How far have we progressed in the field of treating cognitive side effects? Six months after the last ECT treatment, about 15% of patients still have such symptoms, limiting daily life. So far, studies in the field of cognitive training for ECT-related cognitive side effects show few positive effects. Nevertheless, these patients seem to help well. Because they have no structural damage to their brain, training with long-term effectiveness may be available for them. Amsterdam University Medical Centers started the CONNECT clinic (Cognitive and Neuropsychological Aftercare ECT) in early 2022 for diagnosis and treatment of patients with long-term cognitive complaints (longer than six months) that hamper their daily functioning. After the intake and neuropsychological diagnostics, treatment starts if there is an indication. Patients are then offered ’cognitive strategy training’ in an individual course. Developed in the field of neuropsychological rehabilitation, these help to get a grip on cognitive complaints by improving memory or executive functioning with learning strategies. Our initial experiences with patients show that patients master these strategies very well and quickly. We present a pilot project from the Amsterdam UMC where an individualized treatment-programme for long-term cognitive complaints after ECT is being implemented and evaluated.

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The theorization focuses on the climate change’s influence to neurobiology. In modern societies, environmental nucleon generates in everyday activities from computers to industrial pollution. The subtle psychiatric changes can be categorized into: 1) the change of media in consciousness formation processes from cognition, such as from paper to electronic reading and from linguistics to coding; 2) activity changes in local reciprocal environment especially in places undergoing industrialization or developmental energy sources; 3) global exchanges underlying the current definitions of climate change but also taken into consideration of media change in cognitive behaviors; and 4) changes from outer space environment to the effects of global-to-local changes.

The objective of the theorization seeks to develop a heuristic paradigm to quantify the climate change’s effects to psychiatry from a neurobiological perspective. Albeit climate change is a complex topical issue, especially regarding the multivariable sources and traditional paradigms of case studies in the psychological and medical sciences, common sources of impacts to psychiatric public health in collective behaviors have been less of a focus. With the higher order of autonomous human functioning governed by the brains, the theorization in psychiatric public health hopes to quantify environmental impacts to brain functionings.

The theorization accumulated from nonproliferation research and the researcher’s developments in dopamine treatments in the high risk social-natural environment on depression. Inspired by the explicit review on electronic warfare’s impact on public health and astronomical research with proton decay outcome, a correlative theorization emerged between the cosmic decay and biodiversity in biochemistry. The theorization draws on developmental psychology to the nucleon heuristics in data research in cosmology, with prior experience documenting proliferation by applied quantum chromodynamics. Psychiatric data can be retrieved from relevant clinical settings of equivalent multi-wavelength brain scans as samples.

From the perspective of cosmology, extremal graph theory can sample climate change on earth’s plasma from cosmic changes. This means earth’s dipole shifts to quantitative local population can be plotted, similar to the wild life researches in birds’ migration pattern changes. Local variants mainly derive from energy source types and energy consumption, however, bona fide data can hardly be retrieved due to deliberate transgressions for certain dire areas. Normative research can be conducted with cross-disciplinary collaborations with due consideration to privacy in public health research ethics.

Environmental monitoring and psychiatric effects in developmental psychology are necessary in fundamental research on human security. This would increase some certainties and predictabilities for human development.

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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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Many metabolic diseases influence brain function and are associated with psychiatric symptoms and neuropsychiatric disorders (including autism-spectrum disorders, ADHD and psychotic disorders). Attention-deficit-/hyperactivity disorder (ADHD) is among the most common neurodevelopmental disorders in children, with a worldwide prevalence of about 5% in childhood. Tyrosinemia is caused by a genetic mutation in the fumarylacetoacetase gene that leads to a deficiency in the encoded enzyme, which catalyzes the cleavage of tyrosine metabolites to acetoacetic acid and fumaric acid. In recent studies of children with tyrosinemia type 1, a strong correlation was observed between symptoms of ADHD and blood levels of tyrosine, supporting a direct role of this amino acid in the pathogenesis.

we report this case of tyrosinemia type 1 associated to ADHD symptoms to contribute in literature to provide more insights into possible shared pathophysiological mechanisms and how these affect their treatment.

We report the case of an 8-year-old child, followed since the age of 3 months for a tyrosinemia type 1 who presented symptoms of ADHD.

scales and questionnaires were used to detect ADHD symptoms, the SNAP IV - Swanson, Nolan and Pelham Teacher and Parent Rating Scale was used with the mother, the items concerning inattention (items 1 to 10) and Hyperactivity-Impulsivity (items 11 to 20) were revealing; The Conners Evaluation Questionnaire was delivered, confirming the same result, a neuropsychological evaluation of the child with IQ evaluation by WISC-IV - Wechsler Intelligence Scale for Children and Adolescents revealed limited intellectual performance with an IQ of 65.

NMDs, such as HT-1, constitute a large group of conditions that are often containable with early clinical intervention, but still present lifelong difficulties and high societal costs. many studies suggest that there may be similar biological mechanisms behind the cognitive difficulties seen in ADHD and HT-1. In clinical settings, the impaired dopamine synthesis due to substrate inhibition in treated HT-1 may be compensated for by standard ADHD medication, such as methylphenidate or amphetamine. Similarly, the reduced serotonin synthesis may be counteracted by tryptophan supplementation.

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Anti N-methyl-d-aspartate receptor (anti-NMDA-R) encephalitis is a potentially reversible cause of psychosis. Nearly all patients (>95.5%) quickly develop additional neurological symptoms, and only about 50 percent fully recover, often with latency. At symptom onset, patients commonly present with isolated psychosis, making it challenging to distinguish the disease from a primary psychiatric disorder: The median time from symptom onset to immunotherapy in adults is 28 days (IQR 14–49), and from symptom onset to surgery in tumor-associated cases 1.4 months (IQR 0.7–2.6). Steroids, intravenous immunoglobulins (IVIG), or plasmapheresis are recommended as first-line immunotherapies.

To highlight a case with improved outcome after very early combined first-line immunotherapy (steroids plus IVIG) and surgery in tumor-associated anti-NMDA-R encephalitis.

Workup of the clinical case followed by a review of the literature.

We present the case of a 33-year-old woman with sudden onset of anxiety and jealousy ideas, which within a few days, developed a manifest psychosis with formal thought disorders, paranoid and guilt delusions, distrust, and orientation disorders in the absence of additional neurological deficits. A lower abdominal tumor suspicious of an ovarian tumor was detected sonographically five days before the onset of the first symptoms. Lumbar puncture and abdominal computer tomography were performed within 30 hours after hospital admission, confirming the diagnosis of tumor-associated anti-NMDA-R encephalitis with autoantibodies in CSF and serum at a very early clinical stage. First-line immunotherapy with steroids (methylprednisolone 1000mg, day 6 to 10 after symptom onset) was started immediately and combined with IVIG therapy (0.35g/kg, day 9 to 13 after symptom onset). Surgery of the ovarian tumor was performed on day 14 after admission, with histology revealing an immature teratoma. The neuropsychatric examination on day 1 after surgery showed complete remission of clinical symptoms, which persisted during clinical follow-up after 1 and 4 months.

The present case highlights the role of early CSF diagnostic and tumor assessment if autoimmune encephalitis is suspected. Very early first-line immunotherapy with steroids and IVIG, complemented by tumor surgery, was associated with improved outcome in this case with anti-NMDA-R encephalitis. Further studies are warranted to evaluate the generalizability of the finding.

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Celiac disease (CD), triggered by gluten ingestion, occurs in people genetically predisposed to develop this chronic autoimmune condition. The triggering environmental factor, gluten, is known as a protein present in wheat, rye and barley. In recent decades, specialists have found more knowledge about the disease mechanisms, how it develops and other disturbances which accompany it. The CD was considered a pediatric main gastrointestinal disorder, associated with symptoms of abdominal pain, diarrhea, constipation and bloating, and characterized by damage to the villi of the small intestine. People with CD may experience anemia, fatigue, osteopenia or osteoporosis, bone fracture, neurological and psychiatric problems beside anxiety as depression, ataxia, neuropathy. However, the results of several studies conducted on the fact that people with CD have an increased level of anxiety are mixed.

The present work is highlighting the importance of observing the anxiety levels in people diagnosed with CD beside the suitable interventions in reducing it.

For our study scientific databases were screened using certain keywords and combinations of it as: ”celiac disease”, ”gluten”, ”gastrointestinal disorder”, ”treatment”, ”neurological problems”, ”anxiety”. Inclusion criteria were studies that (1) investigated anxiety levels in CD people, (2) reported gender results, (3) were written in English, and (4) were published within the last 20 years.

In some cases, as main intervention in CD, gluten removal from the people’s diet usually reported improvements of the present symptoms. In addition, data from literature are describing a higher level of anxiety in females compared to males diagnosed with CD. This can be a consequence of females concerns about how they can manage the CD issues and, especially, what this is bringing in their lifestyle. On the opposite, there are reports which showed that demographic parameters (gender, age, education) are not associated with CD presence.

The balance between CD and anxiety needs to be more investigated in order to identify and fully understand what is the background mechanism and how this can be regulated through specific interventions.

M. Robea Grant / Research support from: ,Platformă multidisciplinară de cercetare-dezvoltare medicală în regiunea N-E,,, acronim: CENEMED, cod mySMIS: 127606, proiect cofinanțat prin Programul Operațional Competitivitate, Axa Prioritară: Cercetare, Dezvoltare tehnologică și Inovare (CDI)., A. Ciobica: None Declared, C. Stanciu: None Declared, A. Trifan: None Declared

Despite the literature regarding the impact of the COVID-19 pandemic on education, there is little research that specifically targets medical students and their relationship with online courses in regards to engagement and feelings of inadequacy.

This cross-sectional study aims to explore such questions by evaluating a small (N=169) sample of Romanian medical students and applying self-reporting questionnaires in order to quantify subjective levels of burnout and imposter phenomenon

Responders filled an online survey with question regarding miscellaneous socio-demographic factors, alont with the Academic Burnout Scale (ABS), Clarence Imposter Phenomenon Scale (CIPS) and Ohio Resilience Scale (ORS). Results were collected and analysed for subsequent correlations.

Predictably, respondents already in favour with online courses showed less signs of burnout and higher levels of resilience. While higher-year students preferred online courses, particularly final year students, it was lower-year students who showed higher level of resilience and lower burnout and imposter phenomenon levels, possibly suggesting a more profound impact of online education on students in clinical rotations, as opposed to pre-clinical ones. No statistically significant correlations were found between socio-demographic factors and the self-reported ratings, showing that feelings of burnout and imposter phenomenon were equally distributed among genders.

The results of this study present a snapshot into the opinions of future Romanian medical professionals on their own education and, in spite of its methodological limitations, can function as a starting point for deeper and more exhaustive inquiry regarding medical education during COVID-19 times.

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Assisted dying (AD) is a general term in the literature to incorporate both physician-assisted suicide (PAS) and voluntary active euthanasia. In 2002 Belgium became the first country in the world to specifically acknowledge mental suffering in law as a valid basis for AD, specifically euthanasia, with other countries passing similar AD legislation more recently. Local legislation stipulates both substantive and procedural criteria that must be met for AD in jurisdictions, with only minor differences in procedural criteria noted accross sites.

In countries without AD legislation it remains a criminal offence for a physician to partake in AD, the offence prosecutable under local laws as manslaughter. It is a fiercely contentious issue within the medical, legal, political, religious and ethical fields with lack of consensus and on-going deliberation.

The author examines literature regarding the ethical issues raised by medical assistance in dying in psychiatry.

A non-systematized review of the literature, using literature available on PubMed, PsychINFO and Medline.

Findings from this review indicate that Beauchamp & Childress’ biomedical approach of equilibrating the ethical principles of ‘respect for autonomy’, ‘beneficience’, ‘nonmaleficence’ and ‘justice’, to act in the best interests of their patients are those most used in contemporary psychiatric practice. There is a fundamental theme suggested in the literature that ‘respect for autonomy’ is both the prevailing and challenging ethical principle to soundly navigate in AD cases. Within this principle, the task of objectively assessing capacity remains dominant.

Psychiatry remains unique in its pathology, biological and social entanglement hence the literature suggests a limit to autonomous decisions be considered, due to the extreme vulnerability and vast potential for abuse of this patient cohort.

Ultimately, the literature suggests physicians adhere to available professional medical ethical guidelines (should they be available), using an objective scale for undertaking capacity assessments, and seeking advice from the courts rather than bearing any outstanding ethical burden in these most complex of cases.

Infinite complexities and dissensus surrounding practice of psychiatric AD. The ethical principle of autonomy retains a significant role in both AD and psychiatric debates, with specific attention drawn the quandary of psychiatric capacity assessment. In addition to the moral question of whether it is appropriate to assist psychiatric patients to end their lives, the appropriateness of this role for psychiatrists is yet to be determined in light of professional disdain. Further analysis of cases are required, as they are published over time, to further reform the ethical and legal arguments.

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Patients with bipolar disorder have a hig risk of becoming overweight and obese, associated with an increased risk of somatic diseases and premature mortality. The Austrian BIPFAT/BIPLONG study aims at investigating lipid metabolism, psychosocial functioning, and cognitive parameters in bipolar disorder (BD).

The aim was to investigate to what extent overweight, obesity and metabolic syndrome (MetS) are associated with clinical symptoms (e.g. suicidality, depressive symptoms) and cognitive factors (attention, memory, executive function) in BD.

In addition to anamnestic interview and psychological tests, all participants were tested with a neuropsychological test battery including the Trail Making Test A/B, the Stroop Color and Word Interference Test, the d2 Test of Attention Revised, Digit Span, Digit-Symbol-Test, and the California Verbal Learning Test. Additionally, body mass index (BMI) and variables defining MetS including waist circumference, serum triglycerides, high-density lipoprotein, blood pressure, and fasting glucose levels have been collected in DSM-5 diagnosed patients with BD and healthy controls.

In our Austrian bipolar cohort (n=290), the median BMI was 27.9 (SD=5.9), 30.5 % of the patients were overweight (BMI = 25.5-29.9) and 24.6% of the patients were obese (BMI ≥ 30.0). In the control group (n=183), the median BMI was 24.5 (SD=4.8), 15.2% were overweight and 8.0% were obese. A sub-analysis in 215 patients showed that compared to overweight patients, normal weight patients showed more suicidal ideation in psychiatric history (χ2(2)=7.97, p=.019). In addition, there was a significant association between suicidal ideation and glucose (r=.15, p=.043) and cholesterol (r=−.17, p=.028). In another sub-analysis with 148 euthymic bipolar patients, we found a high prevalence of MetS in patients with BD (30.4% versus 15.4% in healthy controls) associated with impaired executive function compared to patients without MetS or healthy controls with and without MetS (p=.020). Clinical variables (illness duration, suicidality, number of affective episodes, medication, age of onset, and history of psychosis) did not relate to MetS in BD (p > .05). A longitudinal analysis in 52 patients (35 without MetS and 17 with MetS) did not find an association of MetS on the one-year trajectory of cognitive decline in BD. In contrast, high baseline BMI predicted a decrease in the patient’s performance in working memory in the 12-months observation period.

The BIPFAT/BIPLONG study demonstrated a high prevalence of overweight, obesity and MetS in bipolar patients with adverse effects on cognitive function. Clinical variables such as suicidality were not related to the presence of obesity or MetS. Clinical impact and further (unpublished) results will be presented.

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With the escalation of cannabis legalization and commercialization, the need to differentiate low- vs. high-risk patterns of cannabis use, especially among frequent consumers, becomes essential for development of prevention and intervention strategies and public health messaging. The diversity of cannabis products and methods of intake make this task complex. In particular, the lack of valid methods for quantifying use of the intoxicating component of cannabis, i.e., THC, poses a difficult challenge. This presentation will describe a series of internet-based, personalized survey studies of adults who consume cannabis frequently. The aims of the studies are to develop methods for quantifying THC from self-reports of use, identify patterns of use, and determine associations between use and risk. In the first study of adult daily cannabis consumers (n>4000), rates of CUD were 35% no disorder, 39% mild, 18% moderate, 8% severe disorder. Higher severity was significantly related to younger age, unemployment, and specific reasons for use. Latent class analyses identified four distinct subgroups and preliminary analyses showed that those more likely to report oral use were less likely to meet CUD criteria, and those more likely to report use of high potency products were more likely to meet moderate/severe criteria. Two studies (n’s >2000) compared different quantitative formulas for estimating daily THC consumption from vaping or smoking cannabis products. Findings demonstrated how quantity (mgTHC) relates to socio-demographics, use patterns, and CUD severity. However, substantial variability in the estimates obtained across quantitation methods indicates the need for additional studies to determine optimal approaches. Overall, findings show that specific characteristics of use can discriminate low- from high-risk consumption among those who use frequently, which is critical for developing cannabis policy and public health messaging.

None Declared

Many research studies and clinicians consider a heterogeneous IQ profile as a specific developmental characteristic to High Intellectual Potential (HIP), despite difficulties in handwriting. We propose to illustrate by a case study, the interest of supplementing a scale IQ with a standardized neuropsychomotor assessment.

We report the complex evaluation of a 8.5 years old boy with an IQ = 137, assessed HIP with a heterogeneous profile at the WISC-V but presenting a clumsiness with a dysgraphia (using the right hand) and difficulties in geometry. These disorders have been attributed by a psychologist to a fast thinking that can impact his graphomotor gesture. However, we aimed to better understand the gap between some IQ index scores.

We have conducted a complete standardized assessment of developmental neuropsychomotor functions (NP-MOT battery, Vaivre-Douret. Digital Ed Neuralix®, 2021; https://neuralix-editions.com/) with age-related normative data, and of neuropsychological functions, in addition an oculomotor examination (Eye-tracking).

The IQ index scores are: VCI = 155, VSI = 108, FRI = 137, WMI = 138, PSI = 92. We found with the NP-MOT battery, a left-handed laterality and at the muscular tone examination, a motor dysfunction of the pyramidal tract on the left body distal side (mild spasticity) and oculomotor disorders of the visual pursuits, associated to visual-spatial motor and visual motor integration impairments.

It is a neurologically right-handed child because he can not effectively use his left hand to correctly write but he is not so good with the right hand to write. Moreover, he presents a visual-spatial motor subtype (< -2 SD) of developmental coordination disorder (DCD according the DSM-5) with oculomotor abnormalities, explaining his clumsiness and dysgraphia, and his difficulties in geometry. Thus, the subtests that make up VSI and PSI highlight a motor component (graphomotor, oculomotor, visuomotor) that should be analyzed in the light of additional neuropsychological and normed assessments of developmental neuropsychomotor functions.

Comorbidity of neurological and motor coordination disorders do not spare the child with a high intellectual potential, despite his high mental abilities helping him to compensate. It is important to complete the WISC-V scale by other investigations, particularly in the motor field, to explain the heterogeneity of the IQ profile with scattered index scales.

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Pregnancy and childbirth are moments of great vulnerability in a woman’s life, which can predispose her to the development of psychopathology, ranging from transient depressive symptoms (“baby blues”) to psychotic symptoms. Postpartum delirium is the psychiatric syndrome that some authors refer to as puerperal psychosis par excellence. It was first described in the 18th century and were thought to be associated with painful delivery, then became rare after the introduction of effective analgesia.

The objective of this work is to contribute to a better understanding of this condition, through a literature review.

Bibliographic research using Pubmed® and the keywords: postpartum delirium.

Clinical presentation of postpartum delirium includes: constantly varying degrees of consciousness; perplexity; hallucinations or pseudo-hallucinations of one or more organs of sense; delusions or delusive-type thoughts; great motoric unrest and considerable motoric and verbal abandon; and acute aggressive discharges can also occur. It is thought to be due to organic complications, such as infectious disease, abnormal loss of blood, thrombosis, neurological disease, obstetric disease, vitamin deficiencies, hormonal changes. An article from 1975 mentions how difficult was to treat postpartum delirium despite the development of psychopharmaceutical therapy. The patients remained psychotic for long periods and had many relapses. They mention a comparative study that found that the symptomatic treatment of this syndrome with a combination of perfenazine and lithium carbonate produced relatively favorable results. For that reason, at that time, it was the medication of choice. Nowadays the psychopharmacological treatment of puerperal psychosis, in general, still consists of the combination of lithium and an antipsychotic, such as haloperidol, and possibly a benzodiazepine, such as lorazepam.

Postpartum delirium is rarely mentioned in the literature and just a few cases have been described. It is considered a rare postpartum psychotic condition but would perhaps be less rare if its existence were recognized. On this note, it is important for clinical practice to research on the psychoses of pregnancy and not just the most common.

None Declared

The SARS-CoV-2 pandemic situation forced the Spanish Government to declare a home confinement that was prolonged for three months. The Health System had to focus almost entirely on the treatment of patients with Covid-19 infection and vulnerable populations such as people with severe mental illness were overlooked. In this context, mental health home care as an alternative to hospitalization became a first-line approachment for patients with an acute mental health disorder.

The aim of this study is to describe the professional practice and the patients characteristics attended by a mental health team in Catalonia during the home confinement due to the SARS-CoV-2 pandemic.

This study includes the period between March 15, 2020 and June 21, 2020. Sociodemographic, clinical and team functioning variables were described. The patient data was obtained from medical history whereas the rest of information was collected through the creation of a database by the members of the assistencial team.

Team’s structure was changed with the creation of two mirror teams. Psychological attention was expanded and the weekend coverage was reorganized.During that period 40 patients were treated with a mean age of 47 years. There were no differences regarding the gender (50% were men and 50% were women). 87% of the patients lived with their family. 75% of referrals were made by the hospital and 90% were referred to community services upon discharge. Regarding diagnoses, 57.5% of the patients were diagnosed with a psychotic disorder (10% being reactive to Covid-19). A total of 482 visits were made, of which 51% were conducted in a telematic form. The mean time between the referral and the admission was 37.98h. The team accepted 97% of the referred patients with an occupancy rate of 112.4%.

The re-organisation of a home treatment team during the domiciliary lockdown allowed to increase the occupancy rate and offered a rapid response to patients, avoiding the need of conventional hospitalization and providing a proper care plan.

None Declared

Up to 50% of patients with brain tumors experience psychiatric symptoms, and rates up to 80% have been reported in malignant neoplasms such as glioblastoma multiforme (GBM). Still, clinical presentation as mania-like syndromes is a rare phenomenon, mainly occurring when frontal structures are compromised.

We present the case of a 42-year-old woman who was admitted to our hospital due to manic symptoms coinciding with a recurrence of a bifrontal GBM, for which she underwent surgery 5 months prior.

1) To describe the clinical particularities of this case, focusing on the differential diagnosis.

2) To review the association between manic symptoms and frontal dysfunction caused by brain tumors, with special interest on GBM.

A review of the patient’s clinical history and complementary tests performed was carried out. Likewise, we reviewed the available literature in relation to manic symptoms related to brain tumors.

The patient’s GBM recurrence presented with late onset symptoms of mania, including euphoric mood, increased spending, ideas of grandiosity and hyper-religiosity. She had no previous psychiatric history but, interestingly, she had an extensive affective burden in her family, with 4 consummated suicides. However, she also presented other clinical signs, such as disorientation, perseveration, mild memory impairment and stereotyped motor behaviors, that pointed to relevant frontal lobe dysfunction, suggesting Moria as a possible contribution for the symptoms described.

Manic symptoms in the context of brain tumors appear in 7-15% of patients with psychiatric symptoms, usually associated with right frontal dysfunction (75% of cases). Bifrontal affectation, such as this patient, is only described in 6% of cases. Although fast growing, malignant tumors have been associated with higher rates of psychiatric symptoms, no correlation has been described between these and brain tumor histology.

- The presence of atypical manic symptoms, such as those presented in this case, should raise clinical concern for secondary mania.

- Moria shares similarities with mania, including mood elevation, tendency to hilarity or hyper-sexuality, that may hinder diagnosis of patients with frontal dysfunction.

- This case outlines the difficulties in making a differential diagnosis in patient with both manic and neurological signs, and highlights the implication of frontal structures in the development of manic symptoms.

None Declared

Pharmaceutical slogans presuming a particular antidepressant molecule being the best solely based on a core concept could be proved “not accurate” especially following patients’ actual exposure to the antidepressant for longer than the usual six or twelve weeks’ trials

Reviewing the current situations of SSRI induced anhedonia recognition and its management. Distinguishing anhedonia as a core symptoms of depression from SSRI induced anhedonia and the combination of both.

Review of literatures including theses related to the same topic

Research suggests that, SSRIs might be more effective at treating some symptoms than others. More specifically, it has been suggested that, SSRIs might be more effective at improving symptoms such as low mood and anxiety but not anhedonia (Argyropoulos et al. psych.pharmaology, 2013; 27(10), 869-877). It has been proposed that, catecholaminergic antidepressants might be more effective treatments for anhedonia and emotional blunting in MDD than SSRIs (McCabe et al. Biological psychiatry, 2010; 67(5), 439–445. The primary effect of SSRIs is reduced processing of negative stimuli rather than increased positive stimuli. Emotional blunting is related to SSRI dose and possibly serotonergic effects on the frontal lobes and/or serotonergic modulation of midbrain dopaminergic systems projecting to the prefrontal cortex (PFC). By enhancing serotonergic transmission, SSRIs can activate the inhibitory Gamma Aminobutyric Acid (GABA) interneurons, thereby dampening the noradrenergic and dopaminergic input ( Blier. Int J Neuropsychopharmacol., 2014; 17:997–1008).

Management of SSRI induced anhedonia includes lowering the current SSRI dose. Adding non SSRI antidepressant to the current SSRI dose or to a lowered SSRI dose. Gradual discontinuation of the SSRI and switching to another antidepressant with a different profile (SNRI) that might improve the patient’s emotional response (Koenigs. Behav Brain Res., 2009;201:239–43).

Bupropion is an antidepressant with less possibility to give rise to emotional blunting. (Tomoko et al. Neuroscience Letters., 2021; 749, 135716. agomelatine(Thome et al. Journal of neural transmission., 2015; 122(1), 3-7.Vortioxetine and others (Bing et al. frontiers in psychiatry., Jan, 2019; 10-17. are of inrerest in this regard.

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The most selective SSRI concept assumes that most selective means less affinity to other receptors or secondary binding sites which might suggest less side effects and perhaps being the most efficacious. Not only serotonin but multiple neurotransmitters are in action at the downstream part of a cascade of events underpinning the etiology of MDD. MDD has heterogeneous etiology and this explains why patients respond differently. SSRI induced anhedonia could be tackled and we need to explore how many patients would benefit from that now and have not yet.

None Declared

Background of behavioral addictions, which include smartphone addiction, is complicated and unclear. Belonging to an Internet community that shows many forms of virtual pathology and generates new, artificial trends also favors the development of mental implications which include lowered mental immunity, emotional lability, increased depressiveness, aggression, inadequate self-esteem, lowered self-value and personality disorders. Implications regarding the social sphere are above all related to the gradual alienation from the closest environment as a result of preoccupation with the subject of dependence. Those consequences include deterioration of social relations, loss of interpersonal skills and former interests, as well as the minimization of contacts with the closest ones which lead to the sense of social isolation and loneliness.

The aim of this study was to estimate the scale of mobile phone addiction among young adults as well as to establish whether the low level of perceived social support is related to the problematic smartphone use, and whether an addictive pattern of smartphone use is related to the prevalence of depressiveness and excessive daytime sleepiness.

The study involved 567 young-adult respondents from West Pomeranian Voivodship in Poland. The study was carried out using the diagnostic poll method via questionnaire technique. Both the author’s own questionnaire and the following standardized research tools were used: the Mobile Phone Problem Use Scale for Adolescents (MPPUSA), the Beck Depression Inventory (BDI), the Epworth Sleepiness Scale (ESS), the Multidimensional Scale of Perceived Social Support (MSPSS).

Perceived social support was significantly lower in the group of respondents who problematically used their smartphones in comparison with the ones who used them in a correct way (p < 0.05). Severity of depressive symptoms and daytime sleepiness (p < 0.05) was significantly greater in respondents addicted to their mobiles in comparison with non-addicted ones.

The scale of the mobile phone addiction phenomenon in respondents was low. Many respondents though expressed a subjective sense of being addicted to their smartphones in comparison with the obtained results. Problematic smartphone use concerns to the same degree members of both sexes, residents of villages and cities, as well as singles and ones in relationships (both formal and informal). The mobile phone addiction is associated with the risk of severe symptoms of depression and excessive daytime sleepiness. Pathologic pattern of smartphone use much more frequently concerned individuals who perceived their social support level as low.

None Declared

Negative symptoms has been classically associated with cognition, psychosocial functioning and quality of life in patients with schizophrenia. But negative symptoms are not a unitary construct, encompassing two different factors: diminished expression, and motivation and pleasure. Few works have studied the relationship between these two different negative symptoms factors and cognition (neuro and social cognition), psychosocial functioning and quality of life, jointly, in patients with a first psychotic episode of schizophrenia.

The objective of the present work was to study, in a sample of patients with a first psychotic episode of schizophrenia, the relationship between the negative symptoms (diminished expression and motivation and pleasure) and neurocognition, social cognition, functioning and quality of life.

The study was carried out with 82 outpatients with a first psychotic episode of schizophrenia from two Spanish hospitals (“12 de Octubre” University Hospital, Madrid and “Virgen de la Luz” Hospital, Cuenca). The patients were assessed with the Clinical Assessment Interview for Negative Symptoms (CAINS) for evaluating diminished expression (EXP) and motivation and pleasure (MAP) symptoms, the MATRICS Consensus Cognitive Battery (MCCB) for evaluating neurocognition and social cognition, the Social and Occupational Functioning Assessment Scale (SOFAS), and the Quality of Life Scale (QLS).

A negative correlation was found between neurocognition and the two negative symptoms subscales: CAINS-EXP (r=-0.458, p<0.001) and CAINS-MAP (r=-0.374, p<0.001); but with social cognition only CAINS-EXP was correlated (r=-0.236, p=0.033). Also, it was found a high negative correlation between SOFAS scores and CAINS-MAP (r=-0.717, p<0.001); and a medium negative correlation with CAINS-EXP (r=-0.394, p<0.001). Finally, QLS score was high correlated with both CAINS subscales: CAINS-EXP (r=-0.681, p<0.001) and CAINS-MAP (r=-0.770, p<0.001).

This study found a relationship between negative symptoms and neurocognition, social cognition, functioning and quality of life in a sample of patients with a first psychotic episode of schizophrenia. But the two different negative symptom factors, diminished expression, and motivation and pleasure, are associated differently with psychosocial functioning, but especially with social cognition where the relationship was only found with diminished expression symptoms.

None Declared

Major depressive disorder (MDD) is a highly prevalent mental illness that frequently originates in early development and is pervasive during adolescence. Despite its high prevalence and early age of onset, our understanding of the potentially unique neural basis of MDD in this age group is still not well understood, and the existing primary literature on the topic includes many new and divergent results. This limited understanding of MDD in youth presents a critical need to further investigate its neural basis in youth and presents an opportunity to also improve clinical treatments that target its neural abnormalities.

The present study aims to advance our understanding of the neural basis of MDD in youth by identifying abnormal functional activation in various brain regions compared with healthy controls.

We conducted a meta-analysis of functional magnetic resonance imaging (fMRI) studies of MDD by using a well-established method, multilevel kernel density analysis (MKDA) with ensemble thresholding, to quantitatively combine all existing whole-brain fMRI studies of MDD in youth compared with healthy controls. This method involves a voxel-wise, whole-brain approach, that compares neural activation of patients with MDD to age-matched healthy controls across variations of task-based conditions, which we subcategorize into affective processing, executive functioning, positive valence, negative valence, and symptom provocation tasks.

Youth with MDD exhibited statistically significant (p<0.05; FWE-corrected) hyperactivation and hypoactivation in multiple brain regions compared with age-matched healthy controls. These results include significant effects that are stable across various tasks as well as some that appear to depend on task conditions.

This study strengthens our understanding of the neural basis of MDD in youth and may also be used to help identify possible similarities and differences between youth and adults with depression. It may also help inform the development of new treatment interventions and tools for predicting unique treatment responses in youth with depression.

None Declared

In individuals with first episode psychosis (FEP) and cannabis use disorder (CUD), reducing cannabis use is associated with improved clinical outcomes. Access to evidence-based psychological interventions to decrease cannabis use in FEP clinics is highly variable; E-mental health interventions may help to address this gap. Development of E-interventions for CUD in individuals with FEP is in its incipient phases.

To assess preferences for online psychological interventions aiming at decreasing or stopping cannabis use in young adults with psychosis and CUD.

Individuals aged 18 to 35 years old with psychosis and CUD were recruited from seven FEP intervention programs in Canada and responded to an electronic survey between January 2020-July 2022. We used the Case 2 Best Worst Scaling methodology that is grounded in the trade-off utility concept to collect and analyse data. Participants selected the best or worst option for each of the nine questions corresponding to three distinct domains. For each domain we used conditional logistic regression and marginal models (i.e., three models in total) to estimate preferences for attributes (e.g., duration, frequency of online intervention sessions) and attribute levels (e.g., 15 minutes, every day).

Participants (N=104) showed higher preferences for the following attributes: duration of online sessions; mode of receiving the intervention; method of feedback delivery and the frequency of feedback from clinicians (Table 1). Attribute-level analyses showed higher preferences for participating once a week in short (15 minutes) online interventions (Figure 1). Participants valued the autonomy offered by online interventions which aligns with their preference for completing the intervention outside the clinic and only require assistance once a week (Figure 2). Participants’ preferences were higher for receiving feedback related to cannabis consumption both from the application and clinicians at a frequency of once a week from clinicians (Figure 3).Table 1.Preferences for Attributes. Results of conditional logistic regression

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Using advanced methodologies to assess preferences, our results can inform the development of highly acceptable E-Mental health interventions for decreasing cannabis use in individuals with CUD and FEP.

None Declared

Functional cognitive disorders (FCD) denotes a complaint about memory function or, less commonly, another cognitive process, in the absence of relevant neuropathology and with evidence of inconsistency between symptoms reported and signs identified at assessment.

Increasing numbers of people with FCD are being identified.

Most are discharged back to primary care without a diagnosis or are given the label of mild cognitive impairment, which is not a synonym for FCD.

There is a multitude of terms in the clinic and in the research to describe this kind of complaints. Some terms seem to minimize and normalize the state, whereas others posit an underlying cause.

Given this lack of order, it is a challenge to diagnose it and give it the proper clinical guidance.

This literature-based review aims to fill this gap.

Data was obtained through an internet-based literature search, using the databases PubMed, Cochrane Library and NCBI. The World Health Organization was also utilized. Nine articles from the last two years were included.

It is listed a nosology in six categories and a selection of clinical features which may help with the discrimination of functional and neurological disease causes of memory disorders.

Patients presenting with complaints about memory function require standard psychiatric and neurological history and examination.

It should be emphasized that these conditions are not diagnoses of exclusion but have positive symptoms and signs that should become well-known.

Nevertheless, we remain uncertain about prognosis and treatments, both psychological and pharmacological. Its development would reduce the burden of patients in the healthcare systems.

None Declared