bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predicting adherence in routine internet based cognitive behavioural therapy for depression: Retrospective cohort study
Authors: Jensen E. K. , Mathiasen K. , Riper H. , Lichtenstein M. B. 
Published: August 2023

IntroductionOn average, thirty percent of patients in internet based treatments do not complete the treatment program. The majority of studies predicting adherence have focused on baseline variables. While some consistent predictors have emerged (e.g. gender, education), they are insufficient for guiding clinicians in identifying patients at risk for dropout. More precise predictors are needed. More recently, studies on prediction have started to explore process variables such as early response to treatment or program usage.ObjectivesTo investigate:i)How much variance in adherence is explained by baseline symptoms and sociodemographic variables?ii)Can we improve the model by including early response and program usage as predictors?iii)What is the predictive accuracy of the most parsimonious regression model?MethodsData will be extracted from the Danish ‘Internetpsychiatry’ clinic, which delivers guided internet based cognitive behavioural therapy for depression. Sociodemographic data is collected upon application, and symptoms of depression and anxiety are measured at the start of treatment. Further, symptoms of depression are measured between each session of the online treatment program. Early response to treatment will be conceptualized as the individual regression slope of depression scores for each patient, during the first four weeks of treatment. Program usage data will be collected from the online treatment platform (e.g. number of words per message to therapists, time spent on each session during the first four weeks, number of logins during the first four weeks).Predictors for adherence will be examined in a hierarchical logistic regression. Models will be compared using ANOVA. The most parsimonious model will be determined using the Aikake Information Criterion. Receiver operating characteristic curve analyses will be used to classify the accuracy of the model.ResultsAnalyses have not yet been conducted. Results will be available for presentation at the conference.ConclusionsDetermining more accurate predictors for adherence in internet based treatments is the first step towards improving adherence. Research findings need to be translated into clinically useful guidelines that may inform clinical decision making. Findings from this study could potentially be implemented as a system that monitors patients’ program usage and symptom development and signals therapists if a patient is at risk for dropout.Disclosure of InterestNone Declared
Digitalized Clinical Data, Evidence and Transparency - Digitalization in Depression Treatment in the DECIDE Project
Authors: Wiegand H. F. , Momtahen N. , Frenschkowski E. , Pantle V. , Riedinger D. , Pilz M. , Panholzer T. , Scherrer A. , Lieb K. 
Published: August 2023

IntroductionRoutine psychiatric treatment in Germany suffers from a lack of information exchange in a sectored care system, long and complex treatment courses, insufficient evidence orientation with increasingly complex clinical knowledge, a lack of qualified personnel, and lack of patient involvement. How can a digital solution counteract these problems?ObjectivesFirst, discussion of problems in the care system and second, presentation of the concept and challenges of the DECIDE project, a Decentralized digital Environement for Consultation, data Integration, Decision making and patient EmpowermentMethodsThe project plan and first results will be presented of1.surveys of patients and mental health professionals needs and concerns about digital solutions2.focus groups3.the software solution for mental health professionals and the connected app soltion for patientsResultsImprotant functions of the DECIDE solution for mental health professionals should include:-digitize clinical data to represent longitudinal treatment trajectories and plans and, in the face of increasingly complex knowledge, implement a transparent decision support system based on current guidelines for depression and important comorbidities in a disinterested way secure and transparent data exchange and access in practitioner networks involve patients in this exchange via app/web solution based on patient guidelines for transparency, empowerment and collaborative decision making review improved treatment algorithms in the long term using artificial intelligence based on digitized data lean data collection and compatibility with billing, appointment management, findings management and medication plan solutions.ConclusionsIn psychiatry and psychotherapy digitization of clinical data for transparent exchange between practitioners and patients, presentation of progressions and treatment plans, and evidence-based decision support have a great potential. However, standardization, compatibility and collection of complex data remain a challenge.Disclosure of InterestNone Declared
An Internet-Based Cognitive Behavioral Intervention for Adolescents With Anxiety Disorders: a Study Protocol for a Randomized Controlled Trial
Authors: Skaarnes H. , Sørensen N. M. , Lomholt J. J. , Thastum M. , Mathiasen K. 
Published: August 2023

IntroductionAnxiety disorders are the most prevalent mental health conditions among children and adolescents. However, it is estimated that less than 25% of all children and adolescents with an anxiety disorder receive professional help. Thus, it is of utmost importance to develop novel interventions that aim to increase treatment accessibility.ObjectivesThe aim of this study is threefold, to determine the effectiveness of CoolMinds, an iCBT intervention for adolescents with anxiety disorders. In addition to investigate predictive factors and the networks between symptoms, severity and change from pre- to post- treatment.MethodsThe study is designed as a three-armed randomized controlled trial comparing iCBT with planned feedback, iCBT with on-demand help and a waitlist control, with 56 patients in each group. The participants in the two treatment conditions will receive 12 weeks of iCBT, while participants in the waitlist control wait for 12 weeks, before receiving iCBT with planned feedback. The participants in the two iCBT conditions will be randomized to get a booster session or not, 12 weeks after finishing treatment. The participants are adolescents between the age of 12 and 17 years and their parents. The families must live in the Region of Southern Denmark, and the adolescents must have a principal anxiety diagnosis according to DSM-5 criteria. The primary outcome measure are the Youth Online Diagnostic Assessment - child and parent versions. Outcomes will be evaluated at baseline, post-treatment and at the 3-, 6- and 12-month follow-ups. Symptoms of anxiety and depression are also measured between each session with PHQ-9 and S-SCAS.ResultsThe results from this study will be submitted to high-status international and peer-reviewed journals, as well as be presented at national and international conferences.ConclusionsThis study will allow us to determine the efficacy of iCBT in adolescents with anxiety, where parent involvement is emphasized as part of the treatment. The results from this study intends to enhance accessibility of evidence-based treatment for adolescents with anxiety.Disclosure of InterestNone Declared
Generative models as computational assays for psychiatry
Authors: Frässle S. 
Published: August 2023

AbstractPsychiatry faces fundamental challenges with regard to mechanistically guided differential diagnosis, as well as prediction of clinical trajectories and treatment response. This has motivated novel approaches that aim to develop “computational assays” for inferring patient-specific disease processes from neuroimaging data, which can then be incorporated into decision making in everyday clinical practice. Such computational assays are often based on generative models, which describe how measured data may be caused by a particular mechanism. Combining generative models with machine learning allows translating the inferences from computational assays into patient-specific predictions, an approach referred to as generative embedding.Here, I illustrate the clinical potential of generative embedding for the exemplary case of a generative model of whole-brain effective (directed) connectivity: regression DCM (rDCM). First, I introduce rDCM to the audience and highlight its relevance for understanding the pathophysiology of psychiatric disorders. I then provide an initial demonstration of the clinical utility of rDCM. Specifically, we assessed the ability of rDCM for predicting future episodes of depression in never-depressed adults, using a large dataset (N=906) of resting-state fMRI data from the UK Biobank. Over a 3-year period, half of the participants showed indications of at least one depressive episode, while the other half did not. Using nested cross-validation for training and a held-out test set (80/20 split), we found that a generative embedding procedure based on rDCM in combination with a support vector machine enables statistically significant predictions of future depressive episodes, both on the training (accuracy: 0.63, area under the curve (AUC): 0.66, p<0.001) and test set (accuracy: 0.62, AUC: 0.64, p<0.001). Interpreting model predictions based on SHAP (Shapley Additive exPlanations) values suggested that the most predictive connections were widely distributed and not confined to specific networks.In summary, generative models of brain connectivity in general, and rDCM in particular, show initial promise to serve as computational assays for psychiatry. Our analyses suggest that (i) fMRI-based generative embedding approaches have some capacity for early detection of individuals at-risk for depression and (ii) achieving accuracies of clinical utility may require combination of fMRI with other data modalities.Disclosure of InterestNone Declared
Relatives experience in moroccan psychiatric emergency
Authors: Tounsi A. , Zineb B. , Chebli H. , Laboudi F. , Ouanass A. 
Published: August 2023

IntroductionIn terms of care, family has a major role to play in the evolution of psychiatric illness.Our aim in this work is to determine the family experience during the hospitalization of their sibling in the emergency room of the psychiatric university hospital Ar-Razi in Salé.ObjectivesOur aim in this work is to determine the family experience during the hospitalization of their sibling in the emergency room of the psychiatric university hospital Ar-Razi in Salé.MethodsOur work was carried out with families of patients admitted to the emergency department of the psychiatric university hospital Ar-Razi in Salé.The data collection was carried out with the help of a questionnaire including several items.ResultsSixty-five family members were included in this study. Their relatives hospitalized in the psychiatric emergency department were male in 70% of cases with an average age of 32.4 years.-In 76% of the cases, the family member interviewed was the one who requested hospitalization;-55% of those interviewed were parents.The analysis of relatives’ feelings during the hospitalization showed:-Feelings of guilt were related to feelings of fear of exclusion and worries.-Feelings of fear and exclusion were mostly expressed by mothers of patients hospitalized for the first timeAt the end of the hospitalisation, 90% expressed relief, and 85% of family members were satisfied with their relative’s stay in the psychiatric emergency department.ConclusionsRecognizing families as units of care and understanding their situation and experiences facilitates the post-hospitalization care process. A well-informed family about mental illness and the types of therapeutic treatments available helps optimize the treatment.Disclosure of InterestNone Declared
Prevalence and associated factors to alcohol 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

IntroductionDespite its well-known acute and long-term harmful effects on a person’s mental health and well-being, alcohol remains the most commonly used psychoactive substance among adolescents after tobacco products in many countries.ObjectivesWe aimed at studying the prevalence of alcohol use, and identify associated factors in Tunisian high school adolescents.MethodsWe used national data from the 2021-Mediterranean School Survey Project on Alcohol and Other Drugs (MedSPAD). Based on a clustered two-stage stratification sampling method, a representative sample of teenagers aged 16 to 18 years, was selected. Data collection was performed using a self-administered standardized questionnaire, assessing socio-demographic characteristics and risky behaviours, and including questions about alcoholic beverages patterns of use. Binary logistic regression model was used to assess associated factors and adjusted Odds Ratios (AORs) were presented with 95% confidence intervals (CI). Cspro software was used for data entry and all statistical analysis were performed with STATA software.ResultsA total of 6201 adolescents with a mean age of 16.8 years and a sex ratio female/male of 1.5 were enrolled.Lifetime prevalence of alcoholic beverages consumption was 8.0%, 95% CI [7.0, 9,1] (n=6196). The prevalence of alcohol consumption during the previous year and month were 5.1 % and 1.7% respectively. Cocktails and beer were the most frequently consumed beverages.Prevalence of alcohol use was significantly associated with tobacco, cannabis and e-cigarettes use (AOR 9.5, 6.0 and 1.9 respectively; p≤10-3), a higher frequency of nights spent away from home, school absenteeism for non-medical reasons and enrolment in the private sector.Alcohol intoxication was reported by 2.9% of respondents during their lifetime.Early onset was reported by 17.2% of respondents for alcohol use and 10.1% for alcohol intoxication.ConclusionsAlthough the prevalence of alcohol use was relatively low among Tunisian adolescents compared to European adolescents, early onset- indicating an increased risk of developing an alcohol use disorder- warrant the implementation of primary prevention interventions through mental health promotion and life skill trainings to halt these trends and avert the raising burden of morbidity and mortality attributable to alcohol use.Disclosure of InterestNone Declared
The impact of self-stigma in people with diagnosis of severe mental illness: a cross-sectional pilot study from a community psychiatry unit in Porto, Portugal
Authors: Pinto A. S. , Almada M. , Fonseca I. , Sousa A. , Lopes A. 
Published: August 2023

IntroductionSelf-stigma refers to the process in which a person internalizes negative stereotypes, beliefs, and prejudices about their mental illness, adopting a stigmatized view of themselves. Severe mental illness is one of the most socially exclusive stigmata and is associated with poor clinical and functional outcomes and social withdrawal.ObjectivesIn Portugal, investigation regarding self-stigma is scarce. In this study, we aim to evaluate the impact of self-stigma among people with diagnosis of severe mental illness (SMI). For this goal we assess the prevalence of self-stigma of psychiatric patients with diagnosis SMI; and investigate the correlates of elevated self-stigma levels.MethodsFifty-one outpatients with SMI, were recruited from a community psychiatry unit from Porto, Portugal. After informed consent, evaluations included sociodemographic data, illness characteristics, and self-reported standardized scales. Self-stigma (ISMI), self-esteem (RSES) and quality of life (WHO-QoL) were assessed. Data analyses were performed using the SPSS version 28.0 (IBM Corp., Armonk, NY). p-values<0.05 were considered significant.ResultsFrom the study sample, 66.7% were male, with mean age of 44.8±11.0 and 56.9% were single. 33.3% reported living with their parents while 31.4% were living with a partner/spouse. The majority of participants had a diagnosis of schizophrenia (60.8%). Concerning the level of education, 58.8% completed basic education, but most patients were retired due to illness (62.7%). In this study, moderate to high self-stigma levels was found in 31.4% participants. Proportion of elevated self-stigma was significantly higher in unemployed/retired patients vs. those who were active (39.0% vs. 0%; P=0.021). No significant correlations were found with age, level of education, age at diagnosis, duration of illness, and number of hospitalizations. In the correlations analysis, a negative correlation between self-stigma and self-esteem (rho=-0.745; P<0.001), as well as self-stigma and quality of life (rho=-0.585; P<0.001) was found. A positive relationship between self-esteem and quality of life (rho=0.551; P<0.001) was found.ConclusionsThis study investigates, for the first time, the prevalence of self-stigma among outpatients with SMI in a community psychiatric unit from Porto. Our findings suggest a high prevalence of elevated levels of self-stigma among these patients. A significant association with being unemployed/retired was also found. Our results support previous evidence that internalized stigma is strongly associated with diminished self-esteem and impaired quality of life, in particular those aspects related to physical and psychological complaints. Targeting internalized stigma and self-esteem among patient with SMI will likely improve their quality of life, besides improving their clinical and functional outcomes.Disclosure of InterestNone Declared
Psychological impact of workplace violence towards nurses in the emergency department
Authors: Koubaa A. , Khouja N. , Ismail S. , Bechrifa E. , Baraketi E. , Ben Jemaa A. , Hsinet J. , Benzarti A. 
Published: August 2023

IntroductionGrowing attention has been drawn to workplace violence in healthcare settings and toward healthcare workers. Emergency departments have always been vulnerable to workplace violence since its is usually associated to working with people in extreme distress. Healthcare workers facing numbers of situation with either verbal or physical abuse may face an impact on their mental health.ObjectivesDescribe the psychological impact of workplace violence towards nurses in the emergency departmentMethodsThis is a questionnaire-based cross-sectional study including nurses working in the emergency department of different hospitals of Tunis. The respondents’ data were collected from March 2022 to September 2022.ResultsWe included 164 nurses. They were mainly women (Sex ratio of 0.6) with a median of age was 30.7±7.6 years. Nineteen nurses had history of one or more mental disorders such as anxiety disorder (12 cases) and depressive disorder (11 cases). All nurses were victim of workplace violence, while most (104 nurses) were witness to at least one act of violence. Study population had different degrees of concern about safety in workplace, 29.8% had little to no concern while 29,9% were mildly concerned and 40.2% were severely concerned for which they felt their security compromised (14.6% often and 12.2% always). Violence in workplace had consequences on the quality of their service for 26.8% of nurses. Many (49.4%) felt prejudice on their mental health contrasting with little resort (14%) to mental health providers. Number of nurses presented nightmares (44 cases), avoidance (56 cases) or flashbacks (48 cases) about workplace violence. Psychosomatic symptoms were described by most of the study population (58.5%) such as throbbing (46 cases), nervousness (56 cases), aches (23 cases), fatigue (29 cases) or non-specific digestive signs (17 cases).ConclusionsWorkplace violence in emergency departments, first interface of the care chain, is a real problem with serious consequences. Healthcare workers are forced to provide care in situations that compromise their health and safety. Implementing a national action plan is essential in order to address this dangerous phenomenon.Disclosure of InterestNone Declared
The psychological impact of working in an oncology center
Authors: Khouja N. , Koubaa A. , Hsinet J. , Baraketi E. , Ismail S. , Trabelsi G. , Benzarti A. , Ben Jemaa A. 
Published: August 2023

IntroductionParamedical staffs in oncology are among the most exposed to stress factors in the workplace, predisposing them to develop certain psychiatric pathologies, in particular anxiety disorders, depressive syndromes and burnout.ObjectivesThe objective of this study was to study these psychosocial risk factors and to detect the psychological repercussions on this professional category.MethodsOur cross-sectional, mono-centric, descriptive and analytical study was conducted between November 1st and 8th, 2022 at the Salah Azaiez Institute in Tunis. The screening of anxiety and depression was performed with the Hospital Anxiety and Depression Scale (HADS), the assessment of Burnout was performed with the Maslach Burnout Inventory (MBI).ResultsFifty-four workers were included (mean age 39.72 years and sex ratio 0.22). According to the HADS scale, 68.5% had definite or doubtful anxiety symptoms, 51.8% had definite or doubtful depression symptoms. According to the Maslach scale, 59.3% had a high burnout score, 37% had a high depersonalization score and 38.9% had a low personal accomplishment score. A combination of all three was present in 7.4% of the staff. Anxiety was associated with workplace violence and lack of career prospects, depression was associated with lack of leisure activities, and burnout was associated with age, emergency management for the emotional exhaustion score, and the number of children, workload and workplace violence.ConclusionsWorking in an oncology environment seems to be associated with a number of factors that could significantly increase the risk of psychiatric pathology. Some of these factors are perfectly modifiable, which opens up prospects for targeted preventive actions.Disclosure of InterestNone Declared