bluuebunny/crossref_metadata_2025 huggingface dataset:
Guidance on how to involve people with lived experience in research on digital mental health interventions
Authors: Wells I. , Thelwell E. , Giacco D.
Published: August 2024

Introduction

Digital technologies and interventions (defined as patient-facing or self-administered interventions delivered through a digital platform) have an increasing role in mental health care. It is key to ensure that appropriate patient and public involvement (PPI) is not overlooked when developing new digital mental health interventions (DMHIs). The unique perspective offered by those with lived experience can improve study conduct and design as well as ensure that interventions meet the needs of users, which may improve their quality and acceptability.

Objectives

To develop guidance for the involvement of people with lived experience of severe mental illness in designing and conducting research on DMHIs.

Methods

Four co-production workshops were arranged online with people who have lived experience of severe mental illness. Initial ideas were formulated in the first workshop and were then prioritised in the second workshop using the nominal group technique. The prioritised ideas were then refined in workshops three and four. Minutes were generated from each workshop and were validated by the those who took part. These minutes were analysed using thematic analysis.

Results

Nineteen people with lived experience participated in the co-production workshops overall. Six people took part in one workshop only and 13 took part in multiple workshops. Two main themes were identified in this study: why do people become and remain involved in PPI?; and what areas should be discussed within PPI consultations? Three subthemes associated with the second theme were also identified. These are: areas related to specific types of DMHI; areas related to any type of DMHI; and what can make a difference within DMHIs? To ensure that people become and remain interested in PPI around DMHIs, it is important to provide a non-judgemental space for people with lived experience to discuss any concerns and ensure they feel valued during consultations. Aspects to consider discussing in PPI consultations around the development of DMHIs include the provision of safety and security within DMHIs, issues around digital exclusion and the potential impact of people’s symptoms on DMHI use. Finally, points that were identified as important to consider when developing DMHIs include offering encouragement throughout the DMHI, accommodating for individual and collective needs within DMHIs and developing a structure within the DMHI which includes adding in attainable goals.

Conclusions

If used, the information provided from this study can generate positive and productive PPI consultations where those with lived experience can make significant contributions to the development of DMHIs. Such contributions will increase the acceptability and efficacy of the DMHIs developed.

Disclosure of Interest

None Declared
Acute Stress Disorder among Tunisian Population in the Palestine-Israel War
Authors: Messedi N. , Sehli M. , samet A. , Chaari I. , charfeddine F. , Aribi L. , Aloulou J.
Published: August 2024

Introduction

The Gaza-Israel conflict has far-reaching consequences that extend beyond the immediate geographic confines of the conflict zone.This war certainly has repercussions on people who follow it via the media.

Objectives

To study the prevalence of acute stress disorder among Tunisian people and determinate the factors associated to it.

Methods

It was a cross-sectional, descriptive and analytical study, conducted among Tunisians. Data were collected during October and November 2023, through an anonymous online questionnaire, spread throughout social media (Facebook/Instagram), using the Google Forms® platform.

We used the the National stressful Events survey acute Stress Disorder Short scale (NSESSS) to assess the severity symptoms of acute stress disorder .

The National Stressful Events Survey Acute Stress Disorder Short Scale (NSESSS) is a 7-item patient assessment measures that assesses the severity symptoms of acute stress disorder in individuals age 18 and older following an extremely stressful event or experience.

Results

A total of 1091 participants completed the questionnaire. The participants had a mean age of 32.7 ± 9.8 years. More females (77.7%) than males (22.3%) participated in the study with a sex ratio (F/M) = 3.5. They were divorced in 2.1% .A history of psychiatric follow-up was found in 19,5% of case.

Results demonstrated that 100% of the respondents closely monitored the war, primarily relying on social media (98.6%) as their primary source of information.

According to the NSESSS ,83.4% of the participants had an acute stress disorder. The breakdown of acute stress disorder severity indicated that 29.7% experienced mild symptoms, 27.5% moderate, 21.6% severe, and 4.6% extreme symptoms.

The factors associated with high score of NSESSS were: female sex ( p=0.000), the divorced people (p=0.001)and previous history of psychiatric follow-up (p=0.000)

Conclusions

These findings indicate a substantial impact of the Palestine-Israel conflict on the mental well-being of the Tunisian population, as evidenced by high rates of acute stress disorder.

Understanding the heightened prevalence of acute stress disorder among different demographic groups following such international conflicts is crucial for developing tailored interventions to support the mental health and well-being of affected individuals.

Disclosure of Interest

None Declared
Physical activity and treatment adherence in patients with mental disorders: a randomized controlled trial
Authors: Silvestro R. , Dello Stritto V. , Catapano P. , Di Vincenzo M. , Della Rocca B. , Lapadula M. V. , Toni C. , Bello R. , Luciano M. , Sampogna G. , Fiorillo A.
Published: August 2024

Introduction

Lack of adherence to pharmacological treatment is considered a multifactorial phenomenon, remarkably frequent in clinical practice. Non-adherence is associated with increased number of relapses, poor clinical and functional outcomes, and worsening of patient health status, with a resulting increase in healthcare costs, particularly in people with severe mental disorders (SMD). Treatment adherence rates remain extremely low, highlighting the need to develop innovative and integrated strategies; one of these is represented by the promotion of healthy lifestyle behaviours, including regular physical activity.

Objectives

The aim of this study is to assess how the rates of treatment adherence vary in patients with SMD after receiving a psychosocial intervention, focusing on the positive relationship between treatment adherence and physical activity.

Methods

LIFESTYLE is a randomized controlled trial comparing the efficacy of a structured psychosocial lifestyle intervention involving moderate physical activity exercises over a brief psychoeducational intervention. Levels of physical activity was assessed thorough the IPAQ scale, while treatment adherence was evaluated by the Morisky Medication Adherence Scale (MMAS).

Results

The sample includes 401 patients, with a mean duration of illness was 16.3 (±17.8) years. All patients were receiving a pharmacological drug treatment; in particular, 59.6% (N=239) were treated with a second-generation antipsychotic and 54.9% (N=220) with a mood stabilizer. Our results show that moderate physical activity improves rates of treatment adherence. After 6 months, adherence to treatment increased from 35.8% at baseline to 47.6% at baseline in the experimental group, along with improvement in clinical health parameters (reduction in BMI, weight, and metabolic parameters). Another significant inverse correlation was found between adherence and quality of life (Rho di Person: -.140, p<.005). Furthermore, this study indicates that having a diagnosis of major depression, a better cognitive functioning, a shorter duration of illness and contact time with the local mental health centre are factors that positively influence treatment adherence. Remarkably, treatment adherence was not influenced by symptom severity and type of pharmacological treatment.

Conclusions

Moderate physical activity can represent a valid strategy to increase treatment adherence in patients with SMD. Therefore, promoting physical activity exercises in our clinical practice may be associated with better outcomes. However, further studies that evaluate patients with acute mental disorders are needed.

Disclosure of Interest

None Declared
Combined effects of psychological and life style factors on pain intensity and/or disability in patients with chronic low back pain: A cross-sectional study
Authors: Tsatsaraki E. , Bouloukaki I. , Kontakis G. , Vakis A. , Miliaras A. , Basta M.
Published: August 2024

Introduction

Chronic Lower Back Pain (CLBP) is a frequently encountered health issue in primary care settings, leading to global disability and imposing a considerable economic burden.

Objectives

This study aimed to: (1) compare socio-demographic, health, lifestyle (sleep, physical activity) and psychological factors (depression, anxiety) between people with and without CLBP; and (2) quantify the correlations between these psychological and lifestyle factors, and clinical outcomes (intensity of CLBP and CLBP-related disability) in people with CLBP after considering other confounders.

Methods

A cross-sectional study was undertaken at the neurosurgery and orthopedic outpatient department of Heraklion University Hospital between 2019-2021. Two hundred fifty three volunteers with CLBP and 116 without CLBP provided sociodemographic information, daily habits, medical history, subjective sleep/ sleep complaints, low back pain intensity and disability using a10-point numeric Visual Analogue Scale pain rating scale and Quebec Back Pain Disability Scale, as well as questions assessing impact of pain on mobility, self-care, routine activities and psychological status, respectively. Participants also completed the Zung Self-Rating Scale (SDS) for self-assessment of depression and Self-rating anxiety scale (SAS). Associations among CLBP, demographics, psychosocial or sleep disorders parameters and clinical outcomes were analyzed using multivariate models.

Results

People with CLBP exhibited a substantially greater prevalence of depressive, insomnia and obstructive sleep apnea (OSA) symptoms than controls (p < 0.05). CLBP diagnosis was independently correlated with female gender, older age, as well as worse physical and mental health outcomes measured by (i) higher level of sleep symptoms such as sleepiness, OSA and insomnia symptoms and (ii) higher prevalence of physician-diagnosed depression, and moderate to severe depressive symptoms. The level of functional disability for CBLP patients (based on Quebec score) was independently associated with age, physician diagnosed depression, lower educational status, moderate to severe depressive symptoms and OSA symptoms. The combination of moderate to severe depressive symptoms with OSA or insomnia symptoms was the most important predictive factor for functional disability for CBLP patients (OR 13.686, 95% CI 4.581-40.885; p<0.001).

Conclusions

Depressive symptoms and subjective sleep disorders appear to relate to greater CLBP-intensity and/or CLBP-related disability in people with CLBP. To achieve the desired outcomes when treating patients with chronic CLBP, it is essential to employ a holistic approach, involving assessment and management of their psychological comorbidities, and sleep issues, that may improve quality of life in these patients.

Disclosure of Interest

None Declared
The bifactor model of the Hungarian self-report version of the Strengths and Weaknesses of ADHD and Normal Behaviors scale
Authors: Vajsz K. , Paulina L. R. , Miklósi M.
Published: August 2024

Introduction

Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most common neuropsychiatric conditions, maintaining its presence well into adolescence and adulthood, resulting in impaired functioning. Evaluating ADHD symptoms through self-reporting plays a crucial role in assessing individuals within these age groups. The novel self-report version of the Strengths and Weaknesses of ADHD and Normal Behaviors (SWAN) scale offers a comprehensive assessment of behaviour, extending beyond just focusing on the typical signs and symptoms of ADHD, thus providing a more holistic perspective.

Objectives

Our goal was to assess the factorial validity of the Hungarian version of the SWAN self-report by comparing a two-factor model with bifactor models with a general and 1) two specific factors (inattention, hyperactivity/impulsivity), 2) three specific factors (inattention, motor hyperactivity/impulsivity, verbal hyperactivity/impulsivity) in a community sample.

Methods

Data from 717 adolescents and young adults (mean age = 20.0 years, SD = 3.10, range: 14 - 25 years, female: N = 664, 92.6%) were analysed. Participants completed an online questionnaire including the SWAN scale after giving informed consent. Confirmatory factor analyses were conducted based on the maximum likelihood estimator (ML).

Results

The bifactor model with a general and three specific factors demonstrated the best fit to our data (CFI = .933, RMSEA = .064 [90% CI: .058 – .071], SRMR = .038). While the overall composite reliability was excellent (ω = .91), the reliability of the specific verbal hyperactivity/impulsivity factor fell below acceptable (ωh = .40).

Conclusions

In line with previous studies, the fit indices of the bifactor models were superior to the non-hierarchical two-factor model. Our results support the existence of a strong general factor but suggest uncertainty in the capacity of the specific factors to consistently explain the distinct variance in observed variables, particularly when compared to the overarching influence of the general factor.

This work was supported by the ÚNKP-22-2 New National Excellence Program of the Ministry for Culture and Innovation from the source of the National Research, Development and Innovation Fund (grant number ÚNKP-22-2-I-ELTE-854).

Disclosure of Interest

None Declared
Associations between psychiatric diagnoses in parents and psychiatric, behavioral, psychosocial outcomes in their offspring: a Swedish population-based register study
Authors: Zhou M. , Lageborn C. T. , Sjölander A. , Larsson H. , D’Onofrio B. , Landén M. , Lichtenstein P. , Pettersson E.
Published: August 2024

Introduction

Children with parents with psychiatric diagnoses have an increased probability for not only the same condition as their parent, but also for other conditions and behavioral and psychosocial problems. Whereas many studies have focused on parental severe mental illness due to their significant impairment, less attention has been paid to more common disorders despite their higher prevalence. In addition, because most past research only included one exposure or one outcome at a time, it remains difficult to examine and compare broad patterns of intergenerational transmission.

Objectives

To examine associations between six parental psychiatric diagnoses in parents, and a broad range of psychiatric diagnoses, psychotropic medications, criminality, suicide, violent victimization, accidents, and school and labor performance in their offspring.

Methods

Based on Swedish national registers, we linked all individuals born in Sweden between 1970 and 2000 to their biological parents (N = 3 286 293). We used a matched cohort design, analyzed with stratified Cox regression and conditional logistic regressions to examine associations between six psychiatric diagnoses in the parents, and 32 outcomes in their offspring. All exposed and unexposed children were followed from their date of birth to the date of emigration from Sweden, the death, or 31 December 2013 when the offspring were 14-44 years old.

Results

In terms of absolute risk, most children who had parents with psychiatric diagnoses were not diagnosed in specialist care themselves, as the proportion of having any of the 16 types of psychiatric conditions ranged from 22.17% (exposed to parental depression) to 25.05% (exposed to parental drug-related disorders) at the end of follow-up. Nevertheless, in terms of relative risk, all six parental psychiatric diagnoses increased the probability of all 32 outcomes in their offspring, with the Hazard Ratio ranging from 1.04 to 8.91 for time-to-event outcomes, and the Odds Ratio ranging from 1.29 to 3.36 for binary outcomes. Some specificities were observed for parental psychotic and substance misuse diagnoses, which strongly predicted offspring psychotic-like and externalizing-related outcomes, respectively.

Conclusions

The intergenerational transmission of parental psychiatric conditions appeared largely transdiagnostic, even for non-psychiatric outcomes in offspring. Given the broad spectrum of associations with the outcomes, service providers (e.g., psychiatrists, teachers, and social workers) should consider clients’ broader psychiatric family history when predicting prognosis and planning interventions/treatment.

Disclosure of Interest

None Declared
The Effect of a Virtual Reality Counseling Program Based on Metacognitive Therapy in Reducing Post-Traumatic Stress Disorder among Those Recovering from Covid-19
Authors: Abdelrasheed N. S. G. , Al Majali M. M. M.
Published: August 2024

Introduction

Many COVID-19 survivors who were attacked and suffered severe symptoms of the virus have suffered from post-traumatic stress disorder (PTSD) which persists for long periods. These people need treatment to alleviate the severity of these disorders. Metacognitive therapy (MCT) is one of the modern therapeutic trends in psychological counseling, which focuses on the nature of the thought rather than on identifying and changing the thought as in other cognitive therapies. It is also concerned with whether people possess an aspect of reflective awareness and aims for a broader understanding of the way the mind works. Working on the process of metacognition, that is, the individual’s thinking about what he knows, being aware of his thoughts, and constantly monitoring and organizing them, helps reduce anxiety disorders and mood swings, and this will reduce psychotic disorders.

Objectives

The current study aims to identify the effect of a virtual reality (VR) counseling program based on MCT in reducing the severity of PTSD among survivors of Covid-19. It also examines the continuity of the effectiveness of this program in reducing these disorders.

Methods

The quasi-experimental method (two group design) with experimental and control groups with a pre-posttest and a follow-up test was adopted. The sample for the current study consisted of 60 COVID-19 survivors suffering from PTSD. The PTSD scale was applied online to a group of people recovering from Covid-19 from the Arab Republic of Egypt. Then those who had high scores were selected, contacted and their consent was obtained to apply a virtual reality counseling program to them. The counseling program was implemented via virtual reality technology, and consisted of 20 counseling sessions, each session lasted between 60-90 minutes. The program continued for two months, with two sessions per week.

Results

The results of the current research revealed a significant improvement in the experimental group through a significant reduction in their post-traumatic stress disorders. The results also showed the effectiveness of the counseling program based on metacognitive therapy in reducing the manifestations of post-traumatic stress disorders in those recovering from Covid-19. The results confirmed the continuing effect of the program after the follow-up period.

Conclusions

Using metacognitive therapy has an effective effect in reducing post-traumatic stress disorder, and it can be used with many psychologically disturbed people.

Disclosure of Interest

None Declared
Identifying predictors of resilient coping in students during COVID-19 lockdown
Authors: Laranjeira C. , Querido A. I. , Dixe M. A.
Published: August 2024

Introduction

Although increasing resilient coping throughout life is beneficial, it is particularly important in young people. To prevent the development of mental health problems, it is crucial to understand the factors associated with resilience. However, among university students, the characteristics considered conducive to resiliency have not been sufficiently studied, particularly during pandemic times.

Objectives

The present study examined factors associated with resilient coping in Portuguese higher education students during the COVID-19 pandemic.

Methods

Data were collected from an opportunity large sample of participants during the academic year 2020/2021. Four self-report measures were utilized within the study: Herth Hope Index, Brief Resilient Coping Scale, Depression Anxiety and Stress Scale – 21 items, and Impact of Event Scale-Revised. Additionally, a demographic questionnaire was used to collect data including age, gender, have children, education level, and study area. Ethics clearance was obtained. In order to test the research question, a multiple regression was conducted (using SPSS 28), with resilient coping as the dependent variable and the other variables entered as potential predictor variables.

Results

A total of 1522 students (75.1% women and 24.9% men) took part in this study. Most participants were single (91.2%), had no children (93%), and the ages ranged from 18 to 59, with a mean age of 22.88±6.93 years. In terms of study level, the majority of students (73.7%) are at the undergraduate level and are not working (76.6%). Among the participants, 35.7%, 36.2%, and 28.5% had symptoms of stress, anxiety, and depression above the normal range, respectively. High resilience scores were found in 215 participants (14.1%). The mean hope (HHI) was 35.53 (SD = 5.92). Our results also demonstrated that hope is the only predictor of resilient coping (p<0.001). A higher level of hope is expected to affect people’s psychological adjustment by influencing both their appraisal of, and their coping with, the stressors confronted by them.

Conclusions

Establishing and improving protective factors should increase the likelihood of the individual successfully avoiding negative outcomes and increase their ability to function normally, thus promoting resilient outcomes. We were able to draw practical implications for developing resilience-promoting methods in a university context. These results can be used to help students build resilience by preparing for future problems.

Disclosure of Interest

None Declared
Comparative Analysis of Impulsivity Profiles in Children and Young Patients with Anorexia Nervosa Restrictive Type, Anorexia Nervosa Binge Eating/Purging Type, Bulimia Nervosa, and Binge Eating Disorder
Authors: Arango M. D. M. , Montasell E.
Published: August 2024

Introduction

High levels of impulsivity are associated with individuals suffering from eating disorders. Impulsivity is a complex and multidimensional construct, with elevated impulsivity traits posing a specific risk in relation to binge-eating and purging disorders when compared to restrictive types eating disorders.

Objectives

Our aim was to identify the difference in impulsivity profile in children and young patients with eating disorders, including anorexia nervosa restrictive type (ANR), anorexia nervosa binge eating/purging type (ANP), bulimia nervosa (BN) and binge-eating disorder (BED).

Methods

Patients aged 21 years or younger, meeting the DSM-V criteria for ANR (n=125), ANP (n=48), BN (n=38), and BED (n=37) were enrolled in the study. The participants had an average age of 16.3 ± 2.15 years. Data collection involved the administration of the UPPS Impulsiveness Scale (UPPS). Bilateral Student’s t-tests were conducted to evaluate potential statistically significant differences among the diagnostic groups.

Results

Our results indicated statistically significant differences in total impulsivity between patients diagnosed with ANR and each of the other eating disorders including ANP (T-Stud -2,19 p < .02), BN (T-Stud -2.17p < .03), and BED (T-Stud -2,68 p < .008) (Figure 1). However, no significant differences were observed among the other eating disorder groups. Nevertheless, it is noteworthy that heightened impulsivity traits, particularly sensation-seeking tendencies, were a common feature among all subtypes of eating disorders, regardless of their specific diagnostic category. Impulsivity and age also exhibited a statistically significant negative correlation (r = -0.13, p = .03) (Figure 2).

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Conclusions

Impulsivity in individuals with restrictive and binge/purgative eating disorders differ significantly, with lower levels of impulsivity in ANR (Figure 1), except for sensation-seeking tendencies. This suggests that both groups may share a similar inclination for seeking intense emotions or engaging in emotionally arousing behaviors. As individuals age from adolescence to young adulthood, there is a tendency for impulsivity levels to decrease (Figure 2).

Disclosure of Interest

None Declared
Guidelines of inclusive architecture design for autism spectrum disorder: What is new?
Authors: Abdelmoula E. , Bouayed Abdelmoula N. , Abdelmoula B.
Published: August 2024

Introduction

Autism spectrum disorder (ASD) is a complex neuro-developmental condition. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), restricted interests and repetitive behaviors and difficulties with social communication and interaction characterize ASD. Different ways of learning, moving, or paying attention are related to the degree of impairments. By reducing environmental and social obstacles in school, work, and other areas of life, architecture could play a pivotal role in helping people on the spectrum become more independent and acquire more abilities.

Objectives

The aim of this study was to outline the recommendations and guidelines of the inclusive architecture design for ASD.

Methods

We conducted a comprehensive review of the scientific literature using the following keywords: inclusive design, architecture, autism or ADS.

Results

Our research found that the Autism ASPECTSS design index reported in 2013 by Magda Mostafa from Canada, which was based on the sensory design theory, is the world’s first set of evidence-based design guidelines for managing built environments to serve ADS individuals interaction, particularly in schools and workspaces. ASPECTSS conceptual framework delineate seven design concepts: acoustics, spatial sequencing, escape space, compartmentalization, transition spaces, sensory zoning, and safety. In 2023, the same author published an autism friendly design guide for the world’s first autism-friendly university. This guide is characterized by a better understanding of human-centered design and advocates beyond the mere inclusion, aspiring to a state where the boundaries between ‘normal’ and ‘special’ are blurred in order to treat all users as human beings with equal rights, thus calling for equal opportunities beyond the ADS spectrum.

Conclusions

With such well-established conceptual framework, it is nowadays imperative to expand our buildings in cities, schools, workplaces, hospitals, and public areas using the guidelines of autism-friendly environments. These buildings will enhance our individual and social well-being.

Disclosure of Interest

None Declared
Relevance of measurement of bêta-2-microglobulin in schizophrenia
Authors: Aissa A. , Arij A. B. C. , Jedda S. , Askri F. , Jomli R. , Abaza H.
Published: August 2024

Introduction

There are several arguments supporting the inflammatory hypothesis in schizophrenia (SCZ). Among the inflammatory markers, beta-2- microglobulin (β2M) is associated with abnormalities in neurogenesis and cognitive impairment described in (SCZ).

Objectives

The objectives of our study were to evaluate the level of β2M in a group of patients compared with a control group and to investigate the sociodemographic, clinical, and environmental factors associated with elevated β2M levels

Methods

We conducted a cross-sectional in outpatients with SCZ. We collected patients sociodemographic, environmental, and clinical data. We assessed psychopathology with the PANSS. We measured serum β2M concentration.

Results

We included 30 patients with SCZ compared with 20 controls. Patients mean age was 40,23±10,66. The mean level of β2M was 1,98 ± 0.42 mg/L for patients and 1.65±0.56 mg/L for control group. The difference was significant between the patient group and the control group (p<10-3). No environmental or clinical factors have been associated with β2M levels other than smoking status (p=0.046).

Conclusions

Further research with larger samples investigating the different stages of SCZ especially early psychosis would be needed to confirm the relevance of this biomarker in SCZ.

Disclosure of Interest

None Declared
The Experience sampling method in psychiatry: a state-of-the-art lecture
Authors: Myin Germeys I.
Published: August 2024

Psychiatric problems occur in people’s normal daily life, in a dynamic interaction with the context people are in. Yet, we have very few techniques to assess this dynamical nature of symptoms, nor do we have good insights in how people actually function in their ordinary life. Ambulatory assessment techniques such as Experience Sampling Methodology (ESM) or Ecological Momentary Assessment (EMA) have been proposed as a potential clinical tool to bridge this gap. Yet, very few of these techniques have actually made it to the clinic. In my talk, I will discuss the strengths and limitations of using these digital diary techniques to open up someone’s real life in clinical practice. I will discuss qualitative research identifying barriers and facilitators, identified by patients and clinicians. I also will discuss what is needed in terms of technology and data security, by demonstrating the MoMent app and MoMent Dashboard, that has been developed within the H2020 IMMERSE project. Finally, I will discuss how these digital mental health tools could help in developing a much more fine-grained understanding of how psychopathology emerges in the realm of ordinary life, making patients active partners in the clinical process.

Disclosure of Interest

None Declared
Fictional faces of female suicide: Qualitative analysis of selected Russian-language texts of the school reader
Authors: Lyubov E. B. , Semenova N. D.
Published: August 2024

Introduction

Isaiah Berlin’s (1948) exploration of the self-searching of Russian thinkers includes studies of the writers – Tolstoy and others (now – Russian-language texts of the school reader). These studies refute a widespread misconception about the relations between Russian writers and thinkers: namely, that in Russia literature and radical thought form two distinct traditions related only by mutual hostility. The works of Tolstoy, Dostoevsky, Karamzin, Leskov, Ostrovsky, and of minor novelists too, are penetrated with a sense of their own time, of this or that particular social and historical milieu and its ideological content, to an even higher degree than the ‘social’ novels of the west. The personal characteristics of suicide victims, heroines of Russian literature, along with the gender aspects, deserve attention in suicidal behavior (SP) focus.

Objectives

To study personal characteristics of suicide victims, heroines of fiction.

Methods

Qualitative analysis of selected Russian-language texts of the school reader.

Results

At the dawn of literature, we have seen fiery heroines and tremulous victims in the arms of death. Аs psychology approach was developed, and we get acquainted with the tragiс backstory. Psychotypes of suicides are exaggerated and overlapped. «Hysterical»: manipulative, frigid nymphomaniac (e.g., Anna Karenina). «Freedom-loving rebel» (i.e., Katerina reincarnations from A. Ostrovsky) in conditions of excessive regulation. «She-Devil, or Rebel Without a Cause». The obsession with death turns into a criminal and a victim (e.g., «Lady Macbeth of the Mtsensk» by N. Leskov, Turgenev’s Susanna or Klara Milich). The image of a vindictively furious («velvet and tiger claws») woman descends to the Victorian view of female self-will. «Mimosa» is a sensitive, dreamy person, unable to resist the hardships of life, dependent (dies with her beloved, objection). In suicide, the strength of weakness is the outcome of a humiliating life (e.g., Karamzin’s «Poor Liza», «A Gentle Creature» by F. Dostoevsky. The meaning of suicides is the following: a call (to compassion, salvation), a «cry for help», atonement for one’s (imaginary) – someone else’s (by proxy) guilt, and release from encumbrance.

Conclusions

Fiction and life are united by emotionally unstable characters and/or depression as markers of unsatisfactory resilience. The cultural diversity of gender patterns and interpretations of SP challenges the essentialist view that «femininity» and marriage are protective factors. SP patterns illustrate and complement the explanatory concepts of SP. The inner world of suicidal people is fascinating and contributes to the evidence-based optimism in the «patient-centric» crisis care model.

Disclosure of Interest

None Declared
Research of cognitive disorders and quality of life in patients, who are receiving methadone replacement maintenance therapy
Authors: Halytska-Pasichnyk N. , Ogorenko V.
Published: August 2024

Introduction

Important goals of substitution therapy include: reducing the desire to use opioids - methadone enters the brain with a minimal euphoric effect, reduce the desire to use opioids, allowing to avoid the risk of overdose and control their addiction; prevention of withdrawal syndrome; improving the quality of life - can contribute to the restoration of patients, allowing them to return to a normal life, improve their social, professional and family situation; reducing the risk of transmission of infections HIV and hepatitis; reducing crime - control addiction can reduce related crime and to illicitly obtain opioids; psychosocial support helps patients develop coping strategies and increases their chances of long-term recovery.

The goal of substitution therapy is not to completely get rid of addiction, but it can help stabilize the patient’s life and facilitate the recovery process.

Objectives

Many patients receiving MT also have mental disorders such as cognitive decline, depression, anxiety, PTSD, or even bipolar disorder. These conditions can greatly affect the course and results of treatment.They may also have problems with employment, housing, family conflicts, and legal issues.

Methods

In the course of the study, 134 patients aged 26 to 64 years (105 men and 29 women) with a diagnosis of opioid addiction and receiving methadone therapy were examined. Of them, 48 patients had a period of stay at MT of up to three years and 86 – more than three years. The Montreal Cognitive Scale (MoCA) was used to assess comorbid cognitive impairments. The WHOQOL-BREF questionnaire was used to assess the quality of life.

Results

The range of indicators of cognitive functions varied from 21 to 29 points (average - 25.3). 61 patients (46%) showed a result of 26 and above, indicating the absence of cognitive impairment, 51 patients (38%) received from 24 to 21, indicating moderate cognitive impairment. 22 patients (16%) had borderline indicators.

When assessing the level of quality of life, indicators of physical and psychological components varied from 12 to 31; self-perception in the range from 10 to 27 points; microsocial support from 3 to 14 points; social well-being from 11 to 36. In general, the level of satisfaction with the quality of life was in the range of 38-83%.

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Conclusions

Opioid addiction therapy should be consist of an assessment of physical and psychological status, comorbid disorders, quality of life, etc. We can see, MT does not significantly affect the cognitive functions. The differences in the assessment of the quality of life were noted in the components of microsocial support and social well-being, which indicates the vulnerability of patients in these areas. Duration of opioid dependence, availability of psychosocial support, presence of comorbid conditions affect the quality of life. It is important that treatment is tailored to individual needs of patients.

Disclosure of Interest

None Declared
Factors Associated with Voluntary Discharge in a Hospital Detoxification Unit: An Observational and Descriptive Analysis
Authors: Gamboa Lozada P. , Ortega Hernández G. , Palma Álvarez R. F. , Ríos Landeo A. , Ramos Quiroga J. A. , Grau López L.
Published: August 2024

Introduction

Adherence to treatment for addictive disorders remains a clinical challenge. Despite detoxification admissions being scheduled and initiated voluntarily by the patient, several factors may contribute to treatment discontinuation.1 Understanding these factors will enable the development of specific interventions for a more effective approach.2

Objectives

To identify and analyze the relationship between specific clinical factors and voluntary treatment discontinuation.

Methods

An observational and descriptive study was conducted using a retrospective database of 1146 patients admitted to the “Hospital Universitari Vall d’Hebron” Detoxification Unit between June 2008 and December 2019. Bivariate analysis was conducted to identify individual associations between clinical factors and voluntary discharge. Subsequently, a multivariate analysis was performed to assess the combined influence of these factors while controlling for potential confounding variables.

Results

A total of 135 patients (11.8%) requested voluntary discharge. Significant differences were found between the voluntary discharge and non-voluntary discharge groups in patients with dual diagnosis (91.1% vs 80.9%, p<0.0001), specifically the presence of psychotic disorder (18.7% vs 12%, p<0.05) and cluster B personality disorder (66.7% vs 31%, p<0.0001). Significant associations were also observed with prior detoxification admissions (64.5% vs 54.1%, p<0.05), heroin as the main admission substance (29.6% vs 13.3%, p<0.0001), lifetime use of more than three substances (65.3% vs 45.3%, p<0.0001), and pre-admission binge-pattern substance use (72.1% vs 51.4%, p<0.0001). A significant relationship was found with therapeutic discharge in the diagnosis of major depressive disorder (14.6% vs. 24.8%, p<0.05), admission for alcohol detoxification (25.9% vs. 42.8%, p<0.0001), and participation in group therapy during admission (27.4% vs. 49.9%, p<0.0001).In the multivariate analysis, it was found that cluster B personality disorder (p<0.0001), heroin as the primary substance of admission (p<0.05), and pre-admission binge-pattern substance use (p<0.05) were independently related to voluntary discharge.

Conclusions

Cluster B personality disorder, admission for heroin detoxification, and pre-admission binge-pattern substance use are factors associated with voluntary treatment discontinuation.

Disclosure of Interest

None Declared
Potential Neurobiological and clinical markers in Extreme Weight Conditions: from Anorexia to Obesity
Authors: Fernandez-Aranda F. , Jimenez- Murcia S. ,   Psychoneurobiology of Eating and Addictive Behaviours Group, Neuroscience Program, IDIBELL
Published: August 2024

Extreme eating and weight conditions (EWC) are a construct that emerges as a dimensional and theoretical model that identifies individuals who exhibit inappropriate eating behaviours and abrupt weight fluctuations. According to this spectrum of EWC, one extreme can be represented by individuals with anorexia nervosa (AN), characterised by excessive food restriction and an extremely low body mass index (BMI), whereas the other end of this continuum is represented by individuals with obesity (OB), characterised by a BMI above 30. In addition to AN and OB, some eating disorders (EDs), namely bulimia nervosa and binge eating disorder, are also part of this continuum, given the high risk of falling into one of the extremes, especially that of higher BMI. Studies have described similar changes at the psychological and neurobiological levels associated with their abnormal eating patterns, delineating vulnerability pathways related to the neurobiological basis.

Based on previous literature, individuals suffering from EWC would show dysfunctional brain activity in regions associated with emotional reward processing and cognitive control compared to healthy controls (HC). Similarly, neuroendocrine alterations in EWC are expected to influence clinical symptomatology. It will also be discussed how impairments in executive function and differential brain activity observed in individuals with EWC may negatively impact their clinical course and treatment outcome.

Disclosure of Interest

F. Fernandez-Aranda: None Declared, S. Jimenez- Murcia Grant / Research support from: We thank CERCA Programme/Generalitat de Catalunya for institutional support. This research was supported by grants from Instituto de Salud Carlos III (ISCIII) (FIS PI20/00132) and co-funded by FEDER funds/European Regional Development Fund (ERDF), a way to build Europe. CIBERObn is an initiative of ISCIII. Additional support was received from the Delegación del Gobierno para el Plan Nacional sobre Drogas (2021I031) and Ministerio de Ciencia e Innovación (grant PID2021-124887OB-I00). Additional funding was received by AGAUR-Generalitat de Catalunya (2021-SGR- 00824), European Union’s Horizon 2020 research and innovation program under Grant agreement no. 847879 (PRIME/H2020, Prevention and Remediation of Insulin Multimorbidity in Europe) and the European Union’s Horizon Europe research and innovation program under grant agreement No 101080219 (eprObes)., Consultant of: FFA and SJM received consultancy and speakers honoraria from Novo Nordisk.
A Study on the Disclosure of People with Mental Illness
Authors: Seo M. , Lee M. H. , Kim Y. R.
Published: August 2024

Introduction

People with mental illness often experience a concealable stigmatized identity that may be invisible to others. As a result, they are often faced with the dilemmas of whether to disclosure or conceal their diagnosis and their experience. However, in order to overcome the social stigma and self-stigma that hinder their recovery, they must establish a network and social support through identity disclosure.

Objectives

This study investigates the effect of clinical characteristics (symptom and social function level), self-stigma and social support on the disclosure of people with mental illness.

Methods

The research was conducted with 236 respondents who are currently using community mental health services. (Male: 51.9%, Female: 48.1%; Mean age = 47.97±13.24; SPR: 66.8%, other diagnosis: 33.2%).

Results

Most respondents disclosed their mental illness to health service providers and family, but they are least open about their identity toward neighbors and co-workers. A regression analysis of predictors of disclosure revealed that only social functioning level and social support had significant predictive power. It was discovered that individuals with better level of social function and social support disclosure more about their mental illness.

Conclusions

A program that increases social functions and support network can be recommended to improve disclosure efficacy.

Disclosure of Interest

None Declared
Ethnic differences in pathways to obtain care, maintain care and engage to Early Intervention Service in Spain
Authors: Sanchez-Gistau V. , Algora M. J. , Cabezas A. , Sole M. , Miro P. , Saez C.
Published: August 2024

Introduction

Ethnicity and migration have an impact on illness models and consequently how, when and where people seek and obtain care. Early Intervention Psychosis (EIP) teams attend high rates of migrant and ethnic diverse populations but the study of ethnic differences in pathways to obtain and maintain care is still scarce . The most consistent findings are that minorities are less involved with primary services, have a higher risk of being treated in a coercive way and are at higher risk of early disengagement. Despite the increasing migration rates there has been very little investigation in Spain.

Objectives

To investigate ethno-racial differences in pathways to obtain care, adherence and engagement during their first year of follow-up of subjects who start treatment at EIP of Reus, Catalonia, Spain

Methods

Participants

This is an observational 12 months follow-up retrospective study including all consecutively subjects with First Episode of Psychosis (FEP) referred to the EIP from January 2015 to January 2019. Visible ethno-racial status was self-reported being grouped as belonging to minority ethno-racial group if they were coded “any other than White regardless of country of origin”. ‘White’ was the majority group

Study variables:

At program entry:

Source of referral

At 12-
months:

Adherence to the service:

Admissions to in-patient unit

Disengagement

Results

184 FEP subjects (mean age 22.8 years and 66.1% of males) were included. Nearly 31% belonged to a minority ethno-racial group being the Maghrebi (60.4%) followed by the Latin-American (20.1%) the most frequent minority groups. The 81.2% of the minority group were first-generation migrants and 7.5% second generation migrants. The 52.2 % were referred from community services, 18.5% from emergency unit and 29.3% from inpatient unit. At follow up 64.5%, were highly adherent to EIP (> 75% of attended appointments), 16.7% required hospitalization and 11% disengaged. Multivariate analysis showed that the minority group was 2.19 times more likely to be low adherent [(95% CI 0.78-3.17; p=0.03], 2.89 times more likely to be hospitalised [(95% CI 1.20-6.98); p=0.01], and 4 times more likely to disengage from the EIP [(95% CI 1.35-11.90); p= 0.01] during follow-up than the majority group. No group differences were found in pathways to obtain care or in causes of disengagement.

Conclusions

In agreement with previous studies from other countries we found high rates of ethno-racial diversity in the EIP of Reus. In addition, we also found inequalities in the use of services, being minorities more likely to disengage, to be low adherent to the program and at greater risk of hospitalization. On contrary to other studies we did not find significant differences between groups in the source of referral to EIP

Disclosure of Interest

None Declared