bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vagus nerve stimulation (VNS) as a long-term adjunctive treatment option in patients with difficult-to-treat depression (DTD)
Authors: Kavakbasi E. , Bauermeister H. , Lemcke L. , Baune B. T. 
Published: August 2024

IntroductionVNS is a long-term adjunctive treatment option in patients with DTD. It has been shown that patients with VNS as add-on to treatment-as-usual (TAU) have higher response and remission rates than TAU alone. Data on the impact of VNS on the other complex concomitant treatments are limited.ObjectivesIn this study we evaluated changes in drug load from baseline to 12 months as well as the impact of previous ECT response status at baseline on changes in mean depression severity after 12 months of VNS.MethodsWe included n=20 DTD patients (mean age 52.6 years) in the prospective, observational, naturalistic Restore-Life study, who have been treated with adjunctive VNS as add-on to treatment as usual. The RESTORE-Life study is a multi-center study. In this analysis, we report on exploratory results from a single tertiary center. An index has been calculated for each drug by comparing the actual dose with the standard dose of the drug. The drug load for each patient has been constructed by summing up the indices of all agents prescribed for the patient.Results
We observed a slight decrease in mean drug load from 4.5 at baseline to 4.4 at 12 months (p=0.594). The drug load was lower in previous ECT-responders than in ECT-non-responders at both timepoints. There was a significant decrease in mean MADRS score from 27.3 at baseline to 15.3 at 12 months (p=0.001). Patients with a history of ECT response at baseline have experienced significantly greater improvement in mean MADRS score at 12 months (p=0.013). Number of maintenance electroconvulsive therapy (ECT) and esketamine sessions decreased from 37 ECT and 58 esketamine sessions in the first six months to 17 ECT (-54%) and 29 esketamine (-50%) sessions between months 6 and 12. VNS-related adverse events were present in 50 % of patients at 12 months (voice alteration/hoarseness 45%, dyspnea and pain during stimulation each 5%). There was no discontinuation of VNS due to adverse events.Conclusions
Overall, VNS was associated with significant decrease in mean MADRS score at 12 months, whereas we did not detect any significant change in medication load. A more extended observation period might be necessary to observe changes in medication load. There was a reduction in the need of maintenance treatment sessions of ECT and esketamine. History of ECT response may be predictive for greater improvement of depression severity in VNS patients.Disclosure of InterestE. Kavakbasi Grant / Research support from: The Sponsor of the Restore-Life study is LivaNova. Our institution received fees from LivaNova for study visits of the Restore-Life study. LivaNova had no influence on the content of this work., H. Bauermeister: None Declared, L. Lemcke: None Declared, B. Baune: None Declared
Transient Febrile reaction after Electroconvulsive Therapy : A case report in an adult man with Ultra-Resistant Schizophrenia
Authors: Abdessattar K. , Hkiri A. , khiari H. , Youssef O. , Ghachem R. 
Published: August 2024

IntroductionElectroconvulsive therapy (ECT) is a therapeutic method that induces artificial seizure by electrical stimulation to resolve various psychiatric symptoms. ECT is particularly effective in resistant schizophrenia and may improve response to medication despite the presence of potential adverse side effects. Post-ECT delirium and Headaches are some of the most frequent side effects presented in literature. Fever is yet another unexplained reaction, however there are a few case reports and retrospective studies that report on it.ObjectivesWe aim to illustrate through a clinical case and a review of literature the prevalence of post ECT fever as well as the possible explanatory mechanisms.MethodsIn this study we report the case of a man with ultra-resistant schizophrenia who was treated successfully with ECT despite the development of transient febrile reaction and we present a review of literature on pubmed using the following key words : ECT, fever,resistant psychosis, mechanisms.Results
Our patient is a 48-year-old man with a psychiatric history of schizophrenia evolving since the age of 34. He has a history of matricide in 2021 resulting in his hospitalisation in a forensic psychiatric ward. He underwent trials of classic and atypical antipsychotics that weren’t efficacious thus he was diagnosed with resistant schizophrenia in 2022. He was treated initially with clozapine 500 mg per day and then with the association (clozapine + amisulpride) yet it wasn’t effective on his persecutory delirium and fratricide ideas. Plus, there was no reduction in his PANSS (Positive and Negative Syndrome Scale) scores. The diagnosis of ultra-resistant schizophrenia was established. The staff indicated the adjunction of ECT to Clozapine. In the inpatient unit, hours after his fourth ECT session he developed a fever (40°C), his blood pressure (120/80 mm Hg), pulse(85 beats per minute),and respiratory rate(20 breaths per minute) were normal. Blood samples, including cultures, were drawn, which showed normal blood cell count and CPK(140U/L) but CRP was elevated (31 U/L), a chest x-ray showed no acute pulmonary disease, and his urinalysis result and Covid test were negative. His fever resolved then spontaneously after two hours. The same transient febrile reaction occurred again 3 times. It was postulated in literature that fever may be due to inadequate muscle reaction. Data also suggested the potential influence of ECT on the hypothalamus that is a key region in regulating body temperature.ConclusionsFurther studies are required in order to establish the real prevalence of this side effect and its possible causes.Disclosure of InterestNone Declared
Optimizing Outpatient Mental Health Services: A REBT-Infused Approach to Empowerment and Well-being
Authors: Milutinovic M. , Mitrovska S. , Novotni L. 
Published: August 2024

IntroductionRational Emotive Behavior Therapy (REBT) fundamentally posits that our thoughts, beliefs, and interpretations exert substantial influence over how we perceive and react to life’s occurrences. Central to REBT is the process of recognizing and disputing irrational, self-defeating beliefs, in favor of adopting rational and constructive perspectives.ObjectivesThis presentation endeavors to introduce the foundational principles of REBT, elucidate its applied techniques, demonstrate its efficacy through compelling case studies, and delineate its spheres of applicability.MethodsCase Studies:1.Overcoming Social Anxiety: Illustrating the transformation from debilitating social anxiety to enhanced social functioning.2.Managing Work-related Stress: Exemplifying the alleviation of chronic stress in a high-pressure work environment.3.Overcoming Depression: Demonstrating the journey from persistent despondency to restored vitality and engagement.
ResultsIn total, REBT furnishes a methodical and pragmatic approach to therapy, affording individuals agency in steering their emotional well-being towards positive and enduring transformation. It is imperative to acknowledge that the suitability of REBT hinges on the idiosyncratic needs, inclinations, and circumstances of each patient.ConclusionsBy internalizing and applying these foundational principles, REBT empowers individuals to identify and dispute irrational beliefs, paving the way for more adaptive emotional responses and an enhanced overall state of mental well-being. It equips individuals with tangible tools to navigate life’s challenges with heightened resilience and emotional equilibrium.Disclosure of InterestNone Declared
The association between trajectory of change in social functioning and psychological treatment outcome in university students: a growth mixture model analysis
Authors: Barnett P. , Saunders R. , Buckman J. E. , Naqvi S. A. , Singh S. , Stott J. , Wheatley J. , Pilling S. 
Published: August 2024

IntroductionAttendance at university can result in social support network disruption. This can have a negative impact on the mental health of young people. Demand for mental health support continues to increase in universities, making identification of factors associated with poorer outcomes a priority. Although social functioning has a bi-directional relationship with mental health, its association with effectiveness of psychological treatments has yet to be explored.ObjectivesTo explore whether students showing different trajectories of change in social function over the course of treatment differed in eventual treatment outcome.Methods
Growth mixture models were estimated on a sample of 5221 students treated in routine mental health services. Different trajectories of change in self-rated impairment in social leisure activities and close relationships (Work and Social Adjustment Scale (WSAS) items 3 and 5) during the course of treatment were identified. Associations between trajectory classes and treatment outcomes were explored through multinomial regression.Results
Five trajectory classes were identified for social leisure activity impairment (Figure 1), and three classes were identified for close relationship impairment (Figure 2). For both measures the majority of students remained mildly impaired (Class 1). Other trajectories included severe impairment with limited improvement (Class 2), severe impairment with delayed improvement (Class 3), and, in social leisure activities only, rapid improvement (Class 4), and deterioration (Class 5). There was an association between trajectories of improvement in social functioning over time and positive treatment outcomes. Trajectories of worsening or stable severe impairment were associated with negative treatment outcomes.Image:Image 2:ConclusionsChanges in social functioning impairment are associated with psychological treatment outcomes in students, suggesting that these changes may be associated with treatment effectiveness or recovery experiences. Future research should look to establish whether a causal link exists to understand if additional benefit for students can be gained through integrating social support within psychological treatment.Disclosure of InterestNone Declared
Right to attention to sexuality for people with mental disorders: bridges between health and social services
Authors: Campillo Sanz M. T. , Vallve Elias M. , Casals Arnau A. , Marti Bonany J. , Garcia Hernandez D. , Sanchez Gonzalez R. 
Published: August 2024

IntroductionThe expression of sexuality in the adult with mental disorders depends on the early incorporation of factors for promoting social inclusion. It is fundamental that sexual educators and advisors, in addition to working with the clients, also work with close family members. Intervention programs should establish objectives for developing a positive attitude towards sexuality in people with mental disorders and improving self-esteem (Katz G,Salud Publica Mex. 2008;50 Suppl 2:s239-54).ChallengeAchieving support for people with mental health problems and/or substance use disorder admitted to the Social Rehabilitation Process of a psychiatric hospital so that they develop their sexuality satisfactorily. The right to privacy must be taken into account.ObjectivesPromoting a healthy and satisfactory development of sexuality in people with severe mental disorders. Raising awareness among healthcare teams, families and legal representatives regarding the need and suitability for support. Introducing the concept of sexuality as a dignifying perspective. Promoting sexual education that avoids disadvantages and situations of abuse in the target group. Coordinating the continuity of the project with non-health social services after discharge.HypothesisPossibility of receiving support in the development of sexuality through training, information and improvement in the management of emotions/feelings in people who express the need or willingness to receive it, will contribute to overcoming limitations or difficulties.MethodsDetecting people who during 2021 wish to work on the objectives through the care team. Searching for community resources aimed at attending sexuality issues in people with mental health problems. Proposing the hospital a collaboration with a non-profit entity that develops a specialized program for attention to sexuality in disability. Coordination between Treatment team and Entity. Quantitative and qualitative assessment of one year of experience according to the parameters of the entity.Results2022People includedPercentage of people admittedto the Income Unit (65)Detection concern sex-affectivity
57,69%Verbalized concern34,61%Referral to the entity program23,07%ConclusionsAll patients included have a diagnosis of psychosis. Experience was very positive for the participants. Community intervention projects that lead to an education in healthy and respectful relationships in the field of sexuality and affectivity are necessary. This would allow to prevent behaviours and situations at risk of abuse as well as social and emotional instability.Disclosure of InterestNone Declared
Mental health competencies are stronger determinants of well-being than mental disorder symptoms even in psychiatric samples
Authors: Zábó V. , Erát D. , Vargha A. , Harangozó J. , Iváncsics M. , Vincze Á. , Farkas J. , Balogh G. , Cowden R. , Pongrácz F. , Bognár J. , Nagy E. , Purebl G. , Gonda X. 
Published: August 2024

IntroductionExploring the positive psychological and behavioural dimensions of people living with mental disorders can establish a firm ground in a therapeutic alliance for setting up positive life goals.ObjectivesThe present study aimed to explored whether the strength of the mental health capacities and the severity of mental disorder symptoms and the interaction of the two differ in the strength of their associations with several dimensions of well-being on Hungarian adult psychiatric and non-clinical community samples.MethodsThe psychiatric sample (129 patients (44 male, 85 female)) was collected in four Hungarian healthcare facilities using a cross-sectional design. The non-clinical community sample (253 adults (43 male, 210 female)) was collected online using a cross-sectional design. All the respondents completed the Mental Health Test, six well-being and mental health measures, and the Symptom Checklist-90-Revised.ResultsIncluding both the mental health competencies and mental disorder symptoms variables in one regression model in both samples can predict patients’ well-being even more accurately. Mental health competencies related positively; mental disorder symptoms connected negatively to subjective well-being. In all models and both samples, mental health competencies were found to be a stronger determinant of well-being than the mental disorder symptoms. The interaction of mental health functioning and mental disorders is no more predictive of well-being in either psychiatric or non-clinical samples than when the effects of each are considered separately.ConclusionsThe assessment of mental health competencies has an important predictive value for well-being in the presence of psychopathological symptoms and/or mental disorders.Disclosure of InterestNone Declared
Use of Intranasal Oxytocin to Treat Adult Autism Spectrum Disorder: A Randomized Double Blind Controlled Trial
Authors: Faraji Niri S. , Alaghband-rad J. , Motamed M. , Hojjati S. A. , Seyed Alipour S. , Mohebbi N. 
Published: August 2024

IntroductionAutism Spectrum Disorder (ASD) is characterized by impairments in social interaction and restricted interests. It has been reported that oxytocin may improve processing of social cues and emotions in adults with ASD.ObjectivesThe aim of this study was to evaluate the therapeutic effects and safety of intranasal oxytocin in this population.MethodsThirty-nine patients with ASD were randomly assigned to two groups: one group received intranasal oxytocin and the other group received a placebo, with 24 units administered every 12 hours for 8 weeks. The patients were evaluated using the Autism Quotient (AQ), Ritvo Autism Asperger Diagnostic Scale – Revised (RAADS-R), Social Responsiveness Scale (SRS), Clinical Global Impression (CGI), and World Health Organization Quality of Life-BREF (WHOQL-BREF) questionnaires at weeks 0, 4, and 8.ResultsThe intervention group showed clinical improvements in RAADS-R (P=0.010), social communication subscale of SRS (P=0.002), CGI (P=0.000), physical (P=0.004), psychological (P=0.006), and social relationships (P=0.046) domains of WHOQL-BREF. Improvements reached their maximum at week 4 and were maintained until week 8 (Table 1).Table 1.Effect of group, time time-group interaction and the effect sizeTimeGroupTime-Group Interaction
F
P-Value

Effect Size (Partial Eta Squared)
F
P-Value

Effect Size(Partial Eta Squared)
F
P-Value

Effect Size(Partial Eta Squared)AQ19.440.0000.3440.3910.5360.012.630.0790.066RAADS-R
12.680.0000.2550.9440.3380.0257.2500.0010.164SRS23.630.0000.3900.0500.8230.0017.820.0010.175WHOQL-BREF -Physical Health6.340.0030.1460.1150.7370.0035.70.0050.134WHOQL-BREF -Psychological Health8.310.0010.1830.0480.8280.0016.140.0030.142WHOQL-BREF -Social Relationships7.720.0010.1731.0520.3120.0283.640.0310.090WHOQL-BREF -Environmental Health4.870.0100.1160.1620.6900.0042.690.0740.068CGI22.080.0000.3742.280.1390.0589.420.0040.203AQ : Autism Spectrum Quotient, SRS : Social Responsiveness Scale, SCI : Social Communication Interaction, RRB : Restricted interest and repetitive behavior, WHOQL-BREF : World Health Organization Quality of life-BREF, CGI : Clinical Global ImpressionConclusionsThe findings of this study suggest that nasal oxytocin therapy can significantly improve social skills and quality of life in individuals with ASD. Further research is needed to determine the timing and scope of oxytocin’s effects across the lifespan.Disclosure of InterestNone Declared
Treatment resistant FEP (first episode of psycosis) with neuroanatomical findings
Authors: Papageorgiou K. , Retsou I. , Papadopoulou E. , Antoniadis D. 
Published: August 2024

IntroductionPresentantion of the first psychotic episode of a young man and the investigation of the efficacy of treatment with olanzapine and after cariprazine.ObjectivesAssessing the response to treatment of cariprazine in a psychotic patient with relevant neuroanatomical findings.MethodsA 25-year old man was admitted to the psychiatric intensive care due to his agggressive behavior and verbal abuse, threatening to kill them both. His medical history included long periods of negatively affected mood, social isolation and talking to himself according to his familyResultsWhent the patient was admitted he was very anxious, alert and extremely aggressive. During the interview he admitted auditory and visual hallucinations alongside delusional ideation with a particular aggression towards his father.Upon admission his PANSS score was 121. positive scale score was 23.The patient was treated initially with monotherapy olanzapine, gradually increased up to 20mg OD. Olanzapine caused asymptomatic transaminasemia, a relatively common adverse effect. At this point a change in medication was made and olanzapine was stopped and cariprazine was added gradually increasing its dose from 1,5mg to 6mg OD.Interestingly the medical investigations (brain CT scan) indicated a calcification in falx cerebri.After a period of 48 days since admission the patient was clinically improved and was discharged. His PANSS score was 72. Positive scale was 10.ConclusionsThe use of cariprazine as a treatment for a first psychotic episode of a young male improved his PANSS score after a 22-day treatment. According to the literature neuroanatomical findings have been associated with poor prognosis regarding the course of the illness. There needs to be further investigation on the efficacy of the long term treatment for this patient.Disclosure of InterestNone Declared
Challenges of Sexuality Expression in Individuals with Autism Spectrum Disorder
Authors: Figueiredo M. M. , Afonso P. , Vila Nova V. 
Published: August 2024

IntroductionSexuality, although an essential component of human health, remains a controversial topic shrouded in stigma, particularly in the context of neurodiversity, which includes autism spectrum disorder (ASD), where the expression of sexuality presents unique challenges. Autism and sexuality is a complex and multifaceted topic that involves understanding the unique ways in which individuals on the autism spectrum experience and express their sexuality.ObjectivesThe purpose of this work is to address the complexity of the biopsychosocial sexuality components of people with autism, promoting a shift in the medical perspective, societal attitudes, and supporting greater inclusion of these individuals in current discussions regarding this area of human behavior and experience.MethodsEvidence-based review, through research conducted on PubMed and selection of the most relevant studies on this topic, published in the last decade.ResultsSexuality in autism is now recognized as a normative and integral aspect of development and functioning. Existing research suggests that most individuals with ASD display a clear interest in sexuality and relationships, with a study reviling that 96% of the ASD sample expressed an interest in sexuality. Individuals with high autistic traits tended to identify themselves more times as bisexual or presented a sexuality not definable within the categories of heterosexual. The relationship between autism and gender dysphoria is an area of ongoing research and discussion. Studies have suggested a higher prevalence of gender diverse identities and experiences within the autism community compared to the general population. Various hypotheses have been proposed to explain the increased gender and sexual diversity among individuals with autism. People with ASD may face unique challenges when it comes to their sexuality. The impairments in social skills and communication central to ASD potentially impact an autistic individual’s expression and experience of sexuality by affecting their abilities to understand and interpret social cues, emotions, and nonverbal behaviors of others. Importantly, such individuals may be more vulnerable, as they may have different or even limited understanding of boundaries and consent. To address these challenges, it is important to acknowledge and respect the diversity of sexual experiences and desires among individuals with neuro(bio)logical differences. This can be done by providing accurate and inclusive sex education, creating safe spaces for such individuals to explore and express their sexuality, and working to address discrimination and abuse in intimate contexts.ConclusionsRecognizing and respecting this diversity and fostering inclusive and accepting environments, we can help individuals with neurological differences to fully express and explore their sexuality and have satisfying sexual lives.Disclosure of InterestNone Declared