bluuebunny/crossref_metadata_2025_split huggingface dataset:
The problem of treatment gap in alcohol use disorder (AUD)
Authors: Bramness J. G. 
Published: August 2024

AbstractAlcohol use and alcohol use disorder (AUD) is related to numerous somatic and psychiatric disorders resulting in a high contribution to global burden of disease and premature death. The need to identify and treat alcohol use disorder is high. Yet there is a large treatment gap. Too few people with AUD are recognized and are being offered treatment. In some countries well under 10 percent of those with a treatable AUD are ever offered treatment. Furthermore, there is a dearth of effective treatments and relapse rates remain high. This symposium will address some topics that may change this situation.Disclosure of InterestNone Declared
Are direct costs in schizophrenia influenced by duration of illness? results from a restrospective follow-up study
Authors: Calzavara-Pinton I. , Nibbio G. , Cabassi B. , Invernizzi E. , Di Carlo D. , Necchini N. , Bertoni L. , Lisoni J. , Deste G. , Barlati S. , Vita A. 
Published: August 2024

IntroductionIn Italy, it was recently estimated that the total economic burden for schizophrenia is € 2.7 billions, of which around 50% is derived from direct costs and 81% of these are due to hospitalization, residential facilities and semi-residential facilities, whereas only 10% of direct costs is derived from pharmacotherapy (Marcellusi et al. BMJ Open 2018; 8, e018359). Considered the high economic burden that schizophrenia has on healthcare systems (estimated to be between 1.4 % and 3 % of the total), a better characterization of the clinical variables that mostly influence the costs represent a topic of great clinical interest (Altamura et al. 2014 Official Journal of the Italian Society of Psychopathology 2014; 20, 223–243).ObjectivesThe aim of this study was to analyze whether duration of illness has an impact on the costs derived from the use of services (which account for the majority of the direct costs) in a cohort of subjects living with schizophrenia spectrum disorders (SSD).MethodsA total of 496 subjects receiving treatment from the Community Mental Health Centers (CMHC) of Brescia (Italy) were included in the study: for each patient demographic data, data regarding the duration of illness (in months), and data related to the use of service between January 1st, 2022 and December 31st, 2022 were derived from the regional database of mental health (“SIPRL”). Data on the use of service were then converted to costs using the regional rate tables for outpatient services, residential and semi-residential facilities, and the Diagnosis-Related Groups (DRG)-driven rate tables for hospitalization data. Partial correlations analyses were performed between duration of illness, corrected for age, and cost-related variables. All analyses were performed through SPSS v28 and p values <0.05 were considered significant.ResultsA higher duration of illness was correlated with higher costs for outpatient non-pharmacological interventions (p=0.010), for residential facilities (p=0.025) and total costs, both including and excluding hospital admissions (p=0.005 and p=0.007, respectively), but not with hospitalization costs (p=0.773).ConclusionsThe total expenditure for people living with SSD is higher for people with a longer duration of illness. These findings raise an important issue, which is that the mental health system in Italy invests more in subjects with a longer history of disease: this is in contrast with the international guidelines which prompt to intervene early in the course of the disease in patients living with SSD with outpatient rehabilitation interventions.Disclosure of InterestNone Declared
Psychiatry Pitstop: Enhancing Communication Skills of Medical Students in Mental Health Settings
Authors: Magalhaes D. , Martinho F. , Viegas F. , Cativo M. , Ferreira V. , Manuel C. , Martins S. , Bastos J. , Barata V. , Pimentel A. , Carvalho S. , Santos M. , Almeida D. , Fernandes L. 
Published: August 2024

IntroductionPsychiatry Pitstop is a role-play-based program for medical students aimed to improve communication skills in the framework of mental health. The workshop involved amateur actors who simulated different clinical scenarios and psychiatry residents, who facilitated the sessions and provided constructive feedback following the Pendleton method. Psychiatry Pitstop was originally developed in the United Kingdom and it was expanded to Lisbon, Portugal, in 2019. The authors adapted the course to the Portuguese context, adjusting the number of sessions and altering the scenarios to match common clinical situations faced by junior doctors in Portugal. By now, we conducted four courses.ObjectivesOur study aims to describe the Portuguese adaptation of the program and to learn insights from the students feedback.MethodsThe course was assessed using satisfaction questionnaires, completed by the students after each session. These included a Likert scale ranging from 1 to 5, with items pertaining to Future Importance, Overall Quality, Theoretical Quality, and Practical Quality. Quantitative data was analyzed using Excel and standard descriptive statistics to summarize the results. The open questions invited students to articulate the main positive aspects, suggestions for improvement and future topics. A Natural Language Processing (NLP) software was used to evaluate open-ended responses and extract the main concepts.ResultsWe obtained a total of 39 single-answers from 4 different courses. Evaluation results yielded a mean score of 4.7 for Future Importance, 4.9 for Overall Quality, 4.3 for Theoretical Teaching, and 4.9 for Practical Teaching. Notable positive aspects included students’ appreciation of the immersive interview environment, the dedication exhibited by actors and doctors, well-prepared case scenarios, and engaging interactions with participants. Suggestions for improvement encompass enhanced theoretical introductions, comprehensive topic coverage, universal participation in simulations, and expanded workshop days. Future prospects for the program include practicing interviews with other psychiatric diagnosis, addressing difficult patients, delivering bad news and covering topics related to sexuality, grief and moral dilemmas.ConclusionsOur study shows that Psychiatry Pitstop adaptation to the Portuguese context was successful. Overall, the feedback from medical students has been consistently positive. Subsequent editions will draw upon the findings of this study to enhance overall program quality.Disclosure of InterestNone Declared
HERV-E ƛ 4-1 activation in peripheral blood mononuclear cells of the recurrent depression patients under the influence of human recombinant IL-1β
Authors: Markova E. , Goldina I. , Goldin B. 
Published: August 2024

IntroductionMental disorders represent complex phenotypes and are the leading causes of global disease burden. Human endogenous retroviruses (HERVs) are ancient retroviral DNA sequences established into germline. Their tight regulation is mainly achieved by epigenetic mechanisms, which can be altered by environmental factors - viral infections, inflammation, leading to HERV activation. The aberrant expression of HERVs associates with neurological diseases and mood disorders. We showed earlier that HERV-E ƛ 4-1 activation is associated with the recurrent depression stage of exacerbation and are accompanied by a pronounced increase in the proinflammatory activity of the peripheral blood mononuclear cells (PBMC).ObjectivesThe purpose of the study was to evaluate the activity of HERV-E ƛ 4-1 on PBMCs of patients with recurrent depression in remission, including under the influence of recombinant human IL-1β.MethodsThe study included 30 patients with an established diagnosis of recurrent depression (F 33.0) aged 26–45 years. PBMC were isolated using the Ficoll density gradient method and further cultured in the presence or absence of 1 mkg/ml of recombinant human IL-1β for 24 hours. HERV-E λ 4 – 1 env gene expression was determined by the PCR. Cells proliferative activity was determined by H3-thymidine incorporation. Cytokines content in culture supernatants was assessed by ELISA.ResultsIt was shown that in all samples of PBMC cultured without IL-1β the HERV-E λ 4 – 1 env expression was not determined. After the PBMC cocultivation with recombinant human IL-1β, HERV-E λ 4 – 1 env gene expression was determined in 86,7% of cases. The HERV-E ƛ 4-1 activation in PBMC after IL-1β influence was accompanied by increased cells proliferative activity and production of IL-1β, IL-6.ConclusionsOur data indicate that the HERV-E λ 4 – 1 env expression in PBMC of recurrent depression patients in the stage of remission induced by the influence of proinflammatory cytokines, such as IL-1β. This mechanism may be one of the possible regulators of HERV-E λ 4 – 1 activation in recurrent depression.Disclosure of InterestNone Declared
Prevalence And Risk Factors Of Eating Disorders In The Tunisian General Population
Authors: Turki M. , Hadj Ali A. , Chakchouk G. , Ellouze S. , Halouani N. , Aloulou J. 
Published: August 2024

IntroductionEating disorders (ED) negatively affect physical, mental, and social well-being. The exact psychopathology of ED is still unknown, with research suggesting the interplay of a combination of factors.ObjectivesThe aim of our study was to estimate the prevalence of ED in the Tunisian general population, and to identify associated risk factors.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. All respondents over the age of 18 were included in the study. All participants filled a socio-demographic questionnaire. The Eating Attitudes Test (EAT-26) was used to screen for those at risk of eating disorders.ResultsA total of 528 responses were included in the study. 33.3±11.95 years. The subjects were unmarried in 63.4% of cases, of low socio-economic level in 19.5%, with a university education in 75.2% and with a regular occupation in 56.1% of cases.The mean EAT-26 score was 12.36±10.34. according to this scale, 12.3% of our population were at high risk of developing an ED.In a multivariate analysis, the female gender (p = 0.006), the low economic status (p = 0.012), a psychiatric comorbidity (p < 0.001), and physical activity (p= 0,037) were strongly associated with ED.ConclusionsThis study highlighted the magnitude of the risk of disordered eating attitudes in the Tunisian population and the need for programs to prevent and control these disorders.Disclosure of InterestNone Declared
Efficacy of transcranial direct current stimulation for controlling of food craving in subjects with overweight or obesity
Authors: Kim J. , Yang S. 
Published: August 2024

IntroductionThis study investigates the effects of transcranial direct current stimulation (tDCS) on food craving improvement and changes in brain function associated with craving in overweight and obese subjects.ObjectivesFood craving disregards the homeostatic mechanisms related to appetite and nullifies the rewarding effects of food, directly contributing to body weight and eventually leading to obesity. In this study, we aim to explore the effects of transcranial direct current stimulation (tDCS) on food craving improvement and changes in brain function associated with craving by conducting a total of 10 sessions of tDCS over a period of 2 weeks on overweight and obese subjects.MethodsA total of 86 patients who were overweight or obese (BMI ≥ 23 kg/m2) during the study period were included. The tDCS montage involved placing the anode over the left and the cathode over the right DLPFC. Weight, BMI, neuropsychological variables, and food craving-related variables were assessed. We measured absolute and relative EEG power in 19 channels and analyzed QEEG according to the following frequency ranges: delta (1–4 Hz), theta (4–8 Hz), alpha (8–12 Hz), beta (12–25 Hz), high beta (25–30 Hz), and gamma (30–80 Hz).ResultsAfter the application of tDCS, there was no significant reduction observed in weight and BMI. However, all measures related to food and eating showed a decrease in the intensity of cravings, and there was also a significant reduction in depression, anxiety, and perceived stress. In quantitative EEG analysis, an increase in theta waves was observed in the left frontal area (F7 and F3), an increase in alpha waves in the right parietal area (P4), and a decrease in beta waves in the frontal area (FP2) and occipital area (O1).ConclusionsThis study investigated the effects of tDCS on food craving in overweight and obese individuals, and it was found that there were improvements in psychological factors such as depression and anxiety. Additionally, using quantitative EEG, neurophysiological changes were observed, including an increase in theta waves and a decrease in beta waves.Disclosure of InterestNone Declared
Impact of intrinsic and extrinsic religiosity on cannabis use in adolescents: A structural equation modelling approach to data from the National Survey on Drug Use and Health (NSDUH) 2015–2019
Authors: Carrà G. , Bartoli F. , Canestro A. , Capogrosso C. A. , Bebbington P. E. , Crocamo C. 
Published: August 2024

IntroductionReligiosity is believed to be a factor that may reduce the risk of addiction and substance use both in adults and in young people. It is a complex construct that is neither measurable nor objectifiable, thus it must be estimated from proxy characteristics. For this purpose, researchers differentiate between subjective religiosity (i.e., individual religious experience) and extrinsic religiosity, that is, participation to religious services (extrinsic-personal subtype) or to social activities consistent with religion-based principles (extrinsic-social subtype).Objectives
This work aimed at exploring the role of different facets of religiosity – intrinsic (subjective), extrinsic-personal (service attendance), and extrinsic-social (church-based social activities) – in terms of deterring cannabis use among adolescents.Methods
Aggregated data of NSDUH (2015-2019) on 68,263 adolescents between 12 and 17 years of age were analysed using a structural equation modelling (SEM) to determine pathways of intrinsic and extrinsic components of religiosity in cannabis use. Several covariates were considered in the analyses, including comorbid depression and civil volunteering activities.Results
About 15% of participants admitted cannabis use in the previous year. Intrinsic and extrinsic-personal religiosity was reported by 66% and 25% of the sample, respectively. A percentage of fifty-seven of participants were involved in at least one faith-based activity, while 74% reported participation in secular community activities. Both intrinsic and extrinsic-personal religious components were likely to reduce cannabis use at the SEM regression model analysis controlling for putative confounders (cannabis use coeff.: -0.065, p=0.001; coeff.: -0.176, p<0.001, respectively). Considering the joint contribution of relevant covariates (community-based activities, lifetime MDE, sex, and poverty status), the outputs were similar. Cannabis use was not influenced by extrinsic-social component of religiosity, even though the involvement in non-faith based volunteering activities was protectively associated.ConclusionsFrom a policy-makers perspective, the reduction of cannabis use among young people may be obtained by supporting secular volunteering programs, which seem to be a cost-effective strategy. Moreover, whilst promoting religiosity is beyond the scope of any preventive programs, religious practices should be considered relevant protective factors.Disclosure of InterestNone Declared
The complex dynamics of therapeutic leave in Psychiatry
Authors: Pinto Â. S. , Soares T. P. , Marques A. 
Published: August 2024

IntroductionTherapeutic leave, the temporary and authorized absence of a patient from a psychiatric inpatient facility, is a practice rooted in the shift of mental illness towards more humane and recovery oriented care. This shift began to gain momentum in the mid-20th century, with the deinstitutionalization movement, which sought to treat psychiatric patients in less restrictive environments and facilitate their integration into the community. Today, therapeutic leave remains relevant in general psychiatry inpatient treatment facilities, and on an international level. It’s additionally used as a way to assess the progress and the stability of the patient outside the controlled environment that is the hospital, and to provide a gradual transition back into independent living and potential stressors of the outside world. But it is administered more on tradition and perceived benefits than on solid scientific grounding, reflecting a practice guided by clinical experience rather than empirical data or guidelines.ObjectivesOur review aims to evaluate the existing body of research on therapeutic leave in general psychiatry inpatient units. We intend to identify the outcomes that have been studied, and assess the extent and nature of their impact.MethodsThis scoping review was conducted through a comprehensive search of academic databases, including Google Scholar, PubMed, Embase, Cochrane Library, and PsycINFO. Search terms were carefully selected to capture relevant publications, and the results were screened for their pertinence to the review’s aims. Studies focused on forensic settings were excluded.ResultsThe literature on therapeutic leave is notably limited, and the prevalence of its utilization in clinical practice remains unclear. Scientific publications primarily address readmission rates, with two indicating an increased risk in patients granted leave during their inpatient treatment. However, one report suggested a potential reduction. Length of stay (LOS) was negatively impacted, with prolonged hospitalization in these patients shown in one report. Post-discharge emergency room visits seem unaffected. A rise in readmission rates and LOS typically suggests higher subsequent healthcare costs. However, findings from another study contradict this expectation, with reduction of costs post-initial inpatient treatment. The literature also explores the hazards linked to therapeutic leave, highlighting that a significant portion, between 30 to 80%, of inpatient suicides transpire during such leave. Additional concerns extend to non-fatal self-harm, as well as the possibility of patients causing harm to others or to property.Conclusions
Our review reveals a significant research gap in therapeutic leave’s effects, with a reduced number of outcomes studied and inconclusive findings. Future studies should aim to clarify these outcomes and eventually define therapeutic leave protocols.Disclosure of InterestNone Declared
A scoping review of the literature on interventions to reduce stress and burnout among teachers.
Authors: Belinda A. , Wei Y. 
Published: August 2024

IntroductionExperience of chronic stress among professionals is a risk factor for poor mental and physical well-being. There is limited knowledge regarding the kinds of interventions, and outcomes achieved using different modalities to address stress and burnout among teachers.ObjectivesTo undertake a scoping review of recent literature to determine psychological interventions and reported outcomes related to stress and burnout among teachers.MethodsThe PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews was followed. Relevant search terms were used to determine different interventions adopted to reduce teachers’ stress and burnout. Articles published between 2018 and 2022 were identified using five bibliographic databases. Relevant articles were extracted, reviewed, collated, and thematically analyzed, and findings s were summarized.Results
Forty studies conducted in Asia, North America, Oceania, Europe, and Africa, met the inclusion criteria. Sixteen kinds of burnout and stress-reduction interventions were identified. The most popularly studied intervention were Mindfulness-Based Interventions alone or in combination with yoga or Cognitive Behavioural Therapy (CBT), followed by Rational Emotive Behavioral Therapy (REBT). Mindfulness-Based Interventions led to decreased overall Teacher Stress Inventory (TSI) and emotional exhaustion subscale scores. REBT, primarily used with special education teachers, especially in Africa, has also shown positive results. Other interventions reporting positive outcomes include Inquiry-Based Stress Reduction (IBSR), the Stress Management and Resiliency Training Program (SMART), Cyclic Meditation, Group Sandplay, Progressive Muscle Relaxation, Autogenic Training, Sport-Based Physical Activity, Emotional Intelligence Ability Models and Christian Prayer and Prayer-ReflectionImage:ConclusionsStress and burnout can have a negative impact on teachers and, very often, on the students they teach. Implementing suitable school-based interventions are necessary to improve teachers’ stress-coping ability, reduce the likelihood of burnout and improve general well-being. Policymakers, governments, school boards and administrators should prioritize the implementation of school-based awareness and intervention programs to mitigate teacher stress and burnout.Disclosure of InterestNone Declared
Theta-burst rTMS in schizophrenia to ameliorate negative and cognitive symptoms: a double-blind, sham-controlled, randomized clinical trial
Authors: Orban Szigeti B. , Farkas K. , Herman L. , Zsigmond R. , Rethelyi J. , Csukly G. 
Published: August 2024

IntroductionSchizophrenia is a major mental disorder that affects approximately 1% of the population worldwide. Social cognition impairments and negative symptoms such as blunted affect or emotional withdrawal strongly contribute to the psychosocial functioning deficits and long-term disability in schizophrenia. The state-like and trait-like components of social cognition are impaired in schizophreniaObjectivesTreatment effects of conventional approaches with antipsychotics or psychosocial interventions are limited when it comes to reducing negative and cognitive symptoms in schizophrenia. While there is emerging clinical evidence that new, augmented protocols based on theta-burst stimulation can increase rTMS efficacy dramatically in depression, data on similar augmented therapies are very limited in schizophrenia. The different patterns of network impairments in subjects may underlie that some but not all patients responded to given stimulation locations.MethodsTherefore, we propose an augmented theta-burst stimulation protocol in schizophrenia by stimulating both locations connected to negative symptoms, namely the vermis of the cerebellum and the left Dorsolateral Prefrontal Cortex (DLPFC). Ninety subjects with schizophrenia presenting negative symptoms and aging between 18-50 years will be randomized to active and sham stimulation in a 1:1 ratio. The TBS parameters we adopted follow the standard TBS protocols, with 3-pulse 50-Hz bursts given every 200 ms (at 5 Hz) and an intensity of 100% active motor threshold. We plan to deliver 1800 stimuli to the vermis and 1800 stimuli to the left DLPFC daily in two 9.5-minute blocks for four weeks.ResultsThe primary endpoint is the change in negative symptom severity measured by the Positive and Negative Syndrome Scale (PANSS). Secondary efficacy endpoints are the change in cognitive flexibility measured by the Wisconsin Card Sorting Test and the change in social cognition assessed by the ‘Reading the Mind in the Eyes’, facial emotion recognition, and the ‘Faux pas’ tests. The safety outcome is the number serious adverse events.ConclusionsIn conlucion the aim of our study is to proove the safety and efficacy of theta burst stimulation for treating negativ sympotoms of schizophrenia.Disclosure of InterestNone Declared