bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparing IM Lorazepam and IM Clothiapine for Agitated Psychosis in Hospitalized Patients
Authors: Kverashvili •. , Malik E. , Shelef •. , Stryjer •. 
Published: August 2024

IntroductionWhen patients in a closed hospital ward experience acute psychosis and become highly agitated or pose a risk to themselves and others, it’s often crucial to provide immediate sedative treatment. However, there is currently no consensus on whether the preferred medication for these situations should be antipsychotic drugs or benzodiazepines.ObjectivesThis study aimed to compare how well a single intramuscular dose of 2-4 mg Lorazepam performs against 40 mg Clothiapine in terms of effectiveness and side effects. These treatments were administered as immediate emergency measures to patients experiencing psychosis with severe agitation or behaviors that posed a risk to themselves or their surroundings.MethodsWe conducted a retrospective clinical study involving 100 patients experiencing aggressive psychosis. These patients were divided into two groups. The first group comprised 50 patients who received a single intramuscular (IM) dose of up to 40 mg Clothiapine. The second group consisted of 50 patients who received IM treatment with 2-4 mg Lorazepam. We assessed the patients’ outcomes around 8 hours after treatment or upon receiving any additional treatment.ResultsThere were no significant statistical differences in the demographic and clinical characteristics (e.g., age, gender, number of hospitalizations, duration of illnesses, psychiatric diagnosis, comorbidity) of the patients between the two groups (p > 0.05).Before treatment, there were no statistical differences in the severity of clinical symptoms (CGI-S) between the two groups [CGI-S (Mean ± SD): 5.32 ± 1.09 vs. 5.38 ± 1.4, p = 0.8].However, in the Clothiapine group, a statistically significant clinical improvement (CGI-I) was observed after treatment [CGI-I (Mean ± SD): 2.42 ± 0.9 vs. 1.96 ± 1.16, p = 0.029 *].There were no significant differences in the need for physical restraint or additional medication following the initial treatment between the two groups (p > 0.05).Furthermore, there were no statistically significant differences in the major side effects of the drugs, the necessity for referral to the general emergency room, or incidents of falls (p > 0.05).ConclusionsWhen dealing with a psychotic state marked by severe agitation or threats to oneself and others, the use of IM Clothiapine as a treatment option may offer certain advantages over IM Lorazepam. Importantly, these advantages come without significant exposure to side effects or potential risks associated with Clothiapine.Disclosure of InterestNone Declared
Adverse childhood experiences and 8-year trajectories of depressive symptoms in community-dwelling older adults: Results from the English Longitudinal Study of Ageing
Authors: Chau A. K. C. , Chan J. K. N. , Fung H. W. , Lai E. T. C. , Ho I. Y. Y. 
Published: August 2024

IntroductionThe negative impact of adverse childhood experiences (ACEs) on mental health has been well documented. While most of the evidence comes from samples of adolescents and young adults, few studies have investigated whether ACEs contribute to poorer mental health among older adults. In particular, depressive symptoms are common in old age, and they display heterogeneous patterns of development across individuals. Therefore, it is important to examine if ACEs are predictive of distinct trajectories of depressive symptoms among older adults.ObjectivesUsing longitudinal data from the English Longitudinal Study of Ageing (ELSA), we aimed to examine if ACEs could differentiate between distinct trajectories of depressive symptoms over eight years in community-dwelling older adults.MethodsParticipants from ELSA aged 60 or above who reported no psychiatric diagnoses and completed the items of ACEs at baseline (wave 3) were included in the current study. Nine items of ACEs were subject to a principal component analysis to identify the underlying subtypes. Data of depressive symptoms from waves 3 to 7 (2-year apart), assessed with the 8-item Centre for Epidemiological Studies Depression Scale, were extracted for modelling the distinct trajectories using latent class growth analysis. The trajectories were predicted by subtypes of ACEs using multinomial logistic regression, adjusting for childhood socioeconomic status, sex, age and ethnicity.ResultsThe final sample consisted of 4057 participants (54.4% female, mean age= 71.34 (SD= 8.14)). We identified five trajectories of depressive symptoms (Figure 1): ‘low stable’ (73.4%), ‘increasing then decreasing’ (9.9%), ‘high decreasing’ (7.1%), ‘high stable’ (5.7%) and ‘moderate increasing’ (4.0%). Four subtypes of ACEs (i.e., sexual abuse, separation from natural parents, family dysfunction and physical assault) were evident. Compared to the ‘low stable’ group, higher levels of family dysfunction were reported in the ‘increasing then decreasing’ (aOR = 1.35, 95% CI [1.10 - 1.66], p = .012), ‘high stable’ (aOR = 1.59, 95% CI [1.30 - 1.96], p < .001) and ‘moderate increasing’ (aOR = 1.55, 95% CI [1.18 - 2.04], p = .011) groups. The ‘high stable’ group also reported a higher level of separation from natural parents than the ‘low stable’ group (aOR = 1.34, 95% CI [1.04 - 1.72], p = .047). Sexual abuse and physical assault did not predict any group differences.Image:ConclusionsDistinct trajectories of depressive symptoms among older adults were predicted by family dysfunction in childhood. Our findings suggested that the negative impact of ACEs on mental health may extend beyond adolescence and young adulthood into the old age.Disclosure of InterestNone Declared
Assessing Changes in Quality of Life Measures, Resilience, and Personal Recovery, Pre- and Post-Discharge from Inpatient Mental Health Units in Alberta: Analysis of Control Group Data from a Randomized Trial.
Authors: Owusu E. , Shalaby R. , Mao W. , Elgendy H. , Shalaby N. , Agyapong B. , Nichols A. , Eboreime E. , Lawal M. A. , Nkire N. , Agyapong V. I. 
Published: August 2024

IntroductionThe transition from hospital to community settings for most mental health service users is often hindered by challenges that affect community adjustment and continuity of care. The first few weeks and days after discharge from mental health inpatient units represent a critical phase for many service users.ObjectivesThis paper aims to evaluate the changes in quality of Life status, resilience, and personal recovery of individuals with mental health challenges recently discharged from acute mental health care into the community.MethodsData for this study were collected as part of a pragmatic stepped-wedge cluster-randomized, longitudinal approach in Alberta. A paired sample t-test and Chi-squared/Fisher test were deployed to assess changes from baseline to six weeks in the recovery assessment scale (RAS), brief resilience scale (BRS), and EuroQol-5d (EQ-5D), using an online questionnaire.ResultsA total of 306 service users were recruited, and 88 completed both baseline and six weeks, giving a response rate of 28.8%. There was no statistically significant change in the level of resilience, recovery and quality of life as measured with the brief resilience scale, recovery assessment scale and EQ-5D from baseline to six weeks (p > 0.05).ConclusionsThe study showed that there was neither an improvement nor deterioration in resilience, recovery, or quality of life status of service users six weeks post-discharge from inpatient mental health care. The lack of further progress calls into question whether the support available in the community when patients leave inpatient care is adequate to promote full recovery.Disclosure of InterestNone Declared
Manifestations of antisocial behavior in older adults: A review of current literature
Authors: Arts M. , Videler A. , van Dam A. 
Published: August 2024

IntroductionAntisocial behavior in older adults is a problem for their relatives and health care providers Antisocial behavior may present differently in the older population which makes it more difficult to diagnose adequately and apply therapeutic interventions. This literature review provides an overview of diverse conceptualizations of antisocial behavior in older adults and the way it affects recognizability of diagnostic categories and the applicability of interventions.ObjectivesTo gain insight into the various manifestations of antisocial behavior in older adults.MethodsA systematic review design was performed. In this review, an extensive manual and electronic literature search was conducted for papers published from 1980 to 2023. For this purpose we used the electronic databases PubMed and Embase. The review will include empirical and quantitative studies of older adults with antisocial behavior.ResultsThe results from the literature indicate that antisocial behavior does probably not decrease with age nor the burden on their social environment. Rather, the manifestations of antisocial behavior change as this population ages. Personality disorders are determined by several dimensional trait domains. The domains which are highly predictive for antisocial behavior include antagonism and disinhibition.ConclusionsThese findings challenge the notion of antisocial behavior decreasing with age. This review underscores the need to shift from traditional personality disorder categories to a dimensional trait perspective. Therefore, specific interventions are needed for older adults.Disclosure of InterestNone Declared
Antipsychotic use and associating factors among persons with substance-induced psychosis and first-episode psychotic disorders. A nationwide register-linkage study
Authors: Jeyapalan J. , Niemela S. , Taipale H. 
Published: August 2024

Introduction
Far less is known about the preceding factors of antipsychotic use among persons with substance-induced psychosis (SIP) and first-episode psychosis (FEP). There is no prevention research on how persons with SIP differ from persons with other psychosis episodes like FEP. Antipsychotic medication is the general essential and necessary element in the treatment of SIP and FEP1. Antipsychotics are used as first-line therapy, commencing with a low dose and titrating upwards2. There are no exciting treatment guidelines for treating Substance-induced psychosis in the long term. (A review of some studies published by the Oxford Journals Schizophrenic Bulletin indicated that drug-induced psychosis lasted longer than a month in individuals between 1 and 15% of the time.3)The aim of the study was to investigate antipsychotic use and associated factors in persons with SIP and compare it with persons with other FEPObjectives1 To study the antipsychotic use among persons with SIP compared with FEP from 3 years before until three years after their first diagnosis first incident of psychosis)2.To study associating background factors with antipsychotic use among patients with SIPMethodsIncident Swedish SIP cases (n=7320)during 2006-2016 were identified from health care registers and matched 1: with persons with FEP (n=7320) by age, gender, and calendar year of diagnosis. Prevalence of antipsychotic use was assessed as point prevalence every six months, from 3years before until 3years after the first diagnosis. Factors associating with antipsychotic use among SIP were analyzed with multivariable logistic regression, including information on sociodemographic and work-related background, including disability pension and sickness absence, SIP types, and psychiatric diagnoses.ResultsAmong SIP and FEP, the prevalence of antipsychotic use was low before the first diagnosis (3-7% in SIP, 8-16% in FEP), peaked 6 months after the first diagnosis (23% in SIP, 54% in FEP) and stabilized after that. After 3 years of first diagnosis, 19% of persons with SIP and 45% of persons with FEP used antipsychotics. Antipsychotic use one year after diagnosis among SIP was associated with previous substance use disorder, depression, anxiety, and personality disorder diagnoses, being on disability pension or on long-term sickness absence (>90 days), and cannabis- or multi-substance-induced psychosis.Image:Image 2:ConclusionsAs expected, patients with FEP were using more frequently antipsychotics compared to SIP except for long-acting antipsychotics.Although SIP is considered short-lived, antipsychotic use after an incident SIP episode is relatively common, especially among those with cannabis SIP with the highest prevalence of antipsychotic use.Previous substance use disorder and cannabis SIP were highly associated with patients who use antipsychotics frequently.Disclosure of InterestNone Declared
Anti-amyloid therapies: are they effective and safe?
Authors: Perneczky R. 
Published: August 2024

Abstract
After numerous unsuccessful attempts to create a therapy that could alter the course of Alzheimer’s disease, first monoclonal antibodies targeting amyloid-β in the brain have finally shown consistent evidence of clinical effectiveness. These therapies not only slow the progression of the disease, but also show positive results in secondary clinical outcomes and reduced amyloid-β levels on PET scans. This presentation will examine the main features of the previous failed trials and explore possible reasons for their lack of success in developing a treatment for early-stage Alzheimer’s disease. It will also compare the safety profiles of various antibodies and point out precautions that should be taken when using them in regular clinical practice. Furthermore, it will be discussed how blood-based biomarkers can revolutionize the clinical care pathway, making it easier to adopt antibody treatments. A comprehensive model that integrates case-finding and treatment across various healthcare sectors will be proposed. In conclusion, we may have made a significant breakthrough by demonstrating that reducing amyloid-β levels leads to clinical benefits, not just changes in biomarkers. As the new generation of drugs becomes more commonly used, we will see whether their statistical effectiveness translates into meaningful clinical changes. This could mark the start of a new phase in the development of drugs for Alzheimer’s disease.Disclosure of InterestNone Declared
Certain immune parameters may have a significant impact on suicidal behaviour - a naturalistic study among psychiatric in-patients
Authors: Voros V. , Saghy E. , Molnar C. , Kovacs M. , Peto B. , Kovacs S. , Zemplenyi A. , Fekete S. , Tenyi T. , Osvath P. 
Published: August 2024

IntroductionSeveral research already proved the role of certain immunological factors (neutrophil-lymphocyte (NLR), monocyte-lymphocyte (MLR) and platelet-lymphocyte (PLR) ratio, and C-reactive protein (CRP)) in the background of suicidal behaviour.ObjectivesThe aim of this research was to study the association between routinely measurable low-grade inflammation parameters and suicidal behaviour among patients in the acute psychiatric care setting.MethodsThe study population included psychiatric in-patients (N=100) consecutively treated with depressive disorders and/or suicidal behaviour in a University Clinic between December 1, 2020 and December 31, 2021. Three different patient-groups were generated based on their suicidal behaviour: suicide attempters (N=55) including recent attempters(N=36) and past attempters (N=19) and non-suicidal patients (N=45), who never had a suicide attempt. Basic socio-demographic data, the severity of depression and immunological parameters (white blood cell count: lymphocytes, monocytes, neutrophil, eosinophil, basophil granulocytes; thrombocytes; C-reactive protein) were recorded.Descriptive analyses and multivariate regression model were performed with RStudio version 4.2.3.ResultsCRP was significantly higher (2.00 vs. 1.00; p=0.007) in suicidal patients (N=55), however other immunological parameters did not differ significantly between the suicidal and the non-suicidal groups (NLR: 2.02 vs. 2.19; MLR: 0.22 vs. 0.11; PLR: 118 vs. 130). NLR and MLR showed significantly higher values (NLR: 2.83 vs. 1.93, p=0.021; MLR: 0.28 vs. 0.11, p=0.01) for those who currently attempted suicide (N=36) compared to the patients with no or past suicide attempt (N=64). In the regression analysis, the NLR and MLR showed significantly higher values in current suicide attempters even when gender, age, suicidal risk and severity of depression were included in the model. However, no significant differences were found when comparing current and past suicide attempters with the non-suicidal patients.ConclusionsDespite the small number of cases in the samples, our results confirmed the association of certain immunological parameters (NLR, MLR) and acute suicidal behaviour. This relationship was found to be independent of depression and its severity. Our data suggest that, unlike the NLR and MLR parameters, the higher CRP value may not be related to acute suicide attempt, but rather to suicidal vulnerability, as a trait-marker. Markers of chronic systemic inflammation may help in the prediction of suicidal behaviour and in the development of new therapeutic options, however, further prospective studies are needed to identify the specific role of immunological factors in suicidal behaviour more precisely.Disclosure of InterestNone Declared
Comparison of lithium levels between suicide and non-suicide fatalities: cross-sectional study
Authors: Ando S. , Suzuki H. , Matsukawa T. , Usami S. , Muramatsu H. , Yokoyama K. , Okazaki Y. , Nishida A. 
Published: August 2024

IntroductionEcological studies have suggested the protective effect of micro-dose lithium in drinking water against suicide, however, the association between body lithium level and suicide is unknown.ObjectivesWe aimed to compare body lithium levels between suicide and non-suicide fatalities.MethodsThis cross-sectional study included 12 suicides and 16 non-suicides who were examined or dissected at the Tokyo Medical Examiner’s Office from March 2018 to June 2021. The aqueous humor lithium concentration was measured twice using inductively coupled plasma mass spectrometry. Analysis of covariance (ANCOVA) was used to compare the lithium concentration between suicides and non-suicides. Mixed-effects model was conducted to account for all lithium concentration data.ResultsThe aqueous humor lithium concentration did not change after death (t(7)=-0.70, SE=0.03, 95% CI=[-0.09, 0.05], P=0.51, Cohen’s d=0.01). The aqueous humor lithium concentration was lower in suicides (mean 0.50 μg/L (variance s2 0.04)) than in non-suicides (mean 0.92 μg/L (s2 0.07)) (t(26)=4.47, SE=0.09, 95% CI=[0.22 to 0.61], P<0.001, Cohen’s d=1.71). The ANCOVA showed that death by suicide was significantly associated with lower lithium concentration (F(1, 24)=8.57, P=0.007), and the effect size was large (ηp2=0.26). The random intercept model showed a significant effect of suicide on aqueous humor lithium concentration (b=-0.261, SE=0.102, 95% CI=[-0.471 to -0.051], t(24)=-2.568, P=0.017).ConclusionsThe results of this study demonstrate that even micro-dose lithium is associated with suicide death. Clinical studies are warranted to examine the effects of micro-dose lithium on suicide prevention.Disclosure of InterestNone Declared
Reasons for Individuals not Enrolling for Yoga trial in Addiction
Authors: Sarkar S. , Dhawan A. , Quraishi R. , Negi P. S. , Kumar A. 
Published: August 2024

IntroductionYoga has been demonstrated to have a range of beneficial effects on individuals with substance use disorders, including opioid use disorders. We initiated a randomized clinical trial to find out the efficacy of add-on yoga among patients with opioid dependence stabilized on treatment to find out whether it led to improvement in sleep and quality of life. However, the rate of enrolment into the study was quite low.ObjectivesIn this interim analysis, we present the preliminary data on the reasons for non-enrolment in the yoga trial.MethodsThe single-centre trial involved 1:1 randomization of patients with opioid dependence stabilized on medications (naltrexone or buprenorphine) for a period of at least 4 weeks into two groups (add-on yoga or wait-list control). The yoga included asanas and panchakosha meditation, taught for a period of 7 days and to be practiced by the participants for a period of 12 weeks. We recorded the reasons for non-participation among those who did not participate and asked them questions about their views on yoga.ResultsOf the 310 patients recruited between August 2022 and July 2023 (99.7% male, mean age 34 years, 56.5% married), 255 (82.3%) could not be enrolled in the trial. The most common reasons for non-enrolment were not having time for training (n = 206, 80.8%), not having time for doing yoga (n = 180, 70.6%), not having a smartphone for continued training or contact (n = 31, 12.2%), distance from the center (n = 17, 5.5%) do not feel the need for yoga (n = 16, 5.2%), injury or disability (n = 9, 3.5%), old age or medical condition (n = 7, 2.7%), already doing gym exercises (n = 7, 2.7%), nature of job (n = 5, 2.0%), do not have knowledge of yoga (n = 5, 2.0%), and do not think yoga would be useful (n = 4, 1.6%). Among those who could not be enrolled, 35.1% reported doing yoga sometime in the past, and 21.6% reported that at least one of the family members did yoga. When asked whether they would be interested if yoga was available online, 16 (5.2%) responded ‘yes’ and 45 (14.5%) responded ‘maybe’.ConclusionsExpressed time constraints may be an important factor deterring patients with opioid dependence from engaging in yoga as an add-on yoga. There are other reasons as well that may deter patients from such an intervention. The findings should be seen in the light of the limitation of a single medically oriented center, and patients already stabilized on treatment.Disclosure of InterestNone Declared
Does duration of untreated illness impact long-term outcome in obsessive-compulsive disorder?
Authors: Cipolla S. , Catapano P. , Pascolo S. , Luciano M. , Sampogna G. , Perris F. , Giallonardo V. , Del Vecchio V. , Fabrazzo M. , Fiorillo A. , Catapano F. 
Published: August 2024

IntroductionThe time period between the onset of a mental disorder and its first adequate treatment (duration of untreated illness - DUI) influence long-term prognosis and outcome in patients with severe mental disorders. The relationship between DUI and outcome was originally found in people affected by schizophrenia spectrum disorders, however in patients with Obsessive-Compulsive Disorder (OCD) DUI is significantly longer compared with that of patients with other severe mental disorders, such as schizophrenia and bipolar disorder.Objectives
Aims of the present study is to assess the impact of DUI on long-term outcomes in OCD patients across published studies.Methods
A systematic review was carried out by selecting relevant articles on the topic present in three common on-line databases, such as PubMed, APA PsycInfo, and Scopus, up to June 2023.ResultsAmong included studies, DUI ranged from 7,0±8,5 to 20,9±11,2 years. Patients reporting a longer DUI have a poor long-term outcome, in terms of greater symptom severity and lower level of treatment response, whether pharmacological treatment or psychotherapy or a combination of these two. This is particularly true when the onset of the disease is insidious and subthreshold. However, there are severe early-onset forms of OCD in which the request for help is anticipated due to the severity of the symptoms, the DUI is shorter, but the prognosis is still negative.ConclusionsThe present review confirms that longer DUI has a negative impact on the long-term outcome of patients with OCD. Furthermore, it is reasonable to hypothesize that cultural factors, such as the perception of the disease and the ability to access treatment, may result in a prolongation of the DUI. All these elements cannot be evaluated in our review due to the paucity of studies on the topic. Future studies could be useful to better understand the causes of a longer DUI, to guide and to promote the dissemination of early interventions with a specific focus on OCD symptoms.Disclosure of InterestNone Declared