bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of stigma on people with pre-existing mental disorders during COVID 19 pandemic in Georgia
Authors: Matiashvili G.
Published: August 2023

Introduction

From the beginning of the pandemic in Georgia, Covid clinics and Covid hotels were not ready to receive and manage people confirmed Covid 19 with pre-existing mental disorders, because of stigma. As a result of this, the Ministry of Health created special Covid-Psychiatric clinics.

Objectives

Study the impact of stigma on people with pre-existing mental disorders during Covid 19 pandemic. Also clinical, and dynamic characteristics of Covid 19 infection in people with severe mental illness.

Methods

A retrospective statistical analysis of medical records of all hospitalized patients (total 301) at the specialized Rustavi Covid –Psychiatric clinic from November 23, 2020, to March 15, 2022, according to the following parameters: age, gender, mental disorder diagnosis, comorbid chronic illness, vaccination rates, degree of covid infections ongoing, and outcome.

Results

57% of patients were men. Average age-44 years. 67% were asymptomatic or mild with covid symptoms, 25% with moderate severity and 8% were referred to the intensive care unit. 56% of referred patients were hospitalized already in serious conditions. 46% of patients had schizophrenia spectrum disorders. Among referred patients, 60% were women, and 25% had comorbid diabetes mellitus. 44% of patients transferred to the intensive care unit died. Most of the hospitalized patients with pre-existing mental disorders were in remission, and only 7% were referred to other psychiatric clinics for continuing their inpatient treatment.

Conclusions

The study showed that only due to the lack of readiness of the relevant structures, individuals with Covid 19 infection were hospitalized in psychiatric clinics because of their past mental history. Vaccination rates were extremely low than in the general population. The aforementioned indicates a high degree of stigma in the country that makes obstacles for people with mental disorders from receiving adequate and timely medical care. Comorbidities played a big role in degree of COVID infections ongoing, especially diabetes. Statistics also showed that the majority of hospitalized patients did not require inpatient treatment and covid infection did not aggravate the course of most severe mental disorders.

Disclosure of Interest

None Declared
Burnout due to COVID-19 pandemic in frontline healthcare workers from low- and middle-income countries: A systematic review
Authors: Mammadzada G. , Manucheri-Lalen A.
Published: August 2023

Introduction

The coronavirus pandemic was declared one of the deadliest pandemics in the world’s history, surpassing even the 1918 flu pandemic in some countries. The speed with which the virus spread around the world did not leave the slightest chance to prepare even for protected health systems of developed countries, let alone countries with fragile health systems, experiencing a large number of problems at work even at regular times. Although burnout is included in the ICD-11 classification only as a syndrome caused by occupational stress and not a disease, unrecognized and unaddressed, it has the capacity to transform into a wide range of mental disorders, including depressive and anxiety disorders. This poses a threat to healthcare workers and patients, so it is very important to understand the scale of the problem and the factors that can play protective and triggering roles.

Objectives

Our objective was to evaluate point-prevalence of burnout syndrome among healthcare workers from LMIC during the COVID-19 pandemic.

Methods

We conducted a systematic search in Ovid MEDLINE, Embase and PsycInfo, as well as a manual search in PubMed, Google Scholar and Grey Literature to select studies describing burnout prevalence in healthcare workers from low-and middle-income countries during the pandemic. We used a wide range of subject headings as well as main keywords, such as “mental health”, “burnout”, “coronavirus”, “health personnel”, “depression”, “anxiety”, “developing countries” and their synonyms study design search had no limitations and included cohort, case-control, cross-sectional and randomized controlled studies. All identified studies were screened and a final sample of relevant studies was used for data extraction and quality appraisal.

Results

Data was extracted from 15 studies and included 21,007 individuals from eight countries. The proportion of female healthcare workers in our sample was 69% and the overall mean age of participants was 34.3 (2.3). Burnout prevalence varied from 3.62% to 90.1%. Gender, age, workload-related factors and institutional support were mentioned among the most important aspects influencing the burnout level. Clinical heterogeneity was a major drawback of our study as cut-off points for overall burnout and burnout sub-scales were inconsistent even among studies using the same inventory.

Conclusions

It is of critical importance to adopt a wide range of burnout preventive measures for healthcare workers, in particular, easy access to mental health support services, proper organization of human force and more comprehensive educational training in emergency situations. Furthermore, it is suggested, that researchers use a more precise and evidence-based approach to the use of measurement tools in order to increase the reliability of their work and recommendations.

Disclosure of Interest

None Declared
Sleep disturbances in the Croatian adult population amidst the COVID-19 pandemic
Authors: Miskulin I. , Fotez I. , Miskulin M. , Kristic M.
Published: August 2023

Introduction

It has been shown that various traumatic events, such as social isolation connected with the COVID-19 pandemic, can produce psychological distress and anxiety symptoms which negatively impact sleep quality.

Objectives

This study aimed to investigate the influence of the COVID-19 preventive measures, especially social isolation, on sleep quality of the Croatian adult population during the COVID-19 pandemic.

Methods

This cross-sectional questionnaire study was conducted from February to June 2021 period. A validated, anonymous questionnaire that contained questions regarding demographic data, as well as Pittsburgh Sleep Quality Index (PSQI) was self-administered to a convenient sample of Croatian adults from central and northwestern Croatia.

Results

The study sample included 939 subjects with, median age of 42 years (interquartile range 35-48), 35.4% males, and 64.6% females. According to the PSQI there were 22.6% of subjects who presented sleep disturbances. Sleep disturbances were more frequent among females (p<0.001), inhabitants of the Croatian capital Zagreb (p=0.001), subjects who were not infected with COVID-19 virus (p=0.042), subjects who had fear of coronavirus infection in the workplace (p<0.001), subjects who had fear of coronavirus infection during daily life activities (p<0.001), subjects who had fear of coronavirus infection during daily physical activities (p<0.001) and subjects who worked with limited social contact (p=0.005).

Conclusions

The COVID-19 pandemic has a significant negative influence on the sleep quality of the Croatian general population. Development of appropriate supportive programs that enhance mental health and sleep quality during pandemics is needed to address mental health problems in Croatia during the ongoing pandemic.

Disclosure of Interest

None Declared
Prevalence and factors associated with Posttraumatic Stress Disorder among Healthcare Workers During the COVID-19 Pandemic: Findings from a survey applied on a Portuguese General Hospital
Authors: Paulino Ferreira L. , Ribeiro N. , Duarte M.
Published: August 2023

Introduction

Posttraumatic Stress Disorder (PTSD) consists of an intense, prolonged, and occasionally delayed reaction to a deeply stressful event. PTSD is associated with risk of suicide and chronic psychological impairment. The continued exposure to stress suffered by Healthcare Workers (HCWs) during the COVID-19 pandemic can be considered a mass traumatic event and contribute to higher rates of PTSD in this population.

Objectives

To study the rates of PTSD in a sample group of healthcare professionals working in a Portuguese general hospital and its relationship with a number of individual variables considered to be relevant by the existing literature on the subject.

Methods

We devised a survey to assess the prevalence of PTSD among HCWs in a general hospital and its relationship with sex, social support, profession, work experience in healthcare, time spent caring for COVID-19 patients and place in which the COVID-19-related activities were carried out. PTSD symptoms were assessed using the PCL-5, Portuguese version.

Results

A total of 226 HCWs were included in the study. Provisional diagnosis of PTSD was made based on the PCL-5 responses, considering DSM-5 criteria and the cutoff score of 33.

79 out of 226 (35.0%) HCWs had a provisional diagnosis of PTSD, and a significant association was found between PTSD and time spent working with COVID-19 patients and between PTSD and place of work, namely the COVID-19 Emergency Room and Intensive Care Unit.

Conclusions

Our results are in line with previous studies, highlighting the importance of a serious, wide, and honest discussion about mental health promotion among HCWs. The COVID-19 pandemic has been an undeniable source of stress for HCWs around the globe, and the consequences of this stress are beginning to manifest themselves. It is urgent that this reflection takes place, as it is of paramount importance that what we all have lived in the past years serves as a lesson, and not as a warning of a crisis doomed to repeat itself.

Disclosure of Interest

None Declared
Coping strategies of Health Care Workers during third wave of Covid
Authors: Theodoratou M. , Kanellopoulou P. , Nikitidis N. , Farmakopoulou I.
Published: August 2023

Introduction: Background

During the pandemic, health professionals had the unprecedented experience of dealing with a newdisease with high contagiousness and mortality. The workload, but also the fear of disease management, caused significant levels of stress. Each employee managed stress in his own way. This study detects the level of stress experienced by health workers during the pandemic and the coping strategies they selected accordingly.

Objectives

The aim of this study was to investigate the coping strategies used by health professionals during the pandemic of coronavirus.

Methods

The sample comprised 180 health professionals that were working in a public hospital. The data collection tool was an anonymous questionnaire consisting of socio-demographic questions, the Toulouse Scale for coping , and a sub questionnaire to explore health professionals’ views on the pandemic.

Results

Women (73.9%), young individuals (50.6% are up to 35 years old) and TEI graduates (53.9%) predominate in the sample. The sample consisted mainly of nurses (68.3%) and the great majority were contract workers (67%).

The most frequently used dimensions were “Active focus” (Average 3.91/5.00), “Acceptance” (3.86), “Cognitive Control and Planning” (3.61) and “Social Information Support” (3.60).

Also, health workers used more often the strategies of “Social support” (3.45), “Control” (3.33) and “Focus” (3.23), while they use the “Withdrawal” strategy less often (2.25). Finally, respondents used “Positive strategies” more often (3.54) than negative ones.

Conclusions

The health professionals in the present study preferred to ask for information and use cognitive and informative strategies more often and, to a lesser extent, they were overwhelmed by their emotions. The strategies of social support, control and focus were used more often, while the strategy of withdrawal was selected less often. Furthermore, positive strategies were used to a greater extent.

Disclosure of Interest

None Declared
Regionally decreased cortical gyrification in patients with major depressive disorder
Authors: Han K.-M. , Kang Y. , Ham B.-J.
Published: August 2023

Introduction

Early neurodevelopmental deviations, such as abnormal cortical folding patterns, are a candidate biomarker for major depressive disorder (MDD). Previous studies on patterns of abnormal cortical gyrification in MDD have provided valuable insights; however, the findings on cortical folding are controversial.

Objectives

We aimed to investigate the association of MDD with the local gyrification index (LGI) in each cortical region at the whole-brain level and the association of the LGI with clinical characteristics of MDD, including recurrence, remission status, illness duration, severity of depression, and medication status of patients with MDD.

Methods

We obtained T1-weighted images of 234 patients with MDD and 215 healthy controls (HCs). LGI values were automatically calculated using the FreeSurfer software according to the Desikan–Killiany atlas. LGI values from 66 cortical regions in the bilateral hemispheres were analyzed. We compared the LGI values between the MDD and HC groups using the analysis of covariance, including patients’ age, sex, and years of education as covariates. The association between clinical characteristics and LGI values was investigated in the MDD group.

Results

Compared with HCs, patients with MDD showed significantly decreased LGI values in the cortical regions, including the bilateral ventrolateral and dorsolateral prefrontal cortices, medial and lateral orbitofrontal cortices, insula, right rostral anterior cingulate cortex, and several temporal and parietal regions, with the highest effect size in the left pars triangularis (Cohen’s f = 0.361; P = 1.78 × 10-13). As for the association of clinical characteristics with LGIs within the MDD group, recurrence and longer illness duration of MDD were associated with increased gyrification in several occipital and temporal regions, which showed no significant difference in LGIs between MDD and HC groups.

Conclusions

Considering that the aforementioned cortical regions are involved in emotion regulation, abnormal cortical folding patterns in such regions may be associated with the dysfunction of emotion regulation-related neural circuits, which may lead to MDD. These findings suggest that LGI may be a relatively stable neuroimaging marker associated with the trait of MDD predisposition.

Disclosure of Interest

None Declared
50% Improvement: Should Treatment Response Go Beyond Symptom Improvement When Evaluating the Treatment of Depression?
Authors: Zimmerman M.
Published: August 2023

Introduction

The emphasis on symptom resolution in depression treatment research is at variance with the recommendations of official treatment guidelines and the results of surveys of depressed patients’ views of the most important treatment goals.

Objectives

In the present study, we examined the interrelationship between response rates on various outcome domains and whether response on each domain was associated with patients’ global rating of improvement (PGI) reported upon treatment completion. We also examined whether the PGI was associated with the number of domains on which the patients had achieved responder status and which domains were independent predictors of PGI response.

Methods

Eight hundred and forty-four patients with major depressive disorder completed the Remission from Depression Questionnaire (RDQ), a self-report measure that assesses 6 constructs considered by patients to be relevant to assessing treatment outcome. The patients completed the RDQ at admission and discharge from the treatment program. For each domain, response was defined as a 50% or greater reduction in scores. At discharge, the patients rated the PGI.

Results

The patients significantly improved from admission to discharge on each of the 6 domains assessed on the RDQ. The responders on each domain reported significantly greater improvement on the global rating of improvement at discharge. Responder status in one domain mostly co-occurred with responder status in another domain. In a logistic regression analysis, responses on all domains, except nondepressive symptoms, were independently associated with PGI response.

Conclusions

The results of the present study are consistent with multiple surveys which have suggested that focusing on symptom reduction is too narrow of an approach when measuring outcome in the treatment of depression. Expanding the assessment of outcome beyond symptoms and viewing nonsymptomatic outcome domains as critical composites of primary endpoints would be more consistent with a patient-centered approach towards the treatment of depression.

Disclosure of Interest

None Declared
A 28-Day, Randomized, Controlled, Single-Blind, Phase 2 Study in Treatment-Resistant Major Depressive Disorder (TRD) Patients Receiving Intranasal Esketamine Comparing Addition of Almond Therapy TM with Treatment-as-Usual (TAU)
Authors: Chue P. , Silverstone P. , Hillier T. , Rizvi S. , Phillips S. , Langkaas L.-A. , Davidson K. , Brown M. , Chue J.
Published: August 2023

Introduction

Treatment Resistant Depression (TRD) occurs in up to 30% of patients with Major Depressive Disorder (MDD). New treatments are clearly needed and there is a burgeoning interest in novel agents including ketamine. While ketamine in various formulations has been demonstrated to have a robust antidepressant effect there is a lack of evidence-based psychotherapies specifically designed for combination use.

Objectives

We hypothesize that the combination of “Almond TherapyTM” with intranasal ketamine will result in a statistically significantly better outcome as demonstrated by a greater reduction in MADRS scores and/or response rates and/or remission rates in TRD patients compared with those who receive esketamine plus TAU. Secondary outcome measures include PHQ-9, GAD-7, PCL-5, Asssessment of Quality of Life - 8D (AQOL-8D), and Rosenberg Self-Esteem Scale.

Methods

We have developed a research protocol combining a unique and specifically-designed, multi-modal psychotherapy program, “Almond TherapyTM”, with intranasal esketamine in a randomized, controlled, single-blind 28-day study. The therapy utilizes an individualized, evidence-informed approach for each participant consisting of a number of modules selected using a shared decision-making process determined at the first study visit. This uniquely tailored approach ensures that the chosen modules are personally meaningful to the participant, and thus, promotes therapeutic adherence. The proprietary therapy combines elements of cognitive behavioral therapy (CBT), trauma focused-CBT, Dialectical Behavioral Therapy (DBT), and mindfulness, together with biofeedback. In addition to in-clinic sessions, participants also receive standardized remote therapy sessions by trained therapists.

Results

Patient recruitment and enrolment has begun. Interim results are anticipated.

Conclusions

This study is the first examination of the potential additional clinical benefit of adding a specific therapy program to existing intranasal esketamine treatment. If demonstrated to be of clinical benefit then further studies may potentially provide comparison to other therapy programs and in conjunction with other agents.

Disclosure of Interest

P. Chue Shareolder of: Zylorion, P. Silverstone Shareolder of: Zylorion, Employee of: Zylorion, T. Hillier Shareolder of: Zylorion, Employee of: Zylorion, S. Rizvi: None Declared, S. Phillips Shareolder of: Zylorion, Employee of: Zylorion, L.-A. Langkaas Employee of: Zylorion, K. Davidson Employee of: Zylorion, M. Brown: None Declared, J. Chue: None Declared
Empathy in patients with schizophrenia and antisocial personality disorder
Authors: Tasios K. , Douzenis A. , Gournellis R. , Michopoulos I.
Published: August 2023

Introduction

Violent behavior has been linked to deficits in social cognition, namely cognitive and affective aspects of empathy. Schizophrenia and antisocial personality disorder have been associated with violence and empathy deficits.

Objectives

Our main objective is to search for differences in empathy between patients with schizophrenia who have committed a violent offence, patients with schizophrenia with no history of violent offence and patients with antisocial personality disorder.

Methods

A total sample of Ν=100 participants was divided into four groups: 1) 27 patients with schizophrenia and history of committing a violent offence, 2) 23 patients with schizophrenia with no history of committing a violent offence, 3) 25 participants with antisocial personality disorder and 4) 25 general population participants comprising the control group. Symptoms of schizophrenia were rated using the Positive(P), Negative(N) and General Psychopathology (G) subscales of the Positive and Negative Syndrome Scale (PANSS). Empathy was evaluated using a) The Empathy Quotient (EQ). Theory Of Mind was evaluated using a) The First Order False Belief task, b) The Hinting task, c) The Faux pas Recognition Test and d) The Reading the Mind in the Eyes Test (Revised).

Results

The four groups differed in PANSS scoring (p<0.001), EQ scoring (p<0.001) and Theory of Mind tests (p<0.001), but this difference was only significant between the controls and the three groups of patients. The three groups of patients did not differ to each other in any of the Theory of Mind tests. No difference was also found between the two groups of psychotic patients.

Conclusions

Patients with antisocial personality disorder, schizophrenia and schizophrenia with a history of violent offence do not seem to perform differently in affective and cognitive empathy tests.

Disclosure of Interest

None Declared
Psychometric properties of the Parma Scale for the treatment evaluation of prisoners with mental disorder: a new instrument for routine outcome monitoring in different forensic psychiatric settings
Authors: Pelizza L. , Paulillo G. , Pellegrini P.
Published: August 2023

Introduction

The clinical relevance of Routine Outcome Monitoring (ROM) to formulate longitudinal evaluations of treatment appropriateness/efficacy and to assist decision making aimed at improving the quality of person-centered interventions has been poorly implemented in forensic psychiatry, also in Italy. Indeed, very few assessment instruments have been developed in this crucial field.

Objectives

As reliable ROM instruments are lacking, the aim of the current investigation was to examine psychometric properties (i.e. reliability, concurrent validity and sensitivity to measure scores’ longitudinal changes) of the Parma Scale (Pr-Scale) (a new instrument fro the evaluation of offenders with mental disorder) in an Italian sample of forensic psychiatric patients.

Methods

Participants were male adult offenders with mental disorder recruited within the Parma REMS (“Residence for the Execution of Security Measure”) or the Parma Penitentiary Institute (PPI). Exclusion criteria were known moderate/severe intellectual disability or any other medical condition inducing inability to express a valid consent for participating in the research. The Pr-Scale includes 20 items divided into 3 main domains: “Historical”, “Clinical” (observational) and “Treatment Plannining". To test psychometric properties of the Pr-Scale, we examined interrater reliability, short-term (1-week) test-retest reliability and internal consistency. As measure of concurrent validity, a correlation analysis of Pr-Scale item scores with corresponding HKT-R (the “Historisch, Klinische en Toekomstige – Revisie” instrument) item subscores was performed. Finally, we examined the Pr-Scale sensitivity to measure scores’ longitudinal changes over a 3-month treatment follow-up period.

Results

60 male adult patients were recruited in this study. Our findings showed good to excellent interrater and test-retest reliability, concurrent validity and internal consistency for the Pr-Scale. Pr-Scale scores also display a moderate to large changeability over time (Intra-Class Correlation coefficient = 0.963, coefficient of stability = 0.997, Cronbach’s ɑ = 0.736). Statistically significant correlations of Pr-Scale item scores with the corresponding HKT-R scores were found. Across the 3-month follow-up period, we observed statistically significant sensitivity values in measuring longitudinal changes for the Pr-Scale total score and Pr-Scale domain and item subscores.

Conclusions

Our results support the clinical use of the Pr-Scale in different forensic psychiatric settings (i.e. prison, REMS) as reliable ROM instrument.

Disclosure of Interest

None Declared
Psychiatric hospitalization among offenders: a retrospective study in the acute psychiatric ward in Monza, Italy
Authors: Provenzi M. , Affaticati L. M. , Carrara G. , Di Forti C. L. , Viganò D. , Clerici M.
Published: August 2023

Introduction

The closure of forensic psychiatric hospitals and the conversion to a residential model of care based on secure residential units in the community (REMS) has made Italy the first and only country in the world to have followed the principles of the deinstitutionalization movement. Following the reform, several management issues have emerged, such as the creation of long waiting lists for admission to REMS. Improper hospitalization in Acute Psychiatric Units (SPDC) has often been used to address this issue. In addition, the handover of inmates’ care to Mental Health Departments (DSMD’s) has posed further challenges. To date, the field has received little attention from international literature.

Objectives

Description and analysis of a sample of offender inpatients hospitalized in an acute psychiatric unit.

Methods

We conducted a retrospective study including male offenders admitted to the SPDC of San Gerardo Hospital (ASST Monza), between January 2007 and September 2022. Data analysis was performed by using SPSS.

Results

120 male offenders were included for a total of 204 admissions. 98 offenders (81.7%) were hospitalized once. We observed an absolute (N=1; N=30) and percentage (0.2%;12%) increase in the number of hospitalized offenders per year during the time period under study. Jail was the main provenance in the sample (46.6%), followed by residential care facilities (27%) and the psychiatric observation unit (ROP) of Monza’s jail (10.8%). The two most prevalent diagnoses were personality disorders (37.5%) and psychosis (39.2%). In addition, 66 subjects (55%) had a history of substance abuse. The average duration of hospitalization was 19.45 days; it increased to 77 days for inpatients waiting to be transferred to REMS. Hetero-aggressive behavior as the reason for admission was associated with longer hospitalization (p=0.031), while attempted suicide correlated to shorter hospital stay (p=0.032). Out of the 55 offenders who attempted suicide, 41 came from jail (74.5%). Finally, longer hospitalizations were associated with an increased number of adverse events (p=0.001).

Conclusions

Psychiatric hospitalizations of offenders have increased over the last years. This population tends to require longer hospital stays (regional average of SPDC hospitalization in Lombardy: 14 days), which are even lengthier for inpatients destined to REMS. Longer hospitalizations exert a large burden on DSMD’s and impact the general health of patients, exposing them to a higher risk of adverse events. Further studies are needed to confirm our findings and to develop better strategies for the management and care of offender patients.

Disclosure of Interest

None Declared
The clinical stages of psychosis among violent and non-violent adult prisoners in Australia
Authors: Yee N.
Published: August 2023

Introduction

Past research examining the relationship between psychosis and criminality has typically focused on chronic schizophrenia and violence. However, contact with the criminal justice system is not constrained to the most unwell or most violent. The present study is novel as it examines the different clinical stages of psychosis, from the at-risk mental states (ARMS)/Ultra-High Risk (UHR) to the early and chronic psychotic illness phase, across the entire spectrum of criminal offending.

Objectives

The main study objective is to establish the prevalence of the clinical stages of psychosis among adults entering custody and to examine the sociodemographic and forensic characteristics associated with the different stages of psychosis. A further aim is to examine whether psychosis-spectrum prisoners differ from non-psychotic prison controls across these characteristics.

Methods

Participants consist of unselected 291 adult male and female prisoners entering the largest maximum security reception centres in New South Wales (NSW), Australia. They completed a range of semi-structured questionnaires and adapted mental health screening measures. The Comprehensive Assessment of At Risk Mental States (CAARMS; Yung et al., 2005) was used to ascertain whether participants met the Ultra High Risk (UHR), First Episode of Psychosis (FEP) or Established Psychosis (EP) criteria.

Results

Participants were 34.25 years old (SD = 10.69) on average and men were significantly older than women (p = 0.035). Among prisoners with a psychosis-spectrum illness (n = 121), the prevalence of UHR was 24%, First Episode Psychosis (FEP) was 6% and established psychosis was 11%. Compared to controls, psychosis spectrum prisoners were found to have higher levels of social disadvantage, psychiatric comorbidities and multiple incarceration episodes. However, psychosis was not associated with a greater risk of violent offending. Implications on the complex illness burden associated with psychosis and the need for early identification and intervention across forensic mental health services will be further discussed.

Conclusions

This study is novel as it examines the full spectrum of psychotic illness across the entire spectrum of criminal offending. The findings support the notion that risk of criminal justice contact and complex illness burden exist across the different clinical stages of psychosis, from the UHR to the early FEP and chronic psychosis stages, for both violent and non-violent offending. Early intervention services must consider how to more effectively identify and intervene to reduce the risk of criminal justice system contact among mentally ill individuals.

Disclosure of Interest

None Declared
Association between perceived workload and mental health among electricians
Authors: Sellami I. , Feki A. , Abbes A. , Ghrab M. A. , Kotti N. , Baklouti S. , Masmoudi M. L. , Jmal Hammami K. , Hajjaji M.
Published: August 2023

Introduction

The work conditions of electricians have been associated with heavy physical and psychological workloads. It is essential to know the impact of this perceived workload on the mental health of workers.

Objectives

This study aimed to assess the relationship between perceived workload on the mental health of workers.

Methods

The study was conducted among a group of electricians. Data were gathered between January-June 2022 using a self-administered questionnaire including socio-professional characteristics and Kessler Psychological Distress Scale (K6). To assess the perceived workload, we choose the National Aeronautics and Space Administration Task Load Index (NASA-TLX). In this study, we evaluated raw NASA-TLX scores.

Results

Seventy-four workers participated in the study. They were married in 67,6% of cases. The mean age was 39,3 ± 10,5 years. The average job tenure was 15,5 ± 11,2 years. The mean score of K6 was 5,4±4,8. The proportion of respondents with high levels of psychological distress (K6 score of 13 or greater) was 9.5 %. The mean score of mental demand, physical demand, performance, effort, frustration level and temporal demand were respectively 88.8±14, 60.8±23.6, 85.2±13.1, 82.7±15.4, 34.3±29.3 and 61.8±29.2. The frustration level was correlated with high levels of K6 (p = 0.002, r = 0.36).

Conclusions

A high perceived workload was correlated with the altered mental health of workers. Hence, practices and policies should focus on improving working conditions to enhance the mental health of the employees.

Disclosure of Interest

None Declared
Professional Quality of Life among healthcare workers in a Covid-19 unit
Authors: Sellami I. , Haddar A. , Abbes A. , Halweni H. , Masmoudi M. L. , Jmal Hammami K. , Hajjaji M.
Published: August 2023

Introduction

The pandemic of Covid-19 has overwhelmed healthcare systems including healthcare workers(HCWs) imposing additional physical and mental workloads.

Objectives

We aimed to evaluate the impact of the pandemic on the professional quality of life of HCWs.

Methods

We conducted a cross-sectional study among HCWs working in the Covid-19 unit in Sfax, Tunisia in December 2021. We used a self-administrated questionnaire including sociodemographic and professional information. Professional issues were assessed by The Professional Quality of Life scale.

Results

Our population consisted of 69 participants. The mean age was 31± 6 years. The sex ratio (M/F) was 1.1. Sixty-eight per cent had a university education. On a scale from 0 to 10,76.8% rated their Health Status greater than or equal to 8 and the mean score was 8.89±1. Medical history of Covid-19 infection was found in 37.7% of paricipants and 94,1% were vaccinated against SARS Cov 2.

Most of the workers showed moderate to high levels of compassion (65.2% and 31.9 % respectively). Fifty-five per cent showed moderate burnout levels. Only 2.9% of the population had a high level of secondary traumatic stress.

Secondary traumatic stress was associated with age (p=0.049; R=0.238). The males were more affected with burnout symptoms. Vaccination Status was associated with compassion satisfaction (p=0.042). Health Status Evaluation was not correlated with compassion satisfaction, burnout or secondary traumatic stress.

Conclusions

The current pandemic has affected the HCWs system professional and social lives. A long follow-up should be maintained to support HCWs dealing with the pandemic.

Disclosure of Interest

None Declared
The impact of perceived exertion on satisfaction with life among power line workers
Authors: Sellami I. , Feki A. , Abbes A. , Ghrab M. A. , Masmoudi M. L. , Baklouti S. , Jmal Hammami K. , Hajjaji M.
Published: August 2023

Introduction

The power line workers have a heavy physical workload. It is essential to know the impact of this perceived exertion on their satisfaction with life to improve their mental health.

Objectives

We aimed to evaluate the associations between perceived exertion at work and satisfaction with life among power line workers.

Methods

We conducted a study among a group of power line workers from January to June 2022 using a self-administered questionnaire. We evaluated socio-professional characteristics, physical exertion with the Borg CR-10, and the satisfaction with life scale (SWLS).

Results

Seventy-four male line workers participated in the study. They were married in 67.6% of cases. The mean age was 39.3 ± 10.5 years. The average job tenure was 15.5 ± 11.2 years. The mean of perceived exertion was 6.1±1.9. High to very high exertion was found in 73% of participants. The mean score of satisfaction with life was 26.8 ±6.5. Five (12.6%) participants were dissatisfied to extremely dissatisfied. Fifty-six (75.9%) participants were satisfied to extremely satisfied. High perceived exertion was correlated with higher satisfaction with the lives of line workers (p = 0.03, r = 0.24).

Conclusions

Power line workers with high perceived exertion were more satisfied with their lives. This can be explained by the positive impact of work on the lives of workers. The work environment is paramount to ensuring good mental health.

Disclosure of Interest

None Declared
Clozapine in first episode psychosis – the experience of a Portuguese center
Authors: Soares Da Costa I. , Santos Martins F. , Silveira C.
Published: August 2023

Introduction

Antipsychotics are the standard in the treatment of first psychotic episodes. Although the majority of patients respond to the established treatment, it is currently known that there is a subgroup of patients whose response is not satisfactory. In this group, the subsequent response to a new antipsychotic is generally poor. Clozapine is an antipsychotic with a unique profile, with demonstrated efficacy and approval in the treatment of treatment-resistant schizophrenia. Its role in the first psychotic episodes remains unclear and its use is, to say the least, controversial.

Objectives

This work aims to analyze and evaluate the use of clozapine in patients with a first psychotic episode, taking into account the experience of a Portuguese Hospital Center.

Methods

We carried out a retrospective study, including all patients admitted to the inpatient clinic of adults with a first psychotic episode, in the Department of Psychiatry of Centro Hospitalar Universitário of São João, in Oporto, between 2007 and 2020. Clinical and socio-demographic data were collected.We performed a retrospective analysis of patients who, at discharge, were medicated with clozapine, proceeding to a descriptive analysis.

Results

In this case series, we intended to describe the cases of patients in whom the use of clozapine in the first psychotic episode was initiated. All patients were discharged with the diagnosis of Schizophrenia. Prior to the introduction of clozapine, patients were treated with other antipsychotics, normally two. Patients taking clozapine were younger and had a longer duration of untreated psychosis. They had also longer length of hospital stay. The pattern of prescribing antipsychotics in the first and subsequent episodes has generally been extensively studied. However, the use of clozapine in the first episodes remains unclear.In the literature, and despite clozapine being considered one of the most effective antipsychotics, there is a high prevalence of polypharmacy and a significant delay in its use in the first episodes.Notwithstanding the unfavorable metabolic and hematological profile of clozapine, compared to other antipsychotics, in terms of hospitalization, mortality and discontinuation rates for all causes, it demonstrates a pattern of superiority.

Conclusions

The superiority in effectiveness of clozapine is well established, despite its underutilization and frequent delay in its introduction.The clinicians attitude remains a significant barrier to the commencement of clozapine, although it is important to define and characterize better potential groups of eligible patients. Education resources for clinicians as well as services specifically dedicated to early identification and management of eligible patients would be beneficial.

Disclosure of Interest

None Declared
The suitability of zebrafish (danio rerio) as an optimal organism to further investigate the associated schizophrenia-like phenotype
Authors: Nita I. B. , Ilie O. D. , Ciobica A. S. , Hritcu L. D. , Solcan C. , Dobrin R. P.
Published: August 2023

Introduction

Zebrafish (Danio rerio) has evolved over the years as a preferred organism due to its vast repertoire in research fields that mimic a targeted phenotype, particularly behavioral typologies and specific attributes comparable to murine models and relatively high homology with humans. Considering this consideration, different pharmacological treatments have been tested and proven that under different concentrations may trigger schizophrenia (SCZ)-like symptoms.

Objectives

Starting from the actual stage of knowledge according to which agents used as N-methyl-D-aspartate (NMDA) inhibitors (MK-801, ketamine, and phencyclidine) alongside psychedelic (mescaline, lysergic acid diethylamide), psychoactive substances (amphetamine), and non- and essential amino acids (proline and methionine), we aimed to reunite and review all existing evidence. This approach may offer an updated and critical overview regarding the possible future directions surrounding these compounds regarding the pharmaco-dynamics/kinetics.

Methods

To ensure the coverage of all relevant literature, we performed searches in four databases (PubMed/Medline, ISI Web of Knowledge, Scopus, and ScienceDirect) per combinations of keywords: “schizophrenia” with “MK-801”, “ketamine”, “phencyclidine”, “mescaline”, “lysergic acid diethylamide”, “amphetamine”, “proline”, “methionine”, and “zebrafish”. Eligible studies had to be “research article(s)” written in English.

Results

A total of n = 246 studies were returned during the established interval (2010 – 2022). Precisely, n = 16 were identified in PubMed/Medline, n = 16 in ISI Web of Knowledge, n = 17 in Scopus, and n = 197 in ScienceDirect per database. If taken per year, n = 13 were published in 2010, n = 12 in 2011, n = 15 in 2012, n = 24 in 2013, n = 21 in 2014, n = 21 in 2015, n = 32 in 2016, n = 8 in 2017, n = 12 in 2018, n = 9 in 2019, n = 17 in 2020, n = 34 in 2021, and n = 28 in 2022. Depending on the combination of keywords, we had the following situation: n = 65 for “schizophrenia+MK-801+zebrafish”, n = 42 for “schizophrenia+ketamine+zebrafish”, n = 21 for “schizophrenia+phencyclidine+zebrafish”, n = 4 for “schizophrenia+mescaline+zebrafish”, n = 5 for “schizophrenia+lysergic acid diethylamide+zebrafish”, n = 36 for “schizophrenia+amphetamine+zebrafish”, n = 37 for “schizophrenia+proline+zebrafish”, n = 36 for “schizophrenia+ methionine+zebrafish”.

Conclusions

There can be seen an uprising trend in the current literature of studies focused on the administration of MK-801, ketamine, amphetamine, proline, methionine, and phencyclidine aiming to trigger SCZ-like symptoms as opposed to mescaline and lysergic acid diethylamide. Most of the data is contradicting, with either a decrease/increase in behavior (locomotion, aggression, sociability, circling behavior, and memory deficits), which is why additional studies are mandatory.

Disclosure of Interest

None Declared
Sleep disorders in patients with a first psychotic episode: a case-control study
Authors: Abdellatif M. , Nefzi H. , Nasri J. , Methni M. , Rania K. , Karoui M. , Ellouze F.
Published: August 2023

Introduction

Patients with chronic schizophrenia experience significant disturbances in the quality
and quantity of their sleep and it had been mainly attributed to severity of symptoms and
antipsychotic use. Recent studies suggested that antipsychotic-naïve early course patients
with schizophrenia and their non-psychotic first-degree relatives also show altered sleep
quality.

Objectives

In this study we aimed to compare sleep parameters in antipsychotic-naive
first-episode schizophrenia patients to their healthy siblings and age- and sex-matched
healthy controls.

Methods

We conducted a cross-sectional, descriptive case-control study in the Psychiatry « G »
department at Razi Hospital, for a period of six months. Our sample consisted of three
groups: a group of schizophrenic patients, a group of their healthy siblings and a group of
healthy controls. The three groups were matched by age and sex. The Positive and Negative
Syndrome Scale (PANSS) was used to assess the severity of symptoms in patients with
schizophrenia. The Morningness-Eveningness Questionnaire (MEQr), Epworth Sleepiness Scale
(ESS), and Pittsburgh Sleep Quality Index (PSQI) were used in the three groups to assess
Circadian preference, daytime sleepiness and sleep quality.

Results

There was no significant difference between the groups regarding the chronotype.
Patients had significantly higher daytime sleepiness compared to siblings (p=0.001) and
controls (p<0.001). Patients also had poorer quality sleep (PSQI total score) than
siblings (p<0.001) and controls (p<0.001), longer sleep latency than siblings (p=0.003)
and controls (p<0.001); lower habitual sleep efficiency than siblings (p=0.003) and
controls (p<0.001). Siblings had poorer sleep quality (p=0.001), longer sleep latency
(p=0.006) and shorter sleep duration (p=0.033) compared to control subjects.

Conclusions

Our results joined those of the literature concerning the significant prevalence of
sleep disorders in early psychosis. In addition, the alteration of sleep quality in
unaffected siblings compared to healthy controls supports the hypotheses suggested in the
literature that sleep disorders may be markers of genetic susceptibility to schizophrenia and
serve as a potential endophenotype of the disease.

Disclosure of Interest

None Declared
Google trend analysis and lockdown impact on mental health during the COVID-19 pandemic
Authors: Mastelić T. , Borovina Marasović T. , Kozina S. , Glavina T.
Published: August 2023

Introduction

The COVID-19 pandemic has affected the mental health of the world’s population in numerous ways. One of the methods are certainly lockdown measures. The countries of the European Union (EU) were affected by the pandemic in different ways, but their response was partly coordinated. Google trend analysis has so far proven to be a useful tool for monitoring the reactions of the population and the state of their mental health.

Objectives

The aim of our research was to examine the impact of lockdown measures on the state of mental health through an internet search for terms related to mental health.

Methods

We observed three countries of the European Union in the period from February 1, 2020. until May 17, 2021. According to the average value of the CSI (covid stringency index), as an indicator of the strength of the lockdown measures, we chose Estonia, Belgium and Italy. CSI uses nine indicators (such as school closures, travel bans, …) to assess the strength of the lockdown. Italy is the country that, according to the average value of the CSI, had the strongest closure measures in the mentioned period (average CSI 69.19468). In Estonia, the measures were the mildest (CSI 42.87324895), and Belgium represents the average (CSI 57.6381). We observed to what extent, in the mentioned countries, changing the CSI, i.e. the strength of lockdown measures, correlates with the search for terms in the field of mental health. We used Google trends data for the terms: tension, anxiety, depression, insomnia, concern. We also compared Croatia with the mentioned countries.

Results

In Estonia, there is no significant correlation between lockdown measures and searches for mental health terms. In Belgium, there is a correlation between CSI and searches for the term “anxiety” (r=0.31, p<0.01). In Italy, there is a correlation between CSI and searches for the terms “concern” (r=0.22, p=0.067 ), “tension” (r=0.33, p<0.01), “anxiety” (r=0.55, p<0.001). In Croatia, which is the 4th country with the weakest lockdown measures (CSI 46.90232), there is only a correlation between the strength of lockdown measures and searches for the term “tension” (r=0.27, p<0.05).

Conclusions

In countries with a higher CSI, i.e., stronger lockdown measures, there is a stronger correlation, i.e., a greater influence on the search for terms related to the state of mental health. We can assume that at some point the lockdown measures start to have a negative effect on the state of mental health.

Disclosure of Interest

None Declared