bluuebunny/crossref_metadata_2025 huggingface dataset:
Safety and Tolerability of Intramuscular and Sublingual Ketamine for Psychiatric Treatment in the Roots to Thrive Ketamine Assisted Therapy Program
Authors: Tsang V. W. L. , Tao B. , Dames S. , Walsh Z. , Kryskow P.
Published: August 2023

Introduction

Ketamine has been increasingly used to treat mental health conditions yet there is a lack of safety data on intramuscular (IM) and sublingual (SL) dosing in a community setting. The Roots to Thrive Ketamine assisted Therapy (RTT-KaT) program is a 12-week program with 12 Community of Practice (CoP) group therapy sessions and three ketamine sessions.

Objectives

To provide preliminary data on RTT-KAT adverse events to subsequently inform safe use of IM and SL ketamine for the treatment of psychiatric disorders.

Methods

Retrospective chart review of the RTT-KaT Program on four cohorts (n=128) between September 2020 to December 2021. Eligible patients include those with post-traumatic stress disorder, depression, generalized anxiety, burnout/adjustment disorder, substance use disorder, obsessive compulsive disorder, disordered eating, and disordered sleep. Baseline characteristics and adverse events were captured including medication administration before, during, and after RTT-KaT sessions. Chi-squared test with Yates’ continuity correction was used to assess side effects in subgroups from ketamine administration.

Results

RTT-KaT was well tolerated with no loss to follow up. There were 351 IM (mean dose = 102.553mg) and 96 SL (mean dose = 276.667mg) sessions of ketamine. Of the 448 sessions, the prevalence of elevated blood pressure increased by 12.31% from baseline (36.85%), with all post-treatment elevations being transient. The prevalence of elevated blood pressure post-KaT session was also similar between IM (+11.69% from 37.71% baseline) and SL (+15.12% from 32.98% baseline) administration. Regarding adverse effects, 12.05% of sessions experienced nausea , 2.52% had an episode of vomiting , 3.35% had a headache , and seven sessions experienced dizziness. The incidence of adverse events was not significantly associated with past psychedelic experiences (X2 = 0.0543, p-value = 0.8157), nor past psychiatric diagnosis (X2 = 0.0109, p-value = 0.917). . There was no significant association between administration route and incidence of nausea, which was the most common side effect(X2 = 1.112, p-value = 0.2916). Male gender was also significantly associated with lower incidence of nausea (X2 = 4.2841, p-value = 0.03847).

Conclusions

The group therapy model described provides a comprehensive approach and presents a promising model for operating a KaT program outside of a clinical trial setting.These findings suggest good safety and acceptability for RTT-KaT among individuals seeking treatment for mental health issues. Majority of participants did not experience adverse reactions and the adverse events that were recorded involved transient symptoms that were resolved with rest and/or medications.

Disclosure of Interest

None Declared
Prevalence and factors associated with depression among health care workers in the region of Sousse in Tunisia
Authors: Athimini Z. , Gaddour A. , Brahem A. , El Ghezhal R. , Chouchene A. , Bouhoula M. , Elmaalel O. , Chatti S. , Mrizak N.
Published: August 2023

Introduction

Mental health disorder is common among working population worldwide and among health care-workers (HCWs) in particular. Depression is a major public health problem, with an economic impact because of lost days of work. Its prevention is essential and requires the identification of risk factors.

Objectives

The objectives of this work were to determine the epidemiological characteristics of depressive disorders in health care workers and identify their main risk factors.

Methods

A descriptive retrospective study was conducted on health care workers of Sousse in Tunisia who have had a long-term sick leave for depressive disorders from January 2010 to December 2021. data was collected from the medical records of the patients and completed with a telephone questionnaire

Results

The total number of cases was 650 with a prevalence of 12.8% and an incidence of 2 cases per 100 HCW. The median age was 50 years and the female workers represented 81% of cases. The majority of the sample were married (81%). Most of cases were nurses (43%) and health technician (19%). The median seniority of HCW in their jobs was 23 years with the first quartile at 12 and the third quartile at 31.

Around 48% of cases had severe depression. The severity of depression was significantly associated with working in surgical and emergency services, number of night shifts of 2 or more per week, the history of a psychiatric disorder other than depression, habits such as smoking and drinking, anxiety specificity and melancholy specificity of depression.

Conclusions

This study showed the importance of social and occupational factors of depression among HCW. Action policies focusing on workplace interventions appear to be relevant.

Disclosure of Interest

None Declared
Novel mitochondrial mechanisms of cognitive regulation in subjects with cognitive impairments
Authors: Bigio B. , Lima-Filho R. , Barnhill O. , Sudo F. , Drummond C. , Assunção N. , Vanderborght B. , Tovar-Moll F. , Mattos P. , Ferreira S. , De Felice F. , Lourenco M. , Nasca C.
Published: August 2023

Introduction

Prior mechanistic studies in rodents showed decreased levels of the pivotal mitochondrial metabolite acetyl-L-carnitine (LAC) in relation to cognitive deficits and depressive-like behavior (Neuron 2017, 10.1016/j.neuron.2017.09.020, PNAS 2013, 10.1073/pnas.1216100110), providing the basis for the current translational study.

Objectives

The main objective of this work was to ascertain the role of this specific mitochondrial signaling pathway in subjects with cognitive impairments (CI), and potential sex differences in these mechanisms.

Methods

We used computational approaches, ultraperformance liquid chromatography–tandem mass spectrometry (UPLC-MS/MS) and available plasma samples from a well-characterized cohort of 71 subjects, including subjects with CI and age- and sex-matched cognitively healthy controls (HC).

Results

Our newest findings showed decreased levels of LAC in subjects with CI as compared to age- and sex-matched HC. We also found important sex differences in carnitine levels in relation to cognitive function as assessed by using the Mini Mental Status Exam (MMSE). Specifically, the degree of carnitine deficiency reflected the severity of cognitive dysfunction in a sex-specific manner. Using computational approaches, we found that the integration of these mitochondrial measures with canonical biomarkers improves diagnostic accuracy.

Conclusions

The current findings of sex differences in carnitine deficiency in subjects with CI suggest a possible sex-specific mitochondrial phenotype of vulnerability to cognitive dysfunction, and point to LAC-related mitochondrial metabolism as a new signaling pathway of cognitive regulation.

Disclosure of Interest

None Declared
Predicting unipolar and bipolar depression using inflammatory markers, neuroimaging and neuropsychological data: a machine learning study
Authors: Raffaelli L. , Colombo F. , Calesella F. , Fortaner-Uya L. , Bollettini I. , Lorenzi C. , Maggioni E. , Tassi E. , Poletti S. , Zanardi R. , Attanasio F. , Benedetti F. , Vai B.
Published: August 2023

Introduction

About 60% of bipolar disorder (BD) cases are initially misdiagnosed as major depressive disorder (MDD), preventing BD patients from receiving appropriate treatment. An urgency exists to identify reliable biomarkers for improving differential diagnosis (DD). Machine learning methods may help translate current knowledge on biomarkers of mood disorders into clinical practice by providing individual-level classification. No study so far has combined biological data with clinical data to provide a multifactorial predictive model for DD.

Objectives

Define a predictive algorithm for BD and MDD by integrating structural neuroimaging and inflammatory data with neuropsychological measures (NM). Two different algorithms were compared: multiple kernel learning (MKL) and elastic net regularized logistic regression (EN).

Methods

In a sample of 141 subjects (70 MDD; 71 BD), two different models were implemented for each algorithm: 1) structural neuroimaging measures only (i.e. voxel-based morphometry (VBM), white matter fractional anisotropy (FA), and mean diffusivity (MD)); 2) VBM, FA, and MD combined with NM. In a subsample of 71 subjects (36 BD; 38 MDD), two similar models were implemented: 1) VBM, FA, and, MD combined with only NM; 2) VBM, FA, and MD combined with NM and peripheral inflammatory markers. Finally, the best model was selected for comparison with healthy controls (HC).

Results

Overall, the EN model based on all the modalities achieved the highest accuracy (AUC = 90.2%), outperforming MKL (AUC=85%). EN correctly classified BD and MDD with a diagnostic accuracy of 78.3%, sensitivity of 75%, and specificity of 81.6%. The most significant predictors of BD (variable inclusion probability (VIP) > 80%) were the parahippocampal cingulate, interleukin 9, chemokine CCL5, posterior thalamic radiation, and internal capsule, whereas MDD was best predicted by chemokine CCL23, the anterior cerebellum, and the sagittal stratum. In contrast, NM did not help to differentiate between MDD and BD. However, they help to distinguish patients from HC. Psychomotor coordination and speed of information processing discriminated between MDD and HC (VIP>90%), whereas fluency, working memory, and executive functions differentiated between BD and HC (VIP>80%).

Conclusions

In summary, BD was predicted by a strong proinflammatory profile, whereas MDD was identified by structural neuroimaging data. A multimodal approach offers additional instruments to improve personalized diagnosis in clinical practice and enhance the ability to make DD.

Disclosure of Interest

None Declared
Temperament and Character among mothers of individuals with gender dysphoria: a case-control study
Authors: Talaei A. , Omidvar Tehrani S. , Talaei Z.
Published: August 2023

Introduction

Parents of individuals with gender dysphoria may experience distress when dealing with their child’s condition, and how they react can have a significant effect on their own as well as their child’s mental health.

Objectives

In this study, we aimed to explore the personality traits among mothers of individuals with gender dysphoria in comparison to the mothers of individuals with cis-gender identity by utilizing the Temperament and Character Inventory (TCI) tool.

Methods

We enrolled 27 mothers of GD individuals who had obtained licenses for gender affirmation surgery and 28 mothers of cisgender controls for this case-control study. Personality traits were measured by a validated Farsi version of the Temperament and Character Inventory (TCI) tool.

Results

The mean±standard deviation age of mothers with GD children and controls was 53.95±9.44 and 53.00±7.28 years, respectively. 20 of the GD children were born with the female sex. Overall, TCI scores were statistically different between the two groups (p=0.03); however, this difference was only observed among Character scores (p=0.01) and was not significant in Temperament scores (p=0.33). We found significantly higher mean Cooperativeness (CO) and Self-Transcendence (ST) scores in the case group (p=0.007 and 0.031, respectively). We also identified significantly more individuals with a high CO score amongst mothers of GD individuals (Odds Ratio: 5.0, 95% Confidence Interval 1.2-21.0, p=0.028).characteristicsGroupMeanStd. DeviationP-valueCOGD
Control20.2963
17.67862.28397
4.295160.007SDGD
Control16.7407
15.75003.49277
6.251670.474STGD
Control9.7407
8.00002.98190
2.841490.031HAGD
Control7.7778
6.71434.50071
4.512180.386NSGD
Control7.0370
7.21432.99334
3.403240.839PGD
Control3.5926
3.28571.11835
2.070200.499RDGD
Control8.8519
7.78572.56760
1.931360.087

Conclusions

By showing more mature, understanding, and kind personalities, the mothers of GD cases who have obtained licenses for gender affirmation surgery, have likely provided a positive atmosphere for the gender identity development and transition of their children. Additionally, their personalities were possibly better suited to deal with their child’s condition through having better compensatory adaptive traits.

Disclosure of Interest

None Declared
The association between loneliness and psychiatric symptomatology in older psychiatric outpatients
Authors: Schutter N.
Published: August 2023

Purpose: loneliness in adults increases with age. Although loneliness has been found to be associated with psychiatric disorders and dementia, no information is available on prevalence of loneliness in older psychiatric patients. Given the negative consequences of loneliness for morbidity and mortality, identification of specific populations vulnerable to loneliness is important. The aims of the present research were to examine prevalence of loneliness in older psychiatric outpatients, including gender differences and associations with psychiatric disorders and with social situation.

Methods

interviews were done in 181 patients from an outpatient clinic for geriatric psychiatry between September 2013 and February 2018, using questionnaires regarding loneliness, depression, anxiety, frailty and alcohol use.

Results

prevalence of loneliness was as high as 80%. Loneliness was associated with having less social contacts, in women only. There were no associations with DSM-IV-TR-classifications. However, loneliness was associated with higher scores on a depression questionnaire. There were no significant differences in intensity of treatment between lonely and non-lonely participants.

Conclusion

Loneliness is highly prevalent in older psychiatric outpatients, with men and women equally affected. Loneliness should be assessed in all older psychiatric patients, especially when they show high scores on symptom checklists or have a restricted social network.

Reference

Schutter et al. (2022) The association between loneliness and psychiatric symptomatology in older psychiatric outpatients. Journal of Geriatric Psychiatry and Neurology 35: 778-788.

Disclosure of Interest

None Declared
Smartphone addiction among university students in Tunisia
Authors: Turki M. , Mhiri H. E. , jmil F. , Samet A. , Halouani N. , Ellouze S. , Aloulou J.
Published: August 2023

Introduction

Popularity and availability of smartphones have dramatically increased in the past years, and have led to a great impact on people’s daily lives changing their habits and behaviors. This trend is accompanied by increased concerns regarding potentially adverse effects of problematic smartphone use, particularly with respect to physical and mental health.

Objectives

In this study, we investigated prevalence and associated factors of smartphone addiction among Tunisian university students.

Methods

It was a cross-sectional, descriptive and analytical web-based study, conducted among 144 university students in Tunisia. Data were collected using an online questionnaire spread throughout social media (Facebook), using the Google Forms® platform, during September and October 2022. We used the “Smartphone Addiction Scale-Short Version” (SAS-SV).

Results

The mean age of participants was 23.38±3.27 years, with a sex-ratio of (F/M) of 2.8.

Tobacco, alcohol and cannabis use was noted respectively in 12.5%, 3.5% and 3.5% of cases.

The mean score SAS-SV was 37.92±8.82. Among the students, 68.8% were considered at high risk of Smartphone addiction.

Male students were more likely to be at higher risk of smartphone addiction than females, without a significant relationship.

Scores of SAS-SV were significantly higher among cannabis users (48.4 vs 37.54; p=0.006) and non-medical students (39.07 vs 36.11; p=0.049)

Conclusions

University students are a particularly vulnerable population to smartphone addiction, and this may lead to negative psychosocial effects. Educational awareness and preventive measures should be implemented.

Disclosure of Interest

None Declared
Anabolic–androgenic steroid abuse: psychiatric manifestations and treatment
Authors: Remelhe M. , Barbosa P. , Silva R.
Published: August 2023

Introduction

Anabolic-androgenic steroids (AAS) are synthetic derivatives of steroids which are frequently utilized in order to increase muscle mass and strength. Estimates of AAS abuse vary according to different studies. However, a global lifetime prevalence of 3.3% has been reported. The increasing illicit use of AAS over the years has raised serious public health concerns.

Objectives

To report a clinical case of AAS abuse and review the psychopathology associated with AAS abuse and its treatment.

Methods

The authors report a clinical case and conducted a non-systematic review on the Pubmed database with the terms “anabolic-androgenic steroids”, “abuse” and “psychiatric manifestations”.

Results

A 25-year-old male patient with history of body dysmorphic disorder was admitted to the emergency services following severe psychomotor agitation and verbal and physical aggression towards his family members. He explained he had begun using AAS years prior in order to improve his physical appearance. Recently he had been administering AAS injections on a more regular basis and restricting his food and water intake. His sleep-wake cycle was disrupted and he began experiencing increasing anxiety and persecutory ideation. Additionally, increased aggression was reported and numerous conflicts with his family members took place in the weeks previous to his psychiatric observation. AAS abuse has been associated with psychiatric symptoms such as aggression and violence, mania and less commonly psychosis and suicidal ideation. Moreover, its prolonged abuse can lead to symptoms of dependence and withdrawal following suspension. A biphasic model of steroid dependence has been described. First there is a brief hyperadrenergic state with opoid-like withdrawal symptoms which is then followed by a prolonged period of depression and craving. During this phase symptoms such as fatigue, muscle and joint pain, insomnia, anxiety and depression may occur. There are no established guidelines for treatment. Acute care of agitation should follow a similar course as the one utilized in other forms of substance induced-agitation: firstly, the least invasive interventions should be implemented. If medication is required, haloperidol has been reported to be effective, although evidence is scarce. Benzodiazepines may be considered, although its use with AAS has not been reported. In regards to long term care, AAS discontinuation is vital in conjunction with proper management of withdrawal symptoms. If a patient presents symptoms of opioid-like withdrawal, treatment with clonidine may be initiated. The use of medically prescribed steroids has been suggested in order to alleviate withdrawal symptoms. Other treatment options such as human chorionic gonadotrophin and clomiphene have also been proposed.

Conclusions

AAS abuse is a serious public health concern. Clinicians should be aware of its serious psychiatric effects and possible treatment courses.

Disclosure of Interest

None Declared
Prevalence and psychosocial profile of instagram addiction among Tunisian doctors
Authors: Messedi N. , Kolsi S. , Fakhfakh E. , Chaari I. , Charfeddine F. , Aribi L. , Aloulou J.
Published: August 2023

Introduction

Instagram is the most popular social media platform which is frequently used by population today. Besides, this subject has not been well discussed among doctors.

Objectives

To study the prevalence of addiction to instagram among tunisian doctors and to identify its associated factors.

Methods

This was a cross-sectional descriptive study carried out among doctors (interns, residents and university hospital doctor) during the months of septembre and octobre 2022.

A socio-demographic and clinical characteristics were collected using an online anonymous questionnaire from Google form that we distributed via facebook.

Instagram Addiction Scale (IAS) was used to assess Instagram addiction levels. A score above 37 indicates addiction to instagram.

Results

Our sample included 106 patients. The mean age was 32.32 years (SD=5.66 years) and the sex ratio (M/F) was 0.60. More than half (56.6%) were married and lived with their husband. They were residents in 37% and they were using psychoactive substances in 42.5%.

All of participants used other socialnetwork, the most used was facebook (63.2%).

IAS : The mean score was 31.18 (SD=11.64). The prevalence of addiction to instagram was 42.5%.

The instagram addiction was significantly correlated with : age (p=0,0001), the female gender (p=0.043), the celibacy (p=0.0001), the number of children (p=0.0001) and the number of siblings (p=0.049). Residents were more likely to develop an addiction to instagram (p=0.0001).

Conclusions

The study highlighted the high level of instagram addiction among tunisian doctors and identified individuals who were at higher risk. Specific interventions were necessary to deal with the problem of addiction.

Disclosure of Interest

None Declared
Changes in smoking behaviour among healthcare workers with COVID-19
Authors: Ziedi H. , Mersni M. , Brahim D. , Bahri G. , Mechergui N. , Youssef I. , Ernez S. , Ben Said H. , Ladhari N.
Published: August 2023

Introduction

The COVID-19 pandemic had a considerable psychosocial impact on healthcare workers (HCWs) who were constantly requested during this era with an increased risk of infection. This implies behavioural changes, especially in smoking behaviour.

Objectives

To study smoking behaviour in HCWs with COVID-19.

Methods

A cross-sectional descriptive study conducted in the department of occupational pathology of Charles Nicolle Hospital in Tunis involving the smoking HCWs affected by COVID-19 during the period from September 1, 2020, to February 28, 2021. The data collection was carried out by a telephone call using a standardized questionnaire.

Results

During the study period, 61 smoking HCWs were identified. Thirty-two patients agreed to answer the questionnaire, with a response rate of 52%. The mean age was 41±10 years. The sex ratio (M/F) was 1.46. Half of the participants had comorbidities. The most represented occupational categories were blue-collar workers (n=11) followed by nurses (n=10) and physicians (n=7). The median professional seniority was 13 [3.5; 20] years. The mean age of smoking initiation was 20±5 years. The most common mode of smoking was cigarettes (93%) with an average consumption of 19 cigarettes per day. Water pipe smoking was noted in 3 patients. All patients started smoking before the COVID-19 infection. Strong tobacco dependence was noted in 25% of patients. Twenty-one per cent of the population had moderate dependence. Half of the participants maintained the same level of smoking as before the COVID-19 infection. An increase in smoking was noted in 34% of patients. A decrease in the level of smoking was reported by 15% of respondents. Four participants stopped smoking after COVID-19 infection. The reasons for smoking cessation were COVID-19 damage (n=3) and confinement with family (n=1).

Conclusions

The change in smoking behaviour during the COVID-19 pandemic is notable, particularly in HCWs who are exposed to a high physical and mental load. The presumed association of smoking with severe forms of COVID-19 infection makes tobacco control in HCWs an obligation in order to preserve the continuity of care.

Disclosure of Interest

None Declared
Evaluation of the success rate of various inpatient alcohol addiction treatment programs in the Czech Republic and their comparison
Authors: Skorkovsky T. , Vevera J. , Benis M. , Miovsky M. , Popov P.
Published: August 2023

Introduction

Harmful alcohol use far exceeds other mental disorders in the proportion of patients who do not receive adequate treatment. Despite the long history of anti-alcohol treatment in Czech Republic, there is no published prospective study to this day, in which patients that underwent inpatient addiction treatment are compared to patients on the waiting list and only one prospective randomized study comparing two different medium-term inpatient programs was published.

Almost all the studies published so far only bring results of particular hospitals. Differences in methodology, differences between cohorts of patients, absence of profiling and differences in therapeutic programs and historical changes makes comparison of results of those studies very difficult.

Objectives

This work seeks to present and compare the data from studies that evaluate the success of medium-term inpatient treatment of alcohol dependent patients in the Czech Republic. Another aim was to identify problems that make such comparison difficult.

Methods

Bibliographia Medica Čechoslovaca and Pubmed was used to find studies published in professional medical journals since 1970, in which abstinence of patients who voluntarily completed medium-term inpatient treatment of alcohol dependence is evaluated.

Results

Medium-term inpatient treatment of alcohol addiction leads to one year abstinence in 34 to 76 % of patients. Such variance value is largely caused by different methodology of compared studies. In compared studies there are differences:

1. in definition of abstinence

2. if abstinence rate is assessed in all patients who have entered the treatment or only in those who have completed the treatment properly

3. if abstinence rate is calculated using number of patients entering treatment or the number of patients who have been obtained by valid information (outpatient clinic, questionnaires)

4. in the way the data was collected

5. in the composition of patients

6. in societal background, because there is large time gap present between compared studies

Conclusions

The comparison of individual studies presented many problems. Further steps should be taken to help compare treatment programs in the future, as they provide different therapeutic interventions in different intensity and length to different patients. Adequate patient profiling, detailed description of therapeutic interventions and identification of effective components of the therapeutic program is a way to support further research in this area, optimize existing programs and increase the overall efficiency of treatment.

Disclosure of Interest

None Declared
Mental health and addiction in young refugees-Research on prevalence of alcohol and substance use, PTSD and psychological difficulties experienced by young migrants and refugees placed in two refugee centers in Serbia in the time of COVID-19 pandemic
Authors: Vasic J. , Grujicic Roberto , Toskovic Oliver , Milovancevic Milica Pejovic
Published: August 2023

Abstract: Introduction

As the global resettlement needs are further increasing, the questions on refugee youths’ wellbeing arise. The experience of migration during childhood might interfere with the developmental trajectories in different ways. Refugee youths might be at higher risk of violence, abuse and mental health problems.

Objectives

This study aimed to explore the prevalence of alcohol and substance use among young refugees, along with the indicators of experienced psychological difficulties.

Methods

Data collection was followed by numerous difficulties–C-19 pandemic, linguistic diversity and high respondents’ illiteracy rate.

Results

The sample consisted of 184 participants aged 11–18 years. More than a half of them displayed symptoms of PTSD - more frequently females, those who resided in a greater number of refugee centers and those who were exposed to abuse and domestic violence. Half of the respondents consumed energy drinks, slightly less than a third of them used tobacco, 13% consumed alcohol, 4.6% marijuana, whereby the frequency of other substance use was significantly lower. The significant indicators of individual propensity to use alcohol and substances were shown to be older age (14-18 years), male gender, lower education, being unaccompanied child and exposure to emotional abuse.

Conclusions

Our research confirmed that young refugees, especially unaccompanied, might be at higher risk for mental health difficulties. Research on this topic should aim to link scientific data to sustainable practices, applicable in everyday life.

Disclosure of Interest

None Declared
Comorbid anxiety has schizophrenia diagnosis and management modality
Authors: Korchi A. , Laboudi F. , Ouanass A.
Published: August 2023

Introduction

Schizophrenia is a chronic psychiatric disorder with disorganization progressive and important affecting several spheres: thought, affectivity, cognition and social life of the subject. It is a serious mental disorder with a prevalence of nearly 1%.

Men would present more premorbid difficulties, but the overall prevalence of symptoms of schizophrenia is similar in both sexes.

When it comes to comorbidity, men and women are vulnerable to somewhat different health issues.

Anxiety symptoms are one of the main symptoms in patients with schizophrenia, but the effect of anxiety symptoms on patients is easily overlooked.

About 40% have persistent anxiety symptoms in patients with schizophrenia, and whether they are accompanied depressive symptoms, the symptoms may have a greater impact on the patients. We need to help patients avoid suicide when the symptoms depression appear.

Hallucinations auditory, anxiety symptoms and depressive symptoms may exist simultaneously in patients with schizophrenia.

Most studies focus on studying the relationship between auditory hallucinatory symptoms and depressive symptoms in patients with schizophrenia, the relationship between auditory hallucinatory symptoms and anxiety symptoms, or the relationship between anxiety symptoms and symptoms depressive

Objectives

The objective of this study is to resolve important questions concerning the interaction of anxiety and schizophrenia in patients followed in psychiatry at Arrazi Hospital .

Methods

Descriptive and analytical cross-sectional study, conducted over a period from May 2022 to October 2022 in patients consulted in Arrazi de Salé, using a questionnaire grouping together the sociodemographic characteristics, the risks and the advantages of antipsychotics, medical comorbidities and the mobilization of psychosocial support, and thus the BPRS Anxiety Rating Scale.

Results

Of the 42 patients who completed the study, 18 were female and 24 were male 60% were single. The average age was 36.63 years, 60% have secondary education, 25% primary, and 15% university level, 30% have a family history of schizophrenia.

32 were taking an atypical antipsychotic, 10 were taking classic neuroleptics.

Most schizophrenics encountered in psychiatry are stabilized on antipsychotic treatment, and those who have an anxious comorbidity are still too often underestimated , put on the account of the positive symptoms and the negative symptoms of schizophrenia, it is insufficiently diagnosed and treated.

The effect of anxiety symptoms on patients is easily overlooked.

It should be kept in mind that anxiety in schizophrenia requires special attention when discussing and prescribing antipsychotic medications.

Conclusions

Optimal interventions for patients with comorbid schizophrenia and anxiety differ by quality of life.

At all consultations, preventive strategies should consider mindful interviews and the risks and benefits of treatment for schizophrenia and comorbidities.

Disclosure of Interest

None Declared
TELE-PSYCHOTHERAPY OF ANXIETY AND DEPRESSION DISORDERS
Authors: Lancia I. S. , Festa G. M. , Attouchi A. , Civino M.
Published: August 2023

Introduction

The process of integrating technology into mental health pathways represents a social transformation that we are gradually getting used to. But does it represent a valid alternative to face-to-face care processes? In this paper we will consider telesychology as a tool for treating anxiety and depression and its validity. Anxiety and depression are harmful to individuals, suffering from these disorders, their caregivers, and the economy. Remote delivery of psychotherapy has been established as a viable alternative to traditional in-person psychotherapy for treating anxiety and depression. However, literature comparing and evaluating the variety of remote delivery modalities of psychotherapy has not yet been integrated.

Objectives

This review examines the efficiency – to - practice and the limits of e-therapy and its mediums: telephone, video, and online-administered psychotherapy, for treatment of anxiety and depression.

Methods

A comprehensive literature search, conducted using PubMed and PsycINFO included systematic reviews, randomized controlled trials, and cost-analysis studies focused on a remote delivery method of e-psychotherapy for anxiety and depression

Results

Overall, interventions delivered through telephone, video, and online modalities, have generally demonstrated good efficiency in treating anxiety and depression; also comorbid with other disorders. The literature also suggested that telehealth psychotherapy is accessible, convenient, and cost-effective.

In evaluating the reviews on the databases, it also emerged that among the many psychological therapies for anxiety disorders, delivered digitally (CBT, Attention bias modification, Exposure therapy, Applied relaxation, Bibliotherapy, Psychodynamic therapy, Mindfulness, Behavioral stress management, Counseling), the best digital therapy is internet-based cognitive behavioral therapy (iCBT), in particular for Social Anxiety Disorder (SAD).

Despite this, overall, the efficiency and practical benefits of remote psychotherapy interventions in treating anxiety and depression across a diverse range of patient groups suggested that it is an appropriate alternative for those who cannot access in-person psychotherapy.

Conclusions

Further research evaluating the efficiency and practical benefits of e-psychotherapy for anxiety and depression is much needed for patients with limited access to in-person psychological care. Moreover, it remains to evaluate the maintenance of therapeutic gains after the end of the treatments.

Disclosure of Interest

None Declared
Anxiety and depressive disorders Screening among Healthcare Professionals
Authors: Ayed W. , Chebbi S. , Ayadi A. , Ayari S. , Kebir H. , Magroun I.
Published: August 2023

Introduction

Stress is an integral part of the profession of health care personnel (HCP) and manifests in higher rates of depressive and anxiety disorders (ADD).

Objectives

Screening of anxiety and depressive disorders factors among HCPs

Methods

A descriptive cross-sectional study in two university hospitals in Ariana was carried out ont september 2022. It included HCP who were examined for medical periodic visit. Data was collect from medical records, anxiety and depression Scale (HAD) and somnolence questionnaire (Epworth).

Results

One hundred and nine HCP were included in the study. Women represented 87.2% of cases. The average age was 38 ±10.7 years. The average occupational seniority varied between one to 38 years. Nurses represented 38.5%, technicians 24% and doctors 7%. They had night work in 12% of cases. Depression and anxiety were found for 20% and 31% of cases respectively. Successive daytime sleepiness was found in 7% of cases. A statistically significant relationship was found between excessive daytime sleepiness and anxiety (p=0.005) and between depression (p=0.002).

Conclusions

Anxiety and depressive disorders in HCP were considerable. they were assiciated with sleepiness disorder. Night or day time shift wasn’t statistically correlated with ADD. Referral to psychiatric consultations after psychological opinion was done in order garantee therapeutic support and decide fitness to work.

Disclosure of Interest

None Declared
Deep brain stimulation of the medial forebrain bundle - effects on suicidality in treatment-refractory MDD patients?
Authors: Soares J. C.
Published: August 2023

Deep brain stimulation (DBS) of brain circuits involved in mood regulation is a novel tool that is being investigated as a potential treatment for some of the most severe patients with mood disorders. At UTHealth Houston, we have had an ongoing clinical trial with DBS of the medial forebrain bundle (MFB).

Our preliminary results suggest effects in alleviating depressive symptoms in this very severe, refractory patient group.

In this presentation, we will review our latest findings, and will also discuss the potential effects of the MFB stimulation on measures of suicidality in this patient population.

Disclosure of Interest

None Declared
Long-acting new generation antipsychotics in the maintenance treatment of bipolar disorders
Authors: Yavuz E. , Altınbaş K.
Published: August 2023

Introduction

Maintaining remission, preventing from future episodes, better treatment adherence and improving the quality of life are main aims of long-term treatment in bipolar disorders (BD). In recent years, new generation long-acting injectable (LAI) antipsychotics have been frequently used in maintenance treatment for bipolar disorders.

Objectives

We aimed to review socio-demographic and clinical characteristics of bipolar patients taking LAI treatment for maintenance treatment.

Methods

Clinical records of 56 bipolar patients who are on LAI treatment and followed in Mazhar Osman Mood Clinic (MOMC) of Selcuk University Medical Faculty were evaluated. Descriptive statistical analysis was performed with Statistical Package for the Social Sciences (SPSS).

Results

Nearly half of the patients were male (n:29, 52%). 49,1% of the patients were married. The mean age was 37.1±12.2 years and the mean duration of education was 11.1±4.2 years. All of the patients were diagnosed with bipolar 1 disorder. Most of the patients (64,7%) was on aripiprazole LAI while remaining was receiving paliperidone LAI for maintenance treatment. We found a significant reduction in the number of manic episodes after long-acting treatment (p<0.001), but we could not find any difference for depression. Ten of the patients discontinued the treatment due to the side effects, extrapyramidal side effects were the most common side effects. Eight of the patients were switched from paliperidone treatment to aripiprazole treatment due to side effects, especially hyperprolactinemia. Relapse was observed in 46,4% of the patients and there was no difference between aripiprazole and paliperidone in terms of relapse rate.

Conclusions

LAI new generation antipsychotics are taking place in long-term treatment of bipolar disorder via improving treatment adherence. Side effect profile of aripiprazole and paliperidone are different. However, we could not find any difference between two drugs in terms of side effects and relapse rates. Small sample size and shorter duration of follow-up should be considered as limitations.

Disclosure of Interest

None Declared
The current shapes of cyberviolence in digital relationships
Authors: Yilmaz Karaman I. G.
Published: August 2023

Social life has moved toward the digital world in many aspects. As the original inhabitants of virtual life, young people face several adversities while flirting and dating online. The anonymity of the online environment enables aggression without consequences. Cyberviolence has no boundaries as time or place. Thus it may cause psychological distress.

Young people frequently use online dating and social networking sites, which makes them vulnerable to cyber dating violence, sextortion, and revenge porn. Cyberdating violence usually targets young women and girls. It is mainly related to stereotypical gender beliefs: presented as controlling behavior and psychological violence. Survivors of cyber dating violence tend to feel anger, hostility, and loneliness. Sextortion is image-based sexual abuse, which includes threats with intimate pictures or videos. Perpetrators of sextortion can be hackers, ex-partners, or admirers. Exposure to sextortion is related to shame, fear, and helplessness. Former partners may use revenge porn to control one’s behavior. It is another kind of image-based sexual abuse. Perpetrators may use nonconsensual pornography to punish or humiliate their ex-partners.

Cyber victimization is as traumatic as real-life victimization. That results in depression, anxiety, and posttraumatic stress. Moreover, the absence of time and space restrictions can make cyberviolence even more debilitative. I aim to inform European psychiatrists about the current shapes of cyber psychological trauma in the context of online flirting and dating. So that psychiatrists can better understand its content and outcomes, especially while working with young people.

Disclosure of Interest

None Declared
An Internet-Based Multi-Approach Intervention Targeting University Students Suffering from Psychological Problems: MindBlooming
Authors: Calati Raffaella , Fagadau Ionut Daniel , Ginelli Davide , Madeddu Fabio , Lopez-Castroman Jorge , Romano Daniele , Gabbiadini Alessandro , Preti Emanuele , Micucci Daniela
Published: August 2023

The young adult can experience psychological difficulties related to the delicate phase of life he/she is going through. Many of them show psychological difficulties but only a small portion receive the needed care. In this regard, internet-based interventions represent an important resource.

MindBlooming is a seven-week intervention delivered through a mobile application for university students with mild to moderate psychological difficulties. The application is the result of the interdisciplinary work between the Department of Psychology and the Department of Informatics, Systems and Communication of the University of Milan-Bicocca.

The intervention focused on symptoms of depression, anxiety, sleep problems, self-destructive thoughts, job- and study-related stress and burnout, and chronic pain. It is based on different approaches
(multi-approach), primarily psychoeducation, Cognitive-Behavioral Treatment (CBT), and third-wave CBT. During the first pilot study, the intervention consisted of a 7-week treatment on two problematic areas according to each students’ personal needs, identified through an initial assessment. The achieved results are promising especially in terms of interest shown by students. However, we encountered technical problems that hampered the pilot study. A second pilot will be performed to further test the application.

The MindBlooming project will be discussed in light of the need for further multidisciplinary research that confirms how biomarkers can be sensitive to non-pharmacological internet-based interventions.

Keywords

cognitive-behavioral treatment; internet-based intervention; university students.

Disclosure of Interest

None Declared
Life stress and Bipolar Disorder: regarding a clinical case
Authors: Coelho Rocha T. , Cunha J. F. , Torres S. , Alves Leal J. , Carvalho Moura J. , Seabra D. , Monteiro Lopes I. , Lopes A. , Lima G.
Published: August 2023

Introduction

Research on life stress in bipolar disorder largely fails to account for the possibility of a dynamic relationship between psychosocial stress and episode initiation. The kindling hypothesis states that over the course of recurrent affective disorders, there is a weakening temporal relationship between major life stress and episode initiation that could reflect either a progressive sensitization or progressive autonomy to life stress.

Objectives

To explore the concept of the Kindling model applied to bipolar disorder and to present a clinical case of a bipolar patient whose latter mood episodes were caused by adverse life events.

Methods

We performed a non-systematic literature review using the most relevant papers found on the database PubMed with the keywords “kindling effect”, “allostatic load”, “bipolar disorder” and “prevention”. Description of the clinical case report.

Results

The phenomenon of kindling was first discovered by Goddard in 1967 who described it in epilepsy. Later, Post applied it to the bipolar disorder, arguing that the initial episodes of both unipolar and bipolar affective disorders are often precipitated by psychosocial stressors, but after multiple recurrences, not only do precipitated episodes continue to occur, but so do spontaneous ones as well. We present the case report of a 62 years old woman, divorced, diagnosed with type 1 bipolar disorder since she was 20 years old. She always have had poor adherence to her medication and follow-up with Psychiatry consultation, with a non-containing sociofamily environment that does not promote clinical stability. Over the time, her admissions on the Psychiatry ward were more frequent and precipitated by adverse life events, mainly caused by the deteriorated relationship with her children.

Conclusions

The kindling model clarifies aspects of the longitudinal course of episode development, recurrence, and progression to spontaneity, as well as further conceptual and theoretical rationales for intervention in order to prevent illness progression.

Disclosure of Interest

None Declared
Characteristics of early and late onset pediatric depression
Authors: Díaz-Castro L. , Hoffman K. L.
Published: August 2023

Introduction

Depression, anxiety and suicide are serious psychiatric conditions that affect Mexican youth (Institute for Health Metrics and Evaluation, IHME, 2022), with depression showing a prevalence greater than 16%. Suicide ranks as the second most important cause of deathin this age group, (6/100,000 deaths), the first being violent deaths by firearms (15/100,000 deaths;IHME, 2022).

Objectives

To identify factors related to age of onset of pediatric depression.

Methods

A cross-sectional study was carried out during 2018-2020 in two Children’s Psychiatric Hospitals in Mexico City. Data were collected using a survey method. All participants signed an informed consent form. We applied Cox hazard analysis, with the hazard event being the onset of psychiatric symptoms.

Results

Data from 400 patients were analyzed, 148 girls (37%) and 252 boys (63%). Mean patient age was 12 years, and mean age of symptom onset was 8 years. The most common diagnoses were hyperkinetic disorder (51%), depression (34%), and anxiety (7.8%). Age of depression onset was significantly reduced in association with male sex (HR=1.46), family history of psychiatric disorder (familial depression HR=2.34; hyperkinetic disorder HR=2.67; psychoactive substance abuse HR=5.09), and certain medical comorbidities (asthma HR=6.41; enuresis HR=3.03). These same covariates were not associated with age of onset of hyperkinetic disorder or anxiety.

Conclusions

These analyses indicate that a subgroup of pediatric depression has an early onset and is associated with familial hyperkinetic disorder and depression, the male sex, and certain medical comorbidities.

Disclosure of Interest

None Declared