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Displaying One Session

Oral Communication
Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Oral Communications (ID 1110) AS01. Anxiety Disorders and Somatoform Disorders

O001 - Disgust and Anxiety: what came first, the chicken or the egg?

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
07:00 - 07:12

ABSTRACT

Introduction

Disgust is a basic emotion characterized by the feeling of revulsion and evoked by unpleasant stimuli such as contaminated food, poor hygiene and contact with sick or dead organisms. Disgust is a contributing factor to the development of several mental disorders including anxiety disorders (AD). Several studies have tried to explore the relationship between disgust and eating disorders (ED), with heterogeneous findings. Subjects with ED showed a heightened level of disgust sensitivity (DS) when compared with healthy controls (HC).

Objectives

Our study aims to evaluate levels of disgust and anxiety in ED, AD and HC in order to assess associations between these two emotions.

Methods

We enrolled 74 patients admitted to Psychiatric Unit of Careggi, 41 with diagnosis of Eating Disorder, 33 with Anxiety Disorders, and 40 healthy controls. We administered to all groups: Zung Anxiety Scale (ZSAS) and Disgust Propensity and Sensitivity Scale-revised (DPSS-r).

Results

diagram 1.jpgregressione lineare.pngtable 1.jpgBoth patients with anxiety disorders and eating disorders showed higher levels of disgust propensity

and sensitivity than healthy controls. Moreover, there was no significant differences in anxiety, Disgust

Propensity (DP) and Disgust Sensitivity levels between patients with eating disorders and anxiety disorders.

Among healthy controls there was a significant association between DS and Anxiety levels (B: 0.579, T:3,416 p:0,001).

Conclusions

Anxiety and disgust are typical emotions of anxiety disorders and eating disorders. However, they are

increased both in anxiety and eating disorders and they are associated in healthy controls. The nature of

this association needs to be deeply investigated.

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Oral Communications (ID 1110) AS01. Anxiety Disorders and Somatoform Disorders

O002 - Anxiety disorders and childhood exposure to emotional abuse: the mediating role of disgust

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
07:12 - 07:24

ABSTRACT

Introduction

Several studies demonstrate that disgust, defined as a revulsion response aimed at distancing an individual from a potentially harmful or noxious stimulus, is linked to post-traumatic stress following sexual trauma even when accounting for associated fear and anxiety. One of the suggested mechanisms implicated in this association is a feeling of mental contamination. Recent neuroimaging studies demonstrated that exposure to contamination activates the insular cortex. In addition, disgust sensitivity correlates with the activation of the insular cortex.

Objectives

We aimed to investigate the psychopathological role of the emotion of disgust in the developement of anxiety symptoms in patient with an history of abuse.

Methods

We enrolled 84 patients admitted in Psychiatric Unit of Careggi with diagnosis of Anxiety Disorders. We administered to them: Zung Anxiety Scale (ZSAS), Childhood Trauma Questionnaire (CTQ), Disgust Propensity and Sensitivity Scale-revised (DPSS-r).

Results

path diagram .jpgResults showed a significant mediation of the association between CTQ emotional abuse scores and total ZSAS scores via DPSS disgust sensitivity scores in patients with anxiety disorders (p=0.022). Total effect and indirect effect of emotional abuse on severity of anxiety symptoms were significant (total effect = 0.494; p=0.051, indirect effect: 0.256, p=0.022), while there was no significant direct effect from emotional abuse to anxiety symptoms in the total model (direct effect: 0.237, p=0.356). The model explained 18% of variance in anxiety symptomatology (R2=0.18).

Conclusions

Such preliminary data suggest a possible mediating role of disgust in development and maintenance of childhood abuse-related anxiety, making it a potential target for psychotherapy.

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Oral Communications (ID 1110) AS01. Anxiety Disorders and Somatoform Disorders

O003 - Toxoplasma gondii seropositivity in patients with depressive and anxiety disorders

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
07:24 - 07:36

ABSTRACT

Introduction

Toxoplasma gondii (T. gondii) is an obligate intracellular parasite that is estimated to be carried by one-third of the world population. While evidence has been found for a relationship between T. gondii infection and schizophrenia, its relationship with other psychiatric disorders like depressive and anxiety disorders shows inconsistent results.

Objectives

The aim of the present study was to examine whether T. gondii seropositivity is associated with affective disorders, as well as with aggression reactivity and suicidal thoughts.

Methods

In the Netherlands Study of Depression and Anxiety (NESDA), T. gondii antibodies were assessed in patients with current depressive (n=133), anxiety (n=188), comorbid depressive and anxiety (n=148), and remitted disorders (n=889), as well as in healthy controls (n=373) based on DSM-IV criteria. Seropositivity was analyzed in relation to disorder status, aggression reactivity and suicidal thoughts using multivariate analyses of covariance and regression analyses.

Results

Participants were on average 51.2 years (SD = 13.2), and 64.4% were female. Seropositivity was found in 673 participants (38.9%). A strong positive association between T. gondii seropositivity and age was observed. No significant associations were found between T. gondii seropositivity and disorder status, aggression reactivity and suicidal thoughts. The adjusted odds ratio (OR) for any remitted disorder versus controls was 1.13 (95% CI: 0.87-1.49), and for any current disorder versus controls was 0.94 (95% CI: 0.69- 1.28).

Conclusions

No evidence was found for a relationship between affective disorders and T. gondii infection

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Oral Communications (ID 1110) AS02. Bipolar Disorders

O004 - Lithium-associated hypothyroidism: reversible after lithium discontinuation?

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
07:36 - 07:48
Presenter

ABSTRACT

Introduction

The association between lithium and thyroid dysfunction has long been known. Yet it is not known whether lithium-associated hypothyroidism is reversible, once lithium treatment has been stopped.

Objectives

To determine whether lithium-associated hypothyroidism was reversible in patients who subsequently discontinued lithium.

Methods

Retrospective cohort study in the Swedish region of Norrbotten into the effects and side- effects of lithium treatment and other drugs for relapse prevention (LiSIE). For this particular study, we reviewed medical records between 1997 and 2015 of patients treated with lithium.

Results

Of 1340 patients screened, we identified 90 patients with lithium-associated hypothyroidism who subsequently discontinued lithium. Of these, 27% had overt hypothyroidism at the time when thyroid replacement therapy was initiated. The mean delay from lithium start to thyroid replacement therapy start was 2.3 (SD 4.7) years. Fifty percent received thyroid replacement therapy within 10 months of starting lithium. Of 85 patients available for follow up, 35 (41%) stopped thyroid replacement therapy after lithium discontinuation. Six patients reinstated thyroid replacement therapy subsequently. Only one of these had overt hypothyroidism, occurring 13 days after stopping lithium and 11 days after stopping thyroid replacement therapy.

Conclusions

Lithium-associated hypothyroidism seems reversible in most patients, once lithium has been discontinued. In such cases, thyroid replacement therapy discontinuation could be attempted much more often than currently done. Based on the limited evidence of our study, we can expect hypothyroidism to recur early after discontinuation of thyroid replacement therapy if at all.

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Oral Communications (ID 1110) AS02. Bipolar Disorders

O005 - The WHO-5 well-being scale and its correlation to depressive and manic symptoms among outpatients with bipolar disorder or unipolar depression.

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
07:48 - 08:00

ABSTRACT

Introduction

There is a lack of longitudinal studies of patients with bipolar disorder (BD) or unipolar depression (UD) in terms of psychological well-being as measured by the WHO-5 and the correlation to symptom scores. It is of interest to investigate whether the WHO-5 is useful in monitoring patients with mood disorders over time, as a tool in measurement-based care, and as a supplement to other psychometric measures.

Objectives

In this study we investigate the correlation at baseline between the depressive symptom scores according to the 6-item Hamilton Depression Score (HDS-6) and the WHO-5 scores in outpatients treated for BD or UD. Furthermore, in patients with BD we investigate correlations between manic symptom scores according to the modified Bech-Rafaelsen Mania Scale (MAS-M) and the WHO-5 scores. Lastly, in patients with BD or UD, we investigate the correlations between endpoint-baseline change in WHO-5 and change in MAS-M and HDS-6.

Methods

A longitudinal study of 200 outpatients diagnosed and treated for either BD or UD. Patients will be measured at baseline and at least four weeks later. Baseline data are presented as frequencies, means and standard deviations or medians with interquartile ranges as appropriate. All correlations are presented as scatter plots and a Spearman correlation analysis

Results

The study is ongoing, but the results will be available for presentation at the EPA in 2021.

Conclusions

The WHO-5 may represent a relevant outcome measure in the treatment of BD and UD.

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Oral Communications (ID 1110) AS02. Bipolar Disorders

O006 - Higher illness burden is associated with reduced heart rate variability in bipolar disorder

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
08:00 - 08:12
Presenter

ABSTRACT

Introduction

Bipolar disorder (BD) is associated with premature death and ischemic heart disease is the main cause of excess mortality. The predictive power of heart rate variability (HRV) for mortality has been confirmed in patients with or without cardiovascular disease. While several studies have analyzed the association between HRV and BD, their results are incongruent; and none has analyzed the effect of the clinical factors characterizing illness burden on HRV.

Objectives

To assess the association between HRV and the following factors characterizing illness burden: illness duration, number and type of previous episode(s), duration of the most severe depressive or hypomanic/manic episode, severity of episodes, co-morbid psychiatric disorders, family history of BD or suicide, and duration and polarity of current episode in participants experiencing one.

Methods

We used a wearable device in 53 BD participants to assess the association between HRV using 4 measures (RMSSD, SDANN, SDNN and RR Triangular Index) and the abovementioned clinical factors characterizing illness burden. For each of the 4 HRV measures we ran 11 models, one for each burden of illness clinical factor as an independent variable.

Results

Longer illness duration, higher number of depressive episodes, and family history of suicide were negatively correlated with HRV; in the 14 participants experiencing a depressive episode, the MADRS score was negatively correlated with HRV

Conclusions

Our study analyzed the association between burden of illness and HRV in BD, while controlling for functional cardiovascular status, age, sex, BMI, education, and treatment. Our results showed that high illness burden is associated with reduced HRV.

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Oral Communications (ID 1110) AS02. Bipolar Disorders

O007 - Bipolar Disorder hospitalizations – a Big Data approach

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
08:12 - 08:24

ABSTRACT

Introduction

Bipolar Disorder (BD) is a mental disorder characterized by long hospitalizations and frequent need for acute psychiatric care. Hospitalizations represent a valuable quality of care indicator in BD.

Objectives

The aim of this study was to describe a nationwide perspective of BD related hospitalizations and to use a BigData based approach in mental health research.

Methods

We performed a retrospective observational study using a nationwide hospitalization database containing all hospitalizations registered in Portuguese public hospitals from 2008 to 2015. Hospitalizations with a primary diagnosis of BD were selected based on International Classification of Diseases version 9, Clinical Modification (ICD-9-CM) codes of diagnosis 296.xx (excluding 296.2x; 296.3x and 296.9x).

Results

A total of 20,807 hospitalizations were registered belonging to 13,300 patients. 33.4% of the hospitalizations occurred in male patients and the median LoS was 16.0 days. Mean age was 47.9 years and male patients were younger(46.6 vs. 48.6; p< 0.001). 59 hospitalizations had a deadly outcome (0.3%). The most common cause of hospitalization in BD was the diagnosis code 296.4x (Bipolar I disorder, most recent episode (or current) manic) representing 34.3% of all hospitalizations, followed by the code 296.5x (Bipolar I disorder, most recent episode (or current) depressed) with 21.4%. The mean hospitalization charges were 3,508.5€ per episode, with a total charge of 73M€ in the 8-year period of this study.

Conclusions

This is a nationwide study using BigData analysis giving a broad perspective of BD hospitalization panorama at a nationwide level. We found differences in hospitalization characteristics by gender, age and primary diagnosis.

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Oral Communications (ID 1110) AS02. Bipolar Disorders

O008 - Game changer in the diagnosis of bipolar disorder using RNA editing-based blood biomarkers

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
08:24 - 08:36
Presenter

ABSTRACT

Introduction

In clinical practice, differentiating Bipolar Disorder (BD) from unipolar depression is challenging due to the depressive symptoms, which are the core presentations of both disorders. Patients with BD are often misdiagnosed during depressive episodes resulting in a delay in proper treatment and a poor management of their condition.

Objectives

The aim of the present study is to discriminate between unipolar depression and BD using a panel of RNA edited blood biomarkers.

Methods

Depressed patients were classified according to clinical scores in MADRS and IDSC-30 depression scales. After blood collection and RNA extraction, we used whole-transcriptome sequencing to identify differential A-to-I editing events, and Targeted Next Generation Sequencing to validate those biomarkers.

Results

We discovered 646 variants differentially edited between depressed patients and control in a discovery cohort of 57 participants. After using stringent criteria and biological pathway analysis, 6 biomarker candidates were singled out and tested in a validation cohort of 160 patients suffering from unipolar depression and 95 BD patients in a depressive episode, which allowed a differential diagnosis of BD with an AUC of 0.935 and high specificity (Sp=84.6%) and sensitivity (Se=90.9%).

Conclusions

We have shown that a combination of 6 blood RNA editing-related biomarkers allows to discriminate unipolar and bipolar depression This 6 BMKs panel may be crucial to improve BD diagnosis and orientate the treatment therefore addressing the needs of millions of patients suffering from misdiagnosis and incorrect treatment for their diseases. This will change the game for the management of patients.

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Oral Communications (ID 1110) AS02. Bipolar Disorders

O009 - Lithium treatment and estimate glomerular filtration rate in bipolar disorder patients: a cross-sectional study

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
08:36 - 08:48

ABSTRACT

Introduction

Lithium has been the mainstay therapy for bipolar disorder (BD) for decades, but there is little consensus regarding its possible effects on kidney function and the rate of change in estimated glomerular flow rate (eGFR) over time.

Objectives

To describe patients with BD regarding their renal function and their sociodemographic and clinical characteristics potentially related to eGFR.

Methods

This is a cross-sectional study with an initial sample of 95 patients with BD. Multiple linear regression analysis was applied to investigate the association of lithium serum levels and their duration of treatment with eGFR, independent of confounding factors. We excluded patients without data regarding any of the variables from the final model.

Results

In the multivariable analysis, the model was composed of eight variables (Figure 1). The mean duration of treatment was 10 years (Figure 2). Serum lithium level was associated with low levels of eGFR (β = -18.06 [-34.70 - -1.42], p = 0.03); among the other variables, only age remained associated with it (β = -0.72 (-1.10 - -0.33), p = <0.01).

figure 1.jpg

Note: *P<0.05

figure 2.jpg

Conclusions

We replicated the correlation between serum lithium levels and eGFR. Our results contradict the claim that duration of treatment with lithium correlates with lower levels of eGFR, while suggesting serum lithium level could be a possible early marker of lithium nephrotoxicity.

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Oral Communications (ID 1110) AS02. Bipolar Disorders

O010 - Prospective early warning signals to detect transitions to manic and depressive episodes in bipolar disorder

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
08:48 - 09:00

ABSTRACT

Introduction

For patients with bipolar disorder, early recognition of impending mood episodes is crucial to enable timely intervention. Longitudinal digital mood monitoring using ecological momentary assessment (EMA) enable prospective study of early warning signals (EWS) in momentary affective estates prior to symptom transitions.

Objectives

The present study examined in a unique longitudinal EMA data set whether EWS prospectively signal transitions to manic or depressive episodes.

Methods

Twenty bipolar type I/II patients completed EMA questionnaires five times a day for four months (average 491 observations per person), as well as weekly symptom questionnaires concerning depressive (Quick Inventory for Depressive Symptomatology) and manic (Altman Self-Rating Mania Scale) symptoms. Weekly data was used to determine transitions (i.e., abrupt increase in symptoms). Prior to these transitions, EWS (autocorrelation at lag-1 and standard deviation) were calculated in moving windows over 17 affective EMA states. Kendall’s tau was calculated to detect significant rises in the EWS indicator prior to the transition.

Results

Eleven patients reported one or two transitions to a mood episode. All transitions were preceded by at least one EWS. Average sensitivity for detecting EWS was slightly higher for manic episodes (36%) than for depressive episodes (25%). For manic episodes, EWS in thoughts racing, being full of ideas, and feeling agitated showed the highest sensitivity and specificity, whereas for depression, only feeling tired showed high sensitivity and specify.

Conclusions

EWS show promise in anticipating transitions to mood episodes in bipolar disorder. Further investigation is warranted.

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Oral Communications (ID 1110) AS02. Bipolar Disorders

O011 - Psychiatric hospital utilisation following lithium discontinuation in patients with bipolar I or II disorder: a mirror-image study based on the LiSIE retrospective cohort

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
09:00 - 09:12
Presenter

ABSTRACT

Introduction

Evidence for lithium as a maintenance treatment for bipolar disorder type II remains limited since most treatment-prevention studies focus on bipolar disorder type I or do not distinguish between types of bipolar disorder.

Objectives

To compare the impact of lithium discontinuation on hospital utilisation in patients with bipolar disorder type I or schizoaffective disorder and patients with bipolar disorder type II or other bipolar disorder.

Methods

Mirror-image study, examining hospital utilisation within two years before and after lithium discontinuation as part of LiSIE, a retrospective cohort study into effects and side-effects of lithium for the maintenance treatment of bipolar disorder as compared to other mood stabilisers.

Results

For the whole sample, the number of admissions increased from 86 to 185 admissions after lithium discontinuation, with the mean number of admissions/patient/review period doubling from 0.44 to 0.95 (p < 0.001). The number of bed days increased from 2218 to 4240, with the mean number of bed days/patient/review period doubling from 11 to 22 (p = 0.025). This increase in admissions and bed days was exclusively attributable to patients with bipolar disorder type I or schizoaffective disorder.

Conclusions

Our findings suggest that due to a higher relapse risk in patients with bipolar disorder type I or schizoaffective disorder there is a need to apply a higher threshold for discontinuing lithium than for patients with bipolar disorder type II or other bipolar disorder.

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Oral Communications (ID 1110) AS02. Bipolar Disorders

O012 - Self-injurious behaviour in patients with bipolar disorder and attention deficit hyperactivity disorder after central stimulant start– a retrospective study based on the LiSIE cohort

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
09:12 - 09:24
Presenter

ABSTRACT

Introduction

Currently, our understanding remains limited of how co-occurring bipolar disorder and attention deficit hyperactivity disorder (ADHD) should be treated.

Objectives

To evaluate the impact of central stimulant treatment on self-injurious behaviour in patients with a dual diagnosis of bipolar disorder or schizoaffective disorder and ADHD.

Methods

Retrospective cohort study (LiSIE) into effects and side-effects of lithium as compared to other mood stabilisers. Here, using a mirror-image design, we compared suicide attempts and non-suicidal self-injury events within 6 months and 2 years before and after central stimulant treatment start.

Results

Of 1564 eligible patients, 206 patients met inclusion criteria; having a dual diagnosis of bipolar disorder or schizoaffective disorder and ADHD at first central stimulant initiation. In these, suicide attempts and non-suicidal self-injury events decreased significantly within both 6 months (p = 0.004) and 2 years (p = 0.028) after central stimulant start. After multiple adjustments, this effect was preserved 2 years after central stimulant start (OR 0.63, 95% CI; 0.40 – 0.98, p = 0.041).

Conclusions

Central stimulant treatment may reduce the risk of self-injurious behavior in patients with a dual diagnosis of bipolar disorder or schizoaffective disorder and ADHD. However, to reduce the risk of manic switches, concomitant mood stabilising treatment remains warranted.

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Oral Communications (ID 1110) AS47. Suicidology and suicide prevention

O307 - Screening for suicide risk in medical settings: from research to implementation

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
09:24 - 09:36

ABSTRACT

Introduction

Suicide is an international public health problem and a leading cause of death for youth and adults, worldwide. Prevention efforts in health care systems create opportunities for identifying medical patients with occult suicidality. Detecting suicide risk among patients in medical settings can be a challenge, but successful suicide risk screening programs have been demonstrated in hospital settings.

Objectives

This presentation will discuss how a suicide risk screening tool that was developed for the pediatric emergency department was tested and then implemented in other medical settings in order to leverage healthcare providers as partners in combating the public health crisis of youth suicide. .

Methods

Implementation and quality improvement projects in various medical settings that have adapted the ASQ will be described. Effective management of pediatric patients that screen positive for suicide risk and how mental health clinicians can best be utilized in efficient ways will also be discussed.

Results

Average time to administer the ASQ was 20 seconds. Positive screen rates across ED, inpatient and outpatient settings ranging from 2-14% equating to one additional psychiatric consultation per week. The ASQ Toolkit was developed to help medical providers implement screening including scripts for nurses, flyers for parents and a brief suicide safety assessment (ASQ BSSA) to operationalize next steps for patients at risk.

Conclusions

The medical setting is a key venue for youth suicide risk detection and linking patients with effective interventions. Mental health clinicians have a role in guiding non-mental health providers in the identification and management of patients found to be at risk.

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Oral Communications (ID 1110) AS02. Bipolar Disorders

O016 - Multicentre evaluation of perinatal pharmacological management in women with bipolar disorder

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
09:36 - 09:48

ABSTRACT

Introduction

The pharmacological management of women with bipolar disorder in the perinatal period is challenging. This population has a high recurrence rate, but some medications can be a concern in pregnancy and breastfeeding. Little is known about prescribing practices in perinatal services, and the impact of medication on recurrence rates.

Objectives

To describe 1. the use of medication in women with bipolar disorder in the perinatal period and 2. the impact of medication on the rate of recurrence.

Methods

Clinical data was collected from pregnant women with diagnosis of bipolar disorder in the nine participating centres and who were not experiencing an episode of illness entering the postpartum period. Data were analysed for association using χ2 tests and logistic regression.

Results

In this sample of 167 women, 55% were taking medication at delivery: 37% antipsychotics, 15% mood stabilisers, 25% antidepressants. In 12 cases medication was reduced before delivery. 42% experienced a recurrence, with 30% being a manic/psychotic episode. There was no significant association between taking medication and recurrence c2(1)=0.72, p=0.79. There continued to be no association when adjusted for severity (previous admissions, age at first treatment, bipolar subtype) and type of medication OR 0.57 95%CI [0.08; 4.29], p=0.59.

Conclusions

A high number of bipolar women are taking medication before delivery and in the majority antipsychotics are prescribed. The postnatal recurrence rate in both medicated and unmedicated women is high. Further work is needed in larger samples to provide clinical guidance for women and their clinicians.

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Oral Communications (ID 1110) AS02. Bipolar Disorders

O017 - Polygenic risk and predominant polarity in individuals with bipolar disorder

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
09:48 - 10:00
Presenter

ABSTRACT

Introduction

Individuals with bipolar disorder often have a ‘predominant polarity’ (e.g. depressive or manic) that characterizes the majority of episodes over the course of the illness. Genome-wide association studies have suggested a relationship between genetic risk and phenotypic heterogeneity in bipolar disorder. However, to date, no study has directly examined the association between polygenic liabilities and predominant polarity in bipolar disorder.

Objectives

To estimate the associations between the polygenic risk score for major depressive disorder (PRS-MD), bipolar disorder (PRS-BD) and schizophrenia (PRS-SZ), and predominant polarity among individuals with bipolar disorder in hospital-based settings in Denmark.

Methods

The study sample will include all individuals from the Initiative for Integrated Psychiatric Research (iPSYCH2015) sample who received a diagnosis of bipolar disorder and were successfully genotyped (approximately 3,400). Information on polarity will be computed based on data from the Danish Central Psychiatric Research Register. PRS variables will be generated using the most recent results from the Psychiatric Genomics Consortium. Odds ratios for the associations between PRS variables and polarity will be estimated using logistic regression.

Results

We hypothesize that PRS-MD will be highest among the predominantly depressed patients, that PRS-BD will be highest among those with predominantly manic/mixed episodes, and that PRS-SZ will be highest among those who experience psychotic mania or psychotic bipolar depression. The results will be shown at the conference.

Conclusions

A finding of association between genetic liability and predominant polarity in bipolar disorder could pave the way for stratification on genetic liability in future treatment studies and in clinical practice.

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Oral Communications (ID 1110) AS02. Bipolar Disorders

O018 - The role of affective temperaments in predicting symptom severity in bipolar disorder

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
10:00 - 10:12
Presenter

ABSTRACT

Introduction

Bipolar disorder (BD) is one of the most burdensome psychiatric illnesses, being associated with a
negative long-term outcome and high suicide rate. Although affective temperaments are considered possible mediators
of outcome, their role on the course and outcome of BD remains poorly studied.

Objectives

The aims of the present study are to describe the clinical characteristics of patients with BD more
frequently associated with the different affective temperaments and to verify which affective temperaments are
associated with a more severe clinical picture in a sample of patients with BD.

Methods

All patients with BD referring to the outpatient units of two Italian university sites have been recruited.
Patients’ psychiatric symptoms, affective temperaments, and quality of life were investigated through validated
assessment instruments.

Results

199 patients were recruited. 54.8% of patients had a diagnosis of bipolar I disorder. 56.8% of the sample
reported at least one episode of aggressive behaviours and 30.2% of suicidal attempt. Predominant cyclothymic and
irritable temperaments predicted more frequent relapses, a poorer quality of life (p<;0.05), more aggressive behaviours
and suicide attempts (p<;0.01). The predominant hyperthymic disposition was a protective factor for several outcome
measures, including relapses and suicidality (p<;0.01), and was correlated with a less severity of psychiatric symptoms
and later age at onset (p<;0.05).

Conclusions

Early identification of affective temperaments in BD patients can help clinicians to identify those who
could show a worse prognosis. A screening of affective temperaments can be useful to develop early targeted integrated
pharmacological and psychosocial interventions.

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Oral Communications (ID 1110) AS02. Bipolar Disorders

O019 - The role of Vit D and parathyroid hormone in clinical severity of patients with Bipolar Disorder

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
10:12 - 10:24
Presenter

ABSTRACT

Introduction

Vitamin D modulates the biosynthesis of neurotransmitters and neurotrophic factors, thus influencing mood and its alterations. Decreased blood levels of Vitamin D are involved in many psychiatric disorders, in particular, affective disorders. As regards bipolar disorder (BD), an association between vitamin D deficiency and severity of illness has been found.

Objectives

In this observational study, we assessed calcium homeostasis imbalance in a sample of patients with BD; in particular, we explored whether serum levels of PTH, Vitamin D and calcium influence the clinical presentation of BD and its symptom severity.

Methods

All patients were administered with validated assessment instruments to assess psychopathology, affective temperaments and global functioning. Vitamin D and PTH levels were assessed in all patients. An-ad hoc schedule was administered for socio-demographic and clinical characteristics.

Results

The total sample consisted of 199 patients (females: 51%; mean age: 47.1 ± 13.2 years). Levels of serum PTH were directly correlated with the total number of hospitalizations (p< 0.01), and of depressive (p< 0.0001), manic (p< 0.001) and hypomanic episodes (p< 0.01). Serum levels of Vitamin D were positively associated with age at first psychiatric contact and were inversely correlated with the total number of depressive episodes (p< 0.05) and cyclothymic temperament (p< 0.05).

Conclusions

Increased levels of PTH and Vit D correlate with a worse clinical outcome of patients with BD. Our results highlight the importance to routinely assess PTH, Vit D and calcium levels in BD patients. Moreover, vitamin D may represent a valid add-on treatment for these patients.

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Oral Communications (ID 1110) AS02. Bipolar Disorders

O020 - Predicting functional outcome in bipolar patients: effects of cognitive psychoeducational group therapy after 12 months

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
10:24 - 10:36
Presenter

ABSTRACT

Introduction

Cognitive impairment is known as a core feature in bipolar patients. Persisting neurocognitive impairment has been associated with low psychosocial functioning.

Objectives

The goal of this work was to identify clinical and cognitive predictors for functional impairment, symptom severity and early recurrence in bipolar disorder, as well as to compare the neurocognitive performance of bipolar patients with that of healthy probands.

Methods

43 remitted bipolar patients and 40 healthy controls were compared using a neurocognitive battery testing specifically attention, memory, verbal fluency and executive functions. In a randomized controlled trial, the 43 remitted patients were assigned to two treatment conditions as add-on to state-of-the-art pharmacotherapy: cognitive psychoeducational group therapy over 14 weeks or treatment-as-usual. At 12 months after therapy, functional impairment and severity of symptoms were assessed.

Results

As compared to healthy probands, bipolar patients showed lower performance in executive function (perseverative errors p<0.01, categories correct p<0.001), sustained attention (total hits p<0.001), verbal learning (delayed recall p<0.001) and verbal fluency (pwords p<0.002). Cognitive psychoeducational group therapy and attention predicted occupational functioning with a hit ratio of 87.5%. Verbal memory recall was found to be a predictor for symptom severity (hit ratio 86.8%). Recurrence in the follow-up period was predicted by premorbid IQ and by years of education (hit ratio 77.8%).

Conclusions

Our data show that bipolar patients benefit from cognitive psychoeducational group therapy in the domain of occupational life. Reductions in sustained attention have an impact on occupational impairment.

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Oral Communications (ID 1110) AS02. Bipolar Disorders

O021 - Personal autonomy and hopelessness are associated with antidepressant drugs prescription in currently euthymic bipolar patients

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
10:36 - 10:48
Presenter

ABSTRACT

Introduction

The patterns and clinical correlates related to antidepressant drugs (ADs) prescription for BD remain poorly understood.

Objectives

This study aimed to compare socio-demographic and clinical features of BD patients treated vs. not treated with ADs.

Methods

The sample consists of 287 currently euthymic bipolar patients. Among participants (mean age=51.9±15.02), 157 (40.1%) were receiving ADs.

Results

Based on the main findings, subjects given ADs were older and more frequently retired than those without receiving ADs. Moreover, patients given ADs were more likely to have had a first major depressive episode and present with psychotic symptoms at illness onset. Lifetime substance abuse/dependence history was less frequently reported among patients given ADs. Furthermore, ADs given patients have a higher number of affective episodes, and longer duration of their illness. Additionally, subjects treated with ADs reported higher hopelessness levels, and lower positive reinterpretations than those who were not treated with ADs. Factors associated with ADs-use by multivariate modeling were reduced personal autonomy (OR=.070), and hopelessness levels (OR=1.391).

Conclusions

These results may help clinicians to better understand the clinical correlates of BD subtypes and improve their differential management. Additional studies are needed to replicate these findings, and facilitate the differential trajectories of BD patients based on socio-demographic/clinical profile.

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Oral Communications (ID 1110) AS02. Bipolar Disorders

O022 - Cognitive function and metabolic syndrome in unipolar and bipolar depression: a pilot study

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
10:48 - 11:00
Presenter

ABSTRACT

Introduction

Cognitive function is impaired in depressive disorders. Among several factors implicated in regulation of the cognitive function, metabolic syndrome has been showed have a pivotal role cognitive functioning in healthy controls. However, the role of metabolic syndrome in regulating the cognitive functioning of subjects affected by depressive disorders is little studied.

Objectives

To investigate the effect of metabolic syndrome in regulation of cognition in unipolar and bipolar depression.

Methods

One-hundred-sixty-five people affected by a depressive disorder (unipolar depression, UP; bipolar depression, BP) were enrolled at the Psychiatric and Clinic Psychology Unit of the University of Rome Tor Vergata, Rome, Italy. A group of healthy controls (HC) matched for agender and age was enrolled. The cognitive functions were evaluated with a computerized tool, THINC-it.

Results

UP and BP had lower performances in THINC-it cognitive domains than HC. Metabolic syndrome is a negative, independent predictor of low performance in the THINC-it cognitive domains of people with depressive disorders.

Conclusions

Our findings confirm that metabolic syndrome has a prominent role in determining the cognitive efficiency in depressive disorders, independently by the presence of a unipolar or bipolar depressive disorder. Metabolic syndrome has to be considered a major factor that should be considered in the treatment strategies of cognitive functioning improvement of people affected by depressive disorders.

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Oral Communications (ID 1110) AS02. Bipolar Disorders

O023 - Bipolar mania with Psychosis vs without Psychosis: a clinical characterization with indirect measures of severity

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
11:00 - 11:12

ABSTRACT

Introduction

The presence of psychotic symptoms is highest during acute episodes of bipolar mania. There is no evidence base regarding the implications of psychosis in the prognosis of bipolar disorder, despite common assumption that their occurrence reflects greater disease severity.

Objectives

We aim to compare sociodemographic and clinical characteristics of inpatients admitted for bipolar mania with and without psychotic features.

Methods

Retrospective observational study of inpatients admitted between January 1st 2017 and 31 October 2020 in a psychiatry inpatient unit of a tertiary hospital. Descriptive analysis of the results was performed using the SPSS software, version 26.0.

Results

Between 2017 and October 2020 there were 103 admissions due to mania bipolar I disorder, 53.4% (n=55) with psychotic symptoms. When compared with mania without psychosis, psychotic mania was associated to male gender (71.1% to 39.7%; c2(1, N = 103) = 10,06; p = 0.02) and younger age (t(103) = -2.43; p = 0.017). The proportion of compulsory admissions and average length of stay were similar between mania with psychosis and mania without psychosis. Also, having a manic bipolar episode with psychotic symptoms was not associated to being prescribed a long-acting injectable antipsychotic.

Conclusions

The presence of psychotic symptoms in bipolar manic episodes were associated to male gender and younger age but not to indirect measures of illness severity.

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Oral Communications (ID 1110) AS03. Child and Adolescent Psychiatry

O025 - Correlation between hand functioning, cognition and quality of life of CP children: 2-year prospective randomized study

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
11:12 - 11:24

ABSTRACT

Introduction

For treatment of CP patients multidisciplinary approach is often promoted. But it is not cost-efficient to involve all medical staff and variety of diagnostic/intervention tools for every patient.

Objectives

Having knowledge on pivotal manifestations of CP and what are they related to would ease multidirectional approach in practice. It will shorten a search of pathologies only to those related to main manifestations related to quality of life.

Methods

611 children aged 2 to 18 years (mean age‒6y5m) with CP(G80.0-G80.9): examined by 3 independent doctors. 56%males, 44%females. Randomized blinded assessment. Fine hand function assessed by “9-hole peg”,“Box and Blocks” tests, dynamometry. Intellectual functioning assessment was done using Raven Matrices. Quality of Life(QoL) assessment according to Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD). The intraclass correlation coefficient(ICC) was used for finding out discrepancies between observers. Inferencial statistics including 95%CI and P-value.

Results

ICC coefficient between observers was highly reliable‒0.93(95%CI:0.89–0.95). The mean QoL score for children GMFCS levels I and II was 58.5(SD 16.6), for GMFCS III, IV and V children‒22.4(SD13.4). QoL was more related to fine hand functioning(r=0,344) than to cognition(r=0,295). There was a strong correlation bond between fine hand functioning and cognition (r=0,663). In case fine hand function improved positive changes in cognition were observed in 74% of subjects(p<0,05). Correlation between grasp power and IQ was weak(r=0,184). Grasp power improvement was slightly related to QoL(r=0,102).

Conclusions

Fine hand functioning improves QoL even more that cognition.So training of fine motor skills should be given a priority in case of limited rehabilitation resources.

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Oral Communications (ID 1110) AS03. Child and Adolescent Psychiatry

O026 - Childhood behaviours and adverse economic and social outcomes – Can we improve detection and prevention?

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
11:24 - 11:36

ABSTRACT

Introduction

Disruptive behaviours underpin the most prevalent and costly psychiatric disorders in youth including ADHD and conduct disorder. Yet the association between childhood behavioural problems and economic and social outcomes in adulthood are rarely examined in a population-based samples where early detection and prevention may be possible.

Objectives

To examine the association childhood behavioural problems and economic and social outcomes from age 18-35 years across three studies.

Methods

This study daws on 30-year Canadian birth cohort (n=3017) linked to government tax return records. Behavioural assessments – for inattention, hyperactivity, opposition, aggression, anxiety and prosociality – were prospectively obtained from teachers when children were aged 6-12 years. Regression models were used to link behavioural assessments in kindergarten (age 5/6 years) to earnings at age 33-35 years (Study 1) and to trajectories of welfare receipt (Study 2), while behaviour at age 10-12 years was linked to trajectories of partnering. Children’s IQ and family background were adjusted for.

Results

Inattention, aggression-opposition (males only) and low low-prosociality in kindergarten were associated with lower earnings at age 33-35 years (Study 1), inattention, aggression-opposition and low prosociality in kindergarten predicted following a chronic welfare receipt trajectory from age 18-35 (Study 2), and inattention, aggression-opposition, anxiety and low-prosociality at age 10-12 years were associated with increased likelihood of being unpartnered and with partnership dissolution from age 18-35 years (Study3).

Conclusions

Behavioural assessments made by schoolteachers can identify children at risk of adverse economic and social outcomes in adulthood. The implications of for early screening and prevention will be discussed.

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Oral Communications (ID 1110) AS03. Child and Adolescent Psychiatry

O027 - Association between single nucleotide polymorphisms in oxytocin and vasopressin receptor genes and symptom severity of autism spectrum disorder– preliminary study.

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
11:36 - 11:48

ABSTRACT

Introduction

One of the defining features of autism spectrum disorder (ASD) are deficits in social interaction and communication. Although their etiology is poorly understood, several lines of evidence from studies on humans and rodents suggest that two nonapeptides – oxytocin and vasopressin – might play a pivotal role in their development.

Objectives

To evaluate if single nucleotide polimorphisms in OXTR and AVPR1A genes are linked to the severity of symptoms in autism spectrum disorder.

Methods

The study was conducted on the group of 40 Caucasian males with average age of 14,22 (SD: 1,71) years. ADOS-2 examination was utilized for confirmation of ASD diagnosis as well as evaluation of symptoms severity in each patient. The genotyping of preselected SNPs for each gene (rs10877969; rs7294536; rs2254298; rs53576) was conducted.

Results

“CC” genotype at rs7294536 (p=0,033) was significantly associated with higher outcomes of ADOS-2 especially in terms of social affect. In case of oxytocin receptor gene, frequency of “AA”/”AG” genotype at rs2254298 equaled 100% and of “AA”/”AG” genotype at rs53576 equaled 85% of the study group (expected “A” allele frequency in neurotypical European population was respectively 11% and 35% according to 1000Genomes database). For rs10877969 prevalence of “CC”/”CT” genotype equaled 95% while expected frequency of “C” allele in neurotypical European population was 13%.

Conclusions

Overrepresentation of minor alleles at rs2254298, rs53576 and rs10877969 in patients with ASD might indicate their link to development of ASD. Furthermore, significant association between minor allele at rs7294536 and symptoms severity suggest potential role of arginine-vasopressin receptor deficiency in clinical picture of ASD.

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Oral Communications (ID 1110) AS03. Child and Adolescent Psychiatry

O028 - Restricted visual scanpaths and hyperarousal during emotion recognition in childhood social anxiety disorder

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
11:48 - 12:00

ABSTRACT

Introduction

Social anxiety disorder (SAD) typically develops during late childhood or early adolescence, and often runs a chronic course if left untreated. Maladaptive processing of social information has been suggested to contribute to the etiology and maintenance of SAD. Scanpaths are a succession of visual fixations and saccades through which individuals extract information during face perception. Atypically long scanpaths have previously been reported in adults with SAD but no studies have been conducted on youth samples. SAD has previously also been linked to atypical arousal during face processing.

Objectives

This study aimed to investigate differences in visual attention and arousal to emotional faces comparing children and adolescents with SAD to a non-psychiatric population of youths.

Methods

In one of the largest eye-tracking studies of pediatric SAD to date, children and adolescents with SAD (n = 62) and healthy controls (n = 39) completed a task where they were meant to recognise different emotional expressions in pictures of faces while their eye movements were recorded. The visual scanpath and the pupil dilation response were examined.

Results

Youth with SAD showed restricted scanpaths, suggesting they scanned a more limited part of the face during face perception. Higher pupil dilation was also observed in the children and adolescents with SAD.

Conclusions

The restricted pattern of scanpath observed in youth with SAD is contrary to findings among adults, but similar to what has been reported in neurodevelopmental disorders associated with social interaction impairments such as autism. Restricted scanpaths may partially contribute to the maintencance of social anxiety disorder.

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Oral Communications (ID 1110) AS03. Child and Adolescent Psychiatry

O029 - Mentalization in developmental age’s eating disorders: comparison between Anorexia Nervosa and Avoidant/Restrictive Food Intake Disorder (ARFID).

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
12:00 - 12:12

ABSTRACT

Introduction

Anorexia Nervosa (AN) and Avoidant/Restrictive Food Intake Disorder (ARFID) are two primary restrictive eating disorders described in DSM-5, characterized both of them by insufficient food intake. This behavior In ARFID is not driven by weight and shape concerns that tipify AN. While there are several studies that highlight the presence of mentalizing difficulties in AN, there are still no data about mentalizing profile in ARFID.

Objectives

The aim of this study was to better characterize the mentalizing profile of AN and ARFID children and adolescent.

Methods

Two groups of AN or ARFID outpatients (15+15), aged 6 to 18 years, were assessed by Alexythimia Questionnaire for Children (AQC) and Toronto Alexythimia Scale-20 (TAS-20) to evaluate alexythimia; by Interpersonal Reactivity Index (IRI) and Basic Empathy Scale (BES) to assess empathy; by NEPSY-II social perception subtests to evaluate Theory of Mind and Emotion recognition. Exclusion criteria were the presence of intellectual disability, pervasive developmental disorders and binge eating behavior (eating disorder other than AN or ARFID).

Results

Preliminary results showed different mentalizing profiles between ARFID and AN patients, with differences in the score for affective empathy, lower in ARFID than in AN patients while the score for alexythimia traits resulted higher in AN population.

Conclusions

By our results, mentalization impairment appeared trans-diagnostic across several eating disorders. This first result should be further improved to better analyze this construct in order to develop effective clinical intervention to improve the subject's affective regulation.

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Oral Communications (ID 1110) AS03. Child and Adolescent Psychiatry

O031 - Exploring depression in adolescents: How depression changes in early onset psychosis (EOP), clinical high risk (UHR) and clinical control (CC) patients

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
12:12 - 12:24
Presenter

ABSTRACT

Introduction

Abstract

Introduction. – Depression is very common in adolescent patients and impacts on their quality of life and functioning. Indeed, depression is an important clinical aspect for treatment, outcome, and prognosis.

Objectives

Objectives. – This pilot study investigated the factorial structure of the Calgary depression scale for schizophrenia (CDSS) in a sample of help seeking adolescent patients, stratified in three clinical diagnostic subgroups: early onset psychosis (EOP), clinical high risk (UHR) and clinical control (CC). The relationships between these factors and SIPS domains and subjective experiences were also explored.

Methods

Methods. –Sixty-nine subjects were examined to assess the severity of depressive symptoms and the degree of subjectively felt cognitive-affective vulnerability (i.e. basic symptoms)

Results

Results. – Principal component analysis revealed CDSS to include two main factors, namely: “guilty idea of reference-pathological guilt” (factor I), “depression-hopelessness” (factor II). Two factors revealed multiple correlations with SIPS domains and subjective experiences.

Conclusions

Conclusions. – The results confirm the dual factorial structure of CDSS previously reported in the literature in adult samples, further increase our knowledge of the psychopathological components of depression in adolescents, and strongly suggest that CDSS can also be used in early diagnostic settings

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Oral Communications (ID 1110) AS03. Child and Adolescent Psychiatry

O033 - Mood and Suicidality Amongst Cyberbullied Adolescents- a cross-sectional study from Youth Risk Behavior Survey

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
12:24 - 12:36

ABSTRACT

Introduction

There is a limited literature available showing mental health burden among adolescents following cyberbullying.

Objectives

Aim is to evaluate the association of low mood and suicidality amongst cyberbullied adolescents.

Methods

A study on CDC National Youth Risk Behavior Surveillance (YRBS) (1991-2017). Responses from adolescence related to cyberbullying and suicidality were evaluated. Chi-square and mix-effect multivariable logistic regression analysis was performed to find out the association of cyberbullying with sadness/hopelessness, suicide consideration, plan, and attempts.

Results

A total of 10,463 adolescents, 14.8% of adolescents faced cyberbullying a past year. There was a higher prevalence of cyberbullying in youths aged 15-17 years (25 vs 26 vs 23%), which included more females to males (68 vs 32%).(p<0.0001) Caucasians (53%) had the highest number of responses to being cyberbullied compared to Hispanics (24%), African Americans (11%).(p<0.0001) There was an increased prevalence of cyberbullied youths with feelings of sadness/hopelessness (59.6 vs 25.8%), higher numbers considering suicide (40.4 vs 13.2%), suicide plan (33.2 vs 10.8%), and multiple suicidal attempts in comparison to non-cyberbullied.(p<0.0001) On regression analysis, cyberbullied adolescence had a 155% higher chance of feeling sad and hopeless [aOR=2.55; 95%CI=2.39-2.72], considered suicide [1.52 (1.39-1.66)], and suicide plan [1.24 (1.13-1.36)].

cyberbully table (2).jpg

Conclusions

In our study, cyberbullying was associated with negative mental health outcomes. Further research is warranted to examine the impact and outcomes of cyberbullying amongst adolescents and guiding the policies to mitigate the consequences.

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Oral Communications (ID 1110) AS03. Child and Adolescent Psychiatry

O034 - Multidisciplinary approach in children with autism spectrum disorder

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
12:36 - 12:48

ABSTRACT

Introduction

Autism spectrum disorder (ASD) is characterized by persistent deficits in social communication and social interaction across multiple contexts and it is marked by repetitive sensory–motor behaviours and restricted interests or activities. Now recognized to occur in up to 1% of the population, the prevalence of ASD has registered a steady increase in the past two decades. Heterogeneity of presentation is a hallmark with comorbid psychiatric and medical morbidities frequently reported. Comorbidities mask and delay the diagnosis and are the cause of inadequate therapies.

Objectives

In the present paper, we studied a cohort of patients with ASD, investigating the rates and types of psychiatric and medical comorbidities.

Methods

A retrospective study of psychiatric and medical comorbidities was carried out on a sample of 120 participants that met ASD criteria according to DSM-V. The patients were examined with a detailed medical history, physical examination, as well as some additional functional, imaging, laboratory and genetic investigations. The associated conditions considered were: attention deficit/hyperactivity disorder (ADHD), epilepsy, intellectual disability, gastrointestinal symptoms, ophtalmologic manifestations, infections.

Results

Of the 120 ASD subjects referred, 25 (20.8%) received the diagnosis of epilepsy. ADHD was established in 24 cases (20%). IQ score was obtained in half of the patients, 43.3% of them presenting a severe intellectual disability (IQ<35). Respiratory disorders occured in 25% of the cases. Ophtalmological findings were observed in 9.1% of the cases. Other frequent comorbidities included motor disturbances and feeding problems.

Conclusions

A better understanding of comorbidities in ASD patients improves interdisciplinary collaboration, thus facilitating effective treatment programs.

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Oral Communications (ID 1110) AS03. Child and Adolescent Psychiatry

O037 - Understanding of the prevalence of depression in a sample of gifted children by identifying the developmental trajectory of risk and protective factors

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
12:48 - 13:00

ABSTRACT

Introduction

Developmental studies in infancy remain rare. Studies measuring depressive symptoms in gifted children are contradictory, considering more anxiety or depression than in non-gifted children. Furthermore, questionnaires or anxiety scales are used without taking into account all aspects of mood disorders and thus, rarely depression scales have been conducted.

Objectives

To refine the developmental trajectory of depression in a national sample of French gifted children by identification of the specific risk and protective factors.

Methods

A self-reported depression scale MDI-C (Multiscore-Depression-Inventory-for-Children) were sent to families to be administered to their gifted children from preschool to high school, aged from 4 to 20 years-old (IQ >125) looking for help from gifted associations. A larger wave of data collection on different aspects of child and family history was collected (pregnancy, term and delivery mode, neonatal period, psychomotor development, health, schooling, interpersonal relationships with family and friends, personality, parental socio-economic status).

Results

438 children (> 130) were eligible. Regarding anamnestic fields, Exploratory-Factor-Analysis highlighted six predictive factors of depression with eigenvalues from 1.09 to 3.17. Major factors explaining 62.96% of total variance are: Factor-1 “motor skills disorder” (14.53%). Factor-2 “positive family relationships” (14.04%). Factor-3 “positive social relationships with peers” (14.02%). Factor-4 “integration of social codes” (11.23%). Factor-6 “Learning disabilities and rehabilitation” (10.1%).

Conclusions

Our findings highlight specifics risk factors of depression in the field of learning disabilities or social cognition, while a good quality of social relationships since childhood seems to be a preventive factor.

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Oral Communications (ID 1110) AS03. Child and Adolescent Psychiatry

O038 - Validation of the European Drug Addiction Prevention Trial Questionnaire (EU-Dap) for substance use screening and to assess risk and protective factors among adolescents in Chile

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
13:00 - 13:12
Presenter

ABSTRACT

Introduction

Substance use is highly prevalent among Chilean adolescents, and the damage it causes at the neurobiological, psychological, and social levels is well known. However, there are no validated screening instruments that also assess risk and protective factors for this Chilean population.

Objectives

To evaluate the psychometric properties of the European Drug Addiction Prevention Trial Questionnaire (EU-Dap).

Methods

A cross-sectional study was carried out in 13 schools in Santiago of Chile. The sample included 2,261 adolescents of 10 to 14 years old. The linguistic and cultural adaptation was conducted using focus groups, the construct validity was evaluated using confirmatory factor analysis, and measures of its reliability were also determined. Furthermore, the associations regarding risk and protective factors with substance use were explored.

Results

Substance use questions were well understood by adolescents. Regarding the subscales of risk and protective factors, they needed some changes, and once completed, all new subscales had good or adequate goodness of fit adjustment. Regarding reliability, all of the new subscales had good or acceptable internal consistency according to the omega coefficient (range from 0.69 to 0.89). Finally, most of the risk and protective factors measured by the questionnaire were strongly associated with different substance use outcomes, especially those related to positive and negative beliefs or attitudes towards drugs, normative beliefs, and refusal skills.

Conclusions

The current findings suggest that the EU-Dap questionnaire is a valid and reliable instrument, and it may help to evaluate the effectiveness of preventive interventions in the future.

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Oral Communications (ID 1110) AS03. Child and Adolescent Psychiatry

O039 - Children’s mental health needs and access to specialized services in Mexico

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
13:12 - 13:24

ABSTRACT

Introduction

The prevalence of mental disorders (MD) is greater in children; however, they are the population with less help-seeking and access to mental health-care services (MHS).

Objectives

To explore the characteristics of help-seeking and access to specialized MHS in children with MD.

Methods

A cross-sectional study was carried out from 2018 to 2019, in the Children's Psychiatric Hospital and National Institute of Psychiatry in Mexico City. Sample 397 children and 397 caregivers. The project was approved by the Ethics Committee of both institutions. The patient's family member was questioned on sociodemographic data and help-seeking to MHS. Sample’s descriptive statistics applying measures of central tendency, Inferential statistics with t-test for differences in means between groups (diagnosis), and one-way ANOVA to variables associated with the help-seeking to MHS.

Results

Children´s sample: 37% female, average age 12 years (SD± 3.6), 51% had diagnosis of hyperkinetic disorder (HD), 34% depressive disorder (DD). The children´s age at the time of seeking healthcare was different according to the diagnosis: DD 10.1 (SD ± 4.5) and HD 6.95 (SD ± 3.4), (T = -3.18, p = 0.000); and by sex: girls 10.9 (SD ± 4.5), boys 7.85 (SD ± 4.0); (T = -3.07, p = 0.000). The mother was the first person to notice the symptoms.

Conclusions

The search for MHS differs by sex, diagnosis and family history; it is necessary to design mental health interventions considering gender-based differences, namely, to integrate a gender perspective.

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Oral Communications (ID 1110) AS03. Child and Adolescent Psychiatry

O040 - Event related potentials in children with internet addiction disorder

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
13:24 - 13:36

ABSTRACT

Introduction

Internet addiction disorder (IAD) is defined as one of the commonest disorder in children and adolescents affecting 40 percent of them. Although it does not cause mental disorders it is known that IAD is commonly related with attention deficit and hyperactivity disorder (ADHD). The best approach to asses attention is recording of event related potentials (ERPs) especially late response like P300. There are growing evidence regarding assessment of attention in IAD with different questionnaires but less is known about evidence received with more valid measurements like P300.

Objectives

The aim of our study was to measure attention parameters in IAD subjects by using the most valid test–latency and amplitude of P300 . We have examined 70 children with IAD aged 5-18 years. Children were divided into two groups: Group 1 (40 children) was matched as a study group including children with IAD and group 2 controls (30 children) without IAD and without ADHD.

Methods

IAD was assessed by Young IAD scale. Children with Young scale less than 20 and with IQ less than 85 were excluded from the study. Recording of P300 was done by international protocol using oddball paradigm method. Statistical analysis was done by SSPS 26.

Results

In study group increase in P300 latency was found (mean range 350-375 msc) while amplitude was normal (p <0.05). In controls both parameters were within normal range.

Conclusions

IAD could be related with attention disorders causing poor attention span. This evidence is very important as they affect internet addicted children and adolescents’ social well being.

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Oral Communications (ID 1110) AS03. Child and Adolescent Psychiatry

O041 - The risk of attention deficit hyperactivity disorder symptoms in the adolescent offspring of mothers with anxiety and depressive symptoms. Findings from the Raine Study

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
13:36 - 13:48

ABSTRACT

Introduction

While there exist some studies that explored the association between maternal anxiety and depressive symptoms and the risk of attention-deficit/hyperactivity disorder (ADHD) in early and late childhood, studies exploring the risk in late adolescence are however lacking.

Objectives

This is the first study that aimed to investigate the association between maternal anxiety, depressive, as well as comorbid anxiety and depressive symptoms, and the risk of ADHD symptoms in late adolescence.

Methods

We used data from the Raine Study, a birth cohort in Western Australia. The Depression, Anxiety, and Stress Scale (DASS) was used to assess maternal depressive and anxiety symptoms when the child was aged 10. Whereas, the DSM-oriented scales of the child behavior checklist (CBCL) was used to assess ADHD symptoms offspring in adolescents aged 17. Log-binomial regression model was used to explore the associations.

Results

After adjusting for relevant covariates, we found an increased risk of ADHD symptoms in the adolescent children of mothers with anxiety [RR 2.84 (95%CI 1.18-6.83)] as well as comorbid anxiety and depressive symptoms [RR 5.60 (95%CI 3.02-10.37)]. No association was seen with maternal depressive symptoms.

Conclusions

This study suggested that adolescent offspring of mothers with anxiety as well as comorbid anxiety and depressive symptoms had an increased risk of ADHD symptoms. Early detection and management for ADHD symptoms in children of mothers with anxiety and comorbid anxiety and depressive symptoms are needed.

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Oral Communications (ID 1110) AS03. Child and Adolescent Psychiatry

O043 - Bullying victimization/perpetration and non-suicidal self-injury: a systematic review

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
13:48 - 14:00
Presenter

ABSTRACT

Introduction

Experience of bullying may be a significant risk factor for non-suicidal self-injury (NSSI).

Objectives

This study had three aims: to systematically investigate the association between bullying and NSSI, to analyze the possible mechanisms underlying the two phenomena, and to evaluate any differences between bullying victimization and bullying perpetration with respect to NSSI.

Methods

A systematic search about the association between bullying victimization and perpetration and NSSI was conducted using specific databases (PubMed, Scopus, Science Direct). The following keywords were used in all database searches: "bullying" AND "NSSI" OR "peer victimization" and NSSI.

Results

The searches in PubMed, Scopus and Science Direct revealed a total of 88 articles about bullying or peer victimization and NSSI. However, only 29 met our inclusion criteria and were used for the present review. Overall, all studies examined victimization; 4 studies also evaluated the effects of perpetration and 1 included bully-victims. According to the main findings, both being a victim of bullying and perpetrating bullying may increase the risk of adverse psychological outcomes in terms of NSSI and suicidality in the short and the long run.

Conclusions

To the best of our knowledge, this is the first review to systematically evaluate the relation between bullying victimization/perpetration and NSSI. The main results support a positive association. Future research should evaluate the possible role of specific mediators/moderators of the association between experience of bullying and NSSI.

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Oral Communications (ID 1110) AS05. Comorbidity/Dual Pathologies

O044 - Association between adult ADHD and generalised joint hypermobility, with and without systemic manifestations: A case-control study

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
14:00 - 14:12
Presenter

ABSTRACT

Introduction

There is growing evidence that generalised joint hypermobility (GJH) is associated with several psychiatric conditions. There are no previous studies on adult ADHD.

Objectives

To evaluate, in a large Swedish sample, if generalised joint hypermobility and adult ADHD are associated.

Methods

431 adults with ADHD and 417 controls were included. GJH was assessed by the Beighton Score, a physical examination, and the 5PQ, a self-report screening tool. Exploratively, reported musculoskeletal symptoms and abnormal skin manifestations suggestive of symptomatic GJH (e.g. Ehlers-Danlos syndrome), were assessed to differentiate this group from the general GJH group. Logistic regressions determined the influence of an ADHD diagnosis and known covariates (age, sex and ethnicity) on GJH and symptomatic GJH respectively.

Results

ADHD was associated to GJH, as defined by the Beighton Score and the 5PQ, with adjusted odds ratios of 4.65 (CI 95% 3.01-7.18, p<.005) and 1.86 (CI 95% 1.39-2.48, p<.005), respectively. Likewise, ADHD and symptomatic GJH were associated with adjusted odds ratios of 6.94 (CI 95% 4.05-11.89, p<.005) and 2.66 (CI 95% 1.94-3.66, p<.005).

Conclusions

GJH and adult ADHD are associated conditions. Symptomatic GJH, defined as additional symptoms of pain and/or skin manifestations, has a considerably stronger link to adult ADHD than unspecific GJH has. GJH may represent a marker of an underlying systemic disorder with physical manifestations in connective tissue as well as behavioural manifestations including hyperactivity, impulsiveness and inattentiveness. Future studies should investigate if this represents a novel subtype of ADHD and if symptomatic GJH affects the ADHD management.

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Oral Communications (ID 1110) AS05. Comorbidity/Dual Pathologies

O045 - Substance-specific variability of ADHD symptoms in Riga Psychiatry and Addiction Medicine Centre treatment-seeking substance use disorder outpatient population.

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
14:12 - 14:24

ABSTRACT

Introduction

Studies show a link between attention deficit disorder (ADHD) and substance use disorders (SUD). Patients may abuse illicit drugs or alcohol as means of self-medicating e.g. stimulants for ADHD symptoms. Identifying ADHD symptoms in SUD patients could help improve treatment outcome and quality of life.

Objectives

To evaluate the prevalence of ADHD symptoms in Riga Psychiatry and Addiction Medicine Centre (RPNC) outpatients and study the link between ADHD symptoms and specific SUDs.

Methods

In a period of 30 days, all consentient clients of RPNC outpatient addiction clinic were surveyed for basic sociodemographic data and screened with Adult ADHD Self-report Scale (ASRSv1.1). Results were compared among patients with different types of addictions previously diagnosed using ICD-10 classification. Results were also compared to a control group.

Results

Out of 279 participants, 209 were treatment-seeking SUD patients, 70 controls. Mean age was 37.99, 77.8% were male. Among SUD patients 45,2% had alcohol UD(F10), 52.9% opiate UD(F11), 35.1% stimulant UD(F14;f15), 20.2% sedative UD(F13). Patients who had stimulant addiction as one of their diagnosis and patients with multiple addictions were significantly more likely (p=0.023 and p=0.012 respectively) to screen positive for ASRSv1.1 among SUD patients population. All types of SUDs were significantly more likely to screen positive for ASRSv1.1 when compared to a control group.

Conclusions

There is a strong link between SUD and ADHD symptoms. Patients with stimulant or multiple SUDs are more likely to screen positive for ADHD symptoms than other SUD patients. It is important to identify ADHD symptoms in treatment-seeking SUD patients.

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Oral Communications (ID 1110) AS05. Comorbidity/Dual Pathologies

O048 - Depression in multiple sclerosis: rs-fMRI research.

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
14:24 - 14:36

ABSTRACT

Introduction

Multiple sclerosis (MS) is a demyelinating and neurodegenerative disorder of the CNS, which incapacitates people of working age. Due to progressive disability, the quality of life decreases, adding a number of other diseases to the main one. Several studies have reported high rates of depression in MS with a lifetime prevalence of approximately 50%.

Objectives

Therefore, we would like to pattern the functional activation of the brain of patients with different phenotypes of MS. This would objectify the patient's condition and the effectiveness of therapy for these diseases.

Methods

68 patients with MS were examined: 40 with a relapsing-remitting type of course (RRMS) in remission and 28 with secondary - progressive MS (SPMS). Patients underwent MRI of the brain on a Siemens Tim Trio 3.0 T tomograph and processed the data using CONN 18b software. Clinical features were estimated by tests (BDI, HADS) results.

Results

91% of all MS patients in research have signs of depression. We noted that decreased FC in RRMS patients has a whole-brain type, but it is only decreasing, not losing the connections between brain clusters. Decreased FC and losing the connections between large-scale brain networks and brain clusters. Due to tests, more severe depression was observed in SPMS patients.

Conclusions

Our findings suggest that patients with SPMS have depression, cause of decreasing in FC between the main clusters of the brain, and patients with SPMS have more severe depression, which, as we assume, neurodegeneration has turned into atrophy and loosing all connections between clusters even in large-scale brain networks.

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Oral Communications (ID 1110) AS05. Comorbidity/Dual Pathologies

O049 - Evaluation of depression and anxiety control in Greek patients with major depressive disorder with/without generalized anxiety disorder and Cardiovascular Disease–PRONOI study

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
14:36 - 14:48

ABSTRACT

Introduction

Patients with depression are likely to eventually develop Cardiovascular disease(CVD) and have a higher mortality rate than general population. In addition, anxiety disorders, especially Generalized Anxiety Disorder(GAD), may be associated with mortality and other adverse cardiac outcomes.

Objectives

Evaluation of depression and anxiety control in Greek patients with Major Depressive Disorder(MDD) with/without GAD and CVD, under 6 months of treatment with citalopram, and/or quetiapine, and/or pregabalin.

Methods

565 patients with MDD with/without GAD, enrolled in this observational, study(NCT03317262). The subgroup of 133(24%) patients had CVD. Severity of MDD and GAD symptoms was evaluated using the HAM-D and HAM-A Scores at baseline(V1) and after 6 months(V3) respectively.

Results

Mean HAM-D score in patients with CVD without GAD, at V1 and V3 was 23.94±7.51 and 8.14±4.65 respectively (p<0.0001). Similar results were observed in patients without CVD without GAD (HAM-D score 26.67±8.79 at V1 and 7.44±4.40 at V3). Mean HAM-A score in patients with CVD and GAD at V1 and V3 was 25.64±6.38 and 8.98±3.93, respectively (p<0.0001). Same magnitude reduction in HAM-A score was observed in patients without CVD and GAD, 26.27±8.16 at V1 and 9.28±6.48 at V3 (p<0.0001). Patients’ depression symptoms with/without CVD and GAD showed also a significant reduction between V1 and V3.

Conclusions

MDD patients with CVD without GAD, had a marginally lower baseline HAM-D score versus patients with GAD. After 6 months of treatment with citalopram, and/or quetiapine, and/or pregabalin the improvement of depressive and anxiety symptoms was almost equal between MDD patients with/without GAD regardless of the presence of coexisting CVD.

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Oral Communications (ID 1110) AS05. Comorbidity/Dual Pathologies

O050 - Screening for Hepatitis C in psychiatric population

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
14:48 - 15:00
Presenter

ABSTRACT

Introduction

A meta-analysis from 2016 estimates prevalence of hepatitis C to be superior in people with severe mental illness than general population. In France, positivity for hepatitis C is estimated at 0,75% of general population and 0.3% with a detectable viral load. No recent study was conducted to determine seroprevalence of hepatitis C in population admitted in psychiatric institution.

Objectives

The aims of this study are to determine seroprevalence of hepatitis C in population admitted in psychiatric institution and describe the profile of infected patients.

Methods

From january 2020 to october 2020, screening test for hepatitis C, hepatitis B and HIV was proposed to every patient admitted at the reception unit of Ravenel Hospital. In case of positivity, viral load was realised.

Results

Between January 7th and Octobre 1st , 407 patients greed to the screening test. Among them, 17 (4,2%) were tested positive to hepatits C and viral load was detectable in 9/17 positives, which lead to a 2,2% seroprevalence of hepatitis C infection in the studied population.

The patients with positive screening had a mean age of 40 years old. 82% of them were males. 16 admit using intoxicating substances and 10 were still current users at the time of the study. They were hospitalized for addictology purpose (5/17), psychosis (6/17), mood disorder (5/17), personality disorder (2/17), adjustement disorder (2/7). 10/17 had an alcohol use disorder.

Conclusions

This study confirms seroprevalence of hepatitis C infection in psychiatric population is seven times that of general population. This justifies a systematic screening of this population.

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Oral Communications (ID 1110) AS06. Consultation Liaison Psychiatry and Psychosomatics

O051 - Emotional intelligence in patients with psoriasis and atopic dermatitis: impaired integration of emotions and decision-making.

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
15:00 - 15:12

ABSTRACT

Introduction

Emotional intelligence (EI) is a fundamental requirement to maintaining social activity. Patients with psoriasis and atopic dermatitis have difficulties in emotional awareness.

Objectives

The objective of this study is to assess EI in patients with atopic dermatitis and psoriasis.

Methods

Patients with psoriasis n=67, atopic dermatitis n=59 and control group n=65 were included in cross-sectional study.

EI and its main components (experiential: perceiving emotions and using emotions to facilitate thought; strategic: understanding emotions and managing emotions to promote personal growth and social relations) were assessed using The Mayer–Salovey–Caruso Emotional Intelligence Test 2.0.

Statistical analyses were performed using One-Way ANOVA and One-Way ANOVA (Kruskal-Wallis test). The level of statistical significance was set at p<0.05.Data are presented as the Me (±SD).

Results

Our results show that there is statistically significant lower “strategic” component of EI for psoriasis Me=0.367 (±0.0455) and atopic dermatitis Me=0.369 (±0.0353) than for the control group Me= 0.381(±0.0361), (χ2 =7.15; p= 0.028).

“Managing emotions to promote personal growth and social relations” is presented with statistically significant lower for psoriasis Me= 0,293 (±0.0374) and atopic dermatitis Me= 0.301 (±0.0351) than for the control group Me= 0.312 (±0.0272), (F=0.05; p=0.007).

There is no statistically significant difference between other components of EI and the EI scores in three groups.

Conclusions

Patients with psoriasis and atopic dermatitis have emotional difficulties when it comes to making effective decisions.

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Oral Communications (ID 1110) AS06. Consultation Liaison Psychiatry and Psychosomatics

O054 - Effect of vortioxetine on proinflammatory cytokine levels in patients with heart failure and comorbid depression

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
15:12 - 15:24
Presenter

ABSTRACT

Introduction

Several studies have shown impaired cytokine status in both patients with depression and chronic heart failure (HF).

Objectives

to study the effect of vortioxetine on the level of pro-inflammatory cytokines: interleukin -1β (IL-1β) and interleukin - 6 (IL-6).

Methods

there were examined 80 patients with HF with reduced ejection fraction (HFrEF) of ischemic genesis with functional class (FC) II-III (NYHA), 37 patients were without depression, 43 - with mild or moderate depressive disorders. Those with mild or moderate depressive disorders were divided into 2 subgroups: 21 patients received psychotherapy, 22 patients, in addition to psychotherapy, were prescribed vortioxetine at a dose of 10 mg / day in the morning after meals. The control group consisted of 20 healthy individuals. The level of cytokines in the blood was determined by ELISA method.

Results

Patients with CHF have an increase in levels of pro-inflammatory cytokines. Thus, the concentration in the serum of IL-1β was 2.3 times higher than the same indicator in the control group: (56.45 ± 4.17) pg / ml, against (24.71 ± 4.21) pg / ml p <0.001). Depression caused an additional increase in the levels of IL-1β by 13.5% (p <0.05) and IL-6 - by 17.3% (p <0.01). Additional administration of vortioxetine caused a more rapid decrease in blood levels of both IL-1β (HR 0.87 [95% CI 0.72-0.97; p = 0.034]) and IL-6 (HR 0.81 [95% CI 0.68-0.93; p = 0.029]).

Conclusions

Thus, vortioxetine causes a decrease in the concentration of pro-inflammatory cytokines IL-1β and IL-6 in patients with HF and comorbid depression.

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Oral Communications (ID 1110) AS07. COVID-19 and related topics

O055 - The impact of the COVID-19 pandemic on individuals with mental illness: A two-wave survey of 1180 patients

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
15:24 - 15:36
Presenter

ABSTRACT

Introduction

The crisis caused by the ongoing COVID-19 pandemic is affecting the lives of billions of people across the world. Individuals with mental illness are suspected to be particularly affected by the societal consequences of the pandemic, but there is very limited data on this important aspect.

Objectives

The aim of this study is to gauge the longitudinal impact of the COVID-19 pandemic on the psychological well-being and symptom levels of individuals receiving treatment for mental disorder in psychiatric hospital services.

Methods

We are in the process of conducting a two-wave, questionnaire-based survey among patients with mental disorders receiving treatment in the psychiatric hospital services of the Central Denmark Region. The first wave was conducted in July 2020 and had 1180 respondents representing all major diagnostic categories. The main finding was that the majority of the respondents reported that their mental health had deteriorated during the COVID-19 pandemic. We are currently planning the second wave of the survey, which will be fielded in the fall of 2020. Here, we will reassess the mental health of the respondents from wave 1.

Results

Will be presented at the meeting.

Conclusions

Longitudinal studies of the impact of the COVID-19 pandemic of mental health are lacking. We therefore expect that the findings of this study will be of significant interest to the field.

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Oral Communications (ID 1110) AS07. COVID-19 and related topics

O056 - Relationship quality in couples related to mental health of women and men during the COVID-19 pandemic and stay-at-home orders

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
15:36 - 15:48

ABSTRACT

Introduction

The data on gender differences in mental health make the investigation of the specific impact of the pandemic and of the stay-at-home orders on men and women relevant.

Objectives

The study focuses on the quality of the relationship in couples and mental health in men and women during the COVID-19 pandemic.

Methods

The study was conducted through an online survey a few weeks after the pandemic was declared and the stay-at-home order was introduced in Russia. 274 participants (50 men and 224 women) engaged in long-term relationships aged from 18 to 62 (M=34.2; SD=9.1) took part in the research. The instruments included the Warwick-Edinburgh Mental Well-Being Scale, the Perceived Relationship Quality Components, and the Depression Anxiety Stress Scales.

Results

Women show a considerably higher level of stress (t=3.805; p<0.001), depression (t=3.76; p<0.001) and anxiety(t=2.959; p=0.003). The quality of relationship for women is significantly connected with mental wellbeing(r=0.423; p<0.001) and negatively correlated with the stress level (r= -0.60; p<0.001), depression (r= -0,381; p<0,001) and anxiety (r=-0,313; p<0,001). Meanwhile for men, the quality of the relationship is connected to mental wellbeing (r=0.280; p=0.049), opposed to stress levels (r= -0.316; p=0.025) and is neither connected to depression (r= -0.210; p=0.144) nor to anxiety (r= -0.126; p=0.383).

Conclusions

During the pandemic, a favorable partnership has a positive effect on the mental health of both men and women. However, while the relationship quality affects all investigated indicators of mental health in women, in men the relationship quality is only connected to the level of mental wellbeing and stress.

The reported study was funded by RFBR, project number 20-04-60174.

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Oral Communications (ID 1110) AS07. COVID-19 and related topics

O058 - Suicidality measured by PHQ-9 in Kosovo during the COVID-19 Outbreak

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
15:48 - 16:00
Presenter

ABSTRACT

Introduction

As a consequence of the impact of COVID-19 there are suggestions and projections that suicide rates will rise, although this is not inevitable. It is intriguing what impact it will have on Kosovo as a country with the lowest suicide rate in Europe.

Objectives

The objective of this study was to understand the level of suicidal thinking as a result of the COVID-19 situation and possible associations with sociodemographic variables.

Methods

It’s a comparative study. We examined data of two cross-sectional online surveys conducted during the one-month periods 20.03.20 until 23.04.20 and 27.04.2020 until 05.06.2020. The participants were online respondents, N = 194 (first period) and N = 155 (second period); who completed the Albanian version of PHQ-9. We used the statement number 9 of questionnaire indicative of suicide.

Results

Mean score of suicidal thinking resulted 0.58 (SD = .98) in the first period and 0.84 (SD = 1.16) in the second period. 10.1% of participants in March/April and 18.2% in May/June period scored that almost every day thoughts that would be better off dead, or of hurting yourself in some way. Significantly higher suicidal thinking resulted for females and for respondents who had previously had depression in both periods. Compared to two previous studies (2018 and 2019) in different settings only the results of the second period show an increase in suicidal thinking.

Conclusions

Further studies are needed to better scientifically elaborate these findings. It is important enhanced surveillance of COVID-19-related risk factors contributing to suicidal behaviors and timely preventive efforts.

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Oral Communications (ID 1110) AS07. COVID-19 and related topics

O059 - The psychological impact of COVID-19 and lockdown measures among a sample of Italian patients with Eating Disorders: a longitudinal study.

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
16:00 - 16:12
Presenter

ABSTRACT

Introduction

COVID-19 pandemic and lockdown greatly impact on mental health, especially on individuals with pre-existing psychiatric conditions.

Objectives

To explore the prevalence of specific psychiatric symptoms across a sample of patients with Eating Disorder (ED), compared to a group of healthy controls (HC), during the lockdown period in Italy, and to assess whether patients’ symptoms improved, persisted or worsened with the easing of the lockdown measures.

Methods

Study 1: 59 ED patients and 43 HC were recruited and completed, at the beginning of May 2020(t0), an online survey including: the Depression, Anxiety and Stress Scale – 21 items (DASS-21), the Impact of Event Scale-Revised (IES-R), the Perceived Stress Scale (PSS), and few ad-hoc questions extracted from the Eating Disorder Examination Questionnaire (EDE-Q).

Study 2: 40 ED patients from Study 1 completed the same survey two months after t0 (t1).

Results

Study 1: ED patients scored significantly higher than HC at the DASS-21 (Total Score and subscales), the IES-R (Total Score and subscales) and the PSS. Moreover, they showed higher distress specifically related to food and their body.

Study 2: at t1, levels of stress, anxiety and depression were not different than at t0, but symptoms related to post-traumatic stress disorder (PTSD) improved, together with patients’ reported level of psychological wellbeing and specific ED symptomatology.

Conclusions

During lockdown, ED patients presented significantly higher levels of stress, anxiety, depression, PTSD-related symptoms, and ED-related symptoms than HC. With the easing of lockdown, PTSD-related and ED-related symptoms ameliorated, but high levels of stress, anxiety and depression persisted.

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Oral Communications (ID 1110) AS07. COVID-19 and related topics

O060 - Safety of psychotropic medications in people with COVID-19

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
16:12 - 16:24
Presenter

ABSTRACT

Introduction

People with coronavirus disease (COVID-19) may frequently require treatment with psychotropic medications, but the underlying medical condition and possible interaction with medical treatments might pose serious safety issues.

Objectives

To review the direct and indirect evidence on the safety of psychotropic drugs in people with COVID-19 and provide practical recommendations for frontline clinicians.

Methods

An international, multi-disciplinary working group was established with the aim of producing evidence-based recommendations on the management of psychotropic medications in people with COVID-19, following the WHO Rapid Advice Guidelines methodology in the context of a public health emergency. Evidence retrieved was focused on the risk of respiratory, cardiovascular, infective, hemostatic, and consciousness alterations related to the use of psychotropic medications. Furthermore, drug-drug interactions between psychotropic and medical treatments used in people with COVID-19 was reviewed and critically discussed by the working group.

Results

The analysis of available evidence, although indirect, showed that all classes of psychotropic medications might carry relevant safety risks for people with COVID-19. The working group produced a set of 12 recommendations to support clinicians in the assessment of the anticipated risk of psychotropic-related unfavourable events, and how to practically manage this risk, including when it is appropriate to avoid, withdraw, switch, or adjust the dose of the medication.

Conclusions

The present evidence-based recommendations will improve the quality of psychiatric care in people with COVID-19, allowing an appropriate management of the medical condition without worsening the psychiatric condition and vice versa.

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Oral Communications (ID 1110) AS07. COVID-19 and related topics

O061 - “Young people are not invincible”: What drives young people’s health behaviours during the COVID-19 pandemic in Greece?

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
16:24 - 16:36
Presenter

ABSTRACT

Introduction

The illusion of invulnerability has been linked to lower perceived risk and increased engagement in risky behaviors among youth. Therefore, it has been purported to influence young people’s poor adherence to public health measures aiming to contain the COVID-19 pandemic. Concomitantly, beliefs about the virus and mental health may also shape public health behaviours.

Objectives

To investigate the role of beliefs, perceived invincibility and mental health status in explaining frequency of hand-washing and hours outside the house among youth in Greece

Methods

A total of 1.899 students, aged between 18-29 years old, were recruited from the main universities of the country. An online questionnaire entailing: (i) popular beliefs about COVID-19, (ii) the DASS-21, (iii) the Adolescent Invincibility Tool and (iv) queries about health behaviours, was distributed during the lockdown period.

Results

Most participants reported washing their hands rarely/never within a day (78.6%) and spending 2-6 hours outside the house (68.1%). Handwashing was largely influenced by mental health [OR = 0.94, 95%CI= 0.91 – 0.98 for stress; OR = 0.96, 95%CI = 0.93-0.99 for anxiety and OR = 1.05, 95%CI= 1.02-1.08 for depression]; while hours outside the house by perceptions that the virus is out of control [OR=0.76, 95%CI = 0.61-0.95], manufactured [OR=1.21, 95%CI = 1.53, 95%CI =1.21 – 1.93] and airborne [OR= 0.78, 95%CI = 0.64-0.95].

Conclusions

Addressing stress and anxiety as well as health education interventions should be prioritized to foster young people’s adherence to public health measures amid the pandemic.

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Oral Communications (ID 1110) AS07. COVID-19 and related topics

O062 - Maintaining therapeutic continuity in adolescent Psychiatric Day Hospital programs during the COVID-19 lockdown

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
16:36 - 16:48
Presenter

ABSTRACT

Introduction

The COVID-19 social lockdown imposed important limitation to non-emergency health care services in Italy, between March and May 2020, with many difficulties in the mental health assistance of those chronic conditions needing a continuative therapeutic support.

Objectives

Our study aimed to describe how therapeutic activities have been carried on by remote services in two Adolescent Psychiatric Day Hospital Units (Rome and Turin) and the outcome of these assistance interventions in youths with subacute psychopathology.

Methods

The patient cohort includes 162 adolescents (12-19 years old; QI>70) DH outpatients presenting a complete clinical and neuropsychiatric assessment before the lockdown.

During the several phases of COVID-19 quarantine all patients were monitored and supported by telemedicine interventions. All data were recorded and standardized every 15 days: symptom severity was rated by global severity (CGI-S) and stress level by self-reported measures of stress (IES-R).

Results

Among patients, CGI score remained stable, IES-R score declined over time: higher IES-R score was significantly associated with female gender and but no differences was observed related with the primary diagnosis. 5 patients presented a clinical acute state needing a hospitalization. The rate of hospitalization was not significantly different compared with the rate observed in the same period of 2019.

Conclusions

In youth with psychopathological conditions, remote assistance for psychiatric cares resulted effective and it was associated with a clinical stability with decreasing stress levels.

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Oral Communications (ID 1110) AS07. COVID-19 and related topics

O063 - Rapid development of a decision-aid for people with dementia and their families during COVID-19

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
16:48 - 17:00

ABSTRACT

Introduction

COVID-19 as a pandemic has disproportionately affected older adults, including those with dementia. The effects on health and social care systems has necessitated a rapid-response approach to care planning and decision-making in this population, with reflexivity and responsiveness to changing individual and system needs at its core. In light of this, a decision-making tool to help families of persons with dementia was developed using a combination of qualitative data and evidence synthesis.

Objectives

To develop a decision-aid using a combination of assessment and evidence-gathering methods for families of persons with dementia.

Methods

Semi-structured interviews with helpline staff from national end-of-life and supportive care organisations formed the basis of the tool design. Co-design with people living with dementia, current and former carers and experts in general practice and social care shaped the next stage. Simultaneously, a rapid review of current evidence on making decisions with older people at the end of life was undertaken.

Results

Output from interviews covered many topics, including trust, agency and confusion in making decisions in the context of COVID-19. The rapid review of existing evidence highlighted the need to consider both process and outcome elements of decision-making.

Conclusions

Combining different sources and forms of evidence was efficient and valuable in creating a novel decision-making tool for persons with dementia and their families within the context of COVID-19. The decision-aid covered care planning, caregiver support systems, access to information and contingency considerations. Upon publication, the tool was adopted by NHS England and other leading healthcare organisations.

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Oral Communications (ID 1110) AS07. COVID-19 and related topics

O065 - Perinatal depression and developmental risk of the infant: analysis of a clinical sample and assessment of the impact of the Covid-19 pandemic.

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
17:00 - 17:12
Presenter

ABSTRACT

Introduction

Studies on large samples agree on the negative impact of maternal perinatal depression (PD) on child’s cognitive development. Early experience with insensitive maternal interactions appears to be predictive of poorer cognitive functioning.

These children present a higher risk for the onset of socioemotional development, nutrition, growth and sleep disorders.

Research on Covid-19 pandemic suggests that families, particularly mothers, may be at increased risk of psychological distress.

Objectives

This study evaluates the effect of perinatal depression on child development and the impact of distress caused by the Covid-19 pandemic.

Methods

We designed a case-control study comparing, during Covid-19 pandemic, a group-A of children of mothers with PD (n=19), with a group-B of children of healthy mothers (n=21). The age of the children recruited was 4-35 months. Participating mothers underwent DP3-Interview and the socioemotional and adaptive-behavior Bayley's scales by telephone and completed an online survey (IES-R).

Results

We found significantly lower scores on the Bayley socioemotional scale and in all the DP3-scales, in group-A. There is an inversely proportional correlation between the age of these children and overall development score of the DP3. On the IES-R scale, the medium scores in both groups show no psychological distress as a consequence of the Covid-19 pandemic, although mothers with PD show borderline total scores and higher hyperarousal scale values.

Conclusions

This study confirms that PD is a risk factor for the onset of disorders in all areas of the child's development. Mothers with PD are less likely to manage psychological distress secondary to the pandemic.

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Oral Communications (ID 1110) AS07. COVID-19 and related topics

O066 - The impact of COVID-19 pandemic on suicides in Portugal during the emergency state

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
17:12 - 17:24

ABSTRACT

Introduction

The mental health impact of the COVID-19 pandemic is well documented. Portugal entered the emergency state on 19th march due to rising numbers of infected patients. The emergency state introduced regulatory measures that restricted people’s movements, applied a curfew, and closed most non-essential spaces and activities, such as shops and religious celebrations.

Objectives

To evaluate the rates of suicides during the emergency state in Portugal.

Methods

We obtained the number of probable suicides during 19th march and 2nd may 2020, 2019 and 2018 from SICO/eVM (Real Time Mortality Electronic Surveillance). This system is used for health planning in Portugal and provides provisory data which is updated every 10 minutes. ExcelÒ was used for the statistical analysis.

Results

During the Emergency State in Portugal there were 57 probable suicides. Comparing to the same period in 2018 and 2019, there were 62 and 70 probable suicides, respectively. Social isolation, anxiety, fear of contagion, chronic stress, and economic difficulties may lead to the development or exacerbation of depressive, anxiety, substance use, and other psychiatric disorders. Literature on suicides due to COVID-19 mention not only fear of infection, but also social isolation and distancing and economic recession as causes for suicide attempts and completions.

Conclusions

During the emergency state there was not an increase of probable suicides, compared to previous years. The greater vigilance of people’s movements may have deterred many attempts. However, policymakers and health care providers must be alert as the current psychosocial predispose to an increase in suicide rates.

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Oral Communications (ID 1110) AS07. COVID-19 and related topics

O067 - In this study: Adapting to the new normal in COVID-19 Pandemic; a global survey & literature review 

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
17:24 - 17:36

ABSTRACT

Introduction

Globally, governments have enforced protective measures of social distancing to prevent COVID-19 spread. The lifestyles of public have essentially transformed due to these actions. This study evaluates the effects of COVID-19 on connections and behavior/life adaptations.

Objectives

Changes in life style and behavior in COVID-19-Pandemic

Methods

We conducted a global cross-sectional study via survey on phone apps and social media platforms in population aged ≥ 16, including questions regarding demographic data and lifestyle changes. We also searched databases APA PsycNet, PubMed, PsycINFO, and Medline; reviewed 40 articles and included 3 in this review, a cross-sectional online survey1, a planned questionnaire2, and a study on 600 adolescents, age 10-19 in Palestine3

Results

Our survey data showed total of 1002 responses, 31.7% decreased sleep, 42.1% increased appetite, 70.6% bulk-buying, and 50.2% weight gain. 43.1% less socialization than before, 78.7% increased screen time, 53.5% excessive hand washing/wiping surfaces, 45% reported social distancing facilitated in overpowering the fear of contracting infection, 29.4% negative impact on relationships, 80.7% noticed changes in behavior including shaking hands/hugging/speaking with a mask on, 49.5% adopted new hobbies, 34.9% showed increase in meditation. The literature review revealed that since COVID-19, there is an increase in screen time, weight, appetite, sleep, and a decrease in physical activity1-3, and greater adherence to the Mediterranean diet in younger population2

Conclusions

COVID-19 induced quarantine has caused increased screen time, appetite, weight gain, adoption of new hobbies, bulk-buying, hand washing, , meditation, reduced sleep, and negatively impacted interaction/relationships. COVID-19 pandemic is ongoing and our data needs further assessment in more population studies.

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Oral Communications (ID 1110) AS07. COVID-19 and related topics

O069 - The COVID-19 Lockdown: Impact on the Mental-Wellbeing of Out-patients with chronic Medical conditions in a Teaching Hospital in Nigeria.

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
17:36 - 17:48

ABSTRACT

Introduction

Lock-down restrictions were introduced in most countries of the world at the onset COVID-19 pandemic. It was associated with serious implications for healthcare delivery, with affectation of access to medical services for patients with chronic medical conditions. It is important to assess the impact of this on the subjective feeling of mental wellbeing in these patients.

Objectives

This study aimed to assess the access to health care services during the lock-down as well the perceived affectation of the mental, physical and social wellbeing and their related factors in patients with chronic illnesses in Ilorin.

Methods

This study was a cross-sectional study, involving 166 patients being managed for different chronic medical conditions, attending the Medical Outpatient Clinics of the University of Ilorin Teaching Hospital. A socio-demographic questionnaire and a structured questionnaire designed by the researchers was used.

Results

The mean age of all respondents was 49.5+18.5. 25.3% of respondents were being managed for heart-related conditions. 54 respondents(32.5%) reported a negative affectation of their mental wellbeing, which included changes in mood, sleep pattern and feelings of being overwhelmed and unable to cope properly. The age (p= 0.031) and employment status(p=0.015)of the patient were significantly associated with a subjective feeling of negative affectation of wellbeing.

Conclusions

The impact of the COVID-19 pandemic lockdown on the mental well-being of patients with chronic medical conditions is significant and calls for a more strategic plan for delivery of health care services during pandemic situations with focus on the mental well being of patients.

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Oral Communications (ID 1110) AS07. COVID-19 and related topics

O070 - Psychopathological consequences and dysfunctional behaviours during the COVID-19 epidemic in Italy: a longitudinal study before and after the lockdown

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
17:48 - 18:00
Presenter

ABSTRACT

Introduction

In the first months of 2020 the COVID-19 epidemic spread in Italy, and the Italian government implemented a general lockdown. These events are at high risk for psychiatric symptoms in the general population, including anxiety/depression and post-traumatic stress symptoms (PTSS).

Objectives

To characterize the psychopathological correlates of the spread of COVID-19 and lockdown in a sample of subjects from the Italian population, with a before-after follow-up.

Methods

Six weeks after the lockdown, 671 subjects aged 18-60 years completed the Brief Symptom Inventory and Impact of Event Scale-Revised, for the evaluation of psychopathology and PTSS respectively. Environmental factors and subjectively-perceived deteriorations related to COVID-19 were also investigated. Pre-COVID-19 data on psychopathology, collected in December 2019/January 2020, were available for 130 subjects and were used for longitudinal analyses.

Results

With respect to males, female subjects more frequently reported deteriorations of relations (21.5% vs 10.9%), household arguments (26.0% vs 12.6%), sleep quality (47.6% vs 26.6%), episodes of overeating (22.5% vs 12.5%), worries for oneself (19% vs 8.9%) and for loved ones (55.7% vs 36.5%). These changes were associated with increased psychopathology, PTSS, and numerous environmental conditions, including significant economic damage from COVID-19/lockdown. Longitudinal analyses showed an increase in phobic anxiety in the whole sample, and in depression for female subjects only, following the spread of COVID-19. Pre-existing psychopathology was a significant predictor of PTSS.figuracovidcontrolli.png

Conclusions

COVID-19 epidemic and lockdown have a high impact on psychopathology and PTSS. Female subjects and those with pre-existing psychopathology were found to be more vulnerable and may need additional support.

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Oral Communications (ID 1110) AS07. COVID-19 and related topics

O071 - The impact of COVID-19 on eating disorders: a longitudinal study with assessments before and after the lockdown

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
18:00 - 18:12
Presenter

ABSTRACT

Introduction

The COVID-19 epidemic that spread in Italy in the early 2020, together with the general lockdown, are high-risk events for vulnerable populations who need high levels of assistance, such as patients with eating disorders (EDs).

Objectives

To evaluate the impact of the COVID-19 epidemic and lockdown on subjects suffering from EDs, considering previous vulnerabilities.

Methods

74 patients with anorexia nervosa (AN) or bulimia nervosa (BN) already on treatment and 97 healthy controls were evaluated between November 2019/January 2020 (T1), and again in April 2020, 6 weeks after the start of lockdown (T2). Patients were also evaluated at baseline (T0). At each assessment, general and ED psychopathology (SCL-90-R and EDE-Q) were assessed. Childhood abuse experiences (CTQ) and adult attachment (ECR-R) were investigated at T1, and post-traumatic stress symptoms (IES-R) at T2.

Results

Patients reported a significant increase in compensatory exercise; in addition, patients with BN and those who achieved remission at T1 showed a significant exacerbation of binge-eating. The longitudinal trend (T1-T2) of psychopathology was not different between patients and controls, however the expected benefit from treatment on ED psychopathology was significant only for AN, while no changes were noted in BN. Patients with BN reported more severe post-traumatic stress symptoms than AN and controls, and these symptoms correlated positively with prior traumatic experiences and an insecure attachment style.

figuracoviddca.png

Conclusions

The COVID-19 epidemic and lockdown had a significant impact on subjects with eating disorders, both by interfering with the treatment process and in terms of post-traumatic stress symptoms.

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Oral Communications (ID 1110) AS07. COVID-19 and related topics

O072 - Professionals’ experience of the rapid implementation of a remote consultation model of healthcare: a survey of clinicians in the early stages of the COVID-19 pandemic.

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
18:12 - 18:24

ABSTRACT

Introduction

Despite the availability of remote consolation and the evidence for its effectiveness, its adoption has been relatively limited (Hashiguchi, 2020). In light of COVID social distancing measures, there was an immediate requirement to adopt this technology into routine practice.

Objectives

The objective of this evaluation was to examine clinicians’ experiences of the urgent adoption of digital technology in a NHS provider of mental health and community physical health services.

Methods

From a staff survey (n=234) of experiences of working during a period when there were significant levels of Covid-related restrictions, data was extracted and subject to thematic analysis by a research team made up of clinicians, academics, and quality improvement specialists.

Results

Five key themes relevant to the urgent adoption of digital technology were identified (figure 1): (1) Availability of staff for patient contact was generally felt to be improved; (2) Quality of contact was reported to be variable (e.g. some respondents reporting better rapport with patients, whereas others found remote contact interfered with rapport building); (3) Safeguarding concerns were reported to be more difficult to identify through remote consultation; (4) Contingency plans were recommended to allow for vulnerable patients for whom remote consultation was a problem; (5) Multi-agency working was reported to be strengthened.abract.png

Conclusions

The findings from this evaluation allow for an informed approach to future adoption of remote consultation in routine practice.

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Oral Communications (ID 1110) AS07. COVID-19 and related topics

O073 - Stress, anxiety, depression, and burnout in healthcare workers during two outbreaks of COVID-19 pandemic in Russia

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
18:24 - 18:36

ABSTRACT

Introduction

Mental health of medical workers treating patients with COVID-19 is an issue of increasing concern worldwide, since previous epidemics have shown high levels of anxiety and stress in front-line healthcare professionals. The available data on stress and anxiety symptoms among healthcare workers during the COVID-19 are relatively limited and have not been evaluated in Russia yet.

Objectives

To evaluate stress and anxiety symptoms among healthcare workers directly involved in the diagnosis and treatment of patients with COVID-19 during the peak of disease outbreak in Russia.

Methods

The study was a cross-sectional hospital-based anonymous on-line survey in May 2020 of 1,090 healthcare workers practicing treatment of patients with COVID-19. Stress and anxiety symptoms were assessed using the Russian versions of Stress and Anxiety to Viral Epidemic scale (SAVE-9) and Generalized Anxiety Disorder (GAD-7) scales. Logistic regression analysis was performed to determine the influence of different variables.

Results

The median scores on the GAD-7 and SAVE-9 were 5 and 14, respectively. 49.1% respondents had moderate and 21.9% had severe anxiety according to SAVE-9. 12.3% had severe anxiety, 13.2% had moderate according to GAD-7. Female gender and younger age were associated with higher level of anxiety according to regression model.

Conclusions

Our study has shown that healthcare workers in Russia practicing treatment of patients with COVID-19 reported high rates of stress and anxiety similar to other countries. Female gender, younger age and being a physician were associated with higher levels of anxiety. These results demonstrate the importance of supportive programs for health care workers fighting COVID-19.

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Oral Communications (ID 1110) AS07. COVID-19 and related topics

O074 - New onset of mental disorders, lifestyle changes, and quality of relationships during Covid-19 in Italian population.

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
18:36 - 18:48

ABSTRACT

Introduction

The COVID-19 pandemic has been causing relevant public health and psychosocial consequences.

Objectives

To assess the impact of the COVID-19 pandemic on mental health, lifestyle and personal relationships in the Italian general population.

Methods

An online survey spread between May and June 2020 to collect socio-demographic, clinical, lifestyle, relationship, and mental health self-reported information. Mental disorder screening was performed by the Patient Health Questionnaire and PTSD Checklist for DSM-5.

Results

Participants were 2003, 1504 of which (75%) completed the entire questionnaire (1157 females, 77%). Among the completers who have not had any mental disorder before (n=524, 35%), 263 (51.7%) met cut-off scores for psychiatric diagnoses on the self-report psychiatric screeners during the pandemic (i.e., Major Depressive Disorder, 11.3%, with death thoughts in approximately half of the cases; Panic Disorder, 1.1%; Generalized Anxiety Disorder, 13%.3, Obsessive-Compulsive Disorder, 13.2%, Post-Traumatic Stress Disorder, 7.3%; Alcohol Abuse, 5.5%). In line with this, 39% of completers complained of insomnia, while 12% and 10% started using anxiolytics and antidepressants, respectively. Approximately 7-8 % of completers started/increased alcohol and/or nicotine consumption, 33% quitted/decreased physical activity, and 40% declared decreased sexual satisfaction. Approximately 21% and 38% declared worsening in relationship with partner and difficulty in child-caring, respectively.

Conclusions

The COVID-19 pandemic appears to be a risk factor for new onset of mental disorders and worsening in lifestyle and familial relationships in the Italian population. These results should be confirmed by clinical interviews, and may represent a starting point for further monitoring of the medium and long-term consequences of the COVID-19 pandemic.

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Oral Communications (ID 1110) AS07. COVID-19 and related topics

O075 - Rapid implementation of a Support Intervention for Bereavement at the beginning of the COVID-19 pandemic

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
18:48 - 19:00
Presenter

ABSTRACT

Introduction

There have been over 900,000 deaths from COVID-19, with more than 3 million people bereaved. These deaths are associated with factors leading to poor bereavement outcomes, and distress in frontline-staff

Objectives

to (i)present the rapid implementation of an intervention for bereavement support; (ii)characterize first calls and follow-up.

Methods

We recruited a multidisciplinary team and prepared a structure called “SIB” (Support and Intervention for Bereavement) in a matter of days. There were three steps for the support (Screening, First-line intervention, Second-line intervention (short follow-up). We collected data screening risk factors for complicated grief (CG).

Results

Between March 24th-May 14th(lockdown, March 16th-May 13th), the hotline received nineteen calls for an intervention. The hospital contacts were various, including mortuary. Fifteen relatives were followed, among them thirteen bereaved for ten deaths (on 52 deaths=19.23%). Dead persons were young (m=59.68 years-old, SD=15.25). All contacts reported several risk factors for a CG (no “goodbye”(100%), no funeral rituals(82.35%)). Six relatives were addressed for short follow-up.

Conclusions

The actual pandemic is at high risk for complicated grief and may until 2021. We hope that all hospitals would implement basic bereavement outreach programs to prepare families for the death and to support them afterwards, as well as provide basic support to frontline staff.

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Oral Communications (ID 1110) AS07. COVID-19 and related topics

O076 - Fear of infection and optimism predict following stay-at-home recommendations during COVID-19 pandemic in Russian young people

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
19:00 - 19:12

ABSTRACT

Introduction

Introduction. Self-isolation regime is an effective measure to contain the pandemic (Alfano, Ercolano, 2020), but the psychological factors predicting compliance with stay-at-home recommendations (CSHR) are understudied. We hypothesized that 1) defensive optimism and constructive optimism will have opposite effects on CSHR, 2) the effect of defensive optimism will be mediated through a decrease of anxiety (fear of infection).

Objectives

Objectives. The purpose of this study was to assess the direct and indirect (through the fear of infection) effects of defensive optimism (belief that coronavirus problem is exaggerated) and constructive optimism (belief that people’s efforts help to prevent infection and spread of the virus) on CSHR, controlling for dispositional optimism.

Methods

Methods. A longitudinal study (from 10/4/2020 till 2/6/2020) was conducted on a sample of 306 university students (89% women, MA=21.20, SD=4.54) using a single-item measure of CSHR, LOT-R (Scheier et al., 1994), the scales of defensive and constructive optimism (Gordeeva, Sychev, 2020), and anxiety in a pandemic situation questionnaire (Tkhostov, Rasskazova, 2020).

Results

Results. During seven-week interval CSHR has decreased dramatically (Cohen’s d=0.66, p<0.001) while the other variables remained stable. Using SEM we have showed that CSHR at the end of study (T2) is predicted by the CSHR (T1) and through it by the defensive optimism (negative effect, p<0.05) and constructive optimism (positive effect, p<0.001). Negative effect of defensive optimism on CSHR is also mediated by the fear of infection (T2), reducing it. Dispositional optimism is associated only with constructive optimism.

Conclusions

Conclusions. Defensive and constructive optimism/ pessimism are essential in explaining health-related behavior.

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Oral Communications (ID 1110) AS07. COVID-19 and related topics

O077 - Emotional response to illness in patients hospitalized with COVID-19 in Russia.

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
19:12 - 19:24

ABSTRACT

Introduction

The situation of Covid-19 disease, associated with a high threat to life and uncertainty, had not only somatic, but also psychological consequences for most patients. Emotional reactions of patients to hospitalization and ways to cope with what is happening have become the subject of study in different countries.

Objectives

To assess the severity of signs of depression and anxiety and to study the methods used to regulate the emotional state in patients with COVID-19 at the time of hospitalization.

Methods

The study volunteered 127 hospitalized patients with Covid-19 (67 men (52.8%) and 60 women (47.2%), aged 19 to 77 years, who completed the following methods: Sociological questionnaire, Beck Depression Questionnaire, GAD-7, F-SOZU-22, CERQ, Dembo-Rubinstein self-assessment scales. The study was conducted from 04/25/2020 to 05/31/2020.

Results

A quarter of patients showed pronounced signs of depression and anxiety (25.4% and 24.13%, respectively), with women having higher rates of depression (M = 8.76 and M = 6.32, p<0.01). Anova showed no significant differences in the response to the disease situation in patients of different age groups. Factor analysis made it possible to identify 3 patterns of emotional coping with the disease: «positive decision oriented», «fixed on negative experiences», «accusers» (The resulting factor solution explains 69% of the dispersion). None of the identified patterns were associated with a significant reduction in signs of depression and anxiety.

Conclusions

Despite the duration of the pandemic, there is still no specific pattern of effective coping with these experiences for patients.

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Oral Communications (ID 1110) AS07. COVID-19 and related topics

O078 - Psychiatric Clinical Profiles and Pharmacological Interactions in COVID-19 inpatients referred to a Consultation Liaison Psychiatry Unit

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
19:24 - 19:36
Presenter

ABSTRACT

Introduction

The Coronavirus Disease 2019 (COVID-19) can affect mental health in different ways. There is little research about psychiatric complications in hospitalized patients with COVID-19.

Objectives

The aim of the study was to describe the psychiatric clinical profile and pharmacological interactions in COVID-19 inpatients referred to a Consultation-Liaison Psychiatry (CLP) unit.

Methods

This is a cross-sectional retrospective study, carried out at a tertiary hospital in Spain, in inpatients admitted because of COVID-19 and referred to our CLP Unit from March 17,2020 to April 28,2020. Clinical data were extracted from electronic medical records. The patients were divided in three groups depending on psychiatric diagnosis: delirium, severe mental illness (SMI) and non-severe mental illness (NSMI).

Results

Of 71 patients included (median [ICR] age 64 [54-73] years; 70.4% male), 35.2% had a delirium, 18.3% had a SMI, and 46.5% had a NSMI. Compared to patients with delirium and NSMI, patients with SMI were younger, more likely to be institutionalized and were administered less anti-COVID19 drugs. Mortality was higher among patients with delirium (21.7%) than those with SMI (0%) or NSMI (9.45%). The rate of side effects due to interactions between anti-COVID19 and psychiatric drugs was low, mainly drowsiness (4.3%) and borderline QTc prolongation (1.5%).

Conclusions

Patients affected by SMI were more often undertreated for COVID-19. However, the rate of interactions was very low, and avoidable with a proper evaluation and drug-dose adjustment. Half of the patients with SMI were institutionalized, suggesting that living conditions in residential facilities could make them more vulnerable to infection.

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Oral Communications (ID 1110) AS07. COVID-19 and related topics

O080 - Evaluation of anxiety symptoms and depression in the general Albanian population during quarantine

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
19:36 - 19:48
Presenter

ABSTRACT

Introduction

During the COVID-19 pandemic, the Albanian authorities declared mandatory stay-at-home measures, closing businesses, schools and public places.

Objectives

To investigate the impact of these immediate changes on the mental wellbeing of the population.

Methods

Respondents (N=1678) from 18 to 60 years old were selected through a convenient sampling method. Questionnaires were administered online reporting time spent daily in the COVID-19 topic and genealities; the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7.

Results

Findings suggest a significant negative correlation between age and anxiety scoring (r(n=1678)=-.121, p≤.001) and age and depression scoring (r(n=1678)=-.232, p≤.001), shown also on the ANOVA test for age and anxiety (F=6.019, p≤.05) and age and depression (F=20.326, p≤.05). Differences on the level of education resulted in a lower score of anxiety and depression respectively (F=3.524, p≤.05), (F=7.739, p≤.05) on respondents with higher education. Those who were jobless from the pandemic scored higher on anxiety and depression respectively (F=9.760, p≤.05) (M=6.21, ds=4.686) and (F=16.051, p≤.05) (M=8.18, ds=5.791). Significant differences were found related to different amounts of time spent on the COVID-19 topic, respectively for anxiety and depression (F=25.736, p≤.001), (F=5.936, p≤.003), with people who spend less than 1 hour scoring higher on depression (M=7.57, ds= 5.849) and those who spend more than 3 hours scoring higher on anxiety (M=6.76, ds=5.60).

Conclusions

Higher education individuals, having a job and being in a romantic relationship relate to lower levels of depression during Covid-19 quarantine in Albania. Spending more time on the COVID-19 topic daily and being a female relate to higher level of anxiety.

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Oral Communications (ID 1110) AS07. COVID-19 and related topics

O082 - Psychological impact of the COVID-19 crisis on young Swiss men participating in a cohort study: Differences due to socioeconomic status and work situation

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
19:48 - 20:00

ABSTRACT

Introduction

The COVID-19 pandemic impacted daily life worldwide. It may also have had a psychological impact, especially on those with less resources already before the crisis and those who reported substantial changes to their work situation.

Objectives

To investigate whether socioeconomic status before the crisis and changes in work situation during the crisis (unemployment, home-office) are associated with psychological impact in a cohort of young Swiss men.

Methods

A total of 2345 young Swiss men (mean age = 29) completed assessments shortly before (April 2019 to February 2020) and early during the COVID-19 crisis (May to June 2020). Assessments covered psychological outcomes assessed before and during COVID-19 crisis (depression, perceived stress and sleep quality), and assessed during the crisis (fear, isolation and COVID-19 psychological trauma), socioeconomic status (relative financial status and difficulty to pay bills) before the crisis and changes in work situation (unemployment, home-office).

Results

About a fifth of the sample were in partial unemployment or lost their job during COVID-19 crisis. Those in partial or full unemployment, those mostly working from home and those with a lower socioeconomic status already prior to the crisis showed overall higher levels of depression, stress, psychological trauma, fear and isolation.

Conclusions

Even in a country with high social security such as Switzerland, the COVID-19 crisis had a higher psychological impact on those who were already disadvantaged before the crisis or experienced deteriorations in their work situation. Supporting disadvantaged subpopulations during the crisis may help to prevent an amplification of pre-existing inequalities.

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Oral Communications (ID 1110) AS07. COVID-19 and related topics

O084 - The Coronavirus Pandemic in Israel: A Comparison between Holocaust Survivors and Other Older Adults

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
20:00 - 20:12

ABSTRACT

Introduction

The COVID-19 pandemic places older adults at increased risk for hospitalization and mortality. It also involves social isolation and negative effects of limited mental, social and physical activity. Holocaust survivors could be especially vulnerable to such effects due to their early life traumas. Previous research suggests that in times of life crises, Holocaust survivors may be both most vulnerable (i.e., wear-and-tear hypothesis); yet they may also demonstrate resilience.

Objectives

Thus, the current study examines the effects of the COVID-19 pandemic on the mental health and well-being of Holocaust survivors in Israel, compared to adults who did not experience the Holocaust.

Methods

We collected data from 305 older adults aged 75 and above in Israel during the COVID-19 pandemic. Of these, 114 were Holocaust survivors and 191 did not experience the Holocaust. Participants were asked about their worries of COVID-19 infections, will to live, loneliness and depression and how these changed during the COVID-19 pandemic.

Results

Holocaust survivors were worried to a greater extent from COVID-19 infection and from close others becoming infected, compared to older adults who did not experience the Holocaust. Moreover, survivors reported greater loneliness and depression overall and also reported that these measures became worse during the pandemic. On the other hand, despite these differences, the two groups were similar in their will to live.

Conclusions

Holocaust survivors seem to be more vulnerable to the COVID-19 pandemic, strengthening the vulnerability hypothesis. Policy makers and practitioners should pay special attention to this particularly vulnerable population during these difficult times.

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Oral Communications (ID 1110) AS07. COVID-19 and related topics

O085 - Clinical profile of patients admitted in an Acute Psychiatric Ward before and during the COVID-19 lockdown

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
20:12 - 20:24

ABSTRACT

Introduction

The COVID-19 pandemic entailed several changes in health and medical assistance, economy, and lifestyle. In the Acute Psychiatric Ward of the Hospital Clínic of Barcelona, the implementation of restrictive measures was necessary in order to ensure patients’ safety.

Objectives

To compare clinical profiles and course of hospitalization of patients admitted before and during the COVID-19 lockdown in our Acute Psychiatric Ward.

Methods

All patients admitted from January 7th to February 25th and from March 19th to May 7th of 2020 in the Acute Psychiatric Hospitalization Unit of Hospital Clínic of Barcelona, Spain, were retrospectively included for analysis and divided into two groups according to the period when they were admitted. Statistical analyses were performed using SPSS, 23.0 version.

Results

A total of 117 inpatients were included (73 admitted before lockdown and 44 during lockdown), being 50.4% male, with a mean age of 42.4 (SD 15.73). Patients from the first group presented a significantly higher proportion of antidepressants prescription at discharge (p<0.05) and more substance use disorders (p<0.05). Regarding the lockdown group, 51% of patients manifested COVID-19-related stress. Time of hospitalization was significantly lower in the lockdown group (p<0.05), even though a significantly higher proportion of patients were discharged at home (p<0.05) compared with the first group.

Conclusions

The situation of lockdown led to a series of changes in our unit and also in the profile of patients admitted, having shorter admissions, lower prescription of antidepressants, and often COVID-related stress. These differences should be considered in future situations in which restrictive measures may be necessary.

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Oral Communications (ID 1110) AS07. COVID-19 and related topics

O086 - The Perception of Individuals In Society About Protection Measures From COVID-19 Infection: The Example of Turkey

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
20:24 - 20:36
Presenter

ABSTRACT

Introduction

The course of the epidemics such as COVI9 -19 and SARS has taught us that the management of the epidemic depends primarily on people's adherence to and implementation of the recommended measures.

Objectives

This study aimed to determine the knowledge and opinions of individuals about COVID-19 and transmission methods, sources of information, application status about protection measures and related factors.

Methods

1444 people participated into the digital survey between March 22-April 6, 2020 for this descriptive study. For data collection, a 12-questions questionnaire consisting of questions about the sociodemographic characteristics, information sources they used about the COVID-19, their thoughts the practices to prevent the transmission of COVID-19 was conducted. Using descriptive statistics and comparison tests, individuals' perceptions about methods of protection from Covid-19 and related variables were investigated.

Results

The participants have had sufficient knowledge about Covid-19 and measures.They were using social media platforms, official web sites and TV news to get information about the COVID-19. The rates of believing and applying measures such as staying distant from people, washing hands, staying at home, avoiding from public transportation, using alcohol disinfectants were quite high. The women, people living in large cities, healthcare workers, regular commuters to work believed in measures more, however, their level of anxiety and seeing themselves and their environment at risk were higher.

Conclusions

Despite all the positive results regarding coronavirus infection and protection measures, the fact that the epidemic is spreading rapidly indicates the need for studies to continuously evaluate what has changed in the process and as time increases.

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Oral Communications (ID 1110) AS07. COVID-19 and related topics

O087 - Neuropsychiatric Manifestations of SARS-CoV-2 Infection

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
20:36 - 20:48

ABSTRACT

Introduction

Starting in December 2019, the coronavirus SARS-CoV-2 emerged and soon acquired a pandemic dimension. The evidence that 1 in 3 patients presented neuropsychiatric symptoms highlighted SARS-CoV-2 neurotropic properties. The involvement of the Central Nervous System (CNS) seems to be associated with poor prognosis, and it can occur independently of the respiratory system.

Objectives

To assess neuropsychiatric symptoms in SARS-CoV-2 patients and possible mechanisms of CNS invasion; to reflect on what changes should be made in order to avoid short and long-term complications.

Methods

A non-systematic literature review was performed, including publications between January and August 2020.

Results

The most frequent CNS presentations included fatigue (38-75%), headache (6,5-34%), nausea or vomiting (1-13,7%). Regarding PNS involvement, three kinds of hypoesthesia (hyposmia, hypogeusia, and hypopsia) were commonly present. Additionally, cases of neurological syndromes associated with SARS-CoV2 were reported, being related to a poor prognosis in cases such as brainstem infiltration. Another major concern regarding CNS involvement is the possibility of permanent neurological disabilities. Importantly there are reports of patients who tested positive for SARS-CoV-2 in CFS, without samples from nasopharyngeal swabs.

Different hypothesis are postulated to explain possible mechanisms through which SARS-CoV-2 affects CNS, including: direct invasion through the olfactory nerve, hematogenous route through ACE-2 (angiotensin-converting enzyme) receptor expressed in blood-brain-barrier; or indirect mechanisms.

Conclusions

Here we discuss the neuropsychiatric manifestations of SARS-CoV-2 infection and the potential mechanisms by which they occur at an early stage. Awareness, prevention and early treatment of potential neuropsychiatric symptoms of COVID-19 should not be overlooked, especially because they seem to predict a worse prognosis.

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Oral Communications (ID 1110) AS07. COVID-19 and related topics

O088 - Alcohol consumption during COVID-19 pandemic: what have we learnt so far?

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
20:48 - 21:00

ABSTRACT

Introduction

The current SARS-CoV-2 pandemic has many implications, one of them being alcohol consumption. The impact of long-term distancing measures in terms of alcohol use and misuse is yet unknown. Any increase, would not only add to the usual disease burden associated with alcohol, but also add to the COVID-19 load, given that alcohol use may weaken the immune response.

Objectives

To characterize and compare the pattern of alcohol consumption throughout the pandemic in patients with the diagnosis of Alcohol Use Disorder; to identify factors considered as most relevant in the increase of alcohol consumption.

Methods

We conducted a observational study in an outpatient population in Centro Hospitalar Psiquiátrico de Lisboa (Portugal) with diagnosis of Alcohol Use Disorder, 6 months after the pandemic lockdown. We characterized our sample regarding social, demographic and clinical categories. We applied auto-filled questionnaires, particularly: Mental Health Inventory (MHI), Positive Mental Health Scale (PMHS) and Severity of Alcohol Dependence Questionnaire (SADQ-C).

Results

A total of 65 patients were included. More than 30% changed their drinking habits because of the pandemic. Nearly half of these increased consumption, and half decreased (16% vs 14%). The increase affected particularly men, and was related with the severity of alcohol dependence, stress-related coping strategies and psycopathology; on the other hand, a lowered level of consumption based on the decrease of alcohol accessability and affordability.

Conclusions

The current situation is unique in terms of mass physical distancing and may trigger different behaviours that should be monitored. Governments should give public health warning about excessive alcohol consumption to protect vulnerable individuals.

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Oral Communications (ID 1110) AS07. COVID-19 and related topics

O090 - The coronavirus pandemic impact on involuntary hospitalization

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
21:00 - 21:12

ABSTRACT

Introduction

Compulsory admission is the last line of intervention in individuals who suffer from severe mental disorders, based on the principles of therapeutic need and social protection. In Portugal, the law configures this measure as a hospitalization by court order.

The SARS-CoV-2 coronavirus is a global public health emergency, with multifaceted consequences for people’s lives and health. Several studies are showing a great impact of the pandemic on the overall mental health.

Objectives

The aim is to assess the impact of the pandemic on the number of involuntary hospitalizations, their socio-demographic and clinical characteristics, and study the differences between 2019 and 2020.

Methods

Consultation of all patient’s clinical files that were involuntarily admitted in Hospital Magalhães Lemos during 2019 and 2020. Statistical analysis of data.

Results

The authors claim to investigate the impact of the pandemic on involuntary hospitalizations, the factors of admission and decompensation and other clinical characteristics, by comparing the involuntary hospitalizations during 2019 and 2020. The authors believe that the number of compulsory admissions increased significantly with the pandemic. They also believe that factors such as increased or relapsed consumption of alcohol and drugs, suicide attempts, missed appointments and long-term injectable medication are at the root of this increase in 2020.

Conclusions

This study helps to analyze the impact of the new coronavirus on compulsory hospitalizations and allows to understand the main factors that aggravate the underlying pathologies. Thus, understanding the targets of greater attention from psychiatrists to avoid the decompensation of patients in times of pandemic in which we currently live.

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Oral Communications (ID 1110) AS07. COVID-19 and related topics

O092 - Impact of COVID-19 on Autism Spectrum Disorder management - a therapist perspective.

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
21:12 - 21:24
Presenter

ABSTRACT

Introduction

Therapist led interventions form a core element in the management of children with Autism Spectrum Disorder (ASD) in India. COVID-19 pandemic has disrupted several aspects of ASD management.

Objectives

This study aims to understand the impact of COVID-19 pandemic on ASD therapies from a therapist perspective.

Methods

An online survey was conducted using a google form questionnaire disseminated among ASD therapists. The form was open for response between 23rd of June and 23rd of July 2020. The responses were extracted into an excel sheet and analysed using descriptive statistics.

Results

41 out of 75 therapists with mean age of 44 years (21 – 58 years) responded to the survey. 48% were women. Majority of them were either special educators (49%) or ASD therapists (32%) with professional experience of >5 years (63%). Majority of the therapists felt that there is significant disruption during the pandemic with reduction in conventional therapies (63% to 17%) and increase in online therapies (15% to 61%). They also felt that this disruption had moderate to severe impact on child’s learning (73%) and parents emotional and psychological well being (85%). Only 22% of therapists were using digital based therapy (DBT) before the pandemic. Although 51% of the therapists were not entirely sure whether DBT augments parents and therapists’ efforts, majority (65%) were willing to use them.

Conclusions

COVID-19 pandemic has significantly disrupted ASD therapy in India. Willingness to use online and digital based therapies could open up a new dimension. Reliable and effective Artificial-Intelligence based therapies are the need of the day.

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Oral Communications (ID 1110) AS07. COVID-19 and related topics

O093 - Occupational burnout syndrome among Italian healthcare workers during the COVID-19 pandemic: a real-world study

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
21:24 - 21:36

ABSTRACT

Introduction

The coronavirus disease 2019 (COVID-19) experience in 2019/2020 carrieda devastating impact on hospital systems and personnel. Therising number of cases, unpreparedness, lack of vital resources, excessiveworkload, and the incapacityto contain the spread has producedincreased psychological and physical pressure among thehealthcare workers. During thepandemic,the extreme pressures experienced by healthcare workers increasedthe risk ofburnout, which has negative consequences for individual health, but also for patient care andthe healthcare system.

Objectives

Our study has been developed with the aims to evaluate the impact of COVID-19 pandemic on occupational burnout of Italian healthcare workers and to identify the presence of protective and the risk factors.

Methods

An online survey addressed the Italian healthcare workers using email invitation, dissemination of the link through social media channels and involvement of professional associations.

The snowball sampling procedure gave us the opportunity to recruit a large sample of the Italian healthcare workers with different role, specialties and settings.

Results

During the study period, 5643 responses were recorded. The final sample included 5385 participants.

This included 63.2% of medical practitioners, 35.3% of nurses and social workers and 1.5% non-clinical or other. The majority of participants were female (60.7%), 39.4% had at least 20 years of clinical experience and 3170 participants worked in inpatient unit hospital.A subset of participants screened positively for moderate- to-severe symptoms of depression, anxiety. Front-line workers reported high greater severity of psychological distress.

Conclusions

Understanding the health-related consequences of COVID-19 outbreak on Italian healthcare workers is mandatory to provide timely interventions to protect their health.

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Oral Communications (ID 1110) AS08. Cultural Psychiatry

O094 - Two-Eyed Seeing As A Philosophy To Facilitate Communication Between Indigenous Counselors And Psychiatry About Mind And Mental Health

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
21:36 - 21:48
Presenter

ABSTRACT

Introduction

The term "two-eyed seeing" is spreading across North America as a concept for explanatory pluralism. The concept was brought into academic science by Albert Marshall, a M'iqmaq from Nova, Scotia, Canada. It speaks to the idea that indigenous knowledge is an equally valid way of conceptualizing a phenomenon as is contemporary science. Marshall's famous example compares a traditional M'iqmaq story about the origins of the large tides in the Bay of Fundy with contemporary oceanographic geology findings and simulations.

Objectives

We wanted to explore how this two-eyed seeing model could be applied to mental health to facilitate a dialogue between psychiatry and traditional cultural healers.

Methods

We reviewed the existing literature on two-eyed seeing within mental health care using PubMed, IndexMedicus, OneSearch, and Google Scholar. We presented a course on two-eyed seeing for indigenous mental health services and two-eyed seeing for addressing trauma in indigenous communities and surveyed the participants about the two-eyed seeing concept. We offered this course primarily to providers within indigenous communities and also for other interested counsellors.

Results

Participants in our trainings were enthusiastic about the role of two-eyed seeing for improving communication among indigenous providers and patients and non-indigenous providers. Most indigenous counselors had not heard of two-eyed seeing and were quite enthusiastic about its affirming nature and how it gave them a basis for dialogue with non-indigenous practitioners.

Conclusions

Two-eyed seeing allows a rich dialogue between European-derived practitioners and indigenous people that enabls each to appreciate the other's perspectives, leading to greater cooperation and collaborative treatment.

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Oral Communications (ID 1110) AS08. Cultural Psychiatry

O096 - Group psychological intervention for people affected by conflict in Central African Republic

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
21:48 - 22:00
Presenter

ABSTRACT

Introduction

A large part of the Central African population has been exposed to potentially traumatic events as a result of the recent conflict, which has led to the breakdown of social ties.

Objectives

Faced with this situation, the NGO Action contre la Faim proposed a psychosocial intervention aimed at helping the displaced people to reduce their psychological suffering and strengthen individual and community resilience.

Methods

After psychoeducation sessions organized in communities affected by the conflict, people identified with traumatic symptoms are invited to participate in a psychological support intervention. The protocol used is based on the Problem Management Plus (PM+), developed by the WHO. The approach was adapted in groups to reach more suffering people and also to take advantage of the group dynamic in the possibility of recovering and developing better resilience.

Results

946 IDPs in the country's capital, participated in the group intervention led by a team of paraprofessionals. Data collected from 111 participants show that after five weeks of intervention, there was a significant reduction in post-traumatic symptoms (PCL-5) and functional impairment (WHODAS). These results were confirmed during the post-intervention evaluation four weeks later. In addiction, participants declared that they had observed effects on their ability to live together in the community and to regain social cohesion.

Conclusions

This experience gives encouraging results with regard to the feasibility and replicability of the group protocol, taking into account specific cultural and contextual adaptations.

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Oral Communications (ID 1110) AS08. Cultural Psychiatry

O097 - Cultural competence in modern global world: applications for mental health

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
22:00 - 22:12

ABSTRACT

Introduction

Cultural competence and related terms began to appear in the 1960s in the context of the development of civil rights movements in many countries. The importance of research of cultural competence among mental health professionals is raised with the globalization trends of the modern world, when the growth of ethno-cultural diversity, internal and external migration, temporary movement of people lead to intensification of intercultural interaction.

Objectives

The current study aims to reveal contemporary tendencies in cultural competence understanding and development.

Methods

Theoretical analysis and systematization of research publications in order to clarify concepts, models and applications of cultural competence.

Results

The following tendencies were revealed. Cultural competence continues to attract significant attention of researchers and practitioners, especially among the mental health specialists (psychologists, psychiatrists, psychotherapists) who work with representatives of different cultures. A number of similar concepts and their components have been proposed: cultural competence, intercultural communicative competence, cross-cultural competence, cultural intelligence, cultural awareness, cultural acceptance, intercultural sensitivity, intercultural adaptation, multicultural competence, multicultural orientation. The difficulties and limitations of existing models noted: a shift of attention to a specialist, but not to a client; borrowing static and absolutistic ideas about cultures, without consideration of cultures development and interaction.

Conclusions

There is a trend in contemporary global world for broad research and development of cultural competence that improve professional qualities of healthcare professionals and provide psychological assistance to representatives of different ethnic and culture groups, confessions and minorities. The reported study was funded by the Russian Foundation for Basic Research, project number 17-29-02506.

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Oral Communications (ID 1110) AS09. Depressive disorders

O098 - Adolescent oral contraceptive use and future major depressive disorder

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
22:12 - 22:24

ABSTRACT

Introduction

Previously reported associations between oral contraceptives (OCs) use and depression have been conflicting. Insight into the impact of analytical choices on the association may help to reconcile previous heterogeneous findings.

Objectives

We aimed to examine the association between adolescent OC use and subsequent depression risk in early adulthood analyzing all theoretically justifiable models.

Methods

Women from the prospective cohort study Tracking Adolescents’ Individual Lives Survey (TRAILS) were included in this study. All justifiable associations between adolescent OC use (ages 16-19 years) and major depressive disorder (MDD) in early adulthood (ages 20-25 years) as assessed by the Diagnostic and Statistical Manual of Mental Disorders-IV oriented Lifetime Depression Assessment Self-Report and the Composite International Diagnostic Interview were tested.

Results

A total of 818 analytical models were analyzed in 534 adolescent OC users and 191 nonusers. Overall, there was a tentative association of adolescent OC use and an episode of MDD in early adulthood (median odds ratio [OR] median=1.41; ORmin=1.08; ORmax=2.18, permutation testing p-value 1 = .052, and p-value 2 = .046), which was primarily driven by the group of young women with no history of MDD (ORmedian=1.72; ORmin=1.21; ORmax=2.18, both permutation testing p-values = .02).

Conclusions

Adolescent OC use was associated with an increased risk for experiencing an episode of MDD, but only among women with no history of MDD in adolescence. Understanding the potential side effects of OCs will help women and their doctors make informed choices when deciding among possible methods of birth control.

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Oral Communications (ID 1110) AS09. Depressive disorders

O099 - Exploring Predictors of Depressive Symptoms in Patients With Multiple Sclerosis: The Effect of Neuropathic Pain, Shame, and Mindfulness

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
22:24 - 22:36
Presenter

ABSTRACT

Introduction

Multiple Sclerosis (MS) is a chronic inflammatory, immune-mediated, demyelinating disease of the central nervous system, with a progressive course. It is potentially disabling and affects mainly young adults. Depression is the mental disorder with the greatest comorbidity with MS and tends to worsen its symptomatology and course. However, knowledge about the predictors of depression in patients with MS is scarce.

Objectives

This preliminary study aimed to verify whether neuropathic pain (NP), internal (IS) and external (ES) shame and mindfulness predict depressive symptoms in patients with MS.

Methods

This cross-sectional study included a convenience sample of 95 patients diagnosed with MS and without other identified neurological diseases. Participants completed the Depression Subscale of the Depression, Anxiety and Stress Scales-21, the Analogue Pain Scale of the Pain Detect Questionnaire, the External and Internal Shame Scale, and the Mindfulness Subscale of the Self-Compassion Scale.

Results

All potential predictors exhibited significant correlations with depressive symptoms and significantly predicted this symptomatology in simple linear regression models. Thus, they were included as covariates in the multiple linear regression model. This model explained a high percentage of the variance of depressive symptoms (40.5%) and identified NP, IS and mindfulness as significant predictors.

Conclusions

Interventions aimed at preventing/reducing depression in patients with MS should minimize IS and develop mindfulness and NP coping skills, in order to promote mental health in this target population and possibly prevent the exacerbation and progression of MS symptomatology.

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Oral Communications (ID 1110) AS09. Depressive disorders

O101 - Baseline EEG-correlates of responders/non-responders to combined antidepressive treatment including transcranial magnetic stimulation

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
22:36 - 22:48

ABSTRACT

Introduction

Use of combined antidepressive treatment included high-frequency rhythmic transcranial magnetic stimulation (rTMS) of the left dorsolateral prefrontal cortex (DLPFC) is one of the ways for overcoming of pharmaco-resistance in depressive patients.

Objectives

The aim of the study was the search for possible EEG predictors of antidepressive effects of rTMS of the left DLPFC in combined treatment of depression.

Methods

30 female in-patients (F31.3, F33.0, F33.1, by ICD-10; 20-50 years, mean age 36.9±10.3) with pharmaco-resistant depression were enrolled in the study. Treatment included antidepressants (mainly SSRI) and a 3-week course of rTMS (20 Hz) of the left DLPFC. Correlations between pre-treatment EEG spectral power values, and post-treatment quantitative clinical assessments of patients were analyzed. Responders/non-responders were determined by standard criteria of 50% decrease in HDRS-17 scale total scores after treatment course.

Results

Responders (23 out of 30) revealed significant (p<0.05) negative correlations between post-treatment HDRS-17 scores and pre-treatment EEG spectral power in theta-2 (6-8 Hz) and alpha-1 (8-9 Hz) frequency sub-bands in the parietal-occipital-posterior temporal leads. Non-responders (7 out of 30) showed negative correlations between the post-treatment HDRS-17 scores and pre-treatment theta-2 EEG spectral power in the frontal-central-temporal regions of the right hemisphere.

Conclusions

Even brief course of rTMS of the left DLPFC enhances the action of antidepressants, and allows overcoming partially the pharmaco-resistance in depressive patients. Baseline values of theta-2 and alpha-1 EEG spectral power may serve as possible predictors of the effects of combined antidepressive therapy including rTMS.

The study supported by RBRF grant No.18-01-00029a.

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Oral Communications (ID 1110) AS09. Depressive disorders

O102 - Individual dynamics of daily life functioning of reward system can predict future level of depressive symptoms

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
22:48 - 23:00

ABSTRACT

Introduction

The reward system regulates the processes that motivate people to pursue evolutionary beneficial stimuli. Effective functioning of the reward system can protect against the development of anhedonia. In the daily life, the reward system can be expressed as the dynamic interplay of positive affect (liking), reward anticipation (wanting), and active behavior (engaging). Applying network analysis to daily life experience data allows us to identify such reward dynamics and use them to predict future depressive symptoms.

Objectives

We investigated whether at baseline (i) higher network positive affect in-strength, reflecting how strongly positive affect is influenced by other components and hence the level of anhedonia, and (ii) higher network connectivity, reflecting overall functioning of the reward system, are associated with fewer depressive symptoms on follow-up.

Methods

We used data from 43 participants with mild depressive symptoms from the SMARTSCAN study. The dynamic interplay between momentary positive affect, reward anticipation, and active behavior was assessed with individual vector-autoregressive models and the network analysis. Network positive affect in-strength and connectivity indices were used to predict a six-month depressive symptoms trajectory.

Results

Reward systems networks vary greatly between individuals. On the group level, higher positive affect in-strength (Beta=-3.66, p=0.05) and network connectivity (Beta=-4.06, p=0.03) at baseline were associated with fewer symptoms at follow-up.

Conclusions

Higher influences of reward anticipation and active behavior on positive affect and stronger connections between reward cycle components are associated with fewer future symptoms, suggesting the importance of daily life reward cycle dynamics in depression.

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Oral Communications (ID 1110) AS09. Depressive disorders

O104 - Potential of Antithrombin III as a Biomarker of Antidepressive Effect in Major Depressive Disorder

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
23:00 - 23:12
Presenter

ABSTRACT

Introduction

Previous study has identified increased antithrombin III (ATIII) in patients with major depressive disorder (MDD), supporting ATIII as a potential biomarker for depression diagnosis.

Objectives

This study aimed to reveal the alteration of ATIII after occipital repetitive transcranial magnetic stimulation (rTMS), and illuminate its power to evaluate and predict the curative effects in MDD treatment.

Methods

A total of 90 MDD patients were recruited and further intervened with rTMS in occipital for individualized, standard or sham treatment for five days. Those of 74 patients underwent entire detection, including clinical assessments, blood collection and protein measurement.

Results

After treatment, decreased ATIII were detected in both the individualized and the standard group (p=0.000 and 0.001, respectively) instead of the sham one. Especially, the reduction in ATIII in the individualized group was associated with improvements in several neuropsychological assessments. Besides, ATIII at baseline in the standard group and after the individualized rTMS showed high performance to evaluate or predict the response to the 5-day treatment (AUC=0.771, 95%CI, 0.571-0.971; AUC=0.875, 95%CI, 0.714-1.000, respectively) and the remission in follow-up (AUC=0.736, 95%CI, 0.529-0.943; AUC=0.828, 95%CI, 0.656-1.000, respectively). Furthermore, both baseline ATIII and change in ATIII involved in the prediction of 24-item Hamilton Depression Rating Scale in the follow-up study with significant predictive values (p=0.0240 and 0.0233, respectively).

Conclusions

This study detected a reduction in ATIII after occipital rTMS, further revealed the relationships between change in ATIII and therapeutic response, and ultimately provided evidence for the potential of ATIII as a biomarker for the evaluation and prediction of antidepressive effect.

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Oral Communications (ID 1110) AS09. Depressive disorders

O106 - Use of pharmacotherapies for Treatment Resistant Depression in Finland: a Nationwide Cohort Study

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
23:12 - 23:24

ABSTRACT

Introduction

There is a lack of knowledge on utilized pharmacotherapies for treatment resistant depression (TRD).

Objectives

To investigate the courses of treatment of TRD.

Methods

All patients aged 16-65 years and diagnosed with depression in Finland during 2004-2016 were included (identified from nationwide registers for inpatient and specialized outpatient care, sick leaves and disability pensions). New antidepressant users were identified with six-month washout period and followed up for two years to observe the possible emergence of TRD, which was defined as initiation of a third treatment after having two failed pharmacological treatments with adequate duration. Pharmacological treatments were analyzed using PRE2DUP-method.

Results

During follow-up, 177,144 persons had their first registered depression (mean age:39.5, 62.5% women). Of them, 10.9% (N=19,322) met TRD criteria. Among the TRD patients, most common first and second lines antidepressants were as follows: SSRIs (44.6%), mirtazapine (19.0%) and SNRIs (16.5%). As the third line of treatment, 44.2% of TRD patients had antidepressant monotherapy, 32.1% a combination of ≥2 antidepressants, 15.8% antipsychotic or mood stabilizer augmentation and an antidepressant, 4.9% both combination of antidepressants and an augmentation with a mood stabilizer or antipsychotic, 2.7% antipsychotic or mood stabilizer monotherapy and 0.3% ECT monotherapy. Of TRD patients, 36.2% (N=6985) progressed to the fourth line of treatment and most common treatments were antidepressant monotherapy (37.5%), antidepressant combinations (30.8%) and augmentation (20.3%).

Conclusions

Although antidepressant combination and augmentation strategies became more frequent, antidepressant monotherapies were still the most common third and fourth lines of depression treatment.

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Oral Communications (ID 1110) AS09. Depressive disorders

O108 - Identification of risk-factors for the development of depressive symptoms in perinatal period: a longitudinal study.

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
23:24 - 23:36
Presenter

ABSTRACT

Introduction

Perinatal depression is a severe and disabling condition, which affects negatively both mothers’ and children’s mental health and well-being. About 12.8% of pregnant women report depressive symptoms in the perinatal period.

Objectives

The aims of the present study are to: 1) identify factors (socio-demographic and clinical) associated with an increased risk of developing PD; 2) promote a screening program on PD.

Methods

All pregnant women were assessed at each trimester of pregnancy, three days after the childbirth and after 1, 3, 6 and 12 months, with the Edinburgh Postpartum Depression Scale (EPDS). Women scoring ≥10 on the EPDS were invited to receive a full psychiatric evaluation to confirm the diagnosis.

Results

420 women were recruited. 52.9%, 27.6% and 31.6% of participants presented an EPDS≥ 10 score at The I, II and III trimester of pregnancy, respectively. The percentage of patients with and EPS score ≥19 is 16.6%, 6.8%, 6.8%, 11.3% and 7.8% in 3 days following the childbirth and after 3, 6, 9 and 12 months, respectively. Higher EPDS scores are predicted by the presence of anxiety symptoms before pregnancy and of depressive and anxiety symptoms in previous pregnancies (p<0.05). Women with family conflicts and with anxiety symptoms in the partner are more likely to report higher EPDS scores (p<0.001).

Conclusions

Our results confirm that perinatal depression is a highly prevalent condition. An early identification of depressive symptoms during this period is crucial in order to reduce the long-term negative impact on the mothers, the newborn and other family members.

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Oral Communications (ID 1110) AS09. Depressive disorders

O109 - A specific "at risk" profile related to recent stressful life events in euthymic major depressive disorder

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
23:36 - 23:48
Presenter

ABSTRACT

Introduction

Stressful life events (SLE) may influence the illness course and outcome.

Objectives

The present study aimed to characterize socio-demographic and clinical characteristics of euthymic major depressive disorder (MDD) outpatients with SLE relative to those without.

Methods

This sample included 628 (mean age=55.1 ± 16.1) currently euthymic MDD outpatients, among them 250 (39.8%) reported SLE and 378 (60.2%) did not.

Results

After univariate analyses, outpatients with SLE were most frequently widowed and lived predominantly with friends/others. Furthermore, compared to outpatients without SLE, those with SLE were more likely to have a family history of suicidal behavior, manifested melancholic characteristics and higher Coping Orientation to the Problems Experienced (COPE) positive reinterpretation/growth and less likely to manifest a comorbid panic disorder, residual interepisodic symptoms, have used psychiatric medications, and use current antidepressant medications. After regression analyses, having a family history of suicide (OR=9.697; p=≤.05), history of psychotropic medications use (OR=2.888; p=≤.05), and reduced use of antidepressants (OR=.321; p=.001) were significantly associated with SLE. Mediation analyses demonstrated that the association between current use of antidepressants and SLE was mediated by previous psychiatric medications.

Conclusions

Having a family history of suicide, history of psychotropic medications use, and reduced use of antidepressants may confer a specific "at risk" profile related to the enhanced vulnerability to experience SLE.

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Oral Communications (ID 1110) AS10. E-mental Health

O110 - Screening for depression: the added value of actigraphy and smartphone-based intensive sampling of depressive affect and behaviors

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
23:48 - 00:00

ABSTRACT

Introduction

In many countries, depressed individuals often first visit primary care settings for consultation, but a considerable number of clinically depressed patients remains unidentified. Introducing additional screening tools may facilitate the diagnostic process.

Objectives

This study aims to examine whether Experience Sampling Method (ESM)-based measures of depressive affect and behaviors can discriminate depressed from non-depressed individuals. In addition, the added value of actigraphy-based measures was examined.

Methods

We used data from two samples to develop and validate prediction models. The development dataset included 14 days of ESM and continuous actigraphy of currently depressed (n=43) and non-depressed individuals (n=82). The validation dataset included 30 days of ESM and continuous actigraphy of currently depressed (n=27) and non-depressed individuals (n=27). Backward stepwise logistic regression analyses were applied to build the prediction models. The performance of the models was assessed with the goodness of fit indices, calibration curves, and discriminative ability (AUC, the area under the receiver operating characteristic curve).

Results

In the development dataset, the discriminative ability was good for the actigraphy model (AUC=0.790) and excellent for the ESM (AUC=0.991) and combined-domains model (AUC=0.993). In the validation dataset, the discriminative ability was reasonable for the actigraphy model (AUC=0.648) and excellent for the ESM (AUC=0.891) and combined-domains model (AUC=0.892).

Conclusions

ESM is a good diagnostic predictor and is easy to calculate, and, therefore, holds promise for implementation in clinical practice. Actigraphy shows no added value to ESM as a diagnostic predictor, but might still be useful when active monitoring with ESM is not feasible.

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Oral Communications (ID 1110) AS10. E-mental Health

O111 - Program eSILENCE 1.0 - Self-regulation program in food education via Instagram-Loricorps, study protocol

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
00:00 - 00:12
Presenter

ABSTRACT

Introduction

Social medias are seen as a risk factor for mental health because they increase body dissatisfaction and decrease self-esteem. This program is based on alimentation and physical well-being by relying on integrated intuitive eating and physical self-esteem. This program, implemented in a community setting use social media (i.e. Instagram-Loricorps), is composed of 12 monthly 180-second video capsule that address themes related to the promotion of body sensations and intuitive movement.

Objectives

The main objective of this study is to evaluate the effects of the program into the physical environment targeting the physical self-perceptions (PSP). Specifically, this study evaluates whether the eSILENCE 1.0 Program improves the level of PSP related to nutrition and explores the changes in the level and variability of the PSP.

Methods

This project is a mixed sequential explanatory study. 300 participants (Experimental Group [EG; N=200], Control Group [CG; N=100]) are targeted. Online nomothetic questionnaires evaluate occupational changes and PSP in relation to alimentation and are completed by the EG and the CG at pre-test, mid-test and post-test. Online idiographic questionnaires assess PSP and are completed by the EG before and after each video capsule and by the CG once a month without viewing the capsules. Following a preliminary analysis, a focus group will be formed to explain and deepen these results. Participants (N=5) will be recruited voluntarily into the EG.

Results

Results to come.

Conclusions

Analysis of quantitative data will be used to assess the effectiveness of the program and analysis of qualitative data will provide an in-depth understanding of the linkages between the variables.

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Oral Communications (ID 1110) AS10. E-mental Health

O112 - The benefits of involving general practitioners in the promotion of e-health tools for primary prevention of suicide in the general population: The StopBlues case

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
00:12 - 00:24

ABSTRACT

Introduction

In France about 10,000 suicides/year are recorded. General practitioners (GPs) have an important role in prevention, with consultation rates between 20% and 76% the day preceding suicide. StopBlues is an application/website for primary prevention of suicide in the general population. Its promotion was supported by municipalities and involved GPs.

Objectives

To evaluate how the involvement of GPs in the promotion of StopBlues had an impact on its utilization.

Methods

StopBlues was promoted in 25 French municipalities randomly assigned to a ‘basic’ promotion group organized by municipalities only or an ‘intensified’ promotion group that also includes promotion in GPs’ waiting rooms. StopBlues users were asked how they found out about StopBlues. After two years, an ad hoc questionnaire was sent to all GPs (N=2,111).

Results

StopBlues users from those municipalities (N=885) were 16% to learn about StopBlues from GPs, 93% of them living in municipalities with ‘intensified’ promotion.

In the ‘basic’ group, where no GPs have heard about StopBlues, 15% would like to know more about it/will have a look at it and 8% will use it and recommend it to colleagues.

Half of GPs from the ‘intensified’ group had heard about the program, with 24% who recommended StopBlues to some patients. 21% of GPs agreed that they will use it and recommend it to colleagues.

Conclusions

Involving GPs in the use of e-health tools is of major interest to improve their utilization. Our results show that GPs are in need of those in dealing with patients with psychological pain/distress.

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Oral Communications (ID 1110) AS10. E-mental Health

O115 - VR exposure in CBT is effective and efficacious treatment for simple phobia (flight phobia)

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
00:24 - 00:36

ABSTRACT

Introduction

The virtual environment with realistically rendered fear-inducing stimuli is enough to conduct VR exposure therapy (VRE), although the total control over the virtual environment also enables presentation of stimuli, contexts, and tasks not possible in in vivo exposure therapy (i.e. flight etc.)30 randomized controlled trials revealing high efficacy and effect sizes comparable of VRE-CBT to in vivo exposure therapy. Aerophobia is a very frequent limitation and affect 25% of the population and 30% of the subjects who fly make habitual use of anxiolytics .

Objectives

The aims of this study is to show that conducting VR exposure in CBT for simple phobia (flight phobia) is effective and is an efficacious treatment for fear and anxiety,Vs other treatments.

Methods

Participants (n = 39; age between 19 and 60 years) in the active arms received individual CBT VR exposure for six sessions and outcome was assessed with questionnaires: MSPS;Rathus Assertiveness Scale (RAS); HAM-A; QMAV; QSAV – (Flying fear); QoL INDEX and a behaviour avoidance test (really take the plane ). Wilcoxon tests was using for the statistical analysis.

Results

36 subjects managed to take the plane at the end of treatment and the results obtained showed a significant difference between "before treatment (T0) and after (T1)" with the exception of the Rathus test. All the SF-36 scales show a significant difference between "before-after". 3 subjects was dropped out

Conclusions

Using VR can be advantageous over standard CBT as a potential solution for treatment avoidance and as an efficient, cost-effective and practical medium of exposure.

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Oral Communications (ID 1110) AS10. E-mental Health

O116 - Lessons learned from an e-mental health intervention: the promotion of StopBlues in 41 French cities

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
00:36 - 00:48

ABSTRACT

Introduction

For more than a decade, digital health has held promise for enabling a much broader population to have access to health information, education and services. However, the increasing number of studies on the subject show mixed results and currently, there is a certain disillusionment regarding its benefits. And yet, the Covid-19 crisis has revealed the importance of developing digital-based complementary support to existing resources.

Objectives

Factors associated with higher utilization rates among the target audience need to be investigated.

Methods

In 2018, 41 French cities enrolled in an intervention program aimed at promoting StopBlues®, a digital health tool that helps prevent mental distress and suicide among the general population. After two years of experimentation, a Multiple Correspondence Analysis (MCA) was performed using quantitative and qualitative data collection methods from institutional sources, questionnaires and web analytics tools.

Results

Finding trends show that higher utilization rates were associated with the involvement of general practitioners (GPs) in the promotion of StopBlues and the use of digital marketing channels. Context-specific characteristics also played an important role in the adoption of the tool.

Conclusions

The local context has a strong influence on how digital tools are locally promoted and accepted. Further research is needed to understand how local actors and specifically GPs can be involved in suicide prevention.

More broadly, the challenge today is to ensure acceptance of digital health technology among targeted populations by adapting the digital offer to their needs and promoting the available tools.

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Oral Communications (ID 1110) AS10. E-mental Health

O118 - Eye Movement Desensitization and Reprocessing: exploratory validation study of the potential of a biofeedback digitized approach for burnout therapy optimization

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
00:48 - 01:00

ABSTRACT

Introduction

The Eye Movement Desensitization and Reprocessing (EMDR) therapy has shown to be useful in the treatment of PTSD, general anxiety, stress and burnout. Nonetheless, assessing therapy progress has been limited to subjective appreciations of the patient and therapist, which compromise therapy efficacy, and the continuum of care (clinic and at home) and scalability that digitized approaches can offer.

Objectives

The aim of the present study was to validate the potential of a smartphone-based biofeedback digitized approach for EMDR usage in burnout therapy, as a means to provide quantitative progress assessment and personalized therapy optimization.

Methods

A digitized burnout status assessment app based on Maslach Burnout Inventory was first implemented and tested. Then, an EMDR app was developed by making use of adjustable audiovisual stimuli (e.g. different velocity and horizontal/vertical visual stimuli; and different pitch and left-right surround sound effects) and also of the smartphone’s camera photoplethysmography finger recordings from which heart rate, heart rate variability and breathing rate are derived and used for modulating stimuli (biofeedback). Finally, interviews with several EMDR experts were conducted to assess the potential of the app as a therapeutic adjuvant.

Results

The preliminary interview results showed that the app can be useful for online therapy, to optimize the stimuli presentation, and to quantify the therapy experience and outcomes. The interviews also validated the technical specifications and usability of the tool.

Conclusions

Results so far have shown a promising receptivity and interest from EMDR experts. As such, patient testing is currently on-going.

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Oral Communications (ID 1110) AS10. E-mental Health

O119 - “Telepsychiatry: Lessons from the COVID-19 Pandemic”

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
01:00 - 01:12
Presenter

ABSTRACT

Introduction

Under the umbrella of e-Mental Health (eMH), Telepsychiatry (TP) keeps its place as the oldest and best-documented application. Legislative issues, and the concerns related to the quality of care and patient safety, have kept TP from broader adoption. COVID19 pandemic seems to be a turning point for TP as well as for the eMH in general. The use of TP has exploded as many regulatory barriers to its use have been temporarily lowered during the COVID-19 pandemic.

What has to be done to sustain this momentum?

Objectives

-outline temporary changes in TP regulations made due to COVID19;

-discuss which of these should be maintained, modified, or reversed;

-suggest additional initiatives needed to facilitate patient and professional use of digital technology.

Methods

Examination of the use of digital technology in the light of regulatory, legislative, and other changes and initiatives made due to COVID 19.

Results

Among several policy changes, the most important is e.g. removal of the “originating site” rule so professionals can be paid for a remote appointment wherever the patient is, including in the patient’s home.

Further, professionals were allowed to serve patients through everyday communication technologies such as FaceTime, WhatsApp, Viber, or Skype, all compromising patient/data safety.

Conclusions

EPA is perfectly positioned to be the frontrunner for the required initiatives i.e. mandatory lectures related to eMH at medical educational institutions, launching of TP-competency training of mental health professionals, regulatory and statutory changes e.g. unified licensure regulations, etc that are crucial for modernizing mental health care delivery and preparation for future unprecedented events.

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Oral Communications (ID 1110) AS11. Eating Disorders

O120 - Eating disturbances in subjects with autism spectrum disorder without intellectual disabilities

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
01:12 - 01:24
Presenter

ABSTRACT

Introduction

There is a growing interest in the relationship between Autism Spectrum Disorders (ASD) and Eating Disorders (ED), two relatively common conditions lying on a spectrum from mild to severe clinical features. However, only limited data are available about pathological eating behaviours throughout adults on the autistic spectrum.

Objectives

The aim of the present study is to assess dysfunctional eating behaviours, including ED manifestations and ASD-related eating disturbances, in a population of adults with ASD with no intellectual disabilities.

Methods

We recruited 115 adults on the autistic spectrum, with no intellectual disability and 114 neurotypical adults (NA). Participants completed the “Eating Attitude Test” (EAT-26), to measure symptoms and concerns characteristic of ED, and the “Swedish Eating Assessment for Autism Spectrum Disorders” (SWEAA), to assess eating behaviours frequently seen within the autistic spectrum.

Results

Subjects with ASD scored significantly higher than NA at the EAT-26 and at the SWEAA. Women reported higher scores than men. Moreover, an interaction effect Group*Gender emerged at the EAT-26 only, with women with ASD scoring higher than men with and than NA overall. ASD
subjects scored higher than NA at the EAT-26 subscales Dieting and Bulimia. Furthermore, the higher the SWEAA total score was, the more likely it was that a subject on the autistic spectrum would score above the cut-off of 20 at the EAT-26.

Conclusions

These results indicate that adults with ASD without intellectual disability presented not only a higher prevalence of eating disturbances typical of autistic spectrum, but also other ED symptoms in comparison to NA.

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Oral Communications (ID 1110) AS11. Eating Disorders

O121 - Dysregulated sexuality and childhood trauma in Eating Disorders: psychopathological, biological, and behavioural correlates

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
01:24 - 01:36
Presenter

ABSTRACT

Introduction

Sexual dysfunction is common in eating disorders (EDs), but its relevance is often overlooked.

Objectives

To describe different ED clinical subgroups in terms of psychopathology, putative biological correlates, and consequences of dysregulated sexuality, focusing on the role of childhood trauma.

Methods

Healthy controls (n=60), binge-purging (n=38), and restricting patients (n=24) were compared (age- and BMI-adjusted ANOVA; Bonferroni post-hoc tests), using total scores of Eating Disorder Examination Questionnaire (EDE-Q), Emotional Eating Scale (EES), SCL-90-R Global Severity Index (GSI), Barratt Impulsiveness Scale (BIS-11), Difficulties in Emotion Regulation Scale (DERS), Childhood Trauma Questionnaire (CTQ), Female Sexual Functioning Index (FSFI), Hypersexual Behaviour Inventory (HBI), and patients’ hormonal profiles (gonadal and pituitary hormones, ghrelin). Self-reported voluntary termination of pregnancy (VTP) and promiscuous sexual activity were recorded. For ED patients (N=62), regression analyses between significant variables and HBI were carried, applying moderation models for different CTQ scores.

Results

Table 1 outlines significant between-group comparisons (°: different from controls; *: different from restricting patients; p<0.05). Binge-purging patients had higher FSH, LH, and ghrelin levels, more VTPs and promiscuity. HBI showed significant correlations with EES, SCL-90-R-GSI, DERS, CTQ, and ghrelin levels. CTQ moderated interactions for DERS and EES (Figure 1).

Binge-purging

Restricting

Controls

F

EDE-Q

3.86±1.20°

3.41±1.64°

0.85±0.83

67.32

EES

40.85±22.74°*

16.01±15.88

19.87±15.21

7.01

SCL-90-R GSI

1.73±0.65°

1.27±0.69°

0.68±0.44

20.32

BIS-11

62.47±9.91°

60.81±8.56

57.04±10.04

4.99

DERS

106.97±29.15°*

83.97±33.12

78.14±14.12

10.21

CTQ

55.32±21.06°

49.31±10.81°

38.02±8.32

15.24

FSFI

17.32±11.89°*

11.70±10.98°

29.32±7.45

24.02

HBI

28.75±13.89*

20.56±3.12

26.11±4.90

4.92

figure.png

Conclusions

Dysregulated sexuality is linked to emotion dysregulation and childhood trauma. Binge-purging patients experience adverse behavioural consequences.

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Oral Communications (ID 1110) AS11. Eating Disorders

O122 - Not Everyone is the Same: Latent Profile Analysis of Food Addiction, Personality Traits and Loneliness Among Young Adults

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
01:36 - 01:48

ABSTRACT

Introduction

Introduction: Food addiction (FA) has been found to correlate with personality traits and psychosocial factors (Zhao et al., 2018). However, the vast majority of studies on this subject use the variable-oriented approach, which assumes that relationships between specific variables are identical in a given population (Collins & Lanza, 2010).

Objectives

Objectives: The main aim of this study was to assess the heterogeneity of young adults with respect to food addiction, personality traits (extraversion, conscientiousness and emotional stability) and loneliness. The secondary aim was to examine the relationships between profile membership and well-being.

Methods

Methods: The sample consisted of 1,157 young adults (58.1% women). The Yale Food Addiction Scale, the Ten-Item Personality Inventory and the Short Loneliness Scale were used in the present study. Various aspects of well-being were included (e.g. quality of life). Latent Profile Analysis was performed twice: in the full sample, and in the subsample of individuals with increased FA (defined as z-score ≥ 1; n = 213).

Results

Results: Four profiles were identified both in the full sample and in the subsample. The best functioning was observed in individuals who scored high on extraversion and low on loneliness, despite their relatively high levels of FA. Young adults who scored high on FA and loneliness, and low on extraversion, conscientiousness and emotional stability, were more likely to have the worst functioning.

Conclusions

Conclusions: Our findings suggest that using the person-oriented approach may expand our knowledge on the role of personality traits and psychosocial factors in determining the effects of FA on well-being.

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Oral Communications (ID 1110) AS11. Eating Disorders

O123 - Prevalence and treatment of patients with eating disorders: data of a German health insurance

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
01:48 - 02:00

ABSTRACT

Introduction

Few studies have examined the course of eating disorders and the respective treatments based on insurance data, even though they provide representative information.

Objectives

To assess the epidemiology, treatments, duration of illness, costs of treatment in a data set of a public health insurance.

Methods

Data provided by a German health insurance (data from 4.2 million members from 2005-2010). A matched control group based on age and gender without an eating disorder diagnosis was used for comparisons.

Results

2.734 cases with the diagnoses of an eating disorder (anorexia nervosa AN, bulimia nervosa BN or combination ANBN) were identified. More than 92% of the patients were female. The relative risk for personality disorders, depressive disorders, alcohol abuse and obsessive-compulsive disorders was highly increased. Most of the patients with BN (53.04%) or AN (41.57%) were treated in out-patient care, and many were only treated for three months, whereas most of the patients with ANBN were treated for a longer time. 3-19% with BN, AN or ANBN were treated only in in-patient care. The in-patient costs of treatment for the year of the diagnosis were 5471.15€ for BN, 9080.26€ for AN, 10809.16€ for ANBN and 339.37€ for the control group.

Conclusions

Our findings suggest that patients with ANBN diagnosis have a severe and longer course of treatment. Furthermore, contrary to national guidelines for eating disorders, there is a considerable proportion of patients with BN or AN that are treated only in in-patient care.

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Oral Communications (ID 1110) AS11. Eating Disorders

O125 - Negative affect, affect regulation, and food choice: A value-based decision-making analysis

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
02:00 - 02:12

ABSTRACT

Introduction

Research has shown that negative affect leads to unhealthy eating, the top cause of death in the United States.

Objectives

This project examined whether AR (Affect Regulation) can be applied to incidental negative affect to improve eating behavior.

Methods

We conducted four studies.

Results

In Studies 1 and 2 (n=80), we developed a autobiographical negative affect induction, showed that it induces negative affect, and demonstrated that participants can learn to downregulate this negative affect. In Study 3 (n=40), participants completed a three-phase dietary food choice task. In phase 1, participants made food choices under neutral conditions. In phase 2, participants made food choices after receiving the negative affect induction from Studies 1 and 2. In phase 3, participants made food choices while downregulating the negative affect caused by the induction. In phase 2, participants placed less importance on health (b=-0.15, z=-5.99, p<.001) when making food choices than under neutral conditions (phase 1). In phase 3, participants successfully downregulated their negative affect (b=-1.2, t=-22.01, p<.001) and placed the same level of importance on health when making food choices as in phase 1, indicating that AR applied to incidental affect is an effective method for improving eating behavior. In Study 4 (n=120), we pre-registered and replicated our findings from Study 3. In addition, we fit drift-diffusion models to participants reaction time data and show that these results extent to the by-participant weights participants place on health when making food choices.

Conclusions

These results are a step towards scalable AR interventions to improve eating behavior.

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Oral Communications (ID 1110) AS11. Eating Disorders

O126 - Alexithymia and Cortisol Awakening Response in People with Eating Disorders

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
02:12 - 02:24
Presenter

ABSTRACT

Introduction

Alexithymia, that is the inability to recognize and describe one’s own emotions, is a transdiagnostic feature across eating disorders (EDs) and it has been associated to a prolonged stress exposure.

Objectives

Therefore, we evaluated whether alexithymia affects the hypothalamus-pituitary-adrenal (HPA) axis functioning in patients with anorexia nervosa (AN) or bulimia nervosa (BN).

Methods

Twenty-six women with AN and 26 with BN participated in the study. Alexithymia was evaluated by the Toronto Alexithymia Scale–20 and eating-related psychopathology was measured by the Eating Disorder Inventory-2. The activity of the HPA axis was assessed by the salivary cortisol awakening response (CAR). Group differences in saliva CAR were tested by repeated measures 3-way ANOVA with diagnosis and alexithymia as between-subject factors.

Results

The prevalence of alexithymia did not differ significantly between the two diagnostic groups (c2=1.24, p=0.26). Alexithymia was associated with more severe eating-related psychopathology in AN women but not in BN women. A significant reduction in the magnitude of CAR occurred in alexithymic patients with BN compared to non-alexithymic patients with BN (t = 3.39, p = 0.008), but not in alexithymic women with AN (t = 0.67, p = 0.54).

Conclusions

These results confirm the presence of a more severe eating-related psychopathology in alexithymic individuals with AN and show, for the first time, an association between alexithymia and a dampened basal activity of the HPA axis in BN.

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Oral Communications (ID 1110) AS11. Eating Disorders

O128 - Cortisol, anxiety and cognitive responses to trier social stress test: the first multiple levels assessment of the RDoC “system for social process” in Eating Disorders

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
02:24 - 02:36
Presenter

ABSTRACT

Introduction

Social dysfunction is a putative risk and maintaining factor for Eating Disorders (EDs).

Objectives

We aimed to assess biological, emotional, and cognitive responses to a psychosocial stressor, in order to provide a multilevel investigation of the RDoC social process system in EDs.

Methods

Cortisol response to Trier Social Stress Test (TSST) was measured in 105 subjects: 35 women with anorexia nervosa (AN), 32 with bulimia nervosa (BN) and 38 healthy women. In a subgroup of them (23 AN, 21 BN, and 25 control women) anxiety, hunger, and desire to eat throughout the TSST were also rated.

Results

Compared to healthy women, AN and BN women showed reduced cortisol reactivity that disappeared after controlling for trait anxiety and ineffectiveness. They also displayed increased anxiety response, while only people with AN reported greater decrease in hunger and desire to eat. Baseline ineffectiveness predicted post-stress body dissatisfaction through the mediation of post-stress anxiety while no significant correlations were found between cortisol and anxiety, hunger, or desire to eat responses

Conclusions

People with EDs are characterized by blunted cortisol reactivity and greater anxiety, hunger, and desire to eat responses to a psychosocial stressor. We show a relationship between socio-emotional distress and ED-related attitudes without an association between biological and emotional or cognitive changes. This study provides the first empirical and multilevel support to a deranged functioning of the RDoC “system for social process” in EDs.

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Oral Communications (ID 1110) AS11. Eating Disorders

O129 - Covid-19 pandemic and Eating Disorders: what impact on specific and general psychopathology?

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
02:36 - 02:48
Presenter

ABSTRACT

Introduction

The coronavirus disease 2019 (COVID-19) pandemic and the resulting containment measures, such as “lockdown” and “social distancing”, have had important consequences on people’s mental and physical health.

Objectives

We aimed to study the effect of social isolation and subsequent re- exposure and eventual changes in general and ED-specific psychopathology in people with Eating Disorders (EDs).

Methods

Three-hundred twelve Italian people with EDs (179 Anorexia Nervosa, 83 Bulimia Nervosa, 48 Binge Eating Disorder and 22 Other Specific Feeding Eating Disorder) were asked to fill-in an online survey to explore several dimensions such as: anxiety, depression, panic, insomnia, suicide ideation, stress, post-traumatic stress and obsessive-compulsive symptoms.

Differences in ED specific and general symptoms among the 3 investigated time periods (before, during and after the end of lockdown) were assessed with a one-way ANOVA with repeated measures. Subsequently, ED diagnosis was introduced as covariate in the analysis in order to investigate the possible contribution on psychopathological changes.

Results

ED core symptoms increased during the lockdown but most of them returned to pre-COVID19 levels at re-opening. The severity of general psychopathology also increased during the lockdown and persisted high in the following phase, except for depression and suicide ideation. None of this symptoms was affected by ED diagnosis, participants’age and illness duration.

Conclusions

People with EDs showed worsening of both general and specific psychopathology; moreover, changes in general psychopathology persisted in the re-opening period suggesting a higher stress vulnerability in this kind of patients.

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Oral Communications (ID 1110) AS11. Eating Disorders

O130 - Peripheral Endocannabinoids in Eating Disorders and Obesity and its relationship with clinical and anthropometric variables

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
02:48 - 03:00

ABSTRACT

Introduction

Anandamide (AEA) and 2-Arachidonoylglycerol (2-AG) play a pivotal role in food intake and reward aspects of feeding. Aberrant functioning in the endocannabinoid system has been observed in patients with eating disorders (EDs). This dysfunction may influence the incentive processes stimulating behaviors towards food acquisition or the hedonic evaluation of ingested food.

Objectives

The aims of this study are to compare fasting peripheral levels of AEA and 2-AG in ED patients, obese subjects (OB) and healthy controls (HCs), and to explore their association with clinical and anthropometric variables.

Methods

The sample included a total of 63 adult women. Peripheral blood samples were collected to investigate fasting levels of AEA and 2-AG in 31 ED patients: 22 Anorexia Nervosa (AN) and 9 Binge Eating Disorder (BED), compared to 21 OB and 11 HCs. Several clinical and anthropometric variables were also assessed.

Results

Comparing groups, significant differences in AEA levels were found (p=0.001). Specifically, individuals with AN exhibited lower AEA than OB (p<0.001) and BED (p=0.007), while OB showed higher AEA than HCs (p=0.015). 2-AG was positively correlated with hostility dimension in EDs and negatively associated with impulsive traits in OB. AEA showed a direct association with body dissatisfaction in AN, contrary to OB. Finally, in AN, AEA negatively correlated with the body mass index, while 2-AG was positively associated with the fat mass.

Conclusions

These results suggest an interaction between biological and clinical factors defining a vulnerability pathway that could help fitting personalized therapeutic approaches in each condition.

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Oral Communications (ID 1110) AS11. Eating Disorders

O131 - Clinical, psychopathological, and biological predictors of resumption of menses in subjects with Anorexia Nervosa: a 4-year follow-up study

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
03:00 - 03:12
Presenter

ABSTRACT

Introduction

Amenorrhea is one of the most frequent and serious consequences of Anorexia Nervosa (AN). Resumption of menses (ROM) is considered an important goal and is associated with a better outcome.

Objectives

To investigate the role of age, Body Mass Index (BMI), diagnostic subtype (restrictive vs binge-purging), history of childhood abuse, duration of illness, psychopathology and sex hormones on ROM in AN.

Methods

52 patients with AN and amenorrhea were enrolled at the start of treatment. Clinical parameters of interest were collected, and questionnaires were administered for the assessment of general (SCL-90-R) and specific (EDE-Q) psychopathology. Blood samples were taken to assess FSH, LH and estradiol levels. All patients were monitored regularly through psychiatric checkups until ROM, for up to four years.

Results

A total of 30 (57.7%) subjects recovered their menstrual cycle in the follow-up period (mean time: 18.7 ± 14.8 months). Recovery was more frequent in the binge-purging subtype than in the restrictive subtype (82.4% vs 48.6%, p=0.019), and was significantly associated with diagnostic crossover (odds ratio=10.0, p=0.032).

Multivariate Cox regression showed an increased likelihood of menstrual recovery for binge-purging subtype (p=0.005) and for those reporting a history of childhood abuse (p=0.025). Early ROM was also associated with baseline SCL-90-R scores (p=0.002) and FSH (p=0.011), while a longer duration of illness (p=0.003) and EDE-Q scores (p=0.009) predicted a later recovery.

figurarom.png

Conclusions

This study highlights the role of duration of illness, childhood abuse history and psychopathological characteristics in subjects with AN at the start of treatment in predicting ROM.

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Oral Communications (ID 1110) AS11. Eating Disorders

O132 - Home Treatment For Adolescents With Eating Disorders As An Add-On To Family Based Therapy

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
03:12 - 03:24

ABSTRACT

Introduction

Family-based therapy (FBT) has been proven effective in treating eating disorders among children and adolescents. However, many families have difficulties implementing the measures recommended in outpatient therapy.

Objectives

This study examines the effectiveness of add-on home treatment (HT) to family based therapy (FBT) in adolescents with anorexia nervosa (AN). The HT intervention is delivered by specialized nurses and aims at supporting patients and parents to re-establish family meals in the home environment.

Methods

We performed an case-control study in AN patients comparing 44 (42 female, 2 male) adolescents receiving FBT augmented with HT compared to 22 (22 female, 1 male) participants receiving FBT alone. Eating disorder diagnosis, psychopathology and severity of clinical symptoms were assessed using (EDE, EDI-2) and clinical parameters (BMI, menstrual status, level of over-exercising) at baseline and after 3-months.

Results

After 3 months both treatment groups showed a significant early weight gain, a reduction in the rate of AN diagnoses assessed with the EDE interview and a reduction in EDI-2 total scores. The combined HT/FBT group showed a significantly greater increase in BMI than the FBT-only group. In the combined HT/FBT group none of the patients had to be admitted to hospital while 13.6% of the FBT-only group had to be referred to inpatient treatment. Treatment satisfaction in the combined HT/FBT group was high in both patients and parents.

Conclusions

Our results suggest that HT augmented FBT is superior compared to FBT alone in terms of early weight gain and might reduce the risk of hospital admission in adolescent AN.

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Oral Communications (ID 1110) AS11. Eating Disorders

O133 - The relationship between Perfectionism, Generalized Problematic Internet Use and Bulimic Behaviours

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
03:24 - 03:36

ABSTRACT

Introduction

Perfectionism is a consistent risk factor for various psychopathological conditions, including psychological distress and eating disorders. Recently, we have shown, for the first time, that there is a relationship between perfectionism and generalized problematic internet use/GPIU (Sobral et al. 2020). Specifically, we found that the role of perfectionism in psychological disorder is partially mediated by GPIU.

On the other hand, it has been suggested that the widespread use of digital media can lead to negative body image perception and abnormal eating attitudes and behaviors.

Objectives

To explore, for the first time, the relationship between perfectionism, GPIU and disordered eating behavior.

Methods

475 university students (78.9% girls; mean age 20.22±1.695) answered the Portuguese validated versions of: Composite Multidimensional Perfectionism Scale, GPIU Scale and Eating Attitudes Test-25. SPSS and Hayes’ Process Macro (2020) were used.

Results

Bulimic Behaviours/BB significantly and moderately correlated with Perfectionist efforts (r=.263), Perfectionist concerns (r=.284) and GPIU (r=.25) (all p<.001). The mediation analyses revealed that GPIU is a partial mediator of the relationship between both perfectionism dimensions and BB.

Conclusions

The evidence that both negative and “positive” perfectionism dimensions are associated to eating pathology is in line with our previous research. The present study adds, for the first time, that one of the perfectionism pathways of influence on BB operates through UGPI. Assessment and intervention to diminish eating psychopathology should focus on perfectionism and compulsive traits which could be involved in both ED and GPIU and in their comorbidity.

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Oral Communications (ID 1110) AS12. Emergency Psychiatry

O134 - ECG changes associated with lithium intoxication – a study based on the LISIE project

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
03:36 - 03:48

ABSTRACT

Introduction

It currently remains unclear in how far supratherapeutic lithium serum concentrations can affect the cardiac conduction system. Prolonged QT interval, arrhythmias and cardiac death have all been anecdotally reported, but the systematic studies are few.

Objectives

To examine ECG changes occurring with supratherapeutic lithium concentrations that have given rise to lithium toxicity.

Methods

We examined all episodes of lithium intoxication defined as serum lithium level (≥ 1.5 mmol/L). We analyzed ECG before, during and after intoxication and recorded ECG changes. These, we then assessed according to type of intoxications, clinical and other pharmacological characteristics. The study is based on 20-year data (1997-2020) from the retrospective cohort study (LiSIE) in the Swedish region of Norrbotten.

Results

Of 1101 patients treated with lithium, 77 patients had experienced lithium intoxications. 12 patients had more than one episode of intoxication, yielding 91 episodes. 39 had ECG available both as reference and during lithium intoxication. We found no statistically significant prolongation of the QTc interval during lithium intoxication, compared to respective reference ECG (p = 0.364). Heart rate during lithium intoxication was significantly lower, mean 73 beats/min (SD 16,8, range 43 - 112), compared to the reference ECG, mean 79 beats/min (SD 15,3, range 48-112; p = 0.006). No patient died. All findings were independent of whether an intoxication was acute or chronic.

Conclusions

In our study, heart rate was significantly lower during episodes of intoxication. However, this decrease was of no clinical relevance in most cases. Lithium intoxication was not associated with prolonged QT time.

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Oral Communications (ID 1110) AS12. Emergency Psychiatry

O135 - Intensive home treatment in comparison with care as usual: Cost-utility analysis from a pre-randomized controlled trial in the Netherlands.

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
03:48 - 04:00

ABSTRACT

Introduction

The implementation of Intensive Home Treatment (IHT) aims to decrease the pressure on acute inpatient services that could lead to prevent hospitalization and reduce the number of hospitalization days and, ultimately, reduce cost in the mental health services. Although there are studies assessing the effectiveness of IHT, there is a shortage of research studying the cost-effectiveness.

Objectives

The aim of this study is to present an cost-utility analysis of IHT compared to care as usual (CAU)

Methods

Patients between 18 and 65 years of age whose mental health professionals considered hospitalization were included. These patients were pre-randomized in either IHT or CAU and followed up for 12-months. For this study, the base case analysis was performed from the societal and healthcare perspective. For the cost-utility analyses the Euroqol 5D was used to calculate quality adjusted life years (QALYs) as a generic measure of health gains.

Results

Data of 198 patients were used. From a sociatal perspective, the cost-utility analysis resulted in an incremental cost-effectiveness ratios (ICERs) of €58 730, and a 37% likelihood that IHT leads to higher QALYs at lower costs. The probability of IHT being cost-effective was >50% if there was no willingness to pay more for extra QALY than in the current situation under CAU.

Conclusions

Professionals working in crisis care are able to offer IHT with the same effect as other crisis care interventions at lower costs. IHT seem to be cost-effective compared with CAU over 52 weeks follow-up for patients who experience psychiatric crises.

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Oral Communications (ID 1110) AS12. Emergency Psychiatry

O137 - Longitudinal course of affective disorders in patients presenting with catatonia in a psychiatric emergency setting

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
04:00 - 04:12
Presenter

ABSTRACT

Introduction

Catatonia, a complex psychomotor syndrome and psychiatric emergency, is encountered across various psychiatric disorders. Most findings have been derived in the context of schizohrenia, warranting more comprehensive understanding in affective disorders.

Objectives

To evaluate the longitudinal course of affective disorders presenting with catatonia and factors influencing the same.

Methods

Medical records of 439 patients presenting with catatonia to the psychiatry emergency from 2014 to 2017 were reviewed till June 2020. 135 patients with a final diagnosis of affective disorder (67 bipolar and 68 unipolar) were identified. Poisson regression and survival analysis were used for longitudinal data.

Results

77.6% of bipolar patients were initially diagnosed under psychotic spectrum disorders compared to 3% in unipolar. Bipolar patients had a significantly younger age of first catatonic episode, earlier illness onset, and longer duration of illness. Survival analysis showed no significant difference between groups in time to recurrence of mood episode, readmission or catatonia relapse, with both groups demonstrating a greater likelihood of catatonia relapse in first 20 months. Poisson regression showed that bipolar patients had fewer catatonic relapses longitudinally over 2.5-6.5 years (RR: 0.64, CI: 0.43-0.96), but warranted more electroconvulsive therapy sessions for catatonic relapses (RR: 2.33, CI: 1.49-3.50), with fewer episodes resolving with lorazepam (RR: 0.62, CI: 0.40-0.95) compared to unipolar patients over same time period.

Conclusions

Bipolar disorders appear to have an earlier onset but fewer episodes of catatonia over illness course. Poorer lorazepam response and higher number of ECT sessions for catatonia resolution longitudinally suggest a differential treatment response of catatonia in bipolar disorder.

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Oral Communications (ID 1110) AS13. Epidemiology and Social Psychiatry

O141 - Which psychotherapy is effective in panic disorder? Findings and reflections from a systematic network meta-analysis.

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
04:12 - 04:24
Presenter

ABSTRACT

Introduction

Panic disorder is among the most prevalent anxiety diseases. Although psychotherapy is recommended as first-line treatment for panic disorder, little is known about the relative efficacy of different types of psychotherapies.

Objectives

To evaluate the effectiveness and acceptability of different types of psychotherapies for adults suffering from panic disorder, with or without agoraphobia.

Methods

We are conducting a systematic network meta-analysis of randomized controlled trials examining panic disorder. A comprehensive search was performed to identify relevant studies. The primary efficacy outcome is anxiety symptoms at study endpoint. The primary acceptability outcome is all-cause trial discontinuation at endpoint. Pairwise and network meta-analysis will be conducted. We are considering any kind of psychotherapy delivered by any therapist, as long as they were trained to deliver the therapy, or as self-help.

Results

To date we have identified 126 panic disorder and agoraphobia trials. The publication time span ranges from 1968 to 2020. We are now extracting data to provide an overview of the included study characteristics. The statistical analysis will be conducted between December 2020 and January 2021, and its results presented for the first time at the forthcoming 2021 EPA congress.

Conclusions

126 trials on psychotherapy for panic disorders in adults are available. Because of this huge body of knowledge, it is important that the results of these studies are summarized using network meta-analytic techniques. The findings of this study will guide future research as knowledge gaps will be easily identified. Moreover, policymakers will have the opportunity to use this summarized knowledge to inform evidence-based decision making.

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Oral Communications (ID 1110) AS13. Epidemiology and Social Psychiatry

O142 - Constructing socioeconomic index (SEI) in predicting mental health in young adults

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
04:24 - 04:36

ABSTRACT

Introduction

Socioeconomic status (SES) are well known to be associated with mental health. Previous studies are often restricted by the use of individual SES indicators, while contextual measures aggregating multiple dimensions would present a better picture of SES in multivariate context.

Objectives

The present study aims to construct the socioeconomic index (SEI) by integrating significant socioeconomic factors in predicting mental health of young adults in Hong Kong.

Methods

Data were drawn from the Hong Kong Youth Epidemiological Study of Mental Health (HKYES), a population-based psychiatric study of young people in Hong Kong. The present study exacted data of 1,164 participants who had completed baseline interviews between April 2019 to August 2020. Socioeconomic characteristics including age, gender, education years, income, expenditure, home ownership, housing type, household crowdedness and parental occupation were collected. Data were checked for the assumptions for normality, linearity and homoscedasticity before the standardized SEI were derived using Principal Component Analysis (PCA). Logistic regression analyses were performed to further examine the association between SEI and mental health outcomes.

Results

Our results identified five significant socioeconomic factors (education years, personal income, home ownership, housing type and household crowdedness) which together explained 67.7% of the total variation. SEI was associated with depression (OR=0.671, p=.003) and anxiety (OR=0.667, p=.015) after adjusting for potential confounders.

Conclusions

The PCA-generated SEI took account of the multiple dimensions of SES in younger adults including education, income, expenditure and housing. The indices would provide meaningful contextual information of SES across geographical areas or different groups of interest.

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Oral Communications (ID 1110) AS13. Epidemiology and Social Psychiatry

O143 - Prejudice against and desired social distance from refugees, people with mental illness and patients with COVID-19 in Athens.

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
04:36 - 04:48
Presenter

ABSTRACT

Introduction

Stigma is omnipresent in human societies, both globally and historically; while it is also discerned in other primates. On these grounds, it has been suggested to be the product of natural selection and therefore to protect against threats to effective group functioning. Nonetheless, in contemporary society, stigma raises fundamental ethical concerns, while it actually impinges on public health

Objectives

To explore prejudicial attitudes and desired social distance from recovered COVID-19 patients, people with mental illness and refugees in Athens region.

Methods

A convenience sample of 360 residents of Athens region participated in the study, after being recruited from social media. The questionnaire was distributed online and encompassed: i) the Prejudicial Attitudes Survey, (ii) the Social Distance scale, (iii) the Interpersonal Reactivity Index and information about respondents’ socio-demographic characteristics and personal experience with the three population subgroups. The stigma measures were included three times, one for each out-group.

Results

Repeated ANOVA revealed that negative attitudes were predominantly expressed for refugees. On the contrary, positive attitudes were predominantly expressed for people with mental illness. Interestingly, desired social distance was greater from people with mental illness (mean = 32.37) compared to refugees (mean = 25.47) and recovered COVID-19 patients (mean = 24.17).

Conclusions

Stigma towards people with mental illness and refugees is still prevalent in Greece. Anti-stigma efforts should target prejudices in the case of refugees and social distance in the case of mental illness. To date, no stigma attached to COVID-19 has been discerned in the country

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Oral Communications (ID 1110) AS13. Epidemiology and Social Psychiatry

O145 - Death associated with coronavirus (COVID-19) infection in individuals with severe mental disorders in Sweden during the early months of the outbreak

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
04:48 - 05:00
Presenter

ABSTRACT

Introduction

Individuals with severe mental disorder (SMD) have a higher risk of somatic comorbidity and mortality than the rest of the population.

Objectives

To assess whether individuals with SMD had a higher risk of death associated with a COVID-19 infection (COVID-19 associated death) than individuals without SMD.

Methods

Exploratory analysis with a cross-sectional design in the framework of a population-based register study covering the entire Swedish population. The Swedish Board for Health and Welfare (Socialstyrelsen) provided anonymised tabulated summary data for further analysis. We compared numbers of COVID-19 associated death in individuals with SMD (cases) and without SMD (controls). We calculated the odds ratio (OR) for the whole sample and by age group and four potential risk factors, namely diabetes, cardiovascular disease, hypertension, chronic lung disease.

Results

The sample comprised of 7,923,859 individuals, 103,999 with SMD and 7,819,860 controls. There were 130 (0.1%) COVID-19 associated deaths in the SMD group and 4945 (0.06%) in the control group, corresponding to an OR of 1.98 (CI 1.66-2.35; p < 0.001). The odds were fourfold in the age group between 60 and 79 years. Cardiovascular diseases increased the odds by 50%. Individuals with SMD without any of the risk factors under study had three-folds odds of COVID-19 associated death.

Conclusions

Our preliminary results suggest that individuals with SMD are a further group at increased risk of COVID-19 associated death. The factors contributing to this increased mortality risk require clarification.

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Oral Communications (ID 1110) AS13. Epidemiology and Social Psychiatry

O146 - European study on the attitude of psychiatrists towards their patients

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
05:00 - 05:12
Presenter

ABSTRACT

Introduction

Many people think that people with mental disorders might be dangerous or unpredictable. These patients face various sources of disadvantages and experience discrimination in job interviews, in education, and housing. Mental health-related stigma occurs not only within the public community, it is a growing issue among professionals as well. Our study is the first that investigates the stigmatising attitude of psychiatrists across Europe.

Objectives

We designed a cross-sectional, observational, multi-centre, international study of 33 European countries to investigate the attitude towards patients among medical specialists and trainees in the field of general adult and child and adolescent psychiatry.

Methods

An internet-based, anonymous survey will measure the stigmatising attitude by using the local version of the Opening Minds Stigma Scale for Health Care Providers. Data gathering started in July this year and will continue until December 2020.

Results

This study will be the first to describe the stigmatising attitude of psychiatric practitioners across Europe from their perspectives.

Conclusions

The study will contribute to knowledge of gaps in stigmatising attitude towards people with mental health problems and will provide with new directions in anti-stigma interventions.

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Oral Communications (ID 1110) AS13. Epidemiology and Social Psychiatry

O147 - 24-hour movement behaviours and the risk of common mental health symptoms: A compositional analysis in the UK Biobank

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
05:12 - 05:24

ABSTRACT

Introduction

Sedentary behaviour is potentially a modifiable risk factor for depression and anxiety disorders, but findings have been inconsistent.

Objectives

To assess associations of sedentary behavior with depression and anxiety symptoms and estimate the impact of replacing daily time spent in sedentary behaviors with sleep, light, or moderate-to-vigorous physical activity, using novel compositional data analysis methods.

Methods

Prospective cohort study in with 60,235 UK Biobank participants (mean age: 56; 56% female). Exposure was baseline daily movement behaviours (accelerometer-assessed sedentary behaviour, physical activity, and self-reported total sleep). Outcomes were depression and anxiety symptoms (Patient Health Questionnaire-9 and Generalised Anxiety Disorders-7) at follow up.

Results

Replacing 60 minutes of sedentary behaviour with light activity, moderate-to-vigorous activity, and sleep was associated with lower depression symptom scores by 1·3% (95%CI, 0·4%-2·1%), 12·5% (95%CI, 11·4%-13·5%), and 7·6% (95%CI, 6·9%-8·4%), and lower odds of depression by 0·95 (95%CI, 0·94-0·96), 0·75 (95%CI, 0·74-0·76), and 0·90 (95%CI, 0·90-0·91) at follow-up.

Replacing 60 minutes of sedentary behaviour with moderate-to-vigorous activity and sleep was associated with lower anxiety symptom scores by 6·6% (95%CI, 5·5%-7·6%) and 4·5% (95%CI, 3·7%-5·2%), and lower odds of meeting the threshold for an anxiety disorder by 0·90 (95%CI, 0·89-0·90) and 0·97 (95%CI, 0·96-0·97) at follow-up. However, replacing 60 minutes of sedentary behaviour with light activity was associated with higher anxiety symptom scores by 4·5% (95%CI, 3·7%-5·3%) and higher odds of an anxiety disorder by 1·07 (95%CI, 1·06-1·08).

Conclusions

Sedentary behaviour is a risk factor for increased depression and anxiety symptoms in adults, but different replacement activities differentially influence mental health.

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Oral Communications (ID 1110) AS13. Epidemiology and Social Psychiatry

O148 - Psychiatric morbidity among undergraduate students of University of Ilorin, Kwara State, Nigeria

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
05:24 - 05:36
Presenter

ABSTRACT

Introduction

The Nigerian tertiary education system admits mostly teenagers and young adults from different ethno-religious and family backgrounds, some of whom may have inherent risks and predisposition to mental illness. They then undergo stressful conditions related to the university life such as long durations of lectures, over-crowding, and lack of social amenities, haphazard lecture schedules as well as incessant industrial strike actions of academic and non- academic staff. In spite of these, there appears to be few studies on the burden of emotional and mental disorders among Nigerian University students, and none was cited suggesting interventions that may be appropriate.

Objectives

The objectives of the study is to determine the prevalence of psychiatric morbidity and its associated factors among undergraduate students of Univesity of Ilorin

Methods

This is a cross-sectional study using multi staged systematic randomization. A self-administered socidemographic questionnaire and the 12 item general health questionnaire (GHQ -12) was administered on 3,300 students.

Results

Psychiatric morbidity was found to be 23.6% of the 3179 analyzable returned questionnaires. Factors found to be significantly associated with psychiatric morbidity included female gender, relationship with parents, parental employment status and family structure. Students on scholarship were more likely to have mental illness. Other associated factors include whether course of study was the preferred one and relationships with peers and lecturers on campus. About 46.6% of the students were willing to have internet based mental health intervention programmes.

Conclusions

The data obtained from this study is relevant for the formation of mental health promotion and prevention programs on our campus.

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Oral Communications (ID 1110) AS13. Epidemiology and Social Psychiatry

O149 - Prolonged length of stay in acute psychiatric wards: a descriptive study

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
05:36 - 05:48
Presenter

ABSTRACT

Introduction

The psychiatric care paradigm has shifted towards community-centered models. Yet, prolonged hospitalizations are still a reality, with debated impact at healthcare systems and patients.

Objectives

This work aims to describe prolonged hospitalizations in acute psychiatric wards through patients’ sociodemographic and clinical data.

Methods

We analyzed a national hospitalization database that contained all hospitalization episodes registered in Portuguese public hospitals from 2008 to 2015. All episodes with a primary diagnosis of mental disorder defined as ICD-9-CM codes 290.x-319.x were included. Prolonged hospitalizations were defined as having a LoS ≥ P97.5; LOS ≥180 days or LOS ≥1 year. Age, sex, lengh of stay, in-hospital mortality were analysed.

Results

The LoS ≥ P97.5(≥62 days) group comprised 3911 hospitalizations (2.3% of all psychiatric hospitalizations) and 1755 patients. The median LOS was 81 days and the mean age was 51 years. Sex was equally distributed, though a higher frequency of male patients was found on the ≥180 days (n=364) and ≥ 1 year (n=121) groups. Psychotic disorders were the main diagnosis at discharge (n= 1769, 45.2%), followed by mood disorders (n=1057, 27.0%) and dementia (n=451, 11.5%). In-hospital mortality increased in the higher LoS groups (1.1%; 4.4%; 9.1%, respectively).

Conclusions

Overall, middle aged patients with psychotic disorders represent most of the prolonged hospitalizations occurring in acute psychiatric wards. Community-based programs require further development to meet the existing needs.

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Oral Communications (ID 1110) AS15. Forensic Psychiatry

O151 - Gender differences in a Forensic Psychiatric ward: a retrospective study

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
05:48 - 06:00
Presenter

ABSTRACT

Introduction

The criminality associated with psychiatric disorders has been extensively studied with some studies showing a greater risk of violence in these patients. The gender differences in the general psychiatric population and can have an impact in the characteristics of a forensic population.

Objectives

The authors aim to study the gender differences regarding diagnosis, type of crime and other characteristics in a forensic ward population.

Methods

A retrospective study was designed, including patients admitted in the Forensic ward of Coimbra Hospital and University Center between 2018 and 2020.

Results

Our study included 110 patients, 19 women and 91 men. Although psychotic disorders were the most common in both groups, particularly schizophrenia, mood disorders were significantly more common in women, with a risk of 7,768. This was explained by a greater prevalence of depressive episodes in women. These were associated with a particular type of crime, infanticide, that was not found in the men group. This might contribute to a greater prevalence of violent crimes in women.

There was a chance of committing crimes against the offspring of 24 in women. The use of psychoactive substances was significantly greater in men, with a chance of 12,906.

Conclusions

Considering that mood disorders are more common in women, these findings are easy to understand. The predominance of female perpetrators in infanticide is well described in the literature and can be associated with peripartum depression and gender roles. In this sample substance abuse was more common in man, like it’s seen in the general population.

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Oral Communications (ID 1110) AS15. Forensic Psychiatry

O152 - Comorbidity with Substance Abuse and its influence in a forensic population: a retrospective study

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
06:00 - 06:12
Presenter

ABSTRACT

Introduction

The criminality associated with psychiatric disorders has been extensively studied with some studies showing a greater risk of violence in these patients. Substance abuse has been long linked to criminal and antisocial behaviours, but what happens when is in comorbidity with other psychiatric disorders.

Objectives

The authors aim to study the impact of substance abuse comorbidity in type of crime and other characteristics in a forensic ward population.

Methods

A retrospective study was designed, including patients admitted in the Forensic ward of Coimbra Hospital and University Center between 2018 and 2020.

Results

Our study included 110 patients, 39 of which had comorbidity with substance abuse. Although the authors couldn’t find differences in the type of crime committed regarding the patient’s primary diagnosis, substance abuse was significantly associated with non-violent crimes. The prevalence of homicide was significantly inferior in psychoactive substance users and the prevalence of domestic violence was significantly greater. However, the prevalence of a criminal history was significantly higher in patients with comorbidity with substance abuse. Patients with substance abuse had significantly higher childhood adverse events reports.

Conclusions

Interestingly, criminal behaviors prior to admission were more frequent in patients with substance abuse, which is understandable. However, the type of crimes were significantly less serious in this patients, which can mean that, although these consumptions are a risk factor for criminal behavior, the association in less important in crimes like murder. The exposition to childhood adverse events is a well-known risk factor for substance abuse in adulthood.

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Oral Communications (ID 1110) AS16. Genetics & Molecular Neurobiology

O153 - The DRD2/ANKK1 Taq1A polymorphism in CYP2D6 extensive metabolizers is associated with the severity of extrapyramidal side effects of haloperidol treatment in schizophrenia spectrum disorders patients.

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
06:12 - 06:24

ABSTRACT

Introduction

Schizophrenia is one of the most severe mental disorders. Haloperidol and other first-generation antipsychotics are widely used for schizophrenia treatment, but have prominent side effects, primarily extrapyramidal symptoms (EPS). The EPS severity is highly variable and may be underlied by genetic factors.

Objectives

We performed a prospective study to test the association of DRD2/ANKK1 Taq1A polymorphism (rs18000497) and CYP2D6 phenotype, predicted from genotypes using 8 CYP2D6 alleles (*3, *4, *5, *6,*9, *10,*41, xN) with EPS severity during haloperidol treatment in schizophrenia spectrum disorders patients.

Methods

57 inpatients with schizophrenia spectrum disorders (42,1% females; mean age - 46,7±11,8 y.o (M±SD) of European ancestry were enrolled in the study. Abnormal Involuntary Movement Scale (AIMS), Barnes Akathisia Rating Scale (BARS), Simpson-Angus Scale (SAS) were used to assess EPS on two timepoints: day 1 and day 21 of haloperidol treatment.

Results

TaqIA T-allele carriers in contrast to wild-type allele homozygous patients had higher scores of BARS (p=0.029) and SAS (p=0.024) on day 21. After stratification by CYP2D6 phenotype, these differences were observed only in extensive metabolizers (p=0.006 and p=0.001 respectively), although the CYP2D6 phenotype itself was not associated with EPS severity. The combined effect of TaqIA T allele with CYP2D6 extensive phenotype on BARS score on day 21 was confirmed by General Linear Model (p=0.013).

Conclusions

Our results show that minor TaqIA T-allele is associated with the severity of EPS after 3 weeks of haloperidol treatment only in CYP2D6 extensive metabolizers. That highlights the importance of using both pharmacokinetic and pharmacodynamic genetic markers in pharmacogenetic EPS risk assessment.

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Oral Communications (ID 1110) AS16. Genetics & Molecular Neurobiology

O154 - Associations between genes methylation, postnatal risk factors and psychiatric symptoms in a clinical sample of children and adolescents: preliminar results from the ReMIND longitudinal study

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
06:24 - 06:36
Presenter

ABSTRACT

Introduction

Epigenetics hypothesizes a crucial link between postnatal risk factors, individual response to stress, DNA methylation and psychiatric symptomatology changes during life.

Objectives

We analyzed methylation within two gene exons: NR3C1 and SLC6A4, which are involved in responses to environmental stressors. We investigated the relationship between methylation, postnatal risk factors and psychopathology assessed by Child Behavior Checklist (CBCL) in our help-seeking sample evaluated in infancy (W1), preadolescence (W2) and adult life (W3).

Methods

Postnatal risk factors data were collected at W1 in 205 clinical subjects (156 M, 49 F; age=9,13±1,95). The CBCL scores were collected at W1 and W2 (W2 age=14,52±2,12). Data regarding methylation were collected at W2. At W3 we are also collecting clinical scores.
A Spearman correlation coefficient was calculated between methylation percentage and clinical data at W2. The externalizing and internalizing trajectories were evaluated through repeated measure ANOVA with postnatal risk factors (presence/absence) as between-groups factor.

Results

Significant associations were found between methylation and internalizing and total clinical scores (Table 1). The rm-ANOVA results showed a significant interaction between the CBCL internalizing score and presence/absence of postnatal risk, with higher internalizing problems in subjects that were exposed to postnatal risk factors. This effect was significant at W2 but not at W1 (Figure 1).table1.pngfigure1.png

Conclusions

Psychopathological symptoms trajectories could depend on epigenetics and early environmental risk factors. Further analyses will address a Linear Discriminant Analysis to proceed to a machine learning oriented approach.

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Oral Communications (ID 1110) AS16. Genetics & Molecular Neurobiology

O157 - Epigenetic modulation in Obsessive-Compulsive Disorder: methylation and hydroxymethylation of the BDNF gene exon I promoter

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
06:36 - 06:48
Presenter

ABSTRACT

Introduction

Several evidence recognizes Brain Derived Neurotrophic Factor (BDNF) as a promising biomarker in the pathophysiology of psychiatric disorders, including Obsessive-Compulsive Disorder (OCD), considering the involvement of epigenetic regulation in BDNF altered expression.

Objectives

This study aims to investigate, in a sample of OCD patients, the epigenetic modulation in terms of levels of methylation and hydroxymethylation on the BDNF gene exon I promoter.

Methods

Fifty OCD patients, recruited from Psychiatry Unit 2, Sacco University Hospital in Milan and fifty healthy controls, comparable by age and gender. Saliva samples were collected by oral swab and epigenetic analysis were performed at the University of Teramo. Statistical analyses were performed with t test with Bonferroni correction.

Results

Data analysis showed a significant decrease in 5-methyl cytosine levels (5mC) (mean OCD: 1.221%; mean CTRL: 1.784%; p < 0.001) and a significant increase in 5-Hydroxy-methyl cytosine levels (5hmC) (mean OCD: 1.018%; mean CTRL: 0.527% p< 0.0001) in BDNF gene exon I promoter of OCD patients compared to controls. Regarding 5mC of site 3 and 5hmC of site 1 and 2 of the exon I promoter CpG islands, no statistical significance was found.

Conclusions

Present results showed significant differences in epigenetic modulation of BDNF gene, which might not be univocally interpreted. They could represent an intrinsic OCD characteristic or the effect of antidepressant drugs, assumed by all recruited patients. Further studies, comparing OCD subjects in treatment vs drug-free, are necessary to define BDNF epigenetic modulation role and its possible use as biomarker in the characterization of OCD.

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Oral Communications (ID 1110) AS17. Guidelines/Guidance

O159 - WPA Global Guidelines for Telepsychiatry

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
06:48 - 07:00
Presenter

ABSTRACT

Introduction

The current pandemic has only confirmed the need for international collaboration and more extended use of telepsychiatry than before. Unfortunately, regulatory constraints and lack of standardization are posing significant barriers to the internationalization of telepsychiatry. A need for global guidelines and service standardizations is of utmost importance in this rapidly growing but not yet well-established field. By mastering telepsychiatry, the professionals also may enable the remote provision of other eMH approaches complementary to well-known, traditional service(s). However, first, one ought to become familiar with the basics of telepsychiatry. Globally standardized telepsychiatric service and uniform regulations are prerequisites for fruitful international cooperation.

Objectives

- to present the main objectives and messages of the WPA Global Guidelines for Telepsychiatry.

Methods

A structured review of the main challenges, innovations, and settings in the first Global Guidelines for Telepsychiatry, published by WPA.

Results

With proper preparation and thoughtful risk management, telepsychiatry can be an invaluable tool for allowing greater access to care. However, certain prerequisites must be fulfilled to achieve the desired goals. These prerequisites are e.g. choice of the technology, settings, patient/provider preferences as well as competencies and skills, all outlined in this document.

Conclusions

This WPA document may pave the way for the development of global regulations in order to break down the barriers of accessibility for both the professionals as well as for the patients worldwide. Further, it may help professionals in setting up a standardized telepsychiatry service(s) in addition to the existing mental health system(s).

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Oral Communications (ID 1110) AS18. Intellectual Disability

O160 - Social orienting is reduced in Williams syndrome

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
07:00 - 07:12
Presenter

ABSTRACT

Introduction

Williams syndrome (WS) is a rare genetic disorder caused by a deletion at chromosome 7q1123. WS is associated with high empathy, relatively good face memory and low social anxiety. Despite these strengths, WS individuals typically have an intellectual disability, difficulties with visuospatial perception, non-social anxiety and complex social cognition. Attention to other’s eyes is crucial for adaptive social understanding. Consequently, eyes trigger quick and automatic gaze shifts in typically developing individuals. It is not known whether this process is atypical in WS.

Objectives

To examine visual attention to other’s eyes in Williams syndrome.

Methods

Individuals with WS (n = 35; mean age 23.5 years) were compared to controls (n = 167) in stratified age groups (7 month, 8-12 years, 13-17 years, adults). Participants were primed to look at either the eyes or the mouth of human faces. The latency and likelihood of a first gaze shift from, or to the eyes, was measured with eye tracking.

Results

WS individuals were less likely, and slower to orient to the eyes than typically developing controls in all age groups from eight years of age (all p <.001), but did not differ from 7 months old infants. In contrast to healthy individuals from eight years and above, WS individuals did not show a preference to orient towards the eyes relative to the mouth.

Conclusions

Despite the hyper-social behavioral phenotype, WS is associated with reduced attention to other’s eyes during early stages of processing. This could contribute to the difficulties with complex social cognition observed in this group.

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Oral Communications (ID 1110) AS18. Intellectual Disability

O161 - The psychosocial factors in the formation of symptoms of dementia

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
07:12 - 07:24

ABSTRACT

Introduction

The growing prevalence of severe cognitive impairment in populations, the involvement of a significant number of people of working age in the medical, psychological and social problems associated with dementia, the insufficiency and inconsistency of information about the mechanisms of formation of these disorders actualize a comprehensive social study of dementia.

Objectives

the psychosocial mechanisms of the formation of clinical, functional disorders in dementia, to develop comprehensive medical and psychosocial programs to help patients with dementia and those involved in caring for them, based on the proposals of the psychosocial model of dementia

Methods

A selective observational comparative dynamic study of 315 people with Alzheimer's dementia and 214 people who care for the patients was carried out.

Results

Changes in family-role and social parameters, a high level of “expressed” emotions of caregivers have an adverse effect on the development of psychotic (r = 0.618), affective (r = 0.701), behavioral (r = 0.837) dementia disorders. The degree of adherence to anti-dementia therapy by the caregiver is one of the important factors determining the amount of care received by the patient (r = 0.698). Agitation / aggression (r = 0.761), anxiety (r = 0.562), sleep disturbances (r = 0.521) contribute to increased compliance. The low satisfaction of the caregiver with premorbid (r = 0.698) and current (r = 0.653) relationships with the patient leads to a decrease in the compliance of the caregiver.

Conclusions

The mechanism of psychopathological symptoms, functional disorders is heterogeneous, depending on the biological causes and psychosocial conditions of functioning of patients.

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Oral Communications (ID 1110) AS19. Mental Health Care

O163 - Post traumatic stress disorder symptoms and stress burden among caregivers of patients with severe mental illness

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
07:24 - 07:36
Presenter

ABSTRACT

Introduction

Care givers of patients with severe mental disorders have been shown to be under heavy stress burden that reflect itself through various heterogenous psychiatric symptoms that may mimic PTSD with associated negative impact on interpersonal relations and work performance

Objectives

to assess the prevalence of PTSD symptoms among care givers of patients with severe mental illness

Methods

70 patients care givers of sevely mentally ill patients compred to control 70 care giver of patients with chronic debilitating medical illness were recruited from outpatient of the university hospital outpatient facilities, random selection. Severe mental illness was defined by Global assessment of function GAF score above 50 and duration exceeding 2 years. Both groups were subject to Zarit burden interview to assess stress burden and post traumatic stress diagnostic scale PDS to assess PTSD symptomats

Results

43% of care givers of severly mentally patients showed moderate to severe burden on the Zarit scale compared to only 10% among care givers of medically ill patients , this difference was statistically significant (p<0,001) . Among care givers of severly mental patients showed moderate to severe score on post traumatic stress diagnostic scale compared to 0% among those taking care of medically ill patients. this difference was statistically significant (p<0,001)

Conclusions

Stress burden among care givers of patients with severe mental illness is high and may manifest symptoms of post traumatic disorder. This highlight the importance of particular psychological support and assessment among care givers of patients with sever mental illness

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Oral Communications (ID 1110) AS19. Mental Health Care

O164 - Utilizing a Novel Digital Affect Mirror, Morphii, to Assess Affective Determinants of Health

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
07:36 - 07:48

ABSTRACT

Introduction

Decades of research have shown that affect, emotions and moods, significantly impact all aspects of health behaviors. This research utilized a novel digital analogue technology (Morphii) to assess eight affective domains: stress, anxiety, loneliness, irritability, depression, pain, energy and overall feelings of wellness.

Objectives

To demonstrate the feasibility of use and strength of relationship/comparison to validated measures.

Methods

A U.S. census-based sample of adults ages 18-80 (n=985) completed online assessments including the 8 Morphii’s and additional comparative mental/behavioral health assessments (PSS-4, GAD-7, UCLA Loneliness Scale V3, BITe, PHQ-8 & PHQ-2, P4 Pain Scale, WHO-5, CFQ-11, ESS, and Vitality Subscale SF-36) via the Prolific Academic online platform and were compensated nominally for their participation. The resulting sample was 51.6% female and 74.2% White.

Results

Each Morphii was compared with the common corresponding industry assessment (e.g., Depression Morphii with PHQ) resulting in Pearson correlations ranging from -.519 to .761, with 6 of the 8 showing correlations above .700. Pearson correlations between dysfunction and each of the 8 Morphiis were significant at the p < .000 level, ranging from a low of .421 (Loneliness) to a high of .607 (Depression). Internal reliability was very good (Cronbach’s Alpha = .862). Respondents who expressed an assessment modality preference (55.2%) chose the Morphii type over traditional assessment format at a 2.5:1 ratio.

Conclusions

Morphii provides a reliable and valid assessment option with the ability to obtain a comprehensive (8 domains at once), efficient (less than 60 second administration), assessment with increased patient/client preference and engagement.

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Oral Communications (ID 1110) AS19. Mental Health Care

O165 - Experiences of fear in hospital settings from the perspectives of mental health service users and informal caregivers

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
07:48 - 08:00
Presenter

ABSTRACT

Introduction

In the literature, service users and informal caregivers have been critical towards psychiatric inpatient care. However, little is known about their fears related to hospital care.

Objectives

We describe service users’ and informal caregivers’ experiences of fear in psychiatric hospital settings.

Methods

The data were collected from seven mental health associations located in six Finnish cities. Focus group interviews (f=8) were conducted (2015–2016) with service users (n=20) and informal caregivers (n=15), and were guided to focus on violence and challenging situations in psychiatric care. In a secondary analysis, experiences of fear were extracted from the transcriptions and analyzed using inductive content analysis.

Results

Both groups’ experiences of fear focused on themes related to staff, treatment and fellow patients. Additionally, service users had experiences of fear related to the hospital environment. Fears related to staff involved intimidating personnel using force or acting in threatening ways. Participants also described staff seemingly being afraid of patients and care givers. Three types of fears related to treatment were described: fear of not being admitted to hospital even if needed, fear of being admitted to hospital, and fear of coercive methods used in care. Fear of fellow patients involved being afraid of aggressive, unpredictable behaviors, which could cause, e.g., a lack of sleep at night for service users. Fears related to the environment itself were also discussed.

Conclusions

Being hospitalized can be a difficult experience for service users and informal caregivers. These results can help psychiatric healthcare staff acknowledge areas in care that may potentially cause feelings of fear.

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Oral Communications (ID 1110) AS19. Mental Health Care

O166 - Improving maternal mental health through postnatal services use for South Sudanese mothers and their babies living in Nguynyel refugee camp in Gambella, Ethiopia

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
08:00 - 08:12
Presenter

ABSTRACT

Introduction

Poor maternal mental health during the perinatal period leads to serious complications, especially in humanitarian settings where both mothers and children have often been exposed to multiple stressful events. In those contexts, culturally relevant mental health and psychosocial interventions are required to support mother-infant dyads and ultimately to alleviate potential negative outcomes on child’s health and development.

Objectives

This study aims at assessing the use of postnatal services by mothers and infants under 2 and its impact on maternal mental health.

Methods

A process evaluation of Baby Friendly Spaces (BFS) program was conducted in Nguynyel refugee camp (Ethiopia) and a prospective quantitative assessment was administered to lactating women at baseline and endline (2 months later) to measure maternal functional impairment (WHODAS 2.0), general psychological distress (Kessler scale-K6); depression symptoms (Patient Health Questionnaire-PHQ9) and post-traumatic stress symptoms (PTSD Checklist-PCL-6).

Results

201 lactating women and their babies were enrolled between October 2018 and March 2019. Statistically significant reductions were observed in all mental health outcomes at follow-up. Total mean scores decrease by 19% (p<0.001) for general psychological distress and posttraumatic stress, by 23% (p<0.001) for the depression and by 15% (p<0.001) for the functional impairment. Examination of the compliance to the services revealed that mothers who dropped out early had statistically significantly lower depression scores (p=0.01), and functional impairment scores (p<0.001) than mothers who stayed in the program.

Conclusions

The integration of maternal mental health interventions within perinatal services is challenging but essential for identifying and treating maternal common mental disorders.

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Oral Communications (ID 1110) AS21. Migration and Mental health of Immigrants

O169 - The influence of ethnic minority background and migration history on recovery in psychotic disorders: a systematic literature review

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
08:12 - 08:24

ABSTRACT

Introduction

Recovery in psychotic disorders is a concept that evolved through the last decades. Thanks to the contribution of different researchers, together with the recovery movement, a switch happened from a service-based to a client-based approach towards recovery. The Dutch framework considers recovery as the interplay of symptomatic, personal, functional and societal aspects, determined by different biological, psychological, personal and social factors. Literature on this fourdimensional perspective is still scarce. In addition, even if an increased incidence of psychotic disorders has been recognized in ethnic minority populations and migrants, studies on the influence of ethnicity and migration on recovery in psychotic disorders is limited.

Objectives

To write a systematic literature review on how ethnic minority status and migration history may affect symptomatic, personal, functional and societal recovery.

Methods

A systematic search of the main databases, followed by a four-step selection process to include studies comparing migrants or ethnic minority populations and the non-minoritarian/autochthonous population in terms of recovery. A qualitative, narrative summary has been performed.

Results

Thirty-eight articles have been included. Literature is heterogeneous, focused on clinical outcomes and mostly based on data from the UK and the USA. As a common thread, ethnic minority status and migration history result to negatively influence societal, personal and, to a lower extent, clinical recovery.

Conclusions

Further studies based in different cultural backgrounds and focused on recovery in its multiple aspects are needed, to get a better understanding of the contextual and structural factors that affect the interaction between ethnicity, migration and recovery in psychotic disorders.

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Oral Communications (ID 1110) AS22. Neuroimaging

O171 - Movement, mood and cognition: preliminary insight into the effects of electroconvulsive therapy in depression through a data-driven resting-state connectivity analysis

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
08:24 - 08:36
Presenter

ABSTRACT

Introduction

ECT is an effective treatment for depression. Beyond its therapeutic effect on mood it has a unique impact on psychomotor and cognitive symptoms.Its mechanism of action remains still unclear. To investigate this, we set out to study the brain’s response to ECT from a large-scale brain-network perspective.

Objectives

The aim of this study was to investigate changes in resting-state functional connectivity following ECT at the whole brain, between-network and within-network level, in patients with a depressive episode.

Methods

Resting-state FMRI data were collected from 17 patients with depression before and after an ECT course. Using a group independent component analysis approach, we focused on four networks that are known to be affected in depression: the salience network (SN), default mode network (DMN), cognitive executive network (CEN) and a subcortical network (SCN). Clinical measures including mood, cognition and psychomotor symptoms were assessed.

Results

ECT increased connectivity of the left CEN with the left angular gyrus and left middle frontal gyrus. An increase in left CEN within network connectivity was observed. Both the right CEN and the SCN showed increased connectivity with the precuneus. Furthermore, the anterior DMN showed increased connectivity with the left amygdala. Finally, improvement of psychomotor retardation was positively correlated with an increase of within-posterior DMN connectivity.

Conclusions

We demonstrate that ECT induces a significant increase of connectivity at both the whole brain and within-network level. Furthermore, we provide first evidence on the association between an increase of within posterior DMN connectivity and an improvement of psychomotor retardation, a core symptom of depression.

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Oral Communications (ID 1110) AS22. Neuroimaging

O172 - Gray matter reduction in High-Risk Subjects, Recently Diagnosed and Chronic Patients with Schizophrenia: A Revised Coordinate-Based Meta-Analysis

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
08:36 - 08:48
Presenter

ABSTRACT

Introduction

Characterizing neuroanatomical markers of different stages of schizophrenia (SZ) to assess of how the disorder develops is extremely important for the clinical practice. It still remains uncertain how abnormalities are formed as SZ progresses.

Objectives

We reviewed and analyzed 113 voxel based morphometry studies on people at risk of or with schizophrenia to assess GM alterations at different stages of the disorder and to functionally characterize these GM variations.

Methods

We performed a meta-analysis of voxel-based morphometry studies of genetic and clinical high-risk subjects (g-/c-HR), recently diagnosed (RDSZ) and chronic SZ patients (ChSZ). We quantified gray matter (GM) changes associated with these four conditions and compared them with contrast and conjunctional data. We performed the behavioral analysis and networks decomposition of alterations to obtain their functional characterization.

Results

Compared to previous investigations, results reveal a robust cortical-subcortical, left-to-right homotopic progression of GM loss. The right anterior cingulate is the only altered region in all conditions. Contrast analyses show left-lateralized insular, amygdalar and parahippocampal GM reduction in RDSZ, which appears bilateral in ChSZ. An overlap between RDSZ and ChSZ is observed in the left insula, amygdala, precentral and inferior frontal gyri. Functional decomposition shows involvement of the salience network, with an enlargement of the sensorimotor network in RDSZ and the thalamus-basal nuclei network in ChSZ.

immagine1.jpg

Conclusions

These results can help the research on diagnostic and neuroimaging biomarkers of SZ staging, as well as on the identification of new therapeutics neuroanotomic targets that could be addressed with focused magnetic or non-invasive electric stimulation.

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Oral Communications (ID 1110) AS22. Neuroimaging

O173 - Chronotopic encoding of emotional dimensions in the human brain assessed by fMRI

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
08:48 - 09:00
Presenter

ABSTRACT

Introduction

Affective experiences vary as function of context, motivations and the unfolding of events. This temporal fundamental aspect of emotional processes is often disrupted in psychiatric conditions.

Objectives

To investigate how the brain represents the association between affect and time, we combined fMRI and behavioral ratings during movie watching.

Methods

Participants watched ‘Forrest Gump’ in the fMRI scanner (n=14, 6F). Data were preprocessed (see 10.1101/2020.06.06.137851v1) and average brain activity from 1000 regions was extracted. Independent subjects (n=12, 5F) provided continuous ratings of the intensity of their affective state while watching the same movie. Using PCA, we derived the first 3 affective dimensions (polarity, complexity, intensity; 10.1038/s41467-019-13599-z) and computed their time-varying correlation in windows from 5-1000tps. We identified the window size with the maximum between-subjects accordance and computed the inter-subject functional connectivity (10.1038/ncomms12141). For each region, we obtained connectivity strength and its association in time with changes in affective dimensions (pBonf<0.05).

Results

Fluctuations in connectivity strength of the right rMFG, precuneus, pSTS/TPJ, dmPFC, aINS and left pMTG were associated to polarity. Also, connectivity of the right IPS/SPL, SFG, dpreCS, IFGpOrb, OFC, precuneus, vpreCS and pSTS/TPJ followed the timecourse of perceived intensity of affect.

Conclusions

Connectivity strength of default mode represents the pleasantness of the experience, whereas attention and control networks encode its intensity. Emotional descriptions converge in right temporoparietal and fronto-polar cortex, where the stream of affect is encoded in a chronotopic manner. These results expand our understanding of the neural correlates of emotional processing, a function severely affected by mental disorders.

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Oral Communications (ID 1110) AS22. Neuroimaging

O174 - Multimodal magnetic resonance spectroscopy and surface-based morphometry study of individuals at ultra-high-risk for psychosis

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
09:00 - 09:12

ABSTRACT

Introduction

Studies examining gamma-aminobutyric acid (GABA) or glutamate in ultra-high risk for psychosis (UHR) have shown conflicting results, and a number of multimodal studies examining associations between metabolite and structural characteristics is very limited.

Objectives

We aimed to investigate potential associations between GABA and glutamate levels and cortical thickness in the frontal lobe in UHR individuals and healthy controls (HC).

Methods

20 male UHR individuals and 19 healthy controls (HC) underwent structural MRI and MR spectroscopy at 3T Philips scanner. T1-weighted images were processed via FreeSurfer 6.0 to quantify cortical thickness for selected frontal regions labeled according to Desikan atlas. MEGA-PRESS acquisitions were analyzed with jMRUi (ver. 5.1 Alpha), levels of GABA and glutamate were calculated as ratios to creatine + phosphocreatine.

Results

The study revealed: 1) GABA/Cr ratios reduction in the left frontal lobe (p=0.001) which was not attributable to antipsychotic medication; 2) cortical thickness reductions in the left pars orbitalis (p=0.005) (the anterior part of the inferior frontal gyrus) in the UHR individuals compared to HC. No significant correlations between GABA/Cr ratios and cortical thickness were identified in both groups.

Conclusions

The findings indicate that the UHR state is associated with altered GABA levels and cortical thickness reductions in the prefrontal cortex. The results also show that GABA levels are not directly related to cortical abnormalities, suggesting that altered metabolite levels may be associated with a complex system of structural and functional impairments, rather than directly correlating with structural changes in separate cortical regions.

The work was supported by RFBR grant 19-29-10040.

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Oral Communications (ID 1110) AS22. Neuroimaging

O175 - Cortical thickness abnormalities in long-term remitted Cushing’s disease

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
09:12 - 09:24

ABSTRACT

Introduction

Remitted Cushing’s disease (RCD)-patients commonly continue to present persistent psychological and cognitive deficits, and alterations in brain function and structure. Assessing cortical thickness and surface area of RCD-patients may offer further insight into the neuroanatomical substrates of Cushing’s disease.

Objectives

To assess cortical thickness and surface area in RCD-patients in comparison to healthy controls (HCs).

Methods

Structural 3T MRI's were obtained from 25 long-term RCD-patients, and 25 age-, gender-, and education-matched HCs. T1-weighted images were segmented to extract mean cortical thickness and surface area values of 68 cortical gray matter regions. Paired sample t-tests explored differences between the anterior cingulate cortex (ACC; region of interest), and the whole brain. Validated scales assessed psychiatric symptomatology, self-reported cognitive functioning, and disease severity.

Results

After correction for multiple comparisons, ROI analyses indicated that RCD-patients showed reduced cortical thickness of the left caudal ACC and the right rostral ACC compared to HCs. Whole-brain analyses indicated thinner cortices of the left caudal ACC, left cuneus, left posterior cingulate cortex, right rostral ACC, and bilateral precuneus compared to HCs. No cortical surface area differences were identified. Cortical thickness of the left caudal ACC was inversely associated with anxiety symptoms and disease duration.

Conclusions

In six of 68 regions examined, RCD patients had reduced cortical thickness in comparison to HCs. Cortical thickness of the left caudal ACC was inversely associated with disease duration, suggesting that prolonged and excessive exposure to glucocorticoids may be related to cortical thinning of brain structures involved in emotional and cognitive processing.

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Oral Communications (ID 1110) AS23. Neuroscience in Psychiatry

O178 - Association between Abnormal Fetal Head Growth and Autism Spectrum Disorder

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
09:24 - 09:36
Presenter

ABSTRACT

Introduction

Despite evidence for the prenatal onset of abnormal head growth in ASD children, studies on fetal ultrasound data in ASD are limited and controversial.

Objectives

To understand whether people with ASD have abnormal head growth during gestation

Methods

A longitudinal matched case-sibling-control study on prenatal ultrasound biometric measures of ASD children was conducted. Children with ASD were matched to two control groups: (1) typically developed sibling (TDS) and (2) typically developed population (TDP). The cohort comprised 528 children (72.7% males): 174 ASD, 178 TDS, and 176 TDP.

Results

Second-trimester ASD and TDS fetuses had significantly smaller biparietal diameter (BPD) than TDP fetuses (aORzBPD=0.685, 95%CI=0.527-0.890 and aORzBPD=0.587, 95%CI=0.459-0.751, respectively). However, these differences became statistically indistinguishable in the third trimester. Head biometric measures were associated with the sex of the fetus, with males having larger heads than females within and across groups. A linear mixed-effect model assessing the effects of sex and group assignment on fetal longitudinal head growth indicated faster BPD growth in TDS vs both ASD and TDP in males (β=0.084 and β=0.100 respectively; p<0.001) but not in females, suggesting an ASD–sex interaction in head growth during gestation. Fetal head shape showed sex-specific characteristics, and head growth was inversely correlated with ASD severity in males and females, thus further supporting the sex effect on the association between fetal head growth and ASD.

Conclusions

Our findings suggest that abnormal fetal head growth is a familial trait of ASD, which is modulated by sex and is associated with the severity of the disorder.

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Oral Communications (ID 1110) AS23. Neuroscience in Psychiatry

O179 - The gut-microbiome-endocannabinoid axis and anhedonia/amotivation: a mediation analysis in a general population cohort

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
09:36 - 09:48

ABSTRACT

Introduction

General-population studies investigating the biological correlates of anhedonia/amotivation might be informative for treatment breakthroughs for a number of clinical conditions.
Reduced gut-microbial diversity might lead to an anhedonic/amotivational syndrome (“sickness behaviour”). However, how gut-microbial diversity contribute to this clinical phenotype is a key gap in knowledge.
We hypothesised the endocannabinoid system would be at play.

Objectives

We tested the hypothesis that the endocannabinoid system mediates the association between gut-microbial diversity and anhedonia/amotivation

Methods

Secondary data analysis on 786 volunteer twins (TwinsUK).
Measures of gut-microbiome, faecal endocannabinoid metabolites, and anhedonia/amotivation were collected over five years.
To test our hypothesis we used a multilevel mediation model using alpha diversity as predictor, faecal levels of the endocannabinoid palmitoylethanolamide (PEA) as mediator, and anhedonia/amotivation as outcome. Analyses were adjusted for obesity, diet, antidepressants, and sociodemographic covariates.

Results

Mean age was 65.2±7.6; 27% were obese and 4.7% were on antidepressants.
Alpha diversity was significantly associated with anhedonia/amotivation (β=-0.37; 95%CI: -0.71 to -0.03; P=0.03). Faecal PEA levels mediated this association: the indirect effect was significant (β=-0.13; 95%CI: -0.24 to -0.01; P=0.03), as was the total effect (β=-0.38; 95%CI: -0.72 to -0.04; P=0.03). The direct effect of alpha diversity on anhedonia/amotivation was attenuated fully

Conclusions

We provided the first evidence showing that the association between gut-microbial features and anhedonia/amotivation is mediated by the endocannabinoid system. These findings shed light on a new therapeutic target in an area of unmet clinical need.

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Oral Communications (ID 1110) AS23. Neuroscience in Psychiatry

O180 - Effects of substance misuse and family history of substance use disorder on brain structure in patients with Attention-deficit/Hyperactivity disorder and healthy controls

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
09:48 - 10:00
Presenter

ABSTRACT

Introduction

Literature shows overlapping alterations in brain structure in Attention-deficit/Hyperactivity Disorder (ADHD) and substance use disorder (SUD), suggesting shared pathophysiological mechanisms. It is unclear to what extent family history (trait) effects and/or substance misuse (state) effects explain the observed overlap.

Objectives

Our aim was to examine the effects of (i) SUD family history (FH) and (ii) substance misuse on brain structure in ADHD.

Methods

We compared structural MRI data (cortical thickness; subcortical volumes) between (i) ADHD subjects and controls with or without FH (ADHD-FH+: n=139; ADHD-FH-: n=86; controls-FH+: n=60; controls-FH-: n=74), and (ii) FH-matched ADHD groups with and without substance misuse and controls (ADHD+SM, ADHD-only and controls, n=68 per group). Furthermore, we explored whether FH effects were more pronounced in subjects with SUD in both parents (n=63) compared to subjects with one SUD parent (n=105) and without FH (n=160).

Results

There was no main FH effect on brain structure. ADHD+SM showed decreased CT in inferior frontal gyrus (IFG) compared to controls, while no difference was found between ADHD-only and ADHD+SM or controls. Subjects with SUD in both parents showed decreased thickness of IFG and volume of nucleus accumbens (NAcc), compared to those with one SUD parent.

Conclusions

Substance misuse in ADHD might result in smaller IFG, which is in line with findings in SUD-literature. A contribution of premorbid alterations, due to FH, could not be ruled out, particularly for IFG thickness. Future studies should further investigate the potential role of these regions in treatment and prevention strategies.

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Oral Communications (ID 1110) AS23. Neuroscience in Psychiatry

O181 - Perceptual processing links autism and synesthesia: a twin study

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
10:00 - 10:12
Presenter

ABSTRACT

Introduction

Synesthesia is a non-pathological condition where sensory stimuli (e.g. letters or sounds) lead to additional sensations (e.g. color). It occurs more commonly in individuals diagnosed with Autism Spectrum Condition (ASC) and is associated with increased autistic traits and autism-related perceptual processing characteristics, including a more detail-focused attentional style and altered sensory sensitivity. In addition, autistic traits correlate with the degree of synesthesia (consistency of color choices on an objective synesthesia test) in non-synesthetes.

Objectives

We aimed to investigate whether the degree of synesthesia for graphemes is associated with autistic traits and perceptual processing alterations within twin pairs, where all factors shared by twins (e.g. age, family background, and 50-100% genetics) are implicitly controlled for.

Methods

We investigated a predominantly non-synesthetic twin sample, enriched for ASC and other neurodevelopmental disorders (n=65, 14-34 years, 60% female), modelling the linear relationships between the degree of synesthesia and autistic traits, sensory sensitivity, and visual perception, both within-twin pairs (22 pairs) and across the entire cohort.

Results

A higher degree of synesthesia was associated with increased autistic traits only within the attention to details domain, with sensory hyper-, but not hypo-sensitivity and with being better in identifying fragmented images. These associations were stronger within-twin pairs compared to across the sample.

Conclusions

Consistent with previous findings, the results support an association between the degree of synesthesia and autistic traits and autism-related perceptual features, however restricted to specific domains. Further, the results indicate that a twin design can be more sensitive for detecting these associations.

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Oral Communications (ID 1110) AS23. Neuroscience in Psychiatry

O182 - The effects of recreational use of marijuana in Adolescent brain health: a review

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
10:12 - 10:24

ABSTRACT

Introduction

Marijuana is widely used among people, recreationally and medically. However, recent studies have shown that Marijuana has negative effects on brain structures and functions.

Objectives

To discuss the effects of Marijuana use on brain development in adolescence.

Methods

The method that is used in this study is literature review, through analyzing and summarizing the data that were collected from PubMed, epidemiology articles from BNN and CDC, and other online journals to understand the effects of Marijuana on the brain development in adolescence. There were 25499 articles that were filtered and screened resulting in 10 articles that were used as data of this literature review.

Results

Marijuana effects on the brain are divided into structural changes and functional changes. Structural changes are seen in the brain hemispheres, amygdala, hippocampus, and nucleus accumbens. While functional changes are seen in behavioral and cognitive changes in everyday life and even psychotic disorders.

Conclusions

Marijuana use has shown negative effects on the human body, organs that are rich in cannabinoid receptors, especially the Brain. Therefore, Marijuana use among adolescents may disrupt their developing brain, and cause adolescents to have structural and functional changes in the brain.

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Oral Communications (ID 1110) AS23. Neuroscience in Psychiatry

O183 - Predictive Biomarkers for Negative Symptoms in Schizophrenia

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
10:24 - 10:36

ABSTRACT

Introduction

Increasing evidence shows that impaired neuroplasticity and high inflammation play a crucial role in the pathophysiology of schizophrenia. Prospective studies demonstrated that patients with high inflammation usually have a poor treatment response and clinical practice learns that negative symptoms are challenging to treat. The predictive value of biomarkers for negative symptoms in patients with schizophrenia has sparsely been explored.

Objectives

Here, we investigated whether biomarkers are associated with negative symptoms at baseline, and whether biomarkers could predict negative symptoms after six years in patients with schizophrenia.

Methods

We investigated serum biomarkers in an epidemiological study on schizophrenia (N, baseline=110; N, follow-up=65). Negative symptoms were measured using the Positive and Negative Syndrome Scale. Biomarkers (N=189) were measured with a multi-analyte profiling platform and analysed using linear regression models, adjusted for site, age, gender, ethnicity, anti-inflammatory agents, smoking, cardiovascular disease and diabetes, and adjusted for multiple comparisons (q, Benjamini-Hochberg procedure).

Results

In particular, decreased platelet-derived growth factor (PDGF) (responsible for proliferation of oligodendrocytes) was associated with more negative symptoms at baseline and follow-up (figure). Several other biomarkers associated with inflammation, neuroplasticity and metabolism correlated with the severity of negative symptoms cross-sectionally and/or prospectively.

Figure. Biomarkers for Negative Symptoms in Schizophrenia.

figure.png

Conclusions

Although our sample size at follow-up was limited, we feel that these analyses contribute to further research of possible predictive biomarkers for negative symptoms in schizophrenia. During the conference we will elaborate our findings with applied machine learning techniques which might shed more light on the predictive value of biomarkers for negative symptoms in schizophrenia.

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Oral Communications (ID 1110) AS23. Neuroscience in Psychiatry

O184 - How far in the future can we predict others' affective states?

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
10:36 - 10:48
Presenter

ABSTRACT

Introduction

Human social interactions are rooted in the ability to understand and predict one's own and others emotions. Individuals develop accurate mental models of emotional transitions (MMET) by observing regularities in affective experiences (DOI: 10.1073/pnas.1616056114) and a failure in this regard can produce maladaptive behaviors, one of the hallmark features in several psychiatric conditions.

Objectives

To investigate whether MMET are stable over time and which emotion dimensions (e.g., valence, dominance) influence MMET over time.

Methods

We selected thirty-seven emotion categories (DOI: 10.1177/0539018405058216) and five different time intervals (from 15 minutes to 4 days). Sixty-two healthy participants rated the likelihood of transition between all possible pairs of affective states at each time interval.

Results

As expected, we observed a trend toward uncertainty as the timescale increased. In addition, the probability of shifting between two affective states having the same valence (e.g., happiness and contentment) was rated higher than for emotions with opposite polarity (e.g., happiness and sadness). Even though this pattern becomes gradually noisier for predictions far in the future, it is still present for infradian intervals (Fig.1).

fig_1.jpg

Conclusions

Our results suggest that MMET are informed by the valence dimension and moderately influenced by the timescale of the prediction. These findings in the healthy population may prompt the exploration of emotion dynamics in psychiatric conditions. Future studies could leverage the MMET approach to test whether specific psychiatric disorders (e.g., bipolar disorder) are associated with abnormal patterns of emotion transitions.

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Oral Communications (ID 1110) AS23. Neuroscience in Psychiatry

O185 - Correlation of neurotrophic and neuropsychological parameters in Alzheimer's disease

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
10:48 - 11:00

ABSTRACT

Introduction

Alzheimer's disease (AD) is a neurodegenerative pathology that develops mainly in elderly and senile people.

Disruption of BDNF transport or suppression of its production appears to be typical for people of old age.

Objectives

Objective: To investigate the influence of Alzheimer's disease on the secretion of brain factors and correlate with neuropsychological profiles.

Methods

12 men (2) and women (10) with Alzheimer's disease were examined. The average age of the subjects was 76.25 + 4.89. Methods: MMSE, ADAS-COG, laboratory - BDNF was performed using the G7611 BDNF Emax (R) ImmunoAssaySystem 5 x 96 wells, BDNF Emax® Immunological test.

Results

2 patients have mild dementia, 8 patients have moderate dementia, 2 patients have severe dementia. The average age of patients with mild dementia was 72.0 + 1.0. The average MMSE score is 16.7 + 3.4. Correlation analysis showed a close relationship between a pronounced decrease in memory in memory tests (ADAS-COG) and a pronounced decrease in blood BDNF content (r = 0.676). A close statistically significant relationship was found between a low result of the recognition test and a low blood BDNF content (r = 0.598).

Conclusions

we assume that blood BDNF is a marker of pathologically accelerated aging of the central nervous system, since low test results for mnestic function are an indicator of severe degeneration in Alzheimer's disease

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Oral Communications (ID 1110) AS23. Neuroscience in Psychiatry

O186 - With both eyes open – translational research using eye-tracking combined with performance-based evaluation among people with severe mental illness.

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
11:00 - 11:12
Presenter

ABSTRACT

Introduction

Individuals with severe mental illnesses (SMI) often find it hard to perform daily activities such as grocery shopping, which require intact executive functions. The use of performance-based evaluations is valuable, but lacks the subjects' point of view during task performance.

Objectives

The aim of the current presentation is to bring together performance-based observation and cognitive science methods to provide insights regarding real-life behavior and problem solving in SMI populations.

Methods

In this quasi-experimental study, forty-three individuals performed the Test of Grocery Shopping Skills (TOGSS) while wearing an eye-tracking device. Eye-movement patterns served as a proxy of executive functions in people with and without SMI during a real-life ingredient selection task. We hypothesized that significant differences will be found between people with SMI and controls in TOGSS sub-outcomes as well as in eye-fixation durations.

Results

TOGSS sub-outcomes indicative of performance efficiency (time and redundancy) were significantly higher in the research group compared to matched controls (P<0.01). Average fixation duration was found to be significantly higher for the research group compared to matched controls (P<0.05) for two of the four item-selection tasks.

Conclusions

These preliminary findings indicate that when confronted with a selection task, individuals with SMI spend more dwelling time while selecting ingredients. Further analyses on these data will examine how this time is spent (e.g. focusing on irrelevant information). The outlined approach may prove beneficial in illuminating specific behavioral and physiological difficulties in individuals with SMI, particularly in the evolving Covid-19 situation, which poses novel social and health-related challenges on real-life tasks.

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Oral Communications (ID 1110) AS23. Neuroscience in Psychiatry

O187 - Neuropsychological profile and correlation with outcomes in patients admitted to SPDC

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
11:12 - 11:24

ABSTRACT

Introduction

Literature showed that patients suffering from disorders belonging to the schizophrenic (SZ) and bipolar (DB) spectrum have a qualitatively similar but quantitatively different neurocognitive impairment that correlates with the outcomes. However, the majority of former studies are conducted on patients in remission phase.

Objectives

This study aims to compare cognitive functions between SZ and DB in the acute phase and their possible correlations with treatment outcomes.

Methods

In a prospective longitudinal study conducted at the SPDC Ausl unit of Romagna - Cesena, 57 SZ and 82 DB took part in the study. The diagnosis was based on the SCID5 CV and SCID5 DP. Symptom severity was assessed with BPRS and HONOS both at the beginning and at the end of hospitalization. Executive functions were measured with Tower of London (ToL) and Modified Wisconsin Card Sorting Test (MCST), attention with Attentive Matrices (MA) and Stroop Test (ST), non-verbal logic skills with Colored Matrices by Raven (PM47). The statistical analyzes applied are ANOVA and logistic regression.

Results

The cognitive tests did not reveal significant differences between SZ and DB. The logistic regression analysis showed that the scores obtained at the MCST and MA positively correlate with the efficacy of the treatment for both groups.

Conclusions

Cognition in DB and SZ patients was similarly impaired, supporting recent theories that placed diagnoses on a continuum of severity. Moreover, the results indicated that also in the acute phase the best predictors of the outcome were flexibility in problem solving strategies and visuospatial attention.

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Oral Communications (ID 1110) AS24. Obsessive-Compulsive Disorder

O188 - The role of mood disorders in the longitudinal course of obsessive-compulsive disorder: preliminary data from a 20-year prospective follow-up study.

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
11:24 - 11:36
Presenter

ABSTRACT

Introduction

Although OCD is believed to have a chronic course, little research has been conducted on this, and there are discrepant findings. Studies over the last years have found that a significant proportion of patients with OCD shows symptomatic remission over long term, however there are significant variations in sampling, clinical characteristics, follow-up, and outcome assessments.

Objectives

The present prospective study aims to examine rates of OCD remission after 20 years of follow up and to explore demographic and clinical predictors of remission.

Methods

The study sample consists of adult patients with a principal OCD diagnosis and Y-BOCS total score ≥16, who have been referred to the Department of Neuroscience, University of Turin (Italy). OCD symptoms were assessed every 5 years over the 20-year follow-up period. Course data were examined using standard survival analysis methods; Cox proportional hazards regression was used to estimate relative hazards for predictors of remission.

Results

There were 360 participants in the study. At year 20, the 28.7 % of the total sample showed OCD remission. Predictor of remission were female gender, lower Y-BOCS mean scores at study entry, longer duration of illness and comorbidity with major depressive disorder. No specific predictors of full remission were found. Lower Y-BOCS mean scores and comorbid bipolar disorder predicted partial remission.

Conclusions

This study suggests that a significant proportion of patients with OCD shows remission. Future studies are needed to clearly identify predictors of remission.

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Oral Communications (ID 1110) AS24. Obsessive-Compulsive Disorder

O189 - White matter disconnection and decreased functional connectivity between orbitofrontal cortex and the contralateral temporo-occipital cortex in adults with Obsessive Compulsive Disorder

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
11:36 - 11:48

ABSTRACT

Introduction

Obsessive compulsive disorder (OCD) affects 2-3% of the general population. The neurobiology of OCD has been linked to dysfunction of cortico-striatal circuits connecting the orbitofrontal (OFC) to the striatum. Recently, this loop has become an approved target for non-invasive neuromodulatory treatment of OCD.

Objectives

To explore structural and functional connectivity of the OFC in OCD subjects and healthy controls.

Methods

14 OCD patients and 12 age/sex-matched controls underwent magnetic resonance imaging (MRI) (3T-Philips scanner) for diffusion tensor imaging (DTI) and resting state functional connectivity (rsFC). DTI images were brain extracted and corrected for movement and eddy currents. A diffusion tensor model was fitted to each voxel and used to generate Fractional Anisotropy (FA) maps. Voxel-wise statistical analysis of FA was performed using Tract-Based Spatial Statistics. RsFC images were preprocessed and seed-based correlation (SBC) analysis was performed using Data Processing Assistant for Resting-State fMRI.

Results

We found decreased values of FA in the body of the Corpus Callosum bilaterally (MNI_coordinates: x= 16, y= -16, z= 33 and x= -19, y= -16, z= 42) and left superior longitudinal fasciculus in OCD patients (fig 1, left), as well as decreased rsFC of the right superior orbitofrontal seed with the left inferior frontal gyrus and left middle occipital gyrus (fig 2, right).

figure1.jpgfigure2.jpg

Conclusions

Using an exploratory multimodal approach we found evidence of abnormal structural and functional long-range connectivity of the OFC in OCD. If confirmed in a larger sample these connectivity abnormalities could be explored as potential predictors of response to OFC-targeted non-invasive neuromodulatory interventions.

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Oral Communications (ID 1110) AS24. Obsessive-Compulsive Disorder

O190 - Neurofunctional predictive biomarkers of cognitive-behavioral therapy during fear conditioning in patients with obsessive-compulsive disorder

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
11:48 - 12:00
Presenter

ABSTRACT

Introduction

Altered fear learning processes could be mechanistically linked to the development and/or maintenance of obsessive-compulsive disorder (OCD). From a clinical perspective, the first-line psychological treatment for OCD is cognitive-behavioral therapy (CBT), which is based on the principles of fear learning. However, no previous functional magnetic resonance imaging (fMRI) studies have evaluated the predictive capacity of regional brain activations during fear learning on CBT response in patients with OCD.

Objectives

We aimed at exploring whether brain activation during fear learning in patients with OCD are associated with CBT outcome.

Methods

We assessed 18 patients with OCD and 18 healthy participants during a 2-day experimental protocol where brain activation and skin conductance responses (SCR) where assessed during fear conditioning, extinction learning, and extinction recall within the fMRI scanner. Following the protocol, patients with OCD received CBT.

Results

We found non-significant between-group differences in SCR during fear learning. Patients with OCD showed significantly diminished activation of the dorsal anterior cingulate cortex and the right insula during fear conditioning. Importantly, our analyses revealed a significant negative association between clinical improvement after CBT and activity at the right insula during fear conditioning (x = 39, y = 12, z = -11; t = 5.64; p<0.001; k = 928). This finding is displayed in Figure 1 below.

figure 1.png

Conclusions

Patients with OCD may require less fear-conditioned brain responses to achieve the same level of psychophysiological fear conditioning as healthy participants. Interestingly, insula activations during fear-conditioned responses may represent a potential predictor biomarker of response to CBT for OCD.

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Oral Communications (ID 1110) AS24. Obsessive-Compulsive Disorder

O191 - Sensory experience in Obsessive Compulsive Disorder - SensiOCD: do they think or feel differently?

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
12:00 - 12:12

ABSTRACT

Introduction

Obsessive-compulsive disorder (OCD) is associated to a wide range of symptomatic expression and treatment response variability [1]. Sensory perception has been identified as an emerging factor in this process [2]. Sensory vulnerability and atypical sensory experience were identified as risk factors for the development of OCD [3] and a sensory subtype of the disease was proposed in which there is a positive correlation with early onset sensory symptoms, male gender and family background [4]. Adding to the atypical sensory profile, obsessions are frequently experienced as partially perceptual.

Objectives

Our main goals are to characterize the sensory perception in OCD patients; assess the prevalence and intensity of the sensory properties of the obsessive thoughts and explore the how sensory perception, obsessive thoughts and obsessive dimensions/clusters are interrelated.

Methods

Patients with OCD diagnosis, aged 18 to 65 years and no comorbid mental disorder (except depression) will be recruited. The study battery will include participant form with demographical and clinical features, assessment of depressive and anxiety symptoms (HAM-A and HAM-D) evaluation of clinical outcome measures and obsessive dimensions/clusters (Yale-Brown Obsessive-Compulsive Scale (Y-BOQS) and Obsessive Beliefs Questionnaire-44 (OBQ-44)), assessment of sensory perception and sensory properties of obsessive thoughts (Sensory Perception Quotient (SPQ 21) and Sensory Properties of Obsessive Thoughts Questionnaire (SPOQ)).

Results

The results will help us understand the interaction between perceptual and cognitive processes in OCD.

Conclusions

Better definition of OCD psychopathology and the establishment of a sensory subtype may indicate the need of specific therapeutic indications or a different escalation of treatment measures.

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Oral Communications (ID 1110) AS25. Old Age Psychiatry

O193 - Can we reduce the stigmatisation experience with psychosocial interventions? An investigation of the Meeting Centre Support Programme impact on people with cognitive impairments.

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
12:12 - 12:24
Presenter

ABSTRACT

Introduction

People living with dementia or mild cognitive impairment (MCI) experience stigmatisation and there are not many specific psychosocial interventions dedicated to help them coping with this issue, reducing its impact on their lives.

Objectives

This study aimed to a) investigate the stigmatisation level among people with dementia and MCI in Poland, Italy and the United Kingdom and b) assess the role of the Meeting Centre Support Programme (MCSP) in decreasing stigmatisation.

Methods

We investigated outcomes for 114 people with dementia and MCI living in Italy, Poland and the UK who participated 6 months in MCSP or usual care (UC) using a pre/post-test control group study design. Level of stigmatisation was assessed with the Stigma Impact Scale: neurological impairment (SIS).

Results

Stigmatisation level (SIS) among participants varied from 2 to 65 (median=33.5; Q1=27; Q3=41) with people from the UK experiencing a statistically significantly higher level of stigmatisation than people in Italy and Poland. In Italy, stigmatisation was lower (p=0.02) in the MCSP group following the intervention. In Poland, the social isolation level did not significantly change in MCSP, but increased (p=0.05) in UC. In the UK, the social rejection level raised (p=0.03) in MCSP. Overall, the combined data of the three countries did not show statistically significant differences in SIS between MCSP and UC.

Conclusions

Stigmatisation among people with dementia and MCI is complex and seems culturally dependent. There is a great opportunity in psychosocial interventions to reduce the burden of stigma among people with dementia which requires further investigation.

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Oral Communications (ID 1110) AS25. Old Age Psychiatry

O194 - Rates of 1-year cognitive impairment in older adults who developed delirium due to a systemic infection

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
12:24 - 12:36
Presenter

ABSTRACT

Introduction

Delirium affects a significant proportion of hospitalized older patients with acute infections. There is growing evidence that delirium accelerates the cognitive decline at long term.

Objectives

We aimed to determine if delirium during hospitalization was independently associated with cognitive deterioration at one-year.

Methods

From a total of 22 patients (12 C, 4 Dem, 2 D, and 4 DD) delirium (D and DD groups) was associated with a worse score in MOCA of 3-points (p<.02) and 2.5-points (p<.03), respectively, at one year, follow up. Dementia patients without delirium had a decrease of 2-point (p=.04) while cognitively healthy patients had a decrease in 1.08 points (p=.05) (Graph1). MOCA and NPI scores during hospitalization correlated significantly with cognitive decline in the four groups (r=.658, p<.01 and r=.439, p=.02, respectively.)

Results

From a total of 22 patients (12 C, 4 Dem, 2 D and 4 DD) delirium (D and DD groups) was associated with a worse score in MOCA of 3-points (p<.02) and 2.5-points (p<.03), respectively, at one year follow up. Dementia patients without delirium had a of 2-point (p=.04) while cognitively healthy patients had a decrease in 1.08 points (p=.05) (Graph1). MOCA and NPI scores during hospitalization correlated significantly with cognitive decline in the four groups (r=.658, p<.01 and r=.439, p=.02, respectively.)

graph1epa.png

Conclusions

Individuals developing delirium while recovering from infection have higher rates of cognitive decline after one year, but the cognitive decline is also present to a lower extent for individuals with infections that did not develop delirium.

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Oral Communications (ID 1110) AS25. Old Age Psychiatry

O195 - Prevalence and Nature of Sexual Violence in a Gerontopsychiatric Population in Flanders

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
12:36 - 12:48
Presenter

ABSTRACT

Introduction

Sexual violence (SV) is an important public health concern which may induce important and long lasting mental health problems. However, studies on SV and its mental health impact on older adults and more specifically gerontopsychiatric patients are currently lacking.

Objectives

This study aims to contribute to a better understanding of the prevalence, risk factors and mental health impact of SV in a gerontopsychiatric patient population.

Methods

Between July 2019 and March 2020 100 patients (66%F, 34%M) participated in a face to face interview on health, sexuality and wellbeing during their admission at an old age psychiatry ward in one general hospital and two psychiatric hospitals across Flanders, Belgium. Participation rate was 58%. Interviews were performed by a psychiatric trainee and especially trained master students in medicine.

Results

58% (65%F; 42%M) of the participants were sexually victimised during their life, 45% (51%F, 33%F) experienced hands-off SV, 43% (48%F, 33%M) sexual abuse with physical contact and 16% (6%M, 21%F) was raped. 7% were sexually victimised in the past year. Compared with non-victimized respondents, hands-on SV victims (incl. rape) described more symptoms of depression (p=0.007) and anxiety (p=0.003) and reported lower resilience (p=0.022).

Conclusions

SV appears to be common in the gerontopsychiatric population and is linked to even worse mental health outcomes. These findings confirm the long-lasting mental health impact of SV and highlight the importance of attention to (sexual) trauma in mental health care in old age.

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Oral Communications (ID 1110) AS25. Old Age Psychiatry

O197 - Modeling the Appearance and Progression of Cognitive Impairment

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
12:48 - 13:00
Presenter

ABSTRACT

Introduction

It remains difficult to predict which individuals will develop cognitive impairment and progress to major neurocognitive disorders. Prevention studies suffer from the long time frames and the manner in which this topic does not lend itself to randomized, double-blinded controlled trials.

Objectives

We aimed to construct a computer simulation model that would accurate portray the time course for a series of individuals to develop cognitive impairment and to progress to major neurocognitive disorder.

Methods

We built a computer simulation model that incorporated the role of exercise, genetic load, age, quality of diet, presence of diabetes and level of hemoglobin A1C, ongoing levels of cognitive stimulation, presence or absence of micronutrients, presence or absence of other co-morbidities, an overall general health index, levels of smoking and other substance use, and family history. We modeled the life course of 10 individuals, adjusting parameters to make correct predictions for all 10 people. Then we entered the data from another 10 people to determine how accurate the model would be with ten new individuals for whom it had not been developed.

Results

We defined success as a prediction of onset within 10% of the actual date and a prediction of the slope of the trend within 20%. We had 7 successes. We were able to engage 6 of the 10 in interacting with the model to change health behaviors.

Conclusions

Computer simulation modeling may provide an opportunity to study the long-term effects of health behaviors and to engage people in interacting with the program to change behavior.

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Oral Communications (ID 1110) AS27. Pain

O200 - The role of interoception in the mechanism of pain and fatigue in fibromyalgia and myalgic encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
13:00 - 13:12

ABSTRACT

Introduction

Pain, 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.

Objectives

To 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.

Methods

Sixty-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.

Results

Patients 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.

Conclusions

This 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.

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Oral Communications (ID 1110) AS28. Personality and Personality Disorders

O201 - Do personality traits influence the stigmatizing attitudes toward people with mental illness? A web-survey among university students.

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
13:12 - 13:24

ABSTRACT

Introduction

People from the general population often tend to believe that psychiatric patients may be incurable, dangerous, and unpredictable. Stigma represents a critical issue which should be defeated. In spite of the interest of research, little is known about the relationship between personality traits and level of stigma toward people with mental illness.

Objectives

To evaluate whether certain personality traits can influence the level of stigma towards mental illness in a population of university students.

Methods

A web-survey was spread on social networks between March and June 2020 through Google Forms. Eligibility criteria for inclusion were:1) Being 18 years of age or older; 2) Attending a degree course in an Italian University; 3) Provide informed consent. Socio-demographic characteristics of the participants were collected. Stigma was measured using the Attribution Questionnaire (AQ-27), personality traits were evaluated through the Big Five Inventory (BFI) and the Mental Health Knowledge Schedule (MAKS-i) investigated the knowledge about mental illness. Statistical analyses were performed using SPSS 24.0.

Results

We computed a multiple linear regression to calculate potential predictors of stigma, adjusted on the basis of the knowledge of mental illness. Results showed that age and faculty class were not related to stigma. Agreeableness (A) and Openness to experience (O) were associated with less stigmatizing attitudes. Conversely, Neuroticism (N) and Conscientiousness (C) seemed to predict higher levels of stigma.

Conclusions

Our results suggest an interesting relationship between personality traits and stigmatizing attitudes, which deserves to be further studied. They also confirm the importance of implementing appropriate strategies against the stigma of mental illness.

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Oral Communications (ID 1110) AS28. Personality and Personality Disorders

O202 - Triple Network in adolescents with Borderline Personality Disorder, early traumatic experiences and dissociative symptoms: an eLORETA study.

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
13:24 - 13:36

ABSTRACT

Introduction

Triple Network Model (TNM), which considers the dynamic interaction between Default Mode (DMN), Salience (SN), and Central Executive (CEN) networks, explains clinical features in mental disorders from a neurophysiological perspective. Some studies highlight the increased connectivity in TNM in adults with Borderline Personality Disorder (BPD), but little is known about adolescents.

Objectives

The aim of our preliminary study was to investigate TN functional connectivity (FC) in BPD adolescents with a history of traumatic experiences, and its correlation with dissociative symptoms.

Methods

15 BPD adolescents (DSM-5 criteria) with early traumatic experiences were compared to 15 healthy controls, matched for sex and age. Dissociation Questionnaire (DIS-Q) was administered. Eyes-closed resting-state (RS) EEG recordings were performed (19 electrodes; 10- 20 system) and analyzed using Exact Low-Resolution Electromagnetic Tomography software (eLORETA). FC was computed for all frequency bands and 9 Regions of Interest for TNM.

Results

BPD adolescents showed a hyper-connection between CEN and DMN [dorso-lateral prefrontal cortex (dlPFC) and posterior cingulate cortex (PCC); PCC and left posterior parietal cortex (PPC)] and within the CEN (left and right PPC). The strength of PCC-dlPFC and left-right PPC connections was correlated with dissociative symptoms severity.

Conclusions

FC alterations can already be identified in BPD adolescents, supporting the need for early diagnosis.

Normally DMN and CEN show opposite functioning. In our BPD adolescents, the absence of this "anti-correlation" reflects the typical confusion between internal and external mental states, which clarify their difficulties in metacognition or mentalization. Moreover, in dissociative symptoms, two CEN nodes are also involved, not only DMN as previously described.

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Oral Communications (ID 1110) AS28. Personality and Personality Disorders

O203 - Study retention prediction with AI

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
13:36 - 13:48
Presenter

ABSTRACT

Introduction

Openness, conscientiousness, extroversion, agreeableness and neuroticism are dimensional personality traits known as the Big Five. Study attrition is a common but often hard to anticipate problem. Artificial intelligence (AI) could examine both fronts to mitigate the unpredictability of the latter.

Objectives

To investigate whether AI could predict study attrition employing personality traits scores.

Methods

Data from 2,697 questionnaires were analysed using an AI. The short form of the International Personality Item Pool was used to assess the Big Five personality traits on the first of three planned waves. The personality traits scores were employed to predict the missing of at least one wave. Overall attrition was 17.6%. The AI was conservatively tuned to minimize the negative likelihood ratio when confronting predicted and real attrition. The free and open source programming language R was used for all the analyses. Dataset source: Hansson, Isabelle; Berg, Anne Ingeborg; Thorvaldsson, Valgeir (2018), “Can personality predict longitudinal study attrition? Evidence from a population-based sample of older adults”, Mendeley Data, V1, doi: 10.17632/g3jx8zt2t9.1

Results

Predictions obtained a negative likelihood ratio of 0.333 and a negative predictive value of 0.933. The results were indicative of fair performance.

Conclusions

AI might be useful to predict study retention. Furthermore, the results of this study might indicate a moderate effect of the Big Five on the probability of study retention. Finally, the AI used in this study is freely available, allowing anyone to experiment.

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Oral Communications (ID 1110) AS28. Personality and Personality Disorders

O204 - Dark triad personality traits prediction with AI

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
13:48 - 14:00
Presenter

ABSTRACT

Introduction

The dark triad is composed by the personality traits Machiavellianism, narcissism and psychopathy (MNP). Their complexity can make them difficult to interrelate. Artificial intelligence (AI) could help in this endeavour.

Objectives

To investigate whether AI could predict MNP from themselves.

Methods

Data from 210 questionnaires were analysed using an AI. The short Dark Triad questionnaire (SD3) was used to assess MNP. Two of the MNP scores were employed to predict the third one and the procedure was repeated for all of them alternatively. The AI was conservatively tuned to maximize the one-way random intraclass correlation coefficient (ICC) between predicted and real values. Pearson’s r was calculated too. The free and open source programming language R was used for all the analyses. Dataset source: Borráz-León, Javier I. (2020), “Dark triad, attractiveness, mate value, and sexual partners”, Mendeley Data, V1, doi: 10.17632/87vx6jfnrp.1

Results

Machiavellianism, narcissism and psychopathy predictions obtained ICC of 0.593, 0.335, 0.505 and Pearson’s r of 0.608, 0.346, 0.548 respectively. The results were indicative of fair performance, mainly for Machiavellianism and psychopathy.

Conclusions

AI might be useful to predict MNP. This could be utile in many situations, such as dealing with missing data or deciding whether to formally test someone. Finally, the AI used in this study is freely available, allowing anyone to experiment.

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Oral Communications (ID 1110) AS30. Posttraumatic Stress Disorder

O205 - The psychiatric impact of the 2020 Beirut port explosion on civilians and relief workers

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
14:00 - 14:12

ABSTRACT

Introduction

On August 4th 2020, a massive port explosion shook Beirut, killing at least 200, injuring more than 6,000 people and leaving more than a quarter of a million living in unfit homes. Various factors can participate in the severity of mental health outcomes of a disaster including the number of injuries, the degree of property destruction, unexpectedness of the occurrence of the event, and the type of the disaster.

Objectives

The main aim of this study is to assess the prevalence of post-traumatic stress disorder (acute stress disorder) and major depression at 1 and 6 months following the Beirut explosion. The secondary aim is to determine predictors of PTSD incidence among civilians and relief workers affected by the disaster.

Methods

This is a cross-sectional study with data collected via an online survey through convenience sampling. People will be recruited via social media platforms. To achieve a power of 80% and a two-sided significance of 5% and because gender differences will be explored, assuming a design effect (deff) of 2.5, a minimum sample of 960 participants would be needed. The survey will include sociodemographic data, questions about exposure levels to trauma and a psychiatric symptom inventory. Pearson’s Chi Square test will be used to examine the association between categorical variables and regression models will be run to examine the associations while controlling for confounders, including age, gender and others.

Results

The results from both rounds of data collection (months 1 and 6) will be available in late March 2021.

Conclusions

Conclusions to follow based on results

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Oral Communications (ID 1110) AS30. Posttraumatic Stress Disorder

O206 - Post-traumatic stress,anxiety and depression after intensive care unit stay: findings from a general hospital

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
14:12 - 14:24
Presenter

ABSTRACT

Introduction

Post-traumatic stress disorder(PTSD) following intensive care is a relatively new entity. It is triggered due to traumatic experiences in a setting of threat to life due to illness. Prolonged stay in intensive care predisposes to delusional memories related to the stay experience and may increase likelihood of post-traumatic stress.It may also present as anxiety or depression.

Objectives

This study explored the prevalence of post-traumatic symptoms in intensive care, find its correlates and its impact on health-related quality of life(HRQoL).

Methods

225 adult patients admitted for at least 1 day in the intensive care unit(ICU) of a general hospital in Bangalore,India were recruited and assessed at 1 week,1 month and 3 months after ICU discharge. Subjects were assessed for ICU related memories,PTSD,anxiety and depression scores and quality of life at and post discharge.

Results

59.6% of the study population had significant post-traumatic stress, including anxiety in 62.35%, depression in 10.58% and mixed anxiety-depression in 27.06%. Delusional memories were found in 31.6%. Presence of delusional memories was found to have significant correlation with post-traumatic stress and had a negative impact on HRQoL.

Conclusions

This study was the first of its kind from Asia. More systematic studies on PTSD following ICU stay and its correlates are required as available evidence lacks homogeneity. Suitable preventive measures should be taken to reduce prevalence of post-traumatic stress in intensive care due to its lasting impact on HRQoL.

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Oral Communications (ID 1110) AS30. Posttraumatic Stress Disorder

O207 - A comparison of MDMA-assisted psychotherapy to non-assisted psychotherapy in treatment-resistant PTSD: A systematic review and meta-analysis

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
14:24 - 14:36

ABSTRACT

Introduction

Novel, evidence-based treatments are required for treatment-resistant post-traumatic stress disorder (PTSD). 3,4-Methylenedioxymethamphetamine (MDMA) has beneficially augmented psychotherapy in several small clinical trials.

Objectives

To review the use of MDMA-assisted psychotherapy in treatment-resistant PTSD.

Methods

Systematic searches of four databases were conducted from inception to February 2020. A meta-analysis was performed on trials which were double-blinded, randomised, and compared MDMA-assisted psychotherapy to psychotherapy and placebo. The primary outcomes were the differences in Clinician Administered PTSD Scale (CAPS-IV) score and Beck’s Depression Inventory (BDI). Secondary outcome measures included neurocognitive and physical adverse effects, at the time, and within seven days of intervention.

Results

Four randomised controlled trials (RCTs) met inclusion criteria. When compared to active placebo, intervention groups taking 75mg (MD -46.90; 95% CI -58.78, -35.02), 125mg (MD -20.98; 95% CI -34.35, -7.61) but not 100mg (MD -12.90; 95% CI -36.09, 10.29) of MDMA with psychotherapy, had significant decreases in CAPS-IV scores, as did the inactive placebo arm (MD -33.20; 95% CI -40.53, -25.87). A significant decrease in BDI when compared to active placebo (MD -10.80; 95% CI -20.39, -1.21) was only observed at 75mg. Compared to placebo, participants reported significantly more episodes of low mood, nausea and jaw-clenching during sessions and lack of appetite after seven days.

Conclusions

These results demonstrate potential therapeutic benefit with minimal physical and neurocognitive risk for the use of MDMA-assisted psychotherapy in TR-PTSD, despite little effect on Beck’s Depression Inventory. Better powered RCTs are required to investigate further.

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Oral Communications (ID 1110) AS30. Posttraumatic Stress Disorder

O208 - Suicidality in post-traumatic stress disorder (PTSD) and complex PTSD (cPTSD)

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
14:36 - 14:48
Presenter

ABSTRACT

Introduction

International 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).

Objectives

This 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.

Methods

The 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).

Results

cPTSD 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.

Conclusions

Our 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.

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Oral Communications (ID 1110) AS30. Posttraumatic Stress Disorder

O209 - Efficacy and safety results from the first pivotal Phase 3 randomized controlled trial of MDMA-assisted psychotherapy for treatment of Severe Chronic PTSD

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
14:48 - 15:00

ABSTRACT

Introduction

Posttraumatic stress disorder is a prevalent mental health condition with substantial impact on daily functioning that lacks sufficient treatment options. Previous research has led to the designation of 3,4-methylenedioxymethamphetamine (MDMA) as a Breakthrough Therapy for treatment of post-traumatic stress disorder (PTSD) when administered as an adjunct to psychotherapy.

Objectives

Here we report the findings of the first randomized, double-blind, Phase 3 trial assessing the efficacy and safety of 3 sessions with a flexible dose of MDMA or placebo administered under direct observation to participants with severe PTSD (n = 100) as an adjunct to inner-directed psychotherapy.

Methods

Change in PTSD symptoms (CAPS-5) and functional impairment (SDS) were assessed by a central, blinded Independent Rater Pool at baseline and following each treatment session. Adverse events (AEs), concomitant medications, suicidal ideation and behavior were tracked throughout the study. Vital signs were measured during experimental sessions. The primary endpoint was 18 weeks post-randomization.

Results

Change in CAPS-5 and SDS, placebo-subtracted Cohen’s d effect size, and a responder analysis will be presented. There were three serious AEs of suicidal ideation or behavior reported. MDMA was well tolerated, with some treatment emergent AEs occurring at greater frequency for the MDMA group during and after experimental sessions.

Conclusions

If MDMA-assisted psychotherapy significantly attenuates PTSD symptomatology and associated functional impairment, these results will form the basis for marketing authorization applications worldwide, including among participants with dissociative subtype of PTSD, depression, history of alcohol and substance use disorders, and adverse childhood experiences.

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Oral Communications (ID 1110) AS31. Precision Psychiatry

O210 - Depression patient-derived cortical neurons reveal potential biomarkers for antidepressant response

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
15:00 - 15:12
Presenter

ABSTRACT

Introduction

Major depressive disorder is highly prevalent worldwide and has been affecting an increasing number of people each year. Current first line antidepressants show merely 37% remission, and physicians are forced to use a trial-and-error approach when choosing a single antidepressant out of dozens of available medications.

Objectives

We sought to identify a method of testing that would provide patient-specific information on whether a patient will respond to a medication using in vitro modeling.

Methods

Patient-derived lymphoblastoid cell lines from the STAR*D study were used to rapidly generate cortical neurons and screen them for bupropion effects, for which the donor patients showed remission or non-remission.

Results

We provide evidence for biomarkers specific for bupropion response, including synaptic connectivity and morphology changes as well as specific gene expression alterations.

Conclusions

These biomarkers support the concept of personalized antidepressant treatment based on in vitro platforms and could be utilized as predictors to patient response in the clinic.

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Oral Communications (ID 1110) AS31. Precision Psychiatry

O211 - Individual-specific and subgroup level associations between stress and psychopathology in daily life: a temporal network investigation.

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
15:12 - 15:24

ABSTRACT

Introduction

Stress is a risk factor for developing psychopathology. Emerging evidence suggests that daily experiences of stress may also predict symptoms during the day. It is unclear to what extent the influence of stress on psychopathology during the day is the same across individuals (including across diagnostic boundaries), and which effects are individual-specific

Objectives

This study aims to reveal how stress and symptoms are interrelated in a cross-diagnostic context by modeling individual level temporal networks, and examining subgroups with similar dynamics.

Methods

Hundredtwentytwo young adults (43.4% women) with a wide range of psychopathology in terms of severity and type of problems completed a six-month daily diary study. We used a temporal network approach (i.e., group iterative multiple model estimation) to model how stress and ten specific symptoms (e.g., feeling down, paranoia, restlessness) were related across time at the individual-specific, subgroup, and group level.

Results

After controlling for the lagged influence of stress on itself, stress level predicted the level of restlessness, worrying, nervousness, and feeling down during the same day for >70% of individuals. We observed three larger subgroups with each over 20 individuals, whose temporal networks showed different dynamic patterns involving specific symptoms. Effects of stress on other specific symptoms differed across individuals, and these were not subgroup-specific.

Conclusions

This study showed important overlap between individuals in terms of impact of stress on psychopathology in daily life. Subtle differences between individuals were also observed. Possibly, such differences are relevant for examining individual-specific vulnerability for future psychopathology. This requires further investigation.

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Oral Communications (ID 1110) AS31. Precision Psychiatry

O212 - Pharmacogenetic drug use in young Danish individuals with severe mental disorders

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
15:24 - 15:36
Presenter

ABSTRACT

Introduction

Pharmacogenetics (PGx) studies genetic variance and related differences in drug outcomes. PGx guidelines for psychotropic drugs are available (PGx drugs), but PGx testing is used only limitedly in psychiatric clinical practice.

Objectives

The aim of this study is to pinpoint different aspects of PGx drug use in the population, to support clinical uptake of PGx.

Methods

This drug utilization study investigated prescription PGx drug use in 56,065 young individuals with different severe mental disorders (SMD) in the Danish iPSYCH sample (born 1981-2005). We investigated the number of PGx drug users (incidence, prevalence), age (at first PGx drug use), sex, multiple PGx drugs per user (in light of panel-based PGx testing) and concomitant use of PGx drugs (in light of combinatorial PGx testing).

Results

We identified substantial PGx drug use in terms of incidence rates (e.g. 333 per 10,000 person years for the anticonvulsant lamotrigine) and prevalence (e.g. 15,260 users for the antidepressant citalopram) in patients with SMD. The age of first time PGx drug use ranged from 11.6-20 years, depending on SMD and sex. On average, more than one PGx drug was used by a single person (range 1.6-5.6 drugs, depending on SMD) or even used concomitantly (41-69%) affecting mostly two different PGx genes (84-92% of concomitant PGx drug users).

Conclusions

PGx drugs were frequently used in young individuals with SMD, often subsequently and concomitantly, arguing for panel-based/combinatorial PGx testing over single-gene testing. PGx testing could be applied already at a very young age.

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Oral Communications (ID 1110) AS31. Precision Psychiatry

O213 - Pharmacogenetics and ADHD treatment outcomes in the Danish population-based iPSYCH sample

Date
Sat, 10.04.2021