193 results
Somatic multicomorbidity and disability in patients with psychiatric disorders in comparison to the general population: a quasi-epidemiological investigation in 54,826 subjects from 40 countries (COMET-G study)
- Konstantinos N. Fountoulakis, Grigorios N. Karakatsoulis, Seri Abraham, Kristina Adorjan, Helal Uddin Ahmed, Renato D. Alarcón, Kiyomi Arai, Sani Salihu Auwal, Michael Berk, Sarah Bjedov, Julio Bobes, Teresa Bobes-Bascaran, Julie Bourgin-Duchesnay, Cristina Ana Bredicean, Laurynas Bukelskis, Akaki Burkadze, Indira Indiana Cabrera Abud, Ruby Castilla-Puentes, Marcelo Cetkovich, Hector Colon-Rivera, Ricardo Corral, Carla Cortez-Vergara, Piirika Crepin, Domenico De Berardis, Sergio Zamora Delgado, David De Lucena, Avinash De Sousa, Ramona Di Stefano, Seetal Dodd, Livia Priyanka Elek, Anna Elissa, Berta Erdelyi-Hamza, Gamze Erzin, Martin J. Etchevers, Peter Falkai, Adriana Farcas, Ilya Fedotov, Viktoriia Filatova, Nikolaos K. Fountoulakis, Iryna Frankova, Francesco Franza, Pedro Frias, Tatiana Galako, Cristian J. Garay, Leticia Garcia-Álvarez, Maria Paz García-Portilla, Xenia Gonda, Tomasz M. Gondek, Daniela Morera González, Hilary Gould, Paolo Grandinetti, Arturo Grau, Violeta Groudeva, Michal Hagin, Takayuki Harada, Tasdik M. Hasan, Nurul Azreen Hashim, Jan Hilbig, Sahadat Hossain, Rossitza Iakimova, Mona Ibrahim, Felicia Iftene, Yulia Ignatenko, Matias Irarrazaval, Zaliha Ismail, Jamila Ismayilova, Asaf Jakobs, Miro Jakovljević, Nenad Jakšić, Afzal Javed, Helin Yilmaz Kafali, Sagar Karia, Olga Kazakova, Doaa Khalifa, Olena Khaustova, Steve Koh, Svetlana Kopishinskaia, Korneliia Kosenko, Sotirios A. Koupidis, Illes Kovacs, Barbara Kulig, Alisha Lalljee, Justine Liewig, Abdul Majid, Evgeniia Malashonkova, Khamelia Malik, Najma Iqbal Malik, Gulay Mammadzada, Bilvesh Mandalia, Donatella Marazziti, Darko Marčinko, Stephanie Martinez, Eimantas Matiekus, Gabriela Mejia, Roha Saeed Memon, Xarah Elenne Meza Martínez, Dalia Mickevičiūtė, Roumen Milev, Muftau Mohammed, Alejandro Molina-López, Petr Morozov, Nuru Suleiman Muhammad, Filip Mustač, Mika S. Naor, Amira Nassieb, Alvydas Navickas, Tarek Okasha, Milena Pandova, Anca-Livia Panfil, Liliya Panteleeva, Ion Papava, Mikaella E. Patsali, Alexey Pavlichenko, Bojana Pejuskovic, Mariana Pinto Da Costa, Mikhail Popkov, Dina Popovic, Nor Jannah Nasution Raduan, Francisca Vargas Ramírez, Elmars Rancans, Salmi Razali, Federico Rebok, Anna Rewekant, Elena Ninoska Reyes Flores, María Teresa Rivera-Encinas, Pilar Saiz, Manuel Sánchez de Carmona, David Saucedo Martínez, Jo Anne Saw, Görkem Saygili, Patricia Schneidereit, Bhumika Shah, Tomohiro Shirasaka, Ketevan Silagadze, Satti Sitanggang, Oleg Skugarevsky, Anna Spikina, Sridevi Sira Mahalingappa, Maria Stoyanova, Anna Szczegielniak, Simona Claudia Tamasan, Giuseppe Tavormina, Maurilio Giuseppe Maria Tavormina, Pavlos N. Theodorakis, Mauricio Tohen, Eva Maria Tsapakis, Dina Tukhvatullina, Irfan Ullah, Ratnaraj Vaidya, Johann M. Vega-Dienstmaier, Jelena Vrublevska, Olivera Vukovic, Olga Vysotska, Natalia Widiasih, Anna Yashikhina, Panagiotis E. Prezerakos, Daria Smirnova
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- Journal:
- CNS Spectrums / Volume 29 / Issue 2 / April 2024
- Published online by Cambridge University Press:
- 25 January 2024, pp. 126-149
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Background
The prevalence of medical illnesses is high among patients with psychiatric disorders. The current study aimed to investigate multi-comorbidity in patients with psychiatric disorders in comparison to the general population. Secondary aims were to investigate factors associated with metabolic syndrome and treatment appropriateness of mental disorders.
MethodsThe sample included 54,826 subjects (64.73% females; 34.15% males; 1.11% nonbinary gender) from 40 countries (COMET-G study). The analysis was based on the registration of previous history that could serve as a fair approximation for the lifetime prevalence of various medical conditions.
ResultsAbout 24.5% reported a history of somatic and 26.14% of mental disorders. Mental disorders were by far the most prevalent group of medical conditions. Comorbidity of any somatic with any mental disorder was reported by 8.21%. One-third to almost two-thirds of somatic patients were also suffering from a mental disorder depending on the severity and multicomorbidity. Bipolar and psychotic patients and to a lesser extent depressives, manifested an earlier (15–20 years) manifestation of somatic multicomorbidity, severe disability, and probably earlier death. The overwhelming majority of patients with mental disorders were not receiving treatment or were being treated in a way that was not recommended. Antipsychotics and antidepressants were not related to the development of metabolic syndrome.
ConclusionsThe finding that one-third to almost two-thirds of somatic patients also suffered from a mental disorder strongly suggests that psychiatry is the field with the most trans-specialty and interdisciplinary value and application points to the importance of teaching psychiatry and mental health in medical schools and also to the need for more technocratically oriented training of psychiatric residents.
Crystallochemical characterization of the palygorskite and sepiolite from the Allou Kagne deposit, Senegal
- E. García-Romero, M. Suárez, J. Santarén, A. Alvarez
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- Clays and Clay Minerals / Volume 55 / Issue 6 / December 2007
- Published online by Cambridge University Press:
- 01 January 2024, pp. 606-617
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The Allou Kagne (Senegal) deposit consists of different proportions of palygorskite and sepiolite, and these are associated with small quantities of quartz and X-ray amorphous silica as impurities. No pure palygorskite or sepiolite has been recognized by X-ray diffraction. Textural and microtextural features indicate that fibrous clay minerals of the Allou Kagne deposit were formed by direct precipitation from solution. Crystal-chemistry data obtained by analytical/transmission electron microscopy (AEM/TEM) analyses of isolated fibers show that the chemical composition of the particles varies over a wide range, from a composition corresponding to palygorskite to a composition intermediate between that of sepiolite and palygorskite, but particles with a composition corresponding to sepiolite have not been found. Taking into account the results from selected area electron diffraction and AEM-TEM, fibers of pure palygorskite and sepiolite have been found but it cannot be confirmed that all of the particles analyzed correspond to pure palygorskite or pure sepiolite because both minerals can occur together at the crystallite scale. In addition, the presence of Mg-rich palygorskite and very Al-rich sepiolite can be deduced.
It is infrequent in nature that palygorskite and sepiolite appear together because the conditions for simultaneous formation of the two minerals are very restricted. The chemical composition of the solution controls the formation of the Allou Kagne sepiolite and palygorskite. The wide compositional variation appears as a consequence of temporary variations of the chemical composition of the solution.
Biomarkers and clinical predictors of long-term course in obsessivecompulsive disorder: A prospective cohort study
- S. López-Rodriguez, P. Alonso Ortega, C. Segalàs Cosi, E. Real Barrero, S. Bertolín Triquell, C. Soriano Mas, Á. Carracedo Alvarez, J. M. Menchón Magriña
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S231
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Introduction
The purpose of the research project is to analyze the long-term evolution of obsessive-compulsive disorder (OCD) from of a study of a cohort of patients prospectively followed over a period ranging from 5 to 20 years, treated for according to therapeutic guidelines mediating serotonin reuptake inhibitors (IRS) and drug enhancers (antipsychotics) and cognitive behavioral therapy and evaluated in a standardized manner.
ObjectivesTo assess the long-term course of Obsessive-Compulsive Disorder (OCD) in a cohort of patients treated according to current clinical guidelines; to analyse possible prognostic factors associated with the long-term course of the disorder including clinical and sociodemographic variables, as well as genetic and neuroimaging biomarkers, and their interaction, and finally to study neuroanatomical and functional cerebral connectivity changes after 15 years of treatment in a subsample of patients.
MethodsProspective, descriptive, and observational study of a cohort of OCD patients, receiving treatment at the Department of Psychiatry of Hospital de Bellvitge since 1998, according to a standardized protocol. Follow-up period ranges from 5 (n=423), to 10 (n= 247) and 15 years (123). Baseline clinical and sociodemographic assessment, long-term evolution and information on treatments provided are available for the whole sample. Data on whole exome sequencing is available for 300 of the patients included in the cohort and baseline structural neuroimaging and cerebral functional connectivity has been analysed in 168 subjects. To expand the analysis of genetic biomarkers, we propose the study of de novo variants through exome analysis of 50 trios (patient and both parents) selected among those subjects that have reached 15 years of follow-up (25 trios with patients within the “long-term remission” group and 25 trios with patients with chronic OCD). De novo variants detected in the trio analysis will be replicated in the rest of the sample. A structural and resting state MRI will be obtained in a subsample of 100 patients recruited among those who have completed a minimum follow-up period of 15 years, to assess cerebral changes associated with the long-term course of the disorder.
Resultsin the current moment the recruitment period of the study has ended and all the data is being statistically analysed in order to provide solid results in a short period of time.
ConclusionsThe identification of those factors associated with an increased risk of chronic disease is an element essential to offer personalized treatment to our patients and improve their prognosis, emphasizing the intensive use of those therapeutic strategies for which we can predict a better response and modifying to the extent of, if possible, environmental factors or factors of access to treatment that contribute to perpetuate obsessive symptoms.
Disclosure of InterestNone Declared
The impact of the COVID-19 pandemic on health outcomes in delusional disorder: A systematic review
- E. Román, M. Natividad, M. V. Seeman, E. Izquierdo, E. Martínez, E. Rial, A. Alvarez, A. Guàrdia, J. A. Monreal, A. González-Rodríguez
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S790
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Introduction
The health impact of the COVID-19 pandemic has been widely recognized in both physical and mental health. Relatively little attention has been paid to patients with delusional disorder (DD).
ObjectivesOur goal was to synthesize the known mental and physical health consequences of the COVID-19 pandemic in patients diagnosed with DD.
MethodsA systematic review was carried out using the PubMed and Scopus database (2019-October 2022) following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Search terms: “delusional disorder” or “delusional disorder” AND “COVID-19 OR SARS-CoV2.” Inclusion criteria: 1)DD according to DSM/ICD, 2)languages: English, French, German and Spanish, 3)studies reporting health consequences of COVID-19 pandemic. From a total of 615 records, 6 were included: meta-analysis (n=1), cross-sectional studies (n=2), retrospective study (n=1), case reports (n=2).
ResultsA full third of patients with psychosis (including DD) presented with increased psychiatric symptom severity, reportedly activated by increased daily life stress. Suicidal behavior was reported in a previously undiagnosed DD patient in association with a worsening clinical picture. Perhaps surprisingly, admissions for DD in 2020 were lower than in 2019. The duration of hospitalization was, however, longer. There was a report of new onset DD with delusional material centred on COVID. There was also a report of COVID-19 symptoms being more severe in DD patients than in the larger community.
ConclusionsHealth emergencies affect the seriously mentally ill more than other community members. Awareness and outreach can help to maintain treatment adherence and minimize risk of psychotic exacerbation.
Disclosure of InterestNone Declared
TRANVIA: A program for continuum mental health assistance in transition period
- L. Pérez Gómez, A. González Álvarez, M. A. Reyes Cortina, E. Lanza Quintana, N. Álvarez Alvargonzález, C. Rodríguez Turiel, E. Lago Machado, J. J. Martínez Jambrina
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S728
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Introduction
Transition between adolescence and adulthood represents the most important challenge for personal development and involves several transformations: physical, psychological and social. It is a complex age bracket, concurring the transition from youth psychiatric units to adult ones, with an increased risk for the appearance of mental disorders and risky behaviours. TRANVIA program, developed in Avilés, provides psychiatric assistance to patients between 15 and 25 years old, diagnosed with a severe psychiatric disorder or with an increased risk of having one.
ObjectivesOur objectives are: ensuring clinical continuity assistance, promoting communication among professionals and the empowerment of our patients to improve their functionality and quality of life.
MethodsDescriptive study including patients involved in TRANVIA program from November 2019 to November 2021.
ResultsDuring this two-years period there have been 44 referrals to the program, 11 of them were rejected for failure to comply with diagnostic criteria. In November 2021 there were 33 patients included in the TRANVIA program with an average age of 17 years old (range: 15-22). 70% of them were men and 30% women. All of them had psychiatric assistance from different sources: youth mental health units, neuropediatrics… About 75% of the patients were diagnosed with autistic spectrum disorder and approximately three-quarters of the sample needed pharmacological treatment. Risperidone was the most prescribed drug. We have also developed other assistance alternatives as home-based care, relaxation sessions, social worker interventions and coordination with schools.
ConclusionsTRANVIA program has allowed us to provide continual attention to vulnerable patients that shift from youth psychiatric units to adult ones. Patients that meet inclusion criteria were enrolled independently the type of assistance they have previously received. Accessibility and flexibility were our priority. During the described period there was only one dropout, three patients required psychiatric hospitalization and two others visited the emergency department. There have been no cases of completed suicide.
Disclosure of InterestNone Declared
Stigma and self-stigma in patients with delusional disorder: a systematic review.
- A. González- Rodríguez, A. Alvarez, E. Román, A. Guàrdia, M. Natividad, M. Alberto Marcus, E. Calvo, J. Labad, J. A. Monreal
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S1044
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Introduction
The association between insight, stigma and self-concept has been considered as a potential predictor of poor clinical outcomes and global functioning in psychosis. In patients with delusional disorder (DD), the effects of stigma and self-stigma have been poorly explored.
ObjectivesOur main goal was to systematically review studies addressing stigma and self-stigma in DD to assess whether these phenomena have an impact on clinical symptoms.
MethodsA systematic review was conducted through PubMed and Google Scholar databases from inception to 2022 (PRISMA guidelines). Search terms: (Stigma OR self-stigma) AND (“delusional disorder” OR psychosis OR paranoia). Studies were considered eligible if they included patients with DD.
ResultsA total of 875 records were retrieved, from which 18 were included.
Stigma: (1) Stigma is associated with poor quality of life, poor adherence to medications and acceptation of diagnosis. (2) Support at workplaces would improve stigma and discrimination in DD. (3) Poor interpersonal competence may increase stigma experience in DD.
Self-stigma: (1) Women show higher level of self-stigma than men. (2) Higher rates of psychiatric hospitalizations and higher severity of symptoms associated with greater degree of self-stigma. (3) Suicidal ideation was associated with negative self-schema but not self-stigma, particularly in patients with persecutory delusions. (4) Self-stigmatization negatively associated with quality of life. (5) Depressive symptoms associated with higher levels of self-stigma. (6) Promotion interventions should address self-stigma content.
ConclusionsFurther longitudinal studies are needed to test the influence of stigma and self-stigma on adherence to follow-up and specific interventions to improve them.
Disclosure of InterestNone Declared
“Unspecified organic personality and behavioral disorder due to brain damage from HHV-6 encephalitis in child. case report and literature review”
- A. Oliva Lozano, M. A. Morillas Romerosa, P. Herrero Ortega, J. Garde Gonzalez, B. Orgaz Álvarez, J. Curto Ramos, M. Alcamí Pertejo
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S143-S144
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Introduction
We present a case of a 15 year-old boy diagnosed with Unspecified Personality and Beheavioral Disorder Due to Brain Damage from a Human Herpes Virus-6 Encephalitis.
ObjectivesTo describe a case of an Unspecified Organic Personality and Behavioral Disorder secondary to brain damage from Human Herpes Virus-6 (HHV-6) Encephalitis in an 11 year-old childand to review recent literature, in order to improve clinical practice.
MethodsClinical case report and brief review of literature. A bibliographic research was made in the database PubMed, using the terms “Viral Encephalitis” AND “Neuropsychiatric symptoms”; “Viral Encephalitis” AND “Behavioral Disorder”; “Long-Term Neurological Morbidity” AND “Viral Encephalitis”.
Results15 year-old boy diagnosed with Unspecified Personality and Beheavioral Disorder Due to Brain Damage from a Human Herpes Virus-6 Encephalitis, secondary to immunosupression in the context of haematopoietic progenitor transplantation (HPT) at 11 years old. MRI showed supratentorial ventriculomegaly, atrophic changes in encephalon and right hippocampus with subcortical retraction secondary to previous encephalitis. Clinically, main changes appeared in behavior, presenting a serious frontal syndrome with high disinhibition, what implied severe social and academic difficulties. During the outpatient follow-up, the behavioural disorder is being pharmacologically treated with Risperidone 1,5mg per day with a partially favorable evolution. The patient presented intolerance to olanzapine, with an episode of low level of conciuosness after taking it.
Bibliographic research results indicate that the gold standard treatment for behavioral disturbances are antipsychotics. Risperdidone is proven save for treatment in children. Results point out also the importance of an early multidisciplinar intervention, involving family training, rehabilitation resources and curricular adaptations.
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ConclusionsViral encephalitis may have serious neuropsychiatric consequences, especially during childhood while the brain development is not finished. When the neurological damage affects the frontal lobes of the brain, behavioural and personality disturbances are expected and an early multidisciplinar intervention should be considered. Antypsichotics are the gold standard pharmacological treatment for behavioural disturbances. During the scholar period, special curricular adaptations should be done in order to reduce study-related stress.
Disclosure of InterestNone Declared
The use of long-acting injectable antipsychotics in an acute psychiatric unit
- G. Ortega-Hernández, N. Ramiro, F. Palma-Álvarez, Ó. Soto-Angona, M. F. Mantilla, J. Duque, I. Gonzalo, F. Collazos
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S182-S183
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Introduction
Long-acting injectable antipsychotic (LAI) are an important and arguably under-utilized therapeutic option, particularly where medication adherence is a priority (Pilon et al. Clin Ther 2017; 39 1972-1985).
In recent years, meta-analytic reviews of depot medications concluded that this route of administration produced clinical advantages in terms of overall outcome, with lower probability of relapse, readmissions, shorter hospital admission time, mortality, and thus better long- term prognosis over other oral antipsychotics (Leucht et al. Schizophr Res 2011;127 83-92). Depot treatment is associated with lower overall medical expenditure (Taipal et al. Schizophr Bull 2018;17 1381- 1387).
ObjectivesTo describe the evolution of people diagnosed with a psychotic disorder 6 months before and after the introduction of long-acting injectable antipsychotic (LAI) in the acute psychiatric unit of San Rafael Hospital (Spain) from January 1, 2018 to December 31, 2018.
MethodsRetrospective and prospective naturalistic study. Patients with a diagnosis of psychotic disorder who were admitted to the acute psychiatric unit in 2018 and who were introduced to LAI (paliperidone palmitate, aripiprazole, olanzapine pamoate or risperidone), are selected. Sociodemographic variables (sex, age, ethnicity, migratory status, marital status, occupation, cohabitation) and clinical variables (main and secondary diagnosis, comorbidity with drug use and history of poor adherence) are described. The number of emergency visits and hospital admissions before and after the introduction of LAI antipsychotic treatment is compared.
ResultsThe sample was composed of 99 subjects. The mean age was 42.46 years (SD 13.439) and 67.7% were men. The socio-demographic profile was: european caucasian ethnicity (73.7%), non- migrant status (69.7%), single (67.7%), inactive (43.4%) and residing in the home of relatives (50.5%). 53.5% have a diagnosis of schizophrenia, followed by schizoaffective disorder (24.2%). 45.5% are diagnosed with any drug use disorder, the most frequent being cannabis (30.3%). 76.8% have a history of discontinuing oral treatment. There was a statistically significant decrease (p<0.0001) in number of emergency visits and hospital admissions after the introduction of LAI antipsychotic.
In the general linear multivariate before-after model, there were significant differences (p=0.002) in the number of admissions after long-term IM antipsychotic treatment. As for the comparison of the effects between the different LAIs, there are differences between them (p< 0.0001). Post-hoc analysis (Bonferroni) only showed differential significance for treatment with Paliperidone Palmitate (p<0.0001).
ConclusionsThe use of LAI antipsychotic can reduce the number of emergency room visits and hospital admissions, in line with literature.
Disclosure of InterestNone Declared
Changes in the characteristics of Suicide Attempts during COVID-19 pandemic
- J. Curto Ramos, N. Kishanchandani Chandiramani, M. Torrijos, J. Andreo-Jover, B. Orgaz-Alvarez, M. Velasco, D. García Martínez, G. Juárez, S. Cebolla, P. Aguirre, B. Rodríguez Vega
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S405
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Introduction
Different studies indicate high prevalence’s of suicidal behaviour, anxiety, depression, insomnia, and PTSD associated with the COVID-19 pandemic. There is currently not enough scientific evidence available to analyze the impact that the COVID-19 pandemic has had on the rate of suicide attempts and their characteristics.
ObjectivesTo analyze and compare the characteristics of suicidal behavior (in terms of method, severity, medical damage produced and need for hospitalization) of patients attended during the COVID-19 pandemic compared to previous years.
MethodsA retrospective study was performed based on a standardized data collection of patients attending the University Hospital La Paz between April 2018 and November 2021. 581 patients who attempted suicide at least once were included in this study. We compared the severity using the Beck Suicide Intent Scale. Chi-square ant Student’s t were used to compare clinical characteristics such as medical damage, method of suicide attempt and indication for admission after the attempt, between suicide attempts during the COVID-19 pandemic and previous years.
ResultsOur results suggest that during the COVID-19 pandemic suicide attempts caused more medical damage (p<0.001), had higher severity (p<0.000), and required more admission in Intensive Care Units, General Internal Medicine and Psychiatry compared with pre-Covid years (p<0.000).
ConclusionsThis is the first study in Spain analysing the changes in characteristics of suicide attempts during the COVID-19 pandemic. This has important implications for reducing suicide rates, preventing future attempts, and enabling us to design specific treatments of Suicidal Behaviour.
Disclosure of InterestNone Declared
New insights into cerebellar dysfunction in patients with delusional disorder: A systematic review
- A. González- Rodríguez, A. Guàrdia, A. Alvarez, M. Natividad, C. Pagés, C. Ghigliazza, E. Román, B. Sánchez, J. A. Monreal
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S372-S373
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Introduction
The cerebellum has been implicated in cognitive, affective and motor functions, including emotion regulation, executive control and sensorimotor processing. In schizophrenia, cerebellar dysfunction has been associated with treatment resistance and clinical features. However, few studies have been focused on delusional disorder (DD).
ObjectivesOur main purpose was to review the evidence available on cerebellum abnormalities and dysfunctions in patients with DD.
MethodsA systematic review was conducted through PubMed, Scopus and ClinicalTrials.gov (inception-June 2022) according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) directives. The following search terms were used: cerebellum OR cerebellar AND (“delusional disorder” AND paranoia). Reference lists from included studies were hand-checked to find other potential relevant papers.
ResultsSix studies were included from a total of 119 retrieved records (PubMed: 52, Scopus: 66, ClinicalTrials.gov: 1). Study 1:Patients with DD somatic type (n=14) presented a decreased gray matter volume in cerebellar lobules compared to healthy controls (HC) (n=32, left lobule VIIIa) and non-somatic DD (n=18, lobule V). Cerebellar volumes did not seem to differ between HC and non-somatic DD. Study 2:Abnormalities of voluntary saccadic eye movements, linking frontal and cerebellar functions, were found in DD patients (n=34) compared to HC (n=40). Study 3: Abnormal smooth pursuit eye movements in DD (n=15) compared with HC (n=40) and similar to schizophrenia (n=40). Case reports (n=3): DD associated with Dandy-Walker variant (partial vermian hypoplasia), unruptured intracerebral aneurysm of basilar artery, and megacisterna magna.
ConclusionsCerebellar deficits in patients with DD has been reported, particularly in those presenting somatic delusional contents.
Disclosure of InterestNone Declared
GnRh agonists as precipitating components of psychiatric pathology. A case report.
- A. Guerrero Medina, J. S. García Eslava, A. C. Martín Rodriguez, L. Martinez Salvador, M. J. Alvarez Alonso, M. Aubareda Magriña
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S1042-S1043
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Introduction
GnRh agonists are drugs used in various gynecological pathologies, among which is endometriosis. They act by stimulating GnRh receptors in the pituitary gland. This sustained and continuous stimulation of GnRh, will initially generate an increase in the release of luteinizing hormones and follicle-stimulating hormones, subsequently losing sensitivity to the receptors, internalizing them, and thus suppressing the release of these hormones, which would entail an ovarian suppression, thereby inhibiting the release of estrogens and progesterone. Psychiatric adverse effects have been described. Gonzalez-Rodriguez et al (Front Psychiatry 2020; 11:479), described this association with changes in mood, and the presence of a series of cases where the link between GnRh agonist and the possibility of presenting psychotic symptoms is observed. Wieck (Curr Top Behav Neurosci 2011;8:173-87), Frokjaer (J Neurosci Res 2020;98(7):1283-1292), Brzezinski-Sinai et al (Front Psychiatry 2020;11:693) reported that this association could be related with the relationship of the hypothalamic-pituitary-gonadal axis, hormonal fluctuation and its relationship with the dopaminergic regulation, a genetic component that would increase the predisposition to trigger psychiatric pathology in patients with greater sensitivity to hormonal fluctuations, and the loss of neuroprotection generated by the decrease of estrogens in the central nervous system. All of this in the context of multiple environmental and genetic factors that participate together in the appearance of the disease.
ObjectivesTo describe the importance of detecting the risk factors that can precipitate a psychotic episode, including the use of certain drugs, such as GnRh agonists.
MethodsWe describe a case of a 45 year old patient with endometriosis with multiple organ involvement who went to the emergency room due to behavioral changes in the context of a brief psychotic disorder with “ad-integrum” recovery.
ResultsA retrospective analysis of the case is conducted, observing an association between the introduction of GnRh agonists and the presentation of a first psychotic episode.
ConclusionsThe importance of this case lies in the limited evidence of this association in the literature, and the implication of these drugs in the triggering of psychiatric pathology, being an aspect to be considered by psychiatrists in their patient’s follow-up.
Disclosure of InterestNone Declared
Assessment of beliefs and attitudes about electroconvulsive therapy posted on Twitter: An observational study
- L. de Anta, M. A. Alvarez-Mon, C. Donat-Vargas, F. J. Lara-Abelanda, V. Pereira-Sanchez, C. Gonzalez Rodriguez, F. Mora, M. A. Ortega, J. Quintero, M. Alvarez-Mon
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- European Psychiatry / Volume 66 / Issue 1 / 2023
- Published online by Cambridge University Press:
- 09 January 2023, e11
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Background
Electroconvulsive therapy (ECT) is an effective and safe medical procedure that mainly indicated for depression, but is also indicated for patients with other conditions. However, ECT is among the most stigmatized and controversial treatments in medicine. Our objective was to examine social media contents on Twitter related to ECT to identify and evaluate public views on the matter.
MethodsWe collected Twitter posts in English and Spanish mentioning ECT between January 1, 2019 and October 31, 2020. Identified tweets were subject to a mixed method quantitative–qualitative content and sentiment analysis combining manual and semi-supervised natural language processing machine-learning analyses. Such analyses identified the distribution of tweets, their public interest (retweets and likes per tweet), and sentiment for the observed different categories of Twitter users and contents.
Results“Healthcare providers” users produced more tweets (25%) than “people with lived experience” and their “relatives” (including family members and close friends or acquaintances) (10% combined), and were the main publishers of “medical” content (mostly related to ECT’s main indications). However, more than half of the total tweets had “joke or trivializing” contents, and such had a higher like and retweet ratio. Among those tweets manifesting personal opinions on ECT, around 75% of them had a negative sentiment.
ConclusionsMixed method analysis of social media contents on Twitter offers a novel perspective to examine public opinion on ECT, and our results show attitudes more negative than those reflected in studies using surveys and other traditional methods.
A field assessment of the effect of pre-slaughter conditions and genetic-stress susceptibility on blood welfare indicators in pigs
- MD Guàrdia, J Estany, J Álvarez-Rodríguez, X Manteca, M Tor, MA Oliver, M Gispert, A Diestre
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- Journal:
- Animal Welfare / Volume 21 / Issue 4 / November 2012
- Published online by Cambridge University Press:
- 01 January 2023, pp. 517-526
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The effect of pre-slaughter handling conditions and the RYR1 gene on blood Cortisol, lactate and creatine Phosphokinase (CPK) levels at exsanguination were assessed using 2,923 surveyed pigs from 106 deliveries to five Spanish abattoirs across two seasons. The relationship between blood parameters, carcase skin damage and pork quality traits was also assessed. The season influenced blood cortisol, lactate and CPK values. Females always showed higher concentrations of cortisol, lactate, and CPK than males. Pigs carrying the recessive allele of the RYR1 gene exhibited increased lactate and CPK concentrations but not cortisol. The cortisol concentration decreased in lean pigs that were slaughtered in winter after short lairage periods. The lactate concentration decreased with loading time and increased in summer with lairage time and carcase lean content. The CPK concentration increased with lairage time, carcase weight, and carcase lean content, and with the duration of winter transports. Each truck delivery only explained approximately 10% of the variance in blood parameters. Lairage time is the most influential pre-slaughter handling practice on the assessed welfare indicators. In addition, different optimal lairage times might be appropriate depending on season. Blood cortisol, lactate, and CPK concentrations increased concomitantly with skin damage score. Blood parameters were weakly correlated and they also showed low association with pork quality traits.
Efficacy of bio- and neurofeedback for depression: a meta-analysis
- J. Fernández-Alvarez, M. Grassi, D. Colombo, C. Botella, P. Cipresso, G. Perna, G. Riva
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- Journal:
- Psychological Medicine / Volume 52 / Issue 2 / January 2022
- Published online by Cambridge University Press:
- 15 November 2021, pp. 201-216
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Background
For many years, biofeedback and neurofeedback have been implemented in the treatment of depression. However, the effectiveness of these techniques on depressive symptomatology is still controversial. Hence, we conducted a meta-analysis of studies extracted from PubMed, Scopus, Web of Science and Embase.
MethodsTwo different strings were considered for each of the two objectives of the study: A first group comprising studies patients with major depressive disorder (MDD) and a second group including studies targeting depressive symptomatology reduction in other mental or medical conditions.
ResultsIn the first group of studies including patients with MDD, the within-group analyses yielded an effect size of Hedges' g = 0.717, while the between-group analysis an effect size of Hedges' g = 1.050. Moderator analyses indicate that treatment efficacy is only significant when accounting for experimental design, in favor of randomized controlled trials (RCTs) in comparison to non RCTs, whereas the type of neurofeedback, trial design, year of publication, number of sessions, age, sex and quality of study did not influence treatment efficacy. In the second group of studies, a small but significant effect between groups was found (Hedges' g = 0.303) in favor of bio- and neurofeedback against control groups. Moderator analyses revealed that treatment efficacy was not moderated by any of the sociodemographic and clinical variables.
ConclusionsHeart rate variability (HRV) biofeedback and neurofeedback are associated with a reduction in self-reported depression. Despite the fact that the field has still a large room for improvement in terms of research quality, the results presented in this study suggests that both modalities may become relevant complementary strategies for the treatment of MDD and depressive symptomatology in the coming years.
A new player in the field: Methylphenidate in post-traumatic stress disorder treatment
- R. López-Escribano, M.-J. Alvarez, J. Muñoz-Padrós, A. Marzán Gutierrez
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- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S453
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Introduction
Currently available psychotherapies and psychotropic drugs for post-traumatic stress disorder (PTSD) are poorly effective in a substantial proportion of patients. Dopaminergic dysfunction plays a prominent role in the pathophysiology of PTSD: intrusions, avoidance symptoms, anhedonia and emotional numbing. Dopamine reuptake inhibitors can be studied as novel drugs in PTSD treatment.
ObjectivesExplore methylphenidate as a promising drug in PTSD treatment.
MethodsCase report presentation based on the review of clinical notes and non-systematic review of the PTSD therapeutics state-of-the-art.
ResultsA 72-year-old Portuguese male, a veteran of the Angolan War, sought medical attention four years ago after the death of his brother, which had happened three years before the consultation. The clinical picture consisted of re-experiencing the war and the loss of his brother, flash-backs, nightmares, irritability, a fear of losing control, inner dialogues with occasional intra-psychic voices, emotional numbing with the impossibility of developing loving relationships with his relatives, feelings of unreality, an episode of dissociative fugue and complaints of episodic forgetfulness and time warp. He was diagnosed with PTSD with dissociative symptoms, based on DSM 5 clinical criteria. He was initially treated with SNRIs and risperidone, with little improvement. A year ago, he suffered a flare-up, with suicidal ideation. He was prescribed methylphenidate 36 mg, with progressive improvement, persisting mild PTSD residual symptoms.
ConclusionsThere is enough evidence of the dopamine involvement in PTSD, although research on dopaminergic drugs is scarce. Methylphenidate may be promising in the treatment of at least some individuals that haven’t responded to current psychological and medical interventions.
Vexatious litigant vs paranoia querulans: A systematic review
- J. Pinzón-Espinosa, A. González-Rodríguez, A. Guàrdia, M. Betriu Sabaté, P. Manozzo-Hernandez, A. Alvarez Pedrero, S. Acebillo, J. Labad, D. Palao Vidal
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- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, pp. S381-S382
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Introduction
Paranoia querulans is a type of persistent delusional disorder of the persecutory subtype, recognized under ICD-10 and DSM-IV. Being a classically described entity, evidence is lacking from its conceptualization as a nosological entity to diagnosis and treatment. Furthermore, controversy still exists regarding its interplay between the judicial and mental health systems.
ObjectivesTo summarize current evidence and knowledge regarding Paranoia querulans on its conceptualization, ethiopathological explanations, therapeutical management and interface between psychiatry and the law.
MethodsA systematic review was undertaken between June and October 2020 in the PubMed, Web of Science and Scopus databases according to PRISMA directive. Key-terms: ((querul* OR vexatious) AND (paranoia OR delusio* OR neuros* OR behavi* OR complai*) OR litig*) AND psychiatry. No language or time restrictions were established.
ResultsA total of 1648 studies were initially identified (PubMed: 679; WOS: 945; Scopus: 24; other: 0); after duplicates were removed, n=1381 studies remained. After screening title and abstract, 56 studies were included. Their main content was categorized into: 1. Conceptualization (n=26): Neurosis (n=5), psychosis (n=9), behavioral disorder (n=5); no psychiatric diagnosis (n=7). 2. Descriptive psychopathology (n=8) 3. Etiopathogenesis (n=9): Social or personality basis (n=3), culture (n=4), trauma (n=1), cognitive decline (n=1) 4. Management (n=1) 5. Psychiatry and Law: same object, different objectives (n=12)
ConclusionsThere is controversy regarding the nosological entity of querulousness, from psychosis to neurosis or behavioral disorders. Some authors consider this behavior to not be a psychiatric diagnosis. Furthermore, most papers dealt with a social or nurture-based origin. There is a dearth of information regarding treatment.
Conflict of interestJPE has received CME-related fees from Lundbeck.
Monitoring of antipsychotic plasma levels in the assessment of poor response and nonadherence to antipsychotics in delusional disorder
- A. González-Rodríguez, A. Guàrdia, A. Alvarez Pedrero, M. Betriu, J. Cobo, N. Sanz, S. Acebillo, J.A. Monreal, D. Palao Vidal, J. Labad
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- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S158
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Introduction
Over the last decades, antipsychotic plasma levels have been used to evaluate therapeutic response, adherence and safety of antipsychotics in schizophrenia. Their clinical utility in delusional disorder (DD) has been poorly studied.
ObjectivesTo investigate the relationship between plasma concentrations of risperidone (R), 9-OH-risperidone (9-OH-R) and olanzapine (OLZ), and clinical outcomes in DD.
MethodsCase-series of inpatients and outpatients with DD receiving treatment with risperidone (n=19) or olanzapine (n=2). Determination of R, 9-OH-R (active metabolite) and OLZ levels were obtained by high-performance liquid chromatography with electrochemical detection. Clinical variables such as treatment response or adverse events were recorded for all patients. These variables were correlated with two plasmatic ratios in patients treated with R: R:9-OH-R concentration ratio and total concentration-to-dose (C: D) ratio, indicating CYP2D6 activity and R elimination respectively.
ResultsTwenty-one patients were included: inpatients (n=10) and outpatients (n=11). Dose range: R, 1-6 mg/day; OLZ, 5-10 mg/day. Three outpatients (R, n=2; OLZ, n=1) presented antipsychotic levels under the detection limit (non-adherence). All R patients showed CYP2D6 activity (R: 9-OH-R ratio <1). Eight patients presented C: D > 14, indicating a reduction of R elimination, which was associated with poor clinical response (n=3), adverse events (n=3) and no clinical relevance (n=2). OLZ (n=2), no association between levels and clinical outcomes.
ConclusionsThe determination of antipsychotic plasma levels may be of clinical utility in the assessment of treatment resistance, antipsychotic-adverse events or non-adherence in inpatients or outpatients with DD. Therapeutic drug monitoring should be further studied in future works.
DisclosureAGR has received honoraria, registration for congresses and/or travel costs from Janssen, Lundbeck-Otsuka and Angelini.
Patients with substance use disorder who have higher alexithymia levels present more suicidality history: Preliminary results in an outpatient addiction treatment center in Spain
- R. Palma Álvarez, C. Daigre, E. Ros-Cucurull, P. Serrano-Pérez, G. Ortega-Hernandez, M. Perea-Ortueta, J. Vendrell-Serres, L. Gallego, J.A. Ramos-Quiroga, L. Grau-López, C. Roncero
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- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, pp. S581-S582
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Introduction
Patients with substance use disorders (SUD) have higher alexithymia levels and present frequently suicidal ideation (SI) and suicide (SA) [1,2]. Beside, alexithymia has been related to suicidal behaviors in several psychiatric disorders[3]. Although, there are some studies on alexithymia and suicidality in SUD patients, to our knowledge there are no studies on this issue in Spanish population.
ObjectivesTo compare the alexithymia levels in SUD patients with and without SI and SA in an outpatient addiction treatment center in Spain.
MethodsThis is a cross-sectional study performed on 110 patients (74.3%males; mean age 43.6±14.5years old) for whom we had information from the Toronto Alexithymia Scale(TAS-20) and the presence or not of lifetime SI and SA.
ResultsLifetime SI and SA were present in 55.5% and 35.5% of the sample respectively. The mean score of TAS-20, difficulties identifying feelings (DIF), difficulties describing feelings (DDT), and externally-oriented thinking(EOT) were 57.2±13.3, 20.0±7.0, 14.7±4.5, and 22.5±4.5 respectively.
ConclusionsSI and SA may be related to alexithymia levels. Hence, alexithymia should be further analyzed in SUD patients in longitudinal studies in order to analyze the bilateral association with suicidal spectrum behaviors. REFERENCES Rodríguez-Cintas L, et al. Factors associated with lifetime suicidal ideation and suicide attempts in outpatients with substance use disorders. Psychiatry Res. 2018;262:440-5. Morie KP, et al. Alexithymia and Addiction: A Review and Preliminary Data Suggesting Neurobiological Links to Reward/Loss Processing. Curr Addict Rep. 2016;3(2):239-48. Hemming L, et al. A systematic review and meta-analysis of the association between alexithymia and suicide ideation and behaviour. J Affect Disord. 2019;254:34-48.
Ethno-psychopharmacological aspects of treatment response in patients with delusional syndrome: A systematic review
- A. Guàrdia, A. González-Rodríguez, M.V. Seeman, A. Alvarez Pedrero, M. Betriu, J.A. Monreal, D. Palao Vidal, J. Labad
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- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, pp. S158-S159
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Introduction
Treatment response in schizophrenia can be influenced by cultural and ethno-biological factors. However, in delusional disorder (DD), these potential influences have been poorly investigated.
ObjectivesThis review aims to synthesize what is known about the influence that cultural and biological factors may have on treatment response in DD.
MethodsA systematic review was performed on PubMed from inception to 2020 in keeping with PRISMA directives. Search terms: [(cultural OR ethnic* OR ethno*) AND (treatment OR therap* OR antipsychotic response) AND (delusional disorder)]. We included all studies whose objective was to explore ethno-psychopharmacological aspects of treatment response in DD.
ResultsA total of 182 papers were retrieved. Four studies tested ethno-biological factors and 10 reported cultural aspects of treatment response in DD. 1. Cultural hypothesis: 3 studies reported cultural differences in diagnostic practices; in 2 studies, culturally-determined long durations of untreated psychosis (DUP) and comorbidity with mood disorders was associated with response to both antipsychotics (AP) and antidepressants (AD); 3 studies reported that response and AP dose were similar among cultures and that culturally-sensitive psychotherapy improved adherence; 2 studies showed that, where women had poor access to health care, mortality rates were high. 2. Ethno-biological hypothesis: 1 study reviewed moderators and mediators of ethno-specific treatment response; 1 study presented a culture-bound syndrome (Taijin kyofusho) for which AD were found effective; 2 studies in diverse populations found that DD and schizophrenia were both significantly linked to HLA genes.
ConclusionsThe sociodemographic profile of DD is consistent across various cultures and, when treated appropriately, responds, but in an ethno-culturally-specific manner.
DisclosureNo significant relationships.
Insomnia associated with neutrophil/lymphocyte ratio in female patients with schizophrenia
- G. Paniagua, L. González-Blanco, F. Dal Santo, C. Martínez-Cao, C. Moya-Lacasa, M. Valtueña-García, E. Martín Gil, L. García-Alvarez, P.A. Saiz, M.P. García-Portilla, J. Bobes
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- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S806
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Introduction
Worse sleep quality and increased inflammatory markers in women with schizophrenia (Sch) have been reported (Lee et al. 2019). However, the physiological mechanisms underlying the interplay between sleep and the inflammatory pathways are not yet well understood (Fang et al. 2016).
ObjectivesAnalyze the relationship between Neutrophil/Lymphocyte (NLR), Monocyte/Lymphocyte (MLR) and Platelet/Lymphocyte (PLR) ratios, and insomnia in Sch stratified by sex.
MethodsFinal sample included 176 Sch patients (ICD-10 criteria) [mean age: 38.9±13.39; males: 111(63.1%)]. Assessment: PANSS, Calgary Depression Scale (CDSS), and Oviedo Sleep Questionnaire (OSQ) to identify a comorbid diagnosis of insomnia based on ICD-10. Fasting counting blood cell were performed to calculate ratios. Statistics: U Mann-Whitney, logistic regression.
ResultsInsomnia as comorbid diagnosis was present in 22 Sch (12.5%) with no differences between sex [14 males (12.6%), 8 females (12.3%)], neither in their age. Female patients with insomnia showed increased NLR [2.44±0.69 vs. 1.88±0.80, U=122.00 (p=0.034)]. However, no differences in PLR and MLR were found, neither in any ratio in males. Regression models using insomnia as dependent variable and covariates (age, PANSS-positive, PANSS-negative, CDSS) were estimated. Females: presence of insomnia was associated with NLR [OR=3.564 (p=0.032)], PANSS-positive [OR=1.263 (p=0.013)] and CDSS [OR=1.198 (p=0.092)]. Males: only PANSS-positive [OR=1.123 (p=0.027)] and CDSS scores [OR=1.220 (p=0.005)] were associated with insomnia.
ConclusionsNLR represent an inflammatory marker of insomnia in Sch but only in female patients. Improving sleep quality in these patients could help to decrease their inflammatory response.
DisclosureNo significant relationships.