bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Online Support System for Mental Health Problems After the Earthquake: A Prompt Response from The Psychiatric Association of Turkey
Authors: Yilmaz-Karaman I. G. , Erim B. R. , Karaş H. , Mutlu E. 
Published: August 2024

IntroductionPrevious research demonstrated that disasters have adverse mental health outcomes. Preventive mental health interventions in the golden hours/days after a disaster may reduce psychological harm by getting in the way of emerging mental disorders or alleviating existing ones. The widespread use of smartphones and broad internet access enabled remote mental health interventions during disasters. After the 2023 Turkey earthquake, observing the mental health burden of the earthquake, The Psychiatric Association of Turkey conducted an online platform for psychological first aid. The aim was to unite volunteer psychiatrists and disaster survivors.ObjectivesThis study presents the organization of an online mental health service during a disaster while reporting the characteristics of the service users.MethodsThe Psychiatric Association of Turkey called its members to volunteer for an Online Support System for Mental Problems After the Earthquake. The group regularly united to set standards of care. An action plan and algorithm were set up for applicants with acute suicidal, homicidal risk, or active psychotic symptoms in collaboration with local institutions and field volunteers. Volunteer psychiatrists were asked to collect information on the applicant’s sociodemographic characteristics, disaster experience, and mental health status.ResultsVolunteer psychiatrists collected data on 180 applications. Most cases applied for themselves (%95.5), and some asked for advice to care for their relatives (%4.5). Earthquake survivors have the highest psychopathology rate (%64.9), followed by healthcare workers and search and rescue personnel (%61.1). Figure 1 summarizes the subgroups of the service users. The earthquake survivors group had a mean age of 34.45, % and 76.1 of them were female. Only %15.7 of them had lower educational levels than high school. %75 cases reached safe places on the 5th day of the disaster. Applicants reported discrimination and aggression after the catastrophe, related to experiencing mental health problems, owning a pet, looting, and being seen as less traumatized since their relatives are alive.Image:ConclusionsThe present experience of the Psychiatric Association of Turkey is an example of a fast and collaborative response to a disaster regarding mental health. Our results also represent the characteristics of online mental health service users during a disaster.Disclosure of InterestNone Declared
The association between prenatal cannabis use and congenital birth defects in offspring: A systematic review and meta-analysis
Authors: Tadesse A. W. , Ayano G. , Dachew B. A. , Tusa B. S. , Damtie Y. , Betts K. , Alati R. 
Published: August 2024

IntroductionA body of research has examined the association between prenatal cannabis use and congenital birth defects in offspring; however, these studies have not been synthesised. We performed a comprehensive synthesis of existing research to test whether there is an association between prenatal cannabis use and congenital birth defects in exposed offspring.ObjectivesThe aim of this study was to conduct a comprehensive systematic review and meta-analysis of existing evidence to synthesise the association between prenatal cannabis use and congenital birth defects in exposed offspring.MethodsIn line with the preregistered protocol (PROSPERO: CRD42022368623), we systematically searched PubMed/Medline, CINHAL, EMBASE, Web of Science, ProQuest, Psych-Info, and Google Scholar for published articles until 4 April 2023. The methodological quality of the included studies was appraised by the Newcastle-Ottawa Quality Assessment Scale (NOS). A meta-analysis was carried out to report the pooled effect estimates from the included studies. We further performed subgroup, leave-one-out sensitivity, and meta-regression analyses, which increased the robustness of our findings.ResultsThirty observational studies (i.e., fifteen case-control and fifteen cohort studies) with 229,930 cases of birth defects and 26,826,741 controls (healthy babies) were included in the final analysis. We found that offspring exposed to maternal prenatal cannabis had a 56%, 69%, 47%, 23%, and 13% increased risk of any birth defects (irrespective of specific body system) [RR = 1.56: 95 % CI 1.28 – 1.92], defects of the gastrointestinal [RR = 1.69: 95 % CI 1.37 – 2.09], cardiovascular/heart [RR = 1.47: 95 % CI 1.09 – 1.97], central nervous systems [RR = 1.43: 95 % CI 1.09 – 1.89], and facial/oral cleft [RR = 1.13: 95 % CI 1.08 – 1.18], respectively.ConclusionsThe findings from the current study suggest that maternal prenatal cannabis exposure is associated with a higher risk of birth defects in offspring. The findings highlight the importance of promotive and preventive strategies to reduce cannabis use during pregnancy that contribute to minimising the risk of birth defects in offspring.Disclosure of InterestNone Declared
Mental Disorders in patients hospitalized due to Neurologic Disorders: a nationwide study
Authors: Gonçalves-Pinho M. , Martins B. , Costa A. , Pedro Ribeiro J. , Freitas A. , Azevedo E. , Fernandes L. 
Published: August 2024

IntroductionThe presence of psychiatric comorbidity significantly impacts the quality of life for patients and often goes unnoticed within the realm of neurology.ObjectivesThis study’s objective was to elucidate and characterize psychiatric comorbidity among patients hospitalized for neurological disorders in mainland Portugal.MethodsThis retrospective observational study analyzed hospitalizations categorized with a primary diagnosis of neurological disorders, defined by Clinical Classification Software (CSS) for ICD-9-CM codes 76, 77, 79-85, 95, and 109, occurring in adult patients (≥18 years) between 2008 and 2015. Psychiatric comorbidity was determined by the presence of secondary diagnoses falling under CCS categories 650-670.ResultsA total of 294,806 hospitalization episodes were documented with a primary diagnosis of neurological disorders in adult patients between 2008 and 2015 in Portuguese public hospitals. Approximately 26.9% (n=79,442) of these episodes were associated with documented psychiatric comorbidity (22.1% for female hospitalizations and 32.2% for male hospitalizations). Patients with recorded psychiatric comorbidity were younger (66.2±16.2 vs. 68.6±17.2 for those without psychiatric comorbidity, p<0.001), exhibited a lower overall in-hospital mortality rate, and experienced significantly longer mean hospital stays. Among these comorbidities, ‘Delirium, dementia, amnestic, and other cognitive disorders’ were documented in 7.4% (n=21,965) of hospitalizations, followed by alcohol-related disorders in 6.5% (n=19,302) and mood disorders in 6.1% (n=18,079). Epilepsy/seizures had the highest recorded psychiatric comorbidity rate among neurological disorders (39.9%).ConclusionsPsychiatric comorbidity is present in more than a quarter of hospitalizations with a primary diagnosis of neurological disorders. The prevalence of psychiatric comorbidity varies across different neurological disorders and is associated with distinct demographic and clinical characteristics.Disclosure of InterestNone Declared
Evidence-Informed Approach to De-Prescribing of Atypical Antipsychotics (AAP) in the Management of Behavioral Expressions (BE) in Advanced Neurocognitive Disorders (NCD): Results of a Retrospective Study
Authors: Luthra A. S. , LinBin Gao R. , Carducci P. , Sue J. , Remers S. 
Published: August 2024

IntroductionDiagnosis of behaviors in advanced neurocognitive disorders (aNCD) is one of exclusion, and the framework has been laid out in DSM-V. However, clinical assessments in aNCD become increasingly unreliable, and commonly used psychometric tools for clinical assessments lack reliability and validity, thereby making outcomes unreliable. Consequently, the syndromic and symptom management approaches for behaviors in aNCD behaviors have yielded poor results. To address this, the focus has shifted towards understanding the ‘meaning’ of behaviors in aNCD, recognizing them as a ‘mode of communication’. To date, there are no existing frameworks to ascribe ‘meaning’ to behaviors in aNCD.ObjectivesLuBAIR™ paradigm is the first step in offering such a framework for understanding the ‘purpose’ and ‘meaning’ of behaviors in NCD. The ‘meaning’ ascribed to each behavioral category was used to guide the use of atypical antipsychotics in their management. De-prescribing was attempted on patients who qualified to enter this retrospective study. De-prescribing was defined as successful if individuals were completely withdrawn from AAP and remained off them for 60 days without the re-emergence of behaviors.MethodsThe data collected on the second occasion, in the successful and failed de-prescribed groups, were compared in this retrospective study. MANOVA, Chi-Square paired t-test statistical analyses were used to detect the differences in the behavioral categories between the two cohorts. Cohen d was used to measure effect size.ResultsPatients who did not have Mis-Identification and Goal-Directed Expressions were more likely to successfully de-prescribe: X2 (1, N = 40) = 29.119 p < 0.0001 and X2 (1, N = 40) = 32.374, p < 0.0001, respectively. Alternatively, the same behavioral categories were more likely present in patients who failed de-prescribing: MANOVA and paired t-test (p < 0.0001). Atypical antipsychotics, in their role as an antipsychotic and mood stabilizer, may be used to manage Mis-Identification and Goal-Directed Expressions, respectively.ConclusionsLuBAIR paradigm has the potential to guide the development of specific behavioral care plans and the use of AAP in managing individual behavioral categories. AAP use can be justified for managing Misidentification and Goal-Directed Expressions. Vocal expressions may warrant the use of AAP, pending further study. The LuBAIR paradigm offers guidance for de-prescribing AAP for all other behavioral categories in the LuBAIR Inventory. This study is also a preliminary step in validating the psychological theories used to support the individual categories. This workshop will educate the participants on the LuBAIR paradigm and its application in developing person-centered interventions for behaviors in a NCD.Disclosure of InterestNone Declared
Climate change and mental health. Polish perspective
Authors: Gawrych M. 
Published: August 2024

IntroductionWorld Health Organization estimates that climate changes are expected to cause an additional 250 000 deaths worldwide per year between 2030 and 2050 (1). We do not know, in what extense, population mental health will deteriorate due to climate change. Unfortunately, not all European countries, including Poland collect the evidence-based information about current and possible future risks for mental health.(1)World Health Organization. Climate change and health; 2018. Available from who.int/news-room/ fact-sheets/detail/climate-change-and-health [cited 20 October 2020]ObjectivesThe aims of present study are: (1) summarize the available literature through a current review and (2) make recommendations for future actions/ prevention strategy for Poland.MethodsMedline database (through PubMed) and Polish authorities documents was searched for records published in 2010–2024. Mental health-related descriptors (i.e. „mental health” OR “mental disorders”) and „climate change” and “Poland/ Polish” and “Europe” term were used in particular searches. The results of the screening were included in the final selection list. References of screened full-text articles and raports were manually searched for further literature. Additionally, European and worldwide publications and reports prepared by mental health and/ or climate change organizations were taken into account.ResultsMental health risks of climate change can stem from climate-related natural disasters (e.g., extreme weather events), slower moving events (e.g., drought), or concern about the phenomenon of climate change itself. Primary mental health impact is related mostly to disasters itself and its consequences: environment of disruption, trauma and grief. Direct consequences include increased rates of high-risk behaviours. Secondary effects of climate change are due to various processes of environmental changes and ecological disruptions. They consist of damages to physical and social infrastructure, physical health effects, food and water shortages, conflict, and displacement. Long-term droughts affect food and water supplies and can subsequently affect the economic and mental wellbeing not only the land-based workers.ConclusionsA focus on climate change impact on mental health can help enhance the understanding of factors that strengthening psychosocial resilience and adaptation. The future mental health challenges of climate change in Poland cover:-developing scientific knowledge regarding adaptation process and resilience,-focusing on high-risk groups (i.e. children, rural workers),-strengthened community engagement,-developing available locally strategies for mental health improving.Disclosure of InterestNone Declared
Effectiveness of AI-driven Individualized Learning Approach for Children with Autism Spectrum Disorder (ASD)
Authors: Atturu H. , Naraganti S. 
Published: August 2024

IntroductionAutism Spectrum Disorder (ASD) is a condition with varying degrees of social, emotional and behavioural disability. These children require focused and individualised learning plan to facilitate social integration. Robots have been used for this purpose but are not routinely available in several parts of the world. Effective, point of care (POC) digital therapies that can be used anywhere by anyone is the need of the day.ObjectivesTo evaluate the effectiveness of Artificial Intelligence (AI) driven individualised learning plans delivered through POC digital platform (CognitiveBotics) for children with ASD.MethodsAfter Ethical approval and parental consent, children diagnosed with ASD (Childhood Autism Rating Scale CARS 2) aged 2 years and above were screened for study inclusion and exclusion criteria and enrolled. AI driven individualised learning plan was administered through CognitiveBotics software that could be used on either computer or a tablet. Initially, interactive questions were administered to parents by the AI tool to understand child’s functioning. Based on these, an individualised learning plan was assigned. Each task is delivered using either interactive videos, chatbot and/or animated/AI games. The child’s progress is captured for attention (attempted questions, retries and timeouts) and retention (first time corrects and corrects) continuously. The initial interactive questions administered to parents were repeated to assess child’s progress in real life. Paired ‘t’ test using SPSS version 26 was used to compare initial and final data.ResultsOut of 85 registered children, 41 regularly used the AI tool. Mean age was 43.93 months (range 26 to 72 months). 37 (90.24%) were boys. The baseline mean scores (ranges), were CARS 33.48 (30-39.5); Social quotient 53.4 (27.25-80.32), Developmental quotient 71.35 (45.90-93.33) and IQ 62.34 (36.58-86.83). The base line mean score of parents assessed child function was 115.24 (range 58 to 215). A mean of 15.54 tasks were given (range 5 to 48). At the time of analysis with a mean follow up of 3 months (range 2 to 5 months) the children completed a mean of 10.10 tasks (range 0 to 42). There was significant improvement in child’s learning captured by the AI software based on attention and retention parameters (p = <0.00001). This improvement was also reflected in parent assessed child function (mean 147.15, (59 to 231)) (p = <0.00001). The percentage of improvement in both software captured and parent assessed child function was directly related to the amount of time spent by the child on the software.ConclusionsAI driven individualised learning approach is effective in teaching skills and promote social integration for children with ASD. Such technology can capture the child’s progress on a day-to-day basis and deliver personalised training.Disclosure of InterestNone Declared
Brain magnetic resonance imaging outperforms clinical severity ratings in the prediction of treatment outcomes in major depressive disorder
Authors: Long F. , Chen Y. , Zhang Q. , Wang Y. , Wang Y. , Li Q. , Zhao Y. , Li F. 
Published: August 2024

IntroductionMajor depressive disorder (MDD) is a prevalent and disabling condition. Approximately 30-50% of patients do not respond to first-line medication or psychotherapy. Therefore, several studies have investigated the predictive potential of pretreatment severity rating or neuroimaging features to guide clinical approaches that can speed optimal treatment selection.ObjectivesTo evaluate the performance of 1) severity ratings (scores of Hamilton Depression/Anxiety Scale, illness duration, and sleep quality, etc.) and demographic characteristic and 2) brain magnetic resonance imaging (MRI) features in predicting treatment outcomes for MDD. Second, to assess performance variations among varied modalities and interventions in MRI studies.MethodsWe searched studies in PubMed, Embase, Web of Science, and Science Direct databases before March 22, 2023. We extracted a confusion matrix for prediction in each study. Separate meta-analyses were performed for clinical and MRI studies. The logarithm of diagnostic odds ratio [log(DOR)], sensitivity, and specificity were conducted using Reitsma’s random effect model. The area under curve (AUC) of summary receiver operating characteristic (SROC) curve was calculated.Subgroup analyses were conducted in MRI studies based on modalities: resting-state functional MRI (rsfMRI), task-based fMRI (tbfMRI), and structural MRI (sMRI), and interventions: antidepressant (including selective serotonin reuptake inhibitors [SSRI]) and electroconvulsive therapy (ECT). Meta-regression was conducted 1) between clinical and MRI studies and 2) among modality or intervention subgroups in MRI studies.ResultsWe included ten studies used clinical features covering 6494 patients, yielded a log(DOR) of 1.42, AUC of 0.71, sensitivity of 0.61, and specificity of 0.74. In terms of MRI, 44 studies with 2623 patients were included, revealing an overall log(DOR) of 2.53. The AUC, sensitivity, and specificity were 0.89, 0.78, and 0.75.Studies using MRI features had a higher sensitivity (0.89 vs. 0.61) in predicting treatment outcomes than clinical features (P < 0.001). RsfMRI had higher specificity (0.79 vs. 0.69) than tbfMRI subgroup (P = 0.01). No significant differences were found between sMRI and other modalities, nor between antidepressants (SSRIs and others) and ECT. Antidepressant studies primarily identified predictive imaging features in limbic and default mode networks, while ECT mainly focused on limbic network.ConclusionsOur findings suggest a robust promise for pretreatment brain MRI features in predicting treatment outcomes in MDD, offering higher accuracy than clinical studies. While tasks in tbfMRI studies differed, those studies overall had less predictive utility than rsfMRI data. For MRI studies, overlapping but distinct network level measures predicted outcomes for antidepressants and ECT.Disclosure of InterestNone Declared
Electroconvulsive Therapy (ECT): A Scotland Wide Naturalistic Study of 4,826 treatment episodes
Authors: Langan Martin J. , Fleming M. , Varveris D. , Kelly S. , Martin D. 
Published: August 2024

IntroductionDespite its apparent efficacy in the treatment of a range of psychiatric disorders, electroconvulsive therapy (ECT) is viewed by some as a contentious treatment. Although most clinicians and researchers consider ECT a safe and effective treatment, there are ongoing and significantly publicised concerns about potential side effects.ObjectivesTo explore use of ECT across Scotland in a large naturalistic clinical sample across an 11-year period from 2009 to 2019. To consider the efficacy and side effects of ECT for a range of common psychiatric disorders including, depression, bipolar depression, schizophrenia, and mania.MethodsUsing data from the Scottish Electroconvulsive Therapy (ECT) Accreditation Network (SEAN), information was collected for all adults who had received ECT. Variables included age, sex, Scottish Index of Multiple Deprivation (SIMD) quintile, International Classification of Diseases, Tenth Edition (ICD-10) diagnosis, indication for ECT, Mental Health Act status, consent status, entry and exit Montgomery-Asberg Depression Rating Scores (MADRS), entry and exit Clinical Global Index Severity CGI-S) scores and reported side effects. Side effects were recorded as present if the side effect was reported at any point during the episode of treatment.Results4826 ECT episodes were recorded. The majority of episodes were in women (68.4%, n=3,301). Average age at treatment onset was 58.52 years. Males were slightly younger (m=58.24 years vs f= 58.65 years, p= 0.20). Mean number of treatments/episode was 9.59 (95% CI 9.32 – 9.85). Mean treatment dose delivered was 277.75mC (95%CI 272.88 – 282.63mC).2920 episodes of treatment had CGI-S entry and exit recorded. At entry, mean CGI-S indicated marked illness (5.03 95% CI 4.99-5.07). Recipients with schizophrenia had the highest CGI-S score (5.45 95% CI 5.21-5.60), followed by those with post-partum disorders (5.38, 95% CI 4.61-6.14). At exit, mean CGI scores indicated borderline illness (2.07, 95% CI 2.03-2.11), recipients diagnosed with mixed affective state had the lowest CGI-S score (1.72, 95% CI 0.99-2.47) followed by those with schizoaffective disorder (2.01, 95% CI 1.76-2.42).Anaesthetic complications (n=34) and prolonged seizures (n=38) were rare, occurring in <1% of treatment episodes. Cardiovascular complications were reported in 2.2% (n= 102). Nausea was reported in 7.2% (n= 334) and muscle aches in 12% (n=560). Confusion was reported in 19% (n=879) and cognitive side effects were reported in 26.2% (n=1212). One third of treatment episodes reported confusion or cognitive side effects (33.1%, n=1545).ConclusionsFrom this large naturalistic clinical sample, ECT appears to be effective in improving illness severity as measured by CGI-S score. While some side effects (such as prolonged seizures and cardiovascular complications) were rare, others (such as confusion or cognitive side effects) were relatively common.Disclosure of InterestNone Declared