Previous studies have established a relation between childhood maltreatment and eating disorder behaviors. However, this pattern of relations has not yet been studied within the nuclear family interactions.

The aim of this study was to examine a model illuminating the transgenerational mechanism underlying the association between childhood maltreatment and eating disorder behaviors.

One-hundred-sixty-eight Israeli mothers and their young-adult-daughters (discovery sample) and 143 Israeli grandmother-mother-daughter triads (replication sample) filled out a battery of questionnaires assessing their history of childhood maltreatment and level of eating disorder behaviors.

Results of structural equation modeling (SEM) in the discovery sample indicated that mothers’ childhood maltreatment was associated with daughters’ childhood maltreatment and that mothers’ eating disorder behaviors were also associated with daughters’ eating disorder behaviors. In addition, for both mothers and daughters, childhood maltreatment was associated with eating disorder behaviors. Finally, an indirect effect was found in which the relation between mothers’ childhood maltreatment and daughters’ eating disorders was mediated by mothers’ eating disorders. Partial replication was observed; grandmothers’ childhood maltreatment was significantly associated with mothers’ childhood maltreatment. Grandmothers’ eating disorder behaviors were associated with mothers’ eating disorders and mothers’ eating disorders were associated with daughters’ eating disorders. Finally, an indirect effect was found in which the association between grandmothers’ eating disorders and daughters’ eating disorders were mediated by mothers’ eating disorders.

These findings point to the significant contribution of the mother-daughter relationship in different aspects of the intergenerational transmission of both childhood maltreatment and eating disorder behaviors. These findings highlight the need to include a trauma-informed family-system approach in the treatment of eating disorders.

None Declared

Binge eating behaviors are associated with psychological, social, and biological factors, while it is suggested that they may be triggered by negative emotions, including depression and anxiety, and provide relief from them, which in turn may lead to reinforcement of such behaviors.

This study aimed to examine the eating habits and in particular the binge eating behaviors of a sample of adults during the COVID-19 pandemic, an unprecedented challenge for public health and communities worldwide with multi-level consequences on people’s lives.

The sample consisted of 196 individuals residing in Greece aged 18 to 64 years (76.5% women), who completed an anonymous questionnaire from June to July 2021. This included the following psychometric instruments: Fear of COVID-19 Scale to assess the fear related to COVID-19, Rosenberg Self-esteem Scale to assess self-esteem, Depression Anxiety Stress Scale-21 to assess anxiety, depression and stress, Binge Eating Scale to assess binge eating behaviors, UCLA Loneliness Scale for the evaluation of the perceived feeling of loneliness and Reflective Functioning Questionnaire for the assessment of reflective functioning (i.e., the ability to understand human behavior in terms of underlying mental states).

The majority of participants (86.7%) reported that during the pandemic their diet was less healthy than before the pandemic onset, while almost half (46.4%) of the participants stated that they had experiences an episode of binge eating during the past 6 months, and 36.2% that they had used self-induced vomiting in order to control their weight. Of note, the results of a multiple regression analysis revealed that higher levels of fear of the pandemic as well as of depression were independently associated with higher binge eating, with women presenting higher mean scores in the Binge Eating Scale than men. Conversely, higher self-esteem appeared to be independently associated with lower binge eating levels, thus acting as a protective factor, whereas the remaining psychometric factors were not found statistically significantly related.

In conclusion, the findings of the present study highlight the importance of identifying dysfunctional eating behaviors and related psychological factors that may potentially act as risk or protective factors, especially during the pandemic.

None Declared

Eating disorders (ED) are complex entities of multicausal etiology that mainly affect adolescents and young women. For this reason, EDs frequently cause medical and psychological complications that can cause potentially irreversible developmental sequelae during adolescence.

96% of Spanish youth (15-29 years old) use daily Internet. In addition, 83% use Social Networks. Internet could be a good way to spread information through social media, websites, providing material and means to achieve the body culture purpose.

As we have seen in various papers, social media can influence and trigger the development of EDs.

The objetives of the study are to analyse the preferred social network by adolescents diagnosed with eating disorders, as well as to measure characteristic and time-use of these networks.

We decided to undergo a transversal study to analyse the use of social media. For that, we developed a survey to reflect the use of the main social networks (Instagram, Facebook, Snapchat, Twitter, YouTube and Reddit) in adolescents diagnosed with eating disorders in Spain, who are in outpatient treatment in a specialised ED unit.

The total number of adolescents interviewed was 65; of these 96.9% were females and 3.1% males. The mean age was 14.8 years.

The preferred social network was Instagram (54%), followed by TikTok (34%) and YouTube (6%).

Most of the patients interviewed (68%) admitted checking Instagram daily, and 31% reflected spending between 1-3 hours/day. None of the adolescents reported using Facebook or Reddit.

The majority of adolescents (89%) admitted having ignored friend requests while 12% reflected the importance of having a high number of followers as a way of external validation, getting more ‘likes’ and getting to know more people.

The obtained results reinforce the need of exploring and taking into account the use of Social Media in adolescents with ED and how it may influence their pathology. There is a need for further prospective research in this field.

None Declared

According to the literature, about 35% of patients with Anorexia Nervosa (AN) also have a diagnosis of Autism Spectrum Disorder (ASD), and this comorbidity occurs more frequently in males.

With this work, the authors intend to address the characteristics present in this comorbidity and what is the impact of this comorbidity in the diagnosis, approach and prognosis of AN.

Non-systematic research of the literature through the PubMed database with the terms “autism spectrum disorder” and “anorexia nervosa”. Only surveys conducted in the last 10 years were considered for inclusion.

Although AN and ASD may seem to be quite distinct conditions, the studies found suggest the existence of four characteristics that overlap the two diagnoses: deficits in theory of mind, inability to switch between courses of action fluently, inability to see the whole pictures to the detriment of detail and alexithymia. Studies also point to greater resistance to treatment in AN when an ASD is present in comorbidity.

Scientific evidence suggests that autistic characteristics in people with AN are not a consequence of being underweight, but rather stable characteristics present before and after the onset of AN. The studies thus conclude that comorbidity between the two disorders exists and is frequent enough to warrant greater attention to the diagnosis of ASD in people with AN. However, there are still no specific guidelines for the treatment of AN in people with ASD, which leads to a worse response to treatment, evolution and prognosis of AN in people with ASD.

None Declared

Anorexia Nervosa (AN) is an Eating Disorder (ED), being globally characterized by a low body mass index (BMI), intense fear of gaining weight, and distorted body image that motivates extreme food restrictions. The consequence is massive weight loss.

AN is the third leading cause of chronic illness among adolescents and the leading cause of death among psychiatric conditions.

Among patients with AN it is common the occurrence of psychiatric comorbidities, particularly depressive and anxiety syndromes.

Negative emotions are very common and represent either primary aspects of the disease or arise secondarily to psychopathological or organic processes.

The therapeutic options for AN are scarce and only work for a small percentage of subjects.

It is known that difficulty in emotional regulation is one of the defining characteristics of ED, being a core feature of AN psychopathology.

To highlight the importance of understanding the neurobiology of AN, how it is related to emotional processing and future directions for AN´s management.

Non-systematic review of the literature using Pubmed database. Papers were selected according to their relevance.

In recent literature, in purging AN-type (neurobiology similar to Bulimia Nervosa - BN), binge eating is a method of emotional regulation, while in restricting AN-type, food restriction is the way to deal with emotions, mainly negative emotions.

It is known that in AN, patients tend to eat less than usual in response to a negative emotion and more than usual in response to a positive emotion. In BN, the neurobiology works in a mirrored way, patients eat less than usual in response to a positive emotion and more than usual in response to a negative emotion.

In short, in the face of negative emotions, subjects with AN respond with dietary restriction and, subjects with BN respond with binge eating. On the other hand, more positive emotions seem to resolve the maladaptive eating behaviours inherent to both ED, with AN and BN subjects tending towards more balanced eating behaviours.

One of the brain areas most implicated in the neurobiology of AN is the left dorsolateral prefrontal cortex (L-DLPFC), since this region is recognized as being involved in decision-making process and emotional regulation, and is therefore the target of novel and experimental treatment strategies, namely those related with neuromodulation, particularly Transcranial Magnetic Stimulation (TMS).

Emotional regulation, particularly the processing of negative emotions, appears to be a key element in the neurobiology of AN.

With new neuromodulation techniques, specially TMS, it seems possible to modulate the neuronal circuits inherent to emotional processing, such as the L-DLPFC.

Future randomized clinical trials are needed in order to understand how neuromodulation can contribute to exploring the neurobiology of AN and to become more targeted and effective therapeutic options.

None Declared

Eating disorders severely impair psychosocial functioning, physical health, and quality of life. In particular, Anorexia Nervosa has the highest mortality rate among all psychiatric diseases. Other Specified Feeding or Eating Disorders have the highest lifetime prevalence with weighted means of 7.64% for women. Eating disorders are considered hard-to-treat, and studies have indicated that people suffering from eating disorders prefer low-threshold interventions compared to traditional mental health care. International studies show promising results of internet-based interventions for Other Specified Feeding or Eating Disorders.

To test the effectiveness of an internet-based psychologist-guided cognitive behavioral treatment program (I-TREAT) to reduce eating disorder symptoms in Danish adolescents and adults with Other Specified Feeding or Eating Disorders.

This study is a randomized controlled trial with two arms: 1) an intervention group and 2) an active control group. Participants are adolescents from the age of 15 or above, as well as adults, diagnosed with Other Specified Feeding or Eating Disorders. The intervention group receives the I-TREAT program while the control group receives self-guided mindfulness exercises. I-TREAT comprises 12 text-based treatment sessions with psychoeducation and treatment-related tasks, based on cognitive behavioral therapy and elements of compassion-focused therapy. The treatment duration is approximately 12 to 36 weeks. Videos, pictures, and animations support the treatment content and the program is accessible by web-browser and app. A specialist in eating disorders guides the patient through treatment with task-related feedback and asynchronous written communication. Patients will answer questionnaires regarding eating disorder symptoms, quality of life, and motivational states before, during, and after treatment, with follow-up measures at 3, 6, and 12 months. We expect to include 63 patients to each group and commence recruitment in August 2023. Preliminary results from a feasibility study on I-TREAT show good evaluations from clinicians and patients (N=30).

No results have yet been obtained. The results will be submitted to international scientific journals and presented at conferences.

The internet-based cognitive behavioral treatment program I-TREAT may be a promising tool for effectively treating adolescents and adults with Other Specified Feeding or Eating Disorders in Denmark.

None Declared

Management of patients with anorexia nervosa (AN) desires psychiatric/medical care. In average AN disease onset they represent a younger generation than 18 y.o. In this age typically children and adolescents are under regular dental care. Whether young AN patients should be included to intensive oral supervision may be still questionable. In literature little information on changes in oral cavity caused by AN were reported.

Therefore, the aim of the study was to evaluate caries incidence, tooth wear, gingival inflammation, and oral hygiene level among adolescent AN inpatients, highlighting the aspect of oral health manifestations in case-control study.

Based on clinically confirmed 130 AN restrictive subtype hospitalized female subjects (BMI <15 kg/m2, age 14.8±1.8), dental status has been examined regarding the occurrence of caries lesions using Decay Missing Filling Teeth (DMFT), erosive wear as Basic Erosive Wear Examination (BEWE), gingival condition as Bleeding on Probing (BOP) and plaque deposition as Plaque Control Record (PCR). The results were compared with age-matched 110 female controls (BMI 19.8±2.3 kg/m2, age 15.5±1.8, p=0.744) dentally caried in public University dental clinic (p<0.05) in the same time period.

AN patients compared with healthy adolescents were found to present higher incidence of oral-related complications according to dental status (DMFT 3.9±4.5 vs. 2.0±1.8, p=0.005), erosive tooth wear (BEWE 18.9% vs. 2.9%, p<0.001), less efficient in controlling plaque (PCR 43.8% vs. 13.7%, p<0.001) and gingival inflammation (20.0% vs. 3.9%, p<0.001). AN group, a significant correlation between BOP, BEWE, and duration of AN symptoms (p<0.05), similarly to the number of decayed teeth D, filled teeth F and PCR were detected (p<0.05).

Although the obtained results did not reveal any severe oral complications, AN diagnosis in adolescence may influence to numerous oral-related symptoms from dental caries, the onset of erosive tooth wear, failure in dental hygiene to be continuated as gingival inflammation. After AN diagnosis a regular preventive intervention should be performed during dental recall sessions. There is a need for professional oral hygiene/diet instructions combined with regular oral check up visits to avoid oral complications and disease progress. For clinical revelance an active collaboration between psychiatric and dental specialists is needed.

None Declared

Telepsychiatry (TP) uses communication technology to provide psychiatric consultation to patients unable to reach consultation services. Due to COVID-19 outbreak, many mental health services implemented TP. The University of Milan developed a patient-specialist video consultation service: the Cure Ospedaliere Domiciliari (Home Hospital Care system; COD20).

The aim of the study was to assess the digital skills of the mental health professionals and to assess both the confidence and the satisfaction with the COD20 platform, as well as their skills in handling certain degrees of technostress.

Mental health professionals of the outpatient clinics of the department were interviewed through an online anonymous survey. Data collected were sociodemographic, job position, educational level, digital skills, adequacy of devices in the workplace, satisfaction degree, ease of use of the COD20 tool, as well as main technostress score. Data were analyzed using SPSS v.27.

Among 95 subjects, more than 95% of the sample is familiar with the use of electronic devices, such as smartphones, tablets, and computers; 93% employs appropriate devices in the workplace. Only 12% had an ECDL certificate, while the majority of the sample (77%) learnt the use of electronic devices independently. The levels of the digital skills were considered intermediate-advanced for communication and information research. Despite all the respondents being aware of the use of COD20, only 50% received adequate training; 77% deemed it worthwhile to attend an individual or a group training (40% vs 43%). Telemedicine was used for clinical interviews by 80% of the sample: 41% of these used Telemedicine at least 10 times/year, 18% between 10 and 20 times/year, and 42% more than 20 times/year. With regard to the appreciation of the COD20 platform, 75% of the sample considered this tool useful, while 61% considered it easy to use. There is a significant correlation between the ease of use and a higher level of education (p<0,00). Among all categories, psychologists were more likely to use the platform compared to other workers ( p=0,016). The average score of technostress among operators was 22.78±6.84 (maximum score: 45).

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TP can improve mental health professionals’ working conditions. The COD20 platform represents a valid implementation in mental health care. It is necessary to provide training and updated programs for healthcare workers in order to facilitate the use of TP tools.

None Declared

Telepsychiatry (TP) is the use of telecommunication technologies to provide psychiatric assessment, diagnosis, treatment, and consultation. During the COVID-19 outbreak, TP has shown potential for connecting with people unable to access traditional in-person services, and also enabling patients to receive mental health care safely from home. The Home Hospital care system (Cure Ospedaliere Domiciliari; COD20) is a video consultation service developed by the University of Milan.

We aimed at investigating the potential of Telemedicine (TM) in a sample of psychiatric patients.

As of now, 208 consecutive patients of an outpatient clinic belonging to ASST Fatebenefratelli-Sacco in Milan were interviewed through an online anonymous survey. Data collected were sociodemographic, job position, educational level, digital skills and both satisfaction degree and ease of use of the COD20 tool. Data were analyzed using SPSS v.27.

Among 208 patients, 87.7% had Internet access, 94.5% used a smartphone, 74% used a computer and 37% used a tablet. The levels of digital skills were considered intermediate-advanced in communication and information research for the majority of the cases. A high percentage of patients (80.8%) learned how to use electronic devices by themselves, while only 12.3% had an ECDL certificate. The most represented diagnoses were Mood Disorders (44.5%) and Anxiety Disorders (14%). The majority of the sample (54.8%) was visited using TM for clinical interviews: 24.7% of them used TM at least 10 times/year, and 19.8% more than 20 times/year. Among all the clinical interviews conducted using TM, 61% concerned psychiatric consultation, while 30% were dedicated to psychotherapy. The most used tool was the COD20 platform (21.9%): it was considered easy to use in 47.9% of cases, while 43.8% of patients would like to use it again in the future. The main reasons leading to the usage of TM were the difficulties in reaching the ambulatory (for 43.9%) and the workplace (for 30%).

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TM represents a valid implementation in the traditional clinical practice, and we showed it is well received in terms of appreciation and ease of use. The COD20 platform could increase access to care, and overcome barriers such as distance, travel costs and time management. TP contributes to develop a more inclusive healthcare process for patients, with better performance in terms of compliance.

None Declared

Suicide is a leading cause of preventable death in the world. Interventions that can quickly reach a large and geographically dispersed population are needed. Web-based programs are potentially cost-effective, allowing continuity of care. The iFightDepression-SURVIVE (iFD-Survive) is a web-based program designed as an add-on to iFightDepression, a tool developed by the European Alliance Against Depression to target depressive symptoms (https://ifightdepression.com/en/). iFD-Survive is based on dialectical behavioral therapy skills and includes four modules: a safety plan, mindfulness, emotion regulation, and distress tolerance. The content is presented in various formats, including audio, videos, and registers. In addition, weekly telephone support is offered by a mental health nurse.

To investigate the feasibility (acceptability, usability, and satisfaction) of the iFD-Survive.

30 participants who received the intervention as part of a large RCT completed an online survey. To receive the intervention, participants needed to meet the following criteria: 1) digital literacy, 2) having attempted suicide in the last month, and 3) PHQ-9 scores above 5. The online survey included an ad-hoc questionnaire to collect socio-demographic data and data regarding participants’ opinions on the program’s content. The following instruments were also administered:

System Usability Scale (SUS)

Credibility of analogue of therapy rationales

Most respondents were women (20/30), with a mean age of 44 years, and secondary studies (15/30). Most participants (57%) used a mobile phone to access the website and regarded it as “easy to use” (53%). According to the SUS, many of them (57%) reported that they would like to use it frequently and that the tool was “easy” and “safe” to use (53%). Regarding acceptability, 47% of the sample indicated that the iFD-Survive content was adequate to improve their symptoms, and 56% considered that their symptoms of depression have improved as a result of the intervention. 83% of the sample considered telephone follow-up “very useful.” The majority (70%) consulted the program once a week. The “safety plan” and the mindfulness module were regarded as the most useful, followed by “distress tolerance.” The audio for practicing mindfulness skills and the written material were considered very useful, while the videos were valuable.

Online tools can promote continuity of care, helping to prevent further suicide attempts in vulnerable populations. These preliminary findings suggest that the iFD-Survive is feasible among participants with depressive symptoms who have recently attempted suicide. However, these results are based on a small sample of highly educated women; therefore, future research is needed to determine if these can be transferred to other sub-populations.

None Declared

Existing digital mental health interventions are mainly focused on the symptoms of specific mental disorders such as depression and anxiety. However, digital mental health interventions aiming enhancement of mental health in the general population are rare. Considering that the psychological discomfort of the general public is more complex and subtle, interventions focusing on maladaptive personality and interpersonal schema rather than symptoms per se can be an alternative.

To this end, concise tools for measuring the core personality and interpersonal patterns known to cause psychological discomfort among potential users of digital mental health interventions are essential. For this purpose, the Schema Scale was developed and our study aims to validate and confirm psychometric properties of the scale.

This cross-sectional study was carried out between July and August 2022. Participants were 234 adults aged between 19 to 39 who completed an online survey including the Schema Scale and other 15 questionnaires. Exploratory factor analysis were conducted to construct the factorial structure model.

Exploratory factor analysis showed a five-factor structure with a total variance of 57%; factor 1 consisted of lack of belongingness and poor social skills, factor 2 of lack of patience hot-tempered coping style, factor 3 of maladaptive perfectionism, factor 4 of self-sacrifice and lack of self-confidence and factor 5 of items representing pessimistic and anxious mindset. Internal consistency of each factor was good(Cronbach’s alpha=0.712~0.882), and correlations with existing measures were significant.

The five personality Schema Scale appears to be a short(total 35 items) and a valid tool for measuring five essential personality and interpersonal patterns for adults aged 20~30 years. This tool has been developed for online use and therefore has the advantage of being easily accessible. Most importantly, based on the results of the Schema Scale, the individualized digital interventions can be recommended that targets maladaptive psychological patterns.

None Declared

Virtual reality (VR) enables immersion in an interactive digital world with realistic experiences, that can be applied for controlled and personalized interventions.

This presentation aims in summerizing the current research on VR in the treatment of mental disorders.

Selective literature search in PubMed and Google Scholar.

An increasing number of publications report the therapeutic application of VR for the treatment of mental disorders. Most VR applications are based on established therapy approaches, such as exposure therapy. According to meta-analytic data, virtual exposure therapy (VRET) for specific phobia and agoraphobia with panic disorder is as effective as traditional in vivo exposure therapy. VRET for the treatment of social phobia is significantly more effective than waitlist and placebo control groups with, however, currently inconsistent metanalytic results when compared to in vivo exposure therapy. VRET for the treatment of posttraumatic stress disorder (PTSD) is similar in effectiveness compared to active psychotherapy. For psychosis, positive results have been reported for the VR-based treatment of auditory verbal hallucinations. For patients with a substance use disorder, VR can induce craving, with still unverified diagnostic and therapeutic relevance.

VRET can broaden the psychotherapy options for anxiety disorders. Encouraging results of VR-based treatments for psychosis and PTSD indicate the need for further research concerning its effectiveness and safety. In the field of substance use disorders, evaluation of clinical-orientated VR applications is needed.

N. Tsamitros Grant / Research support from: Berlin Institut of Health (BIH) through the Digital Health Accelerator Program

In individuals with first episode psychosis (FEP) and cannabis use disorder (CUD), reducing cannabis use is associated with improved clinical outcomes. Access to evidence-based psychological interventions to decrease cannabis use in FEP clinics is highly variable; E-mental health interventions may help to address this gap. Development of E-interventions for CUD in individuals with FEP is in its incipient phases.

To assess preferences for online psychological interventions aiming at decreasing or stopping cannabis use in young adults with psychosis and CUD.

Individuals aged 18 to 35 years old with psychosis and CUD were recruited from seven FEP intervention programs in Canada and responded to an electronic survey between January 2020-July 2022. We used the Case 2 Best Worst Scaling methodology that is grounded in the trade-off utility concept to collect and analyse data. Participants selected the best or worst option for each of the nine questions corresponding to three distinct domains. For each domain we used conditional logistic regression and marginal models (i.e., three models in total) to estimate preferences for attributes (e.g., duration, frequency of online intervention sessions) and attribute levels (e.g., 15 minutes, every day).

Participants (N=104) showed higher preferences for the following attributes: duration of online sessions; mode of receiving the intervention; method of feedback delivery and the frequency of feedback from clinicians (Table 1). Attribute-level analyses showed higher preferences for participating once a week in short (15 minutes) online interventions (Figure 1). Participants valued the autonomy offered by online interventions which aligns with their preference for completing the intervention outside the clinic and only require assistance once a week (Figure 2). Participants’ preferences were higher for receiving feedback related to cannabis consumption both from the application and clinicians at a frequency of once a week from clinicians (Figure 3).Table 1.Preferences for Attributes. Results of conditional logistic regression

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Using advanced methodologies to assess preferences, our results can inform the development of highly acceptable E-Mental health interventions for decreasing cannabis use in individuals with CUD and FEP.

None Declared

Psychiatryai.com is a prototype Artificial Intelligence (AI) and Data Science (DS) platform and research project developed for my Evidence-Based Healthcare (EBHC) course at University of Oxford in MSc studies (Kellogg College). This is a singular, multi-disciplinary, and beta-testing project in Computing Science, Psychiatry, and Mental Health for oral presentation at EPA 2023.

AI and DS in Psychiatry and Mental Health have emerged as important research areas in the post Covid-19 pandemic era. This prototype University project (Psychiatryai.com) was launched on 22nd November 2021. It aims to develop a free, secure, and open access platform in near real-time about psychiatry and mental health evidence-based research - for healthcare professionals, doctors, and researchers in psychiatry. The project also aims to integrate findings from the Goldacre Review (2022) into practice and develop novel computing solutions utilising AI and DS, and present findings.

A WordPress site (Psychiatryai.com) was developed with syndicated RSS feeds across 330 psychiatry topics and refreshed by data servers hourly, 24 hours a day, 7 days a week. A total of 43 WordPress plugins were utilised to develop this secure platform. The site is powered by intuitive data modelling and analytics in near real-time and available in open access coding format for peer-review, future development, and research. The primary sources of live evidence for the project are PubMed and University of Helsinki, Finland. The server performance data analytics will be available for poster presentation at EPA 2023. This includes full statistical results and discussion since its inception and launch (including traffic, MESH tags, and PubMed ID), and robust technical analysis and performance outcomes - available freely online to promote research in psychiatry and mental health.

Knowledge Synthesis and Dissemination:

Total Words: 4356886 *

Live Psychiatry and Mental Health Citations from PubMed: Exceeds 325000

Total Evidence Alerts Published: 54391 *

Total Algorithms/Topics: 330

Total site visitors: 8023 *

* Since launch of Psychiatryai.com on 22 November 2021 inclusive to 31 October 2022

Psychiatryai.com was able to demonstrate succesful development of an effective and viable platform to study AI and DS in Psychiatry and Mental Health, as evidenced by results table. The platform has also incorporated findings from the Goldacre Review (2022) and aims to continue to collect valuable insights towards full real-time data analytics and dissemination of peer-reviewed current evidence in the future. The emergence of these technologies will be useful in settings such as disaster psychiatry, psychiatry e-training and research, and e-mental health awareness/promotion ahead.

P. Naik Consultant of: Dr Paras Naik (Psychiatryai.com) Non-profit University Project

Non-Medical Use of Anxiolytics (NMUA) and sedatives is a focus of scientific interest worldwide. In Tunisia, no national epidemiological data related to this issue, are published.

We aimed to determine the prevalence of NMUA in Tunisian adolescents and assess specificities from a gender scope.

Data from the 2021-Mediterranean school Survey on Alcohol and other Drugs (MedSPAD) were used. Based on random sampling method (three-stage stratification), high school teenagers in first and second year of secondary education, were enrolled. Data were collected using a self-administered standardized questionnaire assessing socio-demographic characteristics, and specific questions related to NMUA (among adolescents and close environment), perceived accessibility and initiation age. We studied weighted prevalence estimates of NMUA at least once in a lifetime, presented with 95% Confidence Interval (CI). Epi data software was used for data entry and statistical analysis was performed with STATA software.

The survey included 6.201 adolescents with a mean age of 16.8 years and sex ratio F/M equal to 1.5. Only half of surveyed adolescents, perceived accessibility to NMUA as “impossible” and almost 20% had at least one family member or friend using a nonmedical prescription of anxiolytics. The overall prevalence of NMUA was (8.4%; 95% CI [7.6-9.2]), significantly higher among girls (9.8% Vs 6.1%, p-value<10-4). Initiation age was over 13 years for almost 70% of consumers.

Our study highlighted high prevalence of NMUA, mainly among girls. Although COVID mental health impact might have a role in explaining our findings; however, decisions makers should be aware of non-medically prescribed anxiolytics accessibility especially among this vulnerable population. Audit prescription monitoring programs should be reinforced, and multisectoral collaboration should be reinforced to promote adolescents mental well being and avoid falling into addiction trap.

None Declared

Cannabis use is wrongly deemed “safe” by teenagers worldwide, despite its increased tetrahydrocannabinoids content and its psychosocial and cognitive harmful effectts.

We aimed to estimate the prevalence of cannabis use, identify associated factors among Tunisian adolescents and assess the risk of problem cannabis use among users.

The 2021-Mediterranean School Survey Project on Alcohol and Other Drugs (MedSPAD) is a national survey, targeting Tunisian high school adolescents aged 16 to 18 years.

Based on a self-administered questionnaire, adolescents were asked about their engagement in several risky behaviours including cannabis use. The 6-item Cannabis Abuse Screening Test (CAST) was intended for users to assess the risk of problem cannabis use.

Binary logistic regression was performed to identify factors associated to cannabis use and Adjusted Odds Ratios (AORs) were presented with correspondent 95% confidence intervals (CI). Cspro and STATA software were used for data entry and analysis respectively.

Among 6201 participants (girls: 60.4%), lifetime prevalence of cannabis use was 7.9% ,95% CI [7.0, 8.9] significantly higher among boys (16.1 % Vs. 2.5 % in girls, p<10-4). Early onset (at 13 or younger) was reported by 8.6% of users.

Multivariate analysis showed that cannabis use was more prevalent in Tunis district(p=0.04), and significantly associated to alcohol, tobacco and electronic-cigarettes use (AOR of 6.2, 4.2 and 2.6 respectively, p<10-3). Absenteeism for non-medical reasons and nights spent away from home were also independent factors significantly associated with cannabis use (p<10-3).

The CAST indicated a high risk of cannabis-use-related problems in 67.2% of respondents (n=223).

Cannabis use is increasingly common in Tunisian adolescents. Moreover, the alarming risk of problem cannabis use warrant the urgent need for school-based interventions and screening programs to prevent and control cannabis use especially among vulnerable subgroups.

None Declared

The emergence of New Psycho-active Substances (NPS) such as Synthetic cannabinoid and cathinone, represents a challenging issue for drug policy globally. In order to set up new adjusted measures to limit this phenomenon extension, objective epidemiologic indicators are requested.

We aimed to determine the prevalence of Synthetic cannabinoid and cathinone consumption in Tunisian adolescents by gender and regional distribution.

Data from the Mediterranean school survey on alcohol and other drugs (MedSPAD III-2021) were used. Based on three-stage stratification sampling method, high school teenagers in first and second grades of secondary education, were enrolled. Data collection was performed using a self-administered standardized questionnaire. We examined weighted prevalence estimates of NPS use at least once in a lifetime (Synthetic cannabinoid and cathinone) by gender and regional distribution. Epi data software was used for data entry and all statistical analysis were performed with STATA software.

The survey included 6201 adolescents with a mean age of 16.8 years and a sex ratio female/male of 1.5. Synthetic cannabinoid’s use was reported by 1.9%, 95% CI [1.57-2.39] of students, with statistically significant difference between boys (4.1%) and girls (0.6%), p-value<10-4 . This consumption was the highest in Tunis the capital city, the center-east and the north-east (2.7%, 2.2% and 2% respectively). As for synthetic cathinone’s use, it was reported by 0.36% 95%CI [0.24-0.56] of our study sample, with statistically significant difference between boys (0.8%) and girls (0.8%), p-value<10-4 .

Our study highlighted an emerging use of NPS among high school students with significant male predominance. Further research on NPS epidemiology is, hence, needed to reinforce evidence-based management strategies aiming at fighting this phenomenon. Sensitization of decision makers to control accessibility, and increasing awareness among adolescents’ close family / school-staff environment regarding this issue, are strongly recommended.

None Declared

Air pollution is related to a global increase in mortality and morbidity. The literature on the adverse effects on mental disorders is still limited.

This study aims to investigate the associations between air pollutants and traffic noise with incidence of different categories of mental disorders and drug prescriptions in a large cohort administrative cohort.

We enrolled 1,739,277 individuals 30+ years living in Rome at 2011 census, and followed them up until 31st December 2019. We excluded subjects with prevalent mental disorders at baseline to evaluate the incidence of schizophrenia, bipolar, anxiety, personality and substance use disorders, as well as prescriptions of antipsychotics, antidepressants and anticonvulsants. We assigned annual average concentrations of fine particulate matter (PM2.5), nitrogen dioxide (NO2), Black Carbon (BC), ultrafine particles (UFPs) and noise exposure to baseline residential addresses. We applied Cox regression models with adjustment for individual and area-level covariates.

This study identified variable numbers of incident cases, from 1,280 cases for personality disorders to 200,549 for antidepressants. Each interquartile range increase in PM2.5 (1.13μg/m3) was associated with a hazard ratio (HR) of 1.07 (95% confidence interval: 1.017, 1.127) for schizophrenia spectrum disorder, 1.135 (1.086, 1.186) for depression, 1.097 (1.030, 1.168) for anxiety disorders and 1.112 (1.030-1.200) for substance use disorders. Positive associations were also detected for the other exposures and with the three categories of drug prescriptions. In two-exposure models, PM2.5, UFPs and noise remained associated with schizophrenia spectrum disorders, depression and antidepressant drugs use. The effects were higher in the age group 30-64 than in the 65+. Sensitivity analyses generally yielded similar results

Long-term exposure to air pollutants and noise was associated with increased risks of schizophrenia spectrum disorders, depression and anxiety disorders. The associations with prescriptions of specific drugs increase the credibility of the results.

None Declared

The context of the COVID-19 pandemic has changed the daily life of families and children. Screen exposure was increased during this period to maintain social relationships, work remotely, and occupy leisure time.

To explore the association of continued above-recommendation screen use for one year since May 2020 with behaviour problems in the summer of 2021 in children aged 3 to 14 years.

Data came from the French EpiCov cohort study, and were collected in May 2020 and at first (Autumn 2020) and second follow-up (Summer 2021) among 1,089 participants with children aged 3 to 14. Children had a 1-year above-recommendation screen use if their daily mean time exceeded recommendations at the three follow-up times (one hour, for children aged 3-5, two for the older ones). Behaviour problems were assessed using the Strengths and Difficulties Questionnaire (SDQ) and valid cut-offs for Internalizing (emotional or peer problems) and Externalizing (conduct problems or hyperactivity/inattention) problems completed in summer 2021. Data were analysed using adjusted logistic regression.

1-year above-recommendation screen use was not associated with internalizing problems (OR [95% CI]: 1.20 [0.90-1.59]). Regarding the subscales, it was associated with a higher risk of peer problems (1.42 [1.04-1.95]). A higher risk of externalizing problems was found only in 11-14-year-olds (1.63 [1.01-2.63]), especially conduct problems in 11-14-year-olds (1.91 [1.15-3.22]) but not in other age groups.

This study found that maintaining screen time beyond recommendations for 1 year since the onset of the pandemic was associated with peer problems in children aged 3-14 years and externalizing and conduct problems in 11-14 years. Despite this very specific context, exposure to screens is not trivial. If this situation were to occur again, we would have to anticipate, with prevention messages, by keeping schools open.

None Declared

Cigarette smoking prevalence is significantly higher among people with mental health problems than among the general population. Smoking accounts for much of the reduction in life expectancy associated with mental illness, why the high co-occurrence of smoking and mental health illness is a major public health concern. Persons belonging to socioeconomical disadvantaged groups have higher risk of mental health conditions and also higher smoking rates.

In this study we aim to examine smoking trajectories among adult smokers between 2012 and 2020. Furthermore, we aim to investigate differences in smoking trajectories by adult depression by taking into consideration participants intergenerational socioeconomic mobility (ISEM).

Analyses were based on data from CONSTANCES, a French general population cohort conducted from 2012 to 2020. In total were 107,734 participants included after exclusion of never smokers. Depression was measured by the CES-D scale, and depression was classified with a score ≥16. ISEM is based on childhood (maternal and parental occupational grade) and adult socioeconomic position (SEP), and low ISEM includes those with low SEP as child and adult and high ISEM those with consistent high SEP. Group-based trajectories modelling (GBTM) was used to determine smoking status trajectories. To address the association between ISEM and smoking trajectory class we used multinomial logistic regression with former smokers as reference class adjusted for depression, household income, sex and age.

We identified five smoking trajectories 1) Former smokers (56.6%), 2) Long-term smokers (26.4%), 3) Intermediate smokers (3.3%), 4) Early quitters (5.0%) and 5) Late quitters (8.7%). Preliminary results from multinomial logistic regression showed that persons with low ISEM had higher odds of depression (OR [95%CI]=1.91 [1.77;2.06]) than those with high ISEM. Participants with low ISEM had higher odds of being long-term smoking than former smokers compared to those with high ISEM (ORa [95%CI]=1.55 [1.43;1.67]). Furthermore, those with low ISEM had lower odds of being in any of the other smoking trajectory groups vs. former smokers compared to those with high ISEM (ORa [95%CI]=0.82 [0.69;0.97]) for intermediate smokers, ORa [95%CI]=0.75 [0.66;0.85]) for early quitters, and ORa [95%CI]=0.78 [0.70;0.87]) for late quitters).

Preliminary results showed an association between ISEM and smoking trajectories in our study. Persons with low ISEM are more likely to be long-term smokers. Future analysis should consider the effect of depression as a mediating factor on the association between ISEM and smoking trajectories.

None Declared