bluuebunny/crossref_metadata_2025 huggingface dataset:
Is repetitive Transcranial Magnetic Stimulation really effective in the treatment of major depression? – Results of a Meta-Analysis
Authors: Kovacs S. , Vida R. , Erdosi D. , Jozwiak-Hagymasy J. , Zemplenyi A. , Tényi T. , Voros V. , Osvath P.
Published: September 2022

Introduction

Clinical studies demonstrated the efficacy of rTMS treatment in major depressive disorder. However, the results of meta-analyses are contradictory due to the heterogeneity of the included studies.

Objectives

The aim was to analyse the effectiveness of rTMS for treatment-resistant major depression.

Methods

A systematic literature review of English-language articles published in the last 10 years was performed on PubMed and Scopus databases according to PRISMA guideline principles. To assess the effects of rTMS on response and remission rates, random-effects model and inverse variance method were used.

Results

23 randomized double-blind sham-controlled studies met the inclusion criteria for quantitative analysis for response (n= 1020 patients) and 12 studies for remission (n= 846 patients). The relative risk for response and remission were 2.19 (95% CI: 1.68-2,86, p=0.000 n=912) and 2.65 (95% CI: 1.32-5,31, p=0.002, n=603), respectively using rTMS as add on treatment (in patients after two antidepressant treatment failures) compared to standard pharmacotherapy. I2analysis showed no considerable heterogeneity in the combined effect sizes neither for remission studies (I2=23.36%) nor for response studies (I2=0.00%).

Conclusions

Transcranial magnetic stimulation became an evidence-based, effective treatment for treatment-resistant major depressive disorder, either as a monotherapy or as an augmentation of pharmacotherapy. However, because of the lack of standardized protocol, a substantial methodological heterogeneity exists. According to our results, rTMS was significantly more effective than sham rTMS in both response and remission outcomes, which is consistent with previous meta-analyses, but the effect size was a bit smaller than what was reported previously.

Disclosure

No significant relationships.
The interaction of love in clinical care and its connection with burnout of health professionals
Authors: Batiridou A.–.L. , Dragioti E. , Mantzoukas S. , Kotrotsiou E. , Gouva M.
Published: September 2022

Introduction

The phenomenon of love in the clinical field, in other words, the practical love through specific features, is the “ultimate investment” of the well-being, both to the patient and to the health professional.

Objectives

The aim of this research study is to investigate the role of love and its connection with burnout in the context of clinical professional care.

Methods

The study was cross-sectional and was conducted from September 2020 to February 2021 at the Nursing Department of University of Ioannina, Greece. The sample of the present study was determined to be health professionals, both sex from all over Greece. The research tools which were used in the quantitative study were: 1) Socio-demographic questionnaire, 2) Measurement of social representations of love and 3) Maslach Burnout Inventory - MBI.

Results

The results of the present quantitative research showed that gender, religion, family environment, place of residence, years of work and job position of health professionals affect the love and compassion they can show and offer to their patients, and the love is related to the level of burnout they experience (p <0.05), in the context of clinical occupational care.

Conclusions

In conclusion, love, its traits and expression of the feelings of health professionals, determine the level of clinical care and the burnout of health professionals.

Disclosure

No significant relationships.
The Usefulness of Telemedicine in Perinatal Mental Health Services During and after COVID-19 Pandemic. Detailed Experience of the Team of „Together” Baby-Mother-Father Unit in Budapest
Authors: Kurimay T. , Fenyves T. , Szederkényi J. , Mező G. , Pelikán A.
Published: September 2022

Due to the nature of the perinatal period, it affects generations who are more at home in the electronic space, hence some form of telemedicine can be used in a number of areas. The “Together” Baby-Mother-Father Integrated Program has been running since 2004. Both the condition of those affected and the current epidemic makes it difficult for patients and their families to access adequate perinatal specialist care. At the beginning of the epidemic, the switch to telemedicinal psychiatric care has been rapid and focused mainly on the use of Phone, Skype, Viber and Email. To our findings the advantages include, easier access to care, and more frequent contacts. The home environment is accessible and the families are more involved. Also, care does not compete with the scarce resources of time and space. Some of the possible disadvantages are, that more work on intimacy is needed, and the treatability of certain diseases is questionable (e.g., psychoses). Care is less documentable with the current regulations, and funding has not yet been adapted to the changes. The telemedicinal care and support network in Hungary - among many - contains an online medical system (EESZT) including e-prescription. Online- psychotherapy, consultation, peer-group platforms. There is a non-stop hotline for patients, etc. In 2021 the total number of our cases increased by 34%, but realistically the visit number was also higher, due to the amount of shorter telephone and e-mail interactions. Depression and bipolar disorder were among the highest proportion by the patients present.

Disclosure

No significant relationships.
Delirium and health-related quality of life in severe COVID-19 survivors
Authors: Chorão L. , Martins S. , Ferreira A.R. , Fernandes J. , Vieira T. , Fontes L. , Reis N. , Braga A. , Coimbra I. , Paiva J.A. , Fernandes L.
Published: September 2022

Introduction

Severe COVID-19 survivors experience long-term neuropsychiatric morbidity, particularly those who developed delirium, with a negative impact on health-related quality of life (HRQoL).

Objectives

To identify the cases of delirium in severe COVID-19 patients and to describe its association with post-hospital discharge HRQoL.

Methods

In the context of the longitudinal MAPA project, we included adult patients (≥ 18 years old) admitted with COVID-19 to the Intensive Care Medicine Department (ICMD) of a Portuguese University Hospital (October 2020-April 2021). Exclusion criteria were: ICMD length of stay ≤24h, terminal illness, major auditory loss, or inability to communicate at the time of assessment. Delirium during ICMD stay was ascertained based on patients’ clinical records. HRQoL was evaluated using the 5-Level EQ-5D questionnaire (EQ-5D-5L), at a scheduled telephone follow-up appointment on average 1-2 months after hospital discharge.

Results

Overall, 124 patients were included with a median age of 62 (range: 24-86) years, being mostly male (65%). About 19% had delirium, 42% were deeply sedated and 43% required invasive mechanical ventilation. Most survivors reported problems on the EQ-5D-5L domains: usual activities (85%), mobility (73%) and anxiety/depression (65%). Patients with delirium reported more pain/discomfort (75%vs46%; p=0.011) and considerably anxiety/depression (83%vs60%; p=0.032).

Conclusions

These findings pointed that COVID-19 patients who experienced delirium reported worse HRQoL, regarding pain/discomfort and anxiety/depression. This study highlights the importance of not only prevention but also early screening of delirium during hospital stay, as well as the crucial role of the timely interventions at discharge, in order to minimize delirium long-term impacts.

Disclosure

No significant relationships.
Peripersonal space plasticity in Schizophrenia: a motor training
Authors: Magnani F. , Ferroni F. , Ferri F. , Ardizzi M. , Langiulli N. , Giustozzi F. , Rasmi F. , Volpe R. , Lucarini V. , Marchesi C. , Gallese V. , Tonna M.
Published: September 2022

Introduction

A primary disruption of the bodily self is considered a core feature of schizophrenia patients (SCZ). The “disembodied” self would be underpinned by an inefficient body-related multisensory integration mechanism occurring in the Peripersonal Space (PPS). PPS is a plastic sector of space surrounding our body, whose extent is altered in SCZ. Although PPS represents a malleable interface marking the perceptual border between self and others, no study has investigated the potential alteration of its plasticity in SCZ.

Objectives

We investigated the PPS extension and its plasticity in SCZ and their potential correlations with the clinical scales.

Methods

Thirty SCZ and thirty healthy controls (HC) underwent a multisensory task to estimate PPS boundary before and after a motor training. Patients were also administered the Positive And Negative Syndrome Scale (PANSS) and the Examination of Anomalous Self-Experience (EASE).

Results

Data confirm a narrower PPS extent in SCZ than in HC, whereas no differences in PPS expansion was found in the two groups after the motor training (Figure 1). Positive symptoms were associated directly with PPS extent and inversely with PPS plasticity. No associations were found between PPS and EASE domains. Figure1: Graphical representation of PPS expansion in SCZ and HC. Both panels show individual normalized sigmoid fits

Conclusions

The present study suggests a narrower PPS extent and a preserved PPS plasticity in SCZ with respect to HC. Both PPS extent and plasticity are related to the severity of positive symptoms. These results highlight the potential role of rehabilitation interventions in order to improve patients’ weakened body boundary.

Disclosure

No significant relationships.
Mental Health Screening and Digital Intervention for Thai Seniors Citizen in Primary Care
Authors: Tansupasiri P. , Khaektao P. , Panitaangkool Y.
Published: September 2022

Introduction

Avoidable disability associated with depression, anxiety, and impaired cognition among older adults is pervasive. Incentives for the detection of mental disorders in late life include increased reimbursement, reduced cost, and less burden for patients and families.

Objectives

Mental health problems in the elderly are major public health issues around the world. Thai older adults who experience mental illness rarely seek care from mental health specialists; rather, they tend to seek help from a general physician. Primary health care is, therefore, an important setting for the detection of mental health symptoms and subsequent treatment. We describe the design and implementation of a mental health care model in the Thai primary care system. Initial results of screening for behavioral and emotional problems are reported.

Methods

This work is intended to explore mental health conditions in Thai elderly people to provide of identifying and non-pharmacological treating psychiatric conditions in the Primary care unit. The instruments used in the survey, which consists of twelve symptoms found in the elderly, developed into an online program to suit pandemic conditions.

Results

In an effort to document mental health problems in the primary care system, 4,854 veterans (mean age 68) from 46 provinces across Thailand were screened for multiple mental health symptoms. The sample divided into 1,701 males (35%) and 3,153 females (65%).

Conclusions

While screening for depressed mood is now common in primary care, we found it useful to screen for specific symptoms of depression in older persons (including insomnia, change in eating habits, facial expression, and anxiety) in a primary setting.

Disclosure

No significant relationships.
Integrating services improve the return-to-work process for people on sick leave with stress-related disorders: results from a randomized trial (n=666)
Authors: Hoff A.
Published: September 2022

Introduction

Stress-related disorders are common and associated withsuffering and a large sociatal burden. While treatment appears to be able to reduce symptoms, evidence of interventions to improve work outcomes is inconsistent. Lack of integration different service domains has been suspected to be a barrier in return-to-work (RTW) processes.

Objectives

We aimed to test the effectiveness of intergrating vocational rehabilitation and mental health care.

Methods

We randomized participants on sick leave to I) service as usual (SAU), I) improved mental health care (MHC) or III) integrated interventions (INT). Primary outcome was RTW-rates measured at 12 months. Secondary outcome were proportion in work at 12 months, RTW-rates measured at 6 months, and symptom levels at 6 months.

Results

We randomized 666 participants. Regarding primary outcome, the SAU group was superior to both MHC and INT. Furthermore, SAU was also superior to INT and MHC on almost all other work-related outcomes. INT and MHC did not show differences on any work-related outcome. On several symptom scales, MHC was observed with lower scores than SAU, whilst INT did not differ from the two other groups.

Conclusions

Both the integrated intervention (INT) and the (non-integrated) mental health care (MHC) intervention lowered return-to-work rates compared with service as usual (SAU), and thereby yielded worse outcomes. However, the MHC group intervention showed a tendency towards having lower symptom levels compared with those in the SAU group; accordingly, the SAU group is not unequivocally superior. INT and MHC showed no general differences.

Disclosure

No significant relationships.
The Role of Music in Treating Psychiatric Symptoms
Authors: Volpe U.
Published: September 2022

Music therapy can be defined as the controlled use of music or musical elements by a qualified therapist with a client or a group of clients. The active or passive delivery of musical therapy may facilitate the development of individual potential and/or restore psychological functions of the individual, allowing to obtain better interpersonal, physical, and psychological functioning. Indeed, existing literature suggested that music therapy holds a significant therapeutic potential in a number of psychiatric disorders, including psychosomatic, anxiety and affective syndromes. More recently, evidence concerning the potential of music as a mean to increase group cohesion, acceptance, interpersonal relationships in psychiatric settings has highlighted the potential to improve the patient’s global functioning, social functioning, mental state, and positive/negative symptoms of psychoses. Traditionally, music therapy is delivered in controlled outpatient setting and few evidence point to a possible role in the treatment of acute psychoses, during their hospital stay. Recently, newer evidence has recently piled up and showed that music therapy can induce clinical (in particular, on affective symptoms), functional and quality of life improvement in patients with acute psychoses, even over a short period of time such as during emergency hospitalization. The reported effects might be related to complex neural modulation phenomena involving different interhemispheric, cortical and subcortical brain pathways. Practical clinical experiences, setting or implementation issues and quality standards in music therapy will also be discussed.

Disclosure

No significant relationships.
Prevalence and associated risk factors for intimate partner violence (IPV) in the Himalayan mountain villages of Pakistan
Authors: Yunus S. , Shah S. , Noshad G.
Published: September 2022

Introduction

Intimate partner Violence (IPV) against women includes all actions that violate one’s sense of self, physical body and sense of trust and involves episodes of violence of physical, psychological (emotional), or sexual nature, perpetrated by a current or former intimate partner.

Objectives

We estimated the prevalence of and risk factors for intimate partner violence (IPV) in the Himalayan mountain villages of Gilgit Baltistan in Pakistan.

Methods

We employed a cross-sectional study to randomly select ever married women (n=789) aged 18-49, in Pakistan. We used an adapted World Health Organization screening instrument to assess women’s experience of IPV in the previous 12 months. We used an indigenous validated instrument assess self-reported symptoms of major depression according to the DSM IV. Multivariable logistic regression analysis was used to identify significant predictors of IPV using adjusted odds ratio (AOR) with 95% confidence intervals (CI).

Results

The overall prevalence of IPV was 22.8% (95% CI: 20.0-25.9). Women exposed to IPV were less likely to have husbands educated at a college or a higher (AOR: 0.40; 95%CI: 0.22-0.70), household income in the middle or the highest tertile (AOR: 0.44; 95%CI: 0.29-0.68), and were more likely to have poor or very poor relationship with their mother in law (AOR=2.85; 95% CI: 1.90-4.28), to have a poor quality of health (AOR= 2.74; 95% CI: 1.92-3.92) poor quality of life (AOR= 3.54; 95%CI: 1.90-6.58), and higher odds of experiencing depressive symptoms (AOR=1.97; 95%CI:1.39-2.77).

Conclusions

IPV is a substantial public health burden in Himalayan mountain villages and merits serious attention.

Disclosure

No significant relationships.
Further validation of the European and Brazilian Portuguese short version of the Postpartum Depression Screening Scale-7
Authors: Pereira A.T. , Barros M. , Aguiar M. , Azevedo J. , Soares M.J. , Carvalho F. , Pereira D. , Macedo A.
Published: September 2022

Introduction

We have recently validated the Portuguese shortest version of the Perinatal Depression Screening Scale-PDSS-7 (items selected from the PDSS-21; each one representing a dimension evaluated by the PDSS-35), for the assessment of depression severity in pregnancy, both in Portugal and Brazil.

Objectives

To analyze the validity and reliability of the PDSS-7 Portuguese version to evaluate postpartum women both from Portugal and Brazil.

Methods

The Portuguese sample was composed of 304 women between the 2nd-6th postpartum months (Mean=20.09±7.21 weeks postpartum). These participants were not the same who participated in the psychometric study that led to the selection of the seven items. The Brazilian sample was composed of 121 women (Mean=10.51±4.53 weeks postpartum). All the participants completed the European/Brazilian Portuguese versions of PDSS-21, which was composed of the same items and included the seven items of PDSS-7. Participants also filled in the validated versions of Perinatal Anxiety Screening Scale and Profile of Mood States.

Results

Confirmatory Factor Analysis revealed that the unidimensional model of PDSS-7 presented acceptable/good fit indexes in both samples (Portuguese/Brazilian: χ2/d.f.=2.6598/1.7897; RMSEA=.0740/.0807, CFI=.8289/.7934, TLI=.7901/.8434, GFI=.9298/.9496; p<.001). The PDSS-7 Cronbach’s alphas were of .841/.856 and all the items contributed to the internal consistency. Pearson correlations with postpartum anxiety (.646/.763) and negative affect (.666/.676) were significantly (p<.01) high. PDSS-7 mean scores were higher in the Brazilian sample (16.06±7.39 versus 11.37±4.37, p<.01).

Conclusions

PDSS-7 presented validity (construct and convergent), reliability and utility in clinical and research settings, including in transcultural studies, in Portugal and Brazil, namely in the postpartum.

Disclosure

No significant relationships.
Miss attending risk factors in gynecological prenatal care among pregnant women at risk for dual pathology
Authors: Caro-Cañizares I. , Carmona Camacho R. , Vidal Mariño C. , Lopez Carpintero N. , Baca Garcia E.
Published: September 2022

Introduction

Access to adequate healthcare is the best means we have for detecting and preventing complications during pregnancy and childbirth. Identifying and preventing factors that can interfere with this access become essential (Gulliford et al., 2002). Mother dual pathology during pregnancy is a condition with severe consequences (Cosp & Ontano, 2009). However there is scarce literature regarding barriers to obstetric care among women at risk for dual pathology.

Objectives

The main objective was to explore healthcare access barriers among pregnant women at risk for dual pathology.

Methods

Framed in a broader research (The WOMAP project) 2014 adult pregnant women less than 26 weeks of pregnancy were screened in five hospitals in Madrid (Spain) between 2016-2019. If the screening test (AC-Ok scale) identified the presence of dual pathology during the last month, women were included in the clinical trial and assessed with a more extensive battery (compound by PHQ-9; GAD-7; PCL-5; AUDIT; DAST; and Fagerström Test) and a semi-structured interview.

Results

163 women at risk for dual pathology were assessed. Of them, 152 (93,2%) referred to having attended all scheduled appointments. Socioeconomic level (0.184, p=0.024), depression (-0.174, p=0.034), post-traumatic stress symptoms (-0.214, p=0.011) and alcohol reporting (-0.259, p=0.045) were significantly correlated with attendance level.

Conclusions

Women with more severe symptoms of dual pathology are at higher risk for misatending obstetrical appointments. Social criticism, even subtle or unintentional, related to dual pathology during pregnancy could be restraining these women to attend properly. Thus, care providers should pay attention to women’s mental health and alcohol abuse to prevent miss-attention.

Disclosure

No significant relationships.
CHALLENGE and Face Your Fears: Virtual Reality Treatment for Auditory Hallucinations and Paranoid Ideations
Authors: Glenthøj L. , Smith L. , Mariegaard L. , Due A.S. , Christensen A. , Christensen M. , Vernal D. , Jeppesen U. , Nordentoft M.
Published: September 2022

Background: Many patients suffering from schizophrenia spectrum disorders continue having distressing auditory hallucinations and paranoid ideations despite receiving current treatment. Virtual reality assisted treatment offers the potential of advancing current psychotherapies for psychotic symptoms by creating virtual environments that can elicit responses (e.g. thoughts, feelings, behaviours) mirroring real-world settings. In two large-scale randomised clinical trials, we are investigating whether targeted virtual reality assisted psychotherapy can reduce psychotic symptoms and increase daily life functioning and quality of life. The CHALLENGE trial examines whether nine sessions of virtual reality-assisted psychotherapy is superior to nine sessions of standard treatments in reducing the severity, frequency, and distress of auditory hallucinations in patients with psychosis. In the Face your Fears trial we are investigating whether virtual reality assisted cognitive behavioral therapy (CBT) is superior to standard CBT in reducing levels of paranoid ideation in patients with psychosis spectrum disorders. Methods: The CHALLENGE and Face your Fears trials are randomised, assessor-blinded parallel-groups superiority clinical trials, allocating a total of 266 and 256 patients, respectively to either the experimental intervention or a control condition. The trials are currently enrolling patients; thus, no quantitative data is available yet. The main objective of this presentation is to give a qualitative account of this new psychotherapeutic methods as it is applied in both trials. Results: Qualitative data comprising case descriptions and video material will be presented at the conference. Discussion: The preliminary findings indicate great potential for these innovative treatments albeit important concerns regarding implementation will be raised.

Disclosure

No significant relationships.
Clinical–EEG-Neuroimmunological Correlations in Depressive Female Adolescents with Non-Suicidal Self-Injuries
Authors: Iznak A. , Iznak E. , Oleichik I. , Zozulya S.
Published: September 2022

Introduction

Non-suicidal self-injurious behavior (NSSI) is rather widespread in adolescents, especially in females, and is an important risk factor for future suicide. The search for neurobiological markers of NSSI is therefore an actual medical and social problem.

Objectives

The aim of the study was to determine the relationships between pre-treatment quantitative clinical, EEG, and neuroimmunological parameters in female depressive adolescents with NSSI.

Methods

40 female depressive patients (all right-handed, 16–25 years old, mean 17.6±2.2 years old) were included in the study. Total HDRS-17 scores varied from 14 to 38 (mean 26.0±6.9). Multichannel eyes closed resting EEG was recorded with subsequent spectral power (SP) measurements in narrow frequency sub-bands. Enzymatic activities of leukocyte elastase (LE) and its antagonist α-1 proteinase inhibitor (α1-PI), as neuroinflammation markers, and the levels of autoantibodies to S100b protein (AAB-S100b) and to basic myelin protein (AAB-BMP), as neuroplasticity markers, were measured in the blood plasma. Spearman’s rank correlations were calculated between clinical, EEG, and neuroimmunological parameters.

Results

HDRS-17 scores correlated positively (p<0.05) with beta2 (20-30 Hz) SP in the right anterior and mid-temporal leads. AAB-S100b values correlated positively with alpha2 (9-11 Hz) and alpha3 (11-13 Hz) SP in central-temporal-parietal-occipital leads, and correlated negatively with beta1 (13-20 Hz) and beta2 SP in the right anterior temporal lead.

Conclusions

The structure of clinical–neurobiological correlations obtained indicates that processes of neuroinflammation in depressive adolescents with NSSI are relatively mild and/or compensated by anti-inflammatory mechanisms. The study supported by RBRF grant No.20-013-00129a.

Disclosure

No significant relationships.
The UK AVATAR 1 and 2 Trials for People with Distressing Voices – Findings and Learning from AVATAR1, and AVATAR2 Developments in Theory and Therapy
Authors: Craig T. , Garety P. , Ward T. , Edwards C. , Rus-Calafell M. , Huckvale M. , Emsley R.
Published: September 2022

Introduction

Many people suffering from psychotic disorders report persistent auditory verbal hallucinations (‘voices’) despite pharmacological and psychological therapy. Interest is growing in approaches that emphasise the personal relationship between the patient and their voice(s). AVATAR therapy is one such approach that uses a digital representation (avatar) of a selected voice to facilitate a three-way discussion between patient, therapist and voice, the therapist speaking either as him/herself or in the digitally transformed voice of the avatar. Objectives: To describe AVATAR therapy and an ongoing multi-centre clinical trial. Methods: Encouraging findings from an earlier controlled trial (AVATAR1) comparing AVATAR therapy and supportive counselling informed our current multi-site cost-effectiveness trial of brief and extended versions of the therapy compared to treatment as usual (AVATAR2). Results: AVATAR1 delivered in 7 weekly sessions resulted in a reduction in the frequency, distress and power of voices that was significantly superior to supportive counselling. Clinical experience suggested that some participants improved in response to the early focus on anxiety while others seemed more responsive to later more formulation-driven approach. These findings led us to the current ongoing three arm clinical trial comprising a brief (6 session) focus on anxiety/assertiveness, an extended (12 session) formulation-driven approach both approaches compared to treatment as usual. Conclusion: Previous AVATAR studies suggest this is a therapy with considerable promise. It can be delivered through widely available laptop computers, usually in clinic but also remotely via existing commercial platforms. The current trial will address questions about dissemination, training and cost-effectiveness in NHS settings.

Disclosure

The digital technology employed in AVATAR therapy is provided by licence for the trial from Avatar Therapy Ltd
Mother-Baby Day Hospital (MBDH): preliminary results of effectiveness of multidisciplinary intensive intervention for women with postpartum affective/anxiety disorder
Authors: Gelabert E. , Torres Giménez A. , Andrés-Perpiñá S. , Naranjo C. , Roda E. , Garcia-Esteve L. , Roca Lecumberri A.
Published: September 2022

Introduction

Women experiencing postpartum mental illness have unique needs. Psychiatric Mother Baby Units (MBUs) can provide specialist in-patient care for mothers without separation from their baby. Since 2018, an innovative Mother-Baby Day Hospital (MBDH) have been developed and implemented in a public hospital in Spain, directed at the intensive, integral, and multidisciplinary treatment.

Objectives

The aim of the present study was to obtain preliminary data regarding its effectiveness in postpartum women with affective and anxiety disorders.

Methods

Thirty-three mothers and their babies with affective or anxiety disorders attended to MBDH CLINIC-BCN participated in the study. All women were assessed at admission, discharge, and 3 months follow-up. Primary outcomes were depression (EPDS) and anxiety symptoms (STAI-S), mother-infant bonding (PBQ) and functional impairment (HoNOs).

Results

At discharge, 100% of women no longer met the full criteria for the main diagnosis (PSR≥5). Significant improvements from admission to discharge were achieved in depression and anxiety symptoms, mother infant bonding and functional impairment. Clinical significance was also calculated. After treatment, mothers had greater autonomy for care their babies. Similar results were observed at 3 months follow-up. The MBDH was rated by mothers as an excellent quality program and they would recommend it.

Conclusions

This study found that multidisciplinary intervention at MBDH for postpartum women with affective or anxiety disorders is effective, not only for maternal psychopathology but also for maternal care and bonding. It is imperative to develop specialized devices that integrate the care of the dyad by professionals specialized in perinatal mental health.

Disclosure

No significant relationships.
EEG alpha band functional connectivity and network structure mark hub overload in Mild Cognitive Impairment during memory maintenance
Authors: Fodor Z. , Horváth A. , Hidasi Z. , Gouw A. , Stam C. , Csukly G.
Published: September 2022

Introduction

While decreased alpha-band functional connectivity (FC) and changes in network topology have been reported in Alzheimer’s disease, it is not yet entirely known whether these differences mark cognitive decline in the early stages of the disease.

Objectives

Our study aimed to analyze EEG FC and network differences in the alpha frequency band during visuospatial memory maintenance between Mild Cognitive Impairment (MCI) patients and healthy elderly with subjective memory complaints.

Methods

FC and network structure of 17 MCI patients and 20 control participants were studied with 128-channel EEG during a visuospatial memory task. FC was measured by amplitude envelope correlation with leakage correction (AEC-c), while network analysis was performed by applying the Minimum Spanning Tree approach.

Results

Increasing memory load enhanced the mean alpha-band FC in the control group. In contrast to that, after an initial increase, the MCI group showed significantly (p<0.05) diminished FC in the highest memory load condition. Mean alpha AEC-c correlated significantly with the size and mean diffusivity of medial temporal lobe structures in the entire sample. The network analysis revealed a rerouted network in the MCI group with a more centralized topology and a more unequal traffic load distribution compared to the control group.

Conclusions

Alpha-band FC correlates with cognitive load-related modulation, with medial temporal lobe atrophy, and with the disruption of hippocampal fiber integrity in the earliest stages of cognitive decline. The more integrated network topology of the MCI group is in line with the “hub overload and failure” framework and might be part of a compensatory mechanism.

Disclosure

No significant relationships.
Qualitative description of work of a psychotherapy group in the context of COVID pandemic
Authors: Najbar I. , Guśtak E. , Młynarczyk R. , Łopalewska D.
Published: September 2022

Introduction

COVID pandemic very much influenced therapeutic organisation of psychiatric care. This also applies to our hospital. Especially therapeutic activities in stationary wards.

Objectives

We would like to show changes occurring in psychotherapy group of the patients with psychotic disorder in the stationary ward in core of pandemic.

Methods

I would like to present a qualitative description of psychotherapy group in the context of COVID. The group is designed for patients with experience of psychosis, grounded in psychodynamic school and has a long tradition at an acute admission in stationary psychiatric department.

Results

During the pandemic there were epidemiological constraints. From six members of personnel in the basic assumptions, we reduced to minimum. So from two co-therapists, reflecting team and an observer, we ended leading the group every second time with one of the therapists. Despite of our efforts to maintain a continuous group, the group was closed for more than half a year and then reactivated based on old rules and roots, but less consistent memory of group members. During this most strict reduction of personnel, which would never have been accepted apart from the pandemic restrictions appeared a few interesting phenomenon. One of them was - twin groups. With the colleague we lead the group every second time. The group shows us a similar picture twice.

Conclusions

As we understand, twin groups is a way to try to keep this group together in its already damaged setting. For the moment the abstract submission group is continuing to work within its present arrangement.

Disclosure

No significant relationships.
Successful mentalizing in schizophrenia is associated with specific recruitment of ventromedial prefrontal cortex and precuneus
Authors: Jáni M. , Gajdoš M. , Ustohal L. , Hořínková J. , Kašpárek T.
Published: September 2022

Introduction

Patients with schizophrenia have difficulties in cognitive and affective mentalizing which is manifested by excessive (‘overmentalizing’) or defective (‘undermentalizing’) attribution of mental states. As most of the tests does not differentiate between ‘overmentalizing’ and ‘undermentalizing’, it is not yet clear how are these deficits reflected in mentalizing network in schizophrenia.

Objectives

Investigate how is cognitive and affective ‘overmentalizing’ and ‘undermentalizing’ reflected in mentalizing network in schizophrenia.

Methods

We recruited 30 schizophrenia patients and 30 healthy controls who underwent fMRI session while they completed ‘Social situations assessment task’ consisting of 90 stories with 30 questions on affective, 30 on cognitive mental states and 30 control memory questions and 4 possible answers: no mentalizing, undermentalizing, appropriate mentalizing, overmentalizng (for control condition 1 correct and 3 incorrect).

Results

On a behavioral level, we found increased no mentalizing and undermentalizing and decreased mentalizing in patients, but no difference in overmentalizing between groups. For fMRI results, patients showed lesser recruitment of dorsomedial prefrontal cortex and temporal poles (with right superior temporal sulcus) only during appropriate mentalizing in both affective and cognitive conditions. However, ventromedial prefrontal cortex and precuneus showed increased pattern of activation across all mentalizing levels in healthy controls compared to schizophrenia, but suppressed activation in appropriate cognitive mentalizing corresponding to the level of a schizophrenia group.

Conclusions

Schizophrenia patients show different pattern of mentalizing compared to healthy control that can be associated with specific activity mentalizing brain network.

Disclosure

No significant relationships.
The role of social intelligence and creativity as personal resources for coping with uncertainty during primary career self-determination in late adolescence
Authors: Chesnokova O. , Churbanova S. , Molchanov S. , Markish O.
Published: September 2022

Introduction

Social intelligence (SI) and creativity (Cr) are resources to develop adaptive coping strategies and positive emotions that can help combat feelings of fragility and vulnerability caused by uncertainty during primary career self-determination as the developmental task in late adolescence.

Objectives

The aim of the study was to compare SI and Cr of students with high and low level of tolerance for uncertainty (TU) during two last years in the middle school.

Methods

Participants were 200 students (15-17 years old). The level of TU was estimated by Budner’s scale (Kornilova, 2010). Social intelligence was assessed by O’Sullivan & Guilford’s Tests, creativity was measured by CAP. In addition, we estimate career adapt-abilities applied to present and prospective future career decisions.

Results

Two contrast clusters based on TU level were analysed. The level of SI and Cr were various within each group. There appears to be an association between TU and career adapt-abilities (at r ∼ .37, p < .05). Mostly female students with low level of TU and above average scores on SI and Cr demonstrate the effective coping strategy dealing with stress (at r ∼ .45, p < .01) emotionally focus on nearest professional future, seek social support. Coping strategy of students with high TU, SI and Cr is focusing on nearest and distant professional future, on task-oriented content and the social status of the future profession. They are open to new career experience and flexibility in the use of future professional skills (at r ∼ .56, p < .001).

Conclusions

Employing their SI and Cr give new opportunities to understand and prevent the development of stress and provide age-specific support to prospective students during primary career self-determination.

Disclosure

Research is supported by the Russian Humanitarian Research Foundation, project No. 18-013-01067.
Impact of COVID-19 pandemic on the Acute Confusional Syndrome by the liaison psychiatry service of Hospital del Mar
Authors: Calls M. , Llimona González A. , Dinamarca F. , García Hernández D. , Oller Canet S.
Published: September 2022

Introduction

The coronavirus disease 2019 (COVID-19) pandemic has had a profound worldwide impact on health. Acute Confusional Syndrome (ACS) is the most common neuropsychiatric complication in COVID-19 infection.

Objectives

Describe the characteristics of the admited patients attended by the liaison psychiatry service for acute confusional syndrome during the COVID 19 pandemic. Sociodemographical and clinical variables were descrived.

Methods

We conducted an observational, descriptive study. All patients attended by the liaison psychiatry service of Hospital del Mar, between February and April 2020, with ACS diagnosis were included.

Results

We included 62 patients with acute confusional syndrom; 35 were men (56.5%), and mean age was 71.71 years (standard deviation [SD]:11.345). The mean duration of admision stay was 41.19 days [SD: 38.039]. The mean number of consultations carried out was 6.5 [SD: 5.422]. 52.5% of our sample of our sample had confusional symptoms for 8 days. 50 patients presented complications during admission (80.6%), of which 43 patients developed infectious complications (69.4%). 59 patients had a history of chronic diseases (95.2%). 54 patiens (88.5%) had potencial risk factors associated with acute confusional syndrome including: isolation in 24 (39.3%), active infection in 46 (74.2%), hypoxemia in 25 (40.3%), previous cognitive impairment in 15 (24.6%)

Conclusions

Acute Confusional Syndrome mainly affects people with risk factors such as isolation, active infection and hypoxemia (which in turn are symptoms of Covid-19).

Disclosure

No significant relationships.
Ethnic inequalities in multiple comorbidities among people with psychosis
Authors: Fonseca De Freitas D. , Khondoker M. , Nazroo J. , Hayes R. , Bhui K.
Published: September 2022

Introduction

Studies have shown ethnic inequalities in health, with a higher incidence of illnesses among people of some minoritised ethnic groups. Furthermore, it has been observed that people with severe mental illnesses have a higher risk for multimorbidity. However, no study has investigated ethnic disparities in comorbidity in people with a schizophrenia spectrum disorder.

Objectives

This study investigates potential ethnic disparities in physical health comorbidity in a cohort of people with psychosis.

Methods

Using a cross-sectional design, we identified service-users of the South London and Maudsley NHS Trust who were diagnosed with a schizophrenia spectrum disorder between 2007 and 2020. We assessed the prevalence of asthma, bronchitis, diabetes, hypertension, low blood pressure, overweight or obesity, and rheumatoid arthritis. Latent class analyses were used to investigate distinct profiles of comorbidity. Multinomial regression was then used to investigate ethnic disparities in these profiles. The regression model was adjusted for gender, age, neighbourhood deprivation, smoking and duration of care.

Results

On a sample of 23,418 service-users with psychosis, we identified two classes of comorbidity: low comorbidity and multiple comorbidities. Compared to the White British ethnicity, a higher risk for multiple comorbidities was observed for people with any Black background, Indian, Pakistani, Asian British, and mixed-race ethnicities. Furthermore, Black African women had a significantly higher risk for multiple comorbidities than their male counterparts.

Conclusions

Ethnic disparities are observed in multiple comorbidities among people with psychosis. Further research is needed to understand the impact of these disparities, especially in relation to mortality.

Disclosure

No significant relationships.
Digital self-harm – Social Media and its impact on Non-Suicidal Self-Injury and suicidal behavior. A Longitudinal Mixed Method Study
Authors: Jensen M.E. , Vinberg M. , Andreasson K. , Klausen J. , Joergensen K. , Nordentoft M.
Published: September 2022

Introduction

Several initiatives within psychiatric nursing targets Non-suicidal self-injury (NSSI) in DK, but none targets the new phenomenon Digital Self-harm. Digital self-harm involves the use of Social media (SoMe) to harm oneself for example by communicating condescending content about and to oneself through fake profiles, seeking out conflicts to be humiliated, and consciously get others to say vicious things about themselves. Further, images are exchanged showing wounds, broken extremities, etc. and thoughts and feelings are exchanged about suicidal actions as well as methods for both self-harm and suicide actions. We do not know enough about what constitutes the problem nor do we know how to address neither the behavior nor their consequences. Due to conflicting results, more research is needed to understand how media affects NSSI as well as suicidal behavior.

Objectives

The overall objective of this study is to map, at a national level, how SoMe is used as part of NSSI and suicidal behavior and get insight as to what constitutes the behavior and how we address it through three sub-studies.

Methods

The study will be carried out as a mixed method study and includes a systematic review (Study 1), a qualitative part, which will be examined through interviews (Study 2), and finally a quantitative part that will be conducted through questionnaires (Study 3).

Results

The project is ongoing.

Conclusions

Prospects of this study are that the project will create clarity about the essence of the phenomenon of digital self-harm, how NSSI and suicidal behavior is affected and generate enough knowledge to develop interventions aiming digital self-harming and suicidal behavior.

Disclosure

No significant relationships.
Assessment of the performance of assertive community treatment: the case of Bizkaia (Spain)
Authors: Díaz-Milanés D. , Almeda N. , García-Alonso C. , Salvador-Carulla L.
Published: September 2022

Introduction

A mental health (MH) assertive community treatment (ACT) is always designed expecting for a decrease in the pressure (visits and readmissions) in inpatient services and to increase care quality. An appropriate management of ACT provision can be crucial to develop a balanced community-based MH ecosystems.

Objectives

To assess the impact of the ACT on the performance of the MH ecosystem of Bizkaia (Basque Country, Spain).

Methods

The ecosystem is structured by 19 MH areas, supported by 5 ACT teams. Here ACT provides high intensity mobile outpatient care to people suffering from severe mental disorders. The impact of these teams on the ecosystem performance was assessed by Monte-Carlo simulation, the Data Envelopment Analysis (DEA) and fuzzy inference. The input variables were the availability, number of psychiatrics, nurses and total of professionals of ACT services in each area. The outputs were: frequentation, incidence and prevalence of ACT services in each MH area. Performance indicators were: relative technical efficiency (RTE), statistical stability and entropy.

Results

The global ecosystem performance was high (RTE on average=0.799 -input DEA orientation- and 0.825 -output orientation- up to 1, the maximum), the stability was medium-low (respectively 38,67% and 13.64% up to 100%, the maximum) and the entropy was medium-high (respectively 70,41% and 65.9% up to 100%, the maximum).

Conclusions

Results highlighted a positive impact of ACT in Bizkaia. Nevertheless, stability and entropy levels showed the existence of a high structural variability in ACT services due to the necessity of adjusting them to the user’s specific needs.

Disclosure

No significant relationships.
Alcohol use disorder as a risk factor for violent offending in a sample of female forensic-psychiatric inpatients
Authors: Franke I. , Streb J. , Dudeck M. , Mayer J. , Steiner I. , Wolf V.
Published: September 2022

Introduction

Female gender is associated with a lower risk for aggressive behaviour and violent offending. Well established risk factors for aggressive behaviour are alcohol and other substance use, but previous studies focused mainly on male offenders and the general population. However, for therapeutic and prognostic reasons it is important to understand pathways to female offending.

Objectives

To examine a sample of female forensic-psychiatric inpatients regarding the association of alcohol (AUD) and other substance use disorders (SUD) with violent offending (homicide, assault, robbery).

Methods

We conducted a retrospective cohort study of 334 female patients discharged before 01.01.2019 from a secure psychiatric hospital in Germany.

Results

In total, 72% of the patients with AUD committed a violent crime, leading to admission to secure psychiatric treatment. In comparison a statistically significant lower rate (19%) of the SUD group was convicted of violent offending. Over 70% of the participants with AUD had a family history of AUD, and over 83% experienced physical violence in adulthood. We found no group differences (AUD vs. SUD) regarding aggressive behaviour during inpatient treatment.

Conclusions

According to our results, AUD compared to other SUD, is a significant risk factor for violent offending in women. A family background with AUD and a history of physical abuse might function as a risk factor for both: developing an AUD and violent offending. The comparable rates of aggression in both groups during inpatient treatment suggest that abstinence is a protective factor.

Disclosure

No significant relationships.