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Neoliberal Reason, Contemporary Music, and Proximal Critique
- SAMUEL J. WILSON
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- Twentieth-Century Music , FirstView
- Published online by Cambridge University Press:
- 27 August 2024, pp. 1-34
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Theodor W. Adorno suggested that music is mediated by socially derived forms of reason, a provocation here considered with respect to neoliberalism. Drawing on a Foucauldian understanding of neoliberalism, which in Wendy Brown's summary takes neoliberalism as ‘a specific and normative mode of reason’, I consider what this means for immanent features of music and processes of its composition. This critical attention to music's formal, aesthetic register enables me to go beyond the more well-established (although nonetheless valuable) frameworks for discussing music and neoliberalism, which focus on music's relation to labour conditions and creative industries. A range of music and sonic art is discussed, work by Chino Amobi, Brian Eno, Bryn Harrison, Sarah Hennies, Johannes Kreidler, Wolfgang Rihm, Marina Rosenfeld, and John Zorn. I ultimately argue that some core features of Adorno's conception of critical art and music need reformulating for the neoliberal age.
Investigating Sex Differences in Opioid Use Disorder Risk Factors: Insights from Cross-Section Lebanese Study Population
- K. Chamoun, P. Salameh, H. Sacre, J. Mouawad, L. Rabbaa, B. Megarbane, A. Hajj
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S115
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Introduction
Opioid use disorder (OUD) is a significant public health concern, and understanding the risk factors associated with OUD is crucial for effective prevention and management strategies. However, limited information is available regarding the role of sex differences in OUD risk factors. Women have often been excluded from clinical studies to create more homogeneous samples and simplify the analysis of treatment effects. The underrepresentation of women in clinical trials and the lack of sex stratification, typically limited to binary comparisons without considering gender dynamics, raise concerns about potential sex disparities. Given the emerging evidence suggesting the possibility of sex differences in the likelihood of developing OUD, further research is needed to investigate and understand these potential disparities to optimize the individualized management of OUD.
ObjectivesThe primary objective of this study was to examine and identify any sex-related variations in OUD risk variables within the Lebanese community. By pinpointing sociodemographic, psychiatric, and other factors related to sleep and chronotype, we aim to elucidate their impact on the onset and progression of OUD in both males and females.
MethodsA cross-sectional study was conducted among 581 Lebanese adults using an online questionnaire that included sociodemographic questions, validated scales for substance use disorders and sleep disorders, and assessments for depression and anxiety. Multivariate analyses were performed to identify associations between risk factors and OUD scores in both male and female populations.
ResultsCommon risk factors for OUD were identified, including family and personal history of substance use disorder, co-occurrence of sedative and alcohol misuse, and psychiatric illnesses. Sex-specific risk factors were also observed. Among women, the ASSIST-opioids subscore was significantly associated with the Pittsburgh Sleep Quality Index (B=0.143) and Insomnia Severity Index (B=0.286) scores. Men demonstrated a correlation between ORT-OUD and younger age (B=0.882). Waterpipe consumption was negatively correlated with the ORT-OUD score in men (B=-0.018).
ConclusionsOur study emphasizes the importance of examining sex differences in risk factors for OUD, particularly within the Lebanese population. By acknowledging these gender-specific risk factors, interventions can be customized to address the distinct vulnerabilities of each sex. This approach could potentially improve prevention efforts, facilitate early identification, and implement treatment strategies tailored to the specific needs of individuals with OUD. Further research is needed to delve into the underlying mechanisms and develop targeted interventions for enhanced management of OUD.
Disclosure of InterestNone Declared
Sexual exploitation of male youth: background characteristics and needs from a life-course perspective
- G. Mercera, S. Leijdesdorff, E. Heynen, T. van Amelsvoort
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S253
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Introduction
Sexual exploitation is a human rights violation that has a detrimental impact on the psychological-, physical- and social well-being of victims. Sexually exploited male youth are prevalent, yet underrepresented in clinical practice, policy and research. There are multiple barriers that often prevent male youth to disclose and to seek or receive support, such as gender norms, limited awareness of victimization and feelings of guilt and shame.
ObjectivesBy gaining more insight into the background and clinical characteristics of male victims and their care and support needs, this study aims to raise awareness and to better inform policymakers, care- and educational professionals on adequate prevention and intervention efforts.
MethodsTwenty-six male youth at high-risk or victims of sexual exploitation participated in this qualitative study. By means of semi-structured interviews and case-file analyses, data was collected by to identify risk and protective factors in their life-course and care and support needs.
ResultsResults indicate that several vulnerabilities (e.g. previous experiences of abuse and neglect, mental health problems, household dysfunction, social rejection, running away, substance use) and a lack of positive and supportive relationships led male youth into high-risk situations. Among these were involvement in pay dates, survival sex and criminality, which contributed to victimization. Experiences of stigmatization were often a barrier to express vulnerabilities and to disclose victimization. There was a wide variety in care and support needs, including peer-to-peer support, therapy, support with day-to-day practices and anonymous support.
ConclusionsThese results will contribute to adequate prevention and intervention strategies and meet the unique needs of male youth at risk for, or victim of sexual exploitation.
Disclosure of InterestG. Mercera Grant / Research support from: This research was funded by the Dutch Ministry of Health, Welfare and Sports (grant number: 328604)., S. Leijdesdorff: None Declared, E. Heynen: None Declared, T. van Amelsvoort: None Declared
ORGANIC COMPOSITION OR UT PICTURA POESIS? ΖΩΙΟΝ IN ARISTOTLE'S POETICS
- Luis Galván
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- The Classical Quarterly , First View
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- 27 August 2024, pp. 1-15
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This paper discusses Aristotle's references to a ζῷον in his Poetics (1450b34–51a4 and 1459a20) and evaluates their implications. The usual interpretation, ‘living creature’ or ‘animal’, is one-sided, because the word ζῷον is Aristotle's paradigm of homonymy, applying as it does to both the human being and the drawing (Cat. 1a1–6). After an examination of the two passages containing such references and their contexts, other passages by Aristotle and earlier writers (Plato, Alcidamas and Gorgias) that may shed light on the issue are analysed. The conclusion reflects on the relevance of the interpretation as ‘figure’ for the premises and purpose of the Poetics.
The Sense of Resilience of health care professionals in Latvia measured by Antonovsky’s Sense of Coherence Scale
- D. Janovskis, R. Eglītis
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, pp. S571-S572
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Introduction
In this research work the sense of resilience was studied, which is an essential factor in reducing the stress of health care workers, it also helps to maintain the sustainability of the work of medical specialists and prevents the burnout syndrome. Aaron Antonovsky’s Sense of Coherence scale was used in this study, which helps to determine how health care professionals are able to preserve their mental and physical health.
ObjectivesThis study is aimed to determine the differences in components of Antonovsky’s Sense of Coherence scale for various health care specialists and to describe the factor structure of Coherence scale for health care specialists in Latvia, that forms the sense of resilience for health care specialists.
MethodsThe questionnaire used in the study is Antonovsky’s Sense of Coherence scale’s (Antonovsky, 1987) Latvian version, that was translated into Latvian and adapted in the research work of A. Veylande, N. Bahmačova (2000). 202 respondents who are representatives of medical professions took part in this study. The obtained data were entered into the MS Excel computer program and were statistically processed using the SPSS 22 computer program.
ResultsLooking at the obtained results of this study, it can be stated that Medical Doctors- Specialists have statistically significantly higher Comprehensibility scores than Medical Orderlies (p = 0.01, r = 0.24), while Medical Doctors- Specialists and Medical Doctors- Residents have statistically significantly higher Manageability scores than Medical Orderlies (p= 0.04, r=0.21). Based on the analysis of the results, it has been determined that Doctors-Specialists (p=0.00, r=0.32) and Doctors-Residents (p=0.00, r=0.34) have statistically significantly higher Meaningfulness indicators than Medical Orderlies, as well as Doctors-Specialists (p=0.00, r=0.29) and Doctors-Residents (p=0.00, r=0.31) have statistically significantly higher Meaningfulness scores than Medical Nurses.
ConclusionsHigher scores of the three components of Antonovsky’s scale for Medical Doctors-Specialists and Medical Doctors-Residents compared to Medical Orderlies and Medical Nurses could be explained by a lower overall time that Doctors spend in the department with patients. Higher education helps to overcome stress at work and to become aware of possible strategies for improving the joy of life, ways to reduce stress at work and to relax from work.
Disclosure of InterestNone Declared
Fatal pulmonary embolism related to anti-psychotics: forensic implications. About four autopsy cases with review of the literature
- M. Kacem, W. Bouali, Y. Mahjoub, S. Brahim, L. Zarrouk
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, pp. S581-S582
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Introduction
The association between the intake of antipsychotic drugs and the occurrence of thromboembolic complications is widely described in the literature. The occurrence of this complication may call into question the medical responsibility of the attending physician.
ObjectivesThe objective of this work is to describe the physiopathological mechanisms involved in the occurrence of thromboembolic complications in a patient under antipsychotic treatment, whether or not associated with physical restraint and to discuss the forensic implications.
MethodsOur study is retrospective on cases of fatal pulmonary embolism, discovered at autopsy, in connection with the taking of antipsychotics. The autopsies were carried out in the Department of Forensic Medicine of the Tahar Sfar University Hospital in Mahdia. The cases were collected over a period of 04 years. A review of the literature was carried out. We only selected articles published until February 2021 and dealing with cases of patients on antipsychotics, diagnosed with pulmonary embolism by performing a chest CT scan or during an autopsy.
Results915 autopsy cases were performed during the study period. Twenty cases of pulmonary embolism, discovered at autopsy, were collected. Four cases were related to the taking of antipsychotics (incidence 0.004%), including two men and two women, aged between 25 and 52 years. They were all on antipsychotic treatment for at least 5 years, with the exception of one case who was put on 3 antipsychotics, 7 days before his death, with indication of physical restraint. After analysis of the memorial data, the external examination and the autopsy, the results of additional examinations, the death was attributed, in the 4 cases, to a massive fibrino-cruoric pulmonary embolism. A selection of 45 studies regarding thromboembolic complications associated with taking antipsychotics, was included in the final review.
ConclusionsThe reported cases provided additional evidence on the involvement of antipsychotics in the occurrence of thromboembolic complications. Psychiatrists should be careful when prescribing these treatments. The establishment of therapeutic guidelines, taking into account the thromboembolic risk factors, becomes essential, in order to avoid the occurrence of a complication which could engage both the vital prognosis of patients and the responsibility of the physician.
Disclosure of InterestNone Declared
Anime watching in childhood may affect suicidal risk factors in adult life
- M. Marachev, V. Rudchenko, A. Grigorieva, L. Usova, A. Mokritskaya
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S782
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Introduction
Suicide is one of the leading causes of death worldwide being the fourth major cause of death among young people 15-29 years old. The reduction of suicide mortality is prioritized by the World Health Organization (WHO, 2019). There is a number of internal and external factors associated with suicidality (Soto-Sanz V et al., 2019; Farbstein et al., 2022.). Special attention is paid to the influence of the social media on suicidality (Cheng A. T. A. et al., 2007; Niederkrotenthaler T. et al., 2020; Sedgwick R. et al., 2019). In the Russian Federation, anime, an animation genre and a media cultural phenomenon, is increasingly popular among young people. Characters who are lonely and lost their meaning of life are common in anime. Romanticization and idealization of such characters may lead to increased attractiveness of death and thus have a negative effect on the mental health of adolescents and young adults due to their incomplete identity development (Liu Y. et al., 2022; Backer, H. A., 2023).
ObjectivesWe aimed to study the influence of the anime on the presence of suicidality and depression in adolescents and young adults in the Russian Federation.
MethodsWe interviewed 304 people living in the Russian Federation and watching anime on the regular basis (244 women, mean age 20.9 ± 3.8 years, range 13-36 years). We collected sociodemographic data and age when a person had started watching anime. We performed Reasons for Living Inventory, RFL (M. Linehan et al., 1983), Beck Depression Inventory, BDI (Aaron Beck, 1961). We divided all participants into three groups according to their age: adolescents (13-19 years), young people (20-24 years), adults (25-36 years). In each group, we compared BDI: level of depressive symptoms, cognitive-affective subscale, subscale of somatic manifestations of depression; RFL scales: Survival coping beliefs, responsibility to family, child related concerns, fear of suicide, fear of social disapproval, moral objections between three subgroups based on the age of the anime watching start (<12 years old, 12-15 years old, ≥16 years old) using Kruskall-Wallis test and post hoc Mann-Whitney U-test for pair comparisons with Bonferroni correction for multiple comparisons. Level of significance p<0.05.
ResultsIn the adolescents (n=130), we did not find any differences between the three subgroups. In the young people (n=127), participants who had started watching anime in childhood (<12 years old) had higher level of depression (p= 0,014) and higher level of cognitive-affective symptoms (p= 0,006). In the adults (n=47), participants who had started watching anime in childhood had decreased moral attitudes contrary to suicide (p= 0,004). Other scales not found to differ significantly.
ConclusionsStart of the anime watching in childhood (<12 years old) was associated with increased suicidal risk factors and decreased anti-suicidal factors in the young adults.
Disclosure of InterestNone Declared
Prevalence and predictors of Anxiety and Depression among Adolescents and Young Adults: Findings from the MoreGoodDays Support Program in Alberta, Canada
- A. Belinda, R. Shalaby, K. Hay, R. Pattison, E. Eboreime, M. Korthuis, Y. Wei, V. I. O. Agyapong
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S103
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Introduction
The COVID-19 pandemic has led to a rise in psychological disorders among adolescents and young adults. There is an increase in the prevalence of likely anxiety and likely depression among the subscribers of MoreGoodDays supportive text message program, reflecting the impact of the COVID-19 pandemic on this cohort.
ObjectivesTo assess the prevalence, severity, and correlates of likely generalized anxiety disorder (GAD) and likely major depressive disorder (MDD) among subscribers of MoreGoodDays program.
MethodsThis study used a cross-sectional design. An online survey questionnaire was used to collect sociodemographic and clinical information from subscribers of MoreGoodDays program, a daily supportive text message program co-designed with adolescents and young adults for their peers in Alberta. Validated instruments, the Generalized Anxiety Disorder GAD-7 and Patient Health Questionnaire-9 PHQ-9 were used to collect information on likely GAD and likely major depressive disorder (MDD), respectively. Data was analyzed with SPSS version 25 using chi-squared tests and binary logistic regression analysis.
Results343 subscribers of MoreGoodDays participated in the survey. Overall, 117 (56.0%) respondents had a likely MDD and 97 (46.6%) had a likely GAD. Participants who would like to receive mental health counselling were 27 times more likely to experience GAD (OR = 27; 95% CI: 3.09–250.00) and 40 times more likely to experience MDD (OR = 40.03; 95% CI: 4.43–361.51) than those who did not. Respondents who had received mental health counselling in the past were 18.5 times more likely to experience MDD compared with those who had not (OR = 18.52; 95% CI: 1.55–200.00). Demographic variables, including age, education, employment, and relationship status, and clinical variables, such as history of anxiety, depression, obsessive-compulsive disorder, ADHD, and adverse childhood experience, did not independently the predict presence of likely GAD or MDD in subscribers of MoreGoodDays.
ConclusionsThe prevalence of anxiety and depression was relatively high among subscribers of MoreGoodDays, indicating the long-term effect of the COVID-19 pandemic. This finding has significant implications in the broader context of mental health research and emphasizes the need for more research into innovative mental health support for this cohort. The desire to receive counselling was predictive of both anxiety and depression and is a positive sign of the openness of this cohort to receive psychological intervention. Since this group is mostly adapted to mobile text technology, government agencies and policymakers should prioritize and implement readily accessible interventions such as supportive text messages to support their psychological well-being.
Disclosure of InterestNone Declared
Neuropsychiatric manifestations inaugurating Biermer’s disease
- S. Bader, N. Msadek, S. Ellini, R. Damak, M. Cheour
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S624
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Introduction
Vitamin B12 deficiency gives rise to a wide spectrum of hematological, gastrointestinal, psychiatric, and neurological disorders. Notable among the neuropsychiatric symptoms are mood disturbances, cognitive decline, and psychotic manifestations.
ObjectivesWe present a case of a woman with neuropsychiatric symptoms linked to vitamin B12 deficiency to highlight certain organic aetiologies with psychiatric symptoms in the foreground.
MethodsWe discussed through a clinical case and a literature review, the relationship between neuropsychiatric symptoms and vitamine B12 deficiency in the context of biermer’s disease.
ResultsWe presented a patient aged 51-years-old without neurological or psychiatric history, she was hospitalised in a psychiatry department for behavioral disturbances, hetero-aggression, and incoherent speech. The psychiatric examination revealed distant contact, inappropriate affects, disorganized speech with persecutory delusions, memory problems, and poor insight. Neurological et physical examinations were normal, and cerebral magnetic resonance imaging (MRI) showed no abnormalities. First, haloperidol 25mg was prescribed, however, there was only partial improvement. Complete blood counts revealed macrocytic anemia (Hemoglobin: 8 g/dL, mean corpuscular volume: 106 fL). Her serum B12 assay was 48.19 pmol/L.Given these results we proceed to a Fundic biopsy, performed by fibroscopy, that revealed fundic atrophy and intestinal metaplasia compatible with Biermer’s disease. Vitamin B12 replacement therapy began with hydroxocobalamin at 1000 μg/day intramuscularly for 15 days, followed by 1000 μg every 15 days for one month. Subsequently, there was a remarkable improvement in psychotic symptoms and cognitive function. Follow-up assessments demonstrated a return to baseline functioning.
ConclusionsThis case, coupled with prior studies, emphasizes the importance of considering vitamin B12 deficiency in the differential diagnosis of neuropsychiatric symptoms. Therefore, prompt diagnosis and treatment of vitamin B12 deficiency are imperative in preventing potential irreversible neurological damage.
Disclosure of InterestNone Declared
Metabolic syndrome in psychiatric patients with schizophrenia
- I. Bakija, M. Tripković, S. Kaštelan, M. Bogadi, V. Grošić
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, pp. S733-S734
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Introduction
Metabolic syndrome and cardiovascular diseases are a very important cause of morbidity and mortality among patients with schizophrenia who live an average of 10-20 years less than the general population. Second generation antipsychotics are associated with obesity and other components of the metabolic syndrome.
ObjectivesThe aim of this paper was to provide complete insight into the existing recent evidence for metabolic risks associated with the use of new antipsychotics, and establish recommendations for monitoring metabolic syndrome and other risks, as well as current options for treatment and prevention of metabolic syndrome.
MethodsThis review article is based on a literature search. We identified relevant publications and articles by searching the PUBMED database from 1999 to the present day according to the given parameters. The search criteria were the keywords “metabolic syndrome” combined with “schizophrenia” and “new antipsychotics”.
ResultsAll researches has convincingly shown that patients with schizophrenia tend to be overweight and have a three to four times higher risk of developing diabetes than the general population. There are also more and more evidence in recent literature about the impact of new antipsychotics on the frequency of metabolic syndrome in patients with schizophrenia. The World Health Organization (WHO) defines metabolic syndrome as an elevated insulin level or a fasting glucose concentration of 5.6-6.0 mmol/l in combination with two or more of the following parameters: abdominal or central obesity and dyslipidemia and/or arterial hypertension. The research results systematically showed a 1.5 to 3 times higher frequency of metabolic syndrome in people suffering from schizophrenia compared to the general population. Therefore, regular control of all components of the metabolic syndrome is necessary, from waist circumference, which is the easiest to measure, to all others that can be carried out and done in the general practice doctor’s office.
ConclusionsMetabolic changes in patients with shizophrenia who receive new antipsychotics in addition to their unfavorable lifestyle (improper diet, lack of physical activity, smoking) can lead to the development of metabolic syndrome and increase the risk for diabetes and cardiovascular diseases. It is therefore necessary to establish protocols for monitoring these risks and preventing comorbidities.
Disclosure of InterestNone Declared
Is content of delusions in psychotic depression related to the risk of dementia?
- J. T. Coelho, B. Martins, A. Silva, C. Silveira, A. S. Machado
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S635
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Introduction
Some studies have shown that late-life depression is related to faster cognitive decline and may increase the risk of dementia.
Identifying risk and protective factors for dementia is essential to develop preventive interventions. Some literature has suggested that mood disorders (namely depression) are potential modifiable risk factors for dementia.
Thus, it is important to know clinical presentation of depression that is associated to dementia, as a manifestation of subclinical dementia or as a risk factor for neurocognitive disorders.
ObjectivesWe aim to identify clinical characteristics related to dementia of inpatients admitted for first time due to depressive episode after 55 years old.
MethodsRetrospective cohort study of inpatients admitted between January 1st 2010 and March 31st 2022 in a psychiatry inpatient unit of a tertiary hospital. Descriptive analysis of the results was performed using the SPSS software, version 26.0.
ResultsOur sample included 57 inpatients, 15,8% (n=9) with the diagnosis of dementia 5,2 (SD 5,6) years after admission. All of these patients presented a depressive episode with psychotic symptoms, namely delusion activity. In those with hallucinatory activity, no one developed dementia.
Interestingly, 33,3% of patients with dementia (n=3) presented with delusion of ruin, 55,6% (n=5) with delusion of prejudice/persecutory delusion and 66,7% (n=6) manifested delusion of ruin and/or prejudice.
We also found that 42,9% (n=3) of patients with dementia manifested Cotard delusion while this type of delusion was observed in 13,6% of patients without dementia (p=0,095).
ConclusionsOur study has several limitations because is based on results of only one hospital, with a small sample size.
However, since depressive symptoms are potentially modifiable risk factors for dementia, future studies are essential to understand the mechanisms that link depression to cognitive decline as well as clinical characteristics that may constitute predictors of dementia.
Disclosure of InterestNone Declared
Evaluation of a scalable psychosocial intervention for refugees in Greece
- C. Papathanasiou, A. Kougioumtzi
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S611
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Introduction
The world of the third millennium is witnessing the highest levels of displacement on record. To meet the specific needs of this vulnerable population, a task-shifting approach is developed, where individuals with refugee background and lived experience are trained and supervised my mental health professionals to provide emotional and practical support to members of their communities.
ObjectivesThe evaluation of a scalable psychosocial intervention for refugees based on the task-shifting approach.
MethodsThe intervention consisted of sessions of Problem Management Plus (PM+) and peer case management delivered by a team of community psychosocial workers (trained refugees). The sample consisted of 173 participants, Arabic- and Farsi-speakers male and female, recognized refugees, and asylum seekers. Anxiety, depression, and psychological distress were measured before and after the intervention using the Generalised Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire - 9 (PHQ-9), and Psychological Outcome Profiles (Psychlops) scales respectively. Repeated measures analysis of variance (ANOVA) was adopted to evaluate the difference in the degree of change across patients’ characteristics over the follow up period. Statistical significance was set at p<0.05 and analyses were conducted using SPSS statistical software (version 26.0).
ResultsSignificant decreases were found in all post-test scales, indicating diminution of anxiety, depression symptoms, and psychological distress. Large effects sizes were found in all scales.
ConclusionsThe findings support that task-shifting approach incorporating PM+ and case management is effective for the mental health of refugees. Peer support could be included in a stepped care model for refugee mental health and well-being in high-income countries. For future research a randomized controlled trial is proposed as a study protocol.
Disclosure of InterestNone Declared
Achieving functional remission in schizophrenia: a pilot study
- D. Bošnjak Kuharić, A. Jambrošić Sakoman, Z. Lovrić Makarić, A. Savić, A. Papić, M. Herceg
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, pp. S727-S728
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Introduction
Many patients with schizophrenia are unable to achieve adequate levels of psychosocial functioning and quality of life despite of the remission of illness symptoms. According to previous reports, only one-third of patients with symptomatic remission reach functional remission. While current pharmacotherapy options seem to be relatively effective for different symptoms of schizophrenia (e.g. positive symptoms), more specific psychosocial interventions that could enable functional remission are yet to be developed.
ObjectivesOur objective is to investigate differences in psychopathology, quality of life, functioning, and achieving functional remission before and after specific group treatments developed in our clinic.
MethodsWe will conduct a prospective study including a consecutive cohort of female patients older than 18 years of age, which fulfilled the criteria for schizophrenia and schizoaffective disorder according to the International Classification of Disorders, 10th revision. Exclusion criteria are intellectual disabilities, mental disorders due to known physiological or neurological conditions, lactation or pregnancy, treatment with medications that can provoke psychosis, alcoholism, and other addictions. Patients will be recruited after finished hospital treatment or during individual outpatient controls. The Recovery Helm will be used at the beginning of the treatment, to make individual treatment plan and include patients in specific programs including day hospital treatment and/or outpatient group programs: psychoeducation, relaxation, metacognitive training, and social skills training. Besides collecting sociodemographic data, pre- and post-treatment assessment will include the Positive and Negative Syndrome Scale (PANSS), the Global Assessment of Functioning (GAF), the Quality of Life Scale (QLS), and the “Functional Remission of General Schizophrenia” (FROGS) scale.
ResultsWe will analyze the changes in psychopathology levels, quality of life, functioning, and achieving functional remission between the two assessment points, taking into account different treatment possibilities.
ConclusionsEvaluation of current available programs can help with recognition of specific needs of patients with schizophrenia and provide guidelines for further development of treatment programs that could be helpful in achieving functional remission.
Disclosure of InterestNone Declared
Experience real-time, health and biological outcoMes of personal recovery in PeOple With mEntal disorders in Residential facilities (EMPOWER): a cohort study
- A. Martinelli, G. de Girolamo
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S714
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Introduction
Deinstitutionalization has resulted in diverse mental health care models, influenced by local resources, funding, and cultural factors. In Italy, 127 Department of Mental Health (DMHs) provide care for individuals with mental disorders. People with severe mental disorders (SMD) live independently or in residential facilities (RFs). Approximately half of the Italian DMH budget is allocated to RFs, serving around 3.6% of people with SMD. Italian RFs prioritize personal recovery, empowering individuals with SMD to live fulfilling lives despite symptoms and psychosocial challenges. While personal recovery is known to improve well-being and cost-effectiveness, its implementation in Italian RFs remains incomplete. There is insufficient evidence regarding its impact on various outcomes for residents, including health, psychosocial, and biological factors.
ObjectivesThe EMPOWER Study aims to assess whether adding personal recovery to Treatment As Usual (TAU) in Italian RFs could improve functioning (primary outcome), health, biological status, productivity and interpersonal relationships (secondary outcomes) among patients receiving the personal recovery-oriented treatment, compared with TAU. Additionally, data will be collected from informal caregivers, mental health professionals, and concerning the recovery orientation of RFs.
MethodsThis study employs a longitudinal cohort design, gathering data at baseline and six-month follow-up in Italian RFs. A cohort of residents over 18 y.o. who receive a personal recovery-oriented treatment, the Mental Health Recovery Star (N=20), is compared to a matched group of residents receiving the TAU (N=20). International standardized assessments collect patients’ data on functioning, psychopathology, need for care, quality of life (QoL), positivity, social network, service satisfaction, and patient stigma. Informal caregivers’ data includes burden, QoL, positivity, and service satisfaction. Mental health professionals’ data encompasses burnout, stress, stigma, positivity, and work satisfaction. The working alliance between professionals and patients is assessed. Clinical and biological exams (blood and saliva samples) are collected, along with actigraphy data on patients’ circadian rhythm and physical activities. Digital data through a mobile app captures psychopathology, productive activities, social network, using the Experience Sampling Method with questions defined with patients. Focus groups with patients, professionals, and informal caregivers are facilitated by an expert by experience. Recovery orientation of RFs is assessed.
ResultsNot yet available.
ConclusionsThis study aims to generate novel insight that could improve our treatment approaches for patients in residential facilities.
Disclosure of InterestNone Declared
Esketamine in resistant depression: a case report
- L. Carrión Expósito, G. Chauca Chauca, R. Galan Armenteros, M. Rodriguez Lopez
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, pp. S540-S541
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Introduction
Major depressive disorder is a common psychiatric condition affecting around 264 million people worldwide (WHO: Depression Fact Sheet. [Apr;2021]). Despite pharmacological advances, many patients still do not respond to antidepressant treatment or do so partially.
It is estimated that only 50-70% of patients respond to the initial antidepressant treatment according to the STAR-D study. 15% percent of cases do not respond significantly to various pharmacological and psychotherapeutic attempts (Rush AJ et. STAR*D report. al Am J Psychiatry). The current consensus places resistant depression for a practical approach in one that has been treated with two different antidepressant strategies in adequate doses and time and has not been remitted (Souery D et el, Treatment-resistant depression. J Clin Psychiatry 2006). We present a clinical case of a patient with Major Depressive Disorder, resistant to several therapeutic lines, in which intranasal esketamine was initiated.
ObjectivesThe main objective is to report the result of treatment with esketamine in a clinical case.
MethodsThis work analyze the clinical evolution and reponse of a 62-year-old patient after initiating intranasal esketamine.
This is a patient with a single depressive episode, with no personal psychiatric history of interest that, after exhausting several options of pharmacological and non-pharmacological treatment.
Regulated psychotherapy based on cognitive behavioral therapy was carried out along with different pharmacological strategies according to the recommendations of the main clinical guidelines: antidepressant dose increase, antidepressant change, combination of several antidepressants and potentiation with another drug. We measured clinical changes with MADRS Scale (Montgomery-Asberg Depression Rating Scale) at diferent times.
ResultsFrom the fifth administration of esketamine the patient presented a clear improvement. At three months, the score on the MADRS scale improved markedly and at 6 months, the patient reported euthymia.
Score MADRS:
- Basal 46
- 3 Months 14
- 6 Months 1
As for the adverse effects, the patient presented in all administrations very mild dizziness.
ConclusionsThe use of esketamine is a new therapeutic approach, being fast, safe and well tolerated in patients with depression who do not respond to other treatments (Sapkota A et al. Efficacy and Safety of Intranasal Esketamine in Treatment-Resistant Depression in Adults: A Systematic Review. Cureus.2021 Aug 21;13(8)). In our patient has proven to be effective and fast.
Disclosure of InterestNone Declared
DNA methylation risk scores for depression, not today
- E. Van Assche, C. Hohoff, B. T. Baune
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- Journal:
- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, pp. S585-S586
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Introduction
After the success of polygenic risk scores (PRS) that embed a useful summary of genomic information in a comprehensive score, the wish to develop summary statistics for DNA methylation had become more pressing. Developing such a score faces challenges, as the score has to be specific and sensitive as well. Epidemiological research on DNA methylation and depression would benefit from such score.
ObjectivesHere, we test a score trained on incident depression (case-control), i.e., a list of published weights for particular CpGs, for its validity in the context of depression severity as measured using MADRS in our sample with depressed patients only.
MethodsDNA methylation was assessed using the Illumina Infinium MethylationEPIC 850k BeadChip on a sample of 119 patients with a diagnosis of MDD. After data cleaning, 113 participants were included in the analysis (Mage= 47 years, 57.98% women, MMADRS=27.7). Data processing was conducted using the RnBeads package. From the published reference for the overall sample, a list of 196 CpGs was provided, 170 of these were present in our dataset and used for the score. The list of non-smokers comprised 144 CpGs, of which 124 were available. The score per individual was built using M-values, using the formula: S(weight*DNA methylation value). The score was tested in association with depression and other typical confounders using multiple regression in R. Confounders included ancestry, BMI, age, sex, and 6 cell types. We tested both scores in our sample: smokers and non-smokers.
ResultsIn contrast to our expectations, none of the regression analyses showed a significant association with depression (MADRS-score). Nonetheless, a significant association was seen with biological sex for both analysis (overall: p=0.036, non-smokers: p=0.026). A reduced model with only this predictor explained 5% and 4% of the variance of the summary score calculated (R2), respectively (overall: p=0.013; non-smokers: p=0.019). One of the ancestry components was marginally significant too in the non-smoker summary score (p=0.065). This was not the case anymore in the reduced model.
ConclusionsOur results show that caution is still in place when using methylation risk scores as specificity and sensitivity might not yet be optimized. The score built for depression incidence does not seem fitting for depression severity at this moment. The use of DNA methylation, a marker that is generally sensitive to confounding factors, for a risk score, might pose more challenges in the context of reliable summary statistics, in particular also for cross-trait examination, which is currently a typical use of polygenic risk scores.
Disclosure of InterestNone Declared
Associations between general and specific psychopathology factors in parents and psychiatric, behavioral, and psychosocial outcomes in offspring: a Swedish population-based register study
- M. Zhou, H. Larsson, B. D’Onofrio, M. Landén, P. Lichtenstein, E. Pettersson
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- Journal:
- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, pp. S221-S222
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Introduction
Psychiatric conditions in parents are associated not only with the same condition in offspring, but also with virtually all other psychiatric conditions. However, it remains unknown whether this intergenerational transmission of psychiatric conditions was attributable to broader psychopathology comorbidity or to specific conditions.
ObjectivesTo estimate associations between general and specific factors of psychopathology in parents, and a wide range of register-based outcomes in their offspring.
MethodsBased on Swedish national registers, we linked 2 947 703 individuals born in Sweden between 1970 and 2000 to their biological parents (1 705 780 pairs of parents) and followed them to December 31, 2013. First, we estimated one general and three unrelated (specific) psychopathology factors (capturing internalizing, externalizing, and psychotic problems, respectively, independently of general psychopathology) based on nine parental register-based psychiatric diagnoses and violent criminal court convictions. Second, we regressed each offspring outcome on the latent general and three specific factors simultaneously.
ResultsThe general psychopathology factor in parents was significantly associated with all 31 offspring outcomes (mean Odds Ratio (OR) = 1.22; range: 1.08–1.40), which means that children whose parents scored one standard deviation above the mean on general psychopathology had, on average, a 23% higher probability of all outcomes. The specific psychotic factor in parents was primarily associated with psychotic-like outcomes (mean OR = 1.17; range: 1.05–1.25), and the specific internalizing factor in parents was primarily associated with offspring internalizing (mean OR = 1.11; range: 1.11–1.13) and neurodevelopmental outcomes (mean OR = 1.07; range: 1.02–1.10). The specific externalizing factor in parents was associated with externalizing (mean OR = 1.27; range: 1.21–1.32) and internalizing outcomes (mean OR = 1.10; range: 1.01–1.13).
ConclusionsThe intergenerational transmission of psychiatric conditions across different types of spectra appeared largely attributable to a parental general factor of psychopathology, whereas specific factors were primarily responsible for within-spectrum associations between parents and their offspring. Service providers (e.g., child psychologists, psychiatrists, teachers, and social workers) might benefit from taking the total number of parental mental health problems into account, regardless of type, when forecasting child mental health and social functions.
Disclosure of InterestNone Declared
The Impact of the COVID 19 Pandemic on Psychiatric Hospitalizations in a Portuguese Department: A Retrospective Observacional Study
- J. R. Freitas, C. P. Desport, D. O. Martins, M. Santos, C. Fonseca
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S512
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Introduction
The World Health Organization declared the coronavirus outbreak a pandemic on March 11th 2020. Since then, the containment measures were leading to increasing mental health problems in the general population and worsening of some pre‑existing psychiatric conditions. To our knowledge, there are few studies characterizing the impact of the COVID‑19 pandemic on psychiatric hospitalizations across the world.
ObjectivesWe aimed to compare the number and characteristics of the hospitalizations in the mental health department of a Portuguese psychiatric hospital from March 2nd 2019 to October 31st 2019 with those that occurred in the same period in 2020.
MethodsWe conducted a retrospective observational study including all patients admitted to hospital during these periods (n=805). Sociodemographic data, clinical characteristics and information about the context of hospitalization were collected. Statistical analysis was performed using t Student Test, Mann‑Whitney and Chi‑square.
ResultsIn the pandemic period there was a marked reduction in the number of psychiatric hospitalizations. There was a statistically significant difference in the median length of stay and in the percentage of involuntary hospitalizations between the two periods. In 2019, the most frequent International Classification of Diseases (10th Revision) diagnostic categories were F30‑F39 (mood disorders) and in 2020 were F20‑F29 (schizophrenia, schizotypal and delusional disorders).
ConclusionsThe reorganization of services and the decrease in admissions through the emergency department may explain these results.
Disclosure of InterestNone Declared
The relationship between childhood trauma and adulthood anxiety and depression among Tunisian university students
- M. Turki, W. Hammemi, S. Ellouze, M. Barkallah, I. Mannoubi, N. Halouani, J. Aloulou
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S824
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Introduction
Traumatic childhood has increasingly high incidence rates and can be predictive of negative health outcomes. There is a large consensus indicating that childhood trauma is significantly involved in the development of mood disturbances in adulthood.
ObjectivesThe aim of this study was to examine the relationship between retrospectively recalled childhood trauma and adulthood anxiety and depression in a sample of undergraduate university students.
MethodsA cross-sectional study was conducted among a sample of 365 university students randomly selected from 8 universities in Sfax (Tunisia). Information about childhood maltreatment, depressive and anxiety symptoms were gathered through the Childhood Trauma Questionnaire-Short Form (CTQ-SF), and the Hospital Anxiety and Depression Scale (HADS) respectively. To test the hypothesis, examining the relationship between anxiety, depression, and childhood trauma, we used Spearman’s correlation test. Multivariate logistic regression models were used as well.
ResultsThe mean age of our participants was 20.3 years. More females (68.2%) than males participated in the study. Our findings showed that the five childhood trauma subtypes (emotional abuse and neglect, physical abuse and neglect, sexual abuse) were significantly correlated with anxiety and depression symptoms severity (p<0.01). Emotional abuse was the strongest risk factor for adulthood anxiety symptoms (OR=6.002, 95% CI= [3.238; 11.125]) while emotional neglect was the strongest risk factor for depressive symptoms in adulthood (OR=6.214, 95% CI= [3.428; 11.267]). Multivariate analysis revealed that, in subjects with childhood trauma, scores of anxiety symptoms were positively and highly associated with the severity of emotional abuse (adjusted B=1.438, 95% CI= [1.951; 9.092], p=0.000). Depression symptoms severity were as well positively correlated with severity of emotional abuse (adjusted B=0.848, 95% CI= [1.043; 5.224], p=0.039), and severity of emotional neglect (adjusted B=1.044, 95% CI= [1.263; 6.389], p=0.012).
ConclusionsThis study highlighted the relevance of childhood trauma as a factor contributing to anxiety and depression in adulthood. Thus, early psychological support of victims of childhood trauma can reduce the rate of anxiety and depression among these subjects.
Disclosure of InterestNone Declared
From ADHD to well-being: The Role of Rejection Sensitivity in college life
- V. Müller, B. Pikó
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- Journal:
- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, pp. S284-S285
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Introduction
Rejection-sensitivity is a prevalent yet understudied emotional symptom often associated with adult ADHD. While ADHD research typically focuses on behavioral and cognitive facets, emerging evidence highlights the significance of emotional symptoms. Emotional dysregulation in ADHD impacts psychological well-being and mental health. Our study examines how ADHD symptoms relate to rejection sensitivity, considering factors like resiliency, self-regulation, and overall well-being.
ObjectivesOur study seeks to establish a direct connection between ADHD scores and rejection sensitivity among college students. We also investigate the mediating role of well-being, creative executive efficiency, self-regulation, and resilience, while exploring the moderating role of savoring capacity.
MethodsBetween February and May of 2023, we conducted a cross-sectional study using an online questionnaire, gathering data from 304 Hungarian higher education students aged 18 to 35. The majority, 78.0%, were female, and 71.4% were full-time students. Most participants were pursuing a bachelor’s degree (56.6%), followed by undivided master’s (21.7%), doctoral studies (13.8%), and traditional master’s degrees (6.9%). We administered the Adult ADHD Self-Report Scale (ASRS-v.1.1), The Mental Health Test (MHT), and the Rejection Sensitivity Questionnaire (A-RSQ) for our research.
ResultsFirst, the ADHD scores were significantly associated with each mediator (well-being: β = -.343, p < .001; creative and executive efficiency: β = -.183, p < .01; self-regulation (β = -.230, p < .001; and resilience: β = -.321, p < .001). There was a direct effect of ADHD scores on rejection sensitivity scores (β = .466, p < .001). Finally, we also detected the indirect effects of ADHD scores on rejection sensitivity scores through the four mediators (β = .227, p < .001). Savoring capacity significantly moderated the relationship between ADHD and rejection sensitivity scores (β = -.244, p < .001).
ConclusionsADHD scores in our study population significantly correlate with well-being, creative and executive efficiency, self-regulation, and resilience. Furthermore, these scores directly influence rejection sensitivity, suggesting a heightened vulnerability to perceived rejection among those with higher ADHD scores. The indirect effects emphasize that the relationship between ADHD and rejection sensitivity is mediated by the aforementioned positive psychological constructs. This underscores the need for holistic interventions in ADHD populations, addressing not just core ADHD symptoms but also enhancing well-being, cognitive efficiency, self-regulation, and resilience to potentially mitigate rejection sensitivity.
Disclosure of InterestV. Müller Grant / Research support from: This project received funding from the New National Excellence Program under the Ministry for Culture and Innovation, sourced from the National Research, Development, and Innovation Fund, reference #ÚNKP-23-3-SZTE-66., B. Pikó: None Declared