Welcome to the 21st WCP Virtual Congress Program Scheduling

Objectives

Neuropsychiatric symptoms are increasingly recognized as being key features of Alzheimer disease. Depression and apathy tend to appear in the mild cognitive impairment (MCI) stage of the disease and they often co-occur together. Those NPS are associated with disease progression in patients with MCI. It is still unclear whether these symptoms have a similar impact on cognitive performance as well as brain morphology, which we aimed to investigate.

Methods

215 cognitively healthy participants (CH) and 355 patients with mild cognitive impairment (MCI) from the Alzheimer Disease Neuroimaging Initiative database were assessed with (1) the NeuroPsychiatric Inventory, (2) a comprehensive neuropsychological assessment and (3) a 3T MRI. General Linear Model analysis (FreeSurfer 7.1.1 mri_glmfit) Monte-Carlo corrected (p<0.01) was performed to define the effect of the severity of neuropsychiatric variables on cortical area and thickness in our groups and in a two-by-two comparison.

Results

Intergroup comparison showed a significant difference in cortical thickness in the left entorhinal cortex (independent of the NPS presence). As expected, in the CH group, worse depression correlated with cortical thinning of the left frontal superior cortex. Interestingly, depression did not have significant correlations in the MCI group. On the other hand, apathy showed negative correlations only in the MCI group, specifically with the left parahippocampal and postcentral cortices.

Conclusions

Our data suggest that depression and apathy, as negative NPS, have different influences on brain morphology and might be considered to be studied together in order to better quantify the negative NPS.

Objectives

To design a simple and easy meditation protocol for persons with schizophrenia and evaluate feasibility and acceptability of manualised yoga practice along with manualised meditation in schizophrenia patients and whether it could influence their cognitive performance, clinical variables and quality of life.

Methods

A simple and short meditation protocol consisting of Anapan which is first step in practice of Vipassana, and yog nidra (conscious relaxation) was designed for schizophrenia patients. The protocol was of half an hour duration. Consented persons with schizophrenia (n=145) were randomized to yoga training (YT), meditation + yoga training (MYT) and treatment as usual (TAU). Manualized YT (asanas alone) and MYT (asanas + meditation) were imparted to the participants for three weeks. TAU continued on their ongoing treatment. Cognitive, and social functions were assessed at baseline, after intervention/no intervention and three-months post yoga.

Results

Consented (N=145) patients were randomized to three groups (YT 50; MYT 48 and TAU 47). A total of 41 YT and 40 MYT participants completed intervention and were assessed after three weeks along with TAU; 82% YT and 83% MYT completed intervention successfully, suggesting high acceptability. Reasons among both groups for non-completion were difficulty in performing asanas, irregular attendance, lack of confidence and unavailability of accompanying relative. Other outcome variables are being analyzed.

Conclusions

A short protocol of meditation, developed for schizophrenia, was found to be easy to follow, acceptable and feasible for person with schizophrenia. No adverse effects were reported. Both yoga and meditation could be used in treating schizophrenia for cognitive and physical benefits.

Objectives

Large-scale genome-wide association studies (GWAS) have identified multiple disease-associated genetic variations across different psychiatric disorders, however, these findings are yet to inform novel drug discoveries. To facilitate better clinical translation, we introduce new methods to evaluate whether genes implicated by GWAS for psychiatric disorders are related to the gene targets of their pharmacological treatments.

Methods

For each disorder, we constructed two sets of scores for 2155 genes identified as targets for treatments in the DrugBank database. The first score quantified the involvement of each gene as a treatment target for that disorder, the second score - its similarity to significant GWAS variants according to a range of bioinformatic datasets including position, distance on the protein interaction network (PPI), brain eQTL, and regional brain gene expression.

Results

Using those scores, we investigated which disorders and mapping methods demonstrated significant correspondence between treatment targets and genes implicated by GWAS. We found that PPI-based GWAS scores for bipolar disorder and diabetes show significant correspondence to their respective treatments, indicating that incorporating biologically-relevant information can reveal links between genetic origins and treatment targets. For the majority of other disorders including ADHD no mapping of GWAS SNPs showed overlap with drug targets.

Conclusions

Together, our results demonstrate the potential of exploiting PPI networks to explore the mechanisms underlying current treatments. The lack of correspondence between treatment targets and genes implicated by GWAS across other modalities suggests that current treatments do not match the genetic origins of those disorders and new approaches for understanding psychiatric disorders may be required.

Objectives

Mentally ill. Deviant. Diseased. And in need of a cure.

These were among the terms psychiatrists used to describe lesbians and gay men in the 1950s, 60s, and early 70s. According to the Diagnostic and Statistical Manual of Mental Disorders, every gay person—no matter how well-adjusted—suffered from a curable mental illness. And as long as lesbians and gay men were “sick,” progress toward equality was impossible. Slated for national broadcast on PBS, CURED takes viewers inside the David-versus-Goliath struggle that led the APA to declassify homosexuality as a mental disorder in 1973.

Methods

While CURED is indisputably about science, medicine, and politics, at its core this is a film about the process of social change. It features a diverse group of activists who came together at a crossroads in LGBTQ history. Their tenacity and ingenuity brought about a shift that transformed not only LGBTQ people’s perceptions of themselves, but also the field of psychiatry and the social fabric of America.

Results

Following a screening of the trailer and/or clips from the film, the co-directors will examine the significance of the events chronicled in CURED and the argument that — as one reporter put it in 1973 — the removal of homosexuality from the DSM marked “the greatest gay victory.” Presenters will examine how this decision affected the relationship of LGBTQ+ people to medical institutions and the shift in psychiatry from attempting to “cure” LGBTQ+ people to supporting them in their personal and sexual lives.

Conclusions

Here’s a link to the trailer: https://www.cureddocumentary.com/

Objectives

The Selection of the most suitable instrument for a health outcome or exposure assessment is challenging, as there are many different instruments and their versions, most with unknown validity. Based on our experience, we developed guidelines facilitating the search for the most suitable instrument, and formalized it as a five-step process.

Methods

The first step is the search for systematic reviews of available instruments validity in COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN), International prospective register of systematic reviews (PROSPERO), or conventional (e.g., Medline and Web of Science) databases. If there is no systematic review, the clinician should look for original validation studies and assess them critically. We presented two alternatives for this assessment: qualitative using COSMIN and quantitative using our methodological framework. The latter helps to decide upon the instrument validity completeness and interpret the statistical results from original studies objectively. These steps were translated into guidelines. Three external clinicians tested them independently to select the most appropriate instrument to measure depression, occupational stress, and daily fatigue.

Results

The guidelines were proved to facilitate the instrument search and selection, and found practical and time-saving. The guidelines assessment highlighted that clinicians should check whether the instrument that they are looking for was developed for screening or diagnosing purposes, whether it can be self-administered or not, and for which setting it was validated (academic versus clinical).

Conclusions

These guidelines facilitate the objective choice of the most suitable instrument in clinical practice by making the search simple, systematic, and time-effective.

Objectives

To determine the association between sociodemographic factors and the presence of depressive symptoms in pregnant women

Methods

A cross-sectional study is part of the research project "Biopsychosocial health in low-risk pregnant women in prenatal consultation". Carried out in women from the Clinica Santa Cruz de Bocagrande in the Colombian Caribbean, pregnant of any age, who participated anonymously and voluntarily. A form was designed with sociodemographic characteristics. The Depression Scale of the Center for Epidemiological Studies 10-item version (CES-D10), the Epworth Scale, the PSS-10 scale, and the Jenkins Sleep Evaluation Questionnaire were used. A not adjusted logistic regression was performed. Spearman coefficient was calculated, a p<0.05 was considered significantive.

Results

683 pregnant women with a mean age of 28.3 (SD=6.3) years were included, 50.4% housewives, 32.6% nulliparous, and 60% practitioners of religious beliefs. Depressive symptoms were found in 142 women (20.8%) [95%CI:17.9-24]. Main associated factors wth depressive symptoms were: sleep disorders OR: 8.83[95%CI:5.20-14.90], stress OR: 5.10 [95%CI:3.44-7.55], relationship problems OR: 4.50 [95%CI:2.56-7.89], fatigue: OR:4.08 [95%CI:2.46-6.75], anxiety: OR: 3.75 [95%CI:2.49-5.64] and excessive daytime sleepiness OR: 3.29 [95%CI:2.06-5.25]. Being a practitioner of religious beliefs was found to be a protective factor against suffering depressive symptoms OR: 0.64 [95%CI:0.44-0.92]. Through the Spearman coefficient, it was found that the CES-D10 score increases as the gestational age increases. p<0.01.

Conclusions

In a group of low-risk pregnant women who attended prenatal care: sleep disorders, daytime sleepiness, relationship problems, stress, anxiety, and fatigue were found to be associated with depressive symptoms. Meanwhile being a practitioner of religious beliefs reduce depressive symptoms.

Objectives

Finland published its ten-year national mental health policy strategy on February 11th 2020. An extensive group of experts, including specialists in the mental health services, mental health organizations, and people of experience, was responsible for preparing the content of the Mental Health Policy Strategy through a participatory process with stakeholders and citizens.

Methods

The strategy has five priority areas: mental health as a human capital, mental health of children and young people, mental health rights, services, and mental health management. In addition, the strategy includes the Programme for Suicide Prevention 2020–2030.

Results

The implementation of the strategy began in 2020. Primary care services are strengthened by implementing evidence-based psychosocial interventions to the primary care and by developing multidisciplinary collaboration and integration of primary care with specialized services. Mental health promotion in municipalities is strengthened by improving mental health literacy and skills of professionals working in different sectors and by strengthening intersectoral approach. For people with a severe mental disorder, implementation of an individual placement and support model to Finland has been started to increase work participation. Suicide prevention is targeted especially at high-risk populations as well as areas of residence with high suicide mortality. Finally, a programme for promoting mental health in the workplace has been started.

Conclusions

This presentation will give an overview of the mental health strategy and suicide prevention programme and current progress in their implementation.

Objectives

Studies have suggested a direct relationship between masticatory activity imbalances and cognitive impairment. So, to evaluate the influence of prion disease and reduced mastication, we investigated behavioral performances in spatial memory.

Methods

The animals were maintained in an enriched environment until they complete 9 (9M) or 15 months (15M), representing, young and aged adults. For each age, three diets were imposed: HD - hard diet; HD/SD - hard diet/soft diet; HD/SD/HD - hard diet/soft diet/hard diet. The 9M and 15M animals were inoculated at 5 and 11 months, respectively, using ME7 agent or normal brain homogenate (NBH). To assess spatial memory, the animals were subjected to the Place Memory Test. Differences between groups were tracked using the t-test for independent samples (p <0.05), comparing exploration time in displaced object and in stationary object.

Results

The differences were significant (mean in the displaced object ± standard error) in the 9M NBH (HD 62,92 ± 9,28 p=0,0363; HD/SD 66,79 ± 10,01 p=0,0152; HD/SD/HD 68,43 ± 9,72 p= 0,0089) and 9M ME7 (HD/SD 74,38 ± 9,30 p= 0,0015) groups. In aged age, only in the infected group: 15M ME7 (HD 78,79 ± 8,94 p= 0,0005; HD/SD 93,7 ± 1,94 p<0,0001; HD/SD/HD 60,18 ± 6,54 p=0,0204).

Conclusions

In 9M and 15M NBH groups, chewing activity had no influence on memory functions, as well as in aging adults with prion disease (15M ME7). However, in those 9M ME7, chewing activity seems to influence the performance of the Place Memory Test. There is no conflict of interest.

Objectives

Understand the importance of palliative care in severe mental illness.

Methods

Non-systematic literature review on current knowledge about palliative care principles in psychiatric conditions.

Results

Severe and persistent mental illness (SPMI) is defined by a chronic condition refractory to treatment and where recovery in a curative sense is out of reach. In these cases, Palliative psychiatry (PP) focuses on integrating physical, mental, social and spiritual aspects of patient care. Psychiatry and Palliative care already work together in treatment of life-threatening medical conditions. When it comes to psychiatric disorders, there`s no guidelines accepted for providing palliative care. According to the WHO, palliative care is "an approach that improves quality of life of patients with life-threatening illness, and their families, through prevention and relief of suffering by early assessment and treatment of physical, psychosocial and spiritual problems". Based on this definition some psychiatric interventions can be considered palliative, in patients with SPMI. Changing the perspective from curative to palliative care promotes a patient-centered approach, increasing autonomy and improving overall outcomes for these patients. However, explicitly switching to a palliative treatment route hasn`t been widely implemented in mental health care.

Conclusions

Palliative approach within Psychiatry has the potential to support the individual in reaching life recovery goals through self-determination, dignity and acceptance. The first step toward PP is to recognize the palliative approaches that already exist implicitly in Psychiatry whose competencies include diagnostic and prognostic communication, symptom assessment and management, advanced (mental health) care planning, assessment of caregiver needs and referral to specialized services.

Objectives

To analyse changes in browser search patterns of mental-health (MH) and mental-illness (MI) related topics in Portugal during COVID-19 pandemic, and its relationship with epidemiological and administrative clinical data.

Methods

Data of search patterns of MH and MI-related topics in Portugal, between March 2019 and March 2021, was collected using Google Trends® analytics. National MH-related clinical and administrative data was collected from Directorate-General for Health (DGS) databases, and socioeconomic data was collected from the Statistics Portugal (INE). The data was analysed using Excel® and SPSS® statistical software.

Results

This investigation identified pandemic-associated spikes in Google® searches on general MH information, particularly anxiety symptoms and remote treatments for anxiety. This is consistent with preliminary data from similar published literature. Further results, including association with Portuguese administrative and epidemiological data, will be presented during the 21st WPA World Congress of Psychiatry.

Conclusions

Changes in research patterns on MH-related data during the pandemic appear to be useful to understand its effect on MH on a population level and could potentially guide public health responses on this area. Google Trends® information on research patterns, particularly concerning health-information seeking, has been recently introduced to clinical and medical investigation, although its potential is still underrecognized. Further studies are warranted to better understand the relationship between surveillance of Google® research patterns and population-wide health indicators.

Objectives

Major depressive disorder (MDD) is a debilitating condition with a high disease burden and medical comorbidities. There are currently few validated biomarkers to guide the diagnosis and treatment of MDD. The present study evaluated the differences between patients with MDD and healthy controls (HCs) in terms of cortical haemodynamic changes during the verbal fluency test (VFT) using functional near-infrared spectroscopy (NIRS) and serum amino acid profiles, and these parameters were correlated with clinical characteristics.

Methods

Twenty-five subjects with MDD and 25 age-, gender-, and ethnicity-matched HCs were recruited for the study. Real-time monitoring of the haemodynamic response during completion of a VFT was quantified using a 52-channel NIRS system. Serum samples were analysed and quantified by liquid chromatography-mass spectrometry for metabolite profiling. Receiver-operating characteristic (ROC) curves were used to classify the candidate biomarkers.

Results

MDD patients had lower prefrontal and temporal activation during completion of the task than HCs. MDD patients had lower mean concentrations of oxy-Hb in the left orbitofrontal cortex (OFC) and lower serum histidine levels. When the oxy-haemoglobin response was combined with the histidine concentration, the sensitivity and specificity of results improved significantly from 66.7% to 73.3% and from 65.0% to 90.0% respectively, as compared to results based only on the NIRS response.

Conclusions

These findings demonstrate the use of combination biosignatures to aid in the diagnosis of MDD. This technique could be a useful approach to detect MDD with greater precision, but additional studies are required for validation.

Objectives

Domestic violence can be defined as any behavior used to continuously inflict physical, sexual, mental or economical suffering to anyone who shares the same residence or share(d) an intimate relationship. If these behaviors are perpetrated in the context of a past or actual relationship, we call it “intimate partner violence”, wich is, according to WHO, the most frequent form of violence against women.

Intimate partner violence and domestic violence in general are known to have a propensity to rise during emergency situations, including epidemic crisis, due not only to social isolation measures but also to increased anxiety levels, substance abuse,… Access to health care facilities can be restricted, making it difficult to ask for help or find support.

We try to describe and analyze different methods used on several countries to promote support and assure medical care access to victims of domestic violence during Covid-19 pandemic.

Methods

Non-systematic literature review using Medline and Google Scholar database.

Results

During Covid-19 pandemic, different countries reported an increase in violence, including against women and men, by an intimate partner and against children. This fact created the need to find some alternative ways to provide support and protection to the victims in order to assure their mental and physical health, that varied from one country to another.

Conclusions

Assuring the safety of victims during this troubled period we are living must be a priority for the governments in order to promote their physical and mental health.