bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical factors associated with unipolar mania: A systematic review and meta-analysis
Authors: Bartoli F. , Nasti C. , Palpella D. , Piacenti S. , Di Lella M. E. , Mauro S. , Prestifilippo L. , Crocamo C. , Carrà G. 
Published: August 2023

IntroductionThe existence of a clinical entity on the spectrum of mood disorders characterized by the occurrence of manic episodes without major depressive episodes (Unipolar Mania, UM) is largely debated. Although not classified nosologically, the studies exploring this topic have suggested that UM might differ from bipolar disorder with a manic-depressive course (md-BD), in terms of several clinical characteristics. Individuals with UM might represent a subpopulation with specific clinical profiles and unmet care needs, requiring personalized treatments, as compared with those suffering from md-BD.ObjectivesTo identify clinical factors associated with UM, as compared with md-BD.MethodsWe performed a systematic review and meta-analysis of observational studies according to the MOOSE guidelines. We searched for articles indexed up to July 2022 in the main electronic databases. We conducted random-effects meta-analyses of the association between UM and relevant correlates, using odds ratio for categorical variables and standardized mean difference for continuous variables.ResultsBased on data from 21 studies meeting the eligibility criteria, we found that individuals with UM, as compared with md-BD, were more likely to be males (p = 0.007) and to have an earlier age at onset (p = 0.020). Moreover, UM was significantly associated with a higher number of hospitalizations (p < 0.001), the occurrence of psychotic features (p < 0.001), as well as hyperthymic temperament (p = 0.012). Finally, subjects with UM were less likely to report a family history of depression (p = 0.006) and a personal history of suicide attempts (p < 0.001).ConclusionsOur work supports the hypothesis that UM might represent a distinctive diagnostic construct, with peculiar clinical correlates. Additional research is needed to better differentiate UM in the context of affective disorders.Disclosure of InterestNone Declared
Non-invasive neurostimulation in OCD – implications for widescale application.
Authors: Fineberg N. A. 
Published: August 2023

AbstractBrain-imaging findings implicate aberrant cortico-striatal neurocircuitry in the underlying pathology of OCD, so representing a potential treatment target. Ablative neurosurgery or deep brain (invasive) stimulation (DBS) of tracts or nodes within this circuitry is sometimes found to improve OCD, possibly by enhancing information-processing functions. Non-invasive neurostimulation, targeting superficial cortical nodes within cortico-striatal circuitry, is a safer and more acceptable alternative, with potential for scaling up and applying to a larger patient population, earlier in the course of illness.Repetitive transcranial magnetic stimulation (rTMS) is the form of neuromodulation studied most in OCD. The orbitofrontal cortex (OFC), dorsolateral prefrontal cortex and supplementary motor area (SMA) have been identified as promising targets. The effect is larger for those not resistant to SSRI or failing to respond to only one SSRI trial. Thus, r-TMS may be best implemented earlier in the care pathway. rTMS is also relatively costly, involves specialist technical equipment and staff, and cannot be delivered in patients’ homes.Transcranial direct current stimulation (tDCS) involves applying a low-amplitude (1-3mA) electric current to the brain via electrodes placed on the scalp. Compared with rTMS, tDCS tends to electrically modulate a more diffuse and superficial brain area, but it could represent a preferable option for patients with common mental disorders such as OCD, as it is cheaper, portable, simple and safe to use. In a recent randomised controlled feasibility study, the L-OFC represented the optimal target based on clinical changes. Further investigation of tDCS in OCD is warranted, to determine the optimal stimulation protocol, longer-term effectiveness and brain-based mechanisms of effect. If efficacy is substantiated, home-based approaches represent a rational next step.Disclosure of InterestN. Fineberg Grant / Research support from: In the past three years I have received research funding from the NIHR, COST and Orchard; . I have additionally received financial support to attend meetings from the British Association for Psychopharmacology, European College for Neuropsychopharmacology, Royal College of Psychiatrists, International College for Neuropsychopharmacology, World Psychiatric Association, International Forum for Mood and Anxiety Disorders, American College for Neuropsychopharmacology. In the past I have received funding from various pharmaceutical companies for research into the role of SSRIs and other forms of medication as treatments for OCD., Consultant of: payment for expert advisory work on psychopharmacology for the Medicines and Healthcare Products Regulatory Agency, royalties from Oxford University Press and an honorarium from Elsevier for editorial work., Paid Instructor of: payment for lectures for the Global Mental Health Academy.
Isoniazid-induced acute psychotic episode in a child with lymph nodes tuberculosis: case
report and literature review
Authors: Belhadga H. , Elmaataoui Z. , Kisra H. 
Published: August 2023

Introduction
Tuberculosis (TB) is a bacterial infection caused by Mycobacterium tuberculosis and is
a major public health problem in Morocco. The World Health Organization (WHO) recommends a
four-drug combination therapy for two months (isoniazid (INH), rifampicin, pyrazinamide and
ethambutol), followed by two drugs (INH and rifampicin) for 4 months, as first-line treatment
for newly diagnosed pulmonary TB in children and adults. This regimen is generally considered
effective, safe, and cost-effective. However, adverse effects and drug interactions often
complicate the treatment of TB. Isoniazid is associated with 32% of adverse events, of which
1.9% are psychiatric.

Objectives
focus on drug-induced etiologies of acute psychotic symptoms make the diagnosis of
isoniazid-induced psychosis report the literature on the management of this condition. focus
on drug-induced etiologies of acute psychotic symptomsmake the diagnosis of isoniazid-induced
psychosis report the literature on the management of this condition.

Methods
The patient and guardians were interviewed to obtain information after their consent.
Data from the patient profile forms and laboratory test reports were evaluated. Causality
assessment was done by the WHO scale and the Naranjo scale. Oral informed consent was
obtained from the patient and parents.

Results
We report a case of acute psychosis in a child with a temporal sequence strongly in
favor of INH-induced psychosis. Treatment with risperidone at an appropriate dose improved
the symptomatology while waiting for the end of the antituberculosis protocol. As soon as the
isoniazid was stopped, there was a clear return to the child’s premorbid state.

Conclusions
The acute onset of psychotic symptoms in a patient taking isoniazid should lead to
suspicion of this psychiatric side effect and prompt intervention, involving discontinuation
of isoniazid and/or a trial of an antipsychotic.
As protective measures, the authors suggest adjusting the dose of isoniazid to weight,
possibly performing a genetic test if slow acetylation is suspected, and closely monitoring
patients with a favourable background.
The acute onset of psychotic symptoms in a patient taking isoniazid should lead to
suspicion of this psychiatric side effect and prompt intervention, involving discontinuation
of isoniazid and/or a trial of an antipsychotic.As protective measures, the authors suggest
adjusting the dose of isoniazid to weight, possibly performing a genetic test if slow
acetylation is suspected, and closely monitoring patients with a favourable
background.

Disclosure of Interest
None Declared
Bipolar Disorder and Parkinson disease: a 123I-FP-CIT SPECT study
Authors: D’agostino G. , Cascino G. , Landolfi A. M. , Erro R. , Barone P. , Monteleone P. 
Published: August 2023

IntroductionBipolar Disorder (BD) has been suggested to be a risk factor for development of Parkinson Disease. Psychiatric drugs used as standard treatment of BD includes many drugs that are known to induce drug-induced parkinsonism (DIP).ObjectivesClinical differentiation between PD and DIP is a clinical and scientific crucial result. It might be aided by functional neuroimaging of the dopaminergic nigrostriatal pathway.MethodsTwenty consecutive BD patients with parkinsonism were clinically assessed and underwent 123I-ioflupane dopamine transporter SPECT. Imaging data of BD patients with pathological nigrostriatal pathway were further compared to a population of de-novo PD patients.ResultsFour BD patients had abnormal scans; they had higher putaminal binding ratio and putamen-to-caudate ratios than PD patients, despite similar motor symptom burden.Conclusionsin our initial results, up to 20% of BD patients with parkinsonism might have an underlying dopaminergic deficit, which is higher than excepted in the general population. This evidences supports that BD represents a risk factor for subsequent development of neurodegenerative parkinsonism.Disclosure of InterestNone Declared
Implementing alternatives to coercion as a key component of improving mental health care: the WPA contribution
Authors: Galderisi S. 
Published: August 2023

AbstractTo favor the implementation of alternatives to coercive practices, a WPA Taskforce and reference group on Minimizing Coercion in Mental Health Care was created within the WPA 2017-2020 Action Plan. It included several distinguished colleagues from different countries and cultural as well as experiential background, and representatives from patients and carers organizations. Task force members soon realized the presence of a significant diversity of views and experiences among mental health professionals, people with lived experience and their carers. All members agreed that the debate on minimizing versus eliminating coercion could be endless and unfruitful, while the opportunity to concentrate on improving the quality of mental health care in low-, middle- and high-income countries, and implementing alternatives to coercion as a key component of improving mental health care, was instead a shared goal that could make the task of the group feasible and productive. The General Assembly of the WPA in October 2020 approved a Position statement drafted by the Task Force aimed to set a direction and practical starting point for action. This presentation will illustrate contribution provided by the WPA Working Group for Implementing Alternatives to Coercion in Mental Health Care within the current WPA Action Plan (2020-2023).Disclosure of InterestNone Declared
Psychiatryai.com: An exploratory online Artificial Intelligence and Data Science platform to enable near real-time psychiatry and mental health evidence-based medical research and data dissemination
Authors: Naik P. 
Published: August 2023

IntroductionPsychiatryai.com is a prototype Artificial Intelligence (AI) and Data Science (DS) platform and research project developed for my Evidence-Based Healthcare (EBHC) course at University of Oxford in MSc studies (Kellogg College). This is a singular, multi-disciplinary, and beta-testing project in Computing Science, Psychiatry, and Mental Health for oral presentation at EPA 2023.ObjectivesAI and DS in Psychiatry and Mental Health have emerged as important research areas in the post Covid-19 pandemic era. This prototype University project (Psychiatryai.com) was launched on 22nd November 2021. It aims to develop a free, secure, and open access platform in near real-time about psychiatry and mental health evidence-based research - for healthcare professionals, doctors, and researchers in psychiatry. The project also aims to integrate findings from the Goldacre Review (2022) into practice and develop novel computing solutions utilising AI and DS, and present findings.MethodsA WordPress site (Psychiatryai.com) was developed with syndicated RSS feeds across 330 psychiatry topics and refreshed by data servers hourly, 24 hours a day, 7 days a week. A total of 43 WordPress plugins were utilised to develop this secure platform. The site is powered by intuitive data modelling and analytics in near real-time and available in open access coding format for peer-review, future development, and research. The primary sources of live evidence for the project are PubMed and University of Helsinki, Finland. The server performance data analytics will be available for poster presentation at EPA 2023. This includes full statistical results and discussion since its inception and launch (including traffic, MESH tags, and PubMed ID), and robust technical analysis and performance outcomes - available freely online to promote research in psychiatry and mental health.ResultsKnowledge Synthesis and Dissemination:Total Words: 4356886 *Live Psychiatry and Mental Health Citations from PubMed: Exceeds 325000Total Evidence Alerts Published: 54391 *Total Algorithms/Topics: 330Total site visitors: 8023 ** Since launch of Psychiatryai.com on 22 November 2021 inclusive to 31 October 2022ConclusionsPsychiatryai.com was able to demonstrate succesful development of an effective and viable platform to study AI and DS in Psychiatry and Mental Health, as evidenced by results table. The platform has also incorporated findings from the Goldacre Review (2022) and aims to continue to collect valuable insights towards full real-time data analytics and dissemination of peer-reviewed current evidence in the future. The emergence of these technologies will be useful in settings such as disaster psychiatry, psychiatry e-training and research, and e-mental health awareness/promotion ahead.Disclosure of InterestP. Naik Consultant of: Dr Paras Naik (Psychiatryai.com) Non-profit University Project
1-year above-recommendation screen use and internalizing and externalizing behaviours in French children aged 3 to 14 years
Authors: Descarpentry A. , Davisse-Paturet C. , Galera C. , Hazo J.-B. , Melchior M. , Rouquette A. 
Published: August 2023

IntroductionThe context of the COVID-19 pandemic has changed the daily life of families and children. Screen exposure was increased during this period to maintain social relationships, work remotely, and occupy leisure time.ObjectivesTo explore the association of continued above-recommendation screen use for one year since May 2020 with behaviour problems in the summer of 2021 in children aged 3 to 14 years.MethodsData came from the French EpiCov cohort study, and were collected in May 2020 and at first (Autumn 2020) and second follow-up (Summer 2021) among 1,089 participants with children aged 3 to 14. Children had a 1-year above-recommendation screen use if their daily mean time exceeded recommendations at the three follow-up times (one hour, for children aged 3-5, two for the older ones). Behaviour problems were assessed using the Strengths and Difficulties Questionnaire (SDQ) and valid cut-offs for Internalizing (emotional or peer problems) and Externalizing (conduct problems or hyperactivity/inattention) problems completed in summer 2021. Data were analysed using adjusted logistic regression.Results1-year above-recommendation screen use was not associated with internalizing problems (OR [95% CI]: 1.20 [0.90-1.59]). Regarding the subscales, it was associated with a higher risk of peer problems (1.42 [1.04-1.95]). A higher risk of externalizing problems was found only in 11-14-year-olds (1.63 [1.01-2.63]), especially conduct problems in 11-14-year-olds (1.91 [1.15-3.22]) but not in other age groups.ConclusionsThis study found that maintaining screen time beyond recommendations for 1 year since the onset of the pandemic was associated with peer problems in children aged 3-14 years and externalizing and conduct problems in 11-14 years. Despite this very specific context, exposure to screens is not trivial. If this situation were to occur again, we would have to anticipate, with prevention messages, by keeping schools open.Disclosure of InterestNone Declared
Hyperprolactinemia in patients taking antipsychotics: the importance of a shared approach between psychiatry and endocrinology
Authors: Mousinho M. , Gouveia A. , Pimentel B. 
Published: August 2023

IntroductionHyperprolactinemia is a commonly encountered adverse effect of antipsychotic medication. Short and long-term repercussions of high prolactin, such as amenorrhea, sexual dysfunction, osteopenia and increased cardiovascular risk carry significant burden and may compromise therapeutic adherence. Despite its serious practical implications, hyperprolactinemia is still underscreened and its management neglected.ObjectivesTo review current clinical guidelines regarding the management of hyperprolactinemia associated with the use of antipsychotics, reflecting upon the importance and need to share the management of this risk with an endocrinology expert.MethodsWe performed a literature review to identify clinical guidelines containing specific recommendations for antipsychotic-induced hyperprolactinemia (British Association of Psychopharmacology [BAP], NICE, Maudsley Prescribing Guidelines, Royal Australian and New Zealand College of Psychiatrists), published over the last ten years, with a particular focus on its physical risks.ResultsMost guidelines do not recommend routine monitoring of prolactin levels in asymptomatic patients. NICE and BAP guidelines have suggested measuring the baseline prolactin level, but have not specified follow-up monitoring, while Maudsley guidelines have. Management strategies depend on factors such as sex, age, as well as the clinical manifestations that ensue. Different treatment strategies have been described, such as decreasing the dose of the antipsychotic, switching antipsychotics, adding aripiprazole or adding dopaminergic agonists. Referral to an endocrinology specialist should be made if the aetiology is unclear, prolactin levels continue to rise despite some intervention, the hyperprolactinaemia is severe (>3000 mIU/L) or there is suspected/confirmed pituitary adenoma. Further physical implications of having hyperprolactin are to be dressed by the endocrinology expert, namely those on bone metabolism, gonodal function and cancer risk.ConclusionsGiven the widespread use of antipsychotics and the need to have psychotic patients stabilized (sometimes with a lack of effective alternative), early detection and shared management of hyperprolactinemia are instrumental towards assisting both clinician’s and patients’ decision-making, be it towards lowering prolactin levels or managing its risk without compromising the antipsychotic’s efficacy.Disclosure of InterestNone Declared
Changes in the Rate of Emergency Presentation in Patients with Functional Neurological Disorder Attending a Long-term Community Care Program for FND
Authors: Gheis M. , Sekhon G. 
Published: August 2023

IntroductionPatients with Functional Neurological Disorder have a high return rate to Emergency Rooms.ObjectivesTo assess possible changes in Emergency Room presentation rates in patients with Functional Neurological Disorder following their attendance of specialized long-term multidisciplinary treatment and rehabilitation program.MethodsSeventy-two adult patients with Functional Neurological Disorder were included. These patients were consecutive referrals accepted for ongoing specialist FND treatment.The total number of Emergency Room presentations in the year prior to program admission was obtained from central health records. Patients were provided ongoing treatment for one year, during which the number of ER presentations was monitored. Patients received one or more of the following treatment modalities: psychoeducation, psychological therapy, psychologically informed physical and occupational rehabilitation and psychopharmacological treatments.We subsequently compared high and low emergency service users. Low ER users are those with pre-treatment Emergency Room presentations of less than 3 per year. High emergency service users are those who presented to the emergency room 3 or more times per year before the start of their treatment.ResultsThe mean emergency room presentation per year in the year leading to patients referral was 2.6 per patient, SD 9.4; dropped to 1.2 emergency room presentations per year, with a standard deviation of 4.4 in the year following the start of treatment. The difference was statistically significant (p= 0.02).There was a strong positive correlation between the pre and post-treatment number of presentations with a Pearson Correlation Coefficient of 0.976 (95% Confidence Interval 0.962 to 0.985).The reduction in emergency room presentations in both high and low-emergency service user groups was significant, with a mean difference of 12 ER visits a year in high-frequency emergency service users (p= 0.04) and a mean difference of 0.5 visits a year in low-frequency emergency service users (p < 0.001).ConclusionsOngoing specialist treatment and rehabilitation of patients with Functional Neurological Disorder significantly reduce their need for emergency room presentation, regardless of the treatment modality.Disclosure of InterestNone Declared
Syndrome of inappropiate antidiuretic hormone secretion (SIADH) secondary to sertraline: case report and literature review
Authors: Cardenes-Moreno C. , Yelmo-Cruz S. , Perez-Sagaseta I. , Tascon-Cervera J. J. , Dorta-Gonzalez J. , Crisostomo-Siverio A. , Torres-Tejera L. , Paniagua-Gonzalez M. , Canessa S. , Cejas-Mendez M. R. 
Published: August 2023

IntroductionCurrently, in addition to their frequent use in community medicine, the use of antidepressants is a fundamental pillar of pharmacological treatments used in psychiatry. Due to this frequent use, we must be aware of the possible side effects, in particular the SIADH produced in this clinical case by SSRIs. There are already described cases of this association including other antidepressants and many different types of drugs.ObjectivesTo review the current literature on the management of this pathology when it is secondary to the use of frequently used drugs such as SSRIs.MethodsWe report the case of a 64-year-old woman hospitalised in the psychiatric department for malnutrition secondary to unspecified eating disorder (ED). During admission, treatment with sertraline was started with ascending doses up to 100mg, subsequently producing slight edema with the following analytical results: plasma Na: 123 mEq/L (135-145), plasma osmolarity: 250 mOsm/kg (275-300), urinary Na: 174 mEq/L (>40), fulfilling diagnostic criteria for SIADH.Afterwards, we reduced sertraline until discontinuation and started treatment with water restriction and urea (30 grams/24 hours) during admission and after discharge. During admission, we observed disappearance of the edema and partial improvement of the analytical values (Na:131 mEq/L), which were normalised with home treatment of daily urea.ResultsThe precise prevalence of SIADH from the use of SSRIs is unknown, it is known that patients older than 65 are at higher risk of developing severe hyponatraemia in the first 5 weeks after initiation. Similarly, treatment with water and urea restriction, together with discontinuation of SSRIs, appears to be sufficient.ConclusionsSSRIs can cause SIADH a reversible but potentially life-threatening pathology, and we need to be aware of this possibility especially in the older population and being able to handle itDisclosure of InterestNone Declared