bluuebunny/crossref_metadata_2025 huggingface dataset:
Suicidality among adolescents and young adults in a Psychiatry Inpatient Unit: a two-year retrospective study in Umbria, central Italy
Authors: Valentini E. , Minuti A. , Menculini G. , De Giorgi F. , Sciarma T. , Amantini K. , Moretti P. , Tortorella A.
Published: August 2023

Introduction

Suicide is the fourth leading cause of death among adolescents and young adults (AYA) (Czyz EK, King CA. J Clin Child Adolesc Psychol.2015;44(1):181-19), and psychiatric disorders are a major contributing factor (WHO Global Health Estimates 2000-2019). Studies focusing on suicidality in Italian inpatients samples are scant.

Objectives

The present cross-sectional study aimed to define clinical variables associated with suicidality related phenomena in a sample of young inpatients. The main objectives were to assess the prevalence of suicidal ideation and deliberate self-harm in inpatients aged 16–24 years and to determine the relationship between suicidal behaviours and psychiatric disorders.

Methods

This retrospective study was conducted in a naturalistic setting, at the Psychiatric Inpatient Unit, Perugia Hospital/Local Mental Health Unit 1, from January 2018 to December 2019. Sociodemographic information, clinical history, diagnostic and treatment features were collected. Descriptive and bivariate analyses were performed (p<0,05).

Results

Among 120 patients (14,2% of the overall 850 hospitalizations in the index period) admitted for suicidality-related phenomena, 21 (17,5%) were AYA. Admission was due to deliberate self-harm in 85,7% (n=18) and to suicidal ideation in 14,3% (n=3) cases. Personality disorders (p=0.006), were significantly more prevalent among AYA, while mood disorders were more frequent among adults (p=0.0018) (Tab.1).Tab.1.

Differences in diagnostic features between AYA and adult population.

AYA
n (%)Adults
n (%)χ2PPERSONALITY DISORDERS10 (47.6)17 (17,2)7.5470.006Borderline personality disorder7 (33.3)9 (9.1)6.8380.009MOOD DISORDERS0 (0)26 (26,3)5.5780.018

Conclusions

Personality is under construction among youths, and affective symptoms may have unusual characteristics (Lack CW, Green AL. J Pediatr Nurs. 2009;24(1):13-25), as demonstrated by the fact that irritable rather than depressed mood is a core diagnostic mood symptom for adolescents (Rice F, et al. J Affect Disord. 2019;243:175-181). We hypothesized that symptoms of irritability, emotional dysregulation, and impulsivity could be linked to suicidality (Ghanem M, et al. Arch Suicide Res. 2013;17(3):262-274). Further investigations are needed for the characterization of AYA inpatients who experience suicidal thoughts or self-injurious behaviours, in order to redefine preventive tools and reduce suicide mortality rates.

Disclosure of Interest

None Declared
Alcohol related cognitive impairments in schizophrenia patients : A case-control study
Authors: Angerville B. , Vaucher N. , Gierski F. , Benzerouk F. , Walesa S. , Seree J. , Bralet M.-C. , Benyamina A. , Naassila M. , Dervaux A.
Published: August 2023

Introduction

Cognitive impairment is a well-recognized key feature of schizophrenia. However, these cognitive impairments may be worsened by alcohol consumption. Up to 80% of patients with alcohol use disorders (AUD) display cognitive impairments. Screening for those impairments with a full neuropsychological assessment may be difficult. The Brief Evaluation Alcohol-Related Neuropsychological Impairments (BEARNI) is a specific tool for screening those impairments easy to implement in in clinical practice (Ritz et al. Alcoholism: Clinical and Experimental Research 2015; 39, 2249-60). To our knowledge, no previous studies have assessed the alcohol-related cognitive impairments using the BEARNI test in schizophrenia patients.

Objectives

The objective of the study was to compare BEARNI mean scores between a group of schizophrenia patients with alcohol use disorders and a group of schizophrenia patients without alcohol use disorder.

Methods

39 patients with schizophrenia and AUD (SCZ/AUD +) (82% males, mean age 44.9 ± 11.0 years-old) and 49 patients with schizophrenia without AUD (SCZ/AUD-) (65% males, mean age 42.6 ± 11.4 years-old) consecutively included in the study, were assessed using the BEARNI test. All patients met DSM-5 criteria for schizophrenia and AUD. Demographic and clinical variables were also collected, using the Alcohol Use Disorders Identification Test (AUDIT) and the Positive and Negative Syndrome Scale (PANSS). The primary endpoint of the study was the difference in BEARNI cognitive mean scores between the SCZ/AUD+ and SCZ/AUD- groups.

Results

There was no difference between the two groups regarding demographic variables or PANSS mean scores (59.1 ± 12.8 vs 58.1 ± 14.0; t=-0.3; p=0.7). The AUDIT mean score was higher in the group of patients SCZ/AUD+ (20.6 ± 7.8 vs 1.6 ± 1.5; t=-14.7; p<0.0001). Total BEARNI and cognitive BEARNI mean scores were significantly lower in the group of patients SCZ/AUD+ compared to the group of patients SCZ/AUD- (10.6 ± 4.8 vs 12.6 ± 5.2; t=1.8, p=0.03 and 8.1 ± 3.9 vs 9.8 ± 3.6 t=2.0, p=0.04, respectively). The mean subscores of delayed verbal memory, alphabetical ordination, and alternating verbal fluency subtests were also significantly lower in the group of patients SCZ/+ group (respectively 1,0 ± 0.9 vs 1.6 ± 1.2, t= 2.5, p=0.01; 2,1 ± 1.2 vs 2.5 ± 1.1, t= 1.6, p=0.04; 3.3 ±1.5 vs 3.8 ± 1.5, t= 1.8, p=0.03).

Conclusions

The present study found cognitive impairments using BEARNI test in schizophrenia patients with AUD compared to their counterparts without AUD. Screening alcohol related cognitive impairments using BEARNI could be easier in patients in schizophrenia patients with AUD than usual neurocognitive assessments

Disclosure of Interest

None Declared
Quality of life and psychosocial adjustment: the moderator role of anxiety symptoms in persons with temporal lobe epilepsy due to hippocampal sclerosis
Authors: Lima E. M. , Gois J. , Vincentiis S. , Valente K. D. R.
Published: August 2023

Introduction

Persons with temporal lobe epilepsy due to hippocampal sclerosis (TLE-HS) have a high frequency of psychiatric disorders, namely depression and anxiety. In addition, poor quality of life (QOL) and impairments in psychosocial adjustment are frequently reported. Despite the increasing number of studies aiming to identify predictors of poorer QOL, the role of depressive and anxiety symptoms remains poorly understood.

Objectives

This study aimed to evaluate: (1) if psychosocial adjustment predicts worse QOL; (2) the relationship between psychosocial adjustment and QOL by concurrently examining the role of depressive and anxiety symptoms.

Methods: Participants

Thirty-five persons with TLE-HS ranging from 18 to 60 years old (mean age 39.82 SD 9.05; 20 men 57.14%) followed in a tertiary outpatient center underwent neurologic and psychiatric assessments.

Assessments

The psychiatry interview was performed using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (SCID). Psychosocial adjustment was assessed with the total score of the Social Adjustment Scale (SAS) (SAS Overall). The QOL was evaluated by the total score of the Quality of Life in Epilepsy-31 Inventory (Overall QOLIE-31), the most frequently used instrument in assessing QOL in epilepsy. The Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI-X) were used to assess depressive and anxiety symptoms, respectively.

Analyses

Prediction analysis was performed to evaluate the impact of psychosocial adjustment on QOL (simple linear regression). Simple moderation models were used to examine the moderation effect of depressive and anxiety symptoms on the association between PA and QOL (Figure 1). We used SPSS (version 29 IBM Corp) and PROCESS Macro (version 4.1. for SPSS) to perform regression and moderation analyses (Figures 2 and 3), respectively.

Results

Poor psychosocial adjustment (higher scores on SAS) impacted on poor QOL (lower scores on QOLIE-31) (R=0.39; R2=0.15; adjusted R2= 0.12; B=-0.39; t=-2.28; p=0.03). The severity of anxiety symptoms (Trait and State; coefficient=-0.64; t=-2.01; p=0.05 and coefficient=-1.17; t=-2.20; p=0.03, respectively), but not the severity of depressive symptoms (coefficient=0.77; t= 1.37; p=0.18), moderated the relationship between psychosocial adjustment and QOL.

Image:

Image 2:

Image 3:

Conclusions

Psychosocial adjustment is a predictor of QOL in TLE-HS. Anxiety symptoms moderate this relationship between psychosocial adjustment and QOL. Consequently, higher anxiety symptoms are associated with worse psychosocial adjustment and quality of life.

Disclosure of Interest

None Declared
EEG Correlates of suicidal intentions in depressive patients who survived and have not been ill with COVID-19
Authors: Iznak A. F. , Iznak E. V. , Damyanovich E. V.
Published: August 2023

Introduction

The COVID-19 pandemic has caused an increase in suicidal intentions and attempts. One of the ways to prevent suicides is the timely detection of suicidal intentions. In this regard, it seems relevant to search for objective markers of suicidal intentions.

Objectives

The aim of the study is to identify EEG correlates of suicidal intentions in depressive patients who survived and not have been ill with COVID-19.

Methods

The study included 30 female patients aged 16-25 years with depressive disorders (F31.3-4, F21.3-4 + F34.0, according to ICD-10), who had previously a mild or asymptomatic coronavirus infection (group “COVID”), and 40 depressive patients, matched by sex, age, syndrome and the pre-treatment severity of depression (according to the total score of the Hamilton HDRS-17 scale), but not sick with COVID-19 (“non-COVID” group, The severity of suicidal intentions was quantified by the number of points of item 3 of the HDRS-17 scale. All patients underwent pre-treatment registration of the background EEG in a state of quiet wakefulness with eyes closed in 16 monopolar leads: F7, F3, F4, F8, T3, C3, Cz, C4, T4, T5, P3, Pz, P4, T6, O1 and O2. The analysis of the absolute EEG spectral power (SP) was carried out in 8 narrow frequency sub-bands. Statistical processing of the data obtained was carried out using the methods of descriptive statistics, comparison of means and correlation analysis of the IBM SPSS Statistics, v.22 software package.

Results

In the “COVID” group, the mean number of points of item 3 of the HDRS-17 scale was slightly higher than in the “non-COVID” group (2.1 ± 1.5 and 1.8 ± 1.6, respectively), but these differences did not reach the level of statistical significance (p> 0.05). However, the structure of correlations between the values of this indicator of the severity of suicidal intentions and EEG parameters in the two groups turned out to be different. In the “COVID” group, the largest number of significantly (p<0.05) positive correlation coefficients was noted between the number of points of item 3 of the HDRS-17 scale and the SP values of slow-wave EEG components, e.g. theta2 sub-band (6-8 Hz) in leads F7, F3, F4, F8, T4, C3, C4, P3 and P4, as well as the delta sub-band (2-4 Hz) in leads F7 and P4. In the “non-COVID” group, the number of points of item 3 of the HDRS-17 scale positively correlated with the SP values of the alpha2 sub-band (9-11 Hz) in leads F7, F8, F4, C3, C4, T4, P4 and O2, as well as with SP values of the delta sub-band (2-4 Hz) in leads F7, F3 and C3.

Conclusions

In depressive patients who underwent COVID-19, the severity of suicidal intentions is associated with EEG signs of a more reduced functional state of the cerebral cortex, including the anterior regions, than in patients who did not have coronavirus infection.

The study supported by the RSF grant No. 21-18-00129.

Disclosure of Interest

None Declared
Barriers and facilitators towards recovery and health service utilization among Haredi Jews with mental illness
Authors: Whitley R. , Jarvis E. , Le Blanc M.-N. , Rohr E.
Published: August 2023

Introduction

Evidence suggests that minorities tend to under-utilize mental health services, and may face specific barriers and facilitators towards recovery. One community which remains particularly under-researched in the Western World are Haredi Jews — a diverse group of individuals characterized by a shared devotion to traditional Talmudic and Halakhah teachings and observances.

Objectives

The overarching aim of this study is to document and analyze barriers and facilitators towards recovery and mental health service utilization among Haredi Jews with a history of mental distress. Specific objectives include: (i) eliciting and understanding participants’ mental health knowledge, beliefs, behaviours & attitudes; (ii) exploring their pathways and barriers to mental health care, especially examining the role of religiosity, religious community and rabbinical advice; and (iii) investigating their experience within the official mental health care system.

Methods

To gain an in-depth understanding, we conducted a qualitative study. This involved semi-structured interviews with 24 participants who (i) identified as Haredi Jews; (ii) had used mental health services; and (iii) were 18+ years of age. It also included interviews with several key stakeholders, for example local Rabbis and other community leaders. Data was analyzed using thematic analysis techniques.

Results

Participants typically had experienced mild to moderate mental distress, and tended to view mental health services in a positive light, mainly expressing satisfaction with services received. The analysis revealed three important facilitators and three important barriers to recovery. Facilitators comprised of (i) high levels of social support within the community, including specific well-being support groups; (ii) a positive relationship and connection with G-d, considered to provide guidance and support during troubled times; and (iii) the presence of many bridges and resources within the local Haredi community, including community-run health services, and Rabbis who encouraged mental health care utilization where appropriate. Barriers comprised of (i) stigma related to marriageability of self and offspring, inhibiting disclosure and mental health care use; (ii) acknowledged lack of awareness and knowledge about mental health, mental illness, treatments, and therapies; and (iii) generic health service issues, including long waitlists, limited availability and lack of appropriate therapists.

Conclusions

Study participants tended to have positive views of psychiatric services, and utilized different health care and community-based resources to help foster recovery. However, ongoing issues of stigma and low levels of mental health literacy may inhibit mental health care use and recovery. This implies a need for religiously-informed and community-grounded mental health literacy campaigns among Haredi Jewish communities.

Disclosure of Interest

None Declared
Depression and quality of sleep in patients with type 1 diabetes being under regular diabetes care
Authors: Cyranka K. , Matejko B. , Chrobak A. , Dudek D. , Kieć- Wilk B. , Cyganek K. , Witek P. , Małecki M. , Klupa T.
Published: August 2023

Introduction

Research indicates that co-morbid diabetes and depression is common; however, the implications for clinical practice remain unclear

Objectives

The aim of the study was to check the prevalence of depression in patients with T1DM who are provided with optimal conditions of diabetes care and to identify possible risk factors connected with affective traits

Methods

Out of the 107 patients, 78 (54 females, 24 males) were included for the analysis (HbA1c [%] 7.11±1.0, BMI [kg/m2] 25.3, ± 5.6; Years of T1DM [N] 13.7±8.3). The patients filled in a set of questionnaires during their regular visit to the outpatient clinic. Three patients from the whole group were on intensive insulin therapy with Multiple Daily Injections (MDI) and Self-Monitoring of Blood Glucose (SMBG), all the rest were on various types of personal insulin pumps (years on insulin pump [N] 9.1±4.5). All the patients were on regular diabetologist care, with regular visits in a Centre for Advanced Technologies in Diabetes (at least every 6 months).

Results

In QIDS-S 26 patients (33.8%) were screened positive for depression, in PHQ 57.7% of the patients (45 patients) had symptoms of depression (age was negatively correlated with PHQ score (r= -0.26; p=0.023)). In CES-D 16 (20%) of the patients assessed their present affect as depressed. Quality of sleep was highly correlated with depressive symptoms CESD (r=0.61, p=0.001), PHQ Score (r=0.62; p=0.001), QISD (r=0.68; p=0.001).

Conclusions

The prevalence of affective disorders and poor sleep quality in the examined T1DM patients was much higher than in the general population. Even if the patients have in general good glycemic control, their mental health condition should not be neglected. Well organized cooperation between patients, diabetologists, psychiatrists and psychotherapists is needed.

Disclosure of Interest

None Declared
Mental Illness Stigma among professionals at a Portuguese Medical Center
Authors: Rodrigues D. F. , Adão C. , Sequeira A. S.
Published: August 2023

Introduction

Mental Illness Stigma is a barrier in access to healthcare. Stigma also influences population health outcomes by worsening, undermining adequate processes. The healthcare professionals show several stigmatising behavirous and cognitions, which may impair the adequate provision of care of this population with mental illness.

Objectives

We aimed to measure mental health stigma in healthcare professionals at a portuguese hospital center.

Methods

A cross-sectional study of health profissionals was performed using a survey that included socio-economic and job related questions, personal and familiar questions regarding mental health, and Attribution Questionnaire 27 (AQ-27), a translated and validated stigma questionnaire with nine stigma sub-scales (Responsability, Pity, Anger, Dangerousness, Fear, Help, Coercion, Segregation and Avoidance).

Results

The sample included a total of 388 participants. The majority of the respondants were female (82,5%). The age ranged from 22 to 69 (mean = 40,05). According to the job place distribution, we found statistically significant differences in various stigma subscales among several healthcare settings within our center. The inpatient unit professionals showed lesser stigmatising attitudes in anger, coercion, segregation and avoidance domains; and higher stigmatising attitudes in pity and help domains. However, professionals who work at surgery room showed higher stigmatising attitudes in danger and fear, but lesser levels of help domains. We also found differences in five stigma subscales among various health professions. The study didn’t show differences in stigma domains regarding personal or professional contact with mental illness, neither academic studies in mental health.

Conclusions

Our findings suggest that workplace environment and profession may impact mental ilness stigma levels in healthcare professionals. We propose that future studies could be done to investigate methods to mitigate mental illness stigma, tailored to address different stigma domains in different workplace settings.

Disclosure of Interest

None Declared
Assessment of relationship of mental health and quality of life of COVID-19 Survivors in selected hospitals of Tehran University of Medical Sciences, 2021
Authors: Khosravi H. , Sayadi L. , Mohammadnejad E.
Published: August 2023

Introduction

Survivors from Covid-19 are more prone to psychological distress due to their experience of illness, hospitalization, and severe conditions. Diseases can also affect patients’ quality of life. Nursing of these patients is not limited to hospitalized patients and paying attention to the mental health status and quality of life of patients is one of the roles and responsibilities of nurses. The aim of this study was to determine the relationship between mental health and quality of life of Covid-19 survivors in selected hospitals of Tehran University of Medical Sciences in 2021.

Objectives

Due to the disturbance in mental health and the decrease in the quality of life of the survivors of this disease, the results of the research can be used for policy making and rehabilitation planning for those who have recovered from this disease. Also, considering that the covid-19 virus may remain for years and infect many people, supporting and controlling the physical and mental conditions of these people in the long term can help to increase the quality of life and improve their mental health.

Methods

This study is a cross-sectional study in which the mental health and quality of life of 276 survivors of Covid-19 who were hospitalized in three hospitals of Imam khomeini, Shariati and Baharloo between February 2020 and July 2020 were examined. Data were collected by using demographic and clinical information questionnaire, 12-item general health questionnaire and 36-item quality of life questionnaire. Data analysis was performed using SPSS16 software at a significance level of 0.05.

Results

The results showed that the general health (mental health) score of the participants in this study one year after Covid-19 was equal to 6/26 ± 2/75 and 231 survivor of Covid-19 (83.7%) score more than 3 they had. Regarding quality of life, the results showed that the dimensions of energy and vitality, and general health, had the lowest scores with an average of 53.3 and 54.71 (out of 100 points), respectively.There is an inverse relationship between mental health and all aspects of quality of life, so that with the deterioration of mental health status in Covid-19 survivors, their quality of life score decreases.

Conclusions

The results of the study showed that the mental health status of a large percentage of Covid-19 survivors is impaired and there is also a significant and inverse relationship between the total score of mental health and dimensions of quality of life and their total score of quality of life. Paying attention to the mental health problems of Covid-19 survivors by health system staff, especially nurses, and choosing supportive strategies for them is one of the priorities that should be considered. Psychological support for these people can improve their mental health and indirectly increase their quality of life.

Disclosure of Interest

None Declared
Procrastination among students of Polish universities. Protective and predisposing factors
Authors: Smolarczyk-Kosowska J. A. , Dębski P. , Ngo A. , Piegza M.
Published: August 2023

Introduction

Procrastination is a widely recognized phenomenon that can be defined as a tendency to delay important life activities and decisions. This seems to be a common issue among schoolchildren and students, however is not limited to those populations and may also be observed among other social groups. Research shows that the indices of the occurence of procrastination may reach even as much as 20-25% of the total population. However, the frequency of the phenomenon seems to be considerably higher among academic environment.

Objectives

We sought to investigate the association between the phenomenon of procrastination and the individual’s resiliency, sense of coherence and the development of the identity.

Methods

A web-based questionnaire study was performed on a random sample of Polish students of various fields of study, aged 18-30 years. A 131-item questionnaire was built based on an original questionnaire and four standardized tools for the assessment of procrastination tendencies, resiliency, sense of coherence and the development of the identity (polish-Kwestionariusz Zwlekania-KZ), the Sense of Coherence Questionnaire-SOC-29, the Ego Resiliency Scale, The Dimensions of Identity Development Scale- DIDS).

Results

This questionnaire study included 294 participants, median age 22 (IQR=21-24). Mature forms of identity development (meaning the commitment making (CM) and identification with commitment (IC)) correlated negatively with the occurence of procrastination (R=-0,186, p<0.005 for CM; R=-0.288, p<0.05 for IC). Ruminative exploration (RE) correlated positively with tendency to procrastinate (R=0.218, p<0.05). Procrastination correlated negatively with the resiliency evaluation (R=-0.229, p<0.05) and the optimal regulation(OR) assessment (R=-0.255, p<0.05). All the SOC-29 domains along with its total score correlated negatively with the tendency to procrastinate (p<0.05 for all).

Conclusions

Based on the conducted study, there seem to be measurable psychological benefits regarding the individual’s personal performance resulting from a proper psychoeducation in the field of procrastination.

Disclosure of Interest

None Declared
Working collaboratively with people with lived experience to map and co-create guidance on improving health services for people with attention deficit hyperactivity disorder (ADHD)
Authors: Price A.
Published: August 2023

Background: Attention deficit hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in children and adolescents, with an average worldwide prevalence of 5%. Young people with ADHD experience poorer outcomes than their peers across multiple domains, with treatment shown to reduce these risks. Evidence shows that young people with ADHD can experience multiple challenges when seeking access to healthcare. Debates over how to tackle a ‘failure of healthcare’ for ADHD often include reorganisation of services, including better provision of adult ADHD services, and an expanded role for primary care. However, adult services remain patchy and primary care practitioners feel unsure about how to support young people at this vulnerable stage in their lives, reporting needs for more evidence-based guidance. There is also a lack of national level understanding of the different models, and pathways of care for young people with ADHD aged 16 to 25, hindering efforts to improve access to care and optimise outcomes for this underserved group. Research into this area needs to be guided by people with lived experience of ADHD and informed by perspectives from a range of stakeholders.

Aim: To use collaborative research methods to provide an evidence-base by mapping current services. Then co-produce guidance to improve and better co-ordinate healthcare for young people aged 16-25 with ADHD.

Methods: A national survey about mental health service provision for adults with ADHD (informed by people with lived experience) was developed and distributed. Evidence from this survey stimulated research into primary care service provision, consisting of three interlinked studies guided by research advisory groups of people with lived experience and healthcare professionals

Disclosure of Interest

None Declared
A mobile-based mental health improvement program for non-muscle invasive bladder cancer patients: Program development and feasibility protocol
Authors: Kim Y. , Lee H. , Park J. , Lee S.
Published: August 2023

Introduction

Bladder cancer, which is primarily a non-muscle invasive bladder cancer (NMIBC), is prevalent worldwide and its incidence is increasing. NMIBC shows a high recurrence rate of 50-70%, and in 25% of cases, progresses to muscle-invasive disease (Saginala K et al. Med Sci 2020; 15) (Fernandez-Gomez, J et al. J Urol 2009; 182(5) 2195-2203). Frequent recurrence and consecutive medical interventions in patients with NMIBC lead to psychological problems such as anxiety, fear of recurrence, depression, and stress, resulting in reduced quality of life (Chung et al. Support Care Cancer 2019; 27(10), 3877-3885). It is expected that the increased accessibility and convenience of mobile health (mHealth) will be effective in providing a mobile-based psychological intervention program to promote the mental health of patients with NMIBC.

Objectives

This study aims to develop a mobile-based mental health improvement program for NMIBC patients, design a protocol for evaluating feasibility, and provide preliminary evidence of the efficacy of the developed program.

Methods

The program content was developed based on the results of a needs assessment conducted among patients with NMIBC through a cross-sectional study. The draft program was prepared by referring to the guidelines of the National Comprehensive Cancer Network and publications of the International Continence Society. Based on the developed draft, two professors of nursing, a professor of counseling psychology, a registered nurse, and a counseling practitioner verified the validity of the content before finalizing the program. The final version of the developed program consisted of one session on NMIBC knowledge and symptom management and five sessions on mental health improvement. Researchers sent an online link to the YouTube video comprising lecture materials and voice recordings of health professionals weekly using a mobile messenger (Kakao Talk) (Image 1). The topics of each session were as follows: Session 1 (Understanding of bladder cancer and treatment), Session 2 (Understanding and respecting myself
), Session 3 (Maintaining reasonable thoughts and positive emotions), Session 4 (Benefits of positive emotions and healthy communication), Session 5 (Living in a healthy way through stress management), and Session 6 (Finding happiness and meanings in daily life).

Results

The protocol for evaluating the feasibility of the developed program is outlined in Image 2.

Image:

Image 2:

Conclusions

The feasibility of the mental health improvement program for patients with NMIBC based on mobile messenger (KakaoTalk) will be evaluated through the developed protocol. Moreover, by introducing a program that reflects the feasibility of test results into practice, the results of this study can contribute to improving the quality of life of patients with NMIBC.

Disclosure of Interest

None Declared
The first German evidence-based clinical guidelines on borderline personality disorder
Authors: Stoffers-Winterling J. , Lieb K.
Published: August 2023

Introduction

Though the evidence regarding the psychotherapeutic and drug treatment of borderline personality disorder (BPD) is rapidly accumulating, with more then 120 randomised controlled trial on the clinical treatment being availabe currently, no evidence-based guidelines existed as yet in Germany. This talk will present the first German evidence-based clinical guidelines for BPD.

Objectives

In this talk the German evidence-based clinical guidelines for borderline personality disorder will be presented, and focuses and important recommendations highlighted.

Methods

A diverse, multidisciplinary panel, including members with research and clinical expertise in the treatment and care of individuals with BPD as well as representatives of persons with lived experience and their relatives, has developed the first evidence-based German treatment guidelines for BPD. The Australian NHMRC and the British NICE guidelines were used as source guidelines and adapted, based on the findings of updated literature searches. All recommendations were consented in an independently moderated, formalised consensus process. Special attention was paid to the management of financial and non-financial conflicts of interest.

Results

The guidelines support the early detection and treatment of BPD and recommend that the diagnosis be made in adolescents from the age of twelve years on. Disorder-specific psychotherapies, i.e. structured psychological therapies that are specifically designed for people with BPD, are recommended as the first-line treatment for BPD. If the primary focus is the treatment of self-harm, Dialectical Behaviour Therapy or Mentalisation-Based Treatment are recommended. Drug treatment should only be considered if in crisis psychological interventions do not suffice and should be withdrawn as early as possible. Besides, drug treatment may only have a role if required for the treatment of comorbid psychic disorders. The guidelines also recommend educating significant others of the person concerned about the disorder and including them in the development of crisis plans. It is also recommended to offer support to relatives, especially if they are children or adolescents. Also, the role of individuals with BPD who are parents is considered, and early support to foster parenting skills and attachment relationships is recommended.

Conclusions

The first evidence-based German guidelines on BPD are now available and will help to ameliorate the health care of persons with a diagnosis of BPD. The publication of an English version is impending.

Disclosure of Interest

None Declared
Development of a novel tool to assess therapists’ alliance through medical clinical reports in public mental health settings
Authors: Lewin A. , Tzur Bitan D.
Published: August 2023

Introduction

Many studies demonstrate that monitoring of the therapeutic alliance can assist therapists to identify changes in patient-therapist relations and accommodate their interventions to prevent early termination. Nonetheless, therapists in public mental health institutes are only required to provide a textual description of patient’s visit, and are usually overloaded to complete empirical measures after each session.

Objectives

The aim of this study is to develop a novel empirical tool to assess therapists’ perception of the therapeutic alliance through therapists’ clinical reports completed in public mental health.

Methods

Patients (N=56) and their therapists (N=32) recruited to participate in a randomized controlled trial completed the Session Alliance Inventory- 6 items (SAI-6) after each session. In this measure, the working alliance included three components: an emotional bond, the agreement on goals, and the agreement on tasks. Afterwards, medical records were extracted and ranked using the SAI-6 by two independent researchers. Inter-rater reliability was .94, indicative of excellent reliability.

Results

Overall, 163 sessions were extracted and evaluated, and were compared with 32 therapist evaluations and 56 patient evaluations. The factor structure of both coders demonstrated a two-factor solution explaining 89.38% of the variance for coder 1, and 71.50% of the variance for coder 2. For patients and therapists, a one-factor solution emerged, explaining 73.00% of the variance for patients, and 62.29% of the variance of the therapists. Both coders demonstrated higher factor loadings of the goals and tasks (0.75-0.81 for coder 1, 0.75-0.78 for coder 2) compared with the bond index (0.57-0.62 for coder 1, 0.52-0.56 for coder 2), indicating higher consistency across these subscales. Internal consistency was alpha Cronbach .87 for coder 1, 0.77 for coder 2, 0.92 for patients and 0.87 for therapists. The scale was partially associated with the therapists’ reports, with coder 2 having a stronger association with therapists ratings in all indexes (r= 0.04 -0.25) than coder 1 (r= 0.03- 0.15). Both coders did not correlate with therapists’ ratings on the bond component. As known in the scientific literature, patients rated the alliance higher than therapists (M=5.74, SD=1.36 for patients, and M=4.67, SD=0.84 for therapists, SE=0.10, p<0.001).

Conclusions

The results of the current study demonstrate the feasibility of assessing therapists’ perceptions of the working alliance via therapists’ routine reports. The differences emerging in the factor structure suggests that coding the clinical reports in primarily beneficial for the evaluation of the agreement on the treatment goals and tasks, and less for the evaluation of patient-therapist emotional bond.

Disclosure of Interest

None Declared
Metacognition, emotional dysregulation, psychosocial functioning and subjective well-being after 6 months of CBT treatment in pharmacologically stabilized schizophrenic patients
Authors: Raffone F. , Orrico A. , D’Orsi M. , Ferro S. , Russo M. , Martiadis V.
Published: August 2023

Introduction

Psychoses represent serious psychiatric disorders in which an individual perceptions, thoughts, mood and behavior are significantly altered. Each person who develops a psychosis lives a unique set of symptoms and experiences that may widely vary depending on life circumstances. Although cognitive behavioral psychotherapy (CBT) for psychosis is recommended by main international guidelines, its effectiveness in real-world is still a subject of controversy.

Objectives

The aim of this study was to evaluate, in an Italian outpatient clinical setting, eventual improvements induced by a 6 months intensive CBT specific programme focused on metacognition and emotional regulation and its consequences on psychosocial functioning and subjective well-being in pharmacologically stabilized psychotic patients.

Methods

Eight patients with schizophrenia spectrum disorders (DSM-V), clinically and pharmacologically stabilized, were included in a 6-month program of weekly CBT sessions with focus on metacognition, emotional dysregulation, social functioning and subjective well-being. Patients were assessed with the Metacognitions Questionnaire-30, Difficulties in Emotion Regulation Scale, Heinrichs Quality of Life Scale, The Psychological General Well-Being Index, Brief Psychiatric Rating Scale, Hamilton Depression Rating Scale at baseline and at 3 and 6 months, to verify any improvement on these specific domains and, possibly, on general psychopathology.

Results

In this study CBT showed to be effective on all domains evaluated, most notably for younger patients with a short history of disease (<5 years). Metacognitive capacity was the dimension with most evident improvements, followed by the ability to modulate emotions and the consequent improvement in psychosocial functioning and perceived subjective well-being. During the 6 months follow-up none of the enrolled patients experienced symptoms exacerbation or psychotic relapses.

Conclusions

In conclusion, the 6-month CBT treatment showed to be effective for stabilized psychotic patients, improving metacognitive functions, emotional regulation, psychosocial functioning, and subjective well-being. In addition, insight, adherence and the therapeutic alliance improved. The absence of psychotic relapses is not attributable with certainty to the effect of CBT since, for this purpose, longer duration studies on larger case series and with RCT methods are required. However, it is plausible that the improvement obtained in disease awareness and adherence may be a facilitating factor in relapse reduction.

Disclosure of Interest

None Declared
Brain activation in patients suffering from gambling disorder: an fMRI study using the cue reactivity approach for slot-machine gambling
Authors: Rosenleitner J. , Fuchs-Leitner I. , Kleiser R. , Yazdi K.
Published: August 2023

Introduction

The relevance of behavioral addictions (like gambling or internet gaming disorder) is growing constantly - not only in clinical practice, but also as a topic in addiction research. Furthermore, behavioral addictions were found to share similar neurobiological mechanisms with substance-use disorders like alcohol or drug addiction. Cue reactivity is a well-established concept to study an important concept in addiction: craving, which denotes the strong desire to consume the addictive substance. For instance, images of alcoholic beverages can induce a strong desire to drink alcohol in patients with alcohol addiction, reflected in brain activation in parts of the reward system and regions specifically involved in craving.

Objectives

In order to extend existing findings to the field of slot machine gambling, we focused on patients suffering from gambling disorder (GD) and who mainly played slot-machines. We investigated neural activation as a response to addiction-related cues (in comparison to neutral cues) using a cue reactivity paradigm.

Methods

To that end, participants with a diagnosis of GD (N = 10) and a group of healthy controls (N = 20) viewed pictures of gambling-related cues (slot machines) as well as neutral cues (ticket vending machines), while brain activation was recorded using functional magnetic resonance imaging (fMRI). Direct comparisons of patients suffering from GD with healthy controls were analyzed for the two different image types (gambling-related vs. neutral) separately.

Results

We found stronger activation in the insular cortex for patients with GD only during presentation of the slot-machine images, but not for the neutral cues. Furthermore, for the slot-machine condition also stronger activation in the dorsal anterior cingulate cortex (dACC) and the supplementary motor area (SMA) was documented for the clinical population but not for the healthy controls.

Conclusions

In line with previous findings, the visual presentation of gambling cues led to stronger brain activations in parts of the reward system (dACC) and in the insula, which plays a crucial role in addictive disorders, especially in craving. Our results further add to the notion that brain areas involved in substance-use disorders might also play an important role in behavioral addictions. Specifically, our findings extend existing results to the research field of slot-machine gambling in the context of craving.

Disclosure of Interest

None Declared
Distinct childhood neurodevelopmental trajectories following very preterm birth
Authors: Solerdelcoll Arimany M. , Nosarti C.
Published: August 2023

Introduction

Very preterm birth (VPT; <32 weeks’ gestation) constitutes itself an environmental risk factor for a wide range of severe mental disorders. Particularly, 25% of VPT screen positively for autism spectrum disorder (ASD) and often present with co-occurring developmental difficulties, making it challenging to identify those likely to develop ASD traits. Therefore, neurodevelopmental trajectories associated with ASD outcomes need to be identified.

Objectives

Here, we investigated infant-to-childhood ASD traits trajectories, and their association with neurodevelopmental comorbidities, in a sample of VPT children screening positively and negatively on the Modified Checklist for Autism in Toddlers (M-CHAT).

Methods

VPT individuals from the Evaluation of Preterm Imaging study (ePrime) underwent behavioural assessments at 2 (M-CHAT and Bayley Scales of Infant Development; N=451) and 4-7 years (Social Responsiveness Scale (SRS-2); N=251). To furtherly assess the presence of comorbid neurodevelopmental disorders at children aged 4-7 years, further assessments of cognitive (WPPSI), ADHD (ADHD-RS-IV scale), and emotional and behavioural problems (SDQ and ECBQ) were conducted.

Results

Findings of the ePRIME 4–7-year follow-up substudy will be presented. VPT children will be grouped using M-CHAT scores, as they reportedly show distinct neurodevelopmental characteristics. Preliminary results showed that ASD traits in infancy are associated with increased neurodevelopmental impairment.

Conclusions

VPT infants may be an undescribed “at risk of ASD” or ASD cluster, with clinical features and comorbid neurodevelopmental disorders that differentiate them from other “at-risk” populations. Our findings support the need for routine ASD and ADHD assessments in VPT infants at preschool but also at school ages; and highlight the importance of interpreting ASD screenings in combination with other developmental measures when assessing VPT children. Our results could guide clinicians and researchers to offer personalised interventions aimed at supporting children’s development based on their distinct phenotypic presentations. Further research is needed to develop more accurate screening tools.

Disclosure of Interest

None Declared
A Moderating Role of Social Intelligence and Creativity During Primary Career Exploration in Late Adolescence
Authors: Chesnokova O. B. , Churbanova S. M. , Markish O. V.
Published: August 2023

Introduction

Career self-exploration activities can be defined as orienting oneself in one’s own vocational interests, skills, job, and organizational characteristics and as an important career pre-decision stage (Stumpf et al., 1983). Effective career exploratory behaviors are associated with less anxiety regarding uncertainty and difficulties during first career decision-making (Storme, Celik, 2017; Xu et al., 2014). In Study 1, we showed that productive career self-exploration in adolescence is associated with a high level of tolerance for uncertainty (TU) (Chesnokova, Churbanova et al., 2022).

Objectives

The aim of Study 2 was to compare the social intelligence (SI) and creativity (Cr) of students with high and low level career adapt-abilities applied to present and prospective future career decisions.

Methods

Participants were 67 students (15-17 years old). SI was assessed by O’Sullivan & Guilford’s Tests (1966), Cr was measured by CAP consisted of Test of Divergent Thinking and Test of Divergent Feeling (Williams, 1980). Career adapt-abilities were estimated by CAAS (Savickas & Porfeli, 2012; Pryazhnikov, 2016).

Results

Two contrast clusters based on SI and Cr mediated by TU level were analysed. One cluster included students with high pragmatic motivation concerning career path choice. There were students with high TU, high SI and cognitive Cr and low level of Divergent Feeling who focusing on nearest obstacles like entrance exams and distant professional future (professional revenues, social status and on task-oriented content). They are open to new career experiences and flexible in career choice (at r .56, p .001), but they lack social intelligence’s diplomatic techniques and cognitively complicated interpersonal situational awareness. They mostly rely on academic aptitude and self-efficacy. The second cluster of students was made up of those with low TU, average to low SI, and high levels of divergent feelings. They exhibited less pragmatist motivation and active career exploratory behaviors regarding both immediate and long-term professional paths, professional values, the human aspects of potential careers, the social structure of professional society, and the need to use emotional intelligence when interacting with clients and working in teams. They rely on social support from professional representatives and teachers during their career decision making.

Conclusions

In sum, SI and Divergent feelings may be significant mediators in the development of career adaptability and realistic self-perceived confidence in task-oriented content as well as interpersonal specificity of professional social environments. To reduce stress and anxiety of prospective students, the development of self-efficacy and motivation should be given priority over just academic readiness for exams and narrow professional skills.

Disclosure of Interest

None Declared