bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cannabis use in Tunisian high school adolescents: MedSPAD 2021
Authors: Mallekh R. , Rejaibi S. , Silini A. , Zid M. , Ben Slema I. , Zoghlami N. , Ben Youssef S. , Zribi M. , Ben Salah N. , Aounallah-Skhiri H. 
Published: August 2023

IntroductionCannabis use is wrongly deemed “safe” by teenagers worldwide, despite its increased tetrahydrocannabinoids content and its psychosocial and cognitive harmful effectts.ObjectivesWe aimed to estimate the prevalence of cannabis use, identify associated factors among Tunisian adolescents and assess the risk of problem cannabis use among users.MethodsThe 2021-Mediterranean School Survey Project on Alcohol and Other Drugs (MedSPAD) is a national survey, targeting Tunisian high school adolescents aged 16 to 18 years.Based on a self-administered questionnaire, adolescents were asked about their engagement in several risky behaviours including cannabis use. The 6-item Cannabis Abuse Screening Test (CAST) was intended for users to assess the risk of problem cannabis use.Binary logistic regression was performed to identify factors associated to cannabis use and Adjusted Odds Ratios (AORs) were presented with correspondent 95% confidence intervals (CI). Cspro and STATA software were used for data entry and analysis respectively.ResultsAmong 6201 participants (girls: 60.4%), lifetime prevalence of cannabis use was 7.9% ,95% CI [7.0, 8.9] significantly higher among boys (16.1 % Vs. 2.5 % in girls, p<10-4). Early onset (at 13 or younger) was reported by 8.6% of users.Multivariate analysis showed that cannabis use was more prevalent in Tunis district(p=0.04), and significantly associated to alcohol, tobacco and electronic-cigarettes use (AOR of 6.2, 4.2 and 2.6 respectively, p<10-3). Absenteeism for non-medical reasons and nights spent away from home were also independent factors significantly associated with cannabis use (p<10-3).The CAST indicated a high risk of cannabis-use-related problems in 67.2% of respondents (n=223).ConclusionsCannabis use is increasingly common in Tunisian adolescents. Moreover, the alarming risk of problem cannabis use warrant the urgent need for school-based interventions and screening programs to prevent and control cannabis use especially among vulnerable subgroups.Disclosure of InterestNone Declared
Smoking status trajectories, intergenerational socioeconomic mobility and depression: Preliminary results from 107,734 French adults (18 to 75 years) of the CONSTANCES cohort
Authors: Andersen A. J. , Mary-Krause M. , Melchior M. 
Published: August 2023

IntroductionCigarette smoking prevalence is significantly higher among people with mental health problems than among the general population. Smoking accounts for much of the reduction in life expectancy associated with mental illness, why the high co-occurrence of smoking and mental health illness is a major public health concern. Persons belonging to socioeconomical disadvantaged groups have higher risk of mental health conditions and also higher smoking rates.ObjectivesIn this study we aim to examine smoking trajectories among adult smokers between 2012 and 2020. Furthermore, we aim to investigate differences in smoking trajectories by adult depression by taking into consideration participants intergenerational socioeconomic mobility (ISEM).MethodsAnalyses were based on data from CONSTANCES, a French general population cohort conducted from 2012 to 2020. In total were 107,734 participants included after exclusion of never smokers. Depression was measured by the CES-D scale, and depression was classified with a score ≥16. ISEM is based on childhood (maternal and parental occupational grade) and adult socioeconomic position (SEP), and low ISEM includes those with low SEP as child and adult and high ISEM those with consistent high SEP. Group-based trajectories modelling (GBTM) was used to determine smoking status trajectories. To address the association between ISEM and smoking trajectory class we used multinomial logistic regression with former smokers as reference class adjusted for depression, household income, sex and age.ResultsWe identified five smoking trajectories 1) Former smokers (56.6%), 2) Long-term smokers (26.4%), 3) Intermediate smokers (3.3%), 4) Early quitters (5.0%) and 5) Late quitters (8.7%). Preliminary results from multinomial logistic regression showed that persons with low ISEM had higher odds of depression (OR [95%CI]=1.91 [1.77;2.06]) than those with high ISEM. Participants with low ISEM had higher odds of being long-term smoking than former smokers compared to those with high ISEM (ORa [95%CI]=1.55 [1.43;1.67]). Furthermore, those with low ISEM had lower odds of being in any of the other smoking trajectory groups vs. former smokers compared to those with high ISEM (ORa [95%CI]=0.82 [0.69;0.97]) for intermediate smokers, ORa [95%CI]=0.75 [0.66;0.85]) for early quitters, and ORa [95%CI]=0.78 [0.70;0.87]) for late quitters).ConclusionsPreliminary results showed an association between ISEM and smoking trajectories in our study. Persons with low ISEM are more likely to be long-term smokers. Future analysis should consider the effect of depression as a mediating factor on the association between ISEM and smoking trajectories.Disclosure of InterestNone Declared
What minimal detectable effect size is in your power – An inverted sample size formular for survival data
Authors: Dalgaard M. K. , Christensen A.-E. , Kjeldsen M. K. 
Published: August 2023

IntroductionPower calculations are widely used in the conduct of clinical trials and are often required in funding applications and approvals. There is a recent debate on the role of power calculations in observational studies on existing data with (Hernán J Clin Epidemiol 2022; 144 203-205) and (Moris and Smeden J Clin Epidemiol 2022; 142 261-263) emphasizing the need for planning for all study types without risking discarding imprecise but otherwise relevant studies. In the current study, we construct a graph useful in the planning of a wide range of studies with survival data. We map the minimal detectable effect (MDE) for any possible number of events with a dichotome exposure varying the proportion assigned to the exposure groups.ObjectivesTo provide a visual tool relating the sample size, more precisely the number of events, and the MDE for survival data in unbalanced designs.MethodsThe visualization is based on the formulas used by Stata’s power logrank function by (Schoenfeld Biometrics 1983; 39 499-503) and (Freedman Statistics in medicine 1982; 1 121-129), and the MDE is mapped as a function of the number of events. Furthermore, we apply this to an ongoing project on data from the Danish national registers, comparing the risk of developing polycystic ovary syndrome (PCOS) associated with treatment with valproic acid in a population with bipolar disorder or epilepsy.ResultsPreliminary results (Fig. 1) show, as expected, that a larger sample size is required to obtain an MDE close to one. Also, the MDE increases when the assignment among groups is skewed. Moreover, we find a relevant minimal detectable HRR of 1.78 for developing PCOS in a population of 13,839 patients with bipolar disorder or epilepsy, exposed to valproic acid versus those not exposed to valproic acid, with a total of 203 cases of PCOS.Fig. 1 shows the minimal detectable effect size as a function of the number of events, with α = 0.05 and a power of 1 - β = 0.8, for various assignment ratios φ = PT/PC, where PT and PC are the proportions of patients assigned to the treatment group and the control group, respectively.Image:ConclusionsThe current visualization and corresponding calculation can be used to guide decisions in the design phase of both observational studies as well as in clinical trials. For observational studies, the sample size, or equivalently, the number of events, could well be fixed, and the MDE may help assess the clinical relevance of conducting the study as in the example with PCOS data. The curves can also provide insight into which efforts might lower the MDE, e.g., whether a small increase in sample size or a different assignment proportion would be most beneficial based on a given sample size.Disclosure of InterestNone Declared
Cognitive functions and their correlates in people with psychosis: are there gender differences?
Authors: Fusar-Poli L. 
Published: August 2023

AbstractImpairments in social and non-social cognition are common in psychosis and may be sparsely present even before the onset of the disorder. Genetic and environmental influences have been linked to cognitive dysfunctions, which, in turn, may significantly impact the real-world functioning of people with psychosis. The role of gender in determining the interplay between cognitive skills, risk factors, and outcomes has been relatively unexplored. Nevertheless, identifying putative gender differences in cognitive functions and their correlates may favor the identification of individualized prevention and treatment strategies.Disclosure of InterestNone Declared
Prevention strategies in clinical high-risks states for psychotic disorders: weighing up costs and benefits
Authors: Schultze-Lutter F. 
Published: August 2023

AbstractToday, the indicated prevention of psychosis prior to its first episode is mainly based on clinical high-risk of psychosis (CHR) criteria, namely ultra-high risk criteria and basic symptom criteria. These are associated with conversion-to-psychosis rates of about 30% within three years. Thus, many patients meeting CHR criteria will not progress to psychosis over a medium-term period, and the cost-benefit evaluation of CHR states is always complicated by the largely unknown individual psychosis risk of CHR patients. In consequence, for the lesser risk of adverse events, treatment recommendations commonly favour non-pharmacological strategies, in particular cognitive-behavioural psychotherapy. Yet, individual risk estimation in identified CHR patients is increasingly done with help of machine learning algorithms, which might help to identify CHR patients who would greatly benefit from an additional pharmacological intervention with low-dose antipsychotics. The presentation will discuss the evidence-base of such a multistep, machine learning informed prevention strategy.Disclosure of InterestNone Declared
Child and Adolescent Suicide Rates and Economic Crisis in South Korea using Hierarchical Age-Period-Cohort Analysis
Authors: Song J. , Roh B. R. , Hong H. J. 
Published: August 2023

IntroductionSuicide is a complex problem in which individual, family social factors are interrelated. The 1997 Asian financial crisis caused a major economic crisis in Korea, and Korea received bailout support from the International Monetary Funds(IMF) from December 23, 1997 to August 23, 1997.ObjectivesThis study aimed to investigate the relationship between the suicide rate of children and adolescents who grew up during this economic crisis in Korea.MethodsSuicide rates are calculated according to gender, region, and age of 5 years (10-14 years old, 15-19 years old, 20-24 years old) using suicide death data from the Korea National Statistical Office from 2000 to 2017. The cohort of interest in the study is the group that was in childhood and early adolescence between 1997-2000 and corresponds to 1986-1995 in terms of birth year. Cohorts are divided into 1986-1989 (G1), 1990-1992 (G2), and 1993-1995 (G3) according to birth year. These groups were 8-14 years old for G1 and 5-10 years old for G2, 2-7 years old for G3 during 1997-2000, during the economic crisis. The Age-Period-Cohort analysis and linear mixed-effects regression models are used and the moderating effect on region and age is also analyzed.ResultsThe 10-24 year-old suicide rate was higher in males than females, in older age groups, earlier in birth years in the birth cohort, and in rural than urban areas. Suicide rates between the ages of 20-24 years were particularly high among men living in rural areas. During the national economic crisis, the suicide rate was higher among adolescents than preschoolers (G3 < G1) (p<0.001), and this trend was observed for both men and women. However, the main effect of the cohort was not observed at a statistically significant level.ConclusionsThe national economic crisis has a negative impact on the mental health of children and adolescents, and it is more negative for adolescents than for children, which can increase the suicide rate between the ages of 20-24.Disclosure of InterestNone Declared
What do we know about lithium associated hypercalcemia?
Authors: Laherrán Cantera N. , Palacios - Garrán R. , Sanchez-Guerra Alonso A. , Gutiérrez Santaló C. , Muñoz-Manchado L. I. 
Published: August 2023

IntroductionLithium associated with hypercalcemia may mimic a psychiatric condition and be confused for a relapse of bipolar disorder. The etiology seems to be due to a reduced sensitivity of the parathyroid cells to calcium, altering the parathyroid hormone (PTH) response. Lithium as an essential monovalent cation has some structural similarity to calcium (Ca) and can interact with protein receptors. This leads to changes in the inhibitory configuration of PTH and increased serum calcium concentrations, rising the threshold necessary to suppress hormone secretion.Lithium-induced hyperparathyroidism (HIL) is the main cause of hypercalcemia in these patients.ObjectivesBased on a clinical case of lithium-associated hypercalcemia in a patient with bipolar disorder, review the existing literature and state the needs for periodic monitoring protocols.MethodsCase report and bibliographical review.ResultsA 38-year-old woman, diagnosed with bipolar affective disorder at the age of 18, has been treated with lithium during which she developed secondary tubulointerstitial nephropathy as an adverse effect. Recently, she requested medical evaluation for constitutional syndrome associated with deterioration of general condition with loss of strength and difficulty in walking. Analytically, mild hypercalcemia was detected, and the study was extended to include Ca and PTH.Chronic lithium therapy often develops mild hypercalcemia (approximately 10 to 20 percent of patients taking lithium), most likely due to increased secretion of PTH. Lithium can also unmask previously unrecognized mild hyperparathyroidism in patients with adenomas within a few years of starting therapy or induce parathyroid hyperplasia with a chronic use.The hypercalcemia usually, but not always, subsides when the lithium is stopped. Normalization of serum calcium is more likely to occur one to four weeks post-lithium withdrawal in patients with a relatively short duration of lithium use. It is less likely in patients receiving lithium for more than 10 years.Regarding the case to be presented, a review of the literature is carried out and the need to propose periodic calcium monitoring protocols is exposed.ConclusionsRecommendations include determination of serum calcium every 6 months, urinary calcium and creatinine every 12 months, and bone mineral density monitoring every 1 to 3 years. Regular analytical monitoring including total calcium, PTH and vitamin D, would identify patients with a tendency to hypercalcemia so that appropriate measures could be taken. So as chronic treatment with lithium can develop mild hypercalcemia, I consider it necessary to develop periodic monitoring protocols for this adverse effect.Disclosure of InterestNone Declared
Pharmacological treatment of early psychosis: risks and benefits
Authors: Sīle L. 
Published: August 2023

AbstractPsychiatry has changed a lot during the last decades and lot of effort has been made to ensure that treatment of schizophrenia spectrum disorders is in line with modern science of medicine. Therefore, in everyday practice the psychiatrist is in a constant process of decision making when to start pharmacological treatment of early psychosis and with what dosage. The lecture will include evidence-based treatment options, the aspects of clinical practice and the power of shared decision-making in psychiatry.Disclosure of InterestNone Declared
Sex differences in antipsychotic efficacy and side effects in psychosis
Authors: Erzin G. 
Published: August 2023

AbstractThere are a lot of studies investigating gender differences in the side effects of first and second-generation antipsychotic drugs. Even though some side effects are seen at higher rates in women, it is not determined yet the influence of gender on the efficacy and side effects of antipsychotic agents is still not well clear. In this review, we give a brief overview of antipsychotic side effects leading probably to distinguished clinical outcomes in both sexes.Disclosure of InterestNone Declared
Impact of cannabis use on Schizo-affective disorder
Authors: Zbidi M. , Bouali W. , Haouari W. , Kacem M. , Khouadja S. , Zarrouk L. 
Published: August 2023

IntroductionSchizoaffective disorder (SAD) is a nosographic entity characterized by an association of schizophrenic symptoms with thymic episodes. Addictive substance abuse behaviours precede or appear concomitantly with thymic and/or schizophrenic symptoms for the majority of patients.ObjectivesThe objective of our work was to specify the sociodemographic ,clinical and therapeutic characteristics of this population and to compare them to a group of schizophrenic patients who do not use cannabis.MethodsThis is a retrospective descriptive study of patients with Schizoaffective Disorder (SAD) meeting the criteria of the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association, 5th Version (DSM-5), hospitalized between January 2015 and December 2021 in the psychiatry department of the EPS Tahar Sfar Mahdia.ResultsOur sample was composed of two groups: A first group formed by patients with a positive toxicological assessment to tetra-hydro-cannabinol (n=14) and a second group witha negative toxicological assessment (n=36). In SAD subjects using cannabis, the average age at first hospitalization was younger (27.5 years) than in the other groups, hospitalization was earlier (27.27 vs 33.58; p=0.04), the duration in number of days of hospitalization was greater (29.33 vs. 24.67; p=0.02) and they had required during their hospital stay a higher dosage of antipsychotics in equivalent doses of chlorpromazine (723 vs 603; p=0.04). There was a significant difference (p ≤ 0.04) in the psychometric scales (BPRS, SAPS and SANS) in favour of patients who did not use cannabis.ConclusionsThe deleterious psychic effects of chronic cannabis use have long been suspected for a long time. Patients followed for SAD present more frequently than the reference population addictive behaviours towards cannabis which is associated with many negative events affecting clinical symptomatology, evolution, prognosis and therapeutic response.Disclosure of InterestNone Declared
The Relationship Between Somatization and Depression and Anxiety Levels of Parents with Children Diagnosed with Spina Bifida
Authors: Ulual P. , Özer V. , Uyar M. , Alatas I. , Özpınar G. , Guclu O. 
Published: August 2023

IntroductionSpina Bifida, a congenital neural tube defect causing multi-system dysfunction. The birth of a disabled child in the family inevitably affects the family members, their lives, feelings, behavior and social life negatively. A lifelong challenge with the disease may give rise to severe pathologies to the parents or caregivers; such as somatization disorder which is characterized by various functional somatic symptoms that can not be explained by organic pathology. For the DSM-V, the diagnosis of complex somatic symptom disorder is proposed to replace the current diagnoses of somatization disorder, undifferentiated somatoform disorder, hypochondriasis and pain disorder. The proposed diagnostic criteria for complex somatic symptom disorder require the presence of somatic symptoms, together with misattributions, excessive concern or preoccupation with symptoms and illness and increased healthcare use.ObjectivesWe aimed to find out the relationship between somatization, depression and anxiety levels of parents with children diagnosed with SB.MethodsInterview form, the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and the SCL-90-R (Psychological symptoms screening test) were used. 79 individuals were included.ResultsSeverely depresssed and anxietic parents show correlating levels of somatizaton. Depression and anxiety scores were above normal range. SCL-90-R Test the ratio of general somatization level compared to other values was found to be 1.72. Parameters above 1 are considered high. This ratio was found to be 100 % in pie charts, indicating all parents had somatization.ConclusionsSB is not only physical but also a psychological burden to the child as well as the parents. Families often find themselves in despair and feel powerless while giving care to their child with SB. They have a greater tendency for mood and somatization disorder, long term psychiatric follow-up and more frequent evaluations and interventions should be undertaken.Disclosure of InterestNone Declared
EPA guidance on treatment of cognitive impairment in schizophrenia
Authors: Vita A. 
Published: August 2023

AbstractAlthough cognitive impairment is a core symptom of schizophrenia related to poore outcome in different functional domains, it still remains a major therapeutic challenge. To date, no comprehensive treatment guidelines for cognitive impairment in schizophrenia are implemented.The aim of the European Psychiatric Association (EPA) guidance paper was to provide a comprehensive meta-review of the current available evidence-based treatments for cognitive impairment in schizophrenia, structured into three sections: pharmacological treatment, psychosocial interventions, and somatic treatments.Based on the reviewed evidence, the EPA guidance recommends an appropriate pharmacological management as a fundamental starting point in the treatment of cognitive symptoms in schizophrenia. Among psychosocial interventions, cognitive remediation and physical exercise are recommended for the treatment of cognitive impairment in schizophrenia. As for cognitive remediation, some variables have been confirmed as core elements for treatment effectiveness.The dissemination of the EPA guidance paper may promote the development of shared guidelines concerning the treatment of cognitive functions in schizophrenia, with the purpose to improve the quality of care and to achieve clinical recovery in this population.Disclosure of InterestNone Declared
Family Members’ Experiences in a Psychiatric Hospital During the COVID-19 Pandemic: Implications for Family-Centered Work in Mental Health Systems
Authors: Shor R. , Shalev A. 
Published: August 2023

IntroductionRestricted visitations of family members of persons with mental illness in psychiatric hospitals which may occur during times of public health crises such as the COVID-19 pandemic can have potential adverse consequences on the family members and on their ability to fulfill the caregiving role. Therefore, mental health professionals may encounter difficulties implementing a family centered-care model during such periods.ObjectivesDue to the limited knowledge about the effects of the restrictions during the pandemic a study was conducted in Israel. It examined the difficulties which family members experienced as a result of the restricted visitations and the effects of the restrictions on advancing a family-centered care model,MethodsA semi-structured questionnaire was distributed via digital means to 75 family members who had a family member who was hospitalized in psychiatric hospitals during the pandemic.ResultsThe findings indicate that family members had limited opportunities in the following areas during the COVID-19 area: Developing relationships with the professional staff, being involved in the therapeutic process during the hospitalization, communicating with the hospitalized family member, and receiving help for themselves.ConclusionsMental health professionals in psychiatric hospitals should adapt family-centric procedures to circumvent restrictions on physical presence and maintain the involvement of family members during psychiatric hospitalization.Disclosure of InterestNone Declared