bluuebunny/crossref_metadata_2025_split huggingface dataset:
Attitudes and Perceptions of Early-Career Psychiatrists Towards Electroconvulsive Therapy (ECT) in Poland: A Call for Enhanced Training and Guidelines
Authors: Gołębiewska M. E. , Wilkowska A. , Cubała W. J. , Pinto da Costa M. 
Published: August 2024

Introduction
In Poland, the therapeutic modality of Electroconvulsive Therapy (ECT) boasts a history spanning over seven decades. Despite its documented therapeutic efficacy and safety profile, its integration into clinical practice remains suboptimal. Recent data elucidates a marked paucity in the utilization rate of ECT in Poland. Therefore, it is imperative to discern the barriers impeding its broader adoption of this potentially life-saving treatment.ObjectivesThe aim of this study is to investigate the attitude of early career psychiatrists towards ECT and its place in clinical practice in Poland.MethodsA web-based, anonymous survey was conducted, targeting early career psychiatrists in Poland. The questionnaire, part of an international study, consisted of 36 multiple-choice and Likert scale questions.ResultsThe majority of respondents emphasised the importance of further educational opportunities related to ECT, seeing it as a safe, effective, and possibly lifesaving procedure. Most of them benefited from ECT training during their residency, however less than a half had the opportunity to administer ECT themselves. They exhibited an interest to introduce ECT into their therapeutic repertoire, depending on the provision of requisite financial and infrastructural support.ConclusionsThere is a palpable eagerness among early career psychiatrists in Poland to enhance their proficiency in ECT. A robust curriculum, encompassing both theoretical discourse and hands-on ECT training, is paramount for all psychiatry trainees. Concurrently, there is a pressing need to formulate national ECT guidelines within Poland, which could potentially ameliorate apprehensions surrounding this procedure.Disclosure of InterestNone Declared
Neuroinflammation in Recent Onset Mental Health Disorders – Developing Multi-level Signatures of Early-stage Depression and Psychosis in Young Adults
Authors: Popovic D. , Weyer C. , Ruef A. , Dwyer D. , Griffiths S. L. , Lalousis P. A. , Koutsouleris N. , Upthegrove R. 
Published: August 2024

IntroductionAn early and comprehensive neurobiological characterization of severe mental disorders could elucidate mechanistic pathways, aid the development of novel therapeutics, and therefore enable timely and targeted intervention in at-risk youth and young adults. Therefore, we present an unsupervised transdiagnostic machine learning approach to investigate shared and distinct patterns of early-stage depressive and psychotic disorders on multiple clinical and neurobiological levels.ObjectivesTo derive multi-level neurobiological and clinical signatures of early-stage affective and psychotic disorders in adolescents and young adults.MethodsFrom the multicenter prospective European PRONIA cohort, we acquired data from 678 individuals (51% female) comprising young, minimally medicated in- and outpatients with clinical high-risk (CHR) states for psychosis, with recent-onset depression (ROD) or psychosis (ROP), and healthy control (HC) individuals. Within repeated nested cross-validation frameworks, we employed Sparse Partial Least Squares Analysis to detect associations between blood markers and grey matter volume (GMV), followed by support vector machine prediction of these signatures using biographical, clinical, neurocognitive, proteomic, and functional data.ResultsOur results demonstrated a psychosis staging signature separating ROP from CHR individuals via GMV patterns in the cortico-thalamo-cerebellar circuitry with a blood marker set of elevated of IL-6, TNF-α and CRP (ρ = 0.272; P = 0.002). A depression signature separated ROD from HC individuals via altered GMV in the limbic system with a blood marker set of elevated IL-1ß, IL-2, IL-4, S100B and BDNF (ρ = 0.186; P = 0.021). Only the psychosis staging signature showed a distinct proteomic enrichment regarding innate immune response, abnormal neutrophil function, cellular senescence, and anti-inflammatory drugs (Balanced Accuracy (BAC) = 87.73%; Area Under the Curve (AUC) = 0.94). Childhood trauma differentially predicted psychosis and depression signatures, while past level of functioning, personality and quality of life was predictive of both signatures (BAC = 67.19-78.00%; AUC = 0.71-0.83).Image:Image 2:Image 3:ConclusionsPsychosis and depression exhibit distinct multi-level signatures evident in early disease stages. Enhanced insight into these signatures could help delineate individual trajectories and potentially new mechanisms for pharmacological treatment.Disclosure of InterestNone Declared
Transcranial Magnetic Stimulation-induced Mania: A Risk Worth Taking?
Authors: Pereira M. , Abreu P. , Cameira M. P. , Soares M. R. 
Published: August 2024

Introduction
In the context of treatment-resistant bipolar depression, the use of neuromodulation techniques, notably transcranial magnetic stimulation (TMS), has been on the rise, particularly in the treatment of mood disorders. TMS involves the generation of a strong pulsed magnetic field through an electromagnet placed near the skull, thereby inducing an electrical field capable of depolarizing nerve cell membranes (Dolberg et al., 2001). The magnetic nature of TMS carries advantages compared to direct electric stimulation, such as fewer side effects, reduced invasiveness, and precise targeting. Nevertheless, it is not without its risks. Reported concerns include the induction of manic or hypomanic states, particularly in individuals with bipolar disorder, as well as unipolar depression (Sakkas et al., 2003; Ozten et al.,2013; Knox et al 2021).Objectives
This review aims to assess the safety and viability of TMS as a therapeutic option and how to best optimize its clinical use.MethodsA comprehensive literature review was conducted utilizing resources from Pubmed, Researchgate, and Google Scholar.ResultsDespite some inconsistencies and potential confounding factors, our findings suggest that TMS may not significantly elevate the risk of manic switching, especially when compared to conventional treatments like antidepressants. However, it may potentially induce manic episodes, particularly when used as monotherapy or in combination with other treatments. Variables such as treatment protocol and prior response to medication may contribute to mood switching risk. Proposed safety measures include personalized protocol design, close patient monitoring and the combination with mood-stabilizing medication.ConclusionsTranscranial magnetic stimulation has been associated with manic and hypomanic episodes in mood disorder patients. While the evidence remains limited, it appears that certain individuals may be more susceptible to mood switching. Nevertheless, further research is needed to better elucidate variables influencing mood switching during TMS treatment and to develop effective preventative measures, especially for patients already predisposed to manic switching.Disclosure of InterestNone Declared
Family systemic therapy: intervention in autism spectrum disorder
Authors: Díaz Mayoral C. , Setién Preciados P. , Arroyo Sánchez E. , Gimillo Bonaque J. 
Published: August 2024

IntroductionAutism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by communication impairments and difficulties in social interaction. These impairments can affect relationships with family members, increase stress and frustration for both the patient and family members, and contribute to behavioral disturbances in these patients. They are frequently associated with high rates of psychiatric comorbidity.ObjectivesGiven the impact of this disorder on the family unit, we set out to assess the clinical effectiveness of systemic family therapy, its influence on improving communication and coping with this disorder, strengthening relationships and mental health in these patients and their families.MethodsA literature review was performed by searching for articles in Pubmed on May 24, 2023, focusing the terminology used on “Autism Spectrum Disorder” and “Systemic Family Therapy”. The search was limited to full text articles in English and Spanish, published in the last 10 years.ResultsSeveral authors have stated that systemic family therapy could be beneficial:-Providing education.-Reporting additional educational resources.-Focusing sessions on improving social and communication skills, mood and coping behaviors.-Providing therapy to all family members to cope with this disorder and what it implies. It will be very important that the patient with ASD understands his condition and can receive support from his family, working with siblings on the bonding and coping with this condition.-Contributing to facilitate mourning the loss of the condition of “neurotypical” person, exploring emotions, feelings and belief systems, valuing the social and cultural context of the family.
ConclusionsReviewing a variety of literature on this therapeutic approach, the authors concluded that “strategic, narrative and structural interventions can be applied from multiple approaches, especially suited to the challenges often faced by patients with ASD and their families”. Therapeutic work needs to involve different family members at different times. Therapeutic conversations will consider the child, the family and the family unit in context. Studies so far have not been able to establish whether particular systemic approaches have more favorable outcomes than others, which warrants further research.Disclosure of InterestNone Declared
Clinical and Psychosocial Impact of Psychoeducational Groups for Psychosis
Authors: Leitão F. B. F. , Cunha C. , Loureiro J. , Guedes A. , Ribeiro M. J. , Loureiro C. , Meira J. , Oliveira P. , Silva J. R. , Ferreira P. M. , Moreira A. M. 
Published: August 2024

IntroductionIndividuals with mental health disorders often lack access to appropriate care, including psychosocial rehabilitation programs, which are considered essential for their recovery. In 2019, as part of the intervention by the Community and Mental Health Service,
at Hospital de Magalhães Lemos, we initiated a psychoeducational group for patients with psychotic spectrum disorders, with the purpose of providing our patients with comprehensive information about their condition and effective management strategies. Our 8-week program consisted of 16 sessions, including icebreaker activities, discussion of certain themes, sharing of experiences and practice of stress management techniques.ObjectivesThe aim of this study was to assess and quantify the impact of our 2023 program.MethodsOut of a total of 20 patients interviewed for our program in 2023, 16 began the program and 12 completed it. The program’s evaluation was based on several assessment tools, including a sociodemographic questionnaire, a knowledge assessment questionnaire, the Positive and Negative Syndrome Scale (PANSS), the Insight and Treatment Attitudes Questionnaire (ITAC), the World Health Organization Quality of Life (WHOQOL), and the Medication Adherence Rating Scale (MARS). We also created a health agenda to organize an individual plan of care.ResultsOur findings indicated an improvement in insight and attitudes towards treatment by 8.6%, an enhancement in treatment adherence by 5%, and an increase in knowledge by 11.9%. In terms of quality of life, we observed a slight improvement in the psychological domain by 0.6% and in the social domain by 1.2%. Regarding the impact on psychotic symptomatology, there was an average decrease in 4 points in the negative subscale and in 3 points in the general psychopathology subscale, whereas the positive subscale remained unchanged. None of the patients required hospitalization during this period.Conclusions
Our study revealed some improvement in nearly all the evaluated parameters. There was an improvement of the therapeutic relationship, which we believe has contributed to lower scores in the negative symptoms and general psychopathology subscale. As for the study limitations, we acknowledge that we will need to expand our sample through additional programs in the next years, to include it in early intervention psychosis programs and to re-evaluate our patients’ outcomes after a more extended follow-up period, particularly if they continue to participate in our monthly mutual support group. Additionally, we must consider potential study biases, including the subjectivity of PANSS evaluations and the influence of other confounding factors, such as changes in treatment regimens during the program.Disclosure of InterestNone Declared
Prevalence and impact of comorbid mental disorders in hospitalized patients with obstructive sleep apnea: a protocol for a nationwide retrospective study
Authors: Nora D. , Freitas A. , Fernandes L. , Ferreira A. R. 
Published: August 2024

Introduction
Obstructive sleep apnea (OSA) is a common sleep disorder in the adult population, often associated with an increased prevalence of comorbid conditions such as obesity and diabetes, but also several mental disorders that have been independently associated with worse hospitalization outcomes in a variety of situations. However, and despite such associations, there is a relative dearth of studies exploring comorbid psychopathology beyond depression and anxiety, and no studies seem to address the impact of comorbid mental disorders on the hospitalization outcomes of patients with OSA.ObjectivesThis study aims to characterize and compare mental comorbidities among hospitalization episodes of adult patients with and without OSA held in mainland Portugal, regardless of the primary cause of admission, and to analyze the impact of such comorbidities on hospitalization outcomes.MethodsAn observational retrospective study will be conducted using an administrative database comprising de-identified routinely collected discharge data from all Portuguese mainland public hospitals. Inpatient episodes spanning from 2008 to 2015 will be categorized into two groups according to the presence of an OSA code (ICD-9-CM codes 780.51, 780.53, 780.57, 327.20 and 327.23). For both groups, mental disorders will be identified according to categories 650 to 670 of the Clinical Classifications Software (CCS) for ICD-9-CM. Descriptive, univariate, and multivariate analyses will be performed. Study reporting will comply with the RECORD statement guidelines.Results
Out of 6,072,538 sampled episodes, 57,301 have an OSA code. Prevalence of any comorbid mental disorder is 30.4% in the OSA group, and 19.3% in the non-OSA group. For both groups, sociodemographic, administrative, and clinical variables will be characterized and compared, as well as the prevalence of each mental disorder category, yearly hospitalization trends, and most common primary diagnoses. Hospitalization outcomes, including length of stay, in-hospital mortality, and readmissions, will be compared taking into consideration the presence of CCS categories of mental disorders.ConclusionsWe expect to improve the understanding of the prevalence of mental comorbidities among hospitalized patients with OSA, including understudied mental disorders, and to elucidate their impact on relevant hospitalization outcomes, thus highlighting the need to recognize and treat this common association to achieve optimal outcomes.Disclosure of InterestNone Declared
Neurocognitive functioning and emotional recognition in first-episode psychosis: protocol for a follow- up study
Authors: Bošnjak Kuharić D. , Makaric P. , Brozic K. , Tomasic L. , Savic A. , Ostojic D. , Rojnic Kuzman M. 
Published: August 2024

IntroductionAlthough deficits in neurocognitive functioning and emotional recognition impact treatment outcomes in schizophrenia since the development of the first psychotic episode (FEP), there is still a lack of longer follow-up studies showing the course of these deficits over time.ObjectivesOur objective is to investigate the changes of cognitive functioning over years in a cohort of patients, since their FEP.Methods
This study is developed as a follow-up of the project Biomarkers in schizophrenia- integration of complementary methods in longitudinal follow-up of FEP, that was conducted in several Croatian psychiatric clinics during the period from 2014 to 2019. A cohort of patients with FEP took part in the project with psychopathology, neurocognitive functioning and emotional recognition assessment at two time points- at baseline, during the subacute phase of a psychotic episode, and after 18 months of follow-up. In this study, patients with FEP who completed the baseline assessment of the project (n=159), will be contacted and included in the follow- up. Follow-up assessment will consist of sociodemographic data including information of their treatment so far, battery of neurocognitive tests (Rey Auditory Verbal Learning Test, Rey–Osterrieth complex figure Test, Wechsler paired memory, trail making test a & b, Digit symbol, Digit span, Semantic & Phonetic Fluency, Stroop 1, 2, 3 and Block design test), emotional recognition test (Penn Emotion Recognition Task) and several scales assessing psychopathology (Positive and Negative Syndrome Scale, Self-evaluation of Negative Symptoms, Scale for the Assessment of Negative Symptoms), functioning (Global Assessment of Functioning, WHO Disability Assessment Scale 2.0), quality of life and recovery. The study is funded by the University of Zagreb programmes (Project No. 10106-23-2394).ResultsWe plan to analyze the differences between the three time points (baseline, 18 months, 5 years), taking in account possible correlations with psychopathology, functioning, quality of life and different treatment options.ConclusionsIdentifying specific deficits can help in providing more effective treatment plan including various interventions that can improve treatment outcomes in schizophrenia.Disclosure of InterestNone Declared
Initiation of Paliperidone palmitate 3-monthly injectable in an acute inpatient psychiatric unit
Authors: Pareja Zea A. S. , Vera-Varela C. , Martínez Martínez A. , García Jimenez G. , De Iceta Ibañez de Gauna M. 
Published: August 2024

Introduction
The treatment of patients with severe psychotic disorders presents significant clinical challenges, and the choice of appropriate therapy is essential to ensure long-term stability1. In this context, long-acting injectable antipsychotics (LAIs) have emerged as a promising therapeutic option. LAIs were developed to counteract poor treatment adherence in patients with psychotic disorders2.Paliperidone palmitate 3-monthly injectable (PP3M) is a novel formulation of intramuscular injectable paliperidone palmitate with a significantly longer half-life than the once-monthly formulation.PP3M has shown a longer time to relapse and good safety and tolerability in many studies3.ObjectivesThe aim of this work was to describe the profile of patients initiating PP3M in an acute inpatient psychiatric unit.Methods
A descriptive study was conducted on patients admitted to the acute psychiatric unit from January 2021 to December 2022. The sample included 23 inpatients who initiated PP3M during the admission. Data were collected regarding age, gender, diagnosis, substance abuse, previous antipsychotic treatment, antipsychotic treatment adherence and adverse effects during the admission.Results23 patients sample, with an average age of 44.04 years-old, 16 male and 7 female, diagnosed with psychotic disorder (22) and schizoaffective disorder (1). Out of the 23 patients, 7 had active substance abuse upon admission.
Out of the total simple, 9 of them were prescribed LAIs, with 6 on PP1M (Paliperidone palmitate 1-monthly injectable), 2 on PP3M, and 1 on aripiprazole long-acting injection. Twelve were prescribed oral antipsychotics, including 4 on paliperidone, 4 on risperidone, 1 on aripiprazole, 1 on olanzapine, and 2 on other oral antipsychotics. Two patients did not have a previous antipsychotic prescription.Among the 23 patients, 17 of them did not have previous antipsychotic treatment adherence.5 out of the 23 patients experienced adverse effects, with 3 of them having extrapyramidal symptoms and 2 hyperprolactinemia.Upon discharge, 11 out of the 23 patients were prescribed antipsychotic monotherapy with PP3M.ConclusionsIn this sample, we observed that inpatients who initiated PP3M in an acute psychiatric unit were males, with psychotic disorders, lacked adherence to previous antipsychotic treatment. Most of them did not experience adverse effects with PP3M during admission.More research should be done to assess the use of PP3M in an acute inpatient psychiatric unit.REFERENCES1. Morris MT, Tarpada SP. Psychopharmacol Bull. 2017 May 15;47(2):42-52.2. Brasso, C., Bellino, S., Bozzatello, P., Montemagni, C., & Rocca, P. (2017). Neuropsychiatric Disease and Treatment,3. Edinoff AN, Doppalapudi PK, Orellana C, Ochoa C, Patti S, Ghaffar Y, Cornett EM, Kaye AJ, Viswanath O, Urits I, Kaye AM, Kaye AD. Front Psychiatry. 2021.Disclosure of InterestNone Declared
Long – acting injectable aripiprazole in patients with psychosis is associated with improved quality of life, better general clinical outcome and fewer hospitalizations
Authors: Koiliari E. I. , Mouzas I. , Alevizopoulos G. , Lesch O. , Walter H. , Pasparakis E. L. 
Published: August 2024

IntroductionAripiprazole, a D2 receptor partial agonist is suggested to enhance Prefrontal Cortex (PFC) dopamine functioning resulting to an improvement of working memory and GABA transmission related to social functioning. The LAI form of the medication is documented to improve the long-term adherence of the patients resulting in a better assessment of the effects of the drug on behavioral parameters that require a longer time to evaluate.ObjectivesHypothesis testing: “Aripiprazole LAI antipsychotic treatment is associated with i) reduced hospitalizations, ii) improved quality of life and iii) patient functioning”.Methods65 patients participated (Male to Female ratio corresponds to 2:1). 44 of them, the community population manifested psychosis (23 schizophrenia and 21 patients bipolar disorder with psychotic features). The median age was 41 years. 31.8% had dual diagnosis of psychosis and alcohol use disorders, while 25% had dual diagnosis of psychosis and Cannabis Use disorder. 77.3% were on aripiprazole LAI. 21 patients with BD I were prisoners at the Penitentiary of Neapolis of Lasithi of Crete. Median age was 36 years (all men). 90.5% had comorbidity of bipolar disorder type I (BD-I) and alcohol use disorders. 95.2% had comorbidity of BD – I and Cannabis Use Disorder. All were medicated by aripiprazole LAI 400mg/month. For the evaluation of our hypotheses the instruments WHOQOL-BREF questionnaire and the CGI-S scale were used. The quality of life, functionality, and number of hospitalizations were compared in each patient, before the initiation of the LAI medication and during the active treatment period. The minimum of follow-up period was 6 months.Results
In 44 patients (in community) hospitalizations decreased statistically significantly from 1.3±1.9 to 0.1±0.4 (Paired Samples Wilcoxon Signed Rank Test p-value<0.001). The CGI-S score decreased statistically significantly from 6.0 ±0.8 to 4.0±1.1 (Paired Samples Wilcoxon Signed Rank Test p-value<0.001). The score of the WHOQOL-BREF scale increased statistically significantly from 0.5 ± 0.5, to 2.9 ± 0.8 (Paired Samples Wilcoxon Signed Rank Test p-value<0.001). For the group of 21 patients (imprisoned) hospitalizations decreased from 0.6 ± 1.8 to 0.0 ± 0.0 (Paired Samples Wilcoxon Signed Rank Test p-value=0.066). The CGI-S score decreased statistically significantly from 5.3 ± 0.8 to 3.2 ± 1.3 (Paired Samples Wilcoxon Signed Rank Test p-value<0.001). The quality-of-life scale score increased statistically significantly from 0.9 ±0.6 to 3.09±0.7 (Paired Samples Wilcoxon Signed Rank Test p-value<0.001).ConclusionsAripiprazole LAI significantly improves the quality of life and functionality of patients with psychosis. We suggest that the improvement might be related to the beneficial effects of the molecule on the Prefrontal Cortex (PFC).Disclosure of InterestNone Declared