bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety of repeated neuromodulation by transcranial direct current stimulation (tDCS) in dementia: a narrative review
Authors: Daniel A. A. , De Souza S. 
Published: August 2023

IntroductionTranscranial direct current stimulation (tDCS) is a form of neuromodulation most commonly used in depression. tDCS aims to modulate cortical activity by the application of a weak electrical current to the brain via electrodes placed on the scalp. Several studies have identified the potential of tDCS for managing behavioural and psychological symptoms in a range of dementias, including Alzheimer’s disease, vascular dementia, dementia with Lewy bodies and frontotemporal dementia. Although the preliminary data on efficacy is promising, the safety of repeatedly neuromodulating the brain of a person with dementia, by tDCS, has not been extensively reported.ObjectivesOur aim was to review the current literature on how safe it is to repeatedly neuromodulate a brain with dementia.MethodsAdvanced literature searches of PubMed and the Web of Science Core Collection were conducted to identify relevant publications. The search terms deployed were: “tDCS” or “transcranial direct current stimulation” and “frontotemporal dementia” or “vascular dementia” or “Lewy body” or “Alzheimer’s disease”. The following inclusion criteria were applied to the search: (1) publications which focused on the use of tDCS in patients with either frontotemporal dementia, vascular dementia, dementia with Lewy bodies or Alzheimer’s disease, (2) studies involving human participants and, (3) publications written in, or readily translated to English.Results216 articles were returned in the initial search. Following the removal of 54 duplicate articles, the remaining 162 underwent eligibility screening using the titles and abstracts. 31 articles were then selected for a full text reading and following this, 12 studies were selected to be included in the review. Across all 12 studies, 3590 sessions of active tDCS were performed with no severe adverse effects being reported. The most commonly occurring adverse effect was a tingling/burning sensation underneath the electrodes, followed by headache and skin changes. These reported effects tended to be mild and short lived.ConclusionsOverall, the results of the reviewed papers suggest that repeated neuromodulation by tDCS can be safely performed in dementia patients. More and larger studies should aim to perform a greater number of sessions of tDCS, across a longer time period. Few studies assessed for potential brain damage as a result of tDCS and future studies should consider using MRI or monitoring biomarkers to further investigate this.Disclosure of InterestNone Declared
Knowledge and Attitudes about Transcranial Magnetic Stimulation among Psychiatrists in Oman: A cross sectional study
Authors: Albalushi M. K. 
Published: August 2023

Introduction: Background and ObjectiveRepetitive transcranial magnetic stimulation (rTMS) is a noninvasive treatment method and the only been approved for medication refractory depression by US Food and Drug Administration (FDA). However, comprehensive knowledge about rTMS is not yet widespread among psychiatrists. The aims of this study were to assess psychiatrists’ knowledge of and attitudes toward rTMS and to determine the contributing factors on knowledge of rTMS in Oman.ObjectivesA quantitative observational cross-sectional study will be conducted using an online survey. Demographic information, knowledge of and attitudes towards rTMS measures were collected. Both univariate analysis, multiple linear regression was performed to identify the risk factors associated with knowledge levels.MethodsA quantitative observational cross-sectional study will be conducted using an online survey. Demographic information, knowledge of and attitudes towards rTMS measures were collected. Both univariate analysis, multiple linear regression was performed to identify the risk factors associated with knowledge levels.ResultsA total of 50 psychiatrists participated in this study (response rate = 83%). The average age of the participants is 32.7±4.3 years [26.0-41.0], more than half of them were females (n=28, 56.0%), and resident (Junior/Senior) (n=25, 50.0%). The majority of the samples are Omani (n=45, 90.0%), working in the tertiary hospital (n=38, 76.0%). The average scores on knowledge of and attitudes towards rTMS in this sample were 14.5±3.8 and 22.5±6.3, respectively. Linear model showed that senior residents and above had a higher knowledge level than junior residents (ß=4.65, p<.001). Those samples with the rTMS device in their work-place had a higher knowledge level than don’t have (ß=1.88, p=0.027).ConclusionsThree factors have a directional effect on the level of knowledge among psychiatrists toward rTMS, namely, higher educational level, presence of rTMS device at the workplace and availability of standardized training in Rtms.Disclosure of InterestNone Declared
Searching for bridges between psychopathology and real-world functioning in first-episode psychosis: a network analysis from the OPTiMiSE trial
Authors: Dal Santo F. , Fonseca-Pedrero E. , García-Portilla M. P. , González-Blanco L. , Sáiz P. A. , Galderisi S. , Giordano G. M. , Bobes J. 
Published: August 2023

IntroductionNetwork analysis has been used to explore the interplay between psychopathology and functioning in psychosis, but no study has used dedicated statistical techniques to focus on the bridge symptoms connecting these domains.ObjectivesThe current study aims to estimate the network of depressive, negative, and positive symptoms, general psychopathology, and real-world functioning in people with first-episode schizophrenia or schizophreniform disorder, focusing on bridge nodes.MethodsBaseline data from the OPTiMiSE trial were analysed. The sample included 446 participants (age 40.0±10.9 years, 70% males). The network was estimated with a Gaussian graphical model (GGM), using scores on individual items of the Positive and Negative Syndrome Scale (PANSS), the Calgary Depression Scale for Schizophrenia (CDSS), and the Personal and Social Performance (PSP) scale. Stability, strength centrality, expected influence (EI), predictability, and bridge centrality statistics were computed. The top 20% scoring nodes on bridge strength were selected as bridge nodes.ResultsNodes from different rating scales assessing similar psychopathological and functioning constructs tended to cluster together in the estimated network (Fig. 1). The most central nodes (EI) were Delusions, Emotional Withdrawal, Depression, and Depressed Mood. Bridge nodes included Depression, Conceptual Disorganisation, Active Social Avoidance, Delusions, Stereotyped Thinking, Poor Impulse Control, Guilty Feelings, Unusual Thought Content, and Hostility. Most of the bridge nodes belonged to the general psychopathology subscale of the PANSS. Depression (G6) was the bridge node with the highest value.Image:ConclusionsThe current study provides novel insights for understanding the complex phenotype of psychotic disorders and the mechanisms underlying the development and maintenance of comorbidity and functional impairment after psychosis onset.Disclosure of InterestNone Declared
Association among early life stress, mood features, hopelessness and suicidal risk in bipolar disorder: The potential contribution of insomnia symptoms
Authors: Palagini L. , Gemignani A. , Riemann D. 
Published: August 2023

IntroductionMood disorders are complex illnesses possibly resulting from the interaction of genetic, physiological, psychological, and environmental factors.Within this framework, a role for early life stressors has been proposed. Although this association is probably not specific to Bipolar Disorders BDs, with early life stressors predisposing to trans nosological indicators for severity of psychiatric disorders, it may represent an early marker both for triggering and long-term clinical manifestations of BDs.Insomnia likely plays a triggering role in the onset and maintenance of BDs, as it may might play a key role in BDs by potentially dysregulating the systems involved in mood and emotion regulation, including stress and inflammatory systems and circadian rhythms alterations. Early life stressors have been demonstrated to alter sleep regulation. It has been hypothesized that sleep disruption related to early life stressors might contribute to the development pathways towards BDs in adult life through the epigenetic re-reprogramming of stress and inflammatory systems.ObjectivesWe aimed to study their association with mood symptoms and suicidal risk in BDs with and without clinically significant insomnia symptoms. Since hopelessness is a construct strongly predicting depressive symptoms and suicidal risk in BDs and it has also been related to early life stress and to insomnia symptoms we aimed to specifically assess this symptom in our research.Methodsa sample of 162 adult participants with BD I or II were assessed during depressed phase using the Structural Clinical Interview for DSM-5 (SCID-5), the Beck Depression Inventory-II (BDI-II), the Young Mania Rating Scale (YMRS), the Early Trauma Inventory Self Report-Short Form (ETISR-SF), the Beck Hopelessness Scale (BHS), the Insomnia Severity Index (ISI) and the Scale for Suicide Ideation (SSI). Participants with or without clinically significant insomnia were compared and we carried out correlations, regression and mediation analyses.ResultsParticipants with insomnia showed a greater severity of depressive symptoms,of suicidal risk, of the cognitive component of hopelessness and of early life stressors. Insomnia symptoms mediated the association among early life stress and depressive symptoms (Z = 2.72, p = 0.0006), the cognitive component of hopelessness (Z = 3.02, p = 0.0001) and suicidal ideation and plans (Z = 2.07 p = 0.0006).Conclusionsfnsomnia may mediate the relationship between early life stress and clinical manifestations of BD. Assessing the evolution of insomnia symptoms could offer an approach to characterize BD and to formulate treatment strategies. In particular targeting insomnia symptoms might potentially modify the clinical features of BD in response to early life stressful events.Disclosure of InterestNone Declared
Nightmares and bad dreams preceding suicidal behaviors
Authors: Geoffroy P. A. , Borand R. , Ambar Akkaoui M. , Maruani J. , Lejoyeux M. 
Published: August 2023

IntroductionSleep and circadian markers are of increasingly growing interest to help better predicting suicide. Indeed, specific sleep disorders and circadian rhythm disorders have been associated to suicidal behaviors, and the most replicated findings are insomnia and nightmares. Nevertheless, these interesting preliminary studies did not examine the chronology and trajectories of these dream contents’ alterations before a suicidal crisis.ObjectivesIn this context, we decided to perform a naturalistic study to better understand the characteristic of this population during suicidal crisis, and to evaluate their past dream contents. We aimed to distinguish in this phenomenology three different experiences: bad dreams, nightmares (i.e. awakening bad dreams), and suicidal scenarii during dreams. We hypothesized that these dream experiences may have different chronologies of emergence, and that individuals with dream alterations, compared to individuals without dream alterations, present with different clinical characteristics.MethodsThis naturalistic study included individuals hospitalized between January 2021 and May 2021 in a psychiatric post emergency unit for suicidal crisis (thoughts and attempts).ResultsThe study observed that 80% (n=32/40) of patients had altered dreams (AD) before the suicidal crisis, including 27 (67.5%) with bad dreams, 21 (52.5%) with nightmares -awakening bad dreams- and 9 (22.5%) with suicidal scenarii during dreams. No differences were observed between the AD group versus no altered dream (ND) regarding sociodemographic characteristics. We observed a progression of dream content alterations: bad dreams appear 111 days (4 months) before the suicidal crisis, then nightmares appear 87.3 days before (3 months), and suicidal scenarii were reported 45.2 days before (1.5 month). For the AD and ND population in suicidal crisis, 80% met at least one subtype of dream alterations, 40% had bad dreams and nightmares, and 17.5% had the 3 subtypes. The AD group, compared to ND, had significantly more family history of insomnia (p=0.046). Almost all patients (97.5%) had depressive symptoms (MADRS≥7; 82.5% had moderate to severe symptoms, MADRS≥20), 60% had insomnia (ISI>14), 92.5% had altered sleep quality (PSQI>5), and 57.5% reported sleepiness (ESS>10).ConclusionsDream alterations and their progression could be readily assessed and may help to better identify prodromal signs of suicidal behaviors.Disclosure of InterestNone Declared
Comparison of stress and coping mechanisms among family members of patients abusing licit and illicit substances
Authors: Mehta S. , Jaiswal A. , Khattri S. , Garg S. 
Published: August 2023

Introduction
Addiction has long been recognized as a disease that may have a dramatic influence on the addicted individual’s family members, manifesting as stress or trauma-related physical and psychological symptoms, resulting in increase in the usual family’s use of health-care services. There is little research available to identify and explore problems of families associated with such patients. In this study, we will evaluate stress among family members of substance abuse patients and try to focus on how these family members are dealing with these stress factors. The study will also compare different types of coping mechanisms among family members of patients taking licit and illicit substances.ObjectivesTo identify stress among families of patients abusing licit and illicit drugs and assess and compare their coping mechanisms.Methods
175 family members of patients with licit substance abuse cases and 175 family members of patients with illicit substance abuse were taken for study after informed consent. Stress among participants was evaluated using Symptom Rating Test and The Depression Anxiety and Stress Scales (DASS). Coping Questionnaire (CQ) and Breif COPE was used to assess coping among them.Results
The study demonstrated that the total number and severity of symptoms, including psychological and physical symptoms, are found lesser in caregivers (participants) of patients abusing licit substances than in patients abusing illicit drugs. These symptoms among family members grow as the patient’s age rises. Symptoms in participants are more if their patient is female as compared to male. And also, total symptoms are more if they are living in nuclear family (Table 1). In our results, total coping and engaged coping mechanisms in family members are found to be not significant as per drug type and remains the same for both licit and illicit drugs abusing patients’ families. Avoidant coping mechanisms in family members are more if their patient is female and in nuclear family.
Table 1symp1CoefficientsStd. Err.P Valueage0.005*0.0010.000drug_type-0.114*0.0270.000female_d0.230*0.0280.000nuclear_d0.124*0.0270.000ConclusionsIn our study, it was clearly noticed that the total symptoms, both physical and psychological, were found more in family members of patients abusing illicit drugs. Impact of substance abuse related problems is found more in female members compared to male members of family.Disclosure of InterestNone Declared
Framing substance use disorders among forcibly displaced people through a syndemics lens.
Authors: Tay Wee Teck J. 
Published: August 2023

AbstractSyndemics are synergistically interacting epidemics (for example, the epidemics of substance use disorders and forced displacement) in a particular context with shared drivers such as pre-existing political, structural, social and health conditions. Policymakers may ask what the risks of and needs are for forcibly displaced people with regards to substance use disorder (SUD). Working from a syndemics framework, we would argue that multiple risk and resiliency factors relating to both forced displacement and SUD work synergistically, and impact more significantly upon some populations than others. These risk factors include structural inequality and racism, social deprivation, violence, homelessness, trauma, childhood adversity, and co-morbid physical and mental health disorders. Individuals may become vulnerable while experiencing displacement, during transition, settlement or resettlement, and also through their life across and across generations. In this perspective, our answers to policymakers becomes more nuanced. We may argue for integrated, multi-modal interventions, cross-disciplinary collaborations, cross-pollination of ideas and knowledge and embedding lived experience to bridge gaps and make use of limited resources in sustainable ways. This presentation will detail aspects of the application of a syndemic lens to the evidence base on SUD among forcibly displaced people and generate discussion on what scientists, clinicians and policymakers can and may do with these insights.Disclosure of InterestNone Declared
Prevalence and Correlates of Low Resilience: Aftermath of the Fort McMurray Wildfire Disaster
Authors: Adu M. K. , Eboreime E. , Shalaby R. , Sapara A. , Agyapong B. , Obuobi-Donkor G. , Mao W. , Owusu E. , Oluwasina F. , Pazderka H. , Agyapong V. 
Published: August 2023

IntroductionThe Fort McMurray wildfire (2016) was one of the most expensive and devastating natural disasters that ever happened in the history of Canada. According to the Insurance Bureau of Canada (2016), the cost of this disaster was estimated at USD 3.6 billion in insured losses. Despite the fundamental role of resilience in the daily functioning of individuals in the form of a protective shield that ameliorates the devastating impact of disasters on their mental well-being, to date, the long-term impact of wildfires on resilience and its associated predictors of low resilience has not been well studied and evaluated.ObjectivesThe study aimed to enhance the understanding of the psychological impact of wildfires through the evaluation of the prevalence and predictors of resilience among the affected residents of Fort McMurray five years after the devastating wildfires.MethodsThis study applied a cross-sectional survey design which was used to gather quantitative data through an online-based self-administered questionnaire. The surveys included standardized rating scales for resilience (BRS), depression (PHQ-9), anxiety disorder (GAD-7), and post-traumatic stress disorder (PTSD) (PCL-C) was used to measure the prevalence of resilience and its demographic, clinical, as well as wildfire-related predictors. The data collection spanned between April and June of 2021. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 25 and univariate analysis with done using a chi-squared test and binary logistic regression analysis.ResultsA total of 249 residents accessed the online survey and 186 completed the survey. Therefore, there was a response rate of 74.7%. Most of the respondents were females (85.5%, 159), above 40 years of age (81.6%, 80), employed (94.1%, 175), and in a relationship (71%, 132). The study identified two variables, thus having PTSD symptoms (OR = 2.85; 95% CI: 1.06–7.63), and the age of respondents significantly predicted low resilience in our sample. The prevalence of low resilience in our sample was found to be about 37.4%.ConclusionsThe study finding demonstrated that age and the presence of PTSD were the independent significant risk factors associated with low resilience in the affected population of Fort McMurray five years after the devastating wildfire disaster. This result further provides new information about the association between resilience, demographic, and clinical characteristics while adding to the rising body of evidence on the benefits of resilience in individuals during and after disasters. However, further research is needed to enhance understanding of the pathways toDisclosure of InterestNone Declared
Nutritional Markers and Perinatal Maternal Mental Health: A Network Analysis
Authors: van der Waerden J. , Knox B. , Galéra C. , Sutter-Dallay A.-L. , Heude B. , de Lauzon-Guillain B. 
Published: August 2023

IntroductionPerinatal maternal depression and anxiety are associated with adverse maternal outcomes, and nutrition may play an important role in their emergence. Previous research shows that certain micro and macronutrients found in different dietary patterns may influence perinatal mood disorders.ObjectivesThis study aims to explore relationships between nutrition during pregnancy and perinatal maternal depression and anxiety symptoms using network analyses.MethodsUsing data from the French EDEN mother-child cohort, the sample consisted of 1438 women with available perinatal mental health outcomes (CES-D, STAI and EPDS) and nutritional markers collected from food frequency questionnaires. Four networks were constructed to explore the relationships between prenatal nutrient status, dietary patterns, and perinatal mental health, while accounting for important confounders.ResultsThe Healthy dietary pattern was associated with the presence of vital micronutrients, while the Western dietary pattern was consistently associated with poorer intake of vital micronutrients and contained an excess of certain macronutrients. Western dietary pattern and symptoms of postnatal depression were connected by a positive edge in both the macronutrient and micronutrient networks. Lower education levels were associated with higher Western dietary pattern scores, from which a positive edge linked to postnatal depression symptoms in both models.ConclusionsA Western dietary pattern was associated with increased symptoms of postnatal depression in our adjusted network models; The Healthy dietary pattern was associated with essential micronutrients but not with symptoms of depression or anxiety. Perinatal mental health might be impacted by specific dietary patterns in the context of psychosocial and physical stress associated with pregnancy.Disclosure of InterestNone Declared