bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health and care system assessment aimed at cultural adaptation of MhGAP modules
Authors: Dozio E. , Caron L. 
Published: August 2023

IntroductionAs part of the Global Mental Health (GMH) movement, WHO launched the Mental Health Gap Action Program (mhGAP). One of the key initiatives of the MhGAP is to train lay health professionals to meet the mental health needs of populations, particularly in low- and middle-income countries (LMICs) where the need far exceeds the availability and quality of services. Training modules are standardized and designed for use in many countries and settings. In practice, there is often a stereotyped reproduction of modules without consideration of specific cultural adaptation needs.ObjectivesAs part of a psychosocial support program in two provinces of the eastern Democratic Republic of Congo (Ituri and North Kivu), the NGO Action contre la Faim proposed a health and care system assessment aimed at adapting MhGAP modules for health center staff. The objective was to know the local practices in terms of psychic care as well as to identify the competences already existing to reinforce them, but also to contextualize the tools and the contents of the trainings.MethodsThe methodology used was mixed.A questionnaire based on the WHO situation analysis tools was revised, simplified and adapted to the zone, allowing us to obtain quantitative data on the health centers, the care provided, referrals and supervision. Health care workers were interviewed using the questionnaire from ACF’s “Strengthening the Health Care System” guide, focusing on care methods, knowledge of mental health and the most frequently encountered symptoms. Focus Group Discussions with the Community Relais in the area allowed for the collection of information on the level of knowledge of the population in terms of mental health, their awareness on this subject, their cultural vision and the means of care.ResultsThe data collected from 9 health centers in the two provinces allowed us to learn about:- Poor knowledge of mental health and school readiness- Identification of barriers to access to care- Beliefs around mental health, mental suffering and care- Details about the different pathologies and symptoms as well as the issues related to the therapeutic framework.ConclusionsThe evaluation was fundamental to have a better knowledge of the context, which made it possible to adapt the content of the MhGap training modules les, to design tools more adherent to reality. The data collected may also be the subject of advocacy aimed at mobilizing the country’s policies in terms of mental health, as well as raising awareness in the international community.Disclosure of InterestNone Declared
Digital transcultural psychiatry in times of crisis: the Help for helpers webinar series
Authors: Rojnic Kuzman M. 
Published: August 2023

AbstractThe COVID-19 pandemics brought numerus changes in the European mental health systems. One of the major, was the widespread introduction of digital psychiatry across the globe, as the only possible option to maintain the psychiatric care. On February 28th 2022, the European Psychiatric Association has started a network of solidarity for Ukraine to respond to the needs of people in Ukraine as verbalized by the Ukrainian mental health professionals, but also to the need of surrounding countries where people from Ukraine fled to. As verbalized by the colleagues from Ukraine and surrounding countries, one of the unmet educational needs was the education for first line helpers and volunteers from Ukraine and countries surrounding Ukraine where displaced persons fled to. This resulted in the series of webinars on the topics detected as unmet needs (what is normal response to trauma, how to triage dispaced persons in need of help, how to provide first psychological help, how to approach to children of different ages, how to take care of one-self and what is the role of supervision). The webinars were delivered by experienced clincians, trauma experts and experts with lived experince in the war zones, incliding the ones from Ukraine. These are available freely at the EPA website https://www.europsy.net/resource-page/, in several languages.Disclosure of InterestNone Declared
Organizational features of mental health facilities and adequacy of treatment. Multilevel analysis from the italian region lombardy
Authors: Conflitti C. , Monzio Compagnoni M. , Lora A. , Corrao G. 
Published: August 2023

IntroductionMental healthcare represents a significant issue for the Healthcare System [1]: one of the major causes is the high heterogeneity in the provision of care, due to the differences among the Departments of Mental Health (DMHs).ObjectivesTo identify the predictors of an adequate treatment for patients with severe mental disorders (SMDs), both at an individual and structural level, the latter considering the major features of the Psychiatric Operative Units (POUs), in the Italian region Lombardy.MethodsHealthcare Utilization Databases, collecting data on the services provided to beneficiaries of the National Health Service (NHS), have been used to retrieve data.Patients that during 2015 were resident in Lombardy; suffered from depressive, bipolar or schizophrenic disorder; were in contact with the DMHs, have been identified.Adequateness of treatment has been evaluated according to the Minimally Adequate Treatment (MAT) [2,3]: a combination of psychiatric visits and specific pharmacological treatment, or psychotherapeutic sessions. Having received a MAT has been assessed during a one-year period.Predictive factors have been classified into two hierarchical levels: individual (first) level and structural (second) level. At the first level, clinical and socio-demographics characteristics have been evaluated for each patient. At the second level, the organizational structure of each POU has been examined: the number of patients taken in care, number of community-care facilities, and hours worked by each class of healthcare providers (psychiatrists, nurses, psychologists, psychosocial staff
).A log-binomial model has been used to evaluate the association between the first-level factors and having received a MAT; a multilevel log-binomial model for the second-level factors considered the hierarchical structure of data.Results72115 patients have been identified: 33974 (47.1%), 28407 (39.4%) and 9734 (13.5%) suffering from depressive, schizophrenic or bipolar disorder respectively; 45.4% of them (32773 patients) received a MAT.Compared with patients affected by depression, those with bipolar or schizophrenic disorder show a higher probability of receiving a MAT (+23%, +11% respectively).Patients living alone have a lower probability of receiving a MAT, unlike patients with a higher level of education or employment, underlining the social burden related to SMDs.Organizational features have proven significant: centres with a higher activity volume and with more community-care facilities seem more likely to guarantee MAT. Moreover, the higher the hours worked by psychiatrists, nurses and psychologists, the higher the probability of providing MAT.ConclusionsPatients with SMDs are still untreated in an appropriate way. Results highlight the importance of the community-care facilities, as well as of the composition of the multidisciplinary teams working there.Disclosure of InterestNone Declared
The Contribution of Childhood Adversity and Potentially Traumatic Events During Military Service to PTSD and Complex PTSD Symptoms Among Israeli Women Veterans
Authors: Zerach G. 
Published: August 2023

IntroductionAdverse childhood experiences (ACEs) and exposure to potentially traumatic events (PTEs) during military service are associated with mental health problems. However, knowledge about relative contributions of these factors to non-U.S women combat veterans’ posttraumatic sequalae is sparse.ObjectivesTo examine associations between ACEs, combat exposure, military sexual trauma (MST), potentially morally injurious events (PMIEs), posttraumatic stress disorder (PTSD) and complex PTSD symptoms among women veterans.MethodsA volunteer sample of Israeli women combat veterans (n=885) and non-combat veterans (n=728) responded to self-report questionnaires in a cross-sectional design study.ResultsCombat veterans reported more total average ACEs, were more likely to experience 3 or more ACEs and specific ACEs of physical abuse and emotional neglect, as compared to non-combat veterans. Combat veterans also reported higher levels of combat exposure, PMIEs, higher prevalence of MST and higher levels of PTSD symptoms, but not CPTSD symptoms, as compared to non-combat veterans. Importantly, ACEs, combat exposure, MST-assault and PMIEs of betrayal predicted PTSD symptoms, while only ACEs and PMIEs of betrayal predicted complex PTSD symptoms.ConclusionsThis study emphasized the relatively high exposure to PTEs and PTSD symptoms of women combat veterans as compared to non-combat veterans. Our findings also confirm prior studies demonstrating associations between ACEs, combat exposure, MST and mental health problems. Importantly, we demonstrated the unique contribution of betrayal based PMIEs and the differential associations of PTEs with PTSD and Complex PTSD symptoms among combat veterans.Disclosure of InterestNone Declared
Stress and pain regulation: Parallel processes among traumatized individuals
Authors: Ginzburg K. , Defrin R. 
Published: August 2023

IntroductionThe human reaction to traumatic events is often marked by a dialectic alteration of two emotional states –a state characterized by intrusion, anxiety and hyperarousal, and a state of denial marked by dissociation and numbing. These two seemingly opposite states represent attempts to modulate stress, as gradual reduction of their intensity represents an adaptation to stress. Maladaptive reactions to trauma, however, reflect disrupted regulation capacities, manifested as persistent over-modulation or under-modulation of stress.ObjectivesTo demonstrate that these manifestations of disrupted regulation, as observed among individuals with posttraumatic stress disorder (PTSD) and borderline personality disorder (BPD) are also reflected in patterns of pain modulation.MethodsThree studies using self-report questionnaires and psychophysical tests, assessing sensitivity to pain, as reflected by pain thresholds, and reactivity to suprathreshold noxious stimuli, as implicated in their ratingResultsStudy 1 Included 32 PTSD outpatients, 29 anxiety disorder outpatients, and 20 healthy controls. PTSD patients reported higher rates of chronic pain (83.3%) than anxiety patients (42.0%) and controls (5.0%). PTSD severity correlated with chronic pain severity (r = 0.61, p < 0.01). PTSD patients displayed a unique paradoxical pain profile, according to which their pain thresholds were significantly higher than those of the anxiety patients and controls (p < 0.01), but they perceived suprathreshold stimuli as being much more intense (p < 0.01).Study 2 included 32 PTSD outpatients and 43 healthy controls. Findings replicated the paradoxical pain profile among PTSD patients. Pain thresholds were positively associated with dissociation level (b = 0.49; p < 0.05) and negatively associated with anxiety level (b = -0.63, p < 0.01). Pain ratings were positively associated with anxiety (b = 0.52, p < 0.05) and negatively related to dissociation levels (b = -.51, p < 0.05).Study 3 included 46 women diagnosed with BPD and 47 healthy controls. Women with BPD reported higher levels of childhood trauma (p < 0.05) than the controls. They also demonstrated higher pain thresholds (p < 0.05). Among subjects with high levels of body dissociation, implicated by reduced body awareness, those with BPD demonstrated hyposensitivity to pain, manifested in higher pain thresholds, lower suprathreshold pain ratings, and pain evoked by higher temperature, than the controls. Among those with low levels of body dissociation, BPD subjects demonstrated increased reactivity to pain as manifested in higher pain ratings and pain evoked by lower temperature.ConclusionsThese findings demonstrate the association between over-modulation and under-modulation of stress and over-modulation and under-modulation of pain, respectively, among PTSD and BPD patients. These findings point to parallel processes of disrupted regulation among traumatized individuals.Disclosure of InterestNone Declared
Peripheral Edema associated with Olanzapine: case report
Authors: Jemli H. , Zgueb Y. , Zaibi R. 
Published: August 2023

IntroductionOlanzapine is a second generation antipsychotic. Sedation and weight gain are common treatment side effects. However, other rare side effects such as peripheral edema are yet to be documented.ObjectivesOur study aimed to describe the clinical presentation of edema in a patient taking Olanzapine.MethodsCase reportResultsWe present the case of a 42 male patient hospitalized for a manic episode. He was put on Olanzapine at 10 mg a day. During the hospitalization, the patient exhibited profuse pitting edema on his lower limbs and a rapid weight gain. He presented no other physical sign such as a fever, cutaneous lesions or trouble walking. Thrombophlebitis and erysipelas were eliminated after an extensive physical exam, complete blood work and doppler ultrasound exam of both legs.Olanzapine was discontinued and the patient was prescribed a 4-day course of loop diuretics. Complete resolution of symptoms was noted 5 days later.ConclusionsFurther research regarding the mechanism behind edema in patients taking second generation antipsychotics are needed. We recommend monitoring for edema with initiation and titration of Olanzapine treatment.Disclosure of InterestNone Declared
Current Controversies in Antidepressant Therapy: A Patient-level Perspective
Authors: Hieronymus F. 
Published: August 2023

AbstractThe value of pharmacological antidepressants have been contested since they were first introduced in the 1960s, but the points of contention have varied over time. This session will examine and critically discuss some of the concerns that are commonly voiced today, with particular emphasis on the evaluation of efficacy. The session will cover topics such as the utility of dichotomized outcome measures (e.g., response and remission) and whether the use of these measures risk inflating apparent efficacy, whether antidepressant effect sizes are too small to be clinically meaningful, and whether there is individual variability in the response to pharmacological antidepressants.Disclosure of InterestF. Hieronymus Speakers bureau of: I have received speaker’s fees from Janssen and H Lundbeck.
Access to a psychiatric emergency setting during the COVID-19 pandemic: focus on youth populations
Authors: Masini F. , Caramanico G. , Menculini G. , Latini G. , De Giorgi F. , Amantini K. , Moretti P. , Tortorella A. 
Published: August 2023

IntroductionThe COVID-19 outbreak and the related containment measures led to the emergence of psychological distress in youth populations, possibly due to concern for their families, social isolation, increased time spent on the Internet and social media, and anxiety about the future.ObjectivesThe study aims to evaluate differences in the access of children, adolescents, and young adults to a psychiatric emergency setting before and after the onset of the COVID-19 pandemic.MethodsData concerning the psychiatric consultations carried out at the Emergency Department of the University Hospital of Perugia was collected. Socio-demographic and clinical information, including diagnostic and treatment features, was entered into an electronic database. We considered two different time spans, one before (01.06.2017-31.12.2018) and one after (01.06.2020-31.12.2021) the COVID-19 pandemic outbreak. The characteristics of consultations carried out before and after the pandemic outbreak were compared by means of bivariate analyses (p<0.05).Results2,457 psychiatric consultations were carried out in the index periods. 1,319 (53.7%) were requested before, while 1,138 (46.3%) after the COVID-19 outbreak. As for the latter, these were more frequently requested for female subjects (64.2% vs 54.5%, p=0.0042), while institutionalized people underwent psychiatric consultations less frequently in the post-COVID-19 period (5.6% vs 18.2% p<0.001). A significant difference in the prevalence of anxiety disorders (9.7% post-COVID-19 vs 18.8% pre-COVID-19, p=0.009) and adjustment disorders was found (7.1% vs 1.5%, p=0.009). Substance-related disorders were significantly reduced (8.0% vs 15.8%, p=0.016) after the COVID-19 outbreak. About psychopharmacological treatment, there was an increase in people who had received treatment in the past but were no longer on treatment (52.3% vs 30.8%, p<0.001). The prescription of antipsychotics also increased (29.3% vs 18.5%, p=0.012). At discharge, subjects were more frequently hospitalized in the Psychiatric Inpatient Unit in the post-COVID-19 period (22.2% vs 12.8%, p=0.012).ConclusionsOur data confirms the vulnerability of youth populations during the pandemic. The consequences of health emergencies on the psychological well-being of this population must not be underestimated and tailored treatment strategies should be implemented.Disclosure of InterestNone Declared
Latent profiles for mental health in older people from Concepción, Chile.
Authors: Saldivia S. , Aslan-Parra J. , Bustos C. , Inostroza C. , Cova F. , Castillo A. 
Published: August 2023

IntroductionAging is a demographic global trend and a challenge for public mental health; however, gaps persist for a comprehensive definition of mental health, risk, protective factors, and processes involved, which represent a greater problem in middle-income countries, where evidence is scarce.ObjectivesTo identify combined mental health profiles in older adults, based on self-report of anxiety symptoms, depressive symptoms, and perception of well-being, and to identify risk and protective variables for each of the groups, based on a sample of older adults attending primary health care (PHC) centers in the Province of Concepción, Chile.MethodsA convenience sample of 573 adults of both sexes, over 65 years, autonomous, attending PHC centers in the Province of Concepción, Chile, answered a set of instruments assessing anxiety symptoms (SCL-90), depressive symptoms (PHQ-9) and perception of well-being (Pemberton Happiness Index) and eventually associated variables that included sociodemographic and living arrangements, social participation, threatening life events (LTE), loneliness (ULS-3), and social support (MSPSS). Latent profile mixture analysis was used to identify groups of adults with similar mental health, and pertinence in each group was explained using random forests. The relationship between predictors and latent profiles were analyzed with multinomial regression.ResultsA solution of 4 groups with distinctive mental health profiles was determined: Group 1 (28%) with high depressive symptoms, high anxiety, and low well-being; Group 2 (32%) with moderate depressive symptoms, high anxiety and moderate well-being; Group 3 (24%) with moderate depressive symptoms, low anxiety and moderate well-being and; Group 4 (15%) characterized by individuals with low anxious or depressive symptoms, high well-being, and absence of mental disorder.Using random forests, this model predicts 63% variance between groups. A large number of variables were found to significantly predict membership in one of the 4 groups. Specifically: gender, satisfaction with living arrangement, economic crisis, own disease, and death or illness of friend, perception of general health, intimate, relational and collective loneliness, social support from family and significant others, and social support from friends.ConclusionsThe 4-group classification is a parsimonious solution where group 1 characterize people with poor mental health; groups 2 and 3 languishing with high and low anxiety respectively; and group 4 healthy and flourishing. Overall, these groups highlight the role of close interpersonal relationships or primary ties, both in terms of intimacy versus loneliness/isolation and in satisfaction with living arrangements for the elderly. The importance of these psychosocial predictors on combined mental health in the elderly further the need to understand their role and mechanisms to design promotion and prevention strategies.Disclosure of InterestNone Declared
The effects of the mother’s ADHD on her parenting role
Authors: Moutafi C. 
Published: August 2023

IntroductionAttention Deficit Hyperactivity Disorder (ADHD) is the second most common psychiatric disorder in childhood, affecting 5-7% of the child population. The same disorder in adults is less documented and is estimated at 2.5% of the population. The mothers of children with ADHD are 24 times more likely to develop ADHD than mothers of children without ADHD. About 17% of mothers of children with ADHD meet criteria for the disorder themselves. The core symptoms of ADHD are inattention, hyperactivity and impulsivity.ObjectivesThe objective of this e-poster is to describe the effects of the mother’s ADHD on her parenting roleMethodsThe current poster is based on the bibliographic reviews of papers via the ‘PubMed’ search engines.ResultsIn some studies mothers with ADHD may use ineffective discipline methods in order to limit their children.The mothers with ADHD often have difficulties with executive functions such as planning, organizing and implementing goals and with self-control. Characteristically, in a study with a sample of mothers with children aged 3-6 years were observed difficulties in defining the boundaries of the children, unstable behavior and low self-esteem. Additionally, mothers with ADHD may have difficulty forming and maintaining social relationships and this have a negative effect on children’s social skills. The maternal role is influenced by when the mother suffers from depression, anxiety, uses alcohol or psychotropic substances. In addition, her role is influenced by when there are problems in the marital relationship or she is a single parent. The reactions of the mother with ADHD may be influenced not only by whether she has ADHD but also by whether or not her child has been diagnosed with ADHD. The mother with ADHD and child with ADHD has to deal not only with her own symptoms but also with her child’s symptoms. The coexistence of the specific disorder in both may cause increased levels of stress to the mother. Nevertheless, some research reports that these mothers show empathy towards their children, i.e. they have a more positive and supportive behavior, they are more protective, less irritable and less frustrating (similarity-fit hypothesis). In other studies mothers with ADHD worsen their children’s symptoms with their behavior (similarity-misfit hypothesis). There is a significant correlation between the mother’s ADHD and the child’s emotional, behavioral and social functioning.ConclusionsIn conclusion, mothers with ADHD may experience difficulties in all developmental stages of their children. Therefore, the treatment of the disorder (medication and cognitive-behavioral psychotherapy) is necessary in order to improve the mothers’ symptoms, the mental condition of their children and the family’s quality of life.Disclosure of InterestNone Declared