bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of the demand for mental health consultation and liaison programmes: a comprehensive view.
Authors: Garcia Lazaro F. , Gotor Sanchez-Luengo F. 
Published: August 2024

IntroductionThe mental health consultation and liaison programme plays a crucial role in comprehensive medical care by addressing psychiatric co-morbidities in hospitalised patients.ObjectivesThe aim of this study is to analyse demand and assess referral patterns to the mental health consultation and liaison programme in order to identify areas for improvement and optimise the provision of care.Methods
A descriptive cross-sectional study was conducted by analysing records of referrals to the mental health consultation and liaison programme over a one-year period. Demographic data, origin of demand, type of request, episodic diagnosis, psychiatric diagnoses, follow-up and discharge referral were collected.ResultsA total of 1180 referrals to the mental health consultation and liaison programme were reviewed. Most of the episodic diagnoses were related to anxious-depressive symptomatology, acute stress reaction and acute confusional syndrome. The majority of patients followed up did not require further referral to mental health facilities.ConclusionsAnalysis of the demand for the mental health consultation and liaison programme helps us to optimise care on psychiatric co-morbidities. These results support the importance of integrated care that addresses both medical and psychiatric aspects of inpatient health. Strategies to improve collaboration between different services should be implemented to ensure optimal care and provide a holistic approach.Disclosure of InterestNone Declared
Enhancing Postpartum Mental Health: Evaluation of the Effect of Remote Peer Support Intervention
Authors: Němcová H. , Hrdličková K. , Kuklová M. , Horáková A. , Nosková E. , Švancer P. , Byatt N. , Šebela A. 
Published: August 2024

IntroductionThe postpartum period poses a risk of both onset and relapse of mental health disorders in mothers, which can impact maternal-child relationships and development of children. Timely intervention is crucial, especially considering that majority of at-risk women do not seek professional help.ObjectivesThis study aims to evaluate the effectiveness of Mom Supports Mom, a remote peer support intervention, in improving the mental health of postpartum women.MethodsA randomized controlled trial with 488 Czech postpartum women with depressive symptoms (Edinburgh Postnatal Depression Scale, EPDS score ≥ 10 shortly after giving birth) assessed the impact of Mom Supports Mom on depressive and anxiety symptoms (EPDS and Perinatal Anxiety Screening Scale, PASS) and health-related quality of life (Assessment of Quality of Life, AQoL-8D) at 6 weeks postpartum. The Mini-International Neuropsychiatric Interview 5 (MINI) was used to assess psychiatric diagnoses.ResultsThe intervention significantly reduced depressive (Cohen’s d = 0.30; p = 0.003) and anxiety symptoms (Cohen’s d = 0.29; p = 0.003) and improved health-related quality of life (Cohen’s d = 0.27; p = 0.008) at 6 weeks postpartum. No significant difference was observed in psychiatric diagnoses between the intervention and the control group.ConclusionsMom Supports Mom intervention reduces postpartum depressive and anxiety symptoms and enhances health-related quality of life. These findings support the integration of peer support into perinatal mental health care, addressing barriers that women face in seeking help.Disclosure of InterestNone Declared
Immunological predictors of rhythmic transcranial magnetic stimulation (rTMS) efficiency in patients with treatment-resistant schizophrenia
Authors: Zozulya S. A. , Pomytkin A. N. , Tikhonov D. V. , Kaleda V. G. , Klyushnik T. P. 
Published: August 2024

IntroductionModel and clinical studies demonstrate the efficiency of rhythmic transcranial magnetic stimulation (rTMS) in diseases associated with neuroinflammation. The therapeutic potential of rTMS is related to modulation of neuroplasticity in the CNS, activation of neurogenesis and reduction of neuroinflammatory processes. Presumably, one of the factors that determines the efficiency of rTMS can be the features of the immune status of patients.ObjectivesTo reveal the features of the spectrum of inflammatory markers in patients with treatment-resistant schizophrenia with different efficiency of rTMS.Methods
31 male patients aged 16 to 47 years (mean age 29.9 ± 8.4 years) with treatment-resistant schizophrenia who developed a first psychotic episode in adolescence (19-25 years) were examined. The course of rTMS was conducted for 3 weeks (15 sessions). Depending on the dynamics of clinical and psychometric parameters after the course of rTMS, the patients were divided into three groups: group 1 - with worsening of clinical condition (n=8); group 2 - without therapeutic effect (n=12); group 3 - with good therapeutic response (n=11). Before rTMS, leukocyte elastase (LE) and α1-proteinase inhibitor (α1-PI) activity, and the levels of autoantibodies to S-100B protein and myelin basic protein (MBP) in the plasma of patients were determined. The parameters of 18 healthy male donors without clinical signs of psychiatric and somatic pathology were used as controls.ResultsAll groups of patients were characterised by moderate and high levels of immune system activation, determined by a complex of inflammatory and autoimmune markers. At the same time, the high level of immune system activation in patients with low MTR efficiency was associated with low LE activity in plasma (within the reference range or below the lower limit - 200.6 (168.5- 220.3) nmol/min·mL), which was not consistent with the overall level of inflammation. This group of patients also showed high levels of antibodies to MBP compared to control values (p<0.05). The low LE activity can be explained by the transmigration of neutrophils from the blood to the brain due to a critical increase in the permeability of the blood-brain barrier, which is largely controlled by LE.ConclusionsThe study confirmed the participation of immune mechanisms in the formation of therapeutic resistance in schizophrenia and revealed the characteristics of the spectrum of immune markers in patients with low efficiency of rTMS.Disclosure of InterestNone Declared
Direct adjusted comparison of expressed emotion towards patients with schizophrenia between halfway houses and family settings
Authors: Ferentinos P. , Douki S. , Kourkouni E. , Dragoumi D. , Smyrnis N. , Douzenis A. 
Published: August 2024

IntroductionRates of high expressed emotion (EE) towards patients with schizophrenia have only indirectly been compared between families and community residential facilities, since studies including patients in both settings are unfortunately lacking. High EE rates in staff-patient studies are typically lower than in families, with negligible rates of high emotional overinvolvement (EOI). However, indirect comparisons can suffer from many biases.ObjectivesThis study directly compared patients with schizophrenia living in halfway houses or with their families on the EE of their caregivers, adjusting for patient- and caregiver-related confounders.MethodsWe included 40 inpatients with schizophrenia living in halfway houses and 40 outpatients living with their families and recorded the EE of the caring staff (N=22 nurses) or parents (N=56), respectively, through Five Minutes Speech Sample interviews. Each nurse rated 1-12 inpatients and each inpatient was rated by 2-5 nurses, totaling 155 nurse ratings. Each outpatient was rated by one or both parents. Due to the multilevel structure of EE ratings, generalized linear mixed models were fitted. We first adjusted only for differences in patient-related confounders between groups and then added basic caregiver-related demographics.ResultsCompared to outpatients, inpatients were older (p=0.001), less well educated (p=0.002), had a longer disease duration (p=0.047), more hospitalizations (p=0.012), lower severity of psychotic (p=0.027) and, specifically, negative symptoms (p=0.015), and lower perceived criticism (p=0.001). Nurses were younger (p<0.001) and better educated (p=0.001) than parents. After adjusting for patient-related confounders only, EOI was significantly higher in parents (p=0.027) while criticism did not significantly differ between groups. However, after also adjusting for caregiver demographics (age, gender and education), criticism was significantly higher in nurses (p=0.027) while differences in EOI became non-significant.ConclusionsDifferences in EE, when directly compared between parents and professional caregivers, may be explained by differences in patient-related characteristics, caregiver demographics as well as other caregiver characteristics to be investigated in future studies.Disclosure of InterestNone Declared
Relationship between different PANSS cognitive factors and cognition assessed with MCCB in patients with first psychotic episode of schizophrenia
Authors: Rodriguez-Jimenez R. , Sánchez-Cabezudo Á. , Scala M. , García-Fernández L. , Sánchez-Pastor L. , Rentero D. , Martínez-Gras I. , Caballero M. , Espejo-Saavedra J. M. , Nuñez-Doyle A. , Jiménez-Rodríguez O. , Aparicio-León A. I. , Santos J. L. 
Published: August 2024

IntroductionThe Positive and Negative Syndrome Scale (PANSS) has been used as a universal instrument for clinical assessment of psychopathology in schizophrenia. Different studies have analyzed the factorial structure of this scale and have suggested a five-factor model: positive, negative, excited, depressive, and cognitive/disorganized factors. Two of the most used models are the Marder´s solution and the Wallwork´s one.ObjectivesThe aim of this work was to study the correlations of the two cognitive factors (Marder and Wallwork) with a cognitive assessment performed with a standard cognitive battery, in a sample of patients with first psychotic episode of schizophrenia.MethodsSeventy four patients with first psychotic episode of schizophrenia (26.9, SD:7.8 years old; 70.3% male) were included. The cognitive assessment was performed with the MATRICS Consensus Cognitive Battery (MCCB). The MCCB present seven cognitive domains: Speed of processing, Working memory, Attention/Vigilance, Verbal Learning, Visual Learning, Reasoning and Problem Solving, and Social cognition). Pearson correlations were performed between MCCB scores and Marder´s PANSS cognitive factor (P2, N5, G5, G10, G11, G13, G15) and Wallwork´s one (P2, N5, G11).ResultsCorrelation between MCCB scores and cognitive factors of Marder and Wallwork can be seen in the table.Marder´s cognitive factorWallwork´s cognitive factorSpeed of processingr = -0.461; p<0.001r = -0.455; p<0.001Attention/Vigilancer = -0.414; p<0.001r = -0.415; p<0.001Working memoryr = -0.449; p<0.001r = -0.468; p<0.001Verbal Learningr = -0.511; p<0.001r = -0.405; p<0.001Visual Learningr = -0.252; p=0.024r = -0.254; p=0.029Reasoning and Problem Solvingr = -0.244; p=0.036r = -0.272; p=0.019Social cognitionr = -0.268; p=0.024r = -0.202; p=0.091ConclusionsBoth PANSS cognition factors show a moderate correlations with Speed of processing, Working memory, Attention/Vigilance and Verbal Learning assessed by MCCB. More discrete correlations were found with Visual Learning, Reasoning and Problem Solving, and with Social cognition (in fact, non-significant correlation with Wallwork´s cognitive factor was found).Acknowledgements. This study has been funded by Instituto de Salud Carlos III (ISCIII) through the project PI19/00766 and co-funded by the European Union.Disclosure of InterestNone Declared
Current Challenges and Future Directions of Research in Cell Phone Addiction
Authors: Vasiliu O. 
Published: August 2024

IntroductionBehavioral addictions (BAs) are intensely explored during the last decades due to their impact on the quality of life, functionality, socio-economical negative consequences, and high risk of mental health negative consequences. BAs are new challenges for clinicians and researchers due to a lack of well-defined diagnostic criteria, very few available epidemiological data, and scarce information about efficient therapeutic interventions. Cell phone addiction (CPA) has been raising a significant interest for mental health specialists because of its increasing prevalence and potential long-term physical and mental complications. Therefore, an analysis of the available data about the main characteristics of this pathology seems granted.ObjectivesThe main objective of this review was represented by the need to find relevant reports about the epidemiological, clinical, and therapeutic interventions in CPA.MethodsA narrative review focused on the available treatments for food addiction was performed through a search in four electronic databases (PubMed, Cochrane, EMBASE, and Web of Science/Clarivate) using the paradigm “cell phone addiction” or “smartphone dependence” and “treatment” or “epidemiology” or “diagnostic criteria” or “risk factors.” No inferior time limit for published papers was established, and the superior limit was July 2023.ResultsA relatively large number of papers regarding this topic were found (n=772), but after applying the inclusion and exclusion criteria, only 29 articles remained. Female gender and adolescents, but also high anxiety levels, insomnia, excessive Internet use, less physical activity, and a higher level of dependence have been correlated with CPA. Six validated scales have been identified as possible instruments for monitoring the CPA evolution. Different diagnostic criteria have been suggested, but they still lack clinical validation. Cognitive-behavioral therapy could be helpful, and smartphone applications that limit online time could also be efficient. Treatment of previously mentioned vulnerability factors is also recommended to obtain long-term favorable effects.ConclusionsCPA is an increasingly explored BA, but validated diagnostic criteria are still missing. The treatment is also based on extrapolations from other addictions. Therefore large sample-based therapy trials are needed.Disclosure of InterestNone Declared
Relationship Between Neutrophil-Lymphocyte Ratio and Treatment Retention in Individuals with Opioid Use Disorder
Authors: Taylan Y. , Sönmez M. B. 
Published: August 2024

IntroductionInflammatory processes may play a role in the pathophysiology of substance use disorders. Chronic opiate use may lead to inflammation, and elevated inflammation markers have been observed in individuals with opioid use disorder (OUD). The Neutrophil-Lymphocyte Ratio (NLR) serves as an indicator of systemic inflammation. NLR can be employed in both diagnosis and treatment monitoring as an inflammatory marker to gauge the severity of OUD.ObjectivesOur aim was to assess the utility of NLR as a marker of chronic inflammation in diagnosing and monitoring treatment in individuals with OUD.MethodsA total of 200 patients with OUD and 78 healthy control subjects were enrolled in the study. Patients were initially admitted to a 28-day abstinence-based inpatient program and subsequently transitioned to outpatient buprenorphine/naloxone (B/N) maintenance treatment after hospitalization at the Alcohol and Substance Addiction Treatment Center in Trakya University School of Medicine (Edirne, Türkiye). NLR was employed as a measure of systemic inflammation. Blood samples were collected the morning following admission for detoxification. Patients were categorized into two groups: the treatment retention group and the dropout/relapse group based on their 3-month and 12-month follow-up results. Clinical data were obtained from patient records.ResultsAt the 3-month follow-up, the median NLR with interquartile range was 1.34 (1.05-1.99) in the treatment retention group (n=112) and 1.72 (1.11-2.46) in the dropout/relapse group (n=88). At the 12-month follow-up, the median NLR with interquartile range was 1.28 (0.88-1.85) in the treatment retention group (n=52) and 1.56 (1.07-2.33) in the dropout/relapse group (n=148). The median NLR in the control group (n=78) was 1.36 (1.12-1.74). According to the 3-month and 12-month follow-up data, the difference between the groups concerning NLR was statistically significant (χ2=9.072, p=0.011; χ2=11.165, p=0.004; respectively). Pairwise comparisons indicated that patients in the dropout/relapse group had significantly higher baseline NLR values than those in the treatment retention group and healthy controls according to the 3-month (p=0.038 and p=0.019, respectively) and 12-month follow-up data (p=0.012 and p=0.040, respectively). NLR did not differ significantly between the treatment retention and control groups in both follow-ups (p>0.05).ConclusionsOur findings suggest that elevated baseline NLR is associated with dropout/relapse in OUD, indicating its potential as a marker for treatment follow-up in these patients.Disclosure of InterestNone Declared
The clinical role of rTMS in difficult-to-treat depression
Authors: Baune B. 
Published: August 2024

Abstract
Several meta-analyses demonstrated the efficacy of unilateral High-Frequency Left-sided (HFL) repetitive Transcranial Magnetic Stimulation (rTMS) for individuals with Major Depressive Disorder (MDD); however, results are contradictory due to heterogeneity of the included studies. Empirical evidence on the relative efficacy of rTMS treatment compared with standard pharmacotherapy in Treatment-Resistant Depression (TRD) is presented. Random effects models were used to assess the effects of rTMS on response and remission rates. In 19 randomized double-blinded sham-controlled studies were included for quantitative analysis for response (n = 854 patients) and 9 studies for remission (n = 551 patients), the risk ratio (RR) for response and remission are 2.25 and 2.78, respectively for patients after two treatment failures using rTMS as add-on treatment compared to standard pharmacotherapy. The presentation will conclude, that rTMS is significantly more effective than sham rTMS in TRD in response and remission outcomes and may be beneficial as an adjunctive treatment in patients with MDD after two treatment failures. This finding is consistent with previous meta-analyses; however, the effect size was smaller than in the formerly published literature.Disclosure of InterestNone Declared
Understanding Lithium intoxication in Bipolar Disorder: a comparative analysis and clinical implications
Authors: Martin-Santiago O. , Andres-Lobo C. D. , Jimenez-Aparicio T. , Vallecillo-Adame C. , Perez-Escudero A. 
Published: August 2024

IntroductionLithium treatment is a proven method for bipolar disorder management, but its narrow therapeutic range and the risk of severe side effects, including lithium intoxication, pose significant clinical hurdles. Lithium intoxication, a potentially life-threatening complication, can occur during treatment, raising ongoing questions about its clinical factors, risk elements, and best practices for management.ObjectivesOur objective is a comparative analysis between patients who have experienced lithium intoxication and those who have not, aiming to identify influencing factors and enhance clinical care.MethodsWe collected demographic data, age at lithium treatment initiation, treatment duration, therapeutic adherence, Mental Health consultations, and lithium level monitoring from 14 individuals requiring clinical attention due to lithium intoxication and 14 patients with similar gender, age, and diagnosis with lithium treatment but without intoxication during four years of follow-up.ResultsRegarding the results, the age of onset of lithium treatment in patients with lithium intoxication was 30.2 years (SD=8), and the duration of lithium treatment averaged 11.1 years (SD=8.8), which did not significantly differ from the control group with ages of onset at 38.1 years (SD=15.1) and treatment duration of 9.27 years (SD=8.8), respectively. Lithium intoxication patients developed severe complications, including hospitalizations in medical-surgical units, the necessity for dialysis, and death, one fatal case. Although therapeutic adherence to lithium, measured through pharmaceutical dispensation, exceeded 90% and was comparable in both groups, patients affected by lithium intoxication exhibited a significantly higher treatment discontinuation rate (OR 32.5; 95% CI, 3.1 to 337.8) during the follow-up period. Patients who experienced lithium intoxication had an average of psychiatric consultations every 11.2 months (SD=13.4), with 35.7% not attending at least once a year, while the control group had an appointment every 5.31 months (SD=2.7) (p > 0.05). Lastly, despite both groups having a similar frequency of plasma lithium level monitoring, occurring approximately every 5.5 months (SD=2.6) and 7.8 months (SD=4.8), respectively, in 28.5% of those who suffered from lithium intoxication did not undergo any monitoring for periods exceeding 18 months (p < 0.05).ConclusionsOur research highlights the significance of delivering thorough clinical care and continuous monitoring to patients receiving lithium treatment for bipolar disorder. Ensuring effectiveness therapeutic adherence and maintaining strict monitoring of lithium levels are critical factors that significantly enhance treatment safety. Appropriate management has the potential to improve the quality and safety of care for people with bipolar disorder who are dependent on lithium therapy.Disclosure of InterestNone Declared
Relevance of sociodemographic characteristics on patients with bipolar disorder and substance use disorder
Authors: Silva I. A. , Silva C. , Faria I. , Melo V. S. 
Published: August 2024

IntroductionSubstance use disorder is a common comorbidity with bipolar disorder, having implications on its diagnosis, treatment adherence, and number of hospitalizations. Understanding the particular characteristics of this population is of the utmost importance to improve clinical outcomes.ObjectivesOur aim is to analyze the sociodemographic characteristics of the patients in the inpatient unit of a tertiary hospital and to reflect on its impact on treatment. Our study looks over a 3-year period, and all patients analyzed have a dual diagnosis of both bipolar disorder and substance use disorder.MethodsWe collected, retrospectively, data from the hospital platform and analyzed it on SPSS Statistics 26, along with a literature review.ResultsIn the analyzed period of 3 years, there were 2384 hospitalizations in the Coimbra’s University Hospital psychiatric ward, and 88 hospitalizations were coded with a dual diagnosis of bipolar disorder and substance use disorder.Regarding gender distribution, 41% of the patients were female and 49% of the patients were male, with a mean age of 47 years.There were 12 patients who were re-hospitalized once (7 of them were men) and 6 who were re-hospitalized twice (4 of them were men) during the analyzed period.At the time of hospitalization, 60.5% of male patients were single, 21.1% were divorced, and only 15.8% were married, while female patients were mainly married (35.7%) and only 28.6% were single.Female patients had more frequent support from social and community institutions (17.9% vs 5.3% in men) while 2.6% of men had no support from family or institutions.Regarding education, more men accomplished high school education (21.1% vs 17.9% in women) and university education (18.4% vs 14.3%). In our sample, there were 3.6% of women who were illiterate.During their lifetime, female patients were hospitalized around 5 times and men around 3.7 times, despite the fact that the mean age of female patients on their first hospitalization was 36 years, and in male patients, it was 34 years.Treatment adherence is more significant in female patients (70.3% vs 69.2% in men), even though women maintain active substance abuse more frequently (42.9 vs 39.5%).ConclusionsMale and female patients have different backgrounds and different support either in spouses, family, or social institutions. These nuances may play an important role in the number of re-hospitalizations, treatment adherence, and maintenance of abstinence.Taking these aspects into consideration may help improve clinical outcomes.Disclosure of InterestNone Declared