Schizophrenia (SCH) and bipolar disorder (BD) are severe mental disorders which lead to psychotic, affective and cognitive symptoms and often cause a progressive functional deterioration of the individual. The current diagnosis of SCH and BD essentially depends on clinical observation that often leads to misdiagnosis and the introduction of non-specific treatments. Therefore, an early detection and intervention are determinant for a better prognosis. Improving outcomes of a First Episode of Psychosis (FEP) depends mainly on the identification of reliable and discriminatory biomarkers between both disorders.

Given that oxidative stress has been tightly involved in multiple metal disorders, the major goal of this work was to characterize oxidative alterations in order to identify potential biomarkers which allow the differential diagnosis in an early stage.

The study was carried out on samples from 49 subjects (14 women and 35 men), divided into four groups: a control group of 10 individuals not previously diagnosed with any serious mental disorder, 17 patients who had presented a FEP, 12 patients diagnosed with SCH and 10 patients diagnosed with BP. Biochemical analysis were conducted in erythrocyte fraction to characterize the cellular oxidative damage by measuring lipid peroxidation (LPO) levels and the antioxidant defense system by the evaluation of catalase (CAT) and superoxide dismutase (SOD) activities.

In the present work, we observed a significant increase in LPO levels in both SCH and BD disorders that was not neutralized by the antioxidant defense. It was found that SCH patients, despite exhibiting greater activities of SOD and CAT compared to BD individuals, also showed significantly higher levels of oxidative damage. The differential oxidative profile observed between SCH and BD individuals allowed to perform an individually analysis of patients diagnosed with FEP. Although it was not possible to identify the type of psychotic disorder of all the patients with FEP, the results obtained showed that while several individuals exhibited an oxidative prolife similar to that observed in SCH patients, other individuals presented a prolife very similar to that found in patients with BD.

The current work reveals that LPO is a potential indicator of worse prognosis after being differentially modified in both SCH and BD. Moreover, SOD and CAT have been identified, by presenting an opposite profile between patients with SCH and BD, as potential preliminary biomarkers for a discriminatory diagnosis in an early stage of the disorder.

None Declared

Visual impairment in schizophrenia is of interest as a potential biomarker of the mental state. The study of visual impairment in patients with schizophrenia is difficult due to the fact that visual perception can be influenced not only by the patient’s condition, but also by age, drug treatment, concomitant eye diseases, etc. To reduce the influence of these factors, we studied visual disturbances in schizophrenic patients in dynamics at the second and eighth weeks of stable antipsychotic single treatment.

To reveal changes in visual impairment in inpatients with schizophrenia on the background of changes in mental state.

Eleven inpatients with schizophrenia who received antipsychotic monotherapy and thirteen healthy subjects of the same age and sex were included in the study. Examinations were performed at weeks 2 and 8 of treatment. The contrast-frequency characteristics of the visual system were examined using computer visocontrastometry. Visocontrastometry was performed in Gabor element contrast detection (gratings) with spatial frequencies of 0.4, 0.6, 0.8, 1.0, 4.0, 10.0 and 17.9 cycles/degree. Images of Gabor elements of different spatial frequency were repeated in random order 8 times each. The severity of the mental state was assessed during the interview using the PANSS (Positive and Negative Syndrome Scale).

Patients’ total PANSS score at week 2 averaged 94.09±17.58 and at week 8 averaged 52.45±6.06; at week 8 the total score was significantly lower than at week 2 (V = 66, p-value = 0.004). In the low-frequency region after treatment, patients tended to have lower thresholds (V = 2207, p-value = 0.060), but both at week 2 and week 8, thresholds were significantly higher in patients than in the healthy group (W = 7233, p-value < 2.2e-16, W = 6924.5, p-value = 1.204e-11, respectively). Mid-range frequencies increased at week 8 compared with week 2 (V = 925, p-value = 0.003), but were also lower at weeks 2 and 8 than in the healthy group (W = 1479, p-value = 7.247e-12, W = 3156.5, p-value = 0.004, respectively). In the high frequency region, thresholds also increased after the treatment (V = 908, p-value = 2.084e-05), at week 2, thresholds in patients were significantly lower than in healthy controls (W = 2574.5, p-value = 2.757e-07), and at week 8, thresholds in the patient and healthy groups were not different (W = 4759.5, p-value = 0.461).

The impairments in the low spatial frequencies in schizophrenic patients appear earliest and, apparently, are the most persistent. Changes in the middle and high frequencies appeared to be more variable with changes in the mental state. Unfortunately, our design does not allow us to judge the persistence of the revealed changes. Further prospective studies are needed to investigate the relationship of visual disturbances with other symptoms.

None Declared

This work was supported by a grant from the Russian Science Foundation (project no. 22-18-00074).

Patients with chronic schizophrenia experience significant disturbances in the quality and quantity of their sleep and it had been mainly attributed to severity of symptoms and antipsychotic use. Recent studies suggested that antipsychotic-naïve early course patients with schizophrenia and their non-psychotic first-degree relatives also show altered sleep quality.

In this study we aimed to compare sleep parameters in antipsychotic-naive first-episode schizophrenia patients to their healthy siblings and age- and sex-matched healthy controls.

We conducted a cross-sectional, descriptive case-control study in the Psychiatry « G » department at Razi Hospital, for a period of six months. Our sample consisted of three groups: a group of schizophrenic patients, a group of their healthy siblings and a group of healthy controls. The three groups were matched by age and sex. The Positive and Negative Syndrome Scale (PANSS) was used to assess the severity of symptoms in patients with schizophrenia. The Morningness-Eveningness Questionnaire (MEQr), Epworth Sleepiness Scale (ESS), and Pittsburgh Sleep Quality Index (PSQI) were used in the three groups to assess Circadian preference, daytime sleepiness and sleep quality.

There was no significant difference between the groups regarding the chronotype. Patients had significantly higher daytime sleepiness compared to siblings (p=0.001) and controls (p<0.001). Patients also had poorer quality sleep (PSQI total score) than siblings (p<0.001) and controls (p<0.001), longer sleep latency than siblings (p=0.003) and controls (p<0.001); lower habitual sleep efficiency than siblings (p=0.003) and controls (p<0.001). Siblings had poorer sleep quality (p=0.001), longer sleep latency (p=0.006) and shorter sleep duration (p=0.033) compared to control subjects.

Our results joined those of the literature concerning the significant prevalence of sleep disorders in early psychosis. In addition, the alteration of sleep quality in unaffected siblings compared to healthy controls supports the hypotheses suggested in the literature that sleep disorders may be markers of genetic susceptibility to schizophrenia and serve as a potential endophenotype of the disease.

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CBT for childhood anxiety is used as the gold treatment of choice for anxiety disorders in children. Video-assisted CBT can serve as a cost and time effective intervention method in a low-resource setting.

To develop, validate video-assisted CBT for children and adolescents with Anxiety disorder with secondary objective to explore feasibility of brief video assisted CBT as an additional component to treatment as usual in improving symptom severity.

Study was divided into 2 phases. In the 1st phase videos (1 common introductory video and 2 videos each for children and adolescents,in Tamil and English) based on a validated CBT workbook was made. A second phase involving exploration of feasibility of video-based interventions along with treatment-as-usual was carried out in OPD of tertiary care hospital. Of 13 children recruited with anxiety disorder,2 were lost to follow-up. In 2nd phase, intervention delivered on OPD computer and provided to family members to watch at home through phone. Assessment of symptoms were done using SCARED, CGAS, CGI-S, VAS (parent) at baseline & 8 weeks. Written narratives were taken from participant at baseline & 8 weeks. Parent semi structured proforma was used to assess perceived benefit by parent.

In first phase validation was obtained from 3 experts. All experts agreed or strongly agreed for videos to be appropriate for use in children and adolescents with anxiety disorder. Most frequent diagnosis was social anxiety disorder.Family history of psychiatric illness was there in 61.54% of participants. Post intervention at 8 weeks when compared to baseline found statistically significant reduction in symptom severity on SCARED, CGAS and VAS (parent) scores. In parent semi structured proforma good improvement in understanding, perceived reduction of symptom severity reported.For qualitative data, manual content analysis done with clustering of themes and sub-themes.

In theme of Treatment impact on self, codes of decreased self-esteem and overthinking generated the maximum response. In theme of impact of illness in various contexts, codes of peer relationship and academic performance generated the maximum responses. At the end of 8 weeks participants reported Relaxation techniques as most used, followed by coping skills and challenging negative thoughts with help of tension diary respectively.

In aspects of videos liked by parents, brevity and simplicity generated most responses. In aspects requiring improvement most of parents reported no improvement needed in videos.

This pilot study on video based CBT can serve as a time and cost-effective treatment strategy for anxiety disorders in children and adolescents especially in low resource settings. Similar studies involving development of similar videos can be made for various mental illnesses in various vernacular languages and tested in a larger population.

None Declared

The COVID-19 pandemic has produced negative mental health outcomes, which were more prominent in vulnerable communities, such as Fort McMurray (FMM), the community that experienced prior similar disasters.

This study aimed to examine the likelihood and correlates of anxiety symptoms among FMM residents, during the COVID-19 pandemic.

A cross-sectional online survey questionnaire was applied between 24 April and 2 June 2021, at FMM community to gather a set of data, including sociodemographic, COVID-19, and clinical information. Generalized anxiety disorder was the main outcome of the study, and was measured using GAD-7 scale.

Overall, 186 individuals completed the survey (response rate 74.7%). Most of the respondents were females (159, 85.5%); above 40 years (98, 52.7%); employed (175, 94.1%); and in relationship (132, 71%). The prevalence of moderate-to-severe anxiety was (42.5%, 71) on GAD-7 self-reported scale. Subscribers who reported that they would like to receive mental health support; have received no family support since COVID-19 declaration; and have lost their job during the pandemic were all more likely to report moderate-to-severe anxiety (OR = 3.39; 95% CI: 1.29-8.88), (OR = 4.85; 95% CI: 1.56-15.03), and (OR = 4.40; 95% CI: 1.01-19.24), respectively.

Anxiety levels were high among FMM residents, compared to levels before COVID-19. Clinical and social factors related to the COVID-19 pandemic significantly predicted likely anxiety among Fort McMurray population. It is imperative to mobilize resources to support vulnerable communities during the COVID-19 pandemic.

None Declared

Generalized anxiety disorder (GAD) is a highly prevalent mental illness that is associated with clinically significant distress, functional impairment, and poor emotional regulation. Primary functional magnetic resonance imaging (fMRI) studies of GAD report neural abnormalities in comparison to healthy controls. However, many of these findings in the primary literature are inconsistent, and it is unclear whether they are specific to GAD or shared transdiagnostically across related disorders.

This meta-analysis seeks to establish the most reliable neural abnormalities observed in individuals with GAD, as reported in the primary fMRI activation literature.

We conducted an exhaustive literature search in PubMed to identify primary studies that met our pre-specified inclusion criteria and then extracted relevant data from primary, whole-brain fMRI activation studies of GAD that reported coordinates in Talairach or MNI space. We then used multilevel kernel density analysis (MKDA) with ensemble thresholding to examine the differences between adults with GAD and healthy controls in order to identify brain regions that reached statistical significance across primary studies.

Patients with GAD showed statistically significant (α=0.05–0.0001; family-wise-error-rate corrected) neural activation in various regions of the cerebral cortex and basal ganglia across a variety of experimental tasks.

These results inform our understanding of the neural basis of GAD and are interpreted using a frontolimbic model of anxiety as well as specific clinical symptoms of this disorder and its relation to other mood and anxiety disorders. These results also suggest possible novel targets for emerging neurostimulation therapies (e.g., transcranial magnetic stimulation) and may be used to advance our understanding of the effects of current pharmaceutical treatments and ways to improve treatment selection and symptom-targeting for patients diagnosed with GAD.

None Declared

Virtual reality exposure therapy (VRET) is a treatment in a virtual environment based on the representation of a patient’s disease in virtual reality. VRET means getting used to a specific situation by intentionally facing the patient’s fearful situation based on the ‘exposure technique.’ By repeatedly exposing the patient to a fearful situation, in the end, inducing the intensity of fear to decrease without avoiding the situation. Virtual reality exposure therapy (VRET) was initially used to treat phobias, anxiety disorders, and stress. It has been proven to be an effective psychotherapy method mainly focusing on acrophobia, flight phobia, arachnophobia, social phobia, and post-traumatic stress disorder (PTSD).

Virtual reality exposure therapy (VRET) is used to treat phobias, anxiety disorders, and stress. The virtual reality treatment system can reproduce virtual scenes with the environment modified or removed, and can familiarize patients with such environments. This study aims to verify the degree of improvement of the symptoms of panic disorder by conducting VRET that we have made considering the degree of gradual exposure to the panic disorder group and the control group.

A total of 60 subjects were included in this study, including 43 patients with panic disorder and 17 control group. Subjects were systematically exposed to specific situations over five steps. We checked the heart rate, body temperature, EEG and symptoms before and after exposure using the following assessment instruments; Subjective Units of Discomfort (SUD), Anxiety Sensitivity Index (ASI), Panic Disorder Severity Scale. Repeated measures ANOVA was performed separately for presence, SUDS (distress) scores, and PDSS across time points.

In the patient group, the program proved to be effective as the sensitivity to anxiety decreased significantly after the VR program (F=3.570, p<0.05). Among the subcategories of ASI, the fear of anxiety symptoms showed statistical significance between sessions (F=3.883, p<0.05) and in the interaction between group and time (F=4.585, p<0.01). The study confirmed the effectiveness of the VR program in situations that mainly induce panic attacks in patients diagnosed with panic disorder (elevator riding, driving a car, driving a car in a tunnel, driving a car in rain). The program effect was significant through repeated measurement ANOVA for each variable of EEG (Alpha, Beta, Delta, Gamma, Theta) (F=3.249, p<0.01).

VRET is the process of gradually being exposed to fear stimuli, deliberately confronting and experiencing a fear situation, and learning that nothing dangerous will happen. Even if the patient experiences bodily sensations that are the subject of fear, they can reduce their fear of bodily sensations by repeatedly confirming that they are safe and getting used to them.

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Numerous clinical and epidemiological studies show that the rate of comorbidity of anxiety disorders is high in bipolar patients compared to the general population. This is associated with a poorer prognosis, poorer functioning and higher suicidal risk. Anxiety comorbidity should therefore be carefully investigated.

Our main objectives are to explore the therapeutic complexity of anxiety disorders in patients with bipolar disorder To investigate the existence of psycho-pathological links and vulnerabilities between bipolar disorder and anxiety disorders.

through a clinical vignette and a review of the existing literature on the comorbidity of anxiety disorders and bipolar disorders, and the resulting therapeutic issues

Anxiety comorbidity is quite common in the bipolar population. In the American National Comorbidity Survey (NCS), lifetime comorbidity is close to 90%. Two recent French clinical studies show the existence of at least one anxiety disorder in approximately 25% of bipolar subjects (24% and 27.2%), which will have an impact on the course of the bipolar disorder, with a particular increase in the risk of suicide, hence the importance of adequate treatment. This treatment faces two obstacles: the risk of manic episodes under antidepressants and the risk of dependence on benzodiazepines. Emphasis is also placed on non-drug approaches, including cognitive-behavioural and psycho-educational therapies.

Anxiety comorbidity is not without consequence on the evolution of bipolar disorder. Its particularly high prevalence means that it cannot be neglected or ignored in current practice.

None Declared

In addition to posing major public health challenges, the COVID-19 pandemic has affected psychological and physical stressors in workplaces as well as strain by workers worldwide. Even prior COVID-19, the working conditions of early childhood professionals (ECPs) were described as critical leading to (psycho)somatic complaints. Despite the high societal relevance of ECPs and the potential increase in stressors caused by COVID-19, there is a lack of empirical evidence to which extent work-related demands had an adverse effect on ECPs health during COVID-19.

We aimed to obtain updated prevalence rates of somatic symptoms of ECPs as well as unfavourable working conditions inducing stress (in terms of an effort-reward imbalance; ERI) in childcare. The overall objective was to establish associations between work stress and health during the early phase of the pandemic. Given the tendency of ECPs to overcommit themselves, we further explored the potential moderating role of overcommitment.

Between June 2020 and May 2021, questionnaire data was collected using validated instruments (i.e., ERI, PHQ-15) from ECPs in childcare centers as well as from family providers (N = 1.009). ECPs were informed about the study and contacted through the youth welfare office. Multiple logistic regression tested the influence of ERI and overcommitment on the severity of somatic symptoms. It was controlled for age, gender as well as leadership position. SPSS 28.0 was used to analyze the data.

The ERI ratio of the sample averaged 1.28 (SD = 0.45), with 72.7% of subjects exceeding the critical cut-off value > 1, indicating a gratification crisis. The averaged sum score of the PHQ-15 was 8.99 (SD = 5.43). Based on a PHQ-15 cut-off ≥ 10, the overall prevalence of somatization at a moderate to high level is estimated to be 44.6%. The mean overcommitment score was 15.14 (SD = 3.55) and 23.4% of ECPs were in the highest overcommitment tertile. ERI (OR = 4.12, 95% CI: 2.73 - 6.22) and overcommitment (OR = 5.20, 95% CI: 2.17 - 12.47) were associated with an increased likelihood of greater severity of somatic symptoms. Yet, the interaction effect between both predictors remained non-signifcant. Being female and having no leadership position were predictors for a moderate to high level of somatization.

The results demonstrate the high relevance of work stress for somatic health among ECPs in the midst of a pandemic. Given the high overall prevalence of somatic symptoms and the female-dominated work sector, ECPs may be at high risk for somatoform disorders. There remains a strong need for action to reduce work-related stress in order to decrease the somatic symptom burden. Large-scale and longitudinal studies are needed to further investigate coping with and persistence of somatic symptoms among this occupational group.

None Declared

Psychobiotics are a group of probiotics that affect the central nervous system related functions and behaviors mediated by the gut-brain-axis via immune, humoral, neural, and metabolic pathways to improve not only the gastrointestinal function but also the antidepressant and anxiolytic capacity.

An assessment of psychobiotic and anti-anxiety effects a probiotic supplement containing Lactobacillus Plantarum CECT7485 and Lactobacillus Brevis CECT7480 (PLANTARUM) in patients with anxiety undergoing treatment with selective serotonin reuptake inhibitors (SSRI) antidepressants.

Sixty patients with mixed anxiety and depressive disorder (according to ICD-10 diagnostic criteria F41.2) were included in an 8-week open label study. Thirty participants received either SSRI antidepressants with PLANTARUM at a dose of 1.0 × 109 CFU once per day and thirty patients received SSRI antidepressants only. The severity of anxiety symptoms was assessed using Hamilton Anxiety Rating Scale (HAM-A) and General Anxiety Disorder Scale (GAD-7).

After 8 weeks intervention, a significant reduction of HAM-A total score (from 37,8±5,3 to 23,6±4,4) was detected in patients with anxiety who prescribed SSRI antidepressants and PLANTARUM (p˂0,05), compared with participants who didn’t receive probiotics (p>0,05). Also, a significant reduction of GAD-7 total score (from 21,7±3,3 to 12,5±2,4) was detected in patients with anxiety symptoms who received SSRI antidepressants and PLANTARUM (p˂0,01), compared with patients who didn’t intake probiotics (p>0,05).

The present data illustrated that probiotic supplement PLANTARUM is a feasible for adjunctive to SSRI antidepressants intervention for anxiety treatment.

None Declared

Recent studies have supported that Lactobacillus plantarum can reduce the severity of anxiety and depression. However, previous studies did not focus on the sleep quality. This study determines whether Lactobacillus Plantarum CECT7485 and Lactobacillus Brevis CECT7480 reduce the severity of insomnia, and improves sleep quality in patients who comorbidity of depression and anxiety disorders.

An assessment of insomniac effects a probiotic supplement containing Lactobacillus Plantarum CECT7485 and Lactobacillus Brevis CECT7480 (PLANTARUM) in patients with anxiety and depression comorbidity undergoing treatment with selective serotonin reuptake inhibitors (SSRI) antidepressants.

Sixty patients with mixed anxiety and depressive disorder (according to ICD-10 diagnostic criteria F41.2) were included in an 8-week open label study. Thirty participants received either SSRI antidepressants with PLANTARUM at a dose of 1.0 × 109 CFU once per day and thirty patients received SSRI antidepressants only. The severity of insomnia was assessed using Insomnia Severity Index (ISI). The severity of depressive symptoms was rated using Hamilton Depressive Rating Scale (HDRS). The severity of anxiety symptoms was assessed using Hamilton Anxiety Rating Scale (HAM-A) and General Anxiety Disorder Scale (GAD-7).

After 8 weeks intervention, a significant reduction of ISI total score (from 22,1±2,8 to 14,1±2,1) was detected in patients with anxiety and depression who prescribed SSRI antidepressants and PLANTARUM (p˂0,05), compared with participants who didn’t receive probiotics (p>0,05). Also, we detected a significant improve sleep quality of insomniac patients with comorbidity of anxiety and depressive symptoms (p˂0,05) who received SSRI antidepressants and probiotic supplement Lactobacillus Plantarum CECT7485/Lactobacillus Brevis CECT7480.

The present data illustrated that probiotic supplement Lactobacillus Plantarum CECT7485 and Lactobacillus Brevis CECT7480 is a feasible for adjunctive to SSRI antidepressants intervention for insomniac patients with anxiety and depressive comorbidity

None Declared

The COVID-19 pandemic has disproportionately affected patients with severe mental illness (SMI), a vulnerable population with high morbidity and mortality. A UK-based study found reduced vaccination rates in patients with SMI; they therefore need to be prioritised for prevention and disease management.

The objectives were to determine risk factors for vaccine hesitancy, and how best to manage those in patients with SMI, as well as whether our intervention of calling patients for their vaccines had a positive outcome.

Following approval from the Lambeth Directorate of South London and Maudsley (SLaM) NHS Foundation Trust, we investigated COVID-19 vaccination rates inpatients with SMI from a psychosis community service in South London (n=236). Dates of first and second doses were recorded through audit; reasons for refusal of vaccination were noted. Patients were encouraged to take the vaccine. A re-audit was performed after allowing three months. Chi-squared statistical analysis was performed to determine the value of our intervention.

Before the intervention, 143 patients (60.6%) received at least one vaccine. 24 patients (10.2%) received one dose, and 77 (32.8%) were yet to receive any. There was no statistical significance (p=0.1509) between the number of patients who received a vaccine before and after intervention, with 33.1% of patients still remaining unvaccinated.

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There is limited research on perceptions of receiving vaccines in patients with SMI, despite their cost-effectiveness in disease prevention. Even after intervention, 33.1% of patients remained unvaccinated, compared to 6.6% nationally. A lack of knowledge and recommendations from care teams are reasons for hesitancy. Misinformation, conspiracy theories and propaganda can drive people towards refusal. Patients with SMI typically have disadvantages of healthcare inequality, lower levels of education and access to inaccurate information. Patients and their healthcare team should be knowledgeable about vaccine efficacy and side effects. Studies have shown low uptake in the Black/African/Caribbean ethnic group (49.3%, table 3). Reasons include general mistrust in institutions and access barriers. For minority communities, vaccination sites in community centres or places of worship have proven to be effective, providing familiarity.

Patients taking clozapine may have a weaker immune system due to myelosuppression. 24.3% of our patients take this, with many unsure of interactions or side effects. Poorer prognosis means a focussed approach is needed.

Vaccine hesitancy is complex and requires targeted, tailor-made strategies, with consideration for patients who may lack capacity. It is evident from our results that calling patients alone may not be effective. A future multi-modal approach may be necessary to address poor vaccine uptake and opens up avenues to further explore vaccine hesitancy.

None Declared

While pregnancy itself is a risk factor in the development of anxiety disorders, the COVID-19 pandemic has brought additional pressure on expecting women. Despite these two independent factors, no study regarding their cumulative effect on anxiety in soon-to-be Romanian mothers exists.

This study intends to address this deficiency by measuring the level of anxiety in a sample of pregnant women from the public healthcare sector in Romania.

Sociodemographic data and Zung Self-reported Anxiety Scores (SAS) were used to look at 121 pregnant women to get a fuller picture of anxiety in pregnant women during the pandemic.

Some of the main findings of the study are as follows: anxiety symptoms are more intense during the first trimester of pregnancy, especially in the psychological domain of the scale, as opposed to the third one. High BMI was weakly correlated with lower Zung Scale scores, while marital status and having other children were moderately correlated with less anxiety symptoms. While no association could be found between history of infection, vaccination and anxiety, surprisingly, unvaccinated women showed less psychological distress than vaccinated ones (moderate correlation), suggesting that less anxiety prone women are also less likely to get adequate protection. Getting one’s information from official sources also proved to be weakly correlated with higher Zung Scale scores.

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In conclusions, the findings of this study can serve as a start for further inquiry regarding the impact of the COVID pandemic on the mental health of pregnant women.

None Declared

Although the role of SARS-CoV2 pandemic on psychiatric Emergency Department (ED) encounters, has been analysed, few studies have focused on the pandemic influence on patients’ characteristics and admission rates in a psychiatric ward.

The aim of this cross-sectional study is to analyse characteristics of patients admitted in the psychiatric ward of “San Salvatore” Hospital in L’Aquila (Italy) in a three-year timeframe, from 2019 to 2021, and evaluate the impact of COVID-19 pandemic on admission trends over the course of these three years.

We collected data regarding 1115 patients from the hospital discharge summaries (Scheda di Dimissione Ospedaliera, SDO) of “San Salvatore” Hospital. Patients were sorted according to diagnosis, year of admission and age range. Comparison of mean values from each group was attained using the Student’s t-test, while percentages and ratios were compared by means of the Chi-Square test.

Between January 2019 and December 2021, 1115 patients were admitted in our psychiatric ward. In 2020, during pandemic outbreak, we observed a reduction of the number of admissions, with 351 patients. Although no statistically significant differences were found regarding patients’ gender or age, we observed a higher number of male patients admitted during all three years (male/female ratio: 231/171 in 2019, 217/134 in 2020 and 192/170 in 2021). Admission rates of patients aged between 18 to 30 years were higher during 2020 and 2021, conversely in the previous year the most represented group were patients aged between 41 to 50 years. Regarding diagnostic categories, percentages remained relatively steady during the three years. Nevertheless, it was possible to observe a slight reduction of Schizo-Psychotic disorders (175/402; 45,53% in 2019, 135/351; 38.46% in 2020 and 119/362; 32,87% in 2021) and a slighter reduction of Personality disorders percentages (49/402; 12,19% in 2019, 37/351; 10,54% in 2020 and 36/362; 9,94% in 2021). Conversely, results showed an increase in admission of patients with substance use disorder: 24 out of 402 patients (5,97%) in 2019, 32 out of 351 patients (9,12%) in 2020, and 46 out of 362 patients (12,71%) in 2021.

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Despite biases due to the one-site evaluation, the strength of the present study relies in the retrospectively cross-sectional observation design conducted to evaluate a three-year timeframe, spanning throughout the pandemic. The sharp reduction of admissions rates in 2020, is in line with other data regarding ED accesses’ trends during pandemic. Increasing rates of admission of patients between 18 and 30 years could be a result of a stronger impact of the pandemic on young people’s mental health. Moreover, increasing trends of admission of patients with substance abuse disorders may be potentially addressed to distress symptoms brought by the pandemic.

None Declared

The COVID-19 pandemic has affected the mental health of the world’s population in numerous ways. One of the methods are certainly lockdown measures. The countries of the European Union (EU) were affected by the pandemic in different ways, but their response was partly coordinated. Google trend analysis has so far proven to be a useful tool for monitoring the reactions of the population and the state of their mental health.

The aim of our research was to examine the impact of lockdown measures on the state of mental health through an internet search for terms related to mental health.

We observed three countries of the European Union in the period from February 1, 2020. until May 17, 2021. According to the average value of the CSI (covid stringency index), as an indicator of the strength of the lockdown measures, we chose Estonia, Belgium and Italy. CSI uses nine indicators (such as school closures, travel bans, …) to assess the strength of the lockdown. Italy is the country that, according to the average value of the CSI, had the strongest closure measures in the mentioned period (average CSI 69.19468). In Estonia, the measures were the mildest (CSI 42.87324895), and Belgium represents the average (CSI 57.6381). We observed to what extent, in the mentioned countries, changing the CSI, i.e. the strength of lockdown measures, correlates with the search for terms in the field of mental health. We used Google trends data for the terms: tension, anxiety, depression, insomnia, concern. We also compared Croatia with the mentioned countries.

In Estonia, there is no significant correlation between lockdown measures and searches for mental health terms. In Belgium, there is a correlation between CSI and searches for the term “anxiety” (r=0.31, p<0.01). In Italy, there is a correlation between CSI and searches for the terms “concern” (r=0.22, p=0.067 ), “tension” (r=0.33, p<0.01), “anxiety” (r=0.55, p<0.001). In Croatia, which is the 4th country with the weakest lockdown measures (CSI 46.90232), there is only a correlation between the strength of lockdown measures and searches for the term “tension” (r=0.27, p<0.05).

In countries with a higher CSI, i.e., stronger lockdown measures, there is a stronger correlation, i.e., a greater influence on the search for terms related to the state of mental health. We can assume that at some point the lockdown measures start to have a negative effect on the state of mental health.

None Declared

Having a family member admitted in Intensive Care Unit (ICU) can cause a severe psychological stress, and various psychological disorders gathered into the notion of Post intensive care syndrome-family (PICS-F). In this way, Family-centered care in ICU represents the aim of international accepted recommendations focusing on a partnership approach to health care decision-making between the family and health care provider to prevent PICS-F. During the first SARS-CoV-2 linked lockdown, social restrictions impaired the right application of these recommendations, increasing risk of PICS-F, particularly Post-Traumatic Stress Disorder (PTSD).

The main objective was to compare the PTSD prevalence at 6 months in a group of relatives including during OLAF implementation with a control group in a cohort of ICU-patient relatives.

Considering this, the psychiatric team and the ICU team of the Toulouse University, France, proposed the creation of a temporary device called OLAF (Opération de Liaison et d’Aide aux Familles in French), aiming to bring a psychological phone support to ICU-patient relatives. Besides this operational approach we designed a research approach that aimed to investigate the impact of OLAF device on PICS-F.

We noted that 12 participants (11.5 %) presented a PTSD at 6 months without statistically significant differences between the groups (p=0.8). Considering that OLAF group presented higher PDI (Peritraumatric Distress Inventory) score at screening we also considered a mediation model suggesting that OLAF could have played a role to diminish the PCL-5 score as a covariable. In the multinomial logistic regression analysis, we found that the only factor associated with the PTSD diagnosis was the level of Anxiety and Depression Signs measured with HADS (Hospital Anxiety and Depression Scale) at screening (OR= 1.2, p<0.001).

We found no difference in PTSD prevalence according to OLAF intervention. Nevertheless, our result suggested that the intervention could have play a role in reducing PTSD by acting on anxiety and peri traumatic distress in a mediated model. We found that anxiety score could serve as a risk marker to predict PTSD and should probably be precociously screened and treated in this population.

None Declared

The COVID 19 pandemic had a significant psychological impact worldwide. Health care workers (HCWs) were the most affected because of the pandemic burden and occupational exigencies.

To describe epidemiological characteristics of HCWs with post COVID19 anxiodepressive disorders.

A descriptive cross-sectional study was carried out. It included HCWs of a university hospital who consulted the Occupational Medicine Clinics for the three-month post-COVID‘s medical visit. The study was carried out during the period March 2020 to January 2022. The data was collected using a questionnaire including socio-occupational and medical characteristics. Psychometric evaluation was carried out using « the Hospital Anxiety and Depression Scale »

We have collected 164 HCWs. The sex ratio (M/F) was 0.29. The average age was 41±9.8 years. They belonged to the pneumology (27%), intensive care (11%) and biology laboratory (11%). The prevalence of anxiety and depression was 34% and 30% respectively. We found an association between sleep disorders and anxiety (p=0.000), OR=5 IC95%[2.4-10.3] and depression (p=0.000), OR= 4 IC 95%[2.0-9.3]. We found an association between anxiety and persistent fatigue (p=0,000), OR=4[2,0-8,6], anxiety and concentration and memory difficulties (p=0,000), OR=3 IC 95%[1,7-6,9]. Referral to psychiatric consultations were done in 16% of the cases.

Post-COVID anxiety disorders were frequent among HCWs and associated with neurocognitive disorders. Psychiatric support and early treatment are necessary to prevent mental deterioration.

None Declared

The COVID pandemic has troubled the world and disrupted the professional and personal lives of healthcare workers, putting their mental health at risk.

Determine the prevalence of anxiety-depressive disorders among health personnel assigned to the COVID-19 circuit.

Cross-sectional study carried out on healthcare personnel assigned to departments dedicated to the care of patients hospitalized for a SARS-COV2 infection. The study took place between March and September 2021. Data collection was done from a pre-established sheet. Anxiety-depressive disorders were screened using the HAD scale.

The study included 140 health personnel. The sex ratio (M/W) was 0.62 with 54 men and 86 women. The mean age was 36.4±9 years. Nurses represented the largest professional category (64.6%). Professional seniority was 10 ± 9 years. Staff had been caring for patients with COVID for an average of 9 ±5 months. They worked an average of 4 days a week. The number of patients ranged from 1 to 55 per department. Psychiatric history was found in 29 participants, depression in 7% and anxiety in 2%. The workload was rated very hard at 42.1% and hard at 37.1%. Thirty percent of the population declared having received the moral support necessary to face the wave. The prevalence of anxiety and depression were 75.7% and 72.9% respectively. With 48.6% of patients presenting with definite anxiety and 27.1% with probable anxiety. Depression was certain in 40% of cases and doubtful in 32.9% of cases.

Anxio-depressive disorders are common among healthcare staff assigned to the COVID circuit. Setting up listening cells with regular monitoring of these staff is very important to avoid psychologic impact

None Declared

Internet-based cognitive behavioral therapy (iCBT) programs have been widely acknowledged as effective resources to treat common mental health disorders (CMDs) like depression or anxiety. However, real-world uptake rates remain low, which could be associated to low individualization options of iCBT. Blended cognitive behavioural therapy (bCBT) allows for more personalized care by combining regular face-to-face therapy sessions with digital therapeutics (DTx). However, in-depth experiences with DTx in bCBT programs have yet rarely been examined. In this study, we focused on university students as they are particularly at risk for developing CMDs.

The aim of this study was to evaluate experiences with the smartphone-based DTx elona therapy among university students with mild to moderate depression or anxiety symptoms for the use within bCBT.

Semi-structured interviews were conducted via videoconference between January and April 2022 with N = 102 students from universities in North Rhine-Westphalia, Germany, after they had received weekly individual CBT sessions (25 minutes each) via videoconference for six weeks and regularly used the depression (N = 67) or anxiety module (N = 35) of the DTx. Interviews were coded according to the approach of grounded theory.

In general, most participants stated that they benefitted from the bCBT program. Many highlighted the intuitive handling of the DTx and indicated that they perceived it as useful for structuring their therapy progress. As other benefits, participants listed e.g., increased self-reflection and disorder-specific knowledge as well as the transfer of the content of therapy sessions into their daily life. Participants differed with respect to the preferred design of the DTx. While some liked the clean look, others would have favoured more colours. Participants mentioned time constraints, data security concerns or the feeling of being left alone with potentially arising emotions while working on tasks for the next therapy session as possible barriers to the usage of DTx.

Interviewed participants mostly had positive attitudes toward elona therapy as part of the bCBT program. Our study shows that DTx as part of bCBT can be perceived as helpful tools to accompany university students with mild to moderate anxiety or depression symptoms in their daily life.

P. Braun: None Declared, E. Atik Employee of: Elona Health GmbH, L. Guthardt: None Declared, J. Apolinário-Hagen: None Declared, M. Schückes Shareolder of: Elona Health GmbH

The importance of inter-scale and inter-rater reliability is a well-studied factor in maintenance of data consistency in clinical research. The use of patient reported outcomes poses another risk for compromising data integrity, as some studies show that patients tend to report their symptoms differently in direct clinician-lead interview and self-administered questionnaires. Additionally, as technology is advancing and digital endpoints in CNS clinical trials are becoming a reality, we need to further evaluate if the digital means of self-reporting (e.g., mobile app questionnaires) per se could potentially be a contributing factor in data inconsistency.

To assess reliability between clinician-assisted evaluation and electronic patient reported outcomes of depressive and anxiety symptoms.

Patients not previously diagnosed with depression or anxiety disorders were asked to complete PHQ-9 and/or GAD-7, both verbally administered by a physician. Within 24 hours they were asked to complete a digital form of the same questionnaires.

The analysis of 40 completed double assessments showed no correlation for depressive symptoms presence and severity measured by clinician-lead evaluation and electronic patient reported outcomes (Spearman rho = + 0.191, p=0.686), and poor correlation for anxiety symptoms (Spearman rho = + 0.466, p=0.080).

Many factors interfere with data consistency in clinical research, thus the methods and means of evaluation need to be taken into consideration. The reliability of electronic patient reported outcomes needs to be further assessed and preferably cross-checked by using other validated methods of assessment.

None Declared