bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clozapine to treat aggression and agitation in advanced dementia
Authors: Michael A. E. , Michael N. , Erfurth A. , Kujovic M. 
Published: August 2024

IntroductionAgitation and aggression are a serious problem in clinical psychiatry, especially in multimorbid patients of advanced age, including those with dementia.ObjectivesWe wanted to investigate to what extent clozapine could be an option in the treatment of selected refractory patients.MethodsA retrospective study included patients with a diagnosis of dementia who were treated with clozapine in a specialist geriatric psychiatry unit between August 2018 and February 2022, and medical records were systematically reviewed. The Clinical Global Impressions Scale was used for the assessment of improvement and the Pittsburgh Agitation Scale for the assessment of symptom reduction. In addition, there was detailed documentation of side effects and clinical features.Results
A total of 31 patients with a median age of 82 years were identified.Conclusions
In conclusion, clozapine was effective and well tolerated in 23 patients. This suggests that low-dose clozapine may help alleviate the suffering of difficult-to-treat multimorbid patients with advanced dementia and their carers. However, adverse effects, particularly in patients with cardiovascular and pulmonary impairment, should be carefully monitored.Disclosure of InterestNone Declared
Impulsivity profile analysis and it’s potential role in the differential diagnostics of adult Attention Deficit Hyperactivity Disorder and Borderline Personality Disorder
Authors: Kenézlői E. , Somogyi S. , Balogh L. , Lévay E. , Bajzát B. , Halmai Z. , Unoka Z. S. , Réthelyi J. 
Published: August 2024

IntroductionImpulsivity is a complex construct, having at least three factors: 1) impulsivity as a personality trait, 2) ismpulsive action – waiting and stopping impulsivity and 3) choice impulsivity. Impulsive symptoms are present in Attention Deficit Hyperactivity Disorder (ADHD) and Borderline Personality Disorder (BPD) as well, eventhough impulsvity profile significantly differs.ObjectivesOur aim is to describe the impulsivity profile in adult ADHD (aADHD) and BPD in comparison with the control group, and describe a characteristic pattern, which associates with these disorders.Methods
aADHD (n=100) and BPD Patients (n=63) were included, based on DSM-5 diagnostic criteria. Healthy control subjects (n=100) were screened using the Derogatis Symptom Checklist (SCL-90). Comorbid psychiatric disorders were assessed by structured clinical interviews and those who have both aADHD and BPD were excluded from the study. Participants were further investigated with online questionnaires: e.g. Barratt Impulsiveness Scale (BIS-11) Difficulties in Emotion Regulation Scale (DERS) and neuropsychological tests, like CANTAB Rapid Visual Processing, Stop Signal Task, and the Rogers’ decision-making
test.Results
Based ont the BIS-11 results, significantly higher attentional impulsivity was present in adult ADHD compared to BPD (p<.001) and healthy controls (p<.001). Emotional regulation difficulties, measured by DERS were significantly higher in BPD (p<.001) than aADHD, but the impulse control problems were more pronounced in the aADHD group, compared to BPD (p<.001). Using CANTAB neuropsychological test battery, strategy formulation difficulties (p=0.16) and stopping impulsivity (p<.001) were only present in aADHD compared to HC. BPD patients did not differ significantly from the control group in strategy formulation and in Stop Signal Reaction Time, a measure of stopping impulsivity. The significantly higher level of total false alarms, reflecting on waiting impulsivity were present both in aADHD and BPD.ConclusionsAccording to our results these two disorders have different impulsivity profile characteristics, which can be useful in differentiating these two disorders, and in buiding treatment plans. Stopping impulsivity, measured by SST was found in aADHD, but not in BPD. In BPD impulsive behavior is more likely attached to emotional dysregulation, a trait rooted in childhood traumatization.This study was supported by the National Research, Development and Innovation Office grant K 129195 and K 135437.Disclosure of InterestNone Declared
Development of a Patient-Centred Care Plan for Patients Requiring Maintenance Electroconvulsive Therapy Long-Term
Authors: Seet X. Y. , Lee X. E. , Rahman H. 
Published: August 2024

IntroductionMaintenance electroconvulsive therapy (ECT) can be effective and necessary in the long-term for patients with severe and recurrent mood or psychotic disorders that are not amenable to any other forms of treatment. Patients with such treatment resistance affecting their ability to maintain minimal daily activities may eventually fall within the palliative psychiatric care domain in which advanced medical directives become an important beacon to direct care. There are Psychiatric Advance Directives which allow people with severe mental health conditions to consent to or refuse to consent to hospital admission and psychiatric treatment in the event they lose decision-making capacity and this can be especially important for a potentially controversial treatment such as ECT. However, the focus tends to be on enforcing involuntary treatment and less about a comprehensive long-term care plan. To our knowledge, there is no available framework to structure maintenance ECT as a patient-centred care plan.ObjectivesOur aim is to share the process of development of a patient-centred care plan for patients requiring maintenance ECT. Our objectives are:
1.Constant engagement with patients and family or caregivers2.Regular reviews of clinical and consent aspects of treatment3.Advocating for the welfare of patients and respect of values4.Focus on dignity especially for patients who require treatment well into old age5.Being prepared for termination of treatment if necessary
MethodsWe reviewed our management of previous and existing patients on maintenance ECT and incorporated diligent consent-taking practices. Adopting good practices from known palliative approaches and involving the patient voice helped to form a framework for a patient-centred care plan.ResultsOur patient-centred care plan features half-yearly discussions about the risks and benefits of treatment, as well as an assessment of the patient’s cognition and ability to consent which may change over time. Opportunities for them to share their values and expectations of care and engagement with their caregivers about their quality of life guide the continued treatment. A framework for discussing the disruption or eventual termination of ECT prepares for scenarios where older-aged patients may develop frailty or present with acute, prolonged or devastating medical concerns. This end-of-life care approach manages anticipated psychiatric-specific behavioural concerns and prepares for the possibility of death following the planned termination of ECT for patients who required long-term treatment throughout their life. Lastly, issues of grief amongst caregivers and ethical concerns from medical staff are addressed.Conclusions
We hope that our patient-centred care plan provides a well-considered conversation and structure for the initiation, continuation and termination of maintenance ECT in the long-term.Disclosure of InterestNone Declared
Assessment of addictive behaviors in patients with schizophrenia
Authors: Kacem M. , Bouali W. , Babba H. , Zouali F. , Zarrouk L. 
Published: August 2024

IntroductionSchizophrenia, a chronic and complex psychiatric pathology, can be isolated. However, it can be associated with other comorbidities and thus be accompanied by addictive behaviors that complicate their management.ObjectivesThe objectives of our study were to estimate the prevalence and identify the characteristics of addictive behaviors in patients with schizophrenia.Methods
A retrospective study of 151 patients with schizophrenia hospitalized in the psychiatry department of Taher Sfar University Hospital in Mahdia from January 2017 to December 2021.ResultsThe mean age of the patients was 39.8 ± 11.23 years, with a predominance of the 36-45 age group (38.4%). All patients were male. Three quarters of the patients (75.5%) were users of psychoactive substances (PAS): nearly three quarters (72.8%) were addicted to tobacco, more than one third (39.7%) were addicted to alcohol, more than one quarter (29.1%) were addicted to cannabis and nearly one quarter (26.5%) were addicted to other PAS. In more than half of the cases (54.4%), the age of onset of substance use was between 16 and 25 years. The use of PAS preceded the onset of schizophrenia in 62.3% of cases. The relationship with the entourage was marked by hetero-aggressiveness in 77.5% of patients, withdrawal from the entourage in 16.6% of patients and conflict in 5.3% of patients. The impact on the relationship with oneself was marked by self-aggressiveness in 18.5% of patients. Concerning the professional impact, three quarters of the patients (76.1%) had to stop working. The majority of patients (84.1%) continued their usual treatment, while 15.2% of patients stopped it. Only one patient required an increase in dose.Conclusions
Subjects suffering from schizophrenia are particularly vulnerable to addictions, mainly to tobacco and alcohol. They are thus a group more at risk of the deleterious effects of psychoactive substances and of the aggravation of the clinical and psychosocial evolution of their psychiatric disorders. Measures for early detection and treatment of their addictive behaviors even before the onset of schizophrenia should be proposed.Disclosure of InterestNone Declared
Repetitive transcranial magnetic stimulation (rTMS) is associated with increased abstinence in substance use disorders and comorbid depression
Authors: El Hayek S. , Tolba H. , Elmougy A. , Foad W. 
Published: August 2024

IntroductionSubstance use disorders (SUDs) are associated with high rates of comorbid depression. Finding effective treatments for many of the substances of abuse is still an area of developing research. Repetitive transcranial magnetic stimulation (rTMS) is an established treatment for depression, but its effects in SUDs are less conclusive.Objectives
Therefore, we aimed to investigate the effect of rTMS in patients with SUDs and comorbid major depressive disorder (MDD).MethodsWe conducted a retrospective observational study of 55 patients with SUDs and comorbid MDD who were eligible for rTMS. Craving was measured using the Brief Substance Craving Scale (BSCS). Severity of MDD was measured using the Clinical Global Impression-Severity (CGI-S) scale.ResultsWe found a statistically significant difference between baseline and posttreatment scores in patients receiving rTMS on both CGI-S scores and BSCS scores. The number of rTMS sessions significantly predicted increased days of abstinence in the community, even after controlling for confounders.ConclusionsPatients with SUDs and MDD who received rTMS significantly improved in the areas of severity of depression and craving. The number of rTMS sessions significantly predicted increased abstinence.Disclosure of InterestNone Declared
Prevalence and correlates of psychoactive substance use in domestic and foreign university students
Authors: Nikolaev E. L. , Fakhraei S. S. 
Published: August 2024

IntroductionUse of psychoactive substances is a risk factor for mental health. Studying the peculiarities of using psychoactive substances by university students is extremely important for organizing preventive health careObjectivesTo specify the frequency of smoking and alcohol drinking, as well as the peculiarities of the correlational interconnections, in domestic and foreign university studentsMethodsThe survey covered 546 undergraduate domestic and foreign university students of both genders and different religious backgrounds. As a tool, we used the Sociocultural Health Questionnaire (E. Nikolaev)ResultsIt has been revealed that domestic students smoke cigarettes and hookahs surely more often (p=.01) than foreign students
(30.49% vs 19.08%). It is obvious that they also more often (p=.01) use electronic cigarettes or vaping drugs (25.24% vs 12.86%) and alcohol (54.42% vs 9.96%). Students in both groups denied using other psychoactive substances. Foreign students reveal positive correlational interconnections between smoking and alcohol drinking (r=.44), while there is no evidence of such interconnections in domestic students. Both groups show valid interconnections between the frequency of smoking and the level of stress (r=.15 и r=.17 correspondingly), the frequency of smoking and monthly financial expenses (r=.21 и r=.22 correspondingly). With domestic students, vaping negatively correlates with exercising in gyms (r=-.12), with foreign students it directly correlates with bodybuilding supplements consumption (r=.15). Those foreign students who drink alcohol more often point to the necessity of having a psychologist in the university (r=.13).ConclusionsThe revealed general and specific factors associated with domestic and foreign students’ use of psychoactive substances call for the necessity of developing culturally differentiated preventive programsDisclosure of InterestNone Declared
Comparison of Staging Methods for Treatment-Resistant Depression: Chart Review
Authors: Avanoğlu K. B. , Oktar Erdoğan N. , Ağaoğlu E. , Başar K. 
Published: August 2024

IntroductionTreatment-resistant depression (TRD) lacks a universally consistent definition due to varied interpretations despite attempts to define it based on inadequate response or remission despite sufficient antidepressant treatment. There’s a crucial demand for a uniform definition and staging to streamline its effective management amid diverse treatment options and the complex nature of resistance. Five methods have emerged to define and classify treatment resistance reliably.Objectives
The aim of this study is to compare the five staging methods (Thase&Rush SM (T&R), European Staging Method (ESM), Maudsley Staging Method (MSM), Massachusetts General Hospital Staging Method (MHG-s), Conway Staging Method(Conway)) in assessing treatment resistance within a single sample.Methods
Retrospective analysis involved medical records of inpatient psychiatry clinic admissions at Hacettepe University between October 2012 and October 2014. Patients with a primary diagnosis of bipolar affective disorder, schizophrenia, other chronic psychotic disorders, dementia or cognitive disorders, alcohol and substance use disorders, and those with missing data were excluded.ResultsInitial screening yielded a total of 115 patients. 64 patients were included in the study, 13 patients were excluded due to missing data, and 38 patients were excluded due to comorbidity.CharacteristicTotal (N=64)
Last Episode CharacteristicsTotal (N=64)Female - N(%)44 (69)Episode duration – month (mean ± SD)13.75 ± 16.09Age – yr (mean ± SD)48.39 ± 18.81Psychotic symptoms – N(%)20 (31)Married – N(%)41 (64)Anxiety symptoms – N(%)24 (38)Secondary school and over – N(%)38 (59)Suicidal attempt – N(%)19 (30)Employed – N(%)16 (25)TRD definition and staging method (N=55)
T&R
ESM
MSM
MGH-S

ConwayNot resistant by this method26 (47.3)45 (81.8)0 (0)27 (49.1)43 (78.2)Identified by this method29 (52.7)10 (18.2)55 (100)28 (50.9)12 (21.8)Exclusively identified by this method0 (0)0 (0)21 (38.2)0 (0)0 (0)By this and one other method27 (49.1)0 (0)11 (20)5 (9.1)0 (0)By all methods10 (18.2)10 (18.2)10 (18.2)10 (18.2)10 (18.2)Identified as TRDAge of onset
(mean ± SD)40.28 ± 17.4235.6 ± 18.2740.44 ±18.3840.07 ± 17.938.17 ± 17.71ATHF score
(mean ± SD)7.55 ± 5.4612.1 ± 6.514.93 ± 4.987.43 ± 5.6911.08 ± 6.47Last episode duration (month)
(mean ± SD)17.11 ± 17.2522.10 ± 20.9614.22 ± 17.0816.33 ± 17.6620.83 ± 19.25Conclusions
There is no universally agreed-upon definition for treatment resistance. In this sample, different definition and staging methods were employed to examine the similarities and differences in the clinical and treatment related characteristics of groups with TRD identified with each. The reasons and possible implication of concurrence and discordance between the methods will be discussed.Disclosure of InterestNone Declared
Personality Traits in Patients with Depression: Association with Symptoms of Depression and Anxiety
Authors: Galnaitytė S. , Adomaitienė V. 
Published: August 2024

Introduction
The symptoms of depression and anxiety, which are frequently comorbid, may be significantly impacted by the individual’s personality, even considering the complex etiology of depression. Several studies have shown that while certain personality traits may act as protective factors, others may increase vulnerability to depression and anxiety. Understanding these relationships may be important since personality traits have gained attention as potential determinants of symptom severity and treatment outcomes.ObjectivesTo identify and evaluate the association of personality traits with symptoms of depression and anxiety in patients with depression.Methods
The study involved 80 inpatients (≥ 18 years), hospitalised in University psychiatry department with depression diagnosis based on the ICD-10-AM classification. Subjects were asked to fill the Overall Anxiety Severity and Impairment Scale (“OASIS”), the Big Five Personality Dimensions scale and the Patient Health Questionnaire-9 (PHQ-9). Data analysis included descriptive data, Shapiro-Wilk test, Spearman correlation, Kruskal–Wallis test and Chi-Square test, with a significance threshold of p<0.05.Results
Severe (26.3%) and very severe (41.3%) depressive symptoms were the most prevalent. Extraversion was associated with minimal (p=0.002), conscientiousness with mild (p<0.001), neuroticism with very severe depressive symptoms (p=0.003). The majority of depressed patients had severe (33,75 %) or very severe (32,5 %) anxiety symptoms. Anxiety symptoms were associated with more severe depressive symptoms (r=0.704, p<0.001). The association of conscientiousness and moderate anxiety symptoms was found (p=0.004). In the presence of expressed neuroticism, most of the respondents showed very severe anxiety symptoms, in the absence of neuroticism – moderate anxiety symptoms (p<0.001).Conclusions
The results showed that personality traits were associated with severity of depression and anxiety symptoms in psychiatry inpatient with depression. Therefore, recognition of predominant personality traits in patients with depression may be helpful in selecting treatment and predicting treatment outcomes.Disclosure of InterestNone Declared
Exploring the Interplay of Humor and Quality of Life in Adults Confronting Chronic Diseases: A Comprehensive Systematic Review
Authors: Bartzou E. , Tsiloni E. , Mantzoukas S. , Dragioti E. , Gouva M. 
Published: August 2024

IntroductionChronic diseases, often referred to as non-communicable diseases (NCDs), stand as the leading global cause of mortality. Individuals grappling with chronic ailments frequently experience a decline in their overall quality of life (QoL), encompassing psychological, social, and physical dimensions of well-being.ObjectivesRecognizing that humor has demonstrated the potential to engender favorable effects on QoL, this systematic review seeks to explore the correlation between humor and QoL among adults contending with chronic health conditions.Methods
A thorough examination of quantitative data was conducted in strict adherence to the PRISMA 2020 guidelines. PubMed/MEDLINE, PsycINFO, and CINAHL were comprehensively searched from their inception until June 22, 2023. Furthermore, the reference lists of the included datasets and relevant review articles were exhaustively scrutinized (Figure 1). The Newcastle-Ottawa Scale (NOS) was employed to assess the quality of eligible studies.Results
A total of eighteen studies met the inclusion criteria, encompassing a diverse spectrum of chronic disease categories, including cardiovascular diseases and various types of cancer, among others. Collectively, these studies involved a participant cohort comprising 4,325 individuals. Noteworthy findings emerged, indicating a substantial association between distinct facets of humor—such as one’s sense of humor, coping humor, humor styles, and laughter—and psychological QoL. Nevertheless, the relationship between humor and physical QoL exhibited a more intricate pattern, characterized by mixed outcomes (Figure 2).Image:Image 2:ConclusionsDespite the limited and inconsistent evidence across studies, humor appears to exhibit a positive association with QoL.Disclosure of InterestNone Declared
The Effect of the COVID-19 Pandemic on Suicide Attempts and Self-Harm in Teenagers and Young Adults: An Analysis of Regional Emergency Medical Center Data of a Metropolitan City in South Korea
Authors: Bae S. M. , Ku N. 
Published: August 2024

IntroductionThe COVID-19 pandemic has had a wide-ranging impact on economic and social phenomena worldwide, particularly affecting mental health. However, these impacts have varied significantly across countries. Previous studies have shown that the groups more vulnerable to mental health problems also differ across countries and societies(Gunnel et al. Lancet Psy 2020; 7(6) 468-471, Pirkis et al. Lancet Psy 2021; 8(7) 579-588, Nomura et al. Psy Res 2021; 295 113622). Therefore, by examining changes in self-harm and suicide attempts, which constitute mental health emergencies, at the community level, we can explore the COVID-19 pandemic’s impact on the deterioration of mental health in various age groups within the region and identify the groups most vulnerable to mental health problems.ObjectivesThe aim of this study is to examine the relationship between the COVID-19 pandemic and changes in the number of emergency room visits due to suicide attempts or self-harm in teenagers and young adults in Incheon, a metropolitan city in the capital area of South Korea.Methods
We conducted a retrospective data analysis on the medical records of patients who visited the regional emergency center of Incheon Medical Institution from January 2018 to December 2022 due to suicide attempts or self-harm. As our statistical method, we employed interrupted time series analysis to determine whether the COVID-19 pandemic has a statistically significant correlation with the trend changes in the number of emergency room visits related to suicide attempts or self-harm. This study was approved by the Institutional Review Board of Gil Medical Center, Gachon University of Korea(IRB approval number GFIRB2022-335).Results
The data of 4,030 subjects(35.8% male; n=1,443) who visited the regional emergency center during the study period were analyzed. A total of 556 (13.79%) of the study participants were minors under the age of 19, and a total of 1,789 (44.39%) were young adults aged 20-39. The analysis revealed an increasing trend in the number of emergency room visits due to elevated suicidality in teenagers and young adults (20-39 years old) following the COVID-19 pandemic(figure 1 & figure 2).Image:Image 2:ConclusionsWhile suicide attempts and visits to the emergency room due to self-harm increased both before and after COVID-19, it is noteworthy that past suicide attempts are the most significant risk factor for future suicide attempts. Therefore, the data on vulnerable groups presented in this study can be instrumental for effective prevention and follow-up management of suicide attempts within the field of community psychiatry.Disclosure of InterestNone Declared