bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of smoking reduction on depressive and anxiety symptoms and quality of life in smokers with type 2 diabetes: a study focusing on the role of gender
Authors: Tzartzas K. , Chappuis A. , Clair C.
Published: August 2023

Introduction

There is a complex relationship between smoking, mental health and diabetes. On one side, there is a bidirectional relationship between tobacco and depression: smokers are more at risk to suffer from depression compared with non-smokers and smoking cessation is associated with mood improvement. Moreover, persons with depressive disorders may be particularly vulnerable to nicotine addiction and are less likely to quit smoking. On the other side, a strong association is observed between depression and diabetes. Gender and sex have also been described as influencing the associations between these different pathologies.

Objectives

Our aim was to determine if and how this relationship exist in a population with diabetes and to assess the impact of smoking reduction on depressive, anxiety symptoms and a health assessment score. We tried also to highlight the potential differences that we find between men and women.

Methods

Data were collected from a randomized controlled trial evaluating the 1-year efficacy of smoking cessation interventions in a population of smokers with type 2 diabetes. PHQ-9, GAD-7 and SF12 scores were used to assess depressive, anxiety symptoms and health assessment. We used STATA to perform data analysis.

Results

48 participants were recruited in this study. Women represent 60,4% of the population and men 39,6%. The mean age was 61,9 years old (SD 9.93). The mean depression, anxiety and health assessment scores were 4.1 (SD 4.55), 3.4 (SD 4.83) and 3.0 (SD 0.69) respectively. There were no significant differences between women and men scores. Women tended to have higher depression and anxiety scores, whether they reduced their consumption or not. Men who decreased their smoking consumption (reducers) tended to have better mental health scores than women at baseline. In both genders, we found a trend toward improvement in depressive, anxiety and health assessment scores of participants that reduced their tobacco consumption. We assessed a loss of 1.8 (SD 2.58, p-value= 0.424 ) and 1.7 (SD 3.20, p-value=0.448 ) points to their depressive and anxiety scores respectively while non-reducers only lost 0.6 (SD 4.03*) and 0.7 (SD 2.88**) points respectively.

Conclusions

Our study suggests that differences between genders exist and that there are improvement differences in scores of people who reduced their tobacco consumption compared to people who didn’t reduce their consumption. However, none of our results were significant. A study with a greater number of participants and with more strength should be done to confirm our hypotheses.

Disclosure of Interest

None Declared
Losing psychiatric or psychological follow-up during the first COVID-19 confinement in Portugal: outcomes in mental health
Authors: Gomes M. , Silva Moreira P. , Ferreira S. , Couto B. , Machado-Sousa M. , Raposo-Lima C. , Sousa N. , Picó-Pérez M. , Morgado P.
Published: August 2023

Introduction

The COVID-19 outbreak imposed several periods of lockdown to stop the pandemic, with a determinant impact on access to mental health services. In Portugal, the first State of Emergency was declared on the 18th of March 2020, with the obligation of mandatory confinement and circulation restriction. Restrictive measures were alleviated on the 2nd of May 2020.

Objectives

We aimed to investigate the impact of the first confinement on the maintenance or loss of psychiatric and psychological follow-up. Also, we aimed to explore the outcomes in the mental health of losing psychiatric or psychological consultations.

Methods

We conducted an online survey among the Portuguese population to evaluate demographic, clinical and mental health variables (STAI, DASS-21, PHQ, OCI-R, Quality of Life [QoL] and PSS). Individuals were invited to answer the survey at two timepoints: third week of March 2020 and third week of May 2020. Concerning the first timepoint, we used independent t-tests to compare the mental health variables in the individuals who loss and who did not lose consultations. Then, we evaluated the impact of losing consultations across time in those individuals who continued responding in the second timepoint, through a Linear Fixed Model. All the analyses were performed using JASP software.

Results

From the total sample (n=2040), 334 individuals (84.4% female gender) had psychiatric and/or psychological consultations previously to the confinement. In March 2020, the individuals who maintained the consultations (35.0%) showed best mental health indicators in the QoL Self Evaluation (p=0.002), QoL Satisfaction (p=0.037), STAI State (p<0.001), DASS-21 (p=0.001), PHQ (p<0.001), OCI-R (p=0.002) and PSS (p<0.001). Among the matched individuals who answered the survey in May 2020 (n=93), we found that the group who maintained follow-up (n=24) did not improve significantly more than the other group (n=69) for any of the mental health variables in study.

Conclusions

The results indicate that stopping psychiatric and psychological follow-up represented worse mental health outcomes at the beginning of the first confinement. However, anxiety feelings improved at the end of the first confinement, which happened independently of psychiatric/ psychological follow-up.

Disclosure of Interest

None Declared
Changes in psychiatric admissions to psychiatric wards due to COVID-19
Authors: Martin-Santiago O. , Vallecillo-Adame M. C. , Jimenez-Aparicio T. , Perez-Escudero A.
Published: August 2023

Introduction

Functioning in acute inpatient psychiatric units has been challenged by the Coronavirus disease 2019 (COVID-19). Patients with more severe mental health symptoms changed their rates of voluntary admission to psychiatric wards during the onset of the pandemic. Peritraumatic distress scores and increased likelihood of being psychologically affected by the COVID-19 pandemic can lead to a psychiatric admission. However, other factors could prevent hospitalization.

Objectives

The present investigation aimed at admission rates of patients by depression, adjustment disorder or suicidal behaviour to a General Hospital Psychiatric Ward. We compared the lockdown due to COVID-19 in 2020 to similar periods of 2018 and 2019.

Methods

The data of one general hospital psychiatric ward admissions have been obtained and analysed. We compared admission characteristics of 237 patients between April and June of 2018 and 2019 with 79 patients in the same period of 2020 (lockdown).

Results

During the COVID-19 lockdown, there was a 35.8% reduction in psychiatric admissions and a significant reduction in psychiatric admission was observed due to suicidal behaviour (IRR = 0.49; 95% CI: 0.26-0.89; p=0.002) and depression (IRR = 0.24; 95% CI: 0.08-0.68; p=0.007), but similar rates of adjustment disorders (IRR = 1.12; 95% CI: 0.58-2.15; p=0.73).

Conclusions

We suggest that patients with depression or suicidal behaviour avoided admission, for fear of contagion in hospitals. Also, greater family support could prevent self-injurious behaviours. By contrast, other disorders continued to require the same admission rate, since the social consequences derived from confinement could lead to the genesis or worsening of symptoms, such as adjustment disorders.

Disclosure of Interest

None Declared
Depressive disorders in patients with sleep apnea syndrome
Authors: Rmadi N. , Kammoun N. , Kotti N. , Masmoudi R. , Rekik S. , Masmoudi M. L. , Jmal Hammami K. , Masmoudi J. , Kammoun S. , Msaed S. , Hajjaji M.
Published: August 2023

Introduction

A growing body of literature has documented that obstructive sleep apnea syndrome (OSAS) is associated with an increased risk of depressive disorders.

Objectives

This study aimed to determine whether depression is associated with OSAS.

Methods

This was a descriptive prospective comparative study conducted over two years among patients with OSAS. Excessive daytime sleepiness was assessed by the Epworth Sleepiness Score (SES). The presence and intensity of depressive symptoms were screened using the Patient Health Questionnaire PHQ9. Data were analysed using SPSS software.

Results

A total of 139 patients participated in the survey with an average age of 48.98 ± 9.80 years. According to the SES, the study population was divided into two groups: a group including 70 subjects with normal SES (< 11); and a group including 69 subjects with pathological SES (≥11). The PHQ9 depression score was higher in sleepy subjects with SES ≥ 11 compared to non-sleepless subjects; the difference being very highly significant (PHQ9=11.97 ± 4.99 and 6.54 ± 5.27 respectively; p=0.0000). The frequency of mild to moderate depressive disorders was found to be greater in non-sleepy subjects (94.3% and 78.3% respectively; p=0.007). For moderately severe to severe depression, their frequency was more marked in sleepy subjects (21.7% and 5.7% respectively; p=0.007).

Conclusions

Depressive disorders constitute a major comorbidity in OSAS. Therefore, it is necessary to improve the quality of these patients’ health by the early detection of the symptoms of overlapping OSAS and depression.

Disclosure of Interest

None Declared
Resting State Functional Connectivity is Associated With Treatment Response in Major Depression: A Real World Study
Authors: Harrington Y. , Paolini M. , Bettonagli V. , Colombo F. , Poletti S. , Zanardi R. , Benedetti F.
Published: August 2023

Introduction

Major depressive disorder (MDD) is largely considered the most prevalent psychiatric disorder worldwide. Despite its domineering presence, effective treatment for many individuals remains elusive. Investigation into relevant biological markers, specifically neuroimaging correlates, of MDD and treatment response have gained traction in recent years; however, findings are still inconsistent.

Objectives

In this study, we aimed to investigate the resting state functional connectivity patterns associated with treatment response in MDD inpatients in a real world setting.

Methods

Forty-three inpatients suffering from a major depressive episode were recruited from the psychiatric ward at IRCCS San Raffaele Hospital in Milan, Italy. Symptom severity was assessed via the 21-item Hamilton Depression Rating Scale (HDRS). The percentage of decrease in HDRS scores from admission to discharge was then calculated with the formula [(HDRS admission – HDRS discharge) * 100] / HDRS admission. All patients underwent a 3T MRI scan within one week of admission to acquire resting-state fMRI images, which included 200 sequential T2*-weighted volumes. Images were preprocessed using the CONN toolbox, running within Statistical Parametric Mapping (SPM 12). Preprocessing was performed according to a standard pipeline. A voxel-wise metric, intrinsic connectivity contrast (ICC), was implemented to explore the global resting state functional connectivity (rs-FC) patterns associated with treatment response. ICC-derived maps were then entered in the second-level analyses to examine the effect of the percentage of HDRS decrease, including age, sex, admission HDRS score, duration of hospitalization, and antidepressant dose equivalents as nuisance covariates.

Results

We found that the percentage of HDRS decrease after treatment predicted rs-FC. ICC analysis identified 2 clusters where changes in HDRS scores were significantly associated with rs-FC, with increased connectivity in the supramarginal gyrus (pFDR = 0.002) and decreased connectivity in the amygdala and parahippocampal gyrus (pFDR = 0.047).

Conclusions

Our results suggest that altered connectivity of the supramarginal gyrus, amygdala and parahippocampal gyrus is related to antidepressant treatment response. Given that these brain areas are implicated in emotional processing and mood, it is conceivable that a better integrity of brain connectivity may facilitate treatment response in major depression.

Disclosure of Interest

None Declared
Fight or flight mechanism and sports activities: psychophysiological aspects
Authors: Romaniuk V. , Fedorchuk S.
Published: August 2023

Introduction

Specialists in biology, medicine, and psychology need to pay special attention to theoretical and practical research on the implementation of the fight or flight mechanism in humans in conditions of war and hostilities. Adaptation mechanism of fight or flight is related to individual and social forms of behavior among people and animals, and is aimed at the homeostasis preservation in difficult living conditions. The evolutionary fight or flight mechanism in the functional connection with stress as a general adaptation syndrome and stress reactivity has individual features due to the strengthening of the functions of certain body systems. The systemic mechanism of fight or flight is accompanied by the corresponding functional and clinical symptoms and significantly influences physical and mental health of a person in various conditions of activity.

Objectives

In this regard, the main goal of this work was to determine the relationship between the behavioral strategy of fighting or escaping under stress and during sports activities.

Methods

The following research methods were used to realize the goal of the work: theoretical analysis and generalization of literary sources and Internet data.

Results

In our opinion, possible versions of Walter Cannon’s concept of the fight-or-flight mechanism are: 1) attack-or-flight mechanism; 2) defense or escape mechanism; 3) pursuit or escape mechanism. At the same time, it is advisable to consider aggression as a struggle, and escape as a struggle. In addition, in line with the concept of Walter Cannon and Hans Selye, it is possible to distinguish the stress of struggle and the stress of flight. Any intense muscle activity is accompanied by changes in the hormonal and nervous regulation of metabolism, as a result of which the body adapts to a certain physical load. In the athlete, these functional changes are observed even before the start of physical exercises, in particular, in the conditions of the pre-start and start state. The nature and reaction of neuro-endocrine mechanisms in the pre-start state depend on the nature of the load, as well as on the individual characteristics of the athlete (age, gender, type of nervous system, temperament, character, training, sports experience, etc.). It is important that the pre-start changes in metabolism contribute to the mobilization of the athlete’s functional potential even before the start of the corresponding physical activity. Moderate activation of the neuro-endocrine mechanisms of the athlete’s body (“combat readiness” state) is optimal. Functionally, it is less beneficial for the athlete’s body to have a sharp strengthening of neuro-endocrine mechanisms (“pre-start fever” state) or their paradoxical inhibition (“pre-start apathy” state).

Conclusions

Thus, in humans, sports activities include a behavioral mechanism of fight or flight in combination with physiological and psychological stress.

Disclosure of Interest

None Declared
Is even a probable premenstrual dysphoric disorder diagnosis associated with more severe anxio-depressive symptoms and lower well-being? A preliminary cross-sectional exploratory study
Authors: Kovács I. , Pataki B. , Kis B. L. , Kálmán S.
Published: August 2023

Introduction

Premenstrual dysphoric disorder (PMDD) is a newly introduced category in the 5th version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and is highly underdiagnosed worldwide, despite its strong connections to anxiodepressive symptom severity and perceived well-being.

Objectives

Firstly in Hungary, our aim was to: (a)assess whether even a probable PMDD diagnosis is associated with elevated levels of depressive and anxiety symptoms, and decreased perception of well-being on an adult women sample; (b)to evaluate whether women with a probable PMDD diagnosis report greater fluctuation of their affect during the different phases of their menstrual cycle; (c)to examine whether the elevated levels of anxiodepressive symptoms and lower well-being increase the statistical likelihood of having a probable PMDD diagnosis.

Methods

An online test battery was designed to examine probable PMDD diagnosis, severity of anxiodepressive symptoms and well-being. 393 adult women were screened for eligibility in the study (exclusion criteria involved: irregular cycle; use of hormonal contraceptives), from which 112 were included in the final analyses. DSM-5-Based Screening Tool for Women’s Perceptions of Premenstrual Symptoms, Beck’s Depression Inventory, Spielberger’s State Anxiety Inventory, and the WHO-5 Well-Being Index were assessed.

Results

Based on the DSM-5-Based Screening Tool, the sample was divided into 1)women with probable PMDD diagnosis (PMDD group,n=67) and 2)women without probable PMDD (nonPMDD group,n=45). Menstruation cycles were sorted into menstrual, from-menstruation-to-ovulation, early luteal and late luteal phases. The PMDD group exhibited significantly higher depressive (F(1;56,2)=19.394, p≤0.001) and anxiety (F(1;35,6)=17.714,p≤0.001) symptom severity and lower scores of well-being (F(1;44,3)=4.288,p=0.0442) compared to the nonPMDD group regardless of which menstrual cycle they were in. Binomial logistic regression model was used to test whether higher anxiodepressive symptoms and lower scores of well-being increase the likelihood of having PMDD: the model was significant (χ2(2)=27.287,
p≤0.001), and it explained 29.2% of the variance in PMDD. Elevated levels of anxiety (B=0.058, S.E.=0.022, Waldχ2(1)=7.142, p=0.008,OR=1.060) and depressive (B=0.085,S.E.=0.031,Waldχ2(1)=7.480,p=0.006,OR=1.089) symptoms increased significantly the likelihood of having a probable PMDD diagnosis.

Conclusions

Women with even a probable PMDD diagnosis exhibited significantly elevated levels of anxiodepressive symptoms and lower scores of well-being regardless of which menstrual phase they were assessed in compared to women without meeting the criteria of the PMDD screening tool. These preliminary results underscore the need for prospective clinical studies of differences in affective symptoms exhibited in PMDD.

Disclosure of Interest

None Declared
The role of personality and psychopathology in people with migraines
Authors: Georgiadis I. , Fountas K. , Malli F. , Dragioti E. , Gouva M.
Published: August 2023

Introduction

Several studies have shown that the relationship between migraine and psychological factors is significant, but few have evaluated the relationship between these psychological factors and patients’ social life.

Objectives

Exploring the role of personality and psychopathology in people with migraines.

Methods

The sample consisted of 180 people, more specifically 140 people from the general population and 40 people who have been diagnosed with migraine and receiving treatment for migraine, who completed the following questionnaires voluntarily and anonymously: a) Migraine Experience Questionnaire and Headache Impact Test-6 (HIT-6), b) Eysenck Personality Questionnaire, c) Symtom Checklist 90-R (SCL-90) and socio-demographic and self-reported questionnaire.

Results

Patients scored higher somatization rates (10.21 ± 8.08), phobic anxiety (3.00 ± 4.45), neuroticism (4.09 ± 1.37), than people from the general population who scored lower somatization rates (14.63 ± 3.12), Phobic anxiety (5.28 ± 1.89), Neuroticism (6.53 ± 2.12), with a statistically significant difference between them (p = 0.001), (p = 0.002), (p = 0.000), respectively.

Conclusions

Patients with symptoms of migraine show statistically higher rates of somatization, phobic anxiety, neuroticism and further study is considered necessary.

Disclosure of Interest

None Declared
Moral Injury and Pre-Deployment Personality Factors as Contributors to Psychiatric Symptomatology among Combatants: A Two-Year Prospective Study
Authors: Levi-Belz Y. , Zerach G.
Published: August 2023

Introduction

Combatants who are exposed to events which transgress deeply held moral beliefs might face lasting psychopathological outcomes, referred to as Moral Injury (MI). However, knowledge about pre-deployment factors which might moderate the negative consequences of MI is sparse.

Objectives

In this prospective study, we examined pre-enlistment characteristics and pre-deployment personality factors as possible moderators in the link between exposure to potentially morally injurious events (PMIEs) and psychiatric symptomatology among Israeli active-duty combatants.

Methods

A sample of 335 active-duty Israeli combatants participated in a 2.5-year prospective study with three waves of measurements (T1: 12 months before enlistment, T2: 6 months following enlistment- pre deployment, and T3: 18 months following enlistment- post deployment). Participants’ characteristics were assessed via semi-structured interviews (T1) and validated self-report measures of personality factors: emotional regulation, impulsivity, and aggression (T2) and combat exposure, PMIEs, psychiatric symptomology and post traumatic symptoms (T3) between 2019-2021.

Results

Pre-enlistment psychiatric difficulties and negative life events contributed to higher exposure to PMIEs post deployment. Higher levels of pre-deployment aggression and lower levels of emotional regulation and impulsivity moderated the association between betrayal, PMIEs and psychiatric symptomology post deployment, above and beyond pre-enlistment psychiatric difficulties and life events.

Conclusions

Our results highlight that pre-deployment emotional regulation, impulsivity and aggressiveness levels should be assessed, screened, and identified among combatants, as they all facilitate psychiatric symptomology (and PTSS) after combatants are exposed to PMIEs of betrayal. Such pre-assessment will enable identification of at-risk combatants and might provide them with tailor made preparation regarding moral and ethical situations that should be investigated in future researches.

Disclosure of Interest

Y. Levi-Belz: None Declared, G. Zerach Shareolder of: no, Grant / Research support from: no, Consultant of: no, Employee of: no, Paid Instructor of: no, Speakers bureau of: no
Characterization of a population of transgender individuals and their perceived negative
mental health and life experiences
Authors: Santos M. F. , Mota J. , Figueiredo Z.
Published: August 2023

Introduction

Gender dysphoria (GD) is characterized by a marked incongruence between one’s
experienced/expressed gender and gender assigned at birth, associated with clinically
significant distress or impairment in important areas of functioning. Persons with GD are a
population with specific healthcare needs. In our hospital, psychiatric assessment of these
individuals started in 2008.

Objectives

Characterization of a population of transgender individuals and their perceived
negative mental health and life experiences.

Methods

Since the beginning of evaluations of transgender individuals in our hospital, from
2008 to 2022, they were asked to freely elaborate their “life story”: a report of the most
relevant events in their lives, related to their condition. We retrospectively analyzed the
content of the reports that were sent and associated with the clinical files.

Results

We collected the data of 104 individuals. The gender attributed at birth consisted of
74 (71.2%) females and 30 (28.8%) males. As for the gender identity, the sample consisted of
73 (70.2%) males, 28 (26.9%) females, 2 (1.9%) nonbinary and 1 (1%) person didn’t identify
with any of the existent denominations. The medium age in October of 2022 was 27.4 (minimum
18, maximum 60, SD 7.3). The age at first evaluation at consult was 23.6 (minimum 15, maximum
56, SD 7.2). 99 (95.2%) individuals mentioned symptoms of gender non-conformity beginning in
childhood, and of those who mentioned their adolescence (n=43, 41.3%), all expressed feelings
of anguish relating to their changing bodies. The medium age of recognition of their
condition was 17.2 (minimum 11, maximum 30, SD 4.3). Of those who recall their first contact
with health practitioners regarding their symptoms (n=31, 29.8%), 32.3% admitted they didn’t
feel they were helped. Of those who mentioned early relationships with family and carers
(n=65, 62,5%), 35.4% reveal dysfunctional relationships and 79% mention gender expectations
from their families. Similarly, 42 (40.4%) individuals reveal experiences of victimization
and bullying because of their gender nonconformity. 53 (60.2%) described symptoms of a likely
comorbid psychiatric illness throughout their life, particularly depressive symptoms, anxious
symptoms, suicide attempts and non-suicidal self-injury.

Conclusions

GD has gained more attention in the recent years, and the scientific community has now
developed a more accurate set of criteria for the recognition of this condition. The findings
in our study are in accordance with these criteria. Unfortunately, much of the suffering this
condition entails is also associated with distress related to stigma and societal gender
expectations, and that was evident in this investigation.

Disclosure of Interest

None Declared
Factors associated with sexual disorders in women followed for breast cancer
Authors: Zaouali F. , Abbes I. , Ben Slama A. , Belhaj Youssef I.
Published: August 2023

Introduction

Breast cancer is the most frequently encountered malignant tumor among women in Tunisia and in the world. The quality of sexual life of patients with breast cancer is impaired by multifactorial mechanisms.

Objectives

The aim of our study was to determine the factors associated with sexual disorders in patients followed for breast cancer.

Methods

Cross-sectional analytic study including patients followed for breast cancer at the outpatient medical oncology consultation of Hadj Ali Soua regional hospital from January to March 2021. We collected sociodemographic and clinical data with an assessment of sexuality (FSFI), marital satisfaction (MAT), psychological profile (HAD) and quality of life (SF36).

Results

Fifteen patients were included with a mean age of 49.87 ± 8.48 years and a mean age at diagnosis of 46.73 ± 7.55 years. At the TNM classification, 66.6% of the patients had a T1 or T2 at the time of diagnosis and 80% had an N0. All patients received a surgical intervention, which was conservative in 53.3% of cases. No patient underwent breast reconstruction. Chemotherapy and hormone therapy were prescribed in 86.7% of patients. The mean score of the FSFI questionnaire in our study was 17.25. Eleven patients (73.3%) had an FSFI score below 26.55. We found negative correlations between age and FSFI score (r=-0.622; p=0.013). We noted statistically significant negative correlations between FSFI and HAD-D (r=-0.606; p=0.017) and FSFI and HAD-a (r=-0.707; p=0.01) as well as significant correlations between FSFI and the following items: RE (r=0.84p=0.000), SF (r=0.684 p=0.005), GH (r=0.671 p=0.006) and MCS (r=0.788 p=0.000).

Conclusions

Focusing on a small sample of patients followed for breast cancer, our study provides an assessment of the sexual function in its various areas and shows how sexuality is deeply intertwined with other sections of medical management.

Disclosure of Interest

None Declared
Food addiction and gender aspects: Risk factors, co-morbidites and treatment
Authors: Sönmez Güngör E.
Published: August 2023

Food addiction (FA) is characterized by poorly controlled intake of highly-palatable, calorically-dense, high-sugar, high-fat, and usually processed foods. Although not existing in the DSM-5 or ICD, it has been a widely discussed clinical and research entity for more than a decade, in the understanding of both obesity and also disordered eating behaviours. Most studies indicate that risk factors for FA are similar to substance use disorders. FA is also found to be linked with emotion regulation problems, impulsivity, distinct personality features, and other major psychopathologies including depression and anxiety. Morevoer, in several studies, female gender is found to be associated with more prevalent food addiction, up to 7 times. Female gender is also a predictor of severe food addiction, and high reward sensitivity was significantly associated with more severe FA symptoms in females. It is known that women are more likely to self-medicate than men in the acquisition phase of addiction and show a more rapid escalation of use than men (telescoping), whereas in general substance use disorders are much more common in men. The wide availability of hyperpalatable, high-calorie, and inexpensive food and the contextual and social factors that do not necessarily prevent women from consuming these drugs, contrary to that of illicit drugs, might explain why FA is more frequently observed in women than in men. Also, biological factors, hormonal changes and body-image disturbances might also be among the reasons why females are more affected from FA. Aspects related to gender should be taken into account for proper recognition and treatment of FA, a diagnosis of growing importance.

Disclosure of Interest

None Declared
Mental pain and suicide risk: implications for neuroimaging
Authors: Pompili M.
Published: August 2023

Campaigns have been launched to make sense of what makes a specific individual suicidal. We know that suicidal individuals give definite warning signs, mainly from their ambivalence about ending their own lives. Classical suicidology posited that the suicidal individual experiences unbearable psychological pain (psychache) or suffering and that suicide might be, at least in part, an attempt to escape from this suffering, emphasizing that suicide is not a movement toward death but rather an escape from unbearable emotion and unendurable or unacceptable anguish. Suicide occurs when that individual deems the psychache to be unbearable. Neuroimaging studies demonstrated that such emotional pain shares the same neuroanatomical circuit of somatic pain. Furthermore, concepts related to death, failure, or other unfortunate circumstances activate specific cerebral areas in a suicidal individual compared to a non-suicidal subject. The author conducted a sizeable clinical investigation on mental pain related to psychiatric disorders and suicide risk. Implications for further research are discussed during the presentation.

Disclosure of Interest

M. Pompili Consultant of: Janssen, Lundbeck, Recordati, MSD, Speakers bureau of: Janssen, Lundbeck, Angelini Pharma, Pfizer
Prevalence of HIV infection in patients of a substance use treatment facility
Authors: Baranskaya L. T. , Babushkina E. , Potapov V.
Published: August 2023

Introduction

According to domestic and foreign studies, in the last decade there has been an increase in the number of HIV-infected patients suffering from alcoholic disease. Under the influence of alcohol, the risk of infection and transmission of HIV infection increases, the course of the disease worsens. There is a syndemia between alcohol abuse and HIV infection. This requires new approaches to the tactics of managing patients of a narcological hospital with HIV infection.

Objectives

To identify the prevalence of HIV infection in patients of the substance use treatment facility suffering from alcohol disease of the second stage.

Methods

The authors analyzed 446 medical histories of patients suffering from alcoholic disease who underwent inpatient treatment in 2009-2021. For data processing, a statistical method for calculating relative indicators used.

Results

The study showed that a significant proportion of patients with HIV infection were patients of working age 40-59 years. At the same time, since 2009, there has been an increase in HIV-infected patients from the total number of hospital patients. So, if in 2009 they were 1.2%, then in 2021 they were already 7.2%. Most HIV-infected patients of the narcological hospital are single or divorced. The study notes that abuse is common among patients with HIV infection as a means of combating depression. According to 2019 data, 39.0% of hospital patients suffer from depression. The authors show that alcohol affects the increase in risky forms of sexual relations, or risky situations with unprotected sex. In addition, with alcohol abuse, the viral load increases, and therefore the likelihood of transmitting HIV infection to a partner with unprotected sex increases.

Conclusions

Alcohol abuse is a causative factor in HIV infection. Early detection of people with harmful alcohol consumption and referral to a psychiatrist will increase adherence to antiretroviral therapy, as well as reduce the rate of HIV infection

Disclosure of Interest

None Declared
Temporal trends of drug requests in the Addiction Liaison Psychiatric Unit. 12 years in Hospital del Mar (Barcelona)
Authors: García Jimenez M. , Fuentes Valenzuela J. J. , Fonseca Casals F. F. C. , Torrens Melich M.
Published: August 2023

Introduction

Substance Use Disorders are frequently associated to other medical problems. The temporal evolution of the main drug requests is related to drug and drug users’ facts. COVID-19 pandemic is worthy of investigation.

Objectives

To analyze temporal trends in the characteristics of all medical requests to the Addiction Liaison Psychiatric Unit from January 2010 to December 2022.

Methods

Study data will be obtained from all patients that were referred to the Addiction Liaision Psychiatric Unit during 12 years in Hospital del Mar (Barcelona). Demographics and clinical data (substance use, medical diagnosis, dual diagnosis) will be obtained and analyzed by semesters.

Results

The results will be presented as soon as all data is obtained. We will explore COVID-19 pandemic implications.

Conclusions

.

Disclosure of Interest

None Declared
Incorporating Culture into The Treatment of Substance Use Disorder: A Narrative Review
Authors: Nombora O. , Certo A. , Silva B. F. , Venâncio Â.
Published: August 2023

Introduction

Culture is defined by the shared beliefs, attitudes, values, and practices of a particular group of people which can influence their behaviour and social interactions, including the use of substances.

Objectives

The aim of this review is to identify the evidence of cultural competence in the treatment of people with substance use disorder (SUD) and encourage the professionals and organizations to take cultural context into account.

Methods

Narrative review about the topic, using PubMed/Medline database. MeSH terms: “culture”, “cultural competence”, “addictions”, “substance use disorder”.

Results

Studies show that culture can either be a catalyst for SUD or play a protective role. However, other factors may also play a large role in client’s response substance use and the development of SUD. Acculturation and generational differences can also impact SUD treatment, especially when intergenerational conflict causes stress that leads individuals to engage in risky behaviours. Thus, treatment for SUD has to be sensitive to cultural differences and professionals should provide culturally based approaches. Culturally targeted practices have been linked to greater outcomes, better therapeutic alliance, less dropouts and consequent increased retention in the treatment. These practices include matching clinicians and clients on linguistic and cultural backgrounds as well as being mindful of the impact of culture on client’s experience of SUD. Providing therapy and materials in the client’s language, knowledge, understanding and appreciation for cultural perspectives, involving the family and community and training therapists, are some of culturally competent practices used. These strategies involve knowledge, creativity, and experience.

Conclusions

Cultural competence seems to be a valuable tool for healthcare professionals working in a multicultural context, particularly with people with SUD. Unfortunately, the lack of supporting evidence limits the validity of any particular model of cultural competence. Future methodologically research is necessary in order to provide quality cultural competence models for people with SUD.

Disclosure of Interest

None Declared
The prefrontal cortex: a region of interest in suicidal behaviour
Authors: Olie E.
Published: August 2023

Some evidence converges to consider that suicidal behaviour could be a separate diagnosis and emphasizes the relevance to identify specific biomarkers. Identifying the neural substrates of suicide attempt is key to understanding the etiology of suicide and might be helpful in reducing suicide rates among psychiatric patients by promoting the development of novel therapeutic strategies based on behavioral neuroscience and brain stimulation. Neuroimaging studies have reported structural and functional brain abnormalities located in the prefrontal cortex, insula and striatal regions as well as in the connections between these brain areas. Based on task related and resting state functional MRI studies, we will discuss original data showing the role of the ventral prefrontal cortex in suicide vulnerability.

Disclosure of Interest

None Declared
Diagnostic difficulties in bipolar disorder type II
Authors: Núñez L. , del Val C. A. , Merlos A. F. , Vivero E. X. G. , Carrascosa C. C. , Naval M. H.
Published: August 2023

Introduction

Bipolar disorder is one of the top 10 medical causes of disability according to the WHO and despite this, its diagnosis can be delayed up to 10 years after the appearance of the first symptoms of the disease. A major reason for the difficult diagnosis is the challenge of differentiating bipolar disorder type II from unipolar depression and borderline personality disorder, especially in those patients with no clear history of hypomania.

Objectives

To present a case report of a bipolar disorder undiagnosed for years to remark the importance of recognizing premorbid symptoms of the disease in order to implement an early intervention that potentially improves the prognosis of patients.

Methods

We compiled the patient’s complete medical history and we carried out a non-systematic review of literature containing the key-words “bipolar disorder type II” and “diagnosis”.

Results

We present the case of a 48-year-old woman going through a depressive episode, multiple suicide attempts and more than 10 admissions in the Acute Inpatient Psychiatric Unit. For 3 years, the evolution was torpid with a significant multidomain cognitive impairment in a previously functional patient. Different antidepressant treatments were tested, however they were not tolerated due to adverse effects such as anxiety, insomnia and nervousness. After considering multiple differential diagnoses, bipolar disorder type II was finally diagnosed. A hypomanic episode that took place after 3 sessions of electroconvulsive therapy during an admission for depression, allowed to guide the diagnosis and after the introduction of Lithium and Quetiapine as treatment, the patient experienced a complete remission of the symptoms.

Conclusions

1.

It is important to consider the differential diagnosis of bipolar disorder type II due to its impact on the patient´s life.

2.

An early diagnosis improves the course and prognosis of the disease.

3.

Patients resistant or intolerant to antidepressant treatment could have undiagnosed bipolar disorder.

Disclosure of Interest

None Declared
Effect of psychotherapy on peripheral BDNF concentration levels in patients with bipolar disorder. A systematic review
Authors: Valtueña García M. , Rubio Rodríguez L. , Sánchez-Pastor L. , Martínez-Gras I. , Rodríguez-Jiménez R.
Published: August 2023

Introduction

Psychotherapy is a treatment of proven efficacy in bipolar disorder (BD), but little is known about the molecular and cellular mechanisms that it produces in the brain. Brain-derived neurotrophic factor (BDNF) is thought to be important in neuroplasticity and could be increased by psychopharmaceuticals and psychotherapy in BD patients, but evidence in the literature is limited.

Objectives

To analyze the scientific studies that relate psychotherapies with the increase in BNDF levels in patients with BD.

Methods

Systematic review with PRISMA recommendations in PUBMED and Web of Science in July 2022. The search was performed using the combination of keywords “bipolar disorder” AND (“BDNF” OR “Brain Derived Neurotrophic Factor”) AND “psychotherapy”.

Results

With the initial search, 839 studies were obtained, finally 8 articles were analyzed. The available literature supports the role of psychotherapy in increasing BNDF in patients with BD.

Conclusions

BDNF could be a biomarker of therapeutic efficacy in BD. Psychotherapy increases BDNF levels. No differences were found between the different types of psychotherapies. More studies are needed to determine the mechanisms by which psychotherapies produce molecular changes in the brain.

Disclosure of Interest

None Declared
The analysis of organic diseases in elderly patients diagnosed with bipolar disorders- A retrospective study
Authors: Vasiliu O.
Published: August 2023

Introduction

Both organic and psychiatric comorbidities are frequently detected in bipolar disorders (BD) and this phenomenon has a significant impact on case management in these patients. The most reported general medical conditions in patients with BD are migraine, thyroid illness, obesity, diabetes mellitus, and cardiovascular disease. The screening for comorbidities detection in BD patients is important from multiple perspectives, including the need to construct an adequate therapeutic plan, the need to increase treatment adherence, and to improve these patients’ quality of life.

Objectives

To assess the prevalence of comorbid organic diseases in a clinical sample of BD patients.

Methods

A chart- and register-based analysis of BD patients (i.e., type I and II BD) evaluated in our department during a period of three years (January 2019- January 2022) was conducted in order to detect the prevalence rate of organic diseases. All patients aged over 65 years were evaluated either for acute mood episodes or presented to their treating psychiatrists for follow-up visits.

Results

A number of 87 patients were included in this analysis, 45 male and 42 female, with a mean age of 70.5 years. The most frequently detected organic comorbidities were metabolic disorders (obesity, dyslipidemia, diabetes mellitus- 36.8%), cardiovascular (arterial hypertension, arrhythmias, myocardial ischemia, deep/superficial venous thrombosis- 26.4%), digestive system-related (hepatic, gastric, intestinal diseases- 21.8%), neurologic (i.e., stroke, migraine, Parkinson’s disease) (18.3%), endocrine (mainly thyroid diseases) (17.2%), and other (19.5%). A relatively high rate of organic diseases (38%) were newly diagnosed (in the last 3 months), suggesting there is a certain need to screen for organic pathology in this population, but most of the BD patients presented a long history of investigated and treated comorbid conditions.

Conclusions

Organic diseases are very common in elderly BD patients. Even where no history of somatic conditions exists, comprehensive investigations are granted in order to detect such health problems with important prognostic impact.

Disclosure of Interest

None Declared
Cut From the Same Cloth: Bipolar disorder and Frontotemporal Dementia – Apropos a Clinical Case
Authors: Jesus S. , Costa A. R. , Almeida M. , Garrido P.
Published: August 2023

Introduction

Mood disorders have been reported in the literature as a risk factor for developing cognitive deficits. Bipolar disorder (BD) and Frontotemporal Dementia (FTD) share many common features, often presenting as a differential diagnostic challenge to the clinician. The clinical features of mania, such as euphoria, hyper-sexuality and difficulties in impulse control can mimic the impaired judgment and loss of inhibition seen in FTD. Depressive features such as anhedonia and social isolation can mimic apathy associated with FTD. Of the various subtypes, the behavioural-variant of FTD (bvFTD) is most similar to a manic episode.

Objectives

The authors aim to explore the relationship between BD and FTD, and the implications in differential diagnosis, treatment and prognosis with recourse to a clinical case example.

Methods

A non-systematized review of pertinent literature on the topic with focus on that which is most relevant to the theme was included. The authors present a clinical case of 55 year-old female with history of BD who was hospitalized in the context of a depressive episode with suicidal ideation and disorganized behaviour.

Results

It is not uncommon for patients with bvFTD to be initially diagnosed with BD, whereas on the other hand, patients presenting in late with an inaugural manic episode are considered to have dementia. The literature also reports that patients with BD appear to be at increased risk of a later FTD diagnosis, further contributing the diagnostic difficulties. Core symptoms that present in mood disorders, also make-up the clinical picture of FTD, and vice versa. Correct diagnosis is imperative as early-intervention may have significant impact on prognosis of the clinical pictures. The patient underwent complementary diagnostic imaging testing with magnetic resonance imaging, which documented atrophy in the fronto-temporal regions which were not detected on previous exams, thus strongly suggesting a FTD diagnosis in a patient with history of BD.

Conclusions

The literature establishes, especially through various case reports, an apparent clinical overlap between FTD and mood disorders. A multifaceted connection between BD and FTD appears to exist, with clinical and genetic similarities having been described, although further studies are merited demonstrating this relationship. The clinical case highlights the challenges in FTD diagnosis in a patient with prior history of a mood disorder, especially BD, as well as demonstrating the difficult task in establishing a differential diagnosis between the two conditions when the mood disorder presents late in life. The clinician is alerted to the mimicry between the two conditions, taking into account the possibility of a FTD diagnosis in patients with history of BD presenting with unexpected cognitive and behavioural decline.

Disclosure of Interest

None Declared
Predictors of psychosocial functioning in euthymic patients with bipolar disorder
Authors: Ajmi S. , Sana O. , Najeh S. , Rim F. , Imen G. , Nada C. , Jihen B. T. , Lobna Z. , Mohamed M. , Manel M. B.
Published: August 2023

Introduction

Functional impairment is a major target in the treatment of bipolar disorder (BD), but the magnitude and type of functional difficulties differ across patients.

Objectives

The aim of this study was to assess functioning and identify factors associated with global functioning in euthymic patients.

Methods

It was a descriptive cross-sectional study. The population study consisted of patients diagnosed with BD (DSM 5), who were euthymic and followed up at the psychiatry department of CHU Hedi Chaker.

The Hamilton Depression Scale (HAM-D), the Young Mania Rating Scale (YMRS) and the Functioning Assessment Short Test (FAST) were used to assess depressive, manic symptoms and the functional impairment in bipolar patients respectively. All statistical analyses were performed using the SPSS software package v 18.

Results

We collected 40 patients. They had an average age of 36 years and the sex ratio (M/F) was 1.

They had an educational level not exceeding primary studies in 46% of cases.

The average scores of HAM-D and YMRS were 4.57±4.58 and 3.43±2.89 respectively.

The average total functioning score of our patients was 19.13±16.5. Functional impairment was noted in 60% of them. The domains most affected were: occupational activity (62%), cognitive functioning (63%) and autonomy (50%). Fonctional impairement was associated with residual depressive and manic symptoms (p=0.013) and manic/hypomanic or depressive episodes with mixed features (p=0,005).

Conclusions

Greater efforts should be directed toward targeting functioning in patient care, as it constitutes the most meaningful endpoint of response to treatment, especially with occupational and cognitive rehabilitation, thus allowing patients to overcome the course of illness and carry fulfilling lives.

Disclosure of Interest

None Declared