E. Rancans, Latvia

Riga Stradins University Psychiatry and Narcology
Elmārs Rancāns is Professor of Psychiatry and Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Riga, Latvia. Having graduated from the Faculty of General Medicine, Latvian Academy of Medicine, he completed post-graduate training in psychiatry at the Riga Psychoneurological hospital, Latvia. Dr. Rancans has defended his PhD at the Department of Psychiatry, Umea University, Sweden on the topic of suicide research. Dr. Rancans is currently involved in the teaching of students and he is also a Head of Residency training programme at the Riga Stradins University. He is actively lecturing nationally and internationally at different CME events for GPs and specialists. The current clinical and research interests of Dr. Rancans are epidemiology and psychopharmacological treatment of affective and psychotic disorders. He has participated in numerous international and local trials. Dr. Rancans has published many articles and presented posters at international congresses.

Presenter Of 3 Presentations

Symposium: Early Intervention in Psychoses: Assessment and Treatment to Improve Functional Outcome (ID 352) No Topic Needed

Live Q&A

Session Icon
Pre-Recorded with Live Q&A, Section
Date
Mon, 12.04.2021
Session Time
19:30 - 21:00
Room
Channel 3
Lecture Time
20:38 - 20:58
e-Poster Presentations (ID 1106) AS05. Comorbidity/Dual Pathologies

EPP0234 - Depression, distress and their association with patterns of psychoactive substance use during the COVID-19 emergency state in Latvia

Session Name
e-Poster Presentations (ID 1106)
Date
Sun, 11.04.2021
Session Time
07:30 - 23:59
Room
e-Poster Gallery
Lecture Time
07:30 - 07:30
Presenter

ABSTRACT

Introduction

The WHO warned that the COVID-19 pandemic could have psychiatric consequences such as elevated levels depression, increased alcohol and drug use, and other behaviours that exert a strong influence on health. In Latvia a state of emergency was announced on March 12th, was extended twice and lifted on June 10th.

Objectives

To estimate the prevalence of depression and distress in the general population of Latvia and association with substance use during the state of emergency.

Methods

The nationwide representative online study in the general population of Latvia was conducted in July 2020 during three week period. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to determine the presence of distress/depression. The structured questionnaire to determine psychoactive substance use was applied. Proportions of independent variables across the study groups were compared using Chi-square test.

Results

The study sample included 2608 respondents. The prevalence of depression and distress was estimated at 5.7% (95%CI 4.92 – 6.71) and 13.5% (95%CI 6.85 – 8.91), respectively. Patients with depression (28% vs. 7.4%, p <0.001) and distress (30.9% vs. 7.4% p <0.05) smoked more tobacco compared to respondents without distress/depression. Those with depression or distress were significantly more likely to consume more alcohol during the emergency state than people without depression or distress (14.0% and 17.7% vs. 6.6%, p <0.001). The changes in the use of other psychoactive substances in those who had depression or distress were not statistically significant.

Conclusions

Preparing support systems to mitigate mental health consequences is needed urgently.

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Symposium: Early Intervention in Psychoses: Assessment and Treatment to Improve Functional Outcome (ID 352) No Topic Needed

S0128 - The Challenges in Schizophrenia Treatment in Real-life: The Uncomfortable Truth

Session Icon
Pre-Recorded with Live Q&A, Section
Date
Mon, 12.04.2021
Session Time
19:30 - 21:00
Room
Channel 3
Lecture Time
20:21 - 20:38
Presenter

ABSTRACT

Abstract Body

Certain percentage of the first-episode schizophrenia patients presents with negative symptoms, which persists over the year and influence treatment outcomes (Galderisi et al. 2013). Treatment of negative symptoms has been a significant continuous clinical challenge.

Majority of recently published guidelines recommend antipsychotic monotherapy as the standard of care, recommending antipsychotic combination therapy only after a failed trial with clozapine (George A. Keepers et al. 2020; Faden et al. 2020). However, real-life forces clinicians to look for possible combinations of medications early on, especially to tackle negative symptoms.

The systematic review of global prescribing practices covering four decades found the pooled median rate of antipsychotic combination therapy approximately 20% (Gallego et al. 2012). One of the largest retrospective studies every conducted (n = 62,250) assessed rehospitalisation rates and the long-term use of antipsychotic polypharmacy in schizophrenia. Antipsychotic combination treatment was associated with an approximate 10% lower relative risk of psychiatric rehospitalisation compared with antipsychotic monotherapy (Tiihonen et al. 2019). Real-world effectiveness study of antipsychotic monotherapy vs. polypharmacy in schizophrenia from Eastern Europe is also supporting this approach (Katona, Czobor, and Bitter 2014).

At the same time antipsychotic combination therapy can increase the total antipsychotic dose burden, frequency of adverse effects, potential drug-drug interactions and incur additional costs.

In our recent naturalistic study in schizophrenia outpatients (n=120) with insufficient effectiveness of previous antipsychotics therapy on negative symptoms, we were able successfully switch therapy form several different antipsychotic combinations to monotherapy and gain clinical benefits (Rancans et al, 2020).

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