Family History Of Psychiatric Disorders Research Articles

Evaluation of MMP-9 enzyme in drug-induced suicide cases admitted to the emergency room

ObjectiveThis study investigates MMP-9 enzyme levels in patients who attempted suicide by taking high doses of drugs, considering their sociodemographic characteristics. MethodsThe study included 45 patients who attempted suicide by high-dose drug intake admitted to the emergency room and 45 healthy volunteers with no neuropsychiatric disorders. Blood samples were collected to measure MMP-9 levels, and informed consent was obtained. The samples were centrifuged and analyzed using the ELISA method, with results statistically compared. ResultsFindings indicate that being single and a student significantly increased suicide tendencies (p = 0.002 and p = 0.001, respectively). Psychiatric disorders were the most common cause at 40.0%, followed by antidepressants (55.6%), analgesics (20.0%), and antidiabetics (8.9%) as the most used drugs for suicide. MMP-9 levels were significantly higher in patients who attempted suicide compared to controls (83.74 (±7.14) ng/mL vs. 54.97 (±12.27) ng/mL, p = 0.001). Additionally, MMP-9 levels were higher in single patients compared to married or divorced individuals (p = 0.008). MMP-9 levels were lower in patients with psychiatric disorders, recent psychiatric services, family history of psychiatric disorders, and previous suicide attempts (p = 0.014, p = 0.046, p = 0.035, p = 0.034). ConclusionsThis study shows MMP-9 enzyme can be a potential biomarker for drug-induced suicide attempts, emphasizing the importance of evaluating MMP-9 levels to assess suicide risk and develop prevention strategies.

7173 Cabergoline Induced Psychosis in a Patient with no Previous History of Psychiatric Disorder

Abstract Disclosure: B. Aryal: None. K. Kim: None. A. Shafi: None. M. Ganesh: None. Introduction: Cabergoline is a dopamine agonist (DA) used to treat prolactinomas. It is well established that DAs may cause psychotic symptoms. However, very few cases report cabergoline-associated psychosis in patients without personal or family history of psychiatric disorders. We report a rare case of cabergoline-induced psychosis in a patient with a prolactinoma without any underlying psychiatric disorder, which was managed with the addition of olanzapine. Case: A 41 year old male with no history of psychiatric disorder was started on cabergoline 0.5mg twice a week for a newly diagnosed prolactinoma. 4 weeks later, he presented to the emergency room for aggressive behavior and confusion for the past 2 weeks. He endorsed visual and auditory hallucinations. Cabergoline was discontinued. During hospitalization, he attempted suicide and required 1:1 observation. He was started on olanzapine per the inpatient psychiatry team. Surgical resection of the prolactinoma was considered given his acute psychosis associated with cabergoline. However, complete resection of the tumor was deemed impossible given encasement of the internal carotid arteries. After discussion with the patient, he underwent re-challenge with cabergoline 0.25mg weekly while on olanzapine under 1:1 observation in the ICU. He was monitored for 2 weeks and eventually discharged home on cabergoline 0.25mg twice a week and olanzapine with improvement in prolactin levels to 4973.7 ng/mL after 4 weeks. He continued to remain free of psychotic symptoms upon follow up as an outpatient. Discussion: Psychosis is a rare side effect of DA mediated via D2/D3 receptors in the mesocortical and mesolimbic pathways. Several cases report psychosis associated with cabergoline in patients with a history of psychiatric disorders. However only one case reports de novo psychosis. Our patient developed severe psychosis while on low-dose cabergoline for 4 weeks. This rare case of de novo cabergoline-associated psychosis re-emphasizes that psychosis may occur regardless of previous history of psychiatric disorder and independent of the dose or duration of cabergoline. Treatment of a prolactinoma in the setting of cabergoline-associated psychosis requires a multidisciplinary approach. Alternative treatment of surgical resection was considered for our patient. However surgical resection was not plausible given difficult surgical anatomy. Therefore he was monitored closely to re-initiate cabergoline while on olanzapine. Several cases report successful use of clozapine, aripiprazole, and quetiapine for patients with psychiatric symptoms while on cabergoline. Patients who are on cabergoline should be closely monitored for any psychotic symptoms. Further studies are warranted to identify patients at risk of developing psychosis while on cabergoline to tailor an individualized approach to therapy and monitoring. Presentation: 6/2/2024

A familial subtype of gambling disorder.

Although family history of psychiatric disorders has often been considered potentially useful in understanding clinical presentations in patients, it is less clear what a positive gambling family history means for people with gambling disorder. We sought to understand the clinical impact of having a first-degree relative with gambling disorder in a sample of adults with gambling disorder. Data from 455 participants (aged 18-65 years) who had participated in previous pharmacological and psychotherapeutic clinical trials for gambling disorder were pooled in a secondary analysis. Demographic and clinical variables were compared between those who did versus did not have one or more first-degree relative(s) with gambling disorder. Additionally, we examined whether a family history of gambling disorder was associated with treatment outcome. 223 (49.0%) participants had at least one first-degree family member(s) with gambling disorder. In terms of clinical variables, family history of gambling disorder was significantly associated with being female, having an earlier age of gambling onset, longer duration of untreated gambling illness, a greater likelihood of developing legal problems secondary to gambling, and higher rates of alcohol use disorder in family members. Family history of gambling disorder was also associated with a greater gambling symptom improvement frompharmacotherapy. These results indicate that gamblers with a first-degree family member with a gambling disorder may have a unique clinical presentation and better response to treatment interventions.

Anxio-depressive disorders, traumatic symptoms, and suicidality among limb amputees: A cross-sectional and prospective study

IntroductionLimb amputation represents an ultimate therapeutic option in certain severe or progressive pathologies. We conducted this study to describe anxio- depressive disorders, traumatic symptoms, and suicidality among limb amputees, as well as factors associated with their occurrence. Materials and MethodsThis was a cross-sectional and prospective descriptive and analytical study conducted over a two-year period from October 2020 to October 2022, at the following departments of the Mohammed VI University Hospital Center in Oujda: Traumatological and Orthopedic Surgery departements A and B, and Peripheral Vascular Surgery departement, involving 122 patients. ResultsThe average age of our patients was 46.42 ± 14.76 years, with a predominance of males (male-to-female ratio of 2.21). Preoperative assessment of patients occurred 6 to 24 hours before amputation. Immediate postoperative evaluation took place on average 2.18 ± 1.53 days after surgery, ranging from 1 to 8 postoperative days. The prevalence of anxio-depressive disorders according to the MINI scale was 77%, comprising Depression (9%), Adjustment Disorder (36.9%), Acute Stress Disorder (20.5%), Post-Traumatic Stress Disorder (6.6%), and Anxiety Disorders (10.7%), with suicide attempts reported in 16.4% of cases. The mean score on the Hamilton Depression Rating Scale for our patients was 10.81 ± 3.27, on the Hamilton Anxiety Rating Scale was 16.33 ± 5.54, and on the Ducher Suicide Risk Scale was 0.82 ± 1.33. ConclusionThe occurrence of postoperative anxio-depressive disorders, traumatic symptoms, and suicidal behavior is associated with the following factors: male sex, personal history of depression, family history of psychiatric disorders, quality of diagnostic disclosure, postoperative sleep disturbances, postoperative panic attacks, psychological support, and socio-professional reintegration.

Clinical Features, Psychiatric Comorbidities and Treatments in Childhood OCD in terms of OCD Severity, Age and Gender

Objective: The aim of this study was to investigate the clinical features, psychiatric comorbidities, and treatments of childhood obsessive-compulsive disorder (OCD), with consideration given to OCD severity, gender and age. Method: The study included 104 children and adolescents between the ages of 6 and 17 who were diagnosed with OCD and followed up in Child and Adolescent Psychiatry outpatient clinics between 2016 and 2023. The study examined the sociodemographic characteristics, clinical features, comorbid psychiatric disorders, and treatment approaches of children and adolescents with OCD. Results: The sample had a mean age of 13.1 ± 2.7 years, and the mean age at onset of OCD was 11.9 ± 2.7 years (range: 5-17 years). Those with mild OCD had a significantly lower mean age at presentation and onset of OCD compared to those with moderate and severe OCD (p=0.012, p=0.02, respectively). Patients with severe OCD had longer illness duration (p=0.009) and outpatient follow-up (p=0.004) compared to those with moderate OCD. Boys had significantly higher rates of family history of psychiatric disorders (p=0.006), attention-deficit/hyperactivity disorder/oppositional defiant disorder (p=0.003), and tic disorder (p=0.035) comorbidity rates than girls, while girls had higher rates of anxiety disorders (p=0.022) comorbidity. The study found that repeating and counting compulsions were more common in adolescents than in preadolescents (p=0.003, all). Conclusion: These results suggest that clinical presentation and comorbidity may vary with disease severity, gender and age, in children and adolescents with OCD. Early intervention is crucial to prevent clinical progression, worsening, and mental health sequelae.

Prevalence of the generalized anxiety disorder in Tunisia: A study of 707 primary care outpatients.

This study examined the prevalence and correlates of generalized anxiety disorder (GAD) among primary care outpatients. A multicenter, cross-sectional study was conducted that included 707 primary care outpatients being seen at 20 primary healthcare centers in Tunis and Sfax, Tunisia. The Mini International Neuropsychiatric Interview was used to identify a diagnosis of GAD. The Beck Depression Inventory was used to assess depressive symptom severity, and the Sheehan Disability Scale (SDS) was used to measure functional impairment. The prevalence of GAD was 11%. GAD was positively correlated with female gender (P = .005), family history of psychiatric disorder (P < .001), personal history of suicide attempt (P = .019), and depressive symptoms (P < .001). Based on the SDS, severe to very severe functional limitations were reported at work, in social life, and family life (56.4%, 60.2%, and 73.1%, respectively) among GAD patients. This study indicated a relatively high prevalence of GAD among primary care patients in Tunisia. Risk factors were also determined that may help to identify these patients. This information may help primary care physicians recognize this diagnosis and provide timely referrals to mental health professionals to prevent complications and preserve quality of life.

Olanzapine-Induced Mania: A Case Report with New Characteristics

Abstract olanzapine is an atypical antipsychotic widely used for the treatment of mania as monotherapy. In this case, it paradoxically caused mania symptoms in a 40-year-old patient with intermittent explosive disorder. This case presents different characteristics from previous reports, suggesting a direct link between olanzapine and mania symptoms. The patient did not have any psychotic or mood disorder, and the symptoms rapidly disappeared during a medication-free period. Furthermore, there was no discontinuation of other medications, no prominent family history of psychiatric disorder, and no addiction to substances, all of which suggest a connection between manic symptoms and olanzapine. Possible receptor and genomic explanations for this phenomenon are also discussed.

Exploration of Risk Factors for Language Regression According to Parent Reports in Turkish Children with Autism Spectrum Disorder.

Approximately 30% of autism spectrum disorder (ASD) cases exhibit developmental regression after a period of typical development, leading to what is known as regressive autism. Our understanding of the factors underlying regression, including precise mechanisms, clinical features, and risk factors, remains limited. This study aims to compare children with ASD with language regression (ASD-LR) to those without developmental regression (ASD-NR) in terms of clinical and demographic characteristics and to identify potential predictors. In this cross-sectional retrospective study, children aged 2-6 diagnosed with ASD-LR were matched for age and gender with children diagnosed with ASD-NR between January 2023 and January 2024. The groups were compared in terms of demographic and clinical characteristics. The mean age of the ASD-LR group (n = 32) was 52.16 ± 14.56 months, and the ASD-NR group (n = 50) had a mean age of 48.76 ± 13.41 months. Univariate analyses revealed no significant differences in autism severity between groups in clinician (P = .367) and parent evaluations (P = .541). However, in the ASD-LR group, a significant relationship was found between regression, a history of febrile seizures (P = .012), a father's psychiatric background (P = .002), and a family history of psychiatric disorders (P < .001). Family history of psychiatric disorders (OR 7.54, 95% CI 1.10-51.64, P = .040) and cesarean delivery (odds ratio 3.90, 95% CI 1.05-14.47, P = .042) were identified as independent predictors of language regression. The results indicate that regression may be associated with both genetic and environmental factors, including a family history of psychiatric disorders, cesarean delivery, and febrile seizure. Future research should focus on explaining these factors and identifying potential preventive measures.

Abnormal Electroencephalogram Findings and Its Correlation With Clinical Features From Pediatric Patients in Psychiatric Clinic.

Objective: We aimed to evaluate the occurrence of electroencephalogram (EEG) abnormalities in pediatric patients attending an outpatient psychiatry clinic at a tertiary center. We examined the rates of abnormalities and specific findings based on demographics, specific diagnoses, and clinical severity. Methods: This study included pediatric patients who underwent EEG at the outpatient psychiatry clinic. Patient demographics, psychiatric diagnosis, intellectual disability, intelligent quotient (IQ) score, family history of psychiatric disorders, and Clinical Global Impression-Severity (CGI-S) score were obtained through retrospective electronic health record analysis. The rate of EEG abnormalities was calculated, and specific abnormal findings were reviewed. Relationships between the rate of EEG abnormalities and diagnosis, severity, IQ, and age at EEG examination were analyzed. Results: Of 319 patients who underwent EEG, 21.3% (68 patients) of patients exhibited abnormalities, including background abnormalities (14.7%, 47 patients), interictal epileptiform discharges (IEDs) (10.3%, 33 patients), and a slow posterior dominant rhythm (3.8%, 10 patients). The frontal region was the most commonly affected area. Neurodevelopmental disorders (NDDs) had the most frequent abnormalities (29.8%), followed by anxiety (16.7%), sleep (14.3%), mood (11.7%), psychotic (5%), and conduct disorders (0%). Disease severity did not correlate with the rate of EEG abnormalities. Adjusted for age, sex, severity, and family history, patients with EEG abnormalities exhibited lower IQ scores. Conclusion: EEG abnormalities were common in pediatric patients with psychiatric disorders, with background abnormalities detected as frequently as IEDs. Disease severity was not associated with EEG abnormality, while IQ scores showed a negative correlation.

Professional quality life of psychiatry residents in Tunisia

IntroductionThe professional quality of life for psychiatry residents is a complex and multifaceted aspect of their careers. However, the demanding nature of their work can place significant stress on their own psychological well-being. Balancing the need to care for patients while also managing personal and professional responsibilities can be challenging. Nevertheless, psychiatry residents have the opportunity to make a profound impact on the lives of their patients and find fulfillment in their work.ObjectivesTo assess the prevalence of burnout (BO) and secondary traumatic stress (STS) among psychiatry residents.MethodsWe conducted a descriptive online cross-sectional survey in January 2022 among psychiatry residents practicing at Hedi Chaker University Hospital in the Sfax region in Tunisia. Professional life quality was evaluated using The Professional Quality of Life Scale - 5 “ProQOL-5”.ResultsThe total number of residents was 34, of which 91.2% were female. Their mean age was 27.94 years±2.43. They were single in 67.6%. They were residents in adult psychiatry in 61.8% and in child psychiatry in 39.2%. For 91.2% of them, the specialty of adult or pediatric psychiatry was their own choice. The individuals had been practicing psychiatry for an average of two years. They reported a personal medical or surgical history, a personal psychiatric history, and a family history of psychiatric disorders in 32.4%, 8.8%, and 50%, respectively.On the ProQOL-5 scale, we found that 88.2% of the residents had a moderate level of compassion satisfaction, 67.6% had a moderate level of burnout, and 52.9% had a moderate level of secondary traumatic stress.ConclusionsOur study showed a moderate professional life quality among psychiatry residents, hence the importance of implementing intervention strategies.Disclosure of InterestNone Declared

Perceived stigma evaluation among residents in psychiatry

IntroductionThe nature of psychiatry as a specialty dealing with mental health and emotional well-being may contribute to the perceived stigma. These misconceptions and biases can impact the way psychiatry residents perceive their profession, their own self-esteem, job satisfaction, and overall well-being.ObjectivesOur goal was to evaluate the experience of stigma among psychiatry residents.MethodsA descriptive cross-sectional online survey was conducted in January 2022 among psychiatry residents at Hedi Chaker University Hospital in Sfax, Tunisia.The Clinician Associative Stigma Scale (CASS) was used to assess stigmatization experiences.ResultsA total of 34 residents participated in this survey. Their average age was 27.94 years ± 2.43, with 91.2% being female. Of the participants, 61.8% were adult psychiatry residents, and 39.2% were child psychiatry residents. Additionally, the choice of adult psychiatry or child psychiatry specialty was self-determined in 91.2% of cases. The participants had an average of 2 years of experience in psychiatry. They reported a personal medical or surgical history, a personal psychiatric history, and a family history of psychiatric disorders in 32.4%, 8.8%, and 50%, respectively. The average CASS score was 47.09 ± 8.32.The mean scores for the “discomfort with disclosure” factor, the “stereotypes about mental health professionals” factor, the “negative stereotypes about individuals with serious mental illness” factor, and the “negative stereotypes about effectiveness” factor were respectively 8 ± 3, 9.44 ± 2.57, 15.62 ± 5.7, and 11.35 ± 3.33.ConclusionsOur study highlighted that residents in psychiatry suffered stigma. Special attention should be given to reducing this phenomenon in this population.Disclosure of InterestNone Declared

A multivariate meta-analysis of peripheral cytokine levels in obsessive compulsive disorder

IntroductionObsessive-compulsive disorder (OCD) is a common psychiatric disorder. It is considered that dysregulation of cytokine levels is related to the pathophysiological mechanism of OCD. However, the results of previous studies on cytokine levels in OCD are inconsistent.ObjectivesTo perform a meta-analysis assessing cytokine levels in peripheral blood of OCD patients.MethodsWe searched in PubMed, Web of Science, and Embase from inception to March 31, 2023 for eligible studies. We conducted multivariate meta-analysis in combined proinflammatory cytokines (interleukin-6 [IL-6], IL-1β, IL-2, tumor necrosis factor-α [TNF-α], and interferon-γ [IFN-γ]) and combined anti-inflammatory cytokines (IL-10 and IL-4) respectively, and calculated the same meta-analysis in each cytokine. We also performed sensitivity analysis and publication bias tests, as well as subgroup analysis (i.e. different age groups, varied cytokine measurement methods, medication treated or naïve, and presence of psychiatric comorbidities) and meta-regression analysis (variables including patients’ sex ratio, age, age at symptom onset, illness duration, scores of Y-BOCS, family history of psychiatric disorders, and BMI).Results17 original studies (13, 13, 10, 5, 4, 3, 2 studies for IL-6, TNF-α, IL-1β, IL-10, IL-2, IL-4, and IFN-γ, respectively), 573 patients (mean age, 25.2; 50.3% female) and 498 healthy controls (HC; mean age, 25.3; 51.4% female) were included. The results showed that the levels of combined pro- or anti-inflammatory cytokines and each signle cytokine were not significantly different between OCD patients and HC (all P&gt;0.05), with significant heterogeneities in all analyses (I2 from 79.1% to 91.7%). We did not find between-group differences in cytokine levels in all subgroup analyses. Meta-regression analysis suggested that age at onset (P=0.0003) and family history (P=0.0062) might be the source of heterogeneity in TNF-α level. Sensitivity analysis confirmed that all results were stable, except for IL-4 where different cytokine measurement methods may be the contributing factor. Egger test did not find publication bias.ConclusionsOur study showed no difference in cytokine levels between OCD patients and HC, but age at onset and family history may affect TNF-α level. Confounding factors such as age at onset, family history, and cytokine measurement methods should be controlled in future studies to further explore the immune mechanism of OCD.Disclosure of InterestNone Declared

The Delicate Balance: Aptitude of Physicians with Psychiatric diseases

Introduction The delicate balance between the need to ensure quality patient care and the reality of physicians dealing with psychiatric diseases poses a major challenge within the medical field. This issue raises fundamental ethical, legal, and medical questions, highlighting the complexity of decision-making regarding professional aptitude for practitioners affected by mental disorders.ObjectivesTo examine the impact of psychiatric diseases on the medical aptitude of physicians.MethodsThis was a retrospective descriptive study that focused on physicians with psychiatric diseases referred to the occupational pathology clinic at Charles Nicolle Hospital in Tunis for medical evaluations of their work aptitude between January 1, 2021, and September 15, 2023.ResultsDuring the study period, we collected data from 20 patients. The mean age was 38 ± 11 years, with a sex-ratio (F/M)of 4.5. Five examined physicians had family histories of psychiatric disorders. Medical specialties were the most represented (N=17), including three general practitioners, two family medicine practitioners, and two anesthesiologists. The study population included 10 residents, eight hospital assistants, and two medical interns. The most common psychiatric diagnosis was depression (N=7), followed by bipolar disorder (N=5). The medical treatment prescribed was combinations of antidepressants and anxiolytics in seven cases, antipsychotics in five cases, and antidepressants in two cases. Medication adherence was noted in 10 physicians. Fourteen physicians had taken long-term sick leave, with an average duration of 203 days. Five physicians were declared fit to continue their regular professional activities, seven physicians were declared fit with restrictions on night work, and one physician was declared fit with workplace accommodations.ConclusionsThis study highlights the challenges surrounding the medical aptitude of physicians with psychiatric diseases. However, it is imperative to promote mental health awareness and to implementsupport measures to ensure both compassion for physicians and patient safety.Disclosure of InterestNone Declared

Suicidal ideation amongst medical students in Shiraz, South of Iran: a cross-sectional study

Suicide is a preventable act, but irreversible once committed; Hundreds of thousands of people commit suicide annually around the globe. One of the groups at high risk of suicide is medical students. Suicidal ideation (SI) is a forerunner to suicidal attempts which could be assessed. Since there are not enough data about this issue among Iranian medical students, we aimed to estimate the prevalence of SI and risk factors among Shiraz University of Medical Sciences (SUMS) undergraduate medical students. An institutional-based cross-sectional study was conducted from December 2022 to February 2023 in the medical school of SUMS. Students willing to participate were recruited by stratified random sampling technique. Data were collected using a self-administered questionnaire along with Beck Scale for Suicidal Ideation (BSSI) and Depression, Anxiety, and Stress Scale (DASS-21). Bivariate analysis and multivariate logistic regression model were carried out using BlueSky software. The study identified that 76 out of 308 attendees (24.7%, 95% CI: 19.9%-29.5%) reported experiencing suicidal ideation. Very severe depression [AOR= 26.705, 95% CI: (8.825 – 91.046)], Severe depression [AOR= 17.142, 95% CI: (5.567 – 58.121)], positive family history of psychiatric disorders [AOR= 4.181, 95% CI: (1.773 – 10.014)], comorbid mental illness [AOR= 2.502, 95% CI: (1.123 – 5.553)], were found to be statistically related to having SI. This study showed that one out of every four undergraduate medical students at SUMS has SI, which warns everyone to plan and act to prevent the loss of more lives. Depression, family history of psychiatric disorders, and comorbid mental diseases were found to be strongly associated with SI.

Impact of Brain derived Neurotrophic factor gene polymorphism on its peripheral levels in schizophrenic patients.

To determine serum levels of brain-derived neurotrophic factor and its polymorphism rs12291063 in schizophrenic patients. The case-control study was conducted from January1, 2020, to May 15, 2021, at Dr Abdul Qadeer Khan Institute of Behavioural Sciences, Dow University of Health Sciences, Karachi, and comprised schizophrenia cases aged 14-60 years who were diagnosed using Diagnostic and Statistical Manual of Mental Disorders-V criteria, and healthy controls without any psychiatric illness. Positive and negative syndrome scale score was used to assess disease severity. The genomic deoxyribonucleic acid of the subjects was isolated from peripheral blood, followed by polymerase chain reaction, gel electrophoresis and sequencing of the amplicons. The sequences were analysed using MEGA X software for genotyping. Serum brain-derived neurotrophic factor levels were assessed using enzyme-linked immunosorbent assay. Data was analysed using SPSS 21. Of the 100 subjects, 50(50%) were cases; 36(72%) males and 14(28%) females (p<0.05) with mean age 34.34±10.32 years. There were 50(50%) controls; 32(64%) males and 18(36%) females (p=0.391) with mean age 30.886±8.88 years. Among the cases, the mean age at schizophrenia diagnosis was 25.14±9.54 years, and there was a significant association with positive family history for psychiatric disorders (p<0.05). Sequencing revealed no T>C substitution. Serum brain-derived neurotrophic factor levels were significantly higher in cases compared to controls (p<0.001). There was a weak negative correlation between brain-derived neurotrophic factor levels and positive and negative syndrome scale score (p<0.05). Higher brain-derived neurotrophic factor levels were found to be associated with schizophrenia, while no association of rs12291063 T>C was found with schizophrenia.

Abstract TP24: C-Reactive Protein, and Homocysteine as a Predictors of Post Stroke Depression Among Stroke Patients: A Meta-Analysis and Meta Regression

Background: Post-stroke depression (PSD) is a common neuropsychiatric complication of stroke associated with poor functional outcome and increased mortality. Its pathophysiology is poorly understood, however, evidence suggests that neuroinflammation in reaction to the stroke could play a role in the development of PSD. Aim: To compare C-reactive protein (CRP), and homocysteine (Hcy) levels in post-stroke patients with and without PSD. Methods: We systematically searched all electronic databases from inception until May 30th 2023. We performed a conventional meta-analysis and adopted the DerSimonian and Laird random-effect model for the study variations [30]. Outcomes were reported as standard mean difference (SMD), and their corresponding 95% confidence interval (95% CI). Results: A total of 12 studies with 3,230 Patients were included in this analysis. The mean age of the overall cohort was 65.7 years with PSD patients appearing to be older than non-PSD patients (mean 68.3 years versus 63.1 years). In terms of gender distribution, there were more females in the PSD group compared with non-PSD groups (44.4% versus 40.7%). Compared to patients without post-stroke depression, it was found that patients with post-stroke depression had a higher levels of baseline CRP levels [SMD 0.16, (95% CI 0.08 to 0.25), p&lt;0.001], and Hcy [SMD 0.14, (95% CI 0.05 to 0.22), p&lt;0.001]. Meta-regression was performed using covariates including age, female gender, hypertension, diabetes mellitus, CAD, widowhood and family history of psychiatric disorder. For CRP there was no effect modifier, while for Hcy it was observed that a personal history of widowhood appeared as an only significant effect modifier (coefficient 1.998, p=0.038). Conclusion: Elevated baseline levels of CRP and Hcy were significantly higher in patients that developed PSD, suggesting that both could play a role in the pathophysiology of PSD and as a potential biomarker for diagnosing risk of depression post stroke.

Suicide attempt and death by suicide among parents of young individuals with cancer: A population-based study in Denmark and Sweden.

The psychological toll on parents of a child receiving a cancer diagnosis is known to be high, but there is a knowledge gap regarding suicidal behavior among these parents. The aim of this study was to investigate the risk of suicide attempt and death by suicide in relation to having a child with cancer. We performed a binational population-based and sibling-controlled cohort study, including all parents with a child diagnosed with cancer in Denmark (1978 to 2016) or Sweden (1973 to 2014), 10 matched unexposed parents per exposed parent (population comparison), and unaffected full siblings of the exposed parents (sibling comparison). Suicide attempt was identified through the Patient Register and the Psychiatric Central Register in Denmark and the Patient Register in Sweden, whereas death by suicide was identified through the Danish Causes of Death Register and the Swedish Causes of Death Register. In population comparison, we used Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of suicide attempt and death by suicide associated with cancer diagnosis of a child, adjusting for sex, age, country of residence, calendar year, marital status, highest attained educational level, household income, history of cancer, history of psychiatric disorder, and family history of psychiatric disorder. The sibling comparison was performed to assess the role of familial confounding in the studied associations. The population comparison consisted of 106,005 exposed parents and 1,060,050 matched unexposed parents, with a median age of 56 at cohort entry and 46.9% male. During the median follow-up of 7.3 and 7.2 years, we observed 613 (incidence rate [IR], 58.8 per 100,000 person-years) and 5,888 (IR, 57.1 per 100,000 person-years) cases of first-onset suicide attempt among the exposed and unexposed parents, respectively. There was an increased risk of parental suicide attempt during the first years after a child's cancer diagnosis (HR, 1.15; 95% CI, [1.03, 1.28]; p = 0.01), particularly when the child was 18 or younger at diagnosis (HR, 1.25; 95% CI, [1.08, 1.46]; p = 0.004), when the child was diagnosed with a highly aggressive cancer (HR, 1.60; 95% CI, [1.05, 2.43]; p = 0.03), or when the child died due to cancer (HR, 1.63; 95% CI, [1.29, 2.06]; p < 0.001). The increased risk did not, however, maintain thereafter (HR, 0.86; 95% CI: [0.75, 0.98]; p = 0.03), and there was no altered risk of parental death by suicide any time after the child's cancer diagnosis. Sibling comparison corroborated these findings. The main limitation of the study is the potential residual confounding by factors not shared between full siblings. In this study, we observed an increased risk of parental suicide attempt during the first years after a child's cancer diagnosis, especially when the child was diagnosed during childhood, or with an aggressive or fatal form of cancer. There was, however, no altered risk of parental death by suicide at any time after a child's cancer diagnosis. Our findings suggest extended clinical awareness of suicide attempt among parents of children with cancer, especially during the first few years after cancer diagnosis.

P65: Characteristics of refractory late-life depression in the prodromal phase of neurodegenerative diseases

Objective:Depression is common in neurodegenerative diseases, and a psychiatric diagnosis of late-life depression (LLD) may be changed to neurodegenerative disease during the follow-up period. The aim of this study was to identify clinical characteristics of LLD that might be prodromal state of neurodegenerative diseases.Methods:We conducted a retrospective chart review to collect data (registered between April 2012 and September 2022) from individuals who received electroconvulsive therapy (ECT) for their severe depressive episodes due to major depressive disorder (MDD) or bipolar disorder, were aged 60 years and older, and were followed up more than one year. We compared clinical characteristics between individuals whose diagnosis changed from LLD to neurodegenerative disease (ND) and those whose diagnoses didnʼt change (non-ND). Between-group differences were examined using Mann-Whitney U test for continuous variables as well as χ2 tests and Fisherʼs exact tests for categorical variables.Results:In total, 99 patients (14 patients in ND and 85 patients in non-ND.) were included. All individuals in ND group were diagnosed with MDD. Individuals in ND group showed significantly older onset age, less family history of psychiatric disorders, and tended to show less melancholic features, less ineffective to antidepressants for the current episode. They required ECT because of the need for rapid recovery than non-ND.Conclusion:Among individuals with late-life mood disorders requiring ECT for their severe depressive episodes which require rapid recovery, higher age of onset and no family history of psychiatric disorder may suggest the presence of neurodegenerative diseases.

Comparison of psychological disorders during and after pregnancies caused by assisted reproductive treatments and spontaneous pregnancies.

Mental disorders during pregnancy are one of the major public health problems because of its effect on both mother and child, but the prevalence of psychiatric disorders in infertile women is largely unknown to compare psychiatric disorders during and after pregnancies with assisted reproductive therapies (ART) and spontaneous pregnancies. This cross-sectional study was conducted on pregnant women referring to midwifery centers in Ahvaz City in 2022. Pregnant women were included in two groups of either pregnancy caused by ART (n= 84) or spontaneous pregnancy (n= 256). The Symptom Checklist-90-R (SCL90-R) was used to assess psychiatric disorders during and after pregnancies. A high percentage of women with spontaneous pregnancy (74.6%) and ART (91.7%) had some degree of psychological disorders. The severity of psychological disorders in both groups was higher during pregnancy than after pregnancy (P<0.001). The intensity of various psychological disorders during and after pregnancy in the ART pregnancy group was significantly higher than the control group (P<0.001). An increased risk of psychiatric disorders during pregnancy was associated with the history of psychiatric disorders [odd ratio (OR): 12.393; P= 0.022], family history of psychiatric disorders (OR:26.168; P<0.001), history of infertility (OR: 19.00; P<0.001), primary infertility (OR: 12.714; P=0.004), infertility duration more than three years (OR: 43.424; P<0.001), and frequency of embryo transfer (OR: 18.939; P=0.045). Psychiatric disorders were prevalent among pregnant women in the study area especially in pregnant women with ART. Regular screening programs for mental health problem should be included in an antenatal care service especially in this high-risk group.

Clinical characteristics of probands with obsessive-compulsive disorder from simplex and multiplex families

Genetic and non-genetic factors contribute to obsessive-compulsive disorder (OCD), with strong evidence of familial clustering. Genomic studies in psychiatry have used the concepts of families that are "simplex" (one affected) versus "multiplex" (multiple affected). Our study compares demographic and clinical data from OCD probands in simplex and multiplex families to uncover potential differences. We analyzed 994 OCD probands (501 multiplex, 493 simplex) from the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders (C-TOC). Clinicians administered the Structured Clinical Interview for DSM-IV (SCID-IV) to diagnose, Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) to assess severity, and Dimensional Yale–Brown Obsessive-Compulsive Scale (DY-BOCS) to assess symptom dimensionality. Demographics, clinical history, and family data were collected. Compared to simplex probands, multiplex probands had earlier onset, higher sexual/religious and hoarding dimensions severity, increased comorbidity with other obsessive-compulsive-related disorders (OCRD), and higher family history of psychiatric disorders. These comparisons provide the first insights into demographic and clinical differences between Latin American simplex and multiplex families with OCD. Distinct clinical patterns may suggest diverse genetic and environmental influences. Further research is needed to clarify these differences, which have implications for symptom monitoring and management.