bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cariprazine add-on in resistant bipolar depression. Long-term effectiveness and safety data from a multicentric real-world experience
Authors: Martiadis V. , Pessina E. , Martini A. , Raffone F. , Vignapiano A. , De Berardis D. 
Published: August 2024

IntroductionPersistent depressive episodes and subsyndromic depressive symptoms frequently characterize mood alterations in bipolar disorder (BD) and negatively influence quality of life and suicide risk. BD patients with predominant depressive episodes generally show significantly higher treatment resistance rates. Although not specifically approved in Italy for bipolar depression, recently published observational data suggest that the cariprazine add-on may be a potential effective short-term treatment for resistant bipolar depression. Nevertheless data on long-term cariprazine treatment are lacking.ObjectivesThis study evaluated the efficacy and safety of long-term cariprazine augmentation in patients suffering from treatment-resistant bipolar depression.Methods30 resistant bipolar depressed patients, whose resistance was defined according to The CINP Guidelines on the Definition and Evidence-Based Interventions for Treatment-Resistant Bipolar Disorder, were treated with cariprazine 1,5 -3 mg flexible dose for 4 weeks, added to previous mood stabilizing and/or antidepressant treatment. Psychopathology at time 0 and at 4, 8, 12, 16, 20, 24 weeks of treatment was evaluated using the Hamilton Depression Rating Scale (HDRS), the Hamilton Anxiety Rating Scale (HARS), the Young Mania Rating Scale (YMRS) and the Bipolar Depression Rating Scale (BDRS); safety and tolerability was measured by the UKU Side Effect Rating Scale. The drop-out rate was assessed throughout the study duration.ResultsCariprazine add-on was effective in the study sample but only during the first 4 weeks of treatment. Improvement in depression scores started from the first week, reaching about 40% mean HDRS score reduction at T4; a moderate ulterior decrease (-15%) was reached at T24 but was accompanied by a significant drop-out rate; anxiety symptoms improved (mean HARS score reduction 37% at T4) mainly during the first 4 weeks. The treatment was generally well tolerated. From week 4 to 24 we observed a near 70% drop-out rate (18 total drop-outs) with maximum drop-outs between weeks 4-8 (n=7) and 18-24 (n=7). Discontinuation causes were inefficacy (5/18); clinical worsening (10/18); side effects (3/18); hypomanic shift (2/18).ConclusionsDespite the relatively small population examined and the observational design, our results suggest that cariprazine may represent an effective and safe short-term enhancement strategy in resistant bipolar depression. Long-term treatment, in this sample, did not lead to significant improvements and was burdened by a high drop-out rate, mainly due to inefficacy/clinical worsening. Further studies on larger samples are needed to confirm these preliminary findings, both in short-term and in longer observations.Disclosure of InterestNone Declared
EFPT Exchange programme - Feedback results from 2012 - 2022
Authors: Kraxner F. H. 
Published: August 2024

IntroductionDifferences in psychiatry training vary substantially across Europe. Such organisations as the European Federation of Psychiatry Trainees (EFPT), the European College of Neuropsychopharmacology, and the European Psychiatry Association, have committed to offer international experiences based on the premise that it could foster international collaboration, aid early career professionals to progress professionally and spark discussion regarding different practices across Europe. To date, there are no studies that focus exclusively on the exchange experience in mental health professionalsObjectivesI present the synthesis of the ten years answers from 2012 to 2022 to the post-exchange online evaluation form, which trainees had to fill in in order to receive an attendance certificate.MethodsThe present study analysed the answers of 202 psychiatry trainees or recent graduates who took part in the EFPT exchange program during 2012 and 2022 and filled in the internet-based evaluation form. The inclusion criteria were currently in training or recently finished training as a psychiatrist in Europe and filling in the questionnaire. The exclusion criterion was participation in the EFPT exchange program for the second or subsequent time.All trainees were systemically asked to complete the online evaluation form after the exchange period. The form includes sociodemographic, training in host country-related, and exchange experience-related questions. Experience measures were evaluated using the 4-point Likert scale. Data was anonymized before the analysis. The study followed the principles of the Declaration of Helsinki.ResultsThe majority of participants were females in the second half of their training. The average age was 29 years. The largest number of applicants were from Turkey, whereas the United Kingdom hosted the most participants. One-third of the participants had previous international exchange experience. Most trainees were exposed to both outpatient and inpatient treatment settings and were involved in educational or research activities. 96.7% of participants indicated that they were satisfied or very satisfied with the experience, 95.6% said that the exchange was useful or very useful, and 98.9% were likely or very likely to recommend exchange to colleagues.ConclusionsTo my knowledge, this study is the first to assess the experience of psychiatry trainees who went on exchange during their professional training. Vast majority of trainees were satisfied with their exchange, thought it would be useful for their clinical practice and would recommend it to their colleagues. These findings are in line with other studies that examined medical exchange experiences .Disclosure of InterestNone Declared
Validity and reliability of the Eating Disorder Examination-Questionnaire-7 Portuguese version in the perinatal period
Authors: Pereira A. T. , Lima R. , Pereira D. , Pinto J. M. , Barbosa B. , Araújo A. I. , Marques C. , Macedo A. , Pinto Gouveia C. 
Published: August 2024

IntroductionThe EDE-Q-7 Portuguese version presented good reliability and validity in Portuguese women fro the general population (Pereira et al. 2022).ObjectivesThe aim of our study was to analyse the psychometric properties of the EDE-Q-7 in a sample of Portuguese women during the perinatal period.MethodsParticipants were 346 women with a mean age of 31.68 of years old (± 4.061; range: 18-42). 160 were pregnant (second or third trimester) and 186 were in the post-partum (mean baby´s age=4.37 months (± 2.87; range: 1-12). They answered an online survey including the Portuguese version of the EDE-Q-7 and of the Screen for Disordered Eating/SDE.ResultsConfirmatory factor analysis (CFA) presented adequate fit, in pregnancy (χ2/df=; RMSEA=, p<.001; CFI=; TLI=; GFI=), postpartum (χ2/df=; RMSEA=, p<.001; CFI=; TLI=; GFI=) and considering both – perinatal period (χ2/df=2.7998; RMSEA=.0722, p<.001; CFI=.9709; TLI=.9444; GFI=.9761). The Cronbach’s alpha coefficients were >0.90 for the total and approximately .70 for the three factors - Dietary restraint, Shape/weight overvaluation and Body dissatisfaction. All the items contributed to the internal consistency and presented high internal consistency. Pearson correlations between factors and total scores were significant, positive and high, as well as between the EDE-Q-7 measures and SDE (>.60 with the total; >.40 with the factors), in pregnancy, postpartum and considering both periods.ConclusionsPresented sound psychometric properties across the perinatal period, the EDE-Q-7 and can be very useful to evaluate the presence and severity of eating disorders symptoms in women in pregnancy and post-partum.Disclosure of InterestNone Declared
Epidemiology of a psychiatric day hospital service in rome: descriptive analysis of a two-year period of hospitalizations
Authors: Moschillo A. , Zocchi C. , Pompili M. , Manfredi G. 
Published: August 2024

IntroductionPsychiatric Day Hospital (DH) constitutes an area of semiresidential care for short- and medium-term diagnostic and therapeutic-rehabilitative services. Through a descriptive analysis, we analyzed the clinical rationale and expected goals leading to an admission to the psychiatric day hospital service at St. Andrew’s Hospital in Rome, over a two-year period (2021-2022).ObjectivesWe aim, through the evaluation of the epidemiological data of patients, particularly the causes of admission and sending institutions, to be able to have at our disposal important comparison data to understand the characteristics of the patient population received in psychiatric day hospital services.MethodsMedical records of 218 patients admitted from 01.01.2021 to 31.12.2022 at the Psychiatry Day Hospital of Sant’Andrea Hospital in Rome were analyzed. The main sociodemographic and clinical characteristics and finally the type of psychiatric service from which the admission came were collected and analyzed, in addition to the reason for referral and therapeutic goal. Statistical analyses were conducted using Excel spreadsheets.Results64% of admissions aimed to modify or start new medication regimens with monitoring (e.g., Clozapine, Carbolithium, Esketamine). 19% were for medical evaluations, mainly neurological, cardiological, endocrinological, or internal medicine. 9% were for diagnostics. 2% were for infusion therapy, and an additional 2% for Esketamine treatment. The main findings highlight that Day Hospital use primarily focused on comprehensive patient assessments and therapy adjustments, often involving closely monitored drugs. Notably, 19% were for medical evaluations, with 28% of them being neurological assessments. This suggests challenges in conducting detailed medical assessments outside a context with prioritized access to such services.ConclusionsLimited data in the literature make it challenging to conduct comparative analyses regarding patients in psychiatric day hospital services. However, our data can spark a discussion about admissions with objectives that could potentially be addressed through alternative services. We should also explore why this isn’t happening. It could be interesting to conduct a descriptive analysis comparing epidemiological data from the two years before and after the period under investigation. Conducting retrospective statistical analysis on the collected data can yield more comprehensive results.Disclosure of InterestNone Declared
Trends of the mental health of the Hungarian adult population between 2010-2023
Authors: Kósa K. , Bíró É. 
Published: August 2024

IntroductionSeveral data have been published in the past decade on the mental health of the Hungarian population by different research teams but less information is available about the trends of mental status of the population based on comparable research methods.ObjectivesOur aim is to provide data on the time trends of mental status in Hungary using comparable methodology.MethodsFour cross-sectional mental health surveys of the adult Hungarian population were designed by the authors; data collection was carried out by an opinion polling company between 2010 and 2023. Representative samples were selected by multistage stratified cluster sampling and weighted for analysis. Self-filling questionnaires were used to collect information on demographic data and socioeconomic status; validated scales were used to assess pathological distress (GHQ) and sense of coherence (SOC).ResultsDistribution of the respondents by permanent residence, age and sex in all surveys reflected that of the adult population of the country. The proportion of adults struggling with severe psychological distress approximately halved from 14.53% in 2010 to 6.78% in 2019 showing a significantly improving trend (<0.001) with higher proportions of women being severely stressed compared to men. Sense of coherence, a measure of psychological resilience increased by 3.43 points from 2010 to 2019 (p<0.001), also reflecting a significantly improving trend without gender difference. However, the last survey of 2023 showed significant worsening with 18.85% of adults struggling with pathological distress, and a dramatic decrease in sense of coherence (-13.64 points).Educational level and social support were found to be consistent and significant determinants of mental health.ConclusionsMental health status improved among Hungarian adults in the past decade up until 2019 but the trend turned into the opposite by 2023. Further research is warranted to uncover the underlying causes of the latest changes.Disclosure of InterestNone Declared
Designing youth mental health services to improve access: A qualitative study and framework analysis of youths’ perspectives in Singapore
Authors: Vaingankar J. A. , Subramaniam M. , Samari E. , Chang S. , Tang C. , Lee Y. P. , Chong S. A. , Verma S. 
Published: August 2024

IntroductionAlthough there is an increasing interest in making mental health services (MHS) accessible to youths, there is limited ground-up involvement of youths while designing MHS in Asian settings.ObjectivesThis qualitative study sought to understand what youths considered as important elements of youth centric MHS and how these could be designed to improve access by youths in Singapore.MethodsWe conducted seven focus group discussions, and four semi-structured interviews with 50 multiracial youths aged 15-35 years in Singapore - a high-income Southeast Asian country. Purposive sampling allowed adequate representation of age, gender, and race (mainly Chinese, Malay, and Indian) groups. Participants reflected on the features of an ideal MHS for youths and how these could improve youths’ attitude and access to services. Participants also shared their preferences and additional opinions for culturally tailored and age appropriate MHS. Framework analysis using the ‘Conceptual Framework of Access to Healthcare’ (Levesque et al. Int J Equity Health 2013, 12:18) was used to code transcripts and identify the key themes (Ritchie & Spencer. In Analyzing qualitative data, 1994).ResultsThe average age of the participants was 24 years. About one third of the participants had accessed MHS in the past. Three key themes were identified – making facilities ‘approachable’, ‘available and appropriate’ and ‘affordable’. (i) Making facilities approachable related to having non-stigmatizing, non-threatening and welcoming aesthetics, organizational culture, and personnel. The participants also recommended a range of professional services, digital tools, and online features to enhance the approachability of MHS designed for youths. (ii) Flexible operating hours, easy appointment management, accessible location, and easy availability to youths with unique needs (e.g., employed youths) or socio-cultural backgrounds were necessary for making facilities available and accessible to youths. (iii) While sharing challenges of family involvement in the help-seeking process, most of the participants, particularly those in the lower ages, talked about tailoring MHS to the ability of youths to pay for the services. Preferences such as having cheaper services for teenagers and initial contacts, offering more non-medical but trained professionals, and considering shorter in-person counselling sessions, followed by free online options were brought up by the participants.ConclusionsThe study provided insights into multiple aspects of MHS and how these could be designed to cater to the needs of youths in Singapore from their perspective. MHS that incorporate non-stigmatizing, flexible, non-threatening and affordable design approaches could improve help-seeking and early interventions in youths.Disclosure of InterestNone Declared
Community psychiatric care for people with mental disorder and homelessness, with the involvement of peer support. Cooperation of the Awakenings Foundation and BMSZKI
Authors: Bulyáki T. , Harangozó J. , Harangozó Z. , Kéri P. 
Published: August 2024

IntroductionA person diagnosed with a psychiatric illness, must face labels and discriminiation most of the time. Fear of these undermines the motivation of people in need to seek help. A special example of this phenomenon is the case of people experiencing homelessness and mental disorder, avoiding the additional stigma of homelessness and therefore do not seek any help for their mental ill-health. Availability of the specific services complicates their problem.Fear of stigma, trauma, and previous bad experiences of using services also keep people experiencing homelessness away from services.In Hungary, the February Third Working Group (F3) Report on the 2020 Homelessness Survey After the Penal Code - Before the Pandemic Homelessness - Services Perspectives by Péter Győri shows in his summary paper that only 29% had received psychiatric treatment.ObjectivesMethodology Center of Social and Its Institutions (BMSZKI), in collaboration with the Awakenings Foundation, developed a complex rehabilitation service for people experiencing homelessness and mental disorder. This presentation aims to present this good practice.MethodsComplex rehabilitation based on the methodology of community psychiatric care with the involvement of peer support.Results-provision of community psychiatric care for people experiencing homelessness and mental disorder,-introduction of screening for effective care of undiagnosed persons with mental disorders,-provision of outpatient and day hospital care-focus of care in accommodation services on persons with mental disorders,-the involvement of peer-support work in the service,-building a network of contact points, organizing case conferences,-developing and organizing training on recovery-based rehabilitation for people with mental disorders in cooperation between the two organizations,-telemedicine, making digital mental health available-presence of resources represented by self-help groups

-running a working group to promote improvements based on practical experience homelessness and mental disorder.Conclusionsextra-institutional teamwork multiplies the resources for people experiencing homelessness and mental disorder.Keywordsmental disorder, homelessness, community psychiatric care, peer support, collaborationDisclosure of InterestNone Declared
The Mediating Role of Maladaptive Metacognitive Beliefs between Adverse Childhood Experiences and Trait Anxiety
Authors: Horváth D. , Kovács-Tóth B. , Oláh B. , Fekete Z. 
Published: August 2024

IntroductionAdverse childhood experiences (ACE) have a significant negative impact on health. ACEs lead to more pronounced trait anxiety, among others, which serves as a basis for various mental and somatic symptoms. Recent findings suggest that the fact that individuals with more ACEs also have more maladaptive metacognitive beliefs may contribute to the development of these symptoms.ObjectivesWe aim to study the possible mediating role of maladaptive metacognitive beliefs, resulting from adverse childhood experiences, on trait anxiety.MethodsData was collected online, anonymously, in a non-clinical population of adults over 18 years of age. The sample consisted of 304 subjects (84.21 % women, 15.79 % men). The applied questionnaires included a demographic questionnaire, the Adverse Childhood Experiences Questionnaire 10 item version, the Meta-Cognitions Questionnaire, and the Spielberger Trait Anxiety Questionnaire. The system of correlations between the examined variables was explored using structural equation modeling (SEM). The study was carried out with ethical approval and in accordance with the Declaration of Helsinki.ResultsOur results confirm that ACEs have a significant impact on all the measured dimensions of maladaptive metacognitive beliefs. The direct effect of ACEs on adult trait anxiety is also significant. The results of the study on indirect effects support the joint mediating role of the five metacognitive dimensions. The strongest significant mediating effect was found for the uncontrollability and dangerousness of negative beliefs about worry. Both the direct and indirect effects of cognitive self-consciousness on adult trait anxiety are negative, which means that the more the cognitive self-consiousness is characteristic of someone, the lower the degree of trait anxiety in adulthood is.ConclusionsOur results confirm the mediating effect of metacognitive beliefs on trait anxiety in the context of adverse childhood experiences, which points to the importance of further research on metacognition among the population that suffered early adversities. One of the limitations of the study roots in online data collection: the examined sample is not representative. Moreover, to extend the results, it is recommended to repeat the study on a clinical population. This would enable us to compare our results with those of the clinical population, which could provide further important results in the field of metacognition and adverse childhood experiences.Disclosure of InterestNone Declared
Changing Tactics? Optimizing ECT in difficult-to-treat depression (ChaT): study protocol
Authors: Van den Eynde L. , Vansteelandt K. , Hebbrecht K. , Obbels J. , Verspecht S. , Gistelinck L. , Geerts P.-J. , Schrijvers D. , Sienaert P. 
Published: August 2024

IntroductionElectroconvulsive therapy (ECT) is an evidence-based treatment for difficult-to-treat depression, in which an electrical stimulus is applied via right unilateral (RUL) (Fig 1) or bitemporal (BT) electrodes (Fig 2). Current guidelines recommend to start ECT with RUL placement, except for cases where rapid response is needed. BT ECT has the reputation of exerting a stronger and faster antidepressive effect, but is associated with more pronounced cognitive side effects, as compared to RUL ECT. Recent studies, however, suggest comparable outcomes. In patients responding to ECT, most of the improvement in depressive symptom severity is witnessed early in the treatment course. In case of non-response, it is common practice to switch from RUL to BT electrode placement, although scientific evidence is lacking. As an answer to this research gap, the ChaT-trial was designed: a randomized controlled trial (RCT) to address which treatment strategy (either continue RUL ECT or switch to BT ECT) speeds up recovery with the least impact on cognitive function, in case of early non-response after 4 ECT sessions.Objectives1)To compare the antidepressant efficacy and cognitive effects of continuing RUL ECT vs switching to BT ECT.2)To assess group and subject-specific trajectories of depressive symptom severity and neurocognitive performance during the acute ECT course and up to 3 months post-treatment.
MethodsThis multi-center double-blind RCT includes adult patients with a uni- or bipolar depression. In case of non-response (<50% decrease of IDS-CR score (Inventory of Depressive Symptomatology-Clinician Rated)) after 4 sessions of brief-pulse high-dose RUL ECT, patients are randomized to either continue RUL ECT, or switch to brief-pulse moderate dose BT ECT until remission. Depressive symptoms are assessed by IDS-CR, Psychotic Depression Assessment Scale (PDAS) and CORE assessment of psychomotor change. An extensive neuropsychological test battery is used to assess different domains of cognitive functioning, e.g., autobiographical memory using the Colombia University- Autobiographical Memory Interview Short- Form (CU-AMI-SF)(Fig 3).ResultsOur hypotheses are: (1) continuing RUL ECT is non-inferior to switching to BT ECT in terms of depressive symptom severity, and (2) continuing RUL ECT is superior to switching to BT ECT in terms of cognitive side effects.Image:Image 2:ConclusionsThe ChaT-trial is the first RCT comparing antidepressant efficacy and cognitive effects of continuing RUL ECT with switching to BT ECT in case of early non-response during an acute ECT-course. The results may optimize clinical decision making, speeding up recovery, while minimizing cognitive side effects.Disclosure of InterestNone Declared