International Congress onMental Health and Psychiatry

The delineation of biomarkers and neuropsychiatric symptoms across normal cognition, mild cognitive impairment (MCI), and dementia stages holds significant promise for early diagnosis and intervention strategies. This research investigates the association of neuropsychiatric symptoms, evaluated via the Neuropsychiatric Inventory (NPI), with cerebrospinal fluid (CSF) biomarkers (Amyloid-β42, P-tau, T-tau) across a spectrum of cognitive states to enhance diagnostic accuracy and treatment approaches. Drawing from the National Alzheimer’s Coordinating Center’s Uniform Data Set Version 3, comprising 977 individuals with normal cognition, 270 with MCI, and 649 with dementia. To assess neuropsychiatric symptoms, we employed the NPI to understand the behavioral and psychological symptoms associated with each cognitive category. For the analysis of CSF biomarkers, we measured levels of Amyloid-β42, P-tau, and T-tau using the enzyme-linked immunosorbent assay (ELISA) and Luminex multiplex xMAP assay protocols. These biomarkers are critical in understanding the pathophysiological underpinnings of Alzheimer’s disease and its progression, with specific patterns indicative of disease stage and severity. This study cohort consists of 1896 participants, which is composed of 977 individuals with normal cognition, 270 with MCI, and 649 with dementia. Dementia is characterized by significantly higher NPI scores, which are largely reflective of mood-related symptoms (p < 0.001). In terms of biomarkers, normal cognition shows median Amyloid-β at 656.0 pg/mL, MCI at 300.6 pg/mL, and dementia at 298.8 pg/mL (p < 0.001). Median P-tau levels are 36.00 pg/mL in normal cognition, 49.12 pg/mL in MCI, and 58.29 pg/mL in dementia (p < 0.001). Median T-tau levels are 241.0 pg/mL in normal cognition, 140.6 pg/mL in MCI, and 298.3 pg/mL in dementia (p < 0.001). Furthermore, the T-tau/Aβ-42 ratio increases progressively from 0.058 in the normal cognition group to 0.144 in the MCI group, and to 0.209 in the dementia group (p < 0.001). Similarly, the P-tau/Aβ-42 ratio also escalates from 0.305 in individuals with normal cognition to 0.560 in MCI, and to 0.941 in dementia (p < 0.001). The notable disparities in NPI and CSF biomarkers among normal, MCI and Alzheimer’s patients underscore their diagnostic potential. Their combined assessment could greatly improve early detection and precise diagnosis of MCI and dementia, facilitating more effective and timely treatment strategies.

Statement of the Problem:

In the first year of the COVID-19 pandemic, global prevalence of anxiety and depression increased by 25% according to data released on March 2nd, 2022, from the World Health Organization. There has been an increase in depression and anxiety in children, young adults, millennials and older adults. Moreover, there is a widening gap between those who can receive psychotherapy and treatment based on the individual’s financial resources. The Happiness Control Panel provides a unique set of tools/ interventions to elicit hope and mastery. It facilitates connectivity which can be an antidote to hyperconnectivity and loneliness. The Happiness Control Panel (2023) is based on positive psychology. It is supported by M. Seligman and R. Emmons and offers the 40 percent solution (Lyubomirsky)Forty percent of our happiness quotient is due to our deliberate cognitions, actions and affect which the Happiness Control Panel offers. It fosters resilience, the growth mindset and mastery. It has been effective in deaIing with depression, anxiety, ambiguous loss and stress.   It increases well-being, reduces the risk of cardiovascular disease, improves the immune system and leads to enhanced intrapersonal and interpersonal relationships. (Stone et al,1987, Cohen et al 2003, Marsland et al 2006). The Happiness Control Panel lends itself to various therapeutic approaches.

Intended Outcome:

Participants will be able to use the Happiness Control Panel to enhance well-being and reduce affective disorders. They will be able to identify its uses.

Evidence-based data, clinical data and experiential exercises will be given.

Objectives: To identify psychosocial and motor aspects among Brazilian of both genders with JH, to characterize JH using the Beighton's total score in function of gender and age; by "growing pain," to verify manifestations such as fatigue, attention deficit, anxiety, insomnia, sleepiness, apathy/quietness, depression, delayed ambulation, inability to crawl or difference in crawling technique, impaired spatial and/or temporal orientation, social isolation, and having been stigmatized as "lazy/clumsy/stubborn/quiet."

Methods: This retrospective, observational, quantitative, and cross-sectional study used data obtained through analyses of descriptive and inferential crossings between 2012 and 2020 of 482 medical records of individuals between 1 and 76 years of age, from most Brazilian states. All patients previously diagnosed with “joint hypermobility syndrome” and “Ehlers-Danlos syndrome hypermobility type”, had their medical records reassessed, following the guidelines established in 2017. Analysis of JH using the method proposed by Beighton et al (1973) included determining the ability of a person to sit in the "W" position, in the "concave" position and identifying characteristics of the hands and the presence of "growing pains." Descriptive and inferential statistics were used.

Results: In the complete sample, JH, predominant in the upper limbs, indicated that the majority of the participants were females, ≥ 15 years of age; 64.73% had a total Beighton score of ≥6, which decreased with increasing age. Among the characteristics of psychosocial implications, fatigue predominated, followed by being labeled as clumsy / stubborn / restless individuals, attention deficit, anxiety, stigmatization as "lazy," insomnia, sleepiness, apathy / restlessness, depression, impaired spatial and/or temporal orientation, and social isolation. Among the participants, lower limb pain was reported by 55.81% and "growing pain" by 36.93%. Delayed walking was seen in 19.92%, 15.35% did not crawl or crawled differently, and impaired school performance in 12.86%. Higher total Beighton scores showed a tendency for motor implications and correlation between the variables.

Conclusion: JH was predominant in the upper limbs; most of whom were females, aged ≥15 years, with the Beighton total score of ≥6 in all age-groups. Psychosocial aspects in people with JH are suggestive of increasing evolution since childhood, also influenced by atypical postural patterns, pain, and inadequate motor performance. Predominant total scores in the upper limbs were suggestive of inability to crawl or crawling differently. Higher total Beighton scores showed a tendency not to crawl, to crawl differently, and a tendency for impaired school performance and delayed ambulation. Most are capable of always sitting in the "concave" position and the "W" position, a condition possible for just under half of the total sample. Both sacrifice hip structures and favor falls. Growing pain" is predominantly located in the lower limbs and occurs in more than one third of the total sample. Lower limb pain since childhood, inadequate motor performance, and JH of the hand with impaired functions contributes to explain the psychosocial implications in this population.

We are all born with empty schizoid core, compensate by introjecting Mommy (symbiosis and primary narcissism).

Borderline's introjection failure and consequent introject inconstancy is what gives rise to his/her sense of emptiness (described by Kernberg). She compensates by over-reliance on external objects (anaclitic personality).

Narcissism is compensatory and infantile: object inconstancy, ceaseless introjection and incorporation of internal object MASK the emptiness, compensate for it (introjective personality).