bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in psychiatric admissions to psychiatric wards due to COVID-19
Authors: Martin-Santiago O. , Vallecillo-Adame M. C. , Jimenez-Aparicio T. , Perez-Escudero A. 
Published: August 2023

IntroductionFunctioning in acute inpatient psychiatric units has been challenged by the Coronavirus disease 2019 (COVID-19). Patients with more severe mental health symptoms changed their rates of voluntary admission to psychiatric wards during the onset of the pandemic. Peritraumatic distress scores and increased likelihood of being psychologically affected by the COVID-19 pandemic can lead to a psychiatric admission. However, other factors could prevent hospitalization.ObjectivesThe present investigation aimed at admission rates of patients by depression, adjustment disorder or suicidal behaviour to a General Hospital Psychiatric Ward. We compared the lockdown due to COVID-19 in 2020 to similar periods of 2018 and 2019.MethodsThe data of one general hospital psychiatric ward admissions have been obtained and analysed. We compared admission characteristics of 237 patients between April and June of 2018 and 2019 with 79 patients in the same period of 2020 (lockdown).ResultsDuring the COVID-19 lockdown, there was a 35.8% reduction in psychiatric admissions and a significant reduction in psychiatric admission was observed due to suicidal behaviour (IRR = 0.49; 95% CI: 0.26-0.89; p=0.002) and depression (IRR = 0.24; 95% CI: 0.08-0.68; p=0.007), but similar rates of adjustment disorders (IRR = 1.12; 95% CI: 0.58-2.15; p=0.73).ConclusionsWe suggest that patients with depression or suicidal behaviour avoided admission, for fear of contagion in hospitals. Also, greater family support could prevent self-injurious behaviours. By contrast, other disorders continued to require the same admission rate, since the social consequences derived from confinement could lead to the genesis or worsening of symptoms, such as adjustment disorders.Disclosure of InterestNone Declared
Depressive disorders in patients with sleep apnea syndrome
Authors: Rmadi N. , Kammoun N. , Kotti N. , Masmoudi R. , Rekik S. , Masmoudi M. L. , Jmal Hammami K. , Masmoudi J. , Kammoun S. , Msaed S. , Hajjaji M. 
Published: August 2023

IntroductionA growing body of literature has documented that obstructive sleep apnea syndrome (OSAS) is associated with an increased risk of depressive disorders.ObjectivesThis study aimed to determine whether depression is associated with OSAS.MethodsThis was a descriptive prospective comparative study conducted over two years among patients with OSAS. Excessive daytime sleepiness was assessed by the Epworth Sleepiness Score (SES). The presence and intensity of depressive symptoms were screened using the Patient Health Questionnaire PHQ9. Data were analysed using SPSS software.ResultsA total of 139 patients participated in the survey with an average age of 48.98 ± 9.80 years. According to the SES, the study population was divided into two groups: a group including 70 subjects with normal SES (< 11); and a group including 69 subjects with pathological SES (≥11). The PHQ9 depression score was higher in sleepy subjects with SES ≥ 11 compared to non-sleepless subjects; the difference being very highly significant (PHQ9=11.97 ± 4.99 and 6.54 ± 5.27 respectively; p=0.0000). The frequency of mild to moderate depressive disorders was found to be greater in non-sleepy subjects (94.3% and 78.3% respectively; p=0.007). For moderately severe to severe depression, their frequency was more marked in sleepy subjects (21.7% and 5.7% respectively; p=0.007).ConclusionsDepressive disorders constitute a major comorbidity in OSAS. Therefore, it is necessary to improve the quality of these patients’ health by the early detection of the symptoms of overlapping OSAS and depression.Disclosure of InterestNone Declared
Resting State Functional Connectivity is Associated With Treatment Response in Major Depression: A Real World Study
Authors: Harrington Y. , Paolini M. , Bettonagli V. , Colombo F. , Poletti S. , Zanardi R. , Benedetti F. 
Published: August 2023

IntroductionMajor depressive disorder (MDD) is largely considered the most prevalent psychiatric disorder worldwide. Despite its domineering presence, effective treatment for many individuals remains elusive. Investigation into relevant biological markers, specifically neuroimaging correlates, of MDD and treatment response have gained traction in recent years; however, findings are still inconsistent.ObjectivesIn this study, we aimed to investigate the resting state functional connectivity patterns associated with treatment response in MDD inpatients in a real world setting.MethodsForty-three inpatients suffering from a major depressive episode were recruited from the psychiatric ward at IRCCS San Raffaele Hospital in Milan, Italy. Symptom severity was assessed via the 21-item Hamilton Depression Rating Scale (HDRS). The percentage of decrease in HDRS scores from admission to discharge was then calculated with the formula [(HDRS admission – HDRS discharge) * 100] / HDRS admission. All patients underwent a 3T MRI scan within one week of admission to acquire resting-state fMRI images, which included 200 sequential T2*-weighted volumes. Images were preprocessed using the CONN toolbox, running within Statistical Parametric Mapping (SPM 12). Preprocessing was performed according to a standard pipeline. A voxel-wise metric, intrinsic connectivity contrast (ICC), was implemented to explore the global resting state functional connectivity (rs-FC) patterns associated with treatment response. ICC-derived maps were then entered in the second-level analyses to examine the effect of the percentage of HDRS decrease, including age, sex, admission HDRS score, duration of hospitalization, and antidepressant dose equivalents as nuisance covariates.ResultsWe found that the percentage of HDRS decrease after treatment predicted rs-FC. ICC analysis identified 2 clusters where changes in HDRS scores were significantly associated with rs-FC, with increased connectivity in the supramarginal gyrus (pFDR = 0.002) and decreased connectivity in the amygdala and parahippocampal gyrus (pFDR = 0.047).ConclusionsOur results suggest that altered connectivity of the supramarginal gyrus, amygdala and parahippocampal gyrus is related to antidepressant treatment response. Given that these brain areas are implicated in emotional processing and mood, it is conceivable that a better integrity of brain connectivity may facilitate treatment response in major depression.Disclosure of InterestNone Declared
Fight or flight mechanism and sports activities: psychophysiological aspects
Authors: Romaniuk V. , Fedorchuk S. 
Published: August 2023

IntroductionSpecialists in biology, medicine, and psychology need to pay special attention to theoretical and practical research on the implementation of the fight or flight mechanism in humans in conditions of war and hostilities. Adaptation mechanism of fight or flight is related to individual and social forms of behavior among people and animals, and is aimed at the homeostasis preservation in difficult living conditions. The evolutionary fight or flight mechanism in the functional connection with stress as a general adaptation syndrome and stress reactivity has individual features due to the strengthening of the functions of certain body systems. The systemic mechanism of fight or flight is accompanied by the corresponding functional and clinical symptoms and significantly influences physical and mental health of a person in various conditions of activity.ObjectivesIn this regard, the main goal of this work was to determine the relationship between the behavioral strategy of fighting or escaping under stress and during sports activities.MethodsThe following research methods were used to realize the goal of the work: theoretical analysis and generalization of literary sources and Internet data.ResultsIn our opinion, possible versions of Walter Cannon’s concept of the fight-or-flight mechanism are: 1) attack-or-flight mechanism; 2) defense or escape mechanism; 3) pursuit or escape mechanism. At the same time, it is advisable to consider aggression as a struggle, and escape as a struggle. In addition, in line with the concept of Walter Cannon and Hans Selye, it is possible to distinguish the stress of struggle and the stress of flight. Any intense muscle activity is accompanied by changes in the hormonal and nervous regulation of metabolism, as a result of which the body adapts to a certain physical load. In the athlete, these functional changes are observed even before the start of physical exercises, in particular, in the conditions of the pre-start and start state. The nature and reaction of neuro-endocrine mechanisms in the pre-start state depend on the nature of the load, as well as on the individual characteristics of the athlete (age, gender, type of nervous system, temperament, character, training, sports experience, etc.). It is important that the pre-start changes in metabolism contribute to the mobilization of the athlete’s functional potential even before the start of the corresponding physical activity. Moderate activation of the neuro-endocrine mechanisms of the athlete’s body (“combat readiness” state) is optimal. Functionally, it is less beneficial for the athlete’s body to have a sharp strengthening of neuro-endocrine mechanisms (“pre-start fever” state) or their paradoxical inhibition (“pre-start apathy” state).ConclusionsThus, in humans, sports activities include a behavioral mechanism of fight or flight in combination with physiological and psychological stress.Disclosure of InterestNone Declared
Is even a probable premenstrual dysphoric disorder diagnosis associated with more severe anxio-depressive symptoms and lower well-being? A preliminary cross-sectional exploratory study
Authors: Kovács I. , Pataki B. , Kis B. L. , Kálmán S. 
Published: August 2023

IntroductionPremenstrual dysphoric disorder (PMDD) is a newly introduced category in the 5th version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and is highly underdiagnosed worldwide, despite its strong connections to anxiodepressive symptom severity and perceived well-being.ObjectivesFirstly in Hungary, our aim was to: (a)assess whether even a probable PMDD diagnosis is associated with elevated levels of depressive and anxiety symptoms, and decreased perception of well-being on an adult women sample; (b)to evaluate whether women with a probable PMDD diagnosis report greater fluctuation of their affect during the different phases of their menstrual cycle; (c)to examine whether the elevated levels of anxiodepressive symptoms and lower well-being increase the statistical likelihood of having a probable PMDD diagnosis.MethodsAn online test battery was designed to examine probable PMDD diagnosis, severity of anxiodepressive symptoms and well-being. 393 adult women were screened for eligibility in the study (exclusion criteria involved: irregular cycle; use of hormonal contraceptives), from which 112 were included in the final analyses. DSM-5-Based Screening Tool for Women’s Perceptions of Premenstrual Symptoms, Beck’s Depression Inventory, Spielberger’s State Anxiety Inventory, and the WHO-5 Well-Being Index were assessed.ResultsBased on the DSM-5-Based Screening Tool, the sample was divided into 1)women with probable PMDD diagnosis (PMDD group,n=67) and 2)women without probable PMDD (nonPMDD group,n=45). Menstruation cycles were sorted into menstrual, from-menstruation-to-ovulation, early luteal and late luteal phases. The PMDD group exhibited significantly higher depressive (F(1;56,2)=19.394, p≤0.001) and anxiety (F(1;35,6)=17.714,p≤0.001) symptom severity and lower scores of well-being (F(1;44,3)=4.288,p=0.0442) compared to the nonPMDD group regardless of which menstrual cycle they were in. Binomial logistic regression model was used to test whether higher anxiodepressive symptoms and lower scores of well-being increase the likelihood of having PMDD: the model was significant (χ2(2)=27.287,
p≤0.001), and it explained 29.2% of the variance in PMDD. Elevated levels of anxiety (B=0.058, S.E.=0.022, Waldχ2(1)=7.142, p=0.008,OR=1.060) and depressive (B=0.085,S.E.=0.031,Waldχ2(1)=7.480,p=0.006,OR=1.089) symptoms increased significantly the likelihood of having a probable PMDD diagnosis.ConclusionsWomen with even a probable PMDD diagnosis exhibited significantly elevated levels of anxiodepressive symptoms and lower scores of well-being regardless of which menstrual phase they were assessed in compared to women without meeting the criteria of the PMDD screening tool. These preliminary results underscore the need for prospective clinical studies of differences in affective symptoms exhibited in PMDD.Disclosure of InterestNone Declared
The role of personality and psychopathology in people with migraines
Authors: Georgiadis I. , Fountas K. , Malli F. , Dragioti E. , Gouva M. 
Published: August 2023

IntroductionSeveral studies have shown that the relationship between migraine and psychological factors is significant, but few have evaluated the relationship between these psychological factors and patients’ social life.ObjectivesExploring the role of personality and psychopathology in people with migraines.MethodsThe sample consisted of 180 people, more specifically 140 people from the general population and 40 people who have been diagnosed with migraine and receiving treatment for migraine, who completed the following questionnaires voluntarily and anonymously: a) Migraine Experience Questionnaire and Headache Impact Test-6 (HIT-6), b) Eysenck Personality Questionnaire, c) Symtom Checklist 90-R (SCL-90) and socio-demographic and self-reported questionnaire.ResultsPatients scored higher somatization rates (10.21 ± 8.08), phobic anxiety (3.00 ± 4.45), neuroticism (4.09 ± 1.37), than people from the general population who scored lower somatization rates (14.63 ± 3.12), Phobic anxiety (5.28 ± 1.89), Neuroticism (6.53 ± 2.12), with a statistically significant difference between them (p = 0.001), (p = 0.002), (p = 0.000), respectively.ConclusionsPatients with symptoms of migraine show statistically higher rates of somatization, phobic anxiety, neuroticism and further study is considered necessary.Disclosure of InterestNone Declared
Moral Injury and Pre-Deployment Personality Factors as Contributors to Psychiatric Symptomatology among Combatants: A Two-Year Prospective Study
Authors: Levi-Belz Y. , Zerach G. 
Published: August 2023

IntroductionCombatants who are exposed to events which transgress deeply held moral beliefs might face lasting psychopathological outcomes, referred to as Moral Injury (MI). However, knowledge about pre-deployment factors which might moderate the negative consequences of MI is sparse.ObjectivesIn this prospective study, we examined pre-enlistment characteristics and pre-deployment personality factors as possible moderators in the link between exposure to potentially morally injurious events (PMIEs) and psychiatric symptomatology among Israeli active-duty combatants.MethodsA sample of 335 active-duty Israeli combatants participated in a 2.5-year prospective study with three waves of measurements (T1: 12 months before enlistment, T2: 6 months following enlistment- pre deployment, and T3: 18 months following enlistment- post deployment). Participants’ characteristics were assessed via semi-structured interviews (T1) and validated self-report measures of personality factors: emotional regulation, impulsivity, and aggression (T2) and combat exposure, PMIEs, psychiatric symptomology and post traumatic symptoms (T3) between 2019-2021.ResultsPre-enlistment psychiatric difficulties and negative life events contributed to higher exposure to PMIEs post deployment. Higher levels of pre-deployment aggression and lower levels of emotional regulation and impulsivity moderated the association between betrayal, PMIEs and psychiatric symptomology post deployment, above and beyond pre-enlistment psychiatric difficulties and life events.ConclusionsOur results highlight that pre-deployment emotional regulation, impulsivity and aggressiveness levels should be assessed, screened, and identified among combatants, as they all facilitate psychiatric symptomology (and PTSS) after combatants are exposed to PMIEs of betrayal. Such pre-assessment will enable identification of at-risk combatants and might provide them with tailor made preparation regarding moral and ethical situations that should be investigated in future researches.Disclosure of InterestY. Levi-Belz: None Declared, G. Zerach Shareolder of: no, Grant / Research support from: no, Consultant of: no, Employee of: no, Paid Instructor of: no, Speakers bureau of: no
Characterization of a population of transgender individuals and their perceived negative
mental health and life experiences
Authors: Santos M. F. , Mota J. , Figueiredo Z. 
Published: August 2023

Introduction
Gender dysphoria (GD) is characterized by a marked incongruence between one’s
experienced/expressed gender and gender assigned at birth, associated with clinically
significant distress or impairment in important areas of functioning. Persons with GD are a
population with specific healthcare needs. In our hospital, psychiatric assessment of these
individuals started in 2008.

Objectives
Characterization of a population of transgender individuals and their perceived
negative mental health and life experiences.

Methods
Since the beginning of evaluations of transgender individuals in our hospital, from
2008 to 2022, they were asked to freely elaborate their “life story”: a report of the most
relevant events in their lives, related to their condition. We retrospectively analyzed the
content of the reports that were sent and associated with the clinical files.

Results
We collected the data of 104 individuals. The gender attributed at birth consisted of
74 (71.2%) females and 30 (28.8%) males. As for the gender identity, the sample consisted of
73 (70.2%) males, 28 (26.9%) females, 2 (1.9%) nonbinary and 1 (1%) person didn’t identify
with any of the existent denominations. The medium age in October of 2022 was 27.4 (minimum
18, maximum 60, SD 7.3). The age at first evaluation at consult was 23.6 (minimum 15, maximum
56, SD 7.2). 99 (95.2%) individuals mentioned symptoms of gender non-conformity beginning in
childhood, and of those who mentioned their adolescence (n=43, 41.3%), all expressed feelings
of anguish relating to their changing bodies. The medium age of recognition of their
condition was 17.2 (minimum 11, maximum 30, SD 4.3). Of those who recall their first contact
with health practitioners regarding their symptoms (n=31, 29.8%), 32.3% admitted they didn’t
feel they were helped. Of those who mentioned early relationships with family and carers
(n=65, 62,5%), 35.4% reveal dysfunctional relationships and 79% mention gender expectations
from their families. Similarly, 42 (40.4%) individuals reveal experiences of victimization
and bullying because of their gender nonconformity. 53 (60.2%) described symptoms of a likely
comorbid psychiatric illness throughout their life, particularly depressive symptoms, anxious
symptoms, suicide attempts and non-suicidal self-injury.

Conclusions
GD has gained more attention in the recent years, and the scientific community has now
developed a more accurate set of criteria for the recognition of this condition. The findings
in our study are in accordance with these criteria. Unfortunately, much of the suffering this
condition entails is also associated with distress related to stigma and societal gender
expectations, and that was evident in this investigation.

Disclosure of Interest
None Declared
Factors associated with sexual disorders in women followed for breast cancer
Authors: Zaouali F. , Abbes I. , Ben Slama A. , Belhaj Youssef I. 
Published: August 2023

IntroductionBreast cancer is the most frequently encountered malignant tumor among women in Tunisia and in the world. The quality of sexual life of patients with breast cancer is impaired by multifactorial mechanisms.ObjectivesThe aim of our study was to determine the factors associated with sexual disorders in patients followed for breast cancer.MethodsCross-sectional analytic study including patients followed for breast cancer at the outpatient medical oncology consultation of Hadj Ali Soua regional hospital from January to March 2021. We collected sociodemographic and clinical data with an assessment of sexuality (FSFI), marital satisfaction (MAT), psychological profile (HAD) and quality of life (SF36).ResultsFifteen patients were included with a mean age of 49.87 ± 8.48 years and a mean age at diagnosis of 46.73 ± 7.55 years. At the TNM classification, 66.6% of the patients had a T1 or T2 at the time of diagnosis and 80% had an N0. All patients received a surgical intervention, which was conservative in 53.3% of cases. No patient underwent breast reconstruction. Chemotherapy and hormone therapy were prescribed in 86.7% of patients. The mean score of the FSFI questionnaire in our study was 17.25. Eleven patients (73.3%) had an FSFI score below 26.55. We found negative correlations between age and FSFI score (r=-0.622; p=0.013). We noted statistically significant negative correlations between FSFI and HAD-D (r=-0.606; p=0.017) and FSFI and HAD-a (r=-0.707; p=0.01) as well as significant correlations between FSFI and the following items: RE (r=0.84p=0.000), SF (r=0.684 p=0.005), GH (r=0.671 p=0.006) and MCS (r=0.788 p=0.000).ConclusionsFocusing on a small sample of patients followed for breast cancer, our study provides an assessment of the sexual function in its various areas and shows how sexuality is deeply intertwined with other sections of medical management.Disclosure of InterestNone Declared
Food addiction and gender aspects: Risk factors, co-morbidites and treatment
Authors: Sönmez Güngör E. 
Published: August 2023

AbstractFood addiction (FA) is characterized by poorly controlled intake of highly-palatable, calorically-dense, high-sugar, high-fat, and usually processed foods. Although not existing in the DSM-5 or ICD, it has been a widely discussed clinical and research entity for more than a decade, in the understanding of both obesity and also disordered eating behaviours. Most studies indicate that risk factors for FA are similar to substance use disorders. FA is also found to be linked with emotion regulation problems, impulsivity, distinct personality features, and other major psychopathologies including depression and anxiety. Morevoer, in several studies, female gender is found to be associated with more prevalent food addiction, up to 7 times. Female gender is also a predictor of severe food addiction, and high reward sensitivity was significantly associated with more severe FA symptoms in females. It is known that women are more likely to self-medicate than men in the acquisition phase of addiction and show a more rapid escalation of use than men (telescoping), whereas in general substance use disorders are much more common in men. The wide availability of hyperpalatable, high-calorie, and inexpensive food and the contextual and social factors that do not necessarily prevent women from consuming these drugs, contrary to that of illicit drugs, might explain why FA is more frequently observed in women than in men. Also, biological factors, hormonal changes and body-image disturbances might also be among the reasons why females are more affected from FA. Aspects related to gender should be taken into account for proper recognition and treatment of FA, a diagnosis of growing importance.Disclosure of InterestNone Declared