bluuebunny/crossref_metadata_2025 huggingface dataset:
Short-chain fatty acids in schizophrenia: are they affected by a depressive state?
Authors: Couce-Sánchez M. , Paniagua G. , González-Blanco L. , García-Fernández A. , Martínez-Cao C. , Sabater C. , Margolles A. , Bobes J. , García-Portilla M. P. , Sáiz P.
Published: August 2024

Introduction

Short-chain fatty acids (SCFA) are bacterial metabolites that, within microbiome-gut-brain axis, make a promising research line on etiopathology of mental diseases like schizophrenia (SZ) and major depression disorder. Besides, depressive symptoms are frequent clinical features of SZ.

Objectives

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Describe fecal SCFA concentrations in SZ patients.

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Analyze differences in SCFA depending on:

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Depression.

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Clinical severity, antipsychotics and antidepressants, comorbidities (pro-inflammatory state/obesity/metabolic syndrome [MetS]), lifestyle.

Methods

Cross-sectional study of 67 outpatients [mean age=43.52±12.42, range=22-67; males=40 (59.7%)] with diagnosis (DSM-5) of SZ recruited from their mental health clinics in Oviedo (Spain).

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Assessment:

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Fecal SCFA (gas chromatography;μg/mL).

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Plasmatic C-reactive protein (CPR;mg/dL).

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PANSS, Calgary Depression (CDS), International Physical Activity (IPAQ), Mediterranean Diet Adherence (MEDAS).

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Toxic habits (alcohol use/smoking/cannabis).

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Chlorpromazine equivalent doses (CPZ-ED), use of antidepressants.

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MetS (ATP-III), body mass index (BMI; kg/cm2).

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Statistics: Spearman correlation, U Mann-Whitney, ANCOVA.

Results

14 patients showed clinical depression (CDS≥5). There were no differences in age or sex between groups. 36 patients (53.7%) showed systemic low-grade inflammation (CPR≥0.3mg/dL) and 32 (30.8%) MetS.Table 1 shows fecal SCFA levels by depressive state. Means (SD) are ahown.
Table 1CDS≤4CDS≥5TotalU Mann-Whitney

(p-value)Acetate21.449(12.823)12.911(7.189)19.665(12.328)221.000(0.021)Propanoate9.170(6.819)6.848(6.036)8.685(6.687)268.500(0.114)Butyrate8.529(6.436)7.875(8.232)8.392(6.787)320.000(0.432)Total SCFA39.148(23.770)31.415(24.526)36.742(23.549)250.000(0.062)

Correlations were found in Age with Butyrate (r=-0.248,p=0.043) and weekly alcohol units with Propanoate (r=0.250,p=0.041) plus trend to significance with Butyrate (r=0.232,p=0.059). It also showed a trend towards statistical relation for CPZ-ED with Propanoate (r=-0.253,p=0.039) and Total SCFA (r=-0.253,p=0.039). We found no correlation in SCFA with MetS, CGI, PANSS-N, BMI, IPAQ, MEDAS and other toxic habits.

ANCOVA was performed to Acetate and Total SCFA using depression state as independent variable and Age and CPZ-ED as covariates. There was a trend towards statistical significance for Acetate (F=3.937,p=0.052,η2=0.059) whereas Total SCFA showed no difference (F=1.350,p=2.250,η2=0.021).

Conclusions

There seems to be lower levels of fecal Acetate in SZ patients with depressive symptoms, considering age and antipsychotic intake. In our sample there was no relation between SFCA and clinical severity, lifestyle, comorbidities or antidepressant use.

Disclosure of Interest

None Declared
The role of suicide severity in the association between anxiety symptoms and suicidal ideation: a mediation analysis
Authors: Cifrodelli M. , Rogante E. , Moschillo A. , Longhini L. , Trocchia M. A. , Erbuto D. , Sarubbi S. , Berardelli I. , Pompili M. , Innamorati M.
Published: August 2024

Introduction

Suicide is one of the leading causes of death worldwide and scientific community investigates suicide risk factors relentlessly. Among these, anxiety symptoms were strongly related to suicidal ideation in several studies. Moreover, sleep and its disturbances are closely connected to mental well-being and psychiatric disorders in a bidirectional pathway.

Objectives

The main purpose of the present study is to assess the relationship between anxiety symptoms and suicidal ideation in a sample of psychiatric patients and the mediational role of insomnia in this association.

Methods

Participants were 116 consecutive adult psychiatric inpatients (61 women and 55 men) enrolled to the psychiatric inpatient unit of Sant’Andrea Hospital in Rome. The measures used were a socio-anamnestic form, the Columbia Suicide Severity Rating Scale (C-SSRS), the Hamilton Anxiety Rating Scale (HAM-A), and the Insomnia Severity Index (ISI).

Results

Based on the results of statistical analysis, patients with suicidal ideation showed higher severity of insomnia and higher severity of anxiety symptoms than patients with no suicidal ideation. Moreover, the intensity of suicidal ideation was positively and significantly associated with the severity of anxiety symptoms and with the severity of insomnia. Finally, the mediation analysis showed that the effect of anxiety symptoms on suicidal ideation was completely mediated by insomnia severity.

Conclusions

The main result of the study indicates that patients who perceive more anxiety symptoms were more likely to experience higher suicidal ideation intensity through higher levels of insomnia. These findings implies that screening for sleep disturbances may help identify individuals at risk for suicide, and improving sleep quality through psychosocial and pharmacological treatments could mitigate the association between anxiety and suicidal ideation.

Disclosure of Interest

None Declared
Atypical suicide attempt facilitated by levodopa in a patient with impending Parkinson’s Disease masquerading as a mood disorder: a case report
Authors: Mara A. , Myriknas S. , Tychala S.
Published: August 2024

Introduction

Parkinson’s Disease (PD) is a neuropsychiatric disorder whose diagnosis is mainly based on motor impairment. However, increasing evidence suggests that neurodegeneration precedes the appearance of motor disturbances to manifest itself with hyposmia, sleep, and affective disorders. The disease’s insidious onset and comorbidity with psychiatric symptoms require specialized knowledge and delicate pharmacological maneuvers to provide the patient with the best possible treatment at the most precise moment. Studies have also highlighted the potential increase in impulsivity patients may experience upon initiation with levodopa.

Objectives

Τo raise awareness of the complexity of treating patients with PD that also face psychiatric comorbidities that appeared before the motor symptoms, including preoccupation with death, and highlight the need for intensive interdisciplinary medical follow-up of such patients.

Methods

We report a clinical case of a 54-year-old man who was admitted to the psychiatric emergency department after a suicide attempt by self-inflicting severe bilateral neck, wrists, and femoral triangles injuries, as well as self-cutting his Achilles tendon. The patient had a history of a one-year mixed anxiety and depressive disorder and was treated on an outpatient basis with amitriptyline/perphenazine (10+2)mg, sulpiride 50mg, and clonazepam 2mg. One month before his attempt, the patient started experiencing unilateral upper and lower limb rigidity with bradykinesia and “pill-rolling” resting tremor of the same hand and was prescribed levodopa/benserazide (200+50)mg three times per day. After two days of starting the new medication, the patient attempted suicide by the method mentioned above.

Results

After surgical assessment and care, the patient recovered at the psychiatric department for 21 days and was treated with sertraline 50mg, which was later increased to 100mg. As an adjunctive treatment, the patient also received mirtazapine 15mg/day, quetiapine 200mg/day, and lorazepam 3mg/day. On the 15th day of his hospitalization and after a neurological assessment, the patient was started on levodopa/benserazide (200+50)mg one-quarter three times per day. At discharge, he presented significant clinical improvement regarding both his mental health and neurologic somatic symptoms.

Conclusions

Patients with PD require a multidisciplinary approach by a trained medical team. Clinicians should titrate dopamine replacement agents with caution, especially for those experiencing mood disorders, because they might increase the patient’s impulsivity, “assisting” a depressive patient with suicidal ideation to finally commit suicide.

Disclosure of Interest

None Declared
Promoting well-being: Investigating self-efficacy and academic burnout among trainee teachers
Authors: Boumaaize Z. , Bouhaba A. , Lafraxo M. A. , Guider H. , El Madhi Y. , Hami H.
Published: August 2024

Introduction

Burnout is a widespread problem with far-reaching implications for mental health. Recent studies on working conditions in Morocco have drawn attention to the increasing prevalence of psychosocial hazards, notably stress and burnout, in various professions. The emergence of burnout is mainly determined by the intricate interplay of organizational, environmental, and individual factors. In education, the teaching profession is susceptible to various burnout symptoms. Educators can mitigate this syndrome by maintaining a positive outlook driven by a strong sense of self-efficacy.

Objectives

This study investigated the correlation between academic burnout syndrome and personal resources, specifically a sense of efficacy.

Methods

A cross-sectional survey of 160 Moroccan trainee teachers, with an average age of 27.94±5.44 years, was conducted. Data were collected through a self-administered questionnaire that included the Maslach Burnout Inventory-Student Survey (MBI-SS) and Teachers’ Sense of Efficacy Scale (TSES). The MBI-SS evaluated academic burnout across three dimensions: emotional exhaustion, cynicism, and academic efficacy, whereas the TSES examined efficacy for classroom management, student engagement, and instructional strategies. The questionnaires were translated into Arabic and validated for use in the Moroccan context.

Results

The findings revealed a moderate and statistically significant correlation between efficacy for classroom management and the two components of efficacy related to instructional strategies (r=0.32; p<0.001) and student engagement (r=0.49; p<0.001). Additionally, a significant and positive correlation was observed between instructional strategies’ efficacy and the efficacy for student engagement (r=0.23; p<0.01). A moderate and significant correlation was found between emotional exhaustion and cynicism (r=0.45; p<0.001), whereas academic efficacy and cynicism were negatively and significantly correlated (r=-0.13; p<0.05). It is worth noting that the key component of academic burnout, “emotional exhaustion,” was significantly related to academic efficacy (r=-0.58; p<0.001). Additionally, Pearson’s correlation test demonstrated a positive and statistically significant correlation between emotional exhaustion and efficacy for student engagement (r=0.14; p<0.05). Furthermore, the correlation between academic burnout and self-efficacy showed a negative and statistically significant association (r=-0.13; p<0.05).

Conclusions

Trainee teachers face a range of stressors that affect their well-being. By focusing on personal traits, well-being can be improved and burnout mitigated. This study highlights the key role of self-efficacy as a critical resource in preventing academic burnout, particularly among teachers at the start of their careers.

Disclosure of Interest

None Declared
“Thoroughly out of my depth - A quality improvement project to improve junior clinician’s confidence in undertaking adult ADHD clinic appointments
Authors: Marron B. , McKeown L.
Published: August 2024

Introduction

There has been a 1000% increase in referrals for assessment of adult ADHD within Scotland over the past three years (The Scottish Government. 2023. NAIT adult Neurodevelopmental Pathways Report). These referrals are sent by general practitioners to the local community mental health team. The most junior clinicians (doctors who are pre-membership with the Royal College of Psychiatrists) in the team are often responsible for undertaking the initial assessment of these patients. Patients have on average waited almost a year to be seen and expectations are high.

Objectives

The diagnosis of ADHD can be challenging, and adult ADHD is still a relatively new and evolving diagnostic entity. We set out to explore how junior clinicians were coping with this in their daily practice.

Methods

We developed a questionnaire that was sent to all junior clinicians working within Argyll & Bute (n=8) via an anonymised email link. The link was open for 1 week and then results were analysed.

Results

The response rate to our survey was 87.5%. Prior to starting their current roles none of the respondents had ever undertaken an ADHD assessment before. All respondents answered “No” when asked if they felt they had adequate knowledge on ADHD in order to perform assessments. Only 14% (n=1) felt they had access to adequate resources about how to make an ADHD diagnosis. Participants were asked on a scale of 1-10 (1= not at all,10= very) to rate their confidence in conducting ADHD assessments. The average confidence score was 2.43. There was a space for free text feedback in which participants reported the following: “felt thoroughly out my depth”, “I felt chucked in the deep end”, “I felt very under qualified”

Image:

Conclusions

Our results showed that junior clinicians did not feel confident or knowledgeable about undertaking adult ADHD assessments. In response to this we have now produced, in association with the consultant psychiatrists within our health board, an informative and engaging quick reference poster which explains how to undertake an ADHD assessment (see QR code attached as Image 1). It contains useful pointers about diagnosis, and more importantly guidance on language/phrases to use when explaining to patients whether or not you feel a diagnosis of ADHD is appropriate. It then also explains next steps that can be offered i.e. psychological support/medication options and how to prescribe these. We plan to send out a repeat questionnaire to the next cohort of junior clinicians to assess if they have improved confidence in managing and diagnosing ADHD following this intervention.

Disclosure of Interest

None Declared
ADHD in a women during (peri)menopause: missed diagnoses and cardiac complaints
Authors: Kooij J. S.
Published: August 2024

Introduction

(Abstract for the accepted case-based workshop by the NDAL section at EPA)

Women with ADHD are underdiagnosed in mental health care, and although ADHD starts in early childhood, the symptoms and impairment of women with ADHD may only be recognised for the first time during (peri)menopause.

Objectives

The relationship between decreasing levels of estrogen and the interaction with dopamine function in the brain in women with ADHD will be discussed and illustrated by a clinical case vignet of Mary, age 54.

Methods

Mary presents with a history of repeated burnout episodes, mood swings, lifetime difficulty concentrating, planning and organising daily life, restlessness, sleep problems, and cardiac complaints.Mary has been working hard her whole life to overcome all difficulties, but her problem is she can never stop, leading to getting burnout several times. This time she is exhausted and can no longer cope; she is visiting the cardiologist for palpitations, hypertension and a recent myocardial infarction.

Results

After a positive screening for ADHD, based on her lifetime symptoms of inattention, restlessness and impulsivity, as well as mood swings, she is referred to a psychiatrist for assessment of ADHD, mood and sleep problems. The pathophysiology behind this cluster of disorders during (peri)menopause, as well as the treatment options will be discussed based on Mary’s case.

Conclusions

Both ADHD in women, (peri)menopausal mood disorders as well as the heart complaints in women during menopause are underrecognised and undertreated, leading to unneccesary suffering and cardiac death in women. It is time for psychiatry to join forces with cardiology and gynaecology for better recognition, sharing knowledge and multidisciplinary treatment of women with mental disorders such as ADHD during menopausal transition (see www.h3-netwerk.nl).

Disclosure of Interest

None Declared
Association between Educational Attainment and Risk of Postnatal Depression: Findings from the Czech Republic
Authors: Kuklová M. , Hrdličková K. , Horáková A. , Němcová H. , Šebela A.
Published: August 2024

Introduction

Postnatal depression is a common mental health condition that affects women across the globe. Lower education is frequently considered to be linked to an increased likelihood of postpartum depression. Nevertheless, inconsistent epidemiological evidence has been reported concerning the associations between education and postpartum depression risk. This study investigates the correlation between education level and postpartum depression in the Czech Republic.

Objectives

The aim of this study was to examine whether there is an association between educational attainment and the risk of postnatal depression in women who have recently given birth in the Czech Republic.

Methods

Women aged 18-45, who spoke Czech and had an email address, and had given birth in the hospital were eligible to participate in the study. The research was conducted in the maternity unit, where a medical professional presented the opportunity to take part. All participants were screened using the Edinburgh Postnatal Depression Scale (EPDS), with the cut-off score of ≥10 showing increased of postpartum depression.

Education data was collected via self-reported questionnaires. Binary logistic regression was employed to calculate the odds ratio (OR) with 95% confidence intervals (CI) to assess the relationship between educational attainment and postpartum depression risk, with sociodemographic and health-related characteristics being stepwise adjusted.

Results

Our study consisted of 3,739 postpartum respondents (mean age of 31 years). The prevalence of increased postpartum depression (≥10 EPDS points) was 22.7%. Compared to individuals with higher education (reference category), those with basic education had a higher risk of postpartum depression (OR 1.67; 95% CI 1.26–2.23; p<0.001), even after adjusting for all covariates (OR 1.55; 95% CI 1.08–2.22; p=0.017). Basic education was found to have the strongest association with an increased risk of postpartum depression, even when adjusted for covariates. The association between education and postpartum depression was explained by the covariates.

Conclusions

Having only basic education is a significant risk factor for postpartum depression. Interventions to reduce the burden of postpartum depression ought to focus on individuals with low levels of education.

Disclosure of Interest

None Declared
An educational program, «Women victims of domestic violence: Detection, clinic, help»: Working with the complexity of teaching and Interpreting practice through research
Authors: Semenova N. D. , Kachaeva M. A. , Shport S. V.
Published: August 2024

Introduction

Firstly, we will speak on the violence against women from a Russian perspective. The selected reports from regional psychiatric services and police department reports of domestic violence cases will be presented.

Objectives

Secondly, we will draw upon our work developing and providing a new educational program, «Women victims of domestic violence: Detection, clinic, help,» mainly based on teaching several modules, WPA International Curriculum for Mental Healthcare Providers on Violence Against Women.

Methods

In this present paper, we examine evidence-based practice from the starting points of research as illumination and psychiatry as a discipline with hermeneutic potential, to consider relationships between research and practice and the opportunities available within the current research agenda for psychiatrists and clinical psychologists working in clinical settings.

Results

We contend that the quality of women’s mental health services will only improve when they can acknowledge the considerable impact that intimate partner violence and sexual violence, as well as social inequalities, especially those based on gender, have on women’s mental health. We do not underestimate the difficulty of providing practical help to women whose mental health has been profoundly affected by the violence, damage that is often further compounded by years of mistreatment and revictimization in services.

Conclusions

The paper provides commentaries and reflections on the steps that must be taken to create opportunities to foster dialogue, discussing and exchanging ideas on a diverse range of topics relevant to the advancement of the program in the broader context.

Disclosure of Interest

None Declared
Negative factors of personality hardiness that effect on ability to control situation and cope with the stress
Authors: Tukaiev S. , Kashpur D. , Pogorilska N. , Makarchuk M. , Zyma I. , Ferreira J. M. A.
Published: August 2024

Introduction

Personality hardiness expresses the characteristics that help to overcome stress and achieve well-being.

Objectives

This study focused on the Hardiness as the important personality trait, which allow coping with stress and the relationship of empathy, emotional sensitivity and the personality hardiness.

Methods

88 healthy volunteers, students aged 17 to 26 years (mean age = 19, SD = 1,69), participated in this study. We used Cloninger’s Temperament and Character Inventory (TCI), the Maddi Hardiness Survey (adapted by Leontyev), Buss Perry Aggression Questionnaire (BPAQ), the Barratt impulsiveness scale (BIS-11), Maslach Burnout Inventory (MBI), the Questionnaire Measure of Emotional Empathy (QMEE).

Results

The cluster analysis was used to identify groups of hardy personalities. We demonstrated a negative relationship between hardiness and depression and burnout. It revealed significant differences between these groups by the following traits: Attention (BIS-11), Self-Control (BIS-11), Cognitive Complexity (BIS-11), Hostility (BPAQ), Exploratory activity (NS1 TCI), Shyness of strangers (HA3 TCI), Resourcefulness (S3 TCI). Regression analysis was used to identify Hardiness factors and to build the following regression models. For the first group the models describe 100% of dispersion (R-square=1,000, Durbin-Watson statistic = 1,419) and are:

Control = -16,998 - 2,922*С2 + 3,549*С5 + 3,264*CI + 0,723*ST2 + 0,747*S4 - 0,306*SC + 0,166*RD3 - 0,020*C — 0,003*NS2, where C2 – scale Empathy (TCI), C5 – scale Principles (TCI), CI – cognitive instability, ST2 – Transpersonal identification scale (TCI), S4 – Self-acceptance (TCI), SC – Self-Control (BIS-11), RD3 – Social attachment (TCI), C – Cooperativeness (TCI), NS2 – Impulsive decision making (TCI).

The Hardiness model described 50% (R-square=0,456) of dispersion:

Hardiness = 63,527 – 4,080*C2, where C2 –Empathy scale (TCI) (p=0,003).

The regression models of the second group explain 50% of group dispersion (R-square=0,512) and are Independent variables significance
p<0,05:

Challenge = 12,484 + 0,389*SC + 0,197*EE — 0,702*RD1 — 0,206*A,where SC- Self-Control scale (BIS-11), EE – Emotional Empathy (Personality test of Emotional Empathy), RD1 – Sentimentality scale (TCI), A – Anger (BPAQ).

The Hardiness model describes 35% of dispersion (R-square=0,364, Durbin-Watson statistic = 2,066):

Hardiness = 100,352 + 0,941*SC — 0,527*H, where SC – Self-Control scale (BIS-11) (p=0,009), H – Hostility scale (BPAQ) (p=0,021).

Conclusions

Thus, the attention and self-control problems, hostility, cognitive complexity and shyness have a negative impact on hardiness.Our results suggest that the excessive use of empathy leads to decrease of ability to control situation and cope with the stress.

Disclosure of Interest

None Declared
Artificial Intelligence in Psychiatry: A Comprehensive Literature Review
Authors: Gerantia M.
Published: August 2024

Introduction

The incorporation of artificial intelligence (AI) in healthcare, especially in mental health services, offers potential advancements in efficiency and personalization. As AI technologies like machine learning and natural language processing (NLP) continue to evolve, it’s vital to evaluate their applications in psychiatry comprehensively.

Objectives

This review aims to summarize and characterize studies that used AI, particularly machine learning and NLP, in mental health. Additionally, it endeavors to understand how these technologies may enhance diagnostic tools, symptom monitoring, and delivery of personalized treatment in psychiatry.

Methods

Adhering to PRISMA guidelines, a systematic search was executed across multiple medical databases, including PubMed, Scopus, ScienceDirect, and PsycINFO. Keywords encompassed machine learning, data mining, psychiatry, and mental health. Exclusion criteria included non-English papers, anonymization process descriptions, case studies, conference papers, and other reviews. Data from various segments in the provided information were synthesized to capture the broader picture of AI’s application in psychiatry.

Results

From the 327 articles initially identified, 58 were chosen for detailed review. Studies predominantly revolved around three main populations: patients in medical databases, emergency room visitors, and social media users. The primary applications of AI entailed symptom extraction, illness severity classification, therapy effectiveness comparison, and psychopathological insights derivation. Data sources mainly included medical records and social media, with Python emerging as the preferred platform for most studies.

Conclusions

While AI shows immense promise in revolutionizing mental health care, its current applications largely confirm existing clinical hypotheses. Ethical concerns, such as patient privacy and data biases, remain paramount. Future work should delve deeper into these challenges while further exploring AI’s potential in clinical psychiatry practice.

Disclosure of Interest

None Declared
Text4Hope: An e-Mental Health Tool for Mitigating Psychological Symptoms among Young Adults
Authors: Belinda A. , Shalaby R. , Vuong W. , Surood S. , Greenshaw A. , Gusnowski A. , Wei Y. , Agyapong V. I. O.
Published: August 2024

Introduction

Chronic stress, anxiety, and depression can interfere with young adults’ everyday function, academic achievement, and interpersonal relationships. Interventions aimed at preventing the deterioration or possibly onset of these mental disorders among young people are timely.

Objectives

To assess the impact of a supportive text messaging program (Text4Hope) on the psychological well-being of young adults.

Methods

This study adopted both longitudinal and naturalistic controlled trial designs. Longitudinal study: compared baseline and 6th week outcomes in the same group of young adult subscribers. Naturalistic controlled study: compared clinical parameters in two groups of Text4Hope young adult subscribers: (i) intervention group (IG), subscribers who received once-daily supportive text messages for 6-weeks and completed 6th-week evaluation between 26 April and 12 July 2020, and (ii) control group (CG), subscribers who joined Text4Hope the same time frame, completed a baseline survey and were yet to receive text messages. The prevalence and severity of moderate-high stress, anxiety, and depression was measured using standardized scales. Inferential statistics, including the t-test, McNemar test, chi-square, and binary logistic regression analyses, were used to evaluate the differences in the prevalence and severity of the psychological symptoms.

Results

Longitudinal study: subscribers who completed both the baseline and 6th-week surveys, had significant reduction in the prevalence of moderate-high stress (8%) and likely GAD (20%) from baseline to six weeks. The largest reduction in mean scores was for the GAD-7 scale (18.4%). Naturalistic study: significantly lower prevalence for likely Moderate Depressive Disorder (25.2%) and suicidal thoughts/thoughts of self-harm (48.4%), with a small effect size in the IG compared to CG.

Image:

Conclusions

TheText4Hope program has been demonstrated as an effective e-mental health tool for mental health support for young adult subscribers. This is particularly encouraging, as young adults have already adapted to SMS text messaging and texting. Therefore, this mode of intervention can be used to supplement existing treatments for psychological problems impacting young adults. In addition, the cost effectiveness and easy scalability of supportive text message interventions mean that policymakers and governments can quickly implement similar programs as part of national youth suicide prevention strategies.

Disclosure of Interest

None Declared
Childhood socio-economic disadvantages versus adverse care experiences: Mediation and moderation impacts on late-life depressive symptoms
Authors: Huang Ying Yue , Zhang Wei Sen , Jiang Chao Qiang , Zhu Feng , Jin Ya Li , Au Yeung Shiu Lun , Wang Jiao , Cheng Kar Keung , Lam Tai Hing , Xu Lin
Published: August 2024

Background

Whether material deprivation-related childhood socio-economic disadvantages (CSD) and care-related adverse childhood experiences (ACE) have different impacts on depressive symptoms in middle-aged and older people is unclear.

Methods

In the Guangzhou Biobank Cohort Study, CSD and ACE were assessed by 7 and 5 culturally sensitive questions, respectively, on 8,716 participants aged 50+. Depressive symptoms were measured by 15-item Geriatric Depression Scale (GDS). Multivariable linear regression, stratification analyses, and mediation analyses were done.

Results

Higher CSD and ACE scores were associated with higher GDS score in dose-response manner (P for trend <0.001). Participants with one point increment in CSD and ACE had higher GDS score by 0.11 (95% confidence interval [CI], 0.09–0.14) and 0.41 (95% CI, 0.35–0.47), respectively. The association of CSD with GDS score was significant in women only (P for sex interaction <0.001; women: β (95% CI)=0.14 (0.11–0.17), men: 0.04 (−0.01 to 0.08)). The association between ACE and GDS score was stronger in participants with high social deprivation index (SDI) (P for interaction = 0.01; low SDI: β (95% CI)=0.36 (0.29–0.43), high SDI: 0.64 (0.48–0.80)). The proportion of association of CSD and ACE scores with GDS score mediated via education was 20.11% and 2.28%.

Conclusions

CSD and ACE were associated with late-life depressive symptoms with dose-response patterns, especially in women and those with low adulthood socio-economic status. Education was a major mediator for CSD but not ACE. Eliminating ACE should be a top priority.
Prenatal Cannabis Use Disorder and Risk of Neurodevelopmental Disorders in Offspring: A Linked Data Cohort
Authors: Tadesse A. W. , Dachew B. A. , Ayano G. , Betts K. , Alati R.
Published: August 2024

Introduction

Cannabis use has been increasing among women of reproductive age in the last few decades. In-utero cannabis exposure could be associated with an increased risk of neurodevelopmental disorders such as attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and intellectual disability (ID) during childhood and adolescence; however, existing evidence was generated based on maternal self-report of cannabis use in pregnancy. We conducted a large-scale with data linkage cohort study, in which both exposure and outcome of interests were confirmed using diagnostic tools, ICD-10-AM.

Objectives

This study aimed to examine the association between prenatal cannabis use disorder (CUD) and neurodevelopmental disorders in offspring using a large-scale cohort study.

Methods

We conducted an administrative health data-based cohort study of 222,569 mother-offspring pairs using linked data obtained from health registries in New South Wales (NSW), Australia. Data were drawn from the NSW Perinatal Data Collection (PDC), which included all live births in the Australian state of NSW between January 2003 and December 2005. These were linked with the NSW in-patient and ambulatory data collections for mothers and offspring. The prenatal cannabis use disorder (exposure) and neurodevelopmental disorders in offspring (outcomes of interest) were measured by using ICD-10-AM. Generalized linear regression with a binomial family model was used to explore the association. We also carried out a modification/interaction effect of low birth weight (LBW), smoking and premature births (PTB), which enhanced the methodological robustness of the study.

Results

This study found that offspring from mothers with prenatal CUwD had a 98%, 94% and 46% increased risk of ADHD [aRR = 1.98: 95 % CI 1.36 – 2.88], ASD [aRR = 1.94: 95 % CI 1.34 – 2.82], and ID [aRR = 1.46: 95 % CI 1.01 – 2.63] compared to those non-exposed offspring, respectively. We observed a significant interaction effect between CUD during pregnancy and maternal smoking on the risk of childhood ADHD, ASD and ID [CUD*smoking: RR = 5.62: 95 % CI 3.77 – 8.39, RR = 2.72: 95 % CI 1.78 – 4.18, and RR = 2.84: 95 % CI 1.54 – 5.22, respectively]. Furthermore, we also found significant associations between PCUD and ADHD, ASD and ID when interacting with LBW, and PTB.

Conclusions

Maternal prenatal CUD is associated with a higher risk of ADHD, ASD, and ID in offspring. The effect of maternal CUD on neurodevelopmental disorders was also found to be stronger when mothers also reported smoking during pregnancy, compared to the individual effects of cannabis use or smoking alone. The findings highlight the importance of implementing preventive strategies to reduce cannabis use in pregnancy.

Disclosure of Interest

None Declared
Perceived parental bonding and cortisol awakening response in people with eating disorders
Authors: Attianese N. , Battipaglia M. , Donato S. , Ceres R. , Cerra R. , Cascino G. , Monteleone P. , Monteleone A. M.
Published: August 2024

Introduction

Early life experiences may have an impact on hypothalamic–pituitary–adrenal (HPA) axis functioning in eating disorders (EDs). Parental bonding is defined as the parental contribution of care and control to parent–child relationships. We evaluated whether perceived care and protection of parental bonding in childhood and adolescence were associated with HPA axis functioning in adult patients with EDs. The activity of the HPA axis was assessed by measuring the salivary cortisol awakening response (CAR).

Objectives

We evaluated whether parental care and control in childhood and adolescence were associated with HPA axis functioning in adults with EDs. On the basis of literature data on healthy participants, we hypothesized that people with high levels of parental care would show a reduced CAR compared to people with low levels of parental care.

Methods

We admitted patients according to the following inclusion criteria: (a) female sex, (b) age > 18 years, (c) current diagnosis of AN or BN according to DSM-5 criteria, (d) absence of severe physical disorders, (e) no history of endocrine disorders, psychoactive substance use, schizophrenia or other psychoses, bipolar disorders or head trauma. Participants completed the Italian version of the Parental Bonding Instrument (PBI). To measure the CAR, participants were instructed to collect saliva samples at awakening and 15, 30, and 60 min after awakening.

Results

64 women with EDs participated in the study: 37 with AN and 27 with BN. 28 participants reported low levels of both maternal and paternal care while 12 participants reported high levels of care from both parents; 31 participants reported high levels of both maternal and paternal control, while 12 participants reported low levels of control from both parents. When maternal care was entered as between factor in the analysis, the repeated measures 3-way ANOVA showed a significant time effect (F3, 180 = 2.81, p < 0.05) and a significant maternal care X time interaction (F3, 180 = 2.99, p < 0.05), while, when paternal care was entered as between factor, the repeated measures 3-way ANOVA did not show significant effects for time and no significant paternal care X time interaction.

Conclusions

Our results show an association of perceived maternal care with the time pattern of CAR in female patients with ED, while perceived parental control was not associated with any CAR feature in EDs. Maternal control, paternal care and paternal control were not associated with any difference in the CAR.

Disclosure of Interest

None Declared
Gene expression of protein synthesis, immunity and brain pathways specifically altered in Anorexia Nervosa
Authors: Ramoz N. , Verebi C. , Lebrun N. , Duriez P. , Gorwood P. , Bienvenu T.
Published: August 2024

Introduction

Anorexia nervosa (AN) is a severe and chronic psychiatric disorder, resulting from a voluntary food restriction, vomiting, use of laxatives and excessive exercises, leading in dramatic weight loss and high mortality. AN is a multifactorial disease involving genetic and epigenetic factors supporting that AN is a metabo-psychiatric disorder. The molecular mechanisms involved in the etiology of AN remain unclear. One work reported gene expression by RNA sequencing in peripheral blood before and after weight restoration in 6 AN patients (Kim 2013), and one RNA sequencing in human iiPSC-derived neurons from 4 patients and 4 controls (Negraes 2017). To date, the profile of expression of genes and proteins in AN is undetermined.

Objectives

In this study, our goal is to identify specific gene expression signatures from circulating blood nuclear cells to decipher the pathophysiology of AN and characterize biomarkers that can be used for diagnostic or prognostic of AN.

Methods

All consented participants are recruited at Sainte-Anne Hospital, Paris, France, using DSM5 criteria. They had a blood draw in Paxgene tube for the collection of RNAs. Total RNA was extracted from peripheral blood mononuclear cells of 15 patients suffering of AN and 15 healthy controls. All messenger RNAs are sequenced on a Novaseq plateform. Reads are aligned to the human genome 19 and statistical analyses on the read counts for differentially expressed genes are computed with DESeq2.

Results

The total RNA sequencing allows us to identify 673 dysregulates genes (p adjusted value <0.01, fold change >1,5). Among them, 248 are down-regulated and 425 are up-regulated genes in AN patients compared to controls. From them, 151 transcripts are annotated as pseudogene and 45 are referenced as antisense RNA. Of the 522 remaining transcripts, 424 correspond to a transcript or protein annotated by HGNC and ENSEMBL and 93 are known pseudogenes. A large number of proteins resulting from the expression of deregulated genes interact with each other and form a statistically enriched network impacting biological processes. They are mainly increased and acting in the cellular machinery allowing protein synthesis (biological process: transcription, ribosome, spliceosome and mitochondria). In contrast, down-regulated genes present an enrichment in genes involved in immunity pathways. Finally, several genes are also expressed in the brain. We observed a significant enrichment of genes expressed in the blood and brain tissues.

Conclusions

We identify specific profiles of gene expression in AN. Several genes are both blood and brain tissue expression. Some genes are good candidates for biomarker of the diagnostic in AN that need to be investigated in a longitudinal study to evaluate their useful as prognostic biomarker of AN.

This work is supported by Fondation de France & Fédération Recherche sur le Cerveau.

Disclosure of Interest

None Declared
Physical healthcare gap among patients with severe mental illness through the COVID-19 pandemic. Preliminary results from a real-world investigation in Lombardy, Italy
Authors: Conflitti C. , Monzio Compagnoni M. , Corrao G. , Lora A.
Published: August 2024

Introduction

Patients suffering from mental disorders tend to be less adherent to the recommended therapies. Moreover, the COVID-19 pandemic had a global impact on physical and social well-being, which turned out stronger in the most fragile patients, like those with a mental condition.

Objectives

To assess whether the COVID-19 pandemic influenced the physical healthcare gap between patients with and without severe mental illness (SMI) treated for chronic conditions.

Methods

Data were retrieved from Healthcare Utilization Databases of Lombardy region (Italy). Prevalent users of antihypertensive drugs, statins or antidiabetic drugs, receiving healthcare in Lombardy during 2020, were identified. Among them, those with a previous diagnosis of schizophrenic or bipolar disorder were selected and matched with up to 3 patients without any sign of mental disorder by sex, age and number of contacts with the NHS during the previous year. 3 cohorts (not necessarily independent) were formed.

High adherence to specific recommended drug therapies and discontinuation during 2020 were evaluated.

Association between presence of SMI and high adherence was evaluated by using a log-binomial model (risk ratios, RR with 95% CI); a Cox model (hazard ratios, HR) was used for discontinuation.

As comparison, same analyses were performed to the cohorts of prevalent users in 2019, to evaluate the impact of the COVID-19 pandemic. Results were stratified according to the type of mental disorder.

Results

36'436, 14'136 and 12'597 prevalent users of antihypertensives, statins or antidiabetics respectively were identified, of which 25% with SMI (9'109, 3'536 and 3'152 respectively).

During the pandemic period, for all the three cohorts, patients with mental illness had 10% lower probability of being adherent to the recommended drug therapies.

The association between SMI and discontinuation was significant and varied among the three cohorts, with HR (95% CI): 1.27 (1.21; 1.33) for antihypertensives users, 1.16 (1.07; 1.26) for antidiabetics users and 1.08 (1.01; 1.16) for statins users.

Compared with 2019 the gap remained similar, except for discontinuation of antidiabetics, where the gap diminished from 34% in 2019 to 16% in 2020.

No differences between the two mental disorders were found.

Conclusions

Results show that suffering from a mental disorder in people with chronic physical conditions affects their adherence to recommended drug therapies. During the pandemic period, the restrictive measures adopted may have led to a better care by family members, counteracting any increase in the gap.

The healthcare gap in patients suffering from mental illness remains an unsolved problem of primary importance for public health.

Disclosure of Interest

None Declared
Increasing Physical Activity in Medium Secure Mental Health Services in the UK: (IMPACT) - Preliminary Results from the Phase 4 Feasibility Study, with a highlight into the Women’s Services
Authors: Walker T.
Published: August 2024

Introduction

In the UK there are 3500 individuals detained in medium secure forensic psychiatry units. Service users in such settings have complex and serious mental illness (SMI), often with co-morbid physical health problems and a life expectancy of at least 10 years shorter than the general population. They often have low levels of physical activity. There is little evidence about physical activity interventions for medium secure service users in the United Kingdom.

Objectives

Our objective is to co-produce, with medium secure service users, the content and delivery of an intervention to increase physical activity. We shall assess feasibility, acceptability, and pilot data collection methods for outcomes relevant for a future randomised controlled trial.

Methods

This is a 30-month mixed-methods project that will follow the Medical Research Council (MRC) framework Developing and Evaluating Complex Interventions. The study has 4 phases. Phases 1-2 will gather information required to co-develop an evidence-based intervention in Phase 3. Phase 4 will assess the intervention in a feasibility study, evaluating and testing the intervention for a future pilot study.

Study settings: Two NHS Medium Secure In-Patient Psychiatric Hospitals in the UK.

Results

This paper presents the preliminary findings from Phase 4 and also offers a highlight into the results from the Women’s Services from both study sites. A total of thirty-three service users from both study sites participated in Phase 4 of the study and twenty-six completed the physical activity intervention, known as the IMPACT Intervention. Between both study sites, there were two Women’s Standard Medium Secure Services and one Women’s Enhanced Medium Secure Service, involved in this study. A total of nine female service users participated in Phase 4.

Conclusions

The preliminary findings of Phases 4 are allowing the team to move forward and evaluate the effect of the IMPACT Intervention.

Disclosure of Interest

None Declared
Trends in cannabis consumption: psychotic and anxiety symptoms among users
Authors: Martin-Santiago O. , Martinez.Gimeno P. , Calvo-Valcarcel M. , Alario-Ruiz C. , Arribas-Simon B.
Published: August 2024

Introduction

During cannabis use, some individuals may experience psychotic symptoms, such as unusual perceptions or irrational thoughts, including mild hallucinations or temporary paranoia. Anxiety is also common, characterized by excessive worry or intense fear. The occurrence of these symptoms varies based on cannabis quantity, individual sensitivity, and surroundings. Although not all users experience these effects, the link between cannabis and psychotic or anxiety symptoms highlights the need for a thorough risk assessment.

Objectives

Our goal is to analyze trends in cannabis use, as well as the psychotic and anxiety symptoms experienced by users, and to examine whether cannabis use is associated with other substances consumption.

Methods

We collected demographic and substance consumption data from two groups: 29 individuals aged 18 to 28 who had tried cannabis at least once and 19 regular consumers through a structured questionnaire.

Results

Regular cannabis consumers had a higher proportion of males than those who had tried it once (X²(1)=4.81; p=0.028). There were no significant differences in age, alcohol or tobacco consumption between the groups. Notably, regular cannabis consumers had a history of using other illegal drugs, both in the past and within the last month (X²(1)=8.53; p=0.003). Regarding cannabis effects, regular users more frequently reported sensations like euphoria, relaxation, altered time perception, tachycardia, motor coordination difficulties, and impaired clear thinking compared to one-time users (X²(1)=10.12; p=0.001). Regarding anxiety symptoms during cannabis consumption, both groups experienced a similar frequency. Finally, regular cannabis consumers reported strange ideas or perceptions more often than one-time users (X²(1)=0.743; p=0.019). However, the associated discomfort level was similar in both groups.

Conclusions

This study highlights that regular cannabis use is associated with a greater likelihood of using other substances and experiencing more pronounced effects, including psychotic symptoms. However, it doesn’t necessarily lead to increased anxiety symptoms compared to one-time users. It’s important to acknowledge that the relationship between cannabis and psychosis is intricate and influenced by factors like consumption quantity and individual sensitivity. These findings stress the importance of understanding cannabis’s impact on mental health and its connection to the use of other substances.

Disclosure of Interest

None Declared