bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of interoception in the mechanism of pain and fatigue in fibromyalgia and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)
Authors: Sharp H. , Themelis K. , Amato M. , Barritt A. , Davies K. , Harrison N. , Critchley H. , Garfinkel S. , Eccles J. 
Published: February 2022

IntroductionPain, fatigue and anxiety are common features of fibromyalgia and ME/CFS and significantly impact quality of life. Aetiology is poorly defined but dysfunctional inflammatory, autonomic and interoceptive (sensing of internal bodily signals) processes are implicated.ObjectivesTo investigate how altered interoception relates to baseline expression of pain, fatigue and anxiety symptoms in fibromyalgia and ME/CFS and in response to an inflammatory challenge.MethodsSixty-five patients with fibromyalgia and/or ME/CFS diagnosis and 26 matched controls underwent baseline assessment: pressure-pain thresholds and self-report questionnaires assessing pain, fatigue and anxiety severity. Participants received injections of typhoid (inflammatory challenge) or saline (placebo) in a randomised, double-blind, crossover design, before completing heartbeat tracking tasks. Three interoception dimensions were examined: subjective sensibility, objective accuracy and metacognitive awareness. Interoceptive trait prediction error was calculated as discrepancy between accuracy and sensibility.ResultsPatients with fibromyalgia and ME/CFS had significantly higher interoceptive sensibility and trait prediction error, despite no differences in interoceptive accuracy. Interoceptive sensibility and trait prediction error correlated with all self-report pain, fatigue and anxiety measures, and with lower pain thresholds. Anxiety mediated the positive-predictive relationships between pain (Visual Analogue Scale and Widespread Pain Index), fatigue impact and interoceptive sensibility. After inflammatory challenge, metacognitive awareness correlated with baseline self-reported symptom measures and lower pain thresholds.ConclusionsThis is the first study investigating interoceptive dimensions in patients with fibromyalgia and ME/CFS, which were found to be dysregulated and differentially influenced by inflammatory mechanisms. Interoceptive processes may represent a new potential target for diagnostic and therapeutic investigation in these poorly understood conditions.DisclosureNo significant relationships.
Suicidality in post-traumatic stress disorder (PTSD) and complex PTSD (CPTSD)
Authors: Longo L. , Jannini T. , Merlo M. , Cecora V. , Gagliano M. , D’Imperia B. , Daverio A. , Monaco L. , Rossi R. , Niolu C. , Siracusano A. , Lorenzo G. Di 
Published: February 2022

IntroductionInternational Classification of Diseases 11th Revision (ICD-11) has inserted complex post-traumatic stress disorder (cPTSD) as a clinically distinct disorder, different from PTSD. The diagnosis of cPTSD has the same requirements for the one of PTSD, in addition to disturbances of self-organization (DSO – e.g., disturbances in relationships, affect dysregulation, and negative self-concept).ObjectivesThis study aimed to explore suicidality in PTSD and cPTSD. We examined also the association between clinical dimensions of hopelessness (feelings, loss of motivation, future expectations) and other symptomatologic variables.MethodsThe sample, recruited at the Fondazione Policlinico Tor Vergata, Rome, Italy, consisted of 189 subjects, 132 diagnosed with PTSD, and 57 with cPTSD, according to the ICD-11 criteria. Participants underwent the following clinical assessments: Clinician-Administered PTSD Scale (CAPS), Impact of Event Scale-Revised (IES), Beck Depression Inventory (BDI), Symptom Checklist-90-Revised (SCL-90), Dissociative Experience Scale (DES), Beck Hopelessness Scale (BHS).ResultscPTSD showed significantly higher BHS-total (p = 0.01) and BHS-loss of motivation subscale (p <0.001) scores than PTSD. Besides, cPTSD showed significantly higher scores in all clinical variables except for the IES-intrusive subscale. By controlling for the confounding factor “depression”, suicidality in cPTSD (and in particular the BHS-total) appears to be correlated with IES-total score (p = 0.042) and with DES-Absorption (p = 0.02). Differently, no such correlations are found in PTSD.ConclusionsOur study shows significant symptomatologic differences between PTSD and cPTSD, including suicidality. Indeed, suicidality in cPTSD appears to be correlated with the “loss of motivation” dimension, which fits well within the ICD-11 criteria of DSO.DisclosureNo significant relationships.
EEG and ECG based response predictors in depression: Time for personalised medicine or treatment stratification?
Authors: Arns M. 
Published: February 2022

In depression (MDD) treatment there is a clear need for novel treatments, biomarkers and individualized treatment approaches. One of the most promising and most widely investigated biomarkers for antidepressant treatments is the EEG. Most EEG biomarkers however, still lack robustness and reproducibility and suffer significant publication bias as highlighted in a recent meta-analysis (Widge et al., 2018). Therefore, large controlled validation studies are needed with a focus on robustness, replication and clinical relevance. In this presentation results will be presented from the largest EEG Biomarker study to date, the international Study to Predict Optimized Treatment in Depression (iSPOT-D), where 1008 MDD patients were randomized to Escitalopram, Sertraline and Venlafaxine. Drug-class specific (Arns et al., 2016) and drug-specific (Arns, Gordon & Boutros, 2015) biomarkers will be highlighted as well as preliminary data from a prospective feasibility trial. Furthermore, data will be presented on repetitive Transcranial Magnetic Stimulation (rTMS) treatment in MDD on EEG and clinical predictors (Krepel et al., 2018; 2019) and a new method called Neuro-Cardiac-Guided TMS (NCG TMS), that exploits network connectivity in the frontal vagal pathway, as a target engagement approach (Iseger et al., 2019). Finally, clinical implications and implementations will be discussed from a ‘treatment stratification’ perspective, which might be a more realistic goal relative to ‘personalized medicine’ perspective.DisclosureMA is unpaid research director of the Brainclinics Foundation, a minority shareholder in neuroCare Group (Munich, Germany), and a co-inventor on 4 patent applications related to EEG, neuromodulation and psychophysiology, but receives no royalties related
Does maternal age or related factors influence the appearance of psychopathology in children?
Authors: Lorenzo J. Buesa , García-Blanco A. , Moreno-Giménez A. , Berga L. Campos , Sahuquillo-Leal R. , Nowak A. , Hervás D. , Diago V. , Vento M. 
Published: February 2022

IntroductionMaternal age and related factors, such as social vulnerability, are associated with neurodevelopmental and behavioral disorders in offspring.ObjectivesTo examine the influence of maternal age and its related factors on the appearance of autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), alterations in executive functions and behavioral syndromes of the offspring.MethodsA prospective study was conducted, consisting of 131 healthy pregnant women aged 20 to 41 years, recruited at 38 weeks’ gestation. Their offspring were followed up to 2 years after birth, when psychopatology was assessed. Maternal age and possible related factors were considered predictors. Bayesian ordinal regression models were performed for each outcome variable.ResultsSymptoms of ASD in children were associated with an older maternal age (OR = 0.188; 95% CI[1.062, 1.401]) and a lower educational level of the parents (OR = -0.879; 95% CI[0.202, 0.832]), meanwhile poor social support predicted most ADHD symptoms OR = -0.086; 95% CI[0.838, 1]) and executive dysfunctions OR = -0.661; 95% CI[0.313, 0.845]. Lower parental education predicted both externalizing and internalizing behavior.ConclusionsMaternal age-related factors were the main predictors of neurodevelopmental disorders in offspring, rather than maternal age. The performance of prenatal interventions in pregnant women with advanced age and anxious depressive symptoms or adverse social situation, is crucial to reduce the risk of neurodevelopmental disorders in the offspring. Likewise, being able to carry out an early detection of childhood psychopathology would allow the implementation of resources that improve their long-term prognosis.DisclosureNo significant relationships.
The development of depressive symptomatology, burnout and lifestyle in the Czech population – in years 2014-2020
Authors: Vňuková M. , Ptáček R. 
Published: February 2022

IntroductionIt is clear from the literature that depressive disorder is closely related to lifestyle, however the relationship between burnout and lifestyle remains unclear.ObjectivesThe aim of this study was to present a comprehensive overview of depressive symptoms, burnout and lifestyle over the years. Furthermore, this study looks at the relationship between burnout, depressive symptomatology and lifestyle and seeks to clarify the extent to which burnout can be explained by these variables.MethodsData collection took place in three waves. The first data collection was in 2014 (October/November), the second in 2017 (March) and the third in 2020 (March). The STEM/MARK agency conducted the data collection and collected answers from a representative sample of respondents using the CAWI method - computer-assisted questioning. These respondents were selected from the European National Panel. Because the target group was adults (18-65 years), an online survey was chosen. Internet penetration in this target population is sufficient and it was not necessary to use a combination of methodologies.ResultsAll 3 data collections identically show that for the model explaining burnout statistically significant variables are: age, depression and fatigue during the day. Other variables related to healthy lifestyles did not reach statistical significance.ConclusionsEven though the variables regarding healthy lifestyles have not reached statistical significance, their importance should not be underestimated. Mental well-being is closely linked to physical health and therefore a holistic approach to health should be emphasized and the rate of burnout should be regularly monitored.DisclosureNo significant relationships.
The effectiveness of involuntary electroconvulsive therapy (ECT): A population-based study
Authors: Salagre E. , Rohde C. , Ishtiak-Ahmed K. , Gasse C. , Østergaard S. 
Published: February 2022

IntroductionInvoluntary electroconvulsive therapy (ECT) can be a life-saving intervention for patients suffering from potentially lethal conditions who are unable to give informed consent. However, its use is not widespread, probably partly due to the scarce data on hard outcomes following involuntary ECT. In Denmark, involuntary ECT is only used when patients are at imminent/potential risk of dying if not receiving ECT.ObjectivesWe aimed to assess the effectiveness of involuntary ECT by estimating the 1-year survival following its administration.MethodsWe conducted a register-based cohort study involving i) all patients receiving involuntary ECT in Denmark between 2008 and 2019, ii) age and sex-matched patients receiving voluntary ECT, and iii) age and sex-matched individuals from the general population. 1-year survival rates were compared via mortality rate ratios.ResultsWe identified 618 patients receiving involuntary ECT, 547 patients receiving voluntary ECT, and 3,080 population-based controls. The survival rate in the year after involuntary ECT was 90%. For patients receiving involuntary ECT, the 1-year mortality rate ratios were 3.1 (95% confidence interval (CI)= 1.9-5.2) and 5.8 (95%CI = 4.0-8.2) compared to those receiving voluntarily ECT and to the population-based controls, respectively. Risk factors for early death among patients receiving involuntary ECT were male sex, being ≥70 years old and having organic mental disorder as the treatment indication.ConclusionsTreatment with involuntary ECT is associated with a high survival rate, suggesting that the intervention is effective. However, patients receiving involuntary ECT constitute a high-risk population that should be monitored closely after this treatment.DisclosureNo significant relationships.
Monitoring of antipsychotic plasma levels in the assessment of poor response and nonadherence to antipsychotics in delusional disorder
Authors: González-Rodríguez A. , Guàrdia A. , Pedrero A. Alvarez , Betriu M. , Cobo J. , Sanz N. , Acebillo S. , Monreal J.A. , Vidal D. Palao , Labad J. 
Published: February 2022

IntroductionOver the last decades, antipsychotic plasma levels have been used to evaluate therapeutic response, adherence and safety of antipsychotics in schizophrenia. Their clinical utility in delusional disorder (DD) has been poorly studied.ObjectivesTo investigate the relationship between plasma concentrations of risperidone (R), 9-OH-risperidone (9-OH-R) and olanzapine (OLZ), and clinical outcomes in DD.MethodsCase-series of inpatients and outpatients with DD receiving treatment with risperidone (n=19) or olanzapine (n=2). Determination of R, 9-OH-R (active metabolite) and OLZ levels were obtained by high-performance liquid chromatography with electrochemical detection. Clinical variables such as treatment response or adverse events were recorded for all patients. These variables were correlated with two plasmatic ratios in patients treated with R: R:9-OH-R concentration ratio and total concentration-to-dose (C: D) ratio, indicating CYP2D6 activity and R elimination respectively.ResultsTwenty-one patients were included: inpatients (n=10) and outpatients (n=11). Dose range: R, 1-6 mg/day; OLZ, 5-10 mg/day. Three outpatients (R, n=2; OLZ, n=1) presented antipsychotic levels under the detection limit (non-adherence). All R patients showed CYP2D6 activity (R: 9-OH-R ratio <1). Eight patients presented C: D > 14, indicating a reduction of R elimination, which was associated with poor clinical response (n=3), adverse events (n=3) and no clinical relevance (n=2). OLZ (n=2), no association between levels and clinical outcomes.ConclusionsThe determination of antipsychotic plasma levels may be of clinical utility in the assessment of treatment resistance, antipsychotic-adverse events or non-adherence in inpatients or outpatients with DD. Therapeutic drug monitoring should be further studied in future works.DisclosureAGR has received honoraria, registration for congresses and/or travel costs from Janssen, Lundbeck-Otsuka and Angelini.
Preliminary results of a network meta-analysis on the efficacy of long-acting injectable antipsychotics in schizophrenia
Authors: Medrano R. , Carranza F. , Saucedo E. , Guerrero A. 
Published: February 2022

IntroductionLong-acting injectable antipsychotics (LAIs) are currently the most effective alternative for patients with schizophrenia who exhibit poor adherence. Although a recent meta-analysis reported similar efficacy between first and second-generation LAIs, these results were only based on 3 studies due to the limited number of head-to-head comparisons.ObjectivesPresent the preliminary results of a network meta-analysis on the comparative efficacy of LAIs in schizophrenia.MethodsStudies were obtained from a previous study, where we carried out a systematic search from until May 2019 in various databases. Included trials of adults with schizophrenia compared the efficacy of LAI vs LAI or placebo through the Positive and Negative Syndrome Scale (PANSS). Efficacy was evaluated through the mean differences (MD) from baseline to endpoint in the PANSS total scores. Network meta-analysis was performed in MetaInsight through direct and indirect comparisons using a Bayesian approach.Resultsfrom 12 studies are presented in Figures 1 and 2. All LAIs except zuclopenthixol were more effective than placebo. There were no significant differences between LAIs except for aripiprazole and risperidone, which were more efficacious than zuclopenthixol. The largest change occurred with aripiprazole LAI, but was not significantly higher than haloperidol.Figure 1. Comparison of treatment pairs. Effect sizes are presented as MD and 95% confidence intervals (*p<0.05).Figure 1. Overall change in symptomsConclusionsPreliminary results from a network meta-analysis also suggest that in the long-term haloperidol decanoate is equally effective in overall symptom changes compared to other LAIs. Further analyses are needed to obtain a better perspective on these drugs.DisclosureNo significant relationships.
Bipolar affective disorder
Authors: Young A. 
Published: February 2022

Abstract BodyAbstract: Biomarkers for diagnosis and treatment of Bipolar Disorder: hope or hype? Professor Allan Young, Centre for Affective Disorders, IoPPN, KCL London, SE5 8AF. allan.young@kcl.ac.uk The use of “biomarkers” (biological markers) in basic and clinical research as well as in clinical practice has become so commonplace in many areas of medicine that their presence as primary endpoints in clinical trials is now widely accepted. In clinical disciplines where specific biomarkers have been well characterized and repeatedly shown to correctly predict relevant clinical outcomes across a variety of treatments and populations, this use is entirely justified and appropriate. However, the validity of biomarkers in most psychiatric disorders continues to be evaluated. This lecture will review the current conceptual status of biomarkers as clinical and diagnostic tools for bipolar disorder and as surrogate endpoints in clinical research in bipolar disorder. The conceptual background in terms of current diagnostic categories and research domain criteria will be discussed and the various approaches with putative value (e.g., brain imaging, genetics, and neuroendocrinology) reviewed (1, 2). The lecture will end with a discussion of approaches to evaluating biomarkers of lithium response (3).ReferencesWise et al, Mol Psychiatry. 2016 May 24. doi: 10.1038/mp.2016.72. [Epub ahead of print]; Young AH. Harv Rev Psychiatry. 2014 Nov-Dec;22(6):331–3 Bellivier F, Young AH, et al, Bipolar Disord. 2020 Oct 23. doi: 10.1111/bdi.13023. Online ahead of print.DisclosurePaid lectures and advisory boards for the following companies with drugs used in affective and related disorders: Astrazenaca, Eli Lilly, Lundbeck, Sunovion, Servier, Livanova, Janssen, Allegan, Bionomics, Sumitomo Dainippon Pharma, COMPASS Principal Inve
Factors affecting cognitive remediation outcome in schizophrenia: The role of treatment resistance
Authors: Spangaro M. , Bosia M. , Martini F. , Bechi M. , Buonocore M. , Cavallaro R. 
Published: February 2022

IntroductionTreatment-resistant schizophrenia (TRS) represents a major clinical issue, characterized by worse psychopathological outcome, a more disrupted neurobiological substrate and higher healthcare costs. Cognitive impairment is a core feature of schizophrenia, strongly associated with patients’ functional outcome. Different studies showed that TRS patients exhibit poorer neurocognitive performance, particularly on verbal domains. To date Cognitive Remediation Therapy (CRT) represents the best available tool for treating cognitive deficits in schizophrenia. However, CRT outcomes are highly heterogeneous and significant treatment predictors are still lacking.ObjectivesTo investigate possible differences of CRT outcome among patients with schizophrenia, stratified according to antipsychotic response (TRSs vs. first-line responders - FLRs).Methods150 patients with schizophrenia, (95 FLRs, 55 TRSs) were assessed for neurocognition with BACS and WCST at baseline and after CRT. General Linear Models (GLMs) were performed to investigate possible differences between groups on basal cognition and CRT outcome (Cohen’s d Effect Size).ResultsAt baseline, GLMs showed significant differences in Verbal Memory (F=4,66; p=0,03) and WCST–executive functions (F=5,59; p=0,02), both worse in TRS group. Effecr Sizes of CRT outcome resulted significantly different in domains of Verbal Memory (F=4,68; p=0,03) and WCST–executive functions (F=4,62; p=0,03), with greater improvements among TRS patients.ConclusionsThis is the first study to indicate treatment-resistance as a possible predictor of CRT outcome in schizophrenia. Moreover, we observed that CRT resulted able to fill the cognitive gap between treatment groups. Thus, these results further highlight the importance of early cognitive interventions in order to reduce the neuropsychological and functional burden associated with the disease, especially for TRS patients.DisclosureNo significant relationships.
Negative symptoms in first episode schizophrenia: Results from the “parma early psychosis” program
Authors: Pelizza L. , Leuci E. , Maestri D. , Quattrone E. , Paulillo G. , Pellegrini P. , Azzali S. 
Published: February 2022

IntroductionIdentifying distinct dimensions of negative symptoms in First Episode Schizophrenia (FES) might result in a better understanding and treatment of this invalidating symptomatology.ObjectivesAim of this study was to examine negative symptom structure in FES patients using the Positive and Negative Syndrome Scale (PANSS).MethodsAll 147 participants, aged 12–35 years, completed the PANSS and the Global Assessment of Functioning (GAF) scale. A principal component analysis with varimax rotation was performed to investigate PANSS negative symptom structure in the FES total sample.ResultsA 2-factor model (i.e. “Expressive Deficits” and “Asociality” dimensions) was identified. Only “Expressive Deficits” domain had a significant negative correlation with baseline GAF score.ConclusionsThis bipartite solution seems to be adequate to describe the phenomenological variety of negative symptoms experienced by FES individuals at the point of entry in early intervention services.DisclosureNo significant relationships.
Does insomnia increase the risk of suicide in patients with major depressive disorders? national inpatient sample analysis
Authors: Reddy A. , Mansuri Z. , Vadukapuram R. , Thootkur M. , Trivedi C. 
Published: February 2022

IntroductionInsomnia is strongly associated with Major depressive disorders (MDD). There is strong evidence that it is one of the risk factor for suicide. Studies have shown the relationship of suicidal behavior in MDD patients with insomnia. However, it has not been evaluated in a large inpatient sample.ObjectivesTo evaluate suicidality in MDD patients with insomnia compared to those without insomnia.MethodsFrom the National Inpatient Sample (NIS 2006-2015) database using ICD-9 code, we obtained patients with the primary diagnosis of MDD and comorbid diagnosis of insomnia disorders (MDD+S). We compared it with MDD patients without insomnia disorders (MDD-S) by performing a 1:2 match for primary diagnosis code in the unweighted dataset. Suicidal ideation/attempt data were compared between the groups by multivariate logistic regression analysis.ResultsAfter the diagnostic code matching, 139061 patients were included in the MDD+S group and 276496 patients in the MDD- S group. MDD+S patients were older (47 years vs 45 years, p < 0.001) compared to the MDD-S group. Prevalence of Suicidal ideation/attempt was 56.0% in the MDD+S group and 42.0% in the MDD-S group (p < 0.001). After adjusting for age, sex, and race, MDD+S was associated with 1.8 times higher odds of suicidal behavior compared to the MDD-S group. (Odds ratio: 1.79, 95% confidence interval 1.68-1.91, p < 0.001).ConclusionsInsomnia in MDD patients is significantly associated with the risk of suicide. It is important to be watchful for insomnia in MDD patients.DisclosureNo significant relationships.