bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety and Tolerability of Intramuscular and Sublingual Ketamine for Psychiatric Treatment in the Roots to Thrive Ketamine Assisted Therapy Program
Authors: Tsang V. W. L. , Tao B. , Dames S. , Walsh Z. , Kryskow P. 
Published: August 2023

IntroductionKetamine has been increasingly used to treat mental health conditions yet there is a lack of safety data on intramuscular (IM) and sublingual (SL) dosing in a community setting. The Roots to Thrive Ketamine assisted Therapy (RTT-KaT) program is a 12-week program with 12 Community of Practice (CoP) group therapy sessions and three ketamine sessions.ObjectivesTo provide preliminary data on RTT-KAT adverse events to subsequently inform safe use of IM and SL ketamine for the treatment of psychiatric disorders.MethodsRetrospective chart review of the RTT-KaT Program on four cohorts (n=128) between September 2020 to December 2021. Eligible patients include those with post-traumatic stress disorder, depression, generalized anxiety, burnout/adjustment disorder, substance use disorder, obsessive compulsive disorder, disordered eating, and disordered sleep. Baseline characteristics and adverse events were captured including medication administration before, during, and after RTT-KaT sessions. Chi-squared test with Yates’ continuity correction was used to assess side effects in subgroups from ketamine administration.ResultsRTT-KaT was well tolerated with no loss to follow up. There were 351 IM (mean dose = 102.553mg) and 96 SL (mean dose = 276.667mg) sessions of ketamine. Of the 448 sessions, the prevalence of elevated blood pressure increased by 12.31% from baseline (36.85%), with all post-treatment elevations being transient. The prevalence of elevated blood pressure post-KaT session was also similar between IM (+11.69% from 37.71% baseline) and SL (+15.12% from 32.98% baseline) administration. Regarding adverse effects, 12.05% of sessions experienced nausea , 2.52% had an episode of vomiting , 3.35% had a headache , and seven sessions experienced dizziness. The incidence of adverse events was not significantly associated with past psychedelic experiences (X2 = 0.0543, p-value = 0.8157), nor past psychiatric diagnosis (X2 = 0.0109, p-value = 0.917). . There was no significant association between administration route and incidence of nausea, which was the most common side effect(X2 = 1.112, p-value = 0.2916). Male gender was also significantly associated with lower incidence of nausea (X2 = 4.2841, p-value = 0.03847).ConclusionsThe group therapy model described provides a comprehensive approach and presents a promising model for operating a KaT program outside of a clinical trial setting.These findings suggest good safety and acceptability for RTT-KaT among individuals seeking treatment for mental health issues. Majority of participants did not experience adverse reactions and the adverse events that were recorded involved transient symptoms that were resolved with rest and/or medications.Disclosure of InterestNone Declared
Prevalence and factors associated with depression among health care workers in the region of Sousse in Tunisia
Authors: Athimini Z. , Gaddour A. , Brahem A. , El Ghezhal R. , Chouchene A. , Bouhoula M. , Elmaalel O. , Chatti S. , Mrizak N. 
Published: August 2023

IntroductionMental health disorder is common among working population worldwide and among health care-workers (HCWs) in particular. Depression is a major public health problem, with an economic impact because of lost days of work. Its prevention is essential and requires the identification of risk factors.ObjectivesThe objectives of this work were to determine the epidemiological characteristics of depressive disorders in health care workers and identify their main risk factors.MethodsA descriptive retrospective study was conducted on health care workers of Sousse in Tunisia who have had a long-term sick leave for depressive disorders from January 2010 to December 2021. data was collected from the medical records of the patients and completed with a telephone questionnaireResultsThe total number of cases was 650 with a prevalence of 12.8% and an incidence of 2 cases per 100 HCW. The median age was 50 years and the female workers represented 81% of cases. The majority of the sample were married (81%). Most of cases were nurses (43%) and health technician (19%). The median seniority of HCW in their jobs was 23 years with the first quartile at 12 and the third quartile at 31.Around 48% of cases had severe depression. The severity of depression was significantly associated with working in surgical and emergency services, number of night shifts of 2 or more per week, the history of a psychiatric disorder other than depression, habits such as smoking and drinking, anxiety specificity and melancholy specificity of depression.ConclusionsThis study showed the importance of social and occupational factors of depression among HCW. Action policies focusing on workplace interventions appear to be relevant.Disclosure of InterestNone Declared
Novel mitochondrial mechanisms of cognitive regulation in subjects with cognitive impairments
Authors: Bigio B. , Lima-Filho R. , Barnhill O. , Sudo F. , Drummond C. , Assunção N. , Vanderborght B. , Tovar-Moll F. , Mattos P. , Ferreira S. , De Felice F. , Lourenco M. , Nasca C. 
Published: August 2023

IntroductionPrior mechanistic studies in rodents showed decreased levels of the pivotal mitochondrial metabolite acetyl-L-carnitine (LAC) in relation to cognitive deficits and depressive-like behavior (Neuron 2017, 10.1016/j.neuron.2017.09.020, PNAS 2013, 10.1073/pnas.1216100110), providing the basis for the current translational study.ObjectivesThe main objective of this work was to ascertain the role of this specific mitochondrial signaling pathway in subjects with cognitive impairments (CI), and potential sex differences in these mechanisms.MethodsWe used computational approaches, ultraperformance liquid chromatography–tandem mass spectrometry (UPLC-MS/MS) and available plasma samples from a well-characterized cohort of 71 subjects, including subjects with CI and age- and sex-matched cognitively healthy controls (HC).ResultsOur newest findings showed decreased levels of LAC in subjects with CI as compared to age- and sex-matched HC. We also found important sex differences in carnitine levels in relation to cognitive function as assessed by using the Mini Mental Status Exam (MMSE). Specifically, the degree of carnitine deficiency reflected the severity of cognitive dysfunction in a sex-specific manner. Using computational approaches, we found that the integration of these mitochondrial measures with canonical biomarkers improves diagnostic accuracy.ConclusionsThe current findings of sex differences in carnitine deficiency in subjects with CI suggest a possible sex-specific mitochondrial phenotype of vulnerability to cognitive dysfunction, and point to LAC-related mitochondrial metabolism as a new signaling pathway of cognitive regulation.Disclosure of InterestNone Declared
Predicting unipolar and bipolar depression using inflammatory markers, neuroimaging and neuropsychological data: a machine learning study
Authors: Raffaelli L. , Colombo F. , Calesella F. , Fortaner-Uya L. , Bollettini I. , Lorenzi C. , Maggioni E. , Tassi E. , Poletti S. , Zanardi R. , Attanasio F. , Benedetti F. , Vai B. 
Published: August 2023

IntroductionAbout 60% of bipolar disorder (BD) cases are initially misdiagnosed as major depressive disorder (MDD), preventing BD patients from receiving appropriate treatment. An urgency exists to identify reliable biomarkers for improving differential diagnosis (DD). Machine learning methods may help translate current knowledge on biomarkers of mood disorders into clinical practice by providing individual-level classification. No study so far has combined biological data with clinical data to provide a multifactorial predictive model for DD.ObjectivesDefine a predictive algorithm for BD and MDD by integrating structural neuroimaging and inflammatory data with neuropsychological measures (NM). Two different algorithms were compared: multiple kernel learning (MKL) and elastic net regularized logistic regression (EN).MethodsIn a sample of 141 subjects (70 MDD; 71 BD), two different models were implemented for each algorithm: 1) structural neuroimaging measures only (i.e. voxel-based morphometry (VBM), white matter fractional anisotropy (FA), and mean diffusivity (MD)); 2) VBM, FA, and MD combined with NM. In a subsample of 71 subjects (36 BD; 38 MDD), two similar models were implemented: 1) VBM, FA, and, MD combined with only NM; 2) VBM, FA, and MD combined with NM and peripheral inflammatory markers. Finally, the best model was selected for comparison with healthy controls (HC).ResultsOverall, the EN model based on all the modalities achieved the highest accuracy (AUC = 90.2%), outperforming MKL (AUC=85%). EN correctly classified BD and MDD with a diagnostic accuracy of 78.3%, sensitivity of 75%, and specificity of 81.6%. The most significant predictors of BD (variable inclusion probability (VIP) > 80%) were the parahippocampal cingulate, interleukin 9, chemokine CCL5, posterior thalamic radiation, and internal capsule, whereas MDD was best predicted by chemokine CCL23, the anterior cerebellum, and the sagittal stratum. In contrast, NM did not help to differentiate between MDD and BD. However, they help to distinguish patients from HC. Psychomotor coordination and speed of information processing discriminated between MDD and HC (VIP>90%), whereas fluency, working memory, and executive functions differentiated between BD and HC (VIP>80%).ConclusionsIn summary, BD was predicted by a strong proinflammatory profile, whereas MDD was identified by structural neuroimaging data. A multimodal approach offers additional instruments to improve personalized diagnosis in clinical practice and enhance the ability to make DD.Disclosure of InterestNone Declared
Temperament and Character among mothers of individuals with gender dysphoria: a case-control study
Authors: Talaei A. , Omidvar Tehrani S. , Talaei Z. 
Published: August 2023

IntroductionParents of individuals with gender dysphoria may experience distress when dealing with their child’s condition, and how they react can have a significant effect on their own as well as their child’s mental health.ObjectivesIn this study, we aimed to explore the personality traits among mothers of individuals with gender dysphoria in comparison to the mothers of individuals with cis-gender identity by utilizing the Temperament and Character Inventory (TCI) tool.MethodsWe enrolled 27 mothers of GD individuals who had obtained licenses for gender affirmation surgery and 28 mothers of cisgender controls for this case-control study. Personality traits were measured by a validated Farsi version of the Temperament and Character Inventory (TCI) tool.ResultsThe mean±standard deviation age of mothers with GD children and controls was 53.95±9.44 and 53.00±7.28 years, respectively. 20 of the GD children were born with the female sex. Overall, TCI scores were statistically different between the two groups (p=0.03); however, this difference was only observed among Character scores (p=0.01) and was not significant in Temperament scores (p=0.33). We found significantly higher mean Cooperativeness (CO) and Self-Transcendence (ST) scores in the case group (p=0.007 and 0.031, respectively). We also identified significantly more individuals with a high CO score amongst mothers of GD individuals (Odds Ratio: 5.0, 95% Confidence Interval 1.2-21.0, p=0.028).characteristicsGroupMeanStd. DeviationP-valueCOGDControl20.296317.67862.283974.295160.007SDGDControl16.740715.75003.492776.251670.474STGDControl9.74078.00002.981902.841490.031HAGDControl7.77786.71434.500714.512180.386NSGDControl7.03707.21432.993343.403240.839PGDControl3.59263.28571.118352.070200.499RDGDControl8.85197.78572.567601.931360.087ConclusionsBy showing more mature, understanding, and kind personalities, the mothers of GD cases who have obtained licenses for gender affirmation surgery, have likely provided a positive atmosphere for the gender identity development and transition of their children. Additionally, their personalities were possibly better suited to deal with their child’s condition through having better compensatory adaptive traits.Disclosure of InterestNone Declared
The association between loneliness and psychiatric symptomatology in older psychiatric outpatients
Authors: Schutter N. 
Published: August 2023

AbstractPurpose: loneliness in adults increases with age. Although loneliness has been found to be associated with psychiatric disorders and dementia, no information is available on prevalence of loneliness in older psychiatric patients. Given the negative consequences of loneliness for morbidity and mortality, identification of specific populations vulnerable to loneliness is important. The aims of the present research were to examine prevalence of loneliness in older psychiatric outpatients, including gender differences and associations with psychiatric disorders and with social situation.Methodsinterviews were done in 181 patients from an outpatient clinic for geriatric psychiatry between September 2013 and February 2018, using questionnaires regarding loneliness, depression, anxiety, frailty and alcohol use.Resultsprevalence of loneliness was as high as 80%. Loneliness was associated with having less social contacts, in women only. There were no associations with DSM-IV-TR-classifications. However, loneliness was associated with higher scores on a depression questionnaire. There were no significant differences in intensity of treatment between lonely and non-lonely participants.ConclusionLoneliness is highly prevalent in older psychiatric outpatients, with men and women equally affected. Loneliness should be assessed in all older psychiatric patients, especially when they show high scores on symptom checklists or have a restricted social network.ReferenceSchutter et al. (2022) The association between loneliness and psychiatric symptomatology in older psychiatric outpatients. Journal of Geriatric Psychiatry and Neurology 35: 778-788.Disclosure of InterestNone Declared
Smartphone addiction among university students in Tunisia
Authors: Turki M. , Mhiri H. E. , jmil F. , Samet A. , Halouani N. , Ellouze S. , Aloulou J. 
Published: August 2023

IntroductionPopularity and availability of smartphones have dramatically increased in the past years, and have led to a great impact on people’s daily lives changing their habits and behaviors. This trend is accompanied by increased concerns regarding potentially adverse effects of problematic smartphone use, particularly with respect to physical and mental health.ObjectivesIn this study, we investigated prevalence and associated factors of smartphone addiction among Tunisian university students.MethodsIt was a cross-sectional, descriptive and analytical web-based study, conducted among 144 university students in Tunisia. Data were collected using an online questionnaire spread throughout social media (Facebook), using the Google Forms® platform, during September and October 2022. We used the “Smartphone Addiction Scale-Short Version” (SAS-SV).ResultsThe mean age of participants was 23.38±3.27 years, with a sex-ratio of (F/M) of 2.8.Tobacco, alcohol and cannabis use was noted respectively in 12.5%, 3.5% and 3.5% of cases.The mean score SAS-SV was 37.92±8.82. Among the students, 68.8% were considered at high risk of Smartphone addiction.Male students were more likely to be at higher risk of smartphone addiction than females, without a significant relationship.
Scores of SAS-SV were significantly higher among cannabis users (48.4 vs 37.54; p=0.006) and non-medical students (39.07 vs 36.11; p=0.049)ConclusionsUniversity students are a particularly vulnerable population to smartphone addiction, and this may lead to negative psychosocial effects. Educational awareness and preventive measures should be implemented.Disclosure of InterestNone Declared
Anabolic–androgenic steroid abuse: psychiatric manifestations and treatment
Authors: Remelhe M. , Barbosa P. , Silva R. 
Published: August 2023

IntroductionAnabolic-androgenic steroids (AAS) are synthetic derivatives of steroids which are frequently utilized in order to increase muscle mass and strength. Estimates of AAS abuse vary according to different studies. However, a global lifetime prevalence of 3.3% has been reported. The increasing illicit use of AAS over the years has raised serious public health concerns.ObjectivesTo report a clinical case of AAS abuse and review the psychopathology associated with AAS abuse and its treatment.MethodsThe authors report a clinical case and conducted a non-systematic review on the Pubmed database with the terms “anabolic-androgenic steroids”, “abuse” and “psychiatric manifestations”.ResultsA 25-year-old male patient with history of body dysmorphic disorder was admitted to the emergency services following severe psychomotor agitation and verbal and physical aggression towards his family members. He explained he had begun using AAS years prior in order to improve his physical appearance. Recently he had been administering AAS injections on a more regular basis and restricting his food and water intake. His sleep-wake cycle was disrupted and he began experiencing increasing anxiety and persecutory ideation. Additionally, increased aggression was reported and numerous conflicts with his family members took place in the weeks previous to his psychiatric observation. AAS abuse has been associated with psychiatric symptoms such as aggression and violence, mania and less commonly psychosis and suicidal ideation. Moreover, its prolonged abuse can lead to symptoms of dependence and withdrawal following suspension. A biphasic model of steroid dependence has been described. First there is a brief hyperadrenergic state with opoid-like withdrawal symptoms which is then followed by a prolonged period of depression and craving. During this phase symptoms such as fatigue, muscle and joint pain, insomnia, anxiety and depression may occur. There are no established guidelines for treatment. Acute care of agitation should follow a similar course as the one utilized in other forms of substance induced-agitation: firstly, the least invasive interventions should be implemented. If medication is required, haloperidol has been reported to be effective, although evidence is scarce. Benzodiazepines may be considered, although its use with AAS has not been reported. In regards to long term care, AAS discontinuation is vital in conjunction with proper management of withdrawal symptoms. If a patient presents symptoms of opioid-like withdrawal, treatment with clonidine may be initiated. The use of medically prescribed steroids has been suggested in order to alleviate withdrawal symptoms. Other treatment options such as human chorionic gonadotrophin and clomiphene have also been proposed.ConclusionsAAS abuse is a serious public health concern. Clinicians should be aware of its serious psychiatric effects and possible treatment courses.Disclosure of InterestNone Declared
Prevalence and psychosocial profile of instagram addiction among Tunisian doctors
Authors: Messedi N. , Kolsi S. , Fakhfakh E. , Chaari I. , Charfeddine F. , Aribi L. , Aloulou J. 
Published: August 2023

IntroductionInstagram is the most popular social media platform which is frequently used by population today. Besides, this subject has not been well discussed among doctors.ObjectivesTo study the prevalence of addiction to instagram among tunisian doctors and to identify its associated factors.MethodsThis was a cross-sectional descriptive study carried out among doctors (interns, residents and university hospital doctor) during the months of septembre and octobre 2022.A socio-demographic and clinical characteristics were collected using an online anonymous questionnaire from Google form that we distributed via facebook.Instagram Addiction Scale (IAS) was used to assess Instagram addiction levels. A score above 37 indicates addiction to instagram.ResultsOur sample included 106 patients. The mean age was 32.32 years (SD=5.66 years) and the sex ratio (M/F) was 0.60. More than half (56.6%) were married and lived with their husband. They were residents in 37% and they were using psychoactive substances in 42.5%.All of participants used other socialnetwork, the most used was facebook (63.2%).IAS : The mean score was 31.18 (SD=11.64). The prevalence of addiction to instagram was 42.5%.The instagram addiction was significantly correlated with : age (p=0,0001), the female gender (p=0.043), the celibacy (p=0.0001), the number of children (p=0.0001) and the number of siblings (p=0.049). Residents were more likely to develop an addiction to instagram (p=0.0001).ConclusionsThe study highlighted the high level of instagram addiction among tunisian doctors and identified individuals who were at higher risk. Specific interventions were necessary to deal with the problem of addiction.Disclosure of InterestNone Declared
Changes in smoking behaviour among healthcare workers with COVID-19
Authors: Ziedi H. , Mersni M. , Brahim D. , Bahri G. , Mechergui N. , Youssef I. , Ernez S. , Ben Said H. , Ladhari N. 
Published: August 2023

IntroductionThe COVID-19 pandemic had a considerable psychosocial impact on healthcare workers (HCWs) who were constantly requested during this era with an increased risk of infection. This implies behavioural changes, especially in smoking behaviour.ObjectivesTo study smoking behaviour in HCWs with COVID-19.MethodsA cross-sectional descriptive study conducted in the department of occupational pathology of Charles Nicolle Hospital in Tunis involving the smoking HCWs affected by COVID-19 during the period from September 1, 2020, to February 28, 2021. The data collection was carried out by a telephone call using a standardized questionnaire.ResultsDuring the study period, 61 smoking HCWs were identified. Thirty-two patients agreed to answer the questionnaire, with a response rate of 52%. The mean age was 41±10 years. The sex ratio (M/F) was 1.46. Half of the participants had comorbidities. The most represented occupational categories were blue-collar workers (n=11) followed by nurses (n=10) and physicians (n=7). The median professional seniority was 13 [3.5; 20] years. The mean age of smoking initiation was 20±5 years. The most common mode of smoking was cigarettes (93%) with an average consumption of 19 cigarettes per day. Water pipe smoking was noted in 3 patients. All patients started smoking before the COVID-19 infection. Strong tobacco dependence was noted in 25% of patients. Twenty-one per cent of the population had moderate dependence. Half of the participants maintained the same level of smoking as before the COVID-19 infection. An increase in smoking was noted in 34% of patients. A decrease in the level of smoking was reported by 15% of respondents. Four participants stopped smoking after COVID-19 infection. The reasons for smoking cessation were COVID-19 damage (n=3) and confinement with family (n=1).ConclusionsThe change in smoking behaviour during the COVID-19 pandemic is notable, particularly in HCWs who are exposed to a high physical and mental load. The presumed association of smoking with severe forms of COVID-19 infection makes tobacco control in HCWs an obligation in order to preserve the continuity of care.Disclosure of InterestNone Declared