Adolescence can be seen as a fundamental stage of life for the construction of the subject, resulting from childhood experiences and decisive for adulthood. It is common stressors to appear during adolescence, due to the lack of necessary resources to deal with a stressful problem or event. In this way, the evaluation of a stressful situation by the adolescent is important, because from it he will develop coping strategies that will help him to deal with the problem.

Stressful life experiences, whether important events or even common annoyances, threaten the adolescent’s well-being, in addition to being linked to mental health and behavior problems, both internalizing ones, such as isolation, somatic complaints and anxiety/depression, as well as externalizing factors such as breaking rules and aggressive behavior. Romantic relationships are related to a major source of stress in the lives of these young people when conflicts, jealousy, aggression and infidelity occur, and have a great impact on the mental health of the individuals involved. Breakups, for example, have been linked to the onset of clinical depression in adolescents.

There are three categories of concern for adolescents: (a) related to achievements, such as success in school or opportunity for success in the future; (b) relationships with colleagues or family members; and (c) social problems such as the environment, poverty and unemployment.

To identify and describe stressful life events in adolescents from public schools in a poor community in Brazil.

The study included 64 adolescents, boys (51.56%) and girls (48.43%), aged between 12 and 16 years old (average 13.76%). The Adolescent Perceived Events Scale (APES) was used, which consists of 90 items that correspond to events that may occur in the adolescent’s daily life.

The most significant stressors for the adolescents in this study were those dealing with the death of close people, such as a friend (100%), a family member (96.29%) and a relative (94.73%). Also appearing as major stressors were “plans that did not work” (91.89%), use of alcohol or drugs by family members (87.5%), loss of a job by parents (75%), imprisonment of a family member (75%), fights with boyfriend or girlfriend (86.66%), breakup (75%) and concern about their own appearance (76.52%).

Events referring to interpersonal relationships were considered the greatest stressors, with percentages above 80%. The present study contributed to the understanding of adolescents’ perceptions of their life events. In this way, we can understand the relationship between stressors and the coping strategies. Furthermore, it allows the proposition of preventive intervention strategies in the school context.

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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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Although the effect of lithium treatment on kidney and endocrine systems has been extensively investigated, this literature, however, suffers from substantial heterogeneity and many prior studies are limited by short follow-up on just one marker of interest.

We aimed to determine the impact of long-term lithium therapy on renal, thyroid and parathyroid function within a large real-world cohort.

We performed a cohort study within the Central Region of Denmark (approximately 1.3 million inhabitants). Using the Electronic Patient Record system, we identified all patients with at least one serum-lithium (se-Li) measurement in the period from January 1, 2013 to July 20, 2022, and a reference group of patients diagnosed with bipolar disorder (ICD-10: F30, F31) was matched on age, sex and creatinine level. The outcomes were renal, thyroid, and parathyroid function as indicated by all blood tests taken during follow-up measuring creatinine, estimated glomerular filtration rate (eGFR), thyroid-stimulating hormone (TSH), parathyroid hormone (PTH) and calcium. Multilevel regression analyses adjusted for age, sex, severity of the mental disorder (as indicated by the number of hospitalizations), and somatic comorbidity calculated the association between lithium treatment and development in renal, thyroid, and parathyroid function over time.

A total of 4,709 lithium users (61.5% females, median age 46 years [IQR: 32-60]) and 4,027 control individuals were identified with a total follow-up period of 14,686 person-years (median = 1.7 years, range: 1-9.5). Out of the 4,709 lithium users, a total of 3,157 were incident lithium users. The final results will be shown at the 2023 EPA Congress.

The conclusions will be presented at the congress.

None Declared

REMSs (Residenze per l’Esecuzione delle Misure di Sicurezza, which roughly translates into Facilities for the execution of security measures) are psychiatric residential facilities introduced in Italy following the discontinuation of Forensic Psychiatric Hospitals, a process started between 2012 and 2014 and concluded in 2017. REMSs are forensic psychiatric communities, focusing on treatment and rehabilitation, managed exclusively by the italian NHS. They host psychiatric patients, who have committed crimes, but are not sended into the ordinary jail circuits because judged as mentally impaired and socially dangerous, with the aim that of stabilizing and treating psychiatric symptoms and that of their gradual social re-insertment. After the closure of psychiatric hospitals in 1978, the overcoming of forensic psychiatric hospitals is the big new thing happening in Italy when it comes to mental health. The introduction of REMSs has spotlighted how much is needed a care program used as a prevention tool, putting the mentally impaired with a social danger profile back into their dignity as human beings. Notwithstanding, after 10 years from its greenlight, some remarkable issues about REMSs system are at hand, starting from long waiting lists, which triggers the double risk of illegal jail detention of the mentally impaired; or leaving free without containment socially dangerous subjects.

Purpose of the present study is to offer an overview of the italian REMSs system, focusing on its critical issues such as waiting lists to be admitted and treading prospects for improvement.

Our work involves a research review on litterature on REMSs, forensic psychiatric services and admitting procedures.

There are 33 REMSs in Italy. As of 31st December 2021, 573 in-patients are hosted in REMSs. The most frequent diagnosis is schizophrenia (33%), followed by personality disorders (32%) and substance abuse (21.4%). 80% of the crimes committed involve violence towards human beings. As of 25th March 2022, the REMSs waiting lists include 605 individuals, 42 of whom were already imprisoned and 561 released. The average waiting time for admittance is about 10 months. Positioning on the waiting list follows the exclusive chronological criterion (date of sentence) and is not related to any clinical risk criteria whatsoever. It is estimated that one third of waiting patients remain without adequate care.

Rethinking the admittance criteria to REMSs is crucial. The use of alternative safety measures, the improvement of community mental health services and a real integration between both legal and heatlh systems in terms of management of the offending psychiatric patient are among ways suggested to avoid breaking the dream of deinstitutionalisation.

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Recent research on Schizophrenia (SCZ) suggests that reduced sleep spindle and slow wave density could be particularly informative of underlying thalamocortical and cortical synchronization mechanisms and dysfunctions. Although sleep disturbances are also highly prevalent across all stages of Bipolar Disorder (BD), the objective evaluation of sleep macrostructure and microstructural oscillatory activity remains understudied in this population.

We aimed to investigate sleep EEG activity in BD, with a focus on sleep architecture, sleep spindles and slow waves.

We recorded high-density EEG (64–channel BrainAmp, Brain Products GmbH, Germany) during sleep in 18 euthymic patients with BD and 18 age/gender-matched healthy control (HC) subjects. After sleep scoring and EEG artifact rejection, several parameters of sleep spindles (12-16 Hz), including density and amplitude, and slow waves (0.1-4 Hz) were identified for the first cycle of sleep using automated algorithms and compared between groups using non-parametric statistics.

BD subjects showed significantly higher Wake After Sleep Onset and lower Sleep Efficiency (Table 1). Total (12 - 16 Hz), slow (12 - 14 Hz) and fast (14 - 16 Hz) sleep spindle parameters of density (Image 1) and amplitude did not differ significantly between groups. On the other hand, slow wave density was reduced in a large frontal cluster of electrodes in the BD group (Image 2).Table 1

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The absence of sleep spindle deficits in the BD group suggests that the systems involved in generating and maintaining these thalamocortical oscillations are presevered during periods of clinical stability in Bipolar Disorder. Conversely, reduced sleep slow wave density points to an altered cortical synchronization, which might represent a common neurophysiological feature shared with Schizophrenia. Further research is needed to confirm these preliminary observations in all–night recordings and with a direct comparison of larger cohorts of patients with both diagnoses.

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In this interactive session, we will attempt to create a roadmap toward a research career in psychiatry, particularly in challenging settings. Participants will be able to share their experiences and ask questions. Through dialectical discourse, we will identify the essential skills and key competencies for a research career and how to develop them through key strategies and practical exercises. We will try to answer these questions and more. “I like research, but I don’t know where to start?” “I know writing is important, but how can I make the process less painful and even perhaps enjoy writing?” “There is no research tradition in my workplace; how can I find a mentor?” “How can I build confidence in presenting at scientific conferences?” “It’s important to master hard skills, but what could we do with soft skills?”

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According to the Journal of Laws of the Republic of Poland, juveniles considered to be socially maladjusted are referred to the facilities called Youth Educational Centres. The aforementioned decision must be processed by court. Adolescents held there are guilty mainly of truancy, acts of vandalism, and the crime of theft. Other reasons might include substance abuse, fleeing from home and loitering without legal guardian’s supervision. The key purpose behind those institutions is adjusting to social standards, as well as rehabilitation of each juvenile delinquent. On the other hand, such behaviors may result from various mental disorders, which are often overlooked and underestimated.

The aim of this study was to assess the prevalence of psychiatric disorders among the inmates of Youth Educational Centres with a primary Focus on bipolar disorder. The existing knowledge on this subject is insufficient whereas the only available papers are based on retrospective studies of documents, which may have led to underestimation of mental condition in this population.

Patients were examined in person, using the K-SADS diagnostic interview. The missing details were also collected during reviewing the inmates’ documents. The study group consists of juveniles staying in two Youth Educational Centres, a male and female one, located in Silesian Province of southern Poland. Participation in the research was voluntary whereas information gathered during the interview remains confidential.

The study included 80 adolescents who previously had consented to participate. 60% (n=48) of them were males. Among the male patients 27.08% met the criteria for an episode of mania/hypomania, 37.5% for a depressive disorder whereas 22.92% fulfilled the criteria for both mania and depression. Seven boys were diagnosed beforehand, those included: one case of bipolar disorder, one schizoaffective disorder and five of them were receiving outpatient treatment for depressive episodes. Among female inmates: 40.63% met the criteria for both mania/hypomania and depressive disorder whereas as many as 78.13% claimed to have depressive disorder. Two girls have already been diagnosed – one suffered from bipolar disorder, manic depression and schizophrenia and the other was treated for depressive episodes.

Social maladjustment is often accompanied by a mental disorder or may be caused by one. Psychiatric disorders in adolescents, particularly bipolar disorder, usually have an atypical course, which can delay the appropriate diagnosis. Postponement of the crucial treatment is directly related to significant deterioration of the patient’s prognosis. In order to provide adequate and necessary support, juveniles referred to the Youth Educational Centres should be examined by a certified psychiatrist before the admission to such facility.

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The flood in Fort McMurray (FMM) which occurred between April 26 and May 2, 2020, is known to have displaced an estimated population of 1,500 people, and destroyed or damaged about 1,230 buildings. In all, it is estimated to have caused about $228 million in losses.

This study aims to identify the determinants of likely Generalized Anxiety disorder (GAD) among respondents 12 months after the 2020 flooding

Data for the study were collected through a cross-sectional survey sent through REDCap and hosted online from the 24th of April to the 2nd of June 2021. The self-administered questionnaire was emailed to respondents using community, government, school, and occupational platforms. Demographic, flooding-related variables and clinical data were collected. A validated instrument, the GAD-7 was used to collect information on likely GAD. Consent was implied by completing the survey forms, and the University of Alberta Health Research Ethics Committee approved the study.

Of the 249 residents surveyed, 74.7% (186) respondents completed the online survey, 81.6% (80) were above 40 years, 71% (132) were in a relationship, 85.5% (159) were females, and 94.1% (175) were employed. The prevalence of likely GAD was 42.5% in our study. Predictors of likely GAD among respondents included positive employment status (OR = 30.70; 95% C.I. 2.183–423.093), prior diagnosis of depression (OR = 3.30; 95% C.I. 1.157–9.43), and the perceived need to have mental health counseling (OR = 6.28; 95% C.I. 2.553–15.45).

This study showed that there was an increased magnitude of moderate to high anxiety symptoms among respondents following the natural disaster, particularly the flood in 2020. The predictors of likely GAD include positive employment status, a history of depression diagnosis, and the need to have mental health counseling. Policy formulators may reduce the risk of anxiety after flooding in vulnerable areas by addressing these factors.

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The COVID-19 pandemic has placed extraordinary mental health burdens on healthcare professionals. For women, it is a major challenge to reconcile the diverse roles of a professional, mother, and wife. The COVID-19 pandemic has exacerbated this, increasing their vulnerability to mental health issues.

The aim of the study was to assess COVID-19-related mental health of healthcare professionals and to investigate whether possible gender differences as well as other parameters are associated with mental health disturbances.

We conducted a nationwide cross-sectional study of healthcare professionals working in hospitals or primary care settings in Greece from April to June 2022. Participants answered a questionnaire that included socio-demographic and other parameters, the Coronavirus Anxiety Scale (CAS), the Coronavirus Reassurance-Seeking Behaviors Scale (CRBS), and the Obsession with COVID-19 scale (OCS).

A total of 464 healthcare professionals participated in the study, 71.2% were females and two-thirds were 31-50 years old. Elevated levels of anxiety, frequent reassurance seeking activities and persistent troubling thoughts related to COVID-19 were found in 5.8%, 3.2% and 6.1%, respectively. However, females reported significant higher mean levels on CAS and CRBS compared to males (2.41 vs 1.60, p=0.015, and 3.36 vs 2.64, p=0.041, respectively). Participants living in smaller areas had increased levels on all three scales (CAS, p < 0.001; CRBS, p = 0.007; OCS, p < 0.001), indicating thus higher coronaphobia, more frequent reassurance-seeking behaviors and disturbed thinking about COVID-19, compared to healthcare workers living in urban regions. Furthermore, lower educational level is also associated with higher values on CAS, CRBS and OCS (p < 0.003; p = 0.017; p < 0.023, respectively). Nurses experience higher anxiety scores (2.96) than physicians (1.92, p=0.013) or other healthcare workers (1.87, p=0.016). No dysfunctional thinking about COVID-19 is observed in medical doctors, whereas nurses and other healthcare workers experience higher levels on OCS.

Our study does not show any worrying increased psychological dysfunction related to COVID-19 pandemic among healthcare workers in general. However, females have increased levels than males. Thus, support and mental health protecting strategies should be applied primarily to female healthcare professionals when necessary.

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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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Patients with psychosis are particularly more prone to relapse, emergency presentation and subsequent hospital admissions (1). Hospitalization is not only a stressful experience to patients and carers, but also a financial burden to the National Health Service (NHS). Inpatient and community-based mental health services represent 47% of the annual healthcare costs for patients with SMI in the UK (2). The COVID pandemic had profound effects on health care services including the shift to remote consultations (Telepsychiatry) using video and telephone consultations in outpatient clinics. This shift to tele psychiatry was considered a novel challenge to both service users and service providers. We studied the impact of this change in the delivery of care on the number of admissions in patients suffering from psychoses.

We aimed at examining the factors associated with higher rates of hospital admissions and the effect of telepsychiatry (changes due to COVID) on the rate of hospital admissions in patients with a psychotic illness.

We reviewed the care plans of forty patients with a diagnosis of a psychotic illness who were randomly selected from two specialist psychosis teams in Essex. We looked into a number of factors to identify their associations with the number of hospital admissions. Moreover, we compared patients who had changes in their care due to COVID-19 with those who received care as usual in terms of the number of admissions in the first year of the pandemic.

Patients who were under CTO or were receiving Clozapine had significantly higher total number of admissions compared to those who were not. The change in the type of care to telephone or video consultation during COVID-19 was associated with a lesser number of admissions during the first year of the pandemic.

Patients receiving clozapine have higher total number of admissions. This finding might be explained by the severity of illness in this patient group. It could also be linked to the re-initiation policy within EPUT that mandates inpatient initiation and re-initiation of clozapine even in the absence of relapse signs. The shift from classic face-to-face to telephone and video consultation has its well-known shortcomings. However, it does appear to be a suitable alternative to a group of patients that it was associated with lower rates of hospital admission during the height of the pandemic.

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To conclude, the factors that were associated with a higher number of admissions in patients with psychosis were under CTO or receiving treatment with Clozapine. Preliminary evidence showed that telepsychiatry is a suitable alternative to standard care during the COVID-19 pandemic.

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Obsessive-compulsive disorder (OCD) is a psychiatric disorder affecting 1.3% of the population worldwide where both genetic and environmental factors, such as perinatal events and neuroinflammation, are thought to contribute to the etiology of the disorder. In the past, the description of clinical entities such as Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections (PANDAS), in which an acute neuropsychiatric syndrome with prominent obsessive-compulsive features emerges in children infected with group-A beta-hemolytic streptococcus (GABHS), sparked the hypothesis that infections may be a risk-modifying factor for the development of OCD. Along with streptococcal infections, other pathogens such as Toxoplasma gondii have been implicated in the pathophysiological models of the disorder, although causal associations have not been established for any of beforementioned pathogens.

To perform a systematic review and meta-analysis about the presence of biological evidence of infection in patients diagnosed with OCD.

We conducted a systematic review and a meta-analysis (PROSPERO registration CRD42021223415) by performing a standardized electronic database search in MEDLINE/PubMed, Web of Science, Embase and Scopus. Search was conducted on 17/10/2022. Eligible papers included case-control and cohort studies using a comparator group, that tested for specific biomarkers providing evidence of infection in patients diagnosed with OCD; exclusion criteria included studies without quantitative or qualitative measures of infection, case reports, systematic or scope reviews, and animal studies. Selection process was conducted according to PRISMA 2020 statement guidelines. Study quality was assessed through Newcastle-Ottawa Quality Assessment Scale.

We identified 8911 records through the search after duplicate removal. A total of 22 studies met inclusion criteria after selection process, and 15 were eligible for meta-analysis. Most evidence concerned Toxoplasma gondii (10 studies), and patients with OCD appear to have higher odds of being infected compared to controls, with a meta-analytic odds ratio of 2.39 (95% IC 1.60-3.58), when comparing 467 patients with 5411 controls. However, most studies were methodologically heterogeneous, which compromises the interpretation of meta-analytic results. Information regarding other agents, including GABHS, Borna disease virus and Toxocara canis was gathered but due to an insufficient number of papers it was not possible to perform a meta-analysis for each of them.

Our work suggests that albeit exhaustively reported in the literature, there is no strong evidence of the over-representation of biomarkers of infection in patients with OCD compared to control volunteers. Methodologically robust studies are needed to further test this hypothesis.

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Psychotic disorders carry several economical, psychological and social consequences, both at individual and community levels. Early intervention programs after first-episode psychosis which combine pharmacological and psychosocial strategies are aimed at reducing symptoms, lowering costs in the use of health and non-health care resources and improving overall functioning. AGES-Mind study is based on manualized psychotherapeutic interventions for people with first-psychosis episodes.

The aim of the study was to evaluate the effect of a group psychotherapeutic intervention on the clinical status and use of clinical resources in a sample of patients with first-episode psychosis at 12 and 24 months after the beginning of the intervention. This cohort will be compared to patients with first-psychosis episodes without group psychotherapeutic intervention.

Longitudinal, observational, retrospective study on a cohort of N=46 patients with first-episode psychosis within the last 5 years. Two groups of 23 patients each were formed. The participants of one of those groups received group psychotherapy in the context of the AGES-Mind study and the other group received treatment as usual without group intervention. Non-exposed patients were matched by age, gender and time elapsed since first-episode psychosis with those exposed to the intervention. Sociodemographic data, clinical status and use of clinical resources outcome variables were assessed.

No significant differences were found in clinical status and use of resources between participants and non-participants in the psychotherapeutic group intervention after 12 and 24 months.

After controlling for potentially confounding variables as sociodemographic, age and time since first-episode, participating in a group psychotherapeutic program does not seem to improve clinical variables or use of resources. Further studies with larger samples would be necessary to explore other variables, such as symptoms, satisfaction with the intervention or social functioning.

None Declared

Psychopathic personality traits (PPT) are known to deteriorate emotional and cognitive functions, however, little is known about their role in depression. Nevertheless, depressive symptoms have also shown to be associated with emotional problems and worse cognitive functions and could thus also interact with PPT.

This study aimed to set up an integrative model by examining the correlative relationships and moderating role of PPT in the association between emotional competence and cognitive functioning in individuals with depression.

Data from 373 individuals diagnosed with depression (158 males, 215 females) were investigated. Subjects filled out questionnaires surveying PPT and emotional competences. Furthermore, a comprehensive neuropsychological test battery investigating the cognitive domains Attention/Psychomotor Speed, Executive Functions and Verbal Learning/Memory was administered.

Correlation analyses revealed a significant positive association between emotional competence and overall cognitive functioning. Further, negative associations between emotional competence and the PPT “Blame Externalisation” and “Careless Nonplanfulness”, as well as positive associations with psychopathic “Social Potency” and “Stress Immunity” were found. Moderation analyses indicated a significant positive influence of psychopathic “Stress Immunity” and “Social Influence” on the relationship between emotional competence and cognitive parameters.

The findings highlight the importance of considering PPT in further research on depression and reflect their impact in therapeutic settings.

None Declared

Suicidal thinking is relevant in patients with First Episode Psychosis (FEP). However, longitudinal studies specifically examining treatment response for suicidal ideation in FEP are still relatively scarce, especially with long-term design and in real-world clinical settings.

The aims of this research were (A) to longitudinally assess suicidal thoughts in people with FEP along a 2-year follow-up period and (B) to overtime investigate any significant association of suicidal ideation levels with the specific treatment components of an ‘Early Intervention in Psychosis’ (EIP) protocol along the 2 years of follow-up.

At entry, 232 FEP participants (aged 12–35 years) completed the Brief Psychiatric Rating Scale (BPRS), including a ‘Suicidality’ item subscore. Multiple linear regression analysis was then performed.

Across the follow-up, FEP subjects showed a relevant decrease in suicidal thinking levels overtime. This was specifically predicted by the total number of individual psychotherapy sessions offered within the 2-year EIP protocol and antidepressant dose (at least as regards the first year of our intervention).

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Suicidal ideation is clinically relevant in FEP but seems to improve overtime together with the provision of specific, patient-tailored and integrated EIP treatments, especially individual psychotherapy.

None Declared

Perceived sense of control over one’s health contributes to determining health-related behaviors and an individual’s health status. Therefore, it may enhance vulnerability to health anxiety in response to COVID-19 and influence implementation of preventive strategies and adherence to them. Health anxiety may serve as one of the factors that increase the perception of COVID-19 as dangerous and life-threatening. We hypothesized that external health locus of control may demonstrate a connection with higher levels of health anxiety, whereas internal health locus of control may be considered a protective factor alongside some personality traits due to its role in determination of coping strategies.

To assess health locus of control (HLC) in patients with COVID-19 and evaluate its connection with the levels of health anxiety.

The study has involved 62 participants, average age is 23,4±8,2, with 36 of them being diagnosed with COVID-19 one or more times, average age is 24,5±8,9, whereas 26 of them were healthy, average age is 21,8±7,1. The following methods were used: Brief Illness Perception Questionnaire (modified for COVID-19), Perceived Stress Scale, the state scale from the State-Trait Anxiety Inventory, Short Health Anxiety Inventory, Illness- and Treatment-Related Locus of Control Scale, HEXACO-24 Personality Inventory, Self-Government Test.

COVID-19 patients differed from healthy participants by the following parameters: perceived danger of COVID-19 (31,53±9,51 vs 33,92±11,5; p>0,05); perceived stress (28±8,68 vs 26,5±7,3; p>0,05); state anxiety level (23,3±11,1 vs 25,1±12,5; p>0,05); health anxiety (14,3±6,76 vs 13,8±5,7; p>0,05); internal HLC (18,8±3,24 vs 17,8±4,67; p>0,05); external HLC (5,97±1,89 vs 5,81±1,92; p>0,05); extraversion (11,8±3,36 vs 13,10±3,71; p>0,05).

Correlation analysis has revealed mild positive correlations between health anxiety level and both external HLC (0,32; p<0,05) and chance HLC (0,25; p<0,05), mild negative correlation between health anxiety and internal HLC (-0,18; p>0,05). Analysis of COVID-19 related variables found that health anxiety levels were positively correlated with perceived danger of coronavirus disease (0,37; p<0,01), perceived stress (0,59; p<0,001) in the whole sample. Negative correlation was observed between extraversion and health anxiety (-0,49; p<0,05) in the group of COVID-19 patients.

The results obtained in our study demonstrate the connection of the higher levels of health anxiety in COVID-19 patients with more external orientation of HLC. The connection between extraversion and health anxiety is also observed. Our study indicates that participants diagnosed with COVID-19 one or more times tend to have higher health anxiety levels in comparison to healthy participants.

None Declared

According to CEOWORLD Magazine‘s 2019 “Health Care Indicators” rating of 89 countries in the world, Taiwan ranks first in the world. The coverage of the National Health Insurance covers all necessary medical treatment, including outpatient, hospitalization, and prescription drugs etc. The psychiatrist was wondering which item with the highest service cost–performance (CP) ratio of the psychiatrist performance in a general hospital and used proportion of PPF as performance indicator. He used allocation to distribute the hours across job activities.

The purpose of this study is to investigate items allocation proportion for outpatient and inpatient ward in a specific month, examining the distribution of performance and figure out an appropriate model to optimal medical service.

Demographic data were collected through PPF projects included 15 outpatient items and 19 inpatient ward items from the third-month of the psychiatrist’s employment in the general hospital, as shown in Table 1. Items related to physiological examination has been excluded. The performance is calculated by combining outpatient and inpatient wards.

Demographic data analysis found that proportion of inpatient ward PPF (67.01%) was significantly greater than proportion of outpatient PPF (32.99%) (Figure 1). The inpatient ward performance was 2 times the outpatient performance. This result showed that most performance came from inpatient ward. Among all items of the proportion of PPF unit, the highest two for inpatient ward items were general hospital bed inpatient consultation (32.58%) and special treatment for psychiatric inpatients (14.35%), and for outpatient, the highest was psychiatric outpatient consultation - more than two (11.31%) (Table 1).

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National Health Insurance is an important system to assist in epidemic prevention during the COVID-19 period. The most PPF of psychiatrist service in a general hospital came from the service of inpatient ward items, including the general hospital bed inpatient consultation with the highest CP ratio. These findings may suggest that the inpatient service could offer psychiatrists fair PPF, and the hospital environment could be favorable for recruitment.

None Declared

Obesity, defined by an excessive body fat accumulation, is a non-communicable condition attaining epidemic proportions in economically developed countries.

To provide evidence to the link between serotonin (5-HT), energy metabolism and the human obese phenotype, the present study investigated the binding and function of the platelet 5-HT transporter (SERT), in relation to circulating insulin, leptin, glycolipid metabolic parameters and body-mass indices (BMIs, Kg m-2).

The study included an observational clinical cohort of 74 drug-free subjects (51W; 23M), recruited on the basis of divergent BMIs (16.5-54.8 Kg m-2). All subjects were tested for their blood glycolipid profile together platelet [3H]-paroxetine ([3H]-Par) binding and [3H]-5-HT reuptake measurements from April 1st to June 30th 2019.

The [3H]-Par Bmax (fmol/mg proteins) was progressively reduced with increasing BMIs (p<.001), without changes in affinity. Moreover, Bmax was negatively correlated with BMI, waist/hip circumferences, triglycerides, glucose, insulin and leptin, while positively with HDL cholesterol (p<.01). The reduction of 5-HT uptake rate (Vmax, pmol//min/109platelets) amongst BMI groups was not statistically significant, but Vmax negatively correlated with leptin and uptake affinity values (p<.05). Besides, [3H]-Par affinity values positively correlated with glycaemia and triglycerides, while [3H]-5-HT reuptake affinity with glycaemia only (p<.05). Finally, these correlations were specific of obese subjects, while, from multivariate linear-regression analysis conducted on all subjects, insulin (p=.006) resulting negatively related to Bmax independently from BMI.

The present findings would suggest the presence of a dysfunctional insulin/5-HT/leptin axis in obesity, differentially impinging the density, function and/or affinity of the platelet SERT, as the result of complex appetite/reward-related interactions between the brain, gut, pancreatic islets and adipose tissue. In addition, they support the foremost cooperation of insulin and 5-HT in maintaining energy homeostasis.

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Psychosis onset is a transdiagnostic event that leads to a range of psychiatric disorders, which are currently diagnosed through clinical observation. Since several years, the role of immune system in the pathophysiology of psychosis has been well-recognized, showing differences from the onset to chronic phases. In this lecture, I will show the results of our recent study that tested the hypothesis of the existence of subgroups of first-episode psychosis (FEP) patients identified by distinct peripheral immunomarkers’ profiles, possibly underpinning a subgroup-specific immunopathogenesis. More in detail, I will show the results obtained by the unsupervised machine learning model that we applied to the set of 12 peripheral blood immune gene transcripts, which we recently demonstrated to classify with high accuracy a cohort of FEP patients and HC. Also, I will report the results obtained by performing post-hoc univariate analyses using selective clinical, cognitive, and brain structural phenotypes of FEP patients and HC belonging to each subgroup identified by the computational model. I will extensively discuss two key clusters identified and validated by our model: 1) a FEP cluster characterized by the high expression of inflammatory and immune-activating genes; 2) a cluster consisting of an equal number of FEP and HC subjects, which did not show a relative over or under expression of any immune marker (balanced subgroup). Therefore, in this lecture I will emphasize that our study has been the first to demonstrate the existence of a psychosis onset subgroup identified by a peculiar multivariate pattern of immunomarkers, independently of clinical features or categorical diagnosis. This is paramount as if validated in independent samples, our clustering model could enable the sample selection in clinical trials aiming to test the efficacy of novel immunomodulant or anti-inflammatory therapies tailored to the specific inflammatory subgroup of psychotic patients.

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Negative symptoms (NS) represent an unmet need of treatment in schizophrenia (SCZ). As a result, these symptoms pose a significant burden on patients, their families, and the health care system. In the last decade, the conceptualization model that has received the most support from the literature has described 2 domains of NS: the expressive deficit (EXP), which includes blunted affect and alogia, and the motivational deficit (MAP), which includes avolition, asociality, and anhedonia. However, different confirmatory factor-analytic studies suggest that the bi-dimensional model may not capture the complexity of this construct, which could be better defined by the 5-factor model. To date no study exploiting innovative tools and state of the art assessment instruments has yet been conducted to evaluate the NS structure stability over time.

The aim of this study was to investigate the stability of the latent structure of NS in subjects with SCZ.

NS were assessed in 612 subjects with SCZ using the Brief Negative Symptom Scale (BNSS) at the baseline and after 4-year follow-up. A network invariance analysis was conducted for the data collected longitudinally.

Results showed that the BNSS’ items aggregated to form 5 distinct domains (avolition, asociality, blunted affect, alogia and anhedonia). The result of the network invariance test indicated that the network structure remained unchanged over time (network invariance test = 0.13; p = 0.169) while its overall strength decreased significantly (6.28 baseline, 5.79 at follow-up; global strength invariance test = 0.48; p = 0.016).

The results of this study show how the construct of NS can be better explained by the 5 individual negative symptoms and that this model is almost stable over time. Therefore the 2-dimensional model may be insufficient to describe the characteristics of NS. This data is of important relevance with consequent implications in the study of pathophysiological mechanisms and the development of targeted treatments for NS.

None Declared