This Crisis Intervention Team was born in October 2018 with the aim of intensifying the treatment of people in psychiatric crisis situation.

Provide an intensive and early assessment and approach in a timely manner. It also provides home care if necessary.

The team intensively performs scheduled visits, emergencys, telephone interventions and home care. It is in constant coordination with other structures of the mental health and socio-health network.

A total of 83 patients have been included in our team since its inception. The youngest was 17 years old and the oldest 83 years old (exceptional case in evaluation). The mean age was 45.6 years. 67.4% were female (56 women) and 32.5% male (27 men). The delay in care did not exceed 48 hours.

200 patients were evaluated into suicide protocol, with ages ranging from 15 to 85 years, with a mean age of 45.4 years. The delay in care does not exceed 10 days.

This is a team that offers a rapid response, dedicates the necessary time for a correct evaluation of the risk, of the evolution and tries to establish a therapeutic alliance in record time. It is able to tolerate a certain degree of uncertainty, manage and tolerate the level of risk. He stands out for being flexible and dynamic in order to be able to adapt to the patients and theirs circumstances. This requires empathy, closeness and commitment.

No significant relationships.

The aim of the study was a comparative analysis of the results of neuropsychological tests with the indicators of the study of oral fluid and buccal epithelium cytograms in patients with Alzheimer’s disease.

In the main group of 12 patients with Alzheimer’s disease, m=76.25±4.89. There were 12 cognitively healthy people in the control group. The average MMSE score among the observations of the main group was 13.42±3.63.

The ADAS-COG scale was used to detail the impaired cognitive functions. The concomitant pathology is compensated. The content of BDNF, TNF-α, IL1RA, IL-6, and IL-8 was determined in the oral fluid and in the blood serum.

When analyzing buccal cytograms, attention was drawn to a pronounced increase in the number of cells with micronuclei in patients with AD to 1.8%; in the control group, the median was 0.1% (p<0.05). A direct correlation was established between the number of binuclear cells and the level of BDNF in the blood serum (r=0.646; p=0.03) in patients with AD. It is also important to note that the level of serum BDNF had a significant direct correlation with immediate memory, and the concentration of salivary BDNF correlates with the parameter of naming objects.

Correlations between amnesia, speech disorders, praxis, gnosis and pathology of the oral fluid and buccal epithelium, especially with the severity of karyopycnosis and karyorexis, have been established, indicating a direct correlation between the neurodegenerative process pathogenetically associated with Alzheimer’s disease and the processes of systemic inflammation and degeneration of the buccal epithelium.

No significant relationships.

Autism spectrum disorders (ASD) are a group of neurodevelopmental disorders that show delays and deficits in the development of multiple brain functions, which are characterized by social communication, poor language development, and restricted and stereotyped patterns of interests and behaviours. ASD affects about 1-2 % of the population and are considered to be highly genetic in nature. Structural variations of chromosomes have been identified in some ASD individuals, most common on chromosome 7q, 15q and 22q.

1-To present a systematic literature review of the natural history of individuals with 22q13.3 deletion syndrome, Phelan-McDermid syndrome (PMS). PMS, increase awareness of different phenotypes 2- Correlation of clinical manifestations of PMS with hypothesized underlying biological mechanisms 3-Rational for novel treatments is inferred through translational neuroscience approaches.

We have conducted a systematic literature review of the natural history of individuals with PMS, including both cross-sectional and long-term longitudinal analyses and correlation with hypothesized underlying biological mechanisms, including roles in regulation synaptic development, function, and plasticity. This systematic review includes the basis for a promising common pathway for ASD pathogenesis and the clinical implications of novel therapeutic strategies inferred through translational neuroscience approaches.

This systematic review, therefore, outlines the: (1) Pathophysiological basis and clinical manifestations of PMS; (2) PMS pre-clinical models and applications to ASD; and (3) clinical implications of novel therapeutic strategies.

A promising common pathway for ASD pathogenesis and rational for novel treatments is inferred through translational neuroscience approaches. Neurobiological basis for lithium treatment is indeed supported by experimental results and current clinical findings.

No significant relationships.

Autism spectrum disorders (ASD) – nosological continuum of genetically and clinically heterogeneous mental disorders united by complex violation of mental development, social interaction and behavior.

Identify the features of brain functioning in children with ASD.

Neuropsychological diagnostics (Zh. Glozman), results acoustic brainstem evoked potentials (ABEP), mathematical methods. The study involved 48 children with diagnoses (ICD-10): F84. 0, F84. 1, F84.5, aged 3 to 8 years (average age 4.18 years).

Neuropsychological examination revealed the main Indices of the functioning of brain blocks: the Index of activation and energy components of activity (I Index), the Index of the right-hemisphere holistic strategy of information processing (Index II-rights), the Index of the left-hemisphere analytical strategy of information processing (Index II-left), the Index of programming, regulation and control of activity (III Index). Then the children were divided into groups (p<0.001): 1 group – 10 children with high I Index (W = -6.03); 2 – 20 children with high Index II-rights (W = -5.74); 3 – 18 children with high III Index (W = -2.32). Correlation analysis showed: for group 1 difficulties in the perception of auditory information are characteristic; for group 2 – reduced level of control over the course of mental activity, difficulties in automating thinking and speech, coordination of movements; for group 3 – relationship is not manifested.

Phonemic perception causes the greatest difficulties in children of group 1. Children of group 2 are characterized by difficulties in the formation of motor speech skills, a decrease in voluntary activity and control over it.

No significant relationships.

Megalomanic ideas in a patient with limited intellectual functioning may be due to the psychotic clinic or be the result of their disability.

This case is intended to highlight the importance of a joint approach between psychiatrists and psychologists to assess functionality before and after the psychotic episode.

34-year-old woman with no mental health history. She came to the emergency department for an episode of aggression at home. Her parents report that they have observed strange behaviour, she is more aggressive, speaks alone, changing voices and global insomnia in the last few days. Her language is incoherent and disorganised, with a long response latency. Megalomaniacal and catastrophic delusions. Possible auditory hallucinations and thought control phenomena.

During admission, antipsychotic treatment was introduced with good tolerance and response on the part of the patient. She has been distancing herself from the ideas and has become somewhat critical. A psychological evaluation was carried out with different scales that showed borderline IQ.

It is important to make a good assessment of the patient’s symptoms in order to make a differential diagnosis. In this case, it is advisable to carry out a control and follow-up, as well as a neuropsychological assessment before and after the acute episode. In addition, a multidisciplinary approach with psychologists, psychiatrists and social workers is important.

No significant relationships.

The research field of disability and mental health is politically and socially relevant, because the psychological well-being of people with intellectual disabilities has often been trivialized in therapy and legislation. Since the pursuit of mental health is coming into focus due to removal of stigma and emerging awareness, people with disabilities must have equal opportunities to choose their place of residence and get suitable psychosocial support.

Our aim is to investigate the influence of assisted outpatient treatment (AOT) on the quality of life and resilience of people with intellectual disabilities who are living self-determined.

A participatory mixed-methods design is chosen as it enables the greatest possible standardization and allows a high flexibility. The project will be divided into three parts: A systematic literature search to gain knowledge about the field and to estimate the sample size, a pre-post-comparison of the WHOQOL-BREF to evaluate AOT in terms of self-perceived quality of life and a focus-group of handicapped people to reflect the study results with attention on resilience.

To foster the doctoral thesis, several questions can be discussed: 1) How is the relation of disability and mental health to be described? 2) What might be the pros and cons of self-determined living? 3) Which steps need to be taken to implement AOT more often?

The topic is relevant in the public health sector and the results could help to sensitize professionals and the general society regarding to participation in everyday life. The recommendations developed may serve to implement comparable forms of housing.

No significant relationships.

Klinefelter’s syndrome (KS) is considered as a genetic risk factor for intellectual disability and specifically for impairment on verbal skills. Prenatal and perinatal morbidity concurrent with this diagnosis determine the entity and typology of neurodevelopmental deficits.

To describe the intellectual and adaptive functioning of a patient with KS and prenatal and perinatal difficulties, assessed in the Service of Psychiatry, Clinical Psychology and Mental Health at La Paz University Hospital (Madrid).

A descriptive study was conducted of a 6 year and 7-month-old boy with diagnosis of KS (karyotype XXY), extremely low weight at birth (752 gr.), Arnold Chiari type I malformation with post-hemorrhagic hydrocephalus and periventricular leukomalacia, bronchopulmonary dysplasia, intra-atrial septal defect, left kidney agenesis with iatrogenic adrenal insufficiency, and acute ventriculitis due to E. Coli. Neuropsychological evaluation was carried out in October 2021. Leiter-3 scale was selected due to the absence of expressive language; and his parents completed the questionnaire Adaptive Behavior Assessment System-II.

The nonverbal intelligence quotient was observed in the very low range (full-scale IQ = 69). The result of general adaptive behavior (z = -2.83), showed very high functional disability both in the conceptual, social, and practical domains.

The high number of causes of disability in this patient is consistent with a high degree of functional disability. Efficient evaluation sessions of intellectual performance, adaptive functioning, and necessary supports, due to the absence of expressive language and limited receptive language, are required. A specific neuropsychological evaluation profile should be established for KS.

No significant relationships.

Involving carers in the care of people with severe mental illness is known to bring positive treatment and psychosocial outcomes. However, evidence-based procedures to guide clinicians on how to involve carers in the acute care are lacking.

To provide an online training to clinicians working in the acute care regarding the organisation of a standardised meeting with the service user and their carer within the first week of hospitalisation, and explore their views after its implementation.

We trained six clinicians across four urban and rural sites in England, asked them to incorporate the meeting in their routine care provision and interviewed them to explore their experiences.

Clinicians reported training advantages such as ease of use, comprehensiveness and transferable skills, and meeting advantages such as shared goals development and acknowledgement of carer involvement value. They also mentioned challenges related to organisational/time constraints, expectations management, and distance to the hospital for carers. Clinicians suggested to further focus on carer motivation to engage, to use skills throughout admission rather than in a one-off session, and to provide a structured meeting summary. Those experiences were shared across sites, indicating similar benefits and challenges, not depending on the specific setting characteristics.

Providing structured training to clinicians may increase carer involvement in routine care in acute settings. Given the workload in such settings training endeavours should be brief and include skills that clinicians can apply to facilitate shared goal development and expectations management. The use of online meetings may allow increased carer participation in the acute care.

No significant relationships.

The involvement of informal carers (family and friends) in the care of people with severe mental illness (SMI) contributes to positive clinical outcomes, such as relapse prevention and symptom reduction. To date, the care pathway between inpatient and community care is not clearly defined impeding the smooth transition for patients, whilst carers are still barely involved in shared decision-making processes.

To investigate the views and experiences of patients with SMI, carers and clinicians regarding the transition from inpatient to community mental health services.

Four mixed focus groups were conducted with individuals with SMI (n=12), carers (n=10) and clinicians (n=9) across four different mental health catchment areas in England. Participants discussed their experiences and provided their views on facilitators, barriers and solutions for carer involvement during the transition between mental health services. Data were analysed using thematic analysis.

All stakeholders highlighted that factors that impede carer involvement are related to: confidentiality issues, unmet (structural and organisational) needs, and carer expectations. Patients with SMI, carers and clinicians agreed that carer involvement can be improved by providing psychoeducation to carers and training to staff, having accessible and transparent clinical procedures, and allocating specialised staff to carers.

The study findings emphasise that carer involvement is still overlooked, particularly when adults with SMI transition between services. The results provide guidance for practice emphasising the need for systematic involvement of carers across inpatient care, and for future research proposing effective ways of maximising carer involvement in mental health care.

No significant relationships.

Treatment options for ADHD in adults consist of psycho-education, cognitive behavioral therapy (CBT), pharmacotherapy or a combination thereof. Current studies do not yet provide insights into the additive effects of CBT and pharmacotherapy regarding the quality of life in adults with ADHD.

In this study, we investigated the effect of CBT combined with pharmacotherapy on the quality of life in adults with ADHD compared to pharmacotherapy alone.

In this multicenter prospective cohort study a total of 627 patients were included, 305 where included in the pharmacotherapy only group and 322 in de combination group (CBT and pharmacotherapy). The Adult ADHD Quality-of-Life scale (AAQoL) was conducted at baseline and at the end of treatment.

No significant differences were found in gender or age between groups at baseline. The average improvement in the AAQoL total score in the pharmacotherapy group was 26.81(17.12) and in the combination group 25.45(16.33) and showed no significant difference (t(543) = 0.96, p = 0.34). At baseline the average total score in the pharmacotherapy group was 45.5(12.37) and 42.22(12.73) in the combination group (t(543)=2.86, p = 0.004). The average total score at the end of treatment in the pharmacotherapy and combination group was 72.31(12.99) and 67.67(12.45), respectively (t(543)=426, p <0.001).

To our knowledge, this is the first study to describe the value of CBT in addition to pharmacotherapy on the quality of life in adults with ADHD. Contrary to our expectations, there was no significant effect of CBT in addition to pharmacotherapy on the quality of life.

No significant relationships.

Ethnic disparities in treatment with clozapine, the antipsychotic recommended for treatment-resistant schizophrenia (TRS), have been reported. However, these investigations frequently suffer from potential residual confounding. For example, few studies have restricted the analyses to TRS samples and none has controlled for benign ethnic neutropenia.

This study investigated if service-users’ ethnicity influenced clozapine prescription in a cohort of people with TRS.

Information from the clinical records of South London and Maudsley NHS Trust was used to identify a cohort of service-users with TRS between 2007 and 2017. In this cohort, we used logistic regression to investigate any association between ethnicity and clozapine prescription while adjusting for potential confounding variables, including sociodemographic factors, psychiatric multimorbidity, substance use, benign ethnic neutropenia, and inpatient and outpatient care received.

We identified 2239 cases that met the criteria for TRS. Results show that after adjusting for confounding variables, people with Black African ethnicity had half the odds of being treated with clozapine and people with Black Caribbean or Other Black background had about two-thirds the odds of being treated with clozapine compared White British service-users. No disparities were observed regarding other ethnic groups, namely Other White background, South Asian, Other Asian, or any other ethnicity.

There was evidence of inequities in care among Black ethnic groups with TRS. Interventions targeting barriers in access to healthcare are recommended.

During the conduction of the study, DFdF, GKS, and RH received funds from the NIHR Maudsley Biomedical Research Centre. For other activities outside the submitted work, DFdF received research funding from the UK Department of Health and Social Care, Janss

Studies that explain men’s reduced willingness for formal help-seeking for depressive symptoms often did not analyze whether assumed unique barriers, namely, conformity to masculine norms (CMN), reduced self-compassion, and self-stigma are also linked to women’s help-seeking behavior.

The current study analyzed whether CMN, self-compassion, and self-stigma for help-seeking are linked to women’s and men’s willingness to seek formal help for depressive symptoms.

German-speaking participants (N=481; 68.8% women, 31.2% men; Mage=35.6, SD=14.2) of an online-questionnaire study read a vignette about a character with depressive symptoms. Participants indicated how likely they would be to seek medical or psychological help if they were in the character’s situation. Furthermore, the Conformity to Masculine Norms Inventory, Self-Stigma of Seeking Help scale, and Self-Compassion Scale were used.

Women and men were moderately willing to seek formal help for depressive symptoms. A manifest path model revealed that strong CMN and low self-compassion were linked to strong self-stigma in women and men. Strong self-stigma was associated with reduced help-seeking intentions. In men with low self-compassion CMN was directly linked to reduced willingness for help-seeking. In women and men with strong self-compassion no direct, but indirect links between CMN and reduced help-seeking intentions via self-stigma were found.

CMN and self-stigma of help-seeking were not unique barriers in men, but also were relevant for women’s formal help-seeking intentions. Even though increased self-compassion was associated with decreased self-stigma, interventions that aim to increase self-compassion may not help increase help-seeking behaviors.

No significant relationships.

Burnout is an occupational psychological syndrome induced by chronic stress defined by three dimensions: emotional exhaustion (EE), depersonalization (DP) and reduced personal accomplishment (PA).

Estimate burnout among residents and interns in Tunisia. Identify factors related to burnout.

We conducted a cross-sectional, descriptive, and analytical study between March 1 and April 15, 2021. Data collection among young physicians was done by a self-questionnaire published online. The assessment of the degree of burnout was done by the Maslach Burnout Inventory (MBI).

The total number of participants was 56 of which 71.4% were women. The average age was 26.76 years. The pourcentage of the married was 21.4% of which 58.3% had children. 30.4% had parents in charge. Most of the participants worked in university hospitals and 75% of them in a medical department. Residents represented 64.3% of the participants. Number of working hours exceeded 40 hours per week in 60.7% of the cases with an average number of shifts per month estimated at 4.71±2.36. According to MBI, 94.6% of the participants had a score in favor of burnout, of which 19.6% was severe. The number of hours worked per week and the number of shifts per month were significantly associated with the presence of a burnout syndrome with respective correlation factors of 0.027 and 0.047.

Most residents and interns suffered from burnout with a variable degree of severity. The workload with a greater number of working hours and on-call duty favored the emergence of this burnout.

No significant relationships.

Preventing burnout and promoting resilience are important to the well-being of health care professionals and the quality of patient care. Indeed, it’s a promising way to mitigate the negative effects of stressors and allow professional growth.

study the association between job satisfaction and resilience in medical interns and residents.

As part of a descriptive and analytical cross-sectional study, interns and medical residents completed an online self-questionnaire using ’Google Forms’. It collected socio-demographic data and assessed the level of job satisfaction using a 5-point Likert-type scale for each item. The Brief Resilience Scale (BRS) was used to assess the level of resilience.

The total number of participants was 56, of which 64.3% were medical residents.75% of the participants worked in a medical department and most had a number of shifts per month ≥4. The average years of practice was 2.27±1.23 years. Participants expressed dissatisfaction at work with salary (69.6%), task allocation and organization (66.1%), availability of resources (66.1%), comfort (57.1%), safety (53.6%) and supervision (50%). Referring to the BRS scale, higher resilience scores were objectified in male participants (p=0.002). The level of resilience decreased with the number of years of practice (p=0.039). Good satisfaction by management and recognition at work could enhance the level of resilience (p=0.029 and p=0.043 respectively).

The results of our study suggest that dissatisfaction with work-related aspects may influence the level of resilience. These results deserve special attention to improve job satisfaction and preserve resilience.

No significant relationships.

Provision of holisitc, accessible and high quality mental health care to the patients requires sharing of responsibilities & resources, enhanced communication & collaboration at the interface (primary care systems and secondary care mental health services). An innovative model of single point of care for people with severe and enduring mental health problems hosted at a primary care (GP) setting has been developed and evaluated in Walsall, UK.

To develop and evaluate an integrated (multidisciplinary) approach of managing health & social care needs of people with severe mental health disorders.

People with severe & enduring mental health problems were reviewed in primary care (N=65). A comprehensive physical, mental and psychosocial assessments were undertaken by the clinicians that included GP, Psychiatrist and Care-Coordinator.The reviews included: 1) A review of physical health indicators based on the Lester toolkit by practice pharmacist/nurse, including lifestyle, body weight, BMI and blood pressure. 2) Individualised interventions included physical / psychiatric prescribing, social prescribing and advise on lifestyle changes. Stable patients were recommended for stepping down from the secondary care. Outcomes included Patient Satisfaction Questionnaire (PSQ).

Satisfaction on the PSQ was rated from very good to excellent. Results highlighted multiple benefits including trust generation, improved communication among professionals, physical health screening and prompt clinical decision making (e.g. referral / prescribing). Other benefits included patient access & satisfaction, time and cost efficiency by reducing the number of reviews.

The integtrated CPA reviews offers efficient, holisitc & cost effective model of care with high satisfaction levels for patients and is replicable.

No significant relationships.

Psychiatric services in LEDCs face a tripartite challenge: (i) limited financial capital; (ii) scarcity of professionals; (iii) restrictive health beliefs. Inevitably, services developed for the first-world are ill-suited here. Psychiatric services must be designed from the ground up: inspired by but not a replica of best practices in the developed world. The SOUL project in Larkana, Pakistan provides home based assessment by a psychiatrist and fortnightly treatment by a mobile nursing team for schizophrenic patients. Psychoeducation of carers and the community as well as facilitation of work for patients are core aims. This mixed-methods study evaluates the experiences of primary stakeholders - patients and their carers.

1.Are patients and carers satisfied with the care received? 2.Has SOUL been successful in changing health beliefs? 3.How could the programme be improved?

The principal investigator accompanied the team for 4-weeks. Purposive sampling was employed. Satisfaction was assessed quantitatively using the likert based PSQ-18 questionnaire. Thereafter, qualitative data was gathered using semi-structured interviews and analysed using a grounded theory approach. A total of 27 interviews were conducted before data saturation.

100% of interviewees answered ’Satisfied’ or ’Very’ Satisfied to all elements of the PSQ-18. Above all, stakeholders valued that treatment was free and highly accessible (home visits), promoting treatment adherence. They felt psychoeducation events significantly reduced community stigma and made families more likely to seek psychiatrists over faith healers. Provision of respite care was suggested as a future improvement.

SOUL is highly valued by stakeholders and offers an excellent example of LEDC psychiatric care.

No significant relationships.

Despite the limited evidence about the efficacy and safety of dietary supplement use for mental health, people tend to use them quite often. Generally the use of supplements among Saudi population shown to be prevalent, although limited studies that assessed their use for the improvement of mental health.

Identify the prevalence of dietary supplements use for mental health among the population in Saudi Arabia and also determine the factors that affect the use of dietary health supplements for mental health.

A cross-sectional study of a convenience sample of 443 participants from various regions in Saudi Arabia. Questionnaire includes demographics, dietary use supplement assessment, and mental health assessment via the patient health questionnaire (PHQ-9), generalized anxiety disorder questionnaire (GAD-7), and insomnia severity index (ISI).

The prevalence of DS among the Saudi population reached 44%. Vitamin D and Melatonin were the most commonly reported DS used for mental health among the study population. The use of DS was associated with three times higher odds in patients who had previous mental health disorder diagnoses (OR 2.972; 95%CI; 1.602-5.515). The chance of using DS almost doubled in patients with subthreshold and moderate-severe insomnia (OR 1.930;95% CI 1.191-3.126) and (OR 2.485; 95% CI 1.247- 4.954) respectively.

Despite the limited evidence about the efficacy and safety of dietary supplement use for mental health, people tend to use them quite often. Although the use of supplements among Saudi population shown to be prevalent, limited studies assessed their use for the improvement of mental health.

No significant relationships.

Although integrated community care programs specifically tailored to patients with severe mental illness (SMI) are available, recent studies show that these programs are not always provided to the population which would benefit the most from it.

Aims of this study were the selection of clinical and psychosocial characteristics and the development of a screening algorithm indicating the need for integrated community care services in people with mental disorders.

Data of an observational longitudinal study including N=511 participants has been used to examine the hypothesized determinants. At baseline, self-reported empowerment has been assessed via the EPAS and psychosocial impairment and perceived needs have been rated by research workers via the HoNOS and the CAN, respectively. Use of integrated community care services was defined as at least four appointments with service providers over six months and has been recorded via the CSSRI twelve to 18 months after baseline. Mixed-effects regression analyses have been performed to test the predictive value of the hypothesized determinants and marginal predictions were used to define cut-offs for the assessment tool.

EPAS, HoNOS and CAN scores each proved to be significant predictors for using integrated community care services. Cut-off scores for each predictor are presented, forming practical assessment guidelines for future studies.

A screening tool and an algorithm for the identification of mentally ill patients who can be expected to benefit from integrated community mental health care programs is available for the German health care system.

No significant relationships.

Previous studies have found long lasting cognitive delays among children with early childcare experience, especially institutionalised experience. However, little is known about institutions’ effect in late childhood.

Our goal is to identify the characteristics of cognitive functions in connection to attachment related anxiety among adopted children and children living in institutional care.

The participants’ (N=68, Mage=14.20, 29 boys and 39 girls) cognitive functions were measured with the following tests: Rey15 Memory Task, Knock And Tap Task, Simon Says Test, Verbal Fluency Task, D-KEFS 20 Questions Test. Participants completed two questionnaires: the Family Affluence Scale and the Experiences In Close Relationships Revised Scale. The results from the adopted children (N=19) and children living in institutional care (N=18) were compared to the matched control group: children living with their biological parents (N=31).

Children living in institutional care did not differ significantly from their (SES-based) matched controls. Children adopted after the age of 2 years (N=7, M =56,57month) and the low SES control group (N=14) differed from the high SES control group on tests of attention (Verbal Fluency Task, Mhigh.c.=212.50, Mad.aft.2=193.50, U=59.50, z=-2.62, p=0.009) and verbal memory (Rey15, Mhigh.c.=17.94, Mad.aft.2=9.18, U=35.00, z=-2.79, p=0.005). Children adopted before the age of 2 years differed from the high SES control as well, in inhibition (Simon Says Test, Mhigh.c.=12.26, Mad.bef.2=18.88, U=55.55, z=-2.23, p=0.026).

Our findings suggest that only in the early years is child protection experience associated with long-lasting cognitive delays and attachment related anxiety.

No significant relationships.

Measurement-Based Care (MBC) is an emerging healthcare model with a number of potential advantages over traditional approaches for the treatment of substance use disorder (SUD). Despite SUD treatment programs being theoretically well suited for the implementation of MBC, its uptake has been minimal, which in turn limits further research, knowledge synthesis, and translation into clinical practice.

The goal of this knowledge synthesis project is to stimulate greater consideration of MBC models in addictions programs, with three interrelated objectives: 1. To summarize the existing evidence from research literature 2. To complement the literature findings with the data from our clinical research and quality improvement projects 3. To explore potential risks and difficulties of MBC implementation in the SUD treatment programs

Narrative review. Knowledge synthesis.

To date, only two published randomized controlled trials, which along with the data from our pragmatic clinical research, support the wider implementation of MBC in the substance abuse treatment settings, but also indicate the high need for larger-scale clinical trials and quality improvement programs. Potential barriers to the implementation of MBC for SUD are outlined at the patient, provider, organization, and system levels, as well as challenges associated with the use of MBC programs for clinical research. Critical thinking considerations and risk mitigation strategies are offered toward advancing MBC for SUD beyond the current nascent state.

The state-of-the-art of MBC in SUD care settings reviewed and the strategies for further development from adminsitrative, clinical, and research prospectives outlined.

No significant relationships.