bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of an app-based treatment for anxiety disorders including exposure in virtual reality – a randomized controlled trial
Authors: Rubart A. K. , Barrabas T. F. , Manheim I. K. , Korn J. , Berg J. , John L. H. , Zurowski B. 
Published: August 2023

IntroductionAnxiety disorders are among the most prevalent mental disorders. However, only a minority of patients receives adequate psychotherapeutic treatment despite strong empirical evidence for the efficacy of CBT in anxiety disorders (Marcks et al. Psychiatr Serv 2009; 60 823-830). App-based psychotherapy can help to reduce this massive treatment gap.ObjectivesWe aimed at evaluating the efficacy of an app-based treatment for anxiety disorders including exposure in virtual reality.MethodsThe randomized controlled trial was conducted in two university outpatient treatment centers in Northern Germany. Patients were diagnosed with agoraphobia (AP; with or without panic disorder; n=103), panic disorder (PD; n=84) or social anxiety disorder (SAD; n=110) and were randomly assigned to either the app-based intervention or treatment as usual (up to 6 sessions of supportive therapy). The app was developed based on evaluated CBT manuals and includes 14 hours of audio and video content and 15 disorder specific virtual reality exposure scenarios. Participants in the intervention groups also received two appointments with a therapist during the app-based treatment. Primary outcome was the change in Beck Anxiety Inventory (BAI) score pre to post (after 6 months). Mixed ANOVAs were conducted in intention to treat and completer analyses. Secondary outcomes were disorder specific questionnaires (Liebowitz Social Anxiety Scale LSAS for SAD and Panic and Agoraphobia Scale PAS for AP and PD) and health related quality of life measured with a single item (L-1).ResultsIn the ITT analysis, the interaction effect between group and time was significant in patients with AP as well as in patients with PD (AP: p=.014, partial η²=.06; PD: p=.028, partial η²=.06). This indicates a stronger improvement of symptoms in the intervention group compared to the control group. In patients with SAD, there was no significant interaction effect (p=.101, partial η²=.03). The disorder specific measures LSAS and PAS showed a significantly stronger decrease in the intervention group than in the control group for each of the specific disorders. Concerning quality of life, a stronger improvement in the intervention group was only found in patients with PD.ConclusionsA stronger symptom reduction in the app-based intervention group compared to the control group could be found in patients with AP (BAI/PAS), PD (BAI/PAS) and SAD (LSAS). This is particularly remarkable as the app was compared to an active control group with up to 6 sessions of psychotherapy. Effect sizes were comparable to those found in studies comparing face-to-face CBT to an active control group. The lack of an intervention-specific effect on BAI scores in patients with SAD might be due to the poor sensitivity of the BAI for the specific symptoms of SAD.Disclosure of InterestNone Declared
The evaluation of IMR in crisis resolution home treatment, a mixed methods study protocol
Authors: Kieft S. , Schaap I. 
Published: August 2023

IntroductionIn the past years, recovery has become a central concept in psychiatric treatment (Sowers et al. Acad Psychiatry 2016; 40 461-467). However, in acute mental health care the concept of recovery is lacking attention (Rabenschlag et al. Psychiatry Q 2014; 85 225-239; Jaeger et al. Nord J Psychiatry 2015; 69 188-195; Luigi et al. Can. Med. Educ. J. 2010; 11 62-73). In 2021 a short version of Illness Management and Recovery (IMR) was implemented at the Psychiatric Emergency Service Amsterdam-Amstelland (SPAA). IMR is an evidence based group intervention for patients with severe mental illness, based on cognitive-behavioral, psychoeducational and motivational components. The aim of IMR is to support participants to manage their mental illness (Mueser et al. Schizophr Bull 2006; 32 32-43). To our knowledge this the first time that IMR is implemented within an acute mental health care setting Therefore the effects of IMR program on recovery in the acute phase of psychiatric illness are unknown.ObjectivesInsight in effects of IMR in acute mental health care.MethodsWe will carry out a mixed method study. In phase 1 the intervention will be carried out. 25 patients who are admitted to acute mental health care and diagnosed with a severe mental illness (SMI) will take part in the shortened version of IMR. Effects will be measured by the client version of the IMR-scale (Salyers et al. Community Ment. Health J. 2007; 43 459-480).Phase 2 includes qualitative interviews with a subsample from phase 1 (using maximum variety in diagnosis and demographic characteristics) to gain insight in the mechanisms and impact of the program.ResultsThe proposed study will investigate the effects of an adjusted evidenced-based treatment within a population of people who receive treatment in a Psychiatric Emergency Service. The original intervention is shortened in time and topics, to match the needs of people in the acute phase of psychiatric illness. The question that arises is if an existing treatment can be translated to a different group of patients.ConclusionsThe proposed project has some important limitations that we feel deserve mentioning. It is questionable if a person can profit from a recovery program during a phase of acute crisis. Also, can we expect the same effects if the new program is a shortened version of the original evidence based intervention?Disclosure of InterestNone Declared
Medical cannabis use among patients with Post-Traumatic Stress Disorder (PTSD): A nationwide database study
Authors: Yakirevich Amir N. , Treves N. , Davidson E. , Bonne O. , Matok I. 
Published: August 2023

IntroductionIn recent years, cannabis use among PTSD patients has become more common than ever. However, data available today regarding the effectiveness and safety of medical cannabis in PTSD treatment is limited, based on cross sectional studies, self-report surveys and a few clinical studies with small sample size.ObjectivesTo characterize patterns of use and adverse effects over time in patients with PTSD using medical cannabis in real life setting.MethodsData were acquired from the Israeli national database of all patients licensed to use medical cannabis from January 2014 to December 2021. A license for medical cannabis is given to patients with PTSD of at least moderate intensity after treatment failure of at least two drugs and two psychological interventions. Comparative statistics were used to evaluate patterns of use and adverse effects.Results12,977 patients were licensed to use medical cannabis in the study period for PTSD (8.2% of all users; 70% men) during the above-mentioned time period. PTSD was the 3rd most common indication after chronic pain and symptoms related to oncological disease and chemotherapy treatment. Over time, the relative increase in use of medical cannabis among PTSD patients was higher than that found in non-PTSD patients. In 2021 36.2% of all PTSD patients using medical cannabis had their license issued that year compared to 28.1% of all non-PTSD patients. PTSD patients were significantly younger compared to non-PTSD patients (40.9 years vs. 52.9 years). PTSD patients consume slightly higher monthly amount at the beginning of treatment compared to non-PTSD patients (32.1gr vs. 30.6gr) with higher Tetrahydrocannabinol (THC) concentration (15.2% vs. 12.9%) and lower Cannabidiol (CBD) concentration (4.7% vs. 6.0%). Over two years of use, amount, and composition of cannabis among the two groups were comparable and showed an increase in total amount and THC concentration, reaching the maximal available THC concentration of 20%. Data regarding adverse effects were available for 6,242 PTSD patients (48.1%) and 39,497 non-PTSD patients (26.6%). PTSD patients reported more physical adverse effects (RR 1.45 [95%CI 1.34-1.56]), anxiety (RR 1.47 [95%CI 1.13-1.92]), and derealization (RR 3.44 [95%CI 2.42-4.89]).ConclusionsPTSD is one of the leading indications for medical cannabis use in Israel, despite scarcity in good quality data supporting its effectiveness and safety. The increased risk of mental adverse effects among PTSD patients emphasizes the need for cautious use in cannabis in this population. Expanding the knowledge regarding patterns of use and risks in medical cannabis use among PTSD patients is important for understanding the role of cannabis in PTSD treatment and to ensure an effective and safe treatment.Disclosure of InterestNone Declared
““Why shouldn’t I expect things from life?” – what people with lived experience from psychosis highlight as important to their personally defined long-term recovery process”
Authors: Åsbø G. , Haavind H. , Hembre Kruse S. , Fjelnseth Wold K. , Ten Velden Hegelstad W. , Lie Romm K. , Ueland T. , Melle I. , Simonsen C. 
Published: August 2023

IntroductionMany people with lived experience from psychosis recover and thrive, contrary to the common stigmatizing belief that they will be chronic “patients”. But there are several ways to understand recovery, one is as a subjective process best explored through qualitative interviews with people who have recovered from psychosis. However, there is a need for more qualitative interview studies exploring what has been important for long-term subjective recovery for people with lived experience from psychosis outside of treatment. Exploring themes that are novel than previous research will have important clinical implications.ObjectivesThis study aims to qualitatively explore what people with lived experience from psychosis believe has been the most important to attain and sustain their long-term personally defined recovery.MethodsQualitative interviews with 20 individuals participating in two follow-up-studies (TOP and TIPS-study) 10 and years 20 years after first treatment for a psychotic disorder (schizophrenia- or bipolar spectrum), respectively. All participants were in either clinical recovery (symptom remission and adequate functioning) or personal recovery (self-rated questionnaire) or both. Interviews were analyzed with thematic analysis in group meetings between the PhD-candidate, the main supervisor, a professor emerita in qualitative method and a co-researcher with lived experience from bipolar disorder.ResultsParticipants defined recovery differently, but: “understanding myself”, “stable symptoms” and “finding the life that is right for you” were of the most common definitions. Tentatively, five main themes appear to be the most salient contributions to recovery: 1. Balance stress management with taking risks and following personal goals. 2. Accepting experience/”owning your story” in order to strategically disclose and manage stigma. 3. Taking agency over own recovery and mastery of everyday life. 4. Social support is crucial, but should change over time depending on need. 5. Feeling a sense of belonging to society does not need to entail “normality”.ConclusionsRecovery was defined differently by each participant, but common themes across participants highlight that appropriate risk-taking, accepting your experience/owning your story, sense of agency, social support and inclusion are important to long-term recovery in psychosis.Disclosure of InterestNone Declared
Antidepressant Use and Its Association with 28-Day Mortality in Inpatients with
SARS-CoV-2: Support for the FIASMA Model against COVID-19
Authors: Hoertel N. , Sanchez-Rico M. , Kornhuber J. , Gulbins E. , Reiersen A. , Lenze E. , Fritz B. A. , Jalali F. , Mills E. , Cougoule C. , Carpinteiro A. , Mühle C. , Becker-Flegler K. A. , Boulware D. R. , Blanco C. , Alvarado J. M. , Strub-Wourgaft N. , Lemogne C. , Limosin F. 
Published: August 2023

Introduction
To reduce Coronavirus Disease 2019 (COVID-19)-related mortality and morbidity, widely
available oral COVID-19 treatments are urgently needed. Certain antidepressants, such as
fluvoxamine or fluoxetine, may be beneficial against COVID-19.

Objectives
The main objective was two-fold: (i) to test the hypothesis that the prevalence of
antidepressant use in patients hospitalized with COVID-19 would be lower than in patients
with similar characteristics hospitalized without COVID-19, and (ii) to examine, among
patients hospitalized with COVID-19, whether antidepressant use is associated with reduced
28-day mortality. Our secondary aim was to examine whether this potential association could
only concern specific antidepressant classes or molecules, is dose-dependent, and/or only
observed beyond a certain dose threshold.

Methods
We included 388,945 adult inpatients who tested positive for SARS-CoV-2 at 36 AP–HP
(Assistance Publique–Hôpitaux de Paris) hospitals from 2 May 2020 to 2 November 2021. We
compared the prevalence of antidepressant use at admission in a 1:1 ratio matched analytic
sample with and without COVID-19 (N = 82,586), and assessed its association with 28-day
all-cause mortality in a 1:1 ratio matched analytic sample of COVID-19 inpatients with and
without antidepressant use at admission (N = 1482) (Figure 1).

Results
Antidepressant use was significantly less prevalent in inpatients with COVID-19 than
in a matched control group of inpatients without COVID-19 (1.9% versus 4.8%; Odds Ratio (OR)
= 0.38; 95%CI = 0.35–0.41, p < 0.001) (Figure 2). Antidepressant use was significantly
associated with reduced 28-day mortality among COVID-19 inpatients (12.8% versus 21.2%; OR =
0.55; 95%CI = 0.41–0.72, p < 0.001), particularly at daily doses of at least 40 mg
fluoxetine equivalents (Figure 3). Antidepressants with high FIASMA (Functional Inhibitors of
Acid Sphingomyelinase) activity seem to drive both associations.
Image:

Image 2:

Image 3:

Conclusions
Antidepressant use is associated with a reduced likelihood of hospitalization in
patients infected with SARS-CoV-2 and with a reduced risk of death in patients hospitalized
with COVID-19. These associations were stronger for molecules with high FIASMA activity.
These findings posit that prospective interventional studies of antidepressants with the
highest FIASMA activity may be appropriate to help identify variant-agnostic, affordable, and
scalable interventions for outpatient and inpatient therapy of COVID-19.

Disclosure of Interest
None Declared
Changes in UK Pre-Schooler’s Mental Health Symptoms over the first year of the Covid-19 pandemic: data from Co-SPYCE Study
Authors: Dodd H. , Skripkauskaite S. , Shum A. , Waite P. , Lawrence P. 
Published: August 2023

IntroductionThe COVID-19 pandemic caused significant disruption to the lives of children and their families. Pre-school children may have been particularly vulnerable to the effects of the pandemic, with the closure of childcare facilities, playgrounds, playcentres and parent and toddler groups limiting their opportunities for social interaction at a crucial stage of development. Additionally, for parents working from home, caring for pre-school aged children who require high levels of support and care, was likely challengingObjectivesWe aimed to conduct an intensive longitudinal study to examine trajectories of pre-schoolers’ mental symptoms in the United Kingdom during the first year of the COVID-19 pandemic.MethodsUK‐based parents and carers (n = 1520) of pre-school‐aged children (2 to 4 years) completed monthly online surveys about their pre-schoolers’ mental health between April 2020 and March 2021. The survey examined changes in children’s emotional symptoms, conduct problems and hyperactivity/inattention.ResultsPre-schoolers’ emotional problems and hyperactivity/inattention symptoms declined from April through summer 2020 and then increased again during the autumn and winter 2020/2021 as lockdowns were re-introduced. Pre-schoolers who attended childcare showed greater decline in symptom severity than those who did not. Older children, compared to younger, showed greater lability of emotion symptom severity. Attending childcare predicted lower symptom severity across all three domains of conduct problems, emotional symptoms, and hyperactivity/inattention, while the opposite pattern was observed for children whose parent had a mental health problem.ConclusionsOur findings reinforce the importance of examining pre-schoolers’ mental health in the context of micro and macro-level factors. Interventions focusing on family factors such as parent mental health, as well as continued provision of childcare, may have most potential to mitigate the impact of COVID-19 on young children’s mental health.Disclosure of InterestNone Declared
Differential Impact of Social Cohesion in the Lens of U.S. College Students with different Sexual and Gender Identities on their Mental Health during the COVID-19 Pandemic
Authors: Lin Y. , Deng W. , Xie H. 
Published: August 2023

IntroductionSexual and gender minority (SGM) college students endorsed higher psychological distress and worsened mental health outcomes than their cisgender heterosexual peers. Such disparity is exacerbated during the COVID-19 pandemic, during which SGM youth may be sent home to unaccepting environments or presented with fewer healthcare options. The “Black lives matter (BLM)” and “Anti-Asian Hate” also exposed college students disproportionally to more witnessed discrimination and poorer social cohesion, which in turn, might negatively affect the mental health outcomes.ObjectivesThe present study aims to explore the mental health outcome profile within SGM college students by (1) identify mental health disparities across different sexual and gender identities and (2) evaluating the impacts of discrimination, social cohesion and other factors on mental health outcomes of college students with different sexual and gender identities.MethodsThe study utilizes the 2020-2021 Healthy Minds Study data with 139,470 college students across 60 U.S. campuses. Multivariable regression models are built with minority status to predict mental health outcome (depression, anxiety, and suicidal ideation).ResultsSGM students reported higher symptoms of depression, anxiety, and suicidal ideation. Besides, SGM individuals having experienced or witnessed discrimination or hostile behaviors due to their race/ethnicity also showed worse mental health outcomes. Noted, perceived stronger social cohesion is a protective factor for lower depression (OR: 0.59; 95%CI: 0.45, 0.78) and anxiety (OR: 0.69; 95%CI: 0.51, 0.93) symptoms in SGM, while perceived weaker social cohesion is a risk factor for depression (OR: 1.37; 95%CI: 1.14, 1.64) and anxiety symptoms (OR:1.32; 95%CI:1.09-1.59) in cisgender heterosexual individuals.ConclusionsThese findings acknowledge the negative impact of discrimination on mental health, highlight the importance of recognizing social cohesion affect differently in SGM and their peers, and enhance the understanding of differential impact of social cohesion to inform public policy and early intervention in vulnerable populations during COVID-19 pandemic.Disclosure of InterestNone Declared
Severe COVID-19 and breakthrough infections in vaccinated schizophrenia patients: A matched controlled cohort study
Authors: Tzur Bitan D. 
Published: August 2023

IntroductionSchizophrenia patients are at an increased risk for severe SARS-CoV-2 illness. Recent studies indicate that vaccines reduce morbidity gaps between schizophrenia patients and the general population; nonetheless, the ongoing emergence of COVID-19 variants and the increased frequency of breakthrough infections might lead to changes in these risk profiles.ObjectivesIn this study we aimed to bridge this gap by assessing the risk of COVID-19 infection, hospitalization, and mortality among vaccinated individuals with schizophrenia, as compared to vaccinated individuals with no schizophrenia, matched for age, sex, and vaccination coverage (first, second, and booster) throughout the first year of the vaccination plan.MethodsThe study included 50,958 vaccinated individuals: 25,479 individuals with schizophrenia and 25,479 without schizophrenia. Data were derived from the databases of Clalit Health Services, the largest healthcare organization in Israel.ResultsFindings indicated that differences among vaccinated schizophrenia patients and controls were non-significant after adjusting for infection (HR = 0.93, 95%CI 0.84-1.03, p = 0.14) and mortality rates (HR = 2.18, 95%CI 0.80-5.90, p = 0.12). Nonetheless, differences in rates of hospitalization remained significant even after controlling for demographic and clinical factors (HR = 2.68, 95%CI 1.75-4.08, p<0.001). A longitudinal assessment of relative risk indicated that the rate ratio of differences between the groups increased during the fourth infection wave of the B.1.617.2 (delta) variant across all parameters, with schizophrenia patients demonstrating higher relative risk of hospitalization (RR = 4.19, 95%CI 2.41-7.23) and mortality (RR = 7.61, 95%CI 0.93-61.89) during the relevant periods.ConclusionsThese findings suggest that vaccination coverage is effective in narrowing overall morbidity and mortality gaps; nonetheless, individuals with schizophrenia are still at risk for severe COVID-19 outcomes.Disclosure of InterestNone Declared
Antipsychotic treatment and cognitive function in patients with schizophrenia
Authors: Tumova M. A. , Stepanova A. A. , Yanushko M. G. , Kotsyubinsky A. P. , Ivanov M. V. 
Published: August 2023

IntroductionIt is known that cognitive impairment is one of the main symptoms of schizophrenia, which determines the functional outcome. The question of the effect of antipsychotics on the cognitive functions of these patients is still unresolved. Cognitive impairment while taking antipsychotics is thought to be mostly related to extrapyramidal abnormalities. In practice, it is difficult to distinguish what causes a patient’s complaints of cognitive decline. Is it related to taking the medication? Or a worsening mental state? Age, lifestyle, etc.?ObjectivesWe analyzed the relationship of cognitive impairment with the severity of extrapyramidal symptoms, mental status gravity, age, and dose of antipsychotic and cholinergic medication at weeks 2 and 8 of treatment.MethodsWe examined 37 patients with schizophrenia on stable antipsychotic treatment at weeks 2 and 8 of therapy. Thirty patients received a 2nd-generation antipsychotic, and seven patients received a 1st-generation antipsychotic. The anticholinergic drug was trihexyphenidyl. The antipsychotic dose was estimated in olanzapine equivalent. Extrapyramidal symptoms were assessed by The Scale for Extrapyramidal Symptoms (SAS), severity of mental condition was rated by The Positive and Negative Syndrome Scale (PANSS), cognitive function was measured by The Brief Assessment of Cognition in Schizophrenia (BACS).ResultsAs previously described, patients with more severe extrapyramidal symptoms tended to have lower BACS composite scores (rxy = -0.318, p-value = 0.055) at week 8 of therapy. The total score on the SAS scale, as expected, only negatively correlated with scores on the Token Motor Task test (rxy = -0.412, p-value = 0.011) at the 8th week of therapy. There were also negative correlations between Token Motor Task scores and trihexyphenidyl dose (rxy = -0.496, p-value = 0.002). At both weeks 2 and 8, there was a negative relationship between age and Symbol Coding scores (rxy = -0.387, p-value = 0.018; rxy = -0.35, p-value = 0.034, respectively). Verbal Fluency scores were lower in patients with high scores on the PANSS excitement component and at week 2 (rxy = -0.42, p-value = 0.01), this trend continued at week 8 (rxy = -0.31, p-value=0.063) . Tower of London scores were negatively associated at week 8 with cognitive and positive PANSS scores (rxy = -0.46, p-value = 0.004; rxy = -0.336, p-value = 0.042, respectively).ConclusionsThus, we have demonstrated that cognitive impairment in patients with schizophrenia is associated with various factors, and not only antipsychotic treatment.Disclosure of InterestNone Declared