bluuebunny/crossref_metadata_2025 huggingface dataset:
An investigation of depression and inflammation as potential mediators linking adverse childhood experiences with cognitive decline in adulthood: results from a prospective cohort study
Authors: Lowry E. , Mc Inerney A. , Schmitz N. , Deschenes S.
Published: September 2022

Introduction

Adverse childhood experiences (ACEs) have been associated with numerous health consequences in adulthood including cognitive decline. However, the underlying mechanisms implicated remain unclear.

Objectives

In this study, depressive symptoms and systemic inflammation were investigated as potential independent mediators of the association between ACEs and cognitive decline.

Methods

Participants were adults aged 50+ from the English Longitudinal Study of Ageing (N = 3,029; 54.8% female). Measures included self-reported ACEs at wave 3 (2006-2007), C-reactive protein (CRP) and depressive symptoms at wave 4 (2008-2009), and cognitive function at waves 3 and 7 (2014-2015). Mediation analyses examined the direct associations between ACEs and cognitive function at wave 7 and the indirect associations via depressive symptoms and CRP at wave 4 and were conducted using ordinary least squares regression models with the SPSS PROCESS macro. In Step 1, models were adjusted for sociodemographic factors and baseline cognitive function. Models in Step 2 were additionally adjusted for obesity and health behaviours (n = 1,874).

Results

Cumulative ACEs exposure was shown to positively predict later-life depressive symptoms, which in turn predicted cognitive decline. ACEs were also shown to positively predict systemic inflammation as measured by CRP. However, CRP did not mediate the association between ACEs and cognitive decline.

Conclusions

These findings suggest that ACEs are related to cognitive decline partly via depressive symptoms and corroborate prior research linking ACEs with adult systemic inflammation. Efforts towards screening for, preventing, and mitigating the effects of ACEs may therefore represent an important avenue for improving health outcomes in later life.

Disclosure

No significant relationships.
Schizotypal Traits are Associated with Decreased Functional Connectivity between Medial Prefrontal Cortex and Cerebellum in a Non-clinical Sample
Authors: Panikratova Y. , Abdullina E. , Pechenkova E. , Lebedeva I.
Published: September 2022

Introduction

Schizotypy is associated with increased vulnerability to schizophrenia spectrum disorders. Therefore, investigation of its brain correlates seems prominent for better understanding of schizophrenia-spectrum continuum as well as for development of biological treatments for schizotypal personality disorder. Functional alterations of prefrontal cortex (PFC) and their associations with clinical symptoms are well-known to exist in schizophrenia. However, their relevance to schizotypy remains unclear.

Objectives

The aim of the study was to check for associations between schizotypal traits in a non-clinical sample and whole-brain functional connectivity (FC) of lateral as well as medial PFC (lPFC and mPFC, respectively).

Methods

Eighty-two healthy individuals (52 females, mean age 24.8±5.48) filled out the Schizotypal Personality Questionnaire (SPQ-74) and underwent resting-state fMRI (3T). Seeds in lPFC and mPFC were taken from frontoparietal and default mode networks (atlas by Yeo et al., 2011). We analyzed correlations between four schizotypal factors (cognitive/perceptual, paranoid, negative, and disorganization; Stefanis et al., 2004) and whole-brain FC of the seeds (statistical threshold: p<.001 voxelwise; p[FDR]<.05 clusterwise).

Results

Cognitive/perceptual factor (‘Odd beliefs/magical thinking’ and ‘Unusual perceptual experiences’ SPQ-74 subscales) is negatively correlated to FC of bilateral mPFC with a cluster in the right cerebellum (Crus 1, 2).

Conclusions

Prefrontal-cerebellar dysconnectivity may be one of the neurobiological factors underlying positive-symptoms-like schizotypal traits in non-clinical subjects. To some extent, it coincides with the data on associations between functional features of these brain structures and positive symptoms in schizophrenia (Pinheiro et al., 2021; Goghari et al., 2010).

Disclosure

The study was supported by RFBR Grant 20-013-00748.
Organic lesions and Psychiatry: “A sample on a pendant”
Authors: Jiménez Aparicio T. , Medina Ojeda G. , De Andrés Lobo C. , Vallecillo Adame C. , Gonçalves Cerejeira J. , Santos Carrasco I. , Guerra Valera G. , Queipo De Llano De La Viuda M. , Gonzaga Ramírez A. , Fernández Lozano M. , Rodríguez Rodríguez B. , Mateos Sexmero M.J. , Navarro Barriga N. , De Uribe Viloria N.
Published: September 2022

Introduction

Brain lesions may induce psychiatric symptoms in some cases. Imaging tests are important to make a differential diagnosis, and therefore initiate an appropriate treatment.

Objectives

Presentation of a clinical case about a patient with psychiatric symptoms who presented an organic lesion.

Methods

Bibliographic review including the latest articles in Pubmed about psychiatric symptoms induced by organic lesions.

Results

We present a 51-year-old male patient, with adequate previous functionality, who attended psychiatric consultations due to changes in his character, with delusional mystical and megalomaniac ideation, verbiage, hypoprosexia, memory loss and insomnia (diagnosed with Bipolar Disorder type II, hypomanic episode). Eventually, a brain computed tomography scan was performed, in which meningioma was visualized. The patient underwent surgery, and he asked to keep a sample of his tumor to always carry it with him on a pendant. Psychiatric symptoms induced by organic lesions are highly variable, depending on the location and size of the lesion, and they may be the first and/or only symptom of a meningioma (up to 21% according to various studies), so it is important to perform imaging tests in some cases. At this time, the patient is under follow-up, he has remained euthymic and stable, and he refuses to take psychopharmacological medication.

Conclusions

Psychiatric symptoms may be the first and/or only manifestation of an organic lesion in some cases. Neuroimaging tests (CT and MR) may be useful in the differential diagnosis. It is important to carry out an indiviualized treatment based on the patient’s pathology, which may include surgery and/or drugs.

Disclosure

No significant relationships.
Depressions with religious experiences
Authors: Gedevani E. , Kopeiko G. , Borisova O. , Vladimirova T. , Smirnova E. , Kaleda V.
Published: September 2022

Introduction

Despite a significant number of studies devoted to the relationship between depression and religiosity, the diagnosis of depression in religious patients is complicated due to the insufficiently studied psychopathology and the peculiarities of the patient’s experiences.

Objectives

To determine the specific features of psychopathology and phenomenology of depression, masked by a “religious facade”, for timely diagnostics and prevention of suicidal behavior.

Methods

One hundred and fifteen religious (orthodox) inpatients (41 male, 74 female) with depression (F31.3, F31.4, F 32.1., F 32.2, F 33.1, F 33.2 according to ICD-10) were examined. Psychopathological method, HAM-D, SIDAS and statistical analysis were applied.

Results

Five types of depression were specified, which differed in psychopathological structure and content of the religious experiences. Overvalued ideas of guilt and sinfulness were predominant in melancholic depressions, ideas of God-forsakenness and the loss of “living” faith - in apathetic. Depressions with overvalued doubts whether the right faith and confession has been chosen accompanied with anxiety, melancholy and apathy. It should be specially mentioned apathetic and melancholic depressions characterized by “spiritual hypochondria” with specific cenesto-hypochondrical symptomatology. Melancholic depressions characterized by high suicidal risk prevailed (65%) over the other depressions.

Conclusions

Depressions masked by a “religious facade” often are not recognized due to specifical content, which results in lack of timely diagnostics and creates a high risk of suicidal behavior.

Disclosure

No significant relationships.
The prevalence of common mental disorders among Syrian refugees resettled in The Netherlands
Authors: Patanè M. , Cuijpers P. , De Graaff A. , Farell R. , Sijbrandij M.
Published: September 2022

Introduction

Refugees are at elevated risk of developing common mental disorders (CMD) as they may have been exposed to stressors and traumatic experiences before, during and after their movement. However, prevalence rates of CMDs among refugees reported across studies vary strongly.

Objectives

To examine the prevalence of CMDs (PTSD, anxiety, depression and somatic disorder) among Syrian refugees in the Netherlands, and the diagnostic accuracy of self-reporting questionnaires in Arabic.

Methods

A sample of N=1339 adult Syrian refugees was randomly selected from the Dutch national population registry. Participants were approached in December 2020-March 2021 to complete questionnaires on symptoms of PTSD (PCL-5), anxiety/depression (HSCL-25), and somatic disorder (SSS-8). After the survey, a sub-sample was invited for a clinical interview using the Structured Clinical Interview for DSM-5 (SCID-5) to enquire about the presence or absence of PTSD, anxiety, depression or somatic disorder.

Results

In total, 407 participants (53.6% female, M age=34.2yrs, SD=14.1) completed the survey. The majority (65.9%) arrived in the Netherlands in 2015-2017. Using a cut-off of PCL-5 ³33, 75 participants (18.4%) reported probable PTSD. Using a cut-off of ³1.83 on the HSCL-25 depression subscale and ³1.75 on the anxiety subscale, 153 participants (37.6%) reported depression and 135 (33.2%) reported anxiety, and using a cut-off of ³12.0 on the SSS-8, 121 (29.8%) reported somatic complaints. A sub-sample of 214 participants (52.6%) were followed-up with the SCID-5. Psychometric properties will be presented.

Conclusions

Syrian refugees in the Netherlands are at high risk for the development of a CMD. Implications, strengths and limitations of the study will be discussed.

Disclosure

No significant relationships.
The Pandemic’s Impact on Patients with Bipolar Affective Disorder in a Non-COVID Medical Unit
Authors: Gheorman V. , Ghițan A. , Bușe Ș. , Militaru F. , Pîrlog M. , Udriștoiu I.
Published: September 2022

Introduction

Bipolar disorder or manic-depressive illness is a mental disorder which consists of abnormal and long-lasting changes in a person’s mood, energy, and ability to function. The ongoing COVID-19 pandemic restrictions precipitate the condition of those with bipolar affective disorder.

Objectives

We searched for significant differences before and during the pandemic by analyzing socio-demographic
data.

Methods

We carried out a research activity at the I Psychiatry Clinic of the Clinical Hospital of Neuropsychiatry Craiova. We formed two groups of hospitalized patients during 2019 and during 2020, when the pandemic broke out. The inclusion criterion was the presence of bipolar affective disorder as a primary diagnosis.

Results

The number of cases and the total number of hospitalization days was higher during the pandemic, 101 cases versus 94 cases, 1667 days versus 1184 days. We identified a predominance of females during the pandemic, whereas in the previous year the distribution by sex was approximately equal. Regarding environment, the number of patients from urban and rural areas was approximately equal in 2019, while during the pandemic those in urban areas predominated, possibly due to easier access to psychiatric services. The ages of patients maintained a Gaussian distribution with a concentration of cases between 35-55 years.

Conclusions

While other psychiatric disorders were less present in the clinic during the pandemic, the number of bipolar affective disorder cases increased. Bipolar affective disorder is a major challenge due to the wide range of symptoms which cross with comorbidities that increase the likelihood of a SARS-CoV-2 infection.

Disclosure

No significant relationships.
Physiological strength of lipoic acid in copper intoxication
Authors: Jovanovic Mirkovic J. , Kocic G. , Alexopoulos C. , Jurinjak Z.
Published: September 2022

Introduction

The average concentration of copper in the air, e.g. in the USA it ranges from 5–20 ng/m3, in soil from 5–70 mg/kg, and the intake of copper from food is 1.0–1.3 mg/days for adults (0.014–0.019 mg/kg/day) (Barceloux, 1999). The effect of lipoic acid is reflected in the intensification of ATP synthesis, participates in the assimilation of lactic acid, activates the enzyme cycle of tricarboxylic acid, stimulates the growth of lactic acid bacteria by replacing acetate (acetate transfer factor), stimulates CoA synthesis (fatty acid utilization), prevents liver damage by various toxins, normalizes aldolase and transferase levels.

Objectives

The aim of this study is to show the useful role of a supplement, lipoic acid, as an antioxidant in the prevention of oxidative stress.

Methods

All procedures were performed after anesthesia of albino rats with ketal in accordance with the principles of sacrifice in laboratories. After medial laparotomy albino rates Wistar soy, a 10% homogenate of brain tissue was made in an appropriate medium and an analysis of acid and alkaline DNase activity was performed (Kocić i sar., 2004).

Results

DNases are thought to be the main executors of apoptosis, responsible for internucleosomal DNA fragmentation, which is the breakdown of chromosomal DNA into oligonucleosome-sized fragments. Administration of lipoic acid has been shown to protect against oxidative stress caused by copper.

Conclusions

Based on the results of this research, it can be concluded that lipoic acid is a powerful and powerful antioxidant.

Disclosure

No significant relationships.
Genomic imbalances of chromosome 15 in patients with autistic features and global developmental delay
Authors: Budisteanu M. , Papuc S. , Erbescu A. , Albulescu L. , Arghir A.
Published: September 2022

Introduction

Background: Copy-number variants (CNVs) of chromosome 15 have been associated with neurodevelopmental disorders like autism spectrum disorders (ASDs) and developmental delay.

Objectives

We report 6 patients with autistic features and other neurodevelopmental problems carrying CNVs of chromosome 15.

Methods

Materials and methods: The probands belong to a group of patients referred to our clinic and laboratory with autism as main feature. A complete clinical evaluation was performed with focus on neurologic, psychiatric, and psychological evaluation with specific autism tests. Array-based comparative genomic hybridization (array-CGH) was performed using 180K platform (Agilent technology).

Results

six patients investigated by array-CGH had a CNV involving chromosome 15. Four of these patients, previously reported by us (ref 1), had small duplications of 15q13.3 involving CHRNA7 and OTUD7A genes. The other two patients had large deletions of 15q21q22 and 15q24, respectively. A deletion of 15q21.2 - q22.2 was detected in one patient. The deleted region contains 62 genes and has been rarely reported in patients with neurodevelopmental disorders. A deletion of 15q24.1 - q24.2 was detected in the other patient. This region is recurrently deleted in developmentally delayed patients (ref 3).

Conclusions

Our data highlight that chromosome 15 is a hub for neurodevelopmental disorder and illustrates the utility of array-CGH in the investigation of patients with autism, specifically in the context of complex phenotypes. Acknowledgment: The research leading to these results has received funding from the EEA Grant 2014-2021, under the project contract No 6/2019. References: Genes (Basel). 2021 Jul 1;12(7):1025. https://www.omim.org/entry/618060 Clinical Genome Resource. https://dosage.clinicalgenome.org/clingen_region.cgi?id=ISCA-46296

Disclosure

No significant relationships.
Dynamics of subjective pattern of health in frequently ill adolescents
Authors: Shishkova I. , Pervichko E.
Published: September 2022

Introduction

It is known that frequently ill adolescents are significantly more likely to have a disharmonious subjective pattern of health and associated maladaptive behavior in the field of health.

Objectives

To study dynamics of subjective pattern of health in frequently ill adolescents.

Methods

The sample: 57 frequently ill adolescents (mean age 10.6±0.1) in 2014-2015, 2017 and 2019. We used: The method of unfinished sentences about health (Yakovleva, 2014), “Index of attitude toward health” (Deryabo, Yasvin, 1999).

Results

The index of emotionality has decreased (98.93 vs 84.87, p=0.015), while the cognitive indicator of the attitude toward health remains unchanged. The rate of positive self-assessment of health reduces and the rate of negative self-assessment of health increases. Frequently ill teenagers in older age are more likely to give an objective definition of the disease and less likely to emotionally assess it. At a young age they often pointed out active lifestyle as the main reason for health, with age the psychological characteristics of a person (strength of will, cheerfulness, etc.) this reason becomes. The rate of health recognition as the absolute value of man decreases (in the second cut answers, this category accounted for only 24.4%), but at a later age teenager show “adult” category of “quality of life” (noted by 7.4% of older teenagers).

Conclusions

The study of the dynamics of the subjective pattern of health in frequently ill adolescents has high practical significance due to the possibility of preventive and correctional work with these adolescents. Research is supported by the Russian Science Foundation, project No. 21-18-00624.

Disclosure

Research is supported by the Russian Science Foundation, project No. 21-18-00624.
Toward the clinical application of the Child Psychosis-Risk Screening System (CPSS)
Authors: Hamasaki Y. , Matsuo M. , Sakaue Y. , Sanada R. , Nakayama T. , Michikoshi S. , Ueba S. , Kurimoto N. , Hikida T.
Published: September 2022

Introduction

In our previous study, we have developed the Child Psychosis-risk Screening System (CPSS), which incorporates psychological and behavioral characteristics of childhood into an algorithm, based on a retrospective survey.

Objectives

In this study, we actually tried to evaluate the risk of psychosis in pediatric and psychiatric outpatients using the CPSS.

Methods

We conducted an epidemiological study of 323 outpatients aged 6-18 years visiting pediatric and psychiatric departments using CBCL and clinical data (sex, age, winter birth, chief complaint, diagnosis, abuse, bullying, hikikomori). ROC analysis was used to assess the accuracy of CPSS predictions. Cross-sectional logistic regression analysis was performed on the clinical data to identify factors associated with risk groups exceeding the cutoff value.

Results

The results of the ROC analysis showed that the AUC (Area under the ROC Curve) was 80.3%, indicating that the CPSS has Moderate accuracy. The cutoff value was 98.11% (sensitivity: 0.857, specificity: 0.835), and 18% of the subjects were identified as risk groups above this value. Cross-sectional logistic regression analysis showed that schizophrenia diagnosis, no abuse, winter birth, and hikikomori were associated with the risk group, with respective odds ratios of 22.88, 10.76, 1.91, and 1.37.

Conclusions

The results of this study suggest that the CPSS can be applied to pediatric practice for early detection of risk for psychosis. The risk group is also present among pediatric patients with physical chief complaints. The factors suggested to be associated with risk groups may reflect the factors acting on the critical period of psychosis onset and the dynamic state.

Disclosure

No significant relationships.
Upside down: dissecting impulsivity in attention-deficit hyperactivity disorder through genotype-phenotype association analyses
Authors: Balogh L. , Pulay A. , Angyal N. , Vincze K. , Kilencz T. , Nemoda Z. , Réthelyi J.
Published: September 2022

Introduction

Better evaluation and understanding of the core symptoms have key importance both in clinical practice and the research of attention-deficit hyperactivity disorder (ADHD). One hallmark neurocognitive feature of ADHD is impaired inhibition, related to impulsivity. Given the high heritability of ADHD, the assessment of genetic background of impaired inhibition may contribute to our knowledge about the genetic background of the disorder.

Objectives

In our study we investigated whether different forms of impulsivity (attentive, motor, and nonplanning) and polymorphisms in genes of the noradrenergic, serotonergic, and dopaminergic neurotransmission, i.e. dopamine transporter-1 (DAT1), cathecoloamin-O-metiltransferase (COMT), and serotonin receptor-1B (HTR1B genes show association.

Methods

208 aADHD patients diagnosed according to DSM-5 criteria from a clinical sample and 142 individuals from a population sample who screened positive for aADHD were included in the study. DNA samples were genotyped for the HTR-1B gene rs1321041 and the COMT gene rs4680 SNPs, moreover the DAT-1 VNTR polymorphism. Dimensional variables for impulsivity were compared between genotypes with the Generalized Linear Model procedure corrected for sex and age, using the PLINK 1.9 statistical software.

Results

The 9 repeat polymorphism in DAT1 was associated with the severity of hyperactivity, moreover, all impulsivity factors. The A allele in COMT was associated with hyperactivity and better motor inhibition activity. In carriers of the G allele in HTR1B we detected significantly higher inattention scores and increased reaction time.

Conclusions

Our results support the putative role of the investigated genetic polymorphisms in the etiology of impulsivity. Nevertheless, these polymorphisms demonstrate a heterogeneous associations.

Disclosure

No significant relationships.
Being a psychiatric resident during COVID times – personal experiences of Hungarian trainees
Authors: Asbóth C. , Gergics E. , Gurzó S. , Herczeg A. , Hrapcsák A. , Kupcsik F. , Nagy P. , Oláh O. , Szilvágyi G. , Szocsics P. , Szűcs Z. , Bitter I.
Published: September 2022

Introduction

During the COVID-19 pandemic residents of the central region of Hungary also had to adapt to several challenges such as changes of hospitals’ specialty profiles and delegation of health care workers to COVID wards.

Hungarian residents have their practical training in various hospitals, while their psychiatric academic training is organised in groups.

Objectives

Our aim is to share our personal experiences about how our work and training have changed during the pandemic and it’s effect on our patients.

Methods

Participants of the study were the authors of the poster. Responses to open questions were structured based on the following topics: competencies in internal medicine, infectious diseases and psychiatry, our collaboration with other medical disciplines, psychiatric training and attitudes towards mental health patients.

Results

We worked min 2 weeks max 8 months at COVID wards and also treated COVID-19 infected psychiatric patients, thus gaining a greater experience in general medicine. In psychiatric work, acute care became prominent, communication in PPE and restricted contact with patients’ relatives were particularly difficult. Our relationship with other specialists has improved, consultation became easier. Increased use and misuse of psychiatric consultation requests led to further pressure. Restrictions, stigmatisation and discrimination increased against psychiatric patients, including difficult access to care. Psychiatric training in the hospitals became limited, however seminars organized by the university continued online with our active participation.

Conclusions

During the pandemic we gained greater experience in general medicine. Psychiatric care and our training was negatively affected, however the latter was mitigated by online seminars.

Disclosure

No significant relationships.
Assessing the feasibility of MOVING FORWARD, a multicentre transition intervention model across adolescent secure services in England: A cluster randomised feasibility trial
Authors: Livanou M. , Lane R.
Published: September 2022

Introduction

Young people moving from adolescent secure inpatient units to adult care in the UK present with multiple and complex needs and are more likely to experience poor transition outcomes related to enduring dependency on mental health services. However, there is lack of knowledge about the feasibility of transitional care models improving transition outcomes.

Objectives

The MOVING FORWARD study aims to implement a new transition intervention model for young people transitioning from adolescent secure services to adult-oriented settings and test the feasibility of a future cluster trial measuring its effectiveness.

Methods

The design of the study is a three-arm feasibility, cluster randomised controlled trial comparing the MOVING FORWARD intervention against standard transition preparation in six adolescent secure services.Young people between 17-19 years, their parents/carers and key workers will be allocated in two conditions and will receive four transition preparation workshops across six months. Data will be collected at three time points: (T0) baseline, (T1) 6-12 months post-intervention, and (T2)18-24 months post-baseline.

Results

Thirteen young people and 17 staff members have contributed to the intervention design through online Advisory Groups. Common identified themes included appropriateness of module content and support during delayed transitions. An intra-class correlation coefficient will be calculated to inform the power of sample size. With a sample size of 50, we will be able to estimate a drop-out rate of 80%.

Conclusions

This research will provide practitioners and policy makers with an evidence-based framework about barriers and facilitators to the proposed intervention and will enable services to reflect on quality of transitional care delivery.

Disclosure

No significant relationships.
How mothers of terminally ill children cope and appraise their life situation
Authors: Bityutskaya E. , Lebedeva N.
Published: September 2022

Introduction

Mothers of terminally ill children experience chronic stress that can lead to physical and emotional exhaustion. A better understanding of their experiences, resources, and vulnerabilities can help plan psychological interventions.

Objectives

The research is aimed to study mothers’ appraisals of their life situation related to the child’s terminal illness and their coping strategies.

Methods

Participants: 21 women (aged 26-49) whose children were patients at the hospice. Women answered a set of open-ended questions and completed questionnaires: “Appraisal Criteria of the Difficulty of a Life Situation”, “Types of Orientations in Difficult Situation”, “Ways of Coping Checklist”. Data were analyzed with Pearson’s r.

Results

Planned coping was associated with evaluations of opportunity (r=0.78) and threat to the future (r=0.61). Despite the deteriorating health status of most of the children, women reported a high degree of subjective control. This might be related to outside help. Participants stated that helping by the family, doctors, and psychologists was essential. Unexpectedly, the “need for a quick and active response” score correlates with that for the coping strategy “fantasizing” (r=0.62). This can be explained by the depletion of resources; deprivation of sleep and active rest is often observed. An important feature is that half of the participants report high self-blame.

Conclusions

We suggest that self-blame, an analysis of opportunities, and probable future scenarios are important psychotherapy targets for mothers of terminally ill children. The consequences of threat appraisal are twofold: admitting the threat can be painful, but it also mobilizes one’s energy. Funding: The study was funded by RFBR, project number 20-013-00838.

Disclosure

No significant relationships.
Clozapine placental passage at delivery: an update
Authors: Imaz M.L. , Lera S. , Roda E. , Roca A. , Torres A. , Solé E. , Andres S. , Mallorquí A. , Garcia-Esteve L.
Published: September 2022

Introduction

Clozapine is an effective second-generation antipsychotic that is approved for treatment-resistant schizophrenia and risk reduction of recurrent suicidal behavior in schizophrenia or schizoaffective disorder. Its available pregnancy pharmacikinetics data remain limited, which presents a challenge for clinicians managing women taking clozapine during perinatal period .

Objectives

The aim of this study was to provide new data of clozapine and norclozapine placental passage and neonatal outcomes.

Methods

We retrospectively studied a consecutive case series of six pregnancies where there was clozapine exposure (5 in politherapy and 1 in monotherapy). Clozapine and norclozapine serum concentrations were determined in the mother-infant pairs on the day of delivery (intrapartum maternal blood and umbilical cord blood respectively) and measured using a validated high-performance liquid chromatography method. The within- and between-day precision expressed as the coefficient of variation (CV)% were both <10%. The limit of quantification (LoQ) was 5 ng/mL. Neonatal outcomes were reviewed from pediatric records.

Results

The mean infant-mother clozapine and norclozapine ratio at delivery were 0.44 (SD=0.13) and 0.28 (SD=0.05) respectively. There was a weak positive correlation between maternal and umbilical cord clozapine and norclozapine serum concentratios (Pearson correlation coefficient 0.183, p=0.769 and 0.827, p=0.084 respectively). The rate of neonatal complications was 16%. One neonate (16%) , whose mother had drug abuse history during pregnancy, presented with a generalized neurodevelopment delay and the consequent need for continuous intensive care.

Conclusions

In our study, placental passage of clozapine and norclozapine was partial during delivery. Statistical power was limited for examining te association between neonatal clozapine levels and neonatal outcomes.

Disclosure

No significant relationships.
The Portuguese adapted version of the fear of covid-19 scale for the postpartum period
Authors: Pereira D. , Pereira A.T. , Wildenberg B. , Gaspar A. , Cabacos C. , Madeira N. , Macedo A.
Published: September 2022

Introduction

The Portuguese version of the Fear of COVID-19 Scale (FCV-19S; Cabaços et al. 2021), composed of seven items, presented good validity and reliability to be used in general population. To be used within perinatal context, specifically in the postpartum period, we have added an item related to the baby (item 8 – “I’m afraid my baby will be infected with coronavirus-19”).

Objectives

To analyze the psychometric properties of Portuguese adapted version of the Fear of COVID-19 Scale for the postpartum period (FCV-19SP), namely construct validity, internal consistency, and convergent validity.

Methods

207 women (mean age= 33.51 ± 5.23 years) recruited in the postpartum period (9,06 ± 8,52 months after delivery) fill in a set of self-reported validated questionnaires: Perinatal Depression Screening Scale (PDSS), Perinatal Anxiety Screening Scale (PASS) and Coronavirus-19 Fear Scale for the postpartum period (FCV-19SP).

Results

CFA revealed that the unifactorial model composed of eight items presented good fit indexes (X2/df=1.508; CFI=.991; GFI=.974; TLI=.983; p[RMSEA≤.01] = .049), better than those of the seven items version (X2/df=3.963; CFI=.957; GFI=.909; TLI=.905; p[RMSEA≤.01] =.219). Cronbach alpha for the FCV-19SPP was α=.880. The total score significantly (p<.01) and moderately correlated with PDSS (r=.262) and PASS (r=.371).

Conclusions

The FCV-19SP is a valid and reliable questionnaire to assess fear of COVID-19 in women in the postpartum period.

Disclosure

No significant relationships.
Art therapy focused on stimulating the emotional and expressive skills of the atypical children
Authors: Hosu L.-M.
Published: September 2022

Introduction

The role of the art therapist can be to identify the creative potential, to value it and to support social integration through art. Detecting and developing the outstanding and hidden abilities of the atypical child can lead to a normal behavior and to a better social integration.

Objectives

Increasing self-esteem, through personal satisfaction, emotional development and the development of hidden and outstanding skills.

Methods

Stimulating the child through the environment, works as a non-directive method during the art therapy session. Work environments offer various possibilities of expression, he chooses the materials to which he shows an interest, developing his own technique over time.

The child is encouraged during the art therapy sessions, by exhibiting the works and decorating the work environment.

Through these non-directive methods, the evolution of visual thinking is accelerated. The chromatic diversification, the gestures in painting and the alternation of work techniques such as printing, graphic lines and dripping, are signs of a visual thinking. The child discovers the environment and interacts with it trough art.

Observing the potential of the materials around him and also certains physical phenomena, such as a three-dimensional mask that allows the color to outline its volumes by draining it on the shape, the child uses consciously the properties of materials and the movement of the object.

Results

Discovering artistic and decorative skills; Increased self-esteem; Interaction in the artistic environment and even verbal communication in cases of autism.

Conclusions

Through art, the child can get closer to the social life.

Disclosure

No significant relationships.
First case of new-onset psychosis due to DBS in the ventralis intermediate nucleus (Vim) of the thalamus
Authors: Petrykiv S. , Arts M. , De Jonge L.
Published: September 2022

Introduction

Known risk factors for developing of first-time psychosis in patients with deep brain stimulator (DBS) include older age, short time after implant placement and cerebral target for stimulation. In particular, stimulation of subtalamic nucleus and globus pallidus internus has been shown to elicit psychotic symptoms in various case reports. To date, there are no cases describing onset of psychosis due to DBS in the ventralis intermediate nucleus (Vim) of the thalamus.

Objectives

Case describtion of psychotic episode provoked by DBS in Vim region

Methods

Case report of 70 y.o. female with unilateral DBS from 2012 in Vim for essential tremor, who developed therapy resistant psychotic symptoms right after adjusted settings of the DBS.

Results

Psychotic onset of otherwise healthy 70 y.o. patient occurred and gradually worsened after adjustment of DBS settings in absence of other iatrogenic factors, including medication and comorbidity, and required involuntary hospitalization one week after beginning of psychosis. Treatment after hospitalization comprised olanzapine 10 mg. 1dd1 did not cause resolvent of psychosis. Because of therapy resistance to psychofarmaca and worsening of psychotic symptoms, by way of exception neurologists had to change the settings back to basic leading to complete and sustained remission of psychosis within two days.

Conclusions

Among side effects of DBS in Vim, psychotic symptoms have never been reported. However, as in our patient, psychosis occurred after changes of settings in DBS and presented acutely, was severe, resulted in involuntary hospitalization and was therapy resistant. Pathophysiology of DBS-induced psychosis in Vim region is not known and requires further investigation.

Disclosure

No significant relationships.
Low level of perfectionism as a possible risk factor for suicide in adolescents with attention-deficit/hyperactivity disorder
Authors: Katzenmajer-Pump L. , Farkas B. , Varga B. , Jansma J. , Balazs J.
Published: September 2022

Introduction

Previous research highlighted that adolescents with attention-deficit/hyperactivity disorder (ADHD) are four times as vulnerable to suicidal behavior as the healthy population. Maladaptive perfectionism is also viewed as an important risk factor for suicide. Yet, there are no studies which focused on the relationship between perfectionism and suicide among adolescents with ADHD.

Objectives

The objective of the present study was to explore if perfectionism may be a risk factor for suicidal behavior in adolescents with ADHD.

Methods

The clinical group was recruited from outpatient clinics, while the non-clinical group was recruited from high schools around Hungary. The clinical group’s inclusion criterion was ADHD diagnoses, while the non-clinical group required the absence of any current or past psychiatric treatment or diagnoses.

Results

In the ADHD group 88 adolescents participated, and 96 adolescents participated in the non-clinical group. There was no difference regarding the level of perfectionism in the groups, except one dimension of perfectionism, which is ‘Organization’. The ADHD group had significantly higher level of suicidal behavior than the control group ((χ2 (1) = 11.222, p < .001, V = 0.25). Among the ADHD group adaptive perfectionism was significantly negatively correlated with suicidal behaviour.

Conclusions

Adolescents with ADHD did not have a different level of perfectionism than the healthy control group only in ‘Organization’ trait. This result could add to the therapeutic work with adolescents diagnosed with ADHD with underlining the importance to focus on organizational skills. The result highlights that adaptive perfectionism appears to be a protective factor against suicidality.

Disclosure

No significant relationships.
Retrospective Chart Review of Patients with Self-Harm Seen as Liaison Psychiatry in Pakistan
Authors: Malik M.F.A. , Najeeb B.
Published: September 2022

Introduction

Self‑harm is an ‘act of self‑poisoning or self‑injury carried out by a person, irrespective of their motivation’. A history of self-harm is linked with suicide risk. A study in Pakistan found self-harm to be more common in young people with unemployment and interpersonal difficulties as common triggers. Expanding liaison psychiatry services leads to an earlier assessment of patients with self-harm.

Objectives

To study the demographic and clinical variables of patients along with methods and precipitating factors of self-harm.

Methods

A retrospective chart review of patients presenting with self-harm seen as a part of liaison psychiatry from October 2018 to June 2021.

Results

A total of 168 cases were seen of which 10 were excluded due to incomplete data. Of 158 cases gender split was roughly in the middle, with 49.4% males (n=78) and 50.6% females (n=80). The mean age of patients was 27.59 with a range of 12-70, 40.5% belonged to the age group of 20-29 (n=64) (Figure 1).

77.8% (n=123) had a past psychiatric history. The most common being depressive disorder 31.6% (n=50) and borderline personality disorder 30.4% (n=48). 35.4% of patients reportedly had previous attempts of self-harm. The most common methods being the use of sharp objects, rat-pill poisoning, and corrosive intake (Figure 2).

Conflicts with family and relationship difficulties were reported to be the most common precipitating factors.

Conclusions

Self-harm is a challenging and frequent presentation. Patients may present with diverse characteristics and varying needs. Hence physicians must be prepared for timely liaison and prompt management.

Disclosure

No significant relationships.
Reflections, impact and recommendations of a co-produced ecological momentary assessment (EMA) study with young people who have experience of suicidality and psychiatric inpatient care
Authors: Dewa L. , Pappa S. , Mitchell L. , Hadley M. , Cooke J. , Aylin P.
Published: September 2022

Introduction

Patient and public involvement (PPI) in suicide research is ethical, moral and can deliver impact. However, inconsistent reporting of meaningful PPI, and hesitancy in sharing power with people with experience of suicidality (i.e.co-researchers) in research makes it difficult to understand the full potential impact of PPI on the research, researchers and co-researchers.

Objectives

To describe how our ecological momentary assessment (EMA) study, examining the sleep-suicide relationship in young psychiatric inpatients (aged 18-35) transitioning to the community, has been co-produced, whilst reflecting on impact, challenges, and recommendations.

Methods

We built on our experience of co-produced mental health research to conduct meaningful PPI in our study. Young adults with experience of psychiatric inpatient care and suicidality were appointed November 2020 to work across all research stages. Reflections on challenges, recommendations and impact have been collected throughout.

Results

Three young people became co-researchers. Researcher and co-researcher reflections indicated establishing and maintaining safe environments for open discussion, and continued communication (e.g.WhatsApp group) were vital to effectively share power and decision making. Safeguarding and support requirements for both co-researchers (e.g.individualised strategy) and researcher (e.g.clinical supervision) were particularly evident. To date, the co-produced recruitment poster, research documentation, and research article have demonstrated significant impact.

Conclusions

This is the first EMA study focused on suicide-sleep during transitions to be co-produced with young people with experience of suicidality. Co-producing suicide research is intensive, time-consuming, and challenging but makes a significant impact to the research, researchers, and co-researchers. We expect our learning will directly influence, and help others produce, meaningful co-produced suicide research.

Disclosure

No significant relationships.
Nonsuicidal self-injury, psychiatric disorders and pathological internet use among adolescents
Authors: Mészáros G. , Győri D. , Horváth L.O. , Szentivanyi D. , Balazs J.
Published: September 2022

Introduction

Previous studies underline the importance of internalising disorders as risk factors of nonsuicidal self-injury (NSSI), meanwhile only a few research draw the attention to the role of externalising disorders. The possible association between NSSI and pathological internet use (PIU) is also understudied.

Objectives

The purpose of this study was: 1) to investigate the frequency of NSSI among adolescents with different psychopathology and in different internet user groups of adolescents, 2) to understand the mediator role of psychiatric disorders between NSSI and PIU.

Methods

Adolescents were enrolled from a clinical (Vadaskert Child Psychiatric Hospital, Budapest, Hungary) and a school based population (high schools in Budapest, Hungary). The used measurements were: Strengths and Difficulties Questionnaire (SDQ), Deliberate Self-Harm Inventory, Young Diagnostic Questionnaire for Internet Addiction, Mini International Neuropsychiatric Interview Kid.

Results

There was significant difference in the frequencies of NSSI in SDQ subgroups (U=2127.000; z=-6.170; p <0.001). There was also significant difference in NSSI frequency between normal- and pathological internet users (U=2020.000; z=-2,501; p <0.017 p=0.012). According to the mediator model there was no direct association between PIU and NSSI, however it was mediated by different psychiatric disorders (affective disorders, anxiety disorders, attention deficit/hyperactivity disorder, conduct disorder, opposition defiant disorder, psychoactive substance abuse/dependence, psychotic disorders, suicidal behavior).

Conclusions

The results strengthen that both internalising- and externalising psychopathology are associated with NSSI. Moreover this study underlines the importance of careful screening and treating of comorbid disorders with PIU, which can have a role in the prevention of NSSI and suicide as well.

Disclosure

No significant relationships.
Personal construct therapy vs. cognitive behavioural therapy in the treatment of depression in women with fibromyalgia: a multicentre randomized controlled trial with a 6-month follow-up
Authors: Aguilera M. , Paz C. , Salla M. , Feixas G.
Published: September 2022

Introduction

Depressive symptoms are common in patients with Fibromyalgia (FM), a chronic and disabling pain syndrome. Psychological interventions are mostly focused in negative thinking and behavioural activation. However, several studies suggest that personal identity is also affected by FM.

Objectives

We aimed to examine the effects of Personal Construct Therapy (PCT), an idiographic approach that emphasizes identity features and interpersonal construal, on depressive symptoms in women with FM.

Methods

In the context of a multicentre parallel randomized trial (Trial Registry: NCT02711020), 106 women with FM and presenting depressive symptoms were randomized either to either Cognitive Behavioural Therapy (CBT; n = 55), taken as a gold standard comparison, or PCT (n = 51). In total, 69 patients completed the treatment and the six-month follow-up assessment (CBT = 32 and PCT = 37). Both treatments were applied on case formulation premises.

Results

Linear mixed-effects models were performed to compare depressive symptoms between treatment conditions. Anxiety and pain measures were treated as secondary outcomes. Participants in both conditions significantly reduced their levels of depression and anxiety as well as the impact of FM but no significant between treatment differences were found. Analysis of clinically significant change for depressive symptoms and pain was also similar between both conditions.

Conclusions

PCT resulted equally effective in the treatment of depressive symptoms in women with FM when compared with CBT, both offered in a modular format. Thus, PCT with tis focus on identity issues can be considered as an alternative treatment for these patients.

Disclosure

No significant relationships.
What is the link between the antidepressants, the transcranial magnetic stimulation and the peripheral vascular endothelial growth factor?
Authors: Lazáry J. , Elemery M. , Kiss S. , Pogany L. , Faludi G.
Published: September 2022

Introduction

Vascular endothelial growth factor (VEGF) has been implicated in mediating the effect of antidepressants (AD) and electroconvulsive therapy on depression since it plays a significant role in the neurogenesis. However, the serum VEGF level has not been investigated so far in association with rTMS treatment in patients with major depressive disorder (MDD).

Objectives

The aim of our study was to compare the effect of the antidepressants and of the repetitive transcranial magnetic stimulation on the serum vascular endothelial growth factor and its association with the responsiveness to the treatments.

Methods

A dataset of 50 patients with TRD who were treated with AD (n=33) and bilateral rTMS for 2x5 days (n=17) was analysed (sample ’rTMS&AD’). Montgomery-Asberg Depression Scale (MADRS) was used for monitoring the symptom changes. The serum VEGF levels and symptoms were assessed on the first (V1), on the 14th (V2) and on the 28th day (V3). The VEGF levels were measured by ELISA assay.

Results

The baseline VEGF levels were significantly higher in non-responders both in the rTMS&AD (p=0.04) and AD samples (p=0.02) compared to responders. The MADRS reduction and the changes in VEGF levels between V1 and V3 were significantly associated in responders only in the AD&rTMS sample (p=0.03). The baseline VEGF level has been proven as a significant predictive factor of treatment response in the total sample (p=0.018).

Conclusions

The baseline VEGF level can be a predictive factor to be a non-responder to different treatments. Change of the VEGF level is associated with the improvement of depressive symptoms only due to rTMS.

Disclosure

This study was supported by the FK 131315 grant of the National Research, Development and Innovation Office, Hungary. Authors declare no conflict of interest.