bluuebunny/crossref_metadata_2025 huggingface dataset:
Transcranial Magnetic Stimulation and Dual Pathology: An Integrative Protocol
Authors: Moleon A. , Alvarez de Toledo P. , Martín-Bejarano M. , Narbona J.
Published: August 2024

Introduction

Dual pathology, characterized by the simultaneous presence of substance use disorders and psychiatric disorders, is a topic of growing interest in the scientific community. In particular, obsessive-compulsive disorder (OCD) is a common comorbid psychiatric condition in patients with substance use disorders.

Objectives

To evaluate the efficacy of rTMS on comorbid disorder symptoms by applying specific protocols for OCD and substance use disorder in a clinical case of dual pathology.

Methods

Case Description: A 36-year-old male diagnosed with OCD and habitual cocaine use (an average of 6 times per month). Previous unsuccessful attempts to quit substance use. Undergoing psychotherapy and psychopharmacological treatment for OCD since the age of 22 with no significant clinical improvement.

Methodology: The severity of OCD was quantified before and after the intervention using the Yale-Brown Obsessive Compulsive Scale (YBOCS). To assess addictive behavior, the Maudsley Addiction Profile (MAP) was used. During the intervention period, the occurrence of substance use was recorded based on the patient’s and family members’ reports. The intervention involved the administration of an rTMS protocol tailored to the specific case, consisting of the simultaneous application, using a double-cone coil, of rTMS at 20Hz over the right dorsomedial prefrontal cortex (DMPFC) at an intensity of 100% of the resting motor threshold (RMT) to treat OCD symptoms, followed by intermittent theta burst stimulation (TBS) over the left DMPFC at an intensity of 120% of the RMT to address substance addiction. The patient received a total of 30 sessions at a rate of one session per day, five days a week, for six weeks.

Results

Results: The results showed an improvement in the total score on the YBOCS scale, decreasing from a value of 26 in the pre-intervention assessment to 16 in the post-intervention assessment, representing a reduction of more than 35% from pre- to post-intervention, meeting response criteria. Thus, there was a decrease in both obsessive and compulsive symptoms, with reduced associated distress and increased control. Additionally, throughout the intervention, there was a gradual decrease in substance use, decreasing from an average of 6 monthly instances before treatment initiation to a total of 1 in the month the treatment ended.

Conclusions

Conclusions: This unique case study represents a therapeutic window for the treatment of patients with comorbid disorders, demonstrating promising preliminary benefits of the combined rTMS intervention for both conditions, especially in the field of addictions.

Keywords: rTMS, neuromodulation, obsessive-compulsive disorder, addictions

Disclosure of Interest

None Declared
Mental disorders in internally displaced persons: clinical features, therapy, prevention
Authors: Maruta N. O. , Panko T. V. , Fedchenko V. Y. , Yavdak I. O. , Semikina O. E.
Published: August 2024

Introduction

Military aggression significantly worsens the mental health of the population due to losses: human, economic-financial, social-psychological, ecological. One of the negative consequences of military aggression is migration, the movement of the population within the country and outside its borders, which disrupts adaptation and leads to the formation of a wide range of psychological and mental disorders.

Objectives

To study the state of mental health of internally displaced persons (IDPs) and to develop, on this basis, a system of therapy and prevention of mental disorders.

Methods

A combination of clinical-psychopathological and psychodiagnostics methods of studying were used to identify peculiarities of the mental state and various forms of mental pathology.

Results

270 IDPs were examined. It was established that the group of IDPs is heterogeneous and includes 3 categories: 1 group of IDPs who do not have signs of mental disorders (conditionally healthy) (34.81%), 2 group of IDPs who have separate symptoms of mental disorders (risk group) (25.19 %) and the 3 group of IDPs with established mental disorders (40.00 %). The assessment of the general condition of the IDPs of the 1 group shows that they have various somato-neurological disorders and the absence of mental disorders. The assessment of the emotional state of the IDPs of the 2 group indicates the presence of various emotional disorders that include asthenic syndrome (41.18 ± 5.97) %, agripnic syndrome (45.59 ± 6.04) %, somato-vegetative syndrom (30.88 ± 5.60) %, anxiety-depressive syndrome (20.59 ± 4.90) %). That separate syndromеs do not meet the criteria of ICD-10 and were subthreshold. The general features of mental disorders in group 3 IDPs are characterized by the predominance of disorders of the anxiety-depressive spectrum and includes adjustment disorders (F43.2) in 35,18%; post-traumatic stress disorder (F43.1) in 17.59%; a moderate depressive episode (F32.1) in 16, 67%; organic affective (depressive) disorder (F06.3) in 14.81%; organic anxiety disorder (F06.4) in 9.28%; recurrent depressive disorder (33.1) in 6.48%.

Conclusions

A system of treatment of mental disorders in IDPs has been developed, which includes pharmacotherapy (the usage of antidepressants, anxiolytics and, if necessary, antipsychotics), cognitive-behavioral and family psychotherapy. For prevention mental disorders among IDPs of groups 1 and 2, a psychoeducational program was created, aimed at forming awareness of clinical manifestations of mental disorders, opportunities to prevent their formation, and necessary actions in conditions of exacerbation of the mental state. Evaluation of the effectiveness of the developed system of therapy and psychoeducation has testified to their effectiveness.

Disclosure of Interest

None Declared
The feasibility of a combined approach including neuromodulation by tDCS and cognitive remediation for people with borderline personality disorder (BPD)
Authors: Cailhol L.
Published: August 2024

Introduction

BPD is a common and severe mental health condition. Longitudinal studies related to BPD show a reduction of symptoms related to the disorder but very little improvement in functionality. The betterment of executive functions of people with BPD after psychotherapy is very limited. The efficacy of those treatments on functionality appears to be mild with a small effect size. Based on previous studies, transcranial direct current stimulation (tDCS) can be used to improve impulsivity and emotional instability in patients with BPD. Moreover, cognitive remediation focuses on reducing neuropsychological alterations by re-educating patients and apply specific strategies to aid them long term on certain daily functions like developing healthy habits, executive functions, problem solving, attention, working memory and cognition.

Objectives

Our objective is to assess the feasibility and efficacy of the tDCS and cognitive remediation on BPD symptoms and functioning.

Methods

The open study includes 10 daily sessions of tDCS for 2 weeks and 8 weekly group meetings for the cognitive remediation. Based on studies conducted on people with BPD, the settings for the tDCS are as follows; 20 minutes of continuous current at the intensity of 2mA and the electrodes are placed on specific stimulation sites related to impulsivity. To verify the effectiveness of the combination on the symptoms and evaluate the cognition and functionality of the patients, questionnaires at neuropsychological texts are conducted at the beginning of the study, after the tDCS, after the cognitive remediation and 3 months after the end of the study. The expected results of this study are that the combination of the two treatments will reduce the symptoms of BPD and improve executive functions compared to the treatment as usual or tDCS alone. This study would allow the implementation of an efficient and low-cost first-line treatment and a better functional progression of BPD patients.

Results

The expected results of this study are that the combination of the two treatments will reduce the symptoms of BPD and improve executive functions compared to the treatment as usual or tDCS alone. This study would allow the implementation of an efficient and low-cost first-line treatment and a better functional progression of BPD patients.

Conclusions

This study would allow the implementation of an efficient and low-cost first-line treatment and a better functional progression of BPD patients.

Disclosure of Interest

None Declared
Advancing Psychiatric Education: Leveraging Simulated Patients and Actors at the University of Pécs “Shame dies when stories are told in safe places”
Authors: Fekete J. D. , Simon M. , Voros V. , Tényi T. , Hambuch A. , Nagy A.
Published: August 2024

Introduction

The integration of simulated patients and actors (SPs) into psychiatric education has long been recognized as a transformative pedagogical approach, yielding substantial benefits to healthcare students and professionals.

Objectives

The aim of this investigation was to evaluate the SP methodology and to refine it for future implementation in psychiatric education at the University of Pécs, Hungary.

Methods

To investigate the feasibility and utility of incorporating SPs into psychiatric education, we conducted a preliminary study involving participants from the German Program in the University of Pécs, Hungary. This group consisted of 16 medical students in their 5th year of study. The study design involved participants forming groups of three, engaging in psychiatric interview with SPs. After the interview, SPs provided feedback from patient’s perspective, articulating their emotional responses. These sessions lasted 60 to 90 minutes.

Results

Study participants expressed a range of apprehensive feelings, including inadequacy, the desire for correct performance, and acknowledgment of the emotional challenges involved. Another recurring issue was the students’ initial confidence contrasting with their later realization of subpar performance. A subset of students voiced concerns related to performance anxiety, particularly in light of being observed. Nevertheless, by the culmination of the course, students spontaneously recognized and valued the enriching nature of the experience. Pre-existing skills have been confirmed authentically by the feedback of the SP.

Conclusions

Psychiatry, given its intricate and sensitive nature, necessitates a secure and controlled learning environment. SPs precisely provide this environment, facilitating the exploration of a broad spectrum of psychiatric disorders, emotional states, and patient interactions, all while upholding patient safety and confidentiality. Additionally, this methodology promotes the development of essential skills, including empathetic communication, the cultivation of therapeutic relationships. Moreover, the adaptability of SPs enables the creation of diverse scenarios reflecting real-world practice. Our preliminary findings and student feedback have provided a promising foundation for the design of a forthcoming pilot program in the next academic year. The integration of SPs into psychiatric education presents a dynamic, immersive, and highly effective approach, capable of markedly enhancing the quality of training.

Disclosure of Interest

None Declared
Motivation to Motivate: Pilot of motivational interview training in a tertiary university hospital
Authors: Corrigan K. , Crudden G. , Clarke A. M. , Doherty A.
Published: August 2024

Introduction

Motivational interviewing (MI) is an evidence-based communication style that is effective in facilitating behaviour change and patient engagement. Originally developed in the field of addiction, MI can be applied to address a range of health behaviours including smoking cessation, medication adherence and diabetes and weight management. Given its demonstrated efficacy, training clinicians in medical and psychiatry specialties in MI has potential to enhance patient outcomes.

Objectives

1. Enhance awareness and understanding of the basic concepts and methods of MI among NCHDs (Non-Consultant Hospital Doctors) and hospital staff.

1. Assess the perceived effectiveness of the training and help foster a culture of teaching and learning within the hospital.

Methods

MI training was organised by the psychiatry department and delivered by a certified external trainer. The training was structured into 2 sessions, each lasting three hours, with a six-week gap between sessions. The training was integrated into the regular academic teaching for psychiatry trainees and a circular email invite was sent to the medical NCHD cohort and psychology department. Pre and post-training questionnaires were collected from participants with five-point Likert scales used to gather responses

Results

There were 40 attendees across the two sessions. In total, 25 questionnaire responses were collected for the pre training (62.5%) and 30 responses were collected post-training (75%).

Prior to training 48% (12/25) indicated they were familiar with MI, 48% felt confident in using MI and 88% (22/25) felt it was applicable to their practice. Post-training, 73% (22/30) felt confident in using MI, 90% (27/40) felt MI was applicable to their practice and 100% indicated they would use MI in their practice. The perception of applicability (p=0.011) and likely utilisation of MI skills (p<0.001) significantly increased over the course of the training as measured by paired t-test (n=23). Ninety-seven percent of responders stated they would recommend the training and 57% (17/30) indicated that they would use MI on a weekly basis in the future.

Conclusions

NCHDs and other staff welcomed this training and indicated the training was relevant to their practice. MI demonstrated a positive effect on staff perceptions of applicability and future utilisation of MI skills. Increasing clinician self-perceived efficacy through training events may help contribute to a culture of learning and teaching in hospital settings.

Disclosure of Interest

None Declared
Evaluating the role of autistic traits and sensory sensitivity in eating disorders and autistic-like eating behaviours
Authors: Ingrosso G. , Nistico’ V. , Lombardi F. , Morlacchi B. , Cigognini A. C. , Faggioli R. , Mottaran A. , Tramontano M. , Ranzini L. , Redaelli C. A. , Anselmetti S. , Bertelli S. , Gambini O. , Demartini B.
Published: August 2024

Introduction

In recent decades, there has been extensive research on the association between Autism Spectrum Disorders (ASD) and Eating Disorders (ED), as well as the existence of sensory sensitivity alterations in both diagnostic groups.

Objectives

The present study aimed to examine the presence of autistic traits in a sample of adult women diagnosed with different ED, and the concurrent role of autistic traits and sensory sensitivity in both their eating disorder symptomatology and their autism-related eating behaviours.

Methods

Seventy-five women with different ED completed the Eating Attitude Test (EAT-26), the Autism Quotient (AQ), the Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R), the Sensory Perception Quotient - Short Form 35 item (SPQ-SF35) and the Swedish Eating Assessment for Autism Spectrum Disorders (SWEAA), which investigates specific eating behaviour related to autism.

Results

12% of the sample scored above the cut-off at both the AQ and the RAADS-R, while 68% scored above the cut-off at the RAADS-R only. We found an association between: i) hypersensitivity in the taste domain and ED severity and autistic-like eating behaviours; ii) hypersensitivity in the vision domain and autistic-like eating behaviours; iii) higher autistic traits and ED severity and autistic-like eating behaviours.

Conclusions

This study confirms the presence of autistic traits in patients with ED and underscores the significance of conducting additional systematical investigations on this topic across all diagnostic categories of ED. It is becoming progressively evident that identifying and measuring the levels of autistic traits in patients with ASD is crucial not only for a better understanding of the causes of these disorders, but also because it would help to tailor specific therapeutic interventions, especially considering the cognitive flexibility issues presented by these patients and the socio-emotional challenges they face. Additionally, this study has laid the foundation for further insights into the relationship between sensory sensitivity and dysfunctional eating behaviours typical of ED and ASD.

Disclosure of Interest

None Declared
Improving mental wellbeing among families and friends of people with alcohol and drug use issues in Darwin, Australia
Authors: Tari-Keresztes N. , Armstrong N. , Gupta H. , Smith J. A. , Endemann S.-A. , Goding S.
Published: August 2024

Introduction

Families and friends of individuals with alcohol and other drug use (AOD) issues are highly stigmatised and vulnerable, which often leads to social isolation, decreased quality of life, psychosocial vulnerability, heightened distress, less access to social support, and development of maladaptive coping strategies and own mental health challenges and/or AOD use issues. While peer support for families is commonplace in Australia, in Darwin, psychosocial support activities delivered by peers are very sparse.

Objectives

The NT Lived Experience Network (NTLEN), in allyship with a team of researchers from Flinders University, has secured multiple fundings aimed to develop, implement, and evaluate a peer education and recovery program called Circles of Support (CoS) for families and friends of persons with AOD use issues.

Methods

The suitable evaluation approach was co-designed with live experience representatives from NTLEN and other local key stakeholders. It applied a mixed-method approach, including pre and post-program surveys (n=26) and individual interviews with program participants and the program delivery team (n=11). We also used a co-design approach to develop survey instruments to ensure they were strengths-based and recovery-oriented.

Results

While most participants showed sound stress management skills and understanding of stressors at the program start, about 30% did not think they could handle distress if it got worse and did not have the tools to live the life they wanted. Also, about 25% did not know when to ask for help. Many participants (40%) expressed that they were not hopeful about possible changes in their own family context, such as fewer experiences of stress. By the end of the program, participants reported lower stress levels and higher total empowerment scores. The qualitative interviews highlighted the complexities and challenges participant faced in their journeys. Among them, stigma was considered the most critical, especially among participants from culturally and linguistically diverse backgrounds. In some cases, perceived stigma prevented participants from joining the program. The program was well-received and successful in empowering families and friends and improving their own mental wellbeing. Their key learning and experiences included identifying the stage of their situation, learning to cope with challenges, reducing stress, developing hope, experiencing growth, creating a better and more supportive relationship with their loved ones, and implementing self-care on a regular basis.

Conclusions

Our findings emphasise the critical role of peer support for families and friends in improving their mental health and wellbeing. They also draw attention to improving help-seeking behaviours, which may be influenced by stigma, shame and prioritising the person’s needs.

Disclosure of Interest

None Declared
Effectiveness of “Mom Supports Mom” Peer Support Intervention in Reducing Prenatal Anxiety and Psychosocial Stress Levels
Authors: Hrdličková K. , Horáková A. , Kuklová M. , Němcová H. , Knytl P. , Kostýlková L. , Šebela A.
Published: August 2024

Introduction

The prenatal period poses a risk of both onset and relapse of mental health difficulties. Anxiety and depressive symptoms are the most common, with a prevalence of 10-20%. Untreated mental health difficulties can have serious consequences for the child’s development, the quality of the mother-child relationship, and the whole family system. Peer support can be an effective form of care for women at risk.

Objectives

The aim of the study is to examine the effectivness of remote “Mom Supports Mom” peer support intervention in reducing prenatal anxiety, depression and psychosocial stress levels.

Methods

A randomized controlled trial was conducted. The Edinburg Postnatal Depression scale (EPDS) was used to assess the risk of mental health difficulties in pregnant women. Women with EPDS score ≥ 10 were randomized 1:1 to control and intervention groups. The intervention group received the “Mom Supports Mom” peer support intervention. The control group received care as usual. Between group-differences in anxiety, depression and psychosocial stress levels were measured one month after the enrollment/the start of the intervention. The Perinatal Anxiety Screening Scale (PASS), the Edinburg Postnatal Depression Scale (EPDS), and the Prenatal Psychosocial Profile (PPP) were used to assess the mental health difficulties.

Results

The study involved a total of 67 participants in the intervention group, and 77 participants in the control group. Levels of anxiety (U = 2016, P < 0.05) and psychosocial stress (U = 1862, P = 0.001) were significantly decreased in the intervention group, showing a medium effect size of the intervention (Cliff’s delta= -0.218 and -0.317, respectively). There was no significant difference in depression levels (U = 2288.5, P = 0.243; Cliff’s delta = -0.113); see Table 1.
Table 1

Between group differences in study outcomes (n=144)

Measuring instruments
Intervention group (n=67) Median (IQR)Intervention group 95% Confidence Interval
Control group
(n=77) Median (IQR)
Control group 95% Confidence Interval
U value / t valuep-value
EPDS (pre)13 (4)12.513.913 (4)12.814.22429.50.545PASS (pre)36 (17)32.038.036 (15)34.039.50.8460.399PPP (pre)18 (4)17.820.317 (6)16.918.82282.50.233EPDS (dif
)-6 (6)-6.7-4.1-5 (6)-5.4-3.02288.50.243PASS (dif
)-7 (11)-12.3-6.8-5 (13)-7.3-2.420160.024PPP (dif
)-2 (4)-4.0-1.60 (4)-1.20.518620.001

EPDS = Edinburg Postnatal Depression Scale

PASS = Perinatal Anxiety Screening Scale

PPP = Prenatal Psychosocial Profile

pre = administered at baseline

dif = administered post-intervention

IQR = interquartile range

Conclusions

The remote “Mom Supports Mom” peer support intervention can be effective in reducing anxiety and psychosocial stress levels in at-risk pregnant women. Nevertheless, it didn’t show effectivness in reducing depression levels.

Disclosure of Interest

None Declared
Evolution of Depression and Anxiety among Breast Cancer Patients: a prospective analysis using clinical, biological and genetic factors
Authors: Khoury R. , Hachem R. , Salameh P. , Sacre H. , Bedran M. , Rabbaa L. , Chahine G. , Kattan J. , Nasr F. , Hajj A.
Published: August 2024

Introduction

Numerous studies have explored the symptoms and course of depression and anxiety in breast cancer patients and identified various clinical, sociodemographic, and genetic factors associated with their evolution. Nevertheless, these studies have been limited in duration and have focused on specific time points during chemotherapy or post-treatment follow-up. Furthermore, these studies included patients receiving different treatment regimens and used different tools to assess symptoms.

Objectives

To assess the prospective evolution of depression in breast cancer patients over eight consecutive chemotherapy cycles, taking into account sociodemographic, clinical, biological, and genetic factors.

Methods

A prospective longitudinal study was conducted on 69 breast cancer patients treated with intravenous chemotherapy at the oncology outpatient unit of the Hôtel-Dieu de France hospital (2017-2019; Ethics: CEHDF1016). The Hospital Anxiety and Depression Scale (HADS) was used to evaluate anxiety and depression in patients. Genotyping was performed for several genes (ABCB1, COMT, DRD2, OPRM1, CLOCK, CRY2, PER2) using the Lightcycler® 2.0 (Roche).

Results

Univariate repeated measures analysis showed differences in the evolution of depression and anxiety over time. For depression, a polynomial linear contrast for HADS-D scores was noted from cycle 1 to cycle 8, with a significant increase in depression at cycles 7 and 8 compared with cycle 1 (p-value
cycle7=0.004 and p-valuecycle8=0.009; Figures 1 & 2). Repeated measures analysis for anxiety showed a decrease in anxiety scores between cycles 1 and 6 of chemotherapy, followed by an increase starting cycle 6 (a polynomial trend for contrasts) (p-value
cycle6 versus 1=0.038; Figures 1 & 2). Multivariable analysis showed that higher anxiety and depression scores at baseline were both associated with higher depression and anxiety scores over time. Other clinical and genetic factors, including polymorphisms in the OPRM1,
PER2,
and COMT genes, were also significantly associated with higher depression and anxiety scores.

Image:

Image 2:

Conclusions

Our findings highlight the importance of understanding the trajectories of depression and anxiety over time in women with breast cancer and identifying the triggering factors. Such personalized approaches would improve patient quality of life.

Disclosure of Interest

None Declared
The relationship between parental reflective function, cognitive emotion regulation and parental perception of the infant
Authors: Hunyadi K. , Miklósi M. , Szabó B.
Published: August 2024

Introduction

The literature indicates that parental reflective functioning (PRF) is crucial to a good parent-child relationship. Furthermore, genuine parental mentalizing also promotes adaptive emotion regulation in attachment relationships. However, no prior study assessed the relationship between parental mentalizing, emotion regulation and object relation in the early years.

Objectives

We examined the relationship between PRF, cognitive emotion regulation and perception of the infant among parents of children up to five years old.

Methods

In our cross-sectional, non-clinical study, 136 parents completed the Parental Reflective Functioning Questionnaire, the Cognitive Emotion Regulation Questionnaire and the Mother’s Object Relationship Scale - short form. In our 12 moderator models, we chose the subscales of the parental perception of the infant (invasiveness and warmth) as dependent variables, the subscales of adaptive and non-adaptive strategies of cognitive emotion regulation as independent variables, and the three subscales of PRF (pre-mentalization, interest and curiosity, certainty about mental states) as moderators.

Results

Warmth had a positive, weak correlation with adaptive strategies (r(134) = 0.27, p < 0.007), with certainty in mental states (r(134) = 0.24, p < 0.007) and interest and curiosity (r(134) = 0.23, p < 0.007); the correlation between interest and curiosity and non-adaptive strategies was moderate and positive (r(134) = 0.32, p < 0.007). None of the subscales of PRF moderated the relationship between the subscales of emotion regulation and the perception of the infant. The use of adaptive emotion regulation strategies was more likely to affect the perception of warmth (B = 0.05 (t = 2.0584, p = 0.0415), B = 0.04 (t = 1.7887, p = 0.0760)), and the use of non-adaptive strategies was more likely to affect the perception of invasiveness (B = 0.08 (t = 2.1333, p = 0.0348), B = 0.09 (t = 2.3164, p = 0,0221).

Conclusions

Our results suggest that cognitive emotion regulation plays a role in object relation; therefore, we recommend promoting adaptive cognitive emotion regulation strategies among mothers in the early years.

Disclosure of Interest

None Declared
Cardiovascular risk associated with chronic treatment of paliperidone, olanzapine, risperidone and aripiprazole
Authors: Montejo A. L. , Bermejo C. , Matías J. , Martín T. , Matías-Polo J. , Santana Y. , López-López J. , de Alarcón R. , Acosta J. M.
Published: August 2024

Introduction

Weight gain, QT interval prolongation, and dyslipidemias associated with the chronic use of some antipsychotic medications can explain a higher prevalence of cardiovascular risk in these psychiatric population. The D’Agostino Index include some factors such as age, total cholesterol, high-density lipoproteins, systolic blood pressure increased, antihypertensive treatment, smoking, and diabetes, to estimate an individual’s risk (low, moderate or severe) of developing a cardiovascular event through a period of 10 years or throughout the patient’s lifetime.

Objectives

To compare the degree of cardiovascular risk using the D’Agostino Index, among different antipsychotic medications.

Methods

An estimation of cardiovascular risk (low, moderate, or high) was performed with the D´Agostino index in a sample of 144 patients (82 men and 62 women) mean age 45,2 +/- 10.13. All patients were treated for at least one year at a therapeutic dose and adhered to their treatment regimen correctly. Subjects with some relevant pre-existing unstable heart disease were excluded. All patients previously provided informed consent and were of legal age. Clinical data on medical history, concomitant medications, and risk factors were collected. A completed physical exam, waist circumference, lab sample, a lifestyle scale, and an evaluation of vital signs in accordance with European Society of Hypertension were evaluated. Statistical analysis was carried out using the statistical software SPSS version 26.0. A significance level α=0.05 was considered throughout the study.

Results

The four most consumed antipsychotics were risperidone 9.72% (n=14), paliperidone 25.7% (n=37), olanzapine 14.6% (n=21), and aripiprazole 34.7% (n=50). Descriptively, it was observed that the drugs most associated with moderate or high risks were paliperidone (37.8%) and olanzapine (33.3%), risperidone (28.6 %). Aripiprazol (22%) was the less associated compound with moderate/high cardiovascular risk.

Conclusions

Subjects treated with olanzapine and paliperidone showed a higher association with cardiovascular risk. Predicting cardiovascular risk could provide individual benefits by enabling lifestyle modifications, pharmacological treatment changes, or closer monitoring to reduce cardiovascular risk.

Disclosure of Interest

A. Montejo Grant / Research support from: This study has been funded by the Instituto de Salud Carlos III (ISCIII) through the project PI19/1596 and co-funded by the European Union., C. Bermejo: None Declared, J. Matías: None Declared, T. Martín: None Declared, J. Matías-Polo: None Declared, Y. Santana: None Declared, J. López-López: None Declared, R. de Alarcón: None Declared, J. Acosta: None Declared
Easy access to youth mental health services in the Netherlands
Authors: Van Amelsvoort T.
Published: August 2024

Mental health problems have increased following the pandemic and are associated with considerable health, economic and societal outcomes, particularly affecting youth. In co-creation with young people several European prevention and early intervention strategies to promote mental wellbeing of youth are currently being developed. The development and implementation of easy-access youth mental services across Europe will be presented and discussed. In addition pilot data of online, hybrid treatment platforms and self-management ecological momentary intervention apps will be presented. Ultimately the aim is: 1) to develop clinical guidelines, best practices, and policy recommendations to mitigate the youth mental health challenges and 2) improve (cost-) effectiveness of early intervention strategies for promotion and prevention in mental health, including enhancing mental health literacy, resilience and self-management, while 3) actively involving young people in the process of these innovative developments. To amplify the reach, campaigns designed in co-creation with young people, to increase awareness, literacy, wellbeing and help-seeking among young people, targeting schools, further-education colleges, universities and other specific settings will need to be developed, specifically paying attention to high-risk groups within this young population, including children of parents with mental disorders, migrants, young people growing up in poverty, those in/leaving care, and the LGBTQ+ community, with coordination across domains: schools, general practitioners, and specialized mental healthcare facilities.

Disclosure of Interest

None Declared
Retrospective Assessment of Metabolic Syndrome and Cardiovascular Disease Risk Following Monthly and Three-Month Long-Acting Paliperidone Palmitate Treatment in Schizophrenia
Authors: Ispir S. N. , Yıldız E. , Demirel H. R. , Söylemez H. , Aydın M.
Published: August 2024

Introduction

Patients with schizophrenia exhibit a higher prevalence of metabolic syndrome and cardiovascular diseases compared to the general population, resulting in increased mortality rates. The extent of this risk may vary based on the specific treatment employed.

Objectives

This study aims to compare the risk assessments of metabolic syndrome and cardiovascular diseases in schizophrenia patients who transitioned from monthly long-acting paliperidone palmitate (PP1M) treatment to three-month long-acting paliperidone palmitate (PP3M) treatment during both treatment periods.

Methods

The research was conducted at the Psychiatry Clinic and Psychotic Disorders Outpatient Clinic of Selcuk University Faculty of Medicine. Eligible participants included patients under PP3M treatment for a minimum of 6 months and undergoing continuous monitoring in the psychotic disorders outpatient clinic. Sociodemographic and clinical data, scales, laboratory values, and measurements taken both before and during the use of PP3M and PP1M were retrieved from file records, encompassing assessments, analyses, and examinations conducted in accordance with the “Psychotic Disorders - Treatment Monitoring Protocol.” Ethical approval was obtained from the Selcuk University Ethics Committee.

Results

Among the 31 patients transitioning from PP1M to PP3M treatment, 15 (48.4%) were female. The mean age of the patients was 44.4±14.4 years. No statistically significant differences were observed in the mean values of clinical evaluation and side effect assessment scales, body mass index (BMI), waist-to-hip ratio, systolic blood pressure, glucose levels, cholesterol levels, prolactin levels, and thyroid-stimulating hormone (TSH) measurements between the pre- and post-treatment phases (p>0.05). However, a significant difference was identified in the mean Qrisk3 values, a cardiovascular risk index, in two distinct measurements (10-year risk score: PP1M 3.7±4.2 and PP3M 4.6±4.8, p=0.003).

Conclusions

Our study, designed to investigate the impact of the monthly and three-month long-acting formulations of the same antipsychotic drug on patients’ clinical status, side effects, and general health parameters, found that PP3M treatment did not significantly differ from PP1M treatment in terms of Qrisk3 values. Despite the lack of statistical significance between the parameters used in Qrisk3 calculation, the observed significant difference in Qrisk3 values is attributed to variations in age. In order to promote the widespread adoption of long-acting treatments in schizophrenia management, clinicians should engage in comprehensive comparative studies assessing both efficacy and side effects.

Disclosure of Interest

None Declared
Comparative analysis of self-stimulatory behaviors in ASD and ADHD
Authors: Oroian B. A. , Costandache G. , Popescu E. , Nechita P. , Szalontay A.
Published: August 2024

Introduction

The phenomenon of self-stimulatory behaviors, commonly referred to as “stimming,” presents a fascinating avenue of exploration within the context of neurodevelopmental disorders. While stimming behaviors are widely associated with ASD, there is emerging evidence suggesting that individuals with ADHD may also engage in similar behaviors. This study seeks to undertake a comprehensive investigation of the neurophenomenology of stimming in individuals diagnosed with ASD and ADHD, aiming to discern potential shared and distinctive characteristics.

Objectives

The principal objective of this research is to conduct an intricate neurophenomenological analysis of stimming behaviors in cohorts diagnosed with ASD (n=60) and ADHD (n=60), with a concurrent control group of neurotypical individuals (n=60). The study aspires to delineate the prevalence, typology, and neurophysiological underpinnings of stimming behaviors in both ASD and ADHD populations. Moreover, this study endeavors to identify whether particular stimming behaviors exhibit differential prevalence or intensity between the two disorders.

Methods

Participants underwent rigorous neurophenomenological assessments, incorporating structured interviews, validated self-report questionnaires and direct observations. Diagnostic confirmation was established through the administration of gold-standard instruments, such as the Autism Diagnostic Observation Schedule (ADOS-2) for ASD and the Conners’ Parent Rating Scale for ADHD. Stimming behaviors were meticulously categorized (e.g., motor, vocal, sensory) and scrutinized for quantitative metrics, including frequency, duration, and complexity.

Results

Preliminary analyses have uncovered profound disparities in the manifestation of stimming behaviors between ASD and ADHD cohorts. Individuals with ASD displayed a significantly higher prevalence of stimming behaviors, with motor stimming predominating, followed by vocal and sensory manifestations. In contrast, individuals with ADHD exhibited a comparatively reduced frequency and intensity of stimming, primarily within the motor domain, albeit notably less elaborate. Control group participants exhibited a negligible occurrence of stimming behaviors.

Conclusions

This multidimensional exploration illuminates the nuanced neurophenomenological distinctions in self-stimulatory behaviors between ASD and ADHD. Stimming emerges as a pivotal feature in ASD, while its presence in ADHD, though discernible, is markedly attenuated. This study’s findings hold implications for precise diagnostic delineation and the prospect of personalized interventions for these complex neurodevelopmental conditions. Future avenues of research may delve into the neural substrates underpinning stimming behaviors, further enhancing our comprehension of these phenomena.

Disclosure of Interest

None Declared
“Scan Me!”: a rehabilitation approach at the intersection between digital interventions and mountain-therapy
Authors: Barbieri A.
Published: August 2024

Introduction

Mountain-therapy is a therapeutic-rehabilitative approach aimed at secondary prevention, treatment, and rehabilitation of individuals with different pathologies or disabilities. Interventions in this field are based on potentially transformative dimensions of the mountain environment. Activities can include trekking, climbing, hiking, speleology, and winter sports. Benefits associated with these interventions are related to physical health as well as to rehabilitation in the domain of mental health and to the promotion of healthier lifestyles.

Objectives

The pilot project named “Scan Me!” has been developed by mental health services (Centro Diurno) of Cuneo (Italy), drawing on their long-standing experience with Mountain-therapy. The aim was to improve the efficacy of mountain-based activities, introducing elements of digitalisation able to actively engage service users and the broader community.

Methods

“Scan Me!” introduces an innovative activity of mapping, communicating, and digitising the mountain environment. The intervention includes: i) participatory identification of thematic areas (e.g. history of a place; local biodiversity; ancient practices); ii) exploration of the identified areas through readings, interviews and research; iii) preparing of messages (texts, pictures, videos) that the group wishes to convey; iv) creation of QR-codes containing the messages; v) positioning of QR-codes along mountain trails during dedicated excursions; vi) setting up of online surveys to get feedback from QR-codes’ users; vii) group discussion of feedbacks and the overall experience. The project includes monitoring and evaluation tools, such as activity forms (filled in with observational data by mental health professionals), self-administered questionnaires for participants, and engagement indicators.

Results

Findings show that the project enhances the therapeutic-rehabilitative value of mountain-based activities, such as increased self-esteem and self-efficacy that follow the completion of a route and relational skills developed within a group. The project shows encouraging results in the planning ability area (identification of themes, setting up of messages, creation and positioning of QR-codes). Being rooted in participants’ interests, the project promotes service users’ knowledge, its sharing with the group and with the general public (mountain visitors). Furthermore, the project implies group reflection, commitment to a concrete objective, and attunement with the recipients of messages (which needed to be tailored for heterogeneous audiences – e.g.: hikers, students, tourists). Lastly, the project is youth-friendly, allowing services to engage a group they aim, but often struggle, to reach.

Conclusions

The pilot encourages further research to understand the potential of rehabilitation tools at the intersection between nature-based and digital mental health interventions.

Disclosure of Interest

None Declared
The impact of family communication patterns on parent-child attachment and child quality of life
Authors: Békefi A. Z. , Miklósi M. , Szabó B.
Published: August 2024

Introduction

Previous research has demonstrated stable patterns of family communication. The Revised Family Communication Pattern Instrument (RFCP) is a common measure of these patterns. It posits two orientations: conformity orientation, characterized by a tendency to seek agreement within the family and by authoritarian decision-making; and conversation orientation, characterized by shared decision-making with the child and frequent family discussion.

Objectives

The primary aim of our research was to adapt the RFCP questionnaire to the Hungarian language. Based on previous research, we hypothesized a negative relationship of conversation orientation and a positive relationship of conformity orientation with parents’ mentalizing problems, parental stress and burnout. According to our hypothesis, conformity orientation would predict both attachment anxiety and avoidance, whereas conversation orientation would decrease attachment anxiety.

Methods

Parents of children aged 6–17 (N=269, female=86,2%, mean age=42,64 [SD=6,10] yrs) completed the following online questionnaires: Child Quality of Life Questionnaire (ILK) parent version, Reflective Function Questionnaire (RFQ-8), Experiences of Close Relationships Questionnaire (ECR-RS), Parent Burnout Questionnaire (PBA-HUN), Perceived Stress Questionnaire (PSS) and the RFCP instrument. We conducted a confirmatory factor analysis. Linear regression analyses predicting attachment anxiety and avoidance included two factors of the RFCP, the RFQ-8, the PBA-HUN, and the PSS total score, as predictors. In addition, two factors of the ECR-R were included in the linear regression analyses predicting quality of life.

Results

The confirmatory factor analysis confirmed the original two-factor structure of RFCP (χ2=5482.21, df=325 p< .001, χ2/df=16.86, CFI=0.91, TLI=0.90, RMSEA=0.075 (90% CI 0.068–0.082)) and their internal reliability (Cronbach’s alpha = .78 and .74). Attachment avoidance (R2=0.12, F(5)=7.38, p< .001) was only predicted by conversation orientation (β=−0.28, p< .001), while attachment anxiety was predicted (R2=25.2, F(5)=17.7, p< .001) by conformity orientation (β=0.24, p< .001), parental mentalization difficulties (ß=0.20, p< .001) and parenting stress (β=0.15, p= .015). Parental report of the child’s quality of life was predicted most strongly by attachment anxiety (β=−0.28, p< .001), followed by conversation orientation (β=0.21, p< .001) and attachment avoidance (β=−0.18, p< .001, R2=28.8, F(7)=15.17, p< .001).

Conclusions

The Hungarian version of the RFCP questionnaire has proven to be a reliable questionnaire. The importance of family communication patterns is demonstrated by the fact that it explains both the quality of parent-child attachment and the parent’s report on the child’s quality of life.

Disclosure of Interest

None Declared
Exploring the role of the immune-neuroendocrine interplay during affective episodes and euthymia in bipolar patients to seek for a reliable biological signature of the disease
Authors: Berry A. , Di Vincenzo M. , Collacchi B. , Giona L. , Giannini A. , D’Amico D. , Cirulli F. , Cirino A. , Luciano M.
Published: August 2024

Introduction

Bipolar disorder (BD) is characterised by heterogeneous phenotypic manifestations that may affect the achievement of a timely diagnosis delaying its therapeutic management. Increased circulating levels of pro-inflammatory cytokines and cortisol (CORT) have been observed in BD patients in addition to decreased levels of Brain-Derived-Neurotrophic Factor (BDNF) suggesting that the interaction among these mediators may play a role in the occurrence of affective episodes overall disrupting brain plasticity. However, knowledge on BD etiopathogenesis is still limited, including the causal relationship with inflammatory and neuroendocrine markers.

Objectives

To assess whether variations in peripheral neuroendocrine and inflammatory markers during acute phases of the disease and euthymia might predict the occurrence of affective episodes; to evaluate whether the interplay among these biomarkers might be exploited as a signature of BD.

Methods

We are currently recruiting BD patients during depressive or manic/hypomanic phases together with age- and sex-matched healthy controls (CTRLs). Complete blood count, pro-inflammatory, anti-inflammatory cytokines and BDNF will be assessed in serum; salivary cortisol awakening response test will be used to evaluate hypothalamic-pituitary-adrenal axis activity. MADRS, YMRS and HAM-A will be used to assess psychiatric symptoms, PSP and C-SSRS for global functioning and suicidal risk, IPSS and SRRS for stress levels and CIRS to evaluate physical comorbidities. All assessments will be carried out at the time of recruitment (T0) and after 3 (T1) and 6 (T2) months.

Results

Data have been so far collected on 28 BD patients (18 males, 10 females, age: 48.31±11.3) and 26 CTRLs (16 males, 10 females, age: 46.82±10.86). At T0, BD were characterised by a greater total number of white cells (7.83±1.86 BD vs. 6.78±1.87 CTRL, p<0.05), mean number of neutrophils (4.89±1.49 BD vs. 3.92±1.45 CTRL, p<0.05) and neutrophil/lymphocyte ratio (NLR) (2.52±1.1 BD vs. 1.9±0.69 CTRL, p<0.05). Moreover, BD patients showed overall a greater BMI (30.5±6.6 BD vs. 24.45±3.86 CTRL, p<.001). No difference was observed among groups with respect to sex and age.

Conclusions

Although preliminary, these results suggest that the active phases of BD are associated with a low-grade inflammatory state, potentially related to a different metabolic set-point in BD patients. Ultimately, this study will allow us to evaluate whether the presence of affective symptoms is correlated with fluctuations in the levels of inflammatory mediators, salivary cortisol and BDNF and to establish a reliable and highly predictive BD signature.

“Funded by: Bando Ricerca Indipendente ISS 2021-2023 to A. Berry project code ISS20-9286e4091f8e”

Disclosure of Interest

None Declared