Dysfunctional breathing is a pattern of respiratory movements that do not correspond to the physiological needs of the body and can lead to a series of respiratory, cardiovascular, digestive, sensory and neurological symptoms ( Vidotto et al., 2019). The causes of dysfunctional breathing are a combination of biological, psychological and social factors.

To examine the relationship between anxiety and occurrence of dysfunctional breathing in the Russian population under the conditions of the COVID-19 pandemic.

We used a socio-demographic questionnaire, the Naimigen questionnaire (Van Dixhorn, Duivenvoordent, 1985), the State-Trait Anxiety Inventory (Spielberger et al., 1983). The study was conducted online from April 27 to December 28, 2020. It was attended by 1,362 people from all regions of Russia, including 1,153 women and 209 men aged 15 to 88 years (38.3 ±11.4)

It was revealed that with a low level of state anxiety (< 35 points), dysfunctional breathing was detected in 4.8% of respondents; while with a borderline level of anxiety (> 60 points) there were at 55.9%. A similar dependence was found for personal anxiety: at a low level (< 35 points), dysfunctional breathing was detected in only 4% of respondents;while at a borderline level of anxiety (> 60 points) at 62.8%.

Dysfunctional breathing can occur among people with high and borderline levels of situational and personal anxiety during the COVID-19 pandemic. Results allows us to conclude that dysfunctional breathing and anxiety are not equivalent concepts, although they have a common phenomenological field. The study was supported of the Russian Science Foundation, project No. 21-18-00624.

The study was supported of the Russian Science Foundation, project No. 21-18-00624.

Non-suicidal self-harm (NSSH) include deliberate behaviours with the intent to self-injure. NSSH prevalence ranges 15.5%-31.3% in adolescents and young adults<25 years-old.

Our aim is characterizing the psychopathological domains occurring in adolescent and young adults with NSSH during the second COVID-19-related wave (October 2020-August 2021).

A cross-sectional study recruited inpatients aged 15-24 consecutively afferent to psychiatric ward due to NSSH, by investigating anger rumination(ARS), emotional regulation (DERS), dissociation (DES-II), metacognitive capabilities(MCQ-30), perceived stress (PSS), self-criticism (LOSCS), emotional intelligence (Reading the Mind in the Eyes Test-RMET), aggressiveness (AQ), impulsiveness (BIS-11), hopelessness(BHS), alexithymia (TAS-20). NSSH were characterized by using suicide score scale(SSS) and deliberate self-harm interview (DSHI).

A 7-fold increase in young inpatient access was observed from 2019 to 2021. DSHI median was 2 (95%CI=1,17-2,73), SSS-12months median was 5 (95%CI=4.2-6.7), SSS-lifetime median was 5 (95%CI=3.4-5.3) and MINI median was 5 (95%CI=3.4-4.7). Linear regression analysis and Pearson’s correlations revealed strong correlations between DSHI and BHS (r=0.550), TAS-20 (r=0.495), AQ-hostility(r=0.529),AQ-total (r=0.446), PSS(r=0.454), DERS-total (r=0.621), DERS-lack_of_control (r=0.658),MCQ-total(r=0.534),MCQ-perception_danger_not_control (r=0.583); between SSS-12months and AQ-total (r=0.456), AQ-Anger (r=0.443), BIS-total(r=0.457),BIS-Attentional-Impulsiveness (r=0.511),BIS-Complex-Motor-Impulsiveness (r=0.507), PSS (r=0.617), DERS(r=0.571), DES(r=0.559).

COVID-19-related increased perceived stress and depressive symptomatology may have facilitated the onset of severe NSSH in adolescents and young people with trait impulsiveness, hostility and affective dysregulation.

No significant relationships.

COVID-19 pandemic leads to high levels of stress. Individuals who have previously sought psychiatric assistance are more sensitive.

Analysis of the perception of the pandemic by people who have previously sought psychiatric care.

An internet-survey (20.03.2020 - 13.01.2021) (N=659; 152 – previously sought psychiatric assistance); included SCL-90-R; questions about the levels of anxiety, depression, and fear (assessed on 0-10 scale); question about opinion on COVID-19 pandemic (coded further on the basis of meaning); question about epidemiological situation of COVID-19 in respondents’ places of residence and their social circles.

Individuals who had previously sought psychiatric assistance demonstrated higher levels of anxiety (5,533±2,489 versus 4,774±2,590), depression (4,945±2,926 versus 3,861±2,988), and fear (0,195±0,397 versus 0,278±0,448). They showed roughly equivalent reactions to both anticipated and real danger (z-score GSI of SCL-90-R 0,90 versus 0,90 for anticipated and real danger respectively), the same indicator of the control group (0,53 and 0,65). In statements about the pandemic, they are more often referred to the topic of “positive effects” of pandemic (3,30% versus 0,99%), expressed “curiosity” (5,92% versus 2,37%). They were less drawn to conspiracy (9,87% versus 16,17%), and exploited more readily the topic “about myself” (20,39% versus 13,21%), negative images of “the present” (3,64% versus с 1,58%) and “the future” (15,79% versus 9, 47%), vocabulary of “anger” (5,92% versus 2,17%).

Individuals who had previously sought psychiatric assistance were ambivalent in their attitudes towards pandemic, and tended to concentrate more on feelings and the negative vision of the future. They perceived anticipated danger roughly equivalent to real danger.

No significant relationships.

The interest have focused in the effects of COVID-19 in mental symptoms. However, the pandemic and restrictions such as the lockdown decreed in Spain limited access to resources and lead to a change in assistance organization.

to compare the incidence and characteristics of psychiatric emergencies during the Spanish 2020 Lockdown with the same period in 2019

All the emergencies attended the the emergency room (Hospital El Bierzo) From 01/02/2019 to 30/06/2019 and those from 01/02/2020 to 30/06/2020 were analysed by two senior psychiatrists. Cases were selected if attended by any psychiatric reason. The cases were evalueated identifying ICD-10 diagnosis (according to clinical records and best criteria matching), sociodemographics, factors associated to the emergency and resolution.

23360 cases were attended in 2019 (799 psychiatric), 14907 (578) in 2020. That means a 36.19% of reduction in general emergencies and 27.66% in psychiatric emergencies (psychiatric emergencies proportion increased form 3.42% to 4.03%). The reduction started the week just before the lockdown declaration, minimal records coincided with the highest COVID-19 incidence and the recovery starts in early june for psychiatric and late June for general emergencies (figure 1). A decrease of 62.79% of anxiety cases and 45.9% of depresion was observed with no incresaes in any diagnosis. A slight increase in suicide attempts (two cases) was observed.

The lockdown seem to decrease psychiatric emergency care. Only suicidability was maintained/increased during the period. Psychiatry services must be aware of the risk of unattended inicidence that may cause an increase of cases after the lockdown.

No significant relationships.

The COVID-19 pandemic is associated with several psychiatric manifestations leaving undoubtedly psychological consequences. However by escaping death ,do COVID-19 survivors present a higher risk for suicide ?

In this study, we aimed to explore suicidal risk among recovering COVID 19 patients .

Our literature review was based on the PubMed interface and adapted for 2 databases: Science Direct and Google Scholar using the following combination ( suicide [MeSH terms]) AND (COVID-19 survivors[MeSH terms]).

Recovering COVID 19 patients are at risk for developping posttraumatic stress disorder , anxiety , depression and sleep abnormalities , especially in severe forms. Added to that ,cognitive impairment was largely described in COVID 19 causing judgment and reasoning decline. These manifestations would partially explain the suicidiality among survivors regardless to their medical hisotry. Nonetheless,many COVID-19 survivors experience persistent physical symptoms and psychiatric disorders leading to post-COVID syndrome which is associated with increased suicidal ideation and behavior In addition , social factors are considered as a suicide risk factor such as isolation ,loss of loved ones ,loss of job and economic instability .

Over the course of illness , COVID 19 survivors may suffer from psychiatric and medical conditions leading to serieous suicide risk. Therefore ,suicide prevention interventions and appropriate medical management need to be provided to keep survivors alive .

No significant relationships.

Depressive symptoms are common in patients with Fibromyalgia (FM), a chronic and disabling pain syndrome. Psychological interventions are mostly focused in negative thinking and behavioural activation. However, several studies suggest that personal identity is also affected by FM.

We aimed to examine the effects of Personal Construct Therapy (PCT), an idiographic approach that emphasizes identity features and interpersonal construal, on depressive symptoms in women with FM.

In the context of a multicentre parallel randomized trial (Trial Registry: NCT02711020), 106 women with FM and presenting depressive symptoms were randomized either to either Cognitive Behavioural Therapy (CBT; n = 55), taken as a gold standard comparison, or PCT (n = 51). In total, 69 patients completed the treatment and the six-month follow-up assessment (CBT = 32 and PCT = 37). Both treatments were applied on case formulation premises.

Linear mixed-effects models were performed to compare depressive symptoms between treatment conditions. Anxiety and pain measures were treated as secondary outcomes. Participants in both conditions significantly reduced their levels of depression and anxiety as well as the impact of FM but no significant between treatment differences were found. Analysis of clinically significant change for depressive symptoms and pain was also similar between both conditions.

PCT resulted equally effective in the treatment of depressive symptoms in women with FM when compared with CBT, both offered in a modular format. Thus, PCT with tis focus on identity issues can be considered as an alternative treatment for these patients.

No significant relationships.

Recent studies suggest that online repetitive transcranial magnetic stimulation (rTMS) can induce local entrainment of ongoing endogenous oscillatory activity that impacts cognitive performance, and the effect may depend on the function of the oscillation. However, little is known about the effects of task-specific frequencies, especially when using an online rTMS paradigm. Our previous electroencephalogram (EEG) study showed that the frontal theta rhythm is associated with the cognitive giving-up processes during problem-solving tasks.

In this study, we combined online rTMS and EEG to examine the frequency-dependent stimulation effects of rTMS on the performance of problem-solving tasks and ongoing oscillations. We hypothesized that rTMS at the theta frequency would induce ongoing theta activity and accelerate the giving-up behaviour.

rTMS was applied during problem-solving tasks with the following conditions: individual theta (4-6Hz)- and alpha (9-13Hz)-TMS, no-TMS, and sham-TMS; the order of conditions was counterbalanced across participants.

Our results showed that theta-frequency rTMS application induced an increase in theta amplitudes and shortened the giving-up response, while a control alpha-frequency rTMS application induced an increase in alpha amplitudes, but did not change giving-up responses.

This study demonstrated the effectiveness of using specific task-relevant stimulation frequency and target location for the modulation of cognitive and behavioral performance. Furthermore, considering the close resemblance between giving-up behaviour and rumination in depression, neuromodulation of cognitive giving-up processes may lead to a new intervention to treat depression by rTMS.

No significant relationships.

The close association among thyroid metabolism, mood disorders and behavior has long been known. The role of basal thyroid axis in antidepressant treatment response is less known.

The aim of the present study was to study the association of basal serum thyrotropin (TSH) levels, with antidepressant treatment response in major depressive disorder.

Thirty-one depressed adult outpatients were included. Major depressive episode was diagnosed through the MINI (DSM-IV-TR) interview. Clinical symptomatology and blood samples were assessed at baseline, and at 4- and 8-weeks of either escitalopram or sertraline. Treatment response was defined by an improvement ≥50% in MADRS scores at 4-, and 8-weeks. Basal TSH levels were included in a linear regression model as predictor of treatment response.

Twenty-seven patients finished 8-weeks of treatment. Response to treatment was of 74% at 4-weeks, and 63% at 8-weeks of antidepressant treatment. Basal median TSH levels were between normal ranges (M+SD=1.85+1,02 mlU/L). Basal TSH levels not correlated with basal MADRS scores, but with higher MADRS scores at week-4 (r=0,415, p=0,031) and at week-8 (r=0,392, p=0,043). Moreover, less baseline TSH levels trend to be a significant good predictor for treatment response at 4-weeks (R2=.116, p=.083); and a good predictor at 8-weeks treatment (R2=.147, p=.049).

Baseline TSH levels even within the normal range may play a role in predicting antidepressant response.

No significant relationships.

Procalcitonin (PCT) is the prohormone of calcitonin.Whereas calcitonin is only produced in the C cells of thethyroid gland as a result of hormonal stimulus, PCT is secreted by different cells from numerous organs in response to proinflammatory stimulation, particularly bacterial overactivity,also procalcitonin level might be elevated during the depressive episode as a result of inflammatory theory.PCT assessment is not fully studied in different psychaiatric disorders and particularly in major depressive disorder.

1-To study the level of Procalcitonin level in 1st episode drug naive major depressive disorder. 2-To investigate the relation between procalcitonin level and cognitive dysfunctions in these patients 3-To illustrate the role of PCT in psychopathology of Major depressive disorder

1-Socio-demographic data of the target group of patients 2-Psychiatric evaluation using DSM 5 diagnostic criteria 3-Hamilton rating scale of Depression 4-Laboratory assessment of Procalcitonin level (PCT) using VIDAS® B·R·A·H·M·S PCT™ 5-Cogintive evaluation using novel battery of THINC-IT

1-Elevated level of Procalcitonin(PCT) in the targeted patients in comparison to control group 2-The level of PCT is positively associated with the cognitive dysfuctions reported in these patients. 3-The severity of depressive psychopathology is related positively to the elevated level of PCT

Procalcitonin (PCT) assessment played an importnat role in the etiopathogenesis of 1st episode drug naive major depressive disorder,also it has a crucial role in the cognitive dysfunctions commonly reported in these patients

No significant relationships.

Childhood trauma is associated with an increased risk of anxiety and depressive disorders, but its association with anger, irritability, and related constructs has received less attention.

We aimed to investigate (1) the relationship between childhood trauma and anger constructs in adulthood, and (2) which types of childhood trauma is most predictive.

In the Netherlands Study of Depression and Anxiety (NESDA), childhood trauma at baseline was assessed with a semi-structured interview. Childhood trauma was analyzed in relation to the Spielberger Trait Anger Subscale (STAS), the Anger Attacks Questionnaire, and the cluster B personality traits part of the Personality Disorder Questionnaire 4 (PDQ-4), measured at 4-year follow-up, using analysis of covariance (ANCOVA) and multivariable logistic regression analyses, adjusting for sex, age, level of education, BMI, smoking, alcohol dependency/abuse, disorder status.

Participants were on average 42.1 years (SD = 13.1), and 66.3% (n = 1.508) were female. Childhood trauma showed a dose-response association with all anger constructs. Zooming in, emotional neglect, and psychological, and physical abuse were associated with all anger constructs, independently of depression or anxiety. Additionally, sexual abuse and childhood life events were associated with trait anger and borderline personality traits, and trait anger and antisocial personality traits retrospectively.

Childhood trauma is linked with anger in adulthood. Childhood trauma may cause not only anxiety and depression, but also anger, and tailored interventions (at both childhood trauma and anger itself) might help to improve unsatisfactory relationships and prevent violent behaviors.

No significant relationships.

Nurses specializing in maternal and child health are poised to play a pivotal role in the early identification and prompt treatment of perinatal depression. Postpartum period it is well-known for presenting high-risk for the appearance of a mental illness.

This study has been carried out with the aim of investigating the level of knowledge of the nurses and their role in the management of post-partum depression.

73 participants (n=73) were selected which are professional nurses. The data were collected through a questionnaire formed out of 16 questions. The questionnaire is structured on three parts: general information about the participants, the nurse’s knowledge about the postpartum depression, and the identification and the management of the patient’s cases.

73 of the nurses questioned, consider that they were not properly prepared for this role and they were not able to identify and manage the patients with post-partum depression. They also consider that the ideal training should contain more theoretical information. Amongst these (32, 87%) do not know the symptomatology, and 38, 35% are not aware of the risk factors of post-partum depression.

Postpartum depression is seen in approximately 10% of women who have recently given birth, but also in 3, 3% of men. Despite of this numbers, the Romanian medical staff is not yet well prepared in facing this affection.

No significant relationships.

A cross-sectional relationship between low-grade inflammation –characterized by increased blood levels of C-reactive protein (CRP) and pro-inflammatory cytokines– and both MDD and anxiety has been reported, but the potential longitudinal symptom-specific relationships has been less well studied.

We aimed to test our hypothesize that inflammation is predictive of the severity and the course of a subset of MDD and anxiety symptoms, especially symptoms that overlap with sickness behavior, such as anhedonia, anorexia, low concentration, low energy, loss of libido, psychomotor slowness, irritability, and malaise.

We tested the association between basal and lipopolysaccharide (LPS)-induced inflammatory markers with individual MDD symptoms (measured using the Inventory of Depressive Symptomatology Self-Report) and several measures for symptom domains of anxiety over a period of up to 9 years using multivariate-adjusted mixed models in up to 2872 Netherlands Study of Depression and Anxiety (NESDA) participants.

At baseline, 53.9% of the participants had a current mood or anxiety disorder. We found that basal and LPS-stimulated inflammatory markers were more strongly associated with sickness behavior symptoms at up to 9-year follow up compared to non-sickness behavior symptoms of depression. The associations with anxiety symptoms attenuated by 25%-30% after adjusting for the presence of (comorbid) MDD.

Inflammation was related to the presence and the course of specific MDD symptoms, of which the majority overlaped with sickness behavior. The associations between inflammatory markers and anxiety symptoms were partly driven by co-morbid MDD. Anti-inflammatory strategies should be tested in the subgroup of MDD patients who report depressive symptoms related to sickness behavior.

No significant relationships.

Evidence from epidemiological studies indicated that intrauterine exposure to alcohol and tobacco is linked with a number of adverse outcomes in offspring. However, few studies have linked prenatal alcohol and tobacco exposures to offspring depressive symptoms with mixed results.

The objective of this study was to examine the link between maternal prenatal alcohol and tobacco exposures and depressive symptoms in offspring.

Using data from the Raine Study, a prospective multigenerational observational study, we examined the associations between maternal prenatal alcohol and tobacco use and the risk of depressive symptoms in offspring at age 17 years (N=1168). Depressive symptoms in offspring were measured using the Beck Depression Inventory for Youth. Log-binomial regression was used to estimate relative risk (RR) for associations between exposures and outcome. To better investigate the role of potential confounders, risk factors were sequentially added as adjustment variables in separate models.

After adjustment for potential confounders, depressive symptoms in offspring remained related to maternal alcohol use of six or more standard drinks per week during the first trimester of pregnancy [RR 1.59 (95% CI: 1.11-2.26)]. Further, the risk of depressive symptoms was 50% higher for offspring exposed to prenatal tobacco use when compared to non-exposed. The Associations did not appear to be mediated by the effects of prenatal alcohol and tobacco use on adverse pregnancy outcomes.

Early screening and prevention of these exposures could possibly reduce depressive symptoms in offspring. Moreover, future examinations such as Mendelian Randomization that allow a stronger causal inference is warranted.

No significant relationships.

Vascular endothelial growth factor (VEGF) has been implicated in mediating the effect of antidepressants (AD) and electroconvulsive therapy on depression since it plays a significant role in the neurogenesis. However, the serum VEGF level has not been investigated so far in association with rTMS treatment in patients with major depressive disorder (MDD).

The aim of our study was to compare the effect of the antidepressants and of the repetitive transcranial magnetic stimulation on the serum vascular endothelial growth factor and its association with the responsiveness to the treatments.

A dataset of 50 patients with TRD who were treated with AD (n=33) and bilateral rTMS for 2x5 days (n=17) was analysed (sample ’rTMS&AD’). Montgomery-Asberg Depression Scale (MADRS) was used for monitoring the symptom changes. The serum VEGF levels and symptoms were assessed on the first (V1), on the 14th (V2) and on the 28th day (V3). The VEGF levels were measured by ELISA assay.

The baseline VEGF levels were significantly higher in non-responders both in the rTMS&AD (p=0.04) and AD samples (p=0.02) compared to responders. The MADRS reduction and the changes in VEGF levels between V1 and V3 were significantly associated in responders only in the AD&rTMS sample (p=0.03). The baseline VEGF level has been proven as a significant predictive factor of treatment response in the total sample (p=0.018).

The baseline VEGF level can be a predictive factor to be a non-responder to different treatments. Change of the VEGF level is associated with the improvement of depressive symptoms only due to rTMS.

This study was supported by the FK 131315 grant of the National Research, Development and Innovation Office, Hungary. Authors declare no conflict of interest.

We conducted a national longitudinal survey among healthcare workers in the context of the Covid-19 pandemic, (1) to assess mental health and (2) to describe the results of an intervention to improve capacity of resilience. Non-participation is rarely studied despite being an important methodological matter when performing studies on mental health.

The study aims to describe and identify the factors associated with non-participation of healthcare workers to the intervention part of a national longitudinal study on the psychological impact of the COVID-19 pandemic.

Participants were recruited from April to October 2021 via an Internet link widely disseminated. Data collected include participant’ socio-demographic, occupational and working conditions, general health, professional burnout and mental health. The intervention proposed the use of tools for self-management of stress and resilience (PsySTART-Responder® and Anticipate.Plan.Deter™ program). A robust Poisson regression was used to identify factors associated with non-participation.

Among 724 participants, 41% participated to the intervention part. Factors associated to non-participation to the intervention were to work with few or no COVID-19 patients, and low scores in the anxiety scale. Social determinants, occupational characteristics or general health were not associated with non-participation.

Our study provides a better understanding of the participation of healthcare workers that was not frequently studied. The results logically suggest lower participation among those with better mental health and not directly concerned with management of COVID-19 patients. Non-participation to the intervention was not associated with social factors, which is an argument in favour of using such a design/intervention in a socially heterogeneous population.

No significant relationships.

Alzheimer’s disease (AD) is the leading cause of dementia worldwide. About 40-50% of AD patients are also affected by depression, with mounting evidence suggesting its association with worse disease prognosis and negative outcomes, such as lower quality of life, higher mortality and more hospitalizations. However, few studies have specifically measured the association of depression with AD hospitalization outcomes.

To characterize depression among all hospitalizations with a registered diagnosis of AD and to explore its association with hospitalization outcomes, including in-hospital mortality, length of stay and discharge destination.

A retrospective observational study will be conducted following the RECORD statement. A Portuguese nationwide hospitalization database from all mainland public hospitals will be used. Episodes of inpatients ≥65 years old with a primary or secondary diagnosis of AD (ICD-9-CM code 331.0), discharged between 2008-2015, will be selected. Codes 296.2X, 296.3X, 300.4 and 311 will be used to identify episodes with a concomitant registry of depression at any diagnostic position. Descriptive, univariate and multivariate approaches will be used.

A total of 61 361 episodes complying with the fixed criteria will be assigned to one of two groups (with vs without depression). Groups will be compared regarding sociodemographic characteristics, comorbidity profile, type of admission (planned vs urgent) and hospitalization outcomes. Results regarding the association of depression and outcomes will be presented as crude and adjusted odds ratios (OR).

With this nationwide analysis, we expect to contribute to the clarification of depression impact on AD hospitalizations, so that best-practice care may be provided to these patients.

No significant relationships.

Tranylcypromine (TCP), an irreversible monoamine oxidase inhibitor (MAOI), is recommended for difficult-to-treat depression. Besides the requirement of a low-tyramine diet, there are concerns about the safety of TCP treatment during anaesthesia and electroconvulsive therapy (ECT). For safety reasons, many psychiatrists prefer to terminate TCP before ECT.

To assess the safety of tranylcypromine treatment during ECT series in patients with difficult-to-treat depression (DTD).

In this retrospective study we report on n=19 patients, who were treated with tranylcypromine during the ECT series. ECT parameters, clinical and safety data were obtained from our clinical database.

Mean age of patients was 51 years (range 29-77) at time of the first ECT sessions. 58 % (n=11) of patients were female. In total, 198 ECT sessions were analysed (mean 11, median 9,5 per patient). Mean TCP dose was 44 mg at time of first ECT (median 43). Concomitant TCP and ECT treatments were well tolerated during the entire ECT series. In one case TCP treatment was discontinued due to self-limiting bigeminus during the ECT session. In another case TCP and other drugs as well as the ECT series were stopped after the patient developed delirium. At the end of ECT series the mean TCP dosage was 37 mg.

Tranylcypromine appears to be safe during ECT series and does not necessarily have to be terminated prior to electroconvulsive therapy.

No significant relationships.

Desperation for cure led to 19th century invention-- electrotherapeutic devices; replete with hyperbolic claims of cure-all, perceived ineffectiveness, and potential harm rendered the modality as quackery but were used in early brain stimulation, melancholia treatment, and cortex mapping. Here, antique devices are restored, and their electrophysiological qualities ascertained.

Determine the comparative capabilities of these devices in delivering electrostimulation and compare with modern standards to understand possible electrophysiological sequelae.

Devices known as “medical batteries” were analyzed. Power delivery utilized a “voltaic battery”, simple circuit, and a conductor wrapped around an iron core. When the circuit is energized, the core is magnetized by direct current of the battery which induces an alternating current that electrifies probes used on the body. Due to their marked age, a common 9-volt battery was exchanged for the corrosive dry cell paste batteries. Electrical parameters were then measured.

Table 1

Devices for electrotherapeutics ranged from anemic vibrations to dangerous tetany inducing shocks. Measuring the capabilities of these devices shows the robust yields possible if the original higher capacity batteries were utilized. The reality is, cure or not, the devices were surprisingly potent. It is interesting that, albeit unrefined, efficacious doses were available before modern electrification.

No significant relationships.

Structured clinical interviews are the gold standard for assessing mental health. However limited resources may allow the use of only self-report questionnaires. In the context of emergency, such as terrorist attacks, the performance and thresholds of such tools still unclear.

We investigated the performance of the Posttraumatic stress disorder CheckList Scale (PCL-S) and of the Hospital Anxiety and Depression scale (HADS), both compared to the MINI Interview, among civilians and first responders involved in terrorist attacks.

The data came from the IMPACTS survey which was conducted from 6-10 months among civilians (N=190) and first responders (N=232) after the January 2015 terrorist attacks in the Paris Region, France. Sensitivity and specificity of the PCL-S and HADS were estimated by the ROC curve, and the optimal threshold was defined using the Youden index.

Regarding the PCL-S: for civilians and first responders respectively, the overall AUC was 0.947 and 0.899, and the optimal threshold were 38.5 and 39.5. Regarding the HADS-D: for civilians and first responders respectively, the overall AUC was 0.908 and 0.617 and the optimal thresholds were 7.5 and 1.5. For the HADS-A for civilians and first responders respectively, the overall AUC was 0.823 and 0.717, the optimal threshold were 9.5 and 6.5.

In the context of a terrorist attack, compared to the MINI, our study underlined satisfactory performance of the PCL-S and the HADS-D in screening for PTSD and depression respectively, while the screening of anxiety using the HADS-A was unsatisfactory.

No significant relationships.

Clozapine, a unique antipsychotics, is well known for its adverse effects. Myocarditis is a rare but life-threatening complication, however not monitored at a global scale.

This work aims to review the literature on clozapine-induced myocarditis.

Pubmed and Google Scholar search using Mesh terms clozapine, myocarditis, clozapine-induced myocarditis.

Clozapine-induced Myocarditis (CIM) is potentially fatal, with mortality rates environ 21%. According to the World Health Organization Monitoring Program, notification rate is 0,93%, nonetheless incidence found in literature varies dramatically. Highest rates are reported in Australia, where this relationship was first established and a complete monitoring protocol is compulsory in all patients starting clozapine, which causes some authors to defend this condition is generally undernotified. Underlying mechanisms are not fully understood, but an imunomediated hypersensitive reaction occurring in the first 3-4 weeks after treatment is suggested. CIM is rare after 6 weeks. Risk factors include age, cardiac disease, initial high dose, rapid titration and simultaneous valproate or other antipsychotics use. The most common symptoms, fever, tachycardia, dyspnea and malaise, are non-specific and can be indistinguishable from other clozapine benign adverse effects. Analytically, C-reactive protein and Troponine elevation are the most specific diagnostic markers, therefore the most suitable for monitoring. Prompt cardiological observation for further evaluation should be seeked whenever CIM is suspected.

Diagnosis of CIM can be challenging. Systematic monitoring is not consensual but may increase detection, prevent severe outcomes and help clinicians decide whether to keep or suspend therapy. Clozapine is beneficial and shouldn’t be avoided or unjustifiably discontinued.

No significant relationships.