This study was conducted to estimate anxiety levels at the university level to address the issues of changing the healthy lifestyle of students, promoting health, spending their free time properly, being healthy, and developing good habits.

The aim is to study the factors affecting student anxiety.

The study was conducted by random sampling of 1356 students from the 1st to 5th year of the medical school of Etugen University in the academic years 2020-2022.

4.3%(58) of students’ inherent anxiety was low, 62.3%(845) was moderate, and 33.4%(453) were high, while 4.2%(57) had low anxiety and 42.4% (575) were anxious due to the student’s situation. had moderate anxiety and 53.4% (724) had high anxiety.

According to the research, 69.9% (948) had a low level of motivation, 23.4% (317) had a below-average level, 5.6% (76) had an average level, and 1.1% (15) had an above or higher level.

There is a weak inverse relationship between congenital anxiety and the course of study (r=-0.054*), and a weak inverse relationship between age (r=-0.048). There is a weak (r=-0.125**) inverse relationship between situational anxiety and the course of study, and a weak (r=-0.127**) inverse relationship between age.

When examining the relationship between students’ natural anxiety and the factors influencing it, there is a moderate (r=0.630**) direct correlation between natural anxiety and situational anxiety.

According to the one-factor linear regression analysis of students’ congenital anxiety (B=-1.964; 95%CI (-3.07 - 0.858); p<0.01), increasing the age by one increases congenital anxiety by 1.964 times, p<0.01, which means that the linear model is good. indicating a match.

Multivariate linear regression analysis showed that situational anxiety (B=3.845; 95%CI (6.288 - 347.90); p<0.01) or a one-level increase in situational anxiety increased congenital anxiety 3.845 times p<0.00. is relevant

According to the multivariate analysis, there is a linear significant relationship between one increase in student age, and -1.256-fold decrease in situational anxiety, and a -5.464-fold decrease in situational anxiety when not suffering from mental illness.

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Depersonalization/derealization encompasses a series of symptoms that are difficult to describe by the patient, as well as complex to diagnose by the professional, and can go through multiple diagnoses prior to the diagnosis of certainty.

It is proposed, through a clinical case, to know the characteristics of this disorder, evolution, differential diagnosis and therapeutic possibilities

62-year-old male, history of harmful alcohol consumption and a previous admission to a psychiatric short hospitalization unit for self-injury (superficial cuts in the context of severe mental illness of his wife) post-transplantation who is required by ideas of death, anhedonia and lack of collaboration in patient, The day before the evaluation, refusal to take oral treatment, selective mutism. Pre-transplant evaluation where no psychopathological alteration was observed.

What is initially assessed and treated as a confusional episode of inactive type, through a correct psychopathological examination and with subsequent continuous interviews, with mood fluctuations throughout the admission, is subsequently oriented as an acute stress disorder, adaptive reaction with an anxious-depressive component and finally concluding that we are facing a dissociative disorder, highlighting the depersonalization/derealization on a dysfunctional personality base.

Characteristic of depersonalization is the great difficulty in describing symptoms, the feeling of being disconnected from one’s own body, emotions and reality. The latest studies on etiopathogenesis with MRI show an inhibitory response on the limbic system by hyperactivation of the ventrolateral prefrontal cortex as well as a decrease in the autonomic response, the initial result being the attenuation of the processing of emotions. Among the differential diagnoses: post-anxiety illness disorder, major depressive episode, other dissociative disorders, panic disorder, psychotic disorder, substance-induced disorder There are several partially effective treatments, although the results so far are poor. SSRIs, quetiapine and naltrexone have been tried. Partial efficacy with lamotrigine together with SSRIs and, if high levels of anxiety coexist, SSRIs together with clonazepam. There are studies where psychodynamic psychotherapy, behavioral therapy and hypnosis have obtained partially effective results.

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Osteoarthritis is one of the most common diseases and a leading cause of functional limitation and dependence, significantly impacting the quality of life (QOL).

The aim of this study was to evaluate the impact of knee osteoarthritis on QOL and identify associated factors.

This prospective cross-sectional descriptive study was conducted in the Physical Medicine and Functional Rehabilitation Department over a 4-month period, involving patients with symptomatic bilateral knee osteoarthritis (according to the American College of Rheumatology (ACR) criteria). Sociodemographic data, comorbidities, and characteristics of knee osteoarthritis were collected. The assessment of QOL and the functional impact of knee osteoarthritis were based on the KOOS (Knee Injury and Osteoarthritis Outcome Score) self-questionnaire, Lequesne Index, and modified WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) Score. The KOOS questionnaire included 5 subscales: pain (KOOS-Pain), symptoms other than pain (KOOS-Symptoms), activities of daily living (KOOS-ADL), sports and recreational function (KOOS-Sport), and QOL (KOOS-QOL).

We included 30 patients with an average age of 59.27±6.3; the male-to-female ratio was 0.15. Sixty percent of patients lived in urban areas, with varying levels of education: primary (n=10), secondary (n=4), and university (n=4), while the majority were illiterate (40%). Most of our patients were employed, with 64.28% engaging in significant physical activity, resulting in an average of 6±2 days of work absenteeism every 3 months due to knee pain. The mean duration of knee osteoarthritis was 7.97 years±3.14. The average pain visual analog scale (VAS) score was 5.2±0.4. Knee osteoarthritis was classified as stage 2 in 40% and stage 3 in 60% of cases. Regarding functional impact, the mean WOMAC global index was 16.6±4.68, and the mean Lequesne Index was 11.05±3.45; moderate disability was observed in 16.7%, significant disability in 50%, and severe disability in 16.7% of patients. Furthermore, the KOOS questionnaire revealed decreased KOOS-Sport and KOOS-QOL scores, with mean values of 35±10.2 and 37±8.9, respectively. Our study identified factors associated with a poor quality of life: age > 65 years (p<0.05), disease duration (p=0.02), and VAS pain > 5 (p=0.02).

Improving the quality of life is an essential therapeutic goal in managing knee osteoarthritis. Our study demonstrates that advanced age, longer disease duration, and high pain intensity can negatively impact quality of life.

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Obstructive sleep apnea hypopnea syndrome (OSAHS) is a chronic source of stress that can alter the emotional state of affected patients.

This study aimed to assess the impact of OSAHS severity on depression and anxiety disorders in a Tunisian population of apneic patients.

We conducted a cross-sectional study, involving 40 patients diagnosed with OSAHS by polysomnography in the Sleep unit, department of Neurophysilogy at Sahloul university hospital in Sousse, Tunisia. Anxiety and depressive disorders were detected using the Arabic version of the HADS (Hospital Anxiety and Depression Scale).

The mean age was 49.7 ± 7.87 years with a sex ratio of 1.1. The mean apnea-hypopnea index (AHI) was 29.72. OSAHS was mild, moderate and severe in 40%, 22.5% and 37.5% of cases respectively. One third (30%) of patients received a treatment with continuous positive airway pressure (CPAP). The prevalence of depression in the study’s patients, according to the HADS, was 56.4% and that of anxiety was 59%. There was a positive linear relationship between AHI and scores of depression and anxiety (p=0.045 and p=0.037 respectively). Similarly, a significant association was found between HAD scores and treatment with CPAP (p<0.05).

These results show a high frequency of anxiety-depressive disorders in patients with OSAHS. Severity of OSAHS and CPAP treatment proved to be determining factors in anxiety and depressive disorders, hence the importance of detecting these disorders in order to improve patients’ quality of life.

None Declared

In the university stage, the student is exposed to many psychological changes, pressures, and conflicts, which makes him resort to many non-consensual psychological defense mechanisms such as (repression, justification, projection, relapse, denial, delusional illness, reverse transference, daydreaming), which causes an imbalance in the personality and its psychological functions. This may lead to cognitive and mental distortions and physiological imbalances, and the appearance of symptoms that cause psychosomatic disorders that are not due to organic physiological imbalances or bacterial diseases, but rather as a result of imbalances in the psychological functions of the ego ,Which increases the symptoms of headache, vomiting, poor digestion, irritable bowel syndrome, shortness of breath, rapid heartbeat, hormonal imbalance, facial redness, and others.

1.Identifying the degree of use of non-consensual psychological defense mechanisms among university students, and the differences in this according to the variable (gender and degree of academic achievement)

1. 1. Revealing the correlation between the degree of use of non-consensual psychological defense mechanisms and the emergence of disturbed psychosomatic symptoms in the functions of (the respiratory system, the digestive system, the cardiac system, the muscular system, sleep disorders, and bodily disorders).

The correlational analysis approach was used to study the relationship between the variables of the study. The sample consisted of 300 male and female university students. A scale for psychological defense mechanisms was constructed, and a scale for psychosomatic disorders prepared by Diop (2011) was adopted, and its psychometric properties were verified.

The responses in the degrees of non-consensual psychological defense mechanisms were varied, with a high degree in (justification, projection, repression, and delusional illness) and a moderate degree in (relapse, daydreaming, denial, and reverse transference). Differences appeared between males and females in favor of males, while differences in academic grades were in favor of the lowest grade. The results also showed a statistically significant correlation between psychological defense mechanisms and the appearance of psychosomatic symptoms, as it was high in disorders (respiratory system, cardiac system, muscular system, sleep disorders), and moderate in (emotional disorders and somatic disorders).

There is a positive correlation between the degrees of use of non-consensual psychological defense mechanisms and the emergence of psychosomatic disorders, in the functions of several bodily systems and behavioral and emotional disorders.

None Declared

Manifestations of phantom ringing syndrome are widely seen in healthy population. Are there any interrelations between this phenomenon and personal psychological characteristics that are connected with the level of their mental health?

To determine the specificity of interrelations of phantom ringing syndrome related anxiety and personal self-esteem in university students

The anonymous survey covered 546 undergraduate university students. The questions were centered on the students’ patterns of their personal smartphone use.

The research showed that manifestations of phantom ringing syndrome is available in 189 students, or in every third student (34.6%), who use mobile phones. It is equally represented in males (49.7%) and females (50.2). Clinically, it is characterized by a higher level of anxiety, which reliably correlates (p<0.01) with the level of stress (r=.17), level of nervousness caused by absence of a mobile phone (r=.18), the frequency of headache (r=.15), the frequency of medication consumption related to chronic somatic disease (r=.15). We also established valid negative interrelations between the level of phantom ringing syndrome related anxiety and the personal self-esteem based on the parameters of religious belief (r=-.15), personal attractiveness (r=-.16), mind (r=-.17), happiness (r=-.24), liveliness (r=-.25) and well-being (r=-.15). We have not found any proof of valid interrelations with self-assessment of health.

The received results prove that phantom ringing syndrome related anxiety is connected with the personal self-esteem, the level of the perceived stress and some other clinical manifestations

None Declared

The patient was a 34-year-old male admitted to the psychiatric inpatient unit for high anxiety and suicide ideation due to severe toothache.

To show how the antipsychotic pimozide can be an effective option for the treatment of anxiety and obsessive symptoms around physical complaints within the spectrum of somatoform disorders

Case report and literature review

The patient comes to the emergency room with high anxiety and active self-harming ideation. He reports that for months he has been experiencing mouth pain that is becoming more and more intense. He has seen multiple professionals without finding a cause that justifies the pain. In the past she has a history of multiple ailments (knee, abdominal pain…). He is being treated with sertraline 150, clonazepam 3 mg per day and olanzapine 5 mg at night. During admission, treatment with pimozide up to 4 mg per day was started. The patient is progressively less distressed and with more distance from the ideas about pain, being able to carry out more activities during the day. There is remission of suicidal ideation

There is evidence in the literature that the use of pimozide was effective in different psychotic disorders. It has been seen to reduce the intensity of symptoms in cases of delusional disorders with delirum of somatic type or those such as delusions by parasitization. The use of pimozide has also been effective in the treatment of complex tic disorder. In this case it is effective and could be explained by the close relationship of osbsesive symptoms with psychotic symptoms.

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The study aimed to evaluate the effectiveness of a device called “Apollo” in reducing anxiety, as compared to a control group. Participants were divided into two groups: the intervention group (receiving the “Apollo” device) and the control group (receiving no intervention).

The primary outcome measure was the change in Generalized Anxiety Disorder 7-item (GAD-7) scores, calculated as the difference between post-GAD-7 and pre-GAD-7 scores.

Participants were recruited from two different cohorts, with the intervention group derived from the “Apollo” dataset and the control group derived from the “KaT Cohort 9” dataset. Matching was performed based on Age, Sex, and pre-GAD-7 scores to create comparable groups.

For those with full datasets, a total of 4 (out of 5) participants from the “Apollo” group were matched with 15 (out of 45) participants from the “Control” group, based on the selected criteria. Data cleaning was performed to handle missing values and non-numeric entries. Propensity score matching was used to match participants from the “Apollo” and “Control” groups based on Age, Sex, and pre-GAD-7 scores. An independent samples t-test was conducted to compare the mean change in GAD-7 scores between the two groups. Since propensity score matching requires complete data on matching factors (age, sex, pre-GAD-7), those without full datasets were excluded.

The median change in GAD-7 scores in the “Apollo” group was −8.5, indicating a median reduction in anxiety symptoms.The independent samples t-test revealed no statistically significant difference in the change in GAD-7 scores between the “Apollo” and “Control” groups (t = -0.889, p = 0.387). Therefore, the study so far did cannot conclude a significant difference.

Ketamine assisted therapy remains a promising way to decrease anxiety among patients with generalized anxiety disorder and elevated GAD-7 scores. Ways to potentially improve these results are increasing the number of Apollo patients and having more balanced numbers between groups.

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Cannabis use has been reported to cause a myriad of acute adverse reactions, including those linked to anxiety disorders, such as panic attacks and derealization. Notably, in the emergency department, anxiety makes up a significant proportion of the complaints related to cannabinoid consumption. Several reports show these symptoms can persist after the cessation of cannabis consumption. Consequently, some questions have arisen regarding the role of cannabinoids as precipitators for anxiety disorders in vulnerable individuals. Alternatively, it has been hypothesized that patients with anxiety disorders are more prone to using cannabis.

We aim to understand whether there is an established relationship between anxiety disorders and cannabis use. Moreover, we intend to identify what are the factors which make an individual more likely to experience anxiety following cannabis consumption.

A search was conducted in the PubMed database using the MeSH terms “cannabis”, “panic disorder”, “anxiety”, “panic” and “generalized anxiety disorder”. Articles published in the last ten years were considered. Publications were selected after careful reading of their abstract. A non-systematic review of the selected articles was performed.

Eight articles were included in this review. While a majority of these publications did not find a significant association between cannabis use and anxiety disorders, a small subset of analyzed articles found that cannabis use may increase anxiety severity in general, devoid of specific diagnostic association. Individuals who presented to the emergency department with anxiety complaints after cannabis use were likely to be young and to have ingested edible cannabis. History of psychiatric disease, especially substance use disorder, was common in this population.

Most available data suggest cannabis use is not clearly linked to anxiety disorders. However, information around this topic is scarce and heterogenous. Further research is needed focusing on the natural evolution of acute anxiety after cannabis use. Factors such as young age, presence of psychiatric comorbidities and consumption of edible cannabis appear to contribute to a significantly increased risk of experiencing acute anxiety after cannabis use.

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Anxiety disorder affects nearly 9.4% of children aged 3-17 years.1 Virtual Reality (VR) provides an alternative for managing anxiety due to immersive, multisensory, and excellent distraction.

The aim is to evaluate the efficacy of VR therapy in managing anxiety in children.

We searched PubMed, Medline, Embase, Web of Science, and Biosisdatabases with the keywords “Virtual Reality” in the context of “AnxietyDisorders” and included 8 relevant studies published in English until February 10, 2023, for our qualitative synthesis.

The VR-Guided relaxation (VR-GR) effectively decreased anxiety immediately after administration. In another trial, 4 of the 9 patients completely overcame their fears, and 8 of 9 saw an improvement in target behaviors in the autism population even after six weeks after the therapy, and the effect lasted 1 year post-treatment. In another study, VR-based therapy helped reduce anxiety and behavioral scores significantly in the VR group vs. the control. In another study, they found during pediatric intravenous catheter placement, patients who received VR therapy showed significantly less anxiety and pain compared to those who did not. In another study, they found VR therapy helped reduce anxiety during the induction of pre-operative anesthesia in children undergoing elective surgery.

A study discovered benefits with statistically significant results in reducing anxiety in children immediately after VR-based therapy. To explore the full spectrum of benefits and efficacy of VR-based therapy for anxiety as a standalone or adjunct to pharmacotherapy, we recommend future trials with robust study designs.

None Declared

Anxiety is the most prevalent disease in the world. Symptoms of anxiety disorders affect everyone. The symptoms are worse after a long period of time and more severe disease than normal. A study was conducted to support the assumption that it is an opportunity to improve healthcare services.

1. 1. Anxiety disorders of doctors and medical specialists of Selenge Province General Hospital

2. 2. Determine the relationship between certain factors and certain factors of anxiety disorders

The GAD7, SRQ20, and PHQ9, sleep system detection questionnaire methods issued by WHO for doctors of primary health care institutions were analyzed by analytical research snapshot model from 03.15 to 04.05, 2023.03.22. /1/01 was obtained and the survey was conducted.

In the study, 23-65-year-olds received medical care, and the average life expectancy was 37.05 years. 30% (27) of the respondents did not have anxiety disorders, 36.67% (33) had mild anxiety disorders, 18.89% (17) had moderate anxiety disorders, and 14.44% (13) had severe health problems. 6.67% (6) of the respondents had no depression, 10% (9) had very mild depression and could cope on their own, 24.44% (22) had moderate depression and could cope, and 27.78% (25) with healthy depression. 24.44% (22) had major depressive disorder and 6.67% (6) had major depressive disorder. According to correlation analysis, GAD7 score with SRQ20 stress score r=0.76 and PHQ9 mood score with r=0. the inverse association was statistically significant at p=0.00. PHQ9 depression score had a strong effect on SRQ20 stress score r=0.74, p=0.00, and GAD7 score r =0.46, p=0.0000. r=-0.40, p=0.00 had a moderate inverse relationship with age, and r=-0.24, p=0.00 had a weak inverse relationship with age. In linear regression analysis, the GAD7 anxiety disorder score increased by 48.8% (p=0.00) when fixed at one, which was statistically significant. In logistic regression analysis, PHQ9 depression score increased by 35.08% (p=0.01) per entry. In composite logistic regression analysis, the PHQ9 depression score was statistically significant OR=4.07 (p=0.01) multiplied by one.

Doctors and medical professionals include psychological health research, testing, treatment, psychological counseling, and health care. Anxiety disorders are related to stress, depression, satisfaction, and age, while depressive disorders are anxiety disorders.

None Declared

Generalized anxiety disorder (GAD) is characterized by excessive and uncontrollable worry and anxiety about several activities or events. Although some cognitive symptoms are common in GAD patients, there are still controversial results from their linkage. Some studies indicate intact cognitive functions in GAD patients, while others suggest that anxiety and its cognitive aspect, worry, are associated with reduced performance in several cognitive domains.

To assess the linkage and contribution of cognitive impairment to the maintenance and severity of GAD; to determine which specific domains of cognitive function are impaired in patients with GAD; and to examine age differences regarding cognitive impairment in GAD patients

A systematic literature search was executed using the PubMed and Google Scholar databases from 1960 to 2023 and the keywords “generalized anxiety disorder”, “anxiety disorder” “cognitive function”, “cognitive dysfunction”, “cognitive impairment”, “late-life”, “young”, “adult”, and their combination.

Anxiety and worry, as main characteristics of GAD, were shown to be linked and manifested by deficient attentional control, a main function of working memory. Attentional control functions are biased toward threats, which, in turn, hinders cognitive processing efficiency. Moreover, several structural and electrophysiological impairments could be linked to cognitive dysfunction in people with GAD. For example, patients with GAD showed reductions in gray matter volumes, especially in the regions of the hip, midbrain, thalamus, insula and superior temporal gyrus. The hippocampus, middle cingulate gyrus, putamen and head of the caudate nucleus also showed lower activity in response to the neutral words. Also, GAD patients have better inhibitory control, which may be associated with more severe symptomatology. These results are consistent with attentional control theory, which posits that worry might negatively impinge on inhibition and set-shifting. In terms of age differences, we observed that GAD in elderly patients is associated with impairment of short-term and delayed memory. In young adults, GAD is associated with various cognitive impairments, particularly in selective attention, working memory, cognitive flexibility, planning ability or efficiency, and other executive functions (EF).

To sum up, we observed that GAD is associated with worse cognitive functioning in several domains. Further research into cognitive dysfunction in GAD is needed to better understand the impact on daily living and to allow more tailored treatment strategies including medication, therapy and interventions targeted to improve specific cognitive domains.

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Misophonia is a condition characterized by extreme emotional reactions, such as irritation or anger, triggered by specific sounds. Despite its prevalence, there is a lack of evidence-based treatment methods for misophonia.

This case report aims to explore the effectiveness of combining psychoeducation with Cognitive Behavioral Therapy (CBT) in the treatment of a misophonic patient. The focus is on reducing the patient’s emotional distress and improving their quality of life.

The patient is a 28-year-old woman employed as a salesperson in a busy city. Mouth smacking, gum chewing and clock ticking are the sounds that bother her the most. She has never used any medications or attempted any methods to alleviate her misophonia. Neither she, nor her family has a history of a psychiatric disorder.

The therapeutic intervention spanned eight sessions, each lasting around half an hour. The first two sessions, a patient history was taken and Mısophonia Interview Scale (MIS) was conducted. MIS comprised the Misophonia Checklist (MCL), which involved reading fifty misophonic sounds to the patient one by one. She then rated her discomfort in response to each sound on a four-point Likert-type scale. From the MCL responses, a total severity score (Misophonia Total Score - MTS), was calculated.

The treatment commenced with a psychoeducational component focused on enhancing the patient’s comprehension of misophonia. This phase aimed to elucidate the neurobiological underpinnings of the condition, common triggers, and the emotional reactions associated with it.

Then, CBT was employed to identify and challenge the patient’s negative automatic thoughts (NATs) linked to her misophonia. Three sessions primarily concentrated on identifying and managing NATs associated with her misophonia. These sessions equipped the patient with the skills to recognize and confront NATs through structured discussions and practical assignments.

The last three sessions centered on exposure therapy, with the goal of reducing emotional and physiological responses to triggers. Homework assignments during this phase encouraged the patient to independently practice exposure exercises.

The initial MTS was 54, indicating significant distress. After the interventions, the final MTS decreased to 35 and the impact of misophonic symptoms on her life decreased from severe to moderate.

Misophonia is a challenging disorder to treat due to its limited evidence-based interventions. This case report demonstrates that a combination of psychoeducation and CBT methods may hold promise in managing misophonic symptoms. However, it is essential to acknowledge the need for further research in this area, as misophonia’s treatment strategies require more robust empirical support. This case highlights the potential benefits of psychoeducation and CBT, emphasizing the need to explore and develop effective treatments for this debilitating condition.

None Declared

Anxiety disorders represent the most common mental illnesses, which are listed among the ten most important causes of disability worldwide. According to DSM-5, they are defined as “disorders that share characteristics of excessive fear and anxiety and related behavioral disorders”. Patients exhibit low levels of quality of life. Their daily routine is affected negatively. However, Occupational Therapy has been proven to play a crucial role in their treatment, improving quality of life through the involvement in occupations.

To highlight the contribution of Occupational Therapy in ameliorating the quality of life in anxiety disorders.

A review of 50 articles -from 2013 to 2023- on PubMed and Google Scholar, regarding the beneficial impact of Occupational Therapy in the Anxiety Disorders’ treatment.

Occupational Therapists can intervene in many negatively affected -by the disease- life domains such as: Activities of Daily Living, Education, Work, Play, Social Interaction and Sleep. The most effective Occupational Therapy methods are based on the cognitive behavioral approach and include: Psychoeducation, Relaxation techniques, Social skills training and Systematic desensitization.

Other methods involve training in Activities of Daily Living such as feeding, maintaining good personal hygiene, and using public transport. Furthermore, Art Therapy (visual arts, use of clay) has been shown to reduce feelings of anxiety, while promoting creativity and enhancing self-esteem.

Additional research is needed regarding the effectiveness of Occupational Therapy in improving the quality of life for patients suffering from Anxiety Disorders. The important “take home message” is that the amelioration of the patients’ quality of life should be the main goal of the therapeutic intervention and not a secondary result of it.

None Declared

Anxiety disorders are a common type of mental pathology with severe social and medical consequences in the lives of people suffering from them. General population studies indicate their prevalence ranges from 1.7% to 4.7% of the population. According to data from a US national study among the population aged 15 to 54 years, only 2.7% and 4.7%, respectively, suffered from panic disorder, one of the common types of anxiety disorders, during their lifetime. At the same time, the features of the emotional structure of anxiety disorders and the effectiveness of their psychotherapy among the population of low-income countries, especially in countries in a situation of prolonged bloody war and environmental disaster, remain poorly studied.

The purpose of the study was to identify the features of the emotional symptomatic structure of anxiety disorder and evaluate the effectiveness of their psychotherapeutic correction. For this purpose, 180 patients with anxiety disorders who were hospitalized in Ukraine (during the period 2022 - 2023) were examined.

The basic method was group psychotherapy with elements of rational, positive, suggestive and family psychotherapy. Regarding emotional disorders, cognitive behavioural therapy (CBT) was used for phobic-depressive and anxiety-depressive syndromes.

Most patients experienced a decrease in the level of general anxiety and internal anxiety. Almost no spontaneous occurrence of fear was observed. During active interviewing, patients stated that their previous anxieties and fears had lost their relevance and acquired clear emotional overtones. There was also a significant decrease in the symptoms of the depressive cycle, and patients began to feel joy and optimism.

To correct emotional dysfunction in patients with episodic paroxysmal disorders, generalized anxiety disorders and mixed anxiety-depressive disorders, it is optimal to use a system of psychotherapeutic correction built on stepwise and multimodal principles.

None Declared

Acupuncture has long been used in treating anxiety, and a literature exists on its effectiveness. However, acupuncture is rarely covered by government insurance (Medicaid or Medicare) or even by many commercial insurance carriers in the United States, making it inaccessible to those who cannot pay separately.

We asked if adding acupuncture to an anxiety group would improve outcome.

We provided acupuncture during group psychotherapy for anxiety as a non-billable service. This was feasible since patients were already being billed for group psychotherapy. A physician and a social work intern led the group. At the start of the group, the physician went around the circle of group members and inserted acupuncture needles, using points in the ears, head, hands, feet, and, in the summer, arms and lower legs). The size of the group ranged from 4 to 12 people. We used Battlefield auricular points, the four gates (Large Intestine 4 and Liver 3, bilaterally), and GV24, GV29, Ht7, and Sp6. Sometimes, other points were added for other symptoms (back pain, neck pain, etc.) People sometimes joined the group without anxiety as a core problem in getting access to acupuncture. A core group of patients formed who came weekly while others came and went. The Hamilton Anxiety Scale measured anxiety after treatments 4, 8, and 12. The group lasted 90 minutes and consisted of mindfulness training, guided imagery, and CBT for anxiety. All patients met the criteria for generalized anxiety disorder. The t-test procedure was used to compare the differences between the means for the two groups.

Thirty-five patients received acupuncture, while another 55 patients attended the group and did not elect to receive acupuncture. All patients were covered by MaineCare health insurance, Maine’s version of Medicaid. All patients had multiple other medical problems, which was why they were referred to the group. Seventy percent of the patients were women, and 30% were men. The average age was 40.1 years. Anxiety ratings on the Hamilton Anxiety Scale decreased by the last time measured for those not receiving acupuncture by an average of 5.17 points (S.D. 2.9; n = 55). Anxiety ratings for those receiving acupuncture decreased by an average of 7.19 points (S.D. 2.5, n = 35). The difference of the means was -2.02 (S.E. 0.595; 95% CI = -2.203 to -0.837; t = -3.394; p = 0.001). Headaches, shoulder pains, and upper back pain also decreased. Patients reported high levels of benefit from the acupuncture and encouraged other patients to continue to come and try the acupuncture. Usually, the needles could be placed within the first third of the group.

Acupuncture improved anxiety ratings for people in group psychotherapy for anxiety over group alone, though the possibility of a placebo effect cannot be eliminated. Patients chose acupuncture, which could also present a potential bias.

None Declared

Cognitive test anxiety and dysfunctional metacognitions can significantly impact an individual’s performance and overall mental health. However, the effectiveness of various treatment strategies, including Virtual Reality (VR) therapy, is yet to be fully explored.

This study aimed to examine the effectiveness of VR therapy in reducing cognitive test anxiety and dysfunctional metacognitions in adults.

A total of 64 participants were enrolled in the study, with 40 in the treatment group and 24 in the control group. Data were collected using the Metacognition Questionnaire-30, Cognitive Test Anxiety Scale, and a sociodemographic questionnaire. Paired samples t-tests were used to compare pretest and posttest scores, while independent samples t-tests were used to compare the means between the groups.

The findings suggest that the treatment group experienced a significant reduction in cognitive test anxiety and negative metacognition scores following VR therapy. No significant changes were observed in the control group, and there were no significant differences in pretest scores between the treatment and control groups.

The study indicates that VR therapy may be an effective treatment strategy for reducing cognitive test anxiety and dysfunctional metacognitions. Further research is recommended to validate these findings and explore the potential of VR therapy in treating other psychological disorders.

None Declared

Test anxiety includes subjective experience of intense physiological, cognitive and/or behavioral symptoms during test-taking situations such as pacing, headaches, excessive feelings of fear, anger, troubles concentrating, sudden forgetfulness and negative self-talk. Especially students who are striving for flawlessness, have overly critical self-evaluations and beliefs that other expect perfection are sensitive to experiencing these feelings. On the contrary, individuals who believe in their ability, are present in the moment and are open to experiences tend to be more resilient to stressors and anxiety symptoms.

The aim of this study was to investigate perfectionism, self-efficacy, and mindfulness as predictors of test-anxiety among undergraduate and postgraduate students of different study fields.

525 undergraduate and postgraduate students from the fields of Natural, Medical Sciences and Engineering, Social Sciences, Humanities and Art, and Economics, Business and Administration Studies participated in the study. A sociodemographic form, the Test Anxiety Inventory (TAI), 15-Item Five Facet Mindfulness Questionnaire (FFMQ-15), Scale of General Self-efficacy (GSES) and Frost Multidimensional Perfectionism Scale-Brief (FMPS-Brief) were used. Descriptive statistics were used to show the sociodemographics of our sample, while correlational analyses were performed to asses the associations between the variables. To further validate the findings, multiple linear regression analyses were performed.

Higher perfectionistic evaluative concerns and lower self-efficacy showed associations with test-anxiety and were proven as predictors among undergraduate and postgraduate students. In addition, being younger and female in postgraduates, and having perfectionistic strivings and being Mindful-Observe in undergraduate students proved to be significant predictors of test-anxiety.

The found associations of perfectionism and self-efficacy, as well as its predictor roles further validate the information we have in literature, but widen the sample to postgraduate students and various study fields which help us generalize the findings more. What adds the most value in theoretical and practical aspects is the findings associated with mindfulness. Mindfulness techniques are very popular intervention methods for anxiety related symptoms, and the positive relationship of Mindful-Observe with test anxiety opens new viewpoints to mindfulness-based interventions. Particularly focusing on Mindful-Observe while treating test-anxiety may yield better outcomes in alleviation of symptoms.

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Lithium was the first mood stabilizer and today continues to be a first-line treatment in the treatment of bipolar disorder despite its adverse effects, which make it important to monitor blood levels and control kidney function.

Presentation of a case of litium withdrawal and relapse in bipolar disorder. Literature review relating to the risk of relapse when lithium treatment is interrupted.

We present a clinical case of a patient who suffers a deterioration in renal function that requires the withdrawal of lithium and who consequently suffers a relapse. We conducted a bibliographic research of articles in Pubmed on this topic.

A 49-year-old male, with a history of multiple admissions to UHB since the age of 18 with a diagnosis of bipolar disorder and treatment with lithium. Decompensations towards the manic pole have always been related to interruptions in lithium treatment. On several occasions when the patient was feeling well emotionally, he believed himself to be “cured” and abandoned the treatment, triggering a manic episode, showing verbal aggression, increased self-esteem and delusional ideation of harm. Remission was usually achieved with the reintroduction of lithium and the addition of high-dose quetiapine. Between episodes, constant overvalued ideas of economic scarcity seemed to persist, which were accentuated in the form of delusional ideas of ruin in depressive decompensations. After 7 years of stability, control analysis showed blood litemia of 2.2 mEq/L with deterioration of kidney function and generalized tremor was observed, without improvement after serum therapy. He was admitted for dialysis and lithium was suspended. Treatment with valproate was started and a consultation scheduled in a week to adjust the dose. The patient did not attend that consultation and was admitted three days later to Psychiatry Hospitalization showing a challenging attitude, evident dysphoric mood, accelerated speech, with derailments and echolalia. Delusional ideation of harm with auditory hallucinations. Insomnia and hyporexia. Chronic renal failure persisted.

Lithium is a very effective drug but with a narrow therapeutic range that requires adequate monitoring due to the possible consequences of its use at different organs and systems of the body. when lithium is found in the blood at toxic levels with deterioration of kidney function and glomerular filtration fails to recover, lithium treatment should be suspended. Sudden withdrawal of lithium significantly increases the risk of relapse due to rebound effect. More than 50% of patients experience a recurrence within 10 weeks of withdrawal.

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Given the recurrence of mood episodes, with their negative repercussions such as high suicidal risk, significant cognitive decline and the persistence of residual signs with a negative impact on the patient’s family, social and professional functioning, Bipolar Disorder is a mental disorder with a significant social stigma.

Identify the socio-demographic and clinical factors that may influence the experience of stigma in bipolar disorder type I

We conducted a cross-sectional, comparative study over a six-month period at the aftercare unit of Razi Hospital’s psychiatric ward “A”, including patients treated for TB I according to DSM 5 criteria and stable on treatment.

The study was conducted in two stages: first, sociodemographic and clinical characteristics were collected using a pre-established form. The DISCUS scale, validated in Arabic, was then administered.

We included 100 patients (60 men and 40 women) with a mean age of 43.55 years.

The median DISCUS stigma score was 6 (0-19).

The mean value of the DISCUS scale was high for patients of urban origin (p=0.042), with a low socioeconomic level (p=0.001), and poor family dynamics (p<0.001).

The presence of a comorbid personality disorder was significantly associated with stigma (p=0.006). The DISCUS scale was positively associated with the number of years of follow-up, the number of hospitalizations, the number of manic episodes, the number of depressive episodes and the number of episodes with psychotic or melancholic features.

This stigma can have a negative impact on patients’ quality of life in a whole range of ways, including limiting their opportunities for education, employment and housing.

Intensive therapeutic interventions should be considered for vulnerable patients to limit the consequences.

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