Prevalence of Autism Spectrum Disorder (ASD) is 33.6% among children with developmental disabilities in Egypt. Children with ASD have unique needs & interventions must be individualized for successful outcomes. Many systems are involved to provide services or funding resources to assist patients with ASD & their families. Coordination of multiple services is a challenge for families.

To understand the changing needs of the expanding autism population.

This effort would be intended for policymakers, service providers, community organizations & advocacy groups to better understand & address the needs of children with autism in Egypt. Needs assessment countrywide would be the first step in developing system of care for these children.

Surveying of children with autism & their families should be done to assess how or if the needs of children with autism & their families are met along with surveying service providers on the quality of service provided for children with autism.

A questionnaire will be designed for the families to assess the availability of mental health services for ASD patients and its accessibility along with its efficiency & meeting their expectations as regards appropriate care & support, in addition the role of these specialized services in promoting the understanding of the families of ASD patients. Furthermore assessing provision of appropriate primary health care services that are ready to accommodate ASD patients’ special conditions as well as secondary & tertiary services.

Another questionnaire would be provided to mental health professionals dealing with ASD patients, it would include providers at all levels of service like child psychiatrists, general psychiatrists, behavioral therapists, psychologists, nurses, social workers & administrators of services. This questionnaire would assess presence of resources & appropriate management, available funding & if it meets the needs of services, appropriate training for professionals & service providers, coordination between facilities, barriers & limitations they face in their work as well as obtaining their suggestions to enhance the services provided.

All the data will be collected & revised for completeness. Statisticians & community health professionals will be consulted for helping empower the study & guiding our field work. Clustering of data on geographical basis would help understand & prioritize areas of need as well.

To develop system of caring for autism in Egypt we should look at whether Egyptians living with autism are getting the services they need. We should identify barriers to accessing services & examine if the families of children with autism consider the services they do receive to be effective. We believe Egyptians with autism & their families are struggling to find the services they need & are often dissatisfied with the services that are provided.

None Declared

During the COVID-19 pandemic, people with mental disorders were exposed to a common and prolonged source of stress. Studies focusing on the consequences of the pandemic on individuals with a history of mental disorder are scarce, but they suggest a higher vulnerability as compared to the general population.

We aimed at identifying predictors of stress resilience maintained over time among these people during the first two years of the pandemic.

The presented study is part of a larger 2-year, 5-wave international longitudinal online survey.

The Patient Health Questionnaire, the Generalized Anxiety Disorder scale and the PTSD Checklist DSM-5 were used as latent class indicators for a proxy measure of distress. Specifically, a Latent-Class Analysis was performed to identify a group that showed resilient outcomes across all waves.

We investigated socio-demographic characteristics, economic and housing status, lifestyle and habits, pandemic-related issues, and chronic disease. Adherence to and approval of the restrictions imposed, trust in governments and the scientific community during the pandemic were also assessed. Social support, fear of contamination and personal values were investigated respectively through the Oslo Social Support Scale, the Padua Inventory, and the Portrait Values Questionnaire. The aforementioned characteristics were used to predict sustained resilience through a logistic regression.

A total of 1711 participants out of the total sample (8011 participants from 13 different countries) reported a diagnosis of mental disorder before the pandemic. Nine hundred forty-three participants completed at least three of the five versions of the survey and were included in the analysis. A latent class of participants with resilience maintained over time (sustained resilience) was identified, with an estimated probability of 24.8%. The demographic and clinical variables associated with a higher chance of sustained resilience were older age, maintaining a job during the pandemic, and having a larger number of people in the household. In contrast, female gender, losing job during the pandemic, having difficulty meeting basic needs, greater fear of contamination, a stronger focus on hedonism, less social support and feeling lonely resulted in a lower likelihood of being sustained resilient.

This study identified a number of factors that may help predict resilient outcomes maintained over time in people with mental disorders. COVID-19 related predictors of sustained resilience are new findings which might inform resilience-building interventions during pandemics.

None Declared

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.

None Declared

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.

None Declared

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.

None Declared

A broad spectrum of medical conditions manifest with both neurological and psychiatric symptoms. One of them is encephalitis- an inflammatory brain disease, caused by diverse etiological factors. Due to the pronounced psychopathological findings these patients frequently encounter primarily the mental health services or may appear as a part of the consultation-liaison psychiatry practice.

We present the case of a 31-year-old male firstly consulted by a psychiatrist and consequently admitted to neurological ICU. His condition developed over two-year period, developing transient psychiatric symptoms, such as anxiety, auditory hallucinations, persecutory delusions and auto-aggressive behavior; non-specific neurological findings, including pseudobulbar syndrome, oral and manual automatisms; as well as EEG paroxysmal activity. The most notable manifestations were fluctuating orientation and awareness, progressive executive function decline and cognitive impairment. In the course of the illness many psychotropic medicines had been used. The patient had shown either no improvement or low tolerance to adverse effects.

To demonstrate a challenging and provocative case of our liaison psychiatry practice, where an interdisciplinary approach was mandatory.

For the needs of the psychiatric assessment a clinical interview was conducted. A neurocognitive examination via MMSE was performed. Some of the tests that took place in the neurology ward included: virological testing of blood and CSF, immunological screening for paraneoplastic syndrome and autoimmune encephalitis, MRI and EEG. The diagnosis was based on the ICD-10 criteria.

The mental status of the patient during the hospitalization showed no remarkable changes. The MMSE score was 22/30, correlating with a mild cognitive impairment. The neurological status fluctuated slightly over the period. Most of the tests showed none or only borderline deviations, considered nonsignificant. Some of the results were not ready prior the discharge of the patient from the hospital. After an immunomodulatory therapy there was a slight improvement in the condition of the patient.

Based on the course of the disorder, the presence of neurological aberrations, including in the higher cortical functions, the therapeutic resistance and low adverse effects threshold, a primary psychiatric disorder was excluded. Virological, paraneoplastic and autoimmune genesis of the disorder were also ruled out. More result are expected and more examinations are needed. Postinfectious encephalitis was accepted as the most probable diagnosis.

None Declared

Schizophrenia is a severe, common, chronic mental disorder with a prolonged and disabling course, having a high social impact.

Mortality is two to three times higher in schizophrenic patients than in the general population.

Suicide is the main cause of death in patients with schizophrenia. In spite of great efforts in preventing such deaths, suicide rates have remained alarmingly high, highlighting the need for a better understanding of the phenomenon.

The objective of this work is to determine the prevalence of suicide in schizophrenic patients, to investigate the main risk factors in these patients and the characteristics of suicide and the therapeutic management of the patients.

This is a retrospective study on medical records about 43 patients (32 men / 11 women) who were admitted to the Arrazi Hospital in Salé, from september 2021 to september 2022, using an operating form grouping socio-demographic criteria of the patients, personal and family history, characteristics of the suicide attempt and management.

In this study, 75% were male and 25% were female with an average age of 34.5 years. The existence of a personal history of suicidal ideation, plans and attempts is a major risk factor for suicide. The lethality of the means used reflects a higher degree of suicidal intentionality. Clozapine, in particular, plays a protective role by reducing the rate of suicides and suicide attempts.

Despite therapeutic progress, the prevalence of suicide among patients suffering from schizophrenia is still high.

The prevention of suicide in these patients remains fundamental, as does the reduction of positive or negative symptoms, the improvement of quality of life, the reduction of the handicap caused by this illness and the fight against the stigmatization of patients.

None Declared

Physical activity (PA) has multiple health benefits for people with severe mental illness (SMI). People with SMI engage in less exercise and more sedentary behaviour than the general population; this can be further exacerbated by inpatient settings. Staff’s attitudes towards PA may influence patient engagement.

In 2019, a study explored staff’s views on PA for acute psychiatric inpatients. This follow-up study by the same team aimed to establish whether the enablers/barriers to promoting PA have changed and to identify targets for intervention.

In 2022, an online anonymous survey with free text was sent to all multidisciplinary team (MDT) members (n=91) of two acute general adult wards, including nurses, doctors, and allied health professionals (AHPs). A combination of quantitative and qualitative analysis was used to understand participants’ perspectives. Manual thematic analysis was completed to identify discrete themes.

Response rate was significantly lower for the follow-up at 39% as opposed to 63% of the initial study, possibly reflective of post-COVID-19 staffing issues and lack of time for engagement in quality improvement activities. Respondents were nearly unanimous in agreeing that PA was beneficial to physical and mental health. Enablers to PA included higher numbers of staff (24%), more PA resources (22%), more PA-designated staff (19%), more PA-dedicated time (14%), and timetables of available activities (14%). The majority (65%) continued to report that promoting PA was difficult during their shift. Reported barriers included lack of staff (38%), lack of time (27%), and high levels of clinical activity (24%). Noticeably, nurses were much more likely than doctors or AHPs to report short staffing as a barrier to promoting PA (OR=19.8, p < 0.05). Participants described the gym (22%), walking groups (19%), and football (14%) as the most beneficial PA for patients, whilst 14% responded it was “whichever PA patients preferred”. This was mirrored by staff naming “user feedback” as a potential enabler. Reasons for PA being beneficial included “being outside” (24%) and “being inclusive” (11%). Only 45% of MDT members felt they had been provided with PA education/training.

Staff continued to acknowledge the importance of PA for physical and mental health and were aware of multiple enablers and barriers. Post-COVID-19, systemic issues such as staffing levels, lack of time, high levels of clinical activity, and lack of PA education/training remained barriers. Service user preference, enjoying the outdoors and inclusivity were features of activities perceived to be most beneficial. An integrative approach to mental health and wellbeing, providing inclusive activities, educating/training staff, promoting PA in inpatient psychiatric settings, and offering organisational support can contribute to improved PA provision and regular patient engagement.

None Declared

Acute laryngeal dystonia due to antipsychotics is an uncommon but potentially lethal form of extrapyramidal reaction. The initial symptoms may be subtle but progressively appear difficulties in phonation, stridor and dyspnea which are often life-threatening.

To describe a case of acute laryngeal dystonia and oculogyric crisis secondary to risperidone.

The present study is a case report of a patient admitted for schizophrenia who was presented a laryngeal dystonia and oculogyric crisis after being treated with 5mg risperidone. We also searched previously case reports, series and systematic reviews of laryngeal dystonia using a pubmed query.

A 30-year-old Caucasian woman who was admitted for schizophrenia presented rhinolalia, oropharynx paresthesias, mild dyspnea without stridor, and prolonged involuntary upword desviation of the eyes. All these symptoms started within 24 hours of starting risperidone 5mg per day. A laryngoscopy showed abnormal motion of the vocal cords that suggested laryngeal dystonia. Symptoms remitted after administration of intramuscular biperiden 4mg. Risperidone was later switched to olanzapine because of better psychomotor side-effect profile.

Laryngeal dystonia is a medical emergency requiring early diagnosis and immediate treatment. Anticholinergic agents should be carried out, without waiting for the results of complementary tests. The route of administration can be intramuscular or intravenous. This complication should be always kept into account when a patient is taking any antipsychotic, and remembered for the antipsychotic election in following treatments.

None Declared

Long-acting injectable antipsychotics (LAIA) have provided a significant improvement in the treatment of schizophrenia. Although there is already significant clinical experience with paliperidone palmitate, it is important to evaluate the clinical response of patients to this new 6-monthly presentation, so descriptive studies based on real clinical evidence can be very useful for this purpose.

The main objective of the study is to describe the use of 6-monthly paliperidone palmitate in routine clinical practice, providing variables that objectify the evolution such as the number of admissions and visits to the emergency room.

Retrospective descriptive study with a sample selected by non-probabilistic consecutive sampling, retrospective type, in a time interval of 12 months (n=40). The patients selected were all those who received 6-monthly paliperidone palmitate treatment, with a diagnosis of schizophrenia, in 12 months of use at Hospital Universitario Infanta Elena. A descriptive analysis was performed. Mean and standard deviation were calculated for quantitative variables and N and percentage for categorical variables.

A total of 40 administrations of 6-monthly paliperidone palmitate were performed in the study. None of the patients presented adverse reactions related to the administration of the drug, not reporting local pain or inflammation of the puncture area, except for the characteristic discomfort of an intramuscular puncture. Regarding the efficacy of 6-monthly paliperidone palmitate, none of the patients presented a psychotic decompensation after its administration, maintaining psychopathological stability after the change. The switch to 6-monthly paliperidone palmitate was made from both 1-monthly paliperidone palmitate and 3-monthly paliperidone palmitate, both showing the same efficacy. Regarding tolerability, all the patients who were administered 6-monthly paliperidone palmitate were previously treated with the monthly and quarterly presentation of the same molecule, having presented good tolerability to it, maintaining said tolerability after treatment. change to 6-monthly paliperidone palmitate, with no adverse reaction being recorded after the change. The adherence presented by the patients was very good, performing 100% of the administrations of 6-monthly paliperidone palmitate

6-monthly paliperidone palmitate may be an effective and well-tolerated treatment for the treatment of schizophrenia. In the present study, the use of said LAIA in a group of 40 patients is objectified, showing excellent efficacy and tolerability. All study patients were already stable with the 1-monthly and 3-monthly paliperidone palmitate formulations, maintaining said psychopathological stability when switching to the 6-monthly paliperidone palmitate formulation, with excellent adherence and adverse effect profile .

None Declared

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

Image:

Image 2:

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.

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.

None Declared

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

People living with HIV (PLHIV) experience higher levels of mental health issues compared to the general population. Especially depression, anxiety, impulsivity and substance use occur frequently in PLHIV. This is thought to have important consequences for quality of life, sexual risk behaviour and antiretroviral treatment (ART) adherence. Both in PLHIV as well as in the general population, divergent psychiatric symptoms often co-occur, and influence one another.

To assess the interrelatedness of psychiatric symptoms and their potential consequences in PLHIV.

Data from 1615 outpatient PLHIV using suppressive ART from the 2000HIV study (NCT03994835) were analysed. Participants reported on the severity of substance use (MATE-Q), depression and anxiety (HADS), impulsivity (BIS-11), quality of life (EQ-5D-5L), ART adherence (MASS-8) and sexual risk behaviour. For these variables, prevalence rates and mean scores were calculated. After binarizing the data, an Ising network model was constructed. Using this network, interrelations between psychiatric symptoms were assessed, the centrality of symptoms was estimated and connections with clinical consequences were explored.

In our cohort of PLHIV, the increased prevalence of substance use was most pronounced, as shown by a prevalence rate of 28.7% for smoking, 13.6% for cannabis use, 11.1% for heavy alcohol drinking and 9.2% for ecstasy use in the past month. The network analysis revealed that symptoms of depression and anxiety were most strongly interrelated. The depressive symptom “feeling slowed down” was one of the most central symptoms, and was most strongly connected with quality of life. Substance use was associated with a higher occurrence of sexually transmitted diseases, and this relationship was mediated by a higher number of sexual partners. Notably, ART adherence did not display any connections with depression, anxiety, impulsivity or substance use.

Image:

The high occurrence of substance use and its link with sexual risk behaviour, emphasizes it’s role as a potential target for prevention of HIV transmission. Contrary to general assumption, psychiatric symptoms are not associated with lower levels of ART adherence in our cohort. Treatment of depression in PLHIV might be improved by focussing on the symptom of feeling slowed down, since this symptom was most strongly connected with quality of life.

E. Meeder Grant / Research support from: ViiV Healthcare, M. Blaauw: None Declared, L. van Eekeren: None Declared, A. Groenendijk: None Declared, W. Vos: None Declared, Q. de Mast: None Declared, W. Blok: None Declared, A. Verbon: None Declared, M. Berrevoets: None Declared, J. van Lunzen Employee of: ViiV Healthcare, L. Joosten: None Declared, M. Netea: None Declared, V. Matzaraki: None Declared, A. van der Ven: None Declared, A. Schellekens: None Declared

Psychiatric problems occur in people’s normal daily life, in a dynamic interaction with the context people are in. Yet, we have very few techniques to assess this dynamical nature of symptoms, nor do we have good insights in how people actually function in their ordinary life. Ambulatory assessment techniques such as Experience Sampling Methodology (ESM) or Ecological Momentary Assessment (EMA) have been proposed as a potential clinical tool to bridge this gap. Yet, very few of these techniques have actually made it to the clinic. In my talk, I will discuss the strengths and limitations of using these digital diary techniques to open up someone’s real life in clinical practice. I will discuss qualitative research identifying barriers and facilitators, identified by patients and clinicians. I also will discuss what is needed in terms of technology and data security, by demonstrating the MoMent app and MoMent Dashboard, that has been developed within the H2020 IMMERSE project. Finally, I will discuss how these digital mental health tools could help in developing a much more fine-grained understanding of how psychopathology emerges in the realm of ordinary life, making patients active partners in the clinical process.

None Declared

Today the psycho-traumatic impact of quarantine due to the COVID-19 pandemic and the infodemic, as a separate psycho-traumatic factor, on mental health remain unclear

To study the impact of quarantine and infodemic due to the COVID-19 pandemic on the mental health of the population of Ukraine

During quarantine 902 Ukrainian people voluntarily completed the questionnaire in Google format a questionnaire containing psychodiagnostic tools for assessing the level of stress L. Reeder, anxiety response GAD-7, depression PHQ-9, strategies for stress-coping behavior E. Heim, vitality S. Maddy and developed by us based on the AUDIT Test for the detection of disorders related to the obsession with news associated with the COVID-19 pandemic

The investigations carried out suggested that the quarantine restrictions could be predisposing factors for mental health impairments. The threat of coronavirus disease, a disruption of a habitual life stereotype, leisure restrictions, a harmful interest in news about the pandemic, and tobacco abuse play an important role in mechanisms of distress formation. The analysis of examination of the quality of life has demonstrated, that 8.14 % had a low level of its physical component, 15.55 % had a low level of its emotional component, and 10.21 % had a low level of a social activity. Under these conditions, risks of increased stress pressure, anxiety, and depression are rising. During the quarantine period, 10.53% recorded a high level of stress, 11.75% had an average level of anxiety, 7.43% had a high level of anxiety, 9.53% had severe depression, and 7.76% had very severe depression. 5.93% were obsessed with information related to the pandemic, at the level of “addiction”, 9.95% “use” information with “harmful consequences”, 20.14% a “risky” level. A low level of vitality had a direct correlation with an excessive interest in news and the use of maladaptive strategies of the types of ignoring, dissimulation and confusion (cognitive), submissiveness, suppression of emotions and self-blame (emotional), avoidance (behavioral) - that is, passive forms of solving problems due to despair in one’s own strength and intellectual resources, with a deliberate underestimation of troubles

Measures on psycho-prevention should be performed on the base of the regularities identified

None Declared

Schizophrenia is a chronic and multifactorial mental disorder. Research suggests the presence of an abnormality in prolactin secretion during the genesis of the disease and at the same time, the involvement of genetics in its pathogenesis has long been the demand of researchers in the field of genetics since familial forms of schizophrenia have been observed.

The objective of this study was to describe the prolactin profile and and to study its relationship to the patients’ family history of pyshciatric illness.

This was a descriptive, cross-sectional study of thirty male patients hospitalized for a psychotic relapse who were naïve or discontinuing treatment for at least two months. Patients were assessed using a semi-structured questionnaire. A blood sample was taken to measure levels of prolactin.

The age ranged from 17 to 56 years. Most patients had a family medical history. Twenty patients (66%) had a family psychiatric history of schizophrenia (56%), mental retardation (3%), personality disorder (3%) and schizoaffective disorder (3%). Prolactin levels ranged from 0.5 to 45.67 ng/mL with a mean of 14.03 ng/mL. Seven patients (23%) had hyperprolactinaemia. All patients with hyperprolactinaemia had a family history of psychiatry with a statistically significant difference (p= 0.033).

Hyperprolactinemia could be one of the “endophenotypes” that reflect a vulnerability to schizophrenia, found in familial forms of the disease. In this context, longitudinal studies on a larger scale and family studies including siblings without schizophrenia should be undertaken.

None Declared

It has been previously identified that levels of peripheral inflammatory proteins, such as cytokines, are altered in people with schizophrenia spectrum disorders (SSD).

As there is considerable inconsistency in the literature with respect to how inflammatory profiles differ between acute and chronic stages of SSD, a systematic review and network meta-analysis was performed.

Records from CINAHL, the Cochrane Central Register of Controlled Trials, EMBASE, PubMed, and PsycINFO were systematically searched from inception until 31 March 2022 for published studies that had measured levels of inflammatory proteins in cases of SSD and healthy controls. Pairwise and network meta-analyses were performed to determine whether there were significant differences in mean peripheral protein concentrations between acute SSD, chronic SSD, and healthy controls.

After application of the screening process, 215 articles were included for data-analysis. One group of markers were consistently elevated (p<0·05) in both acute and chronic SSD, relative to healthy controls; this group comprised interleukin (IL)-1β, IL-1 receptor antagonist (IL-1RA), soluble interleukin-2 receptor (sIL-2R), IL-6, IL-8, IL-10, tumor necrosis factor (TNF)-α, and high sensitivity C-reactive protein (hsCRP). A second group of markers were inconsistently altered between illness stages: IL-2 and interferon (IFN)-γ were significantly elevated (p<0·05) in acute SSD, whilst IL-4, IL-12 and IFN-γ were significantly decreased (p<0·05) in chronic SSD.

These results indicate that a baseline level of inflammatory protein alteration occurs in SSD throughout the course of illness. This was evident from the group of markers that were consistently elevated in acute and chronic SSD (e.g., IL-6), representing possible trait markers. Moreover, superimposed immune activity may occur in acute SSD, given the group of possible state markers that were increased only in acute illness (e.g., IFN-γ). Further research is required to elucidate whether these peripheral changes are reflected within the central nervous system.

None Declared

Psychiatrists postgraduate training in Ukraine lasts only for 18 months and the curriculum includes psychotherapy. However, little is known about its quality and provision. The aims of the research were to investigate the current psychotherapy training status in Ukraine, to examine how it is included in psychiatry training and to identify access to it. An anonymous online survey was conducted among early career psychiatrists (psychiatry trainees or psychiatrists within 5 years after specialising in psychiatry). The findings show that the minority had access to psychotherapy training though the majority of responders consider it to be an important part of psychiatry training. This study encourages to improve the accessibility and quality of psychotherapy training in Ukraine. It shows that despite the low accessibility of psychotherapy training for psychiatry trainees there is a high need in it. It is even more relevant in times of war, given its negative consequences for mental health and the growing need for educated psychotherapists.

None Declared

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.

None Declared