bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of admission to an assertive outreach service for psychosis in Lebanon
Authors: Kassir G. , El Hayek S. , Charara R. , Cherro M. , Itani H. , El Khoury J. 
Published: August 2024

IntroductionSchizophrenia is a chronic, debilitating mental illness that contributes significantly to the global burden of disease. Assertive outreach treatment for patients with schizophrenia and psychotic disorders has been implemented to improve treatment adherence and outcomes.The suitability of this model of care outside the western context has not been fully established. The Psychosis Recovery Outreach Program (PROP),staffed by a multidisciplinary team that applies principles of early intervention and assertive outreach, was initiated in February 2016 at a leading psychiatric facility in Lebanon.ObjectivesThe aim of this study is to identify and analyze clinical and demographic variables associated with patient enrollment in PROP, out of a typical clinical population attending a psychiatric outpatient department.MethodsThis retrospective study included patients above 18 y.o. at time of first point of care with a primary diagnosis of psychosis according to the International Classi-fication of Diseases 10 (ICD-10), and who presented to the outpatient psychiatry department at the American University of Beirut Medical Center (AUBMC) and were following up in PROP. We collected twelve-month data and used logistic regression models to identify predictor variables for enrollment in the service compared to those receiving standard treatment.ResultsIn total, 45 patients participated in the study. Patients were mostly males (77.8%), younger than 39 years (80%), of college or higher education (68.2%), and diagnosed with schizophrenia (46.7%) or schizoaffective disorder (48.9%). About one-quarter (22.7%) had a comorbid cannabis use disorder. A majority received more than one oral antipsychotic (75.6%) while half (51.1%) were maintained on a long-acting injectable (LAI) antipsychotic.The following variables were significant predictors of enrollment in PROP: having a comorbid cannabis use disorder (OR 2.83 [1.25 – 6.37]), being prescribed a LAI antipsychotic (OR 9.99 [4.93-20.24]) or more than one oral antipsychotic (OR 4.57 [2.22-9.39]), visiting the emergency department more than once (OR 8.7 [2.64-28.68]), and admission to the psychiatry unit (OR 13.91[3.17-60.94]). In addition, those following up in PROP were younger and less likely to be in the oldest age group (over 54 years) [OR 0.11 (0.01-0.93)], less likely to be females (OR0.39 [0.18-0.81]), and less likely to be diagnosed with “other psychotic disorder” as com-pared to schizophrenia (OR 0.14 [0.03 – 0.62]).ConclusionsPROP was the first community treatment program to use the principles of assertive outreachin Lebanon. Our findings highlight that the assertive out-reach model of care is applicable to its target population in the context of psychiatric care in Lebanon, namely young individuals with psychosis, higher comorbidities and a severe course of illness.Disclosure of InterestNone Declared
The Role of Partial Agonists and Specifically Cariprazine in Dual Disorders
Authors: Barabássy Á. , Dombi Z. B. , Csehi R. , Djuric D. , Németh G. 
Published: August 2024

IntroductionThe treatment of dual disorders, the co-occurrence of a major psychiatric disorder and a substance use disorder, represents a great challenge. Recent articles recommend antipsychotics with a dopamine partial agonism as first line treatment for these patients. Studies also postulate that drugs targeting the dopamine D3 receptors specifically might have an advantage, as these receptors are involved in drug-related reward, drug-seeking, and drug-intake behaviour. One compound that has both, partial agonist- and D3- activity is cariprazine.ObjectivesTo evaluate the real-world evidence of the effectiveness of cariprazine in patients with dual disorders.Methods
We performed a systematic literature search on PubMed, looking for English language articles published between January 2017 - September 2023 with the following search terms: (cariprazine) AND (psychosis OR schizophrenia OR schizoaffective OR bipolar depression OR bipolar mania OR bipolar disorder OR major depressive disorder) AND (“substance use disorder” OR cocaine OR alcohol OR cannabis OR heroin OR “double diagnosis” OR “dual diagnosis”) NOT (animal OR rat OR mouse) NOT (review or meta-analysis). An additional targeted hand search of congress reports, posters, and case reports was also conducted.Results
The search yielded 8 articles with 11 case reports. Mental health disorders included psychosis, schizophrenia, schizoaffective disorder, PTSD, and bipolar disorder while the abused substances were methamphetamine, cannabis, alcohol, and cocaine. All case reports described an improvement in both the symptoms of mental and substance use disorder with reduced craving and drug use and in some cases even ceasing drug use all together.ConclusionsIn summary, evidence suggests that cariprazine seem to be a potential candidate for dual disorders as it improves symptoms of both mental and substance use disorders.Disclosure of InterestÁ. Barabássy Employee of: Gedeon Richter Plc., Z. Dombi Employee of: Gedeon Richter Plc., R. Csehi Employee of: Gedeon Richter Plc., D. Djuric Employee of: Gedeon Richter Plc., G. Németh Employee of: Gedeon Richter Plc.
Unmasking the Dual Threat of Fentanyl and Xylazine Abuse in America
Authors: Bicho M. S. , Coelho J. M. , Peixoto B. , Cruz C. , Baião P. , Ferreira I. 
Published: August 2024

IntroductionThe United States of America are currently facing a public health crisis characterized by the abuse of synthetic opioids, notably Fentanyl, and the veterinary sedative Xylazine. While each of these substances has been associated with significant risks, their current misuse presents a formidable challenge to healthcare professionals, law enforcement agencies and policymakers. While the opioid epidemic has long held the nation in its grip, the emergence of Xylazine as complementary agent in substance abuse has added a disturbing layer of complexity to an already terrible situation, due to its cost-cutting, an increase in its addictive properties and its ability to extend the duration of the opioid with which it is combined.ObjectivesThe authors intend to review the relevant and current literature in order to extend the knowledge about this condition and find the best conducts for clinical practice.MethodsNon-systematic literature reviewResults
Various regions of the United States are facing a troubling surge in the co-abuse of Fentanyl, a potent synthetic opioid many times more potent than morphine, and Xylazine, a veterinary sedative and muscle relaxant, particularly in urban areas. The motivations for this combination appear to vary, ranging from the enhanced euphoria to cost-saving measures, further fueling its prevalence. However, the consequences are devastating. Both substances depress the central nervous system, with a sharp increase in overdose deaths and emergency medical services are strained to their limits in responding to these crises. Law enforcement agencies are facing a daunting task in curtailing the distribution of these substances, often grappling with clandestine networks that exploit the accessibility of these drugs.Conclusions
The concurrent abuse of Fentanyl and Xylazine represents a critical public health challenge in the United States of America, demanding immediate attention and a multidisciplinary response. Failure to address this issue comprehensively will have profound implications for the well-being of individuals, families and communities across the nation. It is imperative to mobilize resources, foster interdisciplinary collaboration and develop evidence-based policies to combat this dual-threat crisis. Novel intervention strategies, including community education programs, targeted outreach efforts, and supervised consumption facilities, are urgently needed to address this complex issue.Disclosure of InterestNone Declared
An LC-MS/MS method for the determination of W18 in urine samples
Authors: Quraishi R. , Kumar A. 
Published: August 2024

IntroductionSynthetic drugs pose one of the most significant drug problems worldwide. In this category, W18 emerges as a potent drug of abuse chemically related to fentanyl. W18 has an analgesic potency 10,000 times greater than morphine. Recent in-vitro studies reported no activity of W18 towards opioid receptors. However, its presence in seized drug samples indicates its use as a precursor in fentanyl synthesis. This emphasizes the need to develop methods for its detection in developing countries dealing with emerging new drugs.ObjectivesTo develop an analytical method for the determination of W18 in urine samples.MethodsStandards with W18 concentrations ranging from 5-500 ng/ml were prepared in negative urine along with deuterated internal standard. The samples were diluted with methanol, centrifuged and the supernatant was subjected to Liquid chromatography-tandem mass spectrometry (LC-MS-MS) with time of flight (QTOF) analysis. For chromatographic separation, a C18 column with 50 degrees oven temperature was used. The mobile phase consists of formic acid, water, and acetonitrile. The TOF MS was operated in positive ion mode and multiple reaction monitoring was used for quantification.ResultsThe retention time of W18 was obtained at 9.57 minutes. The parent ion with molecular weight 422.1 along with precursor ions Q1-273, Q2-111.0, Q3-150.0 g/mol were measured. The area of the standards ranges from 1 to 9.0 log 5 with R square of 0.99. The limit of detection (LOD) and quantitation were 5 and 20 ng/ml respectively. The recovery of W18 was estimated to be 96% from the from spiked urine standards.ConclusionsThe developed method is able to detect W18 presence in urine samples. This method has the potential to be used in clinical and research studies.Disclosure of InterestNone Declared
Covid-19 pandemics effects on postpartum depression in the Hungarian Baby-Mother-Father Unit
Authors: Mező G. M. , Budinszki C. , Kurimay T. 
Published: August 2024

Introduction
Our Baby-Mother-Father Unit program in Saint John’s Central Hospital (Budapest) offers mothers and fathers a unique opportunity to get better, receive psychiatric care (hospitalization or outpatient) without being separated from their babies. The Covid-19 pandemic had a strong impact on the whole population, including the parents of babies. During everyday operation the whole team experienced the increased need for health care, but we were not aware of the exact number of this change.Postpartum psychiatric conditions have two main categories that stand out: postpartum psychosis and postpartum depression. As there are better quantifiable tools for measuring depression and strong scientific evidence supporting that the pandemic having increased mood disorders’ intensity and numbers (Chen et al., 2022; Harrison et al., 2023), postpartum depression was chosen as the locus of investigation. Due to the respectively high numbers of parents with babies showing up at our Unit, we wished to get a clearer picture on pandemics effects on these people.ObjectivesGetting a more clear picture of pandemics effects on our Baby-Mother-Father Unit care. Defining numbers of patients, interactions and comparing test results of depression scales before and after the pandemic.Methods
A retrospective study of years 2019 and 2022 was performed. The total number of patients (2019: 173, 2022: 278) and the total number of documented patient-doctor/psychologist interactions (2019: 963, 2022: 1919) were measured. Depression scales’ (BDI, EPDS, PHQ-9), hopelessness scales (HS) results were compared. Due to our samples not showing normal distribution, a deeper analysis of test result categories was carried out by using Mann-Whitney
test.ResultsThe results showed that depression (BDI: W=3165,5 p=0,17; EPDS: W=1693, p=0,42; PHQ-9: W=2502, p=0,39) and hopelessness (RS: W=976,5, p=0,52) average points seem quite constant regardless of the pandemic and showed no significant differences. More detailed data analysis of result categories revealed pattern-like differences, which might tell us more about the subjective experiences of the individuals. The number of patients and patient-doctor/psychologists interactions increased dramatically. Furthermore the number of individual therapeutic sessions rose greatly (2019: 359; 2022: 1182), along with parents receiving therapeutic care (2019: 40, 2022: 95).ConclusionsFrom our findings, assumptions can be made that besides the obvious rise of numbers of patients and interactions, during the pandemic postpartum depression’s and hopelessness’ structure changed.Disclosure of InterestNone Declared
Psychotrophic Medication Prescriptions and Polypharmacy in Geriatric Patients Followed up in a Home-based Health Care Setting
Authors: Tanyeri Kayahan S. , Kayahan A. 
Published: August 2024

IntroductionBy 2050, one out of every six people in the world will be 65 years or older. Chronic diseases and associated multiple drug use are common in elderly. The use of five or more drugs is called polypharmacy and it’s reported between 40-90% in the elderly. The Beers Criteria is the American Geriatrics Association’s guide to current recommendations regarding the safety of pharmacotherapy in older age. Being a part of community-based health services in Türkiye since 2005, “Home-based Health Care Services” is a program in which patients, who are mostly elderly and have difficulty in accessing health institutions, access medical services at their homes.ObjectivesIn our study, it was aimed to examine the chronic disease diagnoses and prescriptions of patients aged 65 and over, registered in a home-based health care unit, in terms of psychotropic drugs and polypharmacy, and to evaluate the compliance of their psychiatric prescriptions with the Beers Criteria.MethodsSociodemographic, psychiatric diagnosis and treatment prescription and home-based health service-specific data were collected from the electronic files of home-based health care unit patients. Chronic diseases were scored according to the Modified Charlson Comorbidity Index (mCCI). The last 6-month prescriptions obtained from the electronic patient files were scanned and included in the analysis. In statistical analysis using SPSS Version 25, a p-value of significance <.05 was determined.ResultsAs of February 2023, 229(83.2%) of 275 patients aged 65 and over constituted the research sample. The mean age of the sample, half of whom were considered as oldest-old(85 years and older), was 83±7.97(median=86,IQR=10.75), 69.9%(n=160) were women and 97.8%(n=224) were diagnosed with at least one chronic disease. The mean mCCI scores were 5.30±1.11(median=5.50, IQR=1.0). Polypharmacy was detected in 78.6% of the sample(n=180), among half(n=114) of whom at least one psychotropic was prescribed, drugs not recommended to be prescribed according to the Beers Criteria in elderly patients were 46%(n=52). Prescription rates were as follows: anti-dementia- 21.5%(n=49), antidepressants- 31.1%(n=71), antipsychotics- 21.5%(49) and benzodiazepines- 5.3%. Most frequently prescribed antidepressant was escitalopram 49.2%, while most frequently prescribed antipsychotic was quetiapine 29.4%. The frequency of quetiapine prescription increased significantly in patients with dementia (Χ²(1)=29.54, p<.001) and insomnia (Χ²(1)=13.11,p<.001).ConclusionsThe frequency of polypharmacy was found to be closer to the higher values reported previously. Almost half of the sample had a prescription for psychotropic drugs, and one out of two of these prescriptions did not meet the Beers Criteria. Considering the aging population, it will be of great importance for clinicans to carefully evaluate psychotropic prescriptions and polypharmacy.Disclosure of InterestNone Declared
Juxtaventricular and periventricular white matter hyperintensities (WMH) are associated with cognitive dysfunction in Patients with Alzheimer’s Disease
Authors: Park J. H. , Yang H. J. , Song J. M. 
Published: August 2024

Introduction
White matter hyperintensities (WMH) is common among the elderly. WMH are associated with accelerated cognitive dysfunction and increased risk for Alzheimer`s disease (AD). Although WMHs play a key role in lowering the threshold for the clinical expression of dementia in AD-related pathology, the clinical significance of their location is not fully understood.Objectives
The aim of this study was twofold: 1) To investigate the quantitative association between WMH and cognitive function in AD; 2) To investigate whether there is any difference in the association between subclassified WMH and cognitive function in AD.MethodsA total of 171 patients with AD underwent clinical evaluations including volumetric brain MRI study and neuropsychological tests using the CERAD-K neuropsychological assessment battery. WMH volume was calculated using automated quantification method with SPM and MATLAB image processing software. According to the distance from the lateral ventricular surface, WMH within 3 mm, WMH within 3-13 mm, and WMH over 13 mm were classified as juxtaventricular WMH (JVWMH), periventricular WMH (PVWMH) and deep WMH (DWMH), respectively. WMH volume data was logarithmically transformed because it was right-skewed.ResultsWMH volume in AD was 20.7 ± 18.2 ml. Total WMH volume was associated with poor performance in categorical verbal fluency test (p = 0.008) and word list memory test (p = 0.023). JVWMH volume was associated with poor performances on categorical verbal fluency test (p = 0.013) and forward digit span test (p = 0.037). PVWMH volume was associated with poor performances on categorical verbal fluency test (p = 0.011) and word list memory test (p = 0.021), whereas DWMH volume showed no association with cognitive tests. Total WMH and PVWMH volume were also related to Clinical Dementia Rating scale sum of boxes score (p=0.022).Image:ConclusionsGreater JVWMH and PVWMH are related with concurrent impairments in semantic memory and frontal function independent of the hippocampal volume. However, DWMH volume is not associated with any cognitive function. Only PVWMH among subclassified WMH are related to the severity of AD.Disclosure of InterestNone Declared
Prolactin level changes according to atypical antipsychotics use: a study based on Clinical Data Warehouse
Authors: Sohn I. , Jeong J.-H. 
Published: August 2024

IntroductionAntipsychotics are associated with increased serum prolactin. It depends on the type of the antipsychotics and gender. There are previous studies, but it is necessary to compare them including new drugs.ObjectivesAntipsychotic drugs are known as the major cause of non-neoplastic hyperprolactinemia. This study aimed to investigate the levels of serum prolactin elevation depending on the use of antipsychotic drugs in patients through the Clinical Data WarehouseMethodsOur study included 118 subjects who were all diagnosed according to ICD-10 for schizophrenia, schizotypal and delusional disorders, manic episodes, and bipolar affective disorders. All the subjects were taking one of risperidone, blonanserin, amisulpride, and olanzapine. They had prolactin blood tests collected retrospectively through CDW.Results
Among the 118 subjects included in the analysis, the mean serum prolactin level was 65.1± 54.7ng/ml. Serum prolactin levels were significantly higher in subjects taking risperidone or amisulpride compared to blonanserin and olanzapine. The female subjects who took amisulpride or olanzapine had significantly higher prolactin levels, but there was no difference in prolactin levels between the sex in the subjects who took risperidone or blonanserin.ConclusionsThis study suggests the need for regular monitoring of serum prolactin levels in patients who are taking antipsychotics, especially in female patients. Further studies on the subjects with controlled confounding variables and larger sample groups are needed.Disclosure of InterestNone Declared
The link between personality dimensions, impulsivity, decision and coping style, and suicide attempts in affective patients.
Authors: Pawlak J. M. , Bilska K. , Skibińska M. , Narożna B. , Zakowicz P. , Rajewska-Rager A. , Kapelski P. , Dmitrzak-Węglarz M. 
Published: August 2024

Introduction
Introduction: Affective patients, especially depressive, have an increased risk of suicidal behavior. Identifying individuals at increased risk remains a challenge. Among the correlates that may be crucial, the impact of personality is emphasized. Attention is paid to impulsivity, measured by subjective or objective tests.ObjectivesObjectives: Comparative analyses were carried out to capture the differences and relationship between personality dimensions, impulsivity, and the decision-making style and coping with stress strategies in suicide attempters and non-attempters in the course of an affective disorder.Methods
Methods: Data were obtained from 276 individuals diagnosed with unipolar and bipolar affective disorder, both sexes. The study group was disaggregated into a subgroup of patients with (N=95) and without (N=181) suicide attempts in an individual’s history. The Temperament and Character Inventory (TCI) was used to assess personality dimensions. The Barratt Impulsiveness Scale version 11 (BIS-11) was used to measure impulsivity subjectively, and the Simple Reaction Time (SRT) test and the Continuous Performance Test (CPT) were objective assessment methods. The Coping Orientation to Problems Experienced (COPE) and Iowa Gambling Task (IGT) were applied to investigate coping and decision-making styles. Statistical analyses were performed in Statistica 13.3 StatSoft, Krakow, Poland.ResultsResults: In TCI, significant differences between suicide attempters and non-attempters concerned the following dimensions: harm avoidance (HA) (p=<0.0000), self-directedness (SD) (p=0.0001), and cooperativeness (C) (p=0.0186). In the CPT test, significant differences concerned correctly responded trials (p=0.0179) and Bias response (p=0.0230). In IGT, significant differences occurred in IGT block1_sum (p=0.0496) only (Table 1). We did not observe any significant differences in other tests applied. In the Spearman rank correlation analysis in the group of suicide attempters, the following correlations (p>0.05) with at least moderate strength rs>0.4 were revealed: Novelty seeking (NS), SD, and C correlated with several CPT parameters; Persistence (P) correlated with SRT variables; NS, HA and SD with BIS-11 variables.ConclusionsConclusions: Objective computerized tests (SRT; CPT; IGT) did not differentiate suicide attempters and non-attempters more clearly than self-reporting personality inventory TCI. Personality traits correlated with SRT and CPT variables. BIS-11 and COPE parameters did not enable to distinguish suicide attempters and non-attempters in the investigated group. This suggests that tests used complement each other, and using a single tool may be insufficient to indicate patients at increased risk of suicidal behavior.Disclosure of InterestNone Declared