bluuebunny/crossref_metadata_2025 huggingface dataset:
Quality of Life Assessment in Female Rheumatoid Arthritis Patients
Authors: Feki A. , Sellami I. , Mnif I. , Gassara Z. , Ben Djemaa S. , Abbes A. , Ezzeddine M. , Kallel M. H. , Fourati H. , Akrout R. , Baklouti S.
Published: August 2024

Introduction

Rheumatoid arthritis (RA) is a chronic inflammatory disease that significantly impacts patients’ quality of life (QOL), affecting both physical and mental well-being. QOL is predictive of morbidity and mortality, making its consideration increasingly important in treatment decisions.

Objectives

This study aims to assess the Quality of Life in Female Rheumatoid Arthritis patients.

Methods

The study included 87 female patients with confirmed RA, diagnosed by an experienced rheumatologist based on the ACR 1987 or ACR/EULAR 2010 criteria. Quality of life was assessed using the World Health Organization Quality of Life assessment, short form (WHOQOL-BREF scale). The scoring ranged from 0 to 100 for each domain. Disease activity was assessed using the Disease Activity Score (DAS28), and functional disability was evaluated using the Health Assessment Questionnaire (HAQ).

Results

The study included 87 patients with a mean age of 54.7 ± 12.2 years and a mean disease duration of 12 ± 9.1 years. The majority of patients had a medium socioeconomic level (81.6%), and a low cultural level with 31% being illiterate, 6% attending university, and 76.9% unemployed. Regarding marital status, 74.7% were married. RA was erosive in 77% of patients, deforming in 68%, and 40% were seropositive (FR and/or anti-CCP). Extra-articular manifestations were present in 34.5% of patients. Sixty-seven patients (77%) were on disease-modifying antirheumatic drugs (DMARDs), with 67.8% on methotrexate. Eighteen percent were treated with biological agents. Corticosteroids were used by 47.1% of patients, while 12.6% used non-steroidal anti-inflammatory drugs, and 6.9% used both. Disease activity varied, with 9.2% having low activity, 43.7% moderate activity, and 24.1% high activity based on DAS28. The mean HAQ index was 1.1 ± 0.8, indicating moderate to severe disability for more than 60% of patients. The mean WHOQOL scores were substantially reduced in the physical health (43 ± 16.2), psychological health (50.3 ± 14.4), social relationships (51.5 ± 18.6), and environment domains (46.8 ± 15). There was a significant inverse correlation between HAQ and the physical health (r = −0.52, p < 0.001), psychological (r = −0.57, p < 0.001), social relationships (r = −0.37, p = 0.001), and environmental domains (r = −0.45, p < 0.001) of QOL. There was no correlation between any domain of QOL and DAS28.

Conclusions

Patients with RA experience reduced QOL across multiple domains, including physical function, mental health, and social relationships. Functional disability, as reflected by HAQ, is the most significant factor affecting QOL in RA. The WHOQOL-BREF should be considered a valid outcome measure for interventions aimed at improving the quality of life for people with rheumatoid arthritis.

Disclosure of Interest

None Declared
Attitude and Perceptions of Healthcare workers regarding ionizing radiation
Authors: Haddar A. , Sellami I. , Ghrab M. A. , Hajjaji M. , Jmal Hammami K. , Masmoudi M. L.
Published: August 2024

Introduction

In operating rooms, the routine use of radiological procedures is commonplace. However, this essential tool brings about significant concerns for healthcare workers due to the associated radiological risks. Understanding healthcare workers’ attitudes and perceptions about ionizing radiation is crucial for addressing these concerns.

Objectives

This study aims to assess the perceptions and concerns of healthcare workers regarding radiation risks and their practices in the operating room.

Methods

A cross-sectional study was conducted in February and March 2023 among the operating room staff of Habib Bourguiba University Hospital in Sfax, Tunisia. We used a self-administered questionnaire that included socio-professional data. Self-assessment of exposure risk and protection level against ionizing radiation was evaluated on a scale from 0 to 10, and attitudes were assessed using a 5-item Likert scale.

Results

Our study population consisted of 92 healthcare workers, with 54.3% being male. When asking operating room workers about the availability, accessibility, and quality of lead aprons, the median scores were 3 (IQR [0;6.5]), 2 (IQR [0;5]), and 2 (IQR [0;5]), respectively. The median self-assessment score for exposure risk was 8 (IQR [5.5; 10]), while the median self-assessment score for protection against ionizing radiation was 1 (IQR [0;3]). Sixty percent of the population had limited knowledge of the harmful effects of ionizing radiation, with a median self-assessment knowledge score of 1.5 (IQR [0;3]). Sixty-two percent reported concerns regarding radiological risks. In terms of practices, 44.5% of the staff maintained a distance from the radiation source during intraoperative radiography, and 21.7% used the apron for protection. Dosimeters were not used by any of the participants. Concerns level was associated with self-assessment of exposure risk (p = 0.027).

Conclusions

In conclusion, awareness of the risks generates anxiety and concern among staff; however, it alone is insufficient to alter our practices. This underscores the imperative for a proactive approach in implementing robust safety measures and comprehensive training programs.

Disclosure of Interest

None Declared
The meaning of work for teachers in educational institutions in the department of magdalena
Authors: Perez Correa K. L. , Pedraza Àlvarez L. P. , Viloria Escobar J. , Gómez Rangel J. J.
Published: August 2024

Introduction

The psychosocial and mental health-oriented variables of people are determinants for their life in society and their roles within organizations, especially educational institutions that are endowed with social complexities.

Objectives

The objective of this research was to understand the meaning of work for teachers in educational institutions in the department in order to recognize elements such as the level of importance that work holds for them and the factors that either promote or hinder that centrality.

Methods

This is a descriptive study with a quantitative methodology, and the sample selection was done for convenience, taking into account ethical aspects such as the handling of confidentiality for both the individuals who participated in this study and the educational institutions involved.

Results

Regarding the meaning attributed to work by teachers, the results indicate that 29.6% of teachers declare themselves neutral when it comes to the statement that “the most important things in people’s lives are related to work”. 26.8% of teachers are neutral regarding the statement that “the primary function of work is to generate income”, and 17.9% somewhat agree. 20.7% disagree to some extent. 15.6% disagree with the statement that “people’s primary goals in life should be oriented toward work”. 25.1% of teachers are neutral, and 17.9% somewhat agree with the statement that “the main function of work is to enable interesting contacts with other people”. Only 11.7% strongly agree with the statement that “work is, in general, one of the most important things in people’s lives.

Conclusions

It is concluded that there is a need to implement strategies that contribute to the strengthening of the teaching profession and contribute to improving educational quality

Disclosure of Interest

None Declared
Association of prosocial personality traits with symptoms of depression, anxiety and stress in psychiatric nurses; Single-centre cross-sectional study in Croatia
Authors: Bosak K. , Topolić Šestan I. , Folnegović Grošić P. , Bajić Ž. , Filipčić I. , Grošić V.
Published: August 2024

Introduction

Symptoms of depression, anxiety and stress are more common in the population of nurses working in psychiatric hospitals than in many other segments of the health care system. These three elements of psychological distress (depression, anxiety, stress) may reduce the nurse’s ability to establish quality therapeutic relationships with patients, which are very important in the treatment of mental disorders. Some studies suggest that prosocial personality traits may have a protective role. Other research suggests that high levels of empathy, for example, may increase secondary traumatisation and lead to more pronounced symptoms of distress.

Objectives

The main objective of the study was to examine the association of prosocial personality traits with symptoms of depression, anxiety and stress in nurses employed in a psychiatric clinic. The hypothesis was that more pronounced prosocial personality traits are associated with a lower expression of symptoms of depression, anxiety and stress.

Methods

The target population were nurses employed in a psychiatric hospital working directly with patients. No sample was selected, but the whole available population was invited to participate. The independent variable was prosocial personality traits measured by the Prosocial Personality Battery (PSB). The outcome was symptoms of distress (depression, anxiety and stress) measured using the Depression, Anxiety, Stress Scale-21 (DASS-21). The hypothesis was tested using three linear regression analyses.

Results

Total of 63 MST were included with a median (interquartile range) age of 34 (24-42) years. Prosocial personality traits were statistically significantly associated with scores on the DASS-21 subscale measuring depression: personal distress (PD) (r = 0.32; P = 0.01) and self-reported altruism (r = 0.30; P = 0.02). Only the subscale measuring the specific personality trait of personal distress (PD) was statistically significantly correlated with the scores of the other two DASS-21 subscales, anxiety and stress (anxiety: r = 0.54; P < 0.001; stress: 0.46; P < 0.001). Helpfulness was negatively related to anxiety (b = -0.29; P = 0.03).

Conclusions

This research partially confirmed the hypothesis that stronger prosocial personality traits are associated with a lower prevalence of symptoms of depression, anxiety and stress in the MST of employees in a psychiatric clinic.

Disclosure of Interest

None Declared
Individual Placement and Support for persons with mental disorders and disability pension: Randomized controlled trial and follow up
Authors: Kawohl W.
Published: August 2024

Introduction

Individual Placement and Support (IPS) is a supported employment method used for the vocational inclusion of individuals with mental disorders. There is vast evidence that IPS is effective for finding jobs. However, evidence concerning the applicability of IPS for persons with mental disorders receiving a disability pension and concerning the sustainability of IPS is scarce.

Objectives

The aim of the studies included in this report was to a) control for the applicability of IPS for persons receiving a disability pension and b) to gain insight in the sustainability of IPS in this context.

Methods

A randomized controlled trial with 250 participants was conducted. The participants in the intervention group received job coaching according to the IPS standard. Members of the control group received no organized support but were allowed to seek assistance on their own. The initial phase of the study lasted 24 month. Job coaching was delivered only in the first phase of the study and discontinued after 24 month. A follow up was performed six years after the start of the study to clarify the further course (number of employment relationships, degree of employment, duration of employment, salary).

Results

In the first phase of the study, the overall dropout rate was 32%. 114 participants (46% of the original number of participants) took part in the follow-up survey. The intervention was superior to the control condition in the first phase. There were no significant differences between the groups in terms of number of employment relationships, degree of employment, length of employment, and salary in the follow up.

Conclusions

The effect of a clear superiority of the IPS intervention with regard to the number of employment relationships, which was measured during the originally planned duration of the study, was only slightly detectable six years after the start of the study and up to four years after the end of the intervention and was no longer statistically significant. This result underlines the importance of continuing job coaching for an unlimited period of time, as called for in the IPS concept, in order to perpetuate the positive effects such as finding and maintaining a job in the primary labor market.

Disclosure of Interest

None Declared
Prevalence of depressive disorders in breast cancer patients
Authors: Starostin R. A. , Kuzmina S. V. , Gataullin I. G.
Published: August 2024

Introduction

Breast cancer is the most common type of cancer and the leading cause of death from malignant neoplasms in women in Russia and in most countries in the world (Lima et al. EClinicalMedicine 2021; 38 100985). According to an analysis of the incidence and mortality from 36 cancers in 185 countries (Sung et al. CA Cancer J Clin 2021. 3 209-249) in 2020, 2261419 new cases of breast cancer were identified in the world in both sexes, which is accounted for 11.7% of the total cancer incidence. Mortality from breast cancer in 2020 amounted to 684996 cases. Patients with comorbid depression and anxiety disorders experience more severe symptoms, have longer recovery time, use more healthcare resources and have poorer outcome compare to those with cancer alone (Katon et al. Gen Hosp Psychiatry 2007; 2 147-155).

Objectives

Analytical review of data on the impact of depressive spectrum disorders as comorbid conditions on the survival of breast cancer patients and their quality of life.

Methods

The following databases were searched for publications: PubMed, Embase, CINAHL, PsycINFO, Scopus, Science Citation Index/Social Sciences Citation Index, Cochrane Evidence Based Medicine database. The searches were limited to English language and studies with more than 100 subjects with diagnosed breast cancer where this information was mentioned. The analyzed period is between 1977 and 2018.

Results

The reported prevalence of depression in breast cancer patients, according to researches, varies 4,5 to 38%. In patients with I-III stage breast cancer depression increased hazards of all-cause mortality by 50% compared to non-depressed patients. Stage-specific analyses demonstrated a 2–2.5 fold increase in breast cancer-specific and all-cause mortality in patients with stage I and II disease (Vodermaier et al. Breast Cancer Res Treat 2014; 2 373-384.). Women with non-metastatic breast cancer who report mild to moderate depressive symptoms in the weeks after surgery have approximately 2.5 times greater risk of death 8–15 years later than women who report little or no depressive symptoms post-surgery (Antoni et al. Gen Hosp Psychiatry 2017; 44 16-21). Depression in advanced cancer not only reduces quality of life but is also an independent predictor of poorer survival (Lloyd-Williams et al. J Affect Disord 2009; 113 127-132.).

Conclusions

Depression and anxiety both have adverse effects on recurrence and all-cause mortality in patients with breast cancer. Untreated depression leads to significant increase in incidence and mortality. Depression can debut at any stage of cancer, including the stage of diagnosis. It proves the necessity for affective disorders screening in patients with cancer on the stage of diagnosis. Patients with diagnosed affective disorders should be observed not only by oncologist, but also by a psychotherapist in order to receive the necessary treatment to improve the quality of life and reduce the risk of mortality.

Disclosure of Interest

None Declared
Abnormal Neural Activation in Attention-Deficit/Hyperactivity Disorder: A Meta-Analysis of Functional Magnetic Resonance Imaging Studies
Authors: Zamora G. , Baten C. , Klassen A. M. , Shepherd J. H. , Catchpole A. , Davis E. , Dillsaver I. , Hunt C. E. , Johnson-Venegas E. , Hamilton P. , Sacchet M. D. , Woo E. , Miller J. A. , Hedges D. W. , Miller C. H.
Published: August 2024

Introduction

Attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent psychiatric condition that frequently originates in early development and is associated with a variety of functional impairments. Despite a large functional neuroimaging literature on ADHD, our understanding of the neural basis of this disorder remains limited, and existing primary studies on the topic include somewhat divergent results.

Objectives

The present meta-analysis aims to advance our understanding of the neural basis of ADHD by identifying the most statistically robust patterns of abnormal neural activation throughout the whole-brain in individuals diagnosed with ADHD compared to age-matched healthy controls.

Methods

We conducted a meta-analysis of task-based functional magnetic resonance imaging (fMRI) activation studies of ADHD. This included, according to PRISMA guidelines, a comprehensive PubMed search and predetermined inclusion criteria as well as two independent coding teams who evaluated studies and included all task-based, whole-brain, fMRI activation studies that compared participants diagnosed with ADHD to age-matched healthy controls. We then performed multilevel kernel density analysis (MKDA) a well-established, whole-brain, voxelwise approach that quantitatively combines existing primary fMRI studies, with ensemble thresholding (p<0.05-0.0001) and multiple comparisons correction.

Results

Participants diagnosed with ADHD (N=1,550), relative to age-matched healthy controls (N=1,340), exhibited statistically significant (p<0.05-0.0001; FWE-corrected) patterns of abnormal activation in multiple brains of the cerebral cortex and basal ganglia across a variety of cognitive control tasks.

Conclusions

This study advances our understanding of the neural basis of ADHD and may aid in the development of new brain-based clinical interventions as well as diagnostic tools and treatment matching protocols for patients with ADHD. Future studies should also investigate the similarities and differences in neural signatures between ADHD and other highly comorbid psychiatric disorders.

Disclosure of Interest

None Declared
Cariprazine add-on in resistant bipolar depression. Long-term effectiveness and safety data from a multicentric real-world experience
Authors: Martiadis V. , Pessina E. , Martini A. , Raffone F. , Vignapiano A. , De Berardis D.
Published: August 2024

Introduction

Persistent depressive episodes and subsyndromic depressive symptoms frequently characterize mood alterations in bipolar disorder (BD) and negatively influence quality of life and suicide risk. BD patients with predominant depressive episodes generally show significantly higher treatment resistance rates. Although not specifically approved in Italy for bipolar depression, recently published observational data suggest that the cariprazine add-on may be a potential effective short-term treatment for resistant bipolar depression. Nevertheless data on long-term cariprazine treatment are lacking.

Objectives

This study evaluated the efficacy and safety of long-term cariprazine augmentation in patients suffering from treatment-resistant bipolar depression.

Methods

30 resistant bipolar depressed patients, whose resistance was defined according to The CINP Guidelines on the Definition and Evidence-Based Interventions for Treatment-Resistant Bipolar Disorder, were treated with cariprazine 1,5 -3 mg flexible dose for 4 weeks, added to previous mood stabilizing and/or antidepressant treatment. Psychopathology at time 0 and at 4, 8, 12, 16, 20, 24 weeks of treatment was evaluated using the Hamilton Depression Rating Scale (HDRS), the Hamilton Anxiety Rating Scale (HARS), the Young Mania Rating Scale (YMRS) and the Bipolar Depression Rating Scale (BDRS); safety and tolerability was measured by the UKU Side Effect Rating Scale. The drop-out rate was assessed throughout the study duration.

Results

Cariprazine add-on was effective in the study sample but only during the first 4 weeks of treatment. Improvement in depression scores started from the first week, reaching about 40% mean HDRS score reduction at T4; a moderate ulterior decrease (-15%) was reached at T24 but was accompanied by a significant drop-out rate; anxiety symptoms improved (mean HARS score reduction 37% at T4) mainly during the first 4 weeks. The treatment was generally well tolerated. From week 4 to 24 we observed a near 70% drop-out rate (18 total drop-outs) with maximum drop-outs between weeks 4-8 (n=7) and 18-24 (n=7). Discontinuation causes were inefficacy (5/18); clinical worsening (10/18); side effects (3/18); hypomanic shift (2/18).

Conclusions

Despite the relatively small population examined and the observational design, our results suggest that cariprazine may represent an effective and safe short-term enhancement strategy in resistant bipolar depression. Long-term treatment, in this sample, did not lead to significant improvements and was burdened by a high drop-out rate, mainly due to inefficacy/clinical worsening. Further studies on larger samples are needed to confirm these preliminary findings, both in short-term and in longer observations.

Disclosure of Interest

None Declared
EFPT Exchange programme - Feedback results from 2012 - 2022
Authors: Kraxner F. H.
Published: August 2024

Introduction

Differences in psychiatry training vary substantially across Europe. Such organisations as the European Federation of Psychiatry Trainees (EFPT), the European College of Neuropsychopharmacology, and the European Psychiatry Association, have committed to offer international experiences based on the premise that it could foster international collaboration, aid early career professionals to progress professionally and spark discussion regarding different practices across Europe. To date, there are no studies that focus exclusively on the exchange experience in mental health professionals

Objectives

I present the synthesis of the ten years answers from 2012 to 2022 to the post-exchange online evaluation form, which trainees had to fill in in order to receive an attendance certificate.

Methods

The present study analysed the answers of 202 psychiatry trainees or recent graduates who took part in the EFPT exchange program during 2012 and 2022 and filled in the internet-based evaluation form. The inclusion criteria were currently in training or recently finished training as a psychiatrist in Europe and filling in the questionnaire. The exclusion criterion was participation in the EFPT exchange program for the second or subsequent time.

All trainees were systemically asked to complete the online evaluation form after the exchange period. The form includes sociodemographic, training in host country-related, and exchange experience-related questions. Experience measures were evaluated using the 4-point Likert scale. Data was anonymized before the analysis. The study followed the principles of the Declaration of Helsinki.

Results

The majority of participants were females in the second half of their training. The average age was 29 years. The largest number of applicants were from Turkey, whereas the United Kingdom hosted the most participants. One-third of the participants had previous international exchange experience. Most trainees were exposed to both outpatient and inpatient treatment settings and were involved in educational or research activities. 96.7% of participants indicated that they were satisfied or very satisfied with the experience, 95.6% said that the exchange was useful or very useful, and 98.9% were likely or very likely to recommend exchange to colleagues.

Conclusions

To my knowledge, this study is the first to assess the experience of psychiatry trainees who went on exchange during their professional training. Vast majority of trainees were satisfied with their exchange, thought it would be useful for their clinical practice and would recommend it to their colleagues. These findings are in line with other studies that examined medical exchange experiences .

Disclosure of Interest

None Declared
Validity and reliability of the Eating Disorder Examination-Questionnaire-7 Portuguese version in the perinatal period
Authors: Pereira A. T. , Lima R. , Pereira D. , Pinto J. M. , Barbosa B. , Araújo A. I. , Marques C. , Macedo A. , Pinto Gouveia C.
Published: August 2024

Introduction

The EDE-Q-7 Portuguese version presented good reliability and validity in Portuguese women fro the general population (Pereira et al. 2022).

Objectives

The aim of our study was to analyse the psychometric properties of the EDE-Q-7 in a sample of Portuguese women during the perinatal period.

Methods

Participants were 346 women with a mean age of 31.68 of years old (± 4.061; range: 18-42). 160 were pregnant (second or third trimester) and 186 were in the post-partum (mean baby´s age=4.37 months (± 2.87; range: 1-12). They answered an online survey including the Portuguese version of the EDE-Q-7 and of the Screen for Disordered Eating/SDE.

Results

Confirmatory factor analysis (CFA) presented adequate fit, in pregnancy (χ2/df=; RMSEA=, p<.001; CFI=; TLI=; GFI=), postpartum (χ2/df=; RMSEA=, p<.001; CFI=; TLI=; GFI=) and considering both – perinatal period (χ2/df=2.7998; RMSEA=.0722, p<.001; CFI=.9709; TLI=.9444; GFI=.9761). The Cronbach’s alpha coefficients were >0.90 for the total and approximately .70 for the three factors - Dietary restraint, Shape/weight overvaluation and Body dissatisfaction. All the items contributed to the internal consistency and presented high internal consistency. Pearson correlations between factors and total scores were significant, positive and high, as well as between the EDE-Q-7 measures and SDE (>.60 with the total; >.40 with the factors), in pregnancy, postpartum and considering both periods.

Conclusions

Presented sound psychometric properties across the perinatal period, the EDE-Q-7 and can be very useful to evaluate the presence and severity of eating disorders symptoms in women in pregnancy and post-partum.

Disclosure of Interest

None Declared
Epidemiology of a psychiatric day hospital service in rome: descriptive analysis of a two-year period of hospitalizations
Authors: Moschillo A. , Zocchi C. , Pompili M. , Manfredi G.
Published: August 2024

Introduction

Psychiatric Day Hospital (DH) constitutes an area of semiresidential care for short- and medium-term diagnostic and therapeutic-rehabilitative services. Through a descriptive analysis, we analyzed the clinical rationale and expected goals leading to an admission to the psychiatric day hospital service at St. Andrew’s Hospital in Rome, over a two-year period (2021-2022).

Objectives

We aim, through the evaluation of the epidemiological data of patients, particularly the causes of admission and sending institutions, to be able to have at our disposal important comparison data to understand the characteristics of the patient population received in psychiatric day hospital services.

Methods

Medical records of 218 patients admitted from 01.01.2021 to 31.12.2022 at the Psychiatry Day Hospital of Sant’Andrea Hospital in Rome were analyzed. The main sociodemographic and clinical characteristics and finally the type of psychiatric service from which the admission came were collected and analyzed, in addition to the reason for referral and therapeutic goal. Statistical analyses were conducted using Excel spreadsheets.

Results

64% of admissions aimed to modify or start new medication regimens with monitoring (e.g., Clozapine, Carbolithium, Esketamine). 19% were for medical evaluations, mainly neurological, cardiological, endocrinological, or internal medicine. 9% were for diagnostics. 2% were for infusion therapy, and an additional 2% for Esketamine treatment. The main findings highlight that Day Hospital use primarily focused on comprehensive patient assessments and therapy adjustments, often involving closely monitored drugs. Notably, 19% were for medical evaluations, with 28% of them being neurological assessments. This suggests challenges in conducting detailed medical assessments outside a context with prioritized access to such services.

Conclusions

Limited data in the literature make it challenging to conduct comparative analyses regarding patients in psychiatric day hospital services. However, our data can spark a discussion about admissions with objectives that could potentially be addressed through alternative services. We should also explore why this isn’t happening. It could be interesting to conduct a descriptive analysis comparing epidemiological data from the two years before and after the period under investigation. Conducting retrospective statistical analysis on the collected data can yield more comprehensive results.

Disclosure of Interest

None Declared
Trends of the mental health of the Hungarian adult population between 2010-2023
Authors: Kósa K. , Bíró É.
Published: August 2024

Introduction

Several data have been published in the past decade on the mental health of the Hungarian population by different research teams but less information is available about the trends of mental status of the population based on comparable research methods.

Objectives

Our aim is to provide data on the time trends of mental status in Hungary using comparable methodology.

Methods

Four cross-sectional mental health surveys of the adult Hungarian population were designed by the authors; data collection was carried out by an opinion polling company between 2010 and 2023. Representative samples were selected by multistage stratified cluster sampling and weighted for analysis. Self-filling questionnaires were used to collect information on demographic data and socioeconomic status; validated scales were used to assess pathological distress (GHQ) and sense of coherence (SOC).

Results

Distribution of the respondents by permanent residence, age and sex in all surveys reflected that of the adult population of the country. The proportion of adults struggling with severe psychological distress approximately halved from 14.53% in 2010 to 6.78% in 2019 showing a significantly improving trend (<0.001) with higher proportions of women being severely stressed compared to men. Sense of coherence, a measure of psychological resilience increased by 3.43 points from 2010 to 2019 (p<0.001), also reflecting a significantly improving trend without gender difference. However, the last survey of 2023 showed significant worsening with 18.85% of adults struggling with pathological distress, and a dramatic decrease in sense of coherence (-13.64 points).

Educational level and social support were found to be consistent and significant determinants of mental health.

Conclusions

Mental health status improved among Hungarian adults in the past decade up until 2019 but the trend turned into the opposite by 2023. Further research is warranted to uncover the underlying causes of the latest changes.

Disclosure of Interest

None Declared
Designing youth mental health services to improve access: A qualitative study and framework analysis of youths’ perspectives in Singapore
Authors: Vaingankar J. A. , Subramaniam M. , Samari E. , Chang S. , Tang C. , Lee Y. P. , Chong S. A. , Verma S.
Published: August 2024

Introduction

Although there is an increasing interest in making mental health services (MHS) accessible to youths, there is limited ground-up involvement of youths while designing MHS in Asian settings.

Objectives

This qualitative study sought to understand what youths considered as important elements of youth centric MHS and how these could be designed to improve access by youths in Singapore.

Methods

We conducted seven focus group discussions, and four semi-structured interviews with 50 multiracial youths aged 15-35 years in Singapore - a high-income Southeast Asian country. Purposive sampling allowed adequate representation of age, gender, and race (mainly Chinese, Malay, and Indian) groups. Participants reflected on the features of an ideal MHS for youths and how these could improve youths’ attitude and access to services. Participants also shared their preferences and additional opinions for culturally tailored and age appropriate MHS. Framework analysis using the ‘Conceptual Framework of Access to Healthcare’ (Levesque et al. Int J Equity Health 2013, 12:18) was used to code transcripts and identify the key themes (Ritchie & Spencer. In Analyzing qualitative data, 1994).

Results

The average age of the participants was 24 years. About one third of the participants had accessed MHS in the past. Three key themes were identified – making facilities ‘approachable’, ‘available and appropriate’ and ‘affordable’. (i) Making facilities approachable related to having non-stigmatizing, non-threatening and welcoming aesthetics, organizational culture, and personnel. The participants also recommended a range of professional services, digital tools, and online features to enhance the approachability of MHS designed for youths. (ii) Flexible operating hours, easy appointment management, accessible location, and easy availability to youths with unique needs (e.g., employed youths) or socio-cultural backgrounds were necessary for making facilities available and accessible to youths. (iii) While sharing challenges of family involvement in the help-seeking process, most of the participants, particularly those in the lower ages, talked about tailoring MHS to the ability of youths to pay for the services. Preferences such as having cheaper services for teenagers and initial contacts, offering more non-medical but trained professionals, and considering shorter in-person counselling sessions, followed by free online options were brought up by the participants.

Conclusions

The study provided insights into multiple aspects of MHS and how these could be designed to cater to the needs of youths in Singapore from their perspective. MHS that incorporate non-stigmatizing, flexible, non-threatening and affordable design approaches could improve help-seeking and early interventions in youths.

Disclosure of Interest

None Declared
Community psychiatric care for people with mental disorder and homelessness, with the involvement of peer support. Cooperation of the Awakenings Foundation and BMSZKI
Authors: Bulyáki T. , Harangozó J. , Harangozó Z. , Kéri P.
Published: August 2024

Introduction

A person diagnosed with a psychiatric illness, must face labels and discriminiation most of the time. Fear of these undermines the motivation of people in need to seek help. A special example of this phenomenon is the case of people experiencing homelessness and mental disorder, avoiding the additional stigma of homelessness and therefore do not seek any help for their mental ill-health. Availability of the specific services complicates their problem.

Fear of stigma, trauma, and previous bad experiences of using services also keep people experiencing homelessness away from services.

In Hungary, the February Third Working Group (F3) Report on the 2020 Homelessness Survey After the Penal Code - Before the Pandemic Homelessness - Services Perspectives by Péter Győri shows in his summary paper that only 29% had received psychiatric treatment.

Objectives

Methodology Center of Social and Its Institutions (BMSZKI), in collaboration with the Awakenings Foundation, developed a complex rehabilitation service for people experiencing homelessness and mental disorder. This presentation aims to present this good practice.

Methods

Complex rehabilitation based on the methodology of community psychiatric care with the involvement of peer support.

Results

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provision of community psychiatric care for people experiencing homelessness and mental disorder,

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introduction of screening for effective care of undiagnosed persons with mental disorders,

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provision of outpatient and day hospital care

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focus of care in accommodation services on persons with mental disorders,

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the involvement of peer-support work in the service,

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building a network of contact points, organizing case conferences,

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developing and organizing training on recovery-based rehabilitation for people with mental disorders in cooperation between the two organizations,

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telemedicine, making digital mental health available

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presence of resources represented by self-help groups

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running a working group to promote improvements based on practical experience homelessness and mental disorder.

Conclusions

extra-institutional teamwork multiplies the resources for people experiencing homelessness and mental disorder.

Keywords

mental disorder, homelessness, community psychiatric care, peer support, collaboration

Disclosure of Interest

None Declared
The Mediating Role of Maladaptive Metacognitive Beliefs between Adverse Childhood Experiences and Trait Anxiety
Authors: Horváth D. , Kovács-Tóth B. , Oláh B. , Fekete Z.
Published: August 2024

Introduction

Adverse childhood experiences (ACE) have a significant negative impact on health. ACEs lead to more pronounced trait anxiety, among others, which serves as a basis for various mental and somatic symptoms. Recent findings suggest that the fact that individuals with more ACEs also have more maladaptive metacognitive beliefs may contribute to the development of these symptoms.

Objectives

We aim to study the possible mediating role of maladaptive metacognitive beliefs, resulting from adverse childhood experiences, on trait anxiety.

Methods

Data was collected online, anonymously, in a non-clinical population of adults over 18 years of age. The sample consisted of 304 subjects (84.21 % women, 15.79 % men). The applied questionnaires included a demographic questionnaire, the Adverse Childhood Experiences Questionnaire 10 item version, the Meta-Cognitions Questionnaire, and the Spielberger Trait Anxiety Questionnaire. The system of correlations between the examined variables was explored using structural equation modeling (SEM). The study was carried out with ethical approval and in accordance with the Declaration of Helsinki.

Results

Our results confirm that ACEs have a significant impact on all the measured dimensions of maladaptive metacognitive beliefs. The direct effect of ACEs on adult trait anxiety is also significant. The results of the study on indirect effects support the joint mediating role of the five metacognitive dimensions. The strongest significant mediating effect was found for the uncontrollability and dangerousness of negative beliefs about worry. Both the direct and indirect effects of cognitive self-consciousness on adult trait anxiety are negative, which means that the more the cognitive self-consiousness is characteristic of someone, the lower the degree of trait anxiety in adulthood is.

Conclusions

Our results confirm the mediating effect of metacognitive beliefs on trait anxiety in the context of adverse childhood experiences, which points to the importance of further research on metacognition among the population that suffered early adversities. One of the limitations of the study roots in online data collection: the examined sample is not representative. Moreover, to extend the results, it is recommended to repeat the study on a clinical population. This would enable us to compare our results with those of the clinical population, which could provide further important results in the field of metacognition and adverse childhood experiences.

Disclosure of Interest

None Declared
Changing Tactics? Optimizing ECT in difficult-to-treat depression (ChaT): study protocol
Authors: Van den Eynde L. , Vansteelandt K. , Hebbrecht K. , Obbels J. , Verspecht S. , Gistelinck L. , Geerts P.-J. , Schrijvers D. , Sienaert P.
Published: August 2024

Introduction

Electroconvulsive therapy (ECT) is an evidence-based treatment for difficult-to-treat depression, in which an electrical stimulus is applied via right unilateral (RUL) (Fig 1) or bitemporal (BT) electrodes (Fig 2). Current guidelines recommend to start ECT with RUL placement, except for cases where rapid response is needed. BT ECT has the reputation of exerting a stronger and faster antidepressive effect, but is associated with more pronounced cognitive side effects, as compared to RUL ECT. Recent studies, however, suggest comparable outcomes. In patients responding to ECT, most of the improvement in depressive symptom severity is witnessed early in the treatment course. In case of non-response, it is common practice to switch from RUL to BT electrode placement, although scientific evidence is lacking. As an answer to this research gap, the ChaT-trial was designed: a randomized controlled trial (RCT) to address which treatment strategy (either continue RUL ECT or switch to BT ECT) speeds up recovery with the least impact on cognitive function, in case of early non-response after 4 ECT sessions.

Objectives

1)

To compare the antidepressant efficacy and cognitive effects of continuing RUL ECT vs switching to BT ECT.

2)

To assess group and subject-specific trajectories of depressive symptom severity and neurocognitive performance during the acute ECT course and up to 3 months post-treatment.

Methods

This multi-center double-blind RCT includes adult patients with a uni- or bipolar depression. In case of non-response (<50% decrease of IDS-CR score (Inventory of Depressive Symptomatology-Clinician Rated)) after 4 sessions of brief-pulse high-dose RUL ECT, patients are randomized to either continue RUL ECT, or switch to brief-pulse moderate dose BT ECT until remission. Depressive symptoms are assessed by IDS-CR, Psychotic Depression Assessment Scale (PDAS) and CORE assessment of psychomotor change. An extensive neuropsychological test battery is used to assess different domains of cognitive functioning, e.g., autobiographical memory using the Colombia University- Autobiographical Memory Interview Short- Form (CU-AMI-SF)(Fig 3).

Results

Our hypotheses are: (1) continuing RUL ECT is non-inferior to switching to BT ECT in terms of depressive symptom severity, and (2) continuing RUL ECT is superior to switching to BT ECT in terms of cognitive side effects.

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Conclusions

The ChaT-trial is the first RCT comparing antidepressant efficacy and cognitive effects of continuing RUL ECT with switching to BT ECT in case of early non-response during an acute ECT-course. The results may optimize clinical decision making, speeding up recovery, while minimizing cognitive side effects.

Disclosure of Interest

None Declared
Changing drinking patterns among Italians: 7 out of 10 students experience Binge Drinking
Authors: Marcolini F. , De Ronchi D. , Atti A. R.
Published: August 2024

Introduction

The expression Binge Drinking (BD) refers to dysregulated alcohol consumption, characterized by the intake of large quantities of alcohol, regardless of their nature, consecutively in a limited period of time. BD is a significant public health problem in many European countries, including Italy. According to data from the Istituto Superiore di Sanità, dated 2020, over 4 million Italians exhibit episodic excessive alcohol consumption (compared to 2019 data, there was an increase of approximately 5,3%).

Objectives

This study aims to examine alcohol consumption habits in the Italian population, evaluating psychopathological correlations that can explain its diffusion.

Methods

Between January and May 2023, an anonymous online questionnaire was randomly sent to the general population. Alongside with tests to evaluate psycho-social features, to estimate the presence of alcohol abuse or dependence the AUDIT scale (Saunders et al. Addict Abingdon Engl. 1993; 88:791–804) was used. It included two specific questions to frame the phenomenon of BD (Cranford et al. Alcohol Clin Exp Res. 2006; 30:1896–905). No other study conducted in Italy has so far used the aforementioned validated questions.

Results

The sample consists of 308 people (189 F, 119 M), with an average age of 32 years (sd 14). The AUDIT indicates a state of chronic alcohol consumption in 11,7% (95% confidence interval 8,5%-15,7%), of the recruited sample, positively correlating with the element of impulsivity (p<0,005) confirming what has already been reported in literature. BD prevalence reaches 56% (M 57%, F 55%) without any significant correlation with impulsivity, personality disorders, emotional dysregulation, or sensitivity to rejection. Among university students the prevalence of BD exceeds 70% (95% confidence interval 60%-76%), with a number of drinks reported for a single occasion reaching up to 25 units and a reported number of binge episodes, in a two-week span, ranging from 2 to 10.

Conclusions

Despite possible
biases,
this study raises the relevant issue of the extremely high prevalence of BD disorder, which is particularly alarming in light of the numerous issues related to the behavior itself. A direct correlation with reduced school performance, an increase in risky sexual behavior, and an increase in cases of drunk driving have been evaluated. Considering these consequences, it is of primary importance on a medical, but even more social level, to best characterize this phenomenon in such a way as to be able to implement awareness-raising and prevention interventions.

Disclosure of Interest

None Declared
A preliminary analysis of clinical characteristics of patient with alcohol use disorder and suicidal ideation
Authors: Palma-Alvarez R. F. , Rios-Landeo A. , Ortega-Hernandez G. , Ros-Cucurull E. , Daigre C. , Perea-Ortueta M. , Sorribes M. , Grau-López L. , Ramos-Quiroga J. A.
Published: August 2024

Introduction

Suicidal behaviors are frequently observed among patients with substance use disorder, including suicidal ideation (SI) (1). Alcohol use disorder (AUD) is one of the most prevalent addictions and may be related to suicidal behaviors (2,3). However, the association between AUD and SI requires a deeper analysis which includes several clinical features observed among AUD patients.

Objectives

To analyze the clinical characteristics and features associated with lifetime SI among patients who had AUD.

Methods

This is a cross-sectional study performed in an outpatient center for addiction treatment in patients seeking for treatment who met the criteria for AUD between 01/01/2010 and 12/31/2021. Patients were evaluated with an ad-hoc questionnaire and the European Addiction Severity Index (EuropASI), SI was evaluated using the item for SI in EuropASI.

Results

From a potential sample of n=3729 patients, only n=1082 (73.8% males; mean age 42.82±12.51) met inclusion criteria and had data for the current analysis. Lifetime SI was present in 50.9% of the AUD patients. Several clinical features were related to SI, including: sex differences, any type of lifetime abuse, polyconsumption, benzodiazepine use disorder, any psychiatric diagnosis aside from SUD, and higher addiction severity according to the EuropASI.

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Conclusions

SI among AUD patients is related to several clinical features which indicate a higher addiction severity, more polyconsumption, and a higher prevalence of psychiatric comorbidities. These findings may contribute to the understanding of suicidal behaviors in AUD patients but it is required further investigations, including longitudinal studies.

REFERENCES

1 Rodríguez-Cintas
L, et al. Factors associated with lifetime suicidal ideation and suicide attempts in outpatients with substance use disorders. Psychiatry Res. 2018;262:440-445. doi:10.1016/j.psychres.2017.09.021

2. MacKillop J, et al. Hazardous drinking and alcohol use disorders. Nat Rev Dis Primers. 2022;8(1):80. doi:10.1038/s41572-022-00406-1

3.Darvishi N, et al. Alcohol-related risk of suicidal ideation, suicide attempt, and completed suicide: a meta-analysis [published correction appears in PLoS One. 2020;15(10):e0241874]. PLoS One. 2015;10(5):e0126870. doi:10.1371/journal.pone.0126870

Disclosure of Interest

None Declared