The study period to become a medical professional is notoriously stressful This label can be attributed to various factors like long tedious training, social expectations, long work hours, high liability, sleep deprivation, and a constant lack of time to relaxin this vulnerable area, physical appearance, either weight loss or obesity, can affect the mental health of these young people.

To determine the role of body mass index (BMI) on the levels of perceived stress in medical students.

Our study was descriptive and analytical cross-sectional, carried out with medical students in the faculty of medicine of sfax (Tunisia) during October 2022.

An anonymous survey was asked to the students.

Data collection was done by a self-administered questionnaire via Google Forms administered in the students’ Facebook groups. The questionnaire was composed of a part for the collection of socio-demographic data and a psychometric scale:

• - Cohen’s Perceived Stress Scale (PSS) to determine the level of stress

A total of 95 responses was collected.The average age of our sample was 25.8±3.4 with female predominance (78,9%).

The half of the population (53,7%) were residents in medicine.

The majority of them (88,4%) had an average socio-economic level and singles (83,2%) .

81,1% had a stressor related to studies in 50,5%,to family in 40 % and financial in 9,5%.

Tobacco consumption were reported by 14,7 % .

A psychiatric history was reported by 17.9% of the students, 76.5% of whom are anxiety disorders.

27.4% tried to control their weight. Several methods of weight control were used, the most frequent (65.4%) was diet, none resorted to laxatives and 8.4% consulted a nutritionist.

Almost half of the population (57,9%) slept between 5 and 7 hours.

The average body mass index was 23.64 kg/m2 (SD=3.53).

According to PSS scores, 21.1% of students had severe level of stress, 69.5% had moderate stress level while 9.5% had low level of stress.

Those followed in psychiatry had a higher level of stress (p<10-3), especially those with anxiety disorder (p=0,02).

The students pressed for weight control were more stressed than their peers.

The levels of stress were higher among underweight students (BMI < 18.5) and overweight students (BMI >25) without significantly correlations.

The current study revealed that medical students, especially underweight or overweight students, are more susceptible to develop stress symptoms,that is why psychic support must be available on their university.

None Declared

Psy-Flex is a brief instrument that assesses psychological flexibility defined, according to the theoretical model of Acceptance and Commitment Therapy, by the set of competencies capable of leading the individual to change behavior, facilitating behaviors that are more adaptive and valued by the individual. This set of psychological skills involved in psychological flexibility is associated with psychological well-being and mental health.

The present research sought to translate and adapt Psy-Flex to the Portuguese language and, consequently, to conduct the factor analysis, reliability, and validity studies of this instrument in the Portuguese population (in non-clinical and clinical samples)

The non-clinical sample consisted of 566 individuals (372 female and 192 male) ranging in age from 18 to 74 (M = 36.64; SD = 15.11). The clinical sample included 30 participants aged between 20 and 69 years (M=43.13 and SD= 13.85). The minimum number of years of education is 4, and the maximum is 19 (M=11.80 and SD=3.32). The non-clinical sample was filled out on an online platform the protocol that assessed psychological flexibility (Psy-Flex), Psychological Inflexibility and Flexibility (MPFI-24), anxiety and depression symptoms (PHQ-4), and perceived mental health (MHC-SF). In the clinical sample, the protocol was applied individually and face-to-face.

Psy-Flex evidenced a unifactorial structure attested to by EFA and CFA. Invariance tests revealed the Psy-Flex model to be invariant in configural, metric, and scalar terms for male and female gender and non-clinical and clinical samples. The Psy-Flex revealed adequate reliability as assessed by Cronbach’s alpha and Composite Reliability in non-clinical and clinic samples. In non-clinical sample, the Psy-Flex showed a positive, moderate to strong, association with flexibility (measured by the MPFI-24-FP) and mental health. It also showed a negative, moderate to strong, association with MPFI-24-IP assessed inflexibility and with depression and anxiety symptoms. Age and years of schooling showed a weak positive association with Psy-Flex. Men and women differed significantly, with men showing higher values of psychological flexibility. Psy-Plex showed discriminant validity, differentiating between non-clinical and clinical groups. The non-clinical group showed significantly higher values of psychological flexibility.

The present study was innovative in making available a new instrument in the Portuguese language that revealed excellent psychometric characteristics that could be used in community and clinical samples. It also allows the evaluation of efficacy studies of interventions that aim to promote psychological flexibility.

None Declared

Restricted visitations of family members of persons with mental illness in psychiatric hospitals which may occur during times of public health crises such as the COVID-19 pandemic can have potential adverse consequences on the family members and on their ability to fulfill the caregiving role. Therefore, mental health professionals may encounter difficulties implementing a family centered-care model during such periods.

Due to the limited knowledge about the effects of the restrictions during the pandemic a study was conducted in Israel. It examined the difficulties which family members experienced as a result of the restricted visitations and the effects of the restrictions on advancing a family-centered care model,

A semi-structured questionnaire was distributed via digital means to 75 family members who had a family member who was hospitalized in psychiatric hospitals during the pandemic.

The findings indicate that family members had limited opportunities in the following areas during the COVID-19 area: Developing relationships with the professional staff, being involved in the therapeutic process during the hospitalization, communicating with the hospitalized family member, and receiving help for themselves.

Mental health professionals in psychiatric hospitals should adapt family-centric procedures to circumvent restrictions on physical presence and maintain the involvement of family members during psychiatric hospitalization.

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People living with HIV are at risk to develop depression, anxiety, and stress. During the pandemic, their access to medical and social care has decreased. Baseline beliefs affect the experience of mental trauma.

The study aimed to determine the levels of depression, anxiety, and stress and assess the baseline beliefs among people living with HIV. In addition, the relationship of emotional reactions to baseline beliefs was analysed.

Data were collected from February 28 to July 11, 2021, using a Google form that we developed. Fifty-nine HIV-positive patients participated in the study. The DASS-21 was used to determine depression, anxiety, and stress levels, and the WAS-37 was used to examine baseline beliefs. Both questionnaires were adapted for use in Russia.

We found that 64 % of the respondents had no symptoms of depression, 61 % of patients reported no anxiety, and 71 % had no stress. Mean values on the scales of “Benevolence in the World” (M = 30.4±7.1) and “Justice” (M = 20.5±4.6) were below the mean normative values for the Russian population. In contrast, the scales of “Self-Image” (M = 30.1±5.4), “Luck” (M = 29.5±7.3), and “Controlling beliefs” (M = 27.1±4.4) were above the mean. Depression was associated with all types of baseline beliefs, anxiety was associated only with benevolence in the world (rxy = -0.309, p < 0.05), and stress was associated with benevolence (rxy = -0.281, p < 0.05) and luck (rxy = -0.258, p < 0.05).

During the COVID-19, beliefs about the world’s benevolence are associated with emotional well-being among people living with HIV.

None Declared

Developing or presenting with a serious mental illness whilst working offshore may result in substantial barriers to treatment, rehabilitation and repatriation to one’s home country, especially amid changes in border control practices over the COVID-19 pandemic. Further difficulties arise arise in relation to language and cultural barriers.

Our aim was to explore the experience of providing safe and effective treatment for a psychiatric patient from another country, culture and language using a non-medical interpreter.

In this report, we describe the case of a 26-year-old Chinese citizen, a cargo ship crew member, who docked at the Port of Santos-Brazil in june 2021 with severe psychiatric disturbance.

Following the hospital assessment, the patient was admitted in the psychiatric ward and started the diagnostic research and treatment. After stabilization of the psychopathological condition, he was repatriated to his country of origin uneventfully. This case shows that treating and communicating with people who do not share the same language is challenging, in particular in a psychiatric context. The use of an interpreter is essential in the assessment process, but there are challenges in accessing and using these services.

With a detailed multi-disciplinary rehabilitation plan a patient with serious mental illness can be rehabilitated in order to facilitate the repatriation in humanized ways and respecting all health protocols of COVID-19 pandemic.

None Declared

Humanization in Mental Health is a concept that treat to conceal in the last decades the quality, efficiency and safety of care of complex diseases and conditions with individual values, needs and preferences and involves the patient and society in the decision-making priority.

to stablish and evaluate the priorities of different groups of interest in the development of a new humanization plan for mental health

During 2022 a Humanization plan for the Spanish region of Castilla y Leon (2.400.000 habs) was developed with a Delphi model. Participants included 36 stakeholders including mental health services, administration, social services, associations, patients and families. They stablished 32 objectives distributed in 7 strategic lines: 1. “People First” (Rights, Autonomy and Information); 2. “From People to Services” (Participation of users in mental heal services); 3. “Person-Centered-Assistance” 4. “Processes sensible to change” (reduction of coercion); 5. “Human ambient” (Improvement of units, psychosocial interventions). 6. Innovation, training and climate (not evaluated here). 7. “People without marks” (battle against stigma).

Priorities in the lines were stablished by representatives from mental health and other healthcare professionals, social and educational stakeholders, scientific societies, patients and families. After agreeing to participate in the process, they had to answer an online survey. For each line, they have to score it from 0 to 10.

500 subjects participated (38.6% Healthcare workers, 14% Mental Health Care users, 9.8% Social Services, 8.8% Associations, 7.8% Drug Services 6% Management of Health System, 5.8% Education Services, 3.8 Justice). Humanization was the most appreciated plan within the mental health plan 2022-2026 in Castilla y Leon (8.81±1.43).

The Highest priority score was given to the Rights (8.68 + 1.54), Information (8.44 + 1.60) and Stigma (8.43 + 1.89) lines and the lowest were the evaluation of satisfaction (7.62 + 1.90) and Reduction of Coercion (7.29 + 2.12). Differences were found between groups. Scores in Rights and Autonomy (F:3.474; p<0.001) were highest in the Associations (9.32 +1.01) and lowest in the Justice group (7.68 + 1.67). In the information line the highest score (F:2.431; p=0,014) was in the Education Services (9.03 +0,94) compared to Scientific Societies (7,65 + 2,13). Highest score for Participation of Users (F:2,968; p=0,003) was in Social Services (8.76 +1.48) compared to Justice (7.47 +1.95). There were differences in the coercion reduction line (F:2.165; p=0,029) but no pairwise differences were found

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Humanization approaches are well appreciated by different stakeholders. Priorities in our region start with rights, information and integration and mental health users in the health system and society

None Declared

Panic disorder is a widespread mental illness associated with the use of high levels of emergency care. However, the clinical characteristics of patients with panic disorder in the emergency department are not known.

This study was designed to investigate datas related to panic attack and treatment in emergency room of panic disorder patients who visited emergency room for panic attack.

A retrospective analysis of medical records was conducted on 92 patients with panic disorder who visited Chungju Konkuk university hospital emergency department due to panic attack and had bodily symptoms from 1st January 2010 to 31th December 2019. In addition to demographic characteristics and comorbid disorders, triggering stressors and alcohol consumption were corrected as pre-panic attack datas, bodily symptoms at the time of panic attack were corrected as datas during attack, electrocardiogram trial, consultation with psychiatrist, admission and information of used psychotropic drugs were corrected as post-attack data. Depending on size of data, Chi-square test or Fisher’s exact test was used. Collected data was analyzed using R 4.03.

Cardiovascular disease was accompanied by 5.4% and depressive disorder was the most common coexisting mental disorder. Among triggering stressors, economic problem/work-related stress was significantly higher in men than women (x2=4.322, p<0.005). The most common physical symptom during attack was circulatory (65.2%), followed by respiratory (57.6%), numbness-paralysis (33.7%), dizziness (19.6%), gastro-intestinal (14.1%) and autonomic symptom (12.0%). Electrocardiogram was taken at higher rate when patients complained circulatory symptom (x2=8.46, p<0.005). The psychotropic drug most commonly used in emergency room was lorazepam, used in 92.1%.

The most common bodily symptom during panic attack was circulatory symptom and the most common triggering stressor in men was economic problem/work-related stress. The most commonly used psychotropic for panic attack was lorazepam.

None Declared

Chronic mental illnesses are long-lasting and recurring, require continuous care as well as an integrated and collaborative approach to organize the care. This study sought to examine whether family center collaborative care is an acceptable treatment option for individuals with chronic mental illness.

Is the family-centered collaborative care suitable for patients with chronic mental illness?

From the years 2000 to 2021, ten electronic databases relating to family-centered collaborative care for mental illness were searched adopting PRISMA’s checklist

After systematic search, 27 articles and a thesis were found. According to moderate to high quality qualitative research, family-centered collaborative care was considered acceptable intervention, though a few studies supporting it.

This study examines theoretical, methodological, and practical considerations as a basis for more robust data collection based on individual experiences and evidence-based practice.

1. 1. Wittchen, H.-U., et al., The size and burden of mental disorders and other disorders of the brain in Europe 2010. European neuropsychopharmacology, 2011. 21(9): p. 655-679.

2. 2. CUTLER, J.L., Kaplan and Sadock’s synopsis of psychiatry. 2016, LWW.

3. 3. Thornicroft, G., et al., The personal impact of schizophrenia in Europe. Schizophrenia research, 2004. 69(2-3): p. 125-132.

4. 4. Vigo, D., G. Thornicroft, and R. Atun, Estimating the true global burden of mental illness. The Lancet Psychiatry, 2016. 3(2): p. 171-178.

None Declared

The boundaries between innovative clinical practices and research-related experimentation can be difficult to distinguish. Whilst mental health research has increased remarkably over recent decades, ethics is required to maintain and improve the standards of mental health research. Ethics and science can be seen as opposing forces with different aims championed by different people. However, ethics should not be a barrier to scientific advancement, but rather as the way that mental health research can be conducted with broader societal support, with the expectation of bringing wider benefit to people with mental illness. Scientific advancements may also lead to novel ethical problems and raise questions in relation to oversight responsibilities. Mental health research faces several unique ethical challenges. This presentation will provide an overview of the ethical issues linked with mental health 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.

None Declared

The heterogeneity of schizophrenia (SCZ) regarding clinical features including symptomatology, disease course and their inter-relationships with underlying biological substrates remain incompletely understood.

In a bid to reduce illness heterogeneity using biological substrates, our study aimed to employ brain neurostructural measures for subtyping SCZ patients, and evaluate each subtype’s relationship with clinical features such as illness duration, psychotic psychopathology, and deficit status.

We recruited 240 subjects (160 SCZ patients, 80 healthy controls) for this study. All participants underwent brain structural magnetic resonance imaging scans and clinical assessments using the Positive and Negative Syndrome Scale. Biological subtypes of SCZ were identified using “Heterogeneity through discriminative analysis” (HYDRA), a clustering technique which accounted for relevant covariates and the inter-group normalized percentage changes in brain volume were also calculated.

We found two neuroanatomical subtypes (SG-1 and SG-2) which were found amongst our patients with SCZ. The subtype SG-1 was associated with enlargements in the third and lateral ventricles, volume increase in the basal ganglia (putamen, caudate, pallidum), longer illness duration, and deficit status. The subtype SG-2 was associated with reductions of cortical and subcortical structures (hippocampus, thalamus, basal ganglia).

These findings have clinical implications in the early intervention, response monitoring, and prognostication of SCZ. Future studies may adopt a multi-modal neuroimaging approach to enhance insights into the neurobiological composition of relevant subtypes.

None Declared

The COVID-19 pandemic impelled a transition from in-person to telehealth psychiatric treatment. The COVID-19 pandemic has been depressogenic. Major disruptions in lifestyle due to social isolation, job loss, financial strain, and deaths of neighbors, family and friends are potential contributors to the increased levels of depression due to the pandemic. As one of the core elements of psychotherapeutic approaches towards treating depression is behavioral activation and increased social contact the psychosocial limitations imposed by COVID-19 might make it more difficult to treat depression during the pandemic.

There are no studies of partial hospital telehealth treatment for major depressive disorder (MDD). In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we compared the effectiveness of partial hospital care of patients with MDD treated virtually versus in-person.

Outcome was compared in 294 patients who were treated virtually from May, 2020 to December, 2021 to 542 patients who were treated in the in-person partial program in the 2 years prior to the pandemic. Patients completed self-administered measures of patient satisfaction, symptoms, coping ability, functioning, and general well-being.

In both the in-person and telehealth groups patients with MDD were highly satisfied with treatment and reported a significant reduction in symptoms from admission to discharge. Both groups also reported a significant improvement in positive mental health, general well-being, coping ability, and functioning. A large effect size of treatment was found in both treatment groups. Contrary to our hypothesis, the small differences in outcome favored the telehealth-treated patients. The length of stay and the likelihood of staying in treatment until completion were significantly greater in the virtually treated patients.

In an intensive acute care setting, delivering treatment to patients with MDD using a virtual, telehealth platform was as effective as treating patients in-person.

None Declared

Scientific disciplines recognize that pregnancy not only refers to the biological dimension. It also constitutes a social category, since sociocultural matrices have implications on what is conceived as the state of gestation (Noguera & Rodríguez, 2008). In this sense, cultures develop protocols to guide the actions of pregnant women and their loved ones regarding self-care during pregnancy in order to contribute to the well-being of mother and child (Carmona, Hurtado and Marín 2007). In this context, the belief category becomes relevant as a form of understanding the ways in which we appropriate reality and intervene it (Peirce, 1903).

To analyze the beliefs that a group of pregnant women belonging to a population group from Montería (Córdoba, Colombia) have about taking care of themselves.

Approach: qualitative. The sample was defined by saturation, for a total of 15 pregnant women affiliated to the Mocarí Hospital in the city of Montería, Córdoba. Instrument: semi-structured open interview; content analysis technique through AtlasTi. Emerging categories: a) care during pregnancy; b) relationships with others.

Main belief: Pregnant women need to take care of themselves physically and psychologically, for which it is necessary to have parents, siblings and partner’s support. Care is based on healthy nutrition, physical activity and mental health prevention. It is assumed that self-care is important for the well-being of mother and child. The importance of the family support networks’ participation is also recognized.

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According to the approaches stated/developed by Peirce (1903), beliefs have implications on the way we behave and intervene in reality. Mental habits function as a link between belief and concrete action. For this research, the beliefs that arise from the sociocultural matrices of the pregnant women are evidenced in their concrete actions.

None Declared

Hyperthyroidism due to Graves-Basedow disease is a common cause of neuropsychiatric manifestations, such as anxiety, psychomotor restlessness, mood disturbances, insomnia and psychosis. Hashimoto’s encephalopathy rarely occurs in so-called autoimmune thyroiditis, which can present with hyperthyroidism and neuropsychiatric symptoms similar to Graves’ disease. We add that the mystical-religious beliefs, present in all human cultures, and decisive in the case at hand, make us propose an evolutionary origin of them.

Clinical case description

A clinical case based on medical reports is described

We present the case of a 72-year-old woman, a member of the Seventh-day Adventist Church, well adapted to the Community. Known history of elevated antithyroid antibodies since 2019, brought to the emergency room involuntarily due to a mystical-religious delusional condition associated with behavioral disturbance. On examination, cachectic appearance, distal tremor, emotional exaltation and megalomanic speech were highlighted. Laboratory tests revealed primary hyperthyroidism with elevated antibodies. During admission, the differential diagnosis between Graves-Basedow disease and Hashimoto’s encephalopathy was considered. Thyroid scintigraphy oriented the diagnosis to Graves-Basedow disease, not requiring lumbar puncture or corticosteroid treatment. Treatment was based on high-dose antithyroid and antipsychotic drugs, with clinical and analytical remission at 3 weeks. The patient was referred to a Social Health Center for functional recovery. The family refers to a similar episode in 2014, of less intensity and self-limited, which is proposed to be a hashitoxicosis.

Differential diagnosis between Graves-Basedow and Hashimoto disease is essential as they differ in treatment and prognosis. The continuity that the delusion presents with the previous beliefs of the patient, differing mainly in the affective-behavioral implication, makes us consider a predisposition to psychosis in our patient. Religiosity can be adaptive in certain environments, since mystical beliefs have existed throughout the history of the human species and seem to be part of our nature.

None Declared

aCGH determines pathogenic copy number variations (CNVs) in about 10% of patients with intellectual disability (ID). In another 20% of patients, probably pathogenic CNVs or variants with uncertain clinical significance are detected. It may be variants that do not fully explain the patient’s symptoms, aberrations with reduced penetrance or inherited from healthy parents. The use of a sequencing method for such cases is advisable.

Improvement of diagnosis of intellectual disability.

aCGH with 60K Agilent microarrays, qPCR, targeted sequencing, whole exome sequencing (WES).

Six patients with ID and inherited deletions/duplications detected by aCGH and their parents if available were further examined by sequencing. Four patients had maternal CNVs: (1) del1q41 (SPATA17, LINC00210, RRP15), (2) del7q35 (TCAF2, exon 8), (3) dup8p22p21.3 (PSD3, exons 1-11), and (4) del12p11.1 (SYT10, exons 1-2). Two patients had paternal CNVs: (5) dup1q44 (SMYD3, exons 2-5) and (6) del15q11.2 (TUBGCP5, CYFIP1, NIPA1, NIPA2, LOC283683). The severe phenotype of patient (5) with dup1q44 could not be explained by the paternally inherited disruption of the single SMYD3 gene. WES determined probably pathogenic SNV in the MID1 gene associated with Opitz GBBB syndrome (OMIM 300000), which corresponds better to the patient’s phenotype and is likely to be the cause of the disease. Although del1q41 is included in the region of chromosome 1q41-q42 deletion syndrome (OMIM 612530) the phenotype of the patient (1) is much milder; WES in the patient detected two pathogenic (MPO, MAN2C1) and one probably pathogenic (ARID1B) SNVs. In patient (6) with del15q11.2 pat WES detected additional pathogenic SNV in exon 7 of the ARSE gene. In patient (3) with dup8p22p21.3 WES determined two SNVs with uncertain significance in the KIDINS220, FOXG1 genes. No SNVs were detected by WES in patient (2) with del7q35. For patient (4) with del12p11.1 targeted SYT10 sequencing revealed no pathogenic SNVs as well.

Sometimes aCGH-analysis is sufficient to identify the causes of ID, however, in the case of detection of CNVs with uncertain clinical significance and/or inherited from healthy parents, it may be necessary to further examine the patient using sequencing methods. So, the accurate diagnosis was made by WES for one patient of eight. For another two patients the combination of CNVs and SNPs should be considered. For the last three patients the described aberrations could not explain the phenotype and whole genome sequencing may be the solution.This study was supported by the Russian Science Foundation, grant 21-65-00017, https://rscf.ru/project/21-65-00017/

None Declared

Death is a complex construct to understand as it is influenced by the perceptions that HCP may have regarding end of life. Understanding these perceptions helps in addressing death anxiety in HCP which can otherwise negatively influence physician well-being and patient interactions such as breaking bad news.

To identify association between attitudes towards death among HCP and their perceived well-being.

This is a cross-sectional study on 109 HCP including nurses (n=29), physicians (n=43), resident (n=25) and interns (n=12) across various specialties at AKU. Death anxiety was assessed through the death attitude profile revised scale and its correlation was seen with the perception of one’s own wellbeing through Perceived well-being scale. A semi-structured pro-forma was used to collect demographic data.

The results showed that death anxiety was highest in interns (150.83 ± 17.94) followed by nurses (139 ± 20.67), residents (137.84 ± 15.79) and physicians (137.99 ± 21.59) and perceived well-being was lowest in interns (71.00 ± 10.10) followed by nurses (72.41 ± 10.43), residents (74.16 ± 12.83) and physicians (75.98 ± 12.19). The results of this study demonstrated a negative correlation between death anxiety and perceived well-being.

The negative correlation between death anxiety and perceived well-being suggest that health care professionals are most vulnerable in the preliminary years of their career. It is therefore recommended that psychology of death and dying is given equal weightage in medical curriculum to enable physicians deal effectively with the trauma of bereavement and loss relating to or patients.

None Declared

Hypomania Check List 33 (HCL-33) constitutes a self-rating questionnaire for lifetime history of hypomanic symptoms, used in patients who present with depressive symptoms and a further screening for bipolar disorder is required.

- Translation and cultural adaptation of HCL-33

- Measuring psychometric abilities, gender and age differences in score

In order to culturally adapt, standardize and validate the instrument for the Albanian context, the reliability and validity of the HCL-33 was examined using an sample of 99 patients, of whom 22 were diagnosed as bipolar disorder but all presented with a depressive episode.

In order to reach reliability, internal consistency analyses were performed.

The factor analysis yielded two factor, with an internal consistency of .838 and .736 from the Cronbach’s alphas, with a total alpha of .765, falling within the “good to excellent” range.

Furthermore, Albanian norm scores and cut-off scores have been generated for the Albanian version of HCL-33. The article provides evidence regarding the psychometric propërties and utility of HCL-33 in the Albanian adult population for clinical assessment, outcome evaluations and research purposes. With a cut-off value of 16, sensitivity was 73% and specificity was 53%, with a prevalence of 22% and positivie predictive value of 30% and negative predictive value 87%.

Gender differences were not relevant in the total scoring, but there was a positive correlation between age an HCL-33 scoring (r(n=99)=.243, p≤.01), especially with Factor II (r(n=99)=.211, p≤.05).

The article provides evidence regarding the psychometric properties and utility of HCL-33 in the Albanian adult population as a screening tool for bipolar disorder in patients presenting with a depressive episode.

None Declared

COVID-19 has been a stressful experience for healthcare providers (HCP), and created an additional distress on dialysis HCP since patients have greater risk of infection, symptom severity and death.

We aimed to investigate the level of psychological difficulties in Turkish dialysis HCP during the early outbreak period.

Participants filled an online survey including a screening questionnaire, Depression Anxiety Stress Scale-21 (DASS-21) and Multidimensional Scale of Perceived Social Support (MSPSS). Chi-Square, Fisher’s exact, Mann- Whitney- U, Kruskal Wallis, Spearman correlation and linear regression analyses were conducted.

Getting infected with COVID-19 and transmitting the disease to their beloveds were the major concerns of HCP. DASS-21 scores were higher in participants who were single and without children, having trouble in finding equipment or worrying about finding equipment in the future, being in contact with COVID-19(+) people; who increased tobacco and alcohol use, and who declared sleep, appetite, somatic problems. Worries about getting COVID-19 [(94.6%) vs. (90.6%) vs. (84.7%); p<0.001] and shortage of equipment [(52.9%) vs. (29.4%) vs. (26.3%); p<0.001]; sleep [(62.2%) vs. (43.5%) vs. (34%); p<0.001] and somatic problems [(58.4%) vs. (50%) vs. (28.2%); p<0.001] and DASS-21 scores [(5-21) vs. (3-15) vs. (0-12); p<0.001] were higher in nurses.

Worries and lifestyle changes associated with the outbreak are related to psychological difficulties. Adequate level of knowledge, self-protection and social support are important issues for HCP. While we recommend the HCP to express and share their worries; institutions should focus on the psychological status of the staff and provide immediate interventions.

None Declared

Borderline personality disorder (BPD) has a significant presence in outpatient psychiatric practice worldwide, but data on the clinical features of patients with BPD in Russia are limited. Clinicians experience a number of difficulties in diagnosing BPD, which is also due to the high comorbidity of BPD with other mental disorders (affective, anxiety, other personality and addictive disorders).

The aim of this pilot study was to investigate clinical characteristics of mental health care for patients с BPD in real clinical practice in community in Saint-Petersburg, Russia.

Fifty patients (72% female; n=36; mean age 22.4±4.3) who were treated in an outpatient community care were included in the study. Diagnosis was made according to the ICD-10 criteria (F60.31), as it does in clinical practice in Russia. Research methods included a clinical-catamnestic method.

The age of onset of BPD symptoms was 14.9±2.7. It was found that 50% of patients had previously received inpatient (20%, n=10) and outpatient (30%, n=15) psychiatric care unrelated to the current mental condition, that is, not due to the BPD. 16% of patients (n=8) referred for the first time for psychiatric care in adolescence. The vast majority of patients (86%; n=43) were not diagnosed with BPD when they first consulted a psychiatrist. Prior to the diagnosis of BPD, patients were diagnosed with mental disorders due to organic brain injury (4%), affective disorders (44%), schizophrenia spectrum disorders (12%), anxiety disorders (20%) and other personality disorders (6%). On average, it took 7.5±4.0 years from the date of first psychiatric assessment before the diagnosis of BPD was confirmed. At the time of inclusion in the study, patients were diagnosed with the following comorbid mental health conditions: affective disorders (12%), anxiety disorders (6%), eating disorders (4%), and addictive disorders (2%).

The hypodiagnosis of BPD in the early stages of the disorder has been identified, making it challenging to obtain high quality mental health care in a timely manner. The frequent comorbidity between BPD and other mental disorders has been confirmed. The study demonstrates the relevance of introducing programs (including education) to improve the diagnosis and study of comorbidity of BPD in real clinical practice. The pilot study results provide the basis for a project to investigate approaches to differential diagnosis and evaluation of treatment strategies for patients with BPD.

None Declared

The disruption of minimal Self is believed to be a core element of Schizophrenia and intimately connected to a disruption of bodily self, which in turn leads to impairments in intersubjectivity dimension. Motor abnormalities have been associated to Schizophrenia since the early conceptualization of the disorder, as well as inefficient body-related multisensory integration processes are considered nowadays a plausible origin of disembodied Self. In particular, there is evidence for significant abnormalities in Peripersonal Space (PPS) extension in Schizophrenia patients. PPS is the plastic sector of space immediately surrounding our body, whose coherent representation is based on efficient body-related multisensory integration processes. With a specific experimental task based on multisensory integration processing, we estimated PPS size and PPS boundary’s demarcation in 27 Schizophrenia patients, confirming a narrower PPS size and weaker bodily boundary in patients, thus paving the way for a deeper investigation of the mechanisms underlying the disruption of bodily self (Ferroni et al., Schziophr.Bull.2022, 5 1085-1093). We suggest that disembodiment might be responsible for the loss of the immediate linkage between Self and others (“intercorporeality”), so linking the disruption of the corporeal dimension to specific anomalies of intersubjectivity in Schizophrenia patients. Since language is one of the most important instrument through which intersubjectivity unfolds, it is intriguing to hypothesize a connection between language and multi-sensory processing.

Therefore, the present study was aimed at investigating possible correlations between patients’ motor impairments in multi-sensory integration processes and their alterations in language and communicative interactions.

Twenty-five outpatients were recruited in an experimental task investigating PPS extension; they were administered the Scale for the Assessment of Thought, Language and Communication (TLC) and the Clinical Language Disorder Rating Scale (CLANG).

Our data showed significant correlations between TLC and CLANG total scores and PPS size, with narrower PPS size for more severe formal thought disorders and higher language and communication impairments.

Our preliminary results seem to confirm the presence of a link between language impairment and multi-sensory processing, suggesting that bodily and linguistic disorganization may have a common origin which has yet to be explored in depth. Future research is needed to identify linguistic and motor endophenotypic patterns, potentially intertwined with each other, capable of early predicting Schizophrenia development and thus usable as early diagnostic tools.

None Declared