bluuebunny/crossref_metadata_2025 huggingface dataset:
Pharmacogenetic intervention in the Child and Adolescent Autism Day Therapeutic Unit
Authors: Alvarez A. , Santamaria N. , Bote V. , Medina R. , Sanchez B. , Mendez I. , Monreal J. A. , Arranz M. J. , Hervas A.
Published: August 2024

Introduction

The ASD Therapeutic Day Unit is a tertiary care unit that consists of 20 beds, designed to facilitate the evaluation and treatment of children and adolescents with ASD who present high psychiatric comorbidity with behavioral problems, communication/language problems, sensory, and/or in the management of their repetitive and restricted interests. In addition to diagnosis and genetic counseling and clinical care, we offer the possibility of performing an individualized pharmacogenetic study in order to offer appropriate pharmacological treatment to patients with ASD and comorbidities.

Objectives

The objective is to promote pharmacological tolerability, avoid unwanted side effects, as well as avoid the use of polypharmacy, in children with a tendency to poor drug metabolism.

Methods

A review of the medical history of the patients included in the Blood Extraction Program of the ASD Day Therapeutic Unit is carried out during the year 2022. The existing medications at admission, the results of the pharmacogenetic analyzes carried out, and the pertinent changes in the pharmacological treatment of these children.

Results

37 children were included in the program during 2022. The genes CYP1A2, CYP2C19, CYP2D6, CYP3A4 and 5-HTT were analyzed. The variant studied is described, as well as the observed genotype and the expected phenotype.

Of the 37 patients, 11 maintained the same pharmacological treatment as at the beginning of admission, 5 were not taking pharmacological treatment and 25 underwent a treatment modification.

The most frequently modified treatment was risperidone with aripiprazole (n=10), secondly risperidone with guanfacine (n=5), and thirdly fluoxetine with aripiprazole (n=2).

Furthermore, the degree of pharmacological polytreatment was reduced. 18 patients switched to a single drug, instead of 14. 11 patients 2 drugs (instead of 14), 3 patients 3 drugs instead of 4 and 5 patients remained without drug treatment.

Conclusions

Patients with ASD have worse tolerability to pharmacological treatments than other patients with severe mental disorders.

The use of pharmacogenetics allows improving the cost/effectiveness of medical prescription, avoiding undesirable side effects or lack of effectiveness in the treatment of patients with ASD.

Promoting the implementation of pharmacogenetics in patients with ASD (among others) would improve the clinical situation of these patients more effectively and would improve the economic expenditure derived from erroneous prescription and/or excessive polypharmacy.

Disclosure of Interest

None Declared
Weight changes in esketamine nasal spray and quetiapine extended-release treated patients with treatment resistant depression: Results from ESCAPE-TRD study
Authors: Reif A. , Fagiolini A. , Buntinx E. , Ruggeri H. , Godinov Y. , Buyze J. , Mulhern-Haughey S. , Bitter I.
Published: August 2024

Introduction

In ESCAPE-TRD, esketamine nasal spray (ESK-NS) significantly increased the probability of remission at Week (Wk)8 and being relapse‑free through Wk32 after remission at Wk8 versus (vs) quetiapine extended-release (QTP-XR), in patients (pts) with treatment resistant depression (TRD). Safety data were consistent with established profiles of each treatment, with no new safety signals identified (Reif et al. DGPPN 2022; P-01-04).

Objectives

To explore weight changes and their impact on treatment discontinuation in ESCAPE-TRD.

Methods

ESCAPE‑TRD (NCT04338321) was a randomised, open-label, rater-blinded, phase IIIb trial comparing efficacy and safety of ESK-NS vs QTP-XR in pts with TRD. Safety analyses were conducted on pts who received ≥1 dose of study treatment. Treatment-emergent adverse events (TEAEs) were defined as occurring at or after the first dose of study treatment and within 14 days/30 days (non-serious/serious) of the last dose. A ≥7% increase/decrease in weight from screening was considered for evaluation as a TEAE. Weights were measured and are reported as observed, with no missing data imputation.

Results

336 and 340 pts were randomised to ESK-NS and QTP-XR; 334 and 336 were included in the safety population. Over the 32-week study, a TEAE of weight increase was reported in fewer pts treated with ESK-NS than QTP-XR (9 [2.7%] vs 42 [12.5%]), leading to treatment discontinuation in 0 vs 6 (1.8%) pts, respectively. Incidences of weight increase TEAEs were balanced across pts categorised as normal, overweight or obsese by baseline body mass index (BMI; Figure). A weight decrease TEAE was reported in 7 pts (2.1%) in the ESK-NS arm vs 0 pts in the QTP-XR arm. Mean (standard deviation [SD]) weight at baseline was 76.4 (16.2) kg (ESK-NS; n=334) vs 79.1 (16.9) kg (QTP-XR; n=336). At Wk32, mean weight was maintained (76.5 [16.3] kg) in ESK-NS treated pts (n=249; mean [SD] change from baseline: 0.1 [4.0] kg) and increased (80.7 [15.6] kg) in QTP-XR treated pts (n=203; mean [SD] change from baseline: 2.5 [5.1] kg).

Image:

Conclusions

Increase in weight was uncommon with ESK-NS; weight increases were more common with QTP-XR and resulted in more treatment discontinuations. Weight increase was independent from baseline BMI.

Acknowledgements

We thank the patients who participated. Funding: Janssen, medical writing: Costello Medical, UK

Disclosure of Interest

None Declared
Cerebrovascular insult as a consequence of poor health behaviour in patients with schizophrenia and bipolar disorder
Authors: Arnautovic Tahirovic M. , Zuko M. , Lokmic Pekic I. , Sirucic N. , Tahirovic A.
Published: August 2024

Introduction

Cerebrovascular insult (CVI) in patients with psychiatric diseases is to a large extent more prevalent and is accompanied by a worse prognosis after a incident. Despite the higher mortality, these patients are less frequently subjected to CT angiography and interventional intervention on the blood vessels of the brain.

Objectives

To show the frequency of cerebrovascular insults in patients with schizophrenia (SCH), bipolar affective disorder (BP), and depression, depending on age, gender, socioeconomic characteristics, professional qualifications, and dietary habits.

Methods

A total of 1200 patients with SCH, BD and depression were treated over a period of five years.

Results

11.1% SCH patients had CVI and 3,7% a cases of bipolar afective diseases. CVI was most often experienced by patients who were married, employed, or retired, and who lived in urban areas. Smoking, elevated blood pressure values, elevated BMI do not have a significant impact on the occurrence of CVI in all groups. Patients with elevated values of glucose, total cholesterol and LDL cholesterol and CRP had a higher incidence of cerebrovascular insult.

Conclusions

It is necessary to work on raising the awareness of people suffering from psychiatric diseases regarding lifestyle and eating habits, and to conduct periodic health examinations. It is important to recognize high-risk patients and educate them about preventive measures.

Disclosure of Interest

None Declared
PTSD, dissociative experiences, and depressive symptoms in a clinical sample of women who featured in pornographic productions
Authors: El Khoury F. K. , Héroin V. , Fareng M.
Published: August 2024

Introduction

The mental health of the people who featured in Pornographic Productions (PP) is underexamined. However, PP frequently involve unsimulated violent acts mostly experienced by women. Furthermore, some women participating in PP also report being coerced into unwanted sexual acts. Therefore, featuring in a PP could be experienced as a traumatic event, and could be associated with negative mental health disorders.

Objectives

Our study examines mental health indicators among Women who have participated in at least one PP (WPP), and who consulted clinical psychologists, after referral by WPP support groups.

Methods

Thirty-six women were recruited by two clinical psychologists during an individual consultation. Participants completed the French versions of the post-traumatic stress disorder (PTSD) Checklist for DSM-5 (PCL-5), the Dissociative Experiences Scale (DES), as well as the 13-item Beck Depression Inventory (BDI-13). Data on socio-demographic characteristics, lifetime experience of sexual violence prior to participating in a PP, as well as the perceived effect of participating in a PP were also measured.

Results

The mean age of participants was 31.2 (std=7), and the average age at first participation in a PP was 23.4 (std=6). The majority (78%) of participants reported lifetime experience of sexual violence prior to participation in a PP. Thirty women (83%) had a PCL5 score over 33 indicative of probable PTSD, and 28 women (78%) had a DES score of 30 or more indicating high levels of dissociation. Further, 16 participants (44%) reported a BDI-13 score over 16 indicating severe depression.

Conclusions

This study highlights the high prevalence of PTSD, dissociative experiences, and depressive symptoms in a clinical population of women who featured in at least one PP. Further studies are needed to better understand the scale of the problem and optimize care interventions.

Disclosure of Interest

None Declared
Association between childhood maltreatment and cortical folding in women with eating disorders
Authors: Cerra R. , Attianese N. , Battipaglia M. , Ceres R. , Donato S. , Monteleone A. M. , Monteleone P. , Cascino G.
Published: August 2024

Introduction

Childhood maltreatment (CM) is associated with distinct clinical and biologi- cal characteristics in people with eating disorders (EDs). The measurement of local gyrification index (lGI) may help to better characterize the impact of CM on cortical structure.

Objectives

The objective of this study was to investigate the association of CM with lGI in women with EDs.

Methods

Twenty-six women with anorexia nervosa (AN) and 24 with bulimia nervosa (BN) underwent a 3T MRI scan. All partici- pants filled in the Childhood Trauma Questionnaire. All neuroimaging data were processed by FreeSurfer. LGI maps underwent a general linear model to evaluate differences between groups with or without CM. People with AN and BN were merged together.

Results

Based on the Childhood Trauma Questionnaire cut- off scores, 24 participants were identified as maltreated and 26 as non- maltreated. Maltreated people with EDs showed a significantly lower lGI in the left middle temporal gyrus compared with non-maltreated people, whereas no differences emerged in the right hemisphere between groups.

Conclusions

The present study showed that in people with EDs, CM is associated with reduced cortical folding in the left middle temporal gyrus, an area that could be involved in ED psychopathology. This finding corroborates the hypothesis of a ‘maltreated ecophenotype’, which argues that CM may allow to biologically, other than clinically, distinguish individuals with the same psychiatric disorder.

Disclosure of Interest

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

Introduction

Despite the increased knowledge about the prevalence and consequences of eating disorders (ED), they continue to be underdiagnosed and undertreated. Being more common in women of childbearing age, the perinatal period may play a decisive role in the incidence and course of these pathologies. The Screen for Disordered Eating (SDE) was developed for the screen of ED in primary care.

Objectives

Our aim was to analyze the psychometric properties of the Portuguese Version of SDE in women during the perinatal period.

Methods

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

Results

Confirmatory Factor Analysis showed that the unidimensional model presented good fit indexes in pregnancy (), post-partum () and considering both – perinatal period (χ2/df=2.0335; RMSEA=.0547, p<.001; CFI=0.9976 TLI=0.9939, GFI=0.9906). The Cronbach’s alfa were ≥ 0.65. All the items contributed to the internal consistency and presented high internal validity. Pearson correlations between SDE and EDE-Q-7 total scores were significant (p<.001) positive and high in pregnancy (.639), postpartum (.583) and the perinatal period (.617).

Conclusions

The Portuguese version of SDE has shown good validity (construct and concurrent) and internal consistency. As such, SDE might be a useful tool to screen ED in women during the perinatal period.

Disclosure of Interest

None Declared
Clinical and psychopathological features of parents of patients with anorexia nervosa.
Authors: Khaustova O. , Sak L.
Published: August 2024

Introduction

Anorexia nervosa (AN) is a widespread chronic mental disorder with severe negative medical and social consequences. Treating patients with AN is a complex and time-consuming process, as persistent forms are often encountered. The studies’ results indicate a possible influence of psychoemotional state and/or existing psychopathological manifestations in parents on AN development.

Objectives

To investigate the clinical and psychopathological characteristics of parents of patients with AN based on the study of emotional regulation, alexithymia, depression, and anxiety.

Methods

The study population (N=110) consisted of fathers (N=47 (42.7%)) and mothers (N=63 (57.3%) of patients with AN. The mean age was M=44.90 (SD=5.9; SE=0.567). All participants completed the emotional regulation scale (DERS), Toronto Alexithymia Scale (TAS-26), Hospital Anxiety and Depression Scale (HADS).

Results

According to DERS: “rejection” - 21.86 (SD=5.675; SE=0.541); “goals” - 19.13 (SD=2.028; SE=0.193); “impulse” - 24.17 (SD=4.908; SE=0.468); “awareness” - 21.93 (SD=1.999; SE=0.191); “strategies” - 30.75 (SD=2.173; SE=0.207); “clarity” - 18.58 (SD=1.486; SE=0.142). The sum was 136.42 (SD=8.119; SE=0.774). The TAS results of the study group were 80.45 (SD=13.699), which characterizes the average personality type as alexithymic. According to HADS, the average values were distributed: the anxiety scale M=7.96 (SD=1.347) the depression scale M=7.95 (SD=1.442). These indicators can be considered as the extreme limit of the norm or subclinically expressed anxiety and depression. The next step was to find statistically significant relationships between the DERS methodology and the HADS and TAS for the study group. According to Spearman’s correlation coefficient, there is a direct stable relationship between the variables “anxiety” and “impulse” (r=0.257), awareness (r=0.255), and the total score of emotional regulation according to “DERS” (r=0.246); A direct correlation was found between the indicators “depression” and “rejection” (r=0.151), “goals” (r=0.233), “awareness” (r=0.138); Alexithymia, in turn, has a direct correlation with the “goals” scale and an inverse correlation with the “strategies” scale (r=-0.141)

Conclusions

Parents of patients with AN have various manifestations of psychoemotional disturbances, namely subclinical levels of depression and anxiety, high levels of alexithymia, and emotional regulation problems. The correlation analysis showed that the anxiety score for parents of patients with AN is higher if difficulties with impulse control, emotional awareness, and general emotional regulation are problematic. Depressive tendencies are also associated with the subjects’ rejection of emotional reactions and problems with goal-directed behavior. The inverse correlation indicates that the higher the index of alexithymia, the less limited access to emotion regulation strategies, and vice versa.

Disclosure of Interest

None Declared
Prenatal psychological distress, access to mental health care and pathways between risk/protective factors and maternal postnatal depressive symptoms in the E.L.F.E. french birth cohort
Authors: Sutter-Dallay A.-L. , Bales M. , Charles M.-A. , Judith V. D. W.
Published: August 2024

Introduction

Mental health of pregnant and post-partum women is sensitive to environmental factors. However, access to mental healthcare remains difficult, while little is known about protective factors nor about interactions between different exposures.

Objectives

To explore on a large sample of women from the general population (i) the environmental and pregnancy characteristics independently associated with prenatal psychological distress and access to mental health care during pregnancy (ii) pathways between maternal, infant and parenthood vulnerabilities or risk/protective factors and postnatal depressive symtoms (PNDS) at 2 months post-partum (PP)

Methods

The data from the French ELFE birth cohort were used. Available information about prenatal psychological status, access to mental health care and vulnerabilities-risk/protective factors for PNDS were collected during the maternity ward stay and at 2 months PP. PNDS were evaluated with the Edinburgh Postnatal Depression Scale (EPDS) at 2 months. Maternal/pregnancy characteristics independently associated with prenatal psychological distress and access to mental health care were explored using multivariate analyses. Pathways between risk/protective factors and PNDS at 2 months were investigated through Structural Equation Modeling.

Results

Of the 15,143 mothers explored in the prenatal part of the study, 12.6% reported psychological distress (PPD), 25% had a prenatal consultation with a mental health specialist, 11% used psychotropic drugs of which 4% had no specialist follow-up. Decreased likelihood to consult a mental health specialist was found in young women, with intermediate educational level and born abroad. PPD was more frequent in women with very low economic status, alcohol/tobacco use, unplanned pregnancy, late pregnancy declaration, multiple and complicated pregnancy. In the postnatal part of the study (n=11,583) partner’s perceived antenatal emotional support, consultation with a mental health specialist before pregnancy, financial difficulties, prenatal psychological distress and experience of pregnancy were directly associated with the severity of maternal PNDS at 2 months PP, as well as perceived postnatal support, infant’s self-regulation skills, maternal ability to understand infant crying and infant hospitalisation.

Conclusions

Perinatal professional support should begin antenatally and target the couple’s prenatal functioning, with particular attention to women presenting history of psychiatric disorders, especially when of low socioeconomic status. After delivery, addressing infant and parenthood characteristics is recommended.

Disclosure of Interest

None Declared
Recovery in Schizophrenia: The Role of Psychosocial interventions
Authors: Wykes T.
Published: August 2024

Recovery in Schizophrenia: The Role of Psychosocial interventions Recovery is individual and so needs individual responses from the mental health services. Different interventions are useful at different stages and of course they only “work” for some people. The paper will describe some psychosocial interventions and the role they might pay in the patient’s journey to their expected recovery. Three main strategies are often referred to – reducing symptoms, reducing barriers to recovery, and extending and maintaining recovery to achieve some stable and acceptable (to the patient) optimal level of functioning. Psychosocial intervention strategies are beneficial for each of these often thought of as independent, but they are inter-related with one type of therapy leading to reductions in the need for other therapies. The process of considering which one to start with is a choice and this paper will describe some decision making to ensure that patients have the best options.

Disclosure of Interest

None Declared
Pursuing Sleep Architecture Remodeling: Effects of Psychopharmaceuticals on Sleep Structure
Authors: Camilo J.
Published: August 2024

Introduction

Sleep plays a pivotal role in overall physical and mental health, exerting a profound influence on general well-being and quality of life. The influence of psychopharmaceuticals on sleep structure is a critical research area, given their widespread use in the treatment of psychiatric disorders, yet their precise effects on sleep remain inadequately understood.

Objectives

This study aims to investigate how psychopharmaceuticals affect sleep architecture by identifying commonalities and disparities among different classes of psychotropic medications.

Methods

Systematic review of the literature encompassing studies assessing the effects of psychopharmaceuticals on sleep structure. Electronic databases such as PubMed were employed to identify pertinent studies published within the last decade.

Results

Diverse classes of psychopharmaceuticals have varying effects on sleep architecture. Additionally, prolonged use of specific psychopharmaceuticals was correlated with sleep disturbances, such as insomnia. These findings hold significant implications for clinical practice, emphasizing the necessity of an individualized approach in treating patients with psychiatric disorders.

Conclusions

Psychopharmaceuticals exert a substantial impact on sleep architecture, with effects contingent on drug class and duration of use. Understanding these alterations is crucial for optimizing the treatment of patients with psychiatric disorders, striking a balance between therapeutic benefits and potential sleep-related adverse effects. Furthermore, these discoveries underscore the importance of closely monitoring the sleep of patients undergoing psychopharmacological treatment and tailoring therapeutic approaches in accordance with individual needs.

Disclosure of Interest

None Declared
Mental Health Policy Name: War and mental health (Croatian experience)
Authors: Rojnic Kuzman M.
Published: August 2024

War represents one of the major traumatic events for humans and comes with enormous consequences for individuals and society over a long period of time. War causes acute psychological trauma, but also results in subacute, chronic psychiatric disorders for all those experiencing or witnessing direct war trauma and to those experiencing indirect war trauma resulting from losing the safety of home and financial income, to losing family members and close ones. Therefore, acute reaction to trauma may result in maladaptive disorders and PTSD within days of experiencing trauma and with chronic posttraumatic stress conditions even years after the traumatic experience. Chronic PTSD is associated with higher morbidity of somatic conditions, including hypertension, hyperlipidemia, metabolic syndrome, all resulting in cardiovascular and cerebrovascular disorders. Additionally, according to reports from World Health Organisation (WHO), it has been projected that in emergencies, on average, the percentage of people with a severe mental disorder increases by 1 per cent over and above an estimated baseline of 2–3 per cent. In addition, the percentage of people with mild or moderate mental disorders, including mood and anxiety disorders (including PTSD), may increase by 5–10 per cent above an estimated baseline of 10 per cent. Furthermore, research indicate the possibility of a transgenerational effect of trauma, via maternal psychosocial stress and socioeconomic disadvantage during pregnancy but also through adverse parenting practices, as parenting style may change when exposed to war traumas.

As war affects mental health of different population groups dramatically and long-term, establishment of long term and coordinated mental health care is necessary. In the presentation, examples of practices from Croatia will be discussed.

Disclosure of Interest

None Declared
Covid-19 pandemic and mental health among adolescents and young adults: results from two studies conducted in North of Italy
Authors: Pedrini L. , Meloni S.
Published: August 2024

Introduction

The northern region of Italy had been the epicenter of the first wave of Covid-19. The youth population residing in this area experienced an extended period of restrictive measures implemented to curb the spread of the virus. Given the adverse effects of social distancing and lockdown measures, there is a concern regarding the mental health of young individuals in this region. However, there remains a notable scarcity of studies exploring the long-term impact of the pandemic on the mental health of this vulnerable population.

Objectives

To assess psychopathological symptoms among adolescents and young adults in order to evaluate the extent of their impact in the context of the Covid-19 pandemic. To explore potential risk factors and resilience factors in youth who have experienced the effects of the pandemic.

Methods

Two studies are performed. Study n1 has observational design and includes 7,146 adolescents and young adults (age range 14–25) evaluated during the fourth wave of the COVID-19 through standardized measures for depression, anxiety, anger, somatic symptoms, resilience, loneliness and post-traumatic growth. Study n2 has prospective design and includes 153 students (mean age 16.1±0.49), evaluated before the Covid-19 pandemic (November 2019–January 2020) and 1 year later (April–May 2021) to measure anxiety, depression, stress, emotional dysregulation, maladaptive behaviours.

Results

Study 1. Clustering methods identifed two groups of students with different psychological features, that we further defined as “poor mental health” and “good mental health”. Those with poor mental health were characterized by higher scores of loneliness and self-harm, followed by being of female gender, presenting binge eating behaviors and, finally, having unsatisfying family relationships.

Study 2. Over the course of one year, significant changes in various psychological parameters were observed: an increase in anxiety, stress for future uncertainty, and higher frequency of maladaptive behaviours.Stress related to social domains (i.e., school attendance, romantic relationships, peer pressure) decreased over the year. Cluster analysis identified three distinct groups of youths based on their changes in psychopathological symptoms over time: those who worsened (N=23; 15%), improved (N=55; 34%), or remained stable (N=75; 46%). Furthermore, adolescents who reported an increase in self-harm (OR=2.61; p<0.001), binge-drinking (OR=3.0; p=0.007), aggressiveness (OR 1.92; p=0.004), and binge-eating (OR 2.55; p=0.003) were more likely to be associated with a worsened mental health condition.

Conclusions

The findings from these studies substantiated the significant psychological distress caused by the COVID-19 pandemic. Furthermore, they yielded valuable further insights regarding into the factors linked to distinct patterns of mental health outcomes.

Disclosure of Interest

None Declared
Mental health assessment during the full-scale invasion within the general Ukrainian population: state, beliefs and behaviors, query to change (cross-sectional study)
Authors: Korniiko Y. , Bajbouj M. , Jonas K. J. , Mueller J. , Kemna S.
Published: August 2024

Introduction

The russian invasion in Ukraine has significantly affected the mental health (MH) of the local population while access to mental health support remains limited due to multiple reasons coming from both the provider and acceptor sides. The war obviously negatively impacts MH but has also paradoxically given an “open window” for shifting current practices both in the healthcare system and within society. Investigation of current people’s attitudes on this matter should be the primary step to address the issue and initiate any change.

Objectives

5 main objectives identified to analyze within the convenience sample were: MH state and self-care behaviors during the full-scale invasion, MH stigma and self-stigma, intention to use professional MH support, beliefs on access to professional MH support, query to change current MH attitudes and practices.

Methods

This research was conducted using primary data collection. The online questionnaire consisted of 5 blocks and was designed based on PHQ-9, DASS-21, PCL-5, Brief-COPE and CAMI. 332 civilians underwent the survey in March-April 2023 and were divided by age, gender, location and situation; inclusion criteria were to be >16 y.o. being affected by war and capable of completing the survey in Ukrainian. Relevant ethical measures were applied. Descriptive and correlational analysis was used to analyze the data.

Results

The majority of respondents rated their mental health as good. Anxiety was the most prevalent emotion, particularly among younger age groups. Different genders and age groups exhibited varying combinations of emotions, such as fatigue, peace, anger, sadness etc. Many participants felt self-reproach for not doing enough; coping strategies varied among age groups. Females were 8.14 times more likely to seek mental health support, and those inside Ukraine were 0.32 times less inclined. 66.2% never seek any MH services, with older men leading; only 8.7% consult specialists during crises, showing gender differences. Distrust in specialist qualifications is one of the barriers on access in people’s beliefs and is more prevalent among older generations. The absence of self-mental health stigma makes individuals 1.91 times more open to accessing support. Location affects openness to change, with Ukraine-based individuals being less open. Lastly, 29.5% consider alternative stress-coping methods, with 40% open to future psychological help.

Conclusions

Our findings show differences in populational attitudes towards MH in Ukraine during the war and therefore the importance of any potential intervention to precisely tailor certain subgroups, beliefs behaviors and needs within them to have a higher chance of being accepted and increase MH support utilization in the population overall.

Disclosure of Interest

None Declared
GWAS in interaction with childhood traumas implicates novel variants and genes previously associated with suicide-related factors in the background of suicidal ideation
Authors: Gonda X. , Krause S. , Erdelyi-Hamza B. , Sutori S. , Gal Z. , Eszlari N. , Bagdy G. , Juhasz G. , Torok D.
Published: August 2024

Introduction

Although suicide claims more lives than war and homicide, we still have no sufficient and effective methods either for its prediction or for its prevention. Our screening methods are laborous and subjective both on the side of the patient and on the side of the clinician. Understanding the genetic background of suicidal behaviour would help identify biomarkers for screening as well as pathways as potential targets for novel intervention and prevention approaches. However, in spite of a number of GWAS studies, results are few and rarely replicate, and generally accurate phenotyping and sufficient consideration of environmental stressors is also missing.

Objectives

In our present study we performed a genome-wide analysis study for suicidal ideation in interaction with early childhood traumas in a deep-phenotyped general population sample.

Methods

Our analysis used data from 1800 volunteers in the NewMood project. As outcome phenotype the suicidal ideation item of the Brief Symptom Inventory was used. A modified version of the Childhood Trauma Questionnaire was used to assess early adverse experiences. A genome-wide association analysis was performed with Plink 1.9, including a total of 3,474,641 variants after quality control steps, followed by genome-wide by environment interaction analyses. Our models included control variables for sex, age, and the top 10 genomic principal components. Functional annotation of SNPs was carried out using FUMA v1.5.6, gene-based tests were performed using MAGMA v1.08.

Results

7 SNPs met suggestive significance in main effect analyses, of which 2 reached genome-wide significance including rs79912020 (p=3.21E-10, β=0.746) and rs10236520 (p=1.71E-08, β=0.484), with no significant findings in gene-based tests. Interaction analyses with childhood adversities yielded 31 SNPs that met genome-wide significance, including rs7983955 (p=2.28E-11, β=0.182), rs141039461 (p=3.90E-11, β=0.0541), rs12692827 (p=3.69E-10, β=0.0612) as the top SNPs. In interaction with childhood adversities, 31 genes showed a significant association in gene-based tests, including RBFOX1 (p=1.09E-10), GRM7 (p=1.20E-10), MTCH1 (p=5.59E-09), and CDH13 (p=6.60E-09) as the most significant findings.

Conclusions

Our results indicate several important novel SNPs associated with suicidal ideation when considered in interaction with the effect of childhood adversities. Furthermore, gene-based analyses replicate several genes playing a key role in central nervous system function such as GRM7 (encoding metabotropic glutamate receptor 7) or previously implicated in association with suicide (CDH13) or suicide-related factors such as aggression (RBFOX1).

Funding: NAP2022-I-4/2022, K143391, 2019-2.1.7-ERA-NET-2020-00005, TKP2021-EGA-25

Disclosure of Interest

None Declared
Essential components of pre-electroconvulsive therapy assessment
Authors: Medved S.
Published: August 2024

A thorough pre-electroconvulsive therapy (ECT) assessment is a integral to ECT preparation. Usually, the assessment encompasses elements such as medical history, cognitive assessment, laboratory tests, imaging diagnostics, and consultation with an anesthesiologist. However, there is currently no universally standardized minimal or optimal pre-ECT evaluation at the international level. Recent results show a high variability of the pre-ECT evaluation practice across Europe. Establishing a standardized approach to pre-ECT evaluation would be of great interest for both patients and practitioners.

Disclosure of Interest

None Declared
Electroconvulsive therapy improves somatic symptoms before mood in patients with depression: a directed network approach
Authors: Hebbrecht K.
Published: August 2024

The recent network perspective of depression conceptualizes depression as a dynamic network of causally related symptoms, this in contrast with the traditional view of depression as a discrete latent entity that causes all symptoms. Electroconvulsive therapy (ECT) is an effective treatment for severe depression, but little is known about the temporal trajectories of symptom improvement during a course of ECT. We will present the results of a study that investigates the temporal trajectories of individual symptoms during treatment with ECT.

Disclosure of Interest

None Declared
Postgraduate students’ mental health, it is the time to be aware and act.
Authors: Alageel A. A.
Published: August 2024

Introduction

Education is markedly associated with well‐being, leading to the acquisition of healthy behaviors while at the same increasing hiring and salary. However, stress among academics is worrying, especially in younger researchers who experience significant levels of job insecurity, the imbalances between life and job, stressful relationships with supervisors and funding difficulties. Several studies have indicated that most graduate students spent over 40 hours per week on their postgraduate program, more than 70 % were not able to complete their programs within the set timeframe, and had uncertainty related to their job

Objectives

In this review, we discuss the mental health of postgraduate students focusing on depression, anxiety, stress, and smartphone addiction.

Methods

a review presentation of the mental health of postgraduate

Results

According to meta-analysis, depression prevalence among postgraduate participants ranges from 6.2% to 85.4% in 36 studies. The pooled prevalence was 34% (26,579 individuals; 95% CI: 28–40). A study using the GAD-7 scale to evaluate the prevalence of anxiety concluded that 41% of postgraduate students suffered moderate to severe GAD, which is about six times the prevalence of GAD among the general population. A Study demonstrated 51.0% of the participants had smartphone addiction. A significant association was also observed between extensive smartphone use and depression (P = 0.001). Of the smokers in this study, 41.5% were addicted to smartphones (P = 0.039). Smartphone addicts had approximately two times the chance of having insomnia (OR = 2.113) (P = 0.013). In addition, they showcased more ADHD symptoms (OR = 2.712) (P < 0.001).

Conclusions

Studies identified a higher prevalence of mental illnesses among postgraduate students than in the general population. Although students affected are highly educated, their awareness of mental health is not sufficient to know their mental symptoms and seek help. Therefore, we suggest launching wellness programs to enhance their mental health.

Disclosure of Interest

None Declared
Impulsivity, suicide risk and cannabis consumption
Authors: Smaoui E. , Mnif D. , Ouali R. , Sellami R. , Feki I. , Baati I. , Masmoudi J.
Published: August 2024

Introduction

Cannabis is the most widely consumed illegal drug in the world and one of the easiest to access. This drug provides a feeling of well-being and euphoria. However, frequent consumption is associated with several complications including increased impulsivity and an increased risk of suicidal behaviour.

Objectives

Our objective was to study the link between cannabis consumption, impulsivity and suicide intentionality.

Methods

We conducted a cross-sectional study, during the period from September 2020 to October 2021, among cannabis users consulting the Sfax Detoxification Center in Tunisia. Impulsivity was studied using the Barrat Impulsivity Scale (BIS 15) and suicide intentionality was assessed using the Suicide intent scale Beck; Pierce (SIS) in subjects with history of a suicide attempt.

Results

We included 38 consumers. The average age is 26 years old and the sex ratio was 8.5 with an over-representation of men. The average BIS15 score was 38.2 ranging between 19 and 45. We have demonstrated that the higher the level of cannabis dependence, the higher the level of impulsivity. A high level of impulsivity was found in younger subjects (p=0,04) and with a low socio-economic level and unemployment (p =0,021). Suicidal intentionality, assessed in 10 patients with a history of suicide attempt, was low and intermediate in 40% and 60% of users respectively, which means a low to intermediate risk of subsequent completed suicide.

Conclusions

Impulsivity is associated with aggressive behaviour, various accidents including motor vehicle accidents, more self-mutilation and a much greater risk of dying by suicide than the general population. Frequent cannabis use is also associated with increased risk of developing all types of suicidal behaviours independently of the existence of depressive symptomatology. Overall, it is important to take into account the issues of impulsivity and substance abuse in daily clinical work as they influence the level of dangerousness.

Disclosure of Interest

None Declared
New treatment perspectives for negative symptoms
Authors: Bitter I.
Published: August 2024

Introduction

Persistent negative symptoms of schizophrenia are generally considered difficult to treat or treatment resistant. A large number of investigational drugs developed and or tested for the treatment of persistent negative symptoms failed to show efficacy leading to pessimism in treatment and disinvestment in treatment research of negative symptoms.

Objectives

1. To demonstrate, that available treatment methods – both pharmacological and non-pharmacological - are in fact effective for the treatment of negative symptoms of schizophrenia 2. To shortly summarize new drug research in this field.

Method

Review of research data.

Results

The overall estimate for the placebo effect had a medium effect size, with a Cohen’s d value of 0.6444 (SE = 0.091).1 The estimates for the placebo effect were similar in the add-on and monotherapy studies. Amisulprid was superior to placebo, cariprazine was superior to risperidone, and “direct comparisons of antipsychotics in patients with predominant negative symptoms indicated no significant difference between amisulpride and olanzapine and between asenapine and olanzapine…”2. Various nonpharmacological interventions improved negative symptoms in randomized controlled trials relative to treatment as usual (e.g. social skills training, music therapy, non-invasive brain stimulation, mindfulness, and exercise-based interventions) 3 There is a progress in research with non-dopaminergic agents for the treatment of negative symptoms (e.g. pimavanserin, roluperidon, ulotaront).

Conclusions

For medication classes other than antipsychotics and antidepressants, we found no reliable support for evidence-based recommendations for using these agents in the treatment of negative symptoms in clinical practice. Effect sizes for psychosocial interventions range from small to moderate. The use of placebo has shown a clinically significant positive effect on negative symptoms, a finding that warrants further research and provides a sense of optimism regarding potential therapeutic benefits.

1.

Czobor, P., Kakuszi, B. and Bitter, I., 2022. Placebo response in trials of negative symptoms in schizophrenia: a critical reassessment of the evidence. Schizophrenia Bulletin, 48(6), pp.1228-1240. 2. Czobor, P., Bitter I. Pharmacologic treatment of negative symptoms: Focus on efficacy. In: Bitter I. (ed): Managing Negative Symptoms of Schizophrenia, Oxford University Press, 2020, p. 67

2.

Savill, M. Psychosocial/non-pharmacologic treatment of negative symptoms: focus on efficacy. In: Bitter I. (ed): Managing Negative Symptoms of Schizophrenia, Oxford University Press, 2020, p. 87

Disclosure of Interest

None Declared
Anxiety disorders and intravenous drug use in chemsex context
Authors: Curto Ramos J. , Rodríguez Laguna A. , Barrio P. , Ibarguchi L. , García A. , Azqueta I. , Dolengevich Segal H.
Published: August 2024

Introduction

Several studies have called atention to the mental health disorders associated with chemsex -the intentional use of drugs before or during sexual intercourse GBMSM (gay, bisexual and men who have sex with men) population-. Sexualized intravenous drug use is also known as slam or slamsex. There are few studies that analyze the mental health differences between intravenous drug users compared to non-intravenous drug users in chemsex context.

Objectives

We aim to describe the mental health outcomes including current and past anxiety disorders diagnosis in a sample of users with sexualized drug use (chemsex) attended by the non-governmental organization Apoyo Positivo in the program “Sex, Drugs and You” and to compare the differences of current and previous diagnosis of anxiety disorders between intravenous drug users compared to non-intravenous drug users.

Methods

A cross-sectional descriptive analysis of a sample of users attended by the non-governmental organization Apoyo Positivo in the program “Sex, Drugs and You” between 2016-2019 was performed.

Results

We included 217 participants. Current or past diagnosis of anxiety disorders was found in 142 participants. Anxiety disorders were significantly higher in the intravenous drug use group compared to the non-intravenous drug use group (p<0.05).

Conclusions

Previous studies have reported that MSM who practiced chemsex were more likely to experience from anxiety. In our study, anxiety disorders where higher in participantes who engaged in intravenous drug use. A multidisciplinary team is necessary to address chemsex and provide care and treatment for mental health problems such as anxiety, depression, suicidal behaviour or drug-induced psychosis.

Disclosure of Interest

None Declared
Acute obsessive symptoms: case report of a PANDAS-like syndrome in an adult patient.
Authors: de Vicente Blanco Á. , Orgaz Álvarez B. , Ibáñez Mendoza P. , Velasco Santos M.
Published: August 2024

Introduction

Neuropsychiatric disorders can develop following a group A β-hemolytic streptococcal infection, through autoimmune inflammation of the nervous system. Sydenham’s chorea and PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infection) are the two most well-known syndromes, primarily affecting children but rarely observed in adults.

Objectives

Our aims are to contribute to the scientific understanding of adult PANDAS-like syndrome and provide a comprehensive literature review on the subject.

Methods

Case report using clinical records and a non-systematic literature review.

Results

A 24-year-old female presented to the emergency department with profound emotional distress triggered by intrusive thoughts of existential dread, accompanied by compulsive praying. She reported that these symptoms had commenced five days earlier. Two days prior to the onset of her obsessions, she had experienced a high fever, odynophagia, cough, and chills and received an empirical diagnosis of tonsillitis following a physical examination. She was prescribed antibiotics with good response. She revealed that she had experienced two prior episodes of similar anxiety and obsessions when she was approximately seven years old.

She developed acute obsessive thoughts, including doubts about the meaning of her life, and engaged in compulsive prayer and seeking reassurance from relatives. Notably, there were no signs of affective, dissociative, or psychotic disorders during her admission to the ED or in the preceding months. She reported suffering from anxiety, insomnia, and loss of appetite in the past five days but did not express any suicidal ideation.

Physical examination indicated mild laryngeal erythema, and laboratory tests showed non-specific signs of infection with no further significant findings. Symptoms were alleviated within a week, aided by treatment with benzodiazepines (lorazepam 1 mg/8h), and she did not require further psychiatric counselling.

Conclusions

It is worth noting that adult patients can experience a PANDAS-like reaction after a streptococcal infection and may also undergo symptom relapse following new immunological challenges upon reinfection. The existence of a PANDAS spectrum has been postulated, encompassing various manifestations. Thus, when presented with acute obsessive symptoms, healthcare providers should consider this diagnosis, inquire about previous episodes, and conduct a comprehensive medical history and etiological assessment.

Disclosure of Interest

None Declared