Severity Of Psychiatric Symptoms Research Articles

No-man land art voices: A quasi-experimental pilot study on the effects of art therapy on psychotic patients of a Psychiatric Day Hospital in Greece

Psychosis is often a debilitating condition that has a dramatic impact on patients' lives. Medication is an integral part of treatment, but the need for complementary therapies has been recognised. One of these is art therapy, the benefits of which have been recognised by many researchers. However, as a relatively new treatment, especially in Greece, it needs to be further investigated if and how it can claim a place among the available therapies in psychosis. The mixed quasi-experimental pilot study aimed to evaluate the effectiveness of art therapy in patients with psychosis. Nine patients with DSM-5 diagnoses of schizophrenia or other mental disorders (bipolar disorder, major depression, anorexia nervosa, mental retardation, obsessive-compulsive disorder) with psychotic symptoms participated in a 9-month art therapy intervention through 15–24 sessions at the day hospital of Eginition Hospital as part of their treatment plan. Assessments were made at baseline and week 23 of the intervention to evaluate the effect of the intervention on reducing psychiatric symptom intensity, improving interpersonal responsiveness/empathy, and functional performance on weighted scale projects. Quantitative research results showed that the art therapy group improved interpersonal responsiveness/empathy and task performance in psychiatric patients, but had no statistically significant effect on reducing the severity of patients' psychiatric symptoms. Limitations and implications for future research are discussed.

Urban vs. rural differences in psychiatric diagnoses, symptom severity, and functioning in a psychiatric sample.

Identifying whether certain groups of people experience elevated rates or severities of psychiatric symptoms provides information to guide healthcare allocation. People living in urban areas have higher rates of some psychiatric disorders relative to people living in rural settings, however, it is unclear if psychiatric severity is more elevated in urban vs. rural settings. This study investigates the urban vs. rural differences in rates of psychiatric disorders and severity of psychiatric symptoms. A cohort of patients (63% women, 85% White) presenting to an outpatient psychiatric treatment center in the U.S. completed patient-reported outcomes at all clinic visits as part of standard care. Rurality was determined by municipality population density. Sociodemographic characteristics, psychiatric diagnoses, trauma exposure, psychiatric symptom severity, functioning, and suicidality were compared by rural vs. urban municipality. There were virtually no differences between patients living in rural vs. urban municipalities on rates of psychiatric disorders, severity of psychiatric symptoms, functional impairment, and suicidality (ps≥.09). The only difference was that patients living in rural municipalities had higher exposure to serious accidents than patients living in urban municipalities (p < .01); exposure to nine other traumatic events did not differ between groups (p≥.07). People living in urban and rural municipalities have a similar need for mental health treatment. Access to care may be one explanatory factor for the occasional rural-urban differences in rates of psychiatric disorders. In other words, if people living in rural areas can access care, their symptom presentations appear unlikely to differ from those of people living in urban areas.

Demographic and clinical associations to employment status in older-age bipolar disorder: Analysis from the GAGE-BD database project.

The current literature on employment in older adults with bipolar disorder (OABD) is limited. Using the Global Aging and Geriatric Experiments in Bipolar Disorder Database (GAGE-BD), we examined the relationship of occupational status in OABD to other demographic and clinical characteristics. Seven hundred and thirty-eight participants from 11 international samples with data on educational level and occupational status were included. Employment status was dichotomized as employed versus unemployed. Generalized linear mixed models with random intercepts for the study cohort were used to examine the relationship between baseline characteristics and employment. Predictors in the models included baseline demographics, education, psychiatric symptom severity, psychiatric comorbidity, somatic comorbidity, and prior psychiatric hospitalizations. In the sample, 23.6% (n = 174) were employed, while 76.4% were unemployed (n = 564). In multivariable logistic regression models, less education, older age, a history of both anxiety and substance/alcohol use disorders, more prior psychiatric hospitalizations, and higher levels of BD depression severity were associated with greater odds of unemployment. In the subsample of individuals less than 65 years of age, findings were similar. No significant association between manic symptoms, gender, age of onset, or employment status was observed. Results suggest an association between educational level, age, psychiatric severity and comorbidity in relation to employment in OABD. Implications include the need for management of psychiatric symptoms and comorbidity across the lifespan, as well as improving educational access for people with BD and skills training or other support for those with work-life breaks to re-enter employment and optimize the overall outcome.

Associations between constructs related to social relationships and mental health conditions and symptoms: an umbrella review

BackgroundLoneliness and social isolation are increasingly recognised as prevalent among people with mental health problems, and as potential targets for interventions to improve quality of life and outcomes, as well as for preventive strategies. Understanding the relationship between quality and quantity of social relationships and a range of mental health conditions is a helpful step towards development of such interventions.PurposeOur aim was to give an overview of associations between constructs related to social relationships (including loneliness and social isolation) and diagnosed mental conditions and mental health symptoms, as reported in systematic reviews of observational studies.MethodsFor this umbrella review (systematic review of systematic reviews) we searched five databases (PsycINFO, MEDLINE, EMBASE, CINAHL, Web of Science) and relevant online resources (PROSPERO, Campbell Collaboration, Joanna Briggs Institute Evidence Synthesis Journal). We included systematic reviews of studies of associations between constructs related to social relationships and mental health diagnoses or psychiatric symptom severity, in clinical or general population samples. We also included reviews of general population studies investigating the relationship between loneliness and risk of onset of mental health problems.ResultsWe identified 53 relevant systematic reviews, including them in a narrative synthesis. We found evidence regarding associations between (i) loneliness, social isolation, social support, social network size and composition, and individual-level social capital and (ii) diagnoses of mental health conditions and severity of various mental health symptoms. Depression (including post-natal) and psychosis were most often reported on, with few systematic reviews on eating disorders or post-traumatic stress disorder (PTSD), and only four related to anxiety. Social support was the most commonly included social construct. Our findings were limited by low quality of reviews and their inclusion of mainly cross-sectional evidence.ConclusionGood quality evidence is needed on a wider range of social constructs, on conditions other than depression, and on longitudinal relationships between social constructs and mental health symptoms and conditions.

Association between Maternal Personality Traits and Children's Sleep Disturbance: A Population-based Cohort Study in Republic of Korea.

Sleep affects the development and severity of psychiatric symptoms in children, and maternal personality traits may influence children's sleep. We aimed to confirm the longitudinal effect of maternal personality traits on children's sleep disturbance using cohort data from the Panel Study on Korean Children. Maternal personality traits were assessed using the Personality Assessment Inventory in 2009, and the sleep disturbance of children was assessed using parent survey data from 2010 to 2014 (2nd-6th waves). Among the 11 clinical scales of the Personality Assessment Inventory, the 5 scales that showed the most significant correlations were analyzed. Presence or absence of child sleep disturbance was evaluated with a chi-square test, and the effect of the Personality Assessment Inventory was assessed by a binary logistic regression analysis with child sleep disturbance as the dependent variable. Of the 171 mother-child dyads, 92 were classified into the sleep disturbance group and 79 were classified into the normal sleep group. Maternal somatic concerns showed a significant relationship with children's sleep disturbance at years 2 and 3. Maternal borderline features demonstrated a significant relationship with children's sleep disturbance from years 2 to 5. The binary logistic regression analysis revealed a significant association between high borderline features and children's sleep disturbance at years 2 and 3. High maternal borderline features evaluated at child age 1 were related to sleep disturbance in early childhood. In assessing a children's sleep problems, it may be important to examine mothers' dysfunctional personality traits.

Gender differences in prevalence and associated factors of metabolic syndrome in first-treatment and drug-naïve schizophrenia patients

BackgroundMetabolic syndromes (MetS) are clinical syndromes involving multiple pathological states with distinct gender-specific clinical patterns. As a serious disorder associated with psychiatric conditions, the prevalence of MetS is significantly higher in the population with schizophrenia (Sch). The aim of this paper is to report gender differences in the prevalence, associated factors and severity-related factors of MetS in first-treatment and drug-naïve (FTDN) patients with Sch.MethodsA total of 668 patients with FTDN Sch were included in this study. We collected socio-demographic and general clinical information on the target population, measured and evaluated common metabolic parameters and routine biochemical indicators, and assessed the severity of psychiatric symptoms using Positive and Negative Symptom Scale (PANSS).ResultsIn the target group, the prevalence of MetS was significantly higher in women (13.44%, 57/424) than in men (6.56%, 16/244). In the males, waist circumference (WC), fasting blood glucose (FBG), diastolic blood pressure (DBP), and triglycerides (TG) were risk factors for MetS, while systolic blood pressure (SBP), TG, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and platelet (PLT) were risk factors for the females. More importantly, for the females, we found that age, LDL-C, PANSS scores and blood creatinine (CRE) were risk factors for higher MetS scores, while onset age and hemoglobin (HGB) were protective factors.ConclusionThere are significant gender differences in the prevalence of MetS and its factors among patients with FTDN Sch. The prevalence of MetS is higher and the factors that influence MetS are more numerous and extensive in females. The mechanisms of this difference need further research and clinical intervention strategies should be formulated with gender differences.

Longitudinal changes in brain structure and their relationship with subclinical psychiatric symptoms in parents who lost their only child in China

ABSTRACT Background: Losing an only child (Shidu) is a grievous traumatic event that may affect brain structure, even if it does not lead to psychiatric disorders. However, longitudinal changes in brain structure and their relationship to subclinical psychiatric symptoms (SPS) have not been well investigated in Shidu parents without any psychiatric disorders (SDNP). Objectives: This study aimed to investigate cross-sectional and longitudinal changes in cortical thickness and surface area in SDNP, and to explore their relationship with SPS. Methods: A total of 50 SDNP and 40 matched healthy controls (HC) were enrolled. All participants underwent structural MRI scans and clinical assessment at baseline and at the 5-year follow-up. Differences in brain structural phenotypes (cortical thickness, surface area, and their annual rate of change) between the SDNP and HC groups were compared using FreeSurfer. Correlations between significant brain structural phenotypes and SPS in the SDNP group were evaluated using multiple linear regressions. Results: The SDNP group showed a smaller surface area in the left inferior parietal cortex than the HC group at baseline and follow-up. The SDNP group showed slower rates of cortical thinning and surface area loss in several brain regions than the HC group from baseline to follow-up. Moreover, slower rates of cortical thinning in the left insula, superior frontal cortex, and superior temporal cortex were associated with greater reductions in avoidance, depression, and trauma re-experiencing symptoms scores over time in the SDNP group, respectively. Conclusions: Shidu trauma-induced structural abnormalities in the inferior parietal cortex may persist over time and be independent of the severity of psychiatric symptoms. The expansion of prefrontal, temporal, and insular cortex implicated in emotional regulation may contribute to improvements in psychiatric symptoms in Shidu parents.

The impact of COVID-19 vaccination on psychiatric symptoms in schizophrenia patients: A retrospective study.

The objective was to investigate the impact of COVID-19 vaccination on anxiety, depression, stress perception, and psychiatric symptoms in patients with schizophrenia, and to explore severity of psychiatric symptoms is associated with vaccine hesitancy in individuals with schizophrenia. Mental health symptoms were evaluated in 273 hospitalized schizophrenia patients who received COVID-19 vaccination, and in 80 patients who refused vaccination, both before and after immunization. The study assessed the effects of vaccination on psychiatric symptoms and the potential association between vaccination behavior and psychological distress. Our findings suggest that COVID-19 vaccination is associated with a small worsening of schizophrenia symptoms in older inpatients. Moreover, vaccination behavior may increase anxiety, depression, and stress perception in hospitalized schizophrenia patients, which has implications for the mental health care team working in the context of the pandemic. The study highlights the importance of monitoring the mental health status of patients with schizophrenia during the COVID-19 pandemic, particularly in relation to vaccination behavior. Further research is needed to better understand the mechanisms underlying the observed effects of COVID-19 vaccination on psychiatric symptoms in patients with schizophrenia.

Peripheral Complement Factor-Based Biomarkers for Patients with First-Episode Schizophrenia.

Schizophrenia (SCZ) is a severe, protracted neurological disorder that causes disruptive conduct in millions of individuals globally. Discovery of potential biomarkers in clinical settings would lead to the development of efficient diagnostic techniques and an awareness of the disease's pathogenesis and prognosis. The aim of the present study was to discover and identify serum complement factor-based biomarkers in discriminating patients with first-episode SCZ from healthy controls. Eighty-nine patients with first-episode SCZ and 89 healthy controls were included in this study. Psychiatric symptom severity of patients with SCZ was measured with the Brief Psychiatric Rating Scale-18 Item Version (BPRS) and the Scales for the Assessment of Negative/Positive Symptoms (SANS/SAPS). A total of 5 complement factors including complement component 1 (C1), C2, C3, C4, and 50% hemolytic complement (CH50) were measured using commercially available enzyme-linked immunosorbent assay (ELISA) kits. The levels of serum complement factors in the SCZ and control groups were compared, and the receiver operating characteristic (ROC) curve method was used to assess the diagnostic values of various complement factors for separating SCZ patients from healthy controls. Pearson's correlation test was used to assess the relationships between serum complement factor concentrations and the psychiatric symptom severity. Therewasanincreaseinserum levels of C1, C2, C3, C4, andCH50amongpatientswith SCZ. Moreover, based on ROC curve analysis, the AUC value of a combined panel of C1, C2, C3, C4, and CH50 was 0.857 when used to discriminate patients with SCZ from healthy controls. Furthermore, serum C2, C3, and CH50 levels were positively correlated to the scores of SANS, SAPS, and BPRS in patients with SCZ, respectively. These results suggested that circulating complement factors including C1, C2, C3, C4, and CH50 may have potential in discovering biomarkers for diagnosing first-episode SCZ.

The Prevalence of Symptomatic Anxiety in Children &amp; Adolescents Suffering From Beta-Thalassemia: “A Longitudinal Study”

This article presents a longitudinal study of symptomatic anxiety in Beta-Thalassemia patients categorically adolescents (both male and female). This study was conducted at Thalassemia center(Afzaal Memorial Thalassemia Foundation,Karachi). Sampleswereselected through purposive sampling. The sampling population comprised of 196 registered Thalassemia patientswith age range between 4and 17 years.The overall percentage of anxiety was indicated in Thalassemia patientsas 63.26%.Among levels of anxiety, we observed mild symptoms comparedto moderate and severe. An overall difference of 5%, was found between young and adolescents. i.e.,65% and 60% respectively, and we found no statistical difference between male and female patients.We found mild symptoms of anxiety in greater number of patients suffering fromthalassemia. The severity of psychiatric symptoms found, increased with age. A multidisciplinary approach is required,to tackle the disorder from earlier stages of life. Childhood and adolescence set the stage for future development,therefore a rapid team of psychologist in adjunct with medical practitioner,is required to make the quality of life of the thalassemia patient much better.

1025 Schizophrenic Patient with Large REM Rebound Following Treatment of Severe Obstructive Sleep Apnea

Abstract Introduction We present a case of uncontrolled schizophrenia with severe obstructive sleep apnea (OSA) and significant REM rebound after bilevel positive airway pressure (BPAP) therapy. Report of case(s) A 74-year-old female, with Schizophrenia on anti-psychotic therapy, presented to the sleep clinic due to excessive daytime sleepiness (EDS) and an Epworth score of 21/24. Diagnostic polysomnogram (PSG) reported an AHI of 162.1 events/hour with SaO2 nadir of 71% with sleep efficiency of 31.6% and no REM-sleep, consistent with severe OSA. The next morning, multiple sleep latency testing (MSLT) demonstrated mean sleep latency (MSL) of 3.6 minutes with 0 REM-onset sleep periods (SOREMPs). Patient underwent CPAP/BPAP titration which improved sleep efficiency to 88.6% and severe REM rebound at 61.7%. MSLT after the titration study demonstrated MSL of 4.0 minutes and 3 SOREMPs and was initiated on BPAP therapy at 20/13 cmH2O. A repeat PSG, 4 weeks later showed normalization of sleep architecture. After starting PAP therapy, the patient had a significant improvement in EDS but also energy and interest levels and denied feelings of sadness, racing or paranoid thoughts. Her social life improved and started exercising regularly and volunteering in the community. There was also improved blood pressure and blood sugar levels. She was followed up in the sleep clinic regularly and remained compliant with and benefiting from BPAP therapy and was continued on anti-psychotic therapy. Conclusion Untreated OSA often requires repetitive arousals to reopen the obstructed upper-airway that results in increased non-REM sleep at the expense of slow wave sleep and REM sleep. PAP therapy can cause a rebound increase in REM and SWS. OSA is under recognized in schizophrenic patients and other psychiatric disorders which results in development of significant comorbidities with greater severity of psychiatric symptoms. Elevated rates of OSA have been seen in the schizophrenic population. Treatment of OSA helps with not only physical but also psychotic symptoms. Many anti-psychotics, due to causing weight gain, may contribute to OSA. Studies also indicated that CPAP response to OSA, was as favorable in people with severe mental illness, compared to other patient groups. Support (if any) REM rebound and CPAP compliance; B. Koo, R. Wiggins, C. Molina

Evaluation of Inflammatory Markers in Patients with Depressed Episodes in Major Depressive Disorder and Bipolar Disorder before and after Treatment.

Depression is one of the current dilemmas in both developed and developing societies. Studies show that the severity of psychiatric symptoms is directly related to the degree of inflammation caused by cytokines secreted by the immune system. Hence, evaluating serum cytokine levels in patients with depression can help to understand the pathogenesis of the disease and make the best therapeutic decisions. The present study investigated the levels of inflammatory cytokines, tumor necrosis factor-α (TNF-α), interleukin-1 (IL-1), and interleukin-6 (IL-6) in patients with major depression or bipolar disorder during depressive episodes (BDDE) before and after a 6-month pharmaceutical intervention. Patients referring to 3 clinics were recruited for the study. The diagnosis of major depression or bipolar disorder in a depressive phase was made according to the Diagnostic and Statistical Manual of Mental Disorders -5(DSM-5) criteria. There was a significant difference in depression levels between the pre-intervention and 6-month follow-up in both groups. After 6 months, IL-1 and IL-6 levels in the bipolar disorder group had decreased while TNF-α levels had increased. There was also a significant difference between pre-intervention and follow-up levels of IL-1. Serum levels of IL-1 and IL-6 decreased significantly in both groups after the 6-month follow-up, and symptom improvement was observed. TNF-α levels, on the other hand, decreased in the major depression group but increased in the bipolar disorder group. Considering that inflammation is a major outcome of depression, treatment strategies to reduce inflammation could be a practical approach to improving psychiatric symptoms.

Prevalence and clinical correlates of abnormal lipid metabolism in first-episode and drug-naïve patients with major depressive disorder: A large-scale cross-sectional study

ObjectiveStudies have shown an association between abnormal lipid profiles and MDD, but there are few studies on the clinical correlates of lipid abnormalities in patients with major depressive disorder (MDD). The purpose of this study was to investigate the prevalence of abnormal lipid metabolism and its correlates in Chinese first-episode and drug-naïve MDD patients, which has not yet been reported. MethodsA total of 1718 outpatients with first-episode and drug-naïve MDD were included. Demographic data were collected by a standardized questionnaire and blood lipid levels were measured, including total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL-C), high density lipoprotein (HDL-C). The Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), Positive and Negative Syndrome Scale (PANSS) positive subscale, and Clinical Global Impression of Severity Scale (CGI-S) were assessed for each patient. ResultsThe prevalence of abnormal lipid metabolism was 72.73% (1301/1718), and the rates of high TC, high TG, high LDL-C and low HDL-C were 51.05% (877/1718), 61.18% (1051/1718), 30.09% (517/1718), 23.40% (402/1718), respectively. Logistic regression showed the risk factors for abnormal lipid metabolism were severe anxiety, HAMD score, CGI-S score, BMI and systolic blood pressure (SBP). Multiple linear regression analysis showed that age at onset, SBP, HAMD score, HAMA score, PANSS positive subscale score, and CGI-S were independently associated with TC levels. BMI, HAMD score, PANSS positive subscale score and CGI-S score were independently associated with TG levels. SBP, HAMD score, PANSS positive subscale score and CGI-S score were independently associated with LDL-C levels. Age of onset, SBP and CGI-S score were independently associated with HDL-C levels. ConclusionsThe prevalence of abnormal lipid metabolism in first-episode and drug-naïve MDD patients is quite high. The severity of psychiatric symptoms may be closely associated with the presence of abnormal lipid metabolism in patients with MDD.

Exploring the performance of during-treatment substance use outcome measures in predicting longer-term psychosocial functioning and post-treatment abstinence

BackgroundThe selection of appropriate efficacy endpoints in clinical trials has been a long-standing challenge for the substance use disorder field. Using data from a large, multi-site National Drug Abuse Treatment Clinical Trials Network trial (CTN-0044; n=474), this secondary data analysis aimed to explore whether specific proximal (during-treatment) substance use outcome measures predict longer-term improvements in psychosocial functioning and post-treatment abstinence, and whether predictions vary depending on the specific substance (cannabis, cocaine/stimulants, opioids, and alcohol). MethodsGeneralized linear mixed models examined associations between six during-treatment substance use outcome measures and social functioning impairment (Social Adjustment Scale Self-Report) and severity of psychiatric symptoms (Brief Symptom Inventory-18) at end-of-treatment, and 3- and 6-months after treatment as well as post-treatment abstinence. ResultsMaximum days of consecutive abstinence, proportion of days abstinent, ≥3 weeks of continuous abstinence, and the proportion of urine specimens negative for the primary substance were associated with post-treatment psychiatric and social functioning improvement and abstinence. However, only the effects of abstinence during the last 4 weeks of the treatment period on all three post-treatment outcomes was stable over time and did not differ between primary substance groups. In contrast, complete abstinence during the 12-week treatment period was not consistently associated with functioning improvements. ConclusionsSubstance use outcome measures capturing the duration of primary substance abstinence during treatment are suitable predictors of post-treatment abstinence and longer-term psychosocial functioning improvement. Binary outcomes, such as end-of-treatment abstinence, may be particularly stable predictors and attractive given their ease of computation and straightforward clinical interpretability.

Factors associated with psychiatric outcomes and coping in Long COVID

The relationship between Long COVID (LC) and psychiatric outcomes, as well as factors associated with presence and absence of these, has so far been insufficiently studied. Here we evaluated psychiatric symptoms and coping among patients with LC and patients recovered from COVID-19 who participated in a large international survey. Given increased rates of psychiatric illness with chronic medical conditions and known immune-inflammatory contributors to psychiatric disease, we hypothesized that a subset, but not the entirety, of LC respondents may have comorbid psychopathology. A substantial minority of both groups experienced suicidality, depression and anxiety symptoms, with these symptoms being more common in the LC group. LC respondents used more adaptive coping styles. Psychiatric outcomes in LC were associated with younger age, greater reductions in overall health, higher symptom severity, limitations to physical capability, lower income, financial hardship, psychiatric history, employment impact, male sex, men and non-binary gender, and negative experiences with medical professionals, family, friends, partners and employers. In a large international survey, a minority subset of individuals with Long COVID experienced greater psychiatric symptom severity that was associated with greater reductions in overall health and other specific outcomes.

0669 Disruptive Nocturnal Behaviors in PTSD Patients are Associated with More Severe Psychiatric Pathology

Abstract Introduction The similarities and differences between trauma associated sleep disorder (TASD) and REM sleep behavior disorder (RBD) are unclear. However, both REM sleep parasomnias are associated with disruptive nocturnal behaviors (DNB) that manifest as episodes of sleep-related vocalizations, and/or complex motor behaviors. Patients who have more DNB are more likely to have a higher prevalence of PTSD. Methods In a cross-sectional study, we examined the relationship between DNB severity and the severity of psychiatric symptoms in PTSD patients. 73 civilian patients with histories of complex developmental trauma (age 47.0 ±13.3 years; 89.6% female) met the DSM-5 criteria for moderate-to-severe PTSD. PTSD Checklist for DSM-5 (PCL-5) was used to obtain an index of current PTSD severity (37.41 ± 19.84; PCL-5 &amp;gt;30 cutoff for PTSD). DNB was defined as the sum of the two items 1f and 1g in the Pittsburgh Sleep Quality Index PTSD Addendum (PTSD-A). The participants rated how often during the past 1 month they had trouble sleeping because of the following: (PTSD-A Item1f) “Had episodes of terror or screaming during sleep without fully awakening” and (PTSD-A Item1g) “Had episodes of ‘acting out’ their dreams, such as kicking, punching, running or screaming”. We used a stepwise multiple regression analysis with DNB as the dependent variable and the variables described below as independent variables. Results We determined the following relationships: 1. PCL-5 (r=0.359, p=0.002); 2. Brief Symptom Inventory which includes Somatization (r=0.476,p&amp;lt; 0.001);Obsessive-compulsiveness (r=0.429, p&amp;lt; 0.001); Interpersonal Sensitivity (r=0.337, p=0.004); Depression (r=0.398, p&amp;lt; 0.001); Anxiety (r=0.449,p&amp;lt; 0.001); Hostility (r=0.577, p&amp;lt; 0.001); Phobic Anxiety (r=0.353, p=0.002); Paranoid Ideation (r=0.412, p&amp;lt; 0.001); and Psychoticism (r=0.414, p&amp;lt; 0.001); 3. Insomnia Severity Index (r=0.363, p=0.002); 4. Beck Suicide Scale or BSS (r=0.268, p=0.025); 5.Beck Anxiety Inventory (r=0.472, p&amp;lt; 0.001); and 6. Fear of Sleep(r=0.493,p&amp;lt; 0.001). Fear of Sleep Inventory (FOS) (Beta=0.442, t=4.258, p&amp;lt; 0.001) and Beck Scale for Suicidal Ideation (BSS) (Beta=0.300, t=2.887, p=0.005) emerged as the significant predictors of DNB. Conclusion DNB was correlated with a wide range of psychiatric pathology in PTSD. This suggests that DNB could be an integral feature of severe PTSD. To our knowledge, this has not been previously reported. Support (if any) None

Psychiatric Symptoms in Women with High-risk Pregnancy in the Postpartum Period: A Case-control Study.

Psychiatric symptoms are common mental issues in pregnancy and the postpartum period. There is limited information regarding the psychiatric symptoms of women with high-risk pregnancy in the postpartum period. This study aimed to compare the severity of psychiatric symptoms and psychological distress in women with high-risk and low-risk pregnancies in the postpartum period. This case-control study examined 250 women in the postpartum period in two groups with low-risk (n = 112) and high-risk (n = 138) pregnancies. Women completed the Brief Symptom Inventory-53 (BSI-53) and the Risk Postnatal Psychosocial Depression Risk Questionnaire (PPDRQ). The mean severity of psychiatric symptoms in women with high-risk pregnancies was significantly higher than that in women with low-risk pregnancies (39.34 ± 17.51 vs. 30.26 ± 17.08). Additionally, the frequency of psychological distress in women with high-risk pregnancies was approximately twice higher than that in women with low-risk pregnancies (30.3% vs. 15.2%). Furthermore, the risk factors for depression in women with high-risk pregnancies were almost 1.5 times (59.8% vs. 39.8%) higher than the factors in women with low-risk pregnancies. The results of the logistic analysis indicated that high-risk pregnancies could be twice the odds ratio of developing postpartum psychological distress (ß = 2.14, 95% CI 1.4-6.3, p= 0.036). Psychiatric symptoms and the psychological distress index are higher in postpartum women with high-risk pregnancies than in postpartum women with low-risk pregnancies. The study suggests that obstetricians and pregnant women's health care providers should strongly consider screening of psychiatric symptoms in women with high-risk pregnancies both during pregnancy and after delivery as the women's routine care priorities.

469 Electroencephalographic Correlate of Sensory Over-Responsivity in Adults with Chronic Tic Disorders

OBJECTIVES/GOALS: To identify an electroencephalographic (EEG) signature of SOR in adults with TS METHODS/STUDY POPULATION: We will recruit 60 adults with CTD and 60 sex- and age-matched healthy controls to complete scales assessing severity of SOR (Sensory Gating Inventory, SGI), tics, and psychiatric symptoms. Subjects will then be monitored on dense-array scalp EEG during sequential auditory and tactile sensory gating paradigms, as such paradigms have been shown to correlate with self-report measures of SOR in other populations. Single-trial EEG data will be segmented into 100-ms epochs and spectrally deconvoluted into standard frequency bands (delta, theta, alpha, beta, gamma) for pre-defined regions of interest. We will conduct between-group contrasts (Wilcoxon rank-sum) of band-specific sensory gating indices and within-group correlations (Spearman rank correlations) between sensory gating indices and SGI scores. RESULTS/ANTICIPATED RESULTS: We hypothesize that, relative to controls, adults with CTD exhibit impaired sensory gating and that extent of impairment correlates with severity of SOR. 14 adults with CTD (9 men, 5 women) and 16 controls (10 men, 6 women) have completed the protocol to date. Within this sample, adults with CTD showed significantly reduced sensory gating compared to controls in frontal (CTD median 0.12 dB (interquartile range -0.15–0.70 dB); control -0.37 dB (-0.80–-0.13 dB); p = 0.01) and parietal (CTD 0.17 dB (-0.08–0.50 dB); control -0.20 dB (-0.43–0.10 dB); p = 0.01) gamma band during the 100-200 ms epoch in the tactile paradigm. No significant between-group differences were evident for the auditory paradigm. Among adults with CTD, multiple sensory gating indices significantly correlated with SGI scores. Enrollment continues. DISCUSSION/SIGNIFICANCE: Results aim to clarify the extent of sensory gating impairment in TS and identify a clinical correlate of neurophysiologic dysfunction in the disorder. Such knowledge has direct implications for identification of candidate neurophysiologic biomarkers, an express goal of the National Institutes of Health.

Effects of Recent IV Drug Use and Severity of Psychiatric Symptoms to Antiviral Treatment in People Who Inject Drugs

Objective: People who inject drugs have major contribution to a rise in hepatitis C virus (HCV) infections. Despite efficacy and safety of direct-acting antiviral (DAA) therapies, patients may have difficulties to receive treatment. In this study we aimed to examine the effect of clinical variables in substance users to access to antiviral treatment and the treatment rate. &#x0D; Method: In this retrospective study, we examined the files of 5586 patients who admitted to Outpatient Treatment Center (OTC) between July 2020-April 2021 and files of 121 patients with positive Anti-HCV results were included. All patients had been routinely assessed by Addiction Profile Index (API) and Adult Attention Deficit Hyperactivity Disorder Self-Rating Scale (ASRS)..&#x0D; Results: Of 121 patients, the most used substance was opiate. Because of the insurance restrictions, DAA treatment might be prescribed in only tertiary referral hospitals. All patients had been referred to a tertiary referral hospital. The mean duration from Anti-HCV testing to treatment was 190.3 days. Actively iv substance users were more likely to use substances every day ( 81.5 % vs 41.5%), start using the current substance at younger age (19.1 vs 20.9), have higher total API scores, have higher depression (4.7 vs 3.7), anxiety subscale scores, and ASRS-A scores (11.3 vs 8.3). Actively iv substance users were no more likely to have longer Anti-HCV – treatment duration (100.4 ve 254.5) and have worse treatment completion rates (% 100 vs 67.7).&#x0D; Conclusion: According to research findings, young adults' expectations to obtain social status and social conformity through the acquisition of a product may affect spending time for online shopping and they may lose control of the use of credit cards.

An examination of distress tolerance, anxiety sensitivity, and intolerance of uncertainty in adults in routine psychiatric care

AimA person's ability to tolerate negative emotional states (Distress Tolerance - DT), uncertainty in their everyday lives (Intolerance of Uncertainty - IU), and a tendency to appraise their own feelings of anxiety as harmful (Anxiety Sensitivity - AS) have all been identified as vulnerability factors for anxiety and depressive disorders. However, the relationship between these variables and broader aspects of psychiatric symptom severity in participants recruited from routine care remains unclear. MethodThe Distress Tolerance Scale (DTS), Anxiety Sensitivity Scale-3 (ASI-3), and Intolerance of Uncertainty Scale-Short Form (IUS-12) were administered to 91 patients receiving treatment at the Lund Outpatient Psychiatric Clinic. Data was collected from their medical records about their psychiatric history and scores on the Brief Symptom Inventory (BSI). The relationship between total scores on the DTS, ASI-3, IUS-12 and BSI were evaluated via correlations and regression analyses. ResultsDTS, ASI-3, and IUS-12 total scores correlated in the moderate to large range, and consistent with previous literature, were moderately to strongly correlated with the severity of self-reported depression, anxiety and overall symptoms (BSI). Regression analyses indicated that together, scores on the DTS, ASI-3 and IUS-12 explained moderate levels of variance in BSI symptom scores, with DTS scores showing the strongest associations. These findings suggest that further studies are needed to examine the construct and criterion validity of the three scales. Further validation of these Swedish-language are also warranted.