bluuebunny/crossref_metadata_2025_split huggingface dataset:
Late diagnosis of attention deficit hyperactivity disorder and cocaine abuse
Authors: De Andrés Lobo C. , Vallecillo Adame C. , Jiménez Aparicio T. , Queipo de Llano de la Viuda M. , Guerra Valera G. , Gonzaga Ramírez A. A. , Fernández Lozano M. , Navarro Barriga N. , Mateos Sexmero M. J. , Rodríguez Rodríguez B. , Calvo Valcárcel M. , Andreo Vidal M. , Pando Fernández M. P. , Martínez Gimeno P. , Santos Carrasco I. D. L. M. , Gonçalves Cerejeira J. I. , Rodríguez Campos A. 
Published: August 2023

IntroductionAdult ADHD diagnosis sometimes represents a challenge for the clinician, due to the comorbid psychiatric diseases that are often associated and which complicate de recognition of the primary symptoms of ADHD. The prevalence of ADHD in adult populations is 2’5% and it is a relevant cause of functional impairment.ObjectivesPresentation of a clinical case of a male cocaine user diagnosed with adult ADHD.MethodsLiterature review on adult ADHD and comorbid substance abuse.ResultsA 43-year-old male who consulted in the Emergency Department due to auditory hallucinosis in the context of an increase in his daily cocaine use. There were not delusional symptoms associated and judgment of reality was preserved. Treatment with olanzapine was started and the patient was referred for consultation. In psychiatry consultations, he did not refer sensory-perceptual alterations anymore, nor appeared any signals to suspect so, and he was willing to abandon cocaine use after a few appointments. He expressed some work concerns, highlighting that in recent months, in the context of a greater workload, he had been given several traffic tickets for “distractions.” His wife explained that he had always been a inattentive person (he forgets important dates or appointments) and impulsive, sometimes interrupting conversations. In the Barkley Adult ADHD Rating Scale he scored 32 points.He was diagnosed with adult ADHD and treatment with extended-release methylphenidate was started with good tolerance and evolution, with improvement in adaptation to his job and social environment. Since then, the patient has moderately reduced the consumption of drugs, although he continues to use cocaine very sporadically.ConclusionsEarly detection of ADHD and its comorbidities has the potential to change the course of the disorder and the morbidity that will occur later in adults. Comorbidity in adult ADHD is rather the norm than the exception, and it renders diagnosis more difficult. The most frequent comorbidities are usually mood disorders, substance use disorders, and personality disorders. Treatment of adult ADHD consists mainly of pharmacotherapy supported by behavioral interventions. When ADHD coexists with another disorder, the one that most compromises functionality will be treated first and they can be treated simultaneously. The individual characteristics of each patient must be taken into account to choose the optimal treatment.Disclosure of InterestNone Declared
Psychedelics for depression: from neurobiology to treatment
Authors: Kuypers K. P. 
Published: August 2023

AbstractDecades ago, the classical psychedelics psilocybin and LSD entered the therapeutic setting and already then showed their therapeutic potential in the treatment of psychiatric disorders. For thousands of years another psychedelic, ayahuasca, is being used by tribes in western Amazonia for healing and divination, and in recent years its use has expanded worldwide.Research into the therapeutic potential of these substances has re-emerged and (preliminary) findings are promising, showing that after one or two administrations remission is reached in depressed patients that were labeled as treatment-resistant. This is a remarkable finding as the therapeutic effects of treatment with conventional pharmacological agents like SSRIs take longer to lead to remission, with one-third of the patients failing to reach this stage.The fast onset of positive therapeutic effects by psychedelics increases the interest to discover the mechanism of action behind this. There is a debate about the importance of the psychological experience caused by these agents in the therapeutic outcome, while science also tries to understand the neurobiological correlates. The latter will be addressed in my talk and I will link it to psychedelics’ therapeutic effects.Disclosure of InterestNone Declared
Use of a Two-Eyed Seeing Approach to Increase Client Satisfaction with Psychiatric Services Among an Indigenous Population
Authors: Mehl-Madrona L. , Mainguy B. 
Published: August 2023

IntroductionPsychiatry has historically had difficult relationships with Indigenous people, tending to dismiss their views on mental health and illness as superstitious or primitive. Indigenous people have responded by refusing to come for services, missing appointments, and dismissing treatment offered. Canadian Mi’qmak elder Albert Marshall introduced the term,
etuaptmumk, to highlight the idea that Indigenous Knowledge and Practice has equal value to contemporary psychiatry. While translated as two-eyed seeing, the term refers to explanatory pluralism and invites a respectful dialogue among cultures as equals.ObjectivesWe implemented a two-eyed seeing research in Indigenous communities to explore the differences of some Indigenous North American cultures in their view of mind and mental health from conventional Euro-American psychiatry and how their cultural practitioners negotiated those differences. We wondered how perception of services would change if mental health practitioners were aware and were more respectful of those differences.MethodsWe engaged in a series of discussions with traditional knowledge keepers about their views on mind and mental health. We used constructivist grounded theory methods to identify what was common among these views. We developed a training program to engage mental health clinicians in understanding and responding to these differences. We engaged community members receiving services in a discussion about their perception in the change in the quality of the services. We summarized their responses.ResultsDifferences between Indigenous views and those of conventional psychiatry included (1) greater emphasis on the role of community and socio-environmental influences on mental health, (2) inclusion of spirituality and spiritual beings in their expectation for cause of problems and treatment, (3) greater emphasis on inter-generational trauma and historical trauma in addressing mental health. After inclusion of practitioners in the mental health services who had been oriented to these differences and integration of ceremony into the mental health services, ninety-four percent of respondents asked if the service had improved responded in the positive. Attendance at scheduled appointments increased from 56% to 81%. Adherence to recommendations increased from 27% to 67%, which were significant.ConclusionsAwareness of cultural differences in beliefs about causes of mental illness and acceptable types of treatment increased client satisfaction with services offered, improved attendance rates, and improved adherence rates to treatments offered among Indigenous people. These results could generalize to other populations who hold different views than those of conventional psychiatry. The concept of two-eyed seeing, or explanatory pluralism, holds heuristic value for psychiatry by allowing multiple points of view to be true at the same time.Disclosure of InterestNone Declared
The impact of lifestyle on adherence to treatment in a sample of patients with Major Depression
Authors: Conti D. , Girone N. , Vanzetto S. , Cocchi M. , Achilli F. , Leo S. , Bosi M. , Benatti B. , Dell’Osso B. 
Published: August 2023

IntroductionPoor adherence to treatment is currently stated to be one of the causes of depression relapse and recurrence.ObjectivesAim of the present study was to assess potential differences in terms of clinical and socio-demographic characteristics specifically related to adherence to treatment features, medical comorbidities, and substance abuse in a sample of patients diagnosed with Major Depression in an Italian psychiatric department.MethodsPatients with a DSM-5 diagnosis of Unipolar or Bipolar Major Depressive Episode, of either gender or any age were recruited from the Psychiatry Department of Luigi Sacco University Hospital in Milan. Main clinical and socio-demographic variables were collected reviewing patients’ medical records. Moreover, adherence to psychopharmacological treatment was assessed using the Clinician Rating Scale (CRS; Kemp et al, 1996; 1998). Adherence was defined as ratings of > or =5 on the CRS. Descriptive and association analyzes were performed, setting the significance level at p<.05.Results80 patients with a diagnosis of Unipolar Major depressive episode (48.9%) and Bipolar Major Depressive Episode (51.1%) were included. For the purposes of the study, the total sample was divided into two subgroups based on adherence to pharmacological treatment (A+ vs A-). Significantly higher rates of inpatients from psychiatric ward were A- compared to A+ patients (84.6% vs 48.1%, p=.011). A- patients were significantly more unemployed (57.9% vs 23.8%, p=.015), were mostly living in their family of origin (50% vs 21.4%, p=.027), and had fewer years of education compared to A+ subgroup (10.52±3.28 vs 12.2±3.1 years, p=.053). Higher rates of Bipolar Depression diagnosis and a prevalent manic polarity lifetime emerged in A- compared to the A+ group (73.1% vs 42.3%, p=.010; 30.8% vs 3%, p=.011, respectively). Moreover, A+ reported significantly higher rates of depressive prevalent polarity lifetime (72.7% vs 30.8%, p=.011). A- reported significantly higher rates of comorbidity with alcohol or other substance use disorders lifetime (46.2% vs 5.7%, p=.006) and almost one involuntary commitment lifetime (23.1% vs 11.1%, p=.013).ConclusionsIn our sample adherence to treatments showed significant differences in terms of clinical and socio-demographic characteristics. Low levels of adherence have been associated with higher hospitalization rates, involuntary commitments, greater comorbidity with alcohol or drugs. Our data therefore seem to suggest that less adherence leads to a worse disease course and a worse quality of life. It therefore appears useful to include an assessment of adherence in the clinical practice and implement interventions to improve therapeutic adherence and ensure a better quality of life.Disclosure of InterestNone Declared
The role of miRNA in diagnosing and clarifying the pathomechanisms in major depressive disorder
Authors: Ho C. S. , Soh M. W. , Tay G. 
Published: August 2023

IntroductionThere are currently no diagnostic or treatment-guiding biomarkers for major depressive disorder (MDD). Microribonucleic acids (miRNA) may facilitate understanding the reorganisation of gene expression networks in MDD. Identifying miRNA and target mRNA pathways that contribute to MDD may open new therapeutic avenues, such as inhibiting endogenous miRNA or administering exogenous miRNA.ObjectivesThis study investigates how miRNAs can clarify the molecular mechanisms of MDD by comparing the miRNA levels in the blood serum of patients with MDD and healthy individuals. The study also investigates the discriminative ability of miRNAs to distinguish between depressed patients and healthy controls.MethodsSixty depressed patients were matched with 60 healthy controls based on age, gender, ethnicity, and years of education. The severity of depression was measured using the Hamilton Depression Rating Scale, and venous blood was collected for miRNA profiling. Using the QIAGEN Ingenuity Pathway Analysis, networks were constructed to identify the biological pathways associated with MDD influenced by the differentially expressed miRNAs. Analyses of the receiver operating characteristic (ROC) were performed to examine the capacity of miRNAs to distinguish between depressed and healthy individuals.ResultsSix miRNAs (miR-542-3p, miR-181b-3p, miR190a-5p, miR-33a-3p, miR-3690, and miR-6895-3p) were significantly down-regulated in untreated depressed patients compared to healthy controls. miR-542-3p has experimentally validated mRNA targets predicted to be associated with MDD. ROC analyses determined that a panel containing miR-542-3p, miR181b-3p, and miR-3690 distinguished between depressed and healthy individuals with an area under the curve value of 0.67.ConclusionsSpecific miRNAs, including miR-542-3p, miR181b-3p, and miR-3690, may be biomarkers with targets implicated in the pathophysiology of depression. They could also be used to distinguish accurately between depressed and healthy individuals.Disclosure of InterestNone Declared
Organic affective disorder due to meningioma, case report
Authors: Garcia-Moreno M. , de Cós Milas A. , Beatobe Carreño L. , del Sol Calderón P. , Izquierdo de la Puente Á. 
Published: August 2023

IntroductionBrain tumors can be associated with psychiatric symptoms in up to 50% of cases. The most frequent primary is meningioma and the clinic will depend on its location. Since surgical treatment does not always guarantee complete resolution of the condition, concomitant psychopharmacological treatment is usually recommended.ObjectivesTo review about organic mania and its differential diagnosis.MethodsWe carry out a literature review about organic affective disorder accompanied by a clinical description of one patient with organic mania.ResultsA 50-year-old woman admitted due to psychotic symptoms. She had a diagnosis of frontal and parietal meningioma treated with surgical treatment 10 years ago. In this context she had a diagnosis of Organic Affective Disorder and 3 previous psychiatric admissions due to affective or psychotic symptoms. Current episode consisted in dysphoria, magalomanic ideation, delusional ideation of harm and mystical-religious content, high speech pressure and insomnia with little awareness of the disease. Cranial magnetic resonance showed postoperative right frontal changes and stability in parietal meningioma, with no significant differences compared to the previous study. Diagnosis of Organic Affective Disorder is maintained and reintroduced treatment with aripiprazole withdrawaled by the patient weeks before. Because of adverse effects and persistence of the symptoms described, it was changed to olanzapine with good response and tolerability. The behavior was progressively adapted with improvement of the dysphoria and without psychotic symptoms at discharge.ConclusionsAffective symptons due to organic disorders such as brain tumors can be treated surgically and with psychopharmacological treatment.Disclosure of InterestNone Declared
Comparison of Machine Learning Algorithms For Beck Depression Inventory Measured Depression Status Classification
Authors: Ballı M. , Okan A. , Gürsan N. Ö. , Gülgöz S. , Yapici Eser H. 
Published: August 2023

IntroductionDepression is a psychiatric disorder characterized by low mood and anhedonia. The diagnosis of depression and the initiation of treatment is important for improving quality of life and avoiding disability. Machine learning (ML), can be used for solving classification and regression problems.In this study, scores of multiple psychiatric scales were used to detect depression and different ML algorithms were used to study if they can help for diagnosing depression accurately.ObjectivesThe purpose of the study is to detect with high accuracy whether people are depressed or not by using widely used ML algorithms. It is also aimed to compare the algorithms used to predict depression with each other.MethodsData were collected from 96 university students. Beck Depression Inventory (BDI), Beck Anxiety Inventory, Neo Personality Inventory, Chronic Stress Scale (CSS), Perceived Stress Scale (PSS), Childhood Trauma Questionnaire, Post-Traumatic Stress Disorder Checklist (PTSD), SHAPS, Relationship Scales Questionnaire and Dissociative Events Scale were applied. 14 points from the BDI was accepted as the cut-off value as depressed. Total scores of each scale was used as the dependent variable in the Xgboost (XGB) to classify the depression. By XGB, the most important 4 of these surveys and scales were selected to use in the Non-Linear (NL) models such as XGB, Decision Trees (DT), Support Vector Machines (SVM), K-Nearest Neighbor (KNN). Lastly, a linear model as a Logistic Regression (LR) model was also used to compare with the NL algorithms. The success of the models was measured with the Cross Validation method, which is the gold standard in ML.ResultsIn the model in which all measurements are used as Independent Variables (IV), the XGB highlighted 4 scale scores: these are CSS, PSS, SHAPS and PTSD. All scale scores were used as IV, both XGB and DT classified depression with a success of 87.5%, while this score increased to 89.6% in both models when 4 prominent scales’ scores were used as IV. In the KNN, the classification made with prominent scales increased the success from 83% to 86%. The variance explanation rate of the LR model using 4 prominent scales remained at 58%.ConclusionsWith ML’s ability to solve NL relationships and dimensional reduction ability, models in which a large number of variables are input and there is no high correlation between dependent variables and IV can be classified with high success. Also, the success of the models was increased by choosing the most importants of the many IV and the variables that contributed negatively to the model could be excluded. The use of ML can yield promising results in fields such as psychiatry where linear relationships cannot be observed much.Disclosure of InterestNone Declared
Childhood maltreatment is associated with cortical thinning in people with eating disorders
Authors: Battipaglia M. , Attianese N. , Donato S. , Ceres R. , Cascino G. 
Published: August 2023

IntroductionChildhood maltreatment (CM) is recognized as non-specific risk factor for the onset of various psychiatric disorders and is associated with a greater severity in their clinical presentation and poorer treatment outcome. These data suggest that maltreated people with eating disorders (ED) may be biologically other than clinically different from non-maltreated people.Objectives
Aim of the present study was to investigate cortical thickness (CT), a possible biomarker of neurodevelopment, in people with ED with or without history of CM and in healthy women.MethodsStudy participation was proposed to patients consecutively admitted to the adult ED outpatient centre of the University of Salerno. Twenty-four healthy women, 26 with anorexia nervosa (AN) and 24 with bulimia nervosa (BN) underwent a 3T MRI scan. All the participants completed the short form of the Childhood Trauma Questionnaire (CTQ). All neuroimaging data were processed by FreeSurfer. Maps of CT were computed in order to perform a vertex-by-vertex analysis. CT maps underwent a general linear model analysis to evaluate differences among groups. Age and body mass index (BMI) were included as nuisance covariates.Results
Based on CTQ cut-off scores, 12 participants with AN and 12 with BN were identified as maltreated and 14 participants with AN and 12 with BN as non-maltreatment. All healthy women were “non-maltreated”. Therefore, participants were split in 3 groups: 26 maltreated participants with ED, 24 non-maltreatment participants with ED and healthy control (HC). Compared to HC, maltreated people with ED showed lower CT values in the left rostral anterior cingulate gyrus, while compared to non-maltreatment people with ED showed lower CT values in the left superior frontal, in right caudal middle frontal and in right superior parietal gyri. No significant differences emerged in CT measures between HC and non-maltreatment people with ED.ConclusionsPresent findings show for the first time that in adult people with ED childhood maltreatment is associated with cortical thinning in areas implicated in the modulation of brain processes that are acknowledged to play a role in the psychopathology of ED.Disclosure of InterestNone Declared
Are clinical severity and real-world functioning associated to committing crimes in people with severe mental illness? Results from a cross-sectional study on three cohorts of forensic and non-forensic patients
Authors: Calzavara Pinton I. , Stanga V. , Di Noto M. , Butti Lemmi Gigli E. , Cerati C. , Savorelli A. , Necchini N. , Nibbio G. , Deste G. , Barlati S. , Turrina C. , Vita A. 
Published: August 2023

IntroductionIn Italy, subjects with severe mental illness (SMI) considered “in danger of posing a threat to others” are hospitalized into structures known as “REMS–Residenze per l’Esecuzione delle Misure di Sicurezza”, designed to provide rehabilitating programs. There are also specialized forensic teams to support Community Mental Health Centers (CMHC) in helping patients who committed crimes. A better characterization of clinical and real-world functioning of forensic patients represents a topic of clinical interest (Caruso R et al. Curr Psychiatry Rep 2021; 7 29; Barlati et al. Eur Arch Psychiatry Clin Neurosci 2022, in press; Fazel et al. Br J Psychiatry. 213 609-614).ObjectivesAims were to compare clinical and psychosocial functioning characteristics in three cohorts of SMI patients.MethodsA total of 29 patients hospitalized in REMS facilities were included into this study; starting from this first group an equal number of individuals matched for sex, age, and diagnosis were included in other two groups of outpatients cared for by the forensic team and of non-forensic outpatients treated by CMHC. Clinical severity was measured through the Clinical Global Impression scale – Severity (CGI-S) and real-world functioning was measured through the Personal and Social Performance scale (PSP). Analyses included Chi-Square test for categorical variables and Kruskall-Wallis test for continuous variables with Mann-Withney U test for post/hoc comparisons. P values < 0.05 were considered significant.ResultsSignificant between-groups differences emerged regarding psychosocial functioning (p=0.013): that was more compromised in the REMS group (mean:34.0) when compared to the forensic team subjects (mean:41.3) and to the subjects in the CMHC group (mean:47.7).Results concerning clinical severity point in the opposite direction: more severe symptoms were observed in the CMHC group (mean:4.7) compared to the REMS group (mean: 4.3) and the forensic outpatients (mean:3.5). The difference in the CGI-S mean scores is significant for the forensic outpatients when compared to the REMS group (p=0.011) and to the CMHC group (p<0.001).ConclusionsSpecialized teams are central in the managing of forensic patients: of particular interest are the data regarding clinical symptoms severity, which could also be read with a de-stigmatizing focus, highlighting that a worse clinical severity is not associated with being more dangerous to other people and to the society in general.Disclosure of InterestNone Declared