bluuebunny/crossref_metadata_2025 huggingface dataset:
Neural Abnormalities in Panic Disorder and Agoraphobia: A Meta-Analysis of Functional Activation Studies
Authors: Baten C. , Klassen A. M. , Zamora G. , Shepherd J. H. , Badawia A. , Kailay A. , Leung C. R. , Sahota J. , Saravia S. , Miller J. A. , Hamilton P. , Sacchet M. D. , Gotlib I. H. , Woo E. , Hedges D. W. , Miller C. H.
Published: August 2024

Introduction

Panic disorder (PD) and agoraphobia (AG) are highly comorbid anxiety disorders with an increasing prevalence that have a significant clinical and public health impact but are not adequately recognized and treated. Although the current functional neuroimaging literature has documented a range of neural abnormalities in these disorders, primary studies are often not sufficiently powered and their findings have been inconsistent.

Objectives

This meta-analysis aims to advance our understanding of the neural underpinnings of PD and AG by identifying the most robust patterns of differential neural activation that differentiate individuals diagnosed with one of or both these disorders from age-matched healthy controls.

Methods

We conducted a comprehensive literature search in the PubMed database for all peer-reviewed, whole-brain, task-based functional magnetic resonance imaging (fMRI) activation studies that compared adults diagnosed with PD and/or AG with age-matched healthy controls. Each of these articles was screened by two independent coding teams using formal inclusion criteria and according to current PRISMA guidelines. We then performed a voxelwise, whole-brain, meta-analytic comparison of PD/AG participants with age-matched healthy controls using multilevel kernel density analysis (MKDA) with ensemble thresholding (p<0.05-0.0001) to minimize cluster size detection bias and 10,000 Monte Carlo simulations to correct for multiple comparisons.

Results

With data from 34 primary studies and a substantial sample size (N=2138), PD/AG participants, relative to age-matched healthy controls, exhibited a reliable pattern of statistically significant, (p<.05-0.0001; FWE-corrected) abnormal neural activation in multiple brain regions of the cerebral cortex and basal ganglia across a variety of experimental tasks.

Conclusions

In this meta-analysis we found robust patterns of differential neural activation in participants diagnosed with PD/AG relative to age-matched healthy controls. These findings advance our understanding of the neural underpinnings of PD and AG and inform the development of brain-based clinical interventions such as non-invasive brain stimulation (NIBS) and treatment prediction and matching algorithms. Future studies should also investigate the neural similarities and differences between PD and AG to increase our understanding of possible differences in their etiology, diagnosis, and treatment.

Disclosure of Interest

None Declared
Parents’ needs during a child’s hospitalisation in a paediatric intensive care unit (PICU): a systematic review
Authors: Boroklinioti A. , Sarantaki A. , Dousis E. , Zartaloudi A. , Evangelou E. , Dafogianni C. , Polikandrioti M. , Vlachou E. , Koutelekos I.
Published: August 2024

Introduction

The admission of children to PICU is a painful experience for parents. Regularly, they are asked to make important decisions about treatment options in collaboration with the care team, which causes them stress, uncertainty and trauma.

Objectives

To investigate the needs of parents during the child’s hospitalization in a pediatric intensive care unit (PICU).

Methods

A systematic review of the literature and a search of articles in the international databases PubMed, Cinahl, Google Scholar, Cochrane Library and Greek scientific journals was performed with a peer review process during the period between April and July 2022. A time limit was set regarding the date of publication of the articles (articles published in the last 15 years).

Results

Nine studies were found that met the criteria for inclusion in the review. The thematic analysis of the results deduced the following sections A: Need for information from health professionals regarding the child’s health status and the possible treatment options available, B: Need for psychological support from health professionals (psychologists, nurses, doctors) in order to be able to manage the difficult situation they are experiencing due to the hospitalization of their child, but also to be able to manage their grief and sorrow in case of loss of the child. C: Need for safe hospitalisation of the child.

Conclusions

Parents have needs during their child’s hospitalization in the PICU, which if put in boundaries-frames and guided by health professionals (who possess knowledge and composure in difficult moments) can bring about a smooth course of the child’s health during hospitalization.

Disclosure of Interest

None Declared
Assessment of the methylome and the cognition in urban dwellers
Authors: Abdelmoula E. , Bouayed Abdelmoula N. , Abdelmoula B.
Published: August 2024

Introduction

The epigenome involving chemical modifications of DNA and chromatin that modulates gene expression in response to external and environmental conditions is characterized by great plasticity and reacts by epigenetic marks such as methylation signatures that can be inherited across generations.

Objectives

Urban dwellers likely adapt to the level and growth of urbanization and resulting environmental changes through epigenetic changes. The aim of this study is to present what is currently known about the DNA methylome (the information of DNA methylation of all cytosines in a genome) and cognition when humans are exposed to changing urban environments.

Methods

We conducted a comprehensive review of the scientific literature using PubMed database with the following keywords: DNA methylation, brain and urbanity.

Results

Our search revealed a scarcity of scientific articles reporting methylome studies with assessment of correlations between methylome, cognitive status and urban environment. Among these papers, a Chinese study (2021) found a significant correlation between childhood urbanicity and better cognitive performance by measuring genome-wide methylation profile using more than 850,000 genome-wide CpG sites. In this study, the authors suggested that the impact of childhood urbanicity on cognition is partially mediated by the methylome and brain structure/function in humans whose childhood urbanicity differed. Other studies using other research approaches, suggested that the impact of living in an urban area is linked to better performance in terms of working memory, processing speed and verbal learning. We also found that the vast majority of studies investigating DNA methylation involved in rapid adaptation to new environments, including urban environments, focused on plant and animal species.

Conclusions

The effects of urbanization on human beings are a topic of ongoing debate. Some studies suggest that urbanization can have beneficial effects on cognition, while others find that it can have harmful effects. Quantitative studies of methylation and the correlations between methylome, cognition, and urbanicity offer new opportunities to measure these effects and gain a better understanding of their mechanisms.

Disclosure of Interest

None Declared
The Impact of Climate Change on Mental Health: A General Population Study
Authors: Uçak R. , Ayhan C. H. , Aktaş M. C. , Kaynar Demirel N.
Published: August 2024

Introduction

Climate change and its impact on mental health is a growing area of research. Several studies have explored the relationship between climate change and mental health, highlighting the various ways in which climate change can affect individuals’ psychological well-being. Incorporating mental health indicators into climate change and health vulnerability and adaptation assessments is another important aspect of research in this area (Hayes & Poland, 2018). The study suggests that standardized methods to measure and predict the psychosocial outcomes of climate change should be implemented to better understand the mental health impacts. While the physical health consequences of climate change have received more attention, the mental health impacts are often overlooked (Nicholas et al., 2020).

Objectives

This study was planned to examine the impact of climate change the impact of climate change on mental health

Methods

This descriptive and cross-sectional study was conducted with individuals who willing to participate the study and above 18 years age. Individuals who saw the online advertisement and click on the study’s link were be brought to the study’s home page on Online Surveys. Should they wish to proceed, they will be brought to an information page detailing the purpose of the study, how their confidentiality and anonymity will be preserved and how their data will be treated.

Socio-Demographic Data Form, Climate Change Worry Scale, Eysenck Personality Questionnaire Revised- Abbreviated, general health questioner and Depression, Anxiety, Stress scale were used for collecting data. Data analyses was planned to run via Statistical Package for the Social Sciences version, 27.0.

Results

The analysis of the data is still ongoing in detail by the researchers. The findings and relational implications of the study will be presented.

Conclusions

In conclusion, this study highlight the importance of understanding the mental health impacts of climate change and developing strategies to address them. Climate change can have direct and indirect consequences on mental health, and vulnerable populations such as children and adolescents may be particularly at risk. Reducing psychological distance and incorporating mental health indicators into assessments can help in understanding and addressing the mental health consequences of climate change.

Disclosure of Interest

None Declared
The activity of platelet enzymes and subpopulation composition of monocytes in schizophrenia
Authors: Prokhorova T. , Boksha I. , Sarmanova Z. , Savushkina O. , Tereshkina E.
Published: August 2024

Introduction

The studies on various groups of patients with schizophrenia revealed impairments in immune system, glutamatergic, and antioxidant systems contributing substantially in schizophrenia pathogenesis.

Objectives

To search for links between the activities of platelet enzymes involved in glutamate and glutathione metabolism and monocytes’ subpopulation compositions in patients with schizophrenia and to identify possible correlations of the biomarkers with clinical data. Research objectives: determination of subpopulation ratio of monocytes; measurement of the activity levels of glutamate dehydrogenase (GDH), phosphate-activated glutaminase (PAG), glutathione reductase (GR) and glutathione S-transferase (GST) in blood platelets; search for correlations between these parameters and the scores by psychometric scales.

Methods

The study included 36 women aged 16-45 years with acute schizophrenia hospitalized in the Mental Health Research Centre with their current condition assessed as depressive-delusional. The control group consisted of 17 women 18-45 years old without somatic or mental pathology. GDH, PAG, GR and GST activities were measured by spectrophotometric methods, and numbers of monocyte subpopulations - “classical”, “intermediate”, “non-classical” - by flow cytometry. The Hamilton Depression Rating Scale (HAMD-17) was used to assess depression severity. The data was processed using the Statistica 8.0 software.

Results

The detected changes in monocyte subpopulations’ composition towards the increase in the proportion of cells having a pro-inflammatory phenotype (CD14++CD16+ “intermediate”) indicated the activation of inflammatory reactions. Also, the activities of platelet enzymes of glutathione metabolism (GR and GST) were significantly decreased (p<0.05). Moreover, GDH and GST activities significantly correlated with the scores by HAMD-17 (r=0.40, p=0.022 and r=0.45, p=0.030, respectively). The results indicate the presence of pathological inflammatory process, the decrease in activities of glutathione antioxidant metabolism enzymes and a link to glutamate metabolism involvement (GDH) in the studied patient group.

Conclusions

The identified redistribution in the monocyte subpopulations’ composition and decrease in the activity of enzymes involved in glutamate metabolism and antioxidant system indicate the involvement of the immune, glutamate and antioxidant systems in the pathogenesis of schizophrenia and may reflect a functional interaction between these systems.

Disclosure of Interest

None Declared
Assessment of Cognitive Performance and Psychophysiological Signals in Mental Patients by a Novel Method
Authors: Fűzi M. , Petró B. , Barna P. , Kósa K.
Published: August 2024

Introduction

Mental disorders often manifest broad cognitive deficits that detrimentally affect daily functioning. Stress indicated by heart rate variability (HRV) has been linked to these cognitive functions.

Objectives

We aimed to develop a new method to assess cognitive performance and simultaneous measurement of psychophysiological signals related to stress and relaxation levels.

Methods

20 adult patients with mental disorders in a rehabilitation program were recruited along with 21 healthy volunteers. A test protocol was carried out with a purpose-developed computerized psychophysiological device. The protocol consisted of a relaxation period; digitized questionnaires on pathological distress (GHQ) and sense of coherence (SOC); gamified cognitive tasks to assess working memory, attention, and decision-making; and a final relaxation period. Acute stress was assessed by heart rate variability measured by a wireless ECG sensor. The inter-beat interval’s root mean square of successive differences (RMSSD) was calculated as an inverse stress measure. Relaxation levels were assessed by the relative power of the alpha frequency band measured by a commercial 4-channel EEG headband. Stress and relaxation levels were compared to the first relaxation period as a baseline.

Results

Patients scored worse than the reference group both regarding distress (d=7, p=0.004) and sense of coherence (d=-8, p=0.047). The cognitive performance of patients was significantly lower (p<0.001) than the reference group for all tasks.

RMSSD at baseline tended to be lower for patients (d=-12.69, p=0.098), reflecting a higher level of physiological stress; 61% of patients started at an elevated stress level compared to 25% of the reference group. In addition, relative alpha levels at baseline were also lower (d=-5.8%, p=0.007) for patients.

Compared to baseline, RMSSD decreased on average to 94% during cognitive assessments in patients and decreased to 91% by the end of the final relaxation. RMSSD decreased to 76% in the reference group and reached a final value of 78% of the baseline. Alpha levels slightly increased among patients during the tasks (103.4%) and then returned close to baseline (99.1%). For the reference group, alpha decreased during the tasks (95.5%) and then slightly increased (97.3%).

Conclusions

Patients displayed heightened distress, reduced sense of coherence, and inferior cognitive scores compared to controls. While starting with higher stress, patients exhibited less elevation in stress during tasks, coupled with alterations in alpha levels, suggesting diminished engagement or focus. Our innovative method could aid in the diagnostics of cognitive performance in mental patients after further measurements for validation.

Disclosure of Interest

None Declared
Intranasal esketamine efficacy as a treatment for treatment-resistant depression, case series
Authors: Delgado Marmisa C. , Álvarez Correa I. , Vizcaíno Herrezuelo H. , Egüen Recuero L. , Garrido Dobrito E. , Gayubo Moreo L. , Sanz-Aranguez B. , Delgado Tellez L. , Caballero Martínez L. , De Arce Cordón R. , Jiménez-Fernández B.
Published: August 2024

Introduction

Intranasal esketamine has been approved as a treatment for patients with treatment-resistant depression. We analyzed the results of its efficacy in 15 patients.

Objectives

To evaluate the efficacy of intranasal Esketamine as a treatment in patients with treatment-resistant depression

Methods

Case series

Results

For the last 8 months, since the treatment with intranasal esketamine was approved for resistant depression, we have treated 14 patients with this drug. Through this process, we followed a standardized method consisting in the following steps:

On the first esketamine session (DAY 1) the patient has to fill a CGI and a MADRS scale.

On the second esketamine session (DAY 7) the patient has to fill a CGI, a MADRS scale, a form about the level of satisfaction with the drug and a last form in which they can include the secondary effects.

On week 6 since the start of the treatment, the patient has to fill again a CGI, a MADRS scale, a form about the level of satisfaction with the drug and a last form in which they can include the secondary effects.

In the 6th month since the start of the treatment, the patient has to fill again a CGI, a MADRS scale, a form about the level of satisfaction with the drug and a last form in which they can include the secondary effects they have perceived.

We analyzed and compared all of the previous data and obtained the following results:

At day 7: 64% of the patients had a response in the form of improvement, of which 66% were feeling “slightly better” and 33% were feeling “better”.

At week 6: 71% of the patients had a response in the form of improvement, of which 50% were feeling “slightly better” and the other 50% were feeling “better”.

At month 6: only 28% of the patients completed the treatment; of which 100% had a response in the form of improvement: 50% were feeling “slightly better”, 25% were feeling “better” and 25% were feeling “far better”.

Conclusions

Although our data suggests that intranasal esketamine has been effective in short term depressive symptoms, we have yet no information about its medium and long-term efficacy or secondary effects. Nevertheless, other potential factors should be evaluated as they could affect the results in the long-term such as the difficulty in maintaining the treatment for more than 6 weeks.

In addition, the patients who experienced the most improvement according to our data were patients with a TAB diagnosis, so this could be an interesting research focus.

Disclosure of Interest

None Declared
Non-Invasive Brain Stimulation for Perinatal Depressive Disorder: A Literature Review
Authors: Pinheiro Ramos C. , Alves M. , Durães D. , Mendes S. , Gamito A.
Published: August 2024

Introduction

Peripartum Depressive Disorder (PPD) is a Peripartum Mental Disorder (PMD) characterized as a Major Depressive Disorder (MDD), wherein the manifestation of depressive symptoms initiates either during pregnancy or within the first 12 months following childbirth.

PPD impacts both maternal well-being and infant health, resulting in unfavorable outcomes during pregnancy and the postpartum period.

Non-Invasive Brain Stimulation (NIBS) is one of the rapidly expanding fields in medicine, using a range of techniques to modulate the brain.

Objectives

This study aimed to summarize the latest evidence about the impact of NIBS (efficacy, tolerance, and safety) in PPD.

Methods

A review was conducted, drawing on reputable (PubMed and Web of Science databases).

Key brain stimulation modalities, such as Transcranial Magnetic Stimulation (TMS), Transcranial Electrical Stimulation (TES), and Electroconvulsive therapy (ECT) were analyzed in the context of PPD.

Results

Preliminary findings indicate promising positive effect of NIBS in reducing symptoms associated with PPD.

In the postpartum, the favorable outlook on the effectiveness of NIBS implies that, when feasible, women diagnosed with mild to moderate PPD, especially those reluctant to initiate pharmacological interventions, should be presented with TMS or TES as an alternative therapeutic approach.

However, some doubts persist about the safety of NIBS regarding fetus and preterm birth.

Conclusions

NIBS constitutes a viable option for pharmacological and psychotherapeutic interventions, and it can also be integrated into comprehensive treatment regimens.

Future research include large-scale clinical trials and longitudinal studies is needed to address the efficacy, security, and long-term effects of NIBS.

Disclosure of Interest

None Declared
The perception of Romanian mental health professionals on electroconvulsive therapy
Authors: Anghel C. E. , Băcilă C.
Published: August 2024

Introduction

The journey for the electroconvulsive therapy began in 1938, when convulsive seizures induced by electrical stimulus were used, for the first time, in the therapy of patients diagnosed with Schizophrenia. Over the time, this therapy remains an important one, due to its applicability and necessity in the therapeutic management of patients with psychiatric pathology.

Objectives

Electroconvulsive therapy has evolved as a technique, nowadays being applied under induced intravenous anesthesia with the administration of oxygen on the mask, and from 2001, the sinus electrical stimulus has been replaced by the one in the form of a short pulse, upon the recommendation of professional organizations, in order to increase its therapeutic effectiveness. However, this form of therapy continues to be stigmatized, largely due to the way it is presented in the mass media. The objective of this work was to analyze how mental health professionals perceive electroconvulsive therapy.

Methods

We conducted a study in which we used a questionnaire applied to the Romanian professionals in the field of mental health.

Results

The results were analyzed in accordance with the objective of the study.

Conclusions

Through this analysis we wanted to understand how electroconvulsive therapy is seen through the eyes of mental health professionals and to identify those aspects that can help us in carrying out information programs, with a major impact on mental health, in order to reduce stigma forasmuch the therapeutic benefits of electroconvulsive therapy outweigh the possible risks.

Disclosure of Interest

None Declared
Compassion and the quality of life of the inpatient healthcare team
Authors: Bredicean A.-C. , Giurgi-Oncu C. , Palaghian L. , Tabugan D. , Neagu A. , Covaci G. , Homeag R. , Ursoniu S.
Published: August 2024

Introduction

Nurse-patient relationships and interactions during inpatient care evoke feelings of empathy and compassion. Compassion can lead to satisfaction, but also to exhaustion. Compassion fatigue is a commonly used concept that signifies the exhaustion of healthcare personnel due to the specific activities and repeated exposure to the suffering of others. This manifests through physical and emotional over-tiredness, anxiety, anger and irritability, low vitality, social isolation, diminished sense of enjoyment of one’s career, cognitive disorders, and sleep disturbances.

Objectives

To assess the level of compassion of the healthcare staff employed in a Romanian general hospital.

Methods

The study sample included 256 nurses working in a general hospital. To identify socio-demographic data we applied a specific questionnaire, and subsequently we also used the PROQOL scale (Professional Quality of Life Scale). All data were statistically analysed.

Results

The majority of healthcare professionals in our sample belong to the 40-49 age group (39.45%). Regarding work experience in the healthcare system, the majority(43%) have been working for over 10 years. 78.52% of nurses reported a high level of compassion satisfaction. Burnout was not identified in the majority of our sample (54.3%). We noted that the number of the staff affected by compassion fatigue increases proportionally with the years of work experience (P=0.033).

Conclusions

A high level of compassion satisfaction in medical professionals leads to a remarkable improvement in the quality of the healthcare they are providing. However, our study results suggest that compassion fatigue tends to increase in line with the years of work in healthcare

Disclosure of Interest

None Declared
Significant beneficial effects of 12-weeks add-on yoga therapy on antipsychotic-stabilized schizophrenia patients through epigenetic modulation: novel findings from a randomized controlled study
Authors: Debnath M. , Mullapudi T. , Govindaraj R. , Raj P. , Varambally S.
Published: August 2024

Introduction

Complementary and alternative therapy, especially yoga, is emerging as an important treatment modality for various complex disorders. Yoga therapy has reportedly been demonstrated to exhibit clinical benefits in schizophrenia. However, the modulatory effects of yoga therapy on the pathobiological pathways of schizophrenia are inadequately explored. Immune dysregulation is a widely recognized etiopathological construct of schizophrenia. It is not precisely known whether yoga therapy can modulate the expression of immune molecules by regulating gene expression and epigenetic processes in schizophrenia.

Objectives

To understand the impact of 12-weeks add-on yoga therapy on the immune-inflammatory pathway in schizophrenia by examining plasma levels and gene expression levels of cytokines and complement proteins as well as by profiling promoter DNA methylation pattern of genes coding for cytokines and complement proteins.

Methods

Fifty-seven schizophrenia patients fulfilling DSM-V criteria were recruited into the study and randomized into Yoga therapy (n=28) and waitlist control (n=29) groups. Plasma levels of IL-1β, IL-6, IL-10, IL-17, C1q, C2, C3, C4, C5, C5a, Factor B and Factor H by Multiplex Suspension Assay, quantification of gene expression of Il1b, Il6, Il10, IL17, C3, C4 and C5 genes by quantitative PCR and promoter DNA methylation of Il1b, Il6, Il10, Il17, C3, C4 and C5 genes by pyrosequencing were carried out in all the study participants.

Results

Plasma levels of IL-1β (Z score= 2.42, p=0.02) dropped significantly and C2 (Z score= 2.24, p=0.03) levels increased after 12-weeks of yoga therapy. The expression of Il1b (Z score=2.45, p=0.01) and Il6 (Z score=2.07, p=0.04) genes were significantly downregulated, while the levels of C4 (Z score=2.23, p=0.03) gene was upregulated in schizophrenia patients of yoga therapy group. Two CpG sites in the promoter region of Il1b (all p≤0.05) and Il6 (all p≤0.05) genes and three CpG sites in the promoter region of C4 (all p<0.05) gene were hypermethylated, while two CpG sites in the gene body of Il6 (all p≤0.05) gene and two CpG sites in the promoter region of Il10 (all p ≤0.05) gene were hypomethylated after 12-weeks of yoga therapy in schizophrenia patients.

Conclusions

Our findings provide important insights into the mode of action of yoga therapy in schizophrenia. This study for the first time reports the epigenetic effects of yoga therapy on immune-inflammatory pathway in schizophrenia.

Disclosure of Interest

None Declared
Connection between self-esteem and discontinuation of medication
Authors: Laabidi S. , Abidi O. , Aissa A. , Hosni R. , Ouali U. , Jomli R.
Published: August 2024

Introduction

Self-esteem entails evaluating oneself positively and often involves the need to be special and above average without comparisons with others. It could play a role in many areas of the patient’s life.

Objectives

The aim of the present study was to find the prevalence of self-esteem and investigate the associations between self-esteem and treatment adherence in patients with schizophrenia spectrum disorders.

Methods

This study involved outpatients with schizophrenia spectrum disorders ,according to (DSM-V) diagnostic criteria, attending the Department of Psychiatry A, Razi hospital between august and September 30, 2023. The level of self-esteem was measured with Rosenberg’s Self-Esteem Rating scale (SERS) and treatment adherence with the Medical Adherence Rating Scale (MARS).Socio-demographic characteristics were also collected.

Results

Thirty stabilized outpatients with schizophrenia (n=18), schizoaffective disorder (n=11), brief psychotic disorder (n=1) were included in the study. The mean (SD) age of the respondents was 43.2years; the mean number of Hospital admissions was 4.7.Almost two thirds of this population (63.33% ) had low self-esteem and 36.67 % had high self-esteem. The level of self-esteem did not differ between diagnostic categories. Self-esteem also positively correlated with higher education and negatively with an increased number of hospitalizations. However, no significant association was found between socio-demographic variables and self-esteem. Adherence was further negatively correlated with age and age of onset of disorders. Patients suffering from schizophrenia had the lowest adherence to treatment.The results of the present preliminary study suggest a positive correlation between the SERS total scores and the MARS scores. It was found that higher levels of self- esteem are related with higher levels of treatment adherence and lower levels of self- esteem are associated with discontinuation of medications without a psychiatrist’s recommendation. This connection was present in all diagnostic groups.

Conclusions

This study shows positive relationship between self-esteem and treatment adherence. Further studies are needed to investigate whether self-esteem is a factor positively influencing adherence to treatment and show if self-esteem training programs like standard psychoeducation and cognitive behavioral therapy could be beneficial to improve treatment adherence among psychiatric patients.

Disclosure of Interest

None Declared
Attachment styles in Tunisian women with schizophrenia
Authors: Walha S. , Chaari I. , Sehli M. , Abdelhedi A. , Aribi L. , Charfeddine F. , Mseddi N. , Aloulou J.
Published: August 2024

Introduction

Attachment refers to the emotional bond between a child and their primary caregiver, reflecting the child’s confidence in the caregiver’s capacity to offer security. Evaluating attachment styles in individuals with schizophrenia spectrum disorders holds significance in pinpointing a potential factor affecting therapeutic relationships. This, in turn, indirectly aids in comprehending the emergence of low adherence as a significant barrier to schizophrenia

Objectives

The goal of this study is to assess attachment styles in women with schizophrenia spectrum disorders.

Methods

We conducted a descriptive and analytical cross-sectional study at the Psychiatry “B” department of Hedi Chaker University Hospital in Sfax, Tunisia, during May and June 2023. Our study involved stabilized female patients diagnosed with either schizophrenia or schizoaffective disorder. We utilized the 26-item Revised Psychosis Attachment Measure (PAM_R) questionnaire translated into Arabic and the Positive and Negative Syndrome Scale (PANSS) score to assess schizophrenic symptoms.

Results

We enrolled a total of 41 female patients in our study, with 65.9% diagnosed with schizophrenia and 34.2% with schizoaffective disorder. The average age of the participants was 49.19 years, ranging from 17 to 79 years old. In terms of attachment styles, avoidant attachment was the most prevalent (60.97%), followed by anxious attachment (24.39%), and disorganized attachment (14.63%). Our study revealed significant associations between avoidant attachment and several factors. Patients who began psychiatric follow-up with hospitalization had a significantly higher level of avoidant attachment compared to those starting with outpatient consultation (p < 0.001). The type of therapy also influenced avoidant attachment, with a significant difference (p < 0.001). Insight into their condition also played a significant role (p < 0.001). Moreover, the age at which psychiatric follow-up began showed a statistically significant correlation with avoidant attachment (Spearman’s ρ = 0.000, p < 0.001). Individuals with higher avoidant attachment tended to have a longer duration of untreated psychosis, supported by a statistically significant positive correlation (Spearman’s ρ = 0.082, p < 0.001). There was also a statistically significant relationship between avoidant attachment and the equivalent dose of chlorpromazine, with a positive correlation (Spearman’s ρ = 0.091, p < 0.001), indicating that individuals with higher avoidant attachment may require higher equivalent doses of chlorpromazine. Finally, higher levels of avoidant attachment were associated with a lower presence of positive symptoms in schizophrenia (Spearman’s ρ = -0.026, p < 0.001).

Conclusions

Insecure attachment is a valuable mechanism for understanding the evolution of schizophrenia spectrum phenomenology and may be a useful target for prophylactic interventions.

Disclosure of Interest

None Declared
Spontaneous mentalizing in patients with schizophrenia – a meta-analysis
Authors: Csulak T. , Herold R. , Berke G. , Sipos Z. , Farkas K. , Hegyi P. , Tényi T. , Hajnal A.
Published: August 2024

Introduction

Mentalizing helps us to understand the behaviour of others in our everyday social interactions. Spontaneous mentalizing without explicit instructions refers to representing mental state attribution. Several studies have described social cognitive deficit in schizophrenia, which largely determines the functional outcome of the disease.

Objectives

To better understand the involvement of spontaneous mentalizing in schizophrenia, we consider it important to summarize the results of studies that used indirect instruction to measure spontaneous mentalizing performance in schizophrenia.

Methods

In our meta-analysis, we conducted a systematic search of four large databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials [CENTRAL], Web of Science). A total of 14 articles were involved.

Results

Based on our findings, the performance of patients with schizophrenia is significantly weaker than in the average population for both scripts with mentalizing interactions (MD: -0.63; 95%CI (-0.90, -0.35); p=0.0021), and with goal-directed movements (SMD: -0.55; 95%CI (-0.97, -0.13); p=0.02). The intentionality of expressions used by patients with schizophrenia is significantly lower compared to the average population (for both animations with complex social interactions: MD: -0.99; 95% CI (-1.39, -0.59); p=0.0003; and with goal-directed movements: MD: -0.31; 95% CI (-0.53, -0.08); p=0.0218). We have found no significant difference neither in appropriateness nor in intentionality of verbal terms between the two goups in the case of animations with random movements.

Conclusions

Based on the meta-analysis, we found poorer performance in schizophrenia in spontaneous mentalizing. We also found poorer performance in tasks with goal-directed movements used as control tasks, suggesting a more pervasive impairment of mentalizing in schizophrenia. These deficits may affect the functional outcome of the disease and could potentially have therapeutic implications.

Disclosure of Interest

None Declared
“Folie à deux,” or shared psychosis: A case report
Authors: Arroyo Sánchez E. , Setién Preciados P. , Diaz Mayoral C.
Published: August 2024

Introduction

“Folie à deux,” or shared psychosis, is a fascinatingpsychiatric phenomenon characterized by the transmission of delusional beliefs and psychotic symptoms from one individual (the “inducer”) to another (the “recipient”) who share a close emotional bond. Despite its rarity, “Folie à deux” presents unique challenges and insights into the understanding of psychosis and the intricacies of interpersonal relationships.

Objectives

The primary objective of this review is to analyze the recent clinical literature on “Folie à deux” to better comprehend its clinical presentation, diagnostic criteria, etiological factors, and therapeutic approaches. By synthesizing the latest research findings, we aim to enhance the awareness and understanding of this intriguing phenomenon among mental health professionals.

Methods

A case report of a couple of a 34-year-old male and a 43-year-old female with a shared delirium. The male was brought to the emergency department by ambulance after being found in the street with behavioral disturbances and delusional symptoms. Individual interviews with both members of the couple revealed shared delirium. He was admitted to the psychiatric ward for the clinical picture consisting of a chronic delusional disorder of years of evolution and and new symptoms such as restlessness and behavioral disturbances.

Results

The review reveals that “Folie à deux” remains a rare but clinically relevant phenomenon, with reported cases spanning diverse cultural and familial contexts. Diagnostic criteria, as outlined in the DSM-5, have been useful in guiding clinicians in identifying and managing cases. The literature emphasizes the importance of a thorough psychiatric evaluation to distinguish “Folie à deux” from other psychopathological conditions. Recent research has also shed light on potential neurobiological mechanisms and genetic factors contributing to shared psychosis. Therapeutically, early intervention and tailored treatment plans are crucial in achieving favorable outcomes. While antipsychotic medications remain a cornerstone of treatment, family therapy and psychoeducation have emerged as valuable adjunctive approaches to address the unique challenges posed by shared psychosis.

Conclusions

In conclusion, “Folie à deux” continues to be a captivating and clinically relevant phenomenon in contemporary psychiatry. This bibliographical review underscores the importance of recognizing and diagnosing shared psychosis in clinical practice. Moreover, it highlights the need for further research to unravel the underlying mechanisms and genetic predispositions associated with this condition. Ultimately, a multidisciplinary approach, including pharmacological, psychotherapeutic, and family-based interventions, holds promise in improving the prognosis of individuals affected by “Folie à deux.”

Disclosure of Interest

None Declared
The Course of Schizophrenia Spectrum Disorders With Episodes of Catatonic Depressions
Authors: Barkhatova A. , Bolgov M. , Smolnikova A.
Published: August 2024

Introduction

Mood symptoms, especially depressive ones, occur in the majority of patients with schizophrenia spectrum disorders (SSD). Therefore, depression is often identified as one of the symptomatological dimensions of schizophrenia. Catatonia is also considered by some researchers as one of the dimensions of schizophrenia, or as an independent transnosological formation. Catatonia in SSD may be associated with affective dysregulation and is often accompanied by depression. Although the clinical course of SSD has been well studied previously, its relationship with psychopathological structure of episodes of SSD remains not entirely clear.

Objectives

To determine the impact of episodes of catatonic depression on the course and prognosis of SSD.

Methods

A sample of 60 patients with episodic course of SSD who met the criteria for catatonia according to the Bush-Francis Catatonia Screening Instrument (BFCSI) and for depression according to the Calgary depression schizophrenia scale (CDSS) was analyzed. An analysis of the clinical course of SSD was carried out on the basis of the medical history of all patients in the study sample and follow-up observation of 42 patients for 5 years. Global Assessment of Functioning Scale (GAF) was used to assess the prognosis of SSD.

Results

Patients were divided into two groups depending on the period of manifestation of catatonia in the clinical course of SSD: during the first episode or during subsequent episodes. The sample of patients with the first episode (n=43, 71.7 %) was divided into three subgroups. A relatively favorable course of SSD was observed only in 13 patients (30.2 %; 21.7 % of SSD sample). The course of disorder was characterized by similar episodes with a high proportion of affective symptoms, long-term remissions and minimally expressed negative symptoms (GAF score=75.2±5.82). A relatively unfavorable course of SSD was observed in 15 patients (34.9 %; 25.0 % of SSD sample). It was characterized by moderate negative and chronic subdepressive symptoms with low frequency of catatonic and psychotic relapses (GAF score=62.3). An unfavorable course of SSD was also observed in 15 patients (34.9 %; 25.0 % of SSD sample). It was characterized by a high frequency of relapses with a tendency to form a chronic conditions with residual catatonic signs and psychotic symptoms (GAF score=50.1). In the sample of patients with manifestation of catatonia in the second or subsequent episodes (n=17; 28.3 %), the clinical course of SSD was unfavorable. It was characterized by a rapid augmenting of negative symptoms with the formation of psychomotor poverty syndrome with residual catatonic symptoms (GAF score=52.7).

Conclusions

Our study shows that the occurrence of catatonic depressive episodes in the clinical course of SSD in most cases is an unfavorable prognostic factor.

Disclosure of Interest

None Declared
Haloperidol induced Pisa syndrome in a patient with treatment resistant schizophrenia
Authors: Yaich I. , Touiti A. , Ben Said C. , Bram N.
Published: August 2024

Introduction

Acute dystonia, an adverse effect of neuroleptics, is linked to D2 neuronal receptor hypersensitivity or neurotoxicity due to oxidative stress mechanisms. Pisa syndrome (PS) or Pleurothotonus, a relatively uncommon condition, manifests as dystonia of the trunk and is potentially reversible with early intervention.

Objectives

To describe PS following haloperidol decanoate injection in a treatment-resistant schizophrenia (TRS) patient, identify associated risk factors, and present therapeutic options.

Methods

We provide a comprehensive case description and perform a PubMed database search using the following keywords: “Pisa syndrome,” “dystonia,” “schizophrenia,” and “antipsychotic”.

Results

A 54-year-old man with TRS, previously treated with 100 mg of haloperidol decanoate and 10 mg of olanzapine due to clozapine-induced myocarditis, exhibited hallucinatory delusional syndrome and behavioral disturbances. Neurological examination, lab tests, and brain imaging confirmed a psychotic relapse. Haloperidol decanoate dosage was increased to 150 mg. Four days later, the patient developed a trunk tilt that resolved after receiving anticholinergic treatment.Despite PS being more common in females and associated with brain conditions, this patient presented multiple risk factors, including prolonged typical antipsychotic treatment, advanced age, and an increase in antipsychotic doses. Discontinuing the causative antipsychotic or adding synthetic anticholinergics led to symptom reversibility.

Conclusions

PS is a rare occurrence. Understanding associated risk factors and frequently implicated medications is crucial for elucidating the phenomenon and managing the disorder

Disclosure of Interest

None Declared
Stigma in first epizode patients with schizophrenia
Authors: Aukst Margetić B. , Margetić B. , Vilibić M.
Published: August 2024

Introduction

Patients with schizophrenia confront with stigmatization in their everyday life. Differences in their perception of stigmatization based on the number of hospitalizations and duration of treatment are unsufficiently researched.

Objectives

Our aim was to investigate whether patients with first-episode schizophrenia differ in their perception of stigmatization from schizophrenia patients with more than one hospitalization,

Methods

A consecutive sample of 120 stable outpatients (70 males, 50 female) diagnosed with schizophrenia were included in the study. Diagnosis of schizophrenia was established with Neuropsychiatric Interview. First episode patients consisted 28.3% of the group.

All patients were at least once hospitalized for mental illness. Patients were dichotomised based on the number of hospitalizations.

The study was approved by Ethic committee of the institutions. Stigma was assessed with Internalized Stigma of Mental Illness (ISMI) scale.

ISMI scale contains 29 Likert items rated on a 4-point scale ranging from “strongly disagree” to “strongly agree”. It contains five subscales: Alienation, Stereotype Endorsement, Discrimination Experience, Social Withdrawal and Stigma Resistance. The overall internal consistency for the global ISMI was 0,89; Alienation-0,76; Stereotype endorsement- 0,63; Discrimination- 0,72; Social withdrawal- 0,57.

All analyses were performed using the SPSS 25.0. The differences between groups on continuous variables were evaluated using t-test with Bonferroni correction. For all analyses, the level of statistical significance was defined as an alpha less than 0.05

Results

There were no differences in first-episode and more episode patietns in ISMI and its subscales. Number of hospitalizations was associated with Stereotype endorsement subscale (r=228;p=0,012) Age was correlated with stigma.

Conclusions

Although stigma did not differ between first-episode patients and patients with two or more hospitalizations, stereotype endorsement was strongy associated with the number of hospitalizations leading to conclusion that stigma is associated with psychiatric treatment and our aim must be to destigmatize the treatment and avoid hospitalizations.

Disclosure of Interest

None Declared
Lymphocyte level and selected cognitive functions in patients with schizophrenia – preliminary results
Authors: Nycz B. , Krysta K.
Published: August 2024

Introduction

Schizophrenia is a mental disorder characterized by negative symptoms, such as cognitive impairment. Recent reports indicate the importance of the immune system in the pathophysiology of schizophrenia. The development of inflammation affects cognitive functioning.

Objectives

The aim of the study was to analyze the association between the level of lymphocytes in venous blood and selected cognitive functions in patients with schizophrenia.

Methods

Lymphocyte levels were determined in the venous blood of patients suffering from schizophrenia and the control group. Additionally, a verbal fluency test (VFT) and a Stroop test were conducted on the same day. The VFT evaluates the ability to express words, and the Stroop test assesses verbal working memory. The inclusion criteria were age up to fifty years, and for the study group – diagnosis of schizophrenia and treatment with neuroleptics. Exclusion criteria included organic brain diseases, electroconvulsive therapy, and use of benzodiazepines within 48 hours before the study. Currently, six patients and six healthy people have been studied.

Results

Patients diagnosed with schizophrenia have an increased lymphocyte concentration in the blood compared to healthy individuals constituting the control group. There are discrepancies in the results of the phonemic fluency test, no significant differences were found between schizophrenics and the control group. Healthy men and women achieved higher results in the semantic fluency test compared to men and women with schizophrenia. Women constituting the control group achieved higher results in the Stroop test compared to women suffering from schizophrenia. Table 1 illustrates the concentration of lymphocytes in venous blood and the number of points in the phonemic fluency test, semantic fluency test, and in the Stroop test of the study and the control groups.

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Conclusions

Patients with schizophrenia are characterized by higher levels of immune system parameters and worse results in terms of semantic fluency. Men with schizophrenia showed no verbal working memory deficits. In turn, women with schizophrenia obtained worse results in the verbal working memory test. In conclusion, there is evidence of immune system activation in schizophrenia, which affects the cognitive functioning of patients.

Disclosure of Interest

None Declared