Honoraria, advisory board, or consulting fees from Angelini, Astra Zeneca, Bristol-Myers Squibb, Gedeon Richter Bulgaria, Innova-Pharma, Janssen Pharmaceuticals, Lundbeck, Otsuka, Pfizer, and Pierre Fabre, for services not related to this abstract

Chronic pain has a significant impact on individuals’ daily lives, and its control is essential for improving quality of life. In this sense, the practice of Mindfulness is a useful non-pharmacological technique for self-management of chronic pain.

This study aims to identify the level of knowledge regarding the effectiveness of Mindfulness for self-control of pain by people with chronic pain.

A cross-sectional study was conducted on a sample of 23 adults with chronic pain. The online survey assessed sociodemographic characterization, Brief Pain Inventory, and knowledge/opinion about the effectiveness of mindfulness strategies.

The sample consisted mostly of middle-aged women, with family support, employed and with higher academic qualifications. 47.8% of the sample had experienced pain for over 20 years with the most prevalent diagnosis being fibromyalgia. The average intensity of chronic pain corresponded to moderate pain and the level of acceptance of it was low, interfering in instrumental activities of daily life. Although they had never tried the technique, most of the sample knew what mindfulness consisted of, considering it as a viable option for self-management of chronic pain. Moderate and positive correlations were found between the level of acceptance of pain and greater availability for the practice of mindfulness (rho=.137; p<.001), the same happened between satisfaction with the practice of mindfulness and self-control of pain (rho=.259; p<.001).

Our findings outline the need to include non-pharmacological measures such as mindfulness in therapeutic schemes for chronic pain management, given the manifest interest of this population.

No significant relationships.

The presentation considers the peculiarities of late adulthood, different views on the periodization of older ages (World health organization, I. Burnside, H.S. Pryazhnikov).

The research is aimed at studying the peculiarities of late adulthood.

The method of work is a bibliographic analysis.

Reveals the structure of psychological age (concept by L.S.Vygotsky), the specificity of the development in late adulthood and features of the social situation of development. Reveals modern ideas of ageing as a process not only of involution and loss, but also a process of continued development. The greatest attention is paid to the peculiarities of development tasks at older ages and the difficulties faced by older people trying to cope with them. There are the brief overview of the positions of C.G.Jung, A.Adler, E.Erikson, R.Peck, G.M.Bryugman, A.G.Liders, N.S.Pryazhnikov, E.E.Sapogova, I.V.Shapovalenko, V.I.Slobodchikov, G.A.Zuckerman, etc. regarding the development tasks in late adulthood. The comparison of the development tasks of early and late age periods by G.M. Bryugman, which shows that the tasks of aging worse defined, at least sequentially ordered, and the results of solution of development tasks is less predictable than in earlier ages.

We can say that in old age is important not only the task of adjusting to different changes of pace of life, quality of life, social circle, etc., and overcome the negative aspects of aging but also issues of self-development. As the primary development task in late adulthood is considered an achievement of his own integrity and finding the meaning of life.

No significant relationships.

The COVID-19 pandemic can affect the mental health of health and social care workers (HSCWs) who are frontline workers in this continuous crisis. Following exposure to potentially morally injurious events (PMIEs) that undermine deeply held moral beliefs and expectations, HSCWs might experience moral injury (MI) and deleterious psychiatric consequences such as depression and anxiety symptoms.

To examine associations between exposure to PMIEs, MI symptoms, depression, and anxiety symptoms. We also aim to assess the moderating role of thwarted belongingness in these associations.

A sample of 243 Israeli HSCWs completed online validated self-report questionnaires in a cross-sectional designed survey in February and March 2021.

About one-third (33.6%) of the sample met the criteria for major depressive disorder, 21.5% met the criteria for generalized anxiety disorder, and 19.1 % reported comorbidity of depression and anxiety. A moderated-mediation model shows that high thwarted belongingness intensified the relations between exposure to PMIEs and MI symptoms, and between MI symptoms and depression and anxiety symptoms. Importantly, the indirect effect of exposure to PMIEs on both depression and anxiety symptoms via MI symptoms existed only among those with high levels of thwarted belongingness.

The study’s findings highlight the mental burden of HSCWs during the COVID-19 pandemic and the contribution of MI to possible mental health consequences. Clinicians should be aware of the importance of high thwarted belongingness in depression and anxiety sequelae of exposure to PMIEs among HSCWs.

No significant relationships.

In patients submitted to refractory epilepsy surgery, psychiatric comorbidity is high (affecting 1 in every 3 patients), with descriptions of improvement, worsening and emergence of de novo psychopathology.

Identifying the prevalence of psychopathology and associated risk factors in a group of patients submitted to refractory epilepsy surgery.

Retrospective observational study. Non systematic literature review.

We observed 42 patients, 45.2% female and 54.8% male, with an average age of 46.5 years (SD±11.6). The average age of presentation of epilepsy was 18.8 years (SD±12.7), 97.6% with temporal lobe epilepsy and 2.4% with parietal lobe epilepsy, 50% in each hemisphere. 19% had surgical complications and 40.5% had post-surgical recurrence of crisis. 45.2% presented with pre-surgical psychopathology (33.3% affective disorders, 16.7% anxiety disorders, 2.4% psychotic disorders, 2.4% neurodevelopmental disorders and 2.4% substance use disorders). Post-surgically, 50% improved, 20.8% maintained and 29.2% worsened their psychopathology and 21.4% had de novo psychopathology. We didn’t find associations between the analyzed variables and the worsening or appearance of de novo psychopathology.

The worsening or appearance of de novo psychopathology is a well known phenomenon in patients submitted to refractory epilepsy surgery. In our sample there were cases of improvement, maintenance, worsening and emergence of de novo psychopathology, however we weren’t able to identify the factors associated with these different outcomes. Our study was retrospective and had a small sample, as limitations. Further, better-designed studies are necessary to identify risk factors for psychiatric disorders, allowing their effective prevention and treatment.

No significant relationships.

ADHD is a neurodevelopmental disorder that frequently persists throughout adulthood. Binaural Beats (BB) are auditory perceptions occurring when two soundwaves of slightly different frequency are carried separately to the ears; they might modulate brain activity and performance.

To evaluate BB efficacy on studing performance, mind-wandering, and core symptoms of a sample of adult ADHD outpatients

In this randomized-controlled trial we recruited a sample of University students in pharmacological treatment for adult ADHD. A track with 15 Hz BB (415 Hz to right and 400 Hz to the left ear) was delivered to the intervention group; whereas, a placebo track consisting of two identical frequencies (400 Hz) was administered to control group. The RCT consisted of a baseline assessment (T0) and two fortnightly follow-ups (T1-T2). Each time, the patient filled the ADHD-RS-5 (ADHD Rating Scale-5) and the MEWS (Mind Excessively Wandering Scale) and executed an online version of SART (Sustained Attention to Response Task). The effect of self-administered acoustic stimulation during individual studying sessions was estimated by a subjective studying performance (SSP) evaluation questionnaire.

A significant improvement of SSP from baseline assessment (T1) to the last observation (T3) was detected in BB group only (mean differences= 2.7, p<.001). A significant between-group contrast for SSP was also found at T3. No other significant changes were detected for ADHD-RS, MEWS and SART at p<.05 level.

BB seem to improve subjective studying performance and ADHD symptoms severity. These preliminary findings must be confirmed in larger sample.

No significant relationships.

Mental health and psychosocial support (MHPSS) staff in humanitarian settings have limited access to clinical supervision and are at high risk of experiencing burnout. We previously piloted an online, peer-supervision program for MHPSS professionals working with displaced Rohingya (Bangladesh) and Syrian (Turkey and Northwest Syria) communities. Pilot evaluations demonstrated that online, peer-supervision is feasible, low-cost, and acceptable to MHPSS practitioners in humanitarian settings.

This project will determine the impact of online supervision on i) the wellbeing and burnout levels of local MHPSS practitioners, and ii) practitioner technical skills to improve beneficiary perceived service satisfaction, acceptability, and appropriateness.

MHPSS practitioners in two contexts (Bangladesh and Turkey/Northwest Syria) will participate in 90-minute group-based online supervision, fortnightly for six months. Sessions will be run on zoom and will be co-facilitated by MHPSS practitioners and in-country research assistants. A quasi-experimental multiple-baseline design will enable a quantitative comparison of practitioner and beneficiary outcomes between control periods (12-months) and the intervention. Outcomes to be assessed include the Kessler-6, Harvard Trauma Questionnaire and Copenhagen Burnout Inventory and Client Satisfaction Questionnaire-8.

A total of 80 MHPSS practitioners will complete 24 monthly online assessments from May 2022. Concurrently, 1920 people receiving MHPSS services will be randomly selected for post-session interviews (24 per practitioner).

This study will determine the impact of an online, peer-supervision program for MHPSS practitioners in humanitarian settings. Results from the baseline assessments, pilot evaluation, and theory of change model will be presented.

No significant relationships.

Depression as a public health concern highlights the importance of prevention. The nature of the disease is complex, linked to numerous biopsychosocial factors. However, it was found that healthiest lifestyle reduced 67% the risk of depressive symptoms.

To review evidence on how exercise, diet, and smoking impact on the risk of depression.

Non-systematic review of literature through search on PubMed/MEDLINE following the terms “Lifestyles”,“risk” and “depression”.

Several studies have shown that exercise reduces the incidence of depressive symptoms and major depressive disorder regardless of intensity, geographic region, age, gender, or follow-up period. Smoking significantly increases the risk of depression, including the ones exposed to second-hand smoking and pregnant women in which prenatal smoking was associated with a three-fold increased risk of postpartum depression. The Mediterranean diet rich in complex carbohydrates, omega-3 fatty acids, B-group vitamins and several amino acids have shown a negative association with the incidence of depression. A high frequency of breakfast consumption, an increased intake of fruits, vegetables, and some specific nutrients (zinc, iron, magnesium, vitamins, and folate) was also inversely correlated with prevalence of depressive symptoms. On the other hand, western dietary patterns, with sweetened beverages, processed food, and foods rich in saturated fatty acids, have been linked to an increased risk. Skipping meals and snacking on unhealthy food also contributes to depressive symptoms.

Relatively modest changes in population diet, tobacco consumption and levels of exercise may have important public mental health benefits preventing a substantial number of new cases of depression.

No significant relationships.

No significant relationships.

Over last decades convincing evident data was accumulated about the positive correlation of religious involvement and better mental health in depression, substance abuse, suicide, stress-related disorders and dementia. The studies of the impact of religion on patients with schizophrenia and schizoaffective disorders are still insufficient and controversial.

To investigate the impact of the religious coping strategies in patients with schizophrenia and shizoaffective disorder with focus on resolution and quality of remission in schizophrenia and schizoaffective disorder.

The pilot 1 year study covers 68 orthodox (group 1) and 55 unbeliever (group 2) outpatients with schizophrenia and schizoaffective disorder in remission on the maintenance therapy in FSBSI MHRC. The groups matched in age (18-60 y.o.), gender, treatment. The orthodox group received religious coping therapy. Number of relapses, remission quality (PANSS), quality of life (QLS), compliance (MARS) were measured 3 times (baseline visit, 6, 12 months). Statistical analysis (regression and correlation) was applied.

Religious coping strategies proposed by Paragment K. (2013) were applied considering the peculiarities of value-semantic structures and selected religious values of the patients as important rehabilitation resource (Kopeyko et al, 2016). Group 1 demonstrated statistically significant better remission at 12-months point – better subjective well-being, social/functional outcomes, higher adherence to medication, less relapses, less psychotic symptoms.

Religion contributes to acquire adaptive functions as the meaning of life, sense of hope, spiritual comfort, supports the overcome the disease burden. Religious coping is an important tool for rehabilitation and preventing the relapses in patients with schizophrenic disorders.

No significant relationships.

Aripiprazole (ARI) is an atypical antipsychotic drug with D2 partial agonist properties, usually prescribed to treat mood disorders (major depression or bipolar disorder) and schizophrenic disorder (schizophrenia or schizoaffective disorder). Dopamine receptor agonists, as is ARI, have been implicated in some cases of impulse-control problems, such as gambling disorder (GD), increased spending, hypersexuality and compulsive eating.

Currently, it is hypothesized that aripiprazole may cause impulse-control problems because it can produce a hyperdopaminergic state in the mesolimbic pathway (reward system) through its predominant action on dopamine D3 receptors. We intend to do a non-systematic review of the scientific information regarding this subject.

The authors revised the published literature about this topic, selecting relevant articles, systematic reviews and case reports, with the topic words: “aripiprazol”, “gambling disorder” and “dopamine receptor” in scientific data base.

Overall, a few cases of ARI-induced pathological gambling as well as ARI-induced hypersexuality have been reported. In one study it was verified that comorbid psychiatric and substance use disorders were common among those who have experienced GD or worsened GD after beginning ARI treatment. In another study, it was verified that the group of patients who reported this alleged side-effect were mostly young (mean age, 33.6 years), mostly men (88.2%) and most lived alone.

Attributing to dopamine agonists the only factor that can explain the onset of GD is simplistic and dangerous. Many other potential risk factors, including individual vulnerability factors (temperament, genetics) as well as environmental factors, must be considered.

No significant relationships.

Bulimia Nervosa (BN) is a debilitating eating disorder characterized by binging and purging episodes generally accompanied by excessive concern with body weight and shape as well as body image disturbance. BN and Borderline Personality Disorder (BPD) may co-occur. In fact, studies estimate that one quarter to one third of patients with BN also meet criteria for BPD. However not much is known about the relationship between these two diseases. Nevertheless, the high comorbidity rate might not be surprising as both BN and BPD may share interacting aetiologies and common core symptoms such as impulsivity and emotional instability. So far, only very little is known about the clinical presentation of patients with both BN and BPD and their response to treatment.

Literature review on BN and comorbid BPD. An illustrative clinical case is presented.

Case report and non-systematic review of the literature - sources obtained through search on Pubmed.gov database.

Female, 19-year-old, student, lived with her mother and stepfather. Developed a poor relationship with her body image due to dental problems during high school. The patient started to binge eat, exhibit compensatory behaviors, restrictive eating pattern, body dissatisfaction and emotional instability while maintaining a normal BMI. Over the last year, she started a self-destructive behavior with slight improvement of BN symptoms.

Special attention should be given to patients suffering from BN and comorbid BPD as they present greater risk of recurrent suicide attempts and non-suicidal self-injury, as well as lower rates of remission. Early interventions that target impulsivity and problematic eating behavior may mitigate risk of future borderline personality features.

No significant relationships.

Self-report questionnaires to screen for symptoms of common mental disorders (CMDs) are commonly used as inexpensive, easy-to-administer tools in research and clinical practice. However, their validity to detect the presence of any CMD across cultures and languages is unclear. Psychometrically sound and brief case-finding instruments are vital for the identification of individuals with mental health needs. With the increasing number of Arabic-speaking refugees in Europe, we aim to evaluate the diagnostic accuracy of Arabic-language screening instruments.

The aim of this systematic review/meta-analysis is to synthesize the diagnostic accuracy of self-report questionnaires to detect depression, anxiety and posttraumatic stress disorder (PTSD) in Arabic-speaking populations.

Five databases were searched (inception-January 2021) (PROSPERO: CRD42018070645) for studies on the diagnostic accuracy of brief questionnaires in Arabic-speaking populations, with a clinical interview as reference standard. Data on sensitivity/specificity were extracted/calculated. Multi-threshold meta-analyses were performed (R diagmeta package). Study quality was assessed using QUADAS-2.

We included 32 studies (N=4042 participants) reporting on questionnaires targeting depression/anxiety (14 questionnaires), distress (2 questionnaires), and PTSD (1 questionnaire). Optimal thresholds were identified for the Edinburgh Postnatal Depression Scale (EPDS; cut-off 11, sensitivity 76.9%, specificity 85.1%), Hospital Anxiety and Depression Scale (HADS) anxiety subscale (cut-off 7, sensitivity 81.9%, specificity 87.6%), depression subscale (cut-off 6, sensitivity 73.0%, specificity 88.6%), and Self-Reporting Questionnaire (SRQ-20; cut-off 8, sensitivity 86.0%, specificity 83.9%).

We present optimal thresholds that can be used by clinicians and researchers for the EPDS, HADS and SRQ-20. More research on Arabic-language questionnaires, especially those targeting PTSD, is needed.

No significant relationships.

Obsessive phenomena, when present, are usually seen in the depressive phase of bipolar disorder.

The peculiar case with aggravation in ruminative and obsessive thinking with simultaneous hypomania may widen our understanding of the phenomenology of antidepressant induced hypomanic symptoms.

We present a case of ruminative hypomania induced by high dose venlafaxine. Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HAM-D) and Yale Brown Obsessive Compulsive Scale (YBOCS) were used for symptom ratings.

The patient was 30 years old and she had treatment history of depression for 3 months. She had two consecutive suicide attempts with drugs in the week before she was hospitalized for suicidal risk. She was using venlafaxine 300 mg/day and olanzapin 2,5 mg/day; continuous ruminative thinking about the past and imaginary sexual affairs with former friends were apparent with an unremitting pattern, leading to intense psychomotor agitation and suicide attempts. Irritable mood, and increased energy was observed with continuous ruminations. She was diagnosed with bipolar-II-disorder, with mixed features and anxious distress (YMRS:17, HAM-D:22, YBOCS:34). After discontinuing venlafaxine and starting anti-manic treatment with haloperidol 10 mg/day in the first week, both affective symptoms and ruminations were improved (YMRS:2, HAM-D:4, YBOCS:8). Aripiprazol 20 mg/day and quetiapine 100 mg/day which were given for continuation treatment were also effective for preserving full remission.

When prescribing high dose venlafaxine for treatment resistant depression, it should be remembered that this may induce hypomanic symptoms and prominent ruminative thinking which can be ameliorated with anti-manic treatment.

No significant relationships.

The behavioural variant of frontotemporal dementia (bvFTD) is a devastating neurodegenerative syndrome with its peak in the early sixties at about 13 per 100,00. The diagnosis of bvFTD relies on clinical assessment as patients present executive and behavioural deficits, like apathy, loss of motivation and personality changes. Current diagnosis criteria lack specificity and symptomatic overlap between bvFTD and primary psychiatric disorders (PPD) pose a diagnostic conundrum, with half of bvFTD patients previously receiving a psychiatric diagnosis.

The goal is to discuss the syntomatic overlap of these two entities.

Brief non-systematic literature review on the topic, illustrated by a case-report presentation.

A 69 year old men, retired and single, is committed for thought and behavior disorganization and insomnia. He presented expansive mood but also temporal and spatial disorientation and periods of incongruous speech. This patient’s clinical presentation could both entice a diagnosis of bvFTD but also of an affective disorder, especially since it has been reported that neuropsychiatric presentations, like late-onset psychosis or mania, can be the initial presentation of this form of dementia, particularly in patients with C9orf72 mutations, who often display persecutory or grandiosity delusions.

This clinical case exemplifies the difficulty that lies in differentiating cases of bvFTD from late-onset idiopathic mood or psychotic disorders. It is important to consider that on cognitive assessment patients with bvFTD score significantly worse on executive function tests that PPD patients No disease- modifying therapies are available for patients with bvFTD, therefore drug treatment should focus on the most disruptive or taggable behaviours.

No significant relationships.

Eating disorders are associated with suicidal behavior in adolescents. But the relationship between subthreshold eating disorders and suicidality is not well understood.

To examine suicidal behavior in adolescent girls with eating disorders (ED) and subthreshold eating disorders (SED).

The study of 917 girls aged 12–17 used the Body Image and Eating Distress scale (Koskelainen et al., 2001) and questions about intentional self-harm (burns or cuts), suicidal thoughts and suicidal attempts. Adolescents were divided into three groups: girls with ED (n = 20); girls with SED (n = 88); and control group (CG, n = 809).

Self-harm was reported by 55% of girls with ED, 35.2% of girls with SED and 20.2% of CG girls (χ2 = 15.82, p <0.001). Suicidal ideation was reported by 65% of girls with ED, 51.1% of girls with SED and 27.2% of CG girls (χ2 = 21.86, p <0.001). Suicidal attempts were reported by 45% of girls with ED, 17.1% of girls with SED and 7.5% of the CG. There were no differences in the prevalence of self-harm and suicidal ideation between the ED and SED groups, rates of suicide attempts were 2.6 times higher in the ED group.

Girls with both ED and SED have a high risk of suicidal behavior: 2.7-4.5 times higher rates of self-harm, 1.9-2.4 times higher rates of suicidal ideation, and 2.3-6 times higher rates of suicidal attempts. Management of such adolescents should include assessment of the risk of suicide.

The study was supported by the Russian Science Foundation grant # 21-15-00033.

Hepatic ones are some of the most described somatic complications in anorexia nervosa (AN) affected patients. They can be due to malnutrition, which is the more usual thing, or due to re-feeding. The first one can lead to more marked elevations of the hepatic enzymes, especially alanine-aminotransferase (ALT). It’s been also described the relation between a sharply decreased body mass index (BMI) and this kind of complications, but there are still to determine more predictors.

Identifying clinical predictors of hepatic complications in AN.

We analysed data from 71 AN affected patients hospitalized at Bellvitge Hospital from January 2016 to October 2021. We used IBM SPSS Statistics 22 to do all the statistics in this work.

The medium age of the sample was 27.66 years with 10.8 years of evolution of AN. The medium BMI was 13.88. 33.80% of them had some sort of hepatic enzymes elevation, two of them a several one. AST, ALT and ALP were significantly more elevated in those patients with lower BMI. GGT was significantly more elevated in patients with more years of disorder development. We didn’t identify correlation between any purgative method and hepatic alterations.

The elevation of ALT, AST and ALP seems to be related with the BMI of the patients, while the elevation of the GGT turns out to be related to the time of evolution of the eating disorder. Purgative methods don’t seem to be related to the development of hepatic alterations in AN.

No significant relationships.

Successful stabilization of patients with mental disorders requires most of the times the use of more than one antipsychotic medications with increase prevalence of clozapine in refractory cases. Constipation consists one of the most debilitating side effect of the therapy, which gradually progresses to a chronic state of bowel movement dysfunction, with recurrent episode of paralytic ileus of various severity.

We describe the case of a middle age male treated with clozapine for refractory mental disorder, who developed ileus and subsequent bowel dysfunction not amenable to laxatives.

The acute episode have been treated conservatively with nasogastric decompression, intravenous replacement of fluids and electrolytes, antibiotics chemoprophylaxis and low molecular weight heparin. His overall physical status was unremarkable for obesity, diabetes, hypertension, allergies, previous operations and a former endoscopic evaluation conducted in the recent past, which had ruled out malignant neoplastic disease.

A course of per os prucalopride have been instituted, which showed preliminary promising results in restoring proper bowel movements, without any serious side effect and without the need to discontinue his course with antipsychotics. Prucalopride is a 5 HT4 agonist which selectively binds to the receptors of the intestine, resulting in muscular contractions as well as clorium secretion from the mucosa promoting an osmotic defecation.The substance has been extensively use in the treatment of irritable bowel disease of the chronic constipation type.

We suggest the more systematic use of this agent in this group of patients after proper endoscopic evaluation and restoration of all secondary causes of constipation.

No significant relationships.

Primary care physicians tend to examine patients with conversion disorder (CD) first. A good knowledge of this disorder will allow an early diagnosis and avoid unnecessary investigations for the patient.

To assess the knowledge of primary care physicians about patients with CD.

We conducted a cross-sectional and descriptive study among 90 primary care physicians in Sfax (Tunisia). We used an anonymous self-questionnaire for data collection.

The response rate to our questionnaire was 60%. The participants’ age ranged from 25 to 70 years, with a median of 41 years. The sex ratio (M/F) was 0.92. The majority of physicians (75.9%) have practiced in the public sector. Among the respondents, 75.9% had theoretical training in CD, 14.8% had continuing medical education (CME), and 42.6% had hospital experience in a psychiatric department. The overall proportion of correct answers was 71.8%. The most recognised symptoms of CD were: dysphonia-aphonia, paresthesia or paresis. All doctors mentioned at least one criterion to distinguish CD from epileptic seizures and loss of consciousness.

There are some gaps in primary care physicians’ knowledge of CD. Thus, we propose to reconsider the conduct of CME, to favour small group training workshops with role-playing and to improve the collaboration between the psychiatrist and the primary care physician.

No significant relationships.

Sleep disturbances are common following traumatic brain injury (TBI) worsening morbidity and other neuropsychiatric symptoms. Post-TBI alterations in sleep architecture require further study.

(1) To evaluate polysomnographic measures of sleep architecture in participants with history of TBI compared to controls and as meta-analyses of pooled means. (2) To evaluate effects of timing and severity of TBI on polysomnographic outcomes.

PRISMA compliant systematic review was conducted of MEDLINE, PsycINFO, EMBASE and Scopus. Inclusion criteria: 1) reporting polysomnography in the context of TBI and 2) operationalizing TBI using clear/formalized criteria. Data were pooled in random-effects meta-analyses with outcomes expressed as mean differences (MD).

In participants with TBI, sleep was comprised of 19.39% REM sleep, 8.13% N1, 51.18% N2, and 17.53% N3, as determined by meta-analyses of single means. Total sleep time was reduced in chronic (>6 months) TBI compared to acute-intermediate TBI (<6 months) (p=0.01). Compared to controls, participants with TBI differed with increased N1 sleep (MD=0.64%; 95%CI=0.02,1.25; p=0.04), reduced sleep efficiency (MD=-1.65%; 95%CI=-3.18,-0.12; p=0.03), and reduced sleep latency on the multiple sleep latency test (MD=-5.90mins; 95%CI=-10.09,-1.72; p<0.01). On sub-group analyses, participants with mild TBI differed from controls with reduced total sleep time (MD=-29.22mins, 95%CI=-54.16,-4.27; p=0.02). Similarly, participants with acute-intermediate TBI exhibited increased sleep latency compared to controls (MD=8.96mins; 95%CI=4.07,13.85; p<0.01) and differed significantly from participants with chronic TBI (X2(1,N=608)=6.54; p=0.01).

Sleep architecture is altered following TBI with potential implications regarding functional outcomes and recovery. These alterations appear to differ based on severity of injury and time since injury.

No significant relationships.