bluuebunny/crossref_metadata_2025_split huggingface dataset:
N-acetylcysteine (NAC) and in psychodermatological conditions. Is it useful?
Authors: Jimenez A. , Gutiérrez T. , Rivera Ruiz I. , Montes L. , Reyes López M. 
Published: August 2023

IntroductionPathologic grooming disorders can lead to clinically significant distress and functional impairment. Various psychopharmacological and nonpharmacological treatments have been used to ameliorate the symptoms of these disorders. N-Acetylcysteine (NAC) is a newer modality in the treatment of these disorders and has shown promise in treatment of obsessive-compulsive and related disorders.ObjectivesTo determine whether NAC is useful in the treatment of body-focused repetitive behavior disorders.MethodsA literature review was carried out in PubMed using the descriptors: “body-focused repetitive behaviour disorders” “grooming disorders” AND “N-Acetylcysteine”.Six results were obtained when using the time limit of 5 years. We selected two of them for their relevance to the PICO question. Subsequently, the search was repeated using the same descriptors and the time limit in the Cochrane Library, Epistemokinos and Tripdatabase, in which no additional results were found.ResultsOverall, thirty-three articles were included in these systematic reviews that we studied, which consisted of 23 case reports, one case series, and seven randomized controlled trials. Dosing of oral NAC ranged from 450 to 3,000 mg per day, and treatment periods lasted from 1 to 8 months. Side effects were uncommon, mild, and usually gastrointestinal in nature, with severe aggression reported in one child. Two randomized controlled trials showed a significant improvement in trichotillomania and excoriation disorder in adults. The other two were performed in pediatric population, showing no statistical difference. Two randomized controlled trials and six case reports studying the effects of NAC in patients suffering from trichotillomania (one performed in adults and the other one in infants) were included. Only the one performed in adults showed improvement when adding NAC to the treatment using the Massachusetts General Hospital, Hairpulling Scale (MGH-HPS). Four case reports and two randomized controlled trials included patients with excoriation disorder showed statistical differences in all of them. Three case reports and one randomized controlled trial in patients with onicotylomania showed a difference that wasn’t consistent after two months of treatment.ConclusionsThere are multiple case reports an several clinical trials supporting both the safety and efficacy of NAC in the treatment of body-focused repetitive behavior disorders. Based on these positive preliminary results and the absence of serious adverse effects, carrying out a therapeutical trial with NAC is a plausible option in the management of this pathology, especially in those in which other therapeutic options have not been effective. Further studies are needed to develop a treatment algorithm and elucidate the difference in the efficacy of NAC between children and adults with this disorder.Disclosure of InterestNone Declared
Relationship between Glycated Hemoglobin (HbA1c) in Adolescents with Type 1 Diabetes Mellitus (T1DM) and Parental Anxiety and Depression
Authors: Silina E. , Taube M. , Zolovs M. 
Published: August 2023

IntroductionT1D is the most common chronic endocrine pathology in children. The management of type 1 diabetes requires strong diet, physical activity, lifelong insulin therapy, and proper self-monitoring of blood glucose and is usually complicated and, therefore may result in a psychosocial problem for the whole family. Metabolic control of the disease is determined by glycated haemoglobin (HbA1c), the main criterion for diabetes compensation. It is assumed that anxiety and depression symptoms negatively affect glycemic control. A correlation was observed between anxiety and depression level and glycaemic control, as well as a three-way interaction among HbA1c, frequency of blood glucose monitoring, and diabetes-related stress (Buchberger et al., 2016). Parental psychological distress was associated with higher child self-report of stress and depressive symptoms, and it had negative effects on diabetes management.ObjectivesTo evaluate the relationship between parental depression and anxiety and metabolic control of their adolescents with T1DM.MethodsThe cross-sectional study recruited adolescents with T1D (N=251) and their parents (N=251). The 7-item Generalized Anxiety Disorder (GAD-7) scale measured anxiety level. The Patient Health Questionnaire – 9 (PHQ-9) detected depressive symptoms. Glycaemic control of patients was assessed using the last glycated haemoglobin (HbA1c) values. GLM mediation analysis was performed to determine the potential mediating effect of parent’ mental health depression and anxiety on the relationship between depression and anxiety of child on the level of HbA1c.Results502 respondents were eligible for screening. Mediation analysis was performed to assess the mediating role of parent GAD-7 on the linkage between HbA1c and child GAD-7 and child PHQ-9. the results relevated that the total effect of child GAD-7 on HbA1c was significant but the total effect of child PHQ-9 was not significant. With the inclusion of the mediating variable (parent GAD-7) (Figure 1), the impact of child GAD-7 and child PHQ-9 was founding insignificant (p ≥ 0.05) but the indirect effect of child GAD-7 and child PHQ-9 on HbA1c though parent GAD-7 was found significant (p ≤ 0,01) (Table 1). This indicates that the relationship between HbA1c and child GAD-7 and PHQ-9 is fully mediated by parent GAD-7.Image:Image 2:ConclusionsGlycated haemoglobin in adolescents with Type 1 diabetes is related to adolescents’ mental health via parents’ anxiety. It means that parents’ anxiety plays more significant role in the level of glycated haemoglobin in adolescents than depression and anxiety of the adolescent.Disclosure of InterestNone Declared
Insecure adult attachment styles are associated with parental reflective functioning pre-mentalizing modes
Authors: Erkoreka L. , Urrutia G. 
Published: August 2023

IntroductionParental Reflective Functioning (PRF) refers to parents’ capacity to view their child’s and their own behavior considering inner mental states, like thoughts, desires, and intentions. It has been related to attachment, mentalizing capacities, and psychopathology in children. An association between adult attachment style and reflective functioning has been described. Studies have also suggested that parental insecure attachment is related to lower levels of PRF.ObjectivesWe aim to study the association between specific adult attachment styles (anxious [Anx] and/or avoidant [Av]) and specific PRF modes (pre-mentalizing [PM], certainty about mental states [CMS] and/or interest and curiosity [IC]).MethodsA sample of 238 parents (228 mothers and 34 fathers) of 263 children aged 0 to 5 years old were recruited through informal difussion of the study in social media. These parents completed the Experiences in Close Relationships-Revised (ECR-R) and the Parental Reflective Functioning Questionnaire-18 (PRFQ-18) online. Sex and age of parents and children were also gathered. In the first place, Pearson’s correlation was conducted to study the association between the ECR-R and the PRFQ-18 subscales. In a second step, general linear models were used to control for the effect of sex and/or age, when necessary.ResultsMothers’ mean age was 35,59±4,55 and fathers’ 38,26±4,47. Among children, a total of 119 were girls (45,2%) and 140 (53,2%) boys; in 4 (1,5%) cases the sex was not specified. The association between attachment and PRF subscales is shown in Table 1.
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78Parent age-Parent sex-0,196**-Child age0,273**0,054-Child sex0,0620,0140,041-PRFQ PM0,120-0,0590,072-0,001-PRFQ CMS-0,1090,135*0,137*0,015-0,256**-PRFQ IC-0,0990,163**0,121-0,069-0,0720,078-ECR-R
Anx0,115-0,138*-0,0270,0060,410**-0,232**-0,035-ECR-R Av0,137*-0,0490,007-0,0910,186**-0,049-0,1030,279****p<.001,*p<.05
In a second step, the influence of Anx attachment on CMS was controlled for parents’ sex and children’s age; β-value of Anx was -0,288 (p<.000) and the whole model explained 70% of the variability of CMS.ConclusionsWe observed that Anx attachment is associated with lower CMS and greater PM. With regard to CMS, both high and low extreme scores have been proposed to be less adaptative than average scores. Av attachment has also been related to higher PM scores. PM mode, which involves “an inability to hold the child’s mental states in mind and/or to have malevolent attributions about the child’s behavior”, is indicative of pathological PRF, and seems to be associated with insecure attachment (↑Anx/Av). Our results are in line with previous works (San Cristobal et al. Front. Psychol. 2017; Luyten et al. PLOS ONE 2017), and suggest that PRF could play a role in the intergenerational transmission of attachment, which should be further investigated.Disclosure of InterestNone Declared
One year later: mental health among employees in long-term care of the elderly after COVID-19 in Italy
Authors: Gesi C. , Grossi C. , Consorti E. , Vercesi E. , Cerveri G. 
Published: August 2023

IntroductionThe COVID-19 emergency have imposed a great burden on the Italian health and social health system. In this context, healthcare workers (HCWs) have been exposed to high levels of stress. While many studies addressed the consequences of COVID-19 on hospital workers, little interest has been devoted to the employees of nursing homes.ObjectivesTo evaluate levels of depressive, anxious and post-traumatic symptoms in a population of nursing homes workers in Italy one year after the begin of the pandemic.MethodsThe research involved 177 nursing homes, to evaluate the Mental Health outcome of the COVID-19 pandemic 12 months after the first lockdown on a large sample of workers. Participants answered a self-assessment tools aimed to assess the level of trauma experienced, the level of anxiety and depression, the quality of professional life and social and work adjustment.ResultsA consistent level of psychological suffering in the HCWs 12 months after the first lock-down and after the third wave of Covid-19 is highlighted, in accordance with what has been observed in similar research. It turns out that about 30% of subjects, more often women, have elements suggestive of symptoms related to PTSD, with moderate levels of anxiety. On the other hand, 15% of the sample presents moderate levels of depressive symptoms and a severe impact on social and occupational functioning. Of these about 40% of staff has significant interference and just over 15% has a severe impact (see figure 1).Image:ConclusionsInterventions tailored to support mental health are needed not only for HCWs from hospital units but also for those working in nursing homes and long-term care units.Disclosure of InterestNone Declared
Mental health and COVID-19 in university students: a qualitative study comparing Italy and the UK
Authors: Riboldi I. , Capogrosso C. A. , Piacenti S. , Calabrese A. , Lucini Paioni S. , Bartoli F. , Armes J. , Crocamo C. , Taylor C. , Carrà G. 
Published: August 2023

IntroductionThe worldwide spread of the COVID-19 pandemic affected all major sectors, including higher education. The measures to contain this deadly disease led to the closure of universities across the globe, introducing several changes in students’ academic and social experience. During the last two years, self-isolation together with the difficulties linked to online teaching and learning, have amplified psychological burden and mental health vulnerability of students.ObjectivesWe aimed to explore in depth students’ feelings and perspectives regarding the impact of the COVID-19 on their mental health and to compare these data among students from Italy and the UK.MethodsData were resulting from the qualitative arm of “the CAMPUS study”, a large ongoing project to longitudinally assess the mental health of university students enrolled at the University of Milano-Bicocca (Unimib, Italy) and the University of Surrey (UoS, Guildford, UK). We conducted in-depth interviews through the Microsoft Teams online platform between September 2021 and April 2022, and thematically analysed the transcripts.ResultsA total of 33 students (15 for Unimib and 18 for UoS), with a wide range of sociodemographic characteristics, were interviewed. Four themes were identified: i) impact of COVID-19 on students’ mental health; ii) causes of poor mental health; iii) most vulnerable subgroups; vi) coping strategies.Anxiety symptoms, social anxiety, and stress were frequently reported as negative effects of the pandemic, while the main sources of poor mental health were identified in loneliness, exceeding time online, unhealthy management of space and time, bad organization/communication with university, low motivation and uncertainty about the future. Freshers, international or off-campus students, as well as both extremely extroverted and introverted subjects, represented the most vulnerable populations, because of their extensive exposure to loneliness. Among coping strategies, the opportunity to take time for yourself, family support, and mental health support were common in the sample.Some differences were found comparing students from Italy and the UK. While at Unimib the impact of COVID-19 on mental health was mainly described in relation to academic worries and the inadequate organization of the university system, UoS students, familiar to the conviviality of campus life, explained these effects as a result of the drastic loss of social connectedness.ConclusionsThe current study highlights the key role of mental health support for university students, mainly during crisis times, and calls for measures to improve communication between students and the educational institution, as well as to encourage social connectedness.Disclosure of InterestNone Declared
Comparison of mental health presentations of 16–25-year-olds to the Emergency Department during the COVID-19 pandemic.
Authors: Mohan C. , Conaty O. , Moughty A. , Doherty A. , Barrett E. , Clarke A. M. 
Published: August 2023

IntroductionStudies reported an initial decrease in the number of presentations and incidence of self-harm in young people during the pandemic. As the pandemic progressed young people may have experienced increased levels of distress, contributing to worsened mental health. There is a need for mental health services to evaluate the presentations of young people presenting to the Emergency Department (ED) so that services can meet the needs of young people.ObjectivesTo examine the mental health presentations of young people (aged 16-25) to the ED and how this may have changed since the start of the pandemic.MethodsThis study reviewed all 16–25-year-olds presenting to the Mater Misericordiae University Hospital (MMUH) who were triaged with a mental health issue in a 2 month period (September-October) over three years – 2019 (Period A), 2020 (Period B), 2021 (Period C). Approval for this service evaluation was granted by the Clinical Audit and Effectiveness Committee at the MMUH.ResultsOf 232 presentations across all periods, there was no significant difference in the number of presentations in each study period - Period A (n=76), Period B (n=79) and Period C (n=77). In all three periods, most presentations occurred out of hours (A: 57.9% [n=44]; B: 74.7% [n=59]; C: 68.8% [n=53]) statistically significant (p=0.034) from before (A) to during the pandemic (B and C). Out of hours arrival by ambulance was most common in in Periods A and B (45.5% and 55.9%). Over all three periods discharge home was the most frequent outcome of assessment (A: 69.7% [n=53]; B: 70.9% [n=56]; C: 76.6% [n=59]). Overall, there was a decrease in self-harm presentations over the period (A: 47.4% [n=36]; B: 41.8% [n=33]; C: 40.3% [n=31]). The percentage of presentations with self-laceration increased during the pandemic (A: 33.3% [n=12]; B: 39.4% [n=13]; C: 48.4% [n=15]). There was a significant increase in attendees who were already taking psychotropic medications (p<0.001).ConclusionsThe findings suggest that the majority of 16–25-year-olds present out of hours and do not require admission. Although the number of presentations remained similar, the increase in out of hours presentations and arrivals by ambulance in Period B may reflect increased distress in the initial stages of the pandemic, and restricted access to services. The higher rates of medication prescribing suggests that these young people are already receiving health care, but that their needs are not being fully met. Mental health services should be designed to provide access to mental health care out of hours when young people are most likely to require them.Disclosure of InterestNone Declared
Dynamic of Covid-19 representations: time, cultural and social factors
Authors: Semenova E. R. , Mitina O. , Pervichko E. , Konyukhovskaya J. , Stepanova O. 
Published: August 2023

IntroductionWe have already noted in our studies (Pervichko et. al., 2020, 2021) that collective representations about Covid-19 disease, based on its totality, the catholicity of its impact on all spheres of people’s lives, are socially and culturally conditioned: they have their own specifics in different countries, associated with many social, economic, political factors. Moreover, these perceptions change over time.ObjectivesTo identify the differences in the Covid-19 representations in residents of different countries and at different stages of the pandemic.MethodsModified questionnaire of the internal picture of the disease (Broadbent, 2006), consisting of 8 questions about COVID-19 pandemic. All the items were rated using a 0-to-10 response scale. 1-5 items assess cognitive illness representations. Items 6 and 8 assess emotional representations. Item 7 assesses illness comprehensibility.ResultsTo test of the research hypothesis, we used the data accumulated on our platform since April 2020. We selected subsamples: Russian respondents who took the survey in April-May 2020 (1st wave) (1), June-September 2020 (decline) (2), October - December 2020 (3) (2nd wave), 1st half of 2021 (4). At the same time as sample 4, respondents from Azerbaijan (5) and Uzbekistan (6) were surveyed. Finally, there was another sample of Uzbekistan respondents surveyed in the 1st half of 2022 (7). Respondents of both sexes and different ages participated in each sample, with a total of 2908 people. The table 1 shows the sample means for all items in all samples.In all seven samples, women are characterized by responses indicating their greater tension, stress, and psychological fatigue caused by life in a pandemic. In almost all samples, younger respondents demonstrate greater involvement in the disease and its experiences. Perhaps this is due to the fact that social restrictions affected young respondents to a greater extent.It was shown that with each new wave, the indicators for the 2, 5, 8 grow, and 3, 4, 7 decreases. At the same time, since no one canceled the pandemic, this year, along with a decrease in indicators for all items corresponding to stress and anxiety, ideas about the possible duration of the pandemic are growing.Image:ConclusionsWe can say that people have adapted to coexist with this disease and are ready for its continued presence in the world. The average indicators of Azerbaijani respondents indicate a more tense attitude towards the pandemic compared to Russia and Uzbekistan. It can be assumed that this is due to longer and more extensive state anti-epidemiological measures in Azerbaijan.Disclosure of InterestNone Declared
Open-label: the clinical effects of adding cannbidiol to usual care of patients with residual symptoms in the diagnosis of Obsessive Compulsive Disorder
Authors: De Morais E. R. , Zuardi A. W. Z. P. W. , Guimarães F. S. , Osório F. L. , Hallak J. E. , Sanches R. F. , Crippa J. A. S. 
Published: August 2023

IntroductionObsessive-compulsive disorder (OCD) is a heterogeneous and debilitating neuropsychiatric disorder. First-line antidepressants with Selective Serotonin Reuptake Inhibitors (SSRIs) and Clomipramine (a tricyclic antidepressant) are unresponsive or partially responsive in 40% of treated patients. Preclinical studies have shown that cannabidiol (CBD) can reduce compulsive behavior in animals, and considering that the release of glutamate in the action of CBD can inhibit terminal axons of neurons in the corticostriatal-thalamo-cortical circuit, we chosefor testing CBD, a drug with few side effects and low toxicity, as an adjuvant in treating OCD.ObjectivesTo evaluate the clinical effects of CBD add-on to the usual pharmacological treatment of outpatients diagnosed with OCD.MethodsMethods: This is an open-label study in which patients received CBD 300mg-day for 30 days in addition to their usual treatments and CBD 600mg-day for an additional 30 days if they have not reduced at least 25% of symptoms compared to the baseline evaluated by the Yale-brown obsessive-compulsive scale (Y-BOCS). Psychometric scales were used to assess the effects of CBD: Y-BOCS, General Anxiety Disorder 7 (GAD-7), Clinical Overall Impressions-Severity (CGI-S), Clinical Global Impressions-Improvement (CGI-I), Patient Health Questionnaire-9 (PHQ-9), Epworth Sleepiness Scale and Udvalg Scale for Kliniske Undersogelser (UKU) scale.Participants: We initially assessed 33 participants in the study. So far, 19 patients have completed the study. Eleven did not complete the study, and 03 patients are still in the study trial.ResultsMean (SD) Y-BOCS scores decreased from 28.0 (4.8) at baseline to 13.8 (8.6) at week 8, corresponding to a - 50.7% reduction (P<.0001). Anxiety symptoms (GAD-7 scale) (P=0.001) and CGI-Severity scales scores (P<0.001) improved significantly.MeasureBaseline, Mean (SD)Week 4, Mean (SD)Week 8, Mean (SD)Mean Change
(Baseline to Week 4)Mean Change
(Baseline to Week 8)Mean (SD)p-valuet-testY-Bocks28.0 (4.8)17.8 (7.3)13.8 (8.6)10.1 (6.5)<0,0017.114.1 (7.9)<0,0017.7GAD-713.8 (4.4)8.14 (4.9)8.0 (5.7)5.7 (6.4)0,0014.05.6 (5.8)0,0014.1CGI-I5.48 (0.9)3.9 (1.3)3.3 (1.5)1.5 (1.3)<0,0015.282.1 (1.2)<0,0017.4an=22;bn=19Image:Image 2:Image 3:ConclusionsWe concluded that there was an important reduction in the psychometric scales used with statistical significance. This is a partial analysis of the results as the study progresses. We believe that in the future we will be able to complete this study and have a better analysis of the results that are promising. At the end of the study, other psychometric scales such as CGI-I, epworth scale and UKU will be analyzed.Disclosure of InterestNone Declared