Recently, some observational studies suggested that romantic love (RL) might influence the phenotypic expression of obsessive-compulsive disorder (OCD). The aim of the present study was to investigate the impact of different stages of RL on the clinical expression of OCD.

Two hundred and twelve patients with OCD onset related to the development or the termination of a romantic relationship (RR) and who were attending outpatient units at the University Psychiatric Clinic of Pisa, Italy, and seven specialized OCD clinics in Brazil were recruited. The assessment instruments were: the Structured Clinical Interview for DSM-5 Disorders (SCID-5), the Yale OCD Natural History Questionnaire, and the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Participants were divided into two groups (love-precipitated [LP-OCD] and break-up OCD [BU-OCD]).

The total Y-BOCS and obsessions and compulsions subscales scores were similar and indicative of severe OCD in the two groups. The average age of onset was significantly lower in the BU-OCD group, perhaps reflecting a vulnerability of the brain’s maturational stages to “undesirable” events in young individuals at risk for OCD. A trend towards aggression and symmetry, and ordering and rearrangement dimensions in BU-OCD patients emerged, possibly reflecting an amplification of some normal features of a RR.

Our findings suggest that different stages of RL may influence some features of OCD, namely the age of onset and specific dimensions. Again, RL poses the risk of developing this pathological condition in vulnerable individuals. Further research on the topic should be encouraged.

Post-procedural antimicrobial prophylaxis is not recommended by professional guidelines but is commonly prescribed. We sought to reduce use of post-procedural antimicrobials after common endoscopic urologic procedures.

A before-after, quasi-experimental trial with a baseline (July 2020–June 2022), an implementation (July 2022), and an intervention period (August 2022–July 2023).

Three participating medical centers.

We assessed the effect of a bundled intervention on excess post-procedural antimicrobial use (ie, antimicrobial use on post-procedural day 1) after three types of endoscopic urologic procedures: ureteroscopy and transurethral resection of bladder tumor or prostate. The intervention consisted of education, local champion(s), and audit-and-feedback of data on the frequency of post-procedural antimicrobial-prescribing.

1,272 procedures were performed across all 3 sites at baseline compared to 525 during the intervention period; 644 (50.6%) patients received excess post-procedural antimicrobials during the baseline period compared to 216 (41.1%) during the intervention period. There was no change in the use of post-procedural antimicrobials at sites 1 and 2 between the baseline and intervention periods. At site 3, the odds of prescribing a post-procedural antimicrobial significantly decreased during the intervention period relative to the baseline time trend (0.09; 95% CI 0.02–0.45). There was no significant increase in post-procedural unplanned visits at any of the sites.

Implementation of a bundled intervention was associated with reduced post-procedural antimicrobial use at one of three sites, with no increase in complications. These findings demonstrate both the safety and challenge of guideline implementation for optimal perioperative antimicrobial prophylaxis.

This trial was registered on clinicaltrials.gov, NCT04196777.

Technological advances allow for increased international collaboration within the medical community (e.g., internet, e-mail, instant messaging, video-teleconferencing [VTC]). Partnering with clinicians and researchers across the globe allows for shared resources, particularly beneficial for underserved populations and communities with poor access to specialty resources, including neuropsychology. Along with the potential benefits of such collaborations comes challenges including language, cultural, and physical barriers. The presented findings detail important lessons learned from an ongoing research collaboration between the Einstein team (Bronx, NY) and a research group in Kerala, India, called the Kerala Einstein Study (KES), a study evaluating pre-dementia syndromes in Indian older adults. Here we highlight the training process of research assistants administering neuropsychological measures to older adults in India, by neuropsychologists in the USA.

One study manager and several research assistants (collectively referred to as RAs) based in India were trained by the first author, a neuropsychology postdoctoral fellow (MS) based in the US via VTC (i.e., Zoom), under supervision of a clinical neuropsychologist. RAs were trained in test administration and scoring for a variety of neuropsychological measures. RAs speak Malayalam and English; training occurred in English. Following training, VTC meetings were held to process testing experience and channels were created for ongoing administration/scoring questions and concerns (i.e., email, WhatsApp). RAs scanned and uploaded scored protocols to a protected web-based platform. MS double-scored several protocols and additional VTC meetings were held to discuss/update scoring procedures.

Physical challenges included time difference between sites, internet connectivity, language barriers (i.e., varying English dialects) cultural considerations (e.g., some test/task directions were changed based on RAs knowledge of more appropriate wording). Test administration challenges included cultural factors (i.e., allowing for continuation of some tasks beyond time limits for rapport) and RA comfort level with administration of some tasks (e.g., trail making test). Scoring challenges included RAs tendency to score too strictly or leniently and confusion regarding specific scoring criteria. At an initial VTC meeting, MS modeled test administration. Then RAs practiced the tests together. To reduce challenges including time difference, connectivity problems, language barriers, and comfort with testing/scoring, VTC training sessions were scheduled individually between MS and each RA. During these sessions, the RA 'tested’ MS and received immediate feedback. Most sessions lasted approximately 90 minutes with one RA requiring a second session (i.e., sessions were tailored for individuals to obtain level of testing comfortability and competency). After each RA was 'cleared’ by MS to start testing, RAs began testing and scoring. Following MS’s review of several scored protocols, meetings took place in groups in order to improve scoring skills and increase consistency between RAs. Given the continued high degree in scoring variability, a third RA was hired with one of his main responsibilities being to double score all protocols.

Findings highlight important challenges and considerations for remotely training study personnel to administer neuropsychological measures (i.e., RAs in India and neuropsychologists in the USA). Important steps to reduce identified barriers included individualized training sessions, specific training in scoring, and open/ongoing communication channels.

This study investigated the challenges and support needs of adults aged 75 and older during and after treatment for a blood cancer to aid targeted supportive resource development.

Adults aged 75 and older with a blood cancer participated in in-depth, semi-structured interviews about challenges and unmet support needs. Participants recruited through The Leukemia & Lymphoma Society were (1) in treatment or previously in treatment for a blood cancer at age 75 or older and (2) living in the United States or its territories. A thematic analysis was conducted with findings compared between 2 groups: (1) chronic -living with a chronic blood cancer; (2) acute -living with an acute blood cancer or both an acute and chronic blood cancer.

Participants (n = 50) ranged from 75 to 91 years old. Both groups described similar experiences and identified 5 challenges and support needs: (1) socioemotional impact, (2) activities of daily living and instrumental activities of daily living (ADLs/iADLs), (3) uncertainty management, (4) treatment-related stressors, and (5) COVID-19-related strain. Properties for these themes illustrate challenges and support needs, with some differences between groups. For instance, those living with a chronic blood cancer highlighted financial strain with treatment-related stressors, while those with an acute blood cancer focused more on iADLs.

Findings inform an agenda for targeted resource development for older adults with a blood cancer nearing the end of the life span. Results demonstrate the need for supportive services and family communication interventions to help patients manage iADLs and navigate socioemotional needs and challenges.

The COVID-19 outbreak is a serious global public health issue with wide-ranging negative effects on people’s lives, which is reflected in steadily rising mental health problems. In order to appropriately respond to the increased occurrence of psychiatric illness, protect mental health and strengthen resilience it is necessary to include new technologies, such as extended reality (XR) or socially assistive robots (SAR) in not only psychiatric treatment but also in the prevention of psychiatric diseases. In this context, the use of new technologies offers innovative ways to strengthen resilience, self-efficacy and stress coping skills and plays an important role in improving psychological wellbeing.

Preliminary results from studies at the Clinical Department of Psychiatry and Psychotherapeutic Medicine in Graz, Austria, dealing with new technologies in psychiatry, show new options for psychiatric settings.

Project AMIGA: The aim of this study is to test the effectiveness of a cognitive training session, conducted with the SAR named Pepper. In this randomized controlled trial, the effectiveness of SAR on depressive symptoms and correlates is evaluated in a sample of 60 individuals with major depression. While the intervention group will receive cognitive training with the SAR Pepper, the control group will receive “treatment-as-usual” therapy with a common PC software. Participants will receive 30 minutes of training 2 times per week over a period of 3 weeks.

Project XRes4HEALTH: The aim of this study is to develop an XR resilience training to increase resilience and stress coping mechanisms in healthcare workers. A total of 40 people will be included. To test the effectiveness of the resilience training, 3 XR training sessions of 15 minutes each will be held. A pre-post measurement will test the effectiveness of the training on wellbeing and stress levels as well as the acceptance and satisfaction with the training.

Project AI-REFIT: The overall goal of this study is to explore key information to increase resilience in healthy individuals who are at increased risk for mental health problems. Through a usability study, the artificial intelligence-based prototype app of the resilience training will be tested for acceptance, usability, functionality, and efficiency. During the resilience training, participants are wearing a smartwatch which measures psychophysiological parameters. Conclusions about the success of the therapy can be drawn based on digital data acquisition.

New technologies including XR and SAR support classical psychiatric treatment in the topics of resilience and cognitive training as an add-on therapy in times of reduced availability of healthcare workers.

The rapid development of new technologies holds a lot of potential in the treatment of psychiatric disorders, which is why it is important to scientifically evaluate those innovative tools.

None Declared

Untreated disrupted sleep is an important precursor for the development of depression. Several studies have confirmed the negative impact of pre-sleep cognitive and emotional activity such as worry and negative affect on subsequent sleep. Emotional stress may affect latencies to sleep onset, to REM-sleep and other markers of sleep disruption such as arousals. The way we cope with emotional stressors and events may have important effects on subsequent sleep.

In this study we investigated the effects of a failure-experience on polysomnographically recorded sleep in volunteers. Furthermore we explored whether dispositional coping factors such as emotion regulation moderate this effect.

In contrast to the control condition the effect of the failure induction was clearly observed in emotional experience as well as within the physiological sleep architecture. Furthermore, we notice a tendency in which not only emotional experience, but also sleep physiology was affected by low and high emotional approach as emotion regulation style (cf. Stanton, 2000).

The present study has shown that emotional stress as a failure experience before sleep-goes together with a worsening of mood, an increase of level of rumination and enhanced sleep fragmentation with a moderating effect of emotion regulation as dispositional factor.

Preliminary data suggest that patients who suffer from both bipolar disorder (BD) and alcohol dependence (AD) may be more vulnerable to cognitive dysfunction than patients with a single diagnosis, especially during periods that are clinically unstable.

The purpose of this study was to examine the cognitive recovery of dually-diagnosed patients during remission from an acute mood disturbance.

The study aimed to replicate our previous comparison of cognitive functioning between BD patients with and without AD, while on the inpatient unit, and to extend this investigation in a longitudinal design post-discharge.

Fifty-five adult inpatients with bipolar I disorder completed a neuropsychological battery, mood measures and substance abuse measures upon discharge from the hospital and at a 3 month follow up. Analyses provided group comparisons on these measures between patients who presented with co-occurrence of AD (n = 21) in the year prior to hospital admission and patients without a Substance Use Disorder (SUD; n = 34).

Compared to patients without SUD, dually-diagnosed patients scored significantly more poorly on measures of visual memory, verbal memory and executive functioning both at hospital discharge and follow-up. They also exhibited more limited recovery of these functions over the course of this period. Mood symptoms decreased in both groups from discharge to follow up.

Patients with co-occurring BD and AD may suffer from more severe cognitive dysfunction and less favorable recovery of cognitive deficits than BD patients without SUD over the course of remission from a mood episode.

The online treatment program Deprexis simulates evidence-based psychotherapy and can be used by psychiatrists for patients on waiting lists, as an adjunct to traditional treatment, or as a stand-alone intervention. The program includes modules such as behavioural activation, cognitive restructuring, mindfulness/acceptance exercises, social skills training, and positive psychology interventions.

In this randomised trial, 60 adults with mild to moderate depression were assigned to 9 weeks of either online-treatment (N = 34) or treatment-as-usual (N = 26).

Taking the program was associated with significant reductions in depression severity and improvements in social functioning, which were maintained over nine weeks of follow-up. In the treatment group, 41% experienced clinically significant improvement, whereas this was true in only 3.8% of the control participants. This corresponds to an odds-ratio of 17.50, indicating that participants in the treatment group were more than 17 times as likely to experience clinically significant improvement, compared to those in the control group. The effect size achieved by Deprexis resembles those achieved in routine community treatments, including medication or psychotherapy (Grawe, 2006; Westbrook & Kirk, 2005). The Deprexis program was also well received by the users: 88% felt that the program had helped them and 97% would recommend it to others suffering from mild depression.

These encouraging preliminary data suggests that Deprexis is an effective, online, self-help intervention for adults suffering from mild to moderate depression.

The aim of the present study was to investigate possible sex differences in the recognition of facial expressions of emotion and to investigate the pattern of classification errors in schizophrenic males and females. Such an approach provides an opportunity to inspect the degree to which males and females differ in perceiving and interpreting the different emotions displayed to them and to analyze which emotions are most susceptible to recognition errors.

Fifty six chronically hospitalized schizophrenic patients (38 men and 18 women) completed the Penn Emotion Recognition Test (ER40), a computerized emotion discrimination test presenting 40 color photographs of evoked happy, sad, anger, fear expressions and neutral expressions balanced for poser gender and ethnicity.

We found a significant sex difference in the patterns of error rates in the Penn Emotion Recognition Test. Neutral faces were more commonly mistaken as angry in schizophrenic men, whereas schizophrenic women misinterpreted neutral faces more frequently as sad. Moreover, female faces were better recognized overall, but fear was better recognized in same gender photographs, whereas anger was better recognized in different gender photographs.

The findings of the present study lend support to the notion that sex differences in aggressive behavior could be related to a cognitive style characterized by hostile attributions to neutral faces in schizophrenic men.

Food craving (FC) has been linked todepressive mood before. However, no study exists evaluating FC in a sample of bipolar disorder (BD).

This study aimed to determine the prevalence of FC in individuals with BD during euthymia.

Fifty individuals with a BD diagnosis according to the DSM-IV guidelines were drawn from the dedicated outpatient center of the University Clinic of Psychiatry Graz. Data were compared with data from a healthy control sample (HC, n=50). All probands took part in the BIPFAT study exploring shared pathophysiological pathways of obesity and brain function in BD. Participants completed a comprehensive diagnostic battery (including the Food Craving Questionnaire by White et al. 2002) measuring anamnestic, anthropometric, and clinical data. We performed a MANCOVA controlling for key covariates including gender, age, body mass index, smoking, mood stabilizing medication, and lipid levels.

BD patients exhibited significantly more total food craving (F=6.10, p=.016) and more sweets craving than controls (F=6.38, p=.014). Additionally, levels of fat craving were higher by trend in the male patient group than in the male control group (F=3.15, p=.087).

A higher prevalence of FC in BD patients than in controls suggests that FC may be of clinical importance in BD. Potentially, FC plays a role in the development of obesity, a well-known risk factor for unfavorable course of illness in BD. Furthermore, the impact of dysfunctions in the serotonergic system and/or an altered activation of the hypothalamic-pituitary-adrenal axis in relationship to increased FC are critically discussed.