bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing possible moderators on the association between frequency of contact with non-cohabitating adult children and depressive symptoms among community-dwelling older adults
Authors: Noh J. , Roh H. W. , Rho Y. , Kim M. , Beon J.
Published: August 2023

Introduction

With the increase of older adult population, late life depression is emerging as a major problem in many countries as it significantly deteriorates function and quality of life in older adults. Late life depression is a multidimensional disease that requires intervention in biopsychosocial perspective. Recent reduction in family size and rapid simplification of generations are making this decrease more dramatic. Thus, single older households are becoming general type of household in late life, emphasizing the importance of social engagement in late life depression

Objectives

the purpose of this study is to assess the correlation between the frequency of face-to-face and non-face-to-face contact with non-cohabitating adult children and late life depression after the COVID-19 pandemic. Additionally, we hypothesized 10 possible moderators and evaluated the moderation effect of each moderator on the correlation. By identifying groups of older adults that are more affected by contact with their children, the understanding of the relationship between late life depression and family contact in older adults might provide insights to set intervention targets in the community.

Methods

Older adults who completed the Living Profiles of Older People Survey in Korea were included. In total, 7,573 participants were analyzed by measuring their contact frequency and depression symptoms. Regression analysis was done adjusting covariates. Process macro was used to verify the moderating effects of variables.

Results

Multivariable logistic regression analysis showed that both infrequent face-to-face (OR=1.87, 95% CI=1.56-2.23) and non-face-to-face contact (OR=1.22, 95% CI=1.03-1.44) with non-cohabitating adult children group was associated with higher risk of late life depression compared to a frequent contact group. Further linear regression analysis, which viewed depressive symptoms as SGDS-K score, indicated consistent results in face-to-face and non-face-to-face contact (estimate=0.468, standard error [SE]=0.091, p<0.001 and estimate=0.262, standard error [SE]=0.079, p<0.001, respectively). Finally, using moderation analysis, association with late life depression and frequency of face-to-face contact was moderated by age, quartiles of household income, number of chronic diseases, frequency of physical activity, existence of spouse, and nutritional status (NSI) whether effect of frequency of non-face-to-face contact on late life depression was increased by participation in social activity, frequent physical activity, and good cognitive function (MMSE-DS score)(p for interaction<0.05).

Conclusions

Frequent contact of non-cohabitating children lowers the risk of later life depression. Several variables were found significant in moderating contact frequency-depression symptoms.

Disclosure of Interest

None Declared
Empathy training models and the effects on psychological concerns in paid and unpaid caregivers of older people: A systematic review
Authors: Pessoa R. M. D. P. P. , Maximiano-Barreto M. A. , Ottaviani A. C. , Luchesi B. M. , Chagas M. H. N.
Published: August 2023

Introduction

Empathy training directed at empathic abilities and/or aspects of providing care can be effective at increasing levels of this ability. Moreover, training in different care contexts can minimize the negative impacts of providing care.

Objectives

To identify empathy training models and the effects on psychological concerns in paid and unpaid caregivers of older people.

Methods

A systematic review was conducted. Searches for relevant articles were performed in the Embase, LILACS, PsycInfo, Pubmed, Scopus and Web of Science databases using the following search strategy: “Empathy AND (Education OR Training OR Intervention) AND Caregiver”. No restrictions were imposed regarding language or year of publication.

Results

Empathy training for caregivers of older people were performed in six studies, three of which identified a significant increase in empathy levels and consequent reduction in psychological concerns. Empathy training focused on aspects of empathy and/or the caregiver had significant effects on the outcome variables. Moreover, training conducted online, by telephone and/or in person can generate satisfactory results. The other three studies that conducted training with a focus on aspects of dementia and/or old age did not present any effect on the outcome variables.

Conclusions

Empathy training for caregivers of older people can increase levels of this ability, especially in the cognitive domain, as well as diminish psychological concerns caused by the negative impact of providing care.

Disclosure of Interest

None Declared
Attitude of Albanian psychiatrists towards their patients
Authors: Dashi E. , Skendi V. , Ori D. , Alikaj V.
Published: August 2023

Introduction

Erving Goffman described stigma as an attribute considered to be undesirable and unpleasant by society and which differentiates the stigmatised person from other members of the community that he or she should belong to. (Hankir AK, et al., 2014). Mental illness has been always associated with stigma, moreover people with serious mental illness have higher rates of mortality and morbidity. (Patrick W. Corrigan, et al., 2014). The contact mental-health-care professionals have with people with mental illness is associated with positive attitudes towards civil rights, however it does not reduce stigma as does social contact such as with friends or family members with mental illness. (Henderson C et al., 2014)

Objectives

This is the Albanian substudy of a larger multicenter study. We aimed to investigate the attitudes of specialists and trainees in psychiatry in Albania.

Methods

An anonymous online questionnaire was sent by email to the participants. We used questions on sociodemographic and professional details as well as requested personal information regarding their lived experience. The self reporting Opening Minds Stigma Scale for Health Care Providers was used to measure stigmatising attitudes, which contains 15-statements and 3-subscales: Attitude, Disclosure and Help-seeking and Social distance.

Results

Altogether 59 professionals completed the questionnaire, 59% of them worked as adult (n=35) and 41% as child psychiatrists (n=24). 58% were specialists (n=34) and 41% trainees (n=24). Based on their responses, 12% of them (n=7) have ever sought help for their own mental health problems. Regarding case discussion, supervision or Balint groups, 81% of the sample (n=48) was open to these; however, it was accessible for only 46% of the sample.

The median stigma scores were the followings: attitude: 13 (11-16), Disclosure: 10 (9-12) and Social distance: 12 (9-13), total score: 35 (31-40); however, none of these were associated with any of the above variables.

Conclusions

Stigma is present towards people with mental health problems and psychiatrist play their part in it as well. Further investigation is needed into Albanian psychiatrists’ stigmatising attitudes to find appropriate anti-stigma interventions for them.

Disclosure of Interest

None Declared
Autoimmune psychosis: a review of diagnostic and treatment guidelines
Authors: Barbosa P. , Remelhe M. , Ribeiro L.
Published: August 2023

Introduction

Over this decade, there has been progressive growth and evolution of the concept of autoimmune encephalitis. However, international consensus overly focus on major neurological signs, while discarding some attenuated presentations, sometimes with just psychiatric manifestations. It was only very recently that a new concept arouse from this disorder, named autoimmune psychosis, which can mimic schizophrenia. Unfortunately, there is still a lack of a structured approach of psychotic patients to cover this disorder. This has numerous implications, namely on management and prognosis of these patients. Not only, these patients have an increased risk of neuroleptic malignant syndrome, but it is also important to intervene early in the course of disease.

Objectives

To conduct a review of the diagnostic and treatment guideliens of autoimmune psychosis

Methods

The authors conducted a non-systematic review, by resorting to the pubmed database, on the concept of autoimmune psychosis and updated proposals of diagnostic orienting lines.

Results

Recently, in 2016, Graus et al proposed diagnostic criteria for possible autoimmune encephalitis, in which the authors acknowledge subacute onset of psychiatric symptoms as a possible clinical manifestation. The authors accept normal diagnostic tests, provided that new neurological focal findings exist. Since then, there have been described a list of signs/symptoms, which should raise suspicion for this diagnostic on psychiatric patients, so called red flags. In accordance to diagnostic guidelines for autoimmune psychosis, defined by Pollak et, the presence of this symptoms should lead clinicians to perform diagnostic exams, as MRI, eletroencephalogram and blood serological tests and lumbar puncture. However, others criticize this initial lineup arguing that some patients could be missed, because they do not have any neurological signs, and so they propose new diagnostic criteria.

Conclusions

Autoimmune psychosis represents an attenuated clinical form of autoimmune encephalitis, although demanding the same medication and prompt initiation of treatment as other autoimmune encephalitis. It is important to acknowledge that there are patients who are seronegative and that some of the diagnostic exams mentioned have sometimes limited availability. As acknowledged by Guasp et al, there are patients with first psychotic episodes that have an autoimmune etiology, but because of the lack of neurological signs, could potentially be missed of treatment. So, it is important to establish formal diagnostic guidelines for this disorder, namely orienting lines for first psychotic episodes, which is the most commson psychiatric manifestation. This also enlightens the need for neurologic and psychiatric cooperation for these patients.

Disclosure of Interest

None Declared
Adjunctive short- and long-term combination treatment of esketamine and VNS in difficult to treat depression (DTD)
Authors: Kavakbasi E. , Baune B. T.
Published: August 2023

Introduction

NMDA-Receptor antagonists have rapid antidepressant and antisuicidal properties. However, the antidepressant effect is short lasting raising the question of best maintenance strategy, which is unanswered so far. Invasive vagus nerve stimulation (VNS) as a treatment option for refractory and chronic major depression was shown to reduce the need of maintenance treatment sessions in electroconvulsive therapy (ECT) patients.

Objectives

There are no published data on the combination of VNS and esketamine. To determine the impact of the combination of VNS and esketamine in DTD.

Methods

In this naturalistic observational study, we investigated the short- and long-term impact of combination of VNS and esketamine in n=8 patients with difficult-to-treat depression (DTD). Follow-up evaluations were scheduled prospectively pre-surgery at baseline and every 3 months after VNS-implantation (follow-up period 12-24 months, mean 17).

Results

The mean age of patients was 50,8 years. 50 % of patients (n=4) were female. All patients suffered from severe DTD (mean MADRS at baseline 30,9). Mean number of hospitalizations per months decreased from 0.17 to 0.11 after VNS implantation. 6 of 8 patients were offered maintenance esketamine treatment. Mean MADRS at 12-months was 19 (38.5 % MADRS reduction). The need of mean esketamine treatment sessions decreased from 2.3 at 6-months visit (V6) to 1.37 at V9 and 0.96 at V12 respectively. Termination of maintenance esketamine was possible in 4 cases after a mean of 11.5 months.

Conclusions

Combination of esketamine and VNS is a safe and effective treatment option in severely ill DTD patients to relieve disease severity and reduce hospitalizations. Need of esketamine treatment sessions decreases 6 months after VNS implantation.

Disclosure of Interest

None Declared
Structural abnormalities of choroid vasculature in first-episode psychosis
Authors: Demirlek C. , Atas F. , Yalincetin B. , Baykara H. B. , Akdede B. B. , Kaya M. , Bora E.
Published: August 2023

Introduction

The eye is considered as a part of the central nervous system and a window of the brain. The eye and the brain, also their microvascular system, share many common features in terms of anatomy and pathophysiology. Choroid and retina related abnormalities have been reported in psychotic disorders, especially in schizophrenia. Choroidal vascularity index (CVI) is a useful tool to assess choroidal structural alterations and CVI is defined as the proportion of luminal area (LA) to the total choroidal area (TCA).

Objectives

This is the first study to investigate choroidal vascularity index in first-episode psychosis (FEP) using optical coherence tomography (OCT).

Methods

31 patients with FEP and 30 age and gender-matched healthy controls (HC) included in this study. All participants underwent psychiatric and ophthalmological clinical assessments. Imaging of the choroid was performed using enhanced deep imaging (EDI) protocol - spectral domain OCT. Central choroidal thickness (CCT) with EDI-OCT was measured manually from the inner border of the sclera to the outer border of the RPE vertically using the calipers of the Heidelberg reader subfoveally. The choroidal vascularity index was assessed using the EDI-OCT images.

Results

There were no statistically significant differences between FEP and HC in terms of CCT (p=0.33), TCA (p=0.809) and LCA (p=0.710). The CVIs were 66.66±2.98% and 62.32±3.32% in FEP and HC, respectively and it was significantly different between groups (p<0.001, effect size d=1.38).

Conclusions

These results suggest that first episode psychosis is characterized by choroidal vascular abnormalities. in vivo ophthalmological imaging with OCT, a non-invasive, fast, and safe technological tool, can be a promising biomarker to quantitatively evaluate microvasculature abnormalities in patients with psychosis.

Disclosure of Interest

None Declared
Anterior pituitary hormones in first-episode psychosis: a systematic review and meta-analysis
Authors: Cavaleri D. , Capogrosso C. A. , Guzzi P. , Misiak B. , Bernasconi G. , Re M. , Crocamo C. , Bartoli F. , Carrà G.
Published: August 2023

Introduction

Although the role of pituitary gland in schizophrenia and psychotic disorders has been studied for decades, evidence on anterior pituitary hormones in the early phases of psychoses – without the influence of chronicity, comorbidities, and pharmacological treatment – is mostly unclear and inconsistent.

Objectives

Our systematic review and meta-analysis was aimed at comparing the blood concentrations of adrenocorticotropic hormone (ACTH), follicle stimulating and luteinizing hormones (FSH and LH), growth hormone (GH), prolactin (PRL), and thyroid-stimulating hormone (TSH) between people with drug-naïve first-episode psychosis (FEP) and healthy controls.

Methods

We searched main electronic databases for articles indexed up to September 2022. We appraised the quality of data. We carried out random-effects meta-analyses, generating pooled standardized mean differences (SMDs) and estimating between-study heterogeneity. Moreover, we performed sensitivity and meta-regression analyses.

Results

Twenty-six studies were included. People with drug-naïve FEP had higher ACTH (p<0.001; moderate-to-high heterogeneity) and PRL (p<0.001; high heterogeneity) concentrations, as well as lower TSH concentrations (p=0.001; low heterogeneity), than healthy subjects. Sensitivity analyses confirmed these findings. Data were not sufficient to perform meta-analyses on other hormones (FSH, LH, and GH).

Conclusions

People with drug-naïve FEP have abnormal ACTH, PRL, and TSH blood concentrations, supporting the hypothesis that anterior pituitary hormone secretion is altered in the first stages of schizophrenia and psychoses. Additional research is needed to clarify the complex interconnections between vulnerability, environmental factors, and pituitary hormones in FEP.

Disclosure of Interest

None Declared
The structure stability of negative symptoms: longitudinal network analysis of the Brief Negative Symptom Scale in subjects with schizophrenia
Authors: Caporusso E. , Giordano G. M. , Mucci A. , Rucci P. , Sanmarchi F. , Giuliani L. , Perrottelli A. , Pezzella P. , Bucci P. , Rocca P. , Rossi A. , Bertolino A. , Galderisi S. , Maj M.
Published: August 2023

Introduction

Negative symptoms (NS) represent an unmet need of treatment in schizophrenia (SCZ). As a result, these symptoms pose a significant burden on patients, their families, and the health care system. In the last decade, the conceptualization model that has received the most support from the literature has described 2 domains of NS: the expressive deficit (EXP), which includes blunted affect and alogia, and the motivational deficit (MAP), which includes avolition, asociality, and anhedonia. However, different confirmatory factor-analytic studies suggest that the bi-dimensional model may not capture the complexity of this construct, which could be better defined by the 5-factor model. To date no study exploiting innovative tools and state of the art assessment instruments has yet been conducted to evaluate the NS structure stability over time.

Objectives

The aim of this study was to investigate the stability of the latent structure of NS in subjects with SCZ.

Methods

NS were assessed in 612 subjects with SCZ using the Brief Negative Symptom Scale (BNSS) at the baseline and after 4-year follow-up. A network invariance analysis was conducted for the data collected longitudinally.

Results

Results showed that the BNSS’ items aggregated to form 5 distinct domains (avolition, asociality, blunted affect, alogia and anhedonia). The result of the network invariance test indicated that the network structure remained unchanged over time (network invariance test = 0.13; p = 0.169) while its overall strength decreased significantly (6.28 baseline, 5.79 at follow-up; global strength invariance test = 0.48; p = 0.016).

Conclusions

The results of this study show how the construct of NS can be better explained by the 5 individual negative symptoms and that this model is almost stable over time. Therefore the 2-dimensional model may be insufficient to describe the characteristics of NS. This data is of important relevance with consequent implications in the study of pathophysiological mechanisms and the development of targeted treatments for NS.

Disclosure of Interest

None Declared
Epidemiology of depression in schizophrenia patients living in Africa: a systematic review and meta-analysis
Authors: Endomba F. T. , Tariku M.
Published: August 2023

Introduction

Various comorbid conditions can worsen the morbidity and mortality of schizophrenia, and this is the case for depression, especially through suicidal behaviors and cardiometabolic impairments. There is a scarcity of summarizing data on depressive symptoms and disorders among schizophrenia patients living in Africa.

Objectives

The aim of this meta-analytic review was to estimate the prevalence of depression in people living with schizophrenia in Africa.

Methods

We systematically searched for relevant articles published from inception to July 05, 2022, in PubMed/MEDLINE, EMBASE, and African Journals Online. We appraised the risk of bias using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for studies reporting prevalence data, and estimated the pooled prevalence of depression among patients with schizophrenia using a random-effects meta-analytic model. We performed meta-regression and subgroup analyses to assess potential mediators of our estimates. We based the report of our findings on the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines (2020). We registered our protocol in PROSPERO (CRD42022315717).

Results

From 791 initial records, 10 studies were finally included in our qualitative and quantitative syntheses (Figure 1). These studies encompassed 2265 patients with schizophrenia (male-to-female ratio = 1.94), and were conducted between 2001 and 2019, in Egypt (n = 1/10), Ethiopia (n = 4/10), Morocco (n = 1/10), Nigeria (n = 1/10), South Africa (n = 2/10), and Tunisia (n = 1/10). The mean age of participants ranged from 33.8 to 49.2 years, and the most used tool was the Calgary Depression Scale for Schizophrenia (n = 4/10). The pooled prevalence rate of depression was 23.93% (95% CI: 19.43% – 28.73%), with substantial heterogeneity (I² = 84%). The prevalence of depression significantly varied according to screening tool used. The frequencies for Northern and Sub-Saharan Africa were respectively 31.9% (95% CI: 24.8% – 39.5%) and 21.1% (95% CI: 16.7% – 25.9%), with a significant difference between these subgroups (Figure 2). A higher prevalence of depression was associated with a lower percentage of schizophrenia patients with high education levels. Among schizophrenia people with depression (n = 250), 46.04% (95% CI: 30.07% – 62.42%) reported past or current suicide behaviors. The risk of bias was low for three studies, moderate for two studies, and high for five studies. The certainty was very low, and we found no publication bias.

Image:

Image 2:

Conclusions

Approximately one in every four schizophrenia patients living in Africa was positively screened for depression. This review draws health professionals’ attention caring people with schizophrenia, and calls for further studies with a harmonization of screening tool, a better representativity of some subregions, and the assessment of key potential factors such as perceived stigma and self-stigma.

Disclosure of Interest

None Declared
Estimating the prevalence of alcohol abuse using phosphatidylethanol
Authors: Razvodovsky Y.
Published: August 2023

Introduction

Currently, there is an active development of methods for the laboratory diagnosis of alcohol abuse using biochemical markers.

Objectives

The aim of this work was to estimate the prevalence of alcohol abuse among the urban population of Belarus using the concentration of phosphatidylethanol in the blood as a biochemical marker of alcoholism.

Methods

220 blood samples from Grodno residents of both sexes aged 15 to 65 were analyzed. The AUDIT questionnaire was used as a screening tool. Determination of the concentration of phosphatidylethanol in the blood was carried out using the method of high performance liquid chromatography - tandem mass spectrometry (HPLC - MS).

Results

The average concentration of phosphatidylethanol in the blood of men and women was 266.11±54.57 and 55.27±9.43 nmol/ml, respectively. In 9.6% of blood samples, the concentration of phosphatidylethanol exceeded the threshold level of alcohol abuse. It was found that the concentration of phosphatidylethanol in the blood does not correlate with the total score, as well as the frequency and quantitative characteristics of the AUDIT screening test.

Conclusions

Determining the concentration of phosphatidylethanol in the blood is a more reliable way to diagnose alcohol abuse than using screening tools.

Disclosure of Interest

None Declared
Effect of Regulated Add-on Sodium Chloride Intake on Stabilization of Serum Lithium Concentration in Bipolar Disorder: A Randomized Controlled Trial
Authors: Maiti R. , George S. , Mishra B. R. , Jena M.
Published: August 2023

Introduction

The therapeutic use of lithium in bipolar disorder is often restricted due to its narrow therapeutic window and adverse drug reactions. Lithium-induced early renal dysfunction is clinically important as it may lead to sodium depletion due to natriuresis leading to lithium retention and lithium toxicity. This is most often seen in the initial phases of therapy, and psychiatrists struggle titrating the dose of lithium and stabilizing the serum lithium level.

Objectives

The present study was conducted to evaluate the effect of add-on sodium chloride on serum lithium levels in bipolar disorder.

Methods

The present randomized controlled trial (NCT04222816) was conducted in 60 patients with type I bipolar disorder who were randomized into the control group who received lithium carbonate with the advice not to take additional salt (at the table) and the test group who received sachets of sodium chloride (1 g/d) as an add-on to lithium carbonate and were advised to restrict their additional salt intake (at the table) to 1 g/d. After baseline assessments, all patients were followed up at 4 weeks, 8 weeks, and 12 weeks when serum lithium, sodium and potassium were estimated. Serum creatinine and aldosterone were repeated at 12 weeks.

Results

In the test group, the fluctuation rate in serum lithium (26.7%) was significantly (p=0.01) lower than in the control group (63.3%). There was a significant difference in serum lithium in the control group at different time points; however, the changes were not significant in the test group. There was a significant difference in serum lithium between the groups at 8 and 12 weeks of follow-up. There were no significant differences in the change in serum sodium, potassium, creatinine, aldosterone, creatinine clearance, and blood pressure within the group and between the groups. A significant positive correlation was found between serum lithium and aldosterone at baseline.

Conclusions

Intake of add-on sodium chloride (1 gm/day) may reduce the fluctuations in serum lithium during the maintenance phase of lithium therapy in type I bipolar disorder.

Disclosure of Interest

None Declared
The effect of long-acting injectable antipsychotics on QRISK3 in patients with bipolar disorder and schizophrenia
Authors: Erbasan V. , Ekici F. , Uçak E. F. , Aydın M. , Altınbaş K.
Published: August 2023

Introduction

Psychiatric diseases are often accompanied by medical comorbidities, and cardiovascular system disease is one of the most important causes of death in bipolar disorder (BD) and schizophrenia (SCH) [1]. The QRISK3 algorithm calculatesa person’s risk of developing cardiovascular disease over the next ten years and it has been used in psychiatric research in recent years [2].

Objectives

In this study, we aimed to evaluate the relationship between cardiovascular risks (by using QRISK3 algorithm) and treatment options in patients of BD and SCH.

Methods

Thirty-six patients with bipolar disorder and thirty-two patients with schizophrenia recruited between the years 2016-2022. All of the patients were treated with long-acting injectable (LAI) antipsychotics. Sociodemographic information, clinical features and medical treatment agents of individuals were recorded. The risk of development of cardiac disease of the patients were evaluated by the QRISK3 algorithm. Descriptive and regression statistical analysis was performed with Statistical Package for the Social Sciences (SPSS).

Results

More than half of the patients were male (n= 39, 57.4%) and single (n= 40, 58.8%). The mean duration of education was 9.2 ±3.5 years and the mean age was 39.7 ±11.9 years of the patients. Nearly half of the patients had a diagnosis of BD (n= 36, 52.9%) while others had SCH (n:32, 47.1%). Most of the patients were treated with LAI of aripiprazole (n= 36, 59.2%) and the rest of them were treated with LAI of paliperidone (n= 32, 40.8%). When demographic and clinical data of BD and SCH patients were compared, there was no significant difference in terms of age. However, SCH patients had a longer disease duration (t= 2.56, p= 0.013) and more hospitalization (t= 3.35, p= 0,002) than BD patients. Our findings showed positive correlations between age (r= 0.74, p<0.01), duration of disease (r= 0.57, p< 0.01), and duration of LAI use (r= 0.55, p< 0.01) with QRISK. A regression analysis to examine related factors associated with QRISK found that having a diagnosis of schizophrenia (β= 0.27, t= 2.58; p= 0.01) and a long disease duration (β= 0.67, t= 6.50, p< 0.01) were associated with the development of cardiovascular disease. However, there was no relationship between LAIs (paliperidone vs aripiprazole) used in the treatment and QRISK.

Conclusions

The significant correlation found between duration of disease and QRISK -that indicate the risk of development of cardiac disease- confirming the progressive nature of the BD and SCH. Moreover, the significant correlation between SCH and QRISK suggests that SCH is a chronic and severe disease that causes more cardiac dysfunction than BD. However, we could not find a significant difference between LAIs in terms of QRISK, these results can be changed by evaluating other variables such as comorbidities, other medical treatments and physical activities in future research.

Disclosure of Interest

None Declared
Correlations of thought disorders with attenuated positive symptoms at clinical high-risk state for psychosis
Authors: Kaleda V. , Omelchenko M. , Arutyunova E.
Published: August 2023

Introduction

One of the methods for early diagnosis in individuals at clinical high-risk state for psychosis could be the identifying specific symptoms, such as thought disorders. Thought disorders may be a separate symptom, unrelated to attenuated positive symptoms (APS) with an independent predictive value.

Objectives

Correlation analysis of thought disorders and APS in patients at clinical high-risk state for psychosis.

Methods

The study included 30 young men (mean age 19.2±2.1 years) hospitalized at the clinic of the FSBSI “Mental Health Research Centre” with the APS in the first depressive episode (F32.1, F32.2, F32.28, F32.8) which is considered as clinical high-risk state for psychosis. The severity of thought impairment was assessed using the Thought, Language and Communication Scale (TLC). Subsequently was performed the search for correlations of scores on the TLC and the severity of “prodromal” symptoms, according to The Scale of Prodromal Symptoms (SOPS).

Results

The median value of the total score on the TLC was 20 [17.25;23.5]. The most important finding is the discovery of only minor correlations of thought disorder with “prodromal” symptoms. Indeed, the total score on the TLC correlated only with the total score on the SOPS at admission (r=0.370, p<0.05). Such symptoms of the TLC scale as «Derailment», «Incoherence», «Perseveration» did not find any correlation with prodromal symptoms (p>0.05).

Conclusions

The obtained data indicates the independent nature of thought disorder in patients at clinical high-risk state for schizophrenia, which leads the need to determine its own prognostic value.

Disclosure of Interest

None Declared
The Relationship between Plasma Erythropoietin Levels and Symptoms of Attention Deficit Hyperactivity Disorder
Authors: Kwon Y.-J.
Published: August 2023

Introduction

There are animal models associating dopamine dysfunction with behavioral impairments that model attention deficit hyperactivity disorder (ADHD). Erythropoietin (EPO) has trophic effects on dopaminergic neurons.

Objectives

The aim of this study was to examine the Erythropoietin (EPO) plasma levels and determine whether there was any correlation between plasma EPO levels and clinical characteristics of Attention-Deficit/Hyperactivity Disorder(ADHD).

Methods

Plasma EPO levels were measured in 78 drug naïve children with ADHD and in 81 healthy children. The severity of ADHD symptoms was determined by scores on the Korean ADHD Rating Scale (K-ARS) in children and healthy controls.

Results

The ADHD group consisted of 64 boys and 14 girls, and the healthy control group of 31 boys and 50 girls. The median plasma EPO levels in ADHD children was 12.9 mIU/mL, whereas it was 12.0 mIU/mL in the healthy controls. This difference was not statistically significant. Participants in the highest tertiles of plasma EPO had a 1.49 times higher risk of ADHD than those in the lowest tertile, and those in the second highest tertile had a 2.39 times higher risk of ADHD than those in the lowest tertile. Plasma EPO levels correlated positively with some K-ARS scores, including hyperactivity-impulsivity score and total score. The significant difference in hyperactivity-impulsivity score comparing participants in the second highest with those in the lowest tertile. total K-ARS score was significantly higher in the second highest tertile of plasma EPO compared to those in the lowest tertile.

Conclusions

These findings suggest that plasma EPO levels were related to some ADHD symptoms, which could be used in the monitoring of the disorder. Further studies are required to clearly understand the source and role of EPO in ADHD.

Disclosure of Interest

None Declared
Gender gap-related issues among mothers revealed by a comparative study of adolescent hikikomori between Japan and France
Authors: Hamasaki Y. , Dorard G. , Tajan N. , Pionnié‑Dax N.
Published: August 2023

Introduction

Around 2010, the number of hikikomori cases increased rapidly. Hikikomori is a global problem that characterizes the current era, and has become an increasingly deep-rooted social issue that affects the younger generation, especially during the coronavirus disease-2019 (COVID-19) pandemic. In our previous comparative study of adolescent hikikomori between Japan and France (Hamasaki et al. BMC Psychiatry 2022; 22, 477), we investigated its psychopathology, including potential cultural influencing factors. The study showed no difference in terms of psycho-behavioral characteristics of hikikomori between Japan and France. However, the sociocultural factors that make hikikomori more severe differed between the two countries, i.e., in Japan: lack of communication between parents, in France: lack of communication between the family and the community.

Objectives

Since these differences in sociocultural factors are closely related to the social context in which the mothers were placed, the factors in terms of maternal gender issues were examined, along with reviewing previous studies.

Methods

Statistical data from the “Global Gender Gap Report 2022” of the World Economic Forum, the “Towards real gender equality 2021” of the Ministry of Gender Equality, Diversity, and Equal Opportunities of France, the “Women and Men in Japan 2020” of the Gender Equality Bureau, Cabinet Office, Government of Japan, and other sources were evaluated. Further, previous literature on the family environmental factors of hikikomori were reviewed.

Results

An absent father, a subsequent mother-child closeness and over-interference, and the inhibition of children’s independence, have been repeatedly mentioned in studies as factors leading to hikikomori. The time spent on housework and childcare by Japanese men is at the lowest level globally (Japan’s gender gap index ranks 116th out of 146 countries, the lowest among the seven major G7 nations). In Japan, where generally little cooperation exists between parents, particularly in those families where communication between parents is self-rated as relatively poor, the above factors may surpass the threshold for triggering hikikomori. In France (ranked 15th in gender gap index), the isolation of mothers and children from society is an important factor associated with hikikomori. Adequate social participation of the mother may be a protective factor against hikikomori.

Conclusions

Gender gap-related issues among mothers may be involved in the root of the hikikomori problem. Hikikomori has emerged from various socio-familial factors. Further studies are warranted to determine the causal relationships of these factors with the onset and severity of hikikomori.

Disclosure of Interest

None Declared
Theory on Extremal Nucleon Heuristics to Psychiatry
Authors: Pachankis Y.
Published: August 2023

Introduction

The theorization focuses on the climate change’s influence to neurobiology. In modern societies, environmental nucleon generates in everyday activities from computers to industrial pollution. The subtle psychiatric changes can be categorized into: 1) the change of media in consciousness formation processes from cognition, such as from paper to electronic reading and from linguistics to coding; 2) activity changes in local reciprocal environment especially in places undergoing industrialization or developmental energy sources; 3) global exchanges underlying the current definitions of climate change but also taken into consideration of media change in cognitive behaviors; and 4) changes from outer space environment to the effects of global-to-local changes.

Objectives

The objective of the theorization seeks to develop a heuristic paradigm to quantify the climate change’s effects to psychiatry from a neurobiological perspective. Albeit climate change is a complex topical issue, especially regarding the multivariable sources and traditional paradigms of case studies in the psychological and medical sciences, common sources of impacts to psychiatric public health in collective behaviors have been less of a focus. With the higher order of autonomous human functioning governed by the brains, the theorization in psychiatric public health hopes to quantify environmental impacts to brain functionings.

Methods

The theorization accumulated from nonproliferation research and the researcher’s developments in dopamine treatments in the high risk social-natural environment on depression. Inspired by the explicit review on electronic warfare’s impact on public health and astronomical research with proton decay outcome, a correlative theorization emerged between the cosmic decay and biodiversity in biochemistry. The theorization draws on developmental psychology to the nucleon heuristics in data research in cosmology, with prior experience documenting proliferation by applied quantum chromodynamics. Psychiatric data can be retrieved from relevant clinical settings of equivalent multi-wavelength brain scans as samples.

Results

From the perspective of cosmology, extremal graph theory can sample climate change on earth’s plasma from cosmic changes. This means earth’s dipole shifts to quantitative local population can be plotted, similar to the wild life researches in birds’ migration pattern changes. Local variants mainly derive from energy source types and energy consumption, however, bona fide data can hardly be retrieved due to deliberate transgressions for certain dire areas. Normative research can be conducted with cross-disciplinary collaborations with due consideration to privacy in public health research ethics.

Conclusions

Environmental monitoring and psychiatric effects in developmental psychology are necessary in fundamental research on human security. This would increase some certainties and predictabilities for human development.

Disclosure of Interest

None Declared
Forced displacement and mental health problems in refugees residing in Quetta for decades
Authors: Sherzad S. , Khan H. A. , Sherzad T.
Published: August 2023

Introduction

As written by Warsan Shire, “no one leaves home until the home is the mouth of a shark”. UNHCR defines forced displacement as “displaced because of persecution, conflict, generalized violence or human rights violations"

Objectives

to study the prevalence of common Mental health disorders among forcibly displaced people and comparing with the common mental health disorders among host community members.

Methods

The OPD of BIPBS in SPH and BMCH of Quetta attends 800+ patients per month the data of the OPD of both hospitals was collected for Jan-May 2022 and was analyzed to numerate both the host community and refugees. out of 4120 for 354 refugee patients identified using their POR card and for 3776 of host community using their CNIC, data was analyzed for the prevalence of mental health disorders among them.

Results

This study states that Afghan Refugees presented to OPD services of BIPBS, 47% were diagnosed as MDD with/without psychosis, 19% with GAD, 5% diagnosed as BAD, 5% With schizophrenia, 4% as PTSD, 3% as migraine, 3% conversion disorder, 2% OCD, 1% somatoform disorder and 10% of them presented with other psychiatric disorders, while in host community 21% were diagnosed as MDD with/without psychosis, 24% as GAD, 12% as somatoform disorder, 10% as OCD, 8% as migraine, 7% as conversion disorder, 4% as BAD, 3% as Schizophrenia, 3% as MBD due to substance misuse and rest of 7% presented with other psychiatric disorders.

Conclusions

The conclusion of this study states that mental health disorders are more common among refugees than in other populations, the result of this study shows that there is a big difference in the prevalence of mental health disorders among displaced people and the rest of the population, some of the Mental health disorders are present in higher percentage among displaced people rather than among host community, while some other disorders are present in lower percentage among displaced people rather than among host community, this study also highlights that further studies are needed to determine, risk and protective factors within the host community.

Disclosure of Interest

None Declared
A tale of excess: the curious case of the woman with 1447 emergency visits
Authors: Sagué Vilavella M. , Giménez Palomo A. , Àvila-Parcet A. , Fernández Plaza T. , Navarro Cortés L. , Oretega Hernández G. , Pons Cabrera M. , Tardón Senabre L. , Vázquez M.
Published: August 2023

Introduction

Frequent attenders to emergency services are challenging and costly. We report the case of a woman in her mid-twenties who stands out for a total of 1447 emergency visits.

Objectives

Our primary objective was to describe the emergency visits of our patient. Secondary objectives were to assess her use of other healthcare services and to calculate her health expenditure.

Methods

This is a clinical case report. We reviewed the patient’s electronic medical records for sociodemographic and clinical data. We obtained detailed information of psychiatric ED visits (length, most frequent times and days) regarding the second most-visited hospital. We assessed the efficacy of hospitalizations in reducing ED visits with a paired samples t Test, comparing the number of visits 30 days pre- and post-hospitalization. We estimated the health expenditure using the regional public health system prices, including three direct costs: emergency visits, hospitalizations and ambulance transportation. We obtained written informed consent from the patient’s legal guardian.

Results

A 26-year-old woman from Barcelona (Catalonia, Spain), diagnosed with mild intellectual disability, made 1447 emergency visits between 2009 and 2021 (figure 1). 946 visits (65%) took place in psychiatric emergency departments (EDs), whilst 353 (24%) in non-psychiatric EDs and 148 (10%) in urgent primary care. She attended 24 hospitals (ranking number one the closest to the patient’s home, with 387 visits) and seven primary care centers, distributed across 17 cities in Catalonia. Most visits were self-referred, being the main presenting problems anxiety and instrumental suicidal behaviour. Saturday was her favorite day for hospital visits (24,1%), while she seeked care on Tuesdays much less often (4.5%). She made 73.5% of consultations between 1pm and 6pm, with a median length per visit of 2.8 hours (range 0.33-20.9 hours). Regarding other therapeutic approaches, she attended day hospitals, psychiatric rehabilitation programs and family therapy, among others (figure 2), for which she showed low adherence and scarce benefit. She had ten acute hospitalizations, interventions that did not reduce ED visits (t=-0.9835, p=0.36). Health expenditure reached 410.035€.

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Conclusions

The most common definition of frequent attendance is a patient who has five or more visits per year. Many times, but not always, repeat visits are also inappropriate. The case we report is a grotesque example of both frequent and inappropriate attendance, which has been resistant to all kinds of interventions and has quality-of-care, financial and ethical implications. As of today, it is still a pending case. Maybe it is worth considering residential treatment?

Disclosure of Interest

None Declared
A systematic review on the link between adverse childhood experiences (ACE) and later involvement in gang violence and extremist groups
Authors: Matei I.-C.
Published: August 2023

Introduction

Adverse childhood experiences are common and have been linked to a number of physical illnesses, as well as socioeconomic problems. Moreover, it has been proven that ACEs can increase chances of people showing criminal behaviour. The question arises whether people with ACEs also have an increased chance of joining extremist groups or violent gangs.

Objectives

The aim of this systematic review is to measure the ACE rates in violent extremists and gangs and to establish whether there is a pattern linking ACEs to violent extremist organizations and gangs.

Methods

The following databases were searched to retrieve relevant studies: the ProQuest Social Science database, Pubmed, Scopus. Eligible studies were articles of any study design that reported ACE rates in either extremists or gang members. Data was extracted and organized into a table and a quality assessment was performed using standardized tools (CASP and NHLBI). A narrative synthesis of the evidence was conducted. A meta-analysis could not be performed due to the heterogeneity of the studies.

Results

22 studies (eight on extremists and fourteen on gang members) were included. The studies varied in terms of research design, sample size, location and measured ACEs. Quality also varied across the studies. The prevalence rates were heterogenous and ranged from 0% to almost 100%.

Physical abuse was the most addressed ACE (5 studies on extremists and 11 on gang members). Sexual abuse was the second most explored ACE (4 studies on extremists and 9 studies on gang members). Neglect and caregiver loss were also common ACEs, while the other ACEs were less represented in the two subpopulations. A comparison between the two subpopulations was difficult due to the differences in the studies.

Conclusions

While overall ACE rates were high in the two groups and some ACEs were salient in the two subpopulations, quality of evidence varied across the studies. No solid ACE pattern across the studies could be found. Moreover, there were only two prospective studies on gang members and none on extremists, so a causal relationship between ACEs and involvement in violent gangs or extremist organizations could not be established. Future research should concentrate on studies of this design, as well as on improving the quality of the evidence.

As ACEs are extremely common, researchers should also look beyond them when searching for causes of extremism or violent gang membership. Other negative events (bullying, racism) should also be explored.

Disclosure of Interest

None Declared