bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physical pain – suicidality association in adults: A meta-analysis
Authors: Rignanese M. , De Filippi M. , Salmè E. , Madeddu F. , Calati R. 
Published: February 2022

IntroductionMultiple epidemiologic and clinical studies have explored the relationship between physical pain and suicidal thoughts and behaviours.ObjectivesThe aim of this meta-analysis was to provide an update of the data already present in literature about this specific association in adults.MethodsStarting from a meta-analysis published by Calati and colleagues in 2015, 28 studies were included in this work. After searching on Pubmed (until March 2020), data were extracted from articles comparing the rates of current and lifetime suicidal thoughts and behaviours (death wish, suicidal ideation, suicidal planning, suicide attempt and suicide death: DW, SI, SP, SA, and SD) in adults with any type of physical pain and in individuals who did not report this condition. Data were analysed using Cochrane Collaboration Review Manager software (RevMan, version 5.4).ResultsAlthough high between-study heterogeneity was detected in most analyses, results suggested that adults with physical pain are more likely to report any form of suicidal outcome, except for death by suicide, compared to individuals not affected by pain. No evidence of publication bias was reported in the main analysis (lifetime SA).ConclusionsCollected data are therefore in line with previous literature on this topic, which considered physical pain an extremely relevant risk factor for suicidal thoughts and behaviours. Future studies should specifically focus on alternative types of physical pain (such as medically unexplained pain or psychogenic pain) or explore the different impact of acute versus chronic pain in terms of increased suicide risk.
Can narcissism be considered a risk factor for suicidal thoughts and behaviors? A systematic review of the literature
Authors: Sprio V. , Madeddu F. , Calati R. 
Published: February 2022

IntroductionAlthough suicide showed an association with personality disorders, few studies focused on narcissism. This association is interesting, especially in what authors called a “narcissism epidemic”, considering narcissistic wounds to which subjects could be subjected.ObjectivesTo systematically review studies investigating the association between narcissism and suicidal risk.MethodsWe focused on the association between narcissism (NPD, narcissistic traits) and suicide (Suicidal Ideation (SI), Non-suicidal Self-Injury (NSSI), Deliberate Self-Harm (DSH), Suicide Attempt (SA) and Suicide (S)). Studies were identified through a PubMed-based search. Reference lists were examined to extract additional articles. This review was performed according to PRISMA Statement.ResultsWe included 33 studies. Most studies evaluated narcissism through DSM, showing heterogeneous results. NPD was associated with low impulsivity and high planning, but also with a higher number of SAs. Studies evaluating narcissism as a trait were more coherent. SI, NSSI and DSH showed an association with vulnerable narcissism. These associations were explained by mediation and moderation models including shame and dissociation. The grandiose component was associated with severe repetitive NSSIs and S in high suicidal risk samples. Impulsivity showed no effect.ConclusionsIt is possible to develop hypothesis, even if not causal relationships, on the association between narcissism and suicidal risk. Grandiose narcissism seemed to be protective for suicidal outcomes with low intent to die, while vulnerable narcissism seemed to be associated. However grandiose narcissism seemed to be a risk factor for suicidal outcomes with high intent to die, showing low impulsivity and high planning and severity. New studies, differentiating between narcissistic components, are needed.
Mental health, suicidal behavior and sexual orientation in Portugal
Authors: Pereira H. 
Published: February 2022

IntroductionSexual minority individuals consistently report higher rates of mental disorders and suicidal behavior than heterosexuals. However, much of this research is limited to Anglo-Saxon studies and no information on Portuguese reality is available.ObjectivesThe purpose of this study is to compare levels of mental functioning and suicidal behavior among heterosexual, bisexual, and homosexual individuals in Portugal.MethodsUsing online surveys, 1140 individuals (62.40% women, Mage = 36.83, SDage = 13.39, 76.4% heterosexual, 9.4% bisexual, and 14.2% gay or lesbian) completed the BSI subscales for depression and anxiety symptoms, as well as the Suicide Behaviors Questionnaire-Revised.ResultsSelf-identified bisexual participants presented higher levels of depressive and anxiety symptoms and higher levels of suicidal ideation and likelihood of suicidal behavior than homosexual and heterosexual participants (who scored the lowest); yet, homosexual participants showed higher levels of suicide attempts. Also, depression and anxiety symptoms were strongly and positively correlated with all dimensions of suicidal behavior. Finally, hierarchical multiple regression analysis showed that higher levels of depression and non-heterosexual sexual orientations were significant predictors of suicidal ideation and the likelihood of suicidal behavior.ConclusionsThe present study adds to the evidence that sexual minority individuals are at risk of increased mental health problems and suicidal behavior, compared to heterosexuals, and reiterates the need for local political and legislative efforts to normalize LGB identities, fighting continued institutional heterosexism, interpersonal intolerance. Mental health providers and mental health policymakers need to consider these results if they want to address inequalities in mental health and in suicidality among these minority groups.
Suicidal behaviour in huntington disease
Authors: Freitas R. Mota , Valadas M.T. 
Published: February 2022

IntroductionHuntington Disease (HD) is a genetic, progressive neurodegenerative disorder. Its clinical features include motor dysfunction, cognitive impairments, and psychiatric symptoms. The association between HD and suicide is well documented, and the risk of suicide in HD is higher than in patients with other neurological diseases.ObjectivesWe aim to review the literature regarding suicidal behaviour in HD.MethodsWe performed an updated review in the PubMed database using the terms “suicide”, “suicidal behaviour” and “Huntington Disease”. The included articles were selected by title and abstract.ResultsThe most relevant risk factors associated with suicidality in HD are depression, anxiety, and aggression, so the presence of psychiatric diagnoses should be closely monitored. No consistent results have been found regarding gender. Evidence for periods of elevated risk of suicidal behaviour in HD is mixed and the data on specific pharmacological interventions for alleviating suicidal ideation in HD is scarce.ConclusionsPatients with HD are at a high risk for suicide. This risk is further increased when a comorbid psychiatric disorder is present. It is important for the practicing psychiatrist to be aware of this association to correctly manage patients with HD, thus helping prevent suicidal behaviour.
Addictive behavior and suicidality in patients followed by the department of psychiatry in the region of southern tunisia
Authors: Kerkeni A. , Abbes W. , Frikha A. , Medhaffer K. , Abbes M. , Zitoun K. , Ghanmi L. 
Published: February 2022

IntroductionAddictive behaviors and suicide have important risks that need to be explored for any patient followed at the department of psychiatry, possibly endangering his vital and psychosocial prognosis.ObjectivesOur study aims to identify the link between addictive behavior and suicidal behavior in patients followed at the psychiatry department at the regional hospital of Gabes.MethodsWe conducted a cross-sectional, descriptive and analytical study carried out on a clinical population who consult in the psychiatry department in the Gabes’s regional hospital during the period from January 1st, 2020 to September 30, 2020.Sociodemographic and clinical data of the patients as well as their personal and family history were assessed. The evaluation of psychopathological disorders was carried out according to the diagnostic criteria of DSM-5. Suicide Behaviors Questionnaire (SBQ) was used for suicide risk assessment. Fagerstrom questionnaire in its validated French version was used to assess the of nicotine dependence. The exploration of childhood physical and emotional trauma was carried out by the Childhood Trauma Questionnaire (CTQ) scale. Data were analysed using the software SPSS.Results100patients were included. The mean age was 45.5years. TableI: Breakdown of addictive behavior and suicide attempts by gender. TableII: Common vulnerability factors between addictive behavior and suicidalityThe analytical study showed that suicide attempts were correlated with addictive behaviors (p = 0.03) and that suicidal recurrence was correlated with addictive behaviors (p = 0.01).ConclusionsSuicidal behavior in patients followed in psychiatry is closely linked to addictive behavior, hence the importance of early management.
Suicidal behaviors: Relationship with body mass index and serological indicators
Authors: Esgalhado G. , Costa I. 
Published: February 2022

IntroductionCurrent research has demonstrated associations between variables of a biomedical nature with the presence of psychological indicators.ObjectivesTo analyze the relationship between levels of total cholesterol, triglycerides, and Body Mass Index (BMI) with suicidal behaviors, on a non-smoking sample, without women who take birth control pills and participants without depressive pathologyTo analyze the relationship between levels of total cholesterol, triglycerides, and Body Mass Index (BMI) with suicidal behaviors, on a non-smoking sample, without women who take birth control pills and participants without depressive pathology.MethodsWe used a sociodemographic questionnaire and the Suicidal Behaviors Questionnaire - revised (SBQ-R) to evaluate the suicide ideation, suicide attempt and the probability of committing suicide. The sample is composed of 166 participants with ages between 18 and 89-years-old, 54.2% are men and 45.8% are women.ResultsWe observed a weak association between serological indicators with some components of suicidal behaviors. It is also observed that higher cholesterol levels are associated with a higher probability of suicide; normal BMI is related to an increase of suicidal ideation; and the age group of 41 to 89 years-old presents a higher probability of committing suicide.ConclusionsIt is further concluded that age, gender, marital status, place of residence, education and professional status are significantly associated with suicidality. Yet, the influence of cholesterol, triglycerides, and BMI levels on suicide behaviors was not supported.
Suicidality and relation with dissociation and alexithymia in PNES and conversion disorder
Authors: Longo L. , Jannini T. , Merlo M. , Bombacci C. , Biancolino M.R. , Rossi R. , Carlo E. Di , Niolu C. , Siracusano A. , Lorenzo G. Di 
Published: February 2022

IntroductionAmongst different subtypes of Conversion Disorder (CD), DSM-V lists the Psychogenic Non-epileptic seizures (PNES). PNES are defined as episodes that visually resemble epileptic seizures but, etiologically, they are not due to electrical discharges in the brain.ObjectivesOur study aims to explore the differences between PNES and other CDs. In particular, we studied the suicidality and its correlations with dissociation and alexithymia.MethodsPatients, recruited from the Psychiatry and Clinical Psychology Unit of the Fondazione Policlinico Tor Vergata, Rome, Italy, were diagnosed with PNES (n=22) and CD (n=16) using the DSM-5 criteria. Patients underwent the following clinical assessments: HAM-D, BDI, DES, BHS, TAS, CTQ.ResultsPNES showed significantly higher scores than CD in all assessments, except for BDI-somatic (p=0.39), BHS-feeling (p=0.86), and the presence of childhood trauma. PNES also showed significantly higher suicidality (p = 0.003). By controlling for the confounding factor “depression”, in PNES suicidality (and in particular the BHS-loss of motivation) appears to be correlated with DES-total score (p = 0.008), DES-amnesia (p = 0.002) and DES -derealization-depersonalization (p = 0.003). On the other hand, in CDs, the BHS-total score shows a correlation with the TAS-total score (p = 0.03) and BHS-Feelings with TAS-Externally-Oriented Thinking (p = 0.035), while only the BHS-Loss of motivation appears correlated with DES-Absorption (p = 0.011).ConclusionsOur study shows significant differences between PNES and CD, in several symptomatologic dimensions, including suicidality. Indeed, in PNES suicidality appears to be related to dissociation, while in CDs it appears mainly to be correlated with alexithymia.
Standardized training in the rating of the six-item positive and negative syndrome scale (PANSS-6)
Authors: Kølbæk P. , Dines D. , Hansen J. , Opler M. , Correll C. , Mors O. , Østergaard S. 
Published: February 2022

IntroductionThe six-item Positive And Negative Syndrome Scale (PANSS-6) is short psychometric valid scale quantifying the severity of core schizophrenia symptoms. Using PANSS-6 to guide treatment decision-making requires that staff members’ ratings are valid and reliable.ObjectivesThe objective of the study was to evaluate whether such valid and reliable PANSS-6 ratings can be obtained through a video-based training program.MethodsOne-hundred-and-four staff members from Aarhus University Hospital - Psychiatry, Denmark participated in the training. Participants conducted baseline PANSS-6 ratings based on a video of a patient being interviewed using the Simplified Positive And Negative Symptoms interview (SNAPSI). Subsequently, a theoretical introduction video was displayed followed by five SNAPSI patient interviews. After each SNAPSI video, individual ratings were performed before a video providing the gold standard scores was displayed. The validity of ratings was estimated by calculating the proportion of participants not deviating from the gold standard scores with >2 points on individual items or >6 points on the PANSS-6 total score. Reliability was evaluated after each step in the training by means of Gwet’s Agreement Coefficient (Gwet).ResultsBy the end of the training, 72% of the participants rated within the acceptable deviations of the gold standard, ranging from 60% (nurses) to 91% (medical doctors/psychologists). The reliability improved (Gwet baseline vs. endpoint) for all PANSS-6 items, except for Blunted affect.ConclusionsThe majority of the staff members conducted valid PANSS-6 ratings after a brief standardized training program, supporting the implementation of PANSS-6 in clinical settings to facilitate measurement-based care.Conflict of interestDr. Opler is a full-time employee of MedAvante-ProPhase Inc. Dr. Correll has been a consultant and/or advisor to or have received honoraria from: Acadia, Alkermes, Allergan, Angelini, Axsome, Gedeon Richter, Gerson Lehrman Group, Indivior, IntraCellular T
Do podcasts improve the learning experience of dyslexic medical students?
Authors: Parsons C. 
Published: February 2022

IntroductionThere has been a rapidly increasing rate of students disclosing specific learning difficulties in higher education- in 2016 dyslexic students accounted for up to 5% of the student population.(Ryder D, Norwich B.)ObjectivesIt is important that provisions for alternative learners are developed in order to increase accessibility to medicine. Podcasts are an inexpensive, accessible and convenient method to both deliver education and interest pieces to a new generation of learners. This poster aims to explore the idea of harnessing the technology available to us to create an accessible, enjoyable platform to improve the experience of students with learning difficulties.MethodsA literature search reviewing the past and present provisions for students with learning difficulties was conducted using a range of databases covering educational, scientific and medical backgrounds. 315 papers were found across the databases, each analysed for relevance and 25 were selected as appropriate.Resultsidentified 5 key themes; the lack of awareness and importance of education, the power of audio learning, the practicalities of podcasts, adjustments to examinations specifically and finally additional provisions which accompany audio learning to create an all-inclusive educational experience. Altogether suggesting podcasts have an improved outcome for students with learning difficulties.ConclusionsIt has been evidenced understanding is key to maximising learning potential and highlighted need to increase awareness of dyslexic needs in higher education institutions, generate audio centred provisions in conjunction to traditional materials and be aware of alternative provisions to cater for the spectrum of dyslexic needs.
To assess the confidence levels of psychiatrists in physical healthcare competencies in one irish region, and to explore whether confidence was related to learning opportunities
Authors: O’Donnell M. , Pradeep V. , Dunne C. , Gulati G. , Kelly B. 
Published: February 2022

IntroductionThe bi-directional relationship between mental and physical illness is well established. Therefore, in order to lower the already high mortality rates associated with psychiatric disorders, physical health issues must be closely monitored in this population [1,2]. A recent Lancet commission highlights emerging strategies and recommendations for improvement of physical health outcomes in patients with chronic mental disorders. These strategies involve better integration of physical and mental health care, combined with broader implementation of lifestyle interventions to reduce elevated cardiometabolic risk and attenuate medication side-effects [3].ObjectivesTo assess psychiatrists’ confidence levels in physical healthcare competencies; to explore whether confidence was related to learning opportunities.MethodsPhysical healthcare learning objectives were extracted from the Irish College of Psychiatrists’ training curriculum. An electronic questionnaire was sent to 50 psychiatrists in one Irish healthcare region with a catchment area of c. 450,000. Participants had to rate confidence levels for each competency on a five-point Likert scale and the availability of learning opportunities for attaining each competency.Results66% response rate was achieved. A majority reported confidence in cardiovascular examination, interpreting blood results and evaluating comorbidities. A minority reported confidence in interpreting imaging, electrocardiograms and recognising medical emergencies. This corresponds to a relative paucity of learning opportunities.ConclusionsClinical implication Programmes for trainee doctors and CME opportunities for consultant psychiatrists would benefit from an emphasis on physical health examination and modules on interpreting investigations and the recognition of medical emergencies.
Knowledge translation research: Teaching psychopharmacology using research domain criteria
Authors: Mehl-Madrona L. , Mainguy B. 
Published: February 2022

IntroductionResearch Domain Criteria are coming to be required for applications for mental health research funding in the United States.ObjectivesTo translate contemporary neuroscience research into teaching medical residents how to prescribe psychiatric medications.MethodsWe explore the neuroscience literature regarding neural circuitry and psychiatric symptoms and examine the neurotransmitters associated with those circuits. We associate psychiatric symptoms with the neural circuitry that produces those symptoms. We correlate medications with circuits which they might affect and symptoms they might ameliorate.ResultsRDC is an alternative to DSM and ICD-10. Contemporary scientific diagnoses are not based on neuroscience. They are overlapping, contradictory, often vague, and hinder adequate research. Diagnoses are needed that are based on brain circuitry and function rather than ”expert” opinion. The basis for RDC lies in psychiatric disorders being brain disorders with a primary focus on circuitry function. This contrasts with neurological disorders that have identifiable structural lesions. Symptoms are normally distributed and exist in everyone. RDC proposes to seek the distribution of traits and characteristics, defining abnormal as the extremes of these distributions rather than by defining mental disorders by signs and symptoms which give a diagnosis. We ask what are the brain system that primarily implements the traits, functions, and characteristics of interest. We explore what accounts for the development of dysregulation or dysfunction in these systems alongside normal-to-abnormal dimensions? We describe resident reactions to this style of teaching and show greater comfort in prescribing medications.ConclusionsTranslating Research Domain Criteria into psychiatric prescribing will move psychopharmacology into contemporary neuroscience.
A risky business: Teaching clinical risk assessment in the midst of a global pandemic
Authors: Oates A. , Wilson-Jones C. , Butler S. 
Published: February 2022

IntroductionAssessing risk is an important core skill yet there is not a consensus as to how to teach it. Clinically, there has been a move away from using risk prediction tools in favour of clinical judgement.We describe an iterative process to develop high quality, online teaching around risk assessment for medical undergraduates.ObjectivesTo teach the clinical skill of risk assessment to enable medical students to evaluate and manage risk when encountering patients with mental health issues.MethodsA half day tutorial was designed and refined in an iterative process using feedback from participants on this session and other concurrent teaching occurring in the department. Sessions were also reviewed by external medical educators to ensure quality and learning objectives were met.ResultsThe average rating from 62 students was 4.4/5. Students commented that the session was well organised and delivered. Following feedback, the use of actors was prioritised to simulate evolving clinical situations. Students placed a high value on this: “simulated patients were amazing! They were really interesting and I was able to practice the skills I learnt over placement”. Logistical changes e.g. more breaks, followed appreciation of the exhausting nature of the session and maintained student engagement. There was increased emphasis on promoting group interaction through functions like a ‘break-out room’.ConclusionsThis session may give educators confidence that they can take risks when teaching the skill of risk assessment. Students were receptive and meaningfully engaged with concepts such as clinical judgement and bio-psycho-social formulations as opposed to ‘tick box’ assessments.