bluuebunny/crossref_metadata_2025_split huggingface dataset:
The influence of paternity leave uptake on parental post-partum depression: An ELFE cohort study
Authors: Barry K. M. , Gomajee R. , Benarous X. , Dufourg M.-N. , Courtin E. , Melchior M. 
Published: August 2023

IntroductionMany countries are currently expanding their paternity leave policies, which have positive effects on parental mental health.ObjectivesWe examined whether two weeks of paid paternity leave are associated with post-partum depression (PPD) in mothers and fathers at two months after the birth of their child.MethodsData originated from The Etude Longitudinale Française depuis l’Enfance (ELFE) cohort study. A total of 10 975 fathers and 13 075 mothers with reported information on paternity leave and PPD at two months were included in the statistical analyses. Logistic regression models, using survey-weighted data and adjusted for confounders using Inverse Probability Weights (IPW), yielded Odds Ratios.ResultsFathers had a median age of 32∙6 (inter-quartile range (IQR) 36∙9 – 22∙6 years), and mothers had a median age of 30∙5 years (IQR 34∙0 – 27∙1 years) at the time of the ELFE child’s birth. Fathers who took paternity leave had reduced odds of PPD [0∙74 (95% CI: 0∙70 -0∙78)] as well as fathers who intended to take paternity leave [0∙76 (95 CI%: 0∙70 – 0∙82)] compared to fathers who did not take paternity leave. Mothers had an increased likelihood of PPD at two months if their partners took paternity leave [1∙13 (95 CI%: 1∙05 – 1∙20)]. Fathers’ educational level, work contract type nor the number of children in the family were found to be interactions (p>0.25).ConclusionsTaking and intending to take a two-week paid paternity leave is associated with lower odds of PPD in fathers. Mothers whose partners take paternity leave experience borderline higher odds of PPD at two months. Offering only a two-week paternity leave may protect fathers against PPD but does not significantly protect may increase mothers’ risk of against PPD onset.Disclosure of InterestNone Declared
Implementation of Early Intervention Services (OPUS) in Denmark and results of 20 year follow-up of the OPUS trial
Authors: Nordentoft M. 
Published: August 2023

Abstract: BackgroundThe OPUS trial is the largest randomized controlled trial (RCT) testing early intervention services with 20-years of follow-up among individuals with a first episode of psychosis in the schizophrenia spectrum.MethodsA total of 547 individuals with first episode psychosis in the schizophrenia spectrum were included into the OPUS I trial between January 1998 - December 2000 and allocated to either two years of early intervention services or treatment as usual. Clinical and trained staff, blinded to the original treatment allocation, performed the five, ten and 20-year follow-up assessments.The early intervention service consisted of two years of assertive community treatment including social skill training, psychoeducation and family involvement delivered by a multi-disciplinary team (staff patient ratio 1:10). The standard treatment was based on the available community mental health treatment (1:20 –1:30).ResultsA total of 164 participants (30%) of 547 were interviewed at the 20-year follow-up. No significant differences were found between the early intervention group (OPUS-group) compared to the Treatment As Usual group (TAU-group) on global functional levels, psychotic and negative symptom scores after 20 years. Likewise, no differences was found ten to 20-years after randomization between the OPUS-group and TAU-group on days of psychiatric hospitalizations (Incidence Rate Ratio (IRR), 1.202, 95% CI 0.733 - 1.997, P=0.46), or number of outpatient contacts (IRR: 1.197, 95% CI 0.889 - 1.612, P=0.24). Of the entire cohort, 40% were in symptom remission and 18% were in clinical recovery at the 20-year follow-up. The mortality rate 20 years after randomization was 13.1% in the OPUS-group and 15.1% in the TAU group, P=.47.Conclusions and RelevanceNew initiatives are needed to maintain the positive outcomes achieved after two years of early intervention servicesDisclosure of InterestNone Declared
Learning how relationships work: a thematic analysis of young people and relationship professionals’ perspectives on relationships and relationship education
Authors: Benham-Clarke S. R. , Ewing J. , Barlow A. , Newlove-Delgado T. 
Published: August 2023

IntroductionRelationships in various forms are an important source of meaning in people’s lives that can benefit their health, wellbeing and happiness. Relationship distress is associated with public health problems such as alcohol misuse, obesity, poor mental health, and child poverty, whilst safe, stable, and nurturing relationships are potential protective factors. Despite increased emphasis on relationship education (RE) in schools, little is known about the views of relationship professionals on relationship education specifically, and how this contrasts with the views of young people (YP).ObjectivesThis Wellcome Centre for the Cultures and Environments of Health funded Beacon project seeks to fill this gap by exploring their perspectives and inform the future development of relationship education.MethodsWe conducted focus groups with YP (n=4) and interviews with relationship professionals (n=10). The data was then thematically analysed.ResultsThemes from YP focus groups included: ‘Good and bad relationships’; ‘Learning about relationships’; ‘the role of schools’ and ‘Beyond Relationship Education’. Themes from interviews with relationship professionals included: ‘essential qualities of healthy relationships’; ‘how YP learn to relate’ and ‘the role of RE in schools’.ConclusionsYP and relationship professionals recognised the importance of building YP’s relational capability in schools with a healthy relationship with oneself at its foundation. Relationship professionals emphasised the need for a developmental approach, stressing the need for flexibility, adaptability, commitment and resilience to maintain relationships over the life course. YP often presented dichotomous views, such as relationships being either good or bad relationships, and perceived a link between relationships and mental health. Although not the focus of current curriculum guidance, managing relationship breakdowns and relationship transitions through the life course were viewed as important with an emphasis on building relational skills. This research suggests that schools need improved RE support, including specialist expertise and resources, and guidance on signposting YP to external sources of help. There is also potential for positive relationship behaviours being modelled and integrated throughout curriculums and reflected in a school’s ethos. Future research should explore co-development, evaluation and implementation of RE programmes with a range of stakeholders.Disclosure of InterestNone Declared
The different effect of adverse childhood experiences on Theory of Mind brain networks in schizophrenia and healthy controls
Authors: Pelucchi A. , Calesella F. , Bechi M. , Cavallaro R. , Poletti S. , Vai B. , Benedetti F. 
Published: August 2023

IntroductionDeficit in Theory of Mind (ToM) is a core feature of schizophrenia (SZ), while adverse childhood experiences (ACEs) can contribute to worsen ToM abilities through their effect on brain functioning, structure and connectivity.ObjectivesHere, we investigated the effects of ACEs on brain functional connectivity (FC) during an affective and cognitive ToM task (AToM, CToM) in healthy control (HC) and SZ, and whether FC can predict the performance at the ToM task and patients’ symptoms severity.MethodsThe sample included 26 HC and 33 SZ. In an fMRI session, participants performed a ToM task targeting affective and cognitive domains. Whole-brain FC patterns of local correlation (LC) and multivariate pattern analysis (MVPA) were extracted. The significant MVPA clusters were used as seeds in further seed-based connectivity analyses. Second-level analyses were modelled to investigate the interaction between ACEs, the diagnosis, and the task, corrected for age, sex, and equivalent doses of chlorpromazine (p<0.05 FWE). FC values significantly affected by ACEs (Risky Family Questionnaire) were entered in a cross-validated LASSO regression predicting symptoms severity (Positive and Negative Syndrome Scale, PANSS) and task performance measures (accuracy and response time).ResultsIn AToM, LC showed significant different effects of ACE between HC and SZ in frontal pole, caudate and cerebellum. MVPA showed significant widespread interaction in cortico-limbic regions, including prefrontal cortex, precuneus, insula, parahippocampus, cingulate cortex, temporal pole, thalamus, and cerebellum in AToM and CToM. SBC analyses found significant target regions in the frontal pole, cerebellum, pre and postcentral gyrus, precuneus, lateral occipital cortex, angular gyrus, and paracingulate gyrus. LASSO regression predicted PANSS score (R2=0.49) and AToM response latency time (R2=0.37).ConclusionsOur findings highlighted a widespread different effect of ACEs on brain FC in ToM networks in HC and SZ. Notably, the FC in these regions is predictive of behavioral ToM performance and clinical outcomes.Disclosure of InterestNone Declared
Multimorbidity patterns and health care utilization among older adults with schizophrenia
Authors: Hwong A. , Li Y. , Morin R. , Byers A. 
Published: August 2023

IntroductionOlder adults with schizophrenia often have multiple chronic conditions, or multimorbidity, yet most prior research has focused on single medical conditions.ObjectivesTo characterize multimorbidity patterns and utilization among older adults with schizophrenia to understand how multimorbidity affects this population and their clinical service needs.MethodsThis retrospective cohort study included veterans aged 50 years and older with schizophrenia and followed their comorbid diagnoses and utilization (outpatient, inpatient, and emergency) from 2012 to 2019. Comorbid diagnoses included myocardial infarction, congestive heart failure, stroke, chronic obstructive pulmonary disease (COPD), cancer, dementia, traumatic brain injury, hepatitis C, osteoarthritis, renal disease, chronic pain, sleep disorder, depression, dysthymia, posttraumatic stress disorder (PTSD), general anxiety disorder, alcohol use disorder, other substance use disorder, and tobacco use disorder. Latent class analysis was used to identify latent profiles of psychiatric and medical comorbidity. Chi-square and F-tests were used to assess differences in demographics, comorbidities, and utilization across the latent classes.ResultsThe cohort included 82,495 adults with schizophrenia. Three distinct multimorbidity classes were identified: Minimal Comorbidity (67.0% of the cohort), High Comorbidity (17.6%) and Substance Use Disorders and Related Conditions (SUDRC) (15.4%). The Minimal Comorbidity class had <10% prevalence of all comorbid diagnoses. The High Comorbidity class had >20% prevalence of congestive heart failure, COPD, dementia, renal disease, sleep disorder, and depression. The SUDRC class had >70% prevalence of alcohol and drug use disorders and >20% prevalence of COPD, hepatitis C, depression, and PTSD. Although the High Comorbidity class had the highest rates of chronic medical conditions, the SUDRC class had the highest rates of emergency and inpatient medical care and emergency, inpatient, and outpatient mental health care utilization. Comparing across classes, all p-values were <.001 for utilization.ConclusionsOlder adults with schizophrenia are a heterogeneous group with distinct multimorbidity classes and different patterns of utilization. Those with high prevalence of substance use disorders had the highest rates of emergency and inpatient medical and overall mental health care utilization. Tailoring integrated care services to target specific clinical needs could improve outcomes for this population.Disclosure of InterestNone Declared
Osteopenia and osteoporosis associated with hyperprolactinemic antipsychotics
Authors: Montejo A. L. , Buch B. , Santana Y. , Matías J. , Matias-Polo J. , Martín-Pinto T. , Matos C. , Cortés B. , de Alarcón R. , Fombellida C. , Acosta J. M. 
Published: August 2023

IntroductionThe main role of prolactin is associated mainly with lactogenesis but additionally it participates in several endocrinological and metabolic processes. The prolactin level may be increased with some antipsychotics such as risperidone, paliperidone, and amisulpride increasing the risk of Bone Mineral Mass (BMM) decrease leading to osteopenia and osteoporosis.ObjectivesTo determine the loss of BMM associated with antipsychotic-related iatrogenic hyperprolactinemia (iHPRL) in a sample of patients suffering of chronic psychotic mental disorder and treated with antipsychotics at least for one year.MethodsA cross-sectional observational and epidemiological study in a sample of 140 patients (males 56.9%; females 43.1%; mean age 48 years), receiving antipsychotics was carried out. After giving informed consent, personal data, prolactin level, antipsychotic use and lifestyle were collected. An evaluation of BMM with a central DEXA Scan was performed. The bone mineral density considering the subject´s age and the peak bone mass in the neck of the femur, hip and in the lumbar vertebrae (L1-L4) was obtained. Inclusion criteria: presence of psychotic disorder, age between 18-65 years and treatment with an antipsychotic at least for one year. Statistical analysis was carried out using the statistical software SPSS version 26.0. A significance level α=0.05 was considered throughout the study.Results45 out of 140 patients (32,13%) had some BMM lost (osteopenia). The prevalence of osteoporosis was 5.71% (n=8). The median prolactin level in the sample was 46.1 ng/dL ± 33.1. Patients with hyperprolactinaemia showed a higher frequency of osteopenia/osteoporosis (50% with mild iHPRL and 48% with moderate/severe iHPRL) than those with normal prolactin levels (25.7%). A strong and significant relationship between the presence of osteoporosis and the treatment with risperidone was found (p=0.007).ConclusionsOsteopenia and osteoporosis are associated with hyperprolactinemic antipsychotic. Risperidone was related with a significant increased osteoporosis risk. The rutinary and systematic control of the BMM is crucial in these patients to avoid progressive bone demineralization. Managing strategies should be individualized to avoid bone demineralization and to preserve physical health.Disclosure of InterestNone Declared
High dose piracetam on alcoholic cerebellar degeneration: A case report
Authors: Öksüz G. , Ergelen M. 
Published: August 2023

IntroductionChronic alcohol use is related to alcoholic cerebellar degeneration that is caused by B1 (thiamine) deficiency and associated with the degeneration of Purkinje cells in the cerebellar cortex.ObjectivesThis report aims to present a case with cerebellar ataxia and tremor due to alcoholic cerebellar degeneration that is unexpectedly regressed after starting piracetam infusion treatment in the inpatient Alcohol and Drug Addiction Research, Treatment and Education Center (AMATEM).MethodsWe investigated the case prospectively. The patient was informed and consent was obtained.A 57-year-old, divorced, retired, male with alcohol use disorder for 48 years (mostly high alcohol, cologne for 2 years) presented to our hospital with upper and lower limb tremors and balance problems for 2 years. Neurological examination revealed dysmetria, cerebellar tremor, hypoesthesia of lower extremities, ataxia so he was unable to tandem-walk. CIWA-Ar score:13. The blood test, including hemogram, biochemical, HbA1C, TFT, serum copper and ceruloplasmin levels, results were all normal. Diazepam 50 mg was started and titrated down by 5 mg per day and discontinued, 600 mg parenteral and 250 mg p.o thiamine initiated for 3 days and continued orally, propranolol 20 mg/day and ecopirin 100 mg/day were continued. Cranial CT, cranial MRI, and EMG were ordered.The patient was consulted to the neurologist for movement disorder.ResultsMRI appearance of the cortical sulcus, fissure, cisterna, and cerebellar folia were obvious. The ventricular system was assessed as ecstatic secondary to atrophy. Therefore the alcoholic cerebellar degeneration was diagnosed and increased propranolol to 30 mg/day dose. Furthermore iv infussion piracetam was empirically started at secuencely dose of 60 g/day for 3 days, 45 g/day for 3 days, 30 g/day for 3 days. Upper and lower limb tremor disappeared and ataxa regressed after the treatment was arranged.Image:Image 2:Image 3:ConclusionsSeveral authors proposed that serotonergic system among other neurotransmitters in the cerebellum might be affected in ACD. Recent studies investigating the use of buspirone in the treatment of ataxia has showed positive results (1-3).The mechanism of action of the piracetam is unclear. Supposed that piracetam binds to the polar head groups of membrane bilayers and induces distinct changes in membrane structure. Its actions in the nervous tissue include indirect modulation of several neurotransmitter systems, neuroprotective and anticonvulsant effects and positive influence on neuronal plasticity.In conclusion, we suggest that high dose piracetam has a potential antiataxic effect in ACD.Cessation of drinking and nutritional supplementation are the only treatments available for ACD. However, gait does not improve in most patients. Pysical therapy, canes, walkers, and wheelchairs are helpful in maintaining mobility (4). Similarly, we observed that the patient’s need for care has been continuing.Disclosure of InterestNone Declared
Actual status of early intervention services in Germany
Authors: Bechdolf A. 
Published: August 2023

AbstractWe will give an overview of the status of early intervention services for psychosis in Germany. We recently established a website which provides people in Germany with the nearest early detection an intervention service available (https://www.psycho-check.com). However, the overall implementation rate of early detction in Germany is quite heterogenous. We will also present recent research and ongoing projects from Germany including the first evaluation of specialized inpatient services for early psychosis, first evaluations of Individual placement and support and a mindfulness based group intervention in people with early psychosis as well as a newly desigend youth mental health service called soulspace (www.soulspace-berlin.de).Disclosure of InterestNone Declared
Etiology and pharmacological treatment of delirious syndrome
Authors: Hamidović J. , Dostović Hamidović L. , Haskic S. , Prljača E. , Brigić A. , Mešanović M. 
Published: August 2023

IntroductionPatients in psychiatric department, especially in the intensive care unit, often develop delirium syndrome, which leads to a high risk of morbidity and mortality. The etiology is multifactorial. The most common causes are alcoholism and dementia. Pharmacological treatment of delirious syndrome is the most important part of the treatment, which includes various psychopharmaceuticals that are effective both in the treatment of delirium and in improving cognitive functions. Haloperidol is the drug of first choice and from atypical antipsychotics, the most commonly used are risperidone and olanzapine. Benzodiazepines are used in the treatment of delirium tremens.ObjectivesThe objective of the work is to determine the most common cause of delirious syndrome and the treatment of those patients.MethodsWe analyzed 52 patients who were treated for delirious syndrome at the Department of Psychiatry , University Clinical Center Tuzla, Bosnia and Herzegovina in the period from January 1, 2019. until June 1, 2022. Data were taken from medical records and the hospital information system.ResultsThe total number of patients was 52 and 23 (44.23%) were treated for delirium tremens, and the rest were treated for delirium syndrome of another cause. The most common other causes were dementia in 21 (40.38%) patients, followed by sepsis, infectious syndrome and tumors in 6 (11.53%) patients, and cerebrovascular cause in 2 (3,84%) patient. In a therapeutic approach of delirious syndrome, all patients with delirium tremens were treated with benzodiazepines: 11 (47.82%) patients with diazepam monotherapy, then diazepam and promazine 7 (30.43%) patients, diazepam and haloperidol 3 (13,04%) patients, and diazepam, olanzapine and haloperidol 2 (8.69%). In the therapy of other delirious syndromes, 11 (37.93%) patients were treated with risperidone, haloperidol 8 (27.58%), promazine 3 (10.34%), quetiapine 4 (13.79%), and olanzapine, clozapine and aripiprazole 1 patient each (3.44%). It is important to point out that there was no fatal outcome in the processed sample of patients.ConclusionsThe most common etiological cause of delirious syndrome is the consequence of alcohol withdrawal. Delirium superimposed on dementia is the second most common. The priority of treatment is focused on pharmacological treatment. Atypical antipsychotics (risperidone) are most often used. Haloperidol is the second most common. Benzodiazepine (diazepam) was most often used in the treatment of delirium tremens.Disclosure of InterestNone Declared
Validation of HCL-33 in screening for bipolar disorder in patients with depressive episode
Authors: Kola K. , Elezi F. 
Published: August 2023

IntroductionHypomania Check List 33 (HCL-33) constitutes a self-rating questionnaire for lifetime history of hypomanic symptoms, used in patients who present with depressive symptoms and a further screening for bipolar disorder is required.Objectives- Translation and cultural adaptation of HCL-33- Measuring psychometric abilities, gender and age differences in scoreMethodsIn order to culturally adapt, standardize and validate the instrument for the Albanian context, the reliability and validity of the HCL-33 was examined using an sample of 99 patients, of whom 22 were diagnosed as bipolar disorder but all presented with a depressive episode.In order to reach reliability, internal consistency analyses were performed.ResultsThe factor analysis yielded two factor, with an internal consistency of .838 and .736 from the Cronbach’s alphas, with a total alpha of .765, falling within the “good to excellent” range.Furthermore, Albanian norm scores and cut-off scores have been generated for the Albanian version of HCL-33. The article provides evidence regarding the psychometric propërties and utility of HCL-33 in the Albanian adult population for clinical assessment, outcome evaluations and research purposes. With a cut-off value of 16, sensitivity was 73% and specificity was 53%, with a prevalence of 22% and positivie predictive value of 30% and negative predictive value 87%.Gender differences were not relevant in the total scoring, but there was a positive correlation between age an HCL-33 scoring (r(n=99)=.243, p≤.01), especially with Factor II (r(n=99)=.211, p≤.05).ConclusionsThe article provides evidence regarding the psychometric properties and utility of HCL-33 in the Albanian adult population as a screening tool for bipolar disorder in patients presenting with a depressive episode.Disclosure of InterestNone Declared