bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adverse incidents and therapy options for opioid use disorders in forensic psychiatry
Authors: Voulgaris A. 
Published: August 2023

IntroductionPatients admitted into Forensic Clinics for Dependency Diseases (FCDD) in Germany are diagnosed with at least one substance use disorder. Opioid use disorders is common in this clinical population. Surprisingly, data on the availability and practice of opioid substitution treatment (OST) options in German FCDD according to Sect. 64 of the German Criminal Code (StGB) is scarce. Additionally, important data on the prevalence of adverse incidents such as violent behavior, relapse or escape from the clinic are missing for this highly specific treatment setting.ObjectivesOur aim ewas to describe the clinical practice regarding opioid substitution therapy in forensic psychiatry in Germany and to identify the prevalence of relevant adverse incidents during the therapy process.MethodsWe conducted a observational study including all FCDD units in Germany via a questionnaire. We assessed the clinical practice and total number of patients that received an OST, clinical reasons for beginning and ending the OST, number of treatments terminated without success, number of successful treatments and relevant adverse incidents such as violent behavior, relapse, escape and reoffending. The data was analyzed descriptively.Results15 of the existing 46 FCDD participated in our study (33%). In total, 2483 patients were treated in the participating FCDD, 18% of the patients were relocated into prison due to treatment termination and 15% were discharged successfully. 275 adverse incidents were reported: violence against a patient (4%), violence against staff (1,6%), escape (4,7%) and reoffending (0,5%). Merely in seven FCDD treating 1153 patients, an OST was availabe. Available options included buprenorphine/naloxone, buprenorphine, methadone and levomethadone. Regarding adverse incidents and successful discharge, no differences were detected in the clinics with or without an OST. In the clinics that offered an OST, we found a significantly higher rate for treatment termination without success (p<0.007) in comparison to clinics without this program. 99 patients received an OAT and this treatment was ended due to illegal drug abuse (57%), refusal to give an urine drug sample (71%) and in cases were the OAT was given away to other patients (85%).ConclusionsSurprisingly, opioid substitution therapy is only accessible in a part of the FCDD in Germany. Reasons for this are unclear. Critical incidents such as violent behavior against staff/patients and escape are not uncommon in this forensic psychiatric treatment setting. Further studies are needed to enhance the understanding of the limited OST practice and the risks for patients and staff in this specific forensic treatment setting.Disclosure of InterestNone Declared
Older adults’ mental health during humanitarian crisis
Authors: De Mendonca Lima C. A. 
Published: August 2023

IntroductionA humanitarian crisis is defined as a singular event or a series of events that are threatening in terms of health, safety or wellbeing of a community or group of individuals, and require action that is usually urgent and often non-routine. Examples of such crisis are wars, natural disasters, epidemics and forced immigration. There is an urgent need of an international commitment to planning for humanitarian emergencies that include individual and community psychosocial support for older adults with mental health conditions. The current lack of inclusion for these older adults in humanitarian response is dramatic and constitute a clear violation of their Human Rights.ObjectivesThe World Psychiatric Association Section of Old Age Psychiatry and the International Psychogeriatric Association are working together since 2020 to promote the older adults’ Human Rights. Articles, position statements, seminars, sympsoia and congress were produced. The ultimate common goal is to support the adoption of an UN Convention on the Human Rights of the Older Persons that include the promotion and protection of the mental health of these persons.MethodsInput to the Independ Expert on Older Adults at the OHCHR who prepared official repports presented during the UN General Assembly in 2022.Publication of articles, organization of seminars, symposia and congressResultsThe main documents pulblished will be presented as well the template of the next Position statement on Older Adult’s mental health during Humanitarian CrisisConclusionsHumanitarian actors must provide assistance in accordance with the principles of humanity, neutrality and impartiality. Promoting and ensuring compliance with these principles are essential elements of effective humanitarian coordination, in respect of the Human Rights principles, in particular when vulnerable people such older adults with mental health conditions are involved.Disclosure of InterestNone Declared
Smoking in an Inpatient Psychiatric Unit in Ireland with a “Tobacco Free Campus” policy: the prevalence, the associated factors, the social consequences and what can be done to address this
Authors: Srikumar K. , Adam A. , Sargaison F. , O’Grady M. 
Published: August 2023

IntroductionSmoking is highly prevalent in patients with mental health disorders and although most literature describes the physical health impact of smoking, there is little which addresses the poverty and social consequences associated with nicotine addiction. In 2022, Ireland’s HSE (Health Service Executive) published clinical guidelines, regarding smoking cessation in healthcare settings, with special attention to mental health settings.ObjectivesThe aim of this study was to assess the current prevalence of smoking among inpatients in a psychiatric unit with a “Tobacco Free Campus” policy in place, and the associated patient factors. We also assess the efficacy at which mental health professionals are addressing smoking in this setting.MethodsWe performed a cross-sectional analysis of all patients admitted to the inpatient psychiatric unit on a single date. All inpatients were interviewed using a standardised format to ascertain smoking history and employment status. Case records were examined to record diagnoses and assess the patient’s inpatient care plan, nursing admission proforma and medical admission proforma. Medication charts were examined to ascertain whether Nicotine Replacement Therapy (NRT) was prescribed to those identified as smokers. Using Microsoft Excel, we analysed the smoking behaviours data gathered, and the identification of smokers and their orientation to the Tobacco Free Campus policy, on admission.ResultsOf the 51 inpatients, 78% (n=40) had an Axis 1 diagnosis according to the DSM-4, 72% (n=37) were unemployed and 67% (n=34) were receiving Social Welfare. 57% (n=29) of inpatients were current smokers. 63% (n=25) of smokers had an Axis 1 diagnosis, 51% (n=19) were unemployed and 53% (n=18) were receiving Social Welfare. Since admission, 52% (n=15) of smokers have been smoking more, and 48% (n=14) have been spending more money on tobacco. 7% of smokers (n=2) started smoking on the unit. 50% (n=9) of smokers receiving Social Welfare were smoking more, with the majority in receipt of long-term disability allowance (n=7). Only 10% (n=3) of smokers were prescribed NRT, with only 1 patient taking NRT. 90% (n=26) of smokers did not have smoking addressed in their care plan. 38% (n=11) had a fully completed smoking history in the nursing admission, while only 14% (n=4) had one in the medical admission.ConclusionsDespite a Tobacco Free Campus policy, smoking continues to be highly prevalent in an inpatient psychiatric setting. Smoking was particularly prevalent in patients with Axis 1 diagnoses, and in the unemployed. A large proportion increased their smoking on admission, and their expenditure on tobacco. More can be done to identify smokers on admission so as to promote quitting, and in turn, reduce the social consequences related.Disclosure of InterestNone Declared
Cannabis and cognitive deficiency: a descriptive study
Authors: Kacem M. , Bouali W. , Henia M. , Brahim S. , Zarrouk L. 
Published: August 2023

IntroductionCannabis is the most widely used illicit drug; 3.8% of the world’s population consumes cannabis on a regular basis. Cannabis use–associated alterations in the domain of cognition have been extensively studied.ObjectivesTo research memory deficiency in the young consumers of cannabis in Tunisia.MethodsThis is a transversal descriptive study conducted during two months (January and February 2022). The research involved about 137 participants aged between 18 and 35 years old, exhaustively recruited amid emergency patients of Mahdia Hospital regardless of the reason for their health care seeking. The patients were declared as consumers of cannabis and accepted to be part of this study. Therefore, Data were collected on a pre-determined data sheet that included various information (age, sex, lifestyle, personal and family psychiatric history, age when first used cannabis and the rate of cannabis use …).Principally, a Functional Impact Assessment (ERF: French abbreviation for échelle d’évaluation des Répercussions Fonctionnelles ) scale was used to assess and review working memory.ResultsIn our study population, there was a noticeable male predominance of 71%. Hence, the age structure ranged between 18 years old and 35 years old. Among the latters, 65.9% were single, and 29.7% experienced school failure. In this sample, 23.2% had a psychiatric history like depression, bipolarity, etc. The average age of the first use of cannabis was between 18 and 25 years old in 70% of cases.Besides, a high percentage of association of other substances was found among cannabis users as follows: use of alcohol 72.5%, tobacco 74.6%, ecstasy 41.3%, and cocaine 25.4%. First and foremost, the use of cannabis was considered as a means of indulgence for 66.7% of the study population, as an anxiolytic for 26.8%, and as a sedative for 23.9%.Additionally, the effect of cannabis use on working memory deficiency according to the functional impact assessment scale was: no deficiency in 19% of cannabis users, minimal in 34%, mild in 32%, moderate in 9%, fairly severe in 4%, very severe in 1%, and extreme in 1% of cases.More importantly, the percentage of consumers with significant memory deficiency (moderate to extreme) was 15%.ConclusionsThe assumption of the effect of cannabis on memory and cognitive deficiency remains controversial and leads us to suggest further in-depth study of this subject.Disclosure of InterestNone Declared
Person-centered approach to work with drug addicts on substitution maintenance therapy
Authors: Halytska-Pasichnyk N. , Moroz S. , Semenikhina V. 
Published: August 2023

IntroductionAccording to the United Nations World Drug Report 2019, there are an estimated 53 million opioid users[1]. Health problems, social problems associated with this abuse are the result of a complex interaction between psychoactive substances, the patient and the environment. There are two main approaches in the treatment - aimed at complete abstinence from the use of a psychoactive substance and substitution maintenance therapy using methadone and buprenorphine [2]. This is due to the pharmacological effects of narcotic substances, the dynamics of physiological processes and the general state of health with the systematic use of psychoactive substances.ObjectivesThe problem of the use of narcotic substances must be considered not only as a physiological problem, but also as a problem of a person resorting to drugs in a specific social situation. In this case, curative and rehabilitation work acquires new content and new opportunities. The emergence of addiction depends on two main reasons: on the one hand, these are certain specific personality traits of a person, formed primarily by the family, and on the other hand, external factors such as the influence of friends, curiosity, life difficulties experienced and other personal problems. The greatest danger of the formation of drug addiction occurs in the case of simultaneous exposure to both groups of causes.MethodsThe study interviewed 123 patients aged 23 to 45 years (109 men and 14 women) diagnosed with opioid addiction. Of these, 17 patients with a period of abuse of up to three years and 105 - longer than three years, respectively. Personality disorders were assessed using the 16-factor Cattell Personality Questionnaire for the study of personality traits [3], the multi-aspect MMPI methodology (mini-mult) [4], and the Luscher color choice method [5].Results14 drug addicts (82%) with a period of abuse of less than 3 years were characterized by impulsivity, reduced stress resistance, risk appetite; in 83 drug addicts (79%) with a period of abuse longer than 3 years, persistent psychosocial maladjustment, communication difficulties, conflicts were detected, social norms were disregarded, increased readiness for open manifestation of aggression; 14 women (100%) had features of mental rigidity, disregard for social norms, conflict, impulsiveness; 88 men (81%) had emotional instability, excitability, hostility.ConclusionsThe formation of opioid dependence is influenced by both the psychophysiological characteristics and the pathopsychological changes that occurred during the use of a psychoactive substance.Addiction therapy should include a psychological analysis of risk factors.Selection of psychological options for social adaptation that contribute to the maximum possible realization of the individual’s potential, will increase the effectiveness of substitution therapy and accelerate the resocialization of drug addicts.Disclosure of InterestNone Declared
Prospective Study of Prolonged Grief Disorder in Relatives of COVID-19 Deceased
Authors: Martins S. N. , Salgado R. , Nogueira Â. , Guedes I. , Carvalho N. , Ribeiro Â. , Ribeiro B. , Mendes D. 
Published: August 2023

Introduction
COVID-19 pandemic along with its social restrictions changed our burial practices and
the way we bury our dead. In consequence, it affected people’s experiences and traditions
which could lead to severe, persistent, or disabling grief.
Thereby, it is relevant to understand how someone may be more susceptible to
developing pathological grief and what can we do to prevent it.

Objectives
To assess the risk of Prolonged Grief Disorder (PGD) in family members of patients who
died from COVID-19 infection and identify possible risk factors.

Methods
Prospectively, we performed follow-up interviews conducted with family members of all
patients who died from COVID-19 infection in 2020 at our hospital. The sample was
characterized, and clinical follow-up was performed for at least 6 months after the date of
death. By that time, the PG-13 scale was applied.

Results
A total of 269 individuals who had some type of relationship with patients who died
from COVID-19 were included, with 68% being female with a mean age of 53.7 years.
After clinical follow-up, 10.8% of the patients met the diagnostic criteria for
PGD.
Regarding the degree of kinship, the only predictor of PGD was “spouse” (OR 11,236,
[4,762; 26,316]; p < 0,001). A closer and more regular interaction with the deceased was
also associated with an increase in PDG (OR 5.682, [1.314; 24.390] p = 0.009).
Feelings of denial and guilt by the time of death notification were also risk
predictors for PGD (OR 2,412, [1,091; 5,332] p = 0,026) and OR 2,888, [1,244; 6,703] p =
0,011, respectively).
The impossibility of being present at the funeral was associated with a risk of about
3 times higher of developing PGD (OR 3,817 [1,727; 8,403] p < 0,001).
Older age (p<0,001) and lower educational qualification (p=0,003) were also
presented as risk factors.
Other characteristics including gender, marital status, previous suicide attempts,
psychiatric or consumption history, previous significant bereavement or the social and family
support of the person contacted were not predictors of PGD.

Conclusions
The present prospective study made it possible to reinforce and support the way in
which the COVID-19 pandemic, associated with significant social modifications, changed the
way people experience grief.

Disclosure of Interest
None Declared
Biomarker Variability, Severity of CORADS and Impact of Psychotropic Medications on Course and Outcome of Neuropsychiatric Sequalae of COVID-19 ICU Patients: A Preliminary Observation from South India
Authors: Kandrakonda S. , Vatte V. R. , Penubarthi S. , Karri S. R. , Kamble A. , Khairkar P. , Pustakaala D. , kanlur A. , Anna S. K. Y. , Penugonda S. S. , Gadde R. , Inakollu V. K. , Soorineedu R. 
Published: August 2023

IntroductionThere is growing evidence of neuropsychiatric presentations in patients of COVID-19, but literature is scarce on laboratory, clinical and radiological markers as well as impact of psychotropic medications during the course of hospitalization in critically ill patients.ObjectivesThe primary outcome measure was variability of clinical biomarkers and CORADS scores with severity of COVID-19 infections and the impact of psychotropic medications like risperidone and aripiprazole.MethodsWe screened 430 ICU patients admitted to our tertiary care hospitals, out of whom 67 were diagnosed positively with definitive neuropsychiatric sequalae and receive psychotropic interventions during their hospital stay. We compared their D-dimer levels, C-reactive proteins, serum ferritin levels, serum procalcitonin and Vitamin D levels and further analyzed CORADS severity score with psychiatric severity and outcome.ResultsThe mean age of the patients was 42.38 years, majority (44.8%) of them belonged to 21-34 years with slight (52.2%) male preponderance and none of them were more than 60 years. We observed a 43.3% were having organic mood disorder and 37.3% of individual had significant history of alcohol dependence while hypertension and diabetes mellitus were noted in 34.3% and 29.9% respectively. Only D-dimer levels were found to be significant and positively associated with outcome of psychiatric disorders (p<0.05), accounting for 41% of covariance on linear regression analysis.ConclusionsOur study has found significant association of elevated levels of D-dimer variability but not the other laboratory biomarkers among various neuropsychiatric comorbid sequalae in ICU admitted COVID 19 patients. This particular observation might have potential for serum D-dimer levels to be possibly used as an early biomarker to screen or suspect for comorbid neuropsychiatric presentations.Disclosure of InterestNone Declared
Lower thyroid stimulating hormone concentrations linked to suicidal ideations among individuals with anxiety and mood disorders
Authors: Liaugaudaitė V. , Podlipskytė A. , Burkauskas J. , Mickuvienė N. , Adomaitienė V. , Zauka E. , Steiblienė V. 
Published: August 2023

IntroductionSuicidal behavior is quite common in individuals with anxiety and mood disorders (AMD). One of the coexistence factors in suicidal behavior is thyroid dysfunction, however the results are still controversial (Shen et al. J Affect Disord 2019;(1)180-185; Zhou et al., Transl Psychiatry. 2021;11(1):97). The role of thyroid function in suicidal ideation among individuals with comorbid AMD have not been thoroughly investigated.ObjectivesThe aim of this cross-sectional study was to identify potential associations between thyroid function and suicidal ideation in a sample of individuals with anxiety and mood disorders.MethodsThis exploratory study comprised 77 consecutive individuals with AMD (age range 18-73 years, 76% were females) attending the Psychiatry Day care unit. All individuals have been evaluated for current psychiatric diagnoses, suicidal ideation using the Mini International Neuropsychiatric Interview [M.I.N.I. 7.0.2]) as well as for socio-demographic factors and for current psychotropic medication use. Severity of depression and anxiety symptoms have been evaluated using the Patient Health Questionnaire-9 (PHQ-9) and the General Anxiety Disorder-7 (GAD-7). The biochemical blood tests were performed for the concentrations of thyroxine (FT4), triiodothyronine (FT3) and thyroid stimulating hormone (TSH). The univariate and multivariable logistic regression analyses were used to assess the association between biochemical parameters and suicidal ideation.ResultsOf all study individuals with AMD – 56% have been identified as having current SI. There were not significant differences according to age, gender, education, BMI, smoking, depression and anxiety symptoms and current psychotropics use between SI and non-SI individuals. Serum FT4, FT3 and TSH concentrations were within normal range. However individuals with SI had significantly lower TSH concentrations in comparison to the non-SI (1.54 (0.77) vs. 2.04 (1.22) IU/L, respectively; p = 0.049), without significantly differences in FT4 and FT3 concentrations. A multiple logistic regression, adjusting for sociodemographic factors and severity of mental symptoms revealed, that non-SI individuals with AMD were likely to have higher TSH levels than SI (odds ratio = 2.15 (95% CI 1.10–4.22; p = 0.027).ConclusionsAmong individuals with AMD, lower levels of TSH concentrations have been associated with presence of suicidal ideation, independently of sociodemographic factors and severity of depression and anxiety.Disclosure of InterestV. Liaugaudaitė Grant / Research support from: European Union (project No P-PD-22-150) under the agreement with the Research Council of Lithuania (LMTLT)., A. Podlipskytė: None Declared, J. Burkauskas Consultant of: Cronos, N. Mickuvienė: None Declared, V. Adomaitienė: None Declared, E. Zauka: None Declared, V. Steiblienė: None Declared
Resting-state gamma oscillations in adult Autism spectrum disorder: A High-Density EEG study
Authors: Kakuszi B. , Szuromi B. , Tóth M. , Bitter I. , Czobor P. 
Published: August 2023

IntroductionAutism is neurodevelopmental disorder with a heterogeneous presentation of symptoms, which include disturbances in sensory, motor and cognitive processes, among which social cognitive impairments and social interaction difficulties play prominent role. Despite the fact that these impairments can lead to lifelong disability and difficulties in everyday functioning, their neurobiological basis remains largely unknown. Neural oscillations in the gamma band have been shown to be an important candidate neurobiological marker of higher order cognitive processes and social interactions. Yet, alterations of gamma oscillations in ASD have received little attention in the literature.ObjectivesThe aim of the current study was to investigate resting state gamma oscillations in the EEG in order to delineate alterations in ASD as compared to typically developing (TD) subjects in the intrinsic activity of the neural networks that have been linked to social cognitive functioning.MethodsResting-state EEGs were obtained in an ongoing study investigating ASD (N=19) and TD subjects (N=15), based on eyes closed condition. EEGs were recorded using a 128-channel BioSemi system. EEG absolute power was investigated in the gamma 30-48Hz frequency band.ResultsGamma activity was significantly (p<0.05) diminished in multiple brain regions in ASD as compared TD subjects. The diminished gamma activity had a distinctive topographical distribution, which included the left and right inferior temporal gyrus, the right superior temporal gyrus, the TPJ and the right extrastriate areas. Additionally, we found a hemispheric asymmetry in the occipital brain areas with a decrease of gamma activity on the right and an increase in the left hemisphere as compared to TD.ConclusionsDiminished gamma activity in the above brain areas may represent a cortical dysfunction which can be present due to a reduced capacity to process socially relevant information and a decreased capacity to omit irrelevant stimuli.Funding: Hungarian Brain Research program,#NAP2022-I-4/2022Disclosure of InterestNone Declared