bluuebunny/crossref_metadata_2025_split huggingface dataset:
Legalization of cannabis for medical and recreational use
Authors: Hasin D. 
Published: August 2023

AbstractSince 1996, 39 of the 50 US states have enacted medical cannabis laws (MCL) and since 2012, 21 states and Washington D.C. (DC) enacted recreational cannabis laws (RCL). Many individuals can use cannabis without harm, and legalization helps achieve social justice and financial aims. However, 20%-33% of cannabis users develop cannabis use disorder (CUD), which is associated with impaired functioning, psychosocial, physical and psychiatric problems. Despite these risks, Americans increasingly see cannabis use as harmless or even beneficial in treating or preventing health problems. The prevalence of frequent cannabis use and CUD has increased in US adults in recent years. Studying the role of MCL and RCL in these nationally increasing prevalences is challenging due to staggered-adoption dates of state legalizations, few years of data available to study RCL, and other potential influences on cannabis use and CUD. Using self-report data from US national surveys, MCL have been shown to have little influence on adolescent cannabis use, but increase adult illicit cannabis use and CUD. Fewer studies have examined RCL; in these, RCL increases adult use and CUD. However, studies are needed in national patient populations with multiple risk factors for CUD, including painful medical conditions and a high prevalence of psychiatric disorders. We used data from the electronic health records (EHR) database of the US Veterans Health Administration (VHA), the largest integrated healthcare system in the US, to examine trends in provider-diagnosed ICD-9-CM and ICD-10-CM CUD over time, differences in these trends by patient characteristics, and the role of MCL and RCL in the trends. CUD diagnoses more than doubled overall in the VHA, from 0.85% in 2005 to 1.92% in 2019. Increases were found across age, sex, and racial/ethnic subgroups of patients, with greater rates and increases among patients with chronic pain and with psychiatric disorders. Among patients living in MCL and RCL states, increases in CUD were larger than among patients in other states, although the size of legalization effects suggested that other factors are important in driving up prevalence, e.g., online commercialized information and other forms of advertising. The tensions between public health aims, social justice and financial gain will be discussed.Disclosure of InterestNone Declared
Culturally adapted psychoeducation for bipolar disorder in a low-resource setting: protocol for a multicentre randomized controlled trial
Authors: Husain I. , Umer M. , Asif M. , Bukhsh A. , Kiran T. , Ansari M. , Aslam H. , Bhatia M. , Dogar F. , Husain O. , Khan H. A. , Mufti A. A. , Mulsant B. , Naeem F. , Naqvi H. A. , De Oliveria C. , Siddiqui S. , Tamizuddin A. , Wang W. , Zaheer J. , Husain N. , Chaudhry N. , Chaudhry I. 
Published: August 2023

IntroductionBipolar disorder (BD) is a source of marked disability, morbidity, and premature death. There is a paucity of research on personalized psychosocial interventions for BD, especially in lowresource settings. A previously published pilot randomized controlled trial (RCT) of a Culturally adapted PsychoEducation (CaPE) intervention for BD in Pakistan reported higher patient satisfaction, enhanced medication adherence, knowledge and attitudes towards BD, and improvement in mood symptom scores and health-related quality of life measures compared to treatment-as-usual (TAU).ObjectivesThis protocol describes a larger multicentre RCT to confirm the clinical and cost-effectiveness of CaPE in Pakistan.MethodsA multicentre individual, parallel arm, RCT of CaPE in 300Pakistani adults with BD. Participants over the age of 18, with adiagnosis of bipolar I and II and who are currently euthymic, will berecruited from seven sites including Karachi, Lahore, Multan,
Rawalpindi,Peshawar, Hyderabad and Quetta. Time to recurrence will be the primaryoutcome assessed using Longitudinal Interval Follow-up Evaluation(LIFE). Secondary measures will include mood symptomatology, qualityof life and functioning, adherence to psychotropic medications, andknowledge and attitudes towards BD.ResultsFull ethics approval has been received from National Bioethics Committee (NBC) of Pakistan and Centre for Addiction and Mental Health (CAMH), Toronto, Canada. The study has completed sixty-five screening across the seven centres, of which forty-eight participants have been randomised.ConclusionsA successful trial will lead to rapid implementation of CaPE in clinical practice, not only in Pakistan, but also in other low-resource settings including those in high-income countries, to improve clinical outcomes, social and occupational functioning, and quality of life in South Asian and other minority patients with BD.Disclosure of InterestNone Declared
Coping strategies in bipolar patients: A comparative study with siblings and healthy controls
Authors: Stambouli M. , Saguem B. N. , Bouhlel S. , Ben Mahmoud I. , Chebbi W. , Nakhli J. 
Published: August 2023

IntroductionData regarding coping strategies used by bipolar patients to deal with psychosocial stress and their consequences in adaptational outcomes are scant. Moreover, family studies have reported the presence of several similarities between bipolar patients and their relatives regarding genetics, biology, personality traits, temperaments and stressful lived life experiences. Bipolar patients and their siblings had significantly higher global score of life events and more events in the field of work, socio-family events and health than control subjects. This might suggest that patients with bipolar disorder would be distinguished from their family members by the coping strategies they use to deal with stress.ObjectivesIn this study, we aimed to compare perceived stress and coping strategies of remitted bipolar I patients with those of their siblings and controls.MethodsA descriptive and comparative study of case-control type was conducted. Were included 46 bipolar I patients, 46 siblings and 50 controls. The three groups were matched for age and sex. Assessments of perceived stress and coping strategies were performed using the 10-item Perceived Stress Scale (PSS) and the 28-item Brief COPE respectively.ResultsMean age of bipolar I patients was 39 ± 13 years. Thirty-one patients (67%) reported family history of one or more psychiatric disorders.Mean duration of bipolar disorder was 11.83 ± 9.92 years.There was no significant difference between the three groups on PSS scores. Bipolar patients and siblings were more likely to use emotion-focused coping strategies than controls (p=0.001). Controls used problem-focused coping strategies more than bipolar patients (p = 0.02). Compared to controls, bipolar patients were less likely to use active coping and planning, but they showed higher scores in the dimensions of humor, religion and behavioral disengagement with intergroup p value: 0.02; 0.019; 0.002 respectively.ConclusionsOur findings suggest that bipolar I patients were more likely to use maladaptive coping strategies to deal with stress than their siblings. Based on this observation, it seems advisable to study coping strategies used by bipolar patients, in order to reinforce adaptive strategies and to reduce maladaptive ones.Disclosure of InterestNone Declared
Familial Autism Spectrum Disorder : A clinical study from South Tunisia
Authors: Boujelben I. , Chaabane M. , Ben ayed I. , Ben Touhemi D. , Gharbi N. , Guirat M. , HajKacem I. , Ayadi H. , Kamoun H. , Moalla Y. 
Published: August 2023

IntroductionAutism Spectrum Disorder (ASD) is a multifactorial neurodevelopmental disorder, with both contribution of genetic and non-genetic factors. A collaboration of de novo mutations and prenatal with postnatal environmental factors are likely to play a role. ASD can be syndromic or non-syndromic. The etiology of non-syndromic ASD is still relatively undefined due to its genetic heterogeneity. Contrary to non-syndromic ASD, syndromic ASD is often associated with chromosomal abnormalities or monogenic alterations. Familial cases of ASD support the strong genetic component of ASD.ObjectivesTo collect clinical arguments supporting a genetic cause of autism spectrum disorder.MethodsWe present a clinical study of familial cases of ASD. The families were recruited as part of a collaborative project between the department of Medical Genetic and the department of Child Psychiatry in Hedi Chaker Hospital, Sfax, Tunisia. The clinical and paraclinical data were collected retrospectively.ResultsOur study included 11 unrelated families from southern Tunisia, each with two ASD children, among them four couples of twins. Most families (80%) are consanguineous belonging to a middle socioeconomic class. None of the parents suffered from psychiatric disorder and a familial history of autism was reported in one family. Perinatal history, including advanced maternal or paternal age, fetal suffering and/or gestational problems, was found in 35% of cases.The average age was 9.89 ± 3.787 (3 to 17 years) with a balanced sex-ratio.ASD was syndromic in seven out of 11 families: facial dysmorphism in half of cases (6/11 families) and/or another comorbidity in 25% of cases (celiac disease, congenital heart disease or idiopathic hydrocephaly). ASD was associated with other(s) neurodevelopmental disorder(s) in all children. Most of cases (14/22) had delayed psychomotor development and all of them had intellectual disability with various degrees. Epilepsy was identified in three cases belonging to unrelated families. Other behavioral problem was identified in 65% of cases.When the autism spectrum disorder is syndromic and/or associated with other(s) neurodevelopmental(s) disorder(s), this points more towards a genetic origin.ConclusionsOur study highlights the interest of clinical investigations to determine genetic risk factors of ASD. The identification of a genetic cause in familial cases would contribute not only to better understand the pathological processes of ASD but also to provide an appropriate genetic counseling.Disclosure of InterestNone Declared
Sensory integration in a department of child and adolescent psychiatry
Authors: Maria Del Carmen M. L. , Nadia B. B. , Irene C. I. 
Published: August 2023

IntroductionThe area of Sensory Integration has its origin in the 1960s, developed by the neuroscientist and occupational therapist Jean Ayres. Although the first studies focused on the relationship between learning problems and atypical sensory processing, today there are new applications in clinical practice.Sensory integration is defined as the neurological process responsible for organizing the sensations that one receives from one’s own body and from the environment, in order to respond and function adequately in relation to environmental demands.ObjectivesThis work has several objectives. On the one hand, review the concept of sensory integration, the definition and theoretical basis as well as the scientific evidence of this theory. On the other hand, review the use of sensory integration in psychiatric practice from the 1960s to the present day. Also, explain the experience of a child and adolescent psychiatry unit with the use of sensory integration as part of the treatment. Finally, new challenges, approaches and needs of psychiatry services will be considered for the implementation or improvement of this new work tool in a multidisciplinary team.MethodsA bibliographic search has been carried out in the main sources of medical information such as pubmed, uptodate as well as in national and international journals. Likewise, the knowledge and clinical experience of the team has been reviewed.ResultsIn our clinical experience, the child and adolescent psychiatry device for intensive outpatient treatment where patients between 12 and 17 years of age with severe mental disorders attend, initially passed the sensory profile by occupational therapy to patients who presented behavioral or emotional symptoms. not consistent with the psychopathological examination. In view of the results and magnificent progress, this intervention began to be carried out systematically to the boys who joined the device.We present the case of a 15-year-old patient who attended the device due to emotional dysregulation and suicidal risk. During evolution, possible difficulties were seen in sensory integration that made it difficult for the patient to improve with psychiatric or psychological therapy alone. The patient was evaluated and treated by the team’s occupational therapist, specifically trained in sensory integration. It was evaluated with the sensory profile, with the results having a sensory sensitivity profile and auditory and tactile avoidance. The specific measures that were carried out were: sensory diet and environmental modifications.ConclusionsSensory integration is a therapy with sufficient clinical evidence to implement it in child and adolescent psychiatry services. Therapy should be performed by suitably trained and validated occupational therapists. This therapy must be included in a multidisciplinary approach to the patient and specific modifications that can be developed at home and at school are provided.Disclosure of InterestNone Declared
Measurement of Cannabis Consumption to Determine Risk and Promote Public Health
Authors: Budney A. J. 
Published: August 2023

AbstractWith the escalation of cannabis legalization and commercialization, the need to differentiate low- vs. high-risk patterns of cannabis use, especially among frequent consumers, becomes essential for development of prevention and intervention strategies and public health messaging. The diversity of cannabis products and methods of intake make this task complex. In particular, the lack of valid methods for quantifying use of the intoxicating component of cannabis, i.e., THC, poses a difficult challenge. This presentation will describe a series of internet-based, personalized survey studies of adults who consume cannabis frequently. The aims of the studies are to develop methods for quantifying THC from self-reports of use, identify patterns of use, and determine associations between use and risk. In the first study of adult daily cannabis consumers (n>4000), rates of CUD were 35% no disorder, 39% mild, 18% moderate, 8% severe disorder. Higher severity was significantly related to younger age, unemployment, and specific reasons for use. Latent class analyses identified four distinct subgroups and preliminary analyses showed that those more likely to report oral use were less likely to meet CUD criteria, and those more likely to report use of high potency products were more likely to meet moderate/severe criteria. Two studies (n’s >2000) compared different quantitative formulas for estimating daily THC consumption from vaping or smoking cannabis products. Findings demonstrated how quantity (mgTHC) relates to socio-demographics, use patterns, and CUD severity. However, substantial variability in the estimates obtained across quantitation methods indicates the need for additional studies to determine optimal approaches. Overall, findings show that specific characteristics of use can discriminate low- from high-risk consumption among those who use frequently, which is critical for developing cannabis policy and public health messaging.Disclosure of InterestNone Declared
Eating Disorders across the life span: the role of biology and psychosocial factors
Authors: Micali N. 
Published: August 2023

AbstractEating Disorders are common. They onset in adolescence and affect individuals of all ages. Women are more affected than men. I will present evidence on the epidemiology of eating disorders across the lifespan. I will also review risk factors focusing in particular on biological risk factors that might explain onset of these disorders in critical periods of a woman’s life. I will also cover pyschosocial risk factors across life stages. I will present results from a series of cohort studies. I will then summarise the evidence from our own and other existing studies.Disclosure of InterestNone Declared
Mental Health Responses to Covid and Lock-down in Auckland, New Zealand
Authors: Soosay I. 
Published: August 2023

IntroductionThe Government of New Zealand closed the borders and introduced a number of restrictions following the first reported case of Covid-19 in February 2020. Comprehensive measures to control the outbreak included a strict managed isolation and quarantine (MIQ) system and rolling lockdowns that restricted movement. There were concerns about the mental health impact on the population. This presentation will outline the approach to maintaining social cohesion and supporting the psycho-social needs of the population through the pandemic.ObjectivesAn overview of the Covid-19 response will be presented, including the Covid-19 alert systems and the strategies to support particular populations.MethodsThis will include:1. The mental health support for the 229,000 people subjected to managed isolation and quarantine in government facilities2. Psycho-social interventions for our Maori and Pacific populations3. Specific approaches for people with severe mental disorders, including vaccination strategies and supporting people in the community with Covid-194. Interventions for homeless and socially vulnerable populationsResultsReflections and learnings from our apprach will be shared.ConclusionsThe government ended the Covid-19 Framework in September 2022 and retrurned to fully open borders in October 2022. There have been over 1.8 million cases and 2000 deaths during the period of restrictions.Disclosure of InterestNone Declared
The psychological impact of Covid on health care professionals during the third wave
Authors: Theodoratou M. , Potoglou A. , Tamiolaki A. , Kalaitzaki A. 
Published: August 2023

IntroductionThe COVID-19 pandemic is a healthcare crisis, with unprecedented impact on healthcare services, notable morbidity and mortality of the public and healthcare workers, economic impact and significant psychosocial impact. Besides, this pandemic has had a profound negative effect on the mental health of people worldwide, particularly among those who are faced with combating the virus.ObjectivesThe aim of this research was to examine the impact of the COVID-19 pandemic on healthcare workers’ mental health (HCWs), as they are on the front line of the pandemic.MethodsAn internet-based questionnaire was created including the following scales: (1)Posttraumatic Stress Disorder Checklist (PCL-5), (2) Secondary Traumatic Stress Scale (STSS) (3) Quality of Professional Life (ProQOL) (4) Post-Traumatic Growth Inventory, (PTGI), (5) Brief Resilience Scale (BRS), (6) Brief Orientation to Problems Experienced Inventory (Brief Cope)], (7) Self-Compassion Scale (SCS-SF). It was distributed to 120 Greek health professionals, including nurses, doctors, midwives and physiotherapists.ResultsMost of the participants were female with an average age of 46 years. HCWs had low levels of both primary and secondary traumatic stress . They presented post-traumatic growth in the dimension of relationship with others. They used predominantly the coping strategies of positive reframing, acceptance of the situation, venting, and instrumental support.Females had statistically significant higher levels of post-traumatic growth, better quality of life, and used more positive coping strategies compared to males. Humor and acceptance were coping strategies used mainly by physicians. Nurses and midwives had worse quality of professional life potentially due to increased workload. HCWs with more functional ways of coping were more resilient and seemed to have better quality of life, such as higher compassion, satisfaction, lower burnout, and lower post-traumatic stress.ConclusionsThe experience of the COVID-19 pandemic highlights the need to implement some strategies to protect health care workers’ mental health and to take extensive prevention measures in highly stressful situations.Further research is needed to clarify the long-term negative and positive psychological effects of the pandemic on healthcare personnel’s mental health.Disclosure of InterestNone Declared
The influence of physical activity during sleep deprivation on mood and reaction speed to visual and auditory stimuli
Authors: Sochal M. , Ditmer M. , Turkiewicz S. , Karuga F. , Strzelecki D. , Gabryelska A. 
Published: August 2023

IntroductionSleep deprivation (SD) is being examined in the treatment of depression and other affective disorders for years. However, studies’ outcomes remain ambiguous, with varying levels of clinical improvement and its ephemeral character. Thus, it is necessary to find new factors accounting for the variability of results to develop new therapeutic protocols.ObjectivesThe study aimed to assess the influence of physical activity on mood and reaction speed following SD.MethodsThe study group consisted of 71 participants. SD lasted about 24 hours, beginning in the morning hours of the SD day to the morning hours of the following day. Physical activity (PA) was controlled using actigraphy (actigraph GENEActive Original, ActivInsights Ltd.) given to each participant. Participants underwent the reaction speed test (Response Time Test Apparatus, AT Smart Systems, Poland) and filled out a questionnaire assessing depression symptoms- Beck Depression Inventory (BDI), in the evening of the SD day, and the following morning. Based on the percentage of sedentary time (gravity-subtracted sum of vector magnitudes<386, DOI 10.1111/sms.13488) participants were classified as inactive (≥70% of SD duration spent sedentary, n= 43) or active (n= 28).ResultsThere were no significant differences between the active and the inactive participants regarding pre/post SD BDI score, reaction speed, and demographic data (age, sex, BMI) (all p>0.05). The inactive group had a significantly lower BDI score following SD in comparison with their baseline parameters (5, IQR 1-12 vs. 3, IQR 0-12, p=0.024) than the active group (3, IQR 1-6 vs. 3, IQR 0-7, p=0.408). Reaction speed after SD was impaired in both active (0.216, IQR 0.206-0.226 vs. 0.231, IQR 0.222-0.46, p<0.001) and inactive group (0.224, IQR 0.216-0.235 vs. 0.238, IQR 0.220-0.251, p<0.001). However, the difference between pre/post SD response time was slightly higher in the active individuals (0.015, IQR 0.011-0.028 vs. 0.012, IQR 0.003-0.022, p=0.047).ConclusionsThis study shows, that a sedentary behavior during SD might improve mood and slightly less impair the response time to auditory or visual stimuli than a higher activity level. Thus, PA could be an important modulator of clinical outcomes observed in individuals with affective disorders subjected to SD. PA should be accounted for in the SD protocols designed for future studies.Disclosure of InterestNone Declared