bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical, genetic and environmental influences on weight gain and metabolic disorders induced by psychotropic drugs
Authors: Eap C. 
Published: September 2022

Introduction
Weight gain and obesity are important health problems associated with psychiatric disorders and/or with psychotropic drug treatments. There is a high inter-individual variability in the susceptibility to drug induced weight gain and/or other cardiometabolic disorders.ObjectivesTo study the genetic and environmental risk factors for weight gain and onset of metabolic syndrome during psychotropic treatmentMethodsAnalysis in PsyMetab, a large (n>3000) ongoing longitudinal prospective cohort study investigating cardiometabolic disorders in psychiatric patients.ResultsAside from well-known clinical risk factors for metabolic worsening (e.g. young age, first episode status, rapid weight gain during the first month of treatment and/or low initial BMI), additional risk factors have been recently identified. We showed an inverse association between socio-economic status (SES) and worsening of cardiometabolic parameters, adult patients with a low SES having a three-fold higher risk of developing metabolic syndrome over one year versus patients with a high SES (n=366). In addition, a causal inverse effect of educational attainment on BMI was revealed using Mendelian randomization in the UKBiobank (n=30’069). Results from an epigenome-wide association study (EWAS) performed in 78 patients before and after one month of treatment and from a genome-wide association study (GWAS) in 1924 patients will also be presented.ConclusionsDifferences in clinical, genetic and environmental factors contribute to the differences in weight gain and metabolic disorders induced by psychotropic drugs. When starting a psychotropic drug at risk, a prospective monitoring of clinical (e.g. weight and blood pressure) and biochemical (fasting glucose, lipid levels) parameters is essential.DisclosureProf. Eap received honoraria for conferences or teaching CME courses from Janssen-Cilag, Lundbeck, Otsuka, Sandoz, Servier, Sunovion, Vifor-Pharma, and Zeller in the past 3 years. The other authors report no potential conflicts of interest. This work has
Benzodiazepine use during cariprazine treatment in acute schizophrenia
Authors: Correll C. , Sebe B. , Csehi R. , Acsai K. , Barabássy Á. 
Published: September 2022

IntroductionAlthough antipsychotics are first-line treatments for schizophrenia, benzodiazepines (BZDs) are often used as concomitant medications in acutely exacerbated patients due to their anxiolytic and sedative effects. Cariprazine (CAR), a D3-preferring dopamine D2/D3 partial agonist antipsychotic, has been examined in many clinical studies for the treatment of acute schizophrenia, with and without benzodiazepines.ObjectivesTo delineate the effects of benzodiazepine-use during cariprazine treatment in acute schizophrenia.MethodsPooled data of cariprazine-treated (1.5-6mg/day) and
placebo-treated patients from four short-term, randomised, double-blind trials (NCT00404573, NCT01104766, NCT01104779, NCT00694707) were analysed. Baseline characteristics (age, duration of illness) and efficacy outcome parameters (Total and Hostility Factor Score of the Positive and Negative Syndrome Scale [PANSS]) were compared in patients receiving benzodiazepines (for more ≥3 consecutive days) and not receiving benzodiazepines (<3 consecutive days).ResultsAltogether, 36.7% and 40.7% of the CAR-treated and PBO-treated patients required BZDs. BZD-taking was associated with a higher age in both the CAR-treated (p=0.0002) and PBO-treated (p<0.0001) patients, and with longer illness-duration in both treatment groups (p<0.0001). PANSS Total Score at baseline was similar for BZD users and non-users (CAR: LS Mean=96.36 and 96.27; PBO: LS Mean=95.55 and 96.66). Change from baseline in the PANSS Total Score was greater for patients who did not use BZD vs those who did (CAR: LS Mean= -23.8 vs LS Mean 17.2, p<0.0001; PBO: LS Mean= -14.0 vs LS Mean 12.9, p=0.5776).ConclusionsThese findings may suggest that requiring benzodiazepines is a potential indicator of longer illness duration and poorer response in acute schizophrenia.DisclosureI am an employee of Gedeon Richter Plc.
Characterising the evolution of antipsychotic polypharmacy and clozapine prescribing patterns in schizophrenia patients during psychiatric hospitalisations
Authors: Lagreula J. , Elens L. , De Timary P. , Dalleur O. 
Published: September 2022

IntroductionA high prevalence of antipsychotic polypharmacy (APP) and low utilisation of clozapine is considered as inappropriate prescribing that can lead to suboptimal treatment, increased risk of poor response or adverse effects.ObjectivesTo explore the evolution of prevalence of APP and associated factors as well as clozapine prescribing patterns between hospital admission and discharge.MethodsWe collected retrospective data on adult inpatients diagnosed with schizophrenia spectrum disorders in 2020-2021 in 6 Belgian hospitals.ResultsOf the 516 patients analysed, APP prescribing significantly increased from 47.9% on hospital admission to 59.1% at discharge. Both on admission and at discharge, APP was associated with treatment with a first-generation antipsychotic, not being treated with an antidepressant nor a mood stabilizer, high antipsychotic dosage, increased number of psychoactive cotreatments and total medicines. A lower number of comorbidities (OR=0.68, CI=0.50-0.91), no treatment with benzodiazepines (OR=0.02, CI=0.01-0.09) nor with trazodone or sedative antihistamines (OR=0.06, CI=0.01-0.03) and two or more previous antipsychotic trials (OR=4.91, CI=1.30-18.57) was associated with APP on admission only. APP at discharge was more frequent in patients with antipsychotic adverse effects (OR=2.57, CI=1.10-6.00), prior clozapine use (OR=16.30, CI=3.27-81.22) and not involuntary admitted (OR=0.26 CI=0.08-0.88). Contrary to admission, treatment with benzodiazepines was associated with APP at discharge (OR=10.9, CI=3.38-5.38). Only 9.3% of admitted patients were treated with clozapine. Although 28.1% were eligible, clozapine was introduced to 10 patients leading to 11% being discharged on it.ConclusionsInappropriate prescribing of antipsychotics to schizophrenia patients persist after psychiatric hospitalisations and are associated with identifiable characteristics.DisclosureNo significant relationships.
SERVICE INNOVATION (SOUL PROGRAMME) - Charitable home-based outreach service for treatment of schizophrenia in Larkano, Pakistan: development, implementation and 10 year outcomes
Authors: Afghan S.S. , Junejo B. , Soomro G. , Soomro F. , Wagan R. , Faruqui R. 
Published: September 2022

IntroductionThere is a huge resource gap in mental health service provision & service utilisation in LAMIC including Pakistan. SOUL Programme has been established in the City of Larkana, on charitable donations, which utilises principles of home-based outreach and produces clinical and functional outcomes.ObjectivesSOUL programme focuses on collaborative working with patients & families. The objectives include recognition, treatment, family education & psychosocial support to maximize clinical, functional & occupational outcomes.MethodsSingle cohort intervention (patients recruited on continual basis over time) with innovative service structure and culturally relevant open label intervention design developed with local academic psychiatric unit in Larkano, Pakistan. Training was provided to local mental health professionals on diagnosis, delivering care & use of recognized clinical outcome measures.ResultsWe have recruited a cohort of 160 patients on continual basis over time. Our analysis show a higher BPRS and lower GAF ratings for men in comparison to female cohort at the baseline. Our Ten year follow up has demonstrated statistically significant clinical / functional improvement on BPRS, CGI & GAF measures. The mean differences recorded for the individual measures after 12 months were BPRS, CGI-I and GAF and were all statistically significant. Innovative home-based community mental health intervention shows significant improvements in clinical and functional outcomes (with good effect size).ConclusionsSOUL Programme is a highly effective and cost-efficient intervention model for treatment of schizophrenia in a developing country setting. Our 10 year follow up study confirms the feasibility of this intervention model through close working with families of our patients.DisclosureNo significant relationships.
Descriptive study on the working conditions of residents of psychiatry in Madrid: working hours and 24-hour on call shifts
Authors: Cerame A. , Coucheiro P. , Cayuela L. , Maiques M. , Franco Soler A. 
Published: September 2022

IntroductionResident physician’s working conditions are linked to poor health outcomes of professionals and patient’s safety. Previous studies suggest that residents in Spain have difficulties enjoying mandatory rest after on-call shifts.Objectives
This study aims at describing the working conditions: working hours and the absence of mandatory rest periods after a 24h on-call shift in residents of psychiatry in the region of Madrid.Methods
A descriptive observational cross-sectional study was carried out through an anonymous survey adapted from the available literature.ResultsUp to 24,1% of the surveyed residents could not enjoy mandatory resting periods after a 24 hour on-call shift and the mandatory weekly rest of at least 36 hours was not done in up to 17% of the cases with statistical significance (p <0.05). The average number of 24 hours on call shifts residents had to work per month was 5, which exceeds the maximum weekly hours allowed by law.ConclusionsThe findings reveal a violation of resident physician labor rights in relation to resting times after on-call shifts, weekly breaks and working hours. These phenomena pose a significant threat to resident physician’s health and patient safety.DisclosureNo significant relationships.
Clinical and immunological profile of patients with schizophrenia
Authors: Petrova N. , Mayorova M. , Churilov L. , Gvozdetskiy A. , Kudryavtsev I. , Sobolevskaia P. , Serazetdinova V. 
Published: September 2022

IntroductionThe question of the involvement of inflammatory and autoimmune processes in schizophrenia pathogenesis has become the most relevant in the last decade and yet is not fully understood.Objectives
The study included 60 patients with paranoid schizophrenia (age 18 - 55 y.o.) and 30 healthy control group participants. Patients were in a stabilization state without a history of organic brain disorder or another verified somatic disease in the exacerbation phase.MethodsResearch methods included follow-up method, neuropsychological (PANSS, BAC-S), laboratory (enzyme immunoassay, flow cytometry), and statistical.ResultsPatients with schizophrenia had significant structural disorders of thinking, passive, apathetic withdrawal, negativism, impaired attention, psychomotor speed, volitional impulses. Cognitive impairment was detected in all study participants. Severe impairments are noted in the executive functioning, hand-eye coordination, attention, psychomotor speed. The severity of cognitive impairments correlated with the severity of clinical symptoms. Patients with schizophrenia had a significant decrease in central memory T-regulators levels, and an increase in Th1 and Th2 subsets, «double-positive» and «сlassic» Th17, Tfh2, «classic» Tfh17, and in Tfh17.1 (Pic.1).Picture. 1. T-helper subsets in patients with schizophrenia. They also had high levels of CCL20, IL-10, IL-12, IL-1β, IL-27, IL-31, IL-4, IL-13, IL-6, IL-9, TNFα in comparison with a control group. A significantly decreased levels of IL-17A, IL-17F, IL-2, IL-22, and TNFβ were also described in this group of patients.ConclusionsPatients with schizophrenia may be characterized by the presence of an inflammatory process and a high chance of autoimmunity. Aknowledgement. This work was supported by the grant of the Russian Federation Government, contract 14.W03.31.0009DisclosureNo significant relationships.
The relationship between the recognition of specific basic emotions and negative symptom domains in patients with schizophrenia spectrum disorders
Authors: Zierhut M. , Boege K. , Bergmann N. , Hahne I. , Braun A. , Kraft J. , Ta T.M.T. , Ripke S. , Bajbouj M. , Hahn E. 
Published: September 2022

IntroductionCurrent research suggests emotion recognition to be significantly impaired in individuals with schizophrenia spectrum disorders (SSD), whereby negative symptoms are theorised to play a crucial role. Emotion recognition deficits are assumed to be predictors of transition from clinical high risk to schizophrenia. So far, little attention has been given hereby to the subdomains of negative symptoms and recognizing the individual basic emotions.ObjectivesOur study aimed to explore the relationship between the recognition of the basic emotions and each negative symptom domain.Methods66 patients with a SSD diagnosis were recruited at the Charité – Universitätsmedizin Berlin. Correlational and regression analyses to control for the covariates (age, education, sex) were conducted between the recognition of the six basic emotions (anger, disgust, fear, happiness, sadness, surprise) using the Emotion Recognition Task of the Cambridge Neuropsychological Test Automated Battery (CANTAB) and the seven different subdomains of negative symptoms of the Positive and Negative Syndrome Scale (PANSS).Results
revealed significantly negative correlations of blunted affect with the recognition of happiness, fear, and disgust. Difficulties in abstract thinking, also correlated positively with the recognition of fear. Additionally, we found a significant positive correlation between stereotyped thinking and difficulties in abstract thinking with the response latency in emotion recognition.ConclusionsIndividuals with SSD and domains of negative symptoms showed specific impairments in recognizing the representation of basic emotions. A longitudinal design to make causality statements would be useful for future research. Moreover, emotion recognition should be considered for early detection and individualized treatment.DisclosureNo significant relationships.
Clinical features of UK Biobank subjects carrying loss of function variants in genes implicated in schizophrenia pathogenesis
Authors: Curtis D. 
Published: September 2022

IntroductionThe SCHEMA consortium has identified ten genes in which severely damaging variants substantially increase schizophrenia risk.ObjectivesTo characterise the clinical features of carriers of variants causing complete loss of function (LOF) of these genes.MethodsThis research was conducted using the UK Biobank Resource and 200,000 exome-sequenced volunteers were screened to identify carriers of LOF variants in these genes. For these subjects, data fields were extracted which reflected educational and occupational functioning as well as clinical features including diagnoses and medication.Results
LOF variants in CACNA1G were commoner than in SCHEMA cases, suggesting this was not a real schizophrenia susceptibility gene. 159 subjects carried LOF variants in one of the other nine genes and overall they did not have poorer educational or occupational functioning or increased mental or physical health problems. Detailed examination revealed that one had schizophrenia, one had psychotic depression and two had a developmental disorder. Otherwise, a number of subjects had features of minor mental illness such as depression or anxiety and these rates were somewhat increased in subjects carrying LOF variants in HERC1, of whom more than half reported having consulted their GP for such problems. However the majority appeared to be entirely normal from a neuropsychiatric point of view.ConclusionsAlthough particular genetic variants can substantially increase the risk of schizophrenia, most people carrying them are entirely normal. This further supports the concept of schizophrenia as a distinct illness rather than representing the extreme of a trait which is present in the population.DisclosureNo significant relationships.
Tryptophan metabolism in bipolar disorder
Authors: Fellendorf F. , Platzer M. , Birner A. , Queissner R. , Bengesser S. , Lenger M. , Maget A. , Tmava-Berisha A. , Dalkner N. , Fuchs D. , Gostner J. , Reininghaus E. 
Published: September 2022

IntroductionImmune mediated inflammatory processes are involved in the aetiopathogenesis of bipolar disorder (BD) and weight associated comorbidities. Tryptophan breakdown via indoleamine 2,3-dioxygenase-1 (IDO-1) along the kynurenine axis concomitant with a pro-inflammatory state was found more active in BD but also associated with overweight/obesity.ObjectivesAims of our study were to investigate 1.) the tryptophan metabolism in BD compared to mentally healthy controls, 2.) differences in weight classes, 3.) in a longitudinal setting, dependent on the incidence of BD episodes and euthymia.MethodsAt the Medical University Graz anthropometric and clinical data as well as peripheral tryptophan and kynurenine were assessed in serum samples of 226 individuals with BD and 142 controls. For 75 individuals with BD a longitudinal assessment with three samples was performed. Serum concentrations of tryptophan and kynurenine were determined by reverse-phase high-performance liquid chromatography. The kynurenine/tryptophan was used as a proxy for IDO-1 activity.Resultsshowed a higher kynurenine/tryptophan ratio in BD compared to controls and in overweight compared to normal weight persons. Levels remained stable over time. In the longitudinal course, no differences were found between individuals who were constantly euthymic or not as well who had an illness episode or none.ConclusionsFindings indicate that IDO-1 activity might constitute more a trait and not a state marker of BD. Accelerated tryptophan breakdown along the kynurenine axis may be further facilitated by overweight. This may increase the risk of accumulation of neurotoxic metabolites which impacts BD symptomatology, cognition, and somatic comorbidities.DisclosureNo significant relationships.
Bipolar Stigma in Jewish Communities in the United States
Authors: Smith L. , Brewer K. , Gearing R. , Carr L.C. , Clark D. , Robinson A. , Roe D. 
Published: September 2022

IntroductionThis study investigated differences in mood disorder public stigma endorsed by Jewish adults. Specifically, it examined the association between public stigma and the symptomatology and gender of individuals with mood disorders and characteristics of respondents. The symptomatology investigated included major depressive disorder and bipolar disorder presenting with mania or depression. The public stigma factors measured for mood disorders were recovery, relationship disruption, hygiene, anxiety, and treatment/professional efficacy.Objectives
Do symptomatology and gender predict stigma for mood disorders? For Jewish adults, do gender, age, religious characteristics, mental health history, and perceived stigma for mental illness predict their stigma toward individuals with mood disorders?MethodsA convenience sample of 243 Jewish adults were randomly administered vignettes using a factorial design. MANCOVA was used for analysis. The Mental Illness Stigma Scale (Day et al., 2007) and the Devaluation of Consumer scale (Struening et al., 2001) were used to measure public and perceived stigma respectively.Resultsshowed that recovery, relationship disruption, and hygiene stigmas were associated with vignette subject symptomatology, an interaction was found between respondent gender and age for treatability/professional efficacy stigma, and perceived stigma was correlated with public stigma factors. Consistent with previous research, the highest levels of stigma were found for individuals with bipolar disorder presenting with mania (Wolkenstein & Meyer, 2008).ConclusionsThese findings increase our knowledge of mood disorder stigma existing in the Jewish community and supports research showing that bipolar disorder presenting with mania is the most stigmatized type of mood disorder symptomatology (Wolkenstein & Meyer, 2008).DisclosureNo significant relationships.
Patient violence towards their family carers: A qualitative exploration of carers’ experiences in psychosis
Authors: Wildman E. , Kuipers E. , Macmanus D. , Onwumere J. 
Published: September 2022

Introduction
Compared to the general population, people living with schizophrenia spectrum disorders (SSD) are more likely to perpetrate acts of violence. When this happens, family members (informal carers) are most commonly the victims. However, family violence by people with SSD is often a taboo topic and largely neglected within public discourse, research, and clinical domains. Consequently, our understanding of families’ experiences and support needs are limited.ObjectivesTo develop a detailed understanding of the subjective experiences, and impact, of patient violence towards family carers.MethodsIndividual semi-structured interviews were held with family carers of adults with SSD and a history of violence perpetration towards their family carer. Interview data were subject to thematic analyses using NVivo software.ResultsTwenty-one UK based carers that were predominately White British (90%) and female (81%) were interviewed. Key themes highlight the range of physical and mental injuries endured by carers following patient violence, and speak to carers’ experiences of suffering, living in a constant state of hypervigilance, as well as social isolation in the context of shame, stigma, and an absence of professional and informal support.Conclusions
Family violence by people living with SSD can and does happen. Yet, too often, carers are left with no option but to continue supporting their relative in the absence of support, even in contexts where this compromises their own safety. The devastating impact of violence is far-reaching, across all levels of the family-system. The findings highlight the danger of neglecting family violence by people with SSD in research and clinical fields.DisclosureNo significant relationships.