Latinx populations are underrepresented in clinical research. Asking Latinx research participants about their research experiences, barriers, and facilitators could help to improve research participation for these populations.

The Salud Estres y Resilencia (SER) Hispano cohort study is a longitudinal cohort study of young adult Latinx immigrants whose design and conduct were tailored for their study population. We administered the Research Participant Perception Survey (RPPS) to SER Hispano participants to assess their experiences in the study. We describe overall results from the RPPS and compare results of surveys administered to SER Hispano participants via email versus telephone.

Of 340 participants who were contacted with the RPPS, 142 (42%) responded. Among respondents, 53 (37%) responded by initial email contact; and 89 (63%) responded by subsequent phone contact. The majority of respondents were between 35 and 44 years of age (54%), female (76%), and of Cuban origin (50%). Overall, research participants expressed high satisfaction with their research experience; 84% stated that they would “definitely” recommend research participation to friends and family, with no significant difference by method of survey administration (P = 0.45). The most common factor that was chosen that would influence future research participation was having summary results of the research shared with them (72%).

We found that culturally tailored studies can be good experiences for Latinx research participants; and we found that use of the RPPS can be administered successfully, particularly when administered by more than one method, including telephone, to evaluate and to improve research experiences for this population.

Mental Health problems and substance misuse during pregnancy constitute a serious social problem due to high maternal-fetal morbidity (Cook et al, 2017; JOCG, 39(10) ,906-915) and low detection and treatment rates (Carmona et al. Adicciones. 2022;34(4):299-308)

Our study aimed to develop and test the feasibility and acceptability of a screening and treatment clinical pathway in pregnancy, based on the combination of e-Health tools with in-person interventions and, secondly, describe the prevalence of mental illness and substance use problems in this population.

1382 pregnant women undergoing her first pregnancy visit were included in a tailored clinical pathway and sent a telematic (App) autoapplied questionnaire with an extensive battery of measures (WHO (Five) Well-Being [WHO-5],Patient Health Questionnaire [PHQ-9], General Anxiety Disorder [GAD-7], Alcohol Use Disorders Identification Test [AUDIT], Drug Abuse Screening Test [DAST], Columbia Suicide Severity Rating Scale [C-SSRS] and specifically designed questions on self-harm and psychopharmacological drugs).

Patients who did not respond to the questionnaire on their own received a counseling call.

Based on the screening results, patients were classified into five groups according to severity (Figure 1) and assigned a specific action pathway (Figure 2) that included a range of intervention intensity that goes from an individual psychiatric appointment to no intervention.

Of the 1382 women included in the clinical pathway, 565(41%) completed the evaluation questionnaires. Of these, 205 (36%) were screened as positive (Grades III,IV or V. Table 1) and 3(0.5%) were classified as needing urgent care. Of the patients offered on-line groups (100), 40% (40) were enrolled in them.Table 1:

Grade distribution of those screened as positives

Concerning prevalence rates, 73 (12,9%) patients endorsed at least moderate anxiety according to GAD-7 (≥10), 65 (11,5%) endorsed at least moderate depression according to PHQ-9 (≥ 10), 17 were positive on DAST (3%) and 63 (11%) patients scored above the threshold in AUDIT-C(≥ 3) for alcohol use.

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High prevalence rates suggest that effective detection and treatment mechanisms should be integrated into usual care. The use of standardized clinical pathways can help with this aim, allowing better clinical management and referral to treatment, but still face challengues to increase retention. The use of e-health tools offers the opportunity to improve accessibility and therapeutic outcomes through online interventions.

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Emotional competencies, according to Bisquerra Alzina & Escoda (2007), refer to “knowledge, skills and attitudes necessary to understand, express and appropriately regulate emotional phenomena” (p. 22) in the management of emotions with oneself and with the other.

Measure the emotional competencies Empathy, Emotional Expression and Emotional Regulation in health professionals in healthcare centers.

Quantitative descriptive. The Inventory of Emotional Competencies for Adults (Mikulic, Crespi, Radusky, 2015) was applied to 30 participants (doctor, psychologist, nurse, dentist).

The grouped measurements show skills at a medium and high level.Table 1.

Measurement of empathy capacity, emotional regulation capacity and emotional expression capacity

The emotional reaction of congruence with the emotional state of the other, empathy, shows a medium level (Table 1), a result consistent with the study by Ruiz González (2019), in the Colombian population, where a medium level of empathy is observed in doctors.

In the strategy for management, support, increase and suppression of the current affective state to self-soothe and find a state of relaxation, it is at an average value between medium and high (table 1.)

In the ability to start and maintain conversations, express one’s own thoughts and feelings clearly, both in verbal and non-verbal communication, and demonstrate to others that they have been well understood, the level is mostly medium (table 1.)

The levels of emotional competencies evaluated are mostly in the middle in the assessment by dimensions, empathy registered a lower level in contrast to other dimensions.Taking into consideration professional practice, response to organic and mental human vulnerability, it is a field for promoting the well-being of the health professional.

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brain white matter integrity as a result of vascular burden is associated with a form of late-life depression, known as vascular depression (VaDep). Black older adults may be particularly vulnerable to developing VaDep due to a higher prevalence of vascular conditions compared to White older adults. The current study examined whether clinical and imaging markers of vascular burden predicted depressive symptoms in an older Black sample. Based on the literature in primarily White samples, we expected greater clinical vascular burden and white matter hyperintensity (WMH) volume to predict greater depressive symptoms both cross-sectionally and over 4-year follow-up. We additionally hypothesized that participants with operationally-defined VaDep would have worse cognitive performance and slower gait speed compared to those without VaDep. Exploratory analyses examined race (Black vs. White) as an additional predictor.

This study used publicly available data from 113 Black older adults who were followed for four years in the Healthy Brain Project (a substudy of the Health, Aging, and Body Composition Study). Clinical vascular burden was defined as the number of vascular conditions (e.g., hypertension, diabetes, stroke); total WMH volume and WMH volume in the uncinate fasciculus, superior longitudinal fasciculus, and cingulum were considered imaging markers of vascular burden. Clinical and imaging-defined vascular burden were used to predict baseline depressive symptoms and average depressive symptoms over follow-up as measured by the Center for Epidemiologic Studies Depression Scale (CES-D). We then formed groups based on cutoffs for vascular burden (two or more conditions) and depressive symptoms (upper tertile of CES-D scores) to compare cognitive (Digit Symbol Substitution Test and 15-Item Executive Interview) and gait speed performance at baseline and changes over four years in VaDep, non-vascular depression, vascular only, and healthy groups. Exploratory analyses included 179 White older adults from the Healthy Brain Project dataset to examine race differences.

Total WMH volume and WMH volume in the uncinate fasciculus predicted higher depressive symptoms both cross-sectionally and longitudinally. However, no similar pattern emerged when using clinically-defined vascular burden as the predictor. The VaDep group had the slowest processing speed but the trajectory of decline over time did not differ between groups. The non-vascular depression group’s executive performance improved over time while performance by the other groups remained stable. Both VaDep and non-vascular depression groups’ gait speed declined over time. There was a stronger association between depression and uncinate fasciculus WMH in Black compared to White individuals, and the Black VaDep group had the slowest baseline processing speed of all groups.

This research supports the validity of the VaDep framework in Black older adults by showing the impact of WMH, particularly in the uncinate fasciculus, on depressive symptoms and identifying cognitive risks associated with VaDep in this population. Moreover, results suggest WMH may confer a greater risk for depression in Black compared to White older adults, and that VaDep disproportionately impacts processing speed in Black older adults. This work addresses an important gap in the VaDep literature by examining a group that has historically been underserved.

The coronavirus disease 2019 (COVID-19) has serious physiological and psychological consequences. The long-term (>12 weeks post-infection) impact of COVID-19 on mental health, specifically in older adults, is unclear. We longitudinally assessed the association of COVID-19 with depression symptomatology in community-dwelling older adults with metabolic syndrome within the framework of the PREDIMED-Plus cohort.

Participants (n = 5486) aged 55–75 years were included in this longitudinal cohort. COVID-19 status (positive/negative) determined by tests (e.g. polymerase chain reaction severe acute respiratory syndrome coronavirus 2, IgG) was confirmed via event adjudication (410 cases). Pre- and post-COVID-19 depressive symptomatology was ascertained from annual assessments conducted using a validated 21-item Spanish Beck Depression Inventory-II (BDI-II). Multivariable linear and logistic regression models assessed the association between COVID-19 and depression symptomatology.

COVID-19 in older adults was associated with higher post-COVID-19 BDI-II scores measured at a median (interquartile range) of 29 (15–40) weeks post-infection [fully adjusted β = 0.65 points, 95% confidence interval (CI) 0.15–1.15; p = 0.011]. This association was particularly prominent in women (β = 1.38 points, 95% CI 0.44–2.33, p = 0.004). COVID-19 was associated with 62% increased odds of elevated depression risk (BDI-II ≥ 14) post-COVID-19 when adjusted for confounders (odds ratio; 95% CI 1.13–2.30, p = 0.008).

COVID-19 was associated with long-term depression risk in older adults with overweight/obesity and metabolic syndrome, particularly in women. Thus, long-term evaluations of the impact of COVID-19 on mental health and preventive public health initiatives are warranted in older adults.

Previous research has shown that neurocognitive deficits, especially deficits in executive functions, may persist during euthymia in in patients with bipolar disorder (BD) and that those are associated with an impairment of psychosocial functioning. The assessment of executive functions (EFs) is normally carried out using laboratory tests. Novel methodologies such as virtual reality (VR) allow the creation of immersive environments, to evaluate executive performance with greater potential for ecological validity than evaluations with standard tasks.

The objectives of this project are to evaluate executive performance in euthymic patients with BD with a novel virtual reality task compared to standard computerized tasks, and to find predictors of functioning associated with cognitive performance.

This is a cross sectional study in which 46 euthymic patients with BD treated at La Fe University and Polytechnic Hospital were assessed with a battery of standard computerized tasks (ST) (TMT/Stroop,/Go-No-Go/TOL/DOT) and with the Cooking Task virtual reality task. The Cooking Task presents 4 tasks of increasing difficulty in which you must cook food in a specific time. It records total time to complete the task, whether food is cooled or burned, the simultaneous use of two fires, the proper use of seasonings and the time to set the table.

Functioning was assessed with the Functioning Assessment Short Test (FAST) that evaluates the overall functioning of patients with a mental illness in 6 subscales.

Correlation analyses between cognitive performance variables and clinical variables were done. Multiple linear regression was performed with the FAST score as a dependent variable and cognitive performance variables and relevant clinical variables to executive functioning (months of euthymia, age, and number of total episodes) were included as independent variables.

A worse psychosocial functioning was significantly associated with a worse performance in standard tasks (TMTA, TMTB, STROOP, and TOL) and cooking task (total time spent on task 2, burning time and total time spent on task 3, and total time spent on task 4). In the regression analysis, the correct simultaneous use of the two fires was the best predictor of a better psychosocial functioning in BD patient. This implies the preserved ability of planning and performing dual tasks.

Our findings suggest that euthymic patients with BD present deficits in executive functions related with a worse psychosocial functioning. Among the tasks, the cooking task may have a greater sensitivity than standards task to predict real functioning. This in an opportunity to design virtual applications for diagnostic and therapeutic purposes.

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Resistant to treatment depression (RTD) is a prevalent disease that implies functional impairment and high resources consumption. Theta Burst Transcranial Magnetic Stimulation (TBS) in dorsolateral prefrontal cortex (DLPFC) is a novel therapy that has shown experimental efficacy and as an adjuvant strategy in RTD. The implementation of TBS in the Public National Health Service requires cost-effective protocols that achieve earlier responses and higher rates of effectiveness, and whose design is based on biomarkers of response so as to adequately select candidate patients.

To assess the efficacy and safety of novel bilateral and unilateral intensive/spaced protocols of TBS in outpatients with unipolar/bipolar RTD compared with sham stimulation. Specific objectives: I) Comparison of mood change at the end of TBS protocol in the groups and maintenance of its effect at 3 months; II) Characterization of cerebral connectivity and metabolism patterns related to the effects of TBS; III) Analysis of the interaction between clinical and neuroimaging predictors so as to determine a RTD profile of patient that can benefit from TBS.

A two-year randomized double-blind clinical trial with 96 outpatients with TRD will be carried out. Participants will be randomized in three groups (active bilateral, active left and sham right and sham bilateral) to receive 22 active/sham sessions of continuous TBS (right DLPFC) and intermittent TBS (left DLPFC) during 6 weeks (w 1-2: 5 sessions/w, w 3-6: 3 sessions/w). Assessments of mood and side-effects will be carried out weekly. Functional neuroimaging will be a a simultaneous PET/MR acquisition previous and at the end of TBS treatment. Between-group comparisons of efficacy in terms of Hamilton Depression Rating Scale (HDRS-17) from basal to 6th week will be performed using controlled mixed regression models. Between-group comparisons will be made at baseline and after treatment, studying the imaging biomarkers obtained. Clinical and neuroimaging predictors of response will be integrated in machine learning models.

The expected results of the project are summarized in the following hypotheses: 1) The intensive and spaced protocols of TBS as an adjuvant antidepressant treatment will have greater efficacy than sham stimulation in patients with TRD. 2) Both protocols will be safe, with mild side effects. 3) Unilateral and bilateral TBS protocols will involve changes in connectivity and cerebral metabolic consumption mainly in regions of the fronto-cingulo-temporal circuitry. 4) PET/MR imaging biomarkers will allow us to differentiate whether patients have responded to treatment with TBS.

This project may help to improve resistant to treatment depression management by personalizing TMS treatment with the use of neuroimaging biomarkers.

None Declared

Bipolar disorder is related with functional impairment in euthymia. The contribution of biological functions such as sleep, sexual functioning; or the presence of obesity on this loss remain understudied.

The aim of this work was to study the influence of biological determinants in context with clinical and demographical determinants of functioning in a 3-year cohort of euthymic BD patients.

In this multicentric study 67 euthymic adult bipolar outpatients were followed during three years. Functioning was assessed with FAST, insomnia severity with Oviedo Sleep Questionnaire (OSQ) and, sexual functioning with Changes on Sexual Functioning Questionnaire (CSFQ-14) and obesity was expressed as body mass index (BMI). The basal effect of sleep, sexual functioning and obesity (Time 0) on FAST (Time 3) was analyzed with a mixed ordinal regression model including time effect, age, sex, number of manic and depressive episodes, euthymia length, and comorbidity with personality disorder. Change in functioning (Time 3 to 0) was analyzed in another mixed model also considering the difference in biological determinants (Time 3 to 0) and the presence of mood episodes during the period.

A basal worse sexual functioning, a higher severity of insomnia and a higher BMI predicted a worse functioning at three years (p=0.005, p=0.043, p=0.05 respectively). Regarding FAST difference from Time0 to 3, only having a manic episode related to an impairment on functioning (p=0.027).

Sexual functioning, quality of sleep and BMI are predictors of functioning in euthymia in BD. Manic episodes in the following contribute to impairments on functioning more than depressive episodes.

No significant relationships.

To examine the cross-sectional and longitudinal (2-year follow-up) associations between dietary diversity (DD) and depressive symptoms.

An energy-adjusted dietary diversity score (DDS) was assessed using a validated FFQ and was categorised into quartiles (Q). The variety in each food group was classified into four categories of diversity (C). Depressive symptoms were assessed with Beck Depression Inventory-II (Beck II) questionnaire and depression cases defined as physician-diagnosed or Beck II >= 18. Linear and logistic regression models were used.

Spanish older adults with metabolic syndrome (MetS).

A total of 6625 adults aged 55–75 years from the PREDIMED-Plus study with overweight or obesity and MetS.

Total DDS was inversely and statistically significantly associated with depression in the cross-sectional analysis conducted; OR Q4 v. Q1 = 0·76 (95 % CI (0·64, 0·90)). This was driven by high diversity compared to low diversity (C3 v. C1) of vegetables (OR = 0·75, 95 % CI (0·57, 0·93)), cereals (OR = 0·72 (95 % CI (0·56, 0·94)) and proteins (OR = 0·27, 95 % CI (0·11, 0·62)). In the longitudinal analysis, there was no significant association between the baseline DDS and changes in depressive symptoms after 2 years of follow-up, except for DD in vegetables C4 v. C1 = (β = 0·70, 95 % CI (0·05, 1·35)).

According to our results, DD is inversely associated with depressive symptoms, but eating more diverse does not seem to reduce the risk of future depression. Additional longitudinal studies (with longer follow-up) are needed to confirm these findings.

1. (1) How can training of CBT techniques such as exposure occur prior to graduate education?

2. (2) Can self-efficacy in conducting exposures meaningfully increase in an experiential training of pre-professionals?

3. (3) How does an individual’s tolerance of disgust impact feelings of competence conducting exposures?