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Correlation between BDNF levels and folic acid levels at baseline in drug-naïve First Episode Psychosis
- A. Toll, D. Bergé, I. Canosa, M. Martín - Subero, T. Legido, C. Fernandez - Hinchado, V. Perez - Sola, A. Mané
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S184-S185
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Introduction
Schizophrenia is a severe and common psychiatric disorder characterized by disturbed brain development. Brain-derived neurotrophic factor (BDNF) mediates differentiation and survival of neurons as well as synaptic plasticity during the brain development. Several studies have shown decreased serum levels of BDNF in chronic, first episode, and drug naïve schizophrenia patients. Folate provides the substrate for intracellular methylation reactions that are essential to normal brain development and function. Abnormal folate metabolism has been implicated in schizophrenia. For example, reduced maternal folate intake associated with an increased risk for schizophrenia. Also, low blood levels of folate have been reported in patients with schizophrenia, and are associated with clinical manifestation especially in the negative symptom domain.
ObjectivesWith this study, we want to know how BDNF levels at baseline in drug-naïve FEP are associated with folic acid.
MethodsFifty drug-naïve FEP treated between April 2013 and July 2017 at the ETEP Program at Hospital del Mar were included. Inclusion criteria were: 1) age 18-35 years; 2) DSM-IV-TR criteria for brief psychotic disorder, schizophreniform disorder, schizophrenia or unspecified psychosis; 3) no previous history of severe neurological medical conditions or severe traumatic brain injury; 4) presumed IQ level > 80, and 5) no substance abuse or dependence disorders except for cannabis and/or nicotine use. All patients underwent an assessment at baseline including sociodemographic and clinical variables. Fasting blood samples were obtained before administering any medication at baseline and used to determine folic acid and BDNF levels.
ResultsIn our drug-naïve FEP sample, folic acid levels showed a significative positive correlation with BDNF levels at baseline (r = 0.584; p = 0.003). Moreover, we did a lineal regression model that showed that the baseline variables that better predict BDNF levels were folic acid levels, and cannabis use.
ConclusionsOur results are consistent with the findings from some of previous studies that also shows that lower folic acid levels are associated with lower BNDF levels at baseline in drug-naïve FEP. Folate deficiency is associated with cerebrovascular and neurological diseases, and mood disorders. The importance of folate in the nervous system was initially demonstrated in studies that established a greatly increased risk of neurodevelopmental disorders in the offspring of folate-deficient pregnant women. In the adult, epidemiological studies have linked lack of folate to neurodegenerative and neuropsychiatric diseases. However, the mechanisms by which chronic folate deficiency adversely affects CNS function are incompletely understood. Some studies in animals models have hypothesized that folate deficiency in animals could be associated with pyramidal cell loss and reduced hippocampal BDNF.
Disclosure of InterestNone Declared
Feasibility of a web-based program for secondary prevention of suicidal behavior: The iFight Depression-Survive
- M. Elices, I. Canosa, A. Toll, A. Justicia, F. Colom, V. Pérez
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S527
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- Article
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- You have access Access
- Open access
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Introduction
Suicide is a leading cause of preventable death in the world. Interventions that can quickly reach a large and geographically dispersed population are needed. Web-based programs are potentially cost-effective, allowing continuity of care. The iFightDepression-SURVIVE (iFD-Survive) is a web-based program designed as an add-on to iFightDepression, a tool developed by the European Alliance Against Depression to target depressive symptoms (https://ifightdepression.com/en/). iFD-Survive is based on dialectical behavioral therapy skills and includes four modules: a safety plan, mindfulness, emotion regulation, and distress tolerance. The content is presented in various formats, including audio, videos, and registers. In addition, weekly telephone support is offered by a mental health nurse.
ObjectivesTo investigate the feasibility (acceptability, usability, and satisfaction) of the iFD-Survive.
Methods30 participants who received the intervention as part of a large RCT completed an online survey. To receive the intervention, participants needed to meet the following criteria: 1) digital literacy, 2) having attempted suicide in the last month, and 3) PHQ-9 scores above 5. The online survey included an ad-hoc questionnaire to collect socio-demographic data and data regarding participants’ opinions on the program’s content. The following instruments were also administered:
System Usability Scale (SUS)
Credibility of analogue of therapy rationales
ResultsMost respondents were women (20/30), with a mean age of 44 years, and secondary studies (15/30). Most participants (57%) used a mobile phone to access the website and regarded it as “easy to use” (53%). According to the SUS, many of them (57%) reported that they would like to use it frequently and that the tool was “easy” and “safe” to use (53%). Regarding acceptability, 47% of the sample indicated that the iFD-Survive content was adequate to improve their symptoms, and 56% considered that their symptoms of depression have improved as a result of the intervention. 83% of the sample considered telephone follow-up “very useful.” The majority (70%) consulted the program once a week. The “safety plan” and the mindfulness module were regarded as the most useful, followed by “distress tolerance.” The audio for practicing mindfulness skills and the written material were considered very useful, while the videos were valuable.
ConclusionsOnline tools can promote continuity of care, helping to prevent further suicide attempts in vulnerable populations. These preliminary findings suggest that the iFD-Survive is feasible among participants with depressive symptoms who have recently attempted suicide. However, these results are based on a small sample of highly educated women; therefore, future research is needed to determine if these can be transferred to other sub-populations.
Disclosure of InterestNone Declared