To explore the impact of an immersive virtual reality (VR) training module on infection prevention and control (IPC) knowledge and attitudes of healthcare personnel (HCP) and to demonstrate the use of VR for performance assessment in cleaning and disinfection of portable medical equipment (PME).

Quasi-experimental study.

Two academic medical centers and three long-term care facilities.

HCP in clinical roles were recruited.

Pilot sites trained participants on an immersive VR training module on PME cleaning and disinfection. Participants completed the VR module and pre- and post-knowledge and attitude assessment surveys, including a post-survey on the user experience of the VR module. Performance data were collected from the head-mounted displays (HMD) on the duration of the VR session, and participant performance including in-module task completion, hand hygiene compliance, PME disinfection percentage, and in-module quiz performance. Statistical significance and effect size were calculated using paired sample t-tests and Cohen’s D for pre- and post-survey results. HMD data were analyzed using descriptive statistics.

A total of 60 participants were recruited; 54 were included for analysis, with improvements in knowledge and attitudes post-training. Participant user experience was rated 50.19/55. HMD data demonstrated: 22-minute mean module duration, mean of 2.15/28 tasks not completed, mean of 2.56 missed hand hygiene opportunities, and 54% PME mean disinfection percentage, and varied performance on in-module quizzes.

Immersive VR training may be effective in improving HCP knowledge and attitudes in IPC concepts. Performance data collected through VR training can evaluate learner performance and be used to target training for improvement.

Just as prospective differentiation between true emergencies and calls for subacute patients is critical to the delivery of prehospital care, retrospective differentiation is critical to research and quality improvement. Determining the acuity of patients based on the type of care they received could complement the vital-sign-based instruments currently popular, yet imperfect. The study aim was to create a consensus definition of time-dependent care and a list of time-dependent interventions in paramedicine.

The study was a Delphi approach consisting of four rounds of voting by a bi-provincial panel of 22 Canadian key informants representing medical first responders, paramedics, and physicians – first to agree on a definition of time-dependent care – then to categorize 29 clinical and 34 pharmacological interventions.

Based on the consensus definition of “A majority of patients who should receive the intervention, according to provincial protocols, would suffer a direct prejudice to their health or safety if the intervention, provided on its own, was not performed within eight minutes of the initial call,” the panel reached consensus on 52 of 63 interventions (82.5%), of which 17 (32.7%) were voted time-dependent (11 clinical [64.7%] and six pharmacological [35.3%]). Clinical interventions included airway suction or de-obstruction, cricothyrotomy, positive pressure ventilation, chest decompression, cardiopulmonary resuscitation, defibrillation, cardioversion, pacing, and hemorrhage control. Pharmacological interventions included medication classed as sympathomimetics, caloric agents, antiarrhythmic agents, anticonvulsants, or tranquilizers.

The panel reached a consensus on a definition of time-dependent care and used this to identify prehospital interventions that could serve as an instrument to improve care and system performance.

Nitrous oxide may possess antidepressant effects; however, limited data exist on repeated administrations and active placebo-controlled studies in treatment-resistant depression (TRD).

We aimed to test the feasibility of a randomised controlled trial examining a 4-week course of nitrous oxide or midazolam, an active placebo.

In this randomised, active, placebo-controlled pilot trial, 40 participants with TRD were assigned either a 1-h inhalation of 50% nitrous oxide plus intravenous saline (n = 20) or a 1-h inhalation of 50% oxygen plus intravenous midazolam (0.02 mg/kg, up to 2 mg; n = 20) once weekly, for 4 weeks. Feasibility was assessed by examining rates of recruitment, withdrawal, adherence, missing data and adverse events. The main measure of clinical efficacy was the change in depression severity (Montgomery–Åsberg Depression Rating Scale (MADRS)) score from baseline to day 42.

The recruitment rate was 22.3% (95% CI 16.9–29.0). Withdrawal rates were 10% (95% CI 2.8–30.1) in both groups and adherence rates were 100.0% (95% CI 82.4–100) in the nitrous oxide group and 94.4% (95% CI 74.2–99.0) in the placebo group. There were no missing primary clinical outcome data in either group (0.0%, 95% CI 0.0–17.6). MADRS score changed by −20.5% (95% CI −39.6 to −1.3) in the nitrous oxide group and −9.0% (95% CI −22.6 to 4.6) in the placebo group. Nearly all adverse events were mild to moderate and transient.

The findings support the feasibility and necessity of conducting a full-scale trial comparing nitrous oxide and midazolam in patients with TRD.

A linguistic feature is a common characteristic associated with various mental disorders. In particular, bipolar disorder is one of the disorders in which verbal abnormalities as symptoms can be prominent. As technology advances and big data processing becomes easier, studies on the linguistic characteristics of bipolar disorder are increasing. However, the results of previous generations, who studied the linguistic features of bipolar disorder without computer-based methods are not considered, and have not been integrated with current research findings. It is necessary to review what methodologies can be used and what limitations should be considered to explore the linguistic characteristics of bipolar disorder.

This scoping review aims to explore how we can analyze linguistic features of bipolar disorder by using textual language. It reviewes the approaches and results of the studies can explain bipolar disorder appropriately.

The study protocol follows the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. Research papers for this review were collected by 3 electronic databases: Google Scholar, PubMed, Web of Science Using inclusion and exclusion criteria, all investigators screened the abstracts and full texts of the articles and extracted the data independently.

We identified 315 potential studies from 3 databases. After screening the abstracts and full texts of articles, 17 (5.3%) articles met our inclusion criteria. We extracted elements such as results, and methodology from the above articles. The purpose of investigating linguistic features is mostly to predict and classify bipolar disorder, and to characterize the linguistic feautres of patients with bipolar disorder and other disorders. The most commonly used methodology is computer-based language analysis, such as natural language processing and learning models. Non-computer based articles, some of them adopted qualitative analysis. We confirmed the following results regarding the linguistic characteristics of bipolar disorder: a reduction in lexical variety, a higher rate of coordinate phrases, words related to power and achievement, and themes of humor and anger. In the narrative description of this, we include discussions on ethical issues.

This scoping study synthesizes a study analyzing the linguistic characteristics of patients with bipolar disorder for the purpose of classification and discrimination. Past and present study uses various collection targets such as letters and web-based data, and adopts various methodologies including computer-based methods and qualitative analysis. In this study, we review the points to consider in order to interpret and apply the results of these studies from a clinical point of view. Additionally, the focus is presented to researchers who analyze the linguistic characteristics of bipolar disorder.

None Declared

Digital phenotyping offers a valuable method for predicting and preventing nonsuicidal self-injury (NSSI) in daily life by providing objective, ecologically valid measurements at multiple time points. This approach quantifies an individual’s phenotype by capturing self-injury-related markers such as mood, step counts, and heart rate.

The aim of this study is to identify real-time predictors and to elucidate the dynamic trajectory of NSSI in individuals.

This study targets individuals in their 20s residing in South Korea who engaged NSSI on five or more days during the past year, and a total of 56 participants were included in the current study. Once participants were enrolled, active (e.g., ecological momentary assessment) and passive (e.g., heart rate, step count) data were collected via a smartphone app and wrist-worn wearables for 14 days. Initially, a random forest algorithm was employed to assess the relative importance of passive and active data in predicting NSSI thoughts. Subsequently, a multilevel logistic regression model was used to capture variability at both the within-person and between-person levels.

After inputting passive data into the random forest algorithm, the model demonstrated an accuracy of 0.619. Among the variables, walking stride had the highest importance score at 0.28, followed by heart rate (0.18) and heart rate variability (0.17). Subsequently, when analyzing the random forest algorithm with active variables, the model’s accuracy was found to be 0.666. In this case, anger toward others had the highest importance score at 0.26, followed by depression (0.22) and anger toward oneself (0.19). In a separate analysis using multilevel logistic regression models for each passive variable, none of the variables produced significant results in either the fixed or random effects analyses. However, when active variables were entered into separate multilevel logistic regression models, all emotional variables yielded significant results in the fixed effects analysis: depression (0.746, p < .001), anxiety (0.521, p < .001), anger toward oneself (0.475, p < .001), anger toward others (0.403, p < .001), loneliness (0.329, p < .001), and shame (0.557, p < .05). In contrast, none of the variables showed significant results in the random effects analysis.

The findings from this study could offer insights into novel mechanisms underlying the occurrence of self-injurious thoughts and their prediction in daily life. Additionally, this advanced approach may help identify optimal strategies for NSSI prevention and enable the delivery of personalized, real-time interventions.

None Declared

The social skills of the chronic schizophrenia is an important factor in assessing the prognosis of patients with schizophrenia.

The object of this study was to investigate the effects of group integrative arts therapy based on social skill training on communication, social adaptive function, and subjective well-being in inpatients with chronic schizophrenia.

Among the 125 patients who had been hospitalized in the mental hospital after being diagnosed with schizophrenia by psychiatrists according to DSM-5, 72 patients were selected by inclusion criteria and 48 patients were randomly assigned into an experimental group(n=16), comparative group(n=16), and control group(n=16). During this study, 4 patients from each groups dropped out. The final subjects of each groups were 12 patients. The experimental group followed a 60 minutes long social skill training based on group integrative arts therapy program for twice a week and 20 times in total. The Comparative group followed a social skill training program only for 60 minutes twice a week for 20 times in total. The control group received no treatment. To assess the social adaptive function, empowerment, subjective well-being of the subjects, Communication Competence Scale(CCS), Empowerment Scale(ES) and Korean Modification of Subjective Well-Being Scale(KmSWN) were used as subjective measuring. Assertiveness Observation Evaluation Scale(AOES), Social Adaptive Functioning Scale(SAFS), and Nurses’ Observation Scale of Inpatient Evaluation-30(NOSIE-30) were also used as objective measuring that were rated by nurses or social workers at the mental hospital.

There was no statistically significant difference except non-verbal communication of CCS among three groups in homogeneity test of sociodemographic and clinical variables. The group integrative arts therapy based on social skill training was found to significantly increase the communication, assertiveness, social adaptive functioning and empowerment of experimental group more than comparative group, and that of comparative group more than the control group. The group integrative arts therapy based on social skill training was found to significantly increase the NOSIE-30 of the experimental group and the comparative group more than control group. NOSIE-positive and irritability of NOSIE-30 in the comparative group was increased more than those of the experimental and the control groups.

The group integrative arts therapy based on social skill training is found to significantly enhance the social adaptive function and empowerment of inpatients with chronic schizophrenia than social skill training. These results suggest that group integrative arts therapy could be utilized as effective mental rehabilitation intervention program for inpatients with chronic schizophrenia.

None Declared

Obsessive-compulsive disorder (OCD) is a chronic condition that frequently co-occurs with mood disorders such as major depressive disorder (MDD) and bipolar disorder (BD), complicating both prognosis and treatment. The presence of MDD or BD in OCD patients is associated with more complex clinical presentations and worse outcomes.

Despite the high prevalence of these comorbidities, few studies have thoroughly compared the traits and states of OCD patients with comorbid mood disorders. This study aims to explore the differences in traits and states among OCD patients with comorbid mood disorders, including MDD, bipolar disorder I (BD1), and bipolar disorder II (BD2).

The study included 114 OCD patients: 21 without mood disorders, 32 with MDD, 47 with BD2, and 14 with BD1. Demographic variables such as family history of psychiatric disorders and history of pharmacological treatment for OCD were analyzed. Participants were evaluated using standardized tools such as the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A), Obsessive-Compulsive Inventory (OCI), Depressive Symptom Inventory Suicidality Subscale (DSI-SS). Statistical analyses including one-way analysis of variance (ANOVA) and chi-squared tests were conducted to identify significant differences between groups.

Patients with comorbid bipolar disorder (BD), particularly those with BD1, had a significantly higher prevalence of psychiatric family history (85.7%, p = .031). Pharmacological treatment for OCD was less frequent in patients with BD, with the lowest rate in the BD2 group (61.7%, p = .008). Compared to patients without mood disorders or those with MDD, OCD patients with BD showed higher scores in several temperament dimensions, including cyclothymic temperament (p < .001), depressive temperament (p = .007), hyperthymic temperament (p = .006), anxious temperament (p < .001), and irritable temperament (p < .001). These patients also exhibited more severe depressive symptoms (p < .001), higher anxiety levels (p < .001), and greater suicidality (p = .002). Obsessive-compulsive symptoms, particularly neutralizing behaviors (p = .010), ordering behaviors (p < .001), and hoarding behaviors (p < .001), were more pronounced in the BD groups.

OCD patients with comorbid BD show distinct clinical profiles compared to those with MDD. They have a stronger genetic predisposition to psychiatric disorders and are less likely to receive pharmacological treatment for OCD. These patients also experience more severe depressive symptoms, anxiety, and obsessive-compulsive traits, complicating treatment. The findings highlight the need for comprehensive evaluations and personalized treatment plans for OCD patients with mood disorder comorbidities.

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Pathological anxiety in social anxiety disorder (SAD) is characterized by dysregulated arousal and altered cardiac autonomic responses, with lower heart rate variability (HRV) potentially indicating emotional dysregulation.

This study aimed to explore the relationship between peripheral and central autonomic nervous system activity during emotional processing in patients with SAD.

Thirty-two patients with SAD and 41 healthy controls participated in a passive viewing task that alternated between neutral and angry faces. We analyzed correlations between brain activation during emotional processing and root mean square of successive differences (RMSSD) in HRV during both resting state and task conditions.

Unlike the controls, the SAD group showed a trend toward significant correlations between baseline RMSSD and left anterior insula activity during neutral face processing (R2 = 0.118, β = -0.003, F= 3.886, p = .058) and significant correlations with both left anterior insula and right amygdala activities during angry face processing (R2 = 0.157, β = -0.003, F= 5.415, p = .027 and R2 = 0.135, β = -0.002, F= 4.360, p = .046, respectively). In the control group, task RMSSD was significantly correlated with right amygdala and right dorsomedial prefrontal cortex activities during neutral face processing (R2 = 0.160, β = -0.003, F=6.284, p = .017 and R2 = 0.222, β = -0.009, F=9.443, p = .004, respectively), while in the SAD group, correlations were found with the right parahippocampal gyrus (R2 = 0.148, β = -0.002, F=4.5, p = .044). Additionally, only in the control group, RMSSD during neutral face trials was significantly correlated with neural activation during angry faces processing (R² = 0.132, β = -0.002, F=4.856, p = .035).

This study identifies distinct patterns of autonomic and neural responses to emotional stimuli in SAD patients, highlighting heightened autonomic readiness and reduced flexibility when processing social threats.

None Declared

The COVID-19 pandemic prompted a significant shift in our approach to healthcare, leading to the widespread adoption of virtual healthcare services, including mental healthcare. In this context, understanding and incorporating the unique perspectives of youths is crucial for improving virtual mental health services for this population.

This qualitative study explores the ideal features of virtual mental health services among youths.

Nine focus group discussions and eight semi-structured interviews were conducted with 65 individuals aged 15-35 in Singapore. To ensure the comprehensive representation of youths’ perspectives, participants from diverse ethnicities (mainly Chinese, Malay, and Indian), ages, and genders were included using purposive sampling. The data was analysed using content analysis through both inductive and deductive approaches.

Four main themes were identified from the data. First, technology and platform: youths stressed the importance of a credible and government-endorsed service provider to deliver a comprehensive and trustworthy experience facilitated by qualified professionals. Second, functionality: they wanted credible affiliations to be displayed prominently on the home page and various tools such as calls, chats, moderated forums, profiles of healthcare professionals, and educational resources. Confidentiality, anonymity, and privacy were also highlighted as necessary. Third, user interface: youths preferred an intuitive and age-tailored interface to ensure a seamless and user-friendly experience, with organised content, appealing aesthetics, and engaging elements on video call sessions. Fourth, usability: they emphasised the need for an affordable and widely compatible operating system to promote accessibility of services.

Virtual mental health services, with their great potential, can expand and effectively meet the needs of youths. By prioritizing credible platforms, comprehensive functionality, confidentiality, an intuitive interface, and broad accessibility, we can enhance help-seeking among youths and create a more effective support system.

None Declared

Intimate partner violence (IPV) is a major public health concern. One of the most common forms of interpersonal violence concerns IPV, one in three women which is approximately 35% of women who experience physical and sexual violence by an intimate partner at some points in their lives. Women with mental illness are a vulnerable risk group for IPV.

The current study aimed to assess the prevalence and clinical correlates of IPV among women outpatients with mental illness in a tertiary care psychiatric hospital.

118 participants with a primary diagnosis of schizophrenia spectrum disorders or depression were recruited. Data on intimate partner violence (IPV) were assessed on the World Health Organization Violence Against Women (WHOVAW) scale, consisting of three domains-psychological, physical and sexual intimate partner violence. Psychopathology was measured using Brief Psychiatric Rating Scale-18 items (BPRS) questionnaire, consisting of five domains- positive symptoms, negative symptoms, resistance symptoms, activation symptoms, and affect symptoms. Data on socio-demographic characteristics were also obtained. Multivariable logistic regression was used for analysis.

The mean (SD) age of women participants was 32.63 years (10.96). The overall prevalence of IPV among women with mental illness was 55.1%. Participants who were separated/widowed/divorced (versus single) were significantly more likely to experience total VAW scores (OR=14.57), and psychological (OR=21.64), and physical (OR=11.30) domains. Those who belong to Malay ethnicity (versus Chinese ethnicity) were significantly more likely to experience sexual abuse (OR=6.25). Women who were unemployed (versus employed) were significantly more likely to experience sexual IPV (OR=3.94). Women who experienced IPV (OR=1.36), psychological abuse (OR=1.30) and physical abuse (OR=1.25) were significantly more likely to have positive symptoms compared to those who did not experience IPV. Women who experienced IPV (OR=1.14) and psychological abuse (OR=1.13) were significantly more likely to have affect symptoms compared to those who did not experience IPV.

The study highlights the prevalence of IPV among women with mental illness. Overall VAW scores, psychological and physical IPV were strongly associated with higher score on the positive and affect symptoms on psychopathology scale. The high prevalence of IPV among this group of patients is concerning and mental health professionals should actively identify IPV and implement holistic interventions to ensure good care of women with mental illness.

None Declared