bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical management of psychotic pregnancy denial: what do we know? Case report and narrative review.
Authors: Martín Velasco M. , Romero Gerechter I. 
Published: August 2023

IntroductionDenial of pregnancy is the lack of awareness of being pregnant. It associates with increased morbidity and mortality of mother and child and can be classified as non-psychotic or psychotic. There is few literature regarding the latter, making it difficult to recognize, let alone to treat, since we do not have robust data on the incidence nor approved interventions.ObjectivesTo get a better understanding on the standard of care for patients with psychotic denial of pregnancy.MethodsWe present a case report alongside a narrative literature review on the topic.ResultsWe report the case of a 39-year-old caucasian woman, foreign, undomiciled, who was admitted to a Psychiatry unit due to psychotic symptoms. Her birthplace and prior medical records were unknown. She did not recognize being pregnant and showed great irritability when asked; her responses ranged from delusional attributions of symptoms related to the pregnancy to partially acknowledging her state but refusing to answer questions. Obstetric ultrasound revealed a low risk 35 weeks pregnancy. Treatment included quetiapine up to 700mg daily and psychological approach. A multidisciplinary team managed the case and arranged a plan for delivery. Eventually, delusional symptoms remitted and she accepted the gestation. She showed full collaboration during delivery, giving birth to a healthy female and presented transient recovery. After being separated from her daughter, her clinical situation worsened.Psychotic denial of pregnancy is rather uncommon. It is usually seen in patients with prior history of major mental illness, most frequently schizophrenia, and important psychosocial vulnerability. It associates with several negative outcomes for mother and baby, including neonaticide. Most studies agree on the need of a multidisciplinary intervention including obstetrics, psychiatry, and others (social agents, ethical consultants…) to generate a plan for mother and baby. Biopsychosocial aspects should always be considered and each case individually formulated. Pregnant women must be given clear and concise information about the process. For some, seeing obstetric ultrasound might help them accept the pregnancy. Some authors propose labour induction prior to 39 weeks and performing a C-section, especially in cases of uncontrolled psychosis or risk of noncompliance. Most studies also recommend antipsychotic treatment. In cases of persistent denial or acute crisis, especially during the third trimester, patients should be admitted to a psychiatry unit with easy access to obstetric care. Supportive psychotherapy and psychosocial intervention should try to identify precipitating stressors for denial, such as prior or anticipated custody loss, which has been linked to psychotic denial.ConclusionsPsychotic denial is a serious illness which requires a multidisciplinary treatment including biopsychosocial and obstetrical aspects.Disclosure of InterestNone Declared
The relationship of the child’s externalizing and internalizing symptoms with the parent’s maladaptive schemas and attachment style
Authors: Lestyán L. , Szabó B. 
Published: August 2023

IntroductionAccording to recent studies, there is a relationship between the parent-child attachment style and the child’s externalizing and internalizing problems. However, the parent’s maladaptive schemas were not examined in this relationship before.ObjectivesWe aimed to examine the relationship between parents’ maladaptive schemas, well-being, their attachment to their child, and the parent’s perception of the child’s symptoms.MethodsIn our cross-sectional, non-clinical study, 442 parents of children between the ages of 22 and 57 completed the Young Schema Questionnaire (YSQ), Experiences in Close Relationships Questionnaire (ECR), Strength and Difficulties Questionnaire (SDQ) and WHO Well-being Questionnaire (WBI-5). We conducted four mediator analyses. We chose the emotional deprivation schema subscale as the independent variable and attachment anxiety and attachment avoidance subscales as mediators, while the models differed in the dependent variables. We chose the SDQ externalizing symptoms, internalizing symptoms, prosociality subscale, and WHO well-being questionnaire as dependent variables.ResultsThe mediation analyses proved to be significant. Emotional deprivation had significant effect on the parent’s attachment anxiety (a1 = 0.01, p < .001), avoidance (a2 = 0.32, p = .002) and on the parent’s well-being (c1 = -0.12 , p < .001), while emotional deprivation was not associated with externalizing symptoms (c2 = 0.002, p = .25), internalizing symptoms (c3 = 0.001, p = .53) and prosociality (c4 = 0.01, p = .26). However, the indirect effects of emotional deprivation through attachment anxiety were significant in case of internalizing symptoms (a1b5 = 0.03 [0.02 – 0.05), prosociality (a1b8 = -0.004 [-0.01 – -0.0002]) and well-being (a1b1 = -0.017 [-0.03 – -0.005]). Furthermore, the indirect effects of emotional deprivation through attachment avoidance were significant in case of internalizing symptoms (a2b6 = 0.009 [0.002 – 0.02]) and prosociality (a2b8 = -0.007 [-0.01 – -0.0002]). While the indirect effects of emotional deprivation through attachment anxiety (a1b3 = 0.007 [-0.001– 0,02]) and avoidance (a2b4 = 0.0001 [-0.006 – 0.006]) on externalizing symptoms were not significant. The indirect effects of emotional deprivation through attachment avoidance on the parent’s well-being were not significant (a2b2 = -0.002 [-0.01 – 0.006]).ConclusionsOur results - taking into account the limitations - suggest that there is a relationship between the parent’s emotional deprivation schema and the child’s internalizing symptoms, prosociality, and the parent’s well-being through the parent-child attachment pattern. Attachment style and maladaptive schema have no effect on externalizing symptoms. These results may also have practical implications.Disclosure of InterestNone Declared
Intervention to promote mental health and psychosocial support to promote social cohesion in the context of ongoing crisis and post conflict
Authors: Dozio E. 
Published: August 2023

IntroductionArmed conflicts, collective situations of adversity, and gross social injustices cause widespread mental suffering in affected populations. In these crises, conflicts break down and traditional community support mechanisms are weakened or destroyed. The loss of trust in others and the lack of hope for change undermine social cohesion at the deepest levels of communities. Therefore, it is important not to overlook the psychosocial impacts of social injustice and violence on the individual and society undermines other efforts to build peaceful societies. Nevertheless, the use of mental health and psychosocial support (MHPSS) approaches to support social cohesion is still very uncommon.ObjectivesThe objective of the proposed intervention in the Ituri province of the Democratic Republic of Congo was to complement the economic recovery activities of the most vulnerable populations with a psychological support approach. This was to ensure more sustainable results in the appropriation of problem management strategies through the strengthening of individual well-being and group support mechanisms.MethodsThe psychosocial intervention is organized around a community psycho-education to sensitize the populations to mental health issues and to promote the awareness of their possible suffering in order to access a psychological care system. The protocol included five weekly group sessions designed to strengthen participants’ individual and collective psychological resources. Several indicators were measured to assess the impact on social cohesion (psychological well-being, psychological resilience, prosocial behavior, etc.)ResultsIn eight months of intervention between July 2021 and February 2022, 1024 people were able to participate in the psychological support program. 90% of them showed improvement in psychological well-being, daily functioning and resilience. In addition to these very optimistic results on individual aspects, 65% of the participants increased the level of prosocial behaviour.ConclusionsThe psychosocial intervention proposed in an area of permanent conflict and adversity was mainly aimed at improving the well-being of people showing signs of distress to make them better able to complete their economic activity project. The results showed that taking into account the psychosocial dimension, not only reduced distress and allowed people to better project themselves in the future, but also promoted prosocial behavior. All these elements contribute strongly to social cohesion.Disclosure of InterestNone Declared
The effect of intervention using an emotional recognition coaching companion robot on the elderly people with depression
Authors: Kim K. , Yoon B.-H. , Sea Y.-H. , Song J.-H. 
Published: August 2023

IntroductionDuring the COVID-19 pandemic, care for the elderly in the community was greatly limited. Accordingly, the demand for alternative community care have increased to cope with changing situations.ObjectivesIn this study, we tried to find out whether the companion robot improved mood state and related problem in depressive or isolated community dwelling elderlyMethodsFor 186 community dwelling elderly who have received social welfare service due to depression or social isolation, we provided companion robot that could support their daily living. The robot was equipped with special program that could recognize and respond to the participant’s own emotion. It was part of behavioral activation techniques which is one of powerful treatment for depression. The self-report questionnaires were used to measure changes in cognitive function, depression, suicidality, loneliness, resilience and satisfaction of life. Outcomes were measured before using companion robot and after 3 months, and we compared them.ResultsThe elderly using companion robot for 3 months showed improved cognitive function (45.7% to 30.1%), depression (p<0.001), suicidality(p<0.001), and loneliness (p=0.033) in the self-report questionnaire. Resilience(p=0.749) and satisfaction of life (p=0.246) were also improved but not reached significance.Image:Image 2:Image 3:ConclusionsThese findings showed that the use of companion robot with emotional recognition coaching program could help improve depression, cognitive function, loneliness and suicidal ideation. In particular, this effect was also useful for those who were diagnosed with depression. Also if we can put more techniques of behavioral activation programs into robot, it could be useful in community care for depressive and isolated elderly.Disclosure of InterestNone Declared
Maternal prenatal and perinatal psychiatric hospitalizations and academic performance in adolescent offspring: a register-based, data linkage, cohort study
Authors: Ayano G. , Dachew B. , Betts K. , Alati R. 
Published: August 2023

IntroductionTo the best of our knowledge, this is the first register-based cohort study to examine the association between maternal psychiatric hospitalizations before, during, and after pregnancy and the risk of lower academic performance in their adolescent children.ObjectivesTo investigate the risk of lower academic attainment in adolescent offspring of mothers with psychiatric hospitalizations before, during, and after pregnancy.MethodsThis administrative health data-based cohort study used linked data obtained from health and educational registries in New South Wales, Australia (n=168, 528). Maternal psychiatric diagnosis before, during, and after pregnancy was measured by using ICD-10. The educational performance of the offspring was assessed by National Assessment Program for Literacy and Numeracy (NAPLAN). A multiple Logistic regression model was employed to investigate the associationResultsAfter controlling for relevant covariates, we found that adolescent children of mothers with psychiatric hospitalizations before, during, and after pregnancy were at increased risk of substandard academic performance in all domains, with the highest odds for numeracy [OR, 2.88 (95%CI 2.50-3.31)] followed by reading [OR, 2.08 (95%CI 1.81-2.38)], spelling [OR, 1.74 (95%CI 1.51-2.01), and writing [OR, 1.56 (95%CI 1.34-1.80). In our sex-stratified analysis, maternal psychiatric hospitalizations demonstrated a stronger impact on the academic performance of females in all academic domains. Severe psychiatric disorders showed greater effects when compared to other psychiatric disorders.ConclusionsEarly intervention strategies that aim to enhance academic performance in the children of mothers with psychiatric diagnoses before, during, and after pregnancy are needed.Disclosure of InterestNone Declared
Evaluation of factors that may influence the development of chronic kidney disease in patients with bipolar disorder treated with lithium.
Authors: Gutiérrez Mora N. , Torres Cortés J. , Esteban Avendaño I. , Burguera Vion V. , Montes Rodríguez J. M. 
Published: August 2023

IntroductionBipolar disorder (BD) is a serious and chronic mental disease of mood. Lithium is used for treatment and studies have demonstrated that it is the most efficient drug, reducing suicide risk in a high percentage of patients. However, this drug has well known side effects, such as kidney damage. Lithium could cause chronic kidney disease, specially with the presence of other risk factors.ObjectivesObservational and retrospective study of creatinine levels and glomerular filtration rates observed in blood analysis
(follow-up period of 11 years). Sample size of 263 patients diagnosed of BD I and BD II in treatment with lithium. We used socio-demographic (age, sex) and clinic variables (diabetes mellitus, hypertension, use of nonsteroidal anti-inflammatory drugs (NSAIDs) and/or diuretics) to generate bivariate and multivariate analysis.MethodsOur main objective is to analyze the deterioration of kidney function and the development of chronic kidney disease that chronic treatment with lithium can induce in patients with BD. Our secondary objective is to determine variables which could promote the development of chronic kidney disease, and to assess if these variables could be considered as risk factors during the treatment with lithium.Results11,3 % of patients in our study developed chronic kidney disease during monitoring. The deterioration of GFR in patients in treatment with lithium was significantly associated with female sex and NSAIDs consumption. A trend towards statistical significance was found regarding the use of diuretics (p=0,060). No statistical significance was found between diabetes mellitus, hypertension or type of BD and the deterioration of kidney function in our sample. An inverse association was found between the GFR decline and the age but no statistical significance was demonstrated.ConclusionsWe conclude that female sex and use of NSAIDs are predicting factors of GFR decline in patients with BD in chronic treatment with lithium. We must take into account these drugs or even avoid concomitant treatment (lithium and NSAIDs) in order to prevent chronic kidney disease. In addition to it, we should recommend careful use of diuretics during treatment with lithium because of risk of dehydration. Diabetes mellitus and hypertension have universally been associated to increase risk of development of chronic kidney disease. However, we have not found statistical significance in our study. Therefore, research should be done in order to determine specific risk factors in this group of patients and, consequently, optimize their treatment.Disclosure of InterestNone Declared
Effects of geography on risk for suicidal ideation and suicide attempts among commercially insured children and youth in the US
Authors: Pathak J. 
Published: August 2023

IntroductionTo study the effects of geography on risk for suicidal ideation and suicide attempts among commercially insured children and youth in the USEffects of geography on risk for suicidal ideation and suicide attempts among commercially insured children and youth in the USObjectivesFew studies have examined the impact of geography on risk factors for suicidal ideation (SI) and suicide attempts (SA). This study used a national representative sample to study how geography may influence the relationships of risk factors for SI and SA in commercially insured children and youth.MethodsThe sample was a nationwide retrospective cohort study of 124,424 patients <25 years using commercial claims from four major insurance companies (Aetna, Humana, Kaiser Permanente, and UnitedHealthcare) in the US. The index visit was a mental health or substance use (MH/SUD) outpatient encounter between January 2014 and June 2015. SI and SA were defined by having an ICD-9 diagnosis code within one year after the index visit. Risk factors in the models were demographic and clinical risk factors, including prior psychiatric diagnoses, prescriptions, and healthcare services utilization. Patients’ geographic regions were assigned to one of the nine divisions defined by the US Census Bureau. We used survival analysis to evaluate the effects of geography on risk factors for SI and SA.ResultsAt each follow-up time period (post 7-, 30-, 90-, 180-, and 365-day), rates of SI and SA varied by geographic division (p<0.001). The Mountain Division consistently had the highest rates for both SI and SA (5.44%-10.26% for SI; 0.70%-2.82% for SA). Having MH emergency department (ED) visits in the past year increased the hazard ratio of SI by 28%-65% for children and youth residing in the New England, Mid-Atlantic, East North Central, West North Central, and East South Central Divisions. The main effects of geographic divisions were significant for SA (p<0.001). Risk of SA was lower in New England, Mid-Atlantic, South Atlantic, and Pacific (HRs=0.57, 0.51, 0.67, and 0.79, respectively) and higher in the Mountain Division (HR=1.46).ConclusionsChildren and youth residing in the Mountain Division had the highest prevalence of SI and SA and the highest risk of SI after having MH ED visits. Studies of indicators of access to MH ED care and other social determinants of health may clarify the reasons for SI and SA geographic differences.Disclosure of InterestNone Declared
The role of single nucleotide polymorphisms within genes for oxytocin and vasopressin receptors in the presentation and severity of autistic traits
Authors: Wilczyński K. M. , Auguściak-Duma A. , Stasik A. , Cichoń L. , Sieroń A. , Janas-Kozik M. 
Published: August 2023

IntroductionAutism spectrum disorder is a heterogeneous group of disorders that affects virtually every population, regardless of their ethnic or socioeconomic origin. The pathogenesis of ASD is probably multifactorial, based on interactions between genetic and environmental factors. Their key elements are disorders in the field of social communication, establishing and maintaining relationships and the so-called stereotypical and repetitive patterns of interests and activities. However, of the above- mentioned symptoms, the most important are communication disorders, which are the basis for many of the functional difficulties observed in these patients.ObjectivesThe aim of the presented study was to analyze the clinical picture of social cognition deficits in males with autism spectrum disorders, and to link its elements with the frequency of alleles of selected polymorphisms within the OXTR and AVPR1A genes.MethodsThe study included 132 people, 77.5% of whom were male (n = 100). 113 participants (85.6%) were diagnosed with autism spectrum disorders confirmed by the ADOS-2 test conducted by a certified diagnostician. In this group, men constituted 76.1% of the population (n = 77). The remaining 28 people did not have a diagnosis of autism spectrum disorders, and in the ADOS-2 study they obtained the result below the cut-off level. The mean age in the whole group was 14.4 years (95% CI: 13.92-14.93).ResultsA higher frequency of the rs53576 A allele and the rs10877969 C allele could be observed than expected on the basis of the European / world population. In the case of the rs7294536 and rs2254298 polymorphisms, no differences in the distribution of alleles in relation to the expected values were observed. In the network analysis reference allele (T) of SNPs rs10877969 was linked to the higher outcome of the “social affect” domain of ADOS-2 and through it influenced ADOS-2 outcome. All other SNPs did not significantly affect neither domain of ADOS-2. Reference allele (A) of rs53576 was linked with higher odds ratio of clinical diagnosis of ASD in logistic regression. Similarly the rs10877969 polymorphism within the AVPR1a gene significantly shaped the risk of autism spectrum disorders, while in the combined analysis with rs7294536 within the haplotype, the observed effect was significantly stronger.ConclusionsThe studied polymorphisms may constitute an element of larger haplotypes which, depending on the number of mutated alleles, may determine the severity of autism spectrum traits, from the neurotypical population, through people with a broad autism phenotype, to people diagnosed with ASD. Further research is required on the potential clinical application of genotype analysis of the studied polymorphisms and on the exact mechanism of their impact on the risk of ASD and the development of social cognition disorders.Disclosure of InterestNone Declared
Oxidative stress as a shared mechanisms for different prenatal stressors: long-term effects on adolescent male and female mouse offspring
Authors: Musillo C. , Berry A. , Creutzberg K. C. , Collacchi B. , Samà M. , Giona L. , Riva M. A. , Cirulli F. 
Published: August 2023

IntroductionStressful experiences in utero can produce physiological changes which become embedded biological traces affecting fetal brain development and ultimately leading to increased vulnerability for psychiatric disorders.ObjectivesWe hypothesized that stressors as diverse as maternal obesity and maternal psychophysical stress might disrupt fetal programming resulting in long-lasting effects on offspring brain development by acting through shared oxidative stress (OS)-mediated mechanisms.MethodsWe compared a mouse model (C57Bl/6N) of maternal high-fat diet (HFD) consumption (13 weeks, until delivery) to prenatal restraint stress (PNS) repeatedly administered during the last week of pregnancy. To counteract the negative effects of both stressors, the antioxidant N-acetyl-cysteine (NAC, 1 g/kg) was administered to female breeders for 8 weeks until delivery. Emotionality was assessed in adolescent male and female offspring through the elevated-plus-maze (EPM). Moreover, hippocampal gene expression levels of Brain-Derived-Neurotrophic-Factor (Bdnf
), Nuclear factor erythroid 2–related factor 2 (Nrf-2) and Kelch-like ECH-associated protein 1 (Keap-1) were measured, by qPCR, as markers of brain plasticity and antioxidant capacity.ResultsPrenatal exposure to both HFD and PNS enhanced behavioral disinhibition, increasing time spent in the open arms of the EPM and decreasing the frequency of risk-assessment behaviors, especially in female offspring. Moreover, both prenatal stressors led to decreased Bdnf (in females) and Nrf-2 levels, and disrupted Keap-1 levels. Prenatal NAC was able to counteract these effects on the brain.ConclusionsOur data support the hypothesis of a “funnel effect” model explaining how different prenatal stressors result in long-term negative effects on the adolescent offspring, increasing risk assessment behaviors and affecting brain plasticity and antioxidant defenses. The beneficial preventive effects of NAC suggest that OS may be a common mechanism, playing a pivotal role in fetal programming of mental disorders. ERANET-NEURON-JTC-2018-Mental Disorders-“EMBED” and Bando Ricerca Indipendente ISS 2021-2023; MOMINFLAM. Unique signatures underlying placental-fetal brain crosstalk in maternal obesity to F Cirulli.Disclosure of InterestNone Declared