Stevens-Johnson Syndrome is a rare life-threatening condition characterized by severe mucocutaneous epidermal necrolysis and detachment of the epidermis. The condition centers around a delayed-type hypersensitivity reaction with a complex etiology stemming from a variety of causes.

To present the case of a patient with a diagnosis of intellectual disability, bipolar disorder and epilepsy who, 14 days after starting treatment with Cariprazine, presented with pseudovesicular skin lesions suggestive of Steven-Johnson syndrome.

A non-systematic literature review on PubMed database on Steven-Johnson syndrome and other autoimmune processes in patients with bipolar disorder, and the impact on the affective symptoms of the former, was conducted. The clinical case report was prepared through the review of clinical records of the patient.

The authors present the case of a 50-year-old woman, undergoing psychiatric follow-up for more than 30 years with a diagnosis of bipolar disorder. She has a moderate intellectual disability and generalized epilepsy diagnosed at the age of 13. Since the age of 20, the patient has presented clinical manifestations compatible with bipolar disorder.

On a dermatological level, the patient had medical records of hypersensitivity reaction to amoxicillin-clavulanic acid, intolerance to carbamazepine; and toxicoderma and hepatitis after treatment with Lamotrigine, compatible with DRESS syndrome.

At the time of the study, psychopharmacological treatment consisted in valproic acid, lithium and cariprazine (the latter being introduced 14 days earlier). Pseudovesicular and papular skin lesions were observed, with a dianiform appearance and central necrosis.

Prior to the debut of the dermatological condition, the patient showed a decompensation of her bipolar disorder, with escalating irritability, soliloquies, verbosity and hostility towards her parents, with episodes of psychomotor agitation.

After the appearance of the skin lesions, a striking clinical change was observed, with an almost complete remission of affective symptoms, temporally coincident with DRESS syndrome and cariprazine withdrawal.

In recent years, research on autoimmune diseases and their relationship with mental disorders, such as bipolar disorder, schizophrenia and depression, has become increasingly abundant. The conclusions point to the fact that both disorders could be interrelated even at an etiopathogenic level. In this case report, we discuss a patient with a diagnosis of bipolar disorder with an important component of autoimmune response to different drugs, which seems to have influenced the clinical course of the mental illness.

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Several factors related to the risk of requiring psychiatric hospitalization have been described in patients diagnosed with schizophrenia treated with methods other than home treatment. With regard to the symptoms, high global illness severity and positive symptoms of schizophrenia have been most frequently related to the risk of hospitalization in patients with schizophrenia. However, there are no studies describing which clinical factors increase the likelihood of being hospitalized while undergoing home follow-up.

To determine which of the clinical factors assessed in the PANSS predict the risk of hospitalization in patients diagnosed with schizophrenia following a home treatment program.

All patients with schizophrenia who were visited by a home treatment team in Barcelona between January 2017 and December 2021 were included in the study. A comparative, bivariate analysis of each item of the PANSS and of the global results of each category was conducted on those who were hospitalized and those who were not hospitalized. Finally, a logistic regression of each category of the PANSS was done on both groups, controlling for other socio-demographic and clinical factors.

A total of 1045 patients with schizophrenia were evaluated in this study. PANSS positive symptom subscale (PANSS-S), PANSS General Psychopathology, PANSS Excited Component and PANSS Global Score scored higher in patients who were finally hospitalized in a conventional acute treatment unit. Regarding the PANSS negative symptom subscale, no significant differences were found between the two groups.

In patients who required hospitalization, the scores of all the PANSS positive symptom subscale (PANSS-P) items and all items on the PANSS excited component (excitement, tension, hostility, uncooperativeness and poor impulse control) were significantly higher. Some items regarding general psychopathology (Somatic concern, anxiety, guilt feelings, tension, and mannerisms) were also significantly higher in the hospitalization group. Only 3 items—blunted affect, guilt feelings and motor retardation—scored significantly higher in patients who did not require hospitalization. In the logistic regression, only the global score of the PANSS-P reached statistical significance (P = 0.001).

Positive symptoms scored in the PANSS seem to be the most predictive factors of hospitalization regarding clinical symptoms in patients with Schizophrenia following home treatment. Other items regarding exciting symptoms and general psychopathology also showed as relevant regarding the risk of conventional hospitalization in those patients.

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Substance abuse is common among patients with schizophrenia, is related toworse course and outcome of illness. Unfortunately, little is known about how substanceabuse affects the cognitive function of schizophrenia patients, whose cognitive function isoften already comprised. Neurocognitive functioning includes inhibition control and decision-making, and both schizophrenia and substance use disorder are related to impairmentsof inhibition control. However, the influence of substance abuse on inhibition capacitiesamong schizophrenia patients is unclear

This study measured the influence of substance use disorder on inhibition capacities and risky decision-making in a group of 39 schizophrenia patients that were evaluated using a socio-demographic questionnaire and clinical assessment using the Positive and Negative Syndromes Scale for Schizophrenia. To assess inhibition control we utilized the Matching Familiar Figure Test (MFFT) and the Stroop task, and to evaluate decision-making we used the Iowa Gambling Task (IGT) and self-report questionnaire, the Barratt Impulsiveness Scale

Univariate analysis found significant differences between the groups with regard to criminal history (v2¼5.97, p¼.015), smoking status (v:12.30, p<.001), and total BIS score (t: 2.69, df¼37, p¼.01). Our model did not find a significant effect of substance abuse on the first response time and number of errors on the MFFT or in the total interference index of Stroop performance and net score on risky decision-making in the IGT.

The two groups did not differ significantly either in first response time or in number of errors on the MFFT (F¼0.54, p¼.47, d¼0.24, 95% CI [-0.4, 0.88]; F¼0.28, p¼.60, d¼0.61, 95% CI [0, 1.26], respectively), nor did they differ in the total interference index of the Stroop task (F(1)¼0.49, p¼.49, d¼0.25, 95% CI [-0.38, 0.88]).

The analyses did not detect any statistically significant effect of substance abuse on inhibition control or risky decision-making processes in outpatients diagnosed with schizophrenia, despite increased impulsivity, criminal history and smoking status. These results neither support nor disprove previous findings.

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Only two out of three patients diagnosed with First Episode Psychosis (FEP) achieve symptom remission after the administration of two different antipsychotics, illustrating the high prevalence of treatment-resistance in FEP. Of those, 84% are treatment-resistant since illness onset. Response to initial treatment is one of the main long-term illness course predictors. The only medication approved for treatment-resistant psychosis is clozapine and studies have demonstrated its superior antipsychotic effect among this drug class.

The aims of this communication are to describe a clinical case of FEP with symptom remission achieved only with clozapine and to review the literature regarding the pattern of clozapine use in FEP, the main difficulties of implementing it and its impact on the prognosis of this patients.

Relevant data from the patient’s medical record were collected. Pubmed database was searched using the terms “clozapine” and “first episode psychosis”.

A 50 year old woman without previous contact with psychiatric services was taken to the emergency room following behavioural disorganisation and heteroagressive conduct. Poisoning and referential delusions, as well as alienation of personal action and elementary auditory hallucinations were found and the patient was admitted in the psychiatric unit. She began treatment with Aripiprazole without therapeutic benefit and a switch to Paliperidone was made, with the same result. Clozapine was then titrated to a dose of 100mg/day, with resolution of all the positive symptoms mentioned above and she acquired total insight to the disease and need for treatment, being discharged with a diagnosis of schizophrenia. 9 articles, all from 2017 onwards, were collected from the Pubmed database.

There’s reluctance in prescribing clozapine in treatment-resistance FEP. This is evidenced by the mean number of antipsychotic prescribed before clozapine - 2.74 to 4.85 - as well as the delay on its prescription - 294 to 2447 days - and its prescription to only 16% in a cohort of patients with FEP. The main reasons for this hesitation are the serious, albeit rare, side-effects, such as agranulocytosis and myocarditis, as well as the difficulty in implementing it in community services, with mandatory weekly blood tests and very slow titration of the drug and treatment compliance issues, making it a very resource-consuming drug. However, in that same cohort, there was a significant reduction of the number of admissions, re-admissions and duration of hospitalisation, highlighting the need for earlier consideration in treatment-resistant FEP. The identification of treatment-resistance should then be proactive by the mental-health services, ensuring an earlier clozapine initiation with the goal of greatly improving the prognosis of these patients

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With a growing number of elderly persons, geriatric depression - associated with important morbidity and mortality- is becoming a significant health problem. Given the risk of polypharmacy and increased side effects, alternative non pharmaceutical treatments such as repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) may be solution. Recently, the FDA approved deep brain TMS (dTMS) for depression, not only stimulating deeper cortical areas but response and remission rates may be better, especially in elderly populations. Nevertheless, beneficial follow-up options following rTMS treatment remains to be determined. Therefore, one week after the last accelerated dTMS, all patients followed a 3 week open label tDCS with a home-use device. Study rationale and preliminary findings will be discussed.

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The pathogenesis of mental disorders occurring during the coronavirus pandemic 2 (SARS-COV-2) includes biological and psychosocial factors. Psychopathological consequences associated with the coronavirus disease COVID-19 may occur in different groups of individuals, including patients with a history of COVID-19 and patients with psychiatric disorders preceding COVID-19.

To investigate the peculiarities of the initial psychopathological manifestations in patients with newly diagnosed mental disorders who suffered from COVID-19 and were exposed to the stressors of the SARS-CoV-2 pandemic.

The study involved 97 patients with newly diagnosed mental disorders who suffered from COVID-19 and were exposed to the stressors of the SARS-CoV-2 pandemic (F 32.0-32.2 – 34 patients, F 40-45 – 32 patients, F 06.3-06.6 – 31 patient). The average age of the examined group was 44.82 ± 5.64 years. Clinico-psychopathological, psychodiagnostic, statistical methods were used.

In the structure of initial psychopathological manifestations detected in patients, the following prevailed: with depressive episodes - weakness and fatigue / asthenia ((87.50 ± 5.94) %), low mood / depression ((71.88 ± 8.07) %) and sleep disturbances ((65.63 ± 8.53) %); with neurotic, stress-related and somatoform disorders – weakness and fatigue / asthenia ((72.73 ± 7.87) %), decreased concentration of attention, memory / cognitive disorders ((66.67 ± 8.33 ) %) and feeling of inner tension ((60.61 ± 8.64) %); with mental disorders of organic genesis – a feeling of internal tension ((75.00 ± 7.78) %), anxiety ((62.50 ± 8.70) %) and weakness and fatigue / asthenia ((59.38 ± 8 .82) %).

In patients with depressive episodes, initial psychopathological manifestations in the form of asthenia, low mood, cognitive disorders, and sleep disorders were detected in a significantly greater number of cases compared to patients with mental disorders of organic genesis (р < 0,05). In the examined subjects of this subgroup, initial psychopathological manifestations in the form of a decrease in mood were recorded in a significantly greater number of cases compared to patients with neurotic, stress-related and somatoform disorders (р < 0,05). In patients with neurotic, stress-related and somatoform disorders, initial psychopathological manifestations in the form of anxiety, fears and obsessions were noted in a significantly smaller number of cases compared to those examined with mental disorders of organic genesis (р < 0,05).

The obtained data will make it possible to improve the effectiveness of diagnosis and therapy of mental disorders, the formation, course and clinical picture of which were affected by the coronavirus disease COVID-19.

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In the last ten to fifteen years, it has become common for researchers to collect both quantitative (Sue & Ritter, 2012) and qualitative data (Jowett, Peel, & Shaw, 2011) online. The Covid-19 pandemic has increased the importance of this process and accelerated it in many disciplines (Torrentira, 2022).

In addition to convenience, recent work suggests that online data collection may be more valid than face-to-face data collection for some populations. This would mean that online data collection may be the most valid and effective for this age group (Barratt, 2012).

Adolescents with an eating disorder tend to be more open about their symptoms via impersonal online data collection than they are in a face-to-face conversation. Symptom underrating has been documented in face-to-face interviews, because “of feelings of shame elicited by the loss of anonymity during face to-face interviews” leading to face-to-face denial, whereas a self-report questionnaire allows for more privacy and hence honesty while answering questions (Berg et al. 2011). This is especially key in the diagnosis of Anorexia Nervosa (AN), as AN patients minimize, deny, and/or fail to recognize their symptoms (Passi, Bryson and Lock 2003).

Given the benefits of collecting data online for both researchers and participants, it is important to determine the quality of the data collected online to guide its use and interpretation. More evidence is needed to confirm the equivalence of online and face-to-face interview data. The current study examines the equivalence of semi-structured interview data collected online versus original face-to-face interviews.

The Eating Disorder Examination (EDE), assessing psychopathology of eating disorders, was administered to 49 adolescents meeting ICD 10 criteria for anorexia nervosa or atypical anorexia nervosa. The same diagnostic interview was administered twice, once via face-to-face and once as an online version, within a week. Method order was counterbalanced among participants and temporal stability was controlled. The Eating Disorder Inventory-2 (EDI-2) was used as a control variable.

Both the equivalence test and the null hypothesis test were significant for the sum score of the EDE. Measures of psychopathology in eating disorders demonstrated equivalence across face-to-face and online format of the EDE.

The aim was to examine the equivalence of face-to-face and online methodologies, controlling for temporal change in the variable under investigation over one week and order of administration. Results demonstrate equivalence across face-to-face and online format of the EDE. These findings suggest that data obtained using EDE online can be interpreted in comparison with normative data obtained in the face-to-face Interview and that corrections trough transformations are not necessary.

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One of the subtypes of schizophrenia is the deficit syndrome (DS). Because of different risk factors, course, response to treatment weak prognosis, researches on this group of patients are important. Etiology of schizophrenia is often hypothesized as the inflammation process. Due to the imbalance of certain cytokines (interleukin-10 (IL-10) -antyinflamation cytokine, among others) changes in the function and structure of central nervous system may occur. That process could stand behind the outbreak of psychotic and deficit symptoms of the illness. Subinflammation can have an impact on the white matter structure. Disturbances in this area can cause impairment of cortical communication and hence, produce psychopathology. One of the structures that seem to have the basis of the deficit syndrome isinferior longitudinal fasciculus (ILF). ILF is a bundle of association fibers with interconnects temporal cortex with ocapital cortex.

The aim of our study was to investigate a relationship between the integrity of ILF and interleukin – 10.

39 schizophrenia subjects divided into two groups DS (16) and non-deficyt sydrome (NDS) (23) and 18 healthy controls (HC) participated in the study. A DTI analysis was performed on all study participants. The psychopathology of schizofrenia was assessed using the Positive and Negative Syndrome Scale (PANSS). The ILF analysis was then conducted using fractional anisotropy (FA) and mean diffusivity (MD) parameters. Blood samples were obtained to analyze serum level of IL-10 level.

The differences in FA value in left ILF between DS and HC group were confirmed. The difference in values of IL-10 between groups were not confirmed. A negative correlation was found between FA values in left ILF and IL-10 (p = 0.033) among DS group.

The imparment of the structure of ILF may be involved in ethiopatogenesis of DS. Moreover, changes in IL-10 levels may be related to the microstructure of ILF bundle.

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ASD is a multifactorial disease. They arise from the interaction of various genetic and environmental factors. These factors affect specific neuronal circuits, oxidative stress, neuroinflammation, mitochondrial dysfunction. This disrupts the development of the nervous system, the formation of synapses, the connection between brain regions, and the size of the brain. Almost 80% of patients with ASD suffer from mitochondrial dysfunction. Therefore, mitochondrial dysfunction plays a crucial role in the pathogenesis of ASD.

Deficiency of adenosine-triphosphate (ATP) and abnormal levels of Reactive oxygen species (ROS) cause mitochondrial dysfunction in ASD. This leads to metabolic disorders, disorders of synaptic plasticity and disorders of the immune response

The negative association between pathogenic mtDNA mutations and IQ is specific for children with ASD / MD. The overall prevalence of these abnormalities is 1.2 times higher in ASD / MD. ASD, researchers reaffirm that autistic probands carry the burden of mutations in mtDNA, especially mutations that are prone to deleterious effects on OXPHOS. According to a number of researchers, all children with ASD should be screened for MD, given: the high prevalence of abnormal markers of mitochondrial function in ASD compared with the control group; relatively high prevalence of MD in ASD; some children with ASD who have MD may be phenotypically indistinguishable from typical children with ASD; the potential clinical significance of MD in children with ASD.

According to a number of researchers, all children with ASD should be screened for MD, given: the high prevalence of abnormal markers of mitochondrial function in ASD compared with the control group; relatively high prevalence of MD in ASD; some children with ASD who have MD may be phenotypically indistinguishable from typical children with ASD; the potential clinical significance of MD in children with ASD.

The pathophysiological mechanisms of ASD are multifactorial. They are largely unclear. But the mitochondrial hypothesis of the pathogenesis of ASD is being clarified. Mitochondrial dysfunction has been identified as a hallmark of diseased neurons in ASD patients, suggesting a critical role for mitochondrial dysfunction in the pathogenesis of ASD and allowing the development of ASD correction by normalizing mitochondrial functions.

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People consume and abuse alcohol for varied reasons. Problematic alcohol use is associated with mental and physical health risks, while people exposed to multiple traumas may be more vulnerable to abusing alcohol.

To evaluate the prevalence and predictors of self-reported alcohol abuse among residents of Fort McMurray and explore the correlates of self-reported alcohol abuse with some mental health conditions.

A cross-sectional study adopted an online questionnaire. Sociodemographic data, trauma exposure, and clinical characteristics were collected to identify the predictors of self-reported alcohol abuse. Data were analyzed using SPSS version 25 using cross-tabulations and logistic regression analysis.

Two hundred and forty-nine individuals received the survey link, of which 186 completed the survey, with a response rate of 74.7%. Most participants were females exposed to COVID-19 and either wildfire or flooding traumas. The prevalence of self-reported alcohol was 27.4%. Participants who desired mental health counselling were likely to self-report alcohol abuse (OR=3.017; 95% CI: 1.349-6.750). There was a significant association between self-reported alcohol abuse and self-rated moderate to high depression (X 2 = 4.783; p = 0.033) and anxiety symptoms (X 2 = 4.102; p = 0.047), and suicidal ideations or thoughts of self-harm (X 2 = 13.536; p = 0.001).

Self-reported alcohol abuse is correlated with suicidal ideations, the desire to receive mental health counselling, and anxiety and depression symptoms. Therefore, initiatives to minimize mental health disorders are crucial to reducing alcohol abuse and promoting health among vulnerable populations.

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The comorbidity of mental and physical disorders is gradually becoming recognized as a major problem for health care. Its public health importance is vast and growing for a variety of reasons including the extension of life expectancy, the imperfection of currently available treatments of mental and many physical disorders and the tendency of fragmentation of medicine into ever more limited specialties. The problems related to comorbidity are also rapidly increasing in low- and middle-income countries where in addition to the issues mentioned above there is also a scarcity of means to deal with them.

The presentation will remind the audience of the complexity of the problems and draw attention to action that could be taken by public health authorities and the medical profession in the areas of teaching, organization of service and research.

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Transsexuality is a form of gender identity, where persons experience a strong dysphoria or dissatisfaction with the original sexual organs and body they are born with, and believe that they belong to the opposite sex -- so many of such persons undertake sex reassignment surgery. Correlates of transsexuality do not suggest causality but they make it possible to better understand transsexuality and its etiology.

It has been shown by previous studies that some signs of transsexuality begin to emerge well before puberty. In our study we wanted to track how transsexual individuals develop from early childhood through adolescence and young adulthood regarding their preferred childhood games and toys, dressing and activities, later sexual partners and social responses to their trans identity.

59 persons participated as volunteers, who have applied to sex-reassignment surgery and the psychiatric evaluation necessary for the surgery, completed a spontaneously written life narrative as an argument for receiving psychiatric approval for the surgery at the Clinique of Psychiatry and Psychotherapy at Semmelweis University, Budapest, Hungary. Narratives were content-analyzed and coded regarding signs of transsexuality occurring in early childhood, elementary school-age, and puberty, conflict with friends, and family, sexual life, and love-life. All participants have signed the informed –consent form, and agreed to the scientific use of their data. The study has been approved by the local ethical committee.

Our results show that there were 24 female-to male, and 35 male-to female transsexual participants in our sample. 45.7% wanted to dress in clothes of the opposite sex in early childhood, whereas only 1.4% said that he/she did not. 41.4% befriended children who were members of the opposite sex, rather than befriending members of the same sex (4.3%), both (7.1%) or none (4.3%). As a young child 55.7% claimed that they preferred toys and games of the opposite sex, whereas 7.1% claimed they did not. The reaction of their families to signs of transsexuality or unusual behavior was supportive, rejecting, indifferent, or mixed in about equal proportion. In elementary school they befriended members of the opposite sex in 37.1% of the time, whereas they befriended members of the same sex in 1.4% of the time, and did not have friends in 22.9%. In elementary school they preferred activities included those of the opposite sex in 45.7%, and they wanted to dress in clothes of the opposite sex in 54.3% of the cases. In adolescence 10% rejected their biological sex, 40% not merely rejected, but desired the body of the opposite sex, and 25.7% was thinking about body/sex alteration procedures.

We can conclude that signs of gender dysphoria emerge in early childhood, and transsexuality may be characterized and anticipated based on such early signs by parents and care takers.

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Non-Medical Use of Anxiolytics (NMUA) and sedatives is a focus of scientific interest worldwide. In Tunisia, no national epidemiological data related to this issue, are published.

We aimed to determine the prevalence of NMUA in Tunisian adolescents and assess specificities from a gender scope.

Data from the 2021-Mediterranean school Survey on Alcohol and other Drugs (MedSPAD) were used. Based on random sampling method (three-stage stratification), high school teenagers in first and second year of secondary education, were enrolled. Data were collected using a self-administered standardized questionnaire assessing socio-demographic characteristics, and specific questions related to NMUA (among adolescents and close environment), perceived accessibility and initiation age. We studied weighted prevalence estimates of NMUA at least once in a lifetime, presented with 95% Confidence Interval (CI). Epi data software was used for data entry and statistical analysis was performed with STATA software.

The survey included 6.201 adolescents with a mean age of 16.8 years and sex ratio F/M equal to 1.5. Only half of surveyed adolescents, perceived accessibility to NMUA as “impossible” and almost 20% had at least one family member or friend using a nonmedical prescription of anxiolytics. The overall prevalence of NMUA was (8.4%; 95% CI [7.6-9.2]), significantly higher among girls (9.8% Vs 6.1%, p-value<10-4). Initiation age was over 13 years for almost 70% of consumers.

Our study highlighted high prevalence of NMUA, mainly among girls. Although COVID mental health impact might have a role in explaining our findings; however, decisions makers should be aware of non-medically prescribed anxiolytics accessibility especially among this vulnerable population. Audit prescription monitoring programs should be reinforced, and multisectoral collaboration should be reinforced to promote adolescents mental well being and avoid falling into addiction trap.

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The Werther effect is a phenomenon that has been demonstrated in the media. These media are being replaced by social media, the use of which has increased greatly over the decade especially among young people, allowing content to be streamed instantly and fostering connections around the world. At the same time, there is a deterioration in mental health among young people.

To know if there is a Werther effect on social networks, as well as to understand the relationship between this effect and social media. It was also wanted to know if the posts follow the guidelines for dealing with suicide if there are differences between types of social media and if this effect is observed after the death of celebrities.

A systematic review was performed with analysis, data extraction and synthesis of the structured results following the PRISMA criteria.

15 articles were included, 11 of which showed Werther effects on social media, while only 4 were unrelated. It was found that most publications did not follow the recommended guidelines. No differences were observed between social media, while a greater effect was observed when it was related to celebrity suicide.

Social media can act as a suicide support network, as it is a space where there is a risk of infection by normalizing suicide and treating it insecurely. However, it has also been shown that it can act as an agent of change and protection, as many public individuals on social media seek help and express their concerns. More studies are needed to know the magnitude of the Werther effect on social media and to know the potential benefits of talking about suicide if it is done safely.

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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.

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Immunological mechanisms may contribute to the causation of mental illness. Autoimmunity is most convincingly shown for anti-NMDA-R encephalitis and Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS); disorders that overlap clinically with schizophrenia and OCD. Altered inflammatory cytokine production, glial activation and auto-antibodies have also been associated with schizophrenia and OCD. In these disorders, however, the treatment results with anti-inflammatory or immunomodulating drugs have hitherto been limited and inconsistent. Yet other targets within the immune system may still be effective and new options are warranted for treatment-resistant patients. Rituximab targets B-lymphocytes and is often used in autoimmune disorders such as rheumatoid arthritis, multiple sclerosis and anti-NMDA-R encephalitis.

We aimed to investigate whether rituximab is clinically effective, safe and tolerable as add-on therapy in markedly ill, treatment-resistant adult psychiatric patients with schizophrenia or OCD. We also wanted to identify putative mediating mechanisms in treatment responders, such as cytokine changes and functional connectivity (FC).

In an open pilot study, adults (18-39 years) with treatment-resistant schizophrenia and/or OCD were included. They received an intravenous infusion of rituximab 1000 mg, once at baseline, in addition to their regular psychiatric medication and were followed for 1 year. The main outcome measures were the Positive and Negative Syndrome Scale (PANSS) or Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Clinical Global Impression-Improvement scale (CGI-I) and the Personal and Social Performance scale (PSP). Treatment response was defined as ≥ 40 % decrease in PANSS or ≥ 35 % decrease in Y-BOCS, and much improved according to CGI-I. Resting-state fMRI was applied at baseline and after 5 months. Plasma cytokines were measured at 0, 3 and 5 months. Cognitive tests and the recently developed PsychoNeuroinflammatory Related Signs and Symptoms Inventory (PNISSI) were used to identify and measure symptoms related to neuro-inflammation and cognitive function.

Nineteen patients were treated with rituximab. 3-5 months after treatment, 6/9 patients with schizophrenia and 1/10 with OCD responded. One schizophrenia patient continues with rituximab every 6 months and has reportedly done well for almost 3 years. No severe side effects were reported apart from recurrent abdominal pain in a schizophrenia patient and one case of post-COVID-19 syndrome. Significant changes of FC were detected in responders only and correlated with PSP changes.

Aberrant B-cell activities may contribute to treatment-resistant schizophrenia and be amenable to treatment with rituximab. However, the results of this pilot study need confirmation in placebo-controlled trials.

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Bipolar disorder (BD) is a common psychiatric condition. However, it is underdiagnosed. Electroencephalography (EEG) has been proposed as a neurophysiological biomarker to delineate psychotic disorders.

To compare the EEG tracings of patients with BD with those of normal subjects to aid in diagnosis.

This was a cross-sectional, descriptive, and analytical case-control study conducted with patients followed for BD in the psychiatry "C" department at the Hedi Chaker hospital in Sfax. Patients were assessed by the Young Mania Scale (YMRS), the Hamilton HDRS-17 Scale, and the Medication Adherence Report Scale (MARS). Healthy controls were included. All participants benefited from an EEG. It was undertaken in resting eyes closed testing conditions at the service of the functional exploration at the Habib Bourguiba hospital in Sfax. The powers of each band were measured using the power spectral density method called absolute power (AP). Statistical analyses were carried out.

Fifteen bipolar patients and 15 healthy controls, all male, were included. The average age of bipolar was 36.07 ± 10.50 years. The one of health control was 47.93 ± 15.61 years. There were no significant differences in age between bipolar patients and healthy controls. The mean scores on the HDRS-17 and YMRS and MARS scales were 2.73±2.08, 1.67±3.53 and 5.8±2.83 respectively.

At the quantitative EEG, differences appeared to be insignificant. There was an overall decrease in AP for alpha band particularly in the parietal and occipital lobes in bipolar patients (158,84 ± 447,71 μV2 and 188,21 ± 415,55 μV2 respectively) compared to controls (335,15 ± 994,73 μV2 and 400,24 ± 1109,95 μV2 respectively). An overall increase in AP for delta and beta was found for bipolar patients compared to controls.

Our main finding was a higher delta and beta frequency activity, and lower alpha frequency activity in bipolar patients compared to controls, which may aid in the diagnosis of this disorder.

None Declared

Eye Movement Desensitization and Reprocessing (EMDR) is a powerful psychotherapy approach developed by Francine Shapiro in 1987 when she realized that rhythmic eye movements reduce disturbing thoughts. The effectiveness of the therapy has been proven by many studies after its discovery. EMDR, which was initially used only in the treatment of Post Traumatic Stress Disorder, has become a treatment option used in the treatment of psychiatric disorders of more than 2 million people today. EMDR, which is used today, contains elements from many therapy schools andconsists of a phased protocol (Shapiro, 2018). Increasing evidence acknowledging the relationship between trauma and psychosis indicates that EMDR can be a vital addition to the treatment of psychosis (Sin & Spain, 2017; Valiente-Gomez et al., 2017). However, the effect of EMDR on psychosis has not yet been sufficiently clarified. There is alsoIt has not yet been clarified whether the curative effect on the psychotic symptoms or on the anxiety symptoms.For this reason, in our study, the effect of EMDR on these symptoms will be investigated by comparing the case and control groups.

This study aims to evaluate the effect of EMDR therapy on post-traumatic stress symptoms, schizophrenia symptom severity and anxiety level in psychotic patients with at least one traumatic event.

This study is a randomized controlled, prospective follow-up study aiming to evaluate the effect of EMDR therapy on post-traumatic stress symptoms, schizophrenia symptom severity and anxiety level in psychotic patients with at least one traumatic event.Written informed consent to participate in the intervention study will be requested from all patients who meet the inclusion criteria. Consent participants receive pre-treatment (T0) measurements. After T0, participants will be randomized to EMDR or waiting list Participants will be randomly assigned to 26 people in each group. These groups will be made by the independent randomization bureau of the Parnassia Institute of Psychiatry using the scientific randomization program on the Internet (www.randomizer.org).

The effects of EMDR therapy on posttraumatic stress symptoms, schizophrenia symptom severity and anxiety level in psychotic patients were obtained from pretest and posttest measurements.

More studies are needed on the effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) therapy.

None Declared

Major depressive disorder (MDD) is a common and severe mental disorder. Although inpatient care may be needed in some cases, little is known on which factors are associated with risk for readmission.

To identify risk factors associated with an increased risk of readmission within 90 days, after being discharged from psychiatric inpatient care for depression.

A medical record review is ongoing based on consecutive inpatients admitted in 2019-2021 at Sahlgrenska University Hospital, in Sweden. Inclusion criteria are MDD-diagnosis, admission > 7 days, no admission during the past half-year. Exclusion criteria are blocked medical record, patients who expired within 90 days after discharge. Time to first readmission for discharged patients was examined within 90 days. Clinical and sociodemographic characteristics were compared between readmitted and no-readmitted patients.

To date, 446 cases have been included with a readmission rate of 19.5%. In a subgroup of 182 patients (admitted between April 2020 and March 2021), psychotic subtype of depression seems to be protective to re-admission (p < .003) while comorbid eating (p < .017) and neurodevelopmental disorder (p < .029) seem to be associated with high risk. At the congress, results from the whole cohort will be presented.

Medical record reviews can give good clinically relevant data for prediction of readmission. Comorbidities and depression subtypes may affect the risk for readmission.

None Declared

Occupational exposure to organic solvents can have multiple health effects for exposed employees.Neuropsychic effects represent an important part of these effects and have a significant impact on patients’ ability to work

• - To describe the socio-professional and medical characteristics of workers exposed to organic solvents

• - To screen among the study population for neuropsychological effects related to an organic psychosyndrome using the Q16 questionnaire.

A retrospective descriptive study of workers exposed to organic solvents, who were referred to the occupational medicine department of Charles Nicolle Hospital in Tunis for a medical assessment of their fitness for work over the period from 2016 to 2022. The socio-professional data were collected from the medical records. The Swedish Q16 questionnaire in its French version was used to screen for neuropsychological signs of organic psycho-syndrome.

A total of 37 workers were included. The mean age was 45.38 ± 8.63 years with a clear male predominance (77%). The mean occupational seniority was 21.39 ± 11.11 years. The average duration of the occupational exposure to organic solvents was 18.25 ± 11.29 years. The most represented sectors of activity were the plastics industry (11%), the automotive industry (19%), the carpentry sector (14%) and the aeronautics sector (9%). Our population was represented by polyvalent workers in 49% of cases and by painter in 24% of cases. Psychiatric history was noted in only one case. The main functional signs reported by the workers were wheezing dyspnea with breathing difficulties (13%) and headaches (11%).

The Q16 questionnaire was found to be positive in 65% of the cases, with a higher rate of positivity for the items relating to unusual fatigue (73%), irritability for no particular reason (67%), short memory (64%) and headaches (58%). Acquired dyschromatopsia detected by a Lanthony test was found in 39% of the cases, 23% of which was associated with a positive Q16 questionnaire. Additional exploration by specific psychotechnical tests was carried out in five cases, all of which came back positive with significant attentional and cognitive impairment.

A declaration of an occupational disease according to the Table n°23 (Halogenated derivatives of aliphatic hydrocarbons) and Table n°40 (other liquid organic solvents for professional use) of the Tunisian list of occupational diseases eligible for compensation was made in three and two cases respectively. A definitive exemption from exposure to organic solvents was indicated for all workers with a positive Q16 questionnaire.

Exposure to organic solvents is a risk encountered in various occupational sectors. Thus, education of the employees to the dangers encountered with a reinforcement of the collective and individual technical protection means are essential in order to avoid their detrimental effects on health.

None Declared