Search results for: substance use disorder

Authors: P. Srisuruk, P. Narot

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The purpose of this research were 1) to develop the curriculum and instructional approach that are suitable for children with autism, attention deficit hyperactivity disorder and learning disability as well as to arrange the instructional approach that can be integrated into inclusive classroom 2) to increase the competency of the children in these group. The research processes were to a) study related documents, b) arrange workshops to clarify fundamental issues in developing core curriculum among the researchers and experts in curriculum development, c) arrange workshops to develop the curriculum, submit it to the experts for criticism and editing, d) implement the instructional approach to examine its effectiveness, e) select the schools to participate in the project and arrange training programs for teachers in the selected school, f) implement the instruction approach in the selected schools in different regions. The research results were 1) the core curriculum to enhance the competency of children with autism, attention deficit hyperactivity disorder and learning disability , and to be used as a guideline for teachers, and these group of children in order to arrange classrooms for students with special needs to study with normal students, 2) teaching and learning methods arranged for students with autism, attention deficit, hyperactivity disorder and learning disability to study with normal students can be used as a framework for writing plans to help students with parallel problems by developing teaching materials as part of the instructional approach. However, the details of how to help the students in each skill or content differ according to the demand of development as well as the problems of individual students or group of students. Furthermore; it was found that most of target teacher could implement the instructional approach based on the guideline model developed by the research team. School in each region does not have much difference in their implementation. The good point of the developed instructional model is that teacher can construct a parallel lesson plan. So teacher did not fell that they have to do extra work it was also shown that students in regular classroom enjoyed studying with the developed instructional model as well.

Keywords: instructional approach, autism, attention deficit hyperactivity disorder, learning disability

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Authors: Maria Klitgaard Christensen, Carmen Lim, Sukanta Saha, Danielle Cannon, Finley Prentis, Oleguer Plana-Ripoll, Natalie Momen, Kim Moesgaard Iburg, John J. McGrath

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Introduction: About a third of the world’s population will develop a mental disorder over their lifetime. Having a mental disorder is a huge burden in health loss and cost for the individual, but also for society because of treatment cost, production loss and caregivers’ cost. The objective of this study is to synthesize the international published literature on the economic burden of mental disorders. Methods: Systematic literature searches were conducted in the databases PubMed, Embase, Web of Science, EconLit, NHS York Database and PsychInfo using key terms for cost and mental disorders. Searches were restricted to 1980 until May 2019. The inclusion criteria were: (1) cost-of-illness studies or cost-analyses, (2) diagnosis of at least one mental disorder, (3) samples based on the general population, and (4) outcome in monetary units. 13,640 publications were screened by their title/abstract and 439 articles were full-text screened by at least two independent reviewers. 112 articles were included from the systematic searches and 31 articles from snowball searching, giving a total of 143 included articles. Results: Information about diagnosis, diagnostic criteria, sample size, age, sex, data sources, study perspective, study period, costing approach, cost categories, discount rate and production loss method and cost unit was extracted. The vast majority of the included studies were from Western countries and only a few from Africa and South America. The disorder group most often investigated was mood disorders, followed by schizophrenia and neurotic disorders. The disorder group least examined was intellectual disabilities, followed by eating disorders. The preliminary results show a substantial variety in the used perspective, methodology, costs components and outcomes in the included studies. An online tool is under development enabling the reader to explore the published information on costs by type of mental disorder, subgroups, country, methodology, and study quality. Discussion: This is the first systematic review synthesizing the economic cost of mental disorders worldwide. The paper will provide an important and comprehensive overview over the economic burden of mental disorders, and the output from this review will inform policymaking.

Keywords: cost-of-illness, health economics, mental disorders, systematic review

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Authors: Luo Lan, Huang Jingjing, Li Huafang

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Hypoactive sexual desire disorder (HSDD) was common in China, and Chinese women's sexual health-seeking behaviors were found to be mainly impeded by their psychological barriers. However, underlying mechanisms for such unhealthy sexual health attitudes and symptoms of HSDD were unknown. Many studies suggested the correlation between women's psychological barriers, HSDD and attachment style but had limitations, so this study further explored their relationship. Chinese women of childbearing age were recruited from May 2020 to December 2022 in Shanghai, China. The Revised Adult Attachment Scale (RAAS), the Female Sexual Function Index (FSFI), the Female Sexual Distress Scale-Desire/Arousal/Orgasm (FSDS-DAO), a sexual health attitude questionnaire, and a psychiatric interview were administered. The analytic sample contained 279 women, of which 107 women were HSDD patients. Women with a fearful attachment style were found to be more likely to be unwilling to communicate sexual health (aOR 2.55, 95%CI 1.05-6.28) and feel ashamed of sexual health-related disorders (aOR 2.66, 95%CI 1.14-6.13). They are also linked with a higher risk of HSDD (aOR 3.25, 95%CI 1.35-8.12). Therefore, fearful attachment style should be given enough attention in the whole process of the diagnosis and treatment of HSDD and should be one of the focuses that guide sexual education.

Keywords: attachment style, hypoactive sexual desire disorder, attitude to health, sexual desire, sexual distress

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Authors: Masaki Yamaguchi, Daimei Sasayama, Shinsuke Washizuka

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The goal of this study was to examine the possibility of salivary cytokines for the screening of attention deficit hyperactivity disorder (ADHD) in children. We carried out a case-control study, including 19 children with ADHD and 17 healthy children (controls). A multiplex bead array immunoassay was used to conduct a multi-analysis of 27 different salivary cytokines. Six salivary cytokines (interleukin (IL)-1β, IL-8, IL12p70, granulocyte colony-stimulating factor (G-CSF), interferon gamma (IFN-γ), and vascular endothelial growth factor (VEGF)) were significantly associated with the presence of ADHD (p < 0.05). An informative salivary cytokine panel was developed using VEGF by logistic regression analysis (odds ratio: 0.251). Receiver operating characteristic analysis revealed that assessment of a panel using VEGF showed “good” capability for discriminating between ADHD patients and controls (area under the curve: 0.778). ADHD has been hypothesized to be associated with reduced cerebral blood flow in the frontal cortex, due to reduced VEGF levels. Our study highlights the possibility of utilizing differential salivary cytokine levels for point-of-care testing (POCT) of biomarkers in children with ADHD.

Keywords: cytokine, saliva, attention deficit hyperactivity disorder, child

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Authors: M. R. Bhuiyan, S. M. M. Hossain, M. Z. Islam

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Autism Spectrum Disorder (ASD) is the fastest growing serious developmental disorder characterized by social deficits, communicative difficulties, and repetitive behaviors. ASD is an emerging public health issue globally which is associated with huge financial burden to the family, community and the nation. The aim of this study was to assess the financial burden of family for the children with Autism spectrum Disorder. This cross-sectional study was carried out from July 2015 to June 2016 among 154 children with ASD to assess the financial burden of family. Data were collected by face-to-face interview with semi-structured questionnaire following systematic random sampling technique. Majority (73.4%) children were male and mean (±SD) age was 6.66 ± 2.97 years. Most (88.8%) of the children were from urban areas with average monthly family income Tk. 41785.71±23936.45. Average monthly direct cost of the children was Tk.17656.49 ± 9984.35, while indirect cost was Tk. 13462.90 ± 9713.54 and total treatment cost was Tk. 23076.62 ± 15341.09. Special education cost (Tk. 4871.00), cost of therapy (Tk. 4124.07) and travel cost (Tk. 3988.31) were the major types of direct cost, while loss of income (Tk.14570.18) was the chief indirect cost incurred by the families. The study found that majority (59.8%) of the children attended special schools were incurred Tk.20001-78700 as total treatment cost, which were statistically significant (p<0.001). Again, families with higher monthly family income incurred higher treatment cost (r=0.526, p<0.05). Difference between mean direct and indirect cost was found significant (t=4.190, df=61, p<0.001). According to the analysis of variance, mean difference of father’s educational status among direct cost (F=10.337, p<0.001) and total treatment cost (F=7.841, p<0.001), which were statistically significant. The study revealed that maximum children with ASD were under five years, three-fourth were male. According to monthly family income, maximum family were in middle class. The study recommends cost effective interventions and financial safety-net measures to reduce the financial burden of families for the children with ASD.

Keywords: autism spectrum disorder, financial burden, direct cost, indirect cost, special education

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Authors: Garima Singh

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Objectives: Behavioral Crisis Center (BCC) is a community solution to a community problem. There has been an exponential increase in the incidence and prevalence of mental health crises around the world. The effects of the crisis negatively impact our patients and their families and strain the law enforcement and emergency room. The goal of the multi-disciplinary care model is to break the crisis cycle and provide 24-7 rapid access to an acre and crisis stabilization. We initiated our first BCC care center in 2020 in the midst of the COVID pandemic and have seen a remarkable improvement in patient ‘care and positive financial outcome. Background: Mental illnesses are common in the United States. Nearly one in five U.S. adults live with a mental illness (52.9 million in 2020). This number represented 21.0% of all U.S. adults. To address some of these challenges and help our community, In May 2020, we opened our first Behavioral crisis center (BCC). Since then, we have served more than 2500 patients and is the first southwest Missouri’s first 24/7 facility for crisis–level behavioral health and substance use needs. It has been proven to be a more effective place than emergency departments, jails, or local law enforcement. Methods: BCC was started in 2020 to serve the unmet need of the community and provide access to behavioral health and substance use services identified in the community. Funding was possible with significant investment from the county and Missouri Foundation for Health, with contributions from medical partners. It is a multi-disciplinary care center consisting of Physicians, nurse practitioners, nurses, behavioral technicians, peer support specialists, clinical intake specialists, and clinical coordinators and hospitality specialists. The center provides services including psychiatry care, outpatient therapy, community support services, primary care, peer support and engagement. It is connected to a residential treatment facility for substance use treatment for continuity of care and bridging the gap, which has resulted in the completion of treatment and better outcomes. Results: BCC has proven to be a great resource to the community and the Missouri Health Coalition is providing funding to replicate the model in other regions and work on a similar model for children and adolescents. Overall, 29% of the patients seen at BCC are stabilized and discharged with outpatient care. 50% needed acute stabilization in a hospital setting and 21% required long-term admission, mostly for substance use treatment. The local emergency room had a 42% reduction in behavioral health encounters compared to the previous 3 years. Also, by a quick transfer to BCC, the average stay in ER was reduced by 10 hours and time to follow up behavioral health assessment decreased by an average of 4 hours. Uninsured patients are also provided Medicaid application assistance which has benefited 55% of individuals receiving care at BCC. Conclusions: BCC is impacting community health and improving access to quality care and substance use treatment. It is a great investment for our patients and families.

Keywords: BCC, behvaioral health, community health care, addiction treatment

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Authors: Saeed Dehnavi, Ismail Asadallahi, Fatemeh Rahmatian, Elahe Rahimian

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Purpose: Due to an increasing prevalence of over eating disorders, this paper aims to investigate the effectiveness of short-term group cognitive-behavioral therapy on reducing binge eating behavior and depression symptoms among females suffered from binge eating disorder (BED) in Qazvin, Iran. Methodology: This is aquasi-experimental study (pre-post testing plan with control group). Using a convenience sampling technique, binge eating scale (BES) and clinical interviews, 30 persons were selected among all clients who had referred to weight loss centers in Qazvin, these persons were randomly placed into two control and experimental groups. The experimental group participated in a seven-session plan on short-term cognitive-behavioral group therapy. Results: The results showed that the short term group cognitive-behavioral therapy results in a significant reduction in binge eating signs and depressive symptoms within the experimental group, compared to the control. Conclusion: Regarding the results, it is known that short-term group cognitive-behavioral therapy is effective in reducing overeating symptoms. Hence, it can be used as an economical and effective treatment method for individuals suffering from BED.

Keywords: cognitive-behavioral group therapy, binge eating disorder, depression

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Authors: Amir Bastani

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The result of the research in the field of human behavioural genetics demonstrates a genetic contribution of behavioural differences in aggression, violence, drug and substance abuse, antisocial personality disorder and other related traits. As the field of human behavioural genetics progresses and achieves credibility, the criminal accused continue to use its types of evidence into the criminal law. One of the most important genetic factors which controls certain neurotransmitters like dopamine and serotonin is the Monoamine Oxidase Acid A (MAOA) gene, known as the 'warrior gene'. The high-profile study by Caspi and colleagues in 2002 showed that the combination between one type of variation of the MAOA gene and childhood maltreatment noticeably predisposes a person to antisocial behaviour. Moreover, further scientific research shows that individuals with the MAOA gene have to some degree difficulties in controlling their impulses. Based on the evidence of MAOA, some criminal accused claimed difficulties in self-control. In the first case – the famous case of Mobley – the court rejected the MAOA evidence on the ground of the lack of scientific support. In contrast, in other cases after the Mobley trial, courts accepted the evidence of MAOA. In this paper, the issue of lack of impulse control produced by the MAOA gene and cases which relied on the MAOA evidence and successfully being accepted will be reviewed in detail. Finally, the anticipation of the paper for the future use of the MAOA evidence in criminal cases will be presented.

Keywords: genetic defence, criminal responsibility, MAOA, self-control

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Authors: Sanjaykumar R. Patel, Parth R. Kayastha

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α-lactose monohydrate is widely used in the pharmaceutical industries as an inactive substance that acts as a vehicle or a medium for a drug or other active substance. It is a byproduct of dairy industries, and the recovery of lactose from whey not only boosts the improvement of the economics of whey utilization but also causes a reduction in pollution as lactose recovery can reduce the BOD of whey by more than 80%. In the present study, levels of process parameters were kept as initial lactose concentration (30-50% w/w), sonication amplitude (20-40%), sonication time (2-6 hours), and crystallization temperature (10-20 ^oC) for the recovery of lactose in ultrasound assisted cooling crystallization. In comparison with cooling crystallization, the use of ultrasound enhanced the lactose recovery by 39.17% (w/w). The parameters were optimized for the lactose recovery using Taguchi Method. The optimum conditions found were initial lactose concentration at level 3 (50% w/w), amplitude of sonication at level 2 (40%), the sonication time at level 3 (6 hours), and crystallization temperature at level 1 (10 °C). The maximum recovery was found to be 85.85% at the optimum conditions. Sonication time and the initial lactose concentration were found to be significant parameters for the lactose recovery.

Keywords: crystallization, lactose, Taguchi method, ultrasound

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Authors: Caroline Kim

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The designation autism spectrum disorder (ASD) groups complex disorders in the development of the brain. Autism is defined essentially as a condition in which an individual lacks a theory of mind. The theory of mind, in this sense, explains the ability of an individual to attribute feelings, emotions, or thoughts to another person. An autistic patient is characteristically unable to determine what an interlocutor is feeling, or to understand the beliefs of others. However, it is possible that autism cannot plausibly characterized as the lack of theory of mind in an individual. Genes, the bran, and its interplay with environmental factors may also cause autism. A mutation in a gene may be hereditary, or instigated by diseases such as mumps. Though an autistic patient may experience abnormalities in the cerebellum and the cortical regions, these are in fact only possible theories as to a biochemical explanation behind the disability. The prevailing theory identifying autism with lacking the theory of mind is supported by behavioral observation, but this form of observation is itself determined by socially constructed standards, limiting the possibility for empirical verification. The theory of mind infers that the beliefs and emotions of people are causally based on their behavior. This paper demonstrates the fallacy of this inference, critiquing its basis in socially constructed values, and arguing instead for a biochemical approach free from the conceptual apparatus of language and social expectation.

Keywords: autism spectrum disorder, sociology of psychology, social construction, the theory of mind

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Authors: Haolin Li, Eric Bair, Jane Monaco, Quefeng Li

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The temporomandibular disorder (TMD) is a series of musculoskeletal disorders ranging from jaw pain to chronic debilitating pain, and the risk factors for the onset and maintenance of TMD are still unclear. Prior researches have shown that the potential risk factors for chronic TMD are related to psychosocial factors, autonomic functions, and pain sensitivity. Using data from the Orofacial Pain: Prospective Evaluation and Risk Assessment (OPPERA) study’s baseline case-control study, we examine whether the risk factors identified by prior researches are still statistically significant after taking all of the risk measures into account in one single model, and we also compare the relative influences of the risk factors in three different perspectives (psychosocial factors, autonomic functions, and pain sensitivity) on the chronic TMD. The statistical analysis is conducted by using ridge logistic regression and bootstrapping, in which the performance of the algorithms has been assessed using extensive simulation studies. The results support most of the findings of prior researches that there are many psychosocial and pain sensitivity measures that have significant associations with chronic TMD. However, it is surprising that most of the risk factors of autonomic functions have not presented significant associations with chronic TMD, as described by a prior research.

Keywords: autonomic function, OPPERA study, pain sensitivity, psychosocial measures, temporomandibular disorder

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Authors: Alireza Monzavi Chaleshtari, Maryam Aliakbari

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Objective: The aim of this study was to investigate the prediction of child attachment style based on a positive and safe combination parenting method mediated by maternal attachment styles in children with attention deficit hyperactivity disorder. Method: The design of the present study was descriptive of correlation and structural equations and applied in terms of purpose. The population of this study includes all children with attention deficit hyperactivity disorder living in Chaharmahal and Bakhtiari province and their mothers. The sample size of the above study includes 165children with attention deficit hyperactivity disorder in Chaharmahal and Bakhtiari province with their mothers, who were selected by purposive sampling method based on the inclusion criteria. The obtained data were analyzed in two sections of descriptive and inferential statistics. In the descriptive statistics section, statistical indices of mean, standard deviation, frequency distribution table and graph were used. In the inferential section, according to the nature of the hypotheses and objectives of the research, the data were analyzed using Pearson correlation coefficient tests, Bootstrap test and structural equation model. findings:The results of structural equation modeling showed that the research models fit and showed a positive and safe combination parenting style mediated by the mother attachment style has an indirect effect on the child attachment style. Also, a positive and safe combined parenting style has a direct relationship with child attachment style, and She has a mother attachment style. Conclusion:The results and findings of the present study show that there is a significant relationship between positive and safe combination parenting methods and attachment styles of children with attention deficit hyperactivity disorder with maternal attachment style mediation. Therefore, it can be expected that parents using a positive and safe combination232 parenting method can effectively lead to secure attachment in children with attention deficit hyperactivity disorder.

Keywords: child attachment style, positive and safe parenting, maternal attachment style, ADHD

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Authors: Wenqiu Cao

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Suicide prevention is a global problem that needs to be taken seriously. Investigating the mechanisms of suicide in major depressive disorder (MDD) separately through neuroimaging technology is essential for effective suicide prevention. And it’s particularly urgent in geriatric depressive patients since older adults are more likely to use rapidly deadly means, and suicidal behavior is more lethal for older adults. The current study reviews five studies related to suicide in geriatric MDD that uses neuroimaging methodology in order to analyze the relevant neurobiological mechanisms. The majority of the studies found significant white matter and grey matter reduction or lesion widespread in multiple brain regions, including the frontal and parietal regions, the midbrain, the external capsule, and the cerebellum. Regarding the cognitive impairment in geriatric MDD, the reward signals were found weakened in the paralimbic cortex. The functional magnetic resonance imaging (fMRI) studies also found hemodynamic changes in the right dorsolateral prefrontal cortex (DLPFC), orbitofrontal cortex (OFC), and right frontopolar cortex (FPC) regions in late-life MDD patients with suicidal ideation. Future studies should consider the age of depression onset, more accurate measurements of suicide, larger sample size, and longitudinal design.

Keywords: brain imaging, geriatric major depressive disorder, suicidality, suicide

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Authors: Léa Chawki, Émilie Cappe

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Context: Nowadays, supporting parents of children with autism spectrum disorder (ASD) and helping them adjust to their child’s condition represents a core clinical and scientific necessity and is encouraged by the French National Strategy for Autism (2018). In France, ASD remains a challenging condition, causing distress, segregation and social stigma to concerned family members concerned by this handicap. The literature highlights that neurodevelopmental disorders in children, such as ASD, influence parental well-being. This impact could be different according to parents’ culture and the child’s particular disorder manifestation, such as developmental coordination disorder (DCC), for instance. Objectives: This present study aims to explore parental stress, anxiety and depressive symptoms, as well as the quality of life in parents of children with ASD or DCD, as well as the explicit individual, psychosocial and cultural factors of parental well-being. Methods: Participants will be recruited through diagnostic centers, child and specialized adolescent units, and organizations representing families with ASD and DCD. Our sample will include five groups of 150 parents: four groups of parents having children with ASD – one living in France, one in the US, one in Canada and the other in Lebanon – and one group of French parents of children with DCD. Self-evaluation measures will be filled directly by parents in order to measure parental stress, anxiety and depressive symptoms, quality of life, coping and emotional regulation strategies, internalized stigma, perceived social support, the child’s problem behaviors severity, as well as motor coordination deficits in children with ASD and DCD. A sociodemographic questionnaire will help collect additional useful data regarding participants and their children. Individual and semi-structured research interviews will be conducted to complete quantitative data by further exploring participants’ distinct experiences related to parenting a child with a neurodevelopmental disorder. An interview grid, specially designed for the needs of this study, will strengthen the comparison between the experiences of parents of children with ASD with those of parents of children with DCD. It will also help investigate cultural differences regarding parent support policies in the context of raising a child with ASD. Moreover, interviews will help clarify the link between certain research variables (behavioral differences between ASD and DCD, family leisure activities, family and children’s extracurricular life, etc.) and parental well-being. Research perspectives: Results of this study will provide a more holistic understanding of the roles of individual, psychosocial and cultural variables related to parental well-being. Thus, this study will help direct the implementation of support services offered to families of children with neurodevelopmental disorders (ASD and DCD). Also, the implications of this study are essential in order to guide families through changes related to public policies assisting neurodevelopmental disorders and other disabilities. The between-group comparison (ASD and DCD) is also expected to help clarify the origins of all the different challenges encountered by those families. Hence, it will be interesting to investigate whether complications perceived by parents are more likely to arise from child-symptom severity, or from the lack of support obtained from health and educational systems.

Keywords: Autism spectrum disorder, cross-cultural, cross-disorder, developmental coordination delay, well-being

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Authors: Valentine Ayo Mebu

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The study examined the efficacy of a brief intervention programme in the treatment of post-traumatic stress disorder (PTSD) symptoms exhibited by secondary school students exposed to conflict in Kano metropolis. The study tested three hypotheses that there is no significant difference between post-test re-experiencing, hyper-arousal, and avoidance mean scores of students exposed to the intervention and those who were not exposed to the intervention. The design of the study was an experimental design, specifically the pre-test and post-test control group design. The purposive sampling technique was used to select 60 research participants (male=30, female=30, Mean Age=15.50) for the study. These participants met the Diagnostic Statistical Manual of Mental Disorders (DSM-5) criteria of PTSD symptoms and were randomly assigned to experimental and control groups, respectively. Instrument for data collection was the University of California Post-Traumatic Stress Disorder Reaction Index (UCLA PTSD Index). Findings from the study indicated that there was a significant effect of the intervention on post re-experiencing symptoms scores [ F (1, 57) = 85.97, p=.00, partial eta squared η²=.60], hyper-arousal symptoms scores[ F (1, 57) = 27.81, p=.00, partial eta squared η² =.33], and avoidance symptoms scores [ F (1, 57) = 59.56, p=.00, partial eta squared η² =.51]. The efficacy of this brief psycho-educational intervention as an effective treatment in reducing PTSD symptoms among secondary school students exposed to conflict is supported by the results of this study and this will also add to the existing literature on the effectiveness of psycho-educational intervention in treating PTSD symptoms among students exposed to conflict.

Keywords: avoidance symptoms, hyper-arousal symptoms, re-experiencing symptoms, post-traumatic stress disorder, psycho-education

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Authors: Pui I. Chao, Shanju Lin

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Purpose: Children with developmental language disorder (DLD) have persistent language difficulties and often face great challenges when demands are high. The aim of this study was to investigate whether verb frequency would trade-off with syntactic complexity when they talk. Method: Forty-five children with DLD, 45 chronological age matches with TD (AGE), and 45 MLU-matches with TD (MLU) who were Mandarin speakers were selected from the previous study. Language samples were collected under three contexts: conversation about children’s family and school, story retelling, and free play. MLU, verb density, utterance length difference, verb density difference, and average verb frequency were calculated and further analyzed by ANOVAs. Results: Children with DLD and their MLU matches produced shorter utterances and used fewer verbs in expressions than the AGE matches. Compared to their AGE matches, the DLD group used more verbs and verbs with lower frequency in shorter utterances but used fewer verbs and verbs with higher frequency in longer utterances. Conclusion: Mandarin-speaking children with DLD showed difficulties in verb usage and were more vulnerable to trade-offs than their age-matched peers in utterances with high demand. As a result, task demand should be taken into account as speech-language pathologists assess whether children with DLD have adequate abilities in verb usage.

Keywords: developmental language disorder, syntactic complexity, trade-offs, verb frequency

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Authors: A. Mech

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Repetitive transcranial magnetic stimulation has proven to be a valuable treatment option for patients who have failed to respond to multiple courses of antidepressant medication. In fact, the American Psychiatric Association recommends TMS after one failed treatment course of antidepressant medication. Genetic testing has proven valuable for pharmacokinetic variables, which, if understood, could lead to more efficient dosing of psychotropic medications to improve outcomes. Pharmacodynamic testing can identify biomarkers, which, if addressed, can improve patients' outcomes in antidepressant therapy. Monotherapy treatment of major depressive disorder with methylated B vitamin treatment has been shown to be safe and effective in patients with MTHFR polymorphisms without waiting for multiple trials of failed medication treatment for depression. Such treatment has demonstrated remission rates similar to antidepressant clinical trials. Combining pharmacodynamics testing with repetitive TMS treatment with NeuroStar has shown promising potential for enhancing remission rates and durability of treatment. In this study, a retrospective chart review (ongoing) of patients who obtained repetitive TMS treatment enhanced by dietary supplementation guided by Pharmacodynamic testing, displayed a greater remission rate (90%) than patients treated with only NeuroStar TMS (62%).

Keywords: improved remission rate, major depressive disorder, pharmacodynamic testing, rTMS outcomes

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Authors: Farzad Jalilian, Mehdi Mirzaei Alavijeh

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Background: Substance addiction is one of the major worldwide problems that destroys economy, familial relationships, and the abuser’s career and has several side effects; in the meantime drug injection due to the possibility of shared use of syringes among drug users could have multiple complications to be followed. The purpose of this study was to determine the prevalence of drug injection among male prisoners in Kermanshah city, the west of Iran. Methods: In this cross-sectional study 615 male prisoners were randomly selected to participate voluntarily in the study. Participants filled out a writing self-report questionnaire. Data were analyzed by the SPSS software (ver. 21.0) at 95% significant level. Results: The mean age of respondents was 31.13 years [SD: 7.76]. Mean initiation age for drug use was 14.36 years (range, 9-34 years). Almost, 39.4 % reported a history of drug use before prison. Opium (33.2%) and crystal (27.1%) was the most used drug among prisoners. Furthermore, 9.3 % had a history of injection addiction. There was a significant correlation between age, crime type, marital status, economic status, unprotected sex and drug injection (P < 0.05). Conclusion: The low age of drug abuse and the prevalence of drug injection among offenders can be as a warning for responsible; in this regard, implementation of prevention programs to risky behavior and harm reduction among high-risk groups can follow useful results.

Keywords: substance abuse, drug injection, prison, Iran

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Authors: Daniele Zullino, Gabriel Thorens, Léonice Furtado, Federico Seragnoli, Radu Iuga, Louise Penzenstadler

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Context: Since the start of the 21st century, there has been a resurgence of interest in psychedelics, marked by a renewed focus on scientific investigations into their therapeutic potential. While psychedelic therapy has gained recognition for effectively treating depression and anxiety disorders, notable progress has been made in the clinical development of substances like psilocybin. Moreover, mounting evidence suggests promising applications of Lysergic acid diethylamide (LSD) and psilocybin in the field of addiction medicine. In Switzerland, compassionate treatment with LSD and psilocybin has been permitted since 2014 through exceptional licenses granted by the Federal Office of Public Health. This treatment approach is also available within the Geneva treatment program, extending its accessibility to patients undergoing opioid-assisted treatment involving substances like morphine and diacetylmorphine. The aim of this study is to assess the feasibility of psychedelic-assisted therapy in patients with opioid use disorder who are undergoing opioid-assisted treatment. This study addresses the question of whether psychedelic-assisted therapy can be successfully implemented in patients with opioid use disorder. It also explores the effects of psychedelic therapy on the patient's experiences and outcomes. Methodology: This is an open case series on six patients who have undergone at least one session with either LSD (100-200 micrograms) or psilocybin (20-40 mg). The patients were assessed using the Five Dimensional Altered States of Consciousness (5D-ASC)-Scale. The data were analyzed descriptively to identify patterns and trends in the patients' experiences. Results: The patients experienced substantial positive psychedelic effects during the psychedelic sessions without significant adverse effects. The patients reported positive experiences and improvements in their condition. Conclusion: The findings of this study support the feasibility and potential efficacy of psychedelic-assisted therapy in patients undergoing opioid-assisted treatment.

Keywords: psychedelics, psychedelic-assisted treatment, opioid use disorder, addiction, LSD, psilocybin

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Authors: Azadeh Mottaghi, Zeynab Shakeri

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Background: Eating disorders (ED) are group of psychological disorders that significantly impair physical health and psychosocial function. EDconsists wide range of morbidity such as loss of eating control, binge eating disorder(BED), night eating syndrome (NES), and bulimia nervosa. Eating behavior is a wide range term that includes food choices, eating patterns, eating problems. In this study, current knowledge will be discussed aboutcomparison of eating disorders and eating behaviors in morbid obese women with and without type 2 diabetes. Methods: 231 womenwith morbid obesity were included in the study.Loss of eating control, Binge eating disorder and Bulimia nervosa, Night eating syndrome, and eating behaviors and psychosocial factorswere assessed. SPSS version 20 was used for statistical analysis. A p-value of <0.05 was considered significant. Results: There was a significant difference between women with and without diabetes in case of binge eating disorder (76.3% vs. 47.3%, p=0.001). Women with the least Interpersonal support evaluation list (ISEL) scores had a higher risk of eating disorders, and it is more common among diabetics (29.31% vs. 30.45%, p= 0.050). There was no significant difference between depression level and BDI score among women with or without diabetes. Although 38.5% (n=56) of women with diabetes and 50% (n=71) of women without diabetes had minimal depression. The logistic regression model has shown that women without diabetes had lower odds of exhibiting BED (OR=0.28, 95% CI 0.142-0.552).Women with and without diabetes with high school degree (OR=5.54, 95% CI 2.46-9.45, P= 0.0001 & OR=6.52, 95% CI 3.15-10.56, respectively) and moderate depression level (OR=2.03, 95% CI 0.98-3.95 & OR=3.12, 95% CI 2.12-4.56, P= 0.0001) had higher odds of BED. Conclusion: The result of the present study shows that the odds of BED was lower in non-diabetic women with morbid obesity. Women with morbid obesity who had high school degree and moderate depression level had more odds for BED.

Keywords: eating disorders binge eating disorder, night eating syndrome, bulimia nervosa, morbid obesity

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Authors: Shaine Mehta, Neelam Parmar, Patrick White, Mark Ashworth

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Patients with a history of substance have a high prevalence of comorbidities, including asthma and chronic obstructive pulmonary disease (COPD). Mortality rates are higher than that of the general population and the link to respiratory disease is reported. Randomised controlled trials (RCTs) support opioid substitution therapy as an effective means for harm reduction. However, whilst a high proportion of patients receiving opioid substitution therapy are smokers, to the author’s best knowledge there have been no studies of respiratory disease and smoking intensity in these patients. A cross sectional prevalence study was conducted using an anonymised patient-level database in primary care, Lambeth DataNet (LDN). We included patients aged 18 years and over who had records of ever having been prescribed methadone in primary care. Patients under 18 years old or prescribed buprenorphine (because of uncertainty about the prescribing indication) were excluded. Demographic, smoking, alcohol and asthma and COPD coding data were extracted. Differences between methadone and non-methadone users were explored with multivariable analysis. LDN contained data on 321, 395 patients ≥ 18 years; 676 (0.16%) had a record of methadone prescription. Patients prescribed methadone were more likely to be male (70.7% vs. 50.4%), older (48.9yrs vs. 41.5yrs) and less likely to be from an ethnic minority group (South Asian 2.1% vs. 7.8%; Black African 8.9% vs. 21.4%). Almost all those prescribed methadone were smokers or ex-smokers (97.3% vs. 40.9%); more were non-alcohol drinkers (41.3% vs. 24.3%). We found a high prevalence of COPD (12.4% vs 1.4%) and asthma (14.2% vs 4.4%). Smoking intensity data shows a high prevalence of ≥ 20 cigarettes per day (21.5% vs. 13.1%). Risk of COPD, adjusted for age, gender, ethnicity and deprivation, was raised in smokers: odds ratio 14.81 (95%CI 11.26, 19.47), and in the methadone group: OR 7.51 (95%CI: 5.78, 9.77). Furthermore, after adjustment for smoking intensity (number of cigarettes/day), the risk was raised in methadone group: OR 4.77 (95%CI: 3.13, 7.28). High burden of respiratory disease compounded by the high rates of smoking is a public health concern. This supports an integrated approach to health in patients treated for opiate dependence, with access to smoking cessation support. Further work may evaluate the current structure and commissioning of substance misuse services, including smoking cessation. Regression modelling highlights that methadone as a ‘risk factor’ was independently associated with COPD prevalence, even after adjustment for smoking intensity. This merits further exploration, as the association may be related to unexplored aspects of smoking (such as the number of years smoked) or may be related to other related exposures, such as smoking heroin or crack cocaine.

Keywords: methadone, respiratory disease, smoking cessation, substance misuse

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Authors: Mansi Chinchanikar

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Homoeopathy is the second most widely used medical system in the world, yet the homoeopaths of India and around the world are sick of reading or hearing about how homoeopathy is only a placebo effect and cannot cure or even manage any disease. However, individuals making such unfounded claims should explain to the group how a homoeopathic placebo, particularly one for a neurodevelopmental disease like Attention Deficit Hyperactivity Disorder (ADHD), can be effective in children, with studies to back it up their skeptics. This literary review work exhibits how homoeopathy with a multimodal approach may show a considerable proportion of ADHD patients in India and throughout the world successfully manageable and treatable according to growing study evidence, ruling out the hazardous conventional medicines. Indeed, homeopathy can help cure ADHD symptoms either on its own or in combination with other types of integrative systems.

Keywords: ADHD, adult ADHD, homoeopathy, integrative approach

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Authors: Ana Rita Conde, Pilar Mota, Tânia Botelho, Suzana Caldeira, Isabel Rego, Jessica Pacheco, Osvaldo Silva, Áurea Sousa

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Tourism promotes well-being and health to children with ASD and their families. Literature indicates the need to provide tourist activities that integrate the therapeutic component, to promote the development and well-being of children with ASD. The study aims to implement tourist offers in Azores that integrate the therapeutic feature, assess their suitability and impact on the well-being and health of the child and caregivers. Using a mixed methodology, the study integrates families that experience and evaluate the impact of tourism products developed specifically for them.

Keywords: austism spectrum disorder, children, therapeutic tourism activities, well-being, health, inclusive tourism

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Authors: Mia Schneeweiss, Joseph Merola

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Atopic dermatitis (AD) is a chronic inflammatory skin condition with a prevalence of 9.6 million in children under the age of 18 in the US, 3.2 million of those suffer severe AD. AD has significant effects on the quality of life and psychiatric comorbidity in affected patients. We sought to quantify the use of psychotropic medications and mental health services in children. We used longitudinal claims data form commercially insured patients in the US between 2003 and 2016 to identify children aged 18 or younger with a diagnosis of AD associated with an outpatient or inpatient encounter. A 180-day enrollment period was required before the first diagnosis of AD. Among those diagnosed, we computed the use of psychiatric services and dispensing of psychotropic medications during the following 6 months. Among 1.6 million children <18 years with a diagnosis of AD, most were infants (0-1 years: 17.6%), babies (1-2 years: 12.2%) and young children (2-4 years: 15.4). 5.1% were in age group 16-18 years. Among younger children 50% of patients were female, after the age of 14 about 60% were female. In 16-18 years olds 6.4% had at least one claim with a recorded psychopathology during the 6-month baseline period; 4.6% had depression, 3.3% anxiety, 0.3% panic disorder, 0.6% psychotic disorder, 0.1% anorexia. During the 6 months following the physician diagnosis of AD, 66% used high-potency topical corticosteroids, 3.5% used an SSRI, 0.3% used an SNRI, 1.2% used a tricyclic antidepressant, 1.4% used an antipsychotic medication, and 5.2% used an anxiolytic agent. 4.4% had an outpatient visit with a psychiatrist and 0.1% had been hospitalized with a psychiatric diagnosis. In 14-16 years olds, 4.7% had at least one claim with a recorded psychopathology during the 6-month baseline period; 3.3% had depression, 2.5% anxiety, 0.2% panic disorder, 0.5% psychotic disorder, 0.1% anorexia. During the 6 months following the physician diagnosis of AD, 68% used high-potency topical corticosteroids, 4.6% used an SSRI, 0.6% used an SNRI, 1.5% used a tricyclic antidepressant, 1.4% used an antipsychotic medication, and 4.6% used an anxiolytic agent. 4.7% had an outpatient visit with a psychiatrist and 0.1% had been hospitalized with a psychiatric diagnosis. In 12-14 years olds, 3.3% had at least one claim with a recorded psychopathology during the 6-month baseline period; 1.9% had depression, 2.2% anxiety, 0.1% panic disorder, 0.7% psychotic disorder, 0.0% anorexia. During the 6 months following the physician diagnosis of AD, 67% used high-potency topical corticosteroids, 2.1% used an SSRI, 0.1% used an SNRI, 0.7% used a tricyclic antidepressant, 0.9 % used an antipsychotic medication, and 4.1% used an anxiolytic agent. 3.8% had an outpatient visit with a psychiatrist and 0.05% had been hospitalized with a psychiatric diagnosis. In younger children psychopathologies were decreasingly common: 10-12: 2.8%; 8-10: 2.3%; 6-8: 1.3%; 4-6: 0.6%. In conclusion, there is substantial psychiatric comorbidity among children, <18 years old, with diagnosed atopic dermatitis in a US commercially insured population. Meaningful psychiatric medication use (>3%) starts as early as 12 years old.

Keywords: pediatric atopic dermatitis, phychotropic medication use, psychiatric comorbidity, claims database

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Authors: Rajesh Ranjan, Marimuthu Palaniswami, A. A. Hashmi

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With the changing lifestyle and environment around us, the prevalence of the critical and incurable disease has proliferated. One such condition is the neurological disorder which is rampant among the old age population and is increasing at an unstoppable rate. Most of the neurological disorder patients suffer from some movement disorder affecting the movement of their body parts. Tremor is the most common movement disorder which is prevalent in such patients that infect the upper or lower limbs or both extremities. The tremor symptoms are commonly visible in Parkinson’s disease patient, and it can also be a pure tremor (essential tremor). The patients suffering from tremor face enormous trouble in performing the daily activity, and they always need a caretaker for assistance. In the clinics, the assessment of tremor is done through a manual clinical rating task such as Unified Parkinson’s disease rating scale which is time taking and cumbersome. Neurologists have also affirmed a challenge in differentiating a Parkinsonian tremor with the pure tremor which is essential in providing an accurate diagnosis. Therefore, there is a need to develop a monitoring and assistive tool for the tremor patient that keep on checking their health condition by coordinating them with the clinicians and caretakers for early diagnosis and assistance in performing the daily activity. In our research, we focus on developing a system for automatic classification of tremor which can accurately differentiate the pure tremor from the Parkinsonian tremor using a wearable accelerometer-based device, so that adequate diagnosis can be provided to the correct patient. In this research, a study was conducted in the neuro-clinic to assess the upper wrist movement of the patient suffering from Pure (Essential) tremor and Parkinsonian tremor using a wearable accelerometer-based device. Four tasks were designed in accordance with Unified Parkinson’s disease motor rating scale which is used to assess the rest, postural, intentional and action tremor in such patient. Various features such as time-frequency domain, wavelet-based and fast-Fourier transform based cross-correlation were extracted from the tri-axial signal which was used as input feature vector space for the different supervised and unsupervised learning tools for quantification of severity of tremor. A minimum covariance maximum correlation energy comparison index was also developed which was used as the input feature for various classification tools for distinguishing the PT and ET tremor types. An automatic system for efficient classification of tremor was developed using feature extraction methods, and superior performance was achieved using K-nearest neighbors and Support Vector Machine classifiers respectively.

Keywords: machine learning approach for neurological disorder assessment, automatic classification of tremor types, feature extraction method for tremor classification, neurological movement disorder, parkinsonian tremor, essential tremor

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Authors: Shweta Jha, Digambar Darekar, Krishna Kadam

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Major Depressive Disorder (MDD) is one of the most common of psychiatric disorders. It has a wide range of symptoms, aetiologies and risk factors, and these reasons make MDD affect not only the primary patient, but also their family, caregivers and associates; by negatively impacting their self dignity, economic condition and self-confidence. Thus, it is important to help individuals suffering from MDD learn adaptive mechanism and deal effectively with their environment, with that aim this study focused on a comparative therapeutic intervention using Behaviour Activation (BA), Rational Emotive Behaviour Therapy (REBT) and Waiting list control (WLC) for management of MDD. This study apart from enhancing personal skills will also help us understand which therapeutic method would be more beneficial in treating and prolonging relapse in patients with MDD in Indian population. Fifteen individuals following application of inclusion and exclusion criteria were selected as study samples. They were randomly assigned to three treatment groups. Ten sessions of therapy, forty-five minutes each according to the proposed sessions plan were conducted for each group. The individuals selected as samples were re–assessed after 2 months and 6 months post intervention. The overall result showed that individuals treated with BA and REBT showed more improvement in comparison to those in WLC.

Keywords: behaviour activation, major depressive disorder, rational emotive behaviour therapy, therapeutic intervention

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Authors: Ezra N. S. Lockhart

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The number of children diagnosed with autism spectrum disorder (ASD) has increased approximately 173% during the last decade making ASD the fastest growing developmental disability in the United States. This rise in prevalence rates indeed has an effect on schools. ASD is overwhelmingly the most reported primary special education eligibility category for students accessing special education, at a national average of 61.3%. ASD is regarded as an urgent public health concern at an estimated annual per capita cost of $3.2 million. Furthermore, considering that ASD is a lifelong disorder estimated lifetime per capita cost reach $35 billion. The resources available to special education programs are insufficient to meet the educational needs of the 6.4 million students receiving special educational services. This is especially true given that there has been and continues to be a chronic shortage of fully certified special education teachers for decades. Reports indicate that 81.1% of students with special needs spend 40% or more in general education classrooms. Regardless of whether support is implemented in the special education or general education classroom the resource demand is obvious. Schools are actively seeking to implement low-cost alternatives and budget saving measures in response to this demand. In public school settings, programs such as Applied Behavior Analysis are challenging to implement and fund at $40,000 per student per year. As an alternative, computer-based interventions are inexpensive, less time-consuming to implement, and require minimal teacher or paraprofessional training to administer. Affordability, pricing schemes, availability, and compatibility of computer-based interventions that support social and emotional skill development in individuals with ASD are discussed.

Keywords: affordability, autism spectrum disorder, computer-based intervention, emotional skills, social skills

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Authors: Radwa R. El-Saadany , Medhat Abu Zeid, Tarek Omar, Marwa S. Maqsoud

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Attention deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders characterized by attention deficit, hyperactivity, and impulsivity. Neurofeedback (NF) is one of the neurotherapy treatments that cause brain wave changes. Method: The current pseudo-experimental study with a pre–post-test design was conducted on a population of children with attention deficit hyperactivity disorder (ADHD).The sample size comprised of (30) children selected by random sampling method and assigned to two therapeutic groups: First therapeutic group received a neurofeedback program. Based on QEEG, it reached (10) children. The second therapeutic group received an organization skills training program, it reached (10) and the control group that did not receive programs, it reached (10) children. Results: There are significant differences between pre- and post-assessments among therapeutic groups in reducing the three core symptoms of ADHD in favor of post measurement. There are no significant differences between post-assessment and follow up measurement of the therapeutic groups.

Keywords: QEEG-based neurofeedback therapy program, organizational skills training program, attention deficit hyperactivity disorder

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Authors: Andre Wittenborn, Jarek Krajewski

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Trauma-related sadness in speech can alter the voice in several ways. The generation of non-linear aerodynamic phenomena within the vocal tract is crucial when analyzing trauma-influenced speech production. They include non-laminar flow and formation of jets rather than well-behaved laminar flow aspects. Especially state-space reconstruction methods based on chaotic dynamics and fractal theory have been suggested to describe these aerodynamic turbulence-related phenomena of the speech production system. To extract the non-linear properties of the speech signal, we used the time delay embedding method to reconstruct from a scalar time series (reconstructed phase space, RPS). This approach results in the extraction of 7238 Features per .wav file (N= 47, 32 m, 15 f). The speech material was prompted by telling about autobiographical related sadness-inducing experiences (sampling rate 16 kHz, 8-bit resolution). After combining these features in a support vector machine based machine learning approach (leave-one-sample out validation), we achieved a correlation of r = .41 with the well-established, self-report ground truth measure (RATS) of post-traumatic stress disorder (PTSD).

Keywords: non-linear dynamics features, post traumatic stress disorder, reconstructed phase space, support vector machine

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Authors: Athena Pedro, Gina Stockingt

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This study aimed to explore current management strategies used by Grade 1 educators working with learners presenting with Attention Deficit Hyperactivity Disorder (ADHD) symptoms in mainstream schools in the Western Cape. A sample of grade 1 educators were selected for the study. The sample comprised of twelve grades 1 educators from four local schools in the Western Cape. All twelve educators were individually interviewed and discussed the management strategies used in the classroom when working with learner presenting with ADHD symptoms. The data was analysed qualitatively with a focus in identifying, sorting and analyse meaning according to the subjective perception, understanding and behaviour of the grade 1 educators within their context. Furthermore, the social, cultural, political and physical environment of the participants were taken into consideration to explore and interpret the link between these elements. The findings were as follows: many educators felt that they did not receive enough training on Attention Deficit Hyperactivity Disorder, therefore lacking knowledge on how to apply management strategies to address this. Managing a diverse range of learners, lack of resources, lack of parental involvement, lack of assistance in the classroom, as well as distracted and disorganised children posed as challenges for educators working with learners presenting with Attention Deficit Hyperactivity Disorder symptoms.

Keywords: ADHD, Grade 1 educators, Learners, Management strategies

Procedia PDF Downloads 182