Influence of Computer Games on the Health and Quality of Students Academic Performance

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PMH40 Spontaneous Abortion is Associated with an Increased Risk of Developing Psychiatric Diseases Kostev K1, Dombrowski S1, Jacob L2 am Main, Germany, 2University of Paris 5, Paris, France

1QuintilesIMS, Frankfurt

Objectives: The aim of this study was to analyze risk factors for depression, anxiety, and adjustment disorders in women with spontaneous abortion in Germany.  Methods: This study included women between the ages of 16 and 45 with a first pregnancy terminated by spontaneous abortion between January 2007 and December 2016 (index date). These women were followed in 262 German gynecological practices. Women with a spontaneous abortion were matched (1:1) with pregnant women without spontaneous abortion by age, index year, diagnosis of female infertility prior to the index date, procreative management prior to the index date, and physician.  Results: This study included 12,158 women with a spontaneous abortion and 12,158 pregnant women without a spontaneous abortion. The mean age was 31.6 (SD: 5.5).years. One year after the index date, 8.9% of women with spontaneous abortion and 5.7% of controls were diagnosed with depression, anxiety, or adjustment disorder. Individuals who had previously undergone a spontaneous abortion were more likely to have one of these three psychiatric disorders compared to controls (OR= 1.53). Similar results were found in the age groups 21-30 and 31-40 years.  Conclusions: Spontaneous abortion is associated with an increased risk of developing psychiatric diseases within the first year. PMH41 Impact of Collaborative Coustomized Patient Education in Psychiatric Diseases Kurian J JSS College of Pharmacy, Mysore, India

Objectives: To study the impact of Pharmacist-Psychiatrist Collaborative customized Patient Education in patients with depression, Bipolar Affective Disorder (BPAD), Schizophrenia and alcohol dependent Syndrome(ADS) in an Ambulatory Care Setting  Methods: A prospective randomized control study was conducted in the psychiatry out-patient department of a tertiary care hospital for a period of 9 months. Eligible patients (225) were randomized into test group and control groups by simple randomization in each disease and followed for a period of six months. Customized patient education was provided to the test group with the help of patient education materials while the control group was on usual care. The medication adherence and quality of life (QOL) of both the groups were assessed and compared once in every two months by using Medication Adherence Rating Scale (MARS) and World Health Organization Quality of Life (WHOQOL) – BREF questionnaire respectively  Results: Among the study population 210 completed all the follow-ups out of which 100 were in control group and 110 in test group. Mean age was found to be 38.07 ± 11.60. Majority [n= 75 (35.71%)] of patients were diagnosed to have had depression followed by BPAD [n= 73 (34.76%)]. A statistically significant increase in the mean medication adherence score of test group was observed in all the follow-ups. The mean medication adherence scores was high in BPAD (1.4) and depression (1.4) compared to schizophrenia and ADS. Upon the analysis QOL, the difference in the overall mean score between test group and control was 8.45 which was statistically significant. Comparison of mean medication adherence scores of all patients in each disease showed that BPAD patients had a mean increase of 2.04 than depression, 1.36 than ADS and 2.01 than schizophrenia patients.  Conclusions: Provision of customized patient education by pharmacist and psychiatrist improved the patient medication adherence and QOL.

MENTAL HEALTH – Health Care Use & Policy Studies PMH42 The Association Between Buprenorphine/Naloxone and All-Cause Mortality in the United Kingdom (UK): An Interim Report Auriacombe M1, Apelt SM2, Scherbaum N3, Mankabady B4 1Université de Bordeaux, Bordeaux, France, 2Certum Consulting, Oberbergkirchen, Germany, 3LVR-Hospital Essen and University of Duisburg-Essen, Essen, Germany, 4Indivior Inc., Richmond, VA, USA

Objectives: The main objectives were: (1) characterize patients in the UK who received a prescription for buprenorphine/naloxone (BUP/NLX), buprenorphine alone, or methadone; and (2) assess all-cause mortality rates in these medication groups.  Methods: In this retrospective observational study, electronic records from The Health Improvement Network (THIN) database were searched for BUP/ NLX (sublingual tablet), buprenorphine (sublingual tablet), and methadone prescriptions issued between 1-Jan-2007 and 31-Dec-2015. Mortality rates were analyzed in the overall population (BUP/NLX= 964; buprenorphine= 1865; methadone= 6363). Two designs were used for comparative analyses: (1) new-user cohort, defined as patients (case subjects) with ≥ 1 year enrollment before first prescription (BUP/ NLX= 615; buprenorphine= 1011; methadone= 2723); and (2) case-control design, nested within the new-user cohort with ≤ 5 matched-controls randomly sampled for each case subject. Cox regression was used to analyze hazard ratios (HRs) for mortality in the new-user cohort; logistic regression was used to analyze odds ratios (ORs) for exposure to study drug (defined as “current”, “recent”, or “past or never”) in the nested case-control cohort. Analyses were adjusted for baseline covariates, and all P-values were two-sided.  Results: Most of the 964 BUP/NLX users were male (70.5%) and aged 20-49 years (94.2%). Mortality rates per 1000 person-year (95% CI) were: BUP/NLX, 5.29 (3.02-8.58); buprenorphine, 10.79 (8.50-13.50); methadone, 28.34 (26.18-30.63). In the new-user cohort, HRs for all-cause mortality for buprenorphine and methadone relative to BUP/NLX were 1.05 (P= 0.90) and 4.47 (P< 0.001), respectively. ORs for “current” and “recent” BUP/NLX exposure relative to “past or never” exposure were 0.47 (P= 0.06) and 1.57 (P= 0.36), respectively.  Limitations: This was

a retrospective analysis of an EMR database, with no randomization to treatment. Results may be confounded by unknown/unmeasured factors such as comorbid mental disorders and/or substance-related disorders.  Conclusions: All-cause mortality rates were lowest among BUP/NLX users and highest among methadone users. Methadone was associated with 3-5 fold increased risk of all-cause mortality. PMH43 A Retrospective Observational Survey of Buprenoprhine/Naloxone Use in France Apelt SM1, Dematteis M2, Benyamina A3, Farah M4, Mankabady B5 Consulting, Oberbergkirchen, Germany, 2University Hospital of Grenoble, Grenoble, France, 3Hôpital Paul-Brousse, Villejuif, France, 4Indivior PLC, Massy, France, 5Indivior Inc., Richmond, VA, USA

1Certum

Objectives: This study was conducted to characterize real-world usage of buprenorphine/naloxone sublingual tablets (BUP/NLX) in France. Methods: This retrospective observational study was conducted using the French IMS Health Cegedim Longitudinal Patient Database (LPD). LPD records were searched for patients with opioid dependence in general practice settings who received a prescription for BUP/NLX, buprenorphine, or methadone between 2-January-2012 and 31-December-2014. Outcomes included: (1) characteristics of patients started on BUP/NLX; (2) switches from BUP/NLX to low-dose buprenorphine (0.4 mg) or methadone; and (3) AEs of general and specific concern in France.  Results: 10,152 patients received a prescription during the inclusion period: buprenorphine, n= 7,987 (78.7%); methadone, n= 2,120 (20.9%); BUP/NLX, n= 495 (4.9%). Prescription cohorts were not mutually exclusive. Mean age in the BUP/NLX cohort was 37.9 years, with 73.2% of patients between 30-49 years; 81.6% were male. The most common comorbidities (> 10%) were pain (34.1%), depression (20.8%), and hepatitis C (10.9%). Most patients (96.4%) had a history of mental disorders due to psychoactive substance use or drug dependence. BUP/NLX was first prescribed for a drug addiction diagnosis in 73.4% of patients, documented either as “addiction unspecified” (35.4%) or “opioids addiction” (38.0%); opioid withdrawal treatment accounted for 13.5% of first prescriptions. Mean daily dose for BUP/NLX was 9.2 mg (individual dose range, 1-32 mg). Mean treatment durations for BUP/NLX, buprenorphine (any dose), and methadone were 52.0, 107.7, and 93.1 days, respectively. Only 9 (1.8%) patients switched from BUP/NLX to buprenorphine 0.4 mg during the study period; 4 (0.8%) switched to methadone. Common AEs (> 1% in any cohort) were as follows (for BUP/NLX, buprenorphine, and methadone, respectively): abscess (1.4%, 2.6%, 4.3%); depression (2.8%, 2.8%, 4.6%); drug withdrawal syndrome (1.6%, 1.8%, 2.4%).  Conclusions: Few patients were switched from BUP/NLX to low-dose buprenorphine or methadone, and no safety concerns were detected for BUP/NLX compared to buprenorphine and methadone. PMH44 Influence of Computer Games on the Health and Quality of Students Academic Performance Satayeva L G , Sagantayeva S Kh , Parmankulova T N , Mirzabaeva N L Kazakchstan National Medical University name Asfendiarov, Almaty, Kazakhstan .

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S.D. Asfendiyarov Kazakh National Medical University, Republic of Kazakhstan. Introduction: The term “computer addiction” appeared in the 90s of the last century. Therefore, the problem of the impact of computer games on the health and academic performance of the students is important. AIM: The objective of this study was to assess the duration of one’s stay in the virtual world and the nature of its influence on the academic progress of the medical students.  Materials and Methods: Our pilot study was conducted by way of an anonymous survey among students studying at a medical university.  Results: We have been identified such negative consequences of computer games - sleeplessness, redness of eyes, loss of appetite, lethargy, disorientation, irritation, abnormal social behavior. The presence and degree of expression of these effects depends on the duration of the game play. Of those surveyed, only 10% said they play computer games only from time to time. While 20 students who played 10 hours a day complained of a feeling of pressure in the eyes, watery eyes, mild disorientation in time, frequent headaches, back pain and memory problems. 15 students who played computer games for more than 16 hours a day had a decrease in visual acuity, dry mucous membranes of the eyes, memory problems, back pain in the elbow brushes, body aches, loss of appetite, disorientation in time and space, insomnia, serious problems with memory and more. All students devote the game for more than 6 hours a day, revealed problems with academic performance. Some students (10%) set academic arrears for previous years of study.  Conclusion: The majority of respondents (60%) play computer games 6 or more hours a day. Consequently, this situation indicates the need for educational work about the dangers of long-term stay in the world of computer games. PMH45 Burden of Moderate to Severe Depression in the US Adult Population Morlock A Acumen Health Research Institute, Ann Arbor, MI, USA

Objectives: To better understand the characteristics and burden of moderate/ severe depression in the United States(US).  Methods: A random stratified sampling framework was used in a 2016 survey of the US adult population to assess health conditions and impact on health related quality of life(HRQoL). Validated HRQoL and screening questionnaires for depression and anxiety were employed. Respondents with no/mild depression were compared to respondents with moderate/severe depression. Chi-squares for categorical data and general linear models were used to analyze comorbidities, age, race, medication use, productivity and resource utilization. Logistic regressions were used to assess predictors of moderate/severe depression.  Results: Approximately 16% of the US adult population reported PHQ-9 scores above 14(moderate/severe depression). Respondents with moderate/severe depression compared to those with no/mild depression had a significantly lower Physical Health Composite Score(PCS)(40.26 vs. 48.84; p< 0.01) and Mental Health Composite Score(MCS)(30.96 vs. 53.77; p< 0.01), as well as a lower