bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical and neuroendocrine correlates of childhood maltreatment history in adults with bipolar disorder
Authors: Donato S. , Attianese N. , Battipaglia M. , Ceres R. , Monteleone A. M. , D’Agostino G. , Cascino G. 
Published: August 2023

IntroductionChildhood maltreatment (CM) has been associated to an increased risk of developing bipolar disorder (BD). A role of the hypothalamus-pituitary-adrenal (HPA) axis in mediating trauma-related risk for adult psychopathology has been suggested but scarcely investigated in BD.ObjectivesThe aim of this study is to explore the impact of childhood maltreatment on clinical features of BD and on the activity of the HPA axis.MethodsOne hundred and six patients participated in the study. On the basis of their history of childhood trauma, as assessed by the Childhood Trauma Questionnaire (CTQ), they were divided into a group with a history of childhood maltreatment (CM+) and a group without (CM−). Twenty-nine participants (16 with a history of childhood trauma and 13 without) underwent the cortisol awakening response (CAR) test. Saliva cortisol concentrations were determined by an enzyme immunoassay method, using a commercially available ELISA kit.ResultsAccording to CTQ, 62 had a history of childhood maltreatment and 44 had not. CM was significantly more frequent in females than males. CM+ patients showed significant higher body mass index (p = .01), number of suicide attempts (p = .03), and more severe mania symptoms (p = .01) than CM− ones. Significant associations between lifetime suicide attempts and any type of childhood maltreatment (OR = 2.79; CI = 1.01-7.73) and between emotional abuse and the presence of psychotic symptoms (OR = 2.74, CI = 1.11-6.74) or mixed mood episodes were found (OR = 2.62, CI = 1.07-6.43). Moreover, CM+ individuals with BD exhibited a significantly reduced CAR with respect to CM− ones.ConclusionsOur results add to literature findings showing a worse clinical course in BD patients with a history of childhood maltreatment and show for the first time that childhood trauma exposure is associated to impaired CAR in adults with BD.Disclosure of InterestNone Declared
The involvement of hyperhomocysteinemia in the development of characterized depressive disorder in children and adolescents
Authors: Elmaataoui Z. , BELHADGA H. , KISRA H. 
Published: August 2023

IntroductionElevated blood levels of homocysteine have been associated with several psychiatric and neurodegenerative disorders such as schizophrenic disorders, Alzheimer’s disease, Parkinson’s disease and depression. The hypothesis is that genetic and environmental factors elevate homocysteine levels, which causes vascular diseases of the brain, and/or changes in neurotransmitters, which cause various mental disorders.ObjectivesThe objective of our work is to discuss the association between hyperhomocysteinemia and the characterized depressive disorderMethodswe conducted our study through the discussion of a clinical vignetteResultsWe report here a case of hyperhomocysteinemia with vitamin B 12 deficiency in a 16-year-old female patient who presented with a characterized depressive disorder.She was initially treated with a selective serotonin inhibitor combined with parenteral injections of vitamin B12. The patient’s clinical condition improved after the first week. The discussion will attempt to clarify the role of vitamin therapy in the improvement of the patient’s depressive symptoms and its relationship with hyperhomocysteinemia.We report here a case of hyperhomocysteinemia with vitamin B 12 deficiency in a 16-year-old female patient who presented with a characterized depressive disorder.She was initially treated with a selective serotonin inhibitor combined with parenteral injections of vitamin B12. The patient’s clinical condition improved after the first week. The discussion will attempt to clarify the role of vitamin therapy in the improvement of the patient’s depressive symptoms and its relationship with hyperhomocysteinemia.ConclusionsStatistical data, physiological and genetic aspects seem to point to the involvement of hyperhomocysteinemia in the development of characterized depressive disorder. However, the results remain variable, even contradictory, and several confounding factors must be considered in these studies: ethnic, geographical, cultural (in terms of diet) and age factors are all elements that seem to intervene and that do not always make it possible to know whether hyperhomocysteinemia is a direct cause of depression or the consequence of mechanisms linked to folate and B12 deficiencies.Disclosure of InterestNone Declared
Refugees, war trauma and mental health: knowledge and experience from trainees and early career psychiatrists
Authors: Bianchi S. , Riboldi I. , Őri D. , Pompili S. , Pavel C. , Seker A. ,   E. Psychiatry Across Borders Working Group
Published: August 2023

IntroductionPsychiatry Across Borders working group of the European Federation of Psychiatric Trainees has the mission to improve psychiatric training in transcultural psychiatry and trauma-related topics in Europe. It started conducting a survey in 2016, to assess trainees’ experiences in forcibly displaced people mental health (Frankova et al. Transcult.Psychiatry, in press).ObjectivesTo investigate European psychiatric trainees’ and Early Career Psychiatrists’ (ECPs) training about trauma and refugees’ mental health, focusing on educational and clinical difficulties occurring while assisting war refugees or in Eastern Europe, due to the ongoing conflict.MethodsA new survey for European psychiatric trainees and ECPs was designed. A web questionnaire was shared through various channels, including social media, in September 2022. It included an informed consent form and investigated socio-demographic data, training in trauma and refugees’ mental health, clinical practice in war areas or with war refugees.ResultsAs of 16/10/22, 31 were the responders, mainly adult psychiatrists (93.6%). Although the 87.1% worked with forcibly displaced people, only 29% received a specific training, and 53.6% didn’t feel prepared to face war trauma-related disorders. However, 64.3% could reach out to a teamwork member specialized in the topic, and 72.2% to interpreters. The 67.7% worked with actual war refugees, mainly addressed to psychiatric services due to new onset of psychiatric symptoms, especially insomnia (66.7%), often diagnosed with Acute Stress Reaction (66.7%) and treated with psychiatric drugs (83.3%). Two colleagues working in war areas participated in the survey: both lost patients at follow-up and experienced increased workload or lack of means (i.e., drug supply) or support.ConclusionsThis survey can spot educational needs in transcultural psychiatry, helping to program targeted interventions for psychiatric trainees and ECPs, aimed at implementing clinical practice towards the common goal of social cohesion.Disclosure of InterestNone Declared
Non-pharmacological interventions for people presenting in crisis to emergency departments and inpatient wards: a scoping, typology, and systematic review
Authors: Huber J. P. , Milton A. , Brewer M. , Norrie L. , Glozier N. 
Published: August 2023

IntroductionPeople presenting to hospital in a crisis of mental ill-health usually present via Emergency Departments, and are often admitted for brief interventions. Unlike drug treatments, the evidence base for brief non-pharmacological interventions has not been systematically evaluated.Objectives1. To describe brief non-pharmacological interventions used in Emergency Departments and inpatient psychiatric units, for those in a crisis of mental ill-health, and evaluate the study types and outcome measures used to evaluate them;2. To conduct a systematic review of this evidenceMethodsWe searched the Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, DARE, Embase, MEDLINE, PsycINFO, and relevant government and non-government organisation websites for peer reviewed journal articles, including both qualitative and quantitative articles. Interventions were sorted into Categories and Types to manage heterogeneity.ResultsWe found 47 studies. Interventions were highly varied, and we created a taxonomy to understand this heterogeneity. Most studies were quasi-experimental trials (n=26; 55%) or qualitative studies (n=13; 27%) and only 8 RCTs (17%). Twelve were high quality (26%). Interventions were mostly found to have no effect on measured outcomes, though outcome measures may not have been best suited to expected domains of change.There was a broad range of outcome foci reflecting inconsistency in goals of interventions. No interventions were found to reduce the incidence of self-harm on the inpatient ward. One study suggests that inpatient safety planning may reduce readmission rates. Aggression-related outcomes for inpatient sensory modulation rooms were equivocal. Brief admissions with psychotherapy may reduce suicide attempt repetition and re-hospitalization, whereas brief admissions without psychotherapy may improve function but not re-hospitalization rates. Face-to-face psychoeducation for panic in the ED was associated with a reduction in ED presentation rates, but brochure-only psychoeducation may increase ED presentation rates.ConclusionsThis review found little evidence to guide much of what clinicians do for people in crisis in hospital. There is a need to develop a framework for brief non-pharmacological interventions, address the quality and size of studies, and identify consistent outcome measures for non-pharmacological interventions. The data is insufficient to make clear recommendations for appropriate brief non-pharmacological interventions for people in crisis in Emergency Departments and Psychiatric Inpatient Units. Multiple promising interventions are available for further study, however there is a dearth of research and more rigorous testing is needed.Disclosure of InterestNone Declared
Follow-up Study Tracking Children’s Development from Preschool till Middle School
Authors: Nomura K. , Yokoyama K. 
Published: August 2023

Introduction
Screening for early detection of health issues and support are provided to children needing developmental support. In Japan, a significant percentage of infants requiring support are identified during health checkups. Sometimes, however, problems are first observed when children are of school age. It is, therefore, important to identify the age at which children need early support.ObjectivesOf the children born in 2005 in Kanie-cho, in Japan, 106 participated in the survey at all time points: age 5, first grade, fifth grade, and eighth grade.MethodsThe medical checkup results of the participants at age 5 were used to determine who among them needed support After entering school, the participants who scored less than 70 points on the Children’s Global Assessment Scale, where their adjustment was assessed based on the interview with the homeroom teacher, were considered maladjusted.ResultsThe results are presented in Table 1.Thirty participants needed supports at age 5; of these, 20 (66.7%) were maladjusted at any point in their school years—19 (95%) in the first grade, 14 (70%) till the fifth grade, and five (25%) till the eighth grade.Of the 76 participants who did not need support in early childhood, 24 (31.6%) were maladjusted at some point in their school years—nine (37.5%) experienced maladjustment in the first grade, but none of them continued to be maladjusted till the fifth grade, and 14 (58.3%) who were not maladjusted in the first grade experienced it in the fifth or eighth grade (adolescents).Thus, the participants maladjusted in their school years were categorized as follows:1. The developmental disorders group (experiencing maladjustment throughout since early childhood): 192. The “first grade problem” group (experiencing transient problems only in the first grade): 93. The adolescent group (experiencing problems during adolescence): 14Image:ConclusionsSince maladjusted children with developmental disabilities are identified in early childhood, support can be provided before they reach school age. Many children with developmental disabilities improve their adjustment as they grow up. It is thus advisable to take a long-term perspective in dealing with problematic behaviors.From late school age to adolescence, problems unrelated to developmental disabilities emerge. By listening to the child’s upbringing, it may be possible to ascertain whether or not the problem stems from a developmental disability.Disclosure of InterestNone Declared
Substance Use among youths in Uganda during the COVID-19 pandemic: Associated factors and prevalence:
Authors: Ssenyonjo L. , Ddumba I. 
Published: August 2023

IntroductionAlthough studies have demonstrated that younger people are at high-risk of instigating alcohol, substance use and development of related disorders, the trend is gradually changing. An observed gradual initiation and substance use among older persons, especially during the COVID-19 pandemic. However, there is dearth of data on about the prevalence and determinant of substance use during COVID-19 pandemic in Uganda.ObjectivesDetermine the prevelence and determinants of susbstance use during COVID-19 pandemic in UgandaMethodsA cross-sectional design and probability based sampling was applied. Data was collected among 474 older persons aged 50 years and above, that resided in the central region of Uganda. A multivariate logistic regression was used to assess the socio-economic, demographic and health related correlates of alcohol and tobacco use.Results9.2% and 5.4% of older persons were taking alcohol and smoking before the COVID-19 pandemic. However, an observed increase of 14% of smoking and alcohol intake among older persons during the pandemic. Being male had higher odds of substance use than their female counterparts. Older persons with tertiary education and low (poor) wealth quantile, had lower odds of substance use than their counterparts.ConclusionsOur finding highlights increased substance use among older persons during the COVID-19 pandemic. Designing targeted measures and policies to deter the substances use among older persons is critical to address this vice, especially during the pandemic and possible future disease outbreaks.Disclosure of InterestNone Declared
Psilocybin as an antidepressant strategy - a review of safety aspects
Authors: Zeiss R. 
Published: August 2023

IntroductionPsilocybin is considered a classical psychedelic and is increasingly attracting scientific and media attention as an alternative approach to the treatment of various mental disorders.Apart from its efficacy, an important question is the tolerability and safety of psilocybin in general and in a controlled environment. Accurate knowledge of drug safety aspects might be essential for applicability in clinical practice and for drug adherence.ObjectivesThis paper aims to provide an overview of drug safety aspects of psilocybin.MethodsA narrative review was conducted. The literature search was conducted using the bibliographic database MEDLINE.ResultsThe literature search of papers published in recent years showed no serious side effects under psilocybin in controlled study conditions. Common reported ADRs were headache, gastrointestinal complaints such as nausea, diarrhoea and vomiting, tachycardia and arterial hypertension. The lethal dose of psilocybin is many times higher than the therapeutic dose and overdose deaths have not been identified.An often mentioned problem is the occurrence of hallucinogenic persisting perception disorder (HPPD) which, however, did not occur in the studies examined and is most likely to be a problem in the context of recreational use. The results on the safety of psilocybin must be regarded as preliminary; in the studies conducted, risk populations were predominantly excluded, which is, however, relevant for everyday clinical practice. The risk of delusional experiences and so-called “bad trips” is also a relevant safety risk, as it can be associated with risky behaviours. However, these would also be observed more in the area of recreational use.ConclusionsThe use of psilocybin in rigorously controlled study designs appears to be predominantly safe and without serious side effects. At the same time, it should be noted that the results must be considered preliminary and many questions remain open. Many of the risks are more likely to occur in uncontrolled recreational use of psilocybin. At the same time, we see a certain risk in the use of a substance associated with high expectations and a certain “fame” that, without appropriate regulations, the boundaries between sensible therapeutic use and abusive use could become blurred and permeable.Disclosure of InterestNone Declared
Factors linked to suicide risk in a diverse sample of psychiatric patients
Authors: Pontiggia M. , Bonaldi S. , Gramaglia C. , Zeppegno P. , Madeddu F. , Calati R. , Magliocca S. 
Published: August 2023

IntroductionSuicidal behavior is a global public health problem. Among the most investigated theories for the explanation of suicide there is the interpersonal-psychological theory of suicide (IPTS) by Thomas E. Joiner. IPTS focuses on 3 variables related to lethal suicide attempt: thwarted belongingness, perceived burdensomeness and acquired capability for suicide.ObjectivesWe aimed to understand which variables were mostly related to suicidal ideation (SI) and suicide attempts (SA) in a sample of psychiatric patients.MethodsA sample of 80 psychiatric patients including inpatients (n=18), outpatients (n=21) and patients from various Italian rehabilitative psychiatric communities (n=41) was recruited between June 7th, 2021 and September 12th, 2022. We administered a battery of various scales, including State-Trait Anxiety Inventory, STAI, Beck Depression Inventory, BDI, Reasons For Living Inventory, RFLI, Acquired Capability for Suicide Scale-Fearlessness About Death, ACSS-FAD, Rosenberg self-esteem scale, RSES, Mental pain questionnaire, MPQ, Interpersonal Needs Questionnaire, INQ. For each scale we compared a) patients with and without lifetime SI; b) patients with and without history of SA. Then, we performed two logistic regression models (stepwise backward method), one for SI and one for SA.ResultsBoth patients with SI and SA have higher anxiety (STAI), depression (BDI), mental pain (MPQ), perceived burdensomeness (INQ), thwarted belongingness (INQ), fearlessness about death (ACSS_FAD) and lower self-esteem (RSES), beliefs about coping strategies (RFLI) and moral objections (RFLI). Depression (BDI) and beliefs about coping strategies (RFLI) were the variables most strongly associated with SI; higher fearlessness about death (ACSS-FAD) and low self-esteem levels (RSES) were the variables most strongly associated with history of SA. The SI model was able to predict 84% of ideation cases; the SA model was able to predict 74% of the attempts.ConclusionsThe results supported that improving the ability to cope with suicidal thoughts is a key component of therapeutic work with suicidal patients. In addition, according to the IPTS, the history of SA has been particularly explained by fearlessness about death. Hence it may be important to focus on these aspects in suicide prevention.Disclosure of InterestNone Declared
European federation of psychiatric trainees - Exchange Programme - appreciated by trainees in spite of language-related challenges
Authors: Kraxner F. H. , Lengvenytė A. , Dias M. C. 
Published: August 2023

IntroductionDifferences in psychiatry training vary substantially across Europe. Such organisations as the European Federation of Psychiatry Trainees (EFPT), the European College of Neuropsychopharmacology, and the European Psychiatry Association, have committed to offer international experiences based on the premise that it could foster international collaboration, aid early career professionals to progress professionally and spark discussion regarding different practices across Europe.To date, there are no studies that focus on the exchange experience in mental health professionals.ObjectivesWe present the synthesis of the first seven years answers from 2012 to 2019 to the post-exchange online evaluation form, which trainees had to fill in in order to receive an attendance certificate.MethodsThe present study analysed the answers of 182 psychiatry trainees or recent graduates who took part in the EFPT exchange program during 2012 and 2019 and filled in the internet-based evaluation form. The inclusion criteria were currently in training or recently finished training as a psychiatrist in Europe and filling in the questionnaire. The exclusion criterion was participation in the EFPT exchange program for the second or subsequent time.All trainees were systemically asked to complete the online evaluation form after the exchange period. The form includes sociodemographic, training in host country-related, and exchange experience-related questions. Experience measures were evaluated using the 4-point Likert scale. Data was anonymized before the analysis. The study followed the principles of the Declaration of Helsinki.ResultsFrom the 198 individuals who filled the questionnaire, 182 were involved in final analyses. The majority of participants were females in the second half of their training. The average age was 29 years. The largest number of applicants were from Turkey, whereas the United Kingdom hosted the most participants. One-third of the participants had previous international exchange experience.Most trainees were exposed to both outpatient and inpatient treatment settings and were involved in educational or research activities. 96.7% of participants indicated that they were satisfied or very satisfied with the experience, 95.6% said that the exchange was useful or very useful, and 98.9% were likely or very likely to recommend exchange to colleagues. A description of trainees and exchange placements is presented in a table (couldn’t be uploaded).ConclusionsTo our knowledge, this study is the first to assess the experience of psychiatry trainees who went on exchange during their professional training. Vast majority of trainees were satisfied with their exchange, thought it would be useful for their clinical practice and would recommend it to their colleagues. These findings are in line with other studies that examined medical exchange experiences .Disclosure of InterestNone Declared