bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychopathology of schizophrenia in the context of the superior longitudinal fascicle integrity – a DTI study
Authors: Podwalski P. , Tyburski E. , Szczygieł K. , Michalczyk A. , Sagan L. , Samochowiec J.
Published: September 2022

Introduction

Schizophrenia is a chronic mental illness with unclear etiology. It is characterized by symptoms in various psychopathological domains (e.g. positive, negative). One of the concepts explaining the etiology of schizophrenia is the disconnection hypothesis. It assumes the existence of structural and functional disorders within the connections of brain regions. White matter is largely responsible for the quality of these connections. One of the important structures of white matter is the superior longitudinal fascicle (SLF) which connects many cortical structures.

Objectives

The main aim of our study was to search for a relationship between the integrity of SLF and various psychopathological dimensions among schizophrenia patients.

Methods

42 schizophrenia subjects (SS) and 32 healthy controls (HC) participated in the study. All study participants underwent DTI-MRI analysis. The psychopathology of SS was assessed using the Positive and Negative Syndrome Scale (PANSS). In the study, we used the PANSS dimensions proposed by Shafer. Then, the SLF analysis was performed using fractional anisotropy (FA) and mean diffusivity (MD) parameters.

Results

The differences in FA and MD values in SLF bilaterally between groups were confirmed. A correlation was found between MD values in left SLF and positive symptoms (p = 0.040) and excitement (p = 0.012). A correlation was found between the MD values in the right SLF and the symptoms of disorganization (p <0.000) and excitement (p = 0.004).

Conclusions

SLF seems to play a role in the etiopathogenesis of schizophrenia. Disturbed SLF integrity may be involved in the development of positive, disorganization and excitement symptoms.

Disclosure

No significant relationships.
Perception of the COVID-19 pandemic by individuals who previously sought psychiatric assistance
Authors: Boyko O. , Medvedeva T. , Enikolopov S. , Vorontsova O. , Kazmina O.
Published: September 2022

Introduction

COVID-19 pandemic leads to high levels of stress. Individuals who have previously sought psychiatric assistance are more sensitive.

Objectives

Analysis of the perception of the pandemic by people who have previously sought psychiatric care.

Methods

An internet-survey (20.03.2020 - 13.01.2021) (N=659; 152 – previously sought psychiatric assistance); included SCL-90-R; questions about the levels of anxiety, depression, and fear (assessed on 0-10 scale); question about opinion on COVID-19 pandemic (coded further on the basis of meaning); question about epidemiological situation of COVID-19 in respondents’ places of residence and their social circles.

Results

Individuals who had previously sought psychiatric assistance demonstrated higher levels of anxiety (5,533±2,489 versus 4,774±2,590), depression (4,945±2,926 versus 3,861±2,988), and fear (0,195±0,397 versus 0,278±0,448). They showed roughly equivalent reactions to both anticipated and real danger (z-score GSI of SCL-90-R 0,90 versus 0,90 for anticipated and real danger respectively), the same indicator of the control group (0,53 and 0,65). In statements about the pandemic, they are more often referred to the topic of “positive effects” of pandemic (3,30% versus 0,99%), expressed “curiosity” (5,92% versus 2,37%). They were less drawn to conspiracy (9,87% versus 16,17%), and exploited more readily the topic “about myself” (20,39% versus 13,21%), negative images of “the present” (3,64% versus с 1,58%) and “the future” (15,79% versus 9, 47%), vocabulary of “anger” (5,92% versus 2,17%).

Conclusions

Individuals who had previously sought psychiatric assistance were ambivalent in their attitudes towards pandemic, and tended to concentrate more on feelings and the negative vision of the future. They perceived anticipated danger roughly equivalent to real danger.

Disclosure

No significant relationships.
The Complexity of Comorbidity in Patients with Severe Mental Disorders
Authors: Sartorius N.
Published: September 2022

Comorbidity of severe mental disorders and physical illness: issues arising Comorbidity of mental and physical illness is a major, perhaps main problem facing medicine in the years before us. In addition to shortening the life expectancy of people with mental illness comorbidity with physical illness comorbidity significantly and negatively affects the quality of life of the people who experience the mental and physical illnesses and their carers and increases the cost of health care. What makes the problem even more and challenging is that medicine is currently in the process of fragmentation into ever more narrow specialties which adds difficulty in the provision of care, Most of the solutions which have been proposed – collaborative care, in-service education of general practitioners and others did not turn out to be effective solutions in dealing with the problems of comorbidity. A significant revision of undergraduate and postgraduate training in medicine is most probably an essential component of the answer to the challenge of this type of comorbidity which will also require a reorganization of health services and their financing.

Disclosure

No significant relationships.
Less basal thyrotropin levels predict antidepressant response in patients with major depression
Authors: Navinés R. , Oriolo G. , Mora M. , Cavero M. , Gómez-Gil E. , Martin-Santos R.
Published: September 2022

Introduction

The close association among thyroid metabolism, mood disorders and behavior has long been known. The role of basal thyroid axis in antidepressant treatment response is less known.

Objectives

The aim of the present study was to study the association of basal serum thyrotropin (TSH) levels, with antidepressant treatment response in major depressive disorder.

Methods

Thirty-one depressed adult outpatients were included. Major depressive episode was diagnosed through the MINI (DSM-IV-TR) interview. Clinical symptomatology and blood samples were assessed at baseline, and at 4-
and 8-weeks of either escitalopram or sertraline. Treatment response was defined by an improvement ≥50% in MADRS scores at 4-, and 8-weeks. Basal TSH levels were included in a linear regression model as predictor of treatment response.

Results

Twenty-seven patients finished 8-weeks of treatment. Response to treatment was of 74% at 4-weeks, and 63% at 8-weeks of antidepressant treatment. Basal median TSH levels were between normal ranges (M+SD=1.85+1,02 mlU/L). Basal TSH levels not correlated with basal MADRS scores, but with higher MADRS scores at week-4 (r=0,415, p=0,031) and at week-8 (r=0,392, p=0,043). Moreover, less baseline TSH levels trend to be a significant good predictor for treatment response at 4-weeks (R2=.116, p=.083); and a good predictor at 8-weeks treatment (R2=.147, p=.049).

Conclusions

Baseline TSH levels even within the normal range may play a role in predicting antidepressant response.

Disclosure

No significant relationships.
The role of the practice nurse in the management of Postpartum depression
Authors: Hogea L. , Tabugan C.D. , Bredicean A.-C. , Anghel T.
Published: September 2022

Introduction

Nurses specializing in maternal and child health are poised to play a pivotal role in the early identification and prompt treatment of perinatal depression. Postpartum period it is well-known for presenting high-risk for the appearance of a mental illness.

Objectives

This study has been carried out with the aim of investigating the level of knowledge of the nurses and their role in the management of post-partum depression.

Methods

73 participants (n=73) were selected which are professional nurses. The data were collected through a questionnaire formed out of 16 questions. The questionnaire is structured on three parts: general information about the participants, the nurse’s knowledge about the postpartum depression, and the identification and the management of the patient’s cases.

Results

73 of the nurses questioned, consider that they were not properly prepared for this role and they were not able to identify and manage the patients with post-partum depression. They also consider that the ideal training should contain more theoretical information. Amongst these (32, 87%) do not know the symptomatology, and 38, 35% are not aware of the risk factors of post-partum depression.

Conclusions

Postpartum depression is seen in approximately 10% of women who have recently given birth, but also in 3, 3% of men. Despite of this numbers, the Romanian medical staff is not yet well prepared in facing this affection.

Disclosure

No significant relationships.
Psychological impact of COVID19 outbreak and coping strategies among Tunisian medical students
Authors: Shiri M. , Bejar M. , Arous A. , Kammoun I.
Published: September 2022

Introduction

The COVID19 pandemic came with unprecedented measures that impacted every aspect of the student’s life making them vulnerable to psychological distress.

Objectives

The aim of this study was to assess anxiety and depressive symptoms in relation to the coping strategies during the COVID19 pandemic among medical students.

Methods

We conducted a web-based cross-sectional study among Tunisian medical students. We used an anonymous survey comprising sociodemographic characteristics, the Hospital Anxiety and Depression scale and the brief COPE.

Results

A total of 216 students participated in the study; 78% were female and most respondents were enrolled in first and second year of medical studies (53%). The frequency of depressive and anxiety symptoms were respectively 28% and 40%; females experienced significantly higher depression and anxiety scores (p<10¯³ and p=0.02 respectively). Most used coping strategies were self-blame, planning, acceptance, distraction, positive reframing, active coping and religion (99%-96%). The least used coping strategies were substance use (13%) and denial (52%). We found that gender was associated with a significant difference in the coping styles where females scored higher on religious coping and denial whereas males used more humor coping. Depression and anxiety were significantly associated with denial coping. Humor, acceptance, positive reframing and active coping were significantly associated with lower depression rates. Humor coping and active coping were associated with lower anxiety rates.

Conclusions

Our study shows alarming rates of depression and anxiety among Tunisian medical students during the COVID19 pandemic. A targeted intervention to promote mental health using the coping styles might be useful in this population.

Disclosure

No significant relationships.
Adherence Scale to the Recommendations for Mental Health during the COVID-19 pandemic from the Portuguese General Directorate of Health (ASR-MH-COVID19) - Development and validation
Authors: Pereira A.T. , Cabacos C. , Soares S. , Pacheco M.J. , Manão A. , Araújo A. , Amaral A.P. , De Sousa R. , Macedo A.
Published: September 2022

Introduction

The COVID-19 crisis has generated an increasing stress throughout the population.

Objectives

To develop and validate the Adherence Scale to the Recommendations for Mental Health during the COVID-19 pandemic from the Portuguese General Directorate of Health (GDH) (ASR-MH-COVID19).

Methods

The items content was based on the GDH guides for the prevention of mental health and psychosocial well-being of the general population during the COVID-19 outbreak. After content and facial validity analysis, the preliminary version of the ASR-MH-COVID19 (8 items to be answered on a Likert scale) was completed by 413 individuals (69.2% female; mean age=31.02±14,272), in September-December 2020 (Sample1) and then by 967 (70.9% female; mean age=34.02±14,272), in February-May 2021 (Sample2). Sample1 was randomly divided in two sub-samples. Sample1A was used for exploratory factor analysis/EFA and Sample1B for confirmatory factor analysis/CFA; CFA was then replicated with Sample2. The online surveys also included the Adherence Scale to the Recommendations of Portuguese GDH to minimize the impact of COVID-19 (ASR-COVID-19; Pereira et al. 2020).

Results

CFAs were informed by EFA and showed that the unidimensional model presented acceptable-good fit indexes (Sample1B: χ2/df=2.747; RMSEA=.0980, p<.001; CFI=.973; TLI=.918, GFI=.972; Sample2: χ2/df=3.327; RMSEA=.0490, p<.001; CFI=.993; TLI=.983, GFI=.990). Cronbach’s alfas were α<.850. Pearson correlations between ASR-MH-COVID19 and ASR-COVID19 were significant (p<.01) and moderate-high for the total (r=.753) and dimensional scores (Distance and respiratory hygiene, r=.739; House and personal hygiene, r=.584; Use of remote services and isolation r=.425).

Conclusions

The new ASR-MH-COVID19 has shown validity and reliability, allowing the investigation of this (mental) health behaviour.

Disclosure

No significant relationships.
Prevalence and covid 19 vaccination rate in a population of patients with schizophrenia and a substance use disorder
Authors: Romero Guillena S.L. , De Burgos Berdud I. , Gálvez Medina R. , Serrano Rodriguez E.
Published: September 2022

Introduction

As of August 27th, 2021, the diagnosed cases of COVID 19 in Spain are 4 758 003 with a prevalence of 10.03%. 68.4% of the Spanish population is fully vaccinated

Objectives

Primary: To compare the prevalence of COVID infection in a cohort of patients with schizophrenia to patients with a dual diagnosis of schizophrenia and substance use disorder Secondary: To compare the rate of fully vaccinated patients diagnosed with schizophrenia with and without a coexisting substance use disorder.

Methods

Retrospective descriptive study. The population in study is made up of patients with schizophrenia (46) and dual diagnosis schizophrenia (28) (following DSM 5 criteria) Confirmed cases were those cases with positive PCR

Results

There was not a stadistically significant difference in the prevalence of COVID 19 infection between both groups of patients. The prevalence of COVID infection among the dual diagnosis schizophrenia was 3.57% compared to 6.5% in those without coexisting substance abuse disorder. Relative to vaccination rate, we didn’t find a stadistically significant difference between both groups. However, there was a higher vaccination rate in the dual diagnosis schizophrenia group (82.12%) compared to the non-dual diagnosis schizophrenia group (69.56%)

Conclusions

The prevalence of COVID 19 infection in the dual diagnosis schizophrenia cohort is 3.57% and in the group of patients with schizophrenia without substance abuse disorder is 6,5%. In those with dual diagnosis schizophrenia the vaccination rate was un 82.12%. It was 69.56% in those without coexisting substance abuse disorder.

Disclosure

No significant relationships.
The identification of treatment-resistant depression patients in electronic health records, a retrospective cohort study in China
Authors: Dong S. , Wu T. , Dong W. , Si T.
Published: September 2022

Introduction

Previous Electronic Health Records (EHR) based studies adopted various definitions in identifying Treatment-Resistant Depression (TRD) patients. There is a lack of similar attempts among Chinese population which limits the understanding of TRD in China.

Objectives

Assess TRD identification using EHR from a major psychiatric hospital in China.

Methods

This study utilized a retrospective Major Depressive Disorder (MDD) cohort of patients who newly initiated pharmaceutical treatment (2010-2018); follow-up was ended upon 1-year or treatment discontinuation (≥120d without treatment). TRD was first identified based on common clinical definition of two prior regimen failures (change of regimen) with 4-week as regimen adequacy threshold (Def1). Alternative adequacy thresholds of 2-week and 6-week were applied. Based on Def1 (4-week), at least 3 distinctive regimens were additionally required in TRD identification (Def2). Further, a data-driven definition (Def3) based on drug count as having ≥3 antidepressants or ≥1 antipsychotic within 1 year was considered (Cepeda et al., 2018).

Results

From 12257 MDD patients included in the cohort, Def1 identified 633 (5.2%) TRD cases, whereas regimen adequacy thresholds of 2-week and 6-week identified 1772 (14.5%) and 61 (0.5%) cases, respectively. Further, Def2 identified 261 (2.4%) TRD cases. Finally, Def3 yielded 2449 (20.0%) TRD cases, including 1966 exclusive cases that were not identified by Def1.

Conclusions

This study showed different definitions for TRD identification had considerable impact on the number of patients identified among Chinese population, obscuring the comparability among EHR-based TRD studies. As first step, we found the criteria of regimen adequacy as major contributor to the observed variability in China.

Disclosure

No significant relationships.
Treatment of the depressive patients at clinical high-risk for psychosis
Authors: Omelchenko M.
Published: September 2022

Introduction

At present, there is no universally approach to treating patients at clinical high-risk for psychosis (CHR) without comorbid mental disorders. However, if there are revealed depressive symptoms, proper treatment becomes necessary.

Objectives

Establish pharmacological classes and doses of drugs that have proved effective in treating depressive patients at CHR.

Methods

A comparative study of pharmacological classes and doses of drugs was carried out, showing the effectiveness in treatment of 219 depressive patients at CHR and 52 depressive patients without CHR. The treatment effectiveness was carried out on the reduction of depression symptoms on the HDRS scale, and the CHR symptoms on the SOPS scale.

Results

A significant reduction of depression symptoms was achieved in the group of depressive patients with and without CHR on the HDRS scale (67.9% and 76.6% respectively). The reductions of the CHR symptoms were 46.1% and 53.3% respectively. There were differences between the severity of depression symptoms and CHR symptoms before and after the treatment. Both groups used antidepressants followed by the prescription of antipsychotics to increase the effectiveness of the therapy. No difference was found in the doses of antidepressants for the fluoxetine equivalent (46.0 vs 42.6 mg per day, p 0.05) and some differences were found for the average effective doses of antipsychotics for the chlorpromazine equivalent (385.4 vs 230.8 mg per day, p 0.05).

Conclusions

The same pharmacological classes are used for the treatment of young depressive patients with and without CHR, but the former have significantly higher doses of antipsychotics.

Disclosure

No significant relationships.
Emergency Psychiatry before and during COVID-19 pandemia
Authors: Giménez-Palomo A. , Sagué M. , Fico G. , Gómez-Ramiro M. , Vázquez M.
Published: September 2022

Introduction

The COVID-19 pandemic had a significant impact worldwide. Consultations in the Emergency Service of the Hospital Clínic of Barcelona varied in terms of reasons for consultations, psychopathology, and other aspects, before and after the pandemic.

Objectives

To examine changes in the profile of patients admitted before and during the COVID-19 pandemic to our Psychiatric Emergency Service.

Methods

All children, adolescent and adult psychiatric inpatients admitted from December 4th 2019 to March 31st 2021 to the Psychiatric Emergency Service of Hospital Clínic of Barcelona, Spain, were retrospectively included for analysis and divided into two groups –groups 1 or 2-
including the first one all patients who attended before lockdown and the second group those who attended during the pandemic.

Results

A total of 1991 patients were included -1224 in the first group and 767 in the second group. The majority of patients were male (52.08%), with a mean age of 41.21 years (SD 16.53). A proportion significantly higher of men was found in the second group (p<0.05). The proportion of patients consulting with substance use disorders was significantly higher in the second group (p<0.05). Patients from the second group presented a significantly higher proportion of admissions in an acute psychiatric ward (p<0.05), and also a significantly higher proportion of consultations of patients with dementia (p<0.05).

Conclusions

The COVID-19 pandemic lead to a significant reduction in the overall consultations, with a higher proportion of severe cases. The lack of availability of caregivers and telework might have influenced the increase in consultations of patients with dementia.

Disclosure

AG has received travel and financial support from Janssen, Otsuka-Lundbeck and Angelini, and research support from Instituto de Salud Carlos III, and declares no support related with the subject of this presentation.
Predictors of Functional Outcome in Patients with Bipolar Disorder
Authors: Erfurth A. , Sachs G.
Published: September 2022

Introduction Bipolar disorder is a severe disorder that is often accompanied by deficits in both neurocognitive (1) and psychosocial function (2). At the Department of Psychiatry and Psychotherapy of the Medical University of Vienna we performed a study to further identify potential cognitive, clinical and treatment-dependent predictors for functional impairment, symptom severity and early recurrence in bipolar patients (3). Methods Forty-three remitted bipolar patients and 40 healthy probands were assessed with a cognitive battery. In a randomized controlled trial, remitted patients were assigned to two treatment conditions as add-on to state-of-the-art pharmacotherapy: cognitive psychoeducational group therapy (CPEGT) over 14 weeks or treatment-as-usual. At 1 year after therapy, functional impairment and severity of symptoms were assessed. Results As compared to healthy probands, bipolar patients showed lower performance in executive function, sustained attention, verbal learning and verbal fluency. Both attention and CPEGT predicted occupational functioning. In our study verbal memory recall was a predictor for symptom severity. Discussion Our data suggest that bipolar patients benefit from CPEGT in the domain of occupational life. Implications for treatment strategies are discussed. Solé B, Jiménez E, Torrent C, Reinares M, Bonnin CDM, Torres I, Varo C, Grande I, Valls E, Salagre E, Sanchez-Moreno
J, Martinez-Aran
A, Carvalho AF, Vieta E. Int J Neuropsychopharmacol (2017) 20:670–80. Tohen M, Zarate CA Jr, Hennen J, Khalsa HM, Strakowski SM, Gebre-Medhin
P, Salvatore P, Baldessarini RJ. Am J Psychiatry (2003) 160:2099–107. Sachs G, Berg A, Jagsch R, Lenz G, Erfurth A. Front Psychiatry (2020) 23;11:530026.

Disclosure

No significant relationships.
Towards patient engagement in violence risk assessment and management: a patient perspective
Authors: Lantta T. , Anttila J.
Published: September 2022

Introduction

In current clinical practices, there exist very few methods that allow patients to be truly engaged in violence risk assessment and management. This may hinder an individual’s experience of basic psychological needs; autonomy, competence, and relatedness.

Objectives

To describe patients’ ideas on how they would develop current violence risk assessment and management practices.

Methods

The data collection took place as part of a larger project in one PICU unit specialized in the treatment of patients with psychosis and violent behavior in Finland. Individual interviews were conducted with patients (n=13) and were guided to focus on the development of violence risk assessment and management. The data were analyzed using inductive content analysis.

Results

Patients’ ideas focused on themes related to developing patient engagement and violence risk management methods. Developing patient engagement involved noticing patient’s individuality and collaboration between a patient and staff: for instance, by shared risk assessment and individualized risk management. Developing violence risk management methods included themes about providing alternative risk management methods and developing nursing staff’s work. Suggestions were, for example, related to providing ways how to calm down, having meaningful activities during treatment days, and ensuring the realization of patient’s rights.

Conclusions

Patients having treatment in the PICU unit have clear and concrete ideas on how violence risk assessment and management methods could be developed further. These findings indicate, that patients need to be given a more active role in their care and thus ensure that basic psychological needs are promoted. Funding by Academy of Finland (316206 ) and TYKS foundation.

Disclosure

No significant relationships.
Effect of increased prolactin and psychosocial stress on erectile function
Authors: Sajdlova R. , Fiala L.
Published: September 2022

Introduction

Sexual dysfunctions in men are complex disorders that consist of organic and psychogenic components. The most common sexual dysfunction is erectile dysfunction. It is the inability to achieve or maintain an erection for satisfactory sexual performance. This disorder can be caused by high blood pressure, heart disease, vascular problems, psychological and hormonal factors such as problems with testosterone and prolactin levels.

Objectives

The most common sexual dysfunction is erectile dysfunction. It usually affects men over the age of 40. The causes of erectile dysfunction can be organic, psychogenic or a combination of both. The most common organic causes of erectile dysfunction may be high blood pressure, diabetes mellitus, obesity or hormonal disorders. Psychogenic reasons are usually related to psychosocial stress. In this study, we tested the relationship between erectile dysfunction, hyperprolactinemia, and psychosocial stress.

Methods

Clinical examinations of 60 patients with erectile dysfunction, which also included psychosocial stress, focused on patient history, comprehensive sexological examination, biochemical analyzes of serum prolactin, total testosterone, thyroid stimulating hormone with psychometric evaluation of erectile function and a checklist of trauma symptoms (TSC-40)

Results

The results show significant Spearman correlations of psychometric evaluation of erectile function with prolactin (R = 0.50) and results of the trauma checklist score (R = 0.55) as well as significant Spearman correlations between TSC-40 and prolactin (R = 0.52). This result indicates a significant relationship between erectile dysfunction, hyperprolactinemia and stress symptoms in men.

Conclusions

Our result indicates a significant relationship between erectile dysfunction, hyperprolactinemia and stress symptoms in men.

Disclosure

No significant relationships.
Interpersonal autonomic synchrony and sexual satisfaction: A preliminary examination
Authors: Freihart B. , Sears M. , Meston C.
Published: September 2022

Introduction

A growing body of literature has increased our understanding of interpersonal autonomic synchrony (IAS), or exchanges across biological systems resulting in physiological covariation. While research suggests that IAS is more likely in relationships characterized by emotional intimacy, no research to date has examined the connection between IAS and the quality of sexual relationships.

Objectives

The current study seeks to elucidate the relationship between IAS and sexual satisfaction (SS) using tasks that have previously been used to assess synchrony (i.e.,gazing, mirroring), as well as several conversation-based tasks (i.e., neutral and sex-related conversation tasks).

Methods

Couples (n=28) completed procedures in a laboratory-based setting where they completed survey measures of SS before connecting to an electrocardiogram. Subsequently, heart rate (HR) data for each dyad were analyzed using a moderated multi-level modeling approach.

Results

IAS was detected, with men reliably predicting the HR of female partners, and women reliably predicting the HR of male partners (respectively, β=0.383, p<0.001; β=0.222, p<0.001). AIC values indicate a better fitting model for men predicting female HR. As such, moderation analyses were conducted for that model by study task, finding a significant interaction between SS and observed IAS during the mirroring task (β=0.004, p=0.009) and neutral-conversation task (β=0.016, p=0.009).

Conclusions

These findings reflect evidence that IAS may be relevant to SS at the couple-level. The ability of couples to coregulate while attempting to synchronize (as in the mirroring task) or exchange information (as in the neutral-conversation task) may meaningfully change how they experience their sexual relationship.

Disclosure

No significant relationships.
Sexual Assault in the Mahdia Region: Medico Legal Aspects
Authors: Brahim S. , Mesrati M.A. , Henia M. , Kacem M. , Zarrouk L.
Published: September 2022

Introduction

Despite recent legislative changes through the enactment of 2017-58 law on the elimination of violence against women and children, sexual violence remains fairly frequent and is often underestimated.

Objectives

to describe the epidemiological peculiarities of victims of sexual assault in the Mahdia region and to discuss their medico legal implications.

Methods

this is retrospective study of 110 cases of victims of sexual assault examined at the legal medicine department of the TAHER SFAR University Hospital in Mahdia. This work was carried out over the period from January 2016 to August 2018.

Results

the majority of victims were female (80%) and the main vulnerability factor was an age under 15 (26%). The perpetrator was generally unique (74%). Sexual assault by penetration was mostly reported (51% of cases), and was almost exclusively penile (98,2 of cases). The gynecological examination revealed a torn hymn in 43 victims, a compliant hymen without traumatic lesions in 7 victims (8%) and recent vulvar traumatic lesions without hymenal crossing in 5 victims (5,6%). Recent anal penetration was diagnosed in 6 male victims (6,8%). Among female victims, recent anal penetration was diagnosed in 5 victims (22,7%). One in four victims reported a market psychological impact with female predominance in 85% of cases. Complications of the most reported sexual assaults were pregnancy in 7% of cases. In total, only 57,3% of the certificates issued made it possible to conclude that the injuries.

Conclusions

The care of victims of sexual assault requires a multi- disciplinary approach; medical, psychiatric, social and legal.

Disclosure

No significant relationships.
Alternative initiation regimen of paliperidone palmitate long-acting injectable
Authors: Menendez Gil I.E. , Romero Guillena S.L. , Plasencia Garcia De Diego B.O.
Published: September 2022

Introduction

Long-acting injectable antipsychotics (LAIs) hold an important place in the treatment of psychosis. Knowledge of the best way to administer LAIs is important to maximize the efficacy and minimize the side-effects

Objectives

To assess the effectiveness of flexible doses of palmitate paliperidone long-acting injectable (PPLAI) against standard doses in initiation regimen in the subset of acutely hospitalized patients with schizophrenia and other psychosis

Methods

Retrospective, noninterventional study. Group of initiation regimen: A)“Standard-doses” (recommended PPLAI initiation regimen: 150mg-Day-1 and 100mg-Day-8±4days), B)“Low-doses” (any dosage lower than the Standard-dose) C)“High-doses” (150mg-Day-1 and 150mg-Day-8±4days) Effectiveness was measured with the number of psychiatric hospital admission and psychiatric emergency visit 6-months post-discharge. Length of stay of the index hospitalization, adherence to treatment and adverse events was confirmed in the medical record. Concomitant use of biperiden was recorded.

Results

51 patients were included. We found no statistically differences in study variables between groups (Table-1). Table-1.Standard doses(n=31)Low-doses(n=13)High-doses(n=7)Length of stay mean±sd17.23±13.0913.77±9.0217±10.55No psychiatric hospitalizations 6-month post-discharge,
%patients( n)71%(n=22)84.6%(n=11)85.7%(n=6)No psychiatric emergency visits 6-month post-discharge, %patients(n)61.3%(n=19)69.2%(n=9)85.7%(n=6)Prescription of biperiden 6-month post-discharge, %patients(n)13.3%(n=4)0%(n=0)14.3%(n=1)Adherence to treatment 6-month post-discharge, %patients(n)80.6%(n=25)84.61%(n=11)57.1%(n=4)

Conclusions

No differences were found in the effectiveness of flexible-doses in PPLAI initiation regimen. The use of low doses of PPLAI could keep the efficacy of the standard dose with a better side effect profile and treatment adherence. The strength of the conclusion is limited by the design and the number of patients.

Disclosure

No significant relationships.
Immune-related genes are differentially associated with negative symptoms subdomains in patients with schizophrenia
Authors: Golimbet V. , Lezheiko T. , Korovaitseva G. , Kolesina N. , Plakunova V. , Mikhailova V.
Published: September 2022

Introduction

Negative symptoms (NS) are a core feature of schizophrenia. NS show heterogeneity proven by factor analysis, which revealed two distinct negative symptoms subdomains: diminished expression (DE) and avolition/apathy (AA) (Marder et al. 2017, Fleischhacker et al. 2019). Some studies showed the different effects of these subdomains on clinical features of schizophrenia that suggest different pathophysiological mechanisms for their development (Stanculete 2021). It has been also shown that the levels of peripheral interleukins (IL) specifically correlate with NS (Enache et al. 2021), in particular, increased IL levels were determined in patients with deficit syndrome compared to non-deficit schizophrenia (Goldsmith et al. 2018).

Objectives

To search for the association of genes for IL-4, IL-6, IL-10 and C-reactive protein (CRP) with NS subdomains.

Methods

The total sample included 551 patients (women 51,4%, aged 18-72 years) with ICD-10 diagnosis of schizophrenia. NS were assessed by PANSS. PANSS-derived factors include AA (items N2, N4, G16) and DE (N1, N3, N6, G5, G7, G13). Genotyping was performed for the following polymorphisms: C-589T IL-4, C-174G IL-6, C-592A IL-10, G-1082A IL-10, CRP (rs2794521).

Results

There are effects of C-592A IL-10 (p=0.017) and G-1082A IL-10 (p=0.012) on AA subdomain. Post-hoc Bonferroni corrected comparisons show that carriers of the haplotype AA (C-592A)- AA (G-1082A) have the highest AA score. A significant effect of CRP (rs2794521) on AA is identified (p=0.007). There is a trend towards the association of C-589T IL-4 and C-174G IL-6 with AA. No association of these polymorphisms with DE was found.

Conclusions

AA and DE may have different genetic background.

Disclosure

No significant relationships.
Evaluation of the role of lisdexamfetamine on attention-deficit/hyperactivity disorder common psychiatric comorbidities: mechanistic insights on binge eating disorder and depression
Authors: Gutiérrez Casares J.R. , Quintero J. , Rodríguez P. , Montoto C. , Pozo-Rubio T. , Segú-Vergés C. , Coma M.
Published: September 2022

Introduction

Attention-deficit/hyperactivity disorder (ADHD) is a psychiatric condition in which children suffer from inattentiveness, hyperactivity, and or impulsivity. ADHD patients frequently present comorbid psychiatric disorders: in adults, the most common are depression, substance-related disorders, anxiety, and eating disorders. Children and adolescents present conduct disorders, learning disorders, anxiety and depression. Since ADHD and its psychiatric comorbidities share similarities, a partial overlap of their pathophysiological mechanisms has been suggested. ADHD, can be treated with lisdexamfetamine (LDX), a prodrug indicated by the FDA as treatment for binge eating disorder (BED) and ADHD.

Objectives

To evaluate, through a systems biology-based in silico method, the efficacy of LDX as first-line ADHD treatment to improve ADHD psychiatric comorbidities. Furthermore, we explored the molecular mechanisms behind LDX’s action.

Methods

We used the systems biology- and artificial intelligence-based Therapeutic Performance Mapping System (TPMS) technology to characterise and model ADHD comorbidities. Artificial neural networks (ANNs) algorithms were used to identify specific relationships between protein sets. Finally, we modelled the mechanisms of LDX for the most relevant comorbidities by using sampling methods and comorbidity-specific virtual patients in each case.

Results

This study predicts a strong relationship between LDX’s targets and proteins involved in BED and depression (Fig 1). Our results could be explained not only by LDX role in neurotransmitter regulation, but also by modulation of neuroplasticity (BDNF/NTRK2, GSK3), neuroinflammation (interleukins, inflammasome), oxidative stress (NOS2, SOD), and the hypothalamic-pituitary-adrenal (HPA) axis (CRH, CRHR1).

Conclusions

These findings could be used in pre-clinical and clinical future investigations to assess optimal treatment for ADHD patients with psychiatric comorbidities.

Disclosure

JRGC: speaker for Takeda and Shire, research funding from Shire and Lumbeck, collaborations with Laboratoires Servier JQ: speaker or scientific advisor for Takeda, Janssen, Rubio. Investigation funding: Instituto de Salud Carlos III. PR, CM, TPR: full-ti
Impact of ADHD as a Risk and a Treatment Factor in Intimate Partner Violence
Authors: Buitelaar N.
Published: September 2022

Intimate partner violence (IPV) has a very high prevalence (25%) in society and has serious consequences for its victims. As former studies showed minimal effectiveness of therapeutic interventions addressing IPV, the Dutch guideline for Familial/Domestic Violence (NVVP, 2008) recommends to focus more on systemic factors and on individual risk factors of IPV. ADHD is one of these individual risk factors. This presentation focuses on the association between ADHD and IPV, presenting data and clinical examples. ADHD was missed in 56% of a sample of forensic outpatients. Reasons for this issue of underdiagnosis of ADHD in case of aggression and IPV are discussed. Also, data of the ITAP (impact of treatment of ADHD on IPV) study are presented, showing that ADHD in offenders of IPV with ADHD scored higher on minor physical aggression, minor and severe psychological aggression and clinician-rated IPV than offenders without ADHD. Further, after a one year treatment of ADHD and IPV, decrease in IPV was mainly associated with decrease in ADHD symptoms. The importance of screening and treatment of ADHD symptoms in all IPV offenders is discussed to make treatment of IPV more effective.

Disclosure

No significant relationships.
Stroke care in people with and without schizophrenia: a retrospective, observational study
Authors: Quarenta J. , Gonçalves-Pinho M. , Freitas A. , Nascimento Ferreira S.
Published: September 2022

Introduction

Serious mental illness tends to course with a higher prevalence of comorbidities and schizophrenia is a disabling disease that affects approximately 1% of the world population. Worldwide, cerebrovascular accidents are an important cause of mortality and disability and in Portugal they are one of the leading causes of death in the general population. There is growing evidence that the prevalence of strokes is higher in people with schizophrenia, with pronounced age and gender variations.

Objectives

To describe the sociodemographic and clinical differences among patients hospitalized with a primary diagnosis of cerebrovascular disease with and without a secondary diagnosis of schizophrenia in Portugal.

Methods

We performed a retrospective observational study using a natiowide hopitalization database containing all hosptalizations registered in Portuguese hosptals from 2008 to 2015. Based on the International Classification of diseases version 9, clinical modification, hospitalizations with a primary diagnosis of stroke were selected (431;433;434), and from those, the ones with a secundary diagnosis of schizophrenia (295.xx) were isolated for a sociodemographic and clinical comparative study. Comorbidities were analysed using the Chalson index score.

Results

Episodes associated with a secondary diagnosis of schizophrenia were younger (mean: 66 vs 73.7 years; p<0.001) and had longer median LoS (10.0 vs 8.0 days; p<0.001). In-hospital mortality was lower in patients with schizophrenia (11.7% vs 13.2%).

Conclusions

The understanding of the association of cerebrovascular accidents with schizophrenia is complex. Although some studies show conflicting evidence, more attention should be given to the investigation of the incidence, prevalence and impact of cerebrovascular diseases within this particular population.

Disclosure

No significant relationships.
Effect of medical education on European primary care physicians’ knowledge in management of major depressive disorder and psychiatric emergencies
Authors: Thevathasan L. , Fairley L. , Phillips C.
Published: September 2022

Introduction

The challenge for primary care physicians (PCPs) is keeping up to date in managing major depressive disorder (MDD) and psychiatric emergencies.

Objectives

We evaluated whether an online educational video lecture directed at PCPs, could improve knowledge and confidence regarding management of psychiatric emergencies associated with MDD.

Methods

Educational effect was assessed using a 3-question repeated pairs, pre/post assessment survey. A paired-samples t-test was conducted to assess overall number correct and confidence change. A McNemar’s test was conducted to assess question-level significance. P values < 0.05 are statistically significant. Cohen’s d test was used to estimate the magnitude of effect of education. The activity launched on 8 April 2021, and preliminary data analysed as of 24 June 2021.

Results

511 PCPs participated in the programme, of which 86 PCPs completed the pre- and post-assessment test. An average overall correct response rate of 28% pre- increased to 64% post- (129% relative increase, P<0.001; Cohen’s d = 1.13). Knowledge on the burden of suicide and MDD improved from 23% pre- to 87% post- (278% relative increase,P<0.001). Knowledge regarding clinical data for novel therapies for use in psychiatric emergencies improved from 29% pre- to 50% post- (72% relative increase, P<0.01). Knowledge regarding signs of suicidal intent in patients with MDD improved from 31% pre- to 53% (71% relative increase, P<0.001) following education.

Conclusions

This study demonstrates the positive effect of online medical education on PCPs’ knowledge and confidence in contemporary management of psychiatric emergencies associated with MDD in Europe.

Disclosure

The results of this study were derived from an educational programme which was developed through independent educational funding from Janssen Neuroscience
A collaborative, computer-assisted, psychoeducational intervention for depressed patients with chronic disease at primary care: protocol for a cluster-randomized controlled trial
Authors: Rojas G. , Martinez Diaz P.A. , Guajardo V. , Campos S. , Herrera P. , Vöhringer P. , Gomez V. , Szabo W. , Araya R.
Published: September 2022

Introduction

Depression treatment recommendations seldom include chronic illness comorbidity.

Objectives

To describe the rationale and methods for a cluster-randomized trial (CRT) in primary care clinics (PCC) comparing a computer-assisted psychoeducational (CAPE) intervention to usual care (UC) for depressed patients with hypertension or diabetes.

Methods

Two-arm, single-blind CRT in Santiago, Chile. Eight PCC will be randomly assigned to the intervention or UC. A total of 360 depressed individuals aged 18 or older PHQ-9 scores ≥ 15 and hypertension or diabetes will be recruited. Patients with alcohol/substance abuse; current treatment for depression, bipolar disorder, or psychosis; illiteracy; severe impairment; and residents in long-term care facilities will be excluded. Patients in the intervention will receive eight CAPE sessions by trained therapists, structured telephone calls to track progress, and usual medical care for chronic diseases. Psychologists and psychiatrists will regularly supervise therapists. To ensure continuity of care, the PCC team will meet monthly with a research team member. Patients in UC will receive standard medical and depression treatment. Three, six, and twelve months after enrollment, outcomes will be assessed. The primary outcome will be a 50% reduction in baseline PHQ-9 scores at six months. Intention-to-treat analyses will be used.

Results

A previous, small-scale pilot study provided valuable insights for study design.

Conclusions

This study will provide first-hand evidence on the effectiveness of a CAPE for depressed patients with chronic diseases at PCC in a Latin American country.

Disclosure

No significant relationships.
Use of Lamotrigine in the pharmacological management of a lady with longstanding history of Trichotillomania
Authors: Tan J.H. , Gangaram P.
Published: September 2022

Introduction

Trichotillomania is characterized by recurrent pulling of one’s hair despite attempts of stopping, resulting in hair loss. Previously classified as impulse control disorder, it is now considered an obsessive-compulsive related disorder in DSM-5. First-line therapy is cognitive behavioural therapy (CBT), with strong support for habit reversal training. For pharmacological therapy, selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed. Clomipramine has been used but is limited by its side effect profile. Many patients continue to experience distressing symptoms despite current treatment methods.

Objectives

Lamotrigine, an anticonvulsant medication, is frequently utilized by psychiatrists to treat conditions like Bipolar Disorder. However, its utility in treating Trichotillomania has not been explored. We are interested to find out if it could benefit patients who have not responded adequately to current available treatment.

Methods

We report a case of a lady suffering from Trichotillomania for many years with limited improvement despite active treatment. We follow her progress after being started on Lamotrigine for six months.

Results

In our case, a lady with longstanding Trichotillomania has previously been treated with SSRIs and Chlomipramine with limited response. An incidental trial of Lamotrigine after stopping her other medications has led to sustained improvement and stabilization of her condition. A possible hypothesis on how Lamotrigine’s mode of action could have led to this improvement will explored in this paper.

Conclusions

This case illustrates the potential of Lamotrigine to treat Trichotillomania in someone who has not responded adequately to usual treatment and could be an area worth looking into for future research.

Disclosure

No significant relationships.