bluuebunny/crossref_metadata_2025_split huggingface dataset:
The medical consequences of eating disorders: the correlation between the severity of the disease and the degree of the cardiological changes in paediatric patients with anorexia nervosa
Authors: Adamo E. , Pisano T. 
Published: August 2023

IntroductionAnorexia nervosa (AN) is associated with several medical complications. The cardiac changes represent the most severe complications and are associated with higher mortality. For this reason, periodic evaluation is necessary, by ECG and echocardiography. Moreover, there is not a protocol that defines the timelines or how to select higher risk patients that must be evaluated more frequently.ObjectivesThis single-center, retrospective, observational and epidemiological study aims to analyze the prevalence of cardiac changes and their correlation with disease severity, in patients admitted to the Child and Adolescent Psychiatry Unit, AOU Meyer, Florence.MethodsThe study population consisted of 123 children between the ages of 7 and 18 years old admitted to inpatient or intensive day hospital, with a diagnosis of AN, between January 1, 2019, to March 31, 2022. Data were collected by retrospectively consulting clinical reports. The correlation between BMI, percentage of weight loss since the onset of symptoms and HR, QTc interval values and pericardial effusion was evaluated. Furthermore, the correlation between cardiac changes and the intake of antidepressant and antipsychotic medications was analyzed.ResultsThe overall prevalence of cardiac changes was 57.7%. In our analysis BMI showed a significant positive correlation whit HR. QTc prolongation was significantly related only to psychotropic drug intake. Pericardial effusion was evidenced exclusively in patients diagnosed with severe or extreme AN. After six months from the hospitalization and the beginning of treatment the prevalence of cardiovascular complications was reduced.ConclusionsThe present study identifies criteria able to select patients with AN at higher risk of developing cardiac changes and underlines the importance of performing more frequent and targeted cardiologic evaluations in this subgroup of patients. This suggests the importance of establishing a common protocol for all clinicians.Disclosure of InterestNone Declared
Stratified therapeutic security and understanding backwards care pathway moves. A 5-year retrospective cohort analysis from the Dundrum Forensic Redevelopment Evaluation (D-FOREST) study in Dublin, Ireland
Authors: Jordan L. , Crudden G. , Mohan D. , Kennedy H. , Davoren M. 
Published: August 2023

IntroductionSecure forensic hospital settings provide care and treatment to mentally disordered offenders with a history of serious violence. Most modern forensic hospitals operate a system of stratified therapeutic security, where patients are placed on the internal care pathway according to individual risks and needs. Unfortunately, at times patients move ‘backwards’ from a unit of lower to a unit with higher therapeutic security. This is a challenge to manage from an individual patient and service perspective.ObjectivesThe aim of this study was to analyse backwards moves along the care-pathway within a complete national cohort of forensic in-patients in Ireland over a five-year period. We aimed to clarify the reasons for these moves and ascertain if they were linked to mental illness, security or other issues.MethodsA naturalistic retrospective five-year observational cohort study was completed. All in-patients in the Central Mental Hospital, Dundrum, Ireland or associated high support hostels between January 2016 and January 2021 were included (60 months). Demographic data, data pertaining to diagnosis, data pertaining to backwards moves and reasons for those moves were gathered. Data was gathered as part of the Dundrum Forensic Redevelopment Evaluation study (D-FOREST study).ResultsA total of n=231 patients were included; the majority (n= 203; 87.9%) were male. The most common diagnosis was schizophrenia (64.1%), followed by schizoaffective disorder (12.6%), bipolar affective disorder (4.8%) and autistic spectrum disorder (3.5%). Mean age at admission was 35.9 years, SD 9.5.Over the 60-month period, a total of 93 backwards moves relating to 50 patients occurred. Reasons for backward moves included deteriorating mental state (8.7%), assaults (4.3%), challenging behaviour (4.3%), security (1%) and others. Binary logistic regression demonstrated that lacking capacity to consent to medication (Odds ratio 0.352, 95%CI 0.198-0.627, p<0.001) and higher (worse) scores on HCR-20 Historical scale (Odds ratio 1.13, 95%CI 1.01-1.27, p=0.035) were associated with backwards moves, when adjusting for age and Dundrum-1 need for therapeutic security scores.ConclusionsBackwards care pathway moves are a major issue in forensic hospitals both nationally and internationally. We were surprised at the strength of association between lacking capacity to consent and backwards moves. Understanding backwards moves will assist in supporting patients and minimising length of stay.Disclosure of InterestL. Jordan Grant / Research support from: This study was funded by the Health Service Executive for the Republic of Ireland as part of the Dundrum Forensic Redevelopment Evaluation (D-FOREST) study, G. Crudden: None Declared, D. Mohan: None Declared, H. Kennedy: None Declared, M. Davoren: None Declared
How to measure autobiographical amnesia: time to upgrade the CUAMI?
Authors: Isidoor B. 
Published: August 2023

AbstractAutobiographical memory loss is a common complaint of patients treated with electroconvulsive therapy (ECT). However, reliable measurement of autobiographical memory loss after ECT is still a subject of debate. In the 1990s, the Colombia University Autobiographical Memory Interview (CUAMI) was developed specifically to monitor changes in autobiographical memory during a course of ECT. However, this instrument has been criticized due to the lack of psychometric data. In this talk, we will discuss the experiences of administrators and preliminary results of a study into the psychometric properties of the CUAMI. Is the CUAMI useful to test autobiographical memory after ECT or could it use an upgrade?Disclosure of Interest
B. Isidoor Grant / Research support from: Isidoor Bergfeld works on a clinical trial of DBS for depression sponsored by Boston Scientific (in kind). He also received grants from ZonMw and Amsterdam Brain and Cognition for studies on DBS and ECT
Evaluation of self-stigma in patients with mental illness from hospitalization in the Mental Health Acute Unit
Authors: Valverde Barea M. , España Osuna A. , Solis Correa M. O. 
Published: August 2023

IntroductionStigma is a complex process and a universal phenomenon that is part of all social groups and that is maintained by its functions related to the establishment of one’s own identity and the facilitation of socialization processes. The stigma of the patient is important to evaluate since it is a subjective experience that can have negative correlations in relation to self-esteem, empowerment and recovery orientation of the patient with mental illness. Hospitalization in mental health takes place at times of mental illness decompensation and is an intervention closely related to the stigma towards mental illness.ObjectivesThe objective of the study is to evaluate the stigma perceived by patients with mental illness hospitalized in an acute mental health unit.MethodsObservational study with 53 patients hospitalized in an acute mental health unit.Variables collected: Sociodemographic variables (age, sex), clinical diagnosis and stigma is evaluated with the Illness Self-stigma Scale (ISMI).ResultsSample of 53 patients, 55% women and 44% men, the most frequent diagnoses among those admitted are psychosis spectrum 26.42%, depressive disorders 24.53%, personality disorders 22.64% and bipolar disorders 11.33%. The average age is 41.96 years, between 18 and 72 years. The self-stigma according to the scale (ISMI) we obtain as a total score the patient with the highest stigma scores 100 points and the one with the least scores 44 points. Regarding diagnoses, depressive disorders score 33-72 points, while psychotic disorders score 36-85 points. The highest scores in self-stigma in our study are in personality disorders 49-100 and borderline personality disorder stands out (100 points). In the 5 subscales such as alienation, self-stigma, perceived discrimination, social isolation and resistance to stigma. Higher scores in alienation stand out in all patients.ConclusionsPatients with personality disorders, especially borderline personality disorder, followed by psychotic disorders, present greater perceived self-stigma in our study than the rest of the patients; it is a very important factor that can affect the evolution of the clinical picture. This factor is important to establish the therapeutic plan and the different interventions, it would be recommended to assess the stigma together with the measures to reduce symptoms.Disclosure of InterestNone Declared
Impact of adapted physical activity on hippocampal N-Acetyl Aspartate in patients with schizophrenia
Authors: Metivier L. , Briend F. , Tréhout M. , Bigot L. , Quarck G. , Herbinet A. , Leroux E. , Dollfus S. 
Published: August 2023

IntroductionAdapted physical activity (APA) has beneficial neurobiological impact but the underlying pathophysiological mechanisms remain poorly described. APA is currently recognized as an adjuvant therapy to antipsychotic treatments in patients with schizophrenia (SCZs) to reduce the severity of negative symptoms and cognitive impairment. SCZs exhibit hippocampal N-acetylaspartate (NAA) reduction, a marker of neuronal viability and integrity whose concentrations can be assessed by proton magnetic resonance spectroscopy (1H-MRS).ObjectivesThe purpose of this study was to evaluate the impact of remote physical activity (e-APA) via the web on the NAA relative variations in the left hippocampus in SCZs compared to a patient control group benefiting from an health education program (HE). This study concerns one of the secondary objectives of the PEPsy V@SI study co-financed by the Pierre Deniker Foundation, the European Union and the Normandy Region within the framework of the FEDER/FSE 2014-2020 operational program.MethodsThirty-five SCZs were randomized in the e-APA active group or in the control group (HE). Participants received the interventions during 16 weeks, with two visioconference sessions per week. A 1H-MRS sequence positioned on the left hippocampus (MRI-3T) was acquired before and after both interventions. Absolute NAA concentrations in the left hippocampus were obtained using Osprey software after partial volume correction. After checking the quality criteria, the spectra of 6 SCZs in the e-APA group and 8 SCZs in the HE group were analyzed. To test the difference between interventions on the NAA relative variations, a Wilcoxon-Mann-Whitney test and effect size were performed. Paired Wilcoxon tests were used in each group before and after the interventions.ResultsNo significant difference was found in NAA relative variations in the left hippocampus between the e-APA group and the HE group (p = 0.18), although the effect size was 0.38 (considered as moderate). However, a trend towards an increase of NAA was observed in the e-APA group (before intervention: 12.08 International Units (I.U); after: 13.81 I.U) (p = 0.06) but not in the HE group (before intervention: 13.75 I.U ; after: 13.85 I.U) (p = 0.84).ConclusionsOur results showed a NAA significant increase in SCZs after an e-APA program, indicating a beneficial impact of e-APA on neuronal viability that might reflect an hippocampal plasticity. However, this increase did not differ significantly between active and control groups probably due to a weak statistical power.Disclosure of InterestL. Metivier: None Declared, F. Briend: None Declared, M. Tréhout: None Declared, L. Bigot: None Declared, G. Quarck: None Declared, A. Herbinet: None Declared, E. Leroux: None Declared, S. Dollfus Consultant of: Fabre,Gedeon,Roche and Takeda, inivited Conferences by Lundbeck, Otsuka, Janssen ; at contracts with Prophase MedAvances and NeuroCogTrials
Primary caregiver Reports of Patient-Initiated and Suffered Violence in Schizophrenia: A cross-sectional study in Tunisia
Authors: Stambouli M. , Fekih Romdhane F. , Ghrissi F. , Cherif W. , Cheour M. 
Published: August 2023

IntroductionAggressive behavior in psychosis is not uncommon. Studies found that among the patients with schizophrenia engaged in violence, more than half committed violence directly against family members. However, few studies have explored violence victimization and perpetration among caregivers of patients with schizophrenia.ObjectivesOur study investigated caregiver reports of aggressive acts committed or suffered by their relative with schizophreniaMethodsThis is a cross-sectional study among caregivers of patients with schizophrenia during the period from June to August 2022.Patients who attended our department of psychiatry at the Razi.The questionnaire was divided into three sections.The first section: contained items regarding patient and caregiver-related information.The second section: caregivers were asked questions about their experience of violence perpetration and victimization involving their relative with schizophrenia in the past 12 months.Beyond frequency, caregivers were also asked to specify, the causes of the violence perpetrated and suffered.The third section contained two measures: The Depression Anxiety and Stress Scales (DASS-21) and the abridged version of the Zarit Burden Interview (ZBI), assessing psychological distress and caregiving burden, respectively.ResultsFinally 110 caregivers were included ,the majority of caregivers were females (63.6%) and consisted of patients’ parents (50.9%). Verbal violence was the most reported type of violence victimization (35.5%). In addition, 54.5% of caregivers disclosed having perpetrated verbal violence at least once against their ill relative.Bivariate analysis showed that lower caregivers’ educational level (p=.017), unemployment (p<.001), other person in charge (p=.027), burden levels (p<.001), depression (p<.001), anxiety (p<.001) and stress (p<.001) symptoms are positively associated with violence victimization occurrence. while being male caregiver (p=.007), having other person in charge (p<.001) and higher levels of depression (p<.001), anxiety (p<.001), and stress (p<.001) were associated with more violence perpetration.ConclusionsOur findings suggested that violence victimization and perpetration in schizophrenia are not uncommon.Appropriate procedures for minimizing it should be considered.Disclosure of InterestNone Declared
Comorbidities of anxiety disorders in bipolar patients: therapeutic complexity
Authors: Bahetta S. , El moussaoui N. 
Published: August 2023

IntroductionNumerous clinical and epidemiological studies show that the rate of comorbidity of anxiety disorders is high in bipolar patients compared to the general population. This is associated with a poorer prognosis, poorer functioning and higher suicidal risk. Anxiety comorbidity should therefore be carefully investigated.ObjectivesOur main objectives are to explore the therapeutic complexity of anxiety disorders in patients with bipolar disorder To investigate the existence of psycho-pathological links and vulnerabilities between bipolar disorder and anxiety disorders.Methodsthrough a clinical vignette and a review of the existing literature on the comorbidity of anxiety disorders and bipolar disorders, and the resulting therapeutic issuesResultsAnxiety comorbidity is quite common in the bipolar population. In the American National Comorbidity Survey (NCS), lifetime comorbidity is close to 90%. Two recent French clinical studies show the existence of at least one anxiety disorder in approximately 25% of bipolar subjects (24% and 27.2%), which will have an impact on the course of the bipolar disorder, with a particular increase in the risk of suicide, hence the importance of adequate treatment. This treatment faces two obstacles: the risk of manic episodes under antidepressants and the risk of dependence on benzodiazepines. Emphasis is also placed on non-drug approaches, including cognitive-behavioural and psycho-educational therapies.ConclusionsAnxiety comorbidity is not without consequence on the evolution of bipolar disorder. Its particularly high prevalence means that it cannot be neglected or ignored in current practice.Disclosure of InterestNone Declared
Reliability of electronic patient reported outcomes vs. clinical assessment
Authors: Krasteva S. , Apostolov Z. , Kozhuharov H. 
Published: August 2023

IntroductionThe importance of inter-scale and inter-rater reliability is a well-studied factor in maintenance of data consistency in clinical research. The use of patient reported outcomes poses another risk for compromising data integrity, as some studies show that patients tend to report their symptoms differently in direct clinician-lead interview and self-administered questionnaires. Additionally, as technology is advancing and digital endpoints in CNS clinical trials are becoming a reality, we need to further evaluate if the digital means of self-reporting (e.g., mobile app questionnaires) per se could potentially be a contributing factor in data inconsistency.ObjectivesTo assess reliability between clinician-assisted evaluation and electronic patient reported outcomes of depressive and anxiety symptoms.MethodsPatients not previously diagnosed with depression or anxiety disorders were asked to complete PHQ-9 and/or GAD-7, both verbally administered by a physician. Within 24 hours they were asked to complete a digital form of the same questionnaires.ResultsThe analysis of 40 completed double assessments showed no correlation for depressive symptoms presence and severity measured by clinician-lead evaluation and electronic patient reported outcomes (Spearman rho = + 0.191, p=0.686), and poor correlation for anxiety symptoms (Spearman rho = + 0.466, p=0.080).ConclusionsMany factors interfere with data consistency in clinical research, thus the methods and means of evaluation need to be taken into consideration. The reliability of electronic patient reported outcomes needs to be further assessed and preferably cross-checked by using other validated methods of assessment.Disclosure of InterestNone Declared
Cognitive effects after ECT: how to treat them?
Authors: Verwijk E. 
Published: August 2023

AbstractHow far have we progressed in the field of treating cognitive side effects? Six months after the last ECT treatment, about 15% of patients still have such symptoms, limiting daily life. So far, studies in the field of cognitive training for ECT-related cognitive side effects show few positive effects. Nevertheless, these patients seem to help well. Because they have no structural damage to their brain, training with long-term effectiveness may be available for them. Amsterdam University Medical Centers started the CONNECT clinic (Cognitive and Neuropsychological Aftercare ECT) in early 2022 for diagnosis and treatment of patients with long-term cognitive complaints (longer than six months) that hamper their daily functioning. After the intake and neuropsychological diagnostics, treatment starts if there is an indication. Patients are then offered ’cognitive strategy training’ in an individual course. Developed in the field of neuropsychological rehabilitation, these help to get a grip on cognitive complaints by improving memory or executive functioning with learning strategies. Our initial experiences with patients show that patients master these strategies very well and quickly. We present a pilot project from the Amsterdam UMC where an individualized treatment-programme for long-term cognitive complaints after ECT is being implemented and evaluated.Disclosure of InterestNone Declared
Adipose Tissue Dysfunction and Energy Balance Paradigms in People Living With HIV
Authors: Ramirez Bustamante Claudia E , Agarwal Neeti , Cox Aaron R , Hartig Sean M , Lake Jordan E , Balasubramanyam Ashok 
Published: August 2023

Abstract
Over the past 4 decades, the clinical care of people living with HIV (PLWH) evolved from treatment of acute opportunistic infections to the management of chronic, noncommunicable comorbidities. Concurrently, our understanding of adipose tissue function matured to acknowledge its important endocrine contributions to energy balance. PLWH experience changes in the mass and composition of adipose tissue depots before and after initiating antiretroviral therapy, including regional loss (lipoatrophy), gain (lipohypertrophy), or mixed lipodystrophy. These conditions may coexist with generalized obesity in PLWH and reflect disturbances of energy balance regulation caused by HIV persistence and antiretroviral therapy drugs. Adipocyte hypertrophy characterizes visceral and subcutaneous adipose tissue depot expansion, as well as ectopic lipid deposition that occurs diffusely in the liver, skeletal muscle, and heart. PLWH with excess visceral adipose tissue exhibit adipokine dysregulation coupled with increased insulin resistance, heightening their risk for cardiovascular disease above that of the HIV-negative population. However, conventional therapies are ineffective for the management of cardiometabolic risk in this patient population. Although the knowledge of complex cardiometabolic comorbidities in PLWH continues to expand, significant knowledge gaps remain. Ongoing studies aimed at understanding interorgan communication and energy balance provide insights into metabolic observations in PLWH and reveal potential therapeutic targets. Our review focuses on current knowledge and recent advances in HIV-associated adipose tissue dysfunction, highlights emerging adipokine paradigms, and describes critical mechanistic and clinical insights.
Esthetic preferences of orthodontists, general dentists, and laypersons for Indian facial profiles: A cross-sectional study
Authors: Reddy Harshini , Singla Ritesh , Singla Nishu , Natarajan Madhumitha , Singhal Deepak Kumar 
Published: August 2023

Background: Disparity in the esthetic perceptions between a patient and clinician could result in patient dissatisfaction with orthodontic treatment outcomes. The aim of this study was to compare the perceptions of a group of orthodontists, general dentists, and laypersons about the attractiveness of Indian facial profiles. Methods: In this study, a male and a female participants’ photographs and lateral cephalograms were digitally manipulated by inserting them into Dolphin software; we considered four soft tissue parameters at a nasolabial angle, upper lip E-line, lower lip E-line, and pg-pg’, so that 20 profiles were created for each model. A visual analog scale (VAS) along with a question about surgical correction opinion was given to 18 orthodontists, 18 general dentists, and 18 laypersons to score (1-5) from least to most attractive. Spearman’s rank correlation was computed to assess correlation, as well as ANOVA, followed by post hoc Tukey analysis to compare the mean scores, and Chi-square test to determine the opinion about surgical treatment. Results: There was an overall weak and negative correlation between the three groups, indicating that orthodontists attributed lower pleasantness scores to almost all the altered female and male facial profiles. Additionally, statistically significantly lower mean scores were attributed by orthodontists to many females and few male facial profiles. More orthodontists identified the need for surgical correction for a few severely distorted profiles but there was a statistically non-significant difference among the groups for most of the profiles. Conclusions: It was concluded that participants in the three groups had diverse concepts of facial attractiveness in all the parameters considered. Compared to general dentists and laypersons, orthodontists were much more precise, firmer, and meticulous in identifying a favorable or good-looking profile.