms of schizophrenia, but also has a positive effect on negative symptoms and cognitive functions. It is a medicine with a multi-receptor mechanism of action: it mainly blocks dopaminergic D2 and serotonergic 5-HT2A receptors. According to the Summary of Product Characteristics, adverse reactions such as leucopenia, neutropenia and anaemia were too rare to estimate their frequency.

Objectives

This study describes case of neutrocytopenia and leukocytopenia that are likely to be related to lurasidone and have resolved after discontinuation of this medicinal product. The aim of the article is to highlight the risk of using second-generation antipsychotics in patients and the occurence of blood cells disorders in particular neutrocytopenia.

Methods

An analysis of the medical history records were done to describe the case report.

Results

39-years-old patient treated psychiatrically for 18 years, initially for mood disorders, irritability, behavioural disorders. In 2014 she was diagnosed with paranoid schizophrenia, herlast psychiatric hospitalization took place in 2021. The patient had a history of neutrocytopenia and leukocytopenia. In December 2020, the patient was admitted to the psychiatric ward on account of active aggression against her mother. She was discharged in January 2021 with the recommendation to take paliperidone intramusculary. Due to incomplete remission of psychotic symptoms, the patient received 37 mg of lurasidone since August 2021. The blood count, which was ordered upon admission to the Department of Psychiatric Rehabilitation, showed moderate neutrocytopenia. After discontinuation of lurasidone and the recommended supplementation, the results gradually improved and finally reached the normal range.
Blood cells type
23.09.2021 r.
04.10.2021 r.
14.10.2021 r.
28.10.2021 r.
10.11.2021 r.
24.11.2021 r.
08.12.2021 r.Leukocytes2,45 x 10^3/μl2,73 x 10^3/μl2,39 x 10^3/μl2,66 x 10^3/μl2,79 x 10^3/μl4,09 x 10^3/μl4,03 x 10^3/μlErythrocytes4,26 x 10^3/μl4,31 x 10^3/μl4,48 x 10^3/μl4,06 x 10^3/μl4,08 x 10^3/μl4,39 x 10^3/μl4,22 x 10^3/μlbNeutrocytes1,04 x 10^3/μl1,60 x 10^3/μl1,24 x 10^3/μl1,53 x 10^3/μl1,78 x 10^3/μl2,72 x 10^3/μl2,62 x 10^3/μlLymphocytes1,05 x 10^3/μl0,70 x 10^3/μl0,72 x 10^3/μl0,73 x 10^3/μl0,64 x 10^3/μl0,83 x 10^3/μl0,92 x 10^3/μl

Conclusions

This case report shows the need for regular monitoring of blood cells parameters in patients treated with second generation antipsychotics, as there is a risk of neutrocytopenia or even agranulocitosis. If there is an obvious correlation, the dose should be reduced or switched to another medicinal product if possible and blood counts should monitored further.

Disclosure of Interest

None Declared
Review of a sample of episodes of forced medication in an area of southern Spain
Authors: Muñoz-Manchado L. I. , Mongil-Sanjuan J. M. , Pérez-Revuelta J. I. , Robledo Casal C. M. , Villagrán-Moreno J. M.
Published: August 2023

Introduction

Forced medication is one of the most frequently used coercive measures in acute mental health units. It is a practice that can lead to physical, psychological and psychopathological consequences. Therefore, it is necessary to implement measures to reduce its use. In this sense, it is interesting to study the variables that can be associated with its use, and thus take measures accordingly.

Objectives

This study attempts to identify the number of forced medication episodes between July 2017 and December 2018 treated in the catchment area of the Mental Health Service at Jerez Hospital. As a secondary objective, it pursues to identify the factors that conducted to the use of forced medication with the intention of being able to reduce the use of these measures.

Methods

A descriptive and retrospective study has been developed reviewing the total number of episodes of forced medication. Patients admitted and discharged from hospital between July 2017 and December 2018 treated in the Mental Health Service at Jerez Hospital. Data were extracted from medical records.

Results

The total number of episodes of forced medication identified was 330. In these episodes, the average age was 41 years, with a predominance of 74% of the male gender. The most used route in the episodes was intramuscular (94.8%), in addition, more than 50% needed the association of two drugs, the most used were haloperidol and olanzapine. The 32.7% of the episodes also required the use of mechanical restraint and 44.2% required the presence of security service.

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Conclusions

We present the descriptive analysis of a further study currently been conducted in hour hospital which means to stablish predictive factors for the use of forced medication. We therefore intend to create patient profile, as well as new measures specifically directed to these factors with which to diminish the use of forced medication.

Disclosure of Interest

None Declared
Evaluation of social autonomy of schizophrenic patients
Authors: Zbidi M. , Bouali W. , Haouari W. , Kacem M. , Bensoussia R. , Zarrouk L.
Published: August 2023

Introduction

Schizophrenia is a debilitating and mutilating mental illness, generally progressing in a Chronic way . It is at the origin of a limitation of social autonomy and source of psychological distress .

Objectives

evaluate the effective social autonomy of schizophrenic patients.

Methods

it is a cross-sectional study carried out at the EPS psychiatry consultation in Mahdia during a period of 3 months, with schizophrenic patients meeting the DSM 5 criteria, having an age varying from 19 to 65 years and whose duration of evolution was at least of one year. Have been excluded those in a state of decompensation, presenting a severe organic disease or having a major cognitive impairment. Information was collected from patients and fromtheir medical records using a pre-established questionnaire. The scale of social autonomy (EAS) of Legay with 17 items grouped into 5 dimensions was used for the evaluation.

Results

The general characteristics of the 360 schizophrenic patients who met the inclusion criteria, revealed an average age of 40.2 years, a sex ratio of 2.33, a majority of single (55.8%), a low level of education(66.7%), an absence of professional activity (67.3%) and a deteriorated socioeconomic level (68.6%).Clinical Characteristics noted an average onset age of the disorder of 26 years, an average duration of evolution of 14 years and a preponderance of the residual type and of the episodic evolutionary course with residual symptoms between episodes respectively in 40.6 and 76.4%. The average of EAS scores were 39.08. Three quarters of the population (75.7%) had a score below 59. 24.3% of patients had scores between 60 and 108 signifying impaired social autonomy.

Conclusions

The evaluation of effective social autonomy is essential for any therapeutic project considering psychosocial integration and rehabilitation of schizophrenic patients.

Disclosure of Interest

None Declared
Schizophrenia and hetero-aggressiveness: management and aggravating factors
Authors: Chtibi M. , Berrada H. , Hanine I. , Belbachir S. , Ouanass A.
Published: August 2023

Introduction

Schizophrenia is a severe mental illness but especially important in terms of its impact on the subject. The stigmatization of these patients is major, leading to a significant decrease in their quality of life. This is partly due to the media coverage of the rare cases of hetero-aggression.

The aggressiveness of schizophrenic subjects remains poorly known and little studied.

Objectives

The objectives of our study are to determine whether the prescription of second-generation antipsychotics is associated with lower levels of aggression than the prescription of first-generation antipsychotics and to identify aggravating factors.

Methods

Materials and methods: We used an anonymous questionnaire based on, in addition to individual status and conditions, a self-administered questionnaire to assess the degree of aggression (the Buss and Perry Aggression Questionnaire (BPAQ)).

Results

Our study demonstrated superiority of second-generation antipsychotics in preventing aggression in subjects with schizophrenia, as well as an association between increased aggression and low insight, low compliance and low social support. In addition, younger age, male gender, and lower education were associated with increased aggression.

Conclusions

The prevention of aggression would then begin with the management of psychotic symptoms and comorbid disorders, as well as work on the compliance and insight of these patients. However, the aggressive dimension persists in some of them.

Disclosure of Interest

None Declared
Catatonia: Development of a neuropsychiatric entanglement through a clinical case
Authors: Chtibi M. , Zarouf H. , Berrada H. , Belbachir S. , Ouanass A.
Published: August 2023

Introduction

Catatonia is a transnosographic and potentially fatal syndrome, most often associated with mood disorders or schizophrenia, but can also develop in autistic disorders, dementia, as well as in general medical conditions such as epilepsy, autoimmune encephalitis, hypercalcemia, hepatic encephalopathy, or diabetic ketoacidosis.

Objectives

the objective is to understand the semiology and treatment of catatonic syndrome in a clinical case

Methods

Clinical case

Results

The work we present is based on a clinical case of a patient with schizophrenia presenting a catatonic syndrome, of which a neurological cause was first evoked but after clinical investigations the diagnosis of schizophrenia was retained and currently the patient is stabilized on Clozapine. It is imperative to recognize a catatonic syndrome in order to treat it quickly, as some of the etiologies that cause this syndrome and the consequences of the syndrome itself can be life-threatening.

Conclusions

Catatonia remains a subject of research for centuries, the diagnosis is clinical, based on a set of criteria grouped in the DSM5, its etiologies are psychiatric and organic including neurological. Rapid diagnostic and therapeutic management is essential to avoid life-threatening complications.

Disclosure of Interest

None Declared
Attitudes towards a Compassion Focus Therapy Group for Psychosis: A Survey of Service Users and Clinicians
Authors: Slingerland N. , Twomey C.
Published: August 2023

Introduction

The Living Through Psychosis (LTP) programme at St Patrick’s Mental Health Services, Ireland (SPMHS) is heavily informed by the Compassion Focus Therapy (CFT) for Psychosis model. LTP offers an opportunity for service users to develop compassion skills to cope with emotional and psychological challenges relating to living with psychosis; and to develop their capacity to for a mindful, non-judgemental and compassionate awareness of distressing thoughts and images.

Objectives

This (ongoing) online survey explores both service user and clinician attitudes towards the CFT-informed LTP group. We also aim to identify any potential concerns that might demotivate referrals to LTP and similar programmes, and to explore what are judged to be its benefits. The study also provides an opportunity to develop and improve the LTP programme to best fulfil service users’ needs.

Methods

The online survey is concise and responses are anonymous. Clinicians and service users complete similar-but-separate sets of questions that are adapted for relevancy and wording. The survey mainly consists of Likert Scale questions in relation to potential participation in, or referral to, LTP (after a visually-aided description of LTP is provided online within the survey). Using convenience sampling, the survey has been distributed among clinicians and service users through email and Internet advertisements within SPMHS and psychosis organisations such as Psychosis Ireland. Descriptive analysis is used for quantitative questions, while thematic analysis covers qualitative questions.

Results

Data collection is currently ongoing and will finish in December 2022. Preliminary results will be presented at the conference.

Conclusions

Conclusions will be derived from the results. It is anticipated that the findings will be helpful in further developing the LTP programme and similar CFT programmes for psychosis.

Disclosure of Interest

None Declared
SLEEP DISTURBANCES AMONG UNIVERSITY STUDENTS : A TUNISIAN STUDY
Authors: Turki M. , Firas J. , Mhiri H. E. , Sahnoun F. , Guermazi A. , Ellouze S. , Halouani N. , Aloulou J.
Published: August 2023

Introduction

Poor sleep quality is a major health problem worldwide. University students tend to suffer from problems of sleep regularity, quantity and quality, which can affect their academic performance, and have a serious impact on their psychological and physical well-being.

Objectives

The aim of this study was to assess the prevalence of insomnia among Tunisian university students, and to identify its associated factors.

Methods

We conducted a cross-sectional web-based study among university students from several Tunisian faculties. Data were collected using a questionnaire spread throughout social media (Facebook), using the Google Forms® platform, during September and October 2022.

We used the “Insomnia Severity Index” (ISI) to assess the severity of insomnia.

Results

A total of 144 students completed the questionnaire. Their mean age was 23.38±3.27 years, with a sex-ration (F/M) of 2.8. Among them, 70.1% were single and 68.8% lived with family. Among our participants, 10.4% were followed for chronic somatic disease, 11.1% for chronic mental disease, while 29.2% have already been diagnosed and treated for sleep disturbances.

ISI showed that 72.2% of students suffered from insomnia: 45.1% Subthreshold insomnia, 19.4% moderate clinical insomnia and 7.6% severe clinical insomnia. Insomnia was significantly more frequent among psychoactive substances users (75.7% vs 57.6%; p=0.043). ISI scores were significantly higher among cannabis users (17.4 vs 11.06; p=0.025).

Conclusions

Our study highlighted that insomnia is prevalent within the university student population, and psychoactive substances consumption seems to worsen it. Thus, when designing interventions to improve sleep quality among students, the main determinants need to be taken into consideration.

Disclosure of Interest

None Declared
suicide among women, its clinical specificities and risk factors
Authors: Douk K. , belabess I. , Nafiaa H. , Ouanass A.
Published: August 2023

Introduction

In the general population, the authors have noted that most suicides are commited by men, this gender difference also includes the methods that suicidal people use to commit suicide; women tend to use less immediately lethal means such as drug ingestion in contrast to the methods that men adopt, which often include poisoning, hanging or the use of firearms. This is partly due to the fact that men verbalize their suffering less in the context of the hegemony of masculinity which delays the request for help.

Objectives

Our objective is to describe the profile of female patients admitted to the AR-RAZI hospital in Salé for suicide attempts and/or with a previous suicide attempts and their treatment and to identify the risk factors, which will allow us to develop preventive therapeutic strategies, taking into account their age, their reasons for hospitalization and clinical presentation on admission; their physiological characteristics, their somatic and psychiatric co-morbidities and their socio-cultural factors.

Methods

We have performed a cross-sectional study of 59 female patients admitted to Ar-Razi Psychiatric Hospital for suicide attempt or having already committed at least one suicide attempt, by means of a questionnaire specifying their age, marital status, occupation, socioeconomic level and residence.

The patients in question were recruited within a 2-year time frame, coming for the most part from the regions of the kingdom that our center covers.

Results

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13 are between 21-25 years old, 10 are between 15-20 years old, 9 are over 51 years old, 7 are between 31-35, 6 are between 26-30, 4 are between 41-45 and only one patient who is in the age range between 46-50.

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31 are single, 16 are married, 11 are divorced or in the process of being divorced and only one widow.

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36 have children between 1 and 6 years old and 23 have never given birth.

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39 women never had a job or have not had one for at least 2 years, 10 are students, 5 are working in the public sector, 3 are working in the private sector and 2 are living from personal or family businesses.

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30 live in a modest socioeconomic level, 25 in a medium level and 4 in a high level.

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21 patients live in Rabat, 14 in Salé, 4 in Témara, and the rest are spread over the urban, rural and urban periphery of the territory that our center covers.

Conclusions

The notion of suicide is quite wide to be reduced to suicide attempts, given the multitude of semiological equivalents of the suicidal act. apart from the etiology, the sex of the suicidal person strongly influences all the parameters of the suicidal person and the suicidal act, including the risk factors, the means used and the means of protection, hence the interest in adapting the preventive, diagnostic and therapeutic approach, both medical and social, by taking into account the sex of the suicidal person for optimal care.

Disclosure of Interest

None Declared
Is Personality Disorder Madness? A Qualitative Study of the perceptions of Medical Students in Somaliland
Authors: Arisna H. R. , Handuleh J. , Bhui K. , Lee T.
Published: August 2023

Introduction

Patients with borderline personality disorder are often a challenge to the mental health system. Psychiatrists see people with BPD as manipulative, difficult to manage, annoying, unlikely to arouse sympathy, clinicians hold negative attitude towards personality disorder.

As the next generation of doctors, medical students’ perception of patients with personality disorder (PD) is critical.

Yet a systematic review of the literature shows this has not been studied.

Objectives

The study aims to identify :

1) the understanding and perception of medical students about PD

2) factors that may relate to this knowledge and perception.

Methods

A focus group discussion (FGD) was conducted with eight medical students in their sixth year at Amoud University, Somaliland.

A case vignette of a patient with typical Borderline PD symptoms was presented to stimulate discussion. Barts Explanatory Model Inventory (BEMI) was used to explore the issue.

The FGD was conducted via MS teams, recorded, transcribed, translated and thematically analysed

Results

The Medical students showed reasonably accurate knowledge regarding Borderline PD, recognising features of unstable mood, impulsiveness, and emptiness. Of note half the participants believed religious intervention would be helpful “I believe in Islam. So,basically so to some degree it could be managed in certain religious centers”. Importantly, medical students, when asked to divest of their professional identity, and to describe their personal views associated PD with madness.

Conclusions

The views of PD as ‘madness’ and that religious intervention has a role have important implications for training and service development.

The importance of a culturally sensitive training to Medical students regarding PD to match local cultural and religious views, and consideration of development of health services which are sensitive to religious practice is highlighted.

We recommend including social and cultural implications in the training of medical students to better prepare them for the complexity of managing PD.

Disclosure of Interest

None Declared
Unit for women with schizophrenia in a community mental health service: Description of current and projected programs and quality evaluation measures
Authors: González- Rodríguez A. , Seeman M. V. , Natividad M. , Barrio P. , Román E. , Balagué A. , Paolini J. P. , Monreal J. A.
Published: August 2023

Introduction

Women with schizophrenia require health interventions and safe spaces sufficiently different from those of men.

Objectives

To describe units in two mental health outpatient services specialized in the treatment of women with schizophrenia and related disorders.

Methods

Two units in Spain projected to treat women with schizophrenia and related disorders - Community Mental Health Programs (CMHU Rambla, CMHU Sant Cugat) will be described. Recruitment, assessment, intervention, and evaluation and satisfaction measures will be characterized, and the need to build-in safety precautions (policy/structural).

Results

Demographics:(Preliminary 2021 data on the two services).

Patients attending (CMHU): 3,393. Forty-five per cent diagnosed with severe mental illness. Schizophrenia and related disorders: 873 patients. 58% women.

Staffing projected: 2 psychiatrists, 2 nurses, 1 clinical psychologist, 2 social workers.

Physical structure: Safe spaces for women/children.

Programs (offered currently and in planning stages): 1)Therapeutic Drug Monitoring/Adherence, 2)Individual/group patient/family sessions, 3)Perinatal Mental Health (preconception, pregnancy, lactation, postpartum, parent training/support), 4)Collaborative programs (primary care, medical specialties especially obstetrics/gynecology and endocrinology, trauma specialists, addiction experts), 5)prevention/intervention of suicide risk, 6)social services (single mothers, family issues, domestic abuse, sexual exploitation) 7)home-based services, 8)peer support, 9)physical activity, 10)psychoeducation for patients and families.

Planned quality evaluation measures: diagnostic assessment (reliability, long-term validity);regular treatment effectiveness evaluation (individualization of treatment plans, assessment of adverse effects of drugs, screening for metabolic syndrome/ physical health, family intervention, psychoeducation (individual/group) assessment of suicidal ideation and global functioning.

Conclusions

Specific services for women with schizophrenia and related disorders represent an important resource to improve patient well-being and offer clinical care leading to individual recovery.

Disclosure of Interest

None Declared
Use of systemic hormonal contraception and depression: a nested case-control study
Authors: Toffol E. , Partonen T. , Heikinheimo O. , Latvala A. , But A. , Haukka J.
Published: August 2023

Introduction

Depression is twice as common in women as in men, especially in the young age group. Multiple factors may contribute to this gender difference. Growing attention is being focused on the role of sex hormones, including those of hormonal contraception
(HC). Some recent studies have indicated a higher risk of depression among women using HC, although the results are inconclusive.

Objectives

The aim of this study is to examine the associations between the use of hormonal contraception and the risk of depression in childbearing age women.

Methods

The original cohorts for the study included all women aged 15-49 years with at least one redeemed prescriptions for HC in Finland in 2017 (n=294,356), and a 1:1 age-matched cohort of non-users. After exclusion of prevalent cases (n=35,102), all incident cases of depression (as recorded in the Care Register of Health Care and Register of Primary Health Care Visits) in 2018-2019 were identified (n=23,480), and a 4:1 age-matched control group (n=93,920) was selected from the above cohorts. Current use of HC in the 180 days before the event was compared in cases and controls, and associations with risk of depression were tested via conditional multivariate logistic regression models.

Results

During the follow-up, 23,480 incident cases of depression were identified. Current use (in the 180 days before the event) of HC (OR 0.82, 95% CI 0.79-0.85), in particular of estradiol- or
ethinylestradiol-containing combined HC was associated with a lower risk of depression (OR 0.83, 95% CI 0.76–0.89; OR 0.74, 95% CI 0.71–0.78, respectively) compared to non-use of HC. The results remained significant (OR 0.87, 95% CI 0.81-0.95; and OR 0.77, 95% CI 0.73-0.81, respectively) after controlling for covariates (marital and socioeconomic status, education level, chronic diseases). Use of progestin-only contraception was not associated with altered risk of depression.

Conclusions

Use of HC in childbearing age women is not associated with increased risk of depression. Rather, the use of estradiol- or ethinylestradiol-containing HC is associated with a lower risk of depression.

Disclosure of Interest

None Declared
Patient iPSC-derived neurons reveal mechanisms underlying antidepressant response: a potential diagnostic tool
Authors: Shohat Koren S. , Kroitorou D. , Albeldas C. , Kugel A. , Askari N. , Cohen Solal T. , Laifenfeld D.
Published: August 2023

Introduction

Depression is a leading cause of disability worldwide despite dozens of approved antidepressants. There are currently no clear guidelines to assist the physician in their choice of drug, with existing tools limited to pharmacogenetics that have shown suboptimal response prediction outcomes resulting in a subscription process that is largely a trial and error one. Consequently, the majority of depressed patients do not respond to their first prescribed antidepressant, with >30% not responding to subsequent drugs. We report here on molecular readouts from an in vitro-based platform that provides patient-specific information on antidepressant mechanisms using cortical neurons derived individually from each patient.

Objectives

To assess gene expression differences in prefrontal cortex neurons derived from responders and non-responders to two commonly used antidepressants, the selective serotonin reuptake inhibitor Citalopram and the atypical antidepressant Bupropion.

Methods

Patient-derived lymphoblastoid cell lines from the Sequenced Treatment Alternatives to Relieve Depression (STARD) study with known response to Citalopram or Bupropion were reprogrammed and then differentiated to cortical neurons. Differential gene expression analysis was preformed to identify genes that are differentially expressed between drug responders and non-responders.

Results

Significant differential expression was shown in 359 genes between Bupropion responders and non-responders (Fig1A) and 12 genes between Citalopram responders and non-responders (Fig1B). Clustering on the differentially expressed genes showed high agreement with the known response to both drugs (Fig1). Functional enrichment analysis revealed biologically relevant pathways that differ between responders and non-responders in Bupropion versus Citalopram.

Image:

Figure 1.

Heatmap of the expression of genes that show significant differential expression between neurons derived from Bupropion (A) and Citalopram (B) responders and non-responders. Color is the scaled gene expression; lines are genes and columns are samples. Column side colors represent the known response of the patient. Colum and line dendrograms are unsupervised hierarchical clustering.

Conclusions

Gene expression patterns of neurons derived from patients with depression differ according to their response to two common antidepressants from different groups. The identification of distinct drug response dependent expression patterns in derived neurons can help elucidate mechanisms underlying antidepressant activity, supporting new drug development and response prediction.

Disclosure of Interest

None Declared
Screening and early therapeutic intervention of bonding disorders at first six months of life: An alternative to prevent disorganised attachment and severe mental disorder
Authors: Hernández-Santillán G. , Alcamí-Pertejo M. , Palacios-Hernández B. , Lahera-Forteza G. , Fernández-Sánchez A. , Bravo-Ortiz M. F.
Published: August 2023

Introduction

Disorganized attachment has been described as an important risk factor for developing serious mental disorders in childhood, adolescence and adulthood, such as borderline personality disorder, psychoses, afective disorders, and a higher suicide risk, for instance. Bonding disorders (BD) in parents are related to insecure and disorganized attachment in children. BD can be early diagnosed at 4 to 6 weeks after birth.

Objectives

Determine if there is a significant difference between the results of the prevalence of affective disorders, disorganized attachment, and suicidal risk five years after the birth of the offspring of parents with and without attachment disorders detected in the first year postpartum during the covid-19 pandemic.

Methods

Describe a pilot project of an analytical prospective study following a cohort of parents from the cohort SAMPECO/PEMHSCO
(Perinatal Mental Health in Spain during the Covid-19 pandemic). The cohort is planned to be divided into two groups: with bonding disorders an without bonding disorders, which was established using the Postpartum Bonding Questionnaire (Brockington, 2006). Follow the offspring of both groups for 5 years and compare the results of disorganized attachment, affective disorders and suicide risk.

Results

The cohort SAMPECO/PEMHSCO was recruited between March 2021 and June 2022. There was measured postpartum depression in mothers and fathers using the EPDS and bonding disorders in parents using the PBQ validated to the Spaniard population. More than 1500 families were involved at the beginning and around 450 families finished the follow-up six months after birth. Around 500 families were lost because of non-right contact information.

Conclusions

The covid-19 pandemic has seriously affected the mental health of the general population. Consequently, there is a higher demand for mental health assistance by public and private sanity sectors. Currently, the youth population is suffering very much from the consequences of isolation and other social factors, and many families who had babies in this period haven’t had enough support to breed and look after both their babies and themselves. Some papers suggest that the prevalence of perinatal mental disorders in parents has increased since the covid-19 pandemic because of several factors. Paradoxically, despite the high preventive potential of early intervention in the perinatal period, there are not yet exist well-equipped perinatal mental health units to solve this problem. It is urgent to boost the development of Perinatal Mental Health Services to prevent a major worsening of the situation and to prevent the increasing rate of severe mental disorders in children, adolescents and adults.

Disclosure of Interest

None Declared
The role of dysregulated ghrelin/LEAP-2 balance in eating disorder: a translational study in anorexia nervosa
Authors: Tezenas du Montcel C. , Duriez P. , Cao J. , Ramoz N. , Viltart O. , Gorwood P. , Tolle V.
Published: August 2023

Introduction

Anorexia nervosa (AN) is a complex psychiatric disorder characterized by a persistant decrease in food intake leading to dramatic weight loss and energy deficit. The ghrelin system is a key regulator of appetite and food intake across species. LEAP-2, a recently discovered ghrelin antagonist, appears to be up-regulated in obesity and opposes to the orexigenic drive of ghrelin. The evolution of LEAP-2 levels could be an interesting insight to reflect the regulation of appetite in eating disorders such as anorexia nervosa (AN).

Objectives

We tested this hypothesis and here provide the first study exploring the ghrelin and LEAP-2 regulation in long-term food restriction followed by refeeding in both mice and patients suffering from AN.

Methods

Using a translational strategy, we compared the regulation of ghrelin and LEAP-2 concentrations in blood during food restriction and after refeeding i/ in female mice exposed to a 14 days protocol combining quantitative food restriction and running wheel activity followed by 10 days of progressive refeeding; ii/ in an ongoing longitudinal study of patients with AN evaluated before and after refeeding (n=30) as well as 6 months after hospital discharge to evaluate if the weight gain was stable (n=7) or unstable (n=10). Plasma concentrations of ghrelin and LEAP-2 were measured with selective immunoassays.

Results

Long-term food restriction in mice was associated with increased ghrelin (p<0.001) and decreased LEAP-2 concentrations (p=0.006) compared to ad libitum fed controls. Refeeding led to a decrease in ghrelin (p<0.01) and increase in LEAP-2 concentrations (p<0.01). Patients with AN displayed increased ghrelin levels (p<0.01) but also higher LEAP-2 concentrations on admission than after refeeding (p=0.04). LEAP-2 decreased with refeeding. On 17 patients re-evaluated 6 months after discharge, patients with unstable weight gain exhibited a greater decrease of LEAP-2 concentrations during refeeding compared to patient with stable weight gain (p=0.02). Decreasing LEAP-2 concentrations was able to predict a negative outcome (i.e. unstable weight gain) in 80% of the cases.

Conclusions

We provide evidence that the ghrelin/LEAP-2 system is not regulated according to the nutritional status in AN as it is in the case of a physiological adaptation to food restriction. Results from an ongoing longitudinal study exploring remission in AN suggest that the evolution of LEAP-2 concentrations during refeeding is opposed to data from preclinical model and could give new insights on the outcome of weight gain in AN.

Disclosure of Interest

None Declared