bluuebunny/crossref_metadata_2025 huggingface dataset:
High risk of psychosis, condition or diagnosis? About a case.
Authors: Maria Del Carmen M. L. , Irene C. I.
Published: August 2023

Introduction

A person with “high-risk mental status (HRMS)” indicates that the person, usually young people between the ages of 14 and 25, is more likely to develop psychosis. These people have attenuated psychotic symptoms without reaching the intensity or frequency of a frank psychotic episode. It is suggested that psychological trauma could favor neurochemical and psychopathological changes in a vulnerable individual. It would be interesting to study the role of psychotherapeutic interventions in the course of high-risk mental states and their possible evolution to a psychotic disorder. We present the case of an 18-year-old adolescent whose diagnosis was high risk of psychosis.

Objectives

This work has several objectives. On the one hand review current information on high-risk mental status (EMAR). On the other hand, develop a discussion about whether the EMAR category should be a diagnostic entity or just a condition.

Methods

A bibliographic search has been carried out in the main sources of medical information such as pubmed, uptodate as well as in national and international journals. Likewise, the knowledge and clinical experience of the team has been reviewed in order to expose its own experience in this field, defining specific interventions as well as results.

Results

The case presented is of an 18-year-old female patient.

She states that the main reason for consultation is something that happened last Sunday, at which time he had “an identity crisis” in which he did not know if he was a girl or a boy. The reasoning behind this fact is that “as Pablo Alborán likes him, perhaps he is a boy”. Given the bizarreness of the explanation and the patient’s particular contact, I explore a previous psychopathological situation. She says that since last year she feels more insecure, with diffuse fear that it is difficult to specify or nominate something specific: “in class and that is very difficult for me, public presentations”, she says that “everything scares me”, she says that she has a non-specific fear that has been maintained even increasing over the months and that has led him to have greater anguish. Even though the patient dates the beginning of the picture on Sunday, it is noteworthy that the previous Thursday she had requested a consultation with psychology in the private circuit that although she does not know how to specify the reason “because of fears” it seems that the anguish resulting from this fear had been increasing, having greater difficulties for the presentations in class. The contact is psychotic and the situation that the patient describes is typical of a “treme” situation, cataloged in the current literature as a High-Risk Mental State.

Conclusions

High-risk mental states are not a diagnostic category according to current classifications, although it is necessary to reach a consensus on what the diagnosis implies and what would be the way to proceed when a patient presents these symptoms.

Disclosure of Interest

None Declared
The influence of substance abuse on inhibition capacities and risky decision in a group of outpatient schizophrenia patients
Authors: Dannon P. , Kertzman S.
Published: August 2023

Introduction

Substance abuse is common among patients with schizophrenia, is related toworse course and outcome of illness. Unfortunately, little is known about how substanceabuse affects the cognitive function of schizophrenia patients, whose cognitive function isoften already comprised. Neurocognitive functioning includes inhibition control and decision-making, and both schizophrenia and substance use disorder are related to impairmentsof inhibition control. However, the influence of substance abuse on inhibition capacitiesamong schizophrenia patients is unclear

Objectives

This study measured the influence of substance use disorder on inhibition capacities and risky decision-making in a group of 39 schizophrenia patients that were evaluated using a socio-demographic questionnaire and clinical assessment using the Positive and Negative Syndromes Scale for Schizophrenia. To assess inhibition control we utilized the Matching Familiar Figure Test (MFFT) and the Stroop task, and to evaluate decision-making we used the Iowa Gambling Task (IGT) and self-report questionnaire, the Barratt Impulsiveness Scale

Methods

Univariate analysis found significant differences between the groups with regard to criminal history (v2¼5.97, p¼.015), smoking status (v:12.30, p<.001), and total BIS score (t: 2.69, df¼37, p¼.01). Our model did not find a significant effect of substance abuse on the first response time and number of errors on the MFFT or in the total interference index of Stroop performance and net score on risky decision-making in the IGT.

Results

The two groups did not differ significantly either in first response time or in number of errors on the MFFT (F¼0.54, p¼.47, d¼0.24, 95% CI [-0.4, 0.88]; F¼0.28, p¼.60, d¼0.61, 95% CI [0, 1.26], respectively), nor did they differ in the total interference index of the Stroop task (F(1)¼0.49, p¼.49, d¼0.25, 95% CI [-0.38, 0.88]).

Conclusions

The analyses did not detect any statistically significant effect of substance abuse on inhibition control or risky decision-making processes in outpatients diagnosed with schizophrenia, despite increased impulsivity, criminal history and smoking status. These results neither support nor disprove previous findings.

Disclosure of Interest

None Declared
Correlation between Negative Life Experiences and Auditory Hallucinations in Schizophrenia
Authors: Godiawala S. P. , Parikh M.
Published: August 2023

Introduction

Auditory Hallucination(AH) is a core & one of the most common symptom seen in schizophrenia. A prevalence study found that 1yr prevalence of AHs is 70% among patients of schizophrenia. Most theories of AHs discuss biological & psychological factors in phenomenology of voices. There definitely is a role of biological & neuroanatomical basis for occurrence of psychotic phenomenon & AHs, however environment & sociocultural background play important role in their genesis. It has been observed that theme of AHs is usually same, repetitive & associated with past life experiences of patients. The Negative Life Experience(NLE) though not always have significant impact on patient’s psyche, may manifest sooner or later in mental illness. Although AHs may be comforting, helping to cope up with unacceptable unconscious conflict, most patients report them to be negative, distressing & affecting socio-occupational functioning, thus making it important to understand & treat them effectively. Often, AHs stays as a residual symptom with which patient has to deal throughout life. This study is an effort to bridge existing gaps for better understanding of AHs & hence, Schizophrenia. It aims to understand effect of NLE on AHs, & thereby contribute to aetiology & therapeutic services to reduce distress of patients.

Objectives

This study aims to find presence of history of past NLE in patients with schizophrenia having AHs, find a correlation between NLE & the content of AHs & hence to establish the role of sociocultural factors in phenomenology of AH in patients with schizophrenia.

Methods

A longitudinal study of 30 patients diagnosed with Schizophrenia as per DSM-5 having AHs visiting Psychiatry Department of Government Hospital was carried out over a period of 2yrs. A quantitative study to find correlation between presence of NLE & AH in patients and a qualitative study by in-depth interview of 10 patients with help of semi-structured questionnaire to understand phenomenology by procedures of interpretative phenomenological analysis was carried out.

Results

A positive statistically significant correlation between NLE & content of AH was found. Majority of patients experienced AHs based on NLE in past & heard voices related to it. Various themes such as Guilt, Fear, Inadequacy, Anger, Frustration surfaced during the qualitative study.

Conclusions

This study thus strengthens the holistic model where sociocultural factors with biological & psychological factors play a role in pathogenesis of AHs. Treatment weighing on addressing NLE & emotions attached to it may help in foreshortening recovery & deal with residual AHs. This can help in therapeutic management of distress in patients, relieve internal conflict within their psyche, where they would feel more understood and learn to live with persistent AHs.

Disclosure of Interest

None Declared
Preliminary study on changes in BDNF in patients with depression after percutaneous coronary intervention
Authors: Medved S. , Sović S. , Ganoci L. , Božina N. , Šagud M. , Bulum J. , Mihaljević-Peleš A.
Published: August 2023

Introduction

Depression and coronary artery disease (CAD) are often comorbid conditions. The presence of depression significantly interferes with the recovery after CAD therapy intervention, such as percutaneous coronary intervention (PCI), one of the most common medical procedures in developed countries. Brain derived neurotrophic factor (BDNF) has a major role in angiogenesis and neuromodulation. Its levels were previously shown to be reduced in patients with depression, and latest studies indicate similar in patients with CAD. However, the correlation of BDNF levels and depression after CAD treatment is unknown.

Objectives

The aim of this preliminary study is to assess the changes in BDNF levels in patients with depressive symptoms during a six-month period upon PCI.

Methods

Antidepressant-free participants that underwent PCI with stent placement due to myocardial infarction or angina pectoris were enrolled in the study. Depressive symptoms were evaluated at baseline using the Beck’s Depression Inventory II (BDI-II) with a cut-off score ≥20 indicating moderate depression. Serum BDNF levels were measured from blood samples drawn a day after (baseline) and six-months upon a successful PCI without complications. The t-test for dependent samples was used with marked significant differences at p<0,05.

Results

Altogether, 76 participants were included in the study, of which 25 finished a six-month follow-up. Participants with BDI-II≥20 at baseline had higher serum BDNF levels in the second measurement (M=23,12, SD=6,20; M=32,02, SD=12,26, respectively). No significant difference was found in serum BDNF levels in measurements between participants with and without depressive symptoms (t=0,33, p=0,74; t=-1,40, p=0,18, respectively). Statistically significant difference was found between serum BDNF in the first and second measurement in the overall sample (t=-2,28, p=0,03) and in participants with baseline moderate depressive symptoms (t=-2,46, p= 0,03), but not in those without (t=-0,59, p=0,57).

Conclusions

Serum BDNF levels in participants with baseline moderate depressive symptoms increased after a six-month period upon successful PCI treatment, whereas that trend was not observed in participants without depressive symptoms. This highlights the potential synergistic role of BDNF in comorbid depression and CAD.

Disclosure of Interest

None Declared
Addictive behaviors in schizophrenic patients: Descriptive and analytical study
Authors: Bouali W. , Babba H. , Zaouali F. , Kacem M. , Brahim S. , Zarrouk L.
Published: August 2023

Introduction

The association of an addictive disorder (harmful use, abuse or dependence) with a schizophrenic disorder is the rule. Genetic vulnerability and social and economic factors are common to both disorders.

Objectives

determine the impact of addictive behavior on patients suffering from schizophrenia.

Methods

A descriptive and analytical retrospective study of 150 patients with schizophrenia hospitalized in the psychiatry department of Taher Sfar University Hospital in Mahdia from January 2017 to December 2021.

Results

The average age of the patients was 39.8 ± 11.23 years with a predominance of the age group 36-45 years (38.4%). All of the patients were male. Three quarters of the patients (75.5%) were consumers of psychoactive substances (PSA): nearly three quarters (72.8%) were dependent on tobacco, more than a third (39.7%) were dependent on alcohol, more than a quarter (29.1%) dependent on cannabis and almost a quarter (26.5%) dependent on other SPAs. Criminal history, suicide attempts and hospitalization in psychiatry were significantly more frequent in patients who consumed SPA than those who did not consume (39.5% vs 8.1%; p=0.008, 17.5% vs 2.7%; p=0.02, 89.5 % vs 75.7%; p=0.03, respectively). Patients who consumed SPA had significantly more positive signs of schizophrenia (51.8% vs 10.8%; p=0.001) and were significantly less observant to treatment (55.3% vs 16.3%; p=0.001) than those who did not consume. Hetero-aggressiveness, self-aggressiveness and job change were significantly more frequent in patients with addictive behaviors than those without addiction (86.8% vs 48.7%; p=0.001, 23.7% vs 2.7%; p= 0.004, 14.9% vs 0%; p=0.015, respectively). Multivariate analysis revealed that criminal history, hetero-aggressiveness, predominant positive symptomatology and work stoppage were the factors independently associated with SPA consumption in patients with schizophrenia in our study (β=14.7 95% CI 3.23–67.01, p=0.001, β=0.099, 95% CI 0.03–0.31, p=0.001, β=7.18, 95% CI 2.09–24.67, p=0.002, β=5.24 95% CI 1.27–21.7; p=0.02, respectively).

Conclusions

According to our study, addictive comorbidities concern three quarters of our patients. They expose them to a higher risk of legal problems, hetero-aggressiveness, predominance of positive signs and instability at work. These results encourage the development of methods for early diagnostic identification of addictive behavior comorbid with schizophrenia as well as integrated care combining psychiatric and addictological care.

Disclosure of Interest

None Declared
Amisulpride Augmentation in Schizophrenia Patients with Poor Response to Olanzapine: A 4-week, Randomized, Rater-Blind, Controlled, Pilot Study
Authors: Bahk W.-M. , Woo Y. S. , Park S.-Y. , Yoon B.-H. , Wang S.-M. , Kim M.-D.
Published: August 2023

Introduction

Olanzapine (OLA) is a common first-prescribed antipsychotic and has shown favorable efficacy in acutely exacerbated patients with schizophrenia. The mixed receptor activity of OLA and its greater affinity for serotonin 5-HT2A rather than dopamine D2 receptors are similar to those of clozapine. Pharmacokinetically, OLA is metabolized mainly by hepatic cytochrome enzyme P450 1A2 (CYP1A2). Because risks of antipsychotic polypharmacy include increased drug-drug interactions, pharmacokinetic considerations are important for selection of antipsychotics to be combined. Due to its pharmacological characteristics, amisulpride (AMI), another atypical antipsychotic with proven efficacy, is a promising adjuvant agent of special interest. AMI is unlikely to interact with other drugs due to the low plasma protein binding and metabolism and does not affect the activity of the CYP system. Furthermore, AMI is highly selective for dopamine D2/D3 receptors; has minimal or no affinity for D1, D4, or D5 receptors. Despite the potential benefits of the combination of OLA and AMI, only a few open-label studies have been conducted, and no randomized clinical trial has been performed to date to examine the efficacy and tolerability of the combination. Hence, the goals of this study were to test the hypothesis that AMI augmentation would improve psychotic symptoms and be well tolerated in schizophrenic patients who showed poor response to OLA monotherapy.

Objectives

The purpose of this study was to compare the efficacy and tolerability of continued olanzapine (OLA) versus amisulpride (AMI) augmentation in schizophrenic patients with poor response to OLA monotherapy.

Methods

The present 4-week, randomized, rater-blinded study included 25 patients with schizophrenia who were partially or completely unresponsive to treatment with OLA monotherapy. Eligible subjects were randomly assigned at a 1:1 ratio to continuation of OLA monotherapy (OLA group) or OLA with AMI augmentation (AMI group). Efficacy was primarily evaluated using the Positive and Negative Syndrome Scale (PANSS) at baseline and at 1, 2, and 4 weeks.

Results

The changes in PANSS total score and PANSS-positive subscale score were significantly different (p < 0.05) between the OLA and AMI groups. The differences between the two groups in PANSS-negative subscale, PANSS-general subscale, Brief Psychiatric Rating Scale, and Clinical Global Impression-Severity (CGI-S) scale scores were not statistically significant.

Conclusions

AMI augmentation could be an effective strategy for patients with schizophrenia who show inadequate early response to OLA monotherapy.

Disclosure of Interest

W.-M. Bahk Grant / Research support from: Handok Pharmaceuticals, Seoul, Korea, Y. S. Woo: None Declared, S.-Y. Park: None Declared, B.-H. Yoon: None Declared, S.-M. Wang: None Declared, M.-D. Kim: None Declared
LONGTERM OFF-LABEL USE OF SSRI IN TREATMENT OF EARLY EJACULATION: TWO CASES REPORT
Authors: Becirovic E. , Becirovic A.
Published: August 2023

Introduction

Early ejaculation is besides erectile dysfunction the most common exual dysfunction amog males. It can create suffering and inflence relationships. Selective serotonin reuptake inhibitors has known side effect and sometimes are used as treatment for early ejaculation.

Objectives

To present successful off-label treatment of early ejaculation.

Methods

Case report. Two cases.

Results

Two male patientes with early ejaculation problems that influenced their romatic and sexual life. Older one of them has devorced because of that. Younger has never had romantic or sexual relationship for the same reason. Prescribing SSRI make their love life more productiv. Older one married for the second time and has functional and stabile relationship. Younger one established several romantic and sexualn relatinship and currently is in a stabile romantic relationship.

Conclusions

Longterm use of low doses SSRI can be very beneficial in treatment of early ejaculation.

Disclosure of Interest

None Declared
Predicting Suicide Attempts among Major Depressive Disorder Patients with Structural Neuroimaging: A Machine Learning Approach
Authors: Fortaner-Uyà L. , Monopoli C. , Calesella F. , Colombo F. , Bravi B. , Maggioni E. , Tassi E. , Poletti S. , Bollettini I. , Benedetti F. , Vai B.
Published: August 2023

Introduction

Every year at least one million people die by suicide, with major depressive disorder (MDD) being one of the major causes of suicide deaths. Current suicide risk assessments rely on subjective information, are time consuming, low predictive, and poorly reliable. Thus, finding objective biomarkers of suicidality is crucial to move clinical practice towards a precision psychiatry framework, enhancing suicide risk detection and prevention for MDD.

Objectives

The present study aimed at applying machine learning (ML) algorithms on both grey matter and white-matter voxel-wise data to discriminate MDD suicide attempters (SA) from non-attempters (nSA).

Methods

91 currently depressed MDD patients (24 SA, 67 nSA) underwent a structural MRI session. T1-weighted images and diffusion tensor imaging scans were respectively pre-processed using Computational Atlas Toolbox 12 (CAT12) and spatial tract-based statistics (TBSS) on FSL, to obtain both voxel-based morphometry (VBM) and fractional anisotropy (FA) measures. Three classification models were built, entering whole-brain VBM and FA maps alone into a Support Vector Machine (SVM) and combining both modalities into a Multiple Kernel Learning (MKL) algorithm. All models were trained through a 5-fold nested cross-validation with subsampling to calculate reliable estimates of balanced accuracy, specificity, sensitivity, and area under the receiver operator curve (AUC).

Results

Models’ performances are summarized in Table 1.Table 1.

Models’ performances.

Input featuresAlgorithmSpecificitySensitivityBalanced accuracyAUCVBMSVM55.00%50.00%52.50%0.55FASVM72.00%54.00%63.00%0.62VBM and FAMKL68.00%54.00%61.00%0.58

Abbreviations: AUC, area under the receiver operator curve; FA, fractional anisotropy; VBM, voxel-based morphometry.

Conclusions

Overall, although overcoming the random classification accuracy (i.e., 50%), performances of all models classifying SA and nSA MDD patients were moderate, possibly due to the imbalanced numerosity of classes, with SVM on FA reaching the highest accuracy. Thus, future studies may enlarge the sample and add different features (e.g., functional neuroimaging data) to develop an objective and reliable predictive model to assess and hence prevent suicide risk among MDD patients.

Disclosure of Interest

None Declared
Particular suicides and psychiatric pathologies: Case Series.
Authors: Ritorto V. , Sacco M. A. , Gualtieri S. , Ricci P. , Tarallo A. P. , Aquila I.
Published: August 2023

Introduction

Suicide is one of the main cause of death in the world. It’s an important public health problem that is growning on new generations.

Objectives

The manners used to die have always been studied from psychiatry to understand which mental illness induced victim to various ways of suicide. They are multiples and are influenced by different factors. This study includes suicides cases defined “atypical”.

Methods

The cases were examined at the Insitute of legal Medicine Institute of Magna Graecia University of Catanzaro. Methods used were autopsies, and psycological autopsies. The study of the three cases also included the first level toxicological tests..

Results

In the first case, the victim died for cut injuries by using a kitchen knife on the lateral-cervical region of neck; the inspection revealed superficial lesions (test cuts) which, with progressive depth, reached the vascular-nervous bundle. In the second case, in a family contest of apparent welfare, the victim decided to go out home in the middle of the night, to reach an isolated place: there, when he still was in his car, he spilled on his head flammable liquid to accelerate fire effects.

In the case number 3, the victim was found at the bottom of a cliff with earplugs; maybe she was hearing voices in her mind that induced her to death. At home, police found a message on paper about her autopsy will.

Conclusions

The autopsy findings on the cases described are atypical. In every three cases of atypical suicide, the victim was not being treated with therapy, and all victims, probably, were very able to hide their socio-relational malaise. Forensic investigations for the study of suicides must not be limited to the study of fatal injuries. Forensic study about the modalities used to commit suicide wants to be a help to improve knowledge on certain psychiatric pathologies at high risk of suicide.

Disclosure of Interest

None Declared
Growing together: Longitudinal trajectory of posttraumatic growth among suicide-loss survivors and its interpersonal predictors
Authors: Levi-Belz Y.
Published: August 2023

Introduction: Background

Recent studies have indicated that grieving after suicide loss can be particularly complex and traumatic. However, studies have recognized the opportunity for personal growth among suicide-loss survivors.

Objectives

This study signifies an effort to develop a comprehensive understanding of the underlying interpersonal facilitators of posttraumatic growth (PTG) among suicide-loss survivors in a longitudinal design.

Methods

Participants included 189 suicide-loss survivors (155 females), aged 21–73, who completed questionnaires of thwarted belongingness (TB), perceived burdensomeness (PB), and self-disclosure at T1. Moreover, participants were assessed on PTG levels at T1, 18 months (T2), and 42 months (T3).

Results

The integrated mediation model indicated that both TB and PB contributed to the PTG trajectory. PB and self-disclosure contributed to PTG at T3 beyond the PTG trajectory across time. We also found self-disclosure to mediate the association of TB and PTG at T2 and T3.

Conclusions

These findings suggest that interpersonal factors play critical roles in contributing to PTG over time among suicide-loss survivors. Basic psychoeducational interventions designed to foster interpersonal behaviors may facilitate achieving PTG among survivors in the aftermath of suicide loss.

Disclosure of Interest

Y. Levi-Belz Shareolder of: no, Grant / Research support from: no, Consultant of: no, Employee of: no, Paid Instructor of: no, Speakers bureau of: no
Moral injury and suicide ideation among combat veterans: The moderating role of self-disclosure
Authors: Levi-Belz Y.
Published: August 2023

Introduction

Modern warfare in a civilian setting may expose combatants to severe moral challenges. Whereas most of these challenges are handled effectively, some potentially morally injurious events (PMIEs) may have deleterious psychological effects on the combatants, such as suicide ideation (SI). Self-disclosure, which includes sharing distressing thoughts and emotions, has been recognized as a protective factor against SI in the aftermath of stressful events.

Objectives

The current study is the first to examine the moderating role of self-disclosure in the relationship between PMIEs exposure and SI among combat veterans.

Methods

A sample of 190 recently discharged Israeli combat veterans completed validated self-report questionnaires in a cross-sectional design study, tapping combat exposure, PMIEs, depressive symptoms, SI, and self-disclosure.

Results

PMIE dimensions, and self-disclosure significantly contributed to current SI. Importantly, the moderating model indicated that self-disclosure moderated the link between PMIE-Self and current SI , as PMIE-Self and current SI were more strongly associated among veterans with low levels of self-disclosure than among high self-disclosing veterans.

Conclusions

Self-disclosure, as a factor promoting a sense of belongingness, interpersonal bonding, and support, might reduce SI risk following PMIE exposure. Various mechanisms accounting for these associations are suggested, and clinical implications of these interactions are discussed.

Disclosure of Interest

Y. Levi-Belz Shareolder of: no, Grant / Research support from: no, Consultant of: no, Employee of: no, Paid Instructor of: no, Speakers bureau of: no
Relevance of Group Training for Psychiatrists: an Experiential-Strategic model.
Authors: Battuello M. , Flore A. , Mele T. I. , Zagaria C. L.
Published: August 2023

Introduction

There are many stressors that lead to burn out and decrease the quality of life of health professionals as a whole and it occurs also to trainee psychiatrists.

Training programs rarely include specific interest in the personal self of students even if they begin to deal with severe human suffering.

Authors present a model of experiential group training in psychiatry that is centred on the person/trainee at the very most.

Objectives

The aim is to focus on unsolved emotional needs of students to allow them to achieve the capacity of relationship with patients. It is not a mere application of empathy but a truth overcoming, for trainees, of major risks of collusion due to reflection of individual conflicts into the patients and/or due to the encounter with strong emotion during clinical training.

Methods

The model is Experiential because it is the space for personal expression and it is Strategic because it is born inside the strategic group training in psychotherapy (Battuello et al. Psichiatria e Psicoterapia 2022; 41, 2, 65-82).

The conductor of the group carries on her/his skin the experience of own training group, to be brought into the trainees’ one.

This is an original approach because the epistemology of the model came directly from the experience.

The group is led by a psychotherapist that plays an active part inside the process instead of being only a facilitator.

The main focus is to allow students to express themselves that includes various steps such as: tuning with their own experiences/emotions, freedom of expressing them to the group, active listening to the other and response to the same other even when feelings don’t resonate but instead are divergent.

This phase is related to the conductor’s participation that is totally immersed into the group bringing personal feelings, stories and emotions to create an undifferentiated space, free from hierarchical roles.

During a second period, students can access a more mature relational capacity that carries the group to a phase of individuation of the self that also engages professional issues.

Results

Students in the group question themselves: it is the root of every health professional that has to explore and overcome personal relational issues. Only after the expressiveness phase, as authors name this part of the training, an individuation phase is truly possible that leads to the definition of the professional.

Conclusions

The training group is necessary for students to explore the wider range of emotions, expressing personal ones, accepting others’, experiencing the tolerance to their frustration, and emerging as professional, that is, in few words, professional of the relationship, the key and the basement of the psychiatrist.

The training in mental health should include, at first, the taking care of the person/student as it is proposed by authors inside the group model.

Disclosure of Interest

None Declared
Affective and physiological responses to human body odors in social anxiety – a pilot study on the possible effects as catalyst for treatment
Authors: Vigna E. , Cecchetto C. , Dal Bò E. , Hadlaczky G. , Wasserman D. , Carli V.
Published: August 2023

Introduction

Understanding the way chemistry influences human communication is important since the reaction to chemosignals has many implications for science and society.

Numerous research points out that human beings are able to identify feelings of fear and happiness through smell. Such emotional information can lead to approach-avoidance behaviors or changes in affective state. Moreover, a heightened sensitivity to social odors has been shown in subjects with social anxiety symptoms. However, more detailed research on the connection between olfaction, affective psychiatric disorders and interpersonal social communication is required.

POTION is an EU funded project within the Horizon2020 initiative that aims at understanding the nature of chemosignals in humans and their sphere of influence on social interaction. Whitin this project, we conducted a preliminary study showing that individuals with social anxiety symptoms benefited from mindfulness training especially when exposed to social chemosignals. A significant reduction in anxiety symptoms was achieved with both the happiness (t(25)=4.37, p=0.029) and the fear (t(25)=4.35, p=0.031) chemosignals. Moreover, individuals exposed to the happiness chemosignal exhibit highier vagal tone compared to subjects exposed to fear chemosignals (p = 0.026), indicating overall increased well-being.

Objectives

Given the exploratory nature of the preliminary study, an hypothesis driven pilot-RCT with larger sample size and refined design has been conducted. The aim was to further explore the catalyst effect of body odor on anxiety reduction. Notably, if the odor groups (happiness, fear or neutral) differ with the control group (clean air) and if they differ between each other in the outcome measure.

Methods

To this end, 96 participants with social anxiety symptoms (women aged between 18 to 35) were randomly allocated to one exposure group (happiness, fear or neutral human body odor or clean air) and followed a mindfulness intervention while being exposed to the odor. Psychological outcomes were measured before and after the intervention through the State-Trait Anxiety Inventory. During the intervention participants’ skin conductance and heart rate was also measured.

Analysis of variance will be performed to assess psychological outcome differences between and within groups, as well as interactions (GroupxTime).

Results

Results of the study will be available and presented at the time of the congress.

Conclusions

This study represents an advancement in the field mental health as it explores the potential impact of using human chemosignals in the clinical setting.

Disclosure of Interest

None Declared
Self esteem among Tunisian women victims of domestic violence
Authors: Jbir R. , Aribi L. , Chaari I. , Mseddi N. , Halouani N. , Aloulou J.
Published: August 2023

Introduction

Intimate partner violence is an under recognized problem in our society that is misjudged and often overlooked.

Violence in women has been linked to chronic health, emotional complications, one of which includes low self-esteem

Objectives

To study the prevalence and predictors of low self-esteem among women victims of domestic violence.

Methods

Our study was descriptive and analytical cross-sectional, carried out with women examined in the context of medical expertise, from May until January 2022.

An anonymous survey was asked to these ladies.

The Rosenberg questionnaire was used to assess the self esteem

Results

122 responses was collected.The average age of the assaulted women in our study was 35.66 years(from18 to 64 years) 98.4%were victims of verbal violence, 95,1% of physical violence, 97,5% of psychological violence and 54.7 %of sexual violence.

Self esteem was very low among 43,4% of women ,low among 18,9%,average among 15,6%,high among 15,6% and very high among 6,6%.

Women with children had lower self-esteem (p=0.02).

Low self-esteem were significantly correlated with: the husband cannabis consumption (p=0.01).

The ladies victims of sexual violence such as an unusual type of relationship had lower self-esteem (p=0.01).

Women who were threatened by their spouses had lower self-esteem (0,01).

An history of aggression during pregnancy was a risk factor for low self-esteem (p=0, 01).

Conclusions

Results suggest domestic violence has on women, not only physically effect but mentally and emotionally, this is why an urgent reaction must be taken by the state to reduce this scourge and hs repercussions on the mental health of the victims.

Disclosure of Interest

None Declared
Associations between polygenic loading, psychosis liability, and clozapine use
Authors: Luykx J.
Published: August 2023

Introduction

Predictors consistently associated with psychosis liability and course of illness in
schizophrenia (SCZ) spectrum disorders (SSD), including the need for clozapine treatment, are
lacking. Longitudinally ascertained medication use may empower studies examining associations
between polygenic risk scores (PRSs) and pharmacotherapy choices.

Objectives

To examine associations between PRS-SCZ loading and groups with different liabilities
to SSD: individuals with SSD on clozapine, individuals with SSD on other antipsychotics,
their parents and siblings, and unrelated healthy controls; and between PRS-SCZ and the
likelihood of receiving a prescription of clozapine relative to other
antipsychotics.

Methods: Design

Six-year follow-up and cross-sectional observational cohort study.

Setting

Multi-center.

Participants

Individuals diagnosed with SSD using clozapine or other antipsychotics, their parents
and siblings, and unrelated healthy controls.

Exposure

PRS-SCZ.

Main Outcomes and Measures

We used multinomial logistic regression to examine possible differences between groups
by computing risk ratios (RRs), i.e., ratios of the probability of pertaining to a particular
group divided by the probability of healthy control status. We also computed PRS-informed odd
ratios (ORs) for clozapine use relative to other antipsychotics.

Results

PRSs-SCZ were generated for 2344 participants (mean age: 36.95 years; 42.4% female)
remaining after quality control (557 individuals with SSD on clozapine, 350 individuals with
SSD on other antipsychotics during six-year follow-up, 542 parents and 574 siblings of
individuals with SSD, and 321 unrelated healthy controls). All RRs were significantly
different from 1; RRs were highest for individuals with SSD on clozapine (RR=3.24 [95%CI
2.76-3.81], p=2.47x10-46), followed by individuals with SSD on other
antipsychotics (RR=2.30 [95%CI 1.95-2.72], p=3.77x10-22), parents
(RR=1.44 [95%CI 1.25-1.68], p=1.76x10-6), and siblings (RR=1.40 [95%CI
1.21-1.63], p=8.22x10-6). PRS-SCZ was positively associated with
clozapine versus other antipsychotic use (OR=1.41 [95%CI 1.22-1.63],
p=2.98x10-6), suggesting a higher likelihood of clozapine prescriptions
in individuals with higher PRS-SCZ.

Conclusions

PRS-SCZ loading differs between groups of individuals with SSD, their relatives, and
unrelated healthy controls, with clozapine users being at the far end of PRS-SCZ loading.
Additionally, PRS-SCZ is associated with a higher likelihood of clozapine prescribing. Our
findings may inform early intervention and prognostic studies into the value of PRS-SCZ for
personalized antipsychotic treatment.

Disclosure of Interest

None Declared
Pharmacogenetics to Personalize Dosing of Tricyclic Antidepressants in Major Depressive Disorder: A Randomized Clinical Trial (PITA study)
Authors: Ter Hark S. , Vos N.
Published: August 2023

Introduction

Tricyclic antidepressants (TCAs) have an important role in pharmacotherapy of Major Depressive Disorder (MDD). TCA dosing is aimed at achieving a concentration in the therapeutic window. Due to inter-individual differences in activity of Cytochrome P450 (CYP) 2D6 and 2C19, (enzymes involved in TCA metabolism) patients require an individualized dose. Currently, finding of a suitable dosage is a process of trial-and-error, including multiple drug concentration measurements and dose adjustments. A starting dose based on a patient CYP2D6 and CYP2C19 metabolizer phenotype may contribute to achieving a therapeutic concentration more quickly, possibly resulting in higher treatment efficacy and the occurrence of fewer adverse effects.

Objectives

We aimed to study whether genotype-informed dosing in TCAs leads to faster attainment of therapeutic plasma concentrations, a higher reduction of depression severity symptoms and less adverse effects.

Methods

We conducted a double-blind randomized clinical trial, in which patients (18-65 years) diagnosed with severe MDD and eligible for treatment with a TCA were randomized in two treatment arms: The intervention arm (Pharmacogenetics Informed Treatment; PIT) and standard treatment (Treatment As Usual; TAU). Patients were treated with nortriptyline, clomipramine or imipramine for seven weeks and depressive symptom severity and adverse effects were monitored weekly. The primary outcome measure, time needed to attain a therapeutic drug concentration, was analyzed using Kaplan-Meier analyses. The secondary outcome measures, reduction in depressive symptoms and adverse effects, were analyzed with mixed model linear regression.

Results

In total, we randomized 111 patients. The PIT group (n=56) reached a therapeutic plasma concentration significantly faster (Kaplan Meier, X2 (1) = 4.3, p=0.039) compared to TAU (n=55), especially for patients treated with nortriptyline. On average depressive symptoms decreased relatively more in PIT than in TAU, although this was not significantly different: F(6) = 0.45, p = 0.84. The severity of adverse events during the study period differed significantly between PIT and TAU (F(6)=3.10, p=0.008). PIT experienced fewer adverse effects than TAU, especially in the last two weeks of the study.

Conclusions

Genotype-informed dosing leads to faster attainment of therapeutic TCA concentrations and does not lead to more adverse effects. Although we were not able to demonstrate that genotype-informed dosing leads to a significantly better response, we conclude that pharmacogenetics can contribute to the optimization of pharmacological treatment. Future research may focus on subgroups for which pharmacogenetics may be of great value, such as specific antidepressants or patients with an abnormal pharmacogenetic profile.

Disclosure of Interest

None Declared
Do children with ADHD symptoms become socially isolated? Longitudinal within-person associations in a nationally-representative cohort
Authors: Thompson K. N. , Agnew-Blais J. C. , Allegrini A. G. , Bryan B. T. , Danese A. , Odgers C. L. , Matthews T. , Arseneault L.
Published: August 2023

Introduction

Social isolation in childhood can be detrimental to physical and mental health. Children with neurodevelopmental disorders, such as attention deficit hyperactivity disorder (ADHD), may be particularly at risk for becoming socially isolated. Similarly, isolated children have limited opportunities to observe, model, and learn age-appropriate interpersonal interactions with other children which could increase ADHD behaviours.

Objectives

This study examined longitudinal associations between ADHD symptoms and social isolation across childhood. We tested the direction of this association across time, while accounting for pre-existing characteristics, and assessed whether this association varied by ADHD presentation, informant, sex, and socioeconomic status.

Methods

Participants included 2,232 children from the Environmental Risk (E-Risk) Longitudinal Twin Study. ADHD symptoms and social isolation were measured at ages 5, 7, 10, and 12. We used random-intercept cross-lagged panel models to assess the directionality of the association across childhood.

Results

Children with increased ADHD symptoms were consistently at increased risk of becoming socially isolated later in childhood, over and above stable characteristics (β=0.05-0.08). These longitudinal associations were not bidirectional; isolated children were not at risk of worsening ADHD symptoms later on. Children with a hyperactive ADHD presentation were more likely to become isolated, compared to an inattentive presentation. This was evident in the school setting, as observed by teachers, but not by mothers at home.

Conclusions

Our findings highlight the importance of enhancing peer social support and inclusion for children with ADHD, particularly in school settings. We add explanatory value over and above traditional longitudinal methods as our results represent how individual children change over time, relative to their own pre-existing characteristics.

Disclosure of Interest

None Declared
Impact of selected single nucleotide polymorphisms in OXTR and AVPR1a genes on their expression in persons with ASD.
Authors: Wilczyński K. M. , Auguściak-Duma A. , Stasik A. , Cichoń L. , Sieroń A. , Janas-Kozik M.
Published: August 2023

Introduction

Autism spectrum disorder is a heterogeneous group of disorders that affects virtually every population, regardless of their ethnic or socioeconomic origin. In recent years, the attention of researchers has been drawn to the participation of the oxytocinergic and vasopressinergic systems in the development of autism spectrum disorders. A relatively large number of studies have investigated the association of SNPs in these genes with the development of ASD, however, there is a lack of studies in the literature focusing on their actual effect on expression and on the effect of their expression on the risk of ASD.

Objectives

The aim of this study was to assess the levels of expression of OXTR and AVPR1a genes and evaluate their links with both risk of ASD and genotypes of the most studied polymorphisms.

Methods

The study included 132 people, 77.5% of whom were male (n = 100). 113 participants (85.6%) were diagnosed with autism spectrum disorders confirmed by the ADOS-2 test conducted by a certified diagnostician. In this group, men constituted 76.1% of the population (n = 77). The remaining 28 people did not have a diagnosis of autism spectrum disorders, and in the ADOS-2 study they obtained the result below the cut-off level. The mean age in the whole group was 14.4 years (95% CI: 13.92-14.93).

Results

Significant decrease in expression of the OXTR gene was found in case of rs53576 where presence of the alternative allele (G) was linked to the 20% decrease in expression (2^(-ΔΔCt) = 0.8). In case of AVPR1a alternative allele (T) of SNP rs10877969 was linked to the 20% increase in the gene expression(2^(-ΔΔCt) = 1.197). SNPs rs2254298 (2^(-ΔΔCt) = 0.97) and rs7294536 (2^(-ΔΔCt) = 0.97) did not influence expression of the appropriate genes in significant way. In comparison between the test and control group in participants with confirmed diagnosis of ASD 13% lower expression of AVPR1a was found (2^(-ΔΔCt) = 0.87).

Conclusions

Genotype of SNPs rs53576 and rs10877969 significantly influenced the levels of expression of the genes OXTR and AVPR1a respectively. In case of rs2254298 and rs7294536 observed effects were negligible. Presence of ASD diagnosis was linked to the 13% lower expression of AVPR1a. Abnormalities in AVPR1a expression seem to be more important for the development of autistic traits than the more attention-grabbing gene abnormalities for the oxytocinergic system.

Disclosure of Interest

None Declared
Cytomegalovirus infection associated with smaller cerebellum in severe mental illness
Authors: Andreou D. , Jørgensen K. N. , Nerland S. , Andreassen O. A. , Yolken R. H. , Agartz I.
Published: August 2023

Introduction

Postnatal cytomegalovirus (CMV) infection of immunocompetent hosts is usually inapparent but typically results in lifelong latency. Congenital CMV infections as well as CMV infections in patients with immunodeficiencies have been linked to major cerebellar pathology. Patients with severe mental illness have been repeatedly found to have smaller cerebellum, and they may be particularly susceptible to CMV infections. Finally, both animal and human studies have shown a differential male and female immune response to CMV.

Objectives

We evaluated whole cerebellar grey matter volumes (CGMV) in CMV immunoglobulin G (IgG) seropositive (CMV+) and seronegative (CMV-) patients with severe mental illness and healthy controls (HC). We hypothesized that CMV seropositivity, reflecting previous infection and current latency, is associated with smaller CGMV in patients but not in HC, and that such a putative association may be sex-dependent.

Methods

We included 529 adult patients with severe mental illness (CMV+ 57%, women 48%), i.e., 324 patients with schizophrenia spectrum disorders and 205 patients with bipolar spectrum disorders, and 494 HC (CMV+ 56%, women 45%). MRI scans were obtained with a 1.5T Siemens scanner (n=596) and two 3.0T General Electric scanners (n=427), and processed with FreeSurfer v6.0. Circulating CMV IgG concentrations were measured with immunoassays. In age-, scanner- and estimated total intracranial volume-adjusted analyses of covariance (ANCOVAs), we investigated main and interaction effects of CMV status and sex on CGMV in patients and HC.

Results

CMV+ patients had smaller CGMV than CMV- patients (p=0.042). There was no CGMV difference between CMV+ and CMV- HC (p=0.858). The adjusted CGMV means in CMV+ patients and CMV- patients were 115078 mm3 and 116725 mm3, respectively (p=0.042); the adjusted CGMV means in CMV+ and CMV- HC were 117980 mm3 and 117840 mm3, respectively (p=0.858) (Image). Among patients, a trend towards CMV-by-sex interaction (p=0.073) was found. Post-hoc analyses showed a significant CMV-CGMV association in the female patient group (p=0.005), with no association among male patients (p=0.840).

Image:

Conclusions

CMV IgG seropositivity is associated with smaller cerebellum in severe mental illness, an effect driven by the female patients, but not among HC. This may indicate a CMV-related deleterious impact on cerebellum restricted to patients.

Disclosure of Interest

None Declared