bluuebunny/crossref_metadata_2025_split huggingface dataset:
A multicentric multimodal in vivo microscopy MRI study of bipolar disorder reveals axonal loss and demyelination
Authors: Sarrazin S. , Poupon C. , Uszynski I. , Mangin J.-F. , Polosan M. , Favre P. , Laidi C. , D’Albis M.-A. , Leboyer M. , Lledo P.-M. , Henry C. , Emsell L. , Shakeel M. , Goghari V. , Houenou J. 
Published: September 2022

IntroductionBipolar disorder has been repeatedly associated with abnormalities of white matter. However, DTI is intrinsically limited and the precise cellular mechanisms that underlie these alterations remains unknown.ObjectivesOur aim was to investigate microscopical characteristics of white matter using MRI in patients with bipolar and healthy controls.Methods77 patients and 71 controls from 3 sites had a T1 structural MRI, a multi-shell HARDI MRI and at one site with a T1-weighted VFA-SPGR acquisition, and a T2 MSME acquisition. The volume fraction and the orientation dispersion was extracted using NODDI from DW images in each site. Myelin Water Fraction was extracted in 33 patients and 36 controls to probe myelin characteristics. White matter bundles were reconstructed using deterministic tractography. Statistical analyses were performed after harmonization by the ComBat algorithm and controlled for age, gender and handedness.ResultsWe found significant lower axonal density in patients along the short fibers of the left cingulum, the left anterior arcuate and the left inferior fronto-occipital fasciculus. We found lower mean MWF in patients along the short fibers of the right cingulum, the left inferior fronto-occipital fasciculus, the left anterior arcuate and the splenium of the corpus callosum. We found higher mean orientation dispersion in patients only along the left uncinate fasciculus.ConclusionsWe report alterations of limbic and inter-hemispheric white matter tracts in patients with bipolar disorder reflecting axonal loss, demyelination and architecture alterations. These results contribute to better capture the plurality of the mechanisms involved in bipolar disorder that cannot be deciphered with classical diffusion MRI.DisclosureNo significant relationships.
Hyponatremia from oxcarbazepine: A case report
Authors: Coucheiro Limeres P. , Cerame A. , Maldonado Orellana S. , Franco Soler A. 
Published: September 2022

IntroductionOxcarbazepine (OXC) is an antiepileptic drug used as a mood stabilizer in patients diagnosed with bipolar disorder (BD). OXC has been reported as a source of hyponatremia in its use in both epilepsy and BD.ObjectivesWe present the case of a 53 year-old male patient diagnosed with Schizoaffective disorder, bipolar type who developed hyponatremia during his treatment with OXC.MethodsThe patient’s treatment was desvelafaxine 100 mg, Paliperidone depot 150 mg, Oxcarbazepine 600 mg which he had maintained for at least one year. He began to manifest headache, asthenia and mild confusion gradually, with morning predominance, without being clearly suggestive of an acute worsening.ResultsIn control analysis, the existence of sodium leveles of 127 and low osmolarity was observed. Therefore it was decided to suspend furosemide, close monitoring of water intake in order to rule out primary polydipsia and extra salt was introduced into the diet. Given the persistence of the symptoms, laboratory abnormalities and ruled out the existence of primary polydipsia, it was decided to suspend treatment with oxcarbazepine. After the discontinuation of the aforementioned drug the analytical findings went back to normal ranges and the symptoms disappeared.ConclusionsCarrying out control tests in patients with psychiatric pathology and multiple psychiatric treatments is essential to be able to rule out analytical alterations which could be asymptomatic or with nonspecific symptoms that could be attributed to the underlying pathology. The easy reversal of symptoms encourages us to emphasize the study and differential diagnosis of each case.DisclosureNo significant relationships.
Review of gastrointestinal bleeding during use of SSRIs combined with use of NSAID
Authors: Arts M. , Petrykiv S. , De Jonge L. 
Published: September 2022

IntroductionIn recent years, more and more attention has been paid to the risks of using SSRIs. This group of antidepressants may be associated with an increased risk of gastrointestinal bleeding. This risk would be even further increased with concomitant use of NSAIDs. A number of studies have described this interaction, however they reported conflicting results.ObjectivesOur objective was to investigate the risk of gastrointestinal bleeding with SSRIs, with or without NSAID use.MethodsWe performed a literature search, using Pubmed, EMBASE, and Cochrane library, in order to investigate controlled trials, cohort, case-control and cross-sectional studies that reported the incidence of gastrointestinal bleeding s on SSRIs with or without concurrent NSAID use, compared to placebo or no treatment.Results15 case-control studies and 4 cohort studies were included in the analysis. There was an increased risk of gastrointestinal bleeding with SSRIs in the cohort studies and case-control studies. The risk of gastrointestinal bleeding was even further increased with the combined use of both SSRIs and NSAIDs.ConclusionsSSRIs are associated with a modest increase of gastrointestinal bleeding. However, this risk is significantly increased when SSRIs are used in combination with NSAIDs. Psychiatrists should be aware of the hazards in prescribing these medications together.DisclosureNo significant relationships.
Development process of artificial intelligence based chatbot to support and promote mental wellbeing in sparsely populated areas of five European countries
Authors: Kuosmanen L. , Vartiainen A.-K. , Nieminen H. , Kostenius C. , Bond R. , Mulvenna M. , Potts C. , Ennis E. , Malcolm M. , Vakaloudis A. , Cahill B. , Dhanapala I. 
Published: September 2022

IntroductionIn many countries, people face problems regarding access to care, 24/7 support and evidence-based support. Digital interventions and services, such as chatbots, can be one option to tackle these challenges. There is a lack knowledge regarding how mental health chatbots are developed and how to ensure that there is collaboration between mental health and digital technology experts and users.ObjectivesThis presentation describes the phases of the development for the ChatPal mental health and wellbeing chatbot.MethodsDevelopment process was conducted in five and with four different languages. First, using an electronic survey for mental health professionals (n =190) we screened how familiar they are with chatbots and how they evaluated their potential. Second, university students and staff, mental health professionals and service users (n=78) participated in workshops to design the chatbot content. Finally, the content and scripts of chatbot were written in multi-professional and multi-national collaboration.ResultsChatPal is based on the PERMAH model of positive psychology and on the idea that we all have mental health which needs boosting and support from time to time. ChatPal includes relevant mental health information, exercises, mood diaries and simple monitoring and self-care tools. Based on preliminary evaluations, the ChatPal chatbot offers an option to offer support in areas where other mental health services are lacking or are insufficient.ConclusionsChatPal is already freely available in application stores and first scientific trials are have started. Preliminary results of 4-week and subsequent 12-week in-the-wild trials will be in place at the time of EPA 2022 conference.DisclosureNo significant relationships.
COVID-19 and the emergence of inpatient tele-ward rounds
Authors: Boland X. , Dratcu L. 
Published: September 2022

IntroductionTelemedicine has been at the heart of healthcare system’s strategic response to the COVID-19 pandemic. Within psychiatry, there has been a surge of research and guidelines into the use of video-teleconferencing to replace face to face consultations across clinical settings. Clinical ward rounds are central to inpatient psychiatric care yet little guidance is available on how best to integrate telemedicine into the multidisciplinary work of inpatient psychiatry.ObjectivesWe report on the introduction of video teleconferencing for psychiatric ward rounds on our acute inner-London psychiatric unit during the outbreak of COVID-19.MethodsIn undertaking the rapid transition to tele-ward rounds, we had to reconcile the multiple functions of psychiatric ward rounds with the technological resources available to us.ResultsTele-ward rounds helped simplify care delivery, facilitate multidisciplinary collaboration and improve accessibility for patients and relatives in a time of crisis. The transition to tele-ward rounds also brought about technical, operational and communication issues that may impact on the patient experience and quality of care including governance challenges, contextual dissonance and technological limitations.ConclusionsThe routine use of newer technology in psychiatry ward rounds is unlikely to succeed on the basis of improvisation, particularly given the stream of technical innovations in telemedicine, and the multifarious quality of social interactions in our clinical setting. Staff training and the development of an adapted etiquette and code of communication are both essential. Patient participation in future developments will also help ensure tele-ward rounds continue to meet the standards of high quality inpatient psychiatric care beyond the COVID-19 pandemic.DisclosureNo significant relationships.
Sociodemographic characteristics associated with an eHealth system designed to reduce depressive symptoms among patients with breast or prostate cancer: a prospective study
Authors: Petros N.G. , Hadlaczky G. , Carletto S. , Martínez S.G. , Meyer B. , Ostacoli L. , Ottaviano M. , Scilingo E.P. , Carli V. 
Published: September 2022

IntroductionElectronic health (eHealth) interventions integrate different elements of care in treating and preventing mental ill-health in patients with somatic illnesses. Identifying different sociodemographic characteristics that might be associated with higher perceived usability can help in improving the usability of these e-health interventions.ObjectivesThis study aimed to identify sociodemographic characteristics that might be associated with the perceived usability of the NEVERMIND e-health system, comprised of a mobile application and a sensorized shirt, developed to reduce co-morbid depressive symptoms in patients with breast or prostate cancer.MethodsThe study included 129 patients with a diagnosis of breast or prostate cancer who received the NEVERMIND system. Sociodemographic data were collected at baseline. Usability outcomes included the System Usability Scale (SUS), the Mobile Application Rating Scale: user version (uMARS), and a usage index.ResultsThe analysis was based on 108 patients (68 breast cancer and 40 prostate cancer patients) who used the NEVERMIND system. The overall mean SUS score at 12-weeks was 73.4 with no statistical differences among different sociodemographic characteristics. The global uMARS score was 3.8, and females scored the app higher than males (β coefficient= 0.16; p=.03, 95% CI 0.02 - 0.3). Females had significant lower usage (β coefficient= -0.13; p=.04, 95% CI -0.25 to -0.01) after adjusting for other covariates.ConclusionsThere was a higher favourability of the mobile application among females compared to males. However, males had significantly higher usage of the NEVERMIND system. The NEVERMIND system does not suffer from ‘digital divide’ where certain sociodemographic characteristics are more associated with higher usability.DisclosureNo significant relationships.
Prevention and Management of Falls in Older Adults admitted to Woodlands Hospital, an inpatient Old Age Psychiatric Unit
Authors: Darod N. 
Published: September 2022

IntroductionFalls are a significant cause of injury in older adults who are disproportionately at higher risk due to multiple factors such as, mobility issues, co-morbidities and polypharmacy. There are several evidence-based interventions that can be implemented to reduce the risk of – and manage falls.ObjectivesAssess whether Woodlands Hospital has implemented the standards set by NICE guidelines on the management of Falls in Older People.MethodsRetrospective audit of patients admitted to Woodlands Hospital from 1st June to 1st December 2018. 113 patient records were analysed to determine; was an falls risk assessment completed on admission, did patients ’at risk of falls’ have individualized interventions in place, was a falls risk assessment completed weekly at MDT, following a fall, were patients checked for signs of fracture before moved, was a medical examination completed and were neurological observations completed in patients with observed head injury or where it could not be excluded?Results100% of patients had individualised interventions to reduce risk of falls and 97.3% of patients had an assessment of risks completed on admission. 60.3% of patients were checked for signs of fracture. 78.3% of patients had a physical examination within 12 hours. 75% of patients had neurological observations completed.ConclusionsRisk assessment for falls and individualized interventions for patients at risk of falls were completed at a high standard. There remains scope for improvement of review of risk of falls during weekly MDT, documentation of checking for signs of fractures and neurological examination. The outcomes were relayed to the unit and plans to re-audit in September 2021.DisclosureNo significant relationships.
Prodromal stage of late-onset psychosis
Authors: Pochueva V. , Sheshenin V. , Savina M. , Safarova T. 
Published: September 2022

IntroductionProdromal stage of psychosis may be an aim of prevention first episode psychosis. In late-onset psychosis it’s low described.ObjectivesThe aim of this investigation is to describe prodromal phase of late-onset psychosis and their connection with psychopathology.Methods74 women with late-onset psychosis (age 64,3±6,7) - late-onset schizophrenia (LOS) (n=49, age 63±8,4), schizoaffective disorder (n=17, age 62,4±6,5), late onset delusion disorder (LoDD) (n=8, age 76,6±4,3) underwent clinical assessment (SOPS, PANSS, HAMD-17), cognitive examination (MMSE, MoCA), structured interviewing on life-time pathology. Spearman’s rho statistics was used.ResultsLOP patients have low prodromal symptoms according to the SOPS score. In LOS patients middle score of SOPS is 18±8,5, in schizoaffective patients middle score of SOPS is 12,3±6,8, and for LoDD SOPS is 13,4 ±4,6. Prodromal disturbances are represented mainly by fragmentary paranoid ideas, thoughts of unusual content, acoasms and affective fluctuations. In LOS patients SOPS negative subscale correlate with HAMD (r=0,384, p<0,05), desorganisation subscale correlate with PANSS common psychopathology subscale (r=0,32, p<0,05) and total PANSS (r=0,28, p<0,05), generous subscale and common SOPS correlate with HAMD (r=0,29, r=0,3, p<0,05). For patients with schizoaffective disorder there is no correlations, and in patients with LoDD SOPS desorganisation subscale negative correlate with PANSS negative subscale (r=-0,71, p<0,05).ConclusionsIn patients with late psychoses, the severity of disorders in the prodromal period is minimal. However, prodromal features are associated with the psychopathology.DisclosureNo significant relationships.
Changes in neuropsychiatric symptoms and caregivers’ distress in behavioral variant frontotemporal dementia and Alzheimer’s disease in 12 months
Authors: Yassuda M. , Lima-Silva T. 
Published: September 2022

IntroductionIn behavioral variant frontotemporal dementia (bvFTD) neuropsychiatric symptoms are a significant concern as they impact care management and caregiver wellbeing.ObjectivesTo describe change in individual neuropsychiatric symptoms and associated caregivers’ distress assessed by the Neuropsychiatry Inventory (NPI) in patients diagnosed with bvFTD and Alzheimer’s disease (AD) from baseline to a 12-month follow-up.MethodsThe sample consisted of 31 patients diagnosed with bvFTD and 28 patients with AD and their caregivers. The NPI and the Addenbrooke´s Cognitive Examination Revised (ACE-R) were applied. Descriptive statistics, Mann-Whitney U test, Wilcoxon test, Chi square (χ2) were used.ResultsAt baseline, significantly higher scores were observed for the bvFTD group for: agitation, disinhibition and eating disturbances. The latter two were also higher in the NPI Distress subdomains. At followup, there were significantly higher scores for the bvFTD group in agitation, disinhibition, eating disturbances, hallucination and irritability. For the NPI Distress subdomains, agitation, eating disturbances and hallucination scores were significantly higher for the bvFTD group.ConclusionsIn 12 months, neuropsychiatric symptoms increased in both bvFTD and AD groups. However, NPI subdomain and caregiver distress scores were statistically higher among bvFTD patients at both assessment points. Neuropsychiatric symptoms may be associated with care burden in bvFTD and should be a focal point in care management decisions.DisclosureNo significant relationships.
Psychiatrist-led treatment of hepatitis C (HCV) at an opioid agonist treatment (OAT) clinic in Stockholm - enhancing the HCV treatment care cascade
Authors: Kåberg M. , Klasa P.-E. , Nordin T. 
Published: September 2022

IntroductionPeople who inject drugs (PWID) and opioid agonist treatment (OAT) patients have an increased hepatitis C (HCV) prevalence. Studies among these populations show promising HCV treatment results, which is essential to reach the WHO goal of eliminating HCV as a major public health threat by 2030.ObjectivesTo introduce psychiatrist-led HCV treatment at an OAT clinic and to investigate HCV treatment results, i.e. sustained virological response at 12 weeks post treatment (SVR12) and numbers of reinfections.MethodsPrima Maria OAT clinic in Stockholm, provides OAT for 450 patients. The majority have a history of injection drug use. Baseline HCV prevalence (January 2018) was retrospectively investigated through medical charts. In January 2018, psychiatrist-led HCV treatment (with consultation support from infectious diseases specialists) was introduced at the clinic. Prospective treatment results, numbers of reinfections and incidence rates between January 2018 and April 2021 were further investigated.ResultsBaseline data (n=418), showed that 46% were not tested for HCV. Of those tested (n=225), 64% had a chronic HCV infection. By January 2021, 104 HCV treatments were initiated. 97/97 (100%) were HCV RNA negative at end-of-treatment. 78/88 (89%) reached SVR12. Overall, 2 reinfections were noted after SVR12 corresponding to a reinfection rate of 3.5/100 PY. Numbers of HCV treatment did not decrease during the COVID-19 pandemic.ConclusionsTo enhance the HCV treatment cascade, targeted HCV diagnosis efforts are needed. Bringing HCV treatment to OAT clinics enhance the HCV care cascade. HCV treatment education for psychiatrists/addiction specialists makes HCV treatment more sustainable, as specifically noted during the COVID-19 pandemic.DisclosureThis study was partly funded by Gilead Nordic Fellowship 2020. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the poster/manuscript.
Covid-19: Lessons for Mental and Brain Health
Authors: Falkai P. 
Published: September 2022

Psychiatry is facing major challenges during times of a pandemic as illustrated by the current COVID-19 pandemic. The challenges involve its actual and perceived role within the medical system, in particular how psychiatric hospitals can maintain their core mission of attending to the mentally ill while at the same time providing relief to general medicine. Since psychiatric disorders are the top leading causes of global burden of disease, we need to strengthen mental health care in the wake of the massive onslaught of the pandemic. While nobody can deny the need to act decisively and swiftly and ramp up intensive care readiness, we believe that the immediate availability of psychiatric care is just as important. In order to provide the best possible treatment conditions for people suffering from mental illness but as well for those suffering from the immediate pandemic’s consequences such as isolation, reduced social interaction etc. instant and comprehensive provision is inevitable.DisclosureNo significant relationships.
Darier-White disease and Psychiatric disorders: A Case Report
Authors: Esteve R.L. , Sánchez-González R. , Campillo M. , Carrió E. 
Published: September 2022

IntroductionDarier-White disease (DD) is a rare genodermatosis of dominant autosomic inheritance characterized by the keratinization of epidermis, nails and mucous membrane. It leads to the formation of papules and brown hyperkeratotic plaques, mainly in seborrheic areas. The disease is associated with a mutation on the ATP2A2 gene, mapped in the 12q23-24 chromosome. There is known a relationship between DD and neuropsychiatric diseases, such as bipolar disorder, depression and schizophrenia.ObjectivesTo discuss the relationship between DD and neuropshychiatric disorders.MethodsWe report the case of a patient with diagnosed schizophrenia, alcohol and cannabis dependence who presented skin lesions.ResultsThe physical exploration of our patient revealed cutaneous lesions and we pointed the diagnostic towards DD. Afterwards, a cross-consultation was done with the dermatology experts. During the physical exploration, the patient shows confluent hyperkeratotic papules, dominant on the sides and center of back and hands, together with nail injuries (see images). The diagnostic was confirmed through anatomic pathology. The patient was treated with 10 mg/day of Acitretin together with emollients twice a day, which improved the patient clinical status and signs. The patient remained stable at a psychiatric standpoint. After 3 years of treatment, the patient keeps the same medication but with a reduced dose of 5 mg/day, with a 70% decrease of the initial hyperkeratotic lesions.ConclusionsPrevious studies concludes that mutations in the ATP2A2 gene, in addition to causing DD, confer susceptibility to neuropsychiatric features.These case report highlight the need for clinicians to asses and recognize neuropsychiatric symptoms in DD.DisclosureNo significant relationships.