bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adolescents’ attitudes towards e-cigarette in Tunisia
Authors: Maalej R. , Zgueb Y. , Aissa A. , Ouali U. , Nacef F. 
Published: February 2022

IntroductionE-cigarette use has increased over the last years. Many studies have examined teenagers’ attitudes towards smoking, but did not examine adolescents’ attitudes towards e-cigarettes.ObjectivesThe aim of this study was to examine high school students’ attitudes regarding e-cigarette safety, addictive properties and social norms and to compare e-cigarettes perceptions among e-cigarette users and non-users in Tunisia.MethodsA survey was conducted with a sample of 234 students in Mohamed Ali high school in Sfax, a town in South of Tunisia, in February 2020. Socio-demographic data and questions about vaping and attitudes towards e-cigarettes were used to evaluate students’ perceptions towards e-cigarettes.ResultsAmong high school students aged 15 to 20, 58,8% have ever used e-cigarette, 38,3% had done so within the previous 30 days and 20,5 % were regular users of vapes. 53.8% of students believed that e-cigarettes are harmful. 78.4% of them thought they were less harmful than regular cigarettes and 50.5% thought they could be addictive, 45.4% of students believed e-cigarette smoking decreased anxiety and a third thought it made them sociable (33.3%) and confident (30.6%).Adolescents who used e-cigarettes had significantly more favorable e-cigarette attitudes than non-users: they believed they were less harmful than tobacco (p=0,019), they were not addictive (p=0,005), they decreased anxiety (p=0,001) and they made the user sociable (p<0,001) and confident (p=0,01).ConclusionsOur results suggest the need to provide teenagers with the correct information about e-cigarettes risks, and the balance risk-benefit of their use.DisclosureNo significant relationships.
Alendronate overdose/intoxication: Suicidal attempt in a case report
Authors: Higueras T. Gutiérrez , Cortés F. Calera , Forés S. Vicent , De La Cuesta Alonso S. Sainz 
Published: February 2022

IntroductionAlendronate is a nitrogen-containing biphosphonate that inhibits osteoclastic bone resorption. Lethal dose (LD50) was aproximately 626mg/kg in male rats, and 552mg/kg in female. Signs and Symptoms of overdose clammy skin, CNS depression, dysphagia, hiccups, miosis, respiratory depression, seizures and wheezing. Supportive therapy and monitor of urine flow, calcium and phsophorous level is essential for the management of voluntary overdose.ObjectivesTo present the case of a 76-year-old woman who made a suicide attempt by ingestion of 8 tablets of 70 mg of alendronate.To describe the treatment of alendronate poisoning and the follow-up parameters for the control of complications.MethodsClinical case presentation through retrospective review of clinical notes and non-systematic literature review.ResultsA 76-year-old woman was taken to the emergency department after voluntarily ingesting 8 alendronate tablets (70 mg per tablet) 1 hour ago reporting “suicidal thoughts”. After clinical evaluation, gastric lavage, administration of activated charcoal, and IV ranitidine were used. After 24-hour observation and after psychiatric evaluation, the patient was discharged.ConclusionsHypocalcaemia, hypophosphataemia and upper gastrointestinal adverse reactions, such as upset stomach, heartburn, oesophagitis, gastritis, or ulcer, may result from oral overdose. In case of overdose with alendronate, milk or antacids should be given to bind alendronate. Giving milk or antacids, to bind the bisphosphonate and minimize absorption, has been suggested for oral overdose. Due to the risk of esophageal irritation, vomiting should not be induced and the patient should remain fully upright. For decontamination is recomended activated charcoal and gastric lavage.DisclosureNo significant relationships.
Suicide postvention in psychiatry
Authors: Castro L. , Desport C. , Freitas J. 
Published: February 2022

IntroductionDuring their career and sometimes during their training psychiatrists have to deal with the suicide of patients and have also to help other colleagues and families to cope with the situation. Suicide postvention should be integrated in psychiatric training and better implemented in both psychiatric and community contexts.ObjectivesTo discuss the concept of suicide postvention in Psychiatry. To discuss the importance of addressing suicide postvention in psychiatric settings including during specialized training of Psychiatry residents.MethodsMEDLINE and PubMed databases searches for peer-reviewed studies, published in the last ten years, using combinations of the key-words suicide postvention and psychiatry. Selection of the relevant studies according to the study aims.ResultsThe literature search retrieved a total of 44 papers. All the articles that didn´t refer to the studied topic were excluded. Relevant articles discussing suicide postvention were selected, comprising a total of 22 articles. The reviewed papers discuss different contexts and strategies of suicide postvention that will be explored and critically discussed.ConclusionsAddressing the topic of suicide postvention and implementing support programs and training in this field is crucial to psychiatry trainees, psychiatrists and other mental health professionals that integrate multidisciplinary teams, patients and their families and also to the community as a whole. Future research in this field can help to improve suicide postvention across different settings.DisclosureNo significant relationships.
Anxiety disorders and childhood exposure to emotional abuse: The mediating role of disgust
Authors: Innocenti M. , Santarelli G. , Gironi V. , Faggi V. , Giaquinta N. , Angeletti L. Lucherini , Castellini G. , Ricca V. 
Published: February 2022

IntroductionSeveral studies demonstrate that disgust, defined as a revulsion response aimed at distancing an individual from a potentially harmful or noxious stimulus, is linked to post-traumatic stress following sexual trauma even when accounting for associated fear and anxiety. One of the suggested mechanisms implicated in this association is a feeling of mental contamination. Recent neuroimaging studies demonstrated that exposure to contamination activates the insular cortex. In addition, disgust sensitivity correlates with the activation of the insular cortex.ObjectivesWe aimed to investigate the psychopathological role of the emotion of disgust in the developement of anxiety symptoms in patient with an history of abuse.MethodsWe enrolled 84 patients admitted in Psychiatric Unit of Careggi with diagnosis of Anxiety Disorders. We administered to them: Zung Anxiety Scale (ZSAS), Childhood Trauma Questionnaire (CTQ), Disgust Propensity and Sensitivity Scale-revised (DPSS-r).ResultsResults showed a significant mediation of the association between CTQ emotional abuse scores and total ZSAS scores via DPSS disgust sensitivity scores in patients with anxiety disorders (p=0.022). Total effect and indirect effect of emotional abuse on severity of anxiety symptoms were significant (total effect = 0.494; p=0.051, indirect effect: 0.256, p=0.022), while there was no significant direct effect from emotional abuse to anxiety symptoms in the total model (direct effect: 0.237, p=0.356). The model explained 18% of variance in anxiety symptomatology (R2=0.18).ConclusionsSuch preliminary data suggest a possible mediating role of disgust in development and maintenance of childhood abuse-related anxiety, making it a potential target for psychotherapy.DisclosureNo significant relationships.
Prospective early warning signals to detect transitions to manic and depressive episodes in bipolar disorder
Authors: Bos F. , Schreuder M. , Doornbos B. , Snippe E. , Bruggeman R. , Van Der Krieke L. , Haarman B. , Wichers M. , George S. 
Published: February 2022

IntroductionFor patients with bipolar disorder, early recognition of impending mood episodes is crucial to enable timely intervention. Longitudinal digital mood monitoring using ecological momentary assessment (EMA) enable prospective study of early warning signals (EWS) in momentary affective estates prior to symptom transitions.ObjectivesThe present study examined in a unique longitudinal EMA data set whether EWS prospectively signal transitions to manic or depressive episodes.MethodsTwenty bipolar type I/II patients completed EMA questionnaires five times a day for four months (average 491 observations per person), as well as weekly symptom questionnaires concerning depressive (Quick Inventory for Depressive Symptomatology) and manic (Altman Self-Rating Mania Scale) symptoms. Weekly data was used to determine transitions (i.e., abrupt increase in symptoms). Prior to these transitions, EWS (autocorrelation at lag-1 and standard deviation) were calculated in moving windows over 17 affective EMA states. Kendall’s tau was calculated to detect significant rises in the EWS indicator prior to the transition.ResultsEleven patients reported one or two transitions to a mood episode. All transitions were preceded by at least one EWS. Average sensitivity for detecting EWS was slightly higher for manic episodes (36%) than for depressive episodes (25%). For manic episodes, EWS in thoughts racing, being full of ideas, and feeling agitated showed the highest sensitivity and specificity, whereas for depression, only feeling tired showed high sensitivity and specify.ConclusionsEWS show promise in anticipating transitions to mood episodes in bipolar disorder. Further investigation is warranted.DisclosureNo significant relationships.
Multicentre evaluation of perinatal pharmacological management in women with bipolar disorder
Authors: Dias M. Casanova , Jones I. , Wieck A. 
Published: February 2022

IntroductionThe pharmacological management of women with bipolar disorder in the perinatal period is challenging. This population has a high recurrence rate, but some medications can be a concern in pregnancy and breastfeeding. Little is known about prescribing practices in perinatal services, and the impact of medication on recurrence rates.ObjectivesTo describe 1. the use of medication in women with bipolar disorder in the perinatal period and 2. the impact of medication on the rate of recurrence.MethodsClinical data was collected from pregnant women with diagnosis of bipolar disorder in the nine participating centres and who were not experiencing an episode of illness entering the postpartum period. Data were analysed for association using χ2 tests and logistic regression.ResultsIn this sample of 167 women, 55% were taking medication at delivery: 37% antipsychotics, 15% mood stabilisers, 25% antidepressants. In 12 cases medication was reduced before delivery. 42% experienced a recurrence, with 30% being a manic/psychotic episode. There was no significant association between taking medication and recurrence c2(1)=0.72, p=0.79. There continued to be no association when adjusted for severity (previous admissions, age at first treatment, bipolar subtype) and type of medication OR 0.57 95%CI [0.08; 4.29], p=0.59.ConclusionsA high number of bipolar women are taking medication before delivery and in the majority antipsychotics are prescribed. The postnatal recurrence rate in both medicated and unmedicated women is high. Further work is needed in larger samples to provide clinical guidance for women and their clinicians.DisclosureNo significant relationships.
Childhood behaviours and adverse economic and social outcomes – can we improve detection and prevention?
Authors: Vergunst F. , Tremblay R. , Nagin D. , Vitaro F. , Cote S. 
Published: February 2022

IntroductionDisruptive behaviours underpin the most prevalent and costly psychiatric disorders in youth including ADHD and conduct disorder. Yet the association between childhood behavioural problems and economic and social outcomes in adulthood are rarely examined in a population-based samples where early detection and prevention may be possible.ObjectivesTo examine the association childhood behavioural problems and economic and social outcomes from age 18-35 years across three studies.MethodsThis study daws on 30-year Canadian birth cohort (n=3017) linked to government tax return records. Behavioural assessments – for inattention, hyperactivity, opposition, aggression, anxiety and prosociality – were prospectively obtained from teachers when children were aged 6-12 years. Regression models were used to link behavioural assessments in kindergarten (age 5/6 years) to earnings at age 33-35 years (Study 1) and to trajectories of welfare receipt (Study 2), while behaviour at age 10-12 years was linked to trajectories of partnering. Children’s IQ and family background were adjusted for.ResultsInattention, aggression-opposition (males only) and low low-prosociality in kindergarten were associated with lower earnings at age 33-35 years (Study 1), inattention, aggression-opposition and low prosociality in kindergarten predicted following a chronic welfare receipt trajectory from age 18-35 (Study 2), and inattention, aggression-opposition, anxiety and low-prosociality at age 10-12 years were associated with increased likelihood of being unpartnered and with partnership dissolution from age 18-35 years (Study3).ConclusionsBehavioural assessments made by schoolteachers can identify children at risk of adverse economic and social outcomes in adulthood. The implications of for early screening and prevention will be discussed.DisclosureNo significant relationships.
Association between single nucleotide polymorphisms in oxytocin and vasopressin receptor genes and symptom severity of autism spectrum disorder– preliminary study
Authors: Wilczyński K. , Cichoń L. , Auguściak-Duma A. , Sieroń A. , Janas-Kozik M. 
Published: February 2022

IntroductionOne of the defining features of autism spectrum disorder (ASD) are deficits in social interaction and communication. Although their etiology is poorly understood, several lines of evidence from studies on humans and rodents suggest that two nonapeptides – oxytocin and vasopressin – might play a pivotal role in their development.ObjectivesTo evaluate if single nucleotide polimorphisms in OXTR and AVPR1A genes are linked to the severity of symptoms in autism spectrum disorder.MethodsThe study was conducted on the group of 40 Caucasian males with average age of 14,22 (SD: 1,71) years. ADOS-2 examination was utilized for confirmation of ASD diagnosis as well as evaluation of symptoms severity in each patient. The genotyping of preselected SNPs for each gene (rs10877969; rs7294536; rs2254298; rs53576) was conducted.Results“CC” genotype at rs7294536 (p=0,033) was significantly associated with higher outcomes of ADOS-2 especially in terms of social affect. In case of oxytocin receptor gene, frequency of “AA”/”AG” genotype at rs2254298 equaled 100% and of “AA”/”AG” genotype at rs53576 equaled 85% of the study group (expected “A” allele frequency in neurotypical European population was respectively 11% and 35% according to 1000Genomes database). For rs10877969 prevalence of “CC”/”CT” genotype equaled 95% while expected frequency of “C” allele in neurotypical European population was 13%.ConclusionsOverrepresentation of minor alleles at rs2254298, rs53576 and rs10877969 in patients with ASD might indicate their link to development of ASD. Furthermore, significant association between minor allele at rs7294536 and symptoms severity suggest potential role of arginine-vasopressin receptor deficiency in clinical picture of ASD.DisclosureNo significant relationships.
Mentalization in developmental age’s eating disorders: Comparison between anorexia nervosa and avoidant/restrictive food intake disorder (ARFID)
Authors: Gigliotti F. , Basile C. , Colaiori M. , Terrinoni A. , Ardizzone I. , Santo F. Di 
Published: February 2022

IntroductionAnorexia Nervosa (AN) and Avoidant/Restrictive Food Intake Disorder (ARFID) are two primary restrictive eating disorders described in DSM-5, characterized both of them by insufficient food intake. This behavior In ARFID is not driven by weight and shape concerns that tipify AN. While there are several studies that highlight the presence of mentalizing difficulties in AN, there are still no data about mentalizing profile in ARFID.ObjectivesThe aim of this study was to better characterize the mentalizing profile of AN and ARFID children and adolescent.MethodsTwo groups of AN or ARFID outpatients (15+15), aged 6 to 18 years, were assessed by Alexythimia Questionnaire for Children (AQC) and Toronto Alexythimia Scale-20 (TAS-20) to evaluate alexythimia; by Interpersonal Reactivity Index (IRI) and Basic Empathy Scale (BES) to assess empathy; by NEPSY-II social perception subtests to evaluate Theory of Mind and Emotion recognition. Exclusion criteria were the presence of intellectual disability, pervasive developmental disorders and binge eating behavior (eating disorder other than AN or ARFID).ResultsPreliminary results showed different mentalizing profiles between ARFID and AN patients, with differences in the score for affective empathy, lower in ARFID than in AN patients while the score for alexythimia traits resulted higher in AN population.ConclusionsBy our results, mentalization impairment appeared trans-diagnostic across several eating disorders. This first result should be further improved to better analyze this construct in order to develop effective clinical intervention to improve the subject’s affective regulation.DisclosureNo significant relationships.
Safety of psychotropic medications in people with COVID-19
Authors: Ostuzzi G. , Papola D. , Gastaldon C. , Barbui C. 
Published: February 2022

IntroductionPeople with coronavirus disease (COVID-19) may frequently require treatment with psychotropic medications, but the underlying medical condition and possible interaction with medical treatments might pose serious safety issues.ObjectivesTo review the direct and indirect evidence on the safety of psychotropic drugs in people with COVID-19 and provide practical recommendations for frontline clinicians.MethodsAn international, multi-disciplinary working group was established with the aim of producing evidence-based recommendations on the management of psychotropic medications in people with COVID-19, following the WHO Rapid Advice Guidelines methodology in the context of a public health emergency. Evidence retrieved was focused on the risk of respiratory, cardiovascular, infective, hemostatic, and consciousness alterations related to the use of psychotropic medications. Furthermore, drug-drug interactions between psychotropic and medical treatments used in people with COVID-19 was reviewed and critically discussed by the working group.ResultsThe analysis of available evidence, although indirect, showed that all classes of psychotropic medications might carry relevant safety risks for people with COVID-19. The working group produced a set of 12 recommendations to support clinicians in the assessment of the anticipated risk of psychotropic-related unfavourable events, and how to practically manage this risk, including when it is appropriate to avoid, withdraw, switch, or adjust the dose of the medication.ConclusionsThe present evidence-based recommendations will improve the quality of psychiatric care in people with COVID-19, allowing an appropriate management of the medical condition without worsening the psychiatric condition and vice versa.DisclosureNo significant relationships.
Maintaining therapeutic continuity in adolescent psychiatric day hospital programs during the COVID-19 lockdown
Authors: Vita G. De , Terrinoni A. , Santo F. Di , Calderoni D. , Rainò E. , Anichini A. , Ferrara M. 
Published: February 2022

IntroductionThe COVID-19 social lockdown imposed important limitation to non-emergency health care services in Italy, between March and May 2020, with many difficulties in the mental health assistance of those chronic conditions needing a continuative therapeutic support.ObjectivesOur study aimed to describe how therapeutic activities have been carried on by remote services in two Adolescent Psychiatric Day Hospital Units (Rome and Turin) and the outcome of these assistance interventions in youths with subacute psychopathology.MethodsThe patient cohort includes 162 adolescents (12-19 years old; QI>70) DH outpatients presenting a complete clinical and neuropsychiatric assessment before the lockdown. During the several phases of COVID-19 quarantine all patients were monitored and supported by telemedicine interventions. All data were recorded and standardized every 15 days: symptom severity was rated by global severity (CGI-S) and stress level by self-reported measures of stress (IES-R).ResultsAmong patients, CGI score remained stable, IES-R score declined over time: higher IES-R score was significantly associated with female gender and but no differences was observed related with the primary diagnosis. 5 patients presented a clinical acute state needing a hospitalization. The rate of hospitalization was not significantly different compared with the rate observed in the same period of 2019.ConclusionsIn youth with psychopathological conditions, remote assistance for psychiatric cares resulted effective and it was associated with a clinical stability with decreasing stress levels.DisclosureNo significant relationships.
The impact of COVID-19 pandemic on suicides in portugal during the emergency state
Authors: Ramos S. Freitas , Vaz Soares M.I. Fonseca Marinho , Correia J. Martins , Jesus B. , Cruz E Sousa D. , Mendes J. 
Published: February 2022

IntroductionThe mental health impact of the COVID-19 pandemic is well documented. Portugal entered the emergency state on 19th march due to rising numbers of infected patients. The emergency state introduced regulatory measures that restricted people’s movements, applied a curfew, and closed most non-essential spaces and activities, such as shops and religious celebrations.ObjectivesTo evaluate the rates of suicides during the emergency state in Portugal.MethodsWe obtained the number of probable suicides during 19th march and 2nd may 2020, 2019 and 2018 from SICO/eVM (Real Time Mortality Electronic Surveillance). This system is used for health planning in Portugal and provides provisory data which is updated every 10 minutes. ExcelÒ was used for the statistical analysis.ResultsDuring the Emergency State in Portugal there were 57 probable suicides. Comparing to the same period in 2018 and 2019, there were 62 and 70 probable suicides, respectively. Social isolation, anxiety, fear of contagion, chronic stress, and economic difficulties may lead to the development or exacerbation of depressive, anxiety, substance use, and other psychiatric disorders. Literature on suicides due to COVID-19 mention not only fear of infection, but also social isolation and distancing and economic recession as causes for suicide attempts and completions.ConclusionsDuring the emergency state there was not an increase of probable suicides, compared to previous years. The greater vigilance of people’s movements may have deterred many attempts. However, policymakers and health care providers must be alert as the current psychosocial predispose to an increase in suicide rates.DisclosureNo significant relationships.