38454 results in European Psychiatry & past titles
Neurobiological Correlation Between Autism Spectrum Disorder and Anorexia Nervosa in Children
- K. Shah, P. Reddy, A. Giri, S. Srinivas
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S451
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Introduction
Anorexia Nervosa (AN) is common in adolescents and has a high mortality and morbidity rate with a lifetime prevalence of 0.5% to 2%.1,2 We aim to review the neurobiology correlation of Anorexia Nervosa in Autism Spectrum Disorder as they are often associated together.
Objectives1. Understand the correlation between the neurobiology of Autism Spectrum Disorder (ASD) and Anorexia Nervosa.
2. Assess the association and prevalence of Anorexia nervosa in the ASD population.
3. To focus on the implications for the pathogenesis of Anorexia Nervosa and treatment of this disorder in the ASD population.
MethodsWe searched PubMed, APA PscyINFO, Embase, CINAHL, and Google scholar databases with the keywords Autism Spectrum Disorder AND Anorexia Nervosa and included 6 relevant human studies out of 187 published in English.
ResultsNeilson et al. studied the outcome of ASD in teenage onset AN, and a statistically significant negative dose-response relationship is found in all the 3 Morgan-Russell Outcome Assessment Schedule (MROAS) domains in stable ASD over time, and the results on the subscales ‘mental state,’ ‘psychosexual state’ and ‘socio-economic state, “personal contacts,’ ‘social activities’ and ‘employment record.’3 The outcome of AN onset in adolescence is generally favorable regarding mortality and the persistence of eating disorders in adulthood. A study by Pruccoli et al. noted a high prevalence of ASD traits in a group of young AN patients, predominantly seen in 4 specific EDI-3 subscales and independent of BMI.4 Margari et al. found only AN diagnosis had a statistically significant difference (p = 0.04) in females vs. males when comparing sex differences for comorbidities.5
ConclusionsMorphological changes in brain areas are linked to social cognition and increase the risk of eating disorders in ASD. We recommend future studies with robust study design to explore the full spectrum of pathogenesis and association of AN in ASD.
Disclosure of InterestNone Declared
Suicidal behaviors in mental illness: A case-control study. Suicidal behaviors in mental illness: A case-control study
- A. Boumnijel, S. Rouached, S. Boudriga, M. Lagha, W. Homri, I. Ben Rhomdhane, R. Labbane
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, pp. S481-S482
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Introduction
The assessment of suicide risk remains a critical concern, especially within the psychiatric community. Mental health professionals continually work to identify and support individuals at risk, emphasizing the need for ongoing research and training in this area.
ObjectivesThe objectives of our study were to understand the characteristics of patients hospitalized after a suicide attempt (SA), analyze the characteristics of these attempts, identify risk factors associated with suicidal behaviors, and determine predictors for recurring suicidal behavior.
MethodsThe study’s methodology was retrospective, descriptive, and comparative. It was conducted with 277 patients hospitalized in the psychiatric department “C” of Razi Psychiatric Hospital in Manouba. The sample consists of 72 individuals who attempted suicide, divided into two groups: first-time attempters and recurrent patients, and 205 controls hospitalized for other reasons during the same period.
ResultsResults showed a significant increase in the frequency of hospitalizations for SA, rising from 0.7% to 2.25% of the total admissions between 2018 and 2022. Those who attempted suicide were on average 32.5 years old, predominantly female, urban residents, with a moderate socioeconomic status, secondary or higher education, unemployed, unmarried, childless, and lacking strong family support.
The study identified several risk factors associated with suicide attempts, including risky behaviors, previous life events, type II bipolar disorders, personality disorders, the number of psychiatric hospitalizations, and the quality of follow-up. However, schizophrenia was negatively correlated with SA.
Suicidal recurrence was observed in 65.5% of attempters and was linked to personal psychiatric follow-up history, mood disorders, personality disorders, the presence of stress factors, and caustic substance ingestion.
ConclusionsIn conclusion, the study underscores the importance of assessing suicide risk among individuals with mental disorders to implement appropriate prevention strategies.
Disclosure of InterestNone Declared
Anxiety disorders and Quality of life: The Role of Occupational Therapy
- V. Moraiti, A. Kalmanti, A. Papadopoulou, G. N. Porfyri
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, pp. S425-S426
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Introduction
Anxiety disorders represent the most common mental illnesses, which are listed among the ten most important causes of disability worldwide. According to DSM-5, they are defined as “disorders that share characteristics of excessive fear and anxiety and related behavioral disorders”. Patients exhibit low levels of quality of life. Their daily routine is affected negatively. However, Occupational Therapy has been proven to play a crucial role in their treatment, improving quality of life through the involvement in occupations.
ObjectivesTo highlight the contribution of Occupational Therapy in ameliorating the quality of life in anxiety disorders.
MethodsA review of 50 articles -from 2013 to 2023- on PubMed and Google Scholar, regarding the beneficial impact of Occupational Therapy in the Anxiety Disorders’ treatment.
ResultsOccupational Therapists can intervene in many negatively affected -by the disease- life domains such as: Activities of Daily Living, Education, Work, Play, Social Interaction and Sleep. The most effective Occupational Therapy methods are based on the cognitive behavioral approach and include: Psychoeducation, Relaxation techniques, Social skills training and Systematic desensitization.
Other methods involve training in Activities of Daily Living such as feeding, maintaining good personal hygiene, and using public transport. Furthermore, Art Therapy (visual arts, use of clay) has been shown to reduce feelings of anxiety, while promoting creativity and enhancing self-esteem.
ConclusionsAdditional research is needed regarding the effectiveness of Occupational Therapy in improving the quality of life for patients suffering from Anxiety Disorders. The important “take home message” is that the amelioration of the patients’ quality of life should be the main goal of the therapeutic intervention and not a secondary result of it.
Disclosure of InterestNone Declared
Comparative analysis of self-stimulatory behaviors in ASD and ADHD
- B. A. Oroian, G. Costandache, E. Popescu, P. Nechita, A. Szalontay
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S220
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Introduction
The phenomenon of self-stimulatory behaviors, commonly referred to as “stimming,” presents a fascinating avenue of exploration within the context of neurodevelopmental disorders. While stimming behaviors are widely associated with ASD, there is emerging evidence suggesting that individuals with ADHD may also engage in similar behaviors. This study seeks to undertake a comprehensive investigation of the neurophenomenology of stimming in individuals diagnosed with ASD and ADHD, aiming to discern potential shared and distinctive characteristics.
ObjectivesThe principal objective of this research is to conduct an intricate neurophenomenological analysis of stimming behaviors in cohorts diagnosed with ASD (n=60) and ADHD (n=60), with a concurrent control group of neurotypical individuals (n=60). The study aspires to delineate the prevalence, typology, and neurophysiological underpinnings of stimming behaviors in both ASD and ADHD populations. Moreover, this study endeavors to identify whether particular stimming behaviors exhibit differential prevalence or intensity between the two disorders.
MethodsParticipants underwent rigorous neurophenomenological assessments, incorporating structured interviews, validated self-report questionnaires and direct observations. Diagnostic confirmation was established through the administration of gold-standard instruments, such as the Autism Diagnostic Observation Schedule (ADOS-2) for ASD and the Conners’ Parent Rating Scale for ADHD. Stimming behaviors were meticulously categorized (e.g., motor, vocal, sensory) and scrutinized for quantitative metrics, including frequency, duration, and complexity.
ResultsPreliminary analyses have uncovered profound disparities in the manifestation of stimming behaviors between ASD and ADHD cohorts. Individuals with ASD displayed a significantly higher prevalence of stimming behaviors, with motor stimming predominating, followed by vocal and sensory manifestations. In contrast, individuals with ADHD exhibited a comparatively reduced frequency and intensity of stimming, primarily within the motor domain, albeit notably less elaborate. Control group participants exhibited a negligible occurrence of stimming behaviors.
ConclusionsThis multidimensional exploration illuminates the nuanced neurophenomenological distinctions in self-stimulatory behaviors between ASD and ADHD. Stimming emerges as a pivotal feature in ASD, while its presence in ADHD, though discernible, is markedly attenuated. This study’s findings hold implications for precise diagnostic delineation and the prospect of personalized interventions for these complex neurodevelopmental conditions. Future avenues of research may delve into the neural substrates underpinning stimming behaviors, further enhancing our comprehension of these phenomena.
Disclosure of InterestNone Declared
The effectiveness of computerized cognitive training on cognitive functions and mental health in people with schizophrenia
- Y. Haghgoo, H. A. Haghgoo
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, pp. S718-S719
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Introduction
People with schizophrenia have multiple and persistent cognitive deficits. These defects have a deep impact on people’s psycho-social functions. Although computerized cognitive training has positive results in some people, the effect of these treatment programs in schizophrenia is not clear.
ObjectivesThe purpose of this study was to investigate the effectiveness of computerized cognitive exercises on the components affecting the mental health and cognitive functions of schizophrenic patients.
MethodsFifty-four adults with schizophrenia were randomly divided into two intervention and control groups. Participants in the intervention group received 30 sessions of 5-45 minutes of computerized cognitive training in addition to the usual treatment programs. While the control group only received their usual rehabilitation programs (Pharmacotherapy, psychotherapy and occupational therapy).
Mental health was evaluated with Warwick-Edinburgh Mental Well-Being Scale and Depression-Anxiety-Stress Scale (DASS), and cognitive functions with CANTAB tests Batteries before the intervention, after and two months after the intervention (follow up). The set of CANTAB tests used in this study included the following tests: Spatial Recognition Memory (SRM), Paired Associates Learning (PAL), Stockings of Cambridge(SOC), Spatial Working Memory (SWM), and Spatial Span (SSP).
ResultsThe analysis of the findings showed that the patients’ performance in the cognitive tests related to memory and executive functions improved significantly in the intervention group after the intervention. In problem solving skills, despite the better performance in the intervention group, the difference between the two groups was not significant. Also, the intervention was able to significantly improve mental health and reduce stress. But no significant difference was observed in reducing anxiety and depression.
ConclusionsAs a result, the study showed that 30 sessions of computerized cognitive training can have a positive effect on overall mental health and some cognitive functions.
Disclosure of InterestNone Declared
Behavioral and neurocognitive phenotypes in Crigler-Najjar syndrome in Tunisia
- N. Bouayed Abdelmoula, R. Zekri, F. Bouaziz, K. Bensalem, M. Feki, A. Etteyeb, B. Abdelmoula
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S586
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Introduction
Crigler-Najjar 1 (CN1) due to exon 3 mutations of the UGT1A1 gene is a not rare genetic disease in Tunisia with a founder effect. CN1 syndrome is very severe, and most of CN1 Tunisian patients die soon after birth, within a maximum of one year, due to kernicterus. Liver transplantation, which is the only available therapeutic method for CN1, remains unreachable.
ObjectivesThe aim of this study was to report behavioral and neurocognitive phenotypes in CN1 patients who survived to school enrollment.
MethodsWe have selected all patients evaluated from 2004 to 2010, both clinically and molecularly, for a deficiency of bilirubin-UGT enzyme activity leading to a pathological elevation of unconjugated bilirubin with a suspicion of CN1 syndrome. Direct sequencing of targeted PCR amplification products was performed for molecular analysis of UGT1A1. Behavioral and mental features of patients were studied through our genetic counselling.
ResultsWe identified 15 patients with the homozygous c.1070 A>G Tunisian mutation. Their age at diagnosis ranged from one week to 9 months for 13 patients. Six of them died within a month of molecular investigation. Only two boys were of school age, i.e. 6 and 9 years. The first had been hospitalized at 3 months year-old for a prolonged jaundice treated with phenobarbital and phototherapy. His psychomotor and neurological development was normal, with school attendance at the age of six. The second patient presented with an unexplored jaundice at the age of 3 days, which was later complicated by seizures and treated with phenobarbital. Despite neurological and motor sequelae associated to language impairments with slurred speech, he attended school at the age of six.
ConclusionsThe neurological and behavioral profile of CN1 patients depends on familial and medical management. Quick diagnosis, close follow up and early liver transplantation can improve prognosis.
Disclosure of InterestNone Declared
Cannabis addiction in Tunisia: sociodemographic profile and neuropsychological complications
- E. Smaoui, D. Mnif, R. Ouali, R. Sellami, I. Feki, I. Baati, J. Masmoudi
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S100
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Introduction
Cannabis consumption constitutes a public health problem both because of its serious repercussions and complications and the psychological and social problems it causes.
ObjectivesOur objective was to assess the level of cannabis dependence in consumers receiving care at the Sfax detoxification center in Tunisia, to describe the sociodemographic profile of these consumers and the neuropsychological complications that may be caused.
MethodsWe conducted a cross-sectional study, over a period of 13 months (September 2020 to October 2021), among cannabis users consulting the Sfax detoxification center in Tunisia. We used the Cannabis Abuse Screening Test (CAST) in order to detect a “problematic” cannabis use, along with a clinical information sheet to collect epidemiological and clinical data. All patients gave their free and informed oral consent to participate in the survey while ensuring anonymity.
ResultsWe included 38 patients. The average age was 26 years old with a median age of starting cannabis use at 17 years old. The sex ratio was 8.5 with an over-representation of men. Most of the subjects were single, lived with their family and had a secondary school education. Consumption was daily for the majority of patients (68.5%) with an average quantity of 4 joints/day. According to the CAST scale, 36 users (94.7%) had problematic cannabis use. The factors favouring cannabis consumption were stress and anxiety in 34 patients (89.5%) followed by depression and the festive atmosphere in 14 subjects (36.8%) each. Among the participants, 26.3% had a psychiatric history including depression (5.3%), a psychopathic personality disorder (10.5%) and cannabis-induced psychotic disorder (10.5%). History of psychiatric hospitalization and history of suicide attempt were found in 21.1% and 26.3% of the patients respectively. Concerning the complications caused by cannabis, 68.4% of the patients described a phenomenon of tolerance, while 63.2% reported the sensation of craving. Psychotic symptoms such as delirium and/or hallucinations were found in 6 patients (15.8%) and 8 subjects (21.1%) reported a history of overdose in the form of cannabis psychosis. Chronic complications were an amotivational syndrome (63.2%) and social disintegration (52.6%). Treatment of cannabis dependence was considered effective with total withdrawal in 31.6% of subjects. Weaning was partial in 42.1% of the patients.
ConclusionsCannabis use is emerging as one among many interacting factors that can affect psychological and physical health, with an impact on various levels including mood, neurocognition and general health. Although studies have shown functional brain mechanisms underlying the effects of cannabis, the exact mechanisms remain unclear. Overall, treatment for substance use disorders generally prevents these complications and improves prognosis.
Disclosure of InterestNone Declared
BUT WHO LOOKS AT ME? About a daily clinical case in treatment in a mental health center
- B. Gamo Bravo, M. E. Gonzalez Laynez, S. M. Bañon Gonzalez, N. Ogando Portilla
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S653
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Introduction
BUT WHO LOOKS AT ME?
Patient around thirty years old, teacher and with obsessive, anxious, paranoid, schizotypic semiology that affects his functionality to the point of isolation, and take sick leave, which with pharmacological treatment with antipsychotics such as aripiprazole and olanzapine and the antidepressant sertraline (at a final dose of 200 mg) and group psychotherapy in multifamily groups remits from these symptoms with functional and symptomatic improvement.
ObjectivesHighlight the diagnostic difficulties due to the coexistence of symptoms that are part of personality imbalances or first-order diagnostic entities as in this case, depressive picture in a personality with obsessive and paranoid traits
MethodsDescribe the evolution and psychiatric clinical decompensation of a patient with depression and anxiety and a personality of cluster A traits, paranoid type and obsessiveness
ResultsCLINICAL DIAGNOSTIC TRIAL
ANXIOUS DEPRESSIVE SYNDROME (PREDOMINANCE OF SYMPTOMS OF OBSESSIVENESS AND DISTRUST)
MIXED CLUSTER A PERSONALITY DISORDER (PARANOID AND SCHIZOTYPIC TRAITS)
ConclusionsDiscussions and conclusions: There is a gap difficult to separate in many cases between obsessiveness and paranoidism as communicating vessels, whose worsening of one worsens another and whose improvement of one leads to the improvement of the other, which at the pharmacological level respond to combined approach versus potentiated atypical antipsychotics and antidepressants such as sertraline that help us neutralize the discomfort
Disclosure of InterestNone Declared
(Ir)reversibility of structural and functional brain alterations in severe anorexia
- L.-K. Kaufmann
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
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- 27 August 2024, p. S5
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Abstract
Anorexia nervosa is characterized by profound structural and functional brain alterations, particularly during the phase of acute underweight. Understanding the reversibility of these changes upon weight normalization is an important question in the pursuit of recovery and relapse prevention. This talk shares findings from recent neuroimaging studies, focussing on the dynamic processes of brain recovery observed during and after inpatient treatment in individuals with severe anorexia nervosa.
Disclosure of InterestNone Declared
Enduring the unseen burden: a qualitative analysis on long-term emotional impact of COVID-19 on long-term care workers
- L. Gonzalez-Spinoglio, A. Monistrol-Mula, C. Vindrola-Padros, S. Aguilar-Ortiz, B. Carreras, J. M. Haro, M. Felez-Nobrega
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, pp. S512-S513
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Introduction
Long-term care facilities, such as nursing homes and other assisted living facilities, have been hit particularly hard by the COVID-19. The overall pandemic created an enormous pressure on long-term care workers (LTCWs), making them particularly vulnerable to mental disorders. However, most of the existing evidence regarding the well-being of care professionals has predominantly focused on frontline healthcare workers.
ObjectivesThis study aimed to identify long-term psychological needs of LTCWs derived from the COVID-19 pandemic, as part of a project that is developing an intervention to reduce psychological distress in this population group.
MethodsWe performed a qualitative study with a rapid research approach. Participants were recruited from long-term care facilities located in Catalonia, Spain. Between April and September 2022, we conducted semi-structured interviews inquiring about the most psychologically challenging stages of the pandemic, perceived emotions during those stages, main determinants of those emotions, and their emotional state at the time of the interview. We used a qualitative content analysis method with an inductive-deductive approach.
ResultsThirty LTCWs participated in the study. Mean age was 44 (SD=11,4), 87% were females and one third were from foreign nationalities. The period of the pandemic with highest mental health burden was the outbreak, with almost every worker having experienced some form of emotional distress. Emotional distress persisted over time in more than half of participants, with fatigue and nervousness being the main emotions expressed at the time of the interview. High workload, feeling that pandemic times are not over and poor working conditions that have remained since then, have been the most frequently expressed determinants of such emotions.
ConclusionsLong after the pandemic outbreak, emotional distress is still relevant. The persistent burden of psychological distress points to a need for institutions to take action to improve working conditions and promote employees’ wellbeing.
Disclosure of InterestNone Declared
How adults with treatment resistant depression experience their first esketamine nasal spray treatment? Preliminary results from a French qualitative study
- E. Manolios, J. Mathé, J. Sibeoni, M. Rotharmel, B. Astruc, B. Falissard, L. Mekaoui, A. Laurin, E. Gaudre-Wattinne, J. Dupin, A. Revah-Levy
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S104
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Introduction
Spravato® (esketamine nasal spray- ENS) is a new adjunctive drug for Treatment Resistant Depression (TRD), i.e. patients with major depressive disorder that failed to adequately respond despite the use of two different antidepressants. In France, a real world non-interventional post-commercialization cohort study is being conducted aiming to describe the conditions of use of the esketamine, and to observe the outcomes.
ObjectivesTo in-depth explore the lived experience of first administered ENS treatment among adults with TRD, we are conducting an ancillary qualitative study.
MethodsThis qualitative study uses the IPSE approach (Sibeoni et al. BMC Medical Research Methodology 20.1(2020):1-21) and has been conducted in four French psychiatric departments. Design was based on the recruitment of patients through the Cohort study, all interviewed twice, the first time 3 to 5 weeks after the first administration of ENS, and the second time around 6 months after, whether treatment has been continued or not. Data analysis follows the IPSE analytic procedure and is conducted in two stages: three individual researchers carry out independent work and the group collectively pools data. These preliminary results are based on the sole analysis of the first interviews conducted from July 2022 to July 2023.
ResultsEighteen participants with moderate to severe TRD, including 13 women, were interviewed and two axes of experience have been produced: (1) the overwhelming experiences of the treatment, perceived differently depending on patients, as a dissociative experience, both inside – described as a trip- and outside of them; (2) A discordant treatment experience with both solitude and relational support from medical team.
ConclusionsThese results highlight the need to better prepare the patients for the initiation of the treatment and to take into consideration the settings in which the treatment is administered, as well as the importance of the support received from the nursing staff.
Disclosure of InterestE. Manolios Grant / Research support from: have recieved financial support to conduct the study, J. Mathé Grant / Research support from: have recieved financial support to conduct the study, J. Sibeoni Grant / Research support from: have recieved financial support to conduct the study, M. Rotharmel Consultant of: Janssen, B. Astruc Consultant of: Janssen, B. Falissard Consultant of: Janssen, L. Mekaoui Consultant of: Janssen, A. Laurin Consultant of: Janssen, E. Gaudre-Wattinne Employee of: Janssen Cilag, J. Dupin Employee of: Janssen Cilag, A. Revah-Levy Grant / Research support from: have recieved financial support to conduct the study
GWAS in interaction with childhood traumas implicates novel variants and genes previously associated with suicide-related factors in the background of suicidal ideation
- X. Gonda, S. Krause, B. Erdelyi-Hamza, S. Sutori, Z. Gal, N. Eszlari, G. Bagdy, G. Juhasz, D. Torok
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, pp. S336-S337
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Introduction
Although suicide claims more lives than war and homicide, we still have no sufficient and effective methods either for its prediction or for its prevention. Our screening methods are laborous and subjective both on the side of the patient and on the side of the clinician. Understanding the genetic background of suicidal behaviour would help identify biomarkers for screening as well as pathways as potential targets for novel intervention and prevention approaches. However, in spite of a number of GWAS studies, results are few and rarely replicate, and generally accurate phenotyping and sufficient consideration of environmental stressors is also missing.
ObjectivesIn our present study we performed a genome-wide analysis study for suicidal ideation in interaction with early childhood traumas in a deep-phenotyped general population sample.
MethodsOur analysis used data from 1800 volunteers in the NewMood project. As outcome phenotype the suicidal ideation item of the Brief Symptom Inventory was used. A modified version of the Childhood Trauma Questionnaire was used to assess early adverse experiences. A genome-wide association analysis was performed with Plink 1.9, including a total of 3,474,641 variants after quality control steps, followed by genome-wide by environment interaction analyses. Our models included control variables for sex, age, and the top 10 genomic principal components. Functional annotation of SNPs was carried out using FUMA v1.5.6, gene-based tests were performed using MAGMA v1.08.
Results7 SNPs met suggestive significance in main effect analyses, of which 2 reached genome-wide significance including rs79912020 (p=3.21E-10, β=0.746) and rs10236520 (p=1.71E-08, β=0.484), with no significant findings in gene-based tests. Interaction analyses with childhood adversities yielded 31 SNPs that met genome-wide significance, including rs7983955 (p=2.28E-11, β=0.182), rs141039461 (p=3.90E-11, β=0.0541), rs12692827 (p=3.69E-10, β=0.0612) as the top SNPs. In interaction with childhood adversities, 31 genes showed a significant association in gene-based tests, including RBFOX1 (p=1.09E-10), GRM7 (p=1.20E-10), MTCH1 (p=5.59E-09), and CDH13 (p=6.60E-09) as the most significant findings.
ConclusionsOur results indicate several important novel SNPs associated with suicidal ideation when considered in interaction with the effect of childhood adversities. Furthermore, gene-based analyses replicate several genes playing a key role in central nervous system function such as GRM7 (encoding metabotropic glutamate receptor 7) or previously implicated in association with suicide (CDH13) or suicide-related factors such as aggression (RBFOX1).
Funding: NAP2022-I-4/2022, K143391, 2019-2.1.7-ERA-NET-2020-00005, TKP2021-EGA-25
Disclosure of InterestNone Declared
Improving prediction of 12-months suicidal attempts in bipolar disorder: a machine learning study
- A. Pigoni, G. Delvecchio, C. Pini, L. Cirella, C. Prunas, N. Turtulici, L. Squarcina, P. Brambilla
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, pp. S348-S349
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Introduction
Bipolar disorder (BD) is a recurrent disorder, causing functional impairment and raised mortality, particularly due to suicide. However, the difficulty in predicting suicidal behaviors relies in the lack of clear biomarkers.
Machine learning (ML) has emerged as a promising tool to enhance suicidal prediction. However, most ML studies focused on lifetime attempts, without having a predictive time window, and did not employ time-dependent variables. Moreover, most studies lie on cross-sectional databases, without including more than one time-point.
ObjectivesFirst, we aimed to predict 12-months suicide attempts in a naturalistic sample of BD patients, using clinical and demographic data.
Second, we aimed to improve the prediction by including information from intermediate visits (1, 3, and 6 months), mimicking more closely the clinician’s way of thinking and the multiple observations a patient receives.
MethodsA sample of 163 BD patients (53% females, mean age 44.7, SD 15.3) were recruited.
Based on EHR, 56 clinical and demographic features were extracted, including hospitalizations, suicidal behaviors lifetime and in the last 12 months, along with comorbidity, family history, work, and therapies. Patients were followed up for 12 months.
Support Vector Machine (SVM) was used to differentiate subjects who attempted suicide versus those who did not in a 12-month time window, within a repeated nested Cross-Validation. The SVM was optimized weighting the hyperplane for uneven group sizes.
Then, we repeated the analysis including information from intermediate visits (1, 3, 6 months after the first contact). For each visit, we created a composite score based on current therapy, new admissions, and ER presentations. To avoid circularity, all the information (ER, admission etc.) related to a suicide attempt were not included.
ResultsDuring the 12-months follow-up, 9.8% of patients attempted suicide. The results from the 12-months suicide prediction model obtained an Area Under the Curve of 0.71(with a Balanced Accuracy (BAC) of 68%).
After incorporating the composite scores based on intermediate visits in the model, the prediction raised to an Area Under the Curve of 0.78 (BAC 73%), suggesting that including intermediate visits is a valid method to improve prediction.
The features that contributed the most to the prediction were the composite score at 6-month visit, lifetime number of suicide attempts, suicide attempts in the last 12 months, substance of abuse (other than cannabis), and antipsychotics.
ConclusionsML proved a good prediction accuracy for suicide in a 12-months time window, and the prediction was improved by including data from intermediate visits. The model showed the importance of time-dependent features, such as attempts in the last 12 months. Our analysis might help in identifying early clinical risk factors and underlies the importance of multiple evaluations in populations at risk.
Disclosure of InterestNone Declared
Brain magnetic resonance imaging outperforms clinical severity ratings in the prediction of treatment outcomes in major depressive disorder
- F. Long, Y. Chen, Q. Zhang, Y. Wang, Y. Wang, Q. Li, Y. Zhao, F. Li
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S85
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Introduction
Major depressive disorder (MDD) is a prevalent and disabling condition. Approximately 30-50% of patients do not respond to first-line medication or psychotherapy. Therefore, several studies have investigated the predictive potential of pretreatment severity rating or neuroimaging features to guide clinical approaches that can speed optimal treatment selection.
ObjectivesTo evaluate the performance of 1) severity ratings (scores of Hamilton Depression/Anxiety Scale, illness duration, and sleep quality, etc.) and demographic characteristic and 2) brain magnetic resonance imaging (MRI) features in predicting treatment outcomes for MDD. Second, to assess performance variations among varied modalities and interventions in MRI studies.
MethodsWe searched studies in PubMed, Embase, Web of Science, and Science Direct databases before March 22, 2023. We extracted a confusion matrix for prediction in each study. Separate meta-analyses were performed for clinical and MRI studies. The logarithm of diagnostic odds ratio [log(DOR)], sensitivity, and specificity were conducted using Reitsma’s random effect model. The area under curve (AUC) of summary receiver operating characteristic (SROC) curve was calculated.
Subgroup analyses were conducted in MRI studies based on modalities: resting-state functional MRI (rsfMRI), task-based fMRI (tbfMRI), and structural MRI (sMRI), and interventions: antidepressant (including selective serotonin reuptake inhibitors [SSRI]) and electroconvulsive therapy (ECT). Meta-regression was conducted 1) between clinical and MRI studies and 2) among modality or intervention subgroups in MRI studies.
ResultsWe included ten studies used clinical features covering 6494 patients, yielded a log(DOR) of 1.42, AUC of 0.71, sensitivity of 0.61, and specificity of 0.74. In terms of MRI, 44 studies with 2623 patients were included, revealing an overall log(DOR) of 2.53. The AUC, sensitivity, and specificity were 0.89, 0.78, and 0.75.
Studies using MRI features had a higher sensitivity (0.89 vs. 0.61) in predicting treatment outcomes than clinical features (P < 0.001). RsfMRI had higher specificity (0.79 vs. 0.69) than tbfMRI subgroup (P = 0.01). No significant differences were found between sMRI and other modalities, nor between antidepressants (SSRIs and others) and ECT. Antidepressant studies primarily identified predictive imaging features in limbic and default mode networks, while ECT mainly focused on limbic network.
ConclusionsOur findings suggest a robust promise for pretreatment brain MRI features in predicting treatment outcomes in MDD, offering higher accuracy than clinical studies. While tasks in tbfMRI studies differed, those studies overall had less predictive utility than rsfMRI data. For MRI studies, overlapping but distinct network level measures predicted outcomes for antidepressants and ECT.
Disclosure of InterestNone Declared
A Study of Dry Mouth and Gastrointestinal Disorders in Patients Taking Antidepressant
- S.-Y. Lee, H.-J. Lee
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- Journal:
- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S498
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Introduction
Dry mouth is a subjective symptom of the feeling of dehydration inside of the mouth and is closely linked to reduced salivary secretion. The occurrence of dry mouth and GI disorders due to antidepressants greatly affects the course of the mental disorder and medication compliance, but it has barely ever been studied.
ObjectivesThe purpose of this study was to identify the characteristics of dry mouth and gastrointestinal (GI) disorders in antidepressant patients.
MethodsThe study included 103 antidepressant-taking patients. Antidepressants were classified according to their mode of action. The GI disorders were investigated using the medical records of the patients. The Patient Health Questionnaire-15 and a questionnaire for assessing dry mouth symptoms were used in this study. The questionnaire for the evaluation of dry mouth symptoms, a visual analog scale (VAS)–based instrument, developed and evaluated for reliability by Lee et al. was used to assess dry mouth. In the questionnaire, 6 VAS items were assessed for the extent of dry mouth (0-100 points) : 1) dry mouth at night or when waking up in the morning, 2) dry mouth during the day, 3) dry mouth when eating, 4) difficulty in swallowing, 5) subjective evaluation of the volume of saliva in the mouth, and 6) overall discomfort in daily life. Additionally, four items examined behaviors due to dry mouth (1-5points) : 1) frequency of waking up from sleep due to dry mouth, 2) frequency of preparing drinking water before going to bed, 3) frequency of drinking water when eating solid foods, and 4) frequency of eating hard candies or chewing gums to help dry mouth.
ResultsThe score for “overall discomfort due to dry mouth in daily life” (31.72±33.82), “dry mouth at night or in the morning” (47.86±35.87), and “dry mouth during the day” (39.83±31.67) were slightly higher than “discomfort in chewing or swallowing foods”. According to somatization severity, the mean values were 116.36±113.34 in the mild, 213.18±136.98 in the moderate, and 277.59±201.44 in the severe, the between-group difference was significant (F=10.294, p<0.001). According to the class of antidepressants, the mean score was 180.00±147.5 for vortioxetine, 194.25±169.33 for selective serotonin reuptake inhibitors (SSRIs), 223.61±156.70 for serotonin and norepinephrine reuptake inhibitors (SNRIs), 75.00±57.00 for norepinephrine dopamine reuptake inhibitors (NDRIs), 201.67±174.66 for Nassau, and 116.67±132.03 for agomelatine. A total of 67 (65.0%) patients had at least one GI disorder.
ConclusionsThe study findings are expected to help increase medication compliance in antidepressant patients by better controlling the side effects experienced by the patients.
Disclosure of InterestNone Declared
Understanding the role of mental pain in suicidal individuals: from clinical to neuroimaging perspective.
- M. Pompili
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- Journal:
- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S790
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Introduction
In the attempt to shed light on the phenomenology of suicide, this contribution focuses on the role of mental pain as a main ingredient of suicide.
ObjectivesPrevious studies have shown that mental pain, childhood negative experiences, and maltreatment are associated with suicide risk. Neuroimaging studies demonstrated that such emotional pain shares the same neuroanatomical circuit of somatic pain. Furthermore, concepts related to death, failure, or other unfortunate circumstances activate specific cerebral areas in a suicidal individual compared to a non-suicidal subject.
MethodsThe author, through a multicenter investigation, conducted a sizeable clinical study on mental pain related to psychiatric disorders and suicide risk. With this aim, a dataset of more than 2200 psychiatric patients is explored to investigate suicide risk, mental pain, childhood trauma, and the role of depressive symptomatology. Implications emerging from neuroimaging studies are investigated.
ResultsA framework emerges about the role of childhood traumatization in mediating between suicide risk and mental pain; furthermore, when individuals experience high mental pain and high depressive symptomatology, regardless of the diagnoses, they are exposed to higher suicide risk.
ConclusionsSuch results are presented in light of neuroimaging studies’ role in identifying how mental pain and brain activation are detected in suicidal individuals. Therefore, this contribution aims to understand better mental pain’s role in clinical practice and research activities.
Disclosure of InterestNone Declared
The Nefashot Initiative’s Journey: Transforming from Local Activism into a Diverse Community Promoting Mental Health through Arts and Culture
- S. Regev, R. Diller
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- Journal:
- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S677
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Introduction
Nefashot, meaning ‘Souls’ and ‘People’ in Hebrew, emerged from a local group of impassioned activists. Our core mission is to promote mental health awareness through cultural and artistic expressions, bridging gaps in open and inclusive conversations.
ObjectivesIn our early years, our primary goal was to infuse MH discussions into public spaces through art. However, as our community has evolved, so too have our objectives. Today, we recognize the profound impact of these connections and discussions, both within and beyond our dynamic community. We’ve come to understand that belonging to this community is, in itself, a catalyst for change. This shift in perspective has allowed us to fully embrace the transformative potential of community engagement and direct our activities.
MethodsAt the heart of our approach is the nurturing of a profound sense of belonging within our diverse community. We achieve this through two vital activities: (1) Ongoing Community Communication: Within our dynamic community, which includes individuals dealing with mental health challenges, professionals, family members, friends, and allies, communication is paramount to our unity. We maintain an open and continuous dialogue through a dedicated WhatsApp group. This platform facilitates connection, sharing of experiences, and mutual support, strengthening the bonds that unite us in our shared mission. (2) Community-Driven Event Production: Beyond our annual ‘Osim Nefashot’ week, held around World Mental Health Day, we seize opportunities throughout the year to organize events or collaborate with larger events like International Women’s Day in March or Book Week in June. Encouraging active participation in event planning and execution not only amplifies the voices of our members but also deepens their sense of belonging within our ever-evolving community.
ResultsOur hallmark is a sustainable process, welcoming new creators, forging connections, and expanding our influence while retaining core members. This renewal and continuity enable us to reach new audiences and expand mental health awareness through art and culture. Our growth is showcased, with 90 events organized last year.
ConclusionsNefashot’s transformation from activists to a diverse community is an ongoing journey requiring commitment and deliberate steps. Our allocated resources and activities ensure each participant, from creators to venues to attendees, plays a vital role in advancing mental health awareness. We remain dedicated to nurturing inclusivity and promoting mental well-being through art and culture.
Disclosure of InterestNone Declared
How is trauma a transdiagnostic risk factor? A biopsychosocial model of risk and protective mechanisms following childhood trauma
- H. Kerbage, D. Purper-Ouakil
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- Journal:
- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, pp. S20-S21
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Abstract
Traumatic exposure is a common global problem across nations. It is currently well established that childhood trauma is associated with increased risk for psychopathology transdiagnostically, with children having experienced trauma being twice as likely to develop a mental health condition compared to those who have never experienced trauma. According to population-based studies, this heightened risk for the emergence of mental health disorders persists throughout adolescence and adulthood. The risk for psychopathology seems to be most marked in children exposed to interpersonal violence (child emotional and physical abuse, neglect, sexual violence). In this presentation, we will summarize the results of an increasing number of published studies that have examined the mechanisms underlying vulnerability to psychopathology following childhood trauma and protective factors that buffer this risk. Specifically, we will highlight the role of emotion dysregulation and interpersonal difficulties, related to disrupted threat processing following trauma exposure, in mediating the impact of trauma on internalizing and externalizing symptoms. Research studies have also identified protective factors accross the lifespan that might mitigate these outcomes, including social support and emotional skills building. Based on this review, we will suggest a conceptual transdiagnostic and biopsychosocial model of risk and resilience, which can provide opportunities and targets for early interventions and treatment, at the primary and secondary healthcare levels, as well as the social, public health and community levels. Our model is based on a socioecological and multisystemic paradigm of risk and resilience, where resilience is conceptualized as an interaction between individuals and resourceful environments and communities.
Disclosure of InterestNone Declared
Prevalence and impact of comorbid mental disorders in hospitalized patients with obstructive sleep apnea: a protocol for a nationwide retrospective study
- D. Nora, A. Freitas, L. Fernandes, A. R. Ferreira
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- Journal:
- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S720
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Introduction
Obstructive sleep apnea (OSA) is a common sleep disorder in the adult population, often associated with an increased prevalence of comorbid conditions such as obesity and diabetes, but also several mental disorders that have been independently associated with worse hospitalization outcomes in a variety of situations. However, and despite such associations, there is a relative dearth of studies exploring comorbid psychopathology beyond depression and anxiety, and no studies seem to address the impact of comorbid mental disorders on the hospitalization outcomes of patients with OSA.
ObjectivesThis study aims to characterize and compare mental comorbidities among hospitalization episodes of adult patients with and without OSA held in mainland Portugal, regardless of the primary cause of admission, and to analyze the impact of such comorbidities on hospitalization outcomes.
MethodsAn observational retrospective study will be conducted using an administrative database comprising de-identified routinely collected discharge data from all Portuguese mainland public hospitals. Inpatient episodes spanning from 2008 to 2015 will be categorized into two groups according to the presence of an OSA code (ICD-9-CM codes 780.51, 780.53, 780.57, 327.20 and 327.23). For both groups, mental disorders will be identified according to categories 650 to 670 of the Clinical Classifications Software (CCS) for ICD-9-CM. Descriptive, univariate, and multivariate analyses will be performed. Study reporting will comply with the RECORD statement guidelines.
ResultsOut of 6,072,538 sampled episodes, 57,301 have an OSA code. Prevalence of any comorbid mental disorder is 30.4% in the OSA group, and 19.3% in the non-OSA group. For both groups, sociodemographic, administrative, and clinical variables will be characterized and compared, as well as the prevalence of each mental disorder category, yearly hospitalization trends, and most common primary diagnoses. Hospitalization outcomes, including length of stay, in-hospital mortality, and readmissions, will be compared taking into consideration the presence of CCS categories of mental disorders.
ConclusionsWe expect to improve the understanding of the prevalence of mental comorbidities among hospitalized patients with OSA, including understudied mental disorders, and to elucidate their impact on relevant hospitalization outcomes, thus highlighting the need to recognize and treat this common association to achieve optimal outcomes.
Disclosure of InterestNone Declared
“Emotional Intelligence, Psychological Distress, and Conflict Resolution Among Healthcare Professionals”
- M. Theodoratou, A. Papadopoulos
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- Journal:
- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, pp. S832-S833
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Introduction
Emotional Intelligence (EI) plays a substantial role in shaping the behavior, overall well-being, and performance of individuals. In the context of healthcare, where professionals frequently confront a demanding work environment, there is a notable prevalence of high Psychological Distress (PD). Consequently, conflicts are a recurrent phenomenon within healthcare settings, exerting impacts on healthcare professionals, patients, and their families.
ObjectivesAims:
1. Investigate the link between Emotional Intelligence (EI) and conflict management among healthcare professionals.
2. Examine how Psychological Distress (PD) relates to conflict management in healthcare.
3. Explore age, specialization, and experience’s influence on EI dimensions.
4. Analyze EI’s impact on healthcare professionals’ conflict resolution choices.
5. Assess how demographics affect conflict resolution preferences among healthcare workers.
These aims explore EI, PD, demographics, and conflict management in healthcare, informing skill enhancement and improved conflict resolution practices.
MethodsThis study involved 143 healthcare professionals from diverse regions of Greece. Electronic surveys gathered demographic data and assessed Emotional Intelligence (via a dedicated questionnaire), Psychological Distress (using the Kessler K6+ questionnaire), and Conflict Resolution strategies.
ResultsThe majority of participants were female (69.2%), with 42.7% aged 46-55 and 30.8% aged 36-45. Age was significantly associated with “Self-awareness” (P=0.032) and “Social Skills” (P=0.009 and 0.007) within Emotional Intelligence dimensions. Negative correlations emerged between Psychological Distress and Emotional Intelligence dimensions (-0.46 to -0.19). Additionally, Psychological Distress showed negative correlations with several Conflict Resolution dimensions: ‘Atmosphere’ (-0.20), ‘Doables’ (-0.28), ‘Mutual Benefit Agreements’ (-0.18), ‘Needs’ (-0.23), and ‘Extra Considerations’ (-0.27). Participants below 35 had higher scores in “Power” (p=0.002), while those aged 46 and above scored higher in “Options” (p=0.002 and 0.009) for conflict resolution.
ConclusionsIn summary, this study underscores EI’s relevance in healthcare, especially its influence on PD and conflict resolution. Developing EI competencies offers promise for improving healthcare professionals’ emotional well-being and conflict-handling abilities, ultimately benefiting patient care and staff satisfaction. Further research and tailored interventions are warranted to advance this field at an academic level.
Disclosure of InterestNone Declared