bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of the Covid-19 pandemic on peripartum affective psychopathology
Authors: Pompili S. , Orsolini L. , Mauro A. , Salvi V. , Volpe U.
Published: September 2022

Introduction

Despite COVID-19 pandemic significantly impacting mental health, few studies evaluated effects on perinatal mental health.

Objectives

Therefore, we aimed at assessing pregnant and puerperal women during first and second COVID-19 waves.

Methods

70 women (41 pregnant and 29 puerperal) consecutively afferent to our outpatient service for Perinatal Mental Health (March 2020-March 2021) were administered Edinburgh Postnatal Depression Scale (EPDS), Fear of COVID-19 (FCV-19-S), Coronavirus Anxiety Scale (CAS) and Wijma Delivery Expectancy/Experience questionnaire (WDEQ).

Results

Women who reported last menstruation date (LMD) in 2019 second semester showed higher EPDS scores (p=0.026), those with estimated delivery date (EDD) in 2021 second semester showed higher CAS scores than those with EDD in 2020 first semester (p=0.020) or in 2021 first semester (p<0.001). Women with clinically significant EPDS Scores reported higher FCV-S-19 (p=0.005) and CAS (p=0.003). Subjects with a previous psychiatric hospitalization showed higher FCV-S-19 (p=0.003). A weak positive correlation (r=0,290; R2=0,084; p=0.015) has been observed between FCV-S-19 and EPDS. Furthermore, there was a strong positive correlation (r=0,377; R2=0,142; P=0.001) between CAS and EPDS and between CAS and FCV-S-19 (r=0,641; R2=0.410; p<0.001). All subjects showed high scores for tocophobia after experiencing delivery.

Conclusions

COVID-19 pandemic significantly impacted pregnant and/or postpartum women also without a previous psychiatric condition. Early identification and screening tools should be routinely provided to all pregnant and postpartum women.

Disclosure

No significant relationships.
The physical-mental health interface during pregnancy planning
Authors: Tosh C. , Kavanagh K. , Flynn A. , White S. , Catalao R. , Wilson C.
Published: September 2022

Introduction

The physical and mental health of women prior to conception can have a significant impact on pregnancy and child outcomes. Given the rising burden of non-communicable diseases, the aim of this analysis was to explore the relationship between mental health, physical health and health behaviour in women planning a pregnancy.

Objectives

To investigate the association between indices of physical and mental health in a large population of women in the UK planning a pregnancy.

Methods

Responses to a preconception health digital education tool provided data on the physical and mental health and health behaviour of 131,182 women planning pregnancy. Logistic regression was used to explore associations between mental health and physical health variables. Multiple imputation by chained equations was implemented to handle missing data.

Results

There was evidence for an association between physical and mental health conditions (OR 2.22; 95% CI 2.14, 2.3). There was also an association between having a mental disorder and physical inactivity (OR 1.14; 95% CI 1.11, 1.18), substance misuse (OR 2.4; 95% CI 2.25, 2.55) and less folic acid use (OR 0.89; 95% CI 0.86,0.92).

Conclusions

There is a need for greater integration of physical and mental healthcare for women in the preconception period, which could support women, including those who wish to conceive, to optimise their health during this time.

Disclosure

No significant relationships.
Premenstrual syndrome as a possible presymtomatic marker for negative outcomes of pregnancy
Authors: Eros E.
Published: September 2022

Introduction

Hungarian Family Planning Service’s mission is decreasing the negative outcomes of pregnancy, including perinatal depression.

Objectives

Childbirth as a great irreversible life event is a normative crisis of the life, thus pregnancy and post-partum period are times of high risk for psychiatric symptoms. Stress in pre- and post-natal period has short and long-term effect on offspring. Women participating in family planning program should be evaluated for the high risk and specific preventive program are provided for them.

Methods

Between 2015-2018, 446 women were participating in family planning service. They were screened for premenstrual syndrome by using the shortened form of PAF questionnaire. We compared healthy and PMS affected patients’ data in according to the prevalence of PPD, spontaneous abortion and period needed for conception.

Results

Prevalence of PMS in our sample was 51.4%. Overage duration between wished and realized conception was 6.1 months in healthy group vs 9.2 months in PMS group. Post-natal depression was screened by Edinburgh Post-natal Scale and it showed about 4-times higher prevalence between affected women by PMS. Surprising the rate of spontaneous abortion was 2-times higher, although the absolute number is rather low for statistical validation.

Conclusions

Women affected by PMS can be considered as high risk for perinatal mood disorders and negative outcomes of pregnancy. PMS can be useful as a presymptomatic marker of perinatal depression and may be increased risk for spontaneous abortion. Psychological aspect should be included into the periconceptional care. Family planning may be an optimal solution to prevent perinatal depression and its complication.

Disclosure

No significant relationships.
Effect of medical education on European psychiatrists’ knowledge in management of major depressive disorder and psychiatric emergencies
Authors: Thevathasan L. , Fairley L. , Phillips C.
Published: September 2022

Introduction

The challenge for psychiatrists is keeping up to date with the latest clinical trial data in managing major depressive disorder (MDD) and psychiatric emergencies.

Objectives

We evaluated whether an online educational video lecture directed at psychiatrists, could improve knowledge and confidence regarding management of psychiatric emergencies associated with MDD.

Methods

Educational effect was assessed using a 3-question repeated pairs, pre/post assessment survey. A paired-samples t-test was conducted to assess overall number correct and confidence change. A McNemar’s test was conducted to assess question-level significance. P values < 0.05 are statistically significant. Cohen’s d test was used to estimate the magnitude of effect of education. The activity launched on 8 April 2021, and preliminary data analysed as of 24 June 2021.

Results

807 psychiatrists participated in the programme, of which 150 completed the pre- and post-assessment test. An average overall correct response rate of 44% pre- increased to 74% post- (67% relative increase, P<0.001; Cohen’s d = 0.91). Knowledge on the burden of suicide and MDD improved from 38% pre- to 85% post- (124% relative increase,P<0.001). Knowledge regarding clinical data for novel therapies for use in psychiatric emergencies improved from 47% pre- to 68% post- (45% relative increase, P<0.01). Knowledge regarding signs of suicidal intent in patients with MDD improved from 49% pre- to 71% (45% relative increase, P<0.001) following education.

Conclusions

This study demonstrates the positive effect of online medical education on psychiatrists’ knowledge in contemporary management of psychiatric emergencies associated with MDD in Europe.

Disclosure

The results of this study were from an educational programme that was developed through independent educational funding from Janssen Neuroscience.
Clinical Indicators of Symptom Dimensions and Cognitive Ability in Schizophrenia
Authors: Farakish L. , Legge S. , Owen M. , O’Donovan M. , Walters J. , Cardno A.
Published: September 2022

Introduction

Schizophrenia is a heterogeneous disorder and it is unknown what causes individual variability in symptoms and cognitive ability.

Objectives

To examine the association between nine clinical predictors measurable at the onset of schizophrenia and five phenotype dimensions: positive, negative (diminished expressivity), negative (motivation and pleasure), disorganised symptoms and cognitive ability.

Methods

852 participants (mean age 49 years old) with a diagnosis of schizophrenia or schizoaffective depression were included from the CardiffCOGS cross-sectional sample. Phenotype dimensions were created using confirmatory factor analysis and a 5-factor model. Associations were tested using linear regression, adjusting for age and sex. A Bonferroni correction was applied for (p<1.1x10-3) for multiple testing.

Results

Age of onset of psychosis was significantly associated with positive symptoms (β=-0.18, p=4.0 x10-6). Lower premorbid IQ was associated with diminished expressivity (β=-0.25, p= 7.0x10-13), reduced motivation and pleasure (β=-0.23, p= 4.3x10-11), disorganised symptoms (β=-0.14, p= 7.6x10-5) and reduced cognition (β=0.54, p= 4.8x10-77). Poor premorbid social adjustment held associations with all except positive. Developmental delay was associated with reduced cognition (β=-0.35, p= 4.3x10-5). Cannabis use (year before onset), psychosocial stressors (within 6 months), childhood abuse and family history of schizophrenia held no associations.

Conclusions

Clinical indicators measurable at schizophrenia onset are associated with lifetime symptom variability. A younger psychosis onset is associated with more severe positive symptoms, suggesting possible age-targeted management. Pre-established links of lower premorbid IQ with poor premorbid social adjustment and negative symptom severity with cognition are strengthened. Further investigation could potentially improve diagnosis and guide treatment choice for aspects of schizophrenia with poor outcomes.

Disclosure

No significant relationships.
A systematic review and meta-analysis of implicit Theory of Mind in schizophrenia
Authors: Csulak T. , Hajnal A. , Kiss S. , Dembrovszky F. , Sipos Z. , Varjú-Solymár M. , Kovács M. , Herold M. , Varga E. , Hegyi P. , Tényi T. , Herold R.
Published: September 2022

Introduction

Everyday social interactions are based on Theory of Mind (ToM) or mentalizing, whose complex processes are involved in understanding, representing one’s own and other people’s mental states. ToM is supposed to have two systems. The implicit ToM seems to be a fast, automatic, non-verbal processing. The explicit ToM is characterized by a slower, but more flexible processing, which is mostly verbal, interpretative. Several studies have described explicit ToM deficit in schizophrenic patients. Less research has investigated implicit ToM in patients, however recently, there has been a growing number of articles examining implicit ToM of patients with schizophrenia.

Objectives

The aim of our systematic review and meta-analysis is to summarize the results of the implicit ToM in schizophrenia.

Methods

A systematic search was performed in four major databases. We included 11 publications. 7 studies; and 5 studies were included the quantitative synthesis and the qualitative synthesis, respectively.

Results

We found significant differences in accuracy, reaction time and brain activation patterns during implicit ToM between schizophrenic patients and controls. The systematic review revealed further alterations in visual scanning, cue fixation, face looking time, and difficulties in perspective taking.

Conclusions

Based on our results implicit ToM is affected in schizophrenia in addition to explicit ToM deficit. However, based on these results we cannot exclude the possibility, that implicit ToM or at least some elements of it might be relatively unaffected (e.g. detection of intentionality), however its effectiveness is limited by non-mentalizing deficits (e.g. certain neurocognitive impairments). Our results may have important implications for the remediation of mentalizing skills.

Disclosure

The research is supported by the Hungarian National Excellence Centrum Grant (FIKP II) and Hungarian Brain Research Program (KTIA-13-NAP-A-II/12).
Clinical recovery is not a requirement for subjective well-being: a longitudinal study in older Dutch patients living with schizophrenia
Authors: Meesters P.D. , Rhebergen D.
Published: September 2022

Introduction

Growing old with schizophrenia is a profound challenge. However, impact and course of the disorder vary widely among individuals. The recovery concept has inspired outcome evaluation. In older schizophrenia patients, research on recovery is limited and mainly cross-sectional.

Objectives

To compare 5-year outcome of clinical recovery (symptomatic remission and adequate community functioning) with outcome of subjective well-being (as a key element of personal recovery).

Methods

Our catchment-area based study sample consisted of 73 older Dutch schizophrenia patients (mean age 65.9 years; SD 5.4), including both community living and institutionalized patients regardless of the age of onset of their disorder.

Results

At baseline (T1) 5.5% of participants qualified for clinical recovery, while at five-year follow-up (T2) this rate was 12.3% (p=0.18, exact McNemar’s test). Subjective well-being was reported by 20.5% of participants at T1, and by 27.4% at T2 (p=0.27, exact McNemar’s test). Concurrent clinical recovery and subjective well-being was exceptional, being present in only one participant at T1 and in two participants at T2. Clinical recovery and subjective well-being were not correlated at T1 (p=0.82; phi=0.027), nor at T2 (p=0.71; phi= -0.044).

Conclusions

Transitions over time confirm a dynamic course of schizophrenia in later life, with room for improvement. In our sample, we found no linkage between clinical recovery and subjective well-being. Results suggest that while clinical recovery is relatively rare in older individuals with schizophrenia it is not a prerequisite to experience subjective well-being. In spite of ongoing symptoms a substantial number of older schizophrenia patients report subjective well-being and thus may find ‘wellness within illness’.

Disclosure

No significant relationships.
Italian validation of Arizona Sexual Experience (ASEX) on patients suffering from psychotic spectrum disorders
Authors: Jannini T. , Rossi R. , Sconci V. , Bonanni R. , De Michele F. , Cavallo G. , Siracusano A. , Rossi A. , Di Lorenzo G. , Jannini E. , Ciocca G.
Published: September 2022

Introduction

Many forms of mental disorders, especially psychotic disorders are characterized also by a worsening of sexual functioning. Sexual dysfunction has been shown to significantly correlate with a longer duration of untreated psychosis and with heavier psychotic symptomatology.

Objectives

The aim of this study is to validate the Italian version of the Arizona Sexual Experience (ASEX), a very handy and reliable tool to assess sexual dysfunction, in a population of people suffering from psychotic spectrum disorders.

Methods

Seventy-three psychiatric patients were recruited and assessed for mental illness and sexual functioning. We administered the Italian version of ASEX, adequately translated by two expert bilinguals. After 15 days we administered once again the test for test-retest reliability.

Results

Validation of ASEX revealed Cronbach’s coefficients >0.70 in both single items as in the total score. In addition, the test-retest reliability revealed Pearson’s coefficients >0.50 in the various domains. Confirmatory factor analysis revealed good fit indexes for the two factors model of ASEX (SRMR=0.54; CFI=0.974; RMSEA=0.135).

Conclusions

This study represents the first validation in the Italian psychiatric context of a very useful specific tool for the sexual assessment in people suffering from mental illness. Our analysis revealed good psychometric characteristics in terms of confirmatory factor analysis, internal consistency, and test-retest reliability.

Disclosure

No significant relationships.
Biomarkers in the Cerebrospinal Fluid of Patients with Psychotic Disorders Compared to Healthy Controls: A Systematic Review and Meta-Analysis
Authors: Rømer T. , Jeppesen R. , Christensen R. , Benros M.
Published: September 2022

Introduction

Biomarkers in CSF could provide etiological clues and diagnostic tools for psychotic disorders. However, an overview of all CSF findings in individuals with psychotic disorders compared to healthy controls is lacking.

Objectives

To analyse CSF findings from individuals with psychotic disorders compared to healthy controls.

Methods

PubMed, EMBASE, Cochrane Library, Web of Science, ClinicalTrials.gov, and PsycINFO were searched November 3rd, 2021. Case-control studies including patients with non-affective, psychotic disorder compared to healthy controls measuring at least one biomarker in CSF are included. Standardized Mean Differences (SMD) and random-effects analyses were used.

Results

141 studies, covering 192 biomarkers, were included. 161 biomarkers have not previously been included in meta-analyses. Most markers measured showed no significant differences, including the dopamine metabolites HVA and DOPAC. Patients with psychotic disorders showed increased CSF levels of noradrenaline (SMD, 0.53; 95% CI, 0.15-0.90), MHPG (SMD, 0.30; 95% CI, 0.05-0.55), 5-HIAA (SMD, 0.11; 95 % CI, 0.01-0.21), kynurenic acid (SMD, 1.58; 95% CI, 0.26-2.91), kynurenine (SMD, 1.00; 95% CI, 0.58-1.42), IL-6 (SMD, 0.58; 95% CI, 0.39-0.77), IL-8 (SMD, 0.47; 95% CI, 0.18-0.77), anandamide (SMD, 0.78; 95% CI, 0.53-1.02), albumin ratio (SMD, 0.53; 95% CI, 0.10-0.96), total protein (SMD, 0.31; 95% CI, 0.14-0.48), and glucose (SMD, 0.57; 95% CI, 0.08-1.06). Neurotensin (SMD, -0.67; 95% CI, -0.89 to -0.46) and GABA (SMD, -0.29; 95% CI, -0.50 to -0.09) were decreased.

Conclusions

These findings suggest that dysregulation of the immune and adrenergic system and blood-brain barrier dysfunction might play a role in the pathophysiology of psychotic disorders.

Disclosure

No significant relationships.
Satisfaction with social connectedness as a predictor for positive and negative symptoms of psychosis: A PHAMOUS study
Authors: Vogel J.S. , Bruins J. , De Jong S. , Knegtering R. , Bartels-Velthuis A.A. , Van Der Gaag M. , Castelein S.
Published: September 2022

Introduction

Social connectedness might positively influence the course of clinical symptoms in people with psychotic disorders.

Objectives

This study examines satisfaction with social connectedness (SSC) as predictor of positive and negative symptoms in people with a psychotic disorder.

Methods

Data from the Pharmacotherapy Monitoring and Outcome Survey (PHAMOUS, 2014-2019) was used from patients diagnosed with a psychotic disorder (N=2109). Items about social connectedness of the Manchester short assessment of Quality of Life (ManSA) were used to measure SSC. Linear mixed models were used to estimate the association of SSC with the Positive and Negative Syndrome Scale (PANSS) after one and two years against α=0.01. Analyses were adjusted for symptoms, time since onset, gender and age. Additionally, fluctuation of positive and negative symptom scores over time was estimated.

Results

Mean duration of illness of the sample was 18.8 years (SD 10.7) with >65% showing only small variation in positive and negative symptoms over a two to five-year time period. After adjustment for covariates, SSC showed to be negatively associated with positive symptoms after one year (β=-0.47, p<0.001, 95% CI=-0.70,-0.25) and two years (β =-0.59, p<0.001, 95% CI = -0.88,-0.30), and for negative symptoms after one year (β=-0.52, p<0.001, 95% CI = -0.77,-0.27). The prediction of negative symptoms was not significant at two years.

Conclusions

This research indicates that interventions on SSC might positively impact mental health for people with psychosis. SSC is a small and robust predictor of future levels of positive symptoms. Negative symptoms could be predicted by SSC at one year.

Disclosure

No significant relationships.
Quantitative detection of methylated SOCS-1 in schizophrenia and bipolar disorder considering SOCS-1 -1478 CA/del polymorphism and clinical parameters
Authors: Aytac H.M. , Pehlivan S. , Pehlivan M. , Oyaci Y.
Published: September 2022

Introduction

Suppressor of cytokine signaling (SOCS) proteins are the critical negative regulators of immune responses that exert their effects by inhibiting the Jak/Stat signaling pathway.

Objectives

To investigate quantitative detection of methylated SOCS-1 in schizophrenia and bipolar disorder considering SOCS-1 -1478CA/del polymorphism and clinical parameters.

Methods

114 patients with SCZ, 86 patients with BD, and 80 healthy volunteers were included in the case-control study. The patients were consecutively admitted to the outpatient clinic for three months and were evaluated with some scales for clinical parameters. To measure the methylation level of the SOCS-1 gene, bisulfite-converted DNA samples were analyzed using the real-time quantitative methylation-specific PCR method. SOCS-1 -1478CA/del gene polymorphism was evaluated by using the PCR-RFLP.

Results

The SOCS-1 promoter methylation levels of SCZ (p = .001) and BD (p = .024) were found to be significantly different from the control group. SOCS-1 methylation was significantly different between SCZ groups due to the age of onset (p = .009). Again, SOCS-1 methylation was significantly different between BD groups due to YMRS scale scores (p = .027). While the SOCS-1 genotype distributions of SCZ patients were not found to be statistically different from the control group, a significant difference in genotype distribution between BD patients and healthy controls was found (p = .013).

Conclusions

The methylated SOCS-1 quantity in DNA samples of both SCZ and BD patients was significantly lower than in control samples. Whereas the SOCS-1 -1478CA/del polymorphism was not related to SCZ, it may be associated with the BD.

Disclosure

No significant relationships.
Covid-19 and impulsivity: an evaluation of self-harm admissions in emergency care
Authors: Mariano A. , Santini R. , Jannini T. , Di Michele F. , Bianchi F. , Siracusano A. , Niolu C.
Published: September 2022

Introduction

Several studies highlighted how COVID-19-related isolation and quarantine deeply weighed on the mental health of both the general and psychiatric population. There has been limited investigation about self-harm and impulsivity during the COVID-19 pandemic.

Objectives

The aim of this study is to evaluate how COVID-19-related lockdown affected self-harm rates in an Italian hospital.

Methods

Data on 59 patients were retrospectively collected from the Emercency deparment of the Policlinico Tor Vergata, Rome, from March 11 to May 4, 2020 (Italian mass quarantine) and the same periods of 2019 and 2021. Demographics, psychiatric history, substance use/abuse, types of self-harm and admission in psychiatric acute unit (PAU) rates were recorded.

Results

No statistical difference was reported in self-harm rates [9.8%(26/266) in 2019 vs 13.2%(10/76) in 2020 vs 10.7%(23/215) in 2021;p>0.05]. In 2020 subjects were younger (31.9±12.1 vs 39.2±14.4,p=0.22;vs 38.1±14.4;p=0.15) and had higher incidence of psychiatric history [90%(9/10) vs 73.1%(19/26), p=0.42;vs 65.2% (15/23),p=0.29],than 2019 and 2021 respectively. Substance use/abuse rates were significantly lower in 2020 compared to 2019 and 2021 [10%(1/10) vs 53.8%(14/26),p=0.04;vs 60.9% (14/23), p=0.02]. In 2020, subjects committing self-harms were more frequently admitted to PAU compared to 2019 and 2021 [60%(6/10)vs19.2%(5/26),p=0.04; vs 17.4% (4/23), p=0.04).

Conclusions

Consistent with the literature, lockdown-related measures negatively impacted on younger people, with higher rates of self-harm between March and May 2020. This, together with a higher rate of admissions to PAU, should warn the mental health system to target with specific programs to support adolescents and youngers.

Disclosure

No significant relationships.
Association of hospital-diagnosed sleep disorders with suicide: a nationwide cohort study
Authors: Høier N. , Madsen T. , Spira A. , Hawton K. , Benros M. , Nordentoft M. , Erlangsen A.
Published: September 2022

Introduction

Sleep disorders and psychiatric disease are closely related, and psychiatric diseases are associated with elevated suicide risks. Yet, the association between sleep disorders and suicide remains to be assessed using a consistent measure of sleep disorders.

Objectives

The aim of this study was to examine whether people with a hospital-diagnosis of sleep disorders had higher suicide rates than people with no diagnosis.

Methods

In a cohort study, nationwide data on all persons aged 15+ years living in Denmark during 1980-2016 were analysed. Sleep disorders were identified through diagnoses recorded during contacts to somatic hospitals. Incidence Rate Ratios (IRR) were estimated using Poisson regression models and adjusted for relevant covariates.

Results

In all, 3,674,563 males and 3,688,164 females were included, of whom 82,223 (2.2%, mean age: 50.2, SD: 17.5) males and 40,003 (1.1%, mean age: 50.6, SD: 19.9) females had sleep disorder diagnoses. Compared to those with no sleep disorders, the adjusted IRRs for suicide were 1.6 (95% CI, 1.4-1.7) and 2.2 (95% CI, 1.8-2.6) for males and females with sleep disorders, respectively. Excess rates for narcolepsy were found for males (IRR:1.2, 95% CI, 1.0-1.5) and females (IRR:3.3, 95% CI, 3.0-4.1), and for sleep apnea in males (IRR:1.8, 95% CI, 1.5-2.2). Males and females had IRRs of 4.1 (95% CI, 3.1-5.5) and 7.0 (95% CI, 4.8-10.1), respectively, 6 months after being diagnosed with a sleep disorder.

Conclusions

Sleep disorders were associated with higher suicide rates even after adjusting for pre-existing mental disorders. Our findings suggest attention towards suicidal ideation in patients suffering from sleep disorders is warranted.

Disclosure

Disclosures and Acknowledgements: Adam Spira has received honoraria for serving as a consultant to Merck and from Springer Nature Switzerland AG for guest editing special issues of Current Sleep Medicine Reports. The other authors report no conflict of in
Decreasing suicide mortality in Hungary – What are the main causes?
Authors: Rihmer Z. , Dome P. , Gonda X. , Bélteczki Z. , Németh A. , Szilágyi S. , Balazs J.
Published: September 2022

Introduction

Depression and suicidal behaviour are major public health problems everywhere but particularly in Hungary where until 2000 the suicide rate was among the highest in the world.

Objectives

To analyse the possible causes of declining national suicide rate of Hungary.

Methods

Review of the scientific literature on Hungarian suicide scene published in the last 40 years.

Results

The peak of Hungarian national suicide rate was in 1985 (46/100.000) but due to a steady and continuous, year by year decline, in 2019 it was only 16/100.000, which represents a more than 65% decrease. Rate of unrecognised/untreated mood disorders, availability of health/psychiatric care, antidepressant and lithium prescription, unemployment, smoking and alcohol consumption as well as lithium and arsenic contents of drinking water were the most investigated possible determinants of suicide mortality of the country. More widespread and effective treatment of psychiatric/mood disorder patients, decreased rate of unemployment and smoking as well as the continuously improving living standards were the most important contributors to the great decline of the national suicide rate. However, in 2020 – the first year of the COVID-19 pandemic – the national suicide rate rose by 16%, which was almost totally accounted for by the increase of suicides among males.

Conclusions

Suicidal behaviour is preventable in many cases, but as it is a complex, multicausal phenomenon, its prevention should involve several medical/psychiatric, psychosocial and community interventions.

Disclosure

No significant relationships.
Implementing Alternatives to Coercion in Mental Health Care
Authors: Galderisi S.
Published: September 2022

Abstract Body

The use of coercive measures in Medicine represents a controversial issue. Even when they comply with all rules and procedures and are enacted with the intention to address the health needs of the patient, and/or protect the patient and/or others, they always represent an infringement of fundamental personal rights and require strong ethical justification.

In Psychiatry the debate around coercive measures has led to a theoretical impasse, as the attempt to solve an ethical dilemma may expose mental health care to other ethical challenges and questions of competing rights. At the same time, the ongoing debate has contributed to raise the awareness that coercive practices are over-used, and mental health care is in need of a profound transformation towards recovery-oriented systems of care.

The implementation and dissemination of alternatives to coercive practices is an essential component of such transformation. Relevant research has provided tools and documented successful practices, and initiatives aimed at making these resources available and adapted to different contexts are being promoted by international organizations, professional associations and associations of users and carers.1

The profound transformation of current mental health care towards recovery-oriented systems of care requires resources and shared goals among the different stakeholders. Integrated and personalised care pathways, respect of human rights, shared decision making, and involvement of users and carers are essential components of this transformation.

Disclosure

No significant relationships.
Schizofrenia: Study of Tendency and Distribution
Authors: Vilella Martín C. , García Vázquez P. , Fernández Perea P. , Barrera García Y. , Serrano García A. , Gómez Martínez R. , Franch Pato C.
Published: September 2022

Introduction

The prevalence of schizophrenia is close to 1 percent internationally. According to the 2019 census, the population in the province of León, our study population, is 460,001 inhabitants.

Objectives

To study the distribution of schizofrenia in the area covered by the Complejo Asistencial Universitario de León, Spain.

Methods

This is a retrospective and cross-sectional descriptive study. The data of the hospitalizations of the last 10 years (2009-2019) will be obtained in any service of the CAULE of the 28 basic health areas of the province of León, with a diagnosis of schizophrenia. Prevalence will be calculated. The rate of schizophrenia will be calculated for the decade per 1000 inhabitants.

Results

3133 admissions identified 1576 unique patients. It is the decade of 50-59 where the largest number of hospitalizations is concentrated. Most entered directly into the psychiatry hospital care. It is 2019 where the most income is produced and 2017 the one with the least. The rate of schizophrenia is 3,2 Per 1000 inhabitants.

Conclusions

Hospitalizations for schizophrenia is concentrated in the decade of the 40-49 years. The diagnosis of schizophrenia is frecuently delayed until negative symptoms appear. There is an upward trend in hospitalizations per year in the last decade. The rate of schizophrenia is higher in areas where consanguinity is present and where the prison is located.

Disclosure

No significant relationships.
COVID-MENTA: an integrated mental health protection system for pandemic frontline healthcare workers
Authors: Szendi Md Habil I. , Bóna O. , Jenei T. , Kovács C. , Nagy Á. , Németh-Rácz K. , Török I.A. , Rudics E. , Dalos V. , Bilicki V. , Bácsfalvi M. , Téglás K. , Szabó Z. , Kelemen E.
Published: September 2022

Introduction

At Kiskunhalas Semmelweis Hospital, a special mobile container hospital was set up to care for patients infected with SARS-CoV-2 during the first wave of the pandemic.

Objectives

We aimed to create a proactive integrated mental health protection system for the frontline healthcare workers that provides an opportunity for psychophysiological monitoring of stress and crisis during shifts, as well as providing staff with more lasting methods of coping with difficulties.

Methods

From the ascending branch of the second wave, every two weeks on the workers’ rest day, mental helpers initiated a phone call to each employee participating in the program. If it was necessary, we provided psychological counseling, crisis intervention, brief psychotherapy, and psychopharmacotherapy. In addition, self-operated psychophysiological screening devices were used at the frontline work site, which provided an opportunity for continuous telemedicine monitoring.

Results

In our department, three psychologists and three psychiatrists kept in touch with an average of 150 frontline workers per month. Interventions were needed for a total of over 24% in December and January, over 17% in February and March, almost 9% in April, and only 4% in May. Helpers rated an average of two-thirds of these cases as moderate. They faced severe stress 2-3 times a month in sum, and for 2-3 workers needed medication.

Conclusions

Without a mental support system, self-report-based data suggest that nearly half of responders working at the frontline reached the threshold of clinically significant mental syndromes (Greenberg et al, 2021). Using our mental health support system, one-fifth of the workers needed intervention.

Disclosure

No significant relationships.
Psychological impact of the covid-19 pandemic on the operating room paramedical staff
Authors: Hamada H. , Soussi M. , Chrigui R. , Guellim S. , Kahloul M. , Naija W.
Published: September 2022

Introduction

the recent covid19 pandemic is not devoid of psychological risks on paramedical staff. Among them, those who work in the operating theaters are exposed to such risks.

Objectives

to determine the perceived stress level and the psychological impact of COVID-19 on paramedics in the operating room.

Methods

This is an observational, descriptive and analytical study carried out in the operating rooms of Sahloul University Hospital during a 3 month period. The data collection tool was a self-administered questionnaire composed of 5 main parts (socio-demographic characteristics, occupational characteristics, exposure to COVID-19, the Perceived Stress Scale (PSS) and the Hospital Anxiety and depression scale (HADS)).

Results

96 paramedical staff participated in our study. The average perceived stress score was significantly higher among anesthetists. 48% of participants had anxiety. Anesthetists had significantly higher anxiety scores (p = 0.001). 26.1% of participants had definite depression. Of those with definite depression, 35.3% were anesthetists (p = 0.028). Factors significantly associated with the occurrence of anxiety were: psychiatric history, increased workload, contact with a positive coronavirus patient in the operating room, and severe perceived stress. However, the factors significantly associated with the occurrence of depression were: initial training in the management of covid-19 patients, personal infection with SARS-COV2 and severe perceived stress.

Conclusions

Covid-19 pandemic is causing significant symptoms of anxiety and depression among operation room staff. Primary and secondary prevention strategies must then be undertaken.

Disclosure

No significant relationships.
Assessing mental health in Aboriginal youth
Authors: Janca A. , Lyons Z.
Published: September 2022

Introduction

The assessment of social and emotional wellbeing (SEWB) among Aboriginal people in Australia and elsewhere is complex and challenging task. A culturally appropriate tool for screening SEWB among Aboriginal adults known as the Here and Now Aboriginal Assessment (HANAA) has been developed and evaluated. The HANAA is based on exploring key domains of Aboriginal concept of SEWB and is based on a yarning process aimed to initiate a semi-structured interview that covers each domain. Over the last ten years the HANAA has been widely used by Aboriginal mental health service providers around Australia and elsewhere.

Objectives

There have been multiple requests by service providers for a similar tool to be developed for young Aboriginal people. The aim of this study was to develop a youth version of the HANAA.

Methods

A Working Group was established to guide the development of the youth HANAA. This work included discussion of assessment domains, prompt words and other adolescent specific considerations that were needed. The evlauation process was also discussed.

Results

The adult version of HANAA was well accepted by participants. Reliability was good with kappa agreements between Aboriginal and non-Aboriginal interviewers ranging from 0.5 to 1.0. Agreement between interviewers and treating clinicians on ecommended course of action was good.

Conclusions

Based on the previous field test results, it is expected that the youth HANAA will also be a culturally appropriate and useful tool which can be used by a range of service providers with differing levels of mental health training to assess SEWB among young Aboriginal people.

Disclosure

No significant relationships.
CBT-based psychological rehabilitation program for oncological patients
Authors: Juhász A. , Horváth Z. , Szekeres T. , Vizin G.
Published: September 2022

Introduction

Although the survival rate of cancer patients show an increasing trend due to more effective treatments plans, cancer mortality rates are still the highest in Hungary among EU countries. From a psychological perspective, undiagnosed psychological disorders, insufficient treatment, and also poor adherence to treatment are recognized factors behind the saddening mortality data.

Objectives

This translational research study aims to measure adherence rates and the extent of different psychological factors (including well-being and shame), in order to shed light on the relationship of these factors, among the population of patients with breast cancer. The secondary objective of the study is to develop a cognitive behavioral therapy -based psychological rehabilitation program for oncological patients (CBT-OP).

Methods

A total of 372 participants took part in our study, consisting of patients with breast cancer (n=70), clinical control subjects (n=200) and healthy controls (n=102). Data collection was conducted with convenience sampling and in an online questionnaire format. Data was analyzed with the IBM SPSS 22.0 software package, using analysis of variance (ANOVA), correlation analysis and moderation analysis.

Results

There was a significant difference between physical health, mental well-being, stigmatization and symptoms of post-traumatic stress disorder in the three groups. The association between adherence and mental well-being was moderated by the extent of experienced shame.

Conclusions

Our results draw attention to the effects of shame and well-being on adherence to cancer treatment plans. Based on these findings we developed CBT-OP program, based on evidence-based CBT methods, focusing on reducing the experience of shame and on strengthening self-compassion skills.

Disclosure

No significant relationships.
The relationship between nonsuicidal self-injury, suicidal behaviour and life events among adolescents
Authors: Horváth L.O. , Győri D. , Komáromy D. , Mészáros G. , Szentivanyi D. , Balazs J.
Published: September 2022

Introduction

Nonsuicidal self-injury (NSSI) is highly prevalent in clinical and non-clinical adolescent populations. Non-clinical studies focus on high school students thus vocational school students are underrepresented in research and prevention programs, despite being exposed to higher levels of stressful life events, a factor associated with NSSI and suicide.

Objectives

This study aimed to explore NSSI, suicidal behavior and life events among adolescents in clinical and non-clinical, i.e. both high school and vocational school settings.

Methods

A clinical (n=202) and non-clinical (n=161) sample of 13-18-year-old adolescents were assessed with the Mini International Neuropsychiatric Interview Kid, the Deliberate Self-Harm Inventory, and the Life Events List. Data were analyzed with R version 3.6.1., using Wilcoxon tests and negative binomial regression models.

Results

The prevalence of suicidal behavior (W=7.306, p<.001), NSSI (W=9.652, p<.001), and life events (W=10.410 p<.001) were significantly higher in the clinical than in the non-clinical group. The relationship between NSSI and suicidal behaviour was significantly stronger in the clinical group (95% CI: [.56,.72]) than in the nonclinical group (95% CI: [.24,.52]). The interaction between NSSI and life events (Χ2(1)=10.49, p<.01) was associated with suicidal behavior. Interpersonal events were associated with both suicidal behavior and had a moderating effect on the NSSI–suicidal behavior relationship.

Conclusions

NSSI is highly prevalent and is strongly associated with suicidal behavior in clinical and non-clinical adolescent populations. Our result call attention to the necessity of including adolescents from various educational settings in NSSI research and prevention projects during which life events, especially interpersonal events, might require special attention.

Disclosure

No significant relationships.
Clinical importance of systematic assessment and psychoeducation in specialised treatment of adolescents with severe functional somatic disorders
Authors: Kallesøe K. , Schröder A. , Wicksell R. , Rask C.
Published: September 2022

Introduction

Functional somatic disorders (FSD) characterized by persistent and disabling physical symptoms are common in youth. Diagnostic uncertainty and insufficient illness explanations are proposed as perpetuating factors for FSD and may furthermore serve as barriers for treatment engagement.

Objectives

The present study is part of a larger randomized trial and aimed at evaluating the impact of systematic assessment and psychoeducation on various clinical outcomes for adolescents suffering from severe FSD.

Methods

Ninety-one adolescents (15-19 years) with severe FSD of at least 1 year’s duration were included in the randomized trial AHEAD (Acceptance and Commitment Therapy for Health in Adolescents). All participants received a thorough assessment (approximately 4 hrs.) and a subsequent psychiatric consultation (1.5 hrs) focusing on further psychoeducation and health promoting strategies. Clinical outcomes included self-reported physical health (SF-36), symptom severity, illness perception, illness related behaviour and psychological flexibility. Questionnaires were distributed at baseline (before assessment) and 2 months after randomisation. Data were analysed using simple t-tests.

Results

Assessment and psychiatric consultation were not associated with a clinically relevant improvement of physical health, mean difference 0.23 95% CI [-0.95;1.41] p=0.701. However, a considerate decline was seen on symptom severity (p=0.017), illness worry (p<0.001) and negative illness perceptions (p<0.001). Furthermore, a decline was seen in limiting illness behaviour (p=0.002) and psychological inflexibility (p=0.001).

Conclusions

The results underpin the importance and the potential positive implications of thorough assessment and psychoeducation. Hence, these elements may be in their own right in the systematic and specialised treatment of adolescents with severe FSD.

Disclosure

No significant relationships.
Routine treatment pathways of patients with major depression and active suicidal ideation with intent in Italy: interim results from the ARIANNA observational study
Authors: Pompili M. , Bellomo A. , Pilotto E. , Rosso G. , Adami M. , Andreis D. , Roncari B. , Delmonte D.
Published: September 2022

Introduction

Major depressive disorder (MDD), especially in case of suicidal risk, is a psychiatric emergency, associated with high patient burden and healthcare resource utilization. Although active and urgent treatment is crucial, little is known on comprehensive care management of this condition in Italy.

Objectives

Here we report the ARIANNA study [NCT04463108] interim results to primarily describe the treatment utilization pathways of patients with MDD and active suicidal ideation with intent in the current clinical practice in Italy.

Methods

This observational prospective cohort study included adult patients with a moderate-to-severe major depressive episode (MDE) and active suicidality from 24 Italian sites. Real-world data on patient characteristics, treatments, clinical outcomes, and healthcare utilization were collected during a 90-day follow-up. Data collection is still ongoing.

Results

Sixty-four evaluable patients were considered for this interim analysis: 41 (64.1%) females, mean [SD] age 46.0 [15.4] years, a concomitant psychiatric diagnosis in 7 (10.9%), and other comorbidities in 26 (40.6%). The baseline mean [SD] MADRS total score was 37.5 [7.2], with severe MDE and prior suicidal behavior in 30 (46.9%) and 21 (32.8%) patients, respectively. Median [25th;75th percentiles] duration of current MDE was 1.1 [0.3;2.1] months. Acute inpatient hospitalization was provided for 43 (67.2%) patients. Antidepressant augmentation with mood stabilizers and/or antipsychotic drugs and optimization were the most frequent early standard-of-care treatment regimens in 32 (53.3%) and 24 (40.0%) patients with available data (N=60), respectively.

Conclusions

Our preliminary results suggest that initial treatment approaches in this critical population are mostly polypharmacological and delivered as inpatient care, with consequent intensive resource utilization.

Disclosure

The ARIANNA study was sponsored by Janssen-Cilag SpA, Italy. DD and MA are employees of Janssen-Cilag SpA. DA and BR are employees of MediNeos S.U.R.L., a company subject to the direction and coordination of IQVIA Solutions HQ Ltd.
45 Years of Research on Psychotherapy for Depression: Lessons for the Future
Authors: Cuijpers P.
Published: September 2022

More than 800 randomised controlled trials have examined the effects of psychotherapies for depression and compared psychotherapies with control conditions, with each other, with pharmacotherapy and with combined treatments. These trials have also examined the effects of therapies in specific target groups, such as women with perinatal depression, children and adolescents, older adults, people with general medical disorders and many others. Furthermore, the effects have not just been examined on depressive symptoms, but also on other outcomes, such as quality of life, functional limitations and social support. In this presentation I will present the results of a large meta-analytic project in which new trials are continuously added. I will show that the most important therapies are effective, that most therapies have comparable effects, that these effects remain significant up to one year follow up and that the therapies are effective in most specific groups. But meta-analyses should also be considered with caution, because they overestimate the effects of therapies. The effects of therapies are comparable to those of pharmacotherapy, but at the longer term psychotherapies are more effective. Combined therapy is more effective than either one alone, at the short and longer term.

Disclosure

No significant relationships.