bluuebunny/crossref_metadata_2025_split huggingface dataset:
M225. EXPRESSED EMOTIONS AND PSYCHOLOGICAL DISTRESS AMONG CAREGIVERS OF PATIENTS WITH CHRONIC MENTAL ILLNESS ATTENDING PSYCHIATRIC DEPARTMENT OF BPKIHS
Authors: Fyak Sanjita , Pradhan Nirmala , Lama Sami , Thapa Kriti , Kumar Rajesh 
Published: May 2020

Abstract

Background
Family expressed emotions had been shown to be predictive of outcome in mental illnesses in variety of cultural settings. Distressed caregivers who provide care to mentally ill relatives are at risk for developing mental health disorders.

Methods
A hospital based cross sectional study was conducted among 85 caregivers of chronic mental illness using purposive sampling technique. Caregivers were interviewed using Family Questionnaire (FQ) and Kessler Psychological Distress Scale (K10) to assess expressed emotions and psychological distress of caregivers respectively.

Results
More than half (55.3%) of the caregivers had low expressed emotions while 44.7% had high expressed emotions. More than half (55.3%) of the caregivers had low psychological distress, followed by medium risk (31.8%) and high risk (12.9%).
Study revealed significant association between caregiver’s expressed emotion with caregiver’s relationship to patient, area of residence, socioeconomic status, age and gender of patients. Caregiver’s psychological distress had a significant association with their relationships with patient and educational qualification of patient. There was positive correlation between caregiver’s expressed emotions and psychological distress.

Discussion
This study illustrated that more than half (55.3%) of the caregivers had low expressed emotions and 44.7% had high expressed emotions while caring their patients with chronic mental illness. This finding is contradictory to the findings of a study conducted in India which depicts that most of the caregivers were designated as high EE (56%) as compared to low EE (44%). Another study conducted in Thailand indicated that large number of caregivers have high expressed emotion (87.5%).Another descriptive quantitative exploratory study done in Saudi Arabia had shown that majority of caregivers had low EE (85%). This differences in the results related to expressed emotions could be possibly due to variations in the sample size and tools used for data collection among these studies.
M232. COORDINATED SPECIALTY CARE FOR FIRST EPISODE PSYCHOSIS IN MINNESOTA
Authors: Fischer Jamie , Mervis Joshua , Begnel Erin , Meyer-Kalos Piper 
Published: May 2020

Abstract

Background
People who are experiencing a First Episode of Psychosis (FEP) often have limited recovery from non-integrated treatment approaches in usual settings. Treatment of FEP typically entails high rates of non-adherence, disengaging from treatment, and increased rates of relapse (Mueser et al., 2015; Kane et al., 2016). NAVIGATE is an evidence-based approach implemented in the Recovery After an Initial Schizophrenia Episode treatment project.

Methods
The present study is a review of archival data with NAVIGATE model teams in Minnesota. Clinical information from 118 people with FEP was reviewed from the first 6-months of treatment, with a subset analyzed for the first 12-months. Individuals were assessed with clinician ratings of current needs, illness management, and global functioning. Self-report assessments addressed symptoms and illness management from the client’s perspective. Data was analyzed using repeated measures analysis of variance with post-hoc honest significant difference testing. Additional data analysis utilized McNemar’s test, a repeated measures test using counts and a chi-square distribution.

Results
Total current needs did not change significantly across time. All other domains assessed showed significant differences between intake and 6-months. All other domains except total needs showed significant differences between intake and 12-months. No domains showed significant differences between 6-months and 12-months. Substance use was not reduced over time. Antipsychotic medication use was not reduced over time. Hospitalizations were substantially reduced from intake to 6-months.

Discussion
Almost all symptoms improved from intake to 6-months. No additional treatment gains were observed from 6-months to 12-months. Improvements from intake were stable from 6-months to 12-months. Most symptoms improved from intake to 6-months but not beyond. The NAVIGATE model was a successful intervention as implemented in Minnesota. Overall, symptom reduction gains were durable at 12-months, hospitalizations were reduced from intake to 6-months, but the intervention did not improve substance use. Substance use, continued improvement of symptoms beyond the 6-month mark, and further improvements in symptoms or reduced hospitalizations are areas for future research and treatment development.
S7. INVESTIGATING THE LINK BETWEEN THE PERIPHERAL ENDOCANNABINOID SYSTEM AND CENTRAL GLUTAMATERGIC NEUROTRANSMISSION IN EARLY PSYCHOSIS: A 7T-MRS STUDY
Authors: Minichino Amedeo , Godlewska Beata , Cowen Philip , Burnet Philip , Lennox Belinda 
Published: May 2020

Abstract

Background
Meta-analytic evidence showed increased levels of peripheral endocannabinoid metabolites in psychotic illness. Alterations in the endocannabinoid system are believed to compromise glutamate and dopamine transmission, which play a central role in pathophysiological models of psychosis. I will present preliminary data from an ongoing high-field proton magnetic resonance spectroscopy (MRS) study aimed at investigating the association between peripheral levels of endocannabinoid system metabolites and central glutamate metabolism in individuals at their first non-affective psychotic episode (NA-FEP) and healthy controls.

Methods
We expect to recruit 17 NA-FEP and 20 healthy controls by January 2020. Currently, we recruited 12 NA-FEP and 18 healthy controls from two different research facilities (Imperial College London and University of Oxford) as part of a cross-sectional study. Participants underwent MRS scanning at 7-T with voxels placed in right dorsolateral prefrontal cortex (right-DLPFC), anterior cingulate cortex (ACC), and occipital cortex. Neuro-metabolites will be calculated using the unsuppressed water signal as reference. Endocannabinoid metabolites were quantified from serum samples, collected during the same imaging session.

Results
Analyses are ongoing. Based on previous evidence, expected findings are: (i) reduced glutamate levels in the ACC and right-DLPFC of NA-FEP compared to controls; (ii) increased peripheral endocannabinoid metabolites in NA-FEP compared to controls; and (iii) inverse association between peripheral endocannabinoid metabolites and glutamate levels in ACC and right-DLPFC in NA-FEP

Discussion
This study will help clarifying the contribution of peripheral endocannabinoid system to central brain mechanisms of key relevance for psychotic illness. It will also add further evidence on the limited literature on high-resolution characterisation of brain metabolites in early psychosis. Strengths of the study include: (i) use of high-field MRS, which allows the estimation of glutamate-related compounds at higher precision than at lower field strength; (ii) reduced heterogeneity of the clinical sample (only male and NA-FEP). Limitations: small sample size and cross-sectional design.
S17. GLOBAL DNA METHYLATION IN CURRENT AND EMERGENT SUICIDAL IDEATION: ANALYSIS IN SCHIZOPHRENIA
Authors: Bani-Fatemi Ali , Raymond Roger , Nobrega Jose , De Luca Vincenzo 
Published: May 2020

Abstract

Background
Several lines of evidence have shown that epigenetic mechanisms influence suicidal behavior, but do not indicate specific susceptibility variants. In a recent study, analysis of global methylation levels found that psychiatric patients with a history of suicide attempt (SA) had significantly higher levels of 5-methyl cytosine (5mC), suggesting that patients with a history of SA have global hypermethylation of their genome. However, there is no study investigated the link between global DNA methylation and suicidal ideation (SI) in schizophrenia. In this study, we analyzed global DNA methylation in suicide ideators and non-ideators in a sample of schizophrenia patients to find if global DNA methylation can predict SI in schizophrenia.

Methods
There are several methods of detecting total 5-methylcytosine content in the genome. We used Cell Biolabs’ Global DNA Methylation ELISA Kit, which is a competitive enzyme immunoassay developed for rapid detection and quantitation of 5’-methyl-2’-deoxycytidine (5MedCyd) in DNA extracted from white blood cells (WBC). We digested the genomic DNA, extracted from WBC, into single nucleotides and the quantity of 5MedCyd was determined by comparing its absorbance with that of a known 5MedCyd standard curve. We measured global DNA methylation in predicting current and emergent suicidal ideation.

Results
In the analysis of current SI in our schizophrenia patients, the average quantity of 5MedCyd was 7.56 ± 0.77 ng 5mC/µg DNA for suicide ideators and 8.72 ± 1.97 ng 5mC/µg DNA for non-ideators. There was no evidence of a significant difference between these two groups in our analysis (p=0.176). Also, we did not find a significant difference between global DNA methylation change (global DNA methylation change between baseline and three-month follow-up visits) in patients with and without emergent SI (p=0.121).

Discussion
This preliminary analysis did not find a predictive role of global DNA methylation in SI in patients with schizophrenia. The small sample size, used in this pilot study, is probably responsible for the fact that the results found here did not support those of previous research, showing that methylation levels are higher in patients with a history of a suicide attempt.
S19. THE ROLE OF ACE AS POSSIBLE BIOMARKER FOR TREATMENT RESISTANCE TO ANTIPSYCHOTICS IN FIRST EPISODE OF PSYCHOSIS
Authors: Luisa Longo , Sawa Akira 
Published: May 2020

Abstract

Background
Angiotensin I–converting enzyme (ACE) is a peptidase that converts angiotensin I into the vasoactive and aldosterone-stimulating peptide angiotensin II, a key protein in controlling blood pressure. Recently, several evidences have shown a role of ACE in psychosis. However, the role of ACE in psychosis is poorly characterized, and at last unknown. In this study we hypothesized that ACE blood and CSF levels are lower in patients at first episode of psychosis (FEP) compared to controls; that blood ACE levels can predict the response to antipsychotics; that low plasma ACE levels correlate with both severity of symptoms and cognitive performance.

Methods
This research used data from a longitudinal cohort study of FEP (N = 138) and controls (N = 115). First of all, we conducted a two-group comparison analyses to assess the differences between patients and controls in terms of ACE levels in both blood and CSF. As a second step, we divided our patients into treatment resistant (TR) and not treatment resistant t(non-TR) to investigate ACE blood levels in these two group. Finally, we evaluated the association between ACE blood levels and clinical phenotype and neurocognition.

Results
Two-group analyses showed lower levels of ACE in patients than controls, both in blood and CSF (p values&lt; 0.05). The two-group analyses between TR and non-TR showed lower ACE blood levels in TRs compared to non-TRs (p value&lt; 0.05). Finally, multiple regressions showed a continuous relationship between cognitive performance and ACE blood levels (p values &lt; 0.05).

Discussion
In conclusion, these findings showed that those FEP with lower ACE blood levels were not only more likely to develop TR conditions, but they also had greater cognitive impairment. These results are very promising, as they suggest that ACE levels can be used as a peripheral biomarker to stratify patients at first episode of psychosis.
S51. ANALYSIS OF SOCIAL COGNITION AS A PREDICTIVE FACTOR OF PSYCHOSIS IN 22Q11 DELETION SYNDROME (DS). DATA FROM THE MULTICENTER STUDY OF THE ITALIAN NETWORK FOR RESEARCH ON PSYCHOSES
Authors: Accinni Tommaso , Frascarelli Marianna , Buzzanca Antonino , Carlone Luca , Ghezzi Francesco , Fanella Martina , Putotto Carolina , Girardi Nicoletta , Pasquini Massimo , Di Fabio Fabio , Biondi Massimo 
Published: May 2020

Abstract

Background
22q11DS is the most important genetic risk factor for schizophrenia: up to 28% of these subjects develop psychosis in adulthood. At present this syndrome represents the strongest biological model to investigate neurobiological underpinnings of schizophrenia. We expected Theory of Mind impairments in subjects at risk for psychosis (22q11DS) and more severe impairments in subjects with an established psychotic disorder. Furthermore we sought to investigate eventual correlations between social cognition and self-esteem levels, hypothesizing that both would be impaired in psychotic groups.

Methods
Data come from Italian Network for Research on Psychoses for the Schizophrenic (SCZ, N=260) and Control groups (HC, N=111). 22q11DS psychotic (22q11DS_SCZ, N=17) and non-psychotic patients (22q11DS, N=46) were enrolled at Policlinico Umberto I, in Rome. The Awareness and Social Inference Test (TASIT) and Self-Esteem Rating Scale (SERS) were administered.

Results
The three main TASIT variables, Emotion Recognition, Minimal Social Inference and Enriched Social Inference, showed no different scores between the three clinical groups, which were significantly lower respect to the control group. The SERS total score showed no significant differences between clinical groups but was for all three significantly lower than control group score. No significant correlation was observed between SERS and TASIT scores for clinical groups.

Discussion
Social Cognition impairments are present in 22q11DS at the same extent as in idiopathic schizophrenia, and thus they represent an endophenotype of psychosis. A low Self-Esteem, even though associated to psychosis, does not affect neurocognitive process, impaired on a neurobiological basis.
S85. MANAGEMENT OF PHYSICAL HEALTH FOR PEOPLE WITH SCHIZOPHRENIA IN PRIMARY CARE: A SYSTEMATIC REVIEW
Authors: Wiener Joshua , Rodrigues Myanca , Anderson Kelly 
Published: May 2020

Abstract

Background
We sought to determine how the physical health of people with schizophrenia is managed by family physicians in a primary care setting relative to those without schizophrenia.

Methods
A comprehensive literature search was conducted in three electronic databases for articles published in English up to January 2019. Studies were included if: (1) study design was observational; (2) population was patients receiving primary care from family physicians; (3) exposure was schizophrenia; (4) comparison was no schizophrenia; and (5) outcome was management of physical health condition. Study details, subject characteristics, methods, and results were extracted from each study and summarized in a qualitative manner. Risk of bias (RoB) for each study was assessed using the CLARITY tool.

Results
A total of 12 articles met inclusion criteria, including 9 retrospective cohort studies with low RoB and 3 case control studies with moderate RoB. Among patients with diabetes (5 studies), those with schizophrenia received lower rates of guideline-recommended monitoring. Among patients with cardiovascular disease (2 studies), those with schizophrenia received lower rates of guideline-recommended prescriptions (e.g., statins). Among patients at risk for cardiovascular disease (3 studies), those with schizophrenia received lower rates of guideline-recommended screening (e.g., serum cholesterol levels). Among patients at risk for cancer (2 studies), those with schizophrenia received lower rates of guideline-recommended screening (e.g., Papanicolaou test).

Discussion
Physical health management is an ongoing concern for individuals living with schizophrenia. These individuals often receive poorer care of their physical health by family physicians when compared to individuals without schizophrenia.
S86. THE RISK OF PHYSICAL HEALTH MULTIMORBIDITY IN PATIENTS WITH PSYCHOSIS: SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Rodrigues Myanca , Wiener Joshua , Stranges Saverio , Ryan Bridget , Anderson Kelly 
Published: May 2020

Abstract

Background
Patients with psychotic disorders have a reduced life expectancy compared to those without psychosis, and this is primarily due to differences in physical illnesses. We aimed to assess the risk of developing multimorbidity or multiple chronic physical health conditions, and quantify its prevalence among this clinical population.

Methods
We identified studies through MEDLINE, EMBASE and PsycINFO from 1990 to September 2019, and reference scanning of included studies. Quantitative studies were included if proportions of 2+ and/or 3+ chronic physical health conditions were evaluated for patients with psychosis. Findings from all studies were descriptively summarized, and estimates for risk and prevalence of multimorbidity were meta-analyzed using random effects models.

Results
Fourteen studies were included, eight of which were meta-analyzed to determine the risk of developing 2+ chronic conditions for patients with psychosis. The pooled meta-analytic estimate suggests that persons with psychosis have an increased risk of developing multimorbidity than those without psychotic disorders (Risk ratio, RR=1.69, 95% CI 1.37, 2.08). All studies employed different operational definitions of multimorbidity, with respect to both the number and types of included chronic conditions. Evidence from included studies suggests gender and age as potential risk factors for developing multiple chronic conditions.

Discussion
Patients with psychosis are 69% more likely to develop multimorbidity than those without psychotic disorders. Clinicians responsible for the management of patients with psychosis should assess their risk for somatic illnesses. Future research examining multimorbidity should employ consistent definitions to better enable cross-study comparisons.
S88. THE EFFECT OF SLEEP QUALITY ON ATTENUATED PSYCHOTIC SYMPTOMS IN A NON-CLINICAL SAMPLE OF YOUNG ADULTS
Authors: Hanna Donncha , James Shannon Ciaran , Clarke Stephen , Davidson Sarah , Mulholland Ciaran 
Published: May 2020

Abstract

Background
Background: One factor known to be associated with attenuated psychotic symptoms is poor sleep but it is not known if poor sleep increases the likelihood of experiencing multiple attenuated psychotic symptoms, which research suggests may be suggestive of an At-Risk Mental State (ARMS). The study aimed to determine if poor sleep quality makes a unique contribution to predicting the number of attenuated psychotic symptoms endorsed in a prodromal questionnaire and the level of distress associated with the symptoms, when accounting for demographics, depression and drug/alcohol use variables.

Methods
Method: An online survey was conducted using Amazon’s online crowdsourcing service Mechanical Turk (MTurk). The sample was 1,013 adults (18 to 36 years) from the general population in the USA. The survey consisted of the Prodromal Questionnaire 16 (PQ-16), the Pittsburgh Sleep Quality Index, the Patient Health Questionnaire 9 (PHQ-9), the DAST-10 and the AUDIT. Regression analyses were performed with the PQ-16 as the dependent variable, and sleep quality as the predictor variable, while controlling for sociodemographic variables, depression, and alcohol/drug abuse.

Results
Results: 37% of the sample endorsed six or more PQ-16 items, which may be suggestive of an at-risk mental state, with sleep disturbance significantly increasing the likelihood (Odds ratio 2.09 &lt;.001) of endorsing six or more PQ-16 items. After controlling for socio-demographic variables, depression and drug/alcohol abuse, poor sleep quality made a unique contribution of 5.8% of the variance accounted for in level of distress experienced by attenuated psychotic symptoms.

Discussion
Conclusion: A significant proportion of young adults in the general population may have an at-risk mental state. The results add to the evidence that sleep disturbance is a contributory factor in attenuated psychotic symptoms. Further research is required to investigate the possible mechanisms (e.g. impaired cognitive processes) through which poor sleep influences attenuated psychotic symptoms and if effective treatment of sleep disturbance can influence the likelihood of developing an at-risk mental state.
S97. IS EARLY DEBUT OF SUBSTANCE USE ASSOCIATED WITH VIOLENT OFFENDING IN SCHIZOPHRENIA?
Authors: Breivik Storvestre Guttorm , Jensen Arvid , Bjerke Espen , Tesli Natalia , Rosaeg Cato , Lagerberg Trine , Friestad Christine , Andreassen Ole A , Melle Ingrid , Haukvik Unn K 
Published: May 2020

Abstract

Background
Substance use is one of many risk factors for schizophrenia, and substance use is also associated with violent offending.
This study compared a group of individuals suffering from schizophrenia with a history of violent offending (SCZ-V) to a group of schizophrenia patients without any history of violent offending (SCZ-NV). We investigated whether there is a difference between the SCZ-V and SCZ-NV groups when it comes to lifetime use, and debut age for use, of alcohol, cannabis, and amphetamines.

Methods
This study examined the overall lifetime substance-use and the debut age of use of alcohol, cannabis and amphetamine among a selected group of patients with schizophrenia and a history of violent offending (SCZ-V n=25) recruited from psychiatric security wards in South-Eastern Norway, compared to a matched group of schizophrenia patients without violent offending (SCZ-NV n=34). Participants completed interviews and questionnaires to confirm diagnoses and to map the history of substance use.

Results
While we found no significant difference in lifetime use of alcohol and cannabis between the groups (alcohol: SCZ-V: 88%, SCZ-NV: 97%, cannabis: SCZ-V: 76%, SCZ-NV: 71%), the SCZ-V group reported significantly more lifetime use of amphetamines compared to the SCZ-NV group (SCZ-V: 76% vs SCZ-NV: 18%, p&lt;0.001). When comparing debut ages for substance use, the SCZ-V group was significantly younger than the SCZ-NV group at debut of alcohol (Mean age SCZ-V: 13.8 vs. SCZ-NV: 16.4, p=.004), cannabis (Mean age SCZ-V: 14.0 vs. SCZ-NV: 18.3, p&lt;.001), and amphetamines (Mean age SCZ-V: 15.6 vs. SCZ-NV: 21.2, p=.001).

Discussion
The SCZ-V group reported significantly more lifetime use of amphetamine and a significantly lower debut age for use of alcohol, cannabis, and amphetamines than the SCZ-NV group.
According to the Norwegian Institute of Public Health, the average lifetime uses of cannabis for the general Norwegian population between 16 and 64 years old is 20.6%, while the average for the population between 16 and 34 years old when it comes to ever have used amphetamines is 4.7%. The numbers for both the SCZ-V and the SCZ-NV groups were noticeably higher than the population averages. What separates the groups are the significantly lower debut age of drug use in the SCZ-V group, and especially the higher number of lifetime amphetamines use.
The findings point towards an association between the early debut of use of alcohol, cannabis, and amphetamines, and later violent offending in patients suffering from schizophrenia.