Depressive disorders frequently coexist with chronic medical conditions like heart failure (HF), significantly impacting patients’ overall health and quality of life. This study aims to explore the correlation between soluble ST2 molecule levels and the presence of depressive disorders in patients with heart failure.

A total of 200 patients, all diagnosed with heart failure, were included in this study. Among them, 30 patients were mentally healthy, and the remaining 170 exhibited medium-level depressive disorders. Blood samples were collected and analyzed for soluble ST2 levels to assess the potential correlation between depressive disorders and soluble ST2 levels in patients with heart failure.

A total of 200 patients, all diagnosed with heart failure, were included in this study. Among them, 30 patients were mentally healthy, and the remaining 170 exhibited medium-level depressive disorders. Blood samples were collected and analyzed for soluble ST2 levels to assess the potential correlation between depressive disorders and soluble ST2 levels in patients with heart failure.

The study demonstrated a statistically significant finding, indicating that the levels of soluble ST2 were 1.6 times higher in patients with depression and comorbid heart failure compared to mentally healthy individuals with heart failure.

This study elucidates a statistically significant correlation between medium-level depressive disorders and elevated soluble ST2 levels in patients with coexisting heart failure, shedding light on the potential role of soluble ST2 as a biomarker in identifying and managing depressive disorders in heart failure patients. The observed 1.6-fold increase in soluble ST2 levels in heart failure patients with depression emphasizes the importance of mental health assessment and intervention in individuals with chronic medical conditions, particularly heart failure, to enhance overall care and outcomes.

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Hiccups are involuntary, spasmodic contractions of the diaphragm and intercostal muscles that cause inspiration and are interrupted by closure of the glottis. Most sources define the term “persistent hiccups” as lasting more than 2 days and “intractable” as lasting more than 1 month. Both are most likely associated with a pathologic process. “Intractable hiccups” should lead to investigation of organic pathology. If it does not improve, it can interfere with the patient’s ability to eat, socialize and sleep, leading to a significant worsening of quality of life. “Intractable hiccups” are more frequent in men (91%), over 50 years of age. Women suffer from psychogenic hiccups more frequently than men. Anxiety or stress can trigger hiccups. Multiple neurotransmitters are involved.

We present a theoretical review on the topic.

A bibliographic review on the topic.

In recent years, new trials and case series have been published, and regulatory agencies have issued new recommendations on the use of pharmacologic agents for this indication. The literature has described the efficacy of several pharmacologic agents in the empiric treatment of persistent and intractable hiccups. Most of these target dopaminergic and GABAergic receptors.

Based on limited efficacy and safety data, Baclofen and Gabapentin can be considered as first-line treatment for intractable and persistent hiccups, as they suggest efficacy and are less likely to cause long-term side effects than standard neuroleptic agents. Dopamine blocking agents such as Metoclopramide, Chlorpromazine, and Haloperidol, could be used as second line. In one study, withdrawal of Benzodiazepines or addition of Pregabalin was found to help reduce hiccups.

The patient we consulted came for persistent hiccups or singultus of 2 years of evolution. Organic pathology was ruled out. She related the onset of the symptoms to different stressors that had caused her anxiety. We administered Escitalopram and Gabapentin and indicated withdrawal of Bromazepam, which she started taking months ago. In follow-up appointments she reported a decrease in the intensity and frequency of the symptoms, with a notable improvement in her quality of life.

Considering all available evidence, a treatment algorithm with Baclofen is recommended as first-line therapy for persistent and intractable hiccups. Gabapentin may also be safe and effective in the long-term treatment of this condition, especially for patients with CNS disease. Metoclopramide is no longer recommended for long-term treatment of hiccups. Clinical experience also supports the use of Chlorpromazine and other neuroleptics for acute, but not long-term, treatment. Going forward, large multicenter studies will be needed to create an adequate evidence base for the treatment of persistent and intractable hiccups. Until then, guidelines will continue to be based on unreliable data and clinical experience.

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According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), post concussive syndrome (PCS) is given a diagnosis of either major or mild neurocognitive disorder (NCD) due to traumatic brain injury TBI. However Persistent post-concussion symptoms (PPCS) are more complex, and typically involve multidisciplinary assessment and management. The symptoms are varied, non-specific and the therapeutic process is defiant for psychiatrist.

To investigate the semiology of persistent post-concussion syndrome (PPCS) and the therapeutic challenges it poses.

A literature review was made on Pubmed, Google Scholar and Cochrane library using keywords: “post-concussive syndrome”,”psychiatric disorder”, “depression”,”post-traumatic stress disorder”,”treatment”, “physiopathology”.

The physiopathology of persistent PCS is controversy.The Symptoms are due to the Concept of “Symptom Generators” which results from the alterations in neurophysiology and neuropathology secondary to the injury, and pre- or post-injury psychological factors physiological concussion. The Global cerebral metabolic disturbance, the autonomic nervous system dysfunction and the cerebral blood flow dysregulation induce biochemical cascade,excitotoxic reaction and immunotoxicity.

Clinical diagnoses associated with PPCS are:Major depressive disorder,Post traumatic stress disorder,Anxiety disorder,Substance abuse disorder,Psychotic disorder and Antisocial personality disorder. For the non pharmacological management: A systematically early information and a graded physical exercise in addition to other treatment are essential.

Antidepressant, benzodiazepine and mood-stabilizer are the most recommended treatments for psychiatric symptoms. Atypical neuroleptics are indicated in delirant disorder, behavior disorder and antisocial personality disorder.Some studies suggest the methylphenidate and biperiden to treat several cognitive impairment and severe behavior disorder.

(PPCS) is far from being a subjective complaint by patients. It is a complex clinical entity that groups symptoms that overlap with other psychiatric diagnoses, such as depression, post-traumatic stress disorder, and mood disorders. Early neuropsychiatric assessment and personalized pharmacological and psychotherapeutic treatment are essential factors in the prognosis of the disease.

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The evaluation of manic behavior with later onset is crucial, as various organic factors such as medications, infections, metabolic disturbances, tumors, and epilepsy can serve as potential etiological causes. While not universally observed, most studies indicate a connection between late-onset mania and neurological disorders like neurosyphilis.

Our study aims to investigate the relationship between late-onset mania and neurosyphilis.

In this paper, we present a case of neurosyphilis presenting exclusively with symptoms of mania.

A 72-year-old Tunisian woman with no prior medical or psychiatric history was referred to the psychiatric emergency room due to alterations in her mental state and behavior over the past ten days. During the psychiatric assessment, she displayed increased motor activity, fluctuating emotions, and rapid flow of ideas. The general physical examination yielded no notable findings. The serum Venereal Disease Research Laboratory (VDRL) test returned a strongly positive result (+++), and the TPHA examination confirmed a positive result at a titer of 1/60. In the serologic analysis of cerebrospinal fluid, VDRL was also positive, thereby confirming the diagnosis of neurosyphilis (NS). The diagnosis of mania secondary to a medical condition was established. The patient was treated with ceftriaxone and antimanic medications, resulting in a significant improvement in her psychiatric symptoms within a few days.

This case underscores the importance of conducting serologic testing for syphilis in patients who present with manic symptoms, experience a late-onset mental disorder, and have no prior history or family history of affective disorders.

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To handle well clinical treatments, it is crucial to know the expectations of patients who seek help. We need to ask ourselves: how do patients interpret subjectively their diagnosis, treatments, and self-care? Medical Psychology brings us theories for this understanding. Grave’s Disease is an autoimmune disorder, a form of hyperthyroidism with a goitre, affecting also the eyes and the skin, as well as emotional manifestations. Weight loss, sometimes psychologically welcome, although due to a disease, can mean a psychoanalytic secondary gain. So, the medicine that leads to clinical improvement can be taken with ambivalence and bad adherence to treatment. It is important to differentiate between disease, a scientific entity explained by the clinical professional, and illness as a patient’s subjective perception of an un-health.

To understand psychodynamically the fantasies, desires, and views related to Graves’ Disease as reported by patients in hyperthyroidism but without ophthalmopathy interviewed at an endocrinology-specialized outpatient clinic. (in the EPA-2023, it was presented the qualitative results of a sample in hyperthyroidism, with ophthalmopathy, studied at the same service).

Clinical-Qualitative Method designed by Turato. Data collected through Semi-Directed Interviews with Open-ended Questions in-Depth; and Field Notes, transcript fully. Treated by the Seven Steps of Clinical-Qualitative Content Analysis of Faria-Schützer, using psychodynamic concepts from Balintian Medical Psychology. Although we have extracted categories that permit us interesting discussions, we intend to close the sample (through the information saturation criterion by Fontanella) when we obtain other categories. The interviewer, a male psychologist, is the first author. The findings are validated by peer-reviewers of the Lab of Clinical Qualitative Research of the State University of Campinas.

Three categories were chosen for this presentation: 1) “An atomic bomb in my life”: How drastic changes of a hormonal disease re-symbolize the patient’s life; 2) “I didn’t think the thyroid did that much”: the disease seen as a metaphor in a psychological blaming language to own disease and to himself as a sick person. 3) “I have so much medicine!”: a mode of referring to treatment that would justify an undisciplined use of medications.

Our findings can help clinical professionals to have a better understanding of some psychological meanings which have sense in the patients’ conscience, often not verbalized clearly in the conversation, and so to handle better the patients and relatives. In this way, it can reduce the patient’s resistance to recommended treatment, as well as encourage the clinical team to construct empathy with them.

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Dry mouth is a subjective symptom of the feeling of dehydration inside of the mouth and is closely linked to reduced salivary secretion. The occurrence of dry mouth and GI disorders due to antidepressants greatly affects the course of the mental disorder and medication compliance, but it has barely ever been studied.

The purpose of this study was to identify the characteristics of dry mouth and gastrointestinal (GI) disorders in antidepressant patients.

The study included 103 antidepressant-taking patients. Antidepressants were classified according to their mode of action. The GI disorders were investigated using the medical records of the patients. The Patient Health Questionnaire-15 and a questionnaire for assessing dry mouth symptoms were used in this study. The questionnaire for the evaluation of dry mouth symptoms, a visual analog scale (VAS)–based instrument, developed and evaluated for reliability by Lee et al. was used to assess dry mouth. In the questionnaire, 6 VAS items were assessed for the extent of dry mouth (0-100 points) : 1) dry mouth at night or when waking up in the morning, 2) dry mouth during the day, 3) dry mouth when eating, 4) difficulty in swallowing, 5) subjective evaluation of the volume of saliva in the mouth, and 6) overall discomfort in daily life. Additionally, four items examined behaviors due to dry mouth (1-5points) : 1) frequency of waking up from sleep due to dry mouth, 2) frequency of preparing drinking water before going to bed, 3) frequency of drinking water when eating solid foods, and 4) frequency of eating hard candies or chewing gums to help dry mouth.

The score for “overall discomfort due to dry mouth in daily life” (31.72±33.82), “dry mouth at night or in the morning” (47.86±35.87), and “dry mouth during the day” (39.83±31.67) were slightly higher than “discomfort in chewing or swallowing foods”. According to somatization severity, the mean values were 116.36±113.34 in the mild, 213.18±136.98 in the moderate, and 277.59±201.44 in the severe, the between-group difference was significant (F=10.294, p<0.001). According to the class of antidepressants, the mean score was 180.00±147.5 for vortioxetine, 194.25±169.33 for selective serotonin reuptake inhibitors (SSRIs), 223.61±156.70 for serotonin and norepinephrine reuptake inhibitors (SNRIs), 75.00±57.00 for norepinephrine dopamine reuptake inhibitors (NDRIs), 201.67±174.66 for Nassau, and 116.67±132.03 for agomelatine. A total of 67 (65.0%) patients had at least one GI disorder.

The study findings are expected to help increase medication compliance in antidepressant patients by better controlling the side effects experienced by the patients.

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The study of the clinical and phenomenological features of psychopathological complications of cardiac surgery (CS) in artificial circulation conditions (ACC), the development of modern approaches to early diagnosis and prognosis of psychopathology is an effective way to solve this problem has valid medical and social significance.

To increase the effectiveness of prevention of psychopathological disorders in cardiosurgical interventions based on personalization of their correction.

The examination included the use of socio-demographic, instrumental, biochemical, clinical-psychopathological, psychometric, and statistical methods.

The study sample consisted of 700 patients who were treated by CS in ACC at the SI “Heart Institute of the MH of Ukraine”.

It was found out that the most common complication is postsurgeon cognitive dysfunction (PCD) (72.0% of patients), postsurgeon encephalopathy (PE) (31.0%) is less common, and cerebral infarction (CI) is the least common (12.2%).

It was revealed that the core psychopathological symptoms associated with CS are cognitive disorders (72.0% of the examined) and affective symptoms, represented by depressive (38.1%) and anxiety (33.9%) manifestations of mild and moderate expressiveness, and auxiliary constructs – dyssomnic (29.7%), asthenic (17.9%) and somatovegetative (9.0%) disorders. The highest prevalence of psychopathological symptoms was found in patients with CI, somewhat less in patients with PE, and the lowest in patients with PCD.

Signs of mild depressive disorder were found in patients who underwent CS in ACC, elevated levels of adynamic depression indicators, depression with fear and agitated depression, as well as increased levels of anxiety: the average level of anxiety, mental and somatic anxiety. The indicators of expressiveness of depression and anxiety in patients with CI turned out to be the highest, in patients with PE – lower, and in patients with PCD – the lowest.

We proposed a mathematical model for predicting the development of psychosocial maladjustment (PM) in patients who have undergone CS in ACC. It is based on a comprehensive assessment of three key vectors that can have a mutually potentiating pathogenetically related effect on the course of the formation of PM: surgical, neurological, and psychopathological. A complex of diagnostic, corrective and preventive measures for each of the risk groups has been developed.

Verification of the proposed model on a representative sample of patients confirmed its high predictive ability and reliability in use.

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We aimed to study predictive factors for burnout (BO) among healthcare workers in a tertiary hospital in Singapore.

We hypothesized that burnout would be assoiciated with singles, females, and foreign born staff recently moved into this country, unaccompanied by family members.

We further hypothesised that BO would be associated with those scoring less on resilience. Recognising that social support mitigated against stress and burnout, we hypothesized that those who perceived less support would be more prone to BO.

The study questionnaire was sent via corporate email to all staff with email access. We stressed that data would be fully anonymised. No financial rewards were given for participation which was carried out on a voluntary basis.

The following instruments were used, viz. F-SozU K-6, a brief form of the perceived social support questionnaire; Connor Davidson Resilience Scale; Oldenburg Burnout Inventory; Patient Health Questionnaire-4 item; Demand Control Support Questionnaire and Leisure Time Satisfaction Scale. Ethics approval for the study was sought from the SingHealth Centralised Institutional Review Board, which granted exemption of participant consent.

Analyses were performed using Stata version 17.0 (StataCorp. 2021), with statistical significance set as 2-sided 5% (p<0.05). The reliability and internal consistency of the scales used were assessed using Cronbach Alphas and Confirmatory Factor Analysis (CFA).

Neither males nor females were more at risk for BO. And contrary to what we hypothesised those who recently moved to this nation were not at greater risk for BO (p>0.05). Multivariate analyses showed that younger workers displayed higher burnout scores (p < 0.001).The psychological demand sub-score was positively associated with burnout [ 0.61 (95% CI 0.45 to 0.77), p < 0.001)]. Conversely, decision latitude [-0.33 (95% CI -0.44 to -0.21), p < 0.001)] and support [-0.47 (95% CI -0.60 to -0.35), p < 0.001] were negatively associated with BO.

Those who experienced anxiety or depressive symptoms were respectively more likely to experience burnout [0.30 (95% CI 0.02 to 0.58), p = 0.035 and 0.72 (95% CI 0.41 to 1.02), p < 0.001], with a clear association between higher PHQ-4 scores and risk for burnout (r = 0.619).

Moreover, satisfaction with utilisation of leisure time was inversely related to BO [-0.55 (95% CI -0.68 to –0.41; p < 0.001)]. We could not find any association between number of years worked, profession, marital status and perceived social support and BO, on multivariate anbalysis (p>0.05).

Strress reduction interventions should be made available for all staff, especially addressing those at highest risk for burnout.

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The COVID-19 pandemic has significantly affected everyday life in most countries of the world. Researches conducted in 2020 showed that COVID-19 was a traumatic experience for 18-60% of respondents in the general population, depending on the country where the research is conducted. Researches for later periods are rare, although we can expect significant changes. We found only one study from 2023 on this topic, although not on the general population.

That is why we were interested in what the situation is like after 3 years of the pandemic, when we have been living without non-pharmacological anti-pandemic measures for almost a year.

The research was conducted at the beginning of 2023. 48 respondents who were not treated psychiatrically or are medical workers were surveyed, because it was shown that these groups were exposed to a greater risk of impaired mental health during the COVID-19 pandemic. To assess the level of traumatic experience, i.e. the risk of developing PTSD as a consequence of the COVID-19 pandemic, we used the Impact of Event Scale With Modifications for COVID-19 (IES-COVID19). A score on that scale of 27 to 34 indicates a clinically significant level of trauma, i.e. there is a 75% chance of developing PTSD. A result of 35 and above suggests that it is necessary to seek professional help.

Our research included 19 (39.6%) men and 29 (60.4%) women. The average age of the respondents is 60.4 years. 29 (60.4%) respondents know that they have recovered from COVID-19. 2 (4.2%) subjects were treated in the hospital due to COVID-19. 8 (16.7%) respondents have a traumatic experience of the COVID-19 pandemic. 5 (10.4%) respondents are in the category of clinically significant level of trauma, while 3 (6.3%) respondents are in the category that should seek professional help. The group traumatized by COVID-19 does not have significantly more respondents who recovered from COVID-19 (p=0.510) nor does it differ in terms of gender representation (p=0.984).

At the beginning of the COVID-19 pandemic, there were discussions about whether it can even be classified as a traumatic experience and whether we can talk about PTSD as a consequence of the pandemic. With this time lag, it seems that in part of the population we are finding PTSD symptoms that are a consequence of the pandemic, but to a lesser extent than research at the beginning of the pandemic suggested. Certainly, additional research is needed on this topic. Also, it is necessary to examine risk factors for possible prevention, as well as therapeutic possibilities.

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The Covid-19 pandemic has generated an unprecedented impact on multiple levels (health, occupational, economic, and social) which affected the general population and has been an enormous stress factor for individuals with obsessive-compulsive disorder (OCD), particularly for those with contamination symptoms. Many patients, as well as healthy individuals, experienced new obsessive-compulsive-like symptoms centered on COVID-19 during the pandemic. However, data on this population are still scarce.

To present a case exemplifying the association between the Covid-19 pandemic and the onset of OCD.

Case presentation and non-systematic review of existing literature on Pubmed using the keywords: Covid-19, OCD, pandemic, depression.

We report a case of a 30-year-old female who presented to the emergency department due to depressive mood and suicidal ideation associated with exacerbation of OCD symptoms, namely intense fear of being infected with Covid-19. These symptoms led to avoidance of touching objects, surfaces or even herself in addition to frequent and long rituals of hand-washing and showers. She was asymptomatic prior to being infected with Covid-19, when she started developing obsessive ideas of contamination. She sought psychiatric support and was medicated with fluoxetine, olanzapine and clonazepam. Due to insufficient symptom control, she was admitted to the psychiatry ward, where treatment was initiated with aripiprazol and fluvoxamine. After dose titration, gradual remission of OCD symptomatology and depressive mood was observed.

The present case illustrates the correlation between Covid-19 and the onset of OCD symptomatology. Existing studies demonstrate that the pandemic worsened the landscape of symptoms of OCD, both in diagnosed patients as well as in previously healthy individuals. However literature is still limited thus, multinational and cross-cultural, longitudinal studies are warranted to gain further insights on this topic.

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Online group therapy has become more popular in the past few years. But as a result of the COVID-19-caused pandemic, it developed suddenly. Due to the conventional face-to-face format no longer being possible and the need for psychotherapists to conduct psychotherapy online, the pandemic has had significant effects on group psychotherapy and the interactions between group therapy members. While therapists are becoming accustomed to the modern form of psychotherapy, its efficacy is being questioned due to technical issues, the problem of the therapeutic alliance, the environment, the ability to read nonverbal signals, breaking group norms, etc. Since the pandemic did not abate, as a part of specialist education training groups were also held online.

The pandemic changed the basic settings of our Group-Analytic Training Group, forcing us to switch to online sessions. This study aimed to find personal experiences that varied throughout online and face-to-face meetings.

Seven out of the twelve participants accepted to take part in the group therapy/training after it was recommended by the group leader that they write a paper. After 30 sessions, the group turned from face-to-face to online group therapy, and the members were asked how they felt about the difference between the two types of therapy. A questionnaire was produced by the group’s leader and a number of other participants, who then forwarded it through email to every group member.

Everyone who participated thought that because one can more quickly pick up on non-verbal signs in a face-to-face scenario, it was simpler to notice feedback from the other group members. Most participant comments focused on the leader’s role. The majority of members claimed that taking part in the experiential group had benefited both their personal and professional lives.However they thought the in-person setting was better since it was more interesting and complex.

Since there were no other options during the epidemic, group therapy has moved to virtual environments, although there are still a lot of problems to this method. The formation of group cohesion becomes difficult by the absence of group members’ physical presence and by the inability to completely understand nonverbal communication.

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Bipolar Disorders have been consistently associated with cognitive dysfunction across a broad range of cognitive domains (patients, who usually took psychiatric drugs, sometimes presented changes of cognitive disorders). Many studies have focused on improving the illness severity of patients with MDD or BD by combining mood-stabilizing drugs with atypical antipsychotics (AA). However, the results are contradictory and have not confirmed the certain superiority of AA to other therapeutic strategies. Among these, the cognitive remedy has demonstrated important effectiveness on cognitive variations in this group of patients.

In our study, we tried to evaluate some changes in cognitive function in patients with BD treated with antipsychotics related to critical problems with typical cognitive tests.

In our observational study, we recruited forty-three inpatients (20 females, 23 males) affected by Bipolar Disorder (DSM-5 criteria; particularly 78.5% affected by BD-I), in a psychiatric rehabilitation center. All patients were included in the ordinary rehabilitation treatment. All patients were treated with mood stabilizers (lithium n. 14; valproate n. 29), and at least one AA. The AAs have been the following: quetiapine, aripiprazole, and olanzapine (authorized in Italy)(Table 1). The observation period lasted three years, during three significant waves of the COVID-19 pandemic.

All patients at baseline (T0) (March-April 2020), T1 (Maj-June 2021), T2 (April-Maj 2022), and T3 (April – June 2023) were administered the following rating scales: BPRS, YMRS, GAF, and HAM-D

The data were statistically analyzed with the EZAnalyze 3.0 software for the Excel platform.

In Table 2 and Graphic the results obtained with the rating scales and statistical analysis are shown. In BRPS the data shows a statistically significant reduction in the total score in all periods analyzed. Similar results were found in the GAF and YRMS scales. However, with the HAM-D Scale, there was evidence of an increase in T2, although the differences were not statistically demonstrated. The differences in mean scores are more evident for quetiapine and olanzapine.

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Our observational study showed that the atypical antipsychotics used in our work allowed a significant improvement of the symptoms in BD. However, the pandemic waves have no correlation with the treatment performed. New studies are necessary to highlight the relationship of the pharmacological treatment of BD with the progress of the COVID-19 pandemic.

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We present the case of a 48-year-old woman, a nurse, referred from the Internal Medicine department for evaluation of depressive symptoms and accompanying somatic presentation following COVID-19. The aim is to highlight a recently emerging condition that we are increasingly encountering in our clinics, which can complicate the diagnosis of an underlying affective disorder

Diagnosed with COVID-19, confirmed by a positive PCR test, 6 months ago following an infection in the workplace. The clinical picture consisted of mild symptoms, with a ten-day course and apparent resolution at the time of hospitalization. She returned to her work activities and gradually began to report fluctuating symptoms, including headaches, mild shortness of breath, fatigue, as well as a tingling sensation in the upper extremities, especially in the hands. Additionally, she described feelings of restlessness, depressive mood, and intense fatigue. In additional tests: (CT-Scan) there are signs of mild bilateral lower lung fibrosis.

Treatment with Duloxetine was initiated for a case of depressive symptoms with accompanying physical symptoms. The differential diagnosis considered Major Depressive Disorder, Single Episode, and Adjustment Disorder with Depressed Mood.”

We are facing a clear case of depressive clinic that may have endogenous features, if we adhere to criteria such as those in the DSM-5, as it would meet the criteria for Major Depressive Disorder, Single Episode. However, we have a clearly identified trigger, so we also need to perform a differential diagnosis, primarily with Adjustment Disorder with Depressed Mood: here, the symptoms appear within 3 months following the stressful agent (in this case, SARS-CoV-2 infection). Unlike Major Depressive Episode, once the agent has ceased, the symptoms do not persist beyond 6 months (which we do not know because the physical symptoms causing disability have not disappeared).In addition to purely psychiatric diagnoses that we are accustomed to, we must consider a new diagnostic entity that is becoming more prevalent as the pandemic progresses, namely “long-covid” or persistent COVID.These are generally middle-aged women who, several months after infection, continue to manifest a multifactorial complex of symptoms. These symptoms persist over time, not only the classical ones but also many others that can appear during the ongoing course of the disease.

Beyond the purely psychiatric diagnoses we are accustomed to, we must also consider a new diagnostic entity that is becoming more prevalent as the pandemic continues to advance: Persistent COVID or ‘long-COVID.’ Generally, this condition affects middle-aged women who, several months after contracting the virus, continue to exhibit a multifactorial complex of symptoms. The most common symptoms include fatigue/asthenia (95.91%); general discomfort (95.47%); headaches (86.53%); and low mood (86.21%)

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The SARS-COV-2 infection emerging in 2019 caused over 600 million infected people worldwide leading to an explosion of multiple physical and mental health problems. In this study we brought the light to the persistent troubles in sleep and pain among the survivors of the pandemic.

We aimed to assess the prevalence of insomnia and the severity of pain among covid-19 survivors, and to seek an association between the two disorders.

We conducted a prospective cohort study including 121 Tunisian COVID-19 inpatients who had been discharged alive from hospital. Each enrolled patient was asked about the period before the hospital stay, and the 6-9 month-period after hospital discharge, using the visual analog scale (VAS) to assess pain, insomnia severity index (ISI) to evaluate insomnia severity and the mMRC (modified British Medical Research Council) to estimate dyspnea.

The median age of participants was 59 years. Among them, 51.2% were females.

Our findings showed a significant increase in VAS score after COVID infection (1 [IQR (1-2] vs 3[1-6]; p<0.001) as well as with the ISI score (1 [IQR (1-1)] vs 5 [IQR (1-9)]; p<0.0001). The prevalence of insomnia and pain in long haulers was 30.56% and 26.4% respectively.

We found a significant correlation between insomnia and pain (p<0.0001, r=0.398). We also found a significant association between dyspnea and insomnia (p<0.0001) and between dyspnea and pain (p=0.001). The age of the patients was correlated with insomnia (p=0.028) and with dyspnea (p=0.007) but not with pain. Female gender was associated with developing insomnia (p<0.0001) and with pain (p=0.001) but not with dyspnea.

Screening for persistent symptoms after the pandemic is important to help the survivors getting a better recovery in the long term.

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In ordinary circumstances, the employed individuals demonstrate significant levels of psychological distress and presenteeism, a situation that has been further intensified by the COVID-19 epidemic. Furthermore, a limited number of studies have examined the phenomenon of presenteeism in the context of the COVID-19 pandemic, therefore necessitating the undertaking of the present study.

The goal of this study was to investigate the levels of presenteeism and its related characteristics, as well as job satisfaction and psychological distress, among a sample of employees employed at a Private Social Solidarity Institution (IPSS) in Portugal.

A cross-sectional survey was undertaken in 2022 to observe personnel from an IPSS located in the central area of Portugal. The research had a sample size of 71 workers who were provided with a signed authorization. The survey was designed to gather both general and professional information from participants. Additionally, it included the Stanford Presenteeism Scale (SPS-6), the Job Satisfaction Questionnaire (S20/23), and the Kessler Psychological Distress Scale (K10) as measurement tools.

The occurrence of presenteeism was seen in 32 employees, accounting for 45.1% of the sample, whereas illness absence was reported by 38 workers, representing 54.3% of the sample. The majority of the individual assessments for S20/23 demonstrated a higher degree of satisfaction (mean ≥ 4.5 points.), with the exception of the salary-related issue, which elicited a higher level of discontent (mean = 3.36 ± 1.9 pts.). Approximately 50.7% of the individuals had a high or very high susceptibility to experiencing or developing a mental condition. The correlation matrix revealed a statistically significant moderate positive association between presenteeism and work satisfaction, as well as a statistically significant moderate negative link between presenteeism and psychological distress (p<0.01). The associated factors of presenteeism were found to be marital status, quality of sleep, illness absenteeism, health perception, and psychological distress. The combined effect of these predictors was shown to account for 35.8% of the variance in presenteeism.

It is expected that the outcomes of our research will stimulate more investigations into the tangible implications of presenteeism in promoting improved health and well-being within the workplace.

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In Tunisia, the 2019 corona virus pandemic was a challenging health situation, with more than 28 000 confirmed deaths in May 2022. The pandemic was responsible for people losing their beloved ones in a sudden and brutal ways. Even though the numbers of bereaved people had been escalating, little attention was paid toward their mental health. Grief is a normal response to losing someone close. However, recent studies have shown that the covid-19 grief is more severe than other causes of grief. It not only causes a negative impact on the bereaved life aspects but also creates severe consequences in the society. Screening a possible dysfunctional grief is a major need to prevent serious outcomes.

To identify the prevalence of covid-19 dysfunctional grief and find out the possible associated risk factors to it.

A cross sectional online survey designed using Google Forms and distributed on social media platforms (Facebook, Instagram, WhatsApp) was conducted from 16 February 2022 to 05 May 2022. The participants provided information related to socio-demographic data. Covid-19 grief scale was assessed using the pandemic grief scale, which was translated into Arabic but not validated.

A sample of 106 participants were recruited to this study .The sample was composed of Approximately 72% female and 28 % males, most of them were aged between 26 and 35 years old (37.7% ) . Overall, individuals who lost a loved one more than 06 months period were more frequent (81%). 91.7 % of the sample scored above the cut score of 7 on the PGS.

Covid-19 grief was higher among those who sought psychological help (p = 0.02). In this sample, there was no associated risk factors between different socio-demographic characteristics and dysfunctional grief, as well as no correlation were found between period of time since the loss and dysfunctional grief ( rho = 0.186, p = 0.56) .

Although our study did not find a significant high prevalence of dysfunctional grief giving the small number of participants. More studies and screening must be conducted to identify those at risk of developing dysfunctional grief to prevent the serious individual and general outcomes.

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Covid-19 does not only have repercussions on the physical level, representing a new way of life, both individually and in society. The pandemic results in invisible consequences for the population’s mental health.

This study aimed to explore the consequences of Covid-19 on mental health in Portugal with a view to understanding and promoting the well-being and happiness of the Portuguese.

The study included 105 young people and adults, aged between 18 and 59 years (M= 21.81, SD= 5.34), with 43.3% males and 52.7% females. A sociodemographic questionnaire was applied to all participants, as well as the Échelle de Mesure des Manifestations du Bien-Être Psychologique (ÈMMBEP; Massé et al., 1998 - Portuguese translation by Monteiro, Tavares & Pereira, 2012) which translates into a response scale 5-point Likert type, with five subscales, including happiness. In addition, a semistructured interview with data collection instruments was administered.

The results obtained demonstrate the negative impact of Covid-19 on the level of well-being, regardless of the participant’s gender or age.

The data presented point to the need to sensitize individuals to the risk of the pandemic in terms of mental health, thus increasing society’s awareness of the psychological effects of this new global disease. Therefore, coping mechanisms are essential to promote well-being and successfully overcome the pandemic.

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Since December 2019, the coronavirus pandemic has led to the deaths of almost 4.37 million people worldwide and 21,905 people in Tunisia. Containment measures, stress due to fear of infection by the virus and death are likely to be traumatic events, particularly in adolescents, and may lead to the development of symptoms of post-traumatic stress disorder (PTSD).

To determine the prevalence of PTSD in a population of adolescents during the COVID-19 pandemic and to identify the factors associated with it.

This study was a cross-sectional among a representative sample of students enrolled in secondary schools, in the region of Hamma- Gabes. We used a pre-established information sheet comprising 27 questions exploring sociodemographic and family data and specific data relating to the COVID-19 pandemic. The Arabic version of The Child PTSD Symptom Scale (CPSS) was used to screen for PTSD symptoms.

326 adolescents were collected which the mean age was 16.6 years (14 to 18 years). The family environment was conflictual in 11.9% of cases. Among the adolescents, 5.5% had a history of somatic pathology. A history of psychiatric pathology was noted in 0.6%, dominated by depression. Personal infection by Covid-19 was noted in 4% of adolescents. A family member was affected in 27.3% of cases. Adolescents were exposed to the death of a close relative in 22.4% of cases. PTSD was diagnosed (according to the CPSS) in 37.4% of cases, with mild severity in 6.5%, moderate in 0.6%, moderately severe in 8%, severe in 5.2% and extremely severe in 17.2%. The analytical study showed that PTSD was correlated with a conflictual family environment (p=0.017), personal infection by COVID (P=0.003), infection of a close relative by COVID (P<0.001) and the death of a close relative by COVID (p<0.001).

According to our study, the frequency of post-traumatic stress disorder among adolescents during the COVID-19 pandemic was high, underlining the need to screen at-risk populations for populations for early intervention.

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The COVID-19 pandemic has caused psychological distress in all the communities and through all ages. Some people seemed to be less affected and to be resilient because of a dynamic interaction between individual, relational and environmental factors.

We aim on this present study to evaluate the resilience and factors associated with it among a representative sample of Tunisian adolescents during the COVID19 pandemic.

We conducted a cross sectional, descriptive and analytic study among Tunisian adolescents enrolled in secondary schools, in the Hamma region of the city of Gabes during the period extending from 5 March to 26 May 2021. Students were asked to complete a pre-established questionnaire, which contains questions about socio demographic features, medical history and knowledge about the pandemic of covid-19. The Child and Youth Resilience Measure (CYRM-28) was used to evaluate the global resilience and resources contributing to it. The CYRM-28 contains three resources including individual, relationship with primary caregivers and contextual factors. Higher scores reflect higher levels of factors associated with resilience.

A total of 326 adolescents aged between 14 and 18 years old participated on this study (mean age 16.65 years 1). There were 92 boys and 234 girls. In our sample, 4% of adolescents were infected by the Covid-19. The infection of a family member by this virus was noted in 27.3 % of cases. Adolescents were exposed to the death of a family member by Covid-19 in 22.4% of cases. The Global CYRM28 score was 105 ± 22.39. We found that adolescents who had loosen a family member because of the COVID infection, were less resilient than others (100 vs 107; p=0.023). Adolescents with a moderate to low socioeconomic level were less resilient especially with regard to contextual resilience (35, 57 vs 37, 83; p= 0.019). On the other hand, adolescents keeping means of leisure during this epidemic were significantly more resilient especially in the personal resources (p = 0.024).

Our findings conclude to some individual, relational and contextual factors that contribute or alters the process of resilience. Recognizing the strengths and capacities of adolescents would allow the development of programs and resources that can help these young people develop resilience skills.

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The coronavirus pandemic has led to sudden changes in the lives of people around the world. The health threat, earthquakes and epidemiological measures caused certain psychological reactions in everyone. Psychiatric patients are particularly vulnerable to stress, so we were interested in how the changes at the beginning of the pandemic affected their psychological functioning.

To check changes in some areas of psychological functioning of outpatient psychiatric patients after the “lockdown” in 2020 and to examine their connection with some sociodemographic and treatment variables.

Patients of the University Psychiatric Hospital Sveti Ivan filled out a survey questionnaire designed for the purpose of research, which consisted of sociodemographic data and items examining different areas of psychological functioning, when they arrived for an outpatient check-up.

Variables were formed that examine: changes in unpleasant emotions, lack of support, lack of social interaction, changes in performing daily duties, changes in self-help behaviors and health concerns. Statistical analysis showed a significant increase in all variables, with the largest occurring in lack of social interaction, health concerns, and unpleasant emotions. The predictors of changes in psychological functioning were female gender, younger age in combination with cohabitation with parents, and the number of hospitalizations.

After the “lockdown” in 2020, psychiatric patients report a deterioration in psychological functioning.

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