Long Acting Buprenorphine (LAB) – Buvidal (CAM2038) – is a prolonged release treatment for opioid dependence in adults. Its extensive use was funded by Welsh Government during the pandemic in Wales and it has been found to be a significantly better than oral medications in improving quality of life, possibly through providing allostatic craving and anxiety reduction

This is a case series of 10 patients who were referred to Community Addiction Services in North and South West Wales with OAD.

Patients were mainly using Codeine or Tramadol and were referred due to either ongoing illicit use or via primary care services requesting support. As part of the pandemic initiative, they were initiated on Buvidal and followed up.

All ten patients successfully started on Buvidal without significant issues. As a group, if transferred straight to Buvidal, they tended to have fewer significant withdrawal symptoms prior to starting on the Buvidal compared to those on Methadone or Heroin. They were treated on the usual range of Buvidal doses (1 on 64mg, the others on 96-128mg monthly). They have all stabilised and successfully moved on with their lives on Buvidal. One has used the time on Buvidal to have psychological input around past traumas and successfully detoxified in the community using Buvidal.

Recommendations for services considering OAD - it is a surprisingly effective treatment which is easy to start. It has the scope for being both an effective OAD recovery medication and a potentially simple detoxification strategy for this patient group.

Professor Melichar has provided consultancy work, presentations, training and chaired panel discussions for all the companies in this area in the UK and some outside the UK. Recent work includes Althea (UK), Britannia (UK), Camurus (UK and Global), Martin

During the COVID-19 pandemic time, teachers have to adapt to many changes that could potentially make them more vulnerable to psychological distress.

To determine the prevalence and the factors for anxiety during the COVID-19 epidemic among the high school teachers in Sfax, Tunisia.

This was a cross-sectional study, for descriptive and analytical purposes, conducted on google drive in May 2021.We involved 97 junior and secondary school teachers from Sfax, Tunisia, practicing in public high schools. Anxiety was assessed by using Generalized Anxiety Disorder tool (GAD-7).

The average age of the participants was 44.23 years old with a sex-ratio (M/F) of 0.32. Since the advent of COVID-19, 54.2% had presented sleep disturbances while 10.4% had suicidal thoughts. Among all participants, 77.8% were afraid of the virus transmission within the classroom or the school and 81.3% reported regular mask wear at work. The median score on the GAD-7 was 6.5 (Q1=3, Q3=11). Scores’ distribution indicated that 68% of the participants had no to mild symptoms of anxiety while 32% had moderate to severe anxiety. Furthermore, the presence of anxiety was associated to the female gender (p=0.01), sleep disturbances (p<0.001), suicidal thoughts (p=0.006), and to the conviction that wearing masks blocks the transmission of voice, information or emotions between teacher and student (p=0.025).

During the COVID-19 outbreak, high school teachers in Sfax, Tunisia have high levels of anxiety.This can lead to a decreased effectiveness of their complex work.

No significant relationships.

Recently, several antidepressants, mood stabilizers, and antipsychotics have been suggested to have favorable effects in the treatment of COVID-19.

The aim of this systematic review was to collect evidence from preclinical and clinical studies concerning the scientific evidence for the repurposing of psychotropic drugs in COVID-19 treatment.

Two independent authors searched PubMed-MEDLINE, Scopus, PsycInfo, Clinical Trial Registration Site US (ClinicalTrials.gov) databases, and reviewed the reference lists of articles for eligible articles published up to May 31st, 2021. All preclinical and clinical studies on the effect of any psychotropic drug on Sars-CoV-2 or patients with COVID-19 were included. The Newcastle-Ottawa scale was used for the quality assessment of clinical studies. This systematic review adheres to the PRISMA guidelines.

22 studies were included in the synthesis: 9 clinical studies, 9 preclinical studies, and 4 computational studies. The use of antidepressants, both SSRI and non-SSRI, was associated with a reduced risk of severe complications of COVID-19. Several antipsychotics showed an increased risk for both Sars-CoV-2 infection and severe complications during COVID-19.

The current evidence supports a potential anti-SARS-CoV-2 role for several antidepressants, while the evidence on mood stabilizers or antipsychotics remains controversial. Drug repurposing proved highly successful in response to the current pandemic and psychotropic medications are widely used in clinical practice with well-known safety and tolerability profiles, showing antiviral, immunomodulatory, and anti-inflammatory properties, being perfect candidates for possible treatment of COVID-19. Further research will deliver optimized and specific therapeutic tools that will increase the preparedness of health systems for possible future epidemics.

No significant relationships.

The Covid-19 pandemic has significantly changed family dynamics and parents experience greater psychological distress. Conduct problems in young people have increased by 35%. However, it is not known how Covid-19 associated stresses have affected parenting practice, conduct problems, and comorbidities and what additional support is needed for families at risk.

This study uses self-report measures and semi-structured interviews to examine and explore the impact of Covid-19 on the families of young people with conduct problems and comorbid mental health conditions.

This is a sequential mixed-methods study. Eligible families with children aged between 11-18 years have participated. One-hundred-and-eighty-two families have completed eight online questionnaires and 12 have participated in semi-structured follow-up interviews.

Analyses indicate that parental harshness, warmth, educational background, and employment have a significant impact on Covid-19 exposure and worries, as well as significantly higher scores of conduct disorder symptoms. Interview codes reveal that young peoples’ behaviour became more severe during the pandemic, and this was associated with reduced in-person support services, reduced personal space at home, and parents taking on the additional role of educator.

The findings suggest that Covid-19 is a significant risk factor to young people with conduct problems and their families. For example, reduced parental warmth and increased parental harshness increased conduct problems for young people during the lockdown. This study highlights that policies and services should work to better support such families. Future online psychosocial interventions are needed to empower families and improve parenting practice at home during the lockdown period and in general.

No significant relationships.

The COVID-19 pandemic grabs attention to the study and solution of this global problem around the world.

The aim of the study is to link the level of anxiety and fear that emerged in Turkey during the epidemic.

A survey was conducted, which contains 10 questions. 433 people took part, 5- 15 - 18 (1.2%), 168 - 19 - 29 years (38.8%), 202 - 30 - 39 (46.7%), 47 - 40-49 (10, 9%) 11 from 50 years (2.5%).

Men with panic attack criteria - 11.3% (11 people), women - 9.8% (35 people). Symptoms of GTR were found in 31% (25) men and 18% (66) women. 328 participants - university graduates: 29% believe that the information of the Ministry of Health is correct. No significant difference between the percentages of compliance with the criteria for diagnosing panic attacks and anxiety was found depending on educational status. 8.3% of participants, 36 people, were diagnosed with Covid. The share of those who did not have a code, but thought they had, is 42%, and among those who had a code (before the disease) - 72%. There is a direct relationship between the level of education and personal protection against epidemics.

From a community mental health perspective, it is important that all covid-positive patients receive psychiatric support, whether or not they meet the DSM-V and ISD 10 diagnostic criteria.

No significant relationships.

The coronavirus disease 2019 (COVID-19) pandemic has had a profound worldwide impact on health. Acute Confusional Syndrome (ACS) is the most common neuropsychiatric complication in COVID-19 infection.

Describe the characteristics of the admited patients attended by the liaison psychiatry service for acute confusional syndrome during the COVID 19 pandemic. Sociodemographical and clinical variables were descrived.

We conducted an observational, descriptive study. All patients attended by the liaison psychiatry service of Hospital del Mar, between February and April 2020, with ACS diagnosis were included.

We included 62 patients with acute confusional syndrom; 35 were men (56.5%), and mean age was 71.71 years (standard deviation [SD]:11.345). The mean duration of admision stay was 41.19 days [SD: 38.039]. The mean number of consultations carried out was 6.5 [SD: 5.422]. 52.5% of our sample of our sample had confusional symptoms for 8 days. 50 patients presented complications during admission (80.6%), of which 43 patients developed infectious complications (69.4%). 59 patients had a history of chronic diseases (95.2%). 54 patiens (88.5%) had potencial risk factors associated with acute confusional syndrome including: isolation in 24 (39.3%), active infection in 46 (74.2%), hypoxemia in 25 (40.3%), previous cognitive impairment in 15 (24.6%)

Acute Confusional Syndrome mainly affects people with risk factors such as isolation, active infection and hypoxemia (which in turn are symptoms of Covid-19).

No significant relationships.

Very few studies have explored mental health among undergraduate students in Chile, especially during the Covid-19 pandemic. International studies have estimated the prevalence of depression at around 28%.

i) To determine the prevalence of mental health problems among undergraduate students at a private university in Chile; ii) to explore the associated factors in the context of the Covid-19 pandemic.

This was a cross-sectional study, approved by the Ethical Committee of the Universidad de los Andes, Santiago Chile (CEC201984). Undergraduate students completed an online survey between August and September 2020. Mental health was assessed using The Depression, Anxiety and Stress Scale-21; suicidality, using the Columbia Suicide Severity Rating Scale; insomnia using the Insomnia Severity Index; and several individual, family, and university factors. Variables regarding the Covid-19 were also assessed, such as personal and family history of covid-19 contagion and death of family members due to Covid-19. A multivariate logistic analysis was performed.

5,037 students responded to the survey. 70.4% were female, mean age, 21 years. 37.1% had depression; 38%, anxiety; 54.6%, stress; 32.6%, insomnia; and 20.5%, suicidal ideation (last month). The most important risk factors were non-medical use of benzodiazepine and fear of contracting Covid-19; the most relevant protective factors were high family functionality and a high sense of university belonging.

This is one of the first studies that has evaluated mental health among undergraduate students in the context of the Covid-19 pandemic in Chile. The findings showed concerning levels of mental health problems.

No significant relationships.

Poor adherence with recommendations during pandemic is wide-spread and increases populational risk of being infected (Smith et al., 2020, Webster et al., 2020, Freeman et al., 2020). Revealing psychological factors of low adherence in adolescents is important for interventions planning. This study tests the role of perceived social support and belongingness in COVID-related anxiety and adherence.

The aim was to reveal relationships between COVID-related anxiety, monitoring of information about pandemic, adherence to recommendations and interpersonal needs in female adolescents.

183 female adolescents (13-21 years old) filled Anxiety Regarding Pandemic Scale, Information Monitoring and Adherence To COVID-related Recommendations Scales (Tkhostov, Rasskazova, 2020), Interpersonal Needs Questionnaire (Van Orden et al., 2012).

Female adolescents moderately (m±sd=3.32±1.40 of 1–6-point scale) worried about negative consequences of pandemic on their life and lowly worried about risk of being infected (m±sd=2.53±1.15). Their adherence to recommendations was upper medium (m±sd=3.42±1.18). Neither worries nor adherence were related to age. Perceived burdensomeness was unrelated to COVID-related anxiety and adherence while thwarted belongingness was related to lower anxiety of being infected (r=-.23, p<.01) and poorer adherence to recommendations (r=-.19, p<.05).

In female adolescents thwarted belongingness is a risk factor of poor adherence to COVID-related recommendations because of lower anxiety of being infected. Research is supported by the Russian Foundation for Basic Research, project No. 20-04-60072.

Research is supported by the Russian Foundation for Basic Research, project No. 20-04-60072.

Contagious disease outbreaks can have major repercussions on medical stuff. Doctors in Tunisia were requested to act as the first-line filter in managing active cases during the beginning of COVID19 pandemic.

This study aims to assess perceived stress in Tunisian doctors during COVID19 pandemic early stages and to identify factors associated to stress in order to guide prevention strategies.

This was a cross-sectional study conducted through an online survey, from April 18th 2020 to June 6th 2020. A 62-item semi-structured survey was created, consisting of 5 series of questions and scales. Linear regression models were performed to identify the associations between the study variables and the perceived stress score of the participants.

We included 203 physicians in this study. Stress levels were high among Tunisian doctors with a mean perceived stress score (PSS) of 28.6. One hundred fifteen participants (56.3%) scored for high PSS. This study identified vulnerable subgroups too stress. The female gender, working in the capital and working in critical medicine units were risk factors for high PSS. Managing COVID19 patients was not itself correlated to stress, however social isolation, stigma and luck of access to information were correlated to high stress levels.

Several stressors can affect the well-being of doctors during the COVID-19 pandemic, which can lead to adverse psychosocial outcomes. The findings of this study may guide decision-makers to implement early mental health interventions for doctors.

No significant relationships.

Studies have shown ethnic inequalities in health, with a higher incidence of illnesses among people of some minoritised ethnic groups. Furthermore, it has been observed that people with severe mental illnesses have a higher risk for multimorbidity. However, no study has investigated ethnic disparities in comorbidity in people with a schizophrenia spectrum disorder.

This study investigates potential ethnic disparities in physical health comorbidity in a cohort of people with psychosis.

Using a cross-sectional design, we identified service-users of the South London and Maudsley NHS Trust who were diagnosed with a schizophrenia spectrum disorder between 2007 and 2020. We assessed the prevalence of asthma, bronchitis, diabetes, hypertension, low blood pressure, overweight or obesity, and rheumatoid arthritis. Latent class analyses were used to investigate distinct profiles of comorbidity. Multinomial regression was then used to investigate ethnic disparities in these profiles. The regression model was adjusted for gender, age, neighbourhood deprivation, smoking and duration of care.

On a sample of 23,418 service-users with psychosis, we identified two classes of comorbidity: low comorbidity and multiple comorbidities. Compared to the White British ethnicity, a higher risk for multiple comorbidities was observed for people with any Black background, Indian, Pakistani, Asian British, and mixed-race ethnicities. Furthermore, Black African women had a significantly higher risk for multiple comorbidities than their male counterparts.

Ethnic disparities are observed in multiple comorbidities among people with psychosis. Further research is needed to understand the impact of these disparities, especially in relation to mortality.

No significant relationships.

Depression and anxiety-related mental health and employment earnings are complexly intertwined but have rarely been studied as parallel processes.

Determine the number of latent parallel trajectories of mental health and employment earnings over two decades among a cohort of American youth entering the labor force, and estimate the association between baseline sociodemographic/health factors and latent trajectory class membership.

This study included 8,173 participants from the American National Longitudinal Survey of Youth 1997, who were 13–17 years old in 1997. The survey occurred annually until 2011 then biennially until 2017. Mental health was measured eight times using the Mental Health Inventory-5 between 2000–2017. Employment earnings were measured annually between 1998–2017, where participants were 33–37 years old. Latent parallel trajectories were estimated using latent growth modeling. The association between baseline predictors and trajectory membership was explored using multinomial logistic regression.

Four latent trajectory classes were identified: good mental health, high earnings (3% of sample, average 2017 earnings ˜$196,000 USD); good mental health, medium earnings (23%, average 2017 earnings ˜$78,100); good mental health, low earnings (50%, average 2017 earnings ˜$39,500); and poor mental, low earnings (24%, average 2017 earnings ˜$32,000). Multinomial models revealed participants who were younger, female, Black, Hispanic, who had lower socioeconomic status, and had used marijuana at baseline had higher odds of belonging to the poor mental health, low earnings class.

Findings highlight the stagnated, parallel course of poor mental health and earnings, and the influence of gender, race, adolescent socioeconomic status, and health behaviors on these trajectories.

No significant relationships.

Many mental disorders take a chronic course, associated with disability and/or participation restrictions. This is well recognized in social psychiatry. It is assumed that in psychotherapy milder disorders are seen, but there are no data available in this regard. In a survey in outpatient psychotherapy the rate of patients with chronic disorders and associated impairment was assessed.

Goal of the present study was to assess the prevalence and meaning of long term and prevailing disorders in psychotherapy

A total of 131 psychotherapists (43.5% psychodynamic, 55.7% cognitive behavior therapy) reported about 322 outpatients. Therapists were interviewed in person by two research psychotherapists in regard to illness characteristics of unselected patients.

The duration of illness was longer than 1 year in 98.1% of patients or longer than a decade in 54.5%. In the judgement of the therapists 79% of disorders had a chronic or recurrent course. In 25% there were relevant participation impairments in regard to daily activities, leisure time, social relations, or work. About one quarter had already been in inpatient treatment.

The data show that chronic disorders are the rule rather than the exception in psychotherapy. This requires a multidimensional and interdisciplinary treatment approach, including sociomedical interventions in order to sustain participation in life. This should be recognized in the treatment concepts and also get proper attention in the education and reimbursement of psychotherapists.

No significant relationships.

Transition of educational institutions to distance learning in pandemic was found to be associated with students’ complaints about difficulties, decrease in effectiveness, interest and well-being (Herbert et al., 2021, Almomani et al., 2021, Puljak et al., 2020).

The aim was to reveal psychological predictors of decreased academic satisfaction, competence, and engagement among students in the digitalization of education during a pandemic.

In December 2020 220 students 18-33 years old were asked about their learning difficulties, academic satisfaction, competence and engagement before the pandemic and now (Cronbach’s alphas .66-.90), well-being (Diener et al., 1985, Diener et al., 2010), educational motivation (Sheldon et al., 2017), pandemic anxiety (Tkhostov, Rasskazova, 2020).

There was a decrease in academic satisfaction, subjective competence and engagement, with moderate learning difficulties (F=60.4-63,3, p<.01, η²=.22). More pronounced learning difficulties during a pandemic were found in students with higher level of negative emotions, lower integrated learning motivation, higher anxiety due to the transition to distance learning and due to a violation of security online (p<.01). The decrease in academic satisfaction, competence and engagement were maximal among students with a lower level of positive emotions, higher level of amotivation, anxiety due to the transition to distance learning and violation of privacy and security online (p<.01).

Students with higher negative emotions and distance learning anxiety regardless of their skills were more vulnerable to the changes in learning in pandemic. The study was funded by Russian Science Foundation project № 18-18-00365.

The study was funded by Russian Science Foundation project № 18-18-00365.

Several initiatives within psychiatric nursing targets Non-suicidal self-injury (NSSI) in DK, but none targets the new phenomenon Digital Self-harm. Digital self-harm involves the use of Social media (SoMe) to harm oneself for example by communicating condescending content about and to oneself through fake profiles, seeking out conflicts to be humiliated, and consciously get others to say vicious things about themselves. Further, images are exchanged showing wounds, broken extremities, etc. and thoughts and feelings are exchanged about suicidal actions as well as methods for both self-harm and suicide actions. We do not know enough about what constitutes the problem nor do we know how to address neither the behavior nor their consequences. Due to conflicting results, more research is needed to understand how media affects NSSI as well as suicidal behavior.

The overall objective of this study is to map, at a national level, how SoMe is used as part of NSSI and suicidal behavior and get insight as to what constitutes the behavior and how we address it through three sub-studies.

The study will be carried out as a mixed method study and includes a systematic review (Study 1), a qualitative part, which will be examined through interviews (Study 2), and finally a quantitative part that will be conducted through questionnaires (Study 3).

The project is ongoing.

Prospects of this study are that the project will create clarity about the essence of the phenomenon of digital self-harm, how NSSI and suicidal behavior is affected and generate enough knowledge to develop interventions aiming digital self-harming and suicidal behavior.

No significant relationships.

According to international publications the burden of mental diseases is considered to be significant and rising.

Scope of analysis is to present 1) patient numbers and 2) direct mental health costs from the database of the National Health Insurance Fund Hungary for patients with F00-F99 ICD code between 2015-2019.

An Oracle database was created with direct mental care costs for each patient in a given year with a three-digit ICD code and type of care (primary, specialist, prescribing) and handled via sql queries. Data on capacity and performance came from the NHIF and NSO website for 2008-2019 and were handled via Microsoft Excel.

Mental problems affected 3 million people (more than 30% of the population) in a five year period, though patient numbers are continuously declining. Almost half of the patients only visit a general practitioner and don’t get a prescription. There is also a drop in proportional mental spending which has fallen from 5,03% to 4,02%. This tendency is accordance with international findings. There is a dramatic fall of inpatient cases and a growing number of outpatient interventions, though we see a move from individual therapy sessions to group interventions and a decline in specialist psychotherapy sessions. We can see a shift towards more young patients both in inpatient and outpatient setting.

The analysis raises the question whether declining patient numbers and shrinking proportional spending are due to smaller provider capacities and unmet need or a mentally healthier population.

No significant relationships.

A mental health (MH) assertive community treatment (ACT) is always designed expecting for a decrease in the pressure (visits and readmissions) in inpatient services and to increase care quality. An appropriate management of ACT provision can be crucial to develop a balanced community-based MH ecosystems.

To assess the impact of the ACT on the performance of the MH ecosystem of Bizkaia (Basque Country, Spain).

The ecosystem is structured by 19 MH areas, supported by 5 ACT teams. Here ACT provides high intensity mobile outpatient care to people suffering from severe mental disorders. The impact of these teams on the ecosystem performance was assessed by Monte-Carlo simulation, the Data Envelopment Analysis (DEA) and fuzzy inference. The input variables were the availability, number of psychiatrics, nurses and total of professionals of ACT services in each area. The outputs were: frequentation, incidence and prevalence of ACT services in each MH area. Performance indicators were: relative technical efficiency (RTE), statistical stability and entropy.

The global ecosystem performance was high (RTE on average=0.799 -input DEA orientation- and 0.825 -output orientation- up to 1, the maximum), the stability was medium-low (respectively 38,67% and 13.64% up to 100%, the maximum) and the entropy was medium-high (respectively 70,41% and 65.9% up to 100%, the maximum).

Results highlighted a positive impact of ACT in Bizkaia. Nevertheless, stability and entropy levels showed the existence of a high structural variability in ACT services due to the necessity of adjusting them to the user’s specific needs.

No significant relationships.

Dual diagnosis is commonly treated by Community Mental Health Team (CMHT). Addiction is a common complicating factor in individuals with major mental illnesses. It is established that businesses on high streets impact on the public’s health.

We hope to generate discussion about the planning and the placement of community mental health services.

The location of County Dublin community mental health teams’ outpatient clinics’ and day hospitals’ were obtained from the Health Service Executive directory website. All off licenses’ and bookmakers’ addresses in County Dublin were obtained from the Irish Revenue Commissioners website. The distances were measured using Google Maps and a programming script to generate a matrix under one-kilometre radius walking distances between the locations. No ethical approval is required. All Data are sought from publicly available websites.

On average, there are 6.29 (SD 4.20; Median 5.) off-licenses and 2.4 (SD 2.28; Median 2) bookmarkers offices per mental health facility within1 km walking distance. The Central Dublin Mental Health Service has the highest prevalence of off-licenses (45, 34.4%), and the Central South Dublin Service(20, 39.2%) has the highest prevalence of bookmakers. Southeast Dublin Service has the lowest in both businesses. The closest distance to an off-license from mental health facilities was 0 meters.

Psychiatrists have a role in advocating the needs of individuals with dual diagnoses. The Department of Health and Health Service Executive (HSE) should develop a guideline and protocol for the community health services in the structuring and planning mental health services in the community health outpatient service setup.

No significant relationships.

Economic evaluations of lifestyle interventions for people with mental illness are needed to inform policy makers and managers about implementing such interventions and corresponding reforms in routine mental healthcare.

We aimed to evaluate changes in healthcare costs 18 months after the implementation of a multidisciplinary lifestyle-enhancing treatment for inpatients with severe mental illness (MULTI) versus treatment as usual (TAU).

In a cohort study (n=114; 65 MULTI, 49 TAU), we retrospectively retrieved cost data in Euros on all patient sessions, ward stay, medication use, and hospital referrals in the quarter year at the start of MULTI (Q1 2014) and after its evaluation (Q3 2015). We used linear regression analyses correcting for baseline values and differences between groups, calculated quality-adjusted life years (QALY) and deterministic incremental cost-effectiveness ratios, and performed probabilistic sensitivity analyses.

Adjusted regression showed reduced total costs per patient per quarter year in favor of MULTI (B=-736.30, 95%CI: -2145.2–672.6). Corresponding probabilistic sensitivity analysis accounting for uncertainty surrounding the parameters showed MULTI was dominant over TAU with a saving in total costs of €417.48 (95%-CI: -2,873.2–2,042.1) against 0.06 improvement in QALY (95%-CI: -0.08–0.20). Costs saving estimates were statistically non-significant showing wide confidence intervals.

Regardless of cost savings, MULTI did not increase healthcare costs while improving QALY and additional previously observed health outcomes. This indicates that starting lifestyle interventions does not need to be hampered by costs. Potential societal and economic value may justify investment to support implementation and maintenance. Further research is needed to study this hypothesis.

No significant relationships.

Stigma and discrimination can disrupt the lives of individuals with a mental illness, preventing their opportunities to become productive citizens. These Individuals must also face either an avoidant attitude by healthcare professionals or prejudices about their adherence to medications and the psychological nature of their physical symptoms.

Assess stigma in terms of explicit and implicit attitudes among medical school students and junior doctors. Evaluate academic factors and interfering with these attitudes.

A cross-sectional study was conducted among students from medical schools in Tunisia.

All participants were invited to complete a brief anonymous electronic survey administered on the google forms online platform.

Data were collected using self-administered questionnaires, Stigma Measurement, Mental Illness: Clinicians’ Attitudes (MICA).

The sample consisted of 1028 respondents. The respondents’ mean age was 24.54 years (SD=3.7). Post-clinical students scored higher than pre-clinical students in questions 2, 6, and 12 on the rating scale. A positive significant relationship was identified with specialization in psychiatry. Residents who were specialized in family medicine, emergency, and intensive care had a higher stigma level compared to other residents (Mean score>0.51). The completion of a psychiatry clerkship did not significantly reduce the level of stigma toward people with a mental illness ( p=0.8).

A combination of medical school experiences of psychiatry’s theoretical learning and clerkship are important factors that shape students. Awareness of this will enable educators to develop locally relevant anti-stigma teaching resources throughout the psychiatry curriculum to improve students’ attitudes towards psychiatry as a discipline and mental illness in general.

No significant relationships.

There are several case reports describing clozapine side effects such as agranulocytosis, constipation,tachycardia but rarely cases describing oesophagitis caused by clozapine were reported.

To report the first case in our country about clozapine induced oesophagitis.

We describe a case in which a patient who has no gastrointestinal past history,has developed an oesophagitis stage 2 of Savary and Miller Classification without any gastroesophageal reflux disease, few weeks after introducing clozapine at therapeutic dose.

A 25 years old male patient with resistant schizophrenia managed with clozapine,was admitted to reinitiate his treatment after weeks of stopping his medication.During hospitalization, our patient developed a sudden haematemesis in 10 days after commencement of clozapine. The patient had no history of gastrointestinal symptoms or disease. The clinical examination and blood tests did not find any signs of bleeding severity.A gastroscopy was performed, revealing esophagitis stage 2 of Savary and Miller classification and a cardiac polyp removed with biopsy forceps that showed no malignant lesions .The patient was treated with acid suppressant therapy.There was no further episode of haematemesis and our patient healed uneventfully within a week.As for clozapine, it wasn’t interrupted and we continued increasing doses very carefully with no further incident.

Although it is a rare side effect, oesophagitis may appear at therapeutic doses of clozapine, and this possibility should be taken into account when treating patients with resistant psychiatric disorders.

No significant relationships.