Affective and cognitive Theory of Mind in patients with alcohol use disorder: Associations with symptoms of depression, anxiety, and somatization

INTRODUCTION

Theory of Mind (ToM) is the ability to ascribe thoughts (cognitive ToM) and feelings (affective ToM) to others. Ample evidence exists for impairments of affective and cognitive ToM in individuals with alcohol use disorder (AUD); however, evidence regarding changes of these impairments during AUD treatment and their possible relationship to comorbid symptoms is ambiguous. The current study analyzed changes in ToM during treatment and tested associations with comorbid symptoms of depression, anxiety, somatization, and social functioning.

METHODS

We analyzed data from 175 individuals with AUD. The study assessed ToM and comorbid symptoms of depression, anxiety, somatization, and social functioning at the time of admission and at the time of discharge from an approximately 60 days long abstinence-oriented inpatient treatment. We assessed affective and cognitive ToM using the Movie for the Assessment of Social Cognition, a measure with high ecological validity.

RESULTS

All symptoms, total and cognitive ToM improved following treatment; however, affective ToM did not improve. Moreover, cognitive ToM at the beginning of treatment was associated with improved symptoms of depression and somatization, while affective ToM was not.

CONCLUSIONS

Our study shows improvements in total and cognitive ToM as well as symptoms of depression, anxiety, somatization, and social functioning following long-term treatment. Furthermore, cognitive ToM was related to improvements in comorbid symptoms. This finding suggests that ToM may be an important treatment target in patients with AUD.

From individualised treatment goals to personalised rehabilitation in osteoarthritis: a longitudinal prospective mapping study using the WHO international classification for functioning, disability and health

BACKGROUND/OBJECTIVE(S)/INTRODUCTION

In clinical practice, treatment goals are often set up without exploring what patients really want. We, therefore, collected individualised treatment goals of patients with osteoarthritis (OA), categorised and mapped them to the World Health Organisation International Classification for Functioning, Disability and Health (ICF).

PATIENTS/MATERIALS AND METHODS

A longitudinal prospective cohort study was conducted (2019-2021). We used descriptive statistics and Chi²/Fisher's Exact Tests, where appropriate, as well as Kruskal-Wallis-Tests for the mean score ranks of the patients' goals.

RESULTS

In total, 305 goals reported by 132 participants were analysed (267 women vs. 38 men). The top 3 ICF categories were sensation of pain (ICF:b280), mobility of joint (ICF:b710) and muscle power functions (ICF:b730). Overall, 51% of all individually reported functional goals were achieved after 3 months. Men were more likely to achieve their goals than women (p = 0.009). The majority of the "very important" goals (51%) and "very difficult" goals (57%) was not improved. Goals' mean score ranks significantly differed between baseline and follow-up.

CONCLUSION(S)

As the human lifespan as well as the number of people affected by OA worldwide increase, there is a growing need to identify and evaluate rehabilitation outcomes that are relevant to people with OA.Key MessagesTreat-to-target agreements between patients and health care providers present a step towards more personalised precision medicine, which will eventually lead to better reported functional and health outcomes.In patients with osteoarthritis, the Goal Attainment Scale instrument can be used to measure health outcomes at different time points and its content may be linked to ICF providing a unified language and conceptual scientific basis.

The lockdown and its consequences-Perspectives and needs of people at increased risk of severe illness from COVID-19 : Results from a qualitative longitudinal study

BACKGROUND

There is a lack of knowledge on how people at increased risk of severe illness from Coronavirus disease 2019 (COVID-19) experienced the infection control measures. This study aimed to explore their perspectives and needs during the coronavirus outbreak.

METHODS

A qualitative longitudinal interview study was conducted in Austria during lockdown due to COVID-19 containment and afterwards. People older than 65 years of age and/or affected by a chronic medical condition participated in individual telephone interviews at two time points. Thematic analysis was used to analyze the data and saturation was defined as no new emerging concepts in at least 10 subsequent interviews.

RESULTS

Thematic saturation was reached when 33 individuals (75.8% female, mean age ± standard deviation [SD] 73.7±10.9 years) were included. A total of 44 lower level concepts were extracted and summarized into 6 higher level concepts. They included (i) a general positive attitude toward COVID-19 measures, (ii) challenges of being isolated from the community, (iii) deterioration of health status, (iv) difficulties with measures due to their health condition, (v) lack of physical contact and (vi) lack of information versus overload. Participants suggested environmental adaptations for strengthening resilience in people at increased risk of severe illness from COVID-19.

CONCLUSION

Strategies and interventions are needed to support people at risk under pandemic conditions. Their perceptions and needs should be addressed to reduce the potential deterioration of health conditions and ensure well-being even during prolonged periods of crisis.

Psychological Distress During the COVID-19 Pandemic in Patients With Mental or Physical Diseases

The coronavirus disease 2019 (COVID-2019) and the consequences of the pandemic on individuals’ social, economic, and public lives are assumed to have major implications for the mental health of the general population but also for patients already diagnosed with psychological disorders. The aim of the present study was to investigate the psychological distress during the COVID-19 pandemic in patients with psychological disorders or physical health conditions in inpatient mental and physical treatment programs. A total 2710 patients completed COVID-19 related questions concerning their psychological distress and financial burden during the pandemic. Patients with psychological disorders reported the highest level of psychological distress and financial burden compared to patients with physical health conditions. Furthermore, most patients with psychological disorders attributed their individual psychological distress to the COVID-19 pandemic. In comparison to patients with physical health conditions, patients with psychological disorders are more strongly impacted by the COVID-19 pandemic and have an additional need for psychological/psychotherapeutic treatment due to the COVID-19 crisis. The findings stress the importance of continuous psychosocial support and availability of psychosocial support services for patients with psychological disorders during the pandemic.

Utilization of occupational therapy services and relation to survival in people taking dementia-specific medication in Austria-A retrospective population-based study with a 13-year observation period

OBJECTIVES

Evidence-based treatment of dementia includes pharmacological and non-pharmacological methods of which psycho-social interventions are an important component, commonly administered by occupational therapists. The aim of this study was to investigate the utilization of occupational therapy (OT) services and its association with survival in people taking dementia-specific medication in a population-based Austrian dataset compared to a two times as large control group without dementia-specific medication.

METHODS/DESIGN

A retrospective study with a 13-year observation period (2003-2016) was conducted on real-world data. Two stratifications were done and we used descriptive statistics, Chi-squared/Fisher's Exact Tests and survival analyses including three Cox models.

RESULTS

Data from 286,553 participants were analysed. Only 4.5% (n = 12,950) received OT services. In the dementia-medication group (n = 111,033), participants who received OT services (3.6%; n = 4032) had significantly more comorbidities (4.7%) compared to those without OT (3.5%; p < 0.001) and were also more likely to be male (4 vs. 3.5%; p < 0.001). While persons taking dementia-specific medication showed a slightly reduced survival with OT (p < 0.001) compared to those without, the result in the control group without dementia-specific medication showed a slightly better result of the participants who received OT (p < 0.001). The reduced survival in the dementia-medication group with OT is likely to be related to the higher number of comorbidities in this group.

CONCLUSION

People receiving dementia-specific medication were more likely to receive OT if they had additional comorbidities, however our analysis showed that utilization of OT services in Austria was very low indicating an overall insufficient accessibility of OT services for patients who needed it.

THU0570 EXPERTS’ VIEWS ON THE IMPACT OF REHABILITATION FOR PATIENTS WITH RHEUMATOID ARTHRITIS IN AUSTRIA

Background:

Rehabilitation methods and standards for patients with rheumatoid arthritis (RA) have significantly changed due to more efficient medication improving the course of the disease. Therefore, physical activity, participation, disease management and patient education are most important goals in rehabilitation of patients with RA.

Objectives:

Aim of this study was to evaluate the significance and impact of rehabilitation methods according to the subjective attitudes and views of experts and professionals in the field of RA. Opinions of members of the task force (TF) “Rehabilitation” of the Austrian Society of Rheumatology (ÖGR) were compared to the estimation of the other members of the ÖGR.

Methods:

All members of the ÖGR were invited to participate in an online survey to rate the impact of rehabilitation for patients with RA between 0 (no impact) and 10 (high impact). Besides sociodemographic and experience related data about the experts and professionals, two main issues were investigated: (1) Impact of rehabilitation related to specific interventions (2) Impact of rehabilitation methods for patients with RA according to different disease and treatment points.

Results:

129 members (50% male, 50% female) of the ÖGR participated in the online survey. 12 persons were members of the TF “Rehabilitation” of the ÖGR. 11 (8.6%) respondents were general physicians, 66 (51.6%) specialists in internal medicine with further expertise in rheumatology, 15 (11.5%) specialists in internal medicine, 14 (10.9%) specialists for physical medicine with further expertise in rheumatology, 2 (1.6%) specialists in orthopaedics, 13 (10.2%) health professionals and 7 (5.5%) persons were from other profession categories such as researchers for example. The majority of respondents (80%) worked already more than five years with patients with RA in a stationary setting. Results of the online survey demonstrate that the ranking of the impact of specific rehabilitation interventions did only marginally differ between the two person groups: Both groups ranked the importance of occupational and physical therapy the highest. Only the subjective importance of splints and assistive technologies was higher assessed by the general members of the ÖGR. Further, the ranking about the estimated impact of rehabilitation methods for patients with RA was very similar between the two person groups: The importance of rehabilitation for patients with functionality restrictions and for patients with RA in the first years of their disease was ranked the highest by both groups.

Conclusion:

Results of the online survey demonstrate that ratings related to the impact of rehabilitation interventions for RA patients do only slightly differ between the investigated member groups of the ÖGR. Finally, the results indicate that rehabilitation methods for RA patients and rehabilitation related knowledge are well accepted and successfully transferred into disease management of patients with RA by professionals and experts in rheumatology in Austria.

Disclosure of Interests:

Claudia Oppenauer: None declared, Elke Böttcher Grant/research support from: UCB,Roche, MSD, Speakers bureau: UCB, Pfizer, BMS,MSD,Roche,Amgen, Lilly, Gabriele Eberl: None declared, Albrecht Falkenbach: None declared, Winfried Habelsberger: None declared, Johannes Kirchheimer: None declared, Werner Kullich Shareholder of: Roche Stocks, Grant/research support from: MedTec Company, Germany - MedizinTechnik, Erich Mur: None declared, Christa Oliveira-Sittenthaler: None declared, Georg Stummvoll Speakers bureau: Lilly, Roche, gsk, Christian Wiederer Consultant of: Firma Grünenthal, Thema Capsaicin, Dezember 2019, Harald Zeindler: None declared, Valerie Nell-Duxneuner Speakers bureau: MSD, Pfizer, Jansen, Abbvie, Lilly, Novartis

Results and implications of the EU-project CARERS ‘Content materials to raise employability and reinforce skills of carers’

Purpose

Theory

Methods

Results and conclusions

Discussion

Usability of assistive technologies in ageing and disabilities

Introduction

Review of the literature

Discussion