bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of anti-thyroid autoantibodies with neuropsychiatric features in patients with affective and schizophrenia spectrum disorders
Authors: Ilhan R. S. , Can K. C. , Lalic S. N. , Halaman E. , Aktay O. , Özdemir F. , Çolak B. , Duman B. , Yazıcı S. , Saka M. C.
Published: August 2024

Introduction

A growing body of evidence has shown the association between autoimmune thyroiditis and mental illness (Rege et al. AUS N J S Psychiatry 2013; 300 141-154). Identifying the neuropsychiatric features associated with thyroid antibody positivity could have significant implications for diagnostic and therapeutic strategies. However, the link between anti-thyroid antibodies and precise underlying pathophysiology requires future research.

Objectives

The aim of the present study was to conduct a retrospective evolution in patients diagnosed with schizophrenia spectrum disorder and affective disorder who were screened for anti-thyroid antibodies at the time of their hospitalization and to investigate neuropsychiatric features of anti-thyroid antibody-positive patients.

Methods

A total of 143  inpatients diagnosed with schizophrenia spectrum disorders and affective disorders between 2021 and 2023 were screened for anti-thyroid antibodies such as thyroid peroxidase (TPO) and thyroglobulin (TG). All patients were women. In order to elucidate the subsequent neuropsychiatric clinical features of individuals with positive anti-thyroid antibodies, the retrospective examination was conducted based on Neuropsychiatric Invetory-Q (NPI-Q) and DSM-V diagnostic criteria utilized at the time of hospitalization.

Results

The main age of the patients was 48.2 (SD 10.4). A total of 143 inpatients with schizophrenia spectrum disorders and affective disorders were screened for anti-thyroid antibodies at the time of their hospitalizations. %23.1 (n=33) tested positive for at least one of the anti-TG or anti-TPO. All patients were euthyroid. The neuropsychiatric diagnoses are shown in Table 1. The most common neuropsychiatric features assessed by NPI-Q are shown in Table 2. 12.1% (n=4) of all patients were treated with IV steroid Pulse therapy.
Table 1.

Neuropsychiatric syndrom-level diagnostic patterns according to DSM-V

Patients with positive thyroid autoantibodies
(n=33)Manic syndrome10 (30.3%)Psychotic Syndrome19 ( 57.6%)Depression syndrome5 (15.2%)Catatonia10 (30.3%)   Exited6 (18.2%)   Stuporus2 (6.1%)   Fluctuating2 (6.1%)
Table 2.

The most common clusters of Neuropsychiatric features

NPI-Q
Positive Thyroid Autoantibodies
(n=33)Delusion15 (45.4%)Agitation/Aggression14 (42.4%)Irrıtability14 (42.4%)Motor abnormality14 (42.4%)Sleep disorder15 (45.4%)Appetite/Eating14 (42.4%)

Conclusions

In particular, in a subset of schizophrenia spectrum disorder or affective disorder patients with positive anti-thyroid antibodies may indicate autoimmunity, especially in cases where catatonic symptoms dominate the clinical presentation.

Disclosure of Interest

None Declared
Hungarian adaptation of the Honest Open Proud program
Authors: Őri D. , Corrigan P. W.
Published: August 2024

Introduction

The Honest, Open, Proud (HOP) program is an effective peer-led group program to support people with mental health problems in their disclosure to manage self and public stigma. The HOP program will be integrated into the National Anti-stigma Program in Hungary, which was initiated in 2020.

Objectives

Our goal was to develop the Hungarian version of the HOP program. We conducted the following measures to achieve our aim.

Methods

The adaptation process was conducted using community-based participatory research (CBPR) between September 2022 and January 2023. Over ten sessions, a group of eight individuals, consisting of both males and females with varying mental health conditions (mean age = 39.6 ± 8.5), participated in the online-led CBPR. The adaptation process was systematically documented, and regular supervision was provided.

Results

The program comprises three lessons and a follow-up section. We have translated the text of the manual and workbook into Hungarian and adjusted the tone, language, locations, and examples as per the Hungarian context. Although our adaptation process did not involve changes to the content and implementation strategies, we will perform structural modifications and adjustments to ensure the content is suitable for the predefined number of sessions and Hungarian participants.

Conclusions

The HOP could be feasibly implemented in the National Anti-stigma Program in Hungary; both online and in-person programs are planned. Given the lack of such a program in Hungary, it will likely be warmly welcomed and strongly supported for the benefit of people with mental health problems.

Disclosure of Interest

D. Őri Grant / Research support from: Fulbright Association supported research, P. Corrigan: None Declared
Gestational age and sex interaction and risk for autism spectrum disorder in extremely preterm newborns: an 18‑month follow‑up study
Authors: Pina-Camacho L. , Merchan-Naranjo J. , Rodriguez-Toscano E. , Martin L. , Romero C. , Boada L. , Zeballos S. , Arriaga M. , Blanco-Bravo D.
Published: August 2024

Introduction

Extremely preterm newborns - EPTN (born ≤28 weeks gestational age) are at increased risk of developing autism spectrum disorders (ASD). Demographic and perinatal risk factors associated with ASD risk in EPTN are understudied.

Objectives

(i) In EPTN and born at full-term healthy controls (HC), to characterize the emergence of ASD traits and autistic symptom load at age 18 months; (ii) in EPTN, to identify the influence of perinatal characteristics such as sex and gestational age on autistic symptom load at corrected-age 18 months.

Methods

Observational, longitudinal, prospective, 18-month follow-up study. We recruited a cohort of n=113 EPTN and n=47 HC (the PremTEA cohort); n=57 EPTN and n=42 HC successfully completed the 18-month follow-up visit. We assessed autistic symptom load & risk at 18 months using the M-CHAT-R/F questionnaire. For all EPTN and HC, we collected demographic and perinatal data. Using GLMs, we assessed, in EPTN, the association between demographic/perinatal variables and 18-month autistic symptom levels.

Results

At 18 months, EPTN children showed higher autistic symptom levels than HC (M-CHAT-R/F score, mean (SD) [range] = 2.21 (3.23) [0-12] in EPTN vs. 0.33 (0.57) [0-2] in HC; d=.873, p=.001. In EPTN, we identified differences by gestational age and sex in autistic symptom levels at 18 months (aR2=0.517, p=.006). In particular, female EPTNs born with lower gestational age showed higher autistic symptom load at age 18 months.

Conclusions

Our findings support the need for early screening of ASD symptomatology in EPTN infants, particularly in higher-risk subgroups, such as female patients born with lower gestational ages.

Disclosure of Interest

None Declared
Retrospective evaluation of sociodemographic and clinical characteristics of patients with schizophrenia receiving clozapine monotherapy and clozapine combined with different antipsychotics
Authors: Yıldız E. , İspir S. N. , Demirel H. R. , Odabaş Ünal S. , Aydın M.
Published: August 2024

Introduction

Schizophrenia is a chronic mental disorder and clozapine is an atypical antipsychotic that can be used in treatment-resistant schizophrenia patients. However, treatment-resistant schizophrenia may also include patients with an inadequate response to clozapine.

Objectives

In our study, we retrospectively analysed the sociodemographic and clinical characteristics of patients receiving clozapine monotherapy and patients receiving clozapine in combination with different antipsychotics. In this way, we aimed to evaluate the factors that influence the response to clozapine.

Methods

Clozapine monotherapy and clozapine in combination with different antipsychotics were identified by retrospective chart review of patients followed up at the Schizophrenia and Other Psychotic Disorders Outpatient Clinic, Department of Psychiatry, Faculty of Medicine, Selçuk University. Sociodemographic and clinical characteristics were recorded and subjected to statistical analysis. The study was approved by the Ethics Committee of Selçuk University.

Results

Of the 143 patients whose data were analysed, 60 (42%) were female. The mean age of the patients was 40.2±12.0 years and the mean duration of training was 10.4±4.3 years. 62 patients (43.4%) used long-acting antipsychotics. 90 patients (62.9%) were using clozapine, 52 (36.4%) were using clozapine as monotherapy, 5 (3.5%) were using clozapine together with another oral antipsychotics drug, and 33 (23.1%) were using clozapine together with a long-acting antipsychotic. No statistically significant difference was found when comparing mean age, age at first antipsychotic initiation, age at clozapine initiation and mean clozapine dose between patients using clozapine monotherapy (n=52) and patients using different antipsychotics in combination with clozapine (n=38). When the two groups were compared, a significant difference was found in the mean number of antipsychotics used before starting clozapine and the mean number of hospitalisations, with a lower number in the monotherapy group (3.1±1.4 vs 4.1±2.0, p=0.01 and 2.8±2.2 vs 4.5±3.2, p=0.006, respectively).

Conclusions

It is important to assess the concept of treatment resistance appropriately in the treatment of schizophrenia patients. The results of our study suggest that starting clozapine treatment promptly in treatment-resistant patients may increase the likelihood that patients will benefit from clozapine and reduce the need for additional treatments. Although our data and criteria for evaluating response to treatment are limited, it is important to draw attention to the clinical results of proceeding in accordance with the guidelines in the treatment of schizophrenia. Evaluating the response to clozapine treatment needs studies with stronger data and larger sample sizes.

Disclosure of Interest

None Declared
Schizo - obsessive disorder - separate clinical entity or elusive comorbidity? - a systematic review
Authors: Niewiadomski R. , Maciejczyk-Kawecka J. , Ciołek M. A. , Wilczyński K. , Janas-Kozik M.
Published: August 2024

Introduction

In some clinical scenarios obsessive and delusive symptoms exhibit several similarities, making it challenging to differentiate between schizophrenia spectrum disorder (SSD) and obsessive-compulsive disorder (OCD). There are numerous reports of patients suffering from those disorders and manifesting both psychotic and obsession-like features, which makes accurate distinction even more complicated. We found several conflicting theories attempting to elucidate this overlap, one being the existence of the separate clinical entity - schizo-obsessive disorder.

Objectives

The aim of this study is to consolidate current knowledge, synthesize existing theories and explore diagnostic implications.

Methods

We conducted a systematic literature review following the PRISMA protocol, we scrutinized studies addressing obsession-like symptoms in SSD, psychotic symptoms in OCD, and comorbidity of those disorders. We included peer-reviewed non-interventional studies published in English and Polish from 2013 onwards. The search was performed in the following medical databases: PubMed, Science Direct, Scopus, and Web of Science. Synthesis utilized a narrative approach due to diverse study designs, outcomes and observational nature of the collected data.

Results

We identified several dozen articles, which revealed a range of diverse findings, often inconclusive, and occasionally conflicting, Although, the collected data indicate the schizo-obsessive spectrum exhibits clinical relevance.

Conclusions

The ambiguity in results emphasizes the necessity for further investigations into pathomechanism of schizophrenia and OCD. Future research, particularly involving children and adolescents, should strive for a comprehensive understanding of the nuanced manifestations of obsessive-like and psychotic symptoms in both disorders, aiding in refining diagnostic criteria and developing effective intervention strategies.

Disclosure of Interest

None Declared
Psychosis following traumatic brain injury: A case study and a brief overview
Authors: Khiari H. , Hakiri A. , Rouai S. , Ghachem R.
Published: August 2024

Introduction

Psychosis resulting from traumatic brain injury (TBI) is a relatively uncommon but potentially severe and disabling outcome. The complex relationship between TBI and the onset of psychosis is marked by significant scientific uncertainty and differing opinions.

Objectives

To investigate the occurrence of psychosis following traumatic brain injury (TBI) and explore the intricate relationship between TBI and the development of psychosis.

Methods

A comprehensive case report was conducted on a 38-year-old patient who, after a severe TBI at the age of 23, exhibited signs of psychosis. Developmental history, family background, clinical assessments, magnetic resonance imaging (MRI), and electroencephalogram (EEG) results were analyzed.

Results

The patient, at the time of writing aged 38, was born at full term with a regular presentation and uneventful delivery, with no indications of perinatal or obstetric complications. Developmentally, he reached all milestones within the expected range, and there were no significant premorbid characteristics. There was no family history of schizophrenia in a first- or second-degree relative; a paternal cousin had had psychosis-like symptoms, but reportedly remained well without any medication.

At the age of 23, the patient was knocked from his motorcycle by a car and sustained a severe traumatic brain injury (TBI), with initial loss of consciousness and was in a coma state for approximatively a month, with later sequelae of cerebellar syndrome and predominant right-sided pyramidal syndrome.

Magnetic resonance imaging (MRI) a year following the TBI showed sequelae of bifrontal and temporal contusion lesions.

An EEG did not indicate any evidence of epilepsy, and a repeat EEG 14 years later revealed no diagnostic abnormality.

A year after the accident, his surroundings have noticed social withdrawal, a turning inward with a religious fervor, and persecutory remarks focused on his brother. At the age of 26, he presented to a psychiatric service having auditory hallucinations. He was deluded, believing himself to be a prophesied redeemer figure who is expected to appear and bring justice and righteousness to the world. He had an inappropriate affect. A diagnosis of schizophrenia was made, and neuroleptics prescribed. His auditory hallucinations faded, but the subsequent course was of repeated episodes of florid psychosis requiring maintenance neuroleptic treatment, eventually haloperidol decanoate (150mg monthly).

Conclusions

Psychosis following TBI is an uncommon yet potentially severe consequence, carrying the risk of significant debilitation. The relationship between TBI and psychosis is complex, but notable distinctions exist in clinical, epidemiological, and neurobiological aspects when compared to primary psychotic disorders.

Disclosure of Interest

None Declared
A Case of Electroencephalography and Machine Learning in Early Diagnosis of Psychotic and Affective Disorders
Authors: Sarisik E. , Popovic D.
Published: August 2024

Electroencephalography (EEG) serves as a non-invasive, cost-effective, and robust tool, directly measuring in-vivo neuronal mass activity with high temporal resolution. Using state-of-the-art machine learning techniques, EEG recordings have the potential to generate in silico biomarkers for severe mental disorders. In this study, we developed EEG-based classification models for schizophrenia and depression taking into account physiological and pathological aging processes.

From a cohort (N=735, 51.6% male) that is acquired in LMU Hospital, Department of Psychiatry and Psychotherapy, comprising healthy control individuals (HC, N=245) and patients with schizophrenia (SCZ, N=250) or major depressive disorder (MDD, N=240), we extracted power spectrum density and connectivity measures based on 60 second resting-state EEG recordings with 19 channels. The support vector machine models were trained to 1) classify patients with SCZ or MDD and HC individuals, and 2) predict age in HC individuals using ten-by-ten repeated nested-cross validation. The age-predicting model was applied to patient groups to calculate EphysAGE (Electrophysiological Age Gap Estimation) by subtracting chronological age from chronological age. The links between diagnosis, medication, and EphysAGE, i.e., accelerated aging, were then further explored with univariate analyses.

The EphysAGE Model had an explained variance of 46% (MAE=8.7 years, T=14.31, P1000<0.001). The patients with SCZ had a significantly higher EphysAGE (mean[SD]=0.61[10.32]) than the patients with MDD (mean[SD]=-1.10[10.49], p=0.04). The classification models discriminated SCZ from HC (Balanced Accuracy, BAC=72.7%, p<0.001), MDD from HC (BAC=67.0%, p<0.001), and SCZ from MDD individuals (BAC=63.2%, p<0.001). Higher EphysAGE was associated with an increased likelihood of being misclassified as SCZ in HC and MDD (ρHC=0.23, p<0.001; ρMDD=0.17, p=0.01) based on percentile rank scores from the SCZ Model. Moreover, in the Differential Diagnostic Model, higher EphysAGE is positively correlated with being misclassified as SCZ in patients with MDD (ρMDD=0.14, p=0.03).

Machine learning models can extract electrophysiological signatures of MDD and SCZ for potential clinical use. However, the impact of aging processes on diagnostic separability calls for timely application of such models, possibly in early recognition settings.

Disclosure of Interest

None Declared
Factors influencing delays in the diagnosis and treatment of bipolar disorder in adolescents and young adults: A systematic scoping review.
Authors: Levit A. , Nunez J.-J. , Morton E. , Keramatian K.
Published: August 2024

Introduction

Bipolar Disorder (BD) is a complex psychiatric condition that typically manifests during late adolescence and early adulthood. Over the past two decades, international studies have reported that BD often goes unrecognized and untreated for several years, which can lead to negative clinical and functional outcomes. However, the components of delay in the diagnosis and treatment of BD in adolescents and young adults and various factors influencing those components have not been systematically explored.

Objectives

To determine the known factors that contribute to delays in the treatment of BD in adolescents and young adults and identify current knowledge gaps.

Methods

A conceptual framework based on the Model of Pathways to Treatment by Scott and colleagues was used as a foundation for our search and extraction strategy to ensure all components of delay and potential factors influencing each component are explored. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline (PRISMA-ScR) to systematically search the electronic databases of MEDLINE (OVID), EMBASE, PsycINFO and CINAHL for peer-reviewed original research articles published from January 01, 2000 through March 29, 2023. Inclusion was restricted to studies with quantitative or qualitative data on individuals diagnosed with bipolar spectrum disorders with symptomatic onset or study participation between the ages of 13-24. Grey literature and studies not published in English were excluded due to resource limitations. Two independent reviewers screened the references retrieved by the literature search based on our inclusion criteria. The findings of included studies were summarized in a narrative and tabular form according to component of delay.

Results

Our search yielded 5180 unique citations, of which 44 articles met our inclusion criteria. We present findings on the patient, illness, and healthcare provider/mental health system factors contributing to the delays in illness appraisal, help-seeking, diagnosis, and treatment.

Conclusions

To the best of our knowledge, this is the first systematic scoping review to explore the potential factors that influence delays in the treatment of BD in adolescents and young adults. Findings from this review will inform clinical practice and policy. We also demonstrate the utility of a systematic approach to identifying the components of delay, from symptom recognition through treatment, as a methodology to help identify knowledge gaps to inform future research.

Disclosure of Interest

None Declared
How Many Criteria Should be Required to Define the DSM-5 Mixed Features Specifier in Depressed Patients?
Authors: Zimmerman M.
Published: August 2024

Introduction

During the past 2 decades there has been intense interest in the clinical significance of the concurrence of manic symptoms in depressed patients. DSM-5 introduced a mixed features specifier for both bipolar depression and major depressive disorder. Studies of the DSM-5 mixed features specifier have generally found a low prevalence of mixed depression. One approach towards increasing the sensitivity of the DSM-5 mixed features criteria is to lower the classification threshold.

Objectives

In the present study we examine the impact of lowering the DSM-5 diagnostic threshold from 3 to 2 criteria on the prevalence and validity of the DSM-5 mixed features specifier for depression.

Methods

Four hundred fifty-nine psychiatric patients in a depressive episode were interviewed by a trained diagnostic rater who administered semi-structured interviews including the DSM-5 Mixed Features Specifier Interview. The patients were rated on clinician rating scales of depression, anxiety and irritability, and measures of psychosocial functioning, suicidality, and family history of bipolar disorder.

Results

If the DSM-5 diagnostic threshold is lowered from 3 to 2 symptoms, then the prevalence of mixed features based on the DSM-5 majority of episode time frame tripled from 3.9% to 13.1% (n=60). Based on a past week time frame prevalence more than doubled from 9.4% to 22.9% (n=105) going from the 2 and 3 symptom threshold, respectively. There was no difference between the patients with 2 mixed features and patients with 0 or 1 mixed features on family history of bipolar disorder, psychosocial impairment, presence of comorbid disorders, age of onset, history of suicide attempts or psychiatric hospitalization.

Conclusions

The results of the present study do not support lowering the DSM-5-TR diagnostic threshold for the mixed features specifier in depressed patients from 3 to 2.

Disclosure of Interest

None Declared
The Influence of Depression in the Evolution of Parkinson’s Disease: A Psychiatric Perspective
Authors: Abu Shehab A. H. I. , Simona T. , Ciureanu I. A. , Voinescu D. C. , Burlea L. , Ciubară A.
Published: August 2024

Introduction

Parkinson’s disease (PD) is a neurodegenerative condition that is predominantly characterised by its motor symptoms. Nevertheless, it is important to note that non-motor symptoms, particularly depression often occur concurrently, exerting a substantial influence on the progression of the disease and the overall well-being of individuals affected by it.

Objectives

The objective of this study is to examine the influence of depression on the advancement of Parkinson’s disease (PD) from a psychiatric perspective. This analysis will involve an assessment of the common neurobiological pathways involved and the potential implications for clinical treatment and care.

Methods

A comprehensive assessment of the literature was conducted, focusing on clinical observations, neurochemical interactions, and neuroimaging investigations that provide insight into the concurrent presence of depression and Parkinson’s disease (PD). This study aimed to investigate the potential impact of depression on the severity of Parkinson’s disease symptoms, the course of the disease, and the responsiveness to treatment.

Results

Depression in Parkinson’s disease (PD) is not only a reactive occurrence, but rather it may be attributed to common pathophysiological mechanisms, such as changes in dopamine and serotonin pathways. The coexistence of depression among individuals with Parkinson’s disease (PD) has been linked to heightened severity of motor and cognitive symptoms, accelerated development of the disease, and diminished effectiveness of therapy interventions. Furthermore, the presence of depression in individuals with Parkinson’s disease intensifies the psychosocial difficulties experienced by both patients and their carers.

Conclusions

The recognition and management of depression in individuals with Parkinson’s disease (PD) is of utmost importance in order to enhance treatment approaches and enhance the overall well-being of patients. The establishment of interdisciplinary collaboration between neurologists and psychiatrists is necessary in order to guarantee a holistic approach to patient care.

Disclosure of Interest

None Declared
Exploring the Link Between Personality Traits and Self-Care Dimensions in Individuals Affected by Type 2 Diabetes Mellitus: A Comprehensive Systematic Review and Meta-Analysis
Authors: Dimou K. , Dragioti E. , Tsitsas G. , Mantzoukas S. , Gouva M.
Published: August 2024

Introduction

Type 2 diabetes mellitus (T2DM) is a prevalent, chronic metabolic disorder that exerts diverse effects on individuals’ physical and psychological well-being.

Objectives

Our aim was to investigate the potential correlation between personality traits and self-care aspects among individuals living with T2DM.

Methods

We conducted a thorough search in PsycINFO, CINAHL, and PubMed/Medline for peer-reviewed articles from inception to January 9, 2023. Following PRISMA guidelines, two reviewers independently screened, extracted data, and assessed bias. We used random-effects meta-analysis for pooling estimates

Results

We identified 23 studies meeting our inclusion criteria. Openness, conscientiousness, and agreeableness were linked to better foot care compliance (OR = 2.53, 95% CI = 1.49-4.28; OR = 1.84, 95% CI = 1.10-3.08; and OR = 2.07, 95% CI = 1.23-3.48, respectively). Openness was also associated with improved overall self-care behaviors (OR = 2.00, 95% CI = 1.17-3.41), while conscientiousness reduced smoking likelihood (OR = 0.96, 95% CI = 0.93-0.99), and agreeableness enhanced medication adherence (OR = 1.68, 95% CI = 1.34-2.31). However, extraversion and neuroticism were linked to lower medication adherence (OR = 0.77, 95% CI = 0.61-0.96 and OR = 0.51, 95% CI = 0.40-0.65, respectively). Neuroticism also negatively affected overall self-care behaviors (OR = 0.67, 95% CI: 0.55-0.81).

Image:

Conclusions

Personality traits should be considered when addressing self-care in T2DM patients.

Disclosure of Interest

None Declared
Randomized Controlled Trials to Treat Obesity in Military Populations: A Systematic Review and Meta-Analysis
Authors: Gravina D. , Keeler J. L. , Akkese M. N. , Bektas S. , Fina P. , Tweed C. , Willmund G. D. , Dell’Osso L. , Treasure J. , Himmerich H.
Published: August 2024

Introduction

In recent years, overweight and obesity have reached an alarmingly high incidence and prevalence worldwide; they have also been steadily increasing in military populations. Military personnel as an occupational group are often exposed to stressful and harmful environments that represent a risk factor for disordered eating with major repercussions on both physical and mental health.

Objectives

This study aims to explore the effectiveness of weight loss interventions and to assess the significance of current obesity treatments for military populations.

Methods

Three online databases (PubMed, PsycInfo, and Web of Science) were screened to identify randomized controlled trials (RCTs) aiming to treat obesity in active-duty military personnel and veterans. Random-effects meta-analyses were conducted for body weight (BW) and body mass index (BMI) values, both longitudinally comparing treatment group from pre-to-post intervention, and cross-sectionally comparing the treatment group to controls at the end of the intervention.

Results

A total of 21 studies were included: 16 cross-sectional (BW: n=15; BMI: n=12) and 16 longitudinal (BW: n=15; BMI: n=12) were meta-analyzed, and 5 studies were narratively synthesized. A significant small overall BW and BMI reduction from baseline to post-intervention was observed (BW: g = -0.10; p = 0.015; BMI: g = -0.32; p < 0.001), together with a decreased BMI (
g = -0.16; p = 0.001) and nominally lower BW (
g = -0.08; p = 0.178) in the intervention group compared to controls at post-intervention time-point. When conducting additional meta-analyses dividing by sample type, a significant decrease in both BMI (g= -0.35; p< 0.001) and BW (g= -0.12; p= 0.041) from pre-to-post intervention was observed in active-duty military personnel but not for veterans.Recommendations for clinical practice have been outlined from the findings of this study and summarized in Figure 1.

Image:

Conclusions

Despite limitations, such as the heterogeneity across the included interventions and the follow-up duration, our findings highlight how current weight loss interventions are effective in term of BW and BMI reductions in military populations, and how a comprehensive approach with multiple therapeutic goals should be taken during the intervention.

Disclosure of Interest

None Declared
From guided self-help to comprehensive ED treatment
Authors: Babusa B. , Bai-Nagy K. , Kovács J. , Dósa Á. , Salavecz G. , Túry F. , Purebl G.
Published: August 2024

Introduction

The incidence of eating disorders is increasing in Hungary and Central-Eastern Europe. The number of complex/severe cases is also increasing. Accordingly, several new unmet needs of the users and their relatives appear in the clinical care.

Objectives

As a possible response to these unmet needs, we have introduced a multifaceted care model for eating disorders. To facilitate easily accessible yet effective care close to home, a support programme with an online guided self-help tool and regular consultations with first responder psychiatrists or clinical psychologists has been introduced. For non (or partial) responders, a multi-faceted modular treatment programme has been developed with an individualised combination of different therapeutic approaches, including family therapy, dialectical behaviour therapy (DBT) specific to binge eating disorder and bulimia, CBT and the use of virtual reality as an adjunct treatment. The most severe cases are referred for (also multifaceted) inpatient treatment. In terms of research, we want to focus on the key issues for rapid, cost-effective treatment. Firstly, we want to develop an individual profiling system at the start of therapy to assess which individual combination of modules can produce a rapid therapeutic response. Secondly, we want to identify the active gamechanger elements of therapy that are associated with the greatest change in symptoms.

Methods

Patients complete the following questionnaires:

-in the guided self-help group: Eating disoreder inventory, (EDI-I), McMaster Family Assessment Device (FAD), Eastin Disorder Diagnostic Scale (EDDS), Eating Behavioral Severity Scale, Eating Disorders Symptom Impact Scale (EDSIS-S)

- in DBT groups: Eating Disorder Examination Questionnarie (EDE-Q), Three Factor Eating Questionnaire-R21, Rosenberg Self-Esteem Scale, Patient Health Questionnaire-(PHQ-9), Cognitive Emotion Regulation Questionnaire (CERQ)

- in individual therapies: Mini International Neuropsychiatric Interview (MINI) and Structured Clinical Interview for DSM 5-
Alternative Model for Personality Disorders (SCIP-5-AMPD), EDI-I., Mentalization Questionnaire (MZQ), Dissociation Questionnaire (DIS-Q), Symptom Checklist-90 (SCL-90), (PHQ-9), Childhood Trauma Questionnaire (CTQ) and Young Parenting Inventory (YPI).

Results

Patient recruitment and therapies are currently underway, the first preliminary results are expected in the spring period.

Conclusions

In order to provide individualized care more effectively, it is important to identify the factors that determine which therapeutic modalities work best for the patient.

Disclosure of Interest

None Declared
A Cost-Effectiveness Analysis of a Ketamine-assisted Psychotherapy Program Compared to Online Group Psychotherapy in British Columbia, Canada
Authors: Tsang V.
Published: August 2024

Introduction

Depression continues to present significant economic burdens to the Canadian healthcare system. Novel therapies, including those that incorporate psychoactive substances such as ketamine, present an opportunity to evaluate both clinical and economic effectiveness against current standards of care, which may be repeatedly proving ineffective in treating depression for some individuals.

Objectives

This paper evaluates the cost-effectiveness of the Roots to Thrive ketamine program compared to group psychotherapy covered through the medical services plan in British Columbia, Canada.

Methods

A discrete-time Markov-model is used to estimate depressive states over five cycles for a treatment cohort and a synthetic control cohort. The transition probabilities for the treatment cohort are calculated from Roots to Thrive program data (n = 62) over the past 3 years, with the control cohort using published values from the literature. Both cohorts use the same starting state distribution, excess healthcare utilization rates for each severity level of depression, and utility outcomes based on depression state severity.

Results

Compared to the control cohort, the Roots to Thrive program was less expensive and produced better outcomes as measured by PHQ-9 scores and Quality-Adjusted life years over 5 treatment cycles. On average, the Roots to Thrive program would save $14,481 and produce 0.94 additional QALY’s per individual compared to group psychotherapy of three patients per provider in the current standard of care.

Conclusions

From an economic perspective, incorporating the Roots to Thrive program - or a program like it - into care in British Columbia would provide both an improvement in health outcomes and reduce expenditure by the ministry of health. These funds could be reinvested into other areas of the healthcare system to improve the lives of all British Columbians, even those that do not engage in psychedelic-assisted psychotherapy.

Disclosure of Interest

None Declared
Does war increases the risk for psychoses?
Authors: Falkai P.
Published: August 2024

The World Health Organization (WHO) has stated that in situations of armed conflict, “Around 10 percent of the people who experience traumatic events will have serious mental health problems, and another 10 percent will develop behavior that will hinder their ability to function effectively.” Problems include post-traumatic stress disorder, anxiety, depression, substance misuse, and possibly precipitation of psychosis. War has a catastrophic effect on the health and well being of nations. Studies have shown that conflict situations cause more mortality and disability than any major disease. Only through a greater understanding of conflicts and the myriad of mental health problems that arise from them, coherent and effective strategies for dealing with such problems can be developed.

Disclosure of Interest

None Declared
A spark of genius and a flash of madness: Nikola Tesla and his struggles with mental illness
Authors: Jesus Magueta S. , Costa A. L. , Simões G. , Gomes A. I. , Madaíl Grego C. , Garrido P.
Published: August 2024

Introduction

An example of the unification of the contrast between artistic creativity and discipline of science, Nikola Tesla engineer and physicist, was also a prolific inventor that contributed to the transformation of modern society. Having resurfaced in the mainstream culture as a mythical figure, he appears to be enjoying a renaissance of posthumous recognition and praise. Throughaccounts available directly from his autobiography and descriptions offered by those who worked with him, the existence of the inventor´s eccentricities appear to reveal the existence of mental health disorder.

Objectives

The authors explore Tesla and the psychopathology that accompanied him throughout his periods of brilliance and as well as hardship.

Methods

The authors conducted a brief non-structured narrative literature review. The keywords used during the research, alone or in combination, included: Nikola Tesla, psychopathology and mental illness. The works consulted included: news articles, autobiographies and biographies. Of these, those that were written in the English language and deemed most pertinent to the explored theme were chosen for review in this work.

Results

The popular image of the mad scientist, which describes a brilliant but solitary and eccentric individual focused on their work is one that could be applied to Tesla. Documents reveal that he suffered a nervous breakdown, as well as having symptoms that point to a probably presence of obsessive-compulsive disorder, of which included counting and cleanliness rituals, exacerbated by chronic insomnia.

Conclusions

There appears to be anecdotal evidence pointing to an eventual relationship between creative genius and mental pathology. Although not formally evidenced through the scientific literature, exploring the life and accomplishments of Tesla serve as a significant example of a spark of genius perhaps ignited by mental illness. Tesla demonstrated suffering associated with his symptoms especially when considering the end of his life. At the time, adequate mental health interventions and treatments were not widely available, with his diagnosis probably being considered the quirks of genius and not the symptoms of disease.

Disclosure of Interest

None Declared
Lithium management around delivery: a retrospective observational cohort study
Authors: Imaz Gurruchaga M. L. , Torra Santamaria M. , Langohr K. , Martin-Santos R.
Published: August 2024

Introduction

During the perinatal period lithium is proven effective as maintenance therapy and to prevent postpartum psychosis. Pregnancy affects all aspects of kidney physiology altering the pharmacokinetics of lithium. To minimize the risk of both maternal and neonatal complications around delivery, several authors have provided clinical advice on lithium dosing around delivery: decreasing dose by 30-50%, suspend lithium therapy 24-48 hours before scheduled cesarean section or induced delivery or even discontinuing lithium after first signs of labour.

Objectives

To evaluate the validity of these recommendations by investigating 1) maternal lithium serum concentrations changes around delivery, 2) the lithium trasplacental passage at delivery and 3) the association between neonatal lithium serum concentration at delivery and neonatal outcomes.

Methods

Psychopathologically stable women with a singleton pregnancy (n=66) who used lithium around delivery, were included in this retrospective observational cohort study (HCB/2020/1305). All women were advised to suspend lithium administration at the onset of labour in the event spontaneous deliveries. Study date: demographic, psychiatric, obstetric and neonatal outcomes for each mother-infant pair obtained from the hospital medical records.Lithium serum concentrations were determined by means of an AVL 9180 electrolyte analyzer based on the ion- selective electrode (ISE) measurement principle. Limit of quantification (LoQ) was 0.20 mEq/L.

Results

The most common psychiatric diagnosis was a bipolar disorder type I (n=54, 90%). Forty mothers (61%) were on lithium monotherapy. Mean (SD) umbilical cord and intrapartum maternal lithium serum concentration was 0.59 (0.13) mEq/L and 0.55 (0.13) mEq/L respectively. There was a strong positive correlation between umbilical cord and maternal lithium serum concentrations (Pearson correlation coefficient 0.95 (95%IC: 0.91,0.97). In a subsample (N=22) a paired t test indicates that the maternal serum lithium concentrations at delivery were significantly lower (mean difference=0.19 mEq/L, 95%CI=0.13-0.25) than those during obtained the day before delivery hospitalization, after a mean (SD) of 31.29 (±11.92) hours (SD=11.92) have elapsed since the taking the last dose of lithium prior to delivery. Four women (6%) relapsed early postpartum.There were no significant differences between lithium monotherapy (N=18/40) and polytherapy (N=11/26) groups with regard to acute neonatal complications (p>0.05). The only acute neonatal complication associated to umbilical cord lithium serum concentration was hypotonia [0.712 (0.298) vs. 0.534 (0.214) (F=5.065; df=1,60; p=0.028)].

Conclusions

When lithium is used around delivery, maternal and neonatal well-being can be maximized by maintaining maternal serum lithium concentrations at the minimal effective level and discontinuing briefly when presenting to hospital for delivery.

Disclosure of Interest

None Declared
Endogenous phenotype of diagnostic transition from major depressive disorder to bipolar disorder: a prospective cohort study
Authors: Shim S.
Published: August 2024

Introduction

This study investigated sensor-level electroencephalography (EEG) power and related source-level cortical activity using resting-state EEG in patients with MDD and BD.

Objectives

This study aims to comparing bipolar disorder (BD) and major depressive disorder (MDD) to understand neuropathology of these disorders.

Methods

A total of 68 patients with MDD were enrolled and recorded EEG. Among patients with MDD, 17 patients with MDD converted to BD during the study periods. Clinical symptoms and EEG measures were compared between two groups. This study applied machine learning to differentiate the two groups using sensor and source-level features

Results

At the sensor level, patients with BD showed higher power of AF3 channel in the theta beta band(p=0.011) and FC5 channel in the low alpha band(p=0.014), compared to MDD. At the source-level, compared to MDD, patients with BD showed higher activity in the right anterior cingulate(p=0.011) and left parahippocampal gyrus(p=0.035). The best classification performance for MDD and BD showed an accuracy of 80.88%, a sensitivity of 76.47%, and a specificity of 82.35% based on theta and low alpha band power and activity features.

Conclusions

Our findings might suggest different theta and low alpha band activity between patients with BD and MDD might serve clinically as a candidate neuromarker for differentiating two distinct mood disorders.

Disclosure of Interest

None Declared
Exploring the impact of religiosity and spirituality on depressive symptoms in homeless people
Authors: Camargo P. H. F. , de Moraes J. V. G. N. , Vitorino L. M.
Published: August 2024

Introduction

Depression is a major concern among homeless individuals. Studies link religiosity and spirituality (RS) with lesser depressive symptoms, but evidence is scarce among the homeless.

Objectives

This study aims to assess the association between RS and depressive symptoms in homeless individuals in Brazil.

Methods

This cross-sectional study involved 456 homeless individuals in São Paulo, Brazil. It received approval from the Ethics and Research Committee of the Faculty of Medicine of Itajubá, Brazil. We used adjusted linear regression models to analyze the association between RS and participants’ depressive symptoms. Depressive symptoms were assessed with the Patient Health Questionnaire-9 (PHQ-9). We used the P-DUREL to measure religiosity, FACIT-Sp12 for spirituality, and the Brief-RCOPE scale for religious-spiritual coping strategies.

Results

Out of 482 invited participants, 456 (94.6%) completed all questionaries, mostly males (75%) with an average age of 44.53 (SD 12.62) years. About 49.6% had depressive symptoms (PHQ-9 ≥10 points). After controlling for sociodemographic and health variables, factors such as temple/church attendance (≥ 3 times per month), increased religiousness (both organizational and intrinsic), positive religious/spiritual coping, and peace, faith and meaning were inversely related to depressive symptoms. Conversely, dysfunctional use of RS, such as in negative spiritual-religious coping strategies, correlated with heightened depressive symptoms.

Conclusions

High depressive symptom prevalence was found among Brazilian homeless individuals. Functional use of RS was negatively linked to depressive symptoms, while dysfunctional RS, like negative spiritual-religious coping strategies, correlated with higher depressive symptoms. These findings can aid healthcare professionals, particularly psychologists and psychiatrists, in addressing RS in the homeless population.

Disclosure of Interest

None Declared
Impact of the COVID-19 pandemic on the manifestation and course of mental illness in elderly
Authors: Pochueva V. , Safarova T. , Yakovleva O. , Sheshenin V.
Published: August 2024

Introduction

COVID-19 is a multisystem disease affecting not only the respiratory, gastroenterstitial and vascular systems, but also the central nervous system, which leads to a wide range of neurological and mental complications. 3 years of experience in combating the pandemic has shown that elderly people burdened with chronic somatic diseases are the most vulnerable risk group for the development of severe course and complications of COVID-19.

Objectives

To study the impact of COVID-19 on the onset and course of mental illness in elderly inpatients

Methods

We examined 67 inpatients aged 50 to 95 years with various mental pathologies, who underwent COVID-19 from February 2020 to December 2021. 46 people had previous history of mentall disease (PHMD), in 21 cases the disease developed for the first time. Statistical analysis was performed.

Results

In the manifest group of patients, depressive episodes predominated (42.9%), including psychotic episodes (9.5%). In 28.6% of cases, organic disorders were diagnosed in the form of emotional lability, organic depression, mild cognitive impairment and delirium. In 23.8% of patients, neurotic disorders were observed in the form of depressive reactions, panic and generalized anxiety disorder. In one case (4.8%), acute polymorphic psychosis with symptoms of schizophrenia was diagnosed. The PHMD group includes affective disorders - 45.7%; organic disorders, including dementia 26.1%; schizophrenic spectrum disorders -19.6% and neurotic somatoform disorders - 8.7%. In the acute and subacute periods of COVID-19, acute psychotic states (APS) developed in both groups of patients (in 23.3% and 30.4%, respectively) in the form of delirium, psychotic depression, or polymorphic psychosis. APS were more common in PHMD patients with organic (50%) and schizophrenic spectrum disorders (33.3%) with a predominance of delirium. In the long-term period of COVID-19, PHMD patients more often than non-PHMD (60.9% and 38.1%) developed cognitive impairment (CI), especially in schizophrenia-like (77.8%) and organic (83.3%) disorders. CI developed twice as often after APS (89.5% and 39.6%, p<0.001), reaching the degree of dementia in 15.8% of cases. APS were significantly associated (p<0.05) with the development of CI (0.567733), the age of patients (0.410696) and the presence of previous cerebrovascular insufficiency (0.404916).

Conclusions

The age-related features of the mental consequences of COVID-19 are the occurrence of APS in the acute period of infection and the deterioration of cognitive activity at a remote stage. The PHMD patients, especially with disorders of organic and schizophrenic spectrum, were found to be more vulnerable to the effects of COVID-19. In them, the occurrence of APS was a risk factor for the development of dementia, while in primary diseased, and patients with affective and neurotic disorders, CI was reversible or had the character of a mild cognitive disorder.

Disclosure of Interest

None Declared