bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chronic diseases among paramedics and their impact on mental health
Authors: Sellami I. , Feki A. , Remadi N. , Kotti N. , Masmoudi M. L. , Jmal Hammami K. , Hajjaji M. 
Published: August 2023

IntroductionWorking in a care setting is characterised by an increased mental and physical load. During their professional life, personnel in this sector can develop essentially degenerative pathologies, which could influence their professional career as well as their psychological balance.ObjectivesWe aimed to evaluate the impact of chronic pathologies on the prevalence of anxiety and depression among this group.MethodsWe conducted a cross-sectional study in hospitals in Sfax using a self-administered questionnaire. This questionnaire evaluated socio-demographic, professional, and clinical characteristics as well as an evaluation of the degree of anxiety and depression by the HAD questionnaire.ResultsOur population consisted of 120 participants. The average age was 37 years, with a female predominance (a sex ratio of 0.69). The chronic pathologies found in the participants were mainly diabetes (18%), high blood pressure (4%), and rheumatic disease (6.7%). The average anxiety score was 8.18± 3.5 and that of depression was 9.02± 3.5. Certain depressive and anxious signs were found in 28.4% and 23.6% of participants, respectively. Although the average scores for anxiety and depression were higher in the subgroup of personnel with chronic pathologies (respectively, 9.8 versus 9.04 and 9.3 versus 8.46), these differences were not statistically significant (p > 0.05).ConclusionsPhysical and mental health are both important to ensure a balanced life. Having good control of somatic illness can improve mental health.Disclosure of InterestNone Declared
Predictors of therapeutic response in schizophrenia – preliminary results
Authors: Kamenova I. , Onchev G. 
Published: August 2023

IntroductionSchizophrenia is a heterogenous disease and there is wide variation in the therapeutic response in patients, with some being good responders and others - severely disabled and defined as treatment resistant.ObjectivesTo identify specific socio-demographic and clinical characteristics as prognostic factors for therapeutic response in the search of course prognosis and disease outcome.MethodsThe study has naturalistic, non-interventional design and includes one-year prospective follow-up. Schizophrenic patients are being evaluated in three time points – at admission (T1), by discharge (T2), and one year after the hospitalization (T3). Psychopathology is evaluated by the Positive and Negative Syndrome Scale (PANSS), as well as negative symptoms – by the Scale for the Assessment of Negative Symptoms (SANS), aggression by the Modified Overt Aggression Scale (MOAS) and functioning by the GlobalAssessment of Functioning (GAF). Statistical analyses are performed using Descriptive methods, Student’s t-test, Wilcoxon Signed Ranks Test, as well as multiple regression. An ethical approval of the study has been obtained.ResultsThe sample consists of 108 patients with mean age of 39 (SD±12.7) and 89.8 % (N=97) of them were prospectively assessed after one year. All symptom dimensions in the 5 -factor model – positive, negative, disorganized, manic, and depressive, measured by PANSS, as well as negative symptoms (objectified by SANS) and aggression (objectified by MOAS) are significantly lower after inpatient treatment. There is an improvement in functioning one year after admission (z=-8.01, p<.001), although both negative symptoms (z=-2,45, p=0.015) and aggressive behavior (z=-4.260, p<.001) are significantly higher one year after discharge. From the multiple regression, at T1, involuntary admission is a significant predictor for higher aggression and lower functioning (p<.001). The duration of hospitalization is longer with lower compliance (p=.022) and the treatment with atypical antipsychotics decreases the hospital stay (p=.021). One year after admission, employment serves as a positive predictive factor as it decreases the psychopathology (p=.001), negative symptoms (p<.001), and improves the functioning (p<.001). Good compliance is a predictor for lower psychopathology (p=.015), less aggression and higher functioning (p<.001).ConclusionsThe inpatient treatment is efficacious in terms of psychopathology, aggression and is linked to better functioning. The naturalistic design shows depletion of the positive effects of treatment in terms of negative symptoms and aggression probably due to incomplete medication compliance, which is a bad prognostic factor for functioning. This implies the need of continuous psychosocial services and better psychoeducation after discharge.Disclosure of InterestNone Declared
What Is A “Difficult To Treat” Schizophrenia Patient
Authors: Petta J. , Nascimento M. , Oliveira C. , Falcão A. L. , Soares G. , Lourenço A. 
Published: August 2023

IntroductionThe Portuguese Plan for Mental Health envisaged the development of teams dedicated to the support of “difficult” patients. However, it was not clarified who these patients were, nor in which dimensions they could be supported. In this regard, there is a need for an objective and pragmatic definition to understand who these patients are.Objectives
To characterize the “difficult” patient with Schizophrenia.MethodsThrough the hospital’s IT services, all acute inpatient episodes at Centro Hospitalar Psiquiátrico de Lisboa were collected since 2017, with the diagnosis of Schizophrenia (ICD10: F20 – n: 1448). Cluster analysis was performed, regarding number of previous admissions (PA) and days of admission. Descriptive analysis of these patients was made, regarding age, gender, destination at discharge, and to the “difficult to treat” patients, whether they attend a medical consultation prior to admission, if they were complying with the therapy and if they were using psychoactive substances.ResultsCluster analysis identified 3 clusters: (G1) a larger, uncharacteristic one; (G2) one of users with many PA; and one with a high number of days of admission (G3).The average age is similar (46 years old), as well as gender (male). Regarding hospitalization days, G1 and G2 presented similar average values (16 days), higher for G3 (60 days). Comparing PA in G2, 47% of patients have between 6 and 10 PA and 25% have between 11 and 20 PA. For the same intervals, G3 has values of 10% and 2% respectively. About the destination after discharge, about 2/3 of both groups were referred for follow-up consultation; in G2, 5% were discharged by abandonment and in G3, 5% were referred to a Rehabilitation service and 6% integrated in Residential homes. Approximately 2/3 of the patients in G2 and G3 did not go to a medical consultation in the three months prior to their admission. Regarding the therapeutic plan, in G2 73% were not following it and in G3 this rate was 66%. Only 5% of G2 and 2% of G3 were in involuntary treatment. Injectable medication was used by 42% of patients in G2 and 23% in G3. Regarding substance use, alcohol was present in 9% of G2 and in 6% of G3; cannabinoids in 18% of G2 and in 11% of G3; and other psychoactive substances were present in 8% of G2 and in 4% of G3.ConclusionsThe findings of this study allow us to outline two profiles of “difficult to treat” patients with Schizophrenia. On the one hand those with multiple relapses (G2), on the other those with prolonged hospitalizations (G3). Both have poor adherence to consultations and are erratic in therapeutic compliance. Injectable medication, although present in G2 and in a lower percentage in G3, and the infrequent involuntary treatment in both, may be considered as possible intervention points. An assertive multidisciplinary approach, focused on current treatment and relapse prevention (including social structures and rehabilitation centers), will be the key to their treatment.Disclosure of InterestNone Declared
Sociodemographic and clinical characteristics of the population with a first psychotic episode attended in the mental health services of area 5 of Madrid (Spain)
Authors: Garde González J. , Herrero Ortega P. , Oliva Lozano A. , Louzao Rojas I. I. , Vidal-Villegas M. P. , Muñoz-Sanjosé A. , Sánchez-Castro M. P. , Lahera G. , Sánchez Quílez S. , Bravo-Ortiz M. F. ,   O. B. O. A.-M. Group
Published: August 2023

IntroductionRisk of functional impairment and progression to chronic illness in people with a first episode of psychosis (FEP) has motivated early intervention programs, showing promising results. Defining the characteristics of people with FEP at local level enables the clinicians to adjust interventional models to the reality of the population. The area 5 of Madrid (Spain) is referred to La Paz University Hospital and it serves a catchment area of roughly 527,000 people.ObjectivesWe aim to identify sociodemographic and clinical characteristics of patients in the area 5 of Madrid (Spain) who meet the criteria of FEP.MethodsA descriptive retrospective study including 179 people (age range 18-40 years) who were attended in mental health services of La Paz University Hospital (area 5 of Madrid, Spain), between January 2019 and May 2020, having suffered a psychotic episode in the last five years.ResultsThe average age of people with FEP was 29.32 years, with a higher proportion of men (62%). The mean duration of untreated psychosis (DUP) was 3.64 months and 47% of patients consume cannabis. We found disparities in DUP among the different districts in the area and we also observed differences depending on the district for inclusion in rehabilitation programs or psychotherapy. The following averages were obtained for the aggregate sample: 1.01 hospitalization/year, 1.42 emergency room visits/year, 1.81 years of illness and a mean dosage equivalent to olanzapine 6.75 mg/day. The incidence of psychosis in our area has been 7.01 cases per 100000 inhabitants/year.ConclusionsThe incidence of psychosis has been as expected according to data recorded at previous studies in Spain. The results obtained in our sample have included a lower DUP and a higher use of cannabis than those described in the literature. We have also found differences when observing the inclusion of patients in different treatments (psychotherapy, rehabilitation), which may be related to the differences in the DUP by districts. Further exploration in this field is needed to draw causal conclusions.Disclosure of InterestNone Declared
Prevalence and Correlates of Anxiety in Fort McMurray Vulnerable Population during the COVID-19 Pandemic
Authors: Shalaby R. , Eboreime E. , Nkire N. , Agyapong B. , Pazderka H. , Obuobi-Donkor G. , Adu M. , Mao W. , Owusu E. , Oluwasina F. , Agyapong V. 
Published: August 2023

IntroductionThe COVID-19 pandemic has produced negative mental health outcomes, which were more prominent in vulnerable communities, such as Fort McMurray (FMM), the community that experienced prior similar disasters.ObjectivesThis study aimed to examine the likelihood and correlates of anxiety symptoms among FMM residents, during the COVID-19 pandemic.MethodsA cross-sectional online survey questionnaire was applied between 24 April and 2 June 2021, at FMM community to gather a set of data, including sociodemographic, COVID-19, and clinical information. Generalized anxiety disorder was the main outcome of the study, and was measured using GAD-7 scale.ResultsOverall, 186 individuals completed the survey (response rate 74.7%). Most of the respondents were females (159, 85.5%); above 40 years (98, 52.7%); employed (175, 94.1%); and in relationship (132, 71%). The prevalence of moderate-to-severe anxiety was (42.5%, 71) on GAD-7 self-reported scale. Subscribers who reported that they would like to receive mental health support; have received no family support since COVID-19 declaration; and have lost their job during the pandemic were all more likely to report moderate-to-severe anxiety (OR = 3.39; 95% CI: 1.29-8.88), (OR = 4.85; 95% CI: 1.56-15.03), and (OR = 4.40; 95% CI: 1.01-19.24), respectively.ConclusionsAnxiety levels were high among FMM residents, compared to levels before COVID-19. Clinical and social factors related to the COVID-19 pandemic significantly predicted likely anxiety among Fort McMurray population. It is imperative to mobilize resources to support vulnerable communities during the COVID-19 pandemic.Disclosure of InterestNone Declared
New research on media coverage of mental illness and suicide: implications for stigma, suicide mortality and social inclusion.
Authors: Calvo Satorres S. 
Published: August 2023

Abstract: IntroductionThe Werther effect is a phenomenon that has been demonstrated in the media. These media are being replaced by social media, the use of which has increased greatly over the decade especially among young people, allowing content to be streamed instantly and fostering connections around the world. At the same time, there is a deterioration in mental health among young people.ObjectivesTo know if there is a Werther effect on social networks, as well as to understand the relationship between this effect and social media. It was also wanted to know if the posts follow the guidelines for dealing with suicide if there are differences between types of social media and if this effect is observed after the death of celebrities.MethodsA systematic review was performed with analysis, data extraction and synthesis of the structured results following the PRISMA criteria.Results15 articles were included, 11 of which showed Werther effects on social media, while only 4 were unrelated. It was found that most publications did not follow the recommended guidelines. No differences were observed between social media, while a greater effect was observed when it was related to celebrity suicide.ConclusionsSocial media can act as a suicide support network, as it is a space where there is a risk of infection by normalizing suicide and treating it insecurely. However, it has also been shown that it can act as an agent of change and protection, as many public individuals on social media seek help and express their concerns. More studies are needed to know the magnitude of the Werther effect on social media and to know the potential benefits of talking about suicide if it is done safely.Disclosure of InterestNone Declared
Psychological impact of the covid 19 pandemic on health care workers
Authors: Ayed W. , Chebbi S. , Ayadi A. , Ayari S. , Hazem K. , Magroun I. 
Published: August 2023

IntroductionThe COVID 19 pandemic had a significant psychological impact worldwide. Health care workers (HCWs) were the most affected because of the pandemic burden and occupational exigencies.ObjectivesTo describe epidemiological characteristics of HCWs with post COVID19 anxiodepressive disorders.MethodsA descriptive cross-sectional study was carried out. It included HCWs of a university hospital who consulted the Occupational Medicine Clinics for the three-month post-COVID‘s medical visit. The study was carried out during the period March 2020 to January 2022. The data was collected using a questionnaire including socio-occupational and medical characteristics. Psychometric evaluation was carried out using « the Hospital Anxiety and Depression Scale »ResultsWe have collected 164 HCWs. The sex ratio (M/F) was 0.29. The average age was 41±9.8 years. They belonged to the pneumology (27%), intensive care (11%) and biology laboratory (11%). The prevalence of anxiety and depression was 34% and 30% respectively. We found an association between sleep disorders and anxiety (p=0.000), OR=5 IC95%[2.4-10.3] and depression (p=0.000), OR= 4 IC 95%[2.0-9.3]. We found an association between anxiety and persistent fatigue (p=0,000), OR=4[2,0-8,6], anxiety and concentration and memory difficulties (p=0,000), OR=3 IC 95%[1,7-6,9]. Referral to psychiatric consultations were done in 16% of the cases.ConclusionsPost-COVID anxiety disorders were frequent among HCWs and associated with neurocognitive disorders. Psychiatric support and early treatment are necessary to prevent mental deterioration.Disclosure of InterestNone Declared
iSupport for Dementia: an analysis of clinical trial records
Authors: Pavarini S. C. I. , Ottaviani A. C. , Monteiro D. , Campos C. , Corrêa L. , Alves L. , Rocha L. , Barbosa G. , Cardoso A. , Maciel L. , Barham E. , Oliveira D. , Cruz K. , Orlandi F. , Gratão A. G. 
Published: August 2023

IntroductionDementia has a significant psychological and emotional impact on families, especially for caregivers of people living with dementia. In this perspective, the World Health Organization has developed iSupport for Dementia, an online training and skills program to prevent and/or reduce mental health problems associated with the provision of care and improve the quality of life of caregivers. It is being translated and adapted in different countries and as of August 2022, 31 adaptations using 27 different languages were in progress. However, the availability of the program should only be carried out after evaluating its effects on caregivers’ mental health outcomes (such as burden, depressive and anxious symptoms, quality of life, among others).ObjectivesTo analyze randomized clinical trial protocols to assess the effects of the iSupport program in different countries.MethodsThis is a data survey carried out in October 2022 on clinical trial registry platforms Clinical Trials, The Brazilian Registry of Clinical Trials, Cochrane Central Register of Controlled Trials, Netherlands Trial Register and Australian New Zealand Clinical Trials Registry by two independent researchers. Descriptive analyzis were performed for sample size, primary outcomes, secondary outcomes and intervention design.ResultsSeven clinical trial registries were identified, conducted in Australia/China, Brazil, Great Britain, the Netherlands, India, Japan and Portugal, published in English, from 2018 to 2022. The sample size ranged from 184 to 390 participants. Regarding the primary outcomes linked to the effect of using iSupport, five countries will analyze burden, anxiety and depression. Only in Australia/China and the Netherlands, the primary outcome will be quality of life and stress, respectively. Secondary outcomes vary between studies, with measures of quality of life (n=6), self-efficacy (n=4), program usability (n=4), cognition and problematic behaviors (n=3), attitudes (n=3), quality of support (n=3), positive aspects of care (n=2), knowledge, competence, resilience and informal costs of care (n=1). Most studies will carry out assessments at baseline, 3 and 6 months after the intervention, with the exception of Japan that will perform at baseline and at 1 and 3 months after the intervention and 6 months.ConclusionsAnalysis of the effectiveness of iSupport is one of the World Health Organization guidelines for countries that are culturally adapting this program. Brazil is the only country in Latin America with a clinical trial registration so far. Burden, anxiety and depression are outcomes considered by most countries. The results could provide evidence to strengthen and expand the possibilities for collaboration between researchers, as internet-based interventions have shown promising results on the mental health and well-being.Disclosure of InterestNone Declared
The impact of COVID-19 on work-related mental health claims of healthcare workers in British Columbia: an interrupted time series analysis
Authors: Banal M. A. , Puyat J. 
Published: August 2023

IntroductionHealthcare workers (HCW) have been at the forefront of providing care since the COVID-19 pandemic. In addition to physical demands, HCW are also vulnerable to mental health conditions due to the nature of their work. As a result, absenteeism among HCW is inevitable. In Canada, mental disorders caused by a stressor at work results in a work-related claim provided it meets the criteria of a governing worker’s compensation agency. While the literature points to varying prevalence rates of mental health illnesses among HCW, it remains unknown how the COVID-19 pandemic affected the number of work-related mental health claims in this population.ObjectivesTo help fill this gap in knowledge, we will conduct this study that aims to determine the impact of the COVID-19 pandemic on the number of work-related mental health claims among HCW.MethodsWe will utilize deidentified individual data from a worker’s compensation agency in all of British Columbia. Mental health claims will be identified using an indicator for mental health. Diagnoses for mental health conditions in these claims are ascertained by a psychologist or psychiatrist. Differences in the number of mental health claims between HCW and non-HCW before (January - February 2020) and after (March 2020 - December 2021) the pandemic will be estimated using interrupted time series analysis.ResultsThe findings will inform disability case managers, healthcare providers, and employers the importance of identifying appropriate work accommodations, return to work programs and additional mental health supports for HCW under mental health claims. Healthcare unions in British Columbia can use the findings to advocate for better work accommodations and mental health support for HCW.ConclusionsFurther understanding the complications of long-term effects of COVID-19 on mental health of HCW will inform workforce planning and patient care.Disclosure of InterestNone Declared
Application of Design of Experiment in the Optimization of Apixaban-Loaded Solid Lipid Nanoparticles: In Vitro and In Vivo Evaluation
Authors: Ramadan Safaa E. , El-Gizawy Sanaa A. , Osman Mohamed A. , Arafa Mona F. 
Published: August 2023

AbstractSolid lipid nanoparticles (SLnPs) are usually utilized as lipid-based formulations for enhancing oral bioavailability of BCS class IV drugs. Accordingly, the objective of this work was to investigate the effect of formulation and processing variables on the properties of the developed SLnPs for oral delivery of apixaban. Randomized full factorial design (24) was employed for optimization of SLnPs. With two levels for each independent variable, four factors comprising both formulations and processing factors were chosen: the GMS content (A), the Tween 80 content (B), the homogenization time (C), and the content of poloxamer 188 used (D). The modified hot homogenization and sonication method was employed in the formulation of solid lipid nanoparticles loaded with apixaban (APX-SLnPs). The size of APX-SLnPs formulations was measured to lie between 116.7 and 1866 nm, polydispersity index ranged from 0.385 to 1, and zeta potential was discovered to be in the range of − 12.6 to − 38.6 mV. The entrapping efficiency of APX-SLnPs formulations was found to be in the range of 22.8 to 96.7%. The optimized formulation was evaluated in vivo after oral administration to rats. Oral administration of APX-SLnPs resulted in significant prolongation in bleeding time compared with both positive and negative control. This indicates the ability of this system to enhance drug therapeutic effect either by increasing intestinal absorption or trans-lymphatic transport. So, this study highlighted the capability of SLnPs to boost the pharmacological effect of apixaban.
Graphical Abstract