bluuebunny/crossref_metadata_2025_split huggingface dataset:
T88. VALIDATION OF THE KOREAN VERSION OF THE 15-ITEM COMMUNITY ASSESSMENT OF PSYCHIC EXPERIENCES (CAPE-15) IN A COLLEGE POPULATION
Authors: Kim Sung-Wan , Jin Kim Jung , Kim Yeonghyeok , Jo Anna , Kim Jae-Kyeong , Kim Jae-Min , Chul Chung Young , Yoon Jin-Sang 
Published: May 2020

Abstract

Background
The Community Assessment of Psychic Experiences-Positive 15-items scale (CAPE-15) is another brief, valid screening tool used to identify people at high risk of psychosis in the community. This study examined the reliability and validity of the Korean version of the CAPE-15 in university students.

Methods
This study had two stages: initial screening with self-report questionnaires including the CAPE-15, and semi-structured interviews to investigate the instrument’s diagnostic validity. The initial screening involved 1,749 college students. The modified Korean version of Prodromal Questionnaire-16 item (mKPQ-16) was also administered. The criteria for ultra-high risk (UHR) of psychosis in the Comprehensive Assessment of At-Risk Mental States (CAARMS) were the gold standard for diagnosis.

Results
Twelve of the interviewed subjects met the CAARMS criteria for UHR of psychosis. The area under the receiver operating characteristic curve was highest (0.936) for the CAPE-15 distress score (p&lt;0.001). The use of 6 as the cutoff for the CAPE-15 distress score resulted in the best balance of sensitivity (91.7%) and specificity (85.2%), with a favorable positive predictive value of 32.4%. The coefficients of correlation between the CAPE-15 and mKPQ-16 were significant.

Discussion
This study showed that the CAPE-15 is a good screening instrument for use in community and school settings. In particular, the better validity of the CAPE-15 suggests that it is a promising alternative to other brief self-report screening tools that are currently used to detect UHR. This validation of a questionnaire with a small number of items may make it feasible to screen large numbers of young adults in the community and shorten the duration of untreated psychosis through prompt early intervention.
T123. RISK FACTORS FOR PSYCHOTIC DISORDERS WITHIN MIGRANT GROUPS IN CANADA
Authors: Anderson Kelly , Edwards Jordan 
Published: May 2020

Abstract

Background
Although there is a large evidence base suggesting elevated rates of psychotic disorder for some migrant groups, relative to the non-migrant host population, less is known about factors that modify the risk of psychosis within migrant groups. Our objective was to assess whether pre-migration, migration-related, and post-migration factors were associated with an elevated risk of psychotic disorder among first-generation migrants in Ontario, Canada.

Methods
Using linked population-based health administrative data, we constructed a retrospective cohort of first-generation migrants to Ontario over a 20-year period between 1992 and 2012. We identified first onset non-affective psychotic disorders using a validated algorithm. Pre-migration factors included sex, country of origin, education, occupation, marital status, and language. Migration-related factors included age at migration, year of migration, duration of residence, and migrant class. Post-migration factors included rural place of residence and neighbourhood-level indicators of marginalization. We used Poisson regression models to compute incidence rate ratios for each pre-migration, migration-related, and post-migration factor to assess its magnitude of effect on the risk of developing psychosis, relative to migrants who did not develop psychotic disorder.

Results
Our cohort included over two million first-generation migrants over the 20-year period. Preliminary findings suggest that males, refugees, and people who set up residence in urban centres have higher rates of psychotic disorder, and people who are older at the time of migration and those who set up residence in high-income areas have lower rates of psychotic disorder. Full results for pre-migration, migration-related, and post-migration risk factors will be presented.

Discussion
Migrant status is one of few well-established risk factors for psychotic disorder, yet we have limited understanding of the underlying etiology. The findings from this study help to identify high-risk groups to target for intervention. Improving our understanding of key risk factors for psychotic disorders within migrant groups is crucial for informing prevention and early intervention efforts.
T126. PSYCHIATRIC PREDICTORS FOR BECOMING HOMELESS AND EXITING HOMELESSNESS: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Nilsson Sandra , Nordentoft Merete , Hjorthøj Carsten 
Published: May 2020

Abstract

Background
Homelessness is an increasing societal problem in high-income countries and often linked to psychiatric disorders. However, a study compiling the existing literature is lacking.
The aim was to identify individual-level predictors for becoming homeless and exiting homelessness in a systematic review and meta-analysis.

Methods
We searched PubMed, EMBASE, PsycINFO, and Web of Science (up to January 2018). Becoming homeless and exiting homelessness were the outcomes. Observational studies with comparison groups from high-income countries were included. The Newcastle Ottawa Quality Assessment Scale was used for bias assessment. Random effects models were used to calculate pooled odds ratios (ORs). In all, 116 studies of predictors for becoming homeless and 18 for exiting homelessness were included.

Results
Psychiatric problems, especially drug use problems (OR 2.9, 95% confidence interval (CI) 1.5–5.1) and suicide attempts (OR 3.6, 95% CI 2.1–6.3) were associated with increased risk of homelessness. However, the heterogeneity was substantial in most analyses (I2&gt;90%), and the estimates should be interpreted cautiously. Adverse life-events, including childhood abuse and foster care experiences, and past incarceration were also important predictors of homelessness. Psychotic problems (95% CI 0.4, 0.2–0.8; I2=0) and drug use problems (OR 0.7, 95% CI 0.6–0.9; I=0) reduced the chances for exiting homelessness. Female sex and having a partner increased the changes of exiting homelessness.

Discussion
Evidence for several psychiatric predictors for becoming homeless and exiting homelessness was identified. Additionally, socio-demographic factors, adverse life-events, and criminal behavior were important factors. There is a need for more focus on psychiatric vulnerabilities and early intervention to reduce the risk of homelessness.
T129. PHARMACOLOGICAL INTERVENTIONS IN TRIALS OF PEOPLE WITH SCHIZOPHRENIA: A REGISTER-BASED CLASSIFICATION OF SEVENTY YEARS OF RESEARCH
Authors: Shokraneh Farhad 
Published: May 2020

Abstract

Background
Drug development is a billion dollar business globally. It is crucial to stay up to date on drug developments all over the world any repetition will be irreversible waste of resources. The only way to keep up with all the development is to keep a living database of all trials running for each condition and covering all studies from every country in any language. An Information Specialist collects and classifies all pharmacological interventions from all schizophrenia trials.

Methods
Cochrane Schizophrenia’s Study-Based Register was developed and used as the source of trials, Emtree and MeSH for synonyms, AdisInsight and CT.gov for research drugs and WHO ATC for marketed drugs. This research took four years from 17 December 2014 and 6 January 2019 and involved 18,500 randomized controlled trial from 90 countries in 23 languages.

Results
One third of tested interventions on patients with schizophrenia are pharmacological (816; belonging to 106 clinical classes) with antipsychotic drugs being the most researched (15.1%). Only 528 of these medications are listed in WHO ATC. Around one third of these drug interventions are seen only in research (236; from 21 pharmacological/biochemical classes). Within the pharmacological evaluations we identified 28 ‘qualifiers’ including dose, route, and timing of drug delivery. Using Data Science approaches, this research revealed unique antipsychotic drugs that are being prescribed only in certain countries such as Japan but the West is not aware of them. This research is also revealed all the research drugs and current trends in developing drugs in pharmaceutical companies.

Discussion
Classification of medication interventions from trials requires use of many sources of information none of which are inclusive of all drugs. Without a global search in all languages the pharmaceutical companies and researchers are missing important successful developments from non-English speaking world. The cycle of developing research/withdrawn drugs does not stop and may end in veterinary medicine, doping agents in sports, and illicit drug market.
T159. STRUCTURAL BRAIN ABNORMALITIES IN SCHIZOPHRENIA IN ADVERSE ENVIRONMENTS: EXAMINING THE EFFECT OF POVERTY AND VIOLENCE IN SIX LATIN AMERICAN CITIES
Authors: Crossley Nicolas , Zugman Andre , Reyes-Madrigal Francisco , Czepielewski Leticia , Castro Mariana , Diaz-Zuluaga Ana María , Pineda-Zapata Julián , Reckziegel Ramiro , Gadelha Ary , Jackowski Andrea , Noto Cristiano , Serra Luz Maria Alliende , Iruretagoyena Bárbara , Ossandon Tomas , Ramirez-Mahaluf Juan Pablo , Paz Castañeda Carmen , Gonzalez-Valderrama Alfonso , Nachar Ruben , León-Ortiz Pablo , Undurraga Juan , Lopez-Jaramillo Carlos , Guinjoan Salvador M , Gama Clarissa , de la Fuente-Sandoval Camilo , Bressan Rodrigo 
Published: May 2020

Abstract

Background
Social and environmental factors such as poverty or violence, modulate the risk and course of schizophrenia, but how they affect the brain in patients with psychosis remains unclear. We here studied how they are related to brain structure in schizophrenia and healthy controls in Latin America, where these factors are large and unequally distributed.

Methods
This is an MRI multi-center study in patients with schizophrenia and healthy controls from six Latin American cities: Buenos Aires, Medellin, Mexico City, Santiago, Sao Paulo and Porto Alegre. Total and voxel-level gray matter volumes obtained from T1-weighted MRI images and their relationship with income and homicide rates were analyzed using a general linear model.

Results
334 patients with schizophrenia and 262 controls were included. Income was differentially related to total gray matter volume in the two groups (P=0.006). Controls showed a positive correlation between total gray matter volume and income (R=0.14, P=0.02). Surprisingly, this relationship was not present in schizophrenia (R=-0.076, P=0.17). Voxel-level analysis confirmed that this interaction was widespread across the cortex. After adjusting for global brain changes, income was positively related to prefrontal cortex volumes only in controls. Conversely, the hippocampus in patients, but not in controls, was relatively larger in affluent environments. There was no significant correlation between environmental violence and brain structure.

Discussion
Our results highlight the interplay between the environment, particularly poverty, and individual characteristics in psychosis. This is particularly important for harsh environments such as those from low and middle-income countries: potentially less brain vulnerability (less gray matter loss) is sufficient to become unwell in adverse (poor) environments. The development of algorithms exploring clinically-useful information from structural brain images in psychosis should include representative samples from low and middle-income countries.
T163. STRUCTURAL AND CONNECTIVITY CHANGES IN THE CEREBELLUM CONTRIBUTE TO EXPERIENCING AUDITORY VERBAL HALLUCINATIONS
Authors: Pinheiro Ana , Bouix Sylvain , Makris Nikos , Schwartze Michael , Shenton Martha , Kotz Sonja 
Published: May 2020

Abstract

Background
Auditory verbal hallucinations (AVH) have been explained in the context of the forward model, giving the cerebellum a prominent role. However, research utilizing multiple neuroimaging modalities has rendered results on the specificity of cerebellar contribution to AVH unclear.

Methods
To examine the reliability and regional specificity of cerebellar changes in AVH, a systematic search of electronic databases through October 2019 was conducted to identify neuroimaging studies of the cerebellum in psychotic patients or nonclinical participants reporting AVH, focusing on structural MRI, diffusion tensor imaging, and resting state functional connectivity studies. Twenty-two studies were selected, including 892 participants with AVH (792 psychotic patients; 100 at-risk subjects) and 775 healthy controls. Activation likelihood estimate analysis (ALE) examined the reported coordinates for reduced volume, fractional anisotropy (FA) or connectivity (control participants &gt; participants with AVH) and increased volume, FA or connectivity (participants with AVH &gt; control participants). The consistency of cerebellar changes and their relationship with sociodemographic and clinical measures were meta-analyzed.

Results
The ALE meta-analysis revealed changes in both anterior and posterior cerebellar lobes, with opposite patterns: whereas decreased volume or connectivity was identified in the right anterior cerebellum (lobule IV/V), increased volume or connectivity was identified in the bilateral posterior cerebellum (Crus I and II). A random-effects model with small sample corrections identified consistent changes in both volume and functional connectivity of the cerebellum in participants with AVH (g = .84; SE = .24, 95% CI [.33, 1.34]), which were enhanced in Crus I (g = 1.52, SE = .28, p = .006, 95% CI [.73, 2.31]) but not moderated by age, sex, medication, or illness duration.

Discussion
The ALE meta-analysis confirms cerebellar structural and connectivity changes in psychotic and nonclinical participants reporting AVH. These changes may contribute to AVH due to altered sensory feedback and consequently to erratic prediction as described by the forward model. The current findings also indicate that not all cerebellar regions are equally affected by AVH: the most pronounced changes were observed in Crus I. Specifically, altered communication between Crus I and neocortical network nodes, including the prefrontal cortex, may contribute to ineffective cognitive control in AVH, leading to external misattributions of auditory feedback and a reduced sense of control over events in the environment.
T193. THE ROLE OF METACOGNITION ON NEGATIVE SYMPTOMS: A PSYCHOLOGICAL MODEL FOR DIMINISHED EXPRESSION IN SCHIZOPHRENIA
Authors: García-Mieres Helena , Lundin Nancy , Minor Kyle , DiMaggio Giancarlo , Cheli Simone , Popolo Raffaele , Ochoa Susana , Lysaker Paul 
Published: May 2020

Abstract

Background
The resistance of negative symptoms to pharmacologic treatment has spurred interest in understanding the psychological factors that contribute to their formation and persistence. However, little is understood about the psychological processes that reinforce and sustain the negative symptoms domain of diminished expression. Prior research has shown that higher levels of diminished expression relate to deficits in metacognitive capacity. We propose a more complex model in which diminished expression occurs when impairments in metacognitive self-reflectivity, alterations in higher-order language structure, and cognitive deficits interact and thus interfere with persons’ ability to understand and express emotions in ways others can recognize.

Methods
Individuals with schizophrenia-spectrum disorders (N=201) provided personal narratives including their life story and reflections regarding their mental illness and a clinician-rated interview of psychotic symptoms (i.e., Positive and Negative Syndrome Scale; PANSS). Self-reflectivity was measured with the Metacognition Assessment Scale-Abbreviated, and situation models were extracted from participants’ personal narratives via Coh-Metrix 3.0, an automated program that calculates basic and complex language indices. Diminished expression and cognitive symptoms were measured with the PANSS. Structural equation models (SEM) examined whether self-reflectivity mediated the impact of cognitive deficits and situation models on diminished expression.

Results
SEM revealed that self-reflectivity partially mediated the impact of situation models on diminished expression (β = -.083, p = .005, ±95% CI [-.141, -.026]) and fully mediated the influence of cognitive symptoms in diminished expression (β = .099, p = .001, ±95% CI [.038, .160]). Findings persisted after controlling for educational level.

Discussion
This study is the first of its kind to utilize a mediational model including higher-order linguistic structures, cognitive impairment and metacognition to explain diminished expression in psychosis. Results suggest that self-reflectivity, situation models and cognitive symptoms may be useful targets for intervention in efforts to decrease diminished expression.
T200. METABOLIC SIDE EFFECTS OF ANTIPSYCHOTIC DRUGS – PROTOCOL OF A SYSTEMATIC REVIEW AND NETWORK- METAANALYSIS
Authors: Schneider-Thoma Johannes , Bighelli Irene , Siafis Spyridon , Leucht Stefan 
Published: May 2020

Abstract

Background
Antipsychotic drugs are the mainstay of the pharmacological treatment of schizophrenia, used in the acute episode of the disorder and for prevention of relapses. Unfortunately, antipsychotics cause side effects. Weight gain is one of the most prominent side effects. In line with weight gain, also alterations of lipid- and glucose homeostasis can occur and increase the risk for cardiovascular disorders. So far, the differences between the multiple antipsychotics in propensity to cause these alterations have not been examined based on data from randomized controlled trial. Therefore, we are conducting a systematic review and network-metaanalysis on metabolic side effects of antipsychotic drugs.

Methods
Systematic review and network-metaanalysis.

Population
Patients with schizophrenia.

Interventions
Antipsychotic drugs and placebo.

Comparator
In network-metaanalysis all interventions are compared with each other. For presentation of Results:, placebo will be used as reference.

Outcomes
The primary outcomes will be continuous change of body weight. Additional outcomes will be continuous change of blood glucose, triglycerides, total cholesterol, LDL cholesterol, HDL cholesterol as well as dichotomous values of these outcomes (i.e. number of patients with a clinically relevant increase over pathological thresholds).

Study design
Randomized controlled trials.

Statistical analysis
Network-metaanalysis.
Planned network-metaregression-, subgroup- and sensitivity-analyses will address the role of the potential effect modifiers baseline weight, study duration, age, gender, ethnicity, previous antipsychotic exposure, antipsychotic dose, sponsorship, and use of enriched-design.

Results
Funding for this project has been received from the German Ministry of Education and Research.
At the time of abstract submission, the project has just started and is currently in the stage of protocol development.

Discussion
At the time of the conference the protocol of the study will be developed further and the literature search will have started. Thus, on the poster, details of the analytic approach can be presented and challenges discussed. Moreover, results of the search process can be presented.
T201. EFFECTS OF PALIPERIDONE PALMITATE ON HEALTHCARE UTILIZATION AND COSTS FOR PATIENTS WITH SCHIZOPHRENIA: A CLAIM-BASED MIRROR-IMAGE STUDY IN SOUTH KOREA
Authors: Hun Jung Myung , Jon Duk-In , Yi Jung-Seo , Chul Lee Boung 
Published: May 2020

Abstract

Background
Long-acting injectable (LAI) antipsychotics, such as paliperidone palmitate (PP), are known to improve treatment adherence in patients with schizophrenia, which can lead to reductions in relapse and hospitalization rates. However, relatively few studies have demonstrated the economic impact of LAIs, especially in Asian populations.

Methods
We conducted a claim-based mirror-image study to explore changes in healthcare utilization and associated costs, among 1,272 South Korean patients with schizophrenia (ICD-10-CM code F20), between the 1-year periods before and after the initiation of PP treatment.

Results
The results showed that patients accessed outpatient services more frequently after versus before starting PP treatment, with the number of prescription days increasing by 133.45 (p &lt; .0001) and the associated costs increasing by USD 1,497.15 (p &lt; .0001). In contrast, the number of admission days was reduced by 11.33 after starting PP treatment (p &lt; .0001) and the associated costs were reduced by USD 1,220.75 (p &lt; .0001).

Discussion
Although the high acquisition cost of PP has been regarded as an obstacle to its clinical use, our results imply that the high prescription costs for PP may be counterbalanced by the reduced admission costs associated with its use. Economic outcomes for patients treated with LAIs should be investigated further to help healthcare decision-makers and providers to determine the value of LAIs relative to other treatment medications.
T216. VARIATION IN SIDE EFFECTS TO ANTIPSYCHOTIC TREATMENT ACROSS SCHIZOPHRENIA SPECTRUM DISORDERS
Authors: Susanne Neumeier Maria , Winkelbeiner Stephanie , Kane John , Seifritz Erich , Huhn Maximilian , Leucht Stefan , Homan Philipp 
Published: May 2020

Abstract

Background
Adverse effects of antipsychotic drugs play a key role in non-compliance and discontinuation of treatment in Schizophrenia Spectrum Disorders (SSD). Precision medicine aims to minimize such adverse effects by selecting the right treatment for the right patients. To determine the need for precision medicine we need to estimate the amount of variation in adverse effects between patients. While clinical experience suggests that such variation is considerable, analyzing how variation differs between treated and untreated patients can answer this question. Here, we hypothesized to find larger variation in treatment compared to control groups of patients treated with second generation antipsychotics.

Methods
We included double-blind, placebo-controlled, randomized trials of adults with a diagnosis of schizophrenia spectrum disorders and prescription for licensed antipsychotic drugs. Means and variances of the pretreatment and posttreatment outcome differences of weight gain, prolactine levels, and corrected QTC times were extracted. Data quality and validity were ensured by following the PRISMA guidelines. The outcome measure was the overall variability ratio of treatment to control across RCTs. Individual variability ratios were weighted by the inverse-variance method and entered into a random-effects model.

Results
We included N = 13 282 patients for weight gain, N = 11 767 for prolactine levels, and N = 7 203 for QTC time. For all the measured adverse effects, variances were greater in treatment compared to control. Specifically, variance ratios were increased for weight gain (VR = 1.13, 95% CI: 1.06, 1.20), prolactine levels (VR = 1.38, 95% CI: 1.13, 1.68) and QTc time (VR = 1.06, 95% CI: 1.01, 1.12).

Discussion
We found increased variability in the major side effects that patients with SSD had under treatment with second generation antipsychotics. Indeed, some patients were more susceptible than others to weight gain, prolactine level increase, and QTC time increase, suggesting that precision medicine in antipsychotic treatment should be informed by individual differences in side effects rather than treatment effects. Future studies should aim at finding biological predictors of such individual differences in side effects.