bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Potential Cardiovascular Benefits of Physical Exercise in Early Onset Psychosis and Bipolar Disorder
Authors: Bohman H. C. , Lundberg M. 
Published: August 2024

IntroductionEarly onset psychosis (EOP) and bipolar disorder (EOBP), occurring before the age of 18, have been linked to early signs of atherosclerosis and an elevated risk of cardiovascular disease (CVD). Physical exercise is a well-established factor in reducing the risk of developing CVD. However, it remains unclear whether regular physical activity can mitigate cardiovascular risk factors and signs of atherosclerosis in individuals with EOP and EOBP.ObjectivesThis study aimed to explore the impact of physical exercise on cardiovascular risk factors in these populations.MethodsWe assessed the physical exercise habits of 71 individuals, including 22 with EOP, 21 with EOBP, and 28 age-matched healthy controls. Participants’ physical exercise routines were categorized as 0, 1, 2, or 3 or more times per week, with each session lasting at least 30 minutes. Our analysis included adjustments for conventional CVD confounders. Additionally, we used high-frequency ultrasound (22 MHz) to evaluate different layers of the arterial wall in the left common carotid artery (LCCA).ResultsCompared to the control group, adolescents with EOP and EOBP exhibited significantly thicker LCCA intima thickness (0.132 vs. 0.095 mm, p<0.001) and intima/media ratio (0.24 vs. 0.17, p<0.001). Remarkably, adolescents with EOP and EOBP who engaged in physical exercise three times or more weekly (n=13) displayed significantly less intima thickness (0.142 vs. 0.116 mm, p<0.01). However, we did not observe a significant association between exercise and other CVD risk factors. Even when considering factors such as the extent of antipsychotic medication use or the severity of the disorders in our regression analysis, the significant association between exercise and reduced intima thickness persisted (p<0.05).ConclusionsAmong adolescents with EOP or EOBP, those who engaged in physical exercise three or more times weekly exhibited less pronounced LCCA intima thickness compared to their less active counterparts, although it remained thicker than that of healthy controls. These findings, if replicated, suggest that regular physical exercise, specifically three or more times a week, could potentially offer protection against the future development of CVD in individuals with EOP and EOBP. Further research is warranted to confirm and expand upon these promising results.Disclosure of InterestNone Declared
Prevalence and predictors of Anxiety and Depression among Adolescents and Young Adults: Findings from the MoreGoodDays Support Program in Alberta, Canada
Authors: Belinda A. , Shalaby R. , Hay K. , Pattison R. , Eboreime E. , Korthuis M. , Wei Y. , Agyapong V. I. O. 
Published: August 2024

IntroductionThe COVID-19 pandemic has led to a rise in psychological disorders among adolescents and young adults. There is an increase in the prevalence of likely anxiety and likely depression among the subscribers of MoreGoodDays supportive text message program, reflecting the impact of the COVID-19 pandemic on this cohort.ObjectivesTo assess the prevalence, severity, and correlates of likely generalized anxiety disorder (GAD) and likely major depressive disorder (MDD) among subscribers of MoreGoodDays program.MethodsThis study used a cross-sectional design. An online survey questionnaire was used to collect sociodemographic and clinical information from subscribers of MoreGoodDays program, a daily supportive text message program co-designed with adolescents and young adults for their peers in Alberta. Validated instruments, the Generalized Anxiety Disorder GAD-7 and Patient Health Questionnaire-9 PHQ-9 were used to collect information on likely GAD and likely major depressive disorder (MDD), respectively. Data was analyzed with SPSS version 25 using chi-squared tests and binary logistic regression analysis.Results343 subscribers of MoreGoodDays participated in the survey. Overall, 117 (56.0%) respondents had a likely MDD and 97 (46.6%) had a likely GAD. Participants who would like to receive mental health counselling were 27 times more likely to experience GAD (OR = 27; 95% CI: 3.09–250.00) and 40 times more likely to experience MDD (OR = 40.03; 95% CI: 4.43–361.51) than those who did not. Respondents who had received mental health counselling in the past were 18.5 times more likely to experience MDD compared with those who had not (OR = 18.52; 95% CI: 1.55–200.00). Demographic variables, including age, education, employment, and relationship status, and clinical variables, such as history of anxiety, depression, obsessive-compulsive disorder, ADHD, and adverse childhood experience, did not independently the predict presence of likely GAD or MDD in subscribers of MoreGoodDays.ConclusionsThe prevalence of anxiety and depression was relatively high among subscribers of MoreGoodDays, indicating the long-term effect of the COVID-19 pandemic. This finding has significant implications in the broader context of mental health research and emphasizes the need for more research into innovative mental health support for this cohort. The desire to receive counselling was predictive of both anxiety and depression and is a positive sign of the openness of this cohort to receive psychological intervention. Since this group is mostly adapted to mobile text technology, government agencies and policymakers should prioritize and implement readily accessible interventions such as supportive text messages to support their psychological well-being.Disclosure of InterestNone Declared
The effect of prophylactic esketamine in labor and cesarian delivery on the prevention of postpartum depression (PPD): A systematic review and meta-analysis of randomized controlled trials
Authors: Kozhokar Mikhaylovskaya A. , Shimit A. Q. 
Published: August 2024

IntroductionPostpartum depression (PPD) is a common psychiatric illness affecting maternal health, which can lead to poor outcomes for the infant, mother and family. Since the usual pharmacological treatment has low efficacy and a delayed onset of action, new treatment options should be explored. A recent meta-analysis demonstrated positive effects of racemic ketamine on PPD, but limited evidence is available on its more potent derivative esketamine.ObjectivesTo determine the effect of esketamine administered prophylactically during labor on the risk of incidence of PPD at 1 week and 6 weeks after delivery.MethodsPubMed, Scopus and GoogleScholar databases were searched for randomized controlled trials that studied the efficacy of esketamine that screened for PPD using the Edinburgh Postpartum Depression Scale (EPDS). Risk ratio was used to determine the effect of incidence on PPD. Heterogeneity was examined with I2 statistics. A random-effects model was used, as per moderate heterogeneity (I2=59%, p-value<0.05).ResultsWe included 7 RCTs with 1287 patients, 635 having received esketamine (49.3%). Patient-controlled intravenous analgesia (PCIA) or single intravenous dose during the delivery or cesarian section were the main drug delivery methods. Follow-up ranged from 4 weeks to 6 months, and EPDS cut-off scores for depression risk differed between studies, from 9 to 13 points. Dosages varied from 0.2mg/kg to 0.5mg/kg for single-dose administration and 0.1mg/kg to 1.25mg/kg for PCIA. Incidence of PPD at one week (RR: 0.459 95%CI 0.217-0.970; p<0.05; figure 1A) and at 6 weeks (RR: 0.470 95%CI 0.273-0.810; p<0.01; figure 1B) was significantly less common in patients who received esketamine during or after labor. Risk of bias was low in 5 studies and moderate in 2 studies. Risk of publication bias is significant.Image:ConclusionsProphylactic esketamine seems to improve EPDS scores in women at one and six weeks after birth. A more thorough analysis of the adverse effects on maternal and neonatal health are required, and long-term benefits are not fully understood. Larger multicenter studies would be a welcome addition to the issue at hand.Disclosure of InterestNone Declared
Role of L-Arginine supplementation in Long Covid-related Fatigue and Depression in Elderly Outpatients
Authors: Moniello G. , Bonfitto I. , Simonetti F. , Dimalta S. , Rizzo M. R. , Bellomo A. 
Published: August 2024

IntroductionChronic fatigue and psychiatric manifestations (depression, anxiety and sleep disturbances) appear to be key features of post-COVID-19 syndrome and increase significantly in prevalence over time (Lavienraj et al. J Neurol Sci 2022;434:120162). Several studies have suggested an association between altered levels of arginine metabolites and depression, anxiety and stress severity (Arisoy et al. J Psychiatr Res 2020;120:21-28). L-arginine supplementation has also been shown to improve walking performance, muscle strength, endothelial function and fatigue in adults with Long COVID (Tosato et al. Nutrients 2022;14(23):4984).ObjectivesTo study effects of L-arginine oral supplementation on chronic fatigue and depressive symptoms reported 3 months or more after acute COVID-19 onset in elderly outpatients without severe comorbid conditions.MethodsThis is a parallel-group, double-blind, randomized controlled trial conducted on 96 over 65 non-hospitalized patients suffering from Long Covid-related fatigue and depression. The first group included patients that received 1,66 g L-arginine twice a day in addition to a standard antidepressant therapy based on Selective Serotonin Reuptake Inhibitors (SSRIs), whereas the second group received antidepressant only. Severity of fatigue and depressive symptoms was evaluated at baseline and after 8 weeks of treatment using Fatigue Symptom Inventory (FSI) and Hamilton Rating Scale for Depression (HAM-D), respectively.ResultsAt baseline, 64 patients (66,7%) reported moderate fatigue (4-6) and the remaining 32 (33,3%) reported severe fatigue (7-10). In this phase the average HAM-D score was 12,85 ± 5,97; among patients, 57,3% experienced mild symptoms of depression, 32,3% experienced moderate symptoms and 6,4% experienced severe symptoms. After two months, patients treated with L-arginine supplementation exhibited a 30% greater improvement in fatigue-related symptom severity (p=0.008) and a significantly decrease in average HAM-D score (p=0.002) compared to the group treated with SSRI only.ConclusionsAccording to our results, adding oral L-arginine to standard antidepressant therapy in elders with Long Covid-related fatigue and depression significantly decreases severity of both physical and affective symptoms. Further studies are needed to clarify the intriguing role of L-arginine in the treatment of Post Covid-19 syndrome and its potential effects in promoting geriatric patients’ health, wellbeing and quality of life.Disclosure of InterestNone Declared
Impact Of Emotion Dysregulation On Eating Behavior Among The Tunisian General Population
Authors: Hadj Ali A. , Turki M. , Zribi A. , Halouani N. , Ellouze S. , Aloulou J. 
Published: August 2024

IntroductionPrevious theoretical models and reviews have documented a strong connection between emotion dysregulation and eating disorders (ED) psychopathology among the general and clinical populations.ObjectivesWe aimed to assess the link between emotional dysregulation and ED in the Tunisian general population.MethodsWe conducted a cross-sectional, descriptive and analytical study among Facebook group members, using an online questionnaire, over the period from February 17, 2023 to May 26, 2023. Emotional dysregulation was assessed via the “Difficulties in Emotion Regulation Scale” (DERS), which is composed of six sub-scores : “Non-acceptance” (N), “Strategies” (S), “Impulse” (I), “Goal” (G), “Clarity” (C) and “Awareness” (A). The Eating Attitude Test (EAT-26) was used to assess the risk of developing ED.ResultsA total of 528 responses were included. The mean EAT-26 score was 12.36±10.34; and 12.3% of our population were at high risk of developing an ED. The mean N, S, I, B, Cl, C and overall DERS scores were 7.78; 8.24; 7.08; 9.57; 6.46; 7.61 and 46.74, respectively.We showed that the EAT-26 score was correlated with the overall DERS score (r=0.260; p<0.001) as well as with the N (r=0.208; p=0.002), S (r=0.228; p<0.001), I (r=0.212; p=0,025), B (r=0.198; p<0.001), C (r=0,122; p=0,005) and Cl (r=0.136; p=0.002) scores.ConclusionsOur study showed that participants with a high risk of developing an ED seem to have more difficulties with emotional regulation. Thus, our findings call for interventions that target emotion regulation in the treatment of ED.Disclosure of InterestNone Declared
The Zen Garden Virtual Reality App for eating disorders: description and preliminary results
Authors: Gravina D. , Kirupakaran S. , Badr M. , Meaburn A. , Kresojevic M. , Dell’Osso L. , Treasure J. , Himmerich H. 
Published: August 2024

IntroductionVirtual Reality (VR) represents an emerging and promising tool to enhance standard care for patients with eating disorders (EDs). Indeed, VR provides an immersive and interactive experience in a safe and controlled environment that can simulate real-life situations, showing encouraging findings on various components of psychological treatments such as exposure therapy, psychoeducation, and emotional regulation.ObjectivesThis study aims to evaluate the Zen Garden VR App in patients with anorexia nervosa (AN) in order to obtain pilot data regarding changes in mood, relaxation, anger, anxiety, and weight and shape concerns. A secondary aim was to receive feedback from participants about the VR experience, its components, and its possible application for people with AN.MethodsSelf-reported baseline and post-intervention data were collected from a sample of six female inpatients with AN recruited at the Eating Disorders Service at the Bethlem Royal Hospital of the South London and Maudsley NHS Foundation trust (SLaM). The technology used during the VR session consisted of an Oculus head-mounted display headset and two controllers which provided continuous rotational and positional tracking (Figures 1, 2 and 3).ResultsFindings showed a global improvement after the VR Zen Garden App session, mainly in reducing levels of anxiety (Cohen’s d= 1.07) and promoting relaxation (Cohen’s d= 0.95), with possible applications especially before and after meals when food fears are at their highest. In addition, the music that was played during the intervention had a particularly positive effect.Image:Image 2:Image 3:ConclusionsDespite limitations, such us the small sample size and the one time point measurement, positive clinical implications have been highlighted for the Zen Garden VR App in patients with AN, although further studies are needed to confirm these preliminary findings. It is possible that VR could usefully augment and personalize care for people with an EDs. A range of interventions might be used to target the most compromised symptoms such as designing interventions that can help with triggers to eating disorder psychopathology.Disclosure of InterestNone Declared
Regional Inequalities in Diagnosis and Therapies in Greece regarding Autism Spectrum Disorders
Authors: Kouznetsov R. , Angelopoulos P. , Moulinos S. , Andrianopoulou A. , Dimakos I. , Gourzis P. , Jelastopulu E. 
Published: August 2024

IntroductionAutism spectrum disorders (ASD) represent a major public health concern on a global scale. The increasing prevalence of ASD worldwide, coupled with the arising demand for treatments, underscores its important role in the public mental health discourse. Ensuring the equitable integration of children with ASD and their families into all aspects of society becomes an imperative task, in order to eradicate the stigma associated with the broad spectrum of autism, encompassing both visible and concealed dimensions.ObjectivesThe primary objective of this study was to determine the crude prevalence of ASD in Greece nationwide, while also examining regional disparities in both prevalence and therapies. The study spanned a three-year period from February 2019 to February 2022 and relied on retrospective data sourced from the Greek National Organization for Healthcare Services Provision (EOPYY).MethodsEOPYY provided de-identified data, including information such as sex, age, diagnosis, and treatment for each child, facilitated by hashed social security numbers. Statistical analysis of the dataset was performed using the open-source statistical program R.ResultsA total of 18,245 children aged 2 -17 years were diagnosed with ASD in Greece, representing a nationwide crude prevalence rate of 1.16%. Regional disparities were evident, with prevalence rates ranging from 0.49% in the North Aegean to 1.57% in Crete. Over the three-year study period, a total of 15,328,327 non-medical therapies were prescribed, corresponding to an annual average of 264 therapies per child. Statistically significant differences between the thirteen regions in Greece were observed, ranging from 230 to 323 annual therapies per child.ConclusionsOur findings align Greece’s ASD prevalence with the global estimate of 1 in 100 children, as per the World Health Organization. Disparities between rural and urban areas in Greece may be attributed to differences in diagnostic procedures and the availability and accessibility of specialized services for autistic individuals. Thus, the establishment of a national surveillance system for ASD is recommended to enhance our understanding of the autism spectrum, monitor changes in prevalence, and identify potential contributing factors to autism conditions. Furthermore, these evidence-based results offer invaluable insights for crafting policies concerning healthcare, education, and employment for individuals with ASD in order to ensure the development of people with autism, their wellbeing, and a good quality of life.Disclosure of InterestNone Declared
Recovery among people with mental health challenges and alcohol and drug use issues in the Northern Territory, Australia
Authors: Tari-Keresztes N. , Armstrong N. , Gupta H. , Smith J. A. , Endemann S.-A. , Goding S. , Downes J. 
Published: August 2024

IntroductionThe Northern Territory (NT) has Australia’s highest mental health burden. It has a diverse and transient population, including Aboriginal and Torres Strait Islander people and various multicultural communities. While peer support has been widely used nationwide, in the NT, peer support is poorly implemented in psychosocial support activities.ObjectivesThe NT Lived Experience Network (NTLEN), in allyship with a team of researchers from Flinders University, has secured multiple fundings aimed to develop, implement, and evaluate a peer education and recovery program called Recovery Together (RT) for individuals with mental health and alcohol and drug use issues and related challenges.MethodsThe suitable evaluation approach was co-designed with live experience representatives from NTLEN and other local key stakeholders. It applied a mixed-method approach, including pre and post-program surveys (n=64) and individual interviews with program participants and the program delivery team (n=32). The evaluation findings were also informed by data collected by NTLEN via feedback forms n=38). We also used a co-design approach to develop survey instruments to ensure they were strengths-based and recovery-oriented.ResultsParticipants reported poor and fair self-perceived health, high stress levels, dissatisfaction with their relationships and relatively low recovery scores, which showed improvements at post-program completion. They discussed their journeys in the interviews and shared their experiences with local mental health services and the Recovery Together program. Many expressed that mental health professionals are not necessarily the care providers they feel comfortable engaging with. However, they described their experience with the peer program as highly positive, empowering, safe, non-judgmental, and beneficial, satisfying their support needs. The program gave them hope and tools to manage their mental health challenges and opportunities to gain insight into non-clinical aspects of recovery. Participants conceptualised personal recovery in their own words and described the facilitators and barriers to their recovery. They emphasised that recovery is being empowered, strong within themselves and the leader of their journey, living their best possible life, understanding themselves, having the necessary knowledge about mental health, and looking forward in a hopeful way.ConclusionsOur findings highlighted the demand and need for ongoing delivery of the RT program in the NT, which was highly effective in supporting personal recovery, addressing the service delivery gap and complementing the available clinical and mental health practices. They also showed the importance of providing recovery-oriented and trauma-informed education for medical and mental health professionals.Disclosure of InterestNone Declared
The impact of clinical context on the recognition of facial expressions
Authors: De Sousa C. , Morgado S. , Ferreira J. , Tukaiev S. , Fonseca R. 
Published: August 2024

IntroductionSeveral authors have demonstrated the relevance of the therapist sensitivity to the affective expression of his client (Merten & Schwab, 2005; 150-158), as well as to his own emotional experience (Haynal-Raymond et al., 2005;142-148) in order to build a more effective therapeutic relationship, and results. An important source of information to decode the emotional expression hints is the face, and its expression (Ekman & Friesen, 1975; Russel & Fernández-Dolls, 1997;275-294). Despite common sense saying that context is relevant to understand the meaning of the emotional facial expression, the literature review shows inconsistent results.ObjectivesThe main goal of this study was to evaluate the impact of clinical context over the perception of the emotional facial expression.MethodsThis study followed a within-subjects design, and its sample consisted of 60 clinical psychologists. 21 combinations of prototypical expression images with mixed emotional signals, and clinical information texts were presented to the participants. Then their judgement on the type of emotion displayed was requested. The presentation of the text-image pairs was randomized between three conditions: consistent, and non-consistent, and neutral.ResultsThe results suggest that emotions are more easily recognized in the presence of a concordant context than a non-concordant or neutral one, and that the greater the similarity between the facial expression of the image presented and the face prototypically associated with the context, the greater the influence of the context.However, In the recognition of mixed emotional signs, there was greater recognition of signs of anger in the facial expression, as a non-dominant emotion, when in the presence of the neutral story than of the story that agreed with the dominant emotion (sadness). There was also greater recognition of sadness, as a non-dominant emotion, in the presence of a story in agreement with fear than in the presence of a neutral story. There was also a statistically significant increase in the attribution of anger to images in which it is not present and whose dominant emotion is fear, when associated with a context of aggression vs. a neutral context.It was also found that there was a significant decrease in the attribution of fear to the sadness-anger image (25%-75%) in the presence of the aggression context compared to the neutral and panic contexts.There was also a statistically significant decrease in the attribution of sadness to an image of fear in the neutral context compared to the other contexts (panic and aggression).ConclusionsIn conclusion, our study have shown an impact of context over overvaluation or the undervaluation of the emotional facial expression as well as either with prototypical expressions or the mixed emotional signals when referring to sadness, fear, and anger. Thus, mental health clinicians should consider the influence of these contexts.Disclosure of InterestNone Declared