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Racial, ethnic, and socio-economic disparities in neonatal ICU admissions among neonates born with cyanotic CHD in the United States, 2009–2018
- Kriyana P. Reddy, Avital B. Ludomirsky, Andrea L. Jones, Rachel J. Shustak, Jennifer A. Faerber, Maryam Y. Naim, Keila N. Lopez, Laura M. Mercer-Rosa
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- Cardiology in the Young , First View
- Published online by Cambridge University Press:
- 24 April 2024, pp. 1-8
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Introduction:
Disparities in CHD outcomes exist across the lifespan. However, less is known about disparities for patients with CHD admitted to neonatal ICU. We sought to identify sociodemographic disparities in neonatal ICU admissions among neonates born with cyanotic CHD.
Materials & Methods:Annual natality files from the US National Center for Health Statistics for years 2009–2018 were obtained. For each neonate, we identified sex, birthweight, pre-term birth, presence of cyanotic CHD, and neonatal ICU admission at time of birth, as well as maternal age, race, ethnicity, comorbidities/risk factors, trimester at start of prenatal care, educational attainment, and two measures of socio-economic status (Special Supplemental Nutrition Program for Women, Infants, and Children [WIC] status and insurance type). Multivariable logistic regression models were fit to determine the association of maternal socio-economic status with neonatal ICU admission. A covariate for race/ethnicity was then added to each model to determine if race/ethnicity attenuate the relationship between socio-economic status and neonatal ICU admission.
Results:Of 22,373 neonates born with cyanotic CHD, 77.2% had a neonatal ICU admission. Receipt of WIC benefits was associated with higher odds of neonatal ICU admission (adjusted odds ratio [aOR] 1.20, 95% CI 1.1–1.29, p < 0.01). Neonates born to non-Hispanic Black mothers had increased odds of neonatal ICU admission (aOR 1.20, 95% CI 1.07–1.35, p < 0.01), whereas neonates born to Hispanic mothers were at lower odds of neonatal ICU admission (aOR 0.84, 95% CI 0.76–0.93, p < 0.01).
Conclusion:Maternal Black race and low socio-economic status are associated with increased risk of neonatal ICU admission for neonates born with cyanotic CHD. Further work is needed to identify the underlying causes of these disparities.
425 Anifrolumab for the treatment of refractory cutaneous lupus erythematosus in patients: interim analysis of real-world outcomes
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- Oluwadamilola Oke, Rochelle L. Castillo, Kimberly B. Hashemi, Ahmad Rajeh, Laura I. Ortiz-López, Karla M. Santiago-Soltero, Neda Shahriari, Avery H. LaChance, Katharina S. Shaw, Ruth Ann Vleugels
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- Journal:
- Journal of Clinical and Translational Science / Volume 8 / Issue s1 / April 2024
- Published online by Cambridge University Press:
- 03 April 2024, pp. 126-127
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OBJECTIVES/GOALS: * Patients with skin of color (SOC) are disproportionately affected by systemic lupus erythematosus (SLE) and cutaneous lupus erythematosus (CLE). In this study, we aim to address this disparity and characterize the real-world efficacy and tolerability of anifrolumab in CLE patients using validated disease activity instruments. METHODS/STUDY POPULATION: This single-center, prospective observational cohort study includes SLE patients with severe or refractory CLE who have received ≥ 1 dose of anifrolumab. Cutaneous disease activity is assessed periodically at 2, 6, 9, 12, and 18 months using the Cutaneous Lupus Disease Area and Severity Index (CLASI). Adverse events and concurrent treatments are also routinely evaluated. To date, 22 patients have been enrolled, with 6-month follow-up data available for 15. At the time of anifrolumab initiation, 95% of participants had discoid LE (DLE), 60% had mucosal DLE, and 13% had subacute CLE. Nine patients identified as SOC, two as White, and four did not report race/ethnicity. RESULTS/ANTICIPATED RESULTS: A Friedman test showed statistically significant changes over time in CLASI activity score (CLASI-A) (χ2(2) =20, p<0.0001) (Figure 1) and CLASI damage score (CLASI-D) (χ2(2) =9.5789, p=0.0083) (Figure. To estimate effect sizes, we employed linear mixed models, which demonstrated statistically significant reductions in the CLASI-A score from baseline by an average of 14 points at 2 months (p<0.001) and 18 points at 6 months (p<0.001); notably, a reduction in CLASI-A of 4 is considered clinically meaningful. At 2 months, 20% of patients experienced a 50% or more reduction in CLASI, which increased to 60% of patients at 6 months. Patients on systemic corticosteroids could taper off. Adverse events were minimal and did not lead to treatment discontinuation. Fig. 1:[blob:https://acts.slayte.com/045319b4-7272-4351-a771-78ba9ee57f5c] Fig. 2:[blob:https://acts.slayte.com/67df7653-0cd8-4e8e-a3e1-d5c565b19dce] DISCUSSION/SIGNIFICANCE: As SOC patients with CLE have significant potential for permanent pigmentary alternations, early treatment is imperative. Effective treatments for refractory CLE are elusive. Our study represents the largest single-center cohort of CLE patients treated with anifrolumab and suggests that it is a promising therapeutic option for patients with SOC.
Lessons learned from implementing a diversity, equity, and inclusion curriculum for health research professionals at a large academic research institution
- LaMisha Hill Weller, Anna D. Rubinsky, Starley B. Shade, Felix Liu, Iona Cheng, Georgina Lopez, Asha Robertson, Jennifer Smith, Kristina Dang, Christian Leiva, Susan Rubin, Suzanna M. Martinez, Kirsten Bibbins-Domingo, Meghan D. Morris
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- Journal:
- Journal of Clinical and Translational Science / Volume 8 / Issue 1 / 2024
- Published online by Cambridge University Press:
- 12 January 2024, e22
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Objective:
Despite advances in incorporating diversity and structural competency into medical education curriculum, there is limited curriculum for public health research professionals. We developed and implemented a four-part diversity, equity, and inclusion (DEI) training series tailored for academic health research professionals to increase foundational knowledge of core diversity concepts and improve skills.
Methods:We analyzed close- and open-ended attendee survey data to evaluate within- and between-session changes in DEI knowledge and perceived skills.
Results:Over the four sessions, workshop attendance ranged from 45 to 82 attendees from our 250-person academic department and represented a mix of staff (64%), faculty (25%), and trainees (11%). Most identified as female (74%), 28% as a member of an underrepresented racial and ethnic minority (URM) group, and 17% as LGBTQI. During all four sessions, attendees increased their level of DEI knowledge, and within sessions two through four, attendees’ perception of DEI skills increased. We observed increased situational DEI awareness as higher proportions of attendees noted disparities in mentoring and opportunities for advancement/promotion. An increase in a perceived lack of DEI in the workplace as a problem was observed; but only statistically significant among URM attendees.
Discussion:Developing applied curricula yielded measurable improvements in knowledge and skills for a diverse health research department of faculty, staff, and students. Nesting this training within a more extensive program of departmental activities to improve climate and address systematic exclusion likely contributed to the series’ success. Additional research is underway to understand the series’ longer-term impact on applying skills for behavior change.
83 Performance Validity in a Monolingual and Bilingual Undergraduate Population
- Daniel W. Lopez-Hernandez, Krissy E. Smith, Kyle B. Boone, Tara L. Victor
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 756-757
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Objective:
Neuropsychological evaluations are used to examine a person’s current cognitive functioning. Performance validity tests (PVT) are included in neuropsychological test batteries to ensure that examinees are performing to the best of their abilities and identify non-credible performance. There are two types of PVTs: freestanding and embedded. A freestanding PVT is a cognitive test created to evaluate performance validity and do not measure any type of cognition directly. Meanwhile, an embedded PVT is a task design to evaluate some sort of cognition (e.g., memory) by using traditional neuropsychological tests (e.g., Trail Making Test) and performance validity. Research suggests that undergraduate college students are not always performing to the best of their abilities when completing a comprehensive neuropsychological battery. In fact, in one study where an undergraduate college sample was given three PVTs, it was reported that 56% of the participants failed at least one PVT in their first session and 31% in their second session. Research has also shown that speaking multiple languages can influence cognition. The purpose of this study was to identify in three credible language groups of college students what PVTs does bilingualism influence higher failure rates. It was predicted that bilingual college students would significantly demonstrate higher PVTs failure rates compared to monolingual college students.
Participants and Methods:The sample consisted of 70 English first language monolinguals (EFLM), 33 English first language bilinguals (EFLB), and 68 English second language bilinguals (ESLB) that were psychologically and neurologically healthy. All participants completed a comprehensive neuropsychological battery in English. The Rey-Osterrith complex figure copy test, Comalli Stroop part A, B, and C, Trail Making Test part A and B, Symbol Digit Modalities Test written and oral parts, Controlled Oral Word Association Test (COWAT) letter fluency, and Finger Tapping Test were the tasks used as embedded PVTs to evaluate failure rates in our sample. Moreover, all participants were credible (i.e., they did not fail two or more PVTs). PVT cutoff scores were selected for each embedded PVT from previous literature. Chi-square analysis were used to evaluate failure rates between language groups on each PVT.
Results:We found no significant failure rate differences between language groups on any of the PVTs. However, while no significant group differences were found, on the COWAT letter fluency results revealed higher failure rates between the three language groups (i.e., 13% EFLM, 24% EFLB, and 22% ESLB) compared to other PVTs.
Conclusions:Our data suggested no significant failure rate differences between language groups. It has been suggested in previous studies that linguistic factors impact PVT performance and test interpretation. On the COWAT letter fluency task, it is possible that language is driving higher failure rates between bilingual speakers, even though we found no significant failure rates or performance differences between the three language groups. Future studies should examine language groups and other cultural variables (e.g., time perspective) to determine what may be driving high failure rates on the COWAT letter fluency task in credible participants.
86 The Examination Between Credible and Non-Credible Groups on Embedded PVT Tests
- Krissy E. Smith, Tara L. Victor, Matthew J. Wright, Kyle B. Boone, Daniel W. Lopez-Hernandez
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 759-760
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Objective:
Performance validity tests (PVTs) are included in neuropsychological testing to ensure examinees are performing to the best of their abilities. There are two types of PVTs: embedded and free standing. Embedded PVTs are tests that are derived from standard neuropsychological tests of various cognitive domains. Freestanding PVTs are tests that are designed with the intention of being a PVT. Research studies show that undergraduate samples do not always performed to the best of their abilities. The purpose of this study was to cross-validate previous research on the topic of performance validity in a college sample. It was predicted that the non-credible group would demonstrate higher failure rates on embedded PVTs compared to the credible group.
Participants and Methods:The sample consisted of 198 neurologically and psychologically healthy undergraduate students with a mean age of 19.69 (SD = 2.11). Participants were broken into two groups: non-credible (i.e., participants that failed two or more PVTs) and credible (i.e., participants that did not failed two or more PVTs). The Rey-Osterrith copy test, Comalli Stroop part A (CSA), B (CSB), and C (CSC), Trail Making Test part A and B, Symbol Digit Modalities Test written (SDMT-W) and oral (SDMT-O) parts, Controlled Oral Word Association Test (COWAT) letter fluency, and Finger Tapping Test were used to evaluate failure rates in our sample. PVT cutoff scores were use from previously validated in the literature. Chi-square analysis was used to evaluate failure rates between the groups.
Results:Chi-square analysis revealed significant failure rate differences between groups on several PVTs. Results revealed that 15% of the non-credible group failed the CSA compared to 1% of the credible group, X2=14.77, p=.000. Meanwhile, 26% of the non-credible group failed the CSB compared to 2% of the credible group, X2=24.72, p=.000. Furthermore, results showed that 11% of the non-credible group failed the CSC compared to 1% of the credible group, X2=13.05, p=.000.Next, 48% of the non-credible group failed the Trail Making Test part A compared to 8% of the credible group, X2=31.61, p=.000. We also found that 15% of the non-credible group failed the SDMT-W part compared to 1% of the credible group,X2=19.18, p=.000. Meanwhile, on the SDMT-O part 19% of the non-credible group failed compared to 1% of the credible group, X2=25.52, p =.000. On the COWAT letter fluency task 74% of the non-credible group failed compared to 19% of the credible group, X2=36.90, p=.000. Finally, results revealed on the Finger Tapping Test 19% of the non-credible group failed compared to 3% of the credible group, X2=10.01, p=.002.
Conclusions:As expected, the non-credible participants demonstrated significantly higher PVT failure rates compared to credible participants. A possible explanation driving higher failure rates in our sample can be due to cultural variables (e.g., bilingualism). It was suggested by researchers that linguistic factors may be impacting higher PVT failure rates and developing a false-positive error. Future research using undergraduate samples need to identify which PVT’s are being impacted by linguist factors.
The potential for using wood mulch for agricultural production
- Matthew L. Richardson, Caitlin G. Arlotta, Francis B. Lopez
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- Journal:
- Renewable Agriculture and Food Systems / Volume 38 / 2023
- Published online by Cambridge University Press:
- 28 November 2023, e47
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Making woody mulch (WM) from organic waste is one solution for repurposing waste. Our work had two primary objectives. First, we wanted to destermine the current use of WM as a soil cover, barriers to use, benefits, and possible motivations for adopting the use of WM by home and commercial growers for cultivating crops in Barbados and the Baltimore-Washington, DC metropolitan region in the USA. To accomplish this objective, we administered a survey to growers in both regions. Second, we wanted to determine the benefits of using WM in agricultural production for sweet potatoes (both regions) and Hungarian hot wax peppers (USA). We measured whether WM influenced crop survival, crop yield, crop nutrients, weed mass, and soil characteristics in replicated plots covered with a layer of WM or left bare. Growers reported that expense, availability, and ease of application were barriers to using WM. Despite the barriers, many growers were using, or had previously used, WM and reported myriad benefits, including improving plant yield and/or nutrients, preventing weed growth, maintaining soil moisture and reducing irrigation needs, improving soil fertility, reducing soil erosion, reducing compaction from heavy rain, and maintaining soil temperature. Our data from replicated field trials verified some of the potential benefits reported by growers. WM in some cases promoted higher crop survival and yield of sweet potatoes, suppressed weeds, conserved soil moisture, and maintained higher soil temperature. Understanding which crops benefit from WM and the longer-term effects of WM on crops and soil are deserving of future study.
Advocacy at the Eighth World Congress of Pediatric Cardiology and Cardiac Surgery
- Bistra Zheleva, Amy Verstappen, David M. Overman, Farhan Ahmad, Sulafa K.M. Ali, Zohair Y. Al Halees, Joumana Ghandour Atallah, Isabella E. Badhwar, Carissa Baker-Smith, Maria Balestrini, Amy Basken, Jonah S. Bassuk, Lee Benson, Horacio Capelli, Santo Carollo, Devyani Chowdhury, M. Sertaç Çiçek, Mitchell I. Cohen, David S. Cooper, John E. Deanfield, Joseph Dearani, Blanca del Valle, Kathryn M. Dodds, Junbao Du, Frank Edwin, Ekanem Ekure, Nurun Nahar Fatema, Anu Gomanju, Babar Hasan, Lewis Henry, Christopher Hugo-Hamman, Krishna S. Iyer, Marcelo B. Jatene, Kathy J. Jenkins, Tara Karamlou, Tom R. Karl, James K. Kirklin, Christián Kreutzer, Raman Krishna Kumar, Keila N. Lopez, Alexis Palacios Macedo, Bradley S. Marino, Eva M. Marwali, Folkert J. Meijboom, Sandra S. Mattos, Hani Najm, Dan Newlin, William M. Novick, Sir Shakeel A. Qureshi, Budi Rahmat, Robert Raylman, Irfan Levent Saltik, Craig Sable, Nestor Sandoval, Anita Saxena, Emma Scanlan, Gary F. Sholler, Jodi Smith, James D. St Louis, Christo I. Tchervenkov, Koh Ghee Tiong, Vladimiro Vida, Susan Vosloo, Douglas J. “DJ” Weinstein, James L. Wilkinson, Liesl Zuhlke, Jeffrey P. Jacobs
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- Journal:
- Cardiology in the Young / Volume 33 / Issue 8 / August 2023
- Published online by Cambridge University Press:
- 24 August 2023, pp. 1277-1287
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The Eighth World Congress of Pediatric Cardiology and Cardiac Surgery (WCPCCS) will be held in Washington DC, USA, from Saturday, 26 August, 2023 to Friday, 1 September, 2023, inclusive. The Eighth World Congress of Pediatric Cardiology and Cardiac Surgery will be the largest and most comprehensive scientific meeting dedicated to paediatric and congenital cardiac care ever held. At the time of the writing of this manuscript, The Eighth World Congress of Pediatric Cardiology and Cardiac Surgery has 5,037 registered attendees (and rising) from 117 countries, a truly diverse and international faculty of over 925 individuals from 89 countries, over 2,000 individual abstracts and poster presenters from 101 countries, and a Best Abstract Competition featuring 153 oral abstracts from 34 countries. For information about the Eighth World Congress of Pediatric Cardiology and Cardiac Surgery, please visit the following website: [www.WCPCCS2023.org]. The purpose of this manuscript is to review the activities related to global health and advocacy that will occur at the Eighth World Congress of Pediatric Cardiology and Cardiac Surgery.
Acknowledging the need for urgent change, we wanted to take the opportunity to bring a common voice to the global community and issue the Washington DC WCPCCS Call to Action on Addressing the Global Burden of Pediatric and Congenital Heart Diseases. A copy of this Washington DC WCPCCS Call to Action is provided in the Appendix of this manuscript. This Washington DC WCPCCS Call to Action is an initiative aimed at increasing awareness of the global burden, promoting the development of sustainable care systems, and improving access to high quality and equitable healthcare for children with heart disease as well as adults with congenital heart disease worldwide.
Resilient functioning is associated with altered structural brain network topology in adolescents exposed to childhood adversity
- Nadia González-García, Elizabeth E.L. Buimer, Laura Moreno-López, Samantha N. Sallie, František Váša, Sol Lim, Rafael Romero-Garcia, Maximilian Scheuplein, Kirstie J. Whitaker, Peter B. Jones, Raymond J. Dolan, NSPN consortium, Peter Fonagy, Ian Goodyer, Edward T. Bullmore, Anne-Laura van Harmelen
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- Journal:
- Development and Psychopathology / Volume 35 / Issue 5 / December 2023
- Published online by Cambridge University Press:
- 26 July 2023, pp. 2253-2263
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Childhood adversity is one of the strongest predictors of adolescent mental illness. Therefore, it is critical that the mechanisms that aid resilient functioning in individuals exposed to childhood adversity are better understood. Here, we examined whether resilient functioning was related to structural brain network topology. We quantified resilient functioning at the individual level as psychosocial functioning adjusted for the severity of childhood adversity in a large sample of adolescents (N = 2406, aged 14–24). Next, we examined nodal degree (the number of connections that brain regions have in a network) using brain-wide cortical thickness measures in a representative subset (N = 275) using a sliding window approach. We found that higher resilient functioning was associated with lower nodal degree of multiple regions including the dorsolateral prefrontal cortex, the medial prefrontal cortex, and the posterior superior temporal sulcus (z > 1.645). During adolescence, decreases in nodal degree are thought to reflect a normative developmental process that is part of the extensive remodeling of structural brain network topology. Prior findings in this sample showed that decreased nodal degree was associated with age, as such our findings of negative associations between nodal degree and resilient functioning may therefore potentially resemble a more mature structural network configuration in individuals with higher resilient functioning.
Gender Differences in the abuse of new technologies, and other addiction problems of patients from primary care
- F. Méndez-López, M. Dominguez-García, B. Oliván-Blázquez, C. Bartolomé-Moreno, A. Aguilar-Latorre, R. Magallón-Botaya
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S327-S328
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Introduction
The use/abuse of Information and Communication Technologies (ICT) has become a topic of great interest in recent years. With advances in technology, today’s population spends a great deal of screen time (ST) making watching television (TV), using computers, smartphones, or playing video games a central component of their daily lives. These studies have analyzed the psychological impact of technological exposure or abuse, such as aggressive behaviors, anxiety, depression and other mental problems.
ObjectivesThe main objective of this study is to explore the differences between men and women and the abusive use of social networks, technologies, pathological gambling and other addiction problems in primary care.
MethodsThis study is an observational study conducted within the framework of primary care in the Spanish region of Aragon. The population of the study were participants of 35-74 years old, had been receiving care from the Aragon Health Service. Recruitment is shown at figure 1. Sociodemographic, quality of life, personal factors on health behaviour, social support, lifestyle patterns and chronic comorbid pathology variables were collected during the period 2021–2023. The project was approved by the Clinical Research Ethics Committee of Aragon Nº PI20/302. The comparisons by sex were carried out using a Student T-test or chi squared test to analyse differences.
ResultsThere are significant differences in the abuse of new technologies between men and women. 25.20% of men (CI 95% 18.26-33.25) compared to 13.41% of women (CI 95% 8.85-19.25) make abusive use of the Internet, with statistically significant differences. In the same way, men present greater abuse of video games (6.25% of men (CI 95% 3.0-11.45) compared to 3.05% of women (CI 95% 1.17-6.55).
Analysing the differences by sex in dependence if it is an urban or rural population. Significant differences in the abuse of new technologies between men and women are present in the urban population, while in the rural population these differences are not observed
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ConclusionsGender modifies the ways in which technologies are used, so that men have a more problematic use of video games and the Internet than women. On the other hand, in relation to emotional symptoms, it was observed that women presented more anxiety and less satisfaction with life than men. The evaluation of abuse of new technologies cts should be incorporated into health services to improve people’s ability their self-care, the level of knowledge of managing their disease and their physical, mental and social health.
Disclosure of InterestNone Declared
Cannabis use in different mental disorders: a descriptive study in a psychiatric hospital
- B. Samso, A. López Fariña, C. González Navarro, L. Morado San Segundo, A. Bilbao Idarraga, U. López Puentes, R. F. Lopez Brokate, T. Ruiz de Azua Aspizua, U. Ortega Pozas, C. Arán Cisneros, E. Garnica de Cos, I. Alonso Salas
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S334-S335
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Introduction
In the last decade, the prevalence of THC use is increasing among adolescents and adults. There is also strong evidence to suggest that cannabis use is associated with psychiatric comorbidities. The strongest evidence is found between cannabis use and psychotic disorder. However, the literature shows that those who have used cannabis in the past or for a large part of their lives are at higher risk of mood disorders, anxiety, personality disorder or other drug use than those who do not use cannabis in a harmful way.
ObjectivesTo provide an overview of the association between cannabis use and the different mental pathologies presented by the patients admitted during the study period. To describe the prevalence of THC use in the study according to the mental pathology presented by the patient.
MethodsA retrospective observational descriptive study was developed for 3 months, of all patients admitted to the acute unit of the psychiatric hospital. No exclusion criteria were included.
ResultsDuring the period of study 172 patients were admitted to the hospital, classified according to the main diagnosis we have: 49 patients suffer from schizophrenia, 26 bipolar affective disorder, 20 with depressive disorder, 20 with personality disorder, 19 with substance use disorder, 18 with other unspecified disorders and 20 patients with no known previous diagnosis. The prevalence of THC use in the study sample according to diagnosis, would be schizophrenia 16%, Bipolar affective disorder 19%, Depressive disorder 5%, Personality disorder 45%, Substance use disorder 21%, Unspecified disorders 11% and patients with no known previous diagnosis 10%.
ConclusionsThe results obtained in the study in terms of THC use are in agreement with those obtained in the literature. In our study, we observed that cannabis use is associated with psychotic disorders as well as with mood, personality and substance abuse disorders. Given that the frequency of use has increased and there is a strong association with different comorbid psychiatric diagnoses, guidance on modifications in medication strategies might be necessary.
Disclosure of InterestNone Declared
Affective state of people suffering from long covid and associated factors. Cross-sectional descriptive study
- B. Oliván-Blázquez, M. Samper-Pardo, S. León-Herrera, A. Aguilar-Latorre, F. López-Mendez, R. Magallón-Botaya
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S778-S779
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Introduction
The “Post-COVID Syndrome” affects approximately 10% of people who have been infected with Covid-19. These people have a physical and mental impact.
ObjectivesThe objective of this study is to analyze factors related to poorer mental health in these patients from primary health care.
MethodsCross-sectional study. The study population was post-COVID-19 patients aged 18 years or older and treated by Primary Health Care (PHC). The main variable was Affective state through the Hospital Anxiety and Depression Scale (HADS) questionnaire. The rest of the variables were: Socio-demographic variables, number of residual symptoms, cognitive using the Montreal Cognitive Assessment (MoCA), physical functioning variable will be measured by Sit to Stand Test and Sleep quality through the Insomnia Severity Index (ISI). A bivariate analysis and also a lineal multivariate model were developed. Ethics approval was granted by the Clinical Research Ethics Committee of Aragón (PI21/139 and PI21/454).
ResultsA total of 100 individuals participated, of whom, 80 were women and 20 were men. The median scores in HADS was 16 and the interquartile range was 12. Multilevel analysis shows that better physical functioning (sit to stand test) and worse sleep quality (Insomnia severity index) are predictors of worse affective state. The models explain 36.5% of the HADS variance.
ConclusionsIt is relevant to take account these variables in the treatment of the affective state of patients with long covid.
Disclosure of InterestNone Declared
Adherence to psychiatric medications and diagnosis
- C. González Navarro, A. Bilbao Idarraga, I. Alonso Salas, L. Morado San segundo, A. López Fariña, U. López Puentes, B. Samsó Martínez, R. F. Lopez Brokate, T. Ruiz de Azua Aspizua, E. M. Garnica de Cos, U. Ortega Pozas
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S240-S241
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Introduction
Patients with mental disorders frequently become non-adherent during their long term prescribed treatment. This situation frequently triggers clinical worsening and hospital admission. Therefore, non-adherence may result in poorer long term clinical outcomes and has economic implications for health-care providers (Carlos De las Cuevas et al. Neuropsychopharmacol Hung 2021; 23(4):347-362).
Objectives- To describe the adherence to oral and long acting injectable treatment in the sample of patients that were admitted to the short stay hospital unit during the period of study.
- To describe the adherence to treatment amongst psychiatric diagnosis in the sample of study.
MethodsIt was a retrospective observational study with a duration of three months. Data was collected from all patients admitted to the short stay hospital unit during the period of study and there were no specific exclusion criteria. Descriptive statistics were performed. To assess the adherence to pharmachological treatment the patient report, the family report and the pharmacy dispensation according to the existent informatic prescription platform was considered. Regarding the long acting injectable treatment the formulary of administration in the clinical history was checked.
ResultsDuring the period of study 172 patients were admitted to the short stay hospital unit. Of those, 146 patients had a previous pharmacologic prescription. Data of treatment was not possible to obtain in 7 patients. In the sample of study, 83.5% were on oral and 16.5% on long acting injectable treatment. The general adherence to treatment in the sample was 61.87%. In the oral treatment group the adherence was 58.4% and in the long acting injectable treatment group was 65.2%.
Amongst the different psychiatric diagnoses the outcomes of adherence to treatment were: 60.4% in schizophrenia and related psychosis, 62.5% in bipolar disorder, 78.6% in depression, 58.3% in personality disorders and 62% in addictive disorders.
ConclusionsIn our descriptive study adherence to treatment was higher in the long acting injectable treatment group, agreeing with the existent scientific literature.
The results of adherence for schizophrenia and bipolar disorder are similar to the ones found in scientific literature but differ from the ones for depression, being higher in our sample (Judit Lazary et al. Neuropsychopharmacol Hung 2021;23(4): 347-362). Moreover, in scientific literature it is found a similar prevalence of adherence across diagnosis (for schizophrenia, bipolar disorder and depression) whereas in our sample patients with depression showed a different and higher adherence to treatment (Judit Lazary et al. Neuropsychopharmacol Hung 2021;23(4): 347-362). In our sample, patients with personality disorders had the lowest adherence to treatment.
Disclosure of InterestNone Declared
Is social media important in adolescents with eating disorders?
- B. Martínez-Núñez, D. S. Cohen, R. Encinas-Encinas, A. Paniagua-Velasco, D. A. Gómez-Guimaraes, C. García-López, B. Muchada-López, M. Faya-Barrios, M. Graell-Berna
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S522-S523
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Introduction
Eating disorders (ED) are complex entities of multicausal etiology that mainly affect adolescents and young women. For this reason, EDs frequently cause medical and psychological complications that can cause potentially irreversible developmental sequelae during adolescence.
96% of Spanish youth (15-29 years old) use daily Internet. In addition, 83% use Social Networks. Internet could be a good way to spread information through social media, websites, providing material and means to achieve the body culture purpose.
As we have seen in various papers, social media can influence and trigger the development of EDs.
ObjectivesThe objetives of the study are to analyse the preferred social network by adolescents diagnosed with eating disorders, as well as to measure characteristic and time-use of these networks.
MethodsWe decided to undergo a transversal study to analyse the use of social media. For that, we developed a survey to reflect the use of the main social networks (Instagram, Facebook, Snapchat, Twitter, YouTube and Reddit) in adolescents diagnosed with eating disorders in Spain, who are in outpatient treatment in a specialised ED unit.
ResultsThe total number of adolescents interviewed was 65; of these 96.9% were females and 3.1% males. The mean age was 14.8 years.
The preferred social network was Instagram (54%), followed by TikTok (34%) and YouTube (6%).
Most of the patients interviewed (68%) admitted checking Instagram daily, and 31% reflected spending between 1-3 hours/day. None of the adolescents reported using Facebook or Reddit.
The majority of adolescents (89%) admitted having ignored friend requests while 12% reflected the importance of having a high number of followers as a way of external validation, getting more ‘likes’ and getting to know more people.
ConclusionsThe obtained results reinforce the need of exploring and taking into account the use of Social Media in adolescents with ED and how it may influence their pathology. There is a need for further prospective research in this field.
Disclosure of InterestNone Declared
Alcohol consumption and cardiovascular risk: a descriptive study in a psychiatric short stay unit
- C. González Navarro, I. Alonso Salas, L. Morado San segundo, A. López Fariña, A. Bilbao Idarraga, U. López Puentes, B. Samsó Martínez, R. F. Lopez Brokate, T. Ruiz de Azua Aspizua, E. M. Garnica de Cos, U. Ortega Pozas
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S754
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Introduction
Patients with mental disorders have a decreased life expectancy, being the main reason the cardiovascular disease. An important proportion of patients present a comorbid drug consumption. Amongst drugs, alcohol is the most frequent, and it is associated with a higher cardiovascular risk. The metabolic syndrome is one of the most employed tools to assess cardiovascular risk.
Objectives- To describe the demographic characteristics of the patients with an active alcohol consumption that were admitted to the hospital during the period of study.
- To describe the prevalence of metabolic syndrome in the sample, according to the Adult Treatment Panel III (ATP-III) criteria.
MethodsRetrospective observational study of three months duration. Data was collected from all patients admitted to the hospital during the period of study, with no specific exclusion criteria. Descriptive statistics were performed.
ResultsDuring the period of study 172 patients were admitted to the hospital (56.4% women and 43.6% men). A 44.8% presented alcohol consumption (25% sporadically, 6.4% weekly and 13.4% daily). Amongst women, 1% presented daily and 1% weekly consumption. Amongst men, 21.3% presented daily and 5.3% weekly consumption.
The prevalence of metabolic syndrome in the study sample was 29.11%. In the alcohol consumption group, the prevalence was 24.7% and differed according to the pattern of consumption: 43.5% in the daily consumption group, 27.3% in the weekly and 14% in the sporadically consumption group.
ConclusionsOn the one hand, in the sample of study a higher percentage of men present an active alcohol consumption, compared to women. It is remarkable the high percentage of daily alcohol consumption amongst men in our sample.
On the other hand, the prevalence of metabolic syndrome in our sample is similar to the one found in scientific literature regarding patients with mental disorders. It is noteworthy in our sample the increased prevalence of metabolic syndrome found in patients with a daily alcohol consumption, and a decreased prevalence in those with a sporadic pattern.
Disclosure of InterestNone Declared
The response to unfolded proteins in schizophrenia and bipolar disorder
- C. Cachán, I. M. Valle, Y. Potes, A. González Rubio, N. Menéndez Coto, D. López Fanjul, I. Vega Naredo, B. Caballero, P. Saiz, J. Bobes, P. García Portilla, A. Coto Montes
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S636-S637
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Introduction
Schizophrenia (SCH) and bipolar disorder (BD) are severe mental disordes, which have high incidence (Whiteford et al. Lancet 2013; 381 1575-86) and are the main causes of diasibility in young people (WHO 2022; https://www.who.int/news-room/fact-sheets/detail/mental-disorders).
Psycological stress appears in different mental disorders, and this is directly related to oxidative stress (Moller et al. Chem Biol Interact. 1996; 102 17-36)(Pupic-Bakrac et al. 2020; Psychiatr Danub. 32 412-9). Oxidative stress causes reticulum edoplasmic stress (ER stress) and this produces high levels of misfolded proteins. Defective proteins are degraded by the proteasome, but but when the density of misfolded proteins exceeds the capacity of the proteosome, the Unfolded and Misfolded Protein Response (UPR) is triggered through three main pathways: Inositol-requiring enzyme 1α (IRE1α); transcription factor 6 alpha (ATF6α) and protein kinase RNA-Like ER kinase (PERK), trying to recover normal protein synthesis capacity (Bermejo-Millo et al. 2018; Mol Neurobiol. 55 7973-86) (González-Blanco et al. 2022; J Cachexia Sarcopenia Muscle 13 919-31).
ObjectivesCharacterizing ER stress and UPR in SCH and BD.
MethodsWe studied ER stress and UPR in peripheral blood mononuclear cells (PBMC) from 50 patients with SCH and an equal number of patients with BD compared to their corresponding controls in order to achieve our objectives.
Western Blot assay were performed following classical procedure () and the results was normalized to Ponceau as loanding control (Nie et al. 2017; BiochemByophys Resp 12 10-13) (Sander et al. 2019; Anal Biochem 575 44-53). Proteasome activity was assessed using Proteasome Activity Assay Kit (ab107921, Abcam, Cambridge, UK).
ResultsER stress was evaluated with BiP/GRP78. Our results showed significantly increased expression in SCH (p<0,01) and BD (p<0,05), being more increased in SCH. Proteasome activity was increased in SCH and BD, being only statistically significant in SQZ (p<0,05). UPR study showed IRE1a cascade significantly activated in SCH (p<0,001) and only slight increased in BD showed without statistical differences. ATF6a pathway is measured by cleavage to active protein (50-kDa). Results showed higher expression in SCH than in BD and controls (p<0,001). In addition, PERK pathway showed higher statistical levels of p-eIF2a/eiF2a ratio in SCH than in BD and control respectively (p<0,05 and p<0,01).
ConclusionsOur results showed a greater alteration in SCH than in BD at the level of protein synthesis, which implies a greater toxicity at the cellular level and, therefore, a clear risk for the survival of cells in this pathology.
Disclosure of InterestNone Declared
Tobacco and hypertension: a descriptive study in a psychiatric short care unit
- I. Alonso Salas, A. Lopez Fariña, C. Gonzalez Navarro, A. Bilbao Idarraga, L. Morado San Segundo, U. Lopez Puentes, R. Lopez Brokate, T. Ruiz de Azua Aspizua, E. M. Garnica de Cos, U. Ortega Pozas, B. Samsó Martinez
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S954-S955
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Introduction
Patients affected by mental disorders are known to have a decreased life expectancy.
One of the main reasons are cardiovascular diseases. It is known that tobacco and hypertension are risk factors to develop them. WHO estimates that hypertension is diagnosed and treated in less than half of adults with hypertension, and even less in patients with severe mental illness.
ObjectivesTo describe the demographic characteristics of patients with tobacco comsumption and hypertension admitted to a short-term hospitalization unit.
MethodsA three-month retrospective observational study. Data were collected by interviewing incoming patients and performing a blood pressure measurement, with no exclusion criteria.
ResultsOf 172 patients admitted, 100 were smokers of whom 49 were men and 51 were women. Among the smokers, a total of 18 patients were diagnosed with hypertension and 79 were not diagnosed. Within the group of patients not diagnosed with hypertension, elevated blood pressure was recorded in 5 of them. A total of 67 patients were non-smokers, 23 of whom were male and 44 female. Among the non-smokers, 19 were diagnosed with hypertension and 48 were not, despite which elevated blood pressure levels were recorded in 4 of them. No data were collected from 5 patients.
ConclusionsThe prevalence of smokers in our sample was 58%. The prevalence of patients diagnosed with hypertension was 21,51% which is coherent with the existent literature. We did not find a higher percentage of hypertensive patients among the smokers admitted. There were patients who suffered from hypertension and were not diagnosed or treated previously.
Disclosure of InterestNone Declared
Effects of Autonomous Sensory Meridian Response (ASMR) on mental health.
- T. Gutierrez Higueras, A. Jiménez Peinado, B. Hernández Gajate, M. Reyes López, L. Montes Arjona, M. Rodriguez Ruzafa
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S963
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Introduction
The Autonomous Sensory Meridian (ASMR) is a static or tingling sensation on the skin that usually starts on the scalp and runs through the back of the neck and upper spine. It has been compared to tactile auditory synesthesia and may overlap with shivering. It is a subjective experience of “low-grade euphoria”, characterized by “a combination of positive feelings and a static tingling sensation on the skin”. It is most commonly triggered by auditory or visual stimuli, and less commonly by intentional attentional control.
ObjectivesTo determine the effects produced by the perception of ASMR in the population with mental disorders.
MethodsA literature review was carried out in Pubmed using the descriptors: “ASMR” AND “mental”. 7 results are obtained. The results of a time limit of 10 years were filtered, obtaining 6 results and selecting all of them for their relevance to the PICO question. Subsequently, the search was repeated using the same descriptors and time limit in the Cochrane Library and NICE, in which no results were found.
ResultsThe first result, an RCT of 475 people between the ages of 18 and 54, showed that 80% of the participants answered positively when asked if ASMR has an effect on their mood, while 14% were not sure and 6 % felt ASMR did not alter their mood. When subjected to a mixed ANOVA with factors for time (before, during, immediately after, and 3 h after ASMR) and for depression status (high, medium, or low as defined by the BDI), we found a significant main effect. of time in mood. [p<0.0005]
In one of these studies, the default neural network (the one that works when the brain is relaxed) was analyzed in 11 volunteers in whom ASMR caused them to relax, in contrast to 11 individuals in the control group. At the end of the study, the ASMR volunteers generally showed less functional connectivity than the other volunteers. It also showed “increased connectivity between regions of the occipital, frontal, and temporal cortices,” suggesting that ASMR favors the association of those networks that are activated in the resting state.
ConclusionsWith the available evidence it is concluded that ASMR could improve of the affective clinic reflected in the parameters of the Beck depression scale as well as a sense of calm and relaxation and it reduces the heart rate or increases the conductivity of the skin, something that happens when certain emotional states are altered.
Disclosure of InterestNone Declared
Phonological fluency norms for Spanish middle-aged and older adults provided by the SCAND initiative (P, M, & R)
- M.L. Delgado-Losada, S. Rubio-Valdehita, R. López-Higes, M. Campos-Magdaleno, M. Ávila-Villanueva, B. Frades-Payo, C. Lojo-Seoane
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- Journal:
- Journal of the International Neuropsychological Society / Volume 30 / Issue 2 / February 2024
- Published online by Cambridge University Press:
- 19 July 2023, pp. 172-182
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Objective:
Verbal fluency tests are quick and easy to administer neuropsychological measures and are regularly used in neuropsychological assessment. Additionally, phonological fluency is a widely used paradigm that is sensitive to cognitive impairment. This paper offers normative data of phonological verbal fluency (letters P, M, R) for Spanish middle- and older-aged adults, considering sociodemographic factors, and different measures such as the total number of words, errors (perseveration and intrusions), and 15 sec-segmented scores.
Method:A total of 1165 cognitively unimpaired participants aged between 50 and 89 years old, participated in the study. Data for P were obtained for all participants. Letters M and R were also administered to a subsample of participants (852) aged 60 to 89 years. In addition, errors and words produced every 15 seconds were collected in the subsample. To verify the effect of sociodemographic variables, linear regression was used. Adjustments were calculated for variables that explained at least 5% of the variance (R2 ≥ .05).
Results:Means and standard deviations by age, scaled scores, and percentiles for all tests across different measures are shown. No determination coefficients equal to or greater than .05 were found for sex or age. The need to establish adjustments for the educational level was only found in some of the measures.
Conclusions:The current norms provide clinically useful data to evaluate Spanish-speaking natives from Spain aged from 50 to 89 years. Specific patterns of cognitive impairment can be analyzed using these normative data and may be important in neuropsychological assessment.
Thyroid disorders in psychiatric patients: a descriptive study in a psychiatric hospital
- U. López, L. Morado San Segundo, C. González Navarro, I. Alonso Salas, A. López Fariña, A. Bilbao Idarraga, B. Samsó Martínez, R. F. López Brokate, E. M. Garnica de Cos, T. Ruiz de Azua Aspizua, U. Ortega Pozas
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S471
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Introduction
Thyroid disorders can present with psychiatric symptons similar to depression, and, at the same time, certain treatments, like litio, can cause changes in thyroid function. Given, therefore, the importance for the treatment and care of patients, the study of thyroid function is one of the parametres that should be requested in patients with psychiatric pathology.
ObjectivesTo study the frequency of thyroid disorders in patients who where admitted to a psychiatric short stay unit.
MethodsRetrospective descriptive observational study is carried out in the acute stay unit of a psychiatric hospital. As a sample, all patients admitted to the unit over a period of three months. During admission, their sociodemographic data, the treatment they receive and their diagnosis are recorded. Secondly, blood test are performed whith differents parameters, including TSH values.
ResultsIn the total sample of 172 patients, 8 of them have TSH abnormalities. 7 of them, all women, present hypothyroidism values.
A single male patient presented values of hyperthryroidism.
ConclusionsAccording to the present study, 4,6% of the patients present alterations at the TSH at admission, although except in one case, the values were not markedly altered.
The thyroid study at admission allows detecting cases of altered TSH that are amenable to treatment and monitoring.
Disclosure of InterestNone Declared
Under-diagnosis of alcohol abuse: a descriptive study in a psychiatric hospital
- A. Lopez Fariña, U. López Puentes, I. Alonso Salas, C. Gonzalez Navarro, A. Bilbao Idarraga, L. Morado Sansegundo, U. Ortega Pozas, C. Aran Cisneros, B. Samso Martinez, R. F. Lopez Brokate, T. Ruiz de Azua Aspizua, E. M. Garnica De Cos
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S333
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Introduction
Incidence of alcohol abuse in our country is high, although it is still under-diagnosed and under-treated. The WHO estimates that a total of 3.3 million deaths worldwide per year are related to alcohol consumption.
ObjectivesThe main objective is to describe the pattern of alcohol consumption in a sample of patients who are admitted to our psychiatric hospital for different reasons, relating with previous diagnoses.
MethodsA retrospective observational descriptive study was carried out in the acute care unit of the psychiatric hospital, after approval of the corresponding protocol by the ethics committee. All patients admitted to this unit during a three-month period were taken as a sample. During admission, sociodemographic data, drug use, treatment type and time and previous diagnoses were collected.
ResultsOut of 172 patients, 81 reported being abstemious, 45 declared occasional consumption, 11 weekly and 22 daily consumption. There is no data about 13 patients. Among those who reported daily alcohol consumption, 59% had a previous diagnosis of Substance Use Disorder (SUD), 23% a previous diagnosis of Schizophrenia, 13.5% of Bipolar Disorder and finally 4.5% of Depressive Disorder. All the patients with a previous diagnosis of SUD reported consumption of more than 10 SDUs/day, the group with Schizophrenia stated less than 5 SDUs/day, of the group with T. Bipolar between 7-10 SDUs/day and with T. Depressive 5 SDUs/day.
ConclusionsThe results obtained are consistent with the literature in relation to the under-diagnosis of alcohol use disorder, taking into account that 40% of patients in the sample with daily alcohol consumption previously had not such a diagnosis and it was not recorded in their medical history. For this reason, and for the sake of being able to treat them, it is essential to question all patients about alcohol consumption, whatever the reason for their admission.
Disclosure of InterestNone Declared