INTERCONNECTION OF COGNITIVE DISORDERS AND CLINICAL AND PSYCHOPATOLOGICAL FEATURES IN PROLONGED DEPRESSIVE REACTION

Aim of research. The aim of the study was to determine the relationship between the clinical and psychopathological features of anxiety and depressive manifestations and the features of cognitive dysfunctions in patients with prolonged depressive reaction. Materials and methods. The study involved 98 patients with prolonged depressive reactions. The study used an integrated approach, which consisted in the use of clinical-psychopathological, psychometric, psychodiagnostic and statistical research methods. Results. According to the research results, a correlation analysis was carried out, which made it possible to determine the combination of clinical and psychopathological symptoms with the features of the cognitive functioning of patients with prolonged depressive reaction. Obsessive thoughts and hypochondriacal ideas have been shown to be associated with marked levels of anxiety; suicidal thoughts - with a protracted onset of depression and a minor depressive episode; mild violations of verbal productivity were associated with a major depressive episode and with a prolonged onset of depression, with 1-2 episodes of depression in anamnesis; a low level of attention switching was associated with an episode duration of up to 2 years, a protracted onset of depression, a major depressive episode, and an increased level of anxiety; average work efficiency correlated with a low level of anxiety, an episode duration of up to a year, 1-2 episodes of depression in anamnesis, a remission duration of more than 24 months; mobilization of mental processes was associated with a remission duration of more than 24 months and a reduced level of anxiety; high selectivity of attention to negative stimuli was combined with the duration of the episode up to 2 years and a pronounced level of anxiety; moderate disturbances in aggressive behavior patterns were associated with an episode duration of up to a year and a moderate level of anxiety. Conclusions. The relationship between clinical and psychopathological features of anxiety and depressive manifestations and features of cognitive dysfunction in patients with prolonged depressive reaction were identified. It should be considered in the differential diagnosis and in the development of psychocorrective measures to reduce cognitive impairment in patients with depressive disorders.

POS0572 THE ASSOCIATED FACTORS OF ULTRASONOGRAPHIC TENOSYNOVITIS IN PATIENTS WITH RHEUMATOID ARTHRITIS IN REMISSION

Background:Tenosynovitis is a common manifestation of rheumatoid arthritis (RA), but, is difficult to assess appropriately by clinical examination. In clinical remission, musculoskeletal ultrasound (MSUS) showed a predictive value of tenosynovitis for flares and joint destruction in RA (1).Objectives:To assess the prevalence, the characteristics, and the factors associated with tenosynovitis in ultrasound examination of patients with RA in clinical remission.Methods:A Cross-sectional study including patients with RA in clinical remission (DAS28 ESR ≤ 2.6) for at least 6 months. MSUS of 20 tendons (in wrists, hands and ankles) was performed in mode B and power Doppler (PD). Tenosynovitis was defined and scored according to the Outcome Measures in Rheumatology Clinical Trials (OMERACT). A total score for the tenosynovitis in B-mode (TBI) and PD (TDI) was calculated by summing the grades for each patient. SDAI and CDAI were calculated. Functional disability was assessed by the Health Assessment Questionnaire (HAQ). For the radiographic evaluations, we used the Van der Heijde score.Results:Thirty-seven patients were enrolled, the mean age was 54.2 years±12.7 years and the sex ratio was 0.37. The mean disease duration was 8.1 years±5.1. The mean remission duration was 36.5 months ± 32.7. The prevalence of tenosynovitis was 40.5% in B-mode and 13.5% for PD. The most affected tendons were: extensor carpi ulnaris (B-mode: 21.6%, PD: 8.1%), tibialis posterior (B-mode: 10%, PD: 2.7%), peroneal (B-mode: 8.1%, PD: 2.7%), flexor digitorum superficialis and profundus (B-mode: 5.4%, PD: 0%) and extensor digitorum (B-mode: 2.7%, PD: 2.7%). Tenosynovitis was most frequently grade1 in B-mode (32.4%) and grade 2 in PD (10.8%). Grade 3 was identified only in B-mode in the peroneal tendons. The mean of TBI was 7.1±5.3 and the mean of TDI was 2.2.±3.1. We found a significant association between remission duration and PD tenosynovitis (mean: 16.2 vs 39.7 months, p = 0.05). Tenosynovitis, in B-mode and PD, weren’t associated with the swollen joints, the tender joints, the patient global health assessment, the HAQ, erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor and anti-cyclic citrullinated peptide, DAS28, CDAI, SDAI, biologic treatment and radiographic structural damage. Multivariate logistic regression analysis didn’t show any association.Conclusion:Ultrasound tenosynovitis was commonly found in RA in remission and the extensor carpi ulnaris tendon was most involved. A shorter duration of remission was associated with PD tenosynovitis in univariate analysis. The MSUS assessment of tendons can be an additional feasible method to assess clinical remission.References:[1]Janta I, Stanciu D, Hinojosa M, Nieto-González JC, Valor L, Bello N, et al. Structural damage in rheumatoid arthritis: comparison between tendon damage evaluated by ultrasound and radiographic damage. Rheumatology (Oxford). 2016;55(6):1042-6.Disclosure of Interests:None declared

P336 Association between the prior duration of remission and efficacy outcomes in patients with Ulcerative Colitis treated with tofacitinib 10 mg twice daily who were in stable remission and either dose-reduced to tofacitinib 5 mg twice daily or remained on 10 mg twice daily: 6-month data from the double-blind, randomised RIVETING study

Background Tofacitinib is an oral, small molecule JAK inhibitor for the treatment of ulcerative colitis (UC). RIVETING (NCT03281304) is an ongoing, double-blind, randomised, parallel-group study designed to evaluate the efficacy and safety of dose reduction to tofacitinib 5 mg twice daily (BID) vs remaining on 10 mg BID in patients (pts) with UC in stable remission on tofacitinib 10 mg BID maintenance therapy. Eligible pts had received tofacitinib 10 mg BID for ≥2 consecutive years in an open-label, long-term extension study (NCT01470612), and had been in stable remission for ≥6 months (M) and corticosteroid-free for ≥4 weeks prior to enrolment.1 We aimed to evaluate the association between the duration of remission prior to enrolment into RIVETING and the efficacy of tofacitinib 5 and 10 mg BID. Methods Pts who were in partial Mayo score (PMS) remission (a PMS of ≤2 with no individual subscore >1, and a rectal bleeding subscore of 0) at RIVETING baseline were included in this analysis. Pts were randomised to dose-reduce to tofacitinib 5 mg BID or remain on 10 mg BID. We evaluated efficacy endpoints at Month 6 in RIVETING, stratified by duration of PMS remission (0–12, 12–24, 24–36, 36–48, >48 M) at RIVETING baseline. Results At RIVETING baseline, 139 of 140 pts were in PMS remission: 69 pts dose-reduced to tofacitinib 5 mg BID and 70 pts remained on tofacitinib 10 mg BID. In both treatment groups, compared with pts with <24M of PMS remission, baseline modified Mayo and total Mayo scores were numerically lower in pts with a PMS remission duration of >24M; these pts also generally had a numerically lower change from baseline modified Mayo and total Mayo scores at Month 6 (Table). At Month 6, following dose reduction to tofacitinib 5 mg BID, PMS remission was maintained in 66.7%, 60.0%, 82.4%, 75.0% and 90.0% of pts with baseline PMS remission durations of 0–12M, 12–24M, 24–36M, 36–48M and >48M, respectively. Corresponding values for pts who continued to receive tofacitinib 10 mg BID were 80.0%, 88.9%, 91.7%, 100.0% and 100.0%. At Month 6, the proportion of pts achieving modified Mayo remission, remission and modified PMS remission was generally higher in pts with baseline PMS remission of >24M vs pts with PMS remission of <24M across treatment groups (Table). Conclusion Following dose reduction from tofacitinib 10 to 5 mg BID, rates of modified Mayo remission, remission and PMS remission were numerically higher in pts with a PMS remission duration of >24M vs pts with <24M of PMS remission duration. The same trend was observed in pts who continued to receive tofacitinib 10 mg BID. These analyses are post hoc and limited by the small sample size. Reference

Reflecting on Life Script, Related Unconscious Beliefs, and Future Projections as a Factor of Remission Duration in Male Patients With Alcohol Dependence

A cross-sectional study performed in a Moscow hospital for addiction treatment (2019—2020) tested a hypothesis that the capacity to reflect on a life script exert¬ed a positive effect on alcohol dependence (AD) remission duration. The sample included 61 males with AD and without dual diagnosis; the mean age was 44.1 (SD = 10.1) years. Methods. (1) Socio-demographic and clinical data was collected using a semi-structured therapeutic interview. (2) Explicit representations of one’s future were evaluated using a Self-defining Future Projections task; “Life Line”, and a “Cultural script” task. (3) Data on life script characteristics was gathered using the semi-structured “Script Questionnaire”. Qualitative data was processed by means of quantitative content analysis performed by experts based on relevant guidelines. Effects of verbalized life script characteristics on several remission parameters were assessed using multiple linear regression. Results and Conclusions. People with AD who were capable of verbalizing and reflecting on long-term, self-relevant repre¬sentations of the future related to the basic beliefs about their own life course, were capable of maintaining longer remissions in contrast to those who failed to reflect on these topics and limited their memories and future projections by overgeneral cultural script events.

INTERCONNECTION OF COGNITIVE DISORDERS AND CLINICAL AND PSYCHOPATOLOGICAL FEATURES IN PATIENTS WITH PROLONGED DEPRESSIVE REACTION

Aim: to determine the relationship between the clinical and psychopathological features of anxiety and depressive manifestations and the features of cognitive dysfunctions in patients with prolonged depressive reaction. Material and methods. The study enrolled 98 patients with prolonged depressive reactions. The study used an integrated approach, which consisted in the use of clinical-psychopathological, psychometric, psychodiagnostic and statistical research methods. Results. According to the research results, a correlation analysis was carried out, which made it possible to determine the combination of clinical and psychopathological symptoms with the features of the cognitive functioning of patients with prolonged depressive reaction. Obsessive thoughts and hypochondriacal ideas have been shown to be associated with marked levels of anxiety; suicidal thoughts – with a protracted onset of depression and a minor depressive episode; mild violations of verbal productivity were associated with a major depressive episode and with a prolonged onset of depression, with 1-2 episodes of depression in anamnesis; a low level of attention switching was associated with an episode duration of up to 2 years, a protracted onset of depression, a major depressive episode, and an increased level of anxiety; average work efficiency correlated with a low level of anxiety, an episode duration of up to a year, 1-2 episodes of depression in anamnesis, a remission duration of more than 24 months; mobilization of mental processes was associated with a remission duration of more than 24 months and a reduced level of anxiety; high selectivity of attention to negative stimuli was combined with the duration of the episode up to 2 years and a pronounced level of anxiety; moderate disturbances in aggressive behavior patterns were associated with an episode duration of up to a year and a moderate level of anxiety. Conclusions. The relationship between clinical and psychopathological features of anxiety and depressive manifestations and features of cognitive dysfunction in patients with prolonged depressive reaction were identified. It should be considered in the differential diagnosis and in the development of psychocorrective measures to reduce cognitive impairment in patients with depressive disorders.