Suicidal behaviour is the most common psychiatric emergency. A large proportion of suicidal behaviour can be prevented, particularly in cases associated with mental disorders. Early recognition of ...suicidality and reliable evaluation of suicide risk are crucial for the clinical prevention of suicide. Evaluation of suicidal risk involves assessment of suicidal intent, previous suicide attempts, underlying psychiatric disorders, the patients’ personality, the social network, and suicide in the family or among acquaintances as well as other well-known risk factors. Suicide risk assessment should take place on several levels and relate to the patient, the family and social network but also to the availability of treatment, rehabilitation and prevention resources in the community. As suicide risk fluctuates within a short period of time, it is important to repeat the suicide risk assessment over time in an emphatic and not mechanistic way. The suicidal person may mislead both family members and hospital staff, giving a false sense of independence and of being able to manage without the help of others. Although extreme ambivalence to living or dying is often strongly expressed by the suicidal individual, it is not seldom missed by others. If observed in the diagnostic and treatment process, dialogue and reflection on such ambivalence can be used to motivate the patient for treatment and to prevent suicide. If ambivalence and suicidal communications go undiscovered, the treatment process and the life of the patient can be endangered. Today, several measurement tools of suicide risk exist, including psychometric and biological measurements. Some of these tools have been extensively studied and measures of their sensitivity and specificity have been estimated. This allows for the formulation of an approximate probability that a suicidal event might happen in the future. However, the low precision of the predictions make these tools insufficient from the clinical perspective and they contribute very little information that is not already gained in a standard clinical interview. Psychiatrists and other mental health professionals have always longed for reliable and precise tools to predict suicidal behavior, which could support their clinical practice, allow them to concentrate resources on patients that really need them, and backup their clinical judgement, in case of eventual legal problems. In order to be useful, however, the approximate probability that a suicidal event might happen in the future is not sufficient to significantly change clinical routines and practices. These should rely on the available evidence base and always consider the safety of the patient as paramount.
PurposeIn several existing studies of Information Encountering (IE), a recurring sub-phenomenon of serendipity arises that indicates the potential for certain unexpected encounters with information ...to be transformative. The author labels this sub-phenomenon Transformative Information Encountering (TIE), deriving its definition from an application of Transformative Education (TE) theory to existing understandings of IE. This paper aims to discuss the potential for librarians and archivists to promote TIE through everyday practices.Design/methodology/approachAfter defining and identifying TIE in existing studies of IE, this article will put models of IE in conversation with theories of TE and propose ways in which TIE may arise in the everyday work of librarians and archivists.FindingsIn TE theory, there are three phases of the process of critical premise reflection that may be especially relevant to the work of libraries and archives. These are a disorienting dilemma (phase 1); recognition that the process of transformation is shared (phase 4); and acquiring knowledge and skills (phase 7). Each of these aligns with aspects of IE models.Practical implicationsUnderstanding how TIE might inform everyday Library and Information Science (LIS) work may increase the positive impact cultural institutions have on the communities they serve.Originality/valueWhile several IE studies have suggested the existence of TIE as a sub-phenomenon, none thus far have attempted to define it or apply an understanding of it to LIS work.
Epidemiological research has shown that hallucinations and delusions, the classic symptoms of psychosis, are far more prevalent in the population than actual psychotic disorder. These symptoms are ...especially prevalent in childhood and adolescence. Longitudinal research has demonstrated that psychotic symptoms in adolescence increase the risk of psychotic disorder in adulthood. There has been a lack of research, however, on the immediate clinicopathological significance of psychotic symptoms in adolescence.
To investigate the relationship between psychotic symptoms and non-psychotic psychopathology in community samples of adolescents in terms of prevalence, co-occurring disorders, comorbid (multiple) psychopathology and variation across early v. middle adolescence.
Data from four population studies were used: two early adolescence studies (ages 11-13 years) and two mid-adolescence studies (ages 13-16 years). Studies 1 and 2 involved school-based surveys of 2243 children aged 11-16 years for psychotic symptoms and for emotional and behavioural symptoms of psychopathology. Studies 3 and 4 involved in-depth diagnostic interview assessments of psychotic symptoms and lifetime psychiatric disorders in community samples of 423 children aged 11-15 years.
Younger adolescents had a higher prevalence (21-23%) of psychotic symptoms than older adolescents (7%). In both age groups the majority of adolescents who reported psychotic symptoms had at least one diagnosable non-psychotic psychiatric disorder, although associations with psychopathology increased with age: nearly 80% of the mid-adolescence sample who reported psychotic symptoms had at least one diagnosis, compared with 57% of the early adolescence sample. Adolescents who reported psychotic symptoms were at particularly high risk of having multiple co-occurring diagnoses.
Psychotic symptoms are important risk markers for a wide range of non-psychotic psychopathological disorders, in particular for severe psychopathology characterised by multiple co-occurring diagnoses. These symptoms should be carefully assessed in all patients.
Abstract Suicide is a major public health problem in the WHO European Region accounting for over 150,000 deaths per year. Suicidal crisis Acute intervention should start immediately in order to keep ...the patient alive. Diagnosis An underlying psychiatric disorder is present in up to 90% of people who completed suicide. Comorbidity with depression, anxiety, substance abuse and personality disorders is high. In order to achieve successful prevention of suicidality, adequate diagnostic procedures and appropriate treatment for the underlying disorder are essential. Treatment Existing evidence supports the efficacy of pharmacological treatment and cognitive behavioural therapy (CBT) in preventing suicidal behaviour. Some other psychological treatments are promising, but the supporting evidence is currently insufficient. Studies show that antidepressant treatment decreases the risk for suicidality among depressed patients. However, the risk of suicidal behaviour in depressed patients treated with antidepressants exists during the first 10–14 days of treatment, which requires careful monitoring. Short-term supplementary medication with anxiolytics and hypnotics in the case of anxiety and insomnia is recommended. Treatment with antidepressants of children and adolescents should only be given under supervision of a specialist. Long-term treatment with lithium has been shown to be effective in preventing both suicide and attempted suicide in patients with unipolar and bipolar depression. Treatment with clozapine is effective in reducing suicidal behaviour in patients with schizophrenia. Other atypical antipsychotics are promising but more evidence is required. Treatment team Multidisciplinary treatment teams including psychiatrist and other professionals such as psychologist, social worker, and occupational therapist are always preferable, as integration of pharmacological, psychological and social rehabilitation is recommended especially for patients with chronic suicidality. Family The suicidal person independently of age should always be motivated to involve family in the treatment. Social support Psychosocial treatment and support is recommended, as the majority of suicidal patients have problems with relationships, work, school and lack functioning social networks. Safety A secure home, public and hospital environment, without access to suicidal means is a necessary strategy in suicide prevention. Each treatment option, prescription of medication and discharge of the patient from hospital should be carefully evaluated against the involved risks. Training of personnel Training of general practitioners (GPs) is effective in the prevention of suicide. It improves treatment of depression and anxiety, quality of the provided care and attitudes towards suicide. Continuous training including discussions about ethical and legal issues is necessary for psychiatrists and other mental health professionals.
Pathological Internet use (PIU) has been conceptualized as an impulse-control disorder that shares characteristics with behavioral addiction. Research has indicated a potential link between PIU and ...psychopathology; however, the significance of the correlation remains ambiguous. The primary objective of this systematic review was to identify and evaluate studies performed on the correlation between PIU and comorbid psychopathology; the secondary aims were to map the geographical distribution of studies, present a current synthesis of the evidence, and assess the quality of available research.
An electronic literature search was conducted using the following databases: MEDLINE, PsycARTICLES, PsychINFO, Global Health, and Web of Science. PIU and known synonyms were included in the search. Data were extracted based on PIU and psychopathology, including depression, anxiety, symptoms of attention deficit and hyperactivity disorder (ADHD), obsessive-compulsive symptoms, social phobia and hostility/aggression. Effect sizes for the correlations observed were identified from either the respective publication or calculated using Cohen's d or R(2). The potential effect of publication bias was assessed using a funnel plot model and evaluated by Egger's test based on a linear regression.
The majority of research was conducted in Asia and comprised cross-sectional designs. Only one prospective study was identified. Twenty articles met the preset inclusion and exclusion criteria; 75% reported significant correlations of PIU with depression, 57% with anxiety, 100% with symptoms of ADHD, 60% with obsessive-compulsive symptoms, and 66% with hostility/aggression. No study reported associations between PIU and social phobia. The majority of studies reported a higher rate of PIU among males than females. The relative risks ranged from an OR of 1.02 to an OR of 11.66. The strongest correlations were observed between PIU and depression; the weakest was hostility/aggression.
Depression and symptoms of ADHD appeared to have the most significant and consistent correlation with PIU. Associations were reported to be higher among males in all age groups. Limitations included heterogeneity in the definition and diagnosis of PIU. More studies with prospective designs in Western countries are critically needed.
Introduction
The EXPERIENCE project aims to enable the creation and sharing of extended-personal realities in virtual reality (VR). Currently, software and hardware technology are under development, ...that will automatically generate VR environments based on neurophysiological, psychological, cognitive, and behavioral data to support not only the recording of personal experiences but the transmission as well to another user. Potential use cases include enhanced treatment and the assessment of symptom severity of affective disorders.
Objectives
The objective is to design and create a virtual reality environment that enables the identification of between-group differences in behavioral measures when comparing depressed and healthy-control participants.
Methods
We conducted a literature review to identify measures that can be implemented in VR and have the potential to show differences between depressed and healthy-control participants. PubMed and ResearchGate databases were screened to identify potential cognitive tasks. A selection protocol was developed considering effect size, homogeneity of results, risk for cybersickness, cognitive demand, domain heterogeneity, and VR compatibility to choose 4 out of the 47 initial tasks. In addition to the cognitive tasks, behavior measures were considered as well and a virtual environment has been equipped to assess (1) exploratory behavior; (2) engagement with emotionally valenced stimuli (via eye-tracking); (3) metacognitive sensitivity, (4) persistence/grit, and (5) possible effects of mood induction.
Results
Based on the above review, a virtual environment has been developed which is composed of four rooms and a hallway where the starting point is. After an initial tutorial on how the environment/controllers work participants are free to explore and instructions are only provided for the specific cognitive tasks which have to be solved to open the doors and move between rooms. The rooms are equipped with numerous interactive objects and images with varying emotional valence. The engagement with the environment and general activity are continuously recorded and can be retrieved for analyses after participants exit the environment.
Conclusions
If the controlled VR environment will be proven effective for the assessment of depressive symptoms in future studies, the EXPERIENCE system could incorporate direct and objective behavioral measures into the assessment depressive symptoms. Consequently, the system has the potential to support the clinical diagnosis of affective disorders.
Acknowledgement
The EXPERIENCE project is funded by the European Commission H2020 Framework Program with the Grant No. 101017727.
Disclosure of Interest
None Declared
Introduction
To understand the way chemistry influences human communication is important since the reaction to chemosignals has many implications for science and society. For instance, previous ...research showed a connection between olfaction and affective psychiatric disorders. Olfactory processing may be impaired in subject presenting depression symptoms (DEP). Furthermore, a heightened sensitivity to social odours has been shown in subject with social anxiety symptoms (SAD). This may be due to the partial overlap of brain areas which are involved in olfactory processing and the pathophysiology of these disorders. Yet, more detailed research on the olfactory processing is required.
Objectives
POTION is an EU funded project within the Horizon2020 initiative that aims to understand the nature of chemosignals in humans and their sphere of influence on social interaction. Within this project, we conducted a preliminary exploratory study examining whether the odours may be utilized to support positive outcomes of psychological therapy. It evaluates the catalyst effect of the odour conditions on the effectiveness of mindfulness meditation for SAD and DEP.
Methods
Thirty subjects per patient group (total=60) are randomly allocated to one exposure group (happy or fearful human body odour or clean air) and follow the intervention while being exposed to the odour. Psychological outcome is measured before and after the intervention through the State-Trait Anxiety Inventory and the Profile of Mood State questionnaires. Analysis of variance is performed to assess outcome differences between groups.
Results
Preliminary results on a subsample of 32 patients show a trend of deeper reduction of anxiety symptoms at post-treatment among odour-exposed groups compared to clean air (F(1,17)=11.08, p=0.004).
Conclusions
Final results on the complete sample will be available and presented at the time of the congress.
Disclosure
No significant relationships.
Introduction
Patients with severe somatic conditions frequently develop depressive symptoms, with a reduction in quality of life, sleep disturbances and suicide as some of the most serious ...consequences. However, there is a lack of evidence-based interventions to reduce this comorbidity. The NEVERMIND system aims to address this issue by collecting biomedical and psychometric data through a smart shirt and questionnaires, which are used to predict patients’ depressive symptoms. Based on the predictions, patients are offered personalised feedback to self-manage their mental health symptoms in the form of lifestyle behavioural advice, mindfulness-based therapy, and cognitive behavioural therapy.
Objectives
The primary objective was to assess the effectiveness of the NEVERMIND system in reducing depressive symptoms in patients with somatic conditions in comparison to treatment as usual. Some of the secondary objectives were to examine the NEVERMIND system’s effectiveness in preventing new depressive symptoms, sustaining the effects of the intervention at 24 weeks post-baseline, and reducing suicide ideation.
Methods
For this pragmatic randomised controlled trial, 425 patients diagnosed with myocardial infarction, breast or prostate cancer, kidney failure, or lower limb amputation were recruited from hospitals in Turin, Pisa and Lisbon. Data from clinical interviews and structured questionnaires was collected at baseline, 12 weeks, and 24 weeks. The primary outcome was depressive symptoms at week 12 as measured by the Beck Depression Inventory II (BDI-II), while secondary outcomes included prevention of depressive symptoms, suicide ideation, self-reported general interest, satisfaction with daily life, illness perception, self-compassion, and the sustainability of the system’s effect at 24 weeks post-baseline. The intention-to-treat analyses included all patients, while the per-protocol analyses included 333 patients.
Results
The intervention group included 213 and the control group 212 patients, with the sample’s mean age being 59.41 (SD=10.70). Those who used the system had statistically significant lower depressive symptoms at 12 weeks (mean difference=-3.05, p=0.004; 95%CI -5.12 to -0.99) compared to controls, with a clinically relevant effect size (Cohen’s
d
=0.41). Notable significant reductions included suicide ideation (mean difference =-0.61, p=0.020; 95%CI -1.13 to -0.10) and incidence of depressive symptoms at week 12 (OR=0.43, p=0.019; 95%CI 0.22 to 0.87). The improvements in depressive symptoms were sustained at week 24 (mean difference =-1.34, p=0.015; 95%CI -2.41 to -0.26). No significant differences were observed for other secondary outcomes.
Conclusions
The NEVERMIND system was shown to be superior to standard care in reducing and preventing depressive symptoms among the studied sample.
Disclosure of Interest
None Declared
Introduction
Understanding the way chemistry influences human communication is important since the reaction to chemosignals has many implications for science and society.
Numerous research points out ...that human beings are able to identify feelings of fear and happiness through smell. Such emotional information can lead to approach-avoidance behaviors or changes in affective state. Moreover, a heightened sensitivity to social odors has been shown in subjects with social anxiety symptoms. However, more detailed research on the connection between olfaction, affective psychiatric disorders and interpersonal social communication is required.
POTION is an EU funded project within the Horizon2020 initiative that aims at understanding the nature of chemosignals in humans and their sphere of influence on social interaction. Whitin this project, we conducted a preliminary study showing that individuals with social anxiety symptoms benefited from mindfulness training especially when exposed to social chemosignals. A significant reduction in anxiety symptoms was achieved with both the happiness (t(25)=4.37, p=0.029) and the fear (t(25)=4.35, p=0.031) chemosignals. Moreover, individuals exposed to the happiness chemosignal exhibit highier vagal tone compared to subjects exposed to fear chemosignals (p = 0.026), indicating overall increased well-being.
Objectives
Given the exploratory nature of the preliminary study, an hypothesis driven pilot-RCT with larger sample size and refined design has been conducted. The aim was to further explore the catalyst effect of body odor on anxiety reduction. Notably, if the odor groups (happiness, fear or neutral) differ with the control group (clean air) and if they differ between each other in the outcome measure.
Methods
To this end, 96 participants with social anxiety symptoms (women aged between 18 to 35) were randomly allocated to one exposure group (happiness, fear or neutral human body odor or clean air) and followed a mindfulness intervention while being exposed to the odor. Psychological outcomes were measured before and after the intervention through the State-Trait Anxiety Inventory. During the intervention participants’ skin conductance and heart rate was also measured.
Analysis of variance will be performed to assess psychological outcome differences between and within groups, as well as interactions (GroupxTime).
Results
Results of the study will be available and presented at the time of the congress.
Conclusions
This study represents an advancement in the field mental health as it explores the potential impact of using human chemosignals in the clinical setting.
Disclosure of Interest
None Declared
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