bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cognitive impairment and frailty in depressed elderly
Authors: Arts M. , Petrykiv S. , Jonge L. 
Published: September 2022

IntroductionCognitive frailty has recently been defined as the co-occurrence of physical frailty and cognitive impairment. Late-life depression (LLD) is associated with both physical frailty and cognitive impairment, especially processing speed and executive functioning.ObjectivesThe objective of this study was to investigate the association between physical frailty and cognitive functioning in depressed older persons.MethodsA total of 378 patients (>60 years) with depression according to DSM-IV criteria and a MMSE score of 24 points or higher were included. The physical frailty phenotype was examined as well as its individual criteria (weight loss, weakness, exhaustion, slowness, low activity). Cognitive functioning was examined in 4 domains: verbal memory, working memory, interference control, and processing speed.ResultsOf the 378 depressed patients (range 60-90 years; 66.1% women), 61 were classified as robust (no frailty criteria present), 214 as prefrail (1 or 2 frailty criteria present), and 103 as frail (>3 criteria). Linear regression analyses, adjusted for confounders, showed that the severity of physical frailty was associated with poorer verbal memory, slower processing speed, and decreased working memory, but not with changes in interference control.ConclusionsPhysical frailty in LLD is associated with poorer cognitive functioning, although not consistently for executive functioning. Future studies should examine whether cognitive impairment in the presence of physical frailty belongs to cognitive frailty and is indeed an important concept to identify a specific subgroup of depressed older patients, who need multimodal treatment strategies integrating physical, cognitive, and psychological functioning.DisclosureNo significant relationships.
Development of a self-replicating plasmid for non-toxic expression of CRISPR-repressors to study schizophrenia-risk genes
Authors: Abashkin D. , Kurishev A. , Karpov D. , Golimbet V. 
Published: September 2022

IntroductionGenome-wide association studies revealed that polymorphisms located within non-coding regions significantly contribute to the genetic architecture of schizophrenia. Such regions may affect the expression of tens and hundreds of neuronal genes. Epigenetic CRISPR editors help to elucidate the causative polymorphisms. However, efficient CRISPR-repressors are highly toxic to neuronal cells, and their activity rapidly declines with time after transfection due to plasmid silencing. Therefore, less toxic, effective, and long-acting epigenetic CRISPR instruments are required to advance schizophrenia genetic research.ObjectivesWe aimed at creating a less toxic and effective CRISPR-repressor for the investigation of schizophrenia-risk genes.MethodsPlasmids were obtained used standard molecular cloning techniques and lipofected into the SH-SY5Y cell line. Cells were cultured using standard conditions and techniques. Cell viability and GFP-reporter fluorescence were observed using a fluorescent microscope.ResultsWe obtained a set of plasmids encoding dCas9-KRAB-MeCP2 repressor under the control of different promoters (hEF1a, hPGK1, mPGK1, hSYN2, synthetic TRE). Non-toxic expression of the CRISPR-repressor was achieved using tetracyclin controllable TRE promoter. Moreover, the Epstein-Barr virus origin of replication (oriP) and its regulator EBNA were introduced to make the self-replicating plasmid. High activity of CRISPR-repressor was confirmed on a schizophrenia-risk gene DDC encoding L-DOPA decarboxylase catalyzing the last step of dopamine biosynthesis.ConclusionsWe have created a plasmid encoding the non-toxic and effective CRISPR repressor encoded by a self-replicating plasmid. The study was supported by the grant from the Russian Science Foundation №21-15-00124, https://rscf.ru/project/21-15-00124/.DisclosureNo significant relationships.
Phenomenology and comorbidity in late onset bipolar disorder : A comparative study
Authors: Mohapatra D. 
Published: September 2022

IntroductionBipolar disorder in later life is a complex & confounding neuropsychiatric syndrome with diagnostic & therapeutic challenges.ObjectivesTo assess the clinical characteristics of late onset bipolar disorder and to compare with adult onset bipolar disorder and to compare the medical co morbidity between age, sex matched healthy control group.MethodsIt was a hospital based, observational, analytical and cross-sectional study conducted over 2 and half years. The patients > 60 years presenting with manic features after satisfying the inclusion and exclusion criteria were the study group. Control group -1 was selected from adult onset bipolar disorder. YMRS, MMSE, SCID were applied for both. Control group -2 was selected from age, sex, education matched normal population and the three groups were compared for co morbidity. Secondary mania cases are excluded from the study.ResultsMean age at onset was 67.4 years. 63.3% of our patients were female. H/O psychiatric illness in family is more in control group (53.3%) than in study group (26.7%) (p=0.035). 86.6% patients present with irritability. 73.3% patients were presented with aggression. Control group –irritability=90%, aggression=75% The difference is not statistically significant. Scoring of each symptom showed significant difference. It means presence & severity of delusion is significantly more in young bipolar control group.(p=0.035 for % score, p=0.015 for mean SAPS score). 70% presented with co morbidities.ConclusionsGeriatric mania shows mixed presentation compared to early onset disease. Psychotic features are more common. Late onset mania is less associated with family history. Common co morbidities are DM, HTN, Hypothyroidism, neurologic disorders.DisclosureNo significant relationships.
The role of Executive Attention in the association between obsessive-compulsive symptoms and relapses in Major Depressive and Bipolar Disorder
Authors: Lucassen L. , Tioli I. , Ferrari M. , Ossola P. , Marchesi C. 
Published: September 2022

IntroductionMajor Depressive (MDD) and Bipolar Disorder (BD) are chronic relapsing condition in which mood episodes are interspersed with periods of euthymia. Impairments in Executive Attention (EA) are a trait characteristic of mood disorder that persists also during remission. Similarly prefrontal dysfunctions are crucial in the genesis and maintenance of Obsessive-Compulsive Symptoms (OCS), which are highly comorbid in both MDD and BD.ObjectivesThe aim of this study is to test a model in which deficits in EA mediate the relationship between the OCS and the relapse in a cohort of patients with MDD and BD.MethodsSixty-four euthymic subjects with BD and MDD performed the Attentional Network Task Revised (ANT-R), that gauges EA in a standard conflict task. Here we adopted a drift diffusion model to measure the task efficiency as the drift rate in incongruent trials. Patients also completed at baseline the YBOCS, a questionnaire that evaluate the severity of OCS. All the participants have been followed-up for up to 5 years and relapses have been recorded.ResultsThe association between OCS and time in euthymia was fully mediated by the EA so that greater OCS were associated with poorer executive functions (beta=-0.341; p=0.006) that in turn predicted a sooner relapse (beta=0.349; p=0.005). This held true even when controlling for classic predictors of recurrence such as previous episode distance, the duration of illness and medications.ConclusionsTreatment targeting executive functions could hence be crucial in preventing relapses in subjects with mood disorders experiencing obsessive compulsive-symptoms.DisclosureNo significant relationships.
Clinical Features of Bipolar Disorder Patients with Metabolic Syndrome: A Cross Sectional Clinic Based Study
Authors: Sahmelikoglu Onur O. , Baş Uluyol Ö. 
Published: September 2022

IntroductionMetabolic Syndrome (MS) is highly prevalent in patients with bipolar disorder(BD), and may affect the functionality of this population.The increased rate of MS in BD might be due to poorer access to physical health care, unhealthy lifestyle related with psychiatric symptoms and adverse effects of pharmacological treatments.ObjectivesWe sought to compare differences in clinical features of patients with Bipolar Disorder Type 1 (BPD-1)with and without MS in euthymic period.MethodsThis study included 67 euthymic BPD-1 patients without MS and 33 age- and sex-matched BPD-1 patients with MS. All participants completed a sociodemographic form; took the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI) and Young Mania Rating Scale score. MS was diagnosed according to the International Diabetes Federation (IDF) criteria.ResultsAge at onset of disease was significantly lower in BPD-1 group with MS than without MS (p < 0.05). Number of suicide attempts, psychiatric hospitalisation, was significantly higher in BPD-1 group with MS than without MS (p < 0.05). Catatonic and melancholic depression were significantly more prevalent in the BPD-1 with MS than without MS (p < 0.05). Having history of comorbid psychiatric diseases, mixed episodes, are significantly more prevalent in the BPD-1 with MS than without MS (p < 0.05). There was not significant difference between groups in terms of the medication between groups (p>0.05)ConclusionsOur findings suggest that MS might have an effect on the course of BD patients. The development and testing of interventions for preventing and treating the MS and its components in patients with BD might be important .DisclosureNo significant relationships.
Kappa accuracy of prototypical diagnosis and ICD-10 criteria for mental disorders: A cross-sectional study in a real-life setting
Authors: Rocha Neto H.G.D. , Cavalcanti M. , Telles Correia D. 
Published: September 2022

IntroductionThe use of “operational criteria” in DSM-III was proposed as a solution to low reliability among psychiatrist’s diagnosis. It is considered a turning point in the psychiatric classification and diagnostic process, furtherly adopted in ICD. However, the utility of using such criteria in everyday clinical practice is still not clear.ObjectivesTo measure agreement between prototypical and ICD-10 categorical diagnosis.MethodsIn IPUB’s outpatient clinics, psychiatry residents work in a real-life clinical scenario, attending patients from Rio de Janeiro/RJ-Brazil. Although regularly trained in ICD criteria, it is not usual to check every criterion in their daily practice. Thus, patients are diagnosed with a prototype-based disorder, not necessarily strictly attached to ICD criteria. We propose a cross-sectional study, where psychiatry residents check their clinical diagnosis according to ICD criteria and compare its agreement with kappa statistics.ResultsThree of thirty residents joined the study, providing diagnosis for 146 patients under their care. Forty-five diagnoses were obtained before and 51 after ICD-10 criterion application. Diagnoses were grouped under 8 groups (Organic, Schizophrenia Spectrum Disorders, Bipolar Affective Disorder, Depression, Anxiety-Related Disorders, Personality Disorders, Neurodevelopmental Disorders), and kappa agreement obtained using ICD-10 diagnosis as the gold standard against prototypical diagnoses. Overall kappa was 0.77 (IC - 0.69 - 0.85), ranging from 0.58 (Personality Disorders) to 0.91 (Schizophrenia Spectrum Disorder). These findings also were reflected as high sensibility, specificity, Positive Predictive, and Negative Predictive values in all groups.ConclusionsPrototypical diagnostic elaboration, while probably based on previously learned, but not applied operational criteria, was equivalent to diagnostic obtained through ICD-10 categories.DisclosureNo significant relationships.
Clinical Feasibility of Speech Phenotyping for Remote Assessment of Neurodegenerative and Psychiatric Disorders (RHAPSODY): a study protocol
Authors: Taylor R. , Hampsey E. , Mészáros M. , Skirrow C. , Strawbridge R. , Chok L. , Aarsland D. , Al-Chalabi A. , Chaudhuri K.R. , Weston J. , Fristed E. , Young A. , Awogbemila O. 
Published: September 2022

IntroductionThe diagnosis of neurodegenerative and psychiatric disorders (NPDs) in primary care can suffer from inefficiencies resulting in misdiagnoses and delayed diagnosis, limiting effective treatment options. The development of speech and language-based profiling biomarkers could aid in achieving earlier motor diagnosis for PD for instance, or more accurate diagnosis of clinically similar or late presenting NPDs.ObjectivesRHAPSODY aims to investigate the feasibility of the remote administration of a battery of speech tasks in eliciting continuous narrative speech across a range of NPDs. The project also aims to determine the feasibility of using acoustic and linguistic biomarkers from speech data to support the clinical assessment and disambiguation of common NPDsMethodsAll participants (n=250) will take part in a single virtual telemedicine video conference with a researcher in which they are screened and complete a battery of speech tasks, in addition to cohort-specific screening measures. Over the following month, participants will be asked to complete a series of short, self-administered speech assessments via a smartphone application.ResultsThe speech tasks will be audio-recorded and analysed on Novoic’s technology platform. Objectives will be analysed using measures including average length of speech elicitation for speech tasks, intra- and inter-subject variance, differences in linguistic patterns, and response rates to speech assessments.ConclusionsThe analyses could help to identify and validate speech-derived clinical biomarkers to support clinicians in detecting and disambiguating between NPDs with heterogeneous presentations. This should further support earlier intervention, improved treatment options and improved quality of life.DisclosureIn terms of significant financial interest and relationships, it is emphasised that the private organisation Novoic, who aim to develop speech algorithms for diagnostic use, is the study’s sponsor and employees or former employees of this company comprise
Impact of WPA’s Telepsychiatry Global Guidelines on Clinical Practice, International Collaboration, and Education
Authors: Mucic D. 
Published: September 2022

IntroductionTelepsychiatry is the best-documented e-Mental Health application. It refers to the use of videoconferencing in the provision of mental health services. During the COVID19 pandemic, in response to physical distancing, mental health services worldwide have turned to online consultations. For the vast majority of clinicians, it was the first time they use telepsychiatry, and very few have received training in how to do it.Objectives- to present the main objectives and messages of the WPA Global Guidelines for Telepsychiatry related to competencies & skills, educational & legislative needs, and international collaboration.MethodsA structured review of the main challenges, innovations, and settings in the first Global Telepsychiatry Guidelines, published by WPA in February 2021.ResultsThe benefits of increased access to telehealth services are apparent for telepsychiatry, but benefits can only be realized if the tools are used by clinicians who have the appropriate training and guidance. With proper preparation and thoughtful risk management, telepsychiatry can be an invaluable tool for allowing greater access to care. However, certain prerequisites must be fulfilled to achieve the desired goals. These prerequisites are e.g. choice of the technology, settings, patient/provider preferences as well as competencies and skills described in this document.ConclusionsThe need for training among health care professionals is the highest priority. The urgent need for clinical training and skills building around e-mental health inclusive telepsychiatry, will determine the influence that psychiatry can have in addressing the mental health sequelae of the COVID19 pandemic via competent practice and increased international collaboration.DisclosureI am the main author of “WPA Telepsychiatry Global Guidelines”
Associations of neuroinflammatory parameters with clinical features in patients with mild cognitive impairment and dementia
Authors: Zorkina Y. , Syunyakov T. , Andriushchenko A. , Abramova O. , Kurmishev M. , Kostyuk G. , Morozova A. 
Published: September 2022

IntroductionMild cognitive impairment (MCI) represent a state of cognitive function between normal aging and dementia and does not always progress to dementia. Neuroinflammation has a key role in the pathogenesis of neurodegeneration. Determining the associations of neuroinflammatory markers in the blood with clinical disease severity may be useful for early diagnosis of cognitive impairment and prediction of the development of severe dementia.ObjectivesThe aim of our study was to compare the serum concentration of a panel of inflammatory markers in patients with MCI and dementia as well as their associations with clinical symptoms.MethodsPatients were evaluated using Mini-Mental State Examination (MMSE), Clock Drawing Test (CDT), Montreal Cognitive Assessment scales (MoCA), Clinical Dementia rating (CDR) and Hospital Anxiety Depression Scale (HADS). We determined the serum concentration of a panel of inflammatory markers (25 units) cytokines, chemokines, growth factors and several others on Mulliplex and prepared multivariate analysis to investigate associations between clinical features and serum concentration.ResultsPatients with dementia had lower scores on scales than the control and MCI groups. MCI patients were equal to the control group, except for the MMSE scale. EGF, eotaxin-1, GRO-α, IP-10, IL-8, MIP-1β, sCD40L, TNF-α, MDC and MCP-1, VEGF were differ between groups. Multivariate analysis identified some neuroinflammatory parameters associated with the severity of the disease.ConclusionsWe identified some neuroinflammatory parameters associated with dementia and MCI. Many of them have been poor described and data is contradictory. It is necessary to investigate these parameters as potential biomarkers of neurodegeneration in further studies.DisclosureNo significant relationships.
Standard Units for Cannabis Dose: Why is it Important to Standardise Cannabis Dose for Drug Policy and How Can we Enhance its Place on the Public Health Agenda?
Authors: López-Pelayo H. , Balcells-Oliveró M. , Gual A. , Matrai S. , Oliveras C. 
Published: September 2022

Regular cannabis use is associated with several adverse health outcomes including psychosis and cannabis use disorders. In the last decade, prevalence of last-month cannabis use increased by 27% and rate of treatment demand rose from 27 to 35.1 per 100000 inhabitants in Europe. Cannabis legal status is changing worldwide, and recently two European countries (Malta and Luxembourg) legalized its production, sales and use. Even United Nations withdrew cannabis from Schedule IV of the Single Convention on Narcotic Drugs (retained in Schedule I). This new scenario aligns cannabis more closely with alcohol, prescribed drugs or tobacco than illegal drugs. Implementing prevention and harm reduction strategies will be even more relevant in the nearly future. Based on the history with alcohol or tobacco, frequency of use alone misestimates the risks due to limited capture of variations of quantity per day of use on regular users. Standardisation of cannabis use has been proposed in the literature as an instrument to assessing the level of risk. In the Lisbon Addictions Conference (2019) a group of 32 professionals from 13 countries and 10 disciplines participated in a back-casting foresight exercise aiming to addresses challenges of implementation of SJU. They proposed three key steps in the implementation of SJU: 1) constitution of task-force for an evidence-based approach to SJU; 2) expanding the available data on cannabis-related risks; 3) examining the relationship between ‘risky use’ and SJU.DisclosureNo significant relationships.
Which residual symptoms predict relapse after successful electroconvulsive therapy for late-life depression?
Authors: Lambrichts S. , Vansteelandt K. , Wagenmakers M. , Oudega M. , Obbels J. , Dols A. , Bouckaert F. , Sienaert P. 
Published: September 2022

IntroductionIntroduction: Residual depressive symptoms are common after a successful acute treatment of late-life depression (LLD), and their presence predicts increased risk of relapse. While electroconvulsive therapy (ECT) is the most effective treatment for LLD, little is known about which particular symptoms remain and impact long-term outcome after a successful acute ECT course.ObjectivesObjectives: We aimed to assess the association between specific residual depressive symptoms after an effective acute ECT course for LLD and relapse at six-month follow-up.MethodsMethods: In this prospective cohort study, including 110 patients aged 55 years and older with LLD, information about relapse was collected six months after the acute ECT course. Relapse was defined as a Montgomery-Åsberg Depression Rating Scale (MADRS) score >15, hospital admission or restart of ECT. We used multivariable stepwise logistic regression models including the scores on the 10 individual MADRS items at the end of the acute ECT course to predict relapse.ResultsResults: Of the 80 responders with available six-month follow-up data, 29 patients (36.25%) had suffered relapse. Higher scores on the MADRS items ‘reduced sleep’ (odds ratio (OR)=2.03, 95% confidence interval (CI)=1.11-3.69, p=0.0214) and ‘lassitude’ (OR=1.62, 95% CI=1.00-2.62, p=0.0497) at the end of the acute ECT course were significantly associated with increased risk of relapse at six-month follow-up.ConclusionsConclusions: Some residual depressive symptoms, including sleep disturbance and fatigue, may help better identify patients vulnerable to relapse following a successful acute ECT course for LLD. Future studies assessing interventions that target specific residual symptoms may further reduce post-ECT depressive relapse.DisclosureNo significant relationships.
Trichotillomania in adulthood, a case report
Authors: Navarro L. , Fernández T. , Tardon L. , Marco O. , Arbelo N. , Baldaquí N. , Cavero M. 
Published: September 2022

IntroductionTrichotillomania is a disorder (estimated prevalence 0.5-2.0%) with common onset in childhood, rarely seen in adulthood, characterized by the repetitive pulling out of one’s own hair leading to hair loss and functional impairment, associated with other comorbidities: major depression (39-65%), anxiety disorder (23-32%), SUDs (15-19%), OCD (13-27%).ObjectivesTo present a case of late-onset trichotillomania in a 60-year-old woman.MethodsThe present study is a case report of a patient visited in outpatient psychiatry for trichotillomania. We also searched previously case reports, series and systematic reviews of clinical trichotillomania using a pubmed query.ResultsThis is a 60-year-old morbidly obese woman diagnosed with dysthymia, binge eating disorder and histrionic personality disorder. She explained a worsening of anxiety associated with work problems of one year of evolution and, for six months, the beginning of the plucking of eyebrow hairs and scabs to decrease this symptom, with inability to avoid the behaviour and without eating the hairs. The mental evaluation highlighted psychic anxiety, hypothymia, low self-esteem and feelings of failure and did not suggest a delirium. We started treatment with topiramate up to 150mg/day which was not successful. After that we switched to fluoxetine up to 60mg/day associated to psychotherapy observing a slight gradual improvement.ConclusionsThe clinical presentation suggested the diagnosis of trichotillomania in the context of dysthymia. No particular medication demonstrates efficacy in the treatment of trichotillomania. Preliminary evidence suggests treatment effects of clomipramine, NAC and olanzapine based on individual trials with small sample sizes. Research findings also recommend psychotherapy based on habit reversal.DisclosureNo significant relationships.