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RECORDED LECTURES
Icon Legend: Pre-Recorded & Scheduled On-Demand 
Filter: Plenary/Presidental Session | Courses | Special Session | State of the Art Symposia |
Interorganizational Symposia | Original Sessions | Panel Discussions
DISCUSSION PAPER ON COMORBIDITIES IN DRUG USE DISORDERS
Abstract
Objectives
Toward the achievement of the SDG Target 3.5, UNODC, in collaboration with WHO and international experts, developed a discussion paper on comorbidities in drug use disorders (DUD) with aims to highlight the evidence related to mental and physical health comorbidities in DUD and to promote the development of innovative, evidence-based policies and practices to treat DUD and comorbid disorders.
Methods
An expert consultation meeting was convened in Vienna in 2017 by inviting international drug treatment experts to discuss the development and framework of the technical document on comorbidities in DUD. The discussion paper has been developed through extensive literature search and review as well as peer-review process.
Results
Over 40 international experts provided input and perspectives through the consultation process. The document describes mental comorbidities in DUD including the relationship between comorbid DUD and other mental health conditions, comorbidity of DUD across different mental health conditions, identification and diagnosis of mental health conditions among people with drug use and DUD. Physical health comorbidities are also discussed including risk factors, comorbidity of DUD across different physical health conditions as well as considerations on prevention and management of comorbidities. The annexes cover screening and diagnostic instruments as well as suggested interventions at different service levels considering gender perspectives.
Conclusions
The discussion paper on comorbidities in DUD strengthens treatment systems and services to enable better management of comorbid conditions among people with DUD, which brings benefits not only to the affected individuals but also to their communities and the whole society.
EFFECTIVENESS OF AN INTERNET-BASED PARENT MANAGEMENT TRAINING (NET PAMA) PROGRAM: A MULTI-CENTER, RANDOMIZED CONTROLLED TRIAL
Abstract
Objectives
To evaluate the effectiveness of a newly developed internet-based parent management training program (Net PAMA).
Methods
Parents of 6-12 years old children were randomized and allocated into three study arms; Net PAMA alone, Net PAMA with online group meeting (Net PAMA plus) and wait list control. Net PAMA comprises of 6 modules. Participants spent 1-2 hour to study and one week to complete daily homework of each module. Positive Parenting Scale (POPS), Pediatric Symptom Checklist (PSC-17) Thai version, and 9 items for oppositional defiant disorder (ODD) of SNAP-IV were utilized to evaluate the effectiveness of the program. Participants completed all scales at 4 timepoints; pre-study (T0), at midpoint (T1), at completion (T2), and 2 months after completing the program (T3). Repeated measure ANOVA was used to detect mean differences at each timepoint. Intention-to-treat (ITT) analysis was applied.
Results
250 out of 290 participants (86.2%) completed the study. The POPS scores, parent’s report, of Net PAMA and Net PAMA plus group were significantly higher than control group at T1, T2, and T3. The PSC-17 scores, parent’s report, of Net PAMA and Net PAMA plus group were significantly lower than control group at T1, T2, and T3. Similar findings were observed in children’s report. The effect sizes (Cohen’s d) of Net PAMA were small to medium. The augmentation of online group meeting to Net PAMA failed to provide add-on benefit.
Conclusions
Net PAMA is effective in improving positive parenting practices and reducing child behavior problems. The benefits lasted at least two months after program completion.
PSYCHIATRIC MANIFESTATIONS IN PERSONS WITH MENTAL ILLNESS DURING COVID-19 INFECTION
Abstract
Objectives
To evaluate prevalence of anxiety, depression and fear in mentally ill patients, who suffered & recovered from the acute phase of COVID-19 infection (Group-A), and those who witnessed the illness in one of their close relatives (Group-B).
Methods
In a cross-sectional online survey, 869 adult mentally ill patients (age 18 to 75 years), recovered from COVID-19 infection (Group-A) and those who witnessed the illness in one of their close relatives (Group-B) completed the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7) Scale, and Fear of COVID-19 Scale (FCV-19S). Additionally, they completed the information about demographics, Medical Comorbidities, Vaccination pattern, Confusion or Fear and Side-Effect of Vaccinations and, treatment continued or discontinued during COVID-19. New psychiatric and sleep medicines started, and Home or Hospital treatment received for COVID -19 infection.
Results
Amongst both the groups 90% participants developed depression and 84% participants developed anxiety. 92% of the participants who suffered from COVID-19 illness (Group A) developed depression against 87% of the participants who witnessed their relative suffering from COVID-19 (Group B). Similarly, 88% of the participants from Group A developed anxiety against 77.9% of the participants from Group B, both are statistically significant. Additionally, 13.9% participants showed high fear, however the data is not statistically significant between both the groups.
Conclusions
Our study concludes that mentally ill persons are more prone to depression and anxiety during COVID-19 infection. Efforts should be made to take care of mentally ill persons as a special group during acute COVID-19 infection, Post COVID and long COVID follow-up care.
THE MENTAL HEALTH OF WOMEN WITH GESTATIONAL DIABETES DURING THE COVID-19 PANDEMIC: AN INTERNATIONAL CROSS-SECTIONAL SURVEY
Abstract
Objectives
There is evidence that women with gestational diabetes are at increased risk of the common mental disorders of anxiety and depression. The COVID-19 pandemic may have exerted an additional burden on the mental health of this population. The aim of this analysis was to compare levels of symptoms of common mental disorders and experiences during the COVID-19 pandemic between pregnant and postnatal women exposed and unexposed to gestational diabetes.
Methods
Cross-sectional study utilizing quantitative data from an online survey administered across 10 countries to women who were pregnant or up to six months postpartum from 15 June to 31 October 2020. Women self-reported gestational diabetes and completed the Edinburgh Postnatal Depression Scale and GAD-7 (Generalised Anxiety Disorder 7 items) measures. The COPE-IS (Coronavirus Perinatal Experiences - Impact Survey) tool was also administered. Complete case analyses were conducted on a sample of 7371 women.
Results
There was evidence of an association between gestational diabetes and increased levels of anxiety and depression symptoms, which was robust to adjustment for age, education and employment status. There was also evidence that women with gestational diabetes experienced higher levels of pandemic-related distress, although they did not experience higher levels of COVID-19 infection in this sample.
Conclusions
The increased risk of common mental disorders in women with gestational diabetes underscores the importance of integrated physical and mental healthcare for pregnant and postnatal women both during and beyond the pandemic.
HEALTHCARE WORKERS EXPERIENCE OF PSYCHOSOCIAL DISTRESS ASSOCIATED WITH COVID-19 AND AVAILABLE PSYCHOSOCIAL SUPPORT IN NIGERIA – A QUALITATIVE STUDY FROM THE GECO DESTRESS NG PROJECT
Abstract
Objectives
The COVID-19 pandemic has placed an unparalleled stress on the healthcare system and healthcare workers. Health workers worldwide were faced with a rapid influx of critically unwell patients. This present study aimed to characterize the experience of healthcare workers (doctors and nurses) in two tertiary institutions in South-West, Nigeria.
Methods
The design was a qualitative interview-based study. We conducted 22 in-depth interviews, 10 key informant interviews and four focus group discussions with 20 participants. A qualitative content analysis using both inductive and deductive approach was carried out.
Results
Common themes among our participants included ‘being emotionally unstable’, ‘fearful’, ‘worried’, ‘anxious’ and ‘depressed’. The fear was particularly heightened among healthcare workers who had flu-like symptoms and had to be placed in isolation centers, and those who perceived having a positive COVID-19 result to be a death sentence. For other healthcare workers, the fear of losing their patients and feeling helpless due to the inundation of the healthcare system contributed to their psychological problems. Common ways of coping included listening to music, praying and support from colleagues. Most participants remarked that there was very little institutional or governmental support available for healthcare workers during the COVID-19 pandemic. Majority of participants opined their readiness to use a mobile health app if made available.
Conclusions
While healthcare workers in Nigeria were at the forefront of treating individuals who were critically ill during the COVID-19 pandemic, very little structural support was available. Our recommendations are that self-help through mobile/online psychological services would alleviate psychological distress among healthcare workers.
EXACERBATION OF PSYCHOSIS RISK DURING THE COVID-19 PANDEMIC AND THE DISPROPORTIONATE IMPACT ON THE LOWER INCOME POPULATION
Abstract
Objectives
Psychotic symptoms in the population manifest in a gradient of severity, with many individuals having transient subclinical psychotic experiences, and only a few developing a psychotic disorder. Environmental stressors—such as the COVID-19 pandemic—are thought to influence this gradient. We aim to compare the prevalence of psychotic experiences in two populational samples of a Brazilian city before and after de pandemic.
Methods
Our study comprises data from two different populational samples of young individuals (18-30 yo) from the city of Sao Paulo, Brazil. The first was recruited in 2016 (n=1950), and the second during the pandemic in late-2020 (n=1804). Sociodemographic data was collected and the Prodromal Questionnaire—Brief Version (PQ-16) was used to assess psychotic experiences.
Results
Upon the establishment of the pandemic, low- and middle-income socioeconomic classes underwent a significantly increase in their psychosis scores (p<0.001). Low-income individuals had both the worst baseline and pandemic scores. Most individuals above the proposed threshold for the PQ-16 were not under psychiatric treatment (89%).
Conclusions
Our results show a selective shift of the psychosis continuum during the pandemic, affecting more the ones in a disfavored socioeconomic situation. We alert for the need to monitor mental health in disadvantaged populations, for they may suffer a greater impact from the COVID pandemic, especially in LAMIC.
MIGRATION AND RISK OF SCHIZOPHRENIA AND BIPOLAR DISORDER
Abstract
Objectives
To examine the risk of schizophrenia (SCZ) and bipolar disorder (BD) in migrants and their children relative to those of Swedish ancestry, and determine whether risk varies by age at migration, region of origin and sex.
Methods
A nested case-control study was conducted using 5,220 SCZ cases and 20,107 BD cases diagnosed 1988-2013 in the Swedish National Patient Register. Each case was matched on year of birth and sex to five controls. Conditional logistic regression was used to evaluate the risk of SCZ and BD by migrant status, region of origin, and age at migration, with models stratified by sex.
Results
First-generation migrants had increased risk of SCZ, and decreased risk of BD. There was a distinct pattern of risk for SCZ by age at migration. Childhood migrants from all regions had increased risk of SCZ, particularly those from Africa. In contrast, there was a smooth decline in risk for BD with increasing age at migration and only child migrants from the Nordic region had significantly higher risk of BD than those of Swedish ancestry. SCZ and BD diagnoses were decreased in adult migrants, elevated in children of migrants (with risk differing by number of migrant parents) and higher in male migrants (vs. female).
Conclusions
Age at migration, sex, and region of origin are characteristics affecting risk of SCZ and BD Further research is required to determine how migration-related factors influence disease etiology and the receipt of these diagnoses.