bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combined clinical and laboratory diagnostics of neurodegenerative disorders
Authors: Sidenkova A. , Litvinenko V. 
Published: August 2023

IntroductionAlzheimer’s disease (AD) is a neurodegenerative pathology that develops mainly in elderly and senile people.ObjectivesThe aim of the study was a comparative analysis of the results of neuropsychological tests with the indicators of the study of oral fluid and buccal epithelium cytograms in patients with Alzheimer’s disease.MethodsIn the main group of 12 patients with Alzheimer’s disease, m=76.25±4.89. There were 12 cognitively healthy people in the control group. The average MMSE score among the observations of the main group was 13.42±3.63. The ADAS-COG scale was used to detail the impaired cognitive functions. The concomitant pathology is compensated. The content of BDNF, TNF-α, IL1RA, IL-6, and IL-8 was determined in the oral fluid and in the blood serum. The concentration of salivary and serum biomarkers was determined by multiparametric fluorescence analysis with magnetic microspheres. Micronuclei, karyopycnosis, karyorexis, and karyolysis were determined in the cellular structures of the buccal epithelium. The material for cytological examination was collected from the inner surface of the cheek.ResultsWhen analyzing buccal cytograms, attention was drawn to a pronounced increase in the number of cells with micronuclei in patients with AD to 1.8%; in the control group, the median was 0.1% (p<0.05). A direct correlation was established between the number of binuclear cells and the level of BDNF in the blood serum (r=0.646; p=0.03) in patients with AD. It is also important to note that the level of serum BDNF had a significant direct correlation with immediate memory, and the concentration of salivary BDNF correlates with the parameter of naming objects.ConclusionsCorrelations between amnesia, speech disorders, praxis, gnosis and pathology of the oral fluid and buccal epithelium, especially with the severity of karyopycnosis and karyorexis, have been established, indicating a direct correlation between the neurodegenerative process pathogenetically associated with Alzheimer’s disease and the processes of systemic inflammation and degeneration of the buccal epithelium.Disclosure of InterestNone Declared
Efficacy of paliperidone palmitate 3-month formulation in preventing hospital admissions and emergency room visits. 66 months of follow-up
Authors: Romero Guillena S. L. , Plasencia Garcia de Diego B. O. , Gomez Gonzalez J. , Gotor Sánchez-Luengo F. 
Published: August 2023

IntroductionPaliperidone Palmitate 3-month formulation (PP3M) has shown a significantly longer time to relapse compared to placebo, with similar efficacy and safety to Paliperidone Palmitate 1-month (PP1M) (Carpiniello et al. Drug Des. Devel. Ther. 2016; 10 1731–1742).ObjectivesThe main objective of this study was to determine the effectiveness of PP3M in preventing hospital admissions and emergency room visits, in people with non-acute schizophrenia in a naturalistic psychiatric outpatient settingMethodsSample: 30 people with diagnosis of schizophrenia (DSM 5 criteria), who had started treatment with PP3M, after being stabilized with PP1M (the dose was not modified in the four months prior to inclusion in the study)Quarterly basis, the following evaluations were performed during a follow-up period of 66 months:The Clinical Global Impression-Schizophrenia scale (CGI-SCH)Treatment adherence, concomitant medication and the number of hospitalizations and emergency visitsEfficacy values: Percentage of patients who remained free of admissions at the end of 66 months of follow-up.Other evaluation criteria: Percentage of patients who never visited the emergency department at the end of 66 months of follow-up. Average change from baseline visit to the final evaluation as assessed by score obtained on the following scale: GSI-SCH, percentage of patients on antipsychotic monotherapy and treatment adherence rate.ResultsThe mean dose of PP3M was 401. 55 mgThe percentage of patients who remained free of admissions at the end of the 66 months was 83.25% and the percentage of patients who never visited the emergency department at the end of 66 months was 79.92%Mean variations from baseline scores at 66 months were: (-0.36 ±0-37) on the GCI-SCH.The percentage of patients on antipsychotic monotherapy at the end of the 66 months was 76.56%The rate of adherence was 86.58%.ConclusionsIn our study, we found that paliperidone palmitate 3-month formulation was effective in reducing the number of admissions and visits to the emergency department, under conditions of daily clinical practice.Disclosure of InterestNone Declared
Irrational polypharmacy and potentially inappropriate medications in patients with dementia: Treatment strategies
Authors: Štuhec M. ,   EPA2023SP-1103
Published: August 2023

AbstractMost patients with dementia are treated with irrational polypharmacy, which leads to higher mortality and other negative consequences (higher costs). Nearly 50% of elderly patients take one or more medications that are not medically necessary, which represents another important aspect of medication optimization. Research has established a strong relationship between irrational polypharmacy and its negative clinical consequences, including a negative impact on dementia, especially in patients with excessive polypharmacy (10 or more medications). These patients are underrepresented in the treatment guidelines and randomized controlled trials, although they represent a substantial patient population. The burden of irrational polypharmacy has also been associated with a greater risk of adverse drug events, drug-drug interactions, medication non-adherence and a higher risk of potentially inappropriate medication (PIM) use. Different treatment strategies have been available to reduce irrational polypharmacy in this population. The best intervention for irrational polypharmacy reduction in this population involves an inter-professional approach (collaborative care approach) that often includes special tools, a basic pharmacological approach and collaboration with a clinical pharmacist.Disclosure of InterestNone Declared
Coercion rates in different mental health care models: flexible assertive community treatment vs care as usual
Authors: Tomcuk A. ,   RECOVER E Montenegro Research Team
Published: August 2023

Abstract: IntroductionIn 2018, within the Horizon 2020 program, RECOVER-E project activities were initiated in Montenegro. During the years 2019 and 2020 Community mental health team (CMHT) within the Special Psychiatric Hospital Kotor was established. This team became responsible for management of treatment of a group of users with severe mental health illnesses, based on the principles of „Flexible Assertive Community Treatment (FACT – A Dutch model). Objectives: The main objective of this research was to establish whether there were substantial differences regarding the use of seclusions, restraints and forced medication during the hospital readmissions in the group of patients treated by the CMHT, compared to usual mental health care in Montenegro.MethodsA sample of 202 users of mental health services from Kotor and surrounding municipalities were recruited. Patients were randomized into two similar-sized groups - intervention group, whose treatment was managed by the multidisciplinary CMHT, and control group where treatment as usual was continued (outpatient treatment without field work and hospital readmissions during the psychotic relapses).To estimate and follow-up the frequency of application of coercive measures in this research, hospital documentation was used.ResultsPatients in the intervention group had statistically significant less coercive intervention (such are mechanical restraining, seclusions, isolations and forced medication) during the study. There were no significant differences in the number of hospital days and readmission rates.ConclusionsThis study showed that CMHT care could reduce some of the coercive measures during the treatment of severe mental illnesses.Disclosure of InterestNone Declared
Determinants of postpartum post-traumatic stress disorder
Authors: Ben Soussia R. , Nour F. , Bouali W. , BelHAdj I. , Bouchahda H. , Zarrouk L. 
Published: August 2023

IntroductionPost-traumatic stress disorder, following stress of a particular intensity, is often related to the perception of childbirth as a traumatic event requiring the optimization of follow-up and the interest of early detection.ObjectivesTo determine the factors associated with post-traumatic stress disorder related to childbirth.MethodsThis is a longitudinal prospective analytical study carried out in the obstetrics gynecology department of the Tahar Sfar Mahdia hospital. The study population was women who gave birth during the study period from March 15, 2020 to September 15, 2020. We used a pre-established questionnaire including sociodemographic and clinical characteristics as well as a psychometric part containing the psychiatric scale for screening for post-traumatic stress disorder.ResultsOur sample included 120 women. The average age was 28.2±5.3.Five participants (4.2%) had a psychiatric history .Thirty-five patients (29.1%) had a pathological obstetric history. However, fifteen patients (12.5%) were hospitalized during their pregnancies. Psychometric assessment revealed a prevalence of PTSD at 5.8% with PTSD symptomatology in 18.4% of women.Twenty-two patients (18.3%) described the childbirth as painful and traumatic.The frequency of PTSD was higher in women with a history of abortion (6.9%)Postpartum PTSD was statistically associated with a low level of education (p=0.02), postpartum complications (p=0.05) and sex of the newborn (p=0.01)ConclusionsThe detection of factors associated with postpartum posttraumatic stress disorder seems to be essential for comprehensive and multidisciplinary management of women at risk.Disclosure of InterestNone Declared
Tyrosinemia type 1 and ADHD like symptoms similarity or comorbidity about a case
Authors: Belhadga H. , Elmaataoui Z. , Kisra H. 
Published: August 2023

IntroductionMany metabolic diseases influence brain function and are associated with psychiatric symptoms and neuropsychiatric disorders (including autism-spectrum disorders, ADHD and psychotic disorders). Attention-deficit-/hyperactivity disorder (ADHD) is among the most common neurodevelopmental disorders in children, with a worldwide prevalence of about 5% in childhood. Tyrosinemia is caused by a genetic mutation in the fumarylacetoacetase gene that leads to a deficiency in the encoded enzyme, which catalyzes the cleavage of tyrosine metabolites to acetoacetic acid and fumaric acid. In recent studies of children with tyrosinemia type 1, a strong correlation was observed between symptoms of ADHD and blood levels of tyrosine, supporting a direct role of this amino acid in the pathogenesis.Objectiveswe report this case of tyrosinemia type 1 associated to ADHD symptoms to contribute in literature to provide more insights into possible shared pathophysiological mechanisms and how these affect their treatment.MethodsWe report the case of an 8-year-old child, followed since the age of 3 months for a tyrosinemia type 1 who presented symptoms of ADHD.Resultsscales and questionnaires were used to detect ADHD symptoms, the SNAP IV - Swanson, Nolan and Pelham Teacher and Parent Rating Scale was used with the mother, the items concerning inattention (items 1 to 10) and Hyperactivity-Impulsivity (items 11 to 20) were revealing; The Conners Evaluation Questionnaire was delivered, confirming the same result, a neuropsychological evaluation of the child with IQ evaluation by WISC-IV - Wechsler Intelligence Scale for Children and Adolescents revealed limited intellectual performance with an IQ of 65.ConclusionsNMDs, such as HT-1, constitute a large group of conditions that are often containable with early clinical intervention, but still present lifelong difficulties and high societal costs. many studies suggest that there may be similar biological mechanisms behind the cognitive difficulties seen in ADHD and HT-1. In clinical settings, the impaired dopamine synthesis due to substrate inhibition in treated HT-1 may be compensated for by standard ADHD medication, such as methylphenidate or amphetamine. Similarly, the reduced serotonin synthesis may be counteracted by tryptophan supplementation.Disclosure of InterestNone Declared
Emotional Intelligence and Attention-deficit/hyperactivity disorder (ADHD)
Authors: Ben Turkia I. , Brahim T. , Sahli L. 
Published: August 2023

IntroductionAttention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in children and adolescents. It is characterized by age-inappropriate inattention/impulsiveness and/or hyperactivity symptoms.However, emotional symptoms are frequent in patients with ADHD and may, in some cases, be responsible for a major part of the negative impact on functioning and outcome.It is now well established that a large number of children with ADHD and without any comorbid disorder exhibit symptoms of emotional lability.Recently , given the importance of the impact of emotional symtoms , several authors have argued that emotional intelligence affects health and is essential for success in academics as well as life in general and it is defined as the ability to perceive, appraise, and express emotions; the ability to access and/or generate feelings when they facilitate thought; and the ability to regulate emotions to promote emotional and intellectual growth.Objectives•Our research aimed to evaluate and compare the emotional and social functioning of two groups of children, with and without ADHD , aged 6 to 19 .Methods•One hundred twenty child (N=60 ADHD, N = 60 Control cases) were assessed with the BarOn Emotional Quotient Inventory: Youth Version (BarOn EQ-i:YV™), providing an estimate of their underlying emotional and social intelligence.•The BarOn EQ-i:YV is specifically designed to assess the coping skills, adaptability, and well-being of children and teenagers.•Children with ADHD and control cases were compared with each other.Results•The results showed that the Emotional Quotient (EQ) was significantly lower in the group of children with ADHD (p=0.01).•Also, our results showed that there are statistically significant differences in intrapersonal skills (p˂0.0010) Adaptability Scale(p=0.005) ; General Mood Scale (p=0.004) and positive impression (p = 0.001) of emotional intelligence between children with ADHD and control cases. Thus, the first group got lower scores than the second one in all aspects.Conclusions•ADHD is a disorder that affects the life quality of the person who suffers from it in the personal and social areas. Therefore, the emotional intelligence study in individuals with this diagnosis is important.•And considering the fact that abilities associated with emotional intelligence can be learned and improved, emotional intelligence can be thought as a target for therapy by individualized education for patients with ADHD who have inadequate abilities compared to the healthy population .Disclosure of InterestNone Declared
Drugs and high hospitalization rate: are they related?
Authors: Figueiredo I. M. , Cargaleiro I. , Nascimento M. 
Published: August 2023

IntroductionSubstance use continues to be an important problem among mental health patients either as main diagnosis or as comorbidity. Acute care visits, including emergency department visits and hospitalizations, related to substance use disorders (SUD) are increasing and can be opportunities to engage individuals to get proper treatment (Suen LW et al. J Gen Intern Med 2022; 37(10):2420–2428).
Both mental disorders and SUD lead to subsequent chronic physical conditions, premature death, suicide or overdose (Bennett AC. Public Health Rep 2019; 134(1):17-26) that can be accidental or not.24% to 32% of patients with Substance Induced Psychosis develop later a schizophrenia spectrum disorder or bipolar disorder (Starzer MSK et al. Am J Psychiatry 2018;175(4):343–350) leading to a chronic use of medication and, in several instances, to a necessity of psychiatric in-patient treatment with long hospital stays and high readmission rates (Khan S. Health Reports (2017) 28(8)3-8).ObjectivesOur goal was to analyze if substance use is associated with higher psychiatric hospitalization rates.MethodsAn independent-samples t-test was run to determine if there were more hospitalizations among patients with substance use. Afterwards, the Cohen’s D was calculated to measure the effect size and to see the magnitude of the experimental effect.ResultsA sample of 2604 in-patient treatment episodes was used. The sample had 1696 female patients, 908 male patients and 823 patients had substance use. We found that patients with substance use had a statistically significant higher hospitalization rate (6.82±5.27) than the ones without it (5.32±4.84), t(1483)=6.945, p<0.001. Cohen’s effect size value (d=.30) suggested a small practical significance.ConclusionsOur findings go mainly accordingly the literature; we found a significant effect of drugs on readmission rates (Böckmann V et al. Front Psychiatry 2019; 10:828) but we might have thought it would be bigger. That could be explain by undiagnosed substance use (refusal to admit the use, drugs not detected on lab tests, not requesting toxic lab tests) or higher sample percentage of confounding comorbid diagnoses.However, is undoubtable the several risks that drugs bring to our health and so the authors aim to raise awareness among the medical community to the importance being alert for signs of use or psychiatric symptoms to avoid reaching a no turning point. It’s known that doctors frequently fail to diagnose SUD in hospitalized patients and given the linkage between use of certain substances and particular medical reasons for admission, it would be well-advised to search for SUD in certain admission diagnoses (Weintraub E et al. Am J Addict 2001;10(2):167-77). Knowledge of substance use behavior may help reducing relapse rates and to reduce the risk of developing a SUD (Andersson HW et al. Nordic Journal of Psychiatry, 75:3, 160-169).Disclosure of InterestNone Declared
Telemedicine in Psychiatry: benefits and challenges of the the Home-Hospital Care system (COD20) project
Authors: Palazzo M. , Prodi T. G. , Cerioli M. , Conti D. , Galbassini A. , Nicolini G. , Dell’Osso B. 
Published: August 2023

IntroductionTelepsychiatry (TP) is the use of telecommunication technologies to provide psychiatric assessment, diagnosis, treatment, and consultation. During the COVID-19 outbreak, TP has shown potential for connecting with people unable to access traditional in-person services, and also enabling patients to receive mental health care safely from home. The Home Hospital care system (Cure Ospedaliere Domiciliari; COD20) is a video consultation service developed by the University of Milan.ObjectivesWe aimed at investigating the potential of Telemedicine (TM) in a sample of psychiatric patients.MethodsAs of now, 208 consecutive patients of an outpatient clinic belonging to ASST Fatebenefratelli-Sacco in Milan were interviewed through an online anonymous survey. Data collected were sociodemographic, job position, educational level, digital skills and both satisfaction degree and ease of use of the COD20 tool. Data were analyzed using SPSS v.27.ResultsAmong 208 patients, 87.7% had Internet access, 94.5% used a smartphone, 74% used a computer and 37% used a tablet. The levels of digital skills were considered intermediate-advanced in communication and information research for the majority of the cases. A high percentage of patients (80.8%) learned how to use electronic devices by themselves, while only 12.3% had an ECDL certificate. The most represented diagnoses were Mood Disorders (44.5%) and Anxiety Disorders (14%). The majority of the sample (54.8%) was visited using TM for clinical interviews: 24.7% of them used TM at least 10 times/year, and 19.8% more than 20 times/year. Among all the clinical interviews conducted using TM, 61% concerned psychiatric consultation, while 30% were dedicated to psychotherapy. The most used tool was the COD20 platform (21.9%): it was considered easy to use in 47.9% of cases, while 43.8% of patients would like to use it again in the future. The main reasons leading to the usage of TM were the difficulties in reaching the ambulatory (for 43.9%) and the workplace (for 30%).Image:Image 2:ConclusionsTM represents a valid implementation in the traditional clinical practice, and we showed it is well received in terms of appreciation and ease of use. The COD20 platform could increase access to care, and overcome barriers such as distance, travel costs and time management. TP contributes to develop a more inclusive healthcare process for patients, with better performance in terms of compliance.Disclosure of InterestNone Declared
Aggressive behavior and severe mental disorders in Prison psychiatry
Authors: Voulgaris A. 
Published: August 2023

IntroductionAggressive behavior can be understood as a compelx and social phenomenon. A number of studies have shown that the risk of aggressive behavior is increased for patients with severe mental disorders such as schizophrenia. Although specialized forensic institutions exist in many countries, most offenders with mental disorders are still found in prison settings what corresponds to international literature suggesting an increased prevalence of mental disorders in prison inmates. Still, data on the specific characteristics of patients demonstrating aggressive behavior in medical and mental health settings is limited, especially for prison environments.ObjectivesThe aim of our study was to identify patient characteristics that are potentially associated with aggressive incidents in a prison psychiatric setting.MethodsIn routine documentation in German prisons, specific incidents, as e.g. aggressive behavior are reported through an official reporting system. Analyzing these official reports, we collected all aggressive incidents concerning at the Department of Psychiatry of the Berlin prison hospital between 1997 and 2019. In addition, for each patient acting aggressively, we collected data on an equal number of patients who did not demonstrate this behavior during their hospital stay. For those patients with more than one inpatient treatment period, only the first stay in the prison hospital was included. Furthermore, patients were excluded based on age (younger than 16 or older than 70) or death during treatment. The statistical data was analyzed descriptively.ResultsIn total, 225 treatment episodes were included of which in 118 cases violent behavior were documented. The items older age, German citizenship, previous violent crimes (OR = 0,40, 95 % KI: 0,35 – 1,17) and antipsychotic (OR = 0,28, 95 % KI: 0,14 – 0,55) or antidepressant (OR = 0,35, 95 % KI: 0,13 – 0,88) treatment within six months prior to admission had a rather protective effect on the occurrence of aggressive behavior during inpatient treatment. Alcohol (OR = 1,21, 95 % KI: 0,64 – 2,27) and drug use disorders (OR = 2.18, 95 % KI: 1,09 – 4,44) tended to be risk factors for aggressive behavior. Thus, the results in this prison psychiatric population correspond to the risk factors described in the literature.ConclusionsThe reported results point in the direction that optimising the availability of psychopharmacological treatment options and offering specialized treatment for patients with comorbid substance use disorder may lead to the prevention of aggressive behavior in patients with a schizophrenia diagnosis.Disclosure of InterestNone Declared