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

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

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

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

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

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

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

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

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

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Software-driven therapeutic interventions aiming at preventing, managing or treating medical or chronic diseases are referred to as Digital Therapeutics (DTx). DTx are developed to target a specific disorder or disease, including mental disorders. DTx are regarded as an emerging class of medicines and, hence, have obtained the approval of the relevant regulatory authorities, based on clinical evidence for the effectiveness similar to conventional medicine supplies and medicines. Social media-based DTx can represent both a means to quantify mental health as well as a source of both positive and negative interactions, including a source of social support for many who have been socially isolated and lonely. Recent researches using monitored social networks as interventions has shown promise in youth with several mental health issues, despite it is noteworthy that social media are not without risks.

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Schizophrenia is a debilitating and mutilating mental illness, generally progressing in a Chronic way . It is at the origin of a limitation of social autonomy and source of psychological distress .

evaluate the effective social autonomy of schizophrenic patients.

it is a cross-sectional study carried out at the EPS psychiatry consultation in Mahdia during a period of 3 months, with schizophrenic patients meeting the DSM 5 criteria, having an age varying from 19 to 65 years and whose duration of evolution was at least of one year. Have been excluded those in a state of decompensation, presenting a severe organic disease or having a major cognitive impairment. Information was collected from patients and fromtheir medical records using a pre-established questionnaire. The scale of social autonomy (EAS) of Legay with 17 items grouped into 5 dimensions was used for the evaluation.

The general characteristics of the 360 schizophrenic patients who met the inclusion criteria, revealed an average age of 40.2 years, a sex ratio of 2.33, a majority of single (55.8%), a low level of education(66.7%), an absence of professional activity (67.3%) and a deteriorated socioeconomic level (68.6%).Clinical Characteristics noted an average onset age of the disorder of 26 years, an average duration of evolution of 14 years and a preponderance of the residual type and of the episodic evolutionary course with residual symptoms between episodes respectively in 40.6 and 76.4%. The average of EAS scores were 39.08. Three quarters of the population (75.7%) had a score below 59. 24.3% of patients had scores between 60 and 108 signifying impaired social autonomy.

The evaluation of effective social autonomy is essential for any therapeutic project considering psychosocial integration and rehabilitation of schizophrenic patients.

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The history of psychiatry is the history of the unitary psychosis concept. Recent studies on this subject by prominent authors (Huda, Stanghellini, Broome, etc.) confirm that the problem has not been resolved but that it reappears now with more force from skeptical positions, based above all on the insufficiency of the classification criteria official (ICD-10, DSM-V). This skepticism has led to an attempt to make the line that separates normality from mental illness disappear with the weak argument that isolated psychotic symptoms are detected in the general population.The proposals to stop these movements that border on the denial of mental illness try to provide more information on the contextual and subjective factors of mental illness, thus reinforcing the so-called biopsychosocial model formulated by Engel in 1976, whose conceptual imprecision is largely responsible for the problems before indicated as well as other more serious ones for the organization of psychiatric care.

Point out the insufficiencies of the biopsychosocial model.-Point out the advantages of acquiring a classic evolutionary approach such as the one designed by Iván Pavlov besides the Volga and improved by some followers.-highlight the differences between researching in psychopathology, a true science, or doing it in clinical psychiatry, its practical application. This distinction is essential.

The works of some authors who have approached this conflict with dedication and rigor will be reviewed.Research lines followed during last hundred years in psychiatry will be contrasted with the results obtained.

New points of view and new tools need to be incorporated to solve this conflict that confuses experts so much are proposed.Ways of working are indicated that should avoid confusion between psychopathology and clinical psychiatry

A psychiatric diagnosis must be established on solid conceptual basis that we currently lack.-Both Kraepelin and Kurt Schneider are two key figures to recover and keep current in our daily practice.-The importance of patient’s subjectivity when taking an anamnesis of their problems seems very important. The question is how to manage that subjectivity in order to analyze it from a classical scientific model, Pavlov’s great desire.-A revisiting of Husserlian phenomenology is essential in the training plans of young psychiatrists and in daily psychiatric care. But this is not enough. We need new tools and new conceptual frameworks so that the phenomenological perspective can contribute to put light in problems as important as those generated by the constant change of diagnosis that is carried out with many patients.If we want a scientific psychiatry we cannot handle with tools that have failed since their creation.

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Anxiety is a common pathology in people who pass through a crisis situations. Thus, it goes without saying that the current global economic crisis will have secondary effects on mental health.

The aim of this study is to identify if there is a correlation between the level of anxiety and the impact of the economic crisis felt patients.

In this study, 517 patients with known associated somatic pathology were selected. According to gender, 2 groups were formed, that of women (n=308) and that of men (n=209). To identify the level of anxiety, we applied the generalized anxiety disorder assessment scale (TAG7) and to quantify the impact of the global economic crisis felt by the patients, an ordinal scale was used.

190 patients (36.7%) reported that they did not feel anxious at all, while only 24 (4.6%) said that they felt anxiety quite often. Related to the gender, we observed that 36.36% of women and 37.3% of men did not appreciate that they would suffer from anxiety. Those who consider themselves to have high levels of anxiety are represented as follows: 5.8% among the female population and 2.8% among the male population. We researched the correlation between the experienced impact of the global crisis and the state of anxiety and we observed that there is no correlation between the 2 (r=0.19).

The study shows that patients with somatic pathology do not have levels of anxiety correlated with the impact of the global economic crisis felt.

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Burnout is a result of emotional exhaustion and lack of motivation after prolonged exposure to chronic emotional and interpersonal stressors at work. (Black et al. SAGE 2020, 609-611)

For the past decade, it has been one of the actual areas of research globally. (Ahola et al. Journal of affective disorders, 88, 2005; 55–62; Ahola et al. Journal of affective disorders,104,2007; 103–110, Shirom, A. Work Stress, 19, 2005; 263–270, Toker et al. The Journal of Applied Psychology, 97, 2012; 699–710.) However, a small number of studies exploring burnout have been conducted in Azerbaijan.

The requirement for supportive interventions for workers with an aim to improve the quality of care and prevention of burnout related to health and sociocultural problems such as difficulties in their personal life, job-shifts has led us to conduct this study.

Above all, the Second Karabakh war that took place in 2020 increased the population of patients that are in urgent need of psychiatric and psychological support.

The purpose of this study is to examine the level of burnout among all mental health workers who have been closely working with veterans and families of deceased soldiers. Similarly, the study is intended to evaluate the impact of various factors, such as secondary traumatic stress, effort-reward imbalance, and socio-demographic variables leading to burnout.

The study design is cross-sectional. 22-item Maslach Burnout Inventory (MBI) is used to measure the level of burnout. Intrusion, avoidance, and arousal symptoms triggered by indirect exposure to traumatic events are evaluated by the 17-item Secondary Traumatic Stress Scale (STSS). 22-item Measurement of the effort-reward imbalance (ERI) is used to define the level of effort, reward, and over-commitment. Demographic questionnaires consist of age, sex, marital status, professional background, years of employment, workload in hours.

The sample size has been estimated as 200 participants. Associations between occupational exhaustion, depersonalization, personal accomplishment assessment, intrusion, avoidance, arousal, effort, esteem, job promotion, job security, overcommitment and professional background, workload in hours will be explored in the current study.

The findings upraised will promote elaborating personalized approaches toward burnout prevention treatment.

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

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

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

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

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

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Depressive symptoms are a common feature of schizophrenia (SCH) and define bipolar disorder and major depressive disorder (MDD). Their emergence is related to altered neurotransmission at the serotonin receptors and potentially at dopamine D3 receptors.

The aim of this analysis was to examine the efficacy of cariprazine (CAR) in treating depressive symptoms in SCH, bipolar depression (BD) and MDD.

Clinical trials with randomised, double-blind, placebo (PLB)-controlled designs were included in these analyses. Data from 3 SCH [NCT00694707, NCT01104766, NCT01104779; 1.5-9 mg/d] and 3 BD [NCT01396447, NCT02670538, NCT02670551; 1.5-3 mg/d] studies were pooled. In MDD, add-on CAR to antidepressant treatment was evaluated against PLB in two studies [NCT03738215: 1.5 and 3 mg/d; NCT01469377: 1-2 mg/d and 2-4.5 mg/d).

Least square (LS) mean changes were analysed using Mixed Model Repeated Measures: from baseline (BL) to Week 6 in the Positive and Negative Syndrome Scale (PANSS)-derived Marder anxiety/depression factor items (schizophrenia); from BL to Week 6 in the Montgomery-Åsberg Depression Rating Scale (MADRS) total scores (bipolar depression); and from BL to Week 6 [NCT03738215] and Week 8 [NCT01469377] in MADRS total score (major depressive disorder).

Altogether, 1466 SCH (PLB=442, CAR=1024) patients were included in the pooled analysis. In the BD analysis, data from 1383 (PLB=460, CAR=923) patients were pooled. In the MDD trials, there were 502 CAR (1.5mg/d=250, 3 mg/d=252) and 249 PLB-treated patients [NCT03738215], and 544 CAR (1-2 mg/d=273, 2-4.5 mg/d=271) and 264 PLB patients in the other study [NCT01469377]. In SCH, CAR achieved significantly greater reductions than PLB on the Marder anxiety/depression factor domain (LS mean change: PLB= -2.66, CAR= -3.26, p<0.01): the effect was driven by 3 out of 4 items. In BD, CAR yielded significantly greater improvement on the MADRS compared to PLB (LS mean change: PLB= -12.05, CAR= -14.69, p<0.001), which was driven by 9 out of 10 items. In MDD [NCT03738215], CAR 1.5 mg/d add-on significantly alleviated depressive symptoms compared to PLB (LS mean change: PLB= -11.5, CAR 1.5mg/d= -14.1, p<0.01), while in the other MDD trial [NCT01469377], CAR 2-4.5 mg/d add-on produced significantly greater reductions than PLB (LS mean change: PLB= -12.5, CAR 2-4.5 mg/d= -14.6, p<0.01).

These findings indicate that CAR is an effective treatment option for the treatment of depressive symptoms independent of disease (in SCH, BD and MDD), being a transdiagnostic broad-spectrum treatment option.

R. McIntyre Grant / Research support from: CIHR/GACD/National Natural Science Foundation of China (NSFC), the Milken Institute, Consultant of: Lundbeck, Janssen, Alkermes, Neumora Therapeutics, Boehringer Ingelheim, Sage, Biogen, Mitsubishi Tanabe, Purdue, Pfizer, Otsuka, Takeda, Neurocrine, Sunovion, Bausch Health, Axsome, Novo Nordisk, Kris, Sanofi, Eisai, Intra-Cellular, NewBridge Pharmaceuticals, Viatris, Abbvie, Gedeon Richter, Recordati, Atai Life Sciences, Speakers bureau of: Lundbeck, Janssen, Alkermes, Neumora Therapeutics, Boehringer Ingelheim, Sage, Biogen, Mitsubishi Tanabe, Purdue, Pfizer, Otsuka, Takeda, Neurocrine, Sunovion, Bausch Health, Axsome, Novo Nordisk, Kris, Sanofi, Eisai, Intra-Cellular, NewBridge Pharmaceuticals, Viatris, Abbvie, Gedeon Richter, Recordati, Atai Life Sciences, R. Csehi Employee of: Gedeon Richter Plc., G. Németh Employee of: Gedeon Richter Plc.

Anxiety and sleep disorders are common and associated comorbidities of dementia. Previous studies has proven the association between anxiety and sleep disorder with a reduced quality of life in hospitalized patients with dementia. However, it is not clear whether the sleep disorders change the association between anxiety and quality of life.

To test the hypothesis that sleep quality modify the association between anxiety and quality of life in hospitalized patients with mild or moderate dementia.

We performed this cross-sectional study during 2017 at University Psychiatric Hospital “Sveti Ivan”, Zagreb, Croatia. Data were collected on a consecutive sample of patients diagnosed with mild or moderate dementia. The outcome was the association between anxiety measured using the Hospital Anxiety and Depression Scale, and quality of life measured using the EQ-5D-5L visual-analogue scale. The independent variable was sleep quality measured using the Pittsburgh Sleep Quality Index (PSQI). We performed a moderation analysis using the Johnson-Neyman technique as implemented in Andrew F. Hayes macro “Process” Template 1, after adjusting for age, gender, education, body mass index, age at the time of onset of dementia, duration of hospitalization, severity of condition measured using Clinical Global Impression scale and Clinical Dementia Rating Scale, treatment with antidementives by multiple linear regression.

The median (interquartile range) age of 47 participants was 80 (76-83) years, 24 (51%) were women, 24 (51%) had nonspecific dementia, 16 (34%) Alzheimer’s Disease and 21 (46%) severe dementia. Hospital anxiety and quality of life were significantly, linearly, and inversely correlated both in bivariable, and in multivariable, adjusted analysis (r= -0.39; p=0.006; adjusted semipartial r= -0.41; p=0.017). After the adjustment for all covariates, the interaction between hospital anxiety, quality of life and sleep quality was not significant. However, hospital anxiety and quality of life were significantly correlated when PSQI score was ≥5.6, that is in 37% patients with the worst sleep quality.

We partially confirmed the hypothesis that sleep quality modifies the association between hospital anxiety and quality of life in patients with mild to moderate dementia.

None Declared

This prospective study aimed to examine changes in mental health and differences due to educational status (ES) and country among young adults aged 20-40 from four countries during the COVID-19 pandemic in a three-month period.

The total of 1714 participants (932 women): students (n = 321) and non-students (n = 519) aged 20-30, educated (n = 388), and non-educated (n = 486) adults aged 31-40 from Poland (n = 445), Slovenia (n = 430), Germany (n = 417), and Israel (n = 422) responded to online survey in February 2021 and May–June 2021. The used measurements were: Perceived Stress Scale (PSS-10), Generalized Anxiety Disorder (GAD-7), and Patient Health Questionnaire (PHQ-8).

A repeated-measures two-way mixed-factor ANOVA was performed to examine changes over time, educational status (ES), and across countries for mental health indicators. The results showed stability over time in anxiety and depression while a small decrease in stress. Students scored significantly higher in stress, anxiety, and depression compared to non-/educated adults and in depression compared to non-studying peers. Participants from Poland and Germany scored higher in anxiety and depression than from Slovenia and Israel. Moreover, Polish participants reported the highest stress among all countries.

The student population is more vulnerable to mental health issues than non-studying peers and adults with and without an academic degree, particularly in Poland and Germany.

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Obsessive-compulsive disorder (OCD) is a disorder diagnosed on the basis of the presence of obsessions (persistently recurring, intrusive thoughts, images, impulses) and compulsions (compulsive and transiently satisfying actions performed in response to obsessions). A separate clinical phenomenon in the broadly understood anankastic spectrum is obsessive-compulsive disorder (OCPD). OCPD is characterized by scrupulousness, over-normative morality, perfectionism and an inability to make concessions in terms of cooperation. It is assumed that the incidence of OCPD in the course of OCD is 25-32% and it is a report with an unfavorable course and a more difficult therapeutic prognosis. It also means an early onset of OCD with a greater intensity of compulsions and a predominance of symptoms related to the sphere of purity, symmetry and gathering.

The main aims of the study were as follows:

1. To assess the prevalence of OCPD in OCD patients.

2. To compare both groups of patients for the severity, level of insight, aggression, impulsiveness and affective symptoms.

3. To verify whether the presence of OCPD depend on factors such as age, gender, treatment duration and delay in starting treatment.

The study was conducted in a group of 78 patients diagnosed with and treated for OCD. The patients were divided into two groups: patients with OCD and OCPD (group 1, n=43) and patients with OCD without OCPD (group 2, n=35). The groups were subsequently compared for the severity of anankastic symptoms, the level of insight, aggression, impulsiveness and its components and affective symptoms (depression, mania). The following tools were used for the diagnosis: Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Hamilton Depression-Rating Scale (HDRS), Young Mania Rating Scale (YMRS), Buss-Perry Aggression Questionnaire (BPAQ), Barratt Impulsiveness Scale (BIS-11), Brown Assessment of Beliefs Scale (BABS) and DSM 5 criteria for OCPD.

Our results confirmed that OCPD is common in OCD and occurred in 55,12% of patients with OCD (n=43; m=21; f=22). The study shows that the presence of OCPD in the course of OCD negatively affects the severity of obsessive-compulsive symptoms, the level of insight, the level of aggression and impulsiveness, and affective disorders. Patients with OCPD obtained higher scores on the YBOCS, BABS, HDRS, and YMRS scales compared to patients with OCD without OCPD. The occurrence of OCPD in the study group did not depend on gender, duration of OCD treatment, or delay in starting it.

The occurrence of OCPD is common in OCD and can cause delay of treatment, worse course, greater intensity of egosyntonic symptoms, and thus worse insight. The presence of OCPD can lead to more hostility and more affective disorders. Screening for OCPD in patients with OCD should be an integral part of an OCD diagnostic process.

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Mental health disorder is common among working population worldwide and among health care-workers (HCWs) in particular. Depression is a major public health problem, with an economic impact because of lost days of work. Its prevention is essential and requires the identification of risk factors.

The objectives of this work were to determine the epidemiological characteristics of depressive disorders in health care workers and identify their main risk factors.

A descriptive retrospective study was conducted on health care workers of Sousse in Tunisia who have had a long-term sick leave for depressive disorders from January 2010 to December 2021. data was collected from the medical records of the patients and completed with a telephone questionnaire

The total number of cases was 650 with a prevalence of 12.8% and an incidence of 2 cases per 100 HCW. The median age was 50 years and the female workers represented 81% of cases. The majority of the sample were married (81%). Most of cases were nurses (43%) and health technician (19%). The median seniority of HCW in their jobs was 23 years with the first quartile at 12 and the third quartile at 31.

Around 48% of cases had severe depression. The severity of depression was significantly associated with working in surgical and emergency services, number of night shifts of 2 or more per week, the history of a psychiatric disorder other than depression, habits such as smoking and drinking, anxiety specificity and melancholy specificity of depression.

This study showed the importance of social and occupational factors of depression among HCW. Action policies focusing on workplace interventions appear to be relevant.

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Perceived stress in the case of health professionals in general and, more specifically, nurses is a frequent phenomenon and occurs when the demands of the clinical environment exceed the available resources in order for nurses to manage the problems that arise.

The objective of our study was to investigate the relationship between social support and psychological empowerment with perceived stress of nurses working in psychiatric acute units.

Our study sample consisted of 153 nurses working in psychiatric acute units, located in Athens area. Participants completed a questionnaire that included a) demographic characteristics, b) the Perceived Stress Scale, c) the Psychological empowerment scale, and d) the Social Support Questionnaire Short Form (SSQ-6).

The majority of our sample were female (62.7%), graduates of Technological Education (47%), married (60.8%), permanent employees (81.7%), working in psychiatric units for over than twenty-one years (34.6%), with an average age of 45.3±6.7 years. The 64.7% of our sample considered the night shift as the most aggravating. The 3 main reasons that caused nurses the greatest stress were (a) lack of staff, (b) dangerousness and (c) workload. Psychological empowerment was positively correlated with social support (r=0.39). When nurses perceived greater social support, were more psychologically empowered as well. Women (b=1.43) compared to men, as well as those who had more years of service in a psychiatric ward (b=0.6), compared to younger employees exhibited a statistically significant higher level of subjective stress. Nurses who considered that night shifts were the most aggravating exhibited more stress (b=1.45). Female nurses (b=3.35), compared to males and those who were scheduled to work more day shifts (b=0.25) exhibited higher levels of psychological empowerment. Married nurses reported higher levels of social support (b=5.66). In contrast, older nurses (b=-0.44), as well as nurses who were scheduled to work more night shifts (b=-1.28), reported statistically significant lower social support.

It is necessary to capture the levels of perceived stress of nurses working in psychiatric acute units and the development of strategies by utilizing the parameters that contribute to reducing stress and act protectively in the workplace, as well as family and wider social environment.

None Declared

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

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

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

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

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

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

None Declared

Psychosis and dissociative disorders are both described in the DSM-5 as different diagnostic categories. However, a high comorbidity of these diagnoses has been observed in different studies, perhaps due to the overlapping of symptoms between them.

A systematic review about overlapping symptoms in psychotic spectrum and dissociative disorders

Presentation of the case of a patient and review of the existing literature on the differential diagnosis between dissociative disorder and other psychotic spectrum disorders.

Both similarities and differences have been found between both diagnoses. Patients with dissociative disorder experienced more dissociative and positive symptoms while those on the psychotic spectrum experienced more negative symptoms. The literature reflects that the two entities overlap on many of their diagnostic symptoms. On some occasions, more dissociation has been detected in patients diagnosed with the psychotic spectrum than those with a diagnosis of dissociative disorder.

Despite the fact of being different diagnostic entities, the literature does not reflect clear boundaries between psychosis spectrum symptoms and dissociative disorder.

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In this second session of our motivational interviewing workshop, we introduce motivational interviewing with its principles. Furthermore, we discuss the pyramid of change and Prochaska’s change model, address the differences between pre-contemplative versus change-resistant patients, and approach different techniques we can use throughout the clinical interview.

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During the last decade there has been a resurgence of interest on the use of psychedelics as novel treatments for mental disorders, including treatment-resistant depression (TRD). Psilocybin, the chemical component of “magic mushrooms”, has been administered with psychotherapy in randomized clinical trials (RCTs) showing large and sustained antidepressant effects. As the use of psilocybin expands, it is becoming more important to understand whether psilocybin’s psychedelic effects are required for psilocybin’s antidepressant effects. Psilocybin’s psychedelic effects are known to be dependent on serotonin 2A receptor (5-HT2AR) activation. Given the safety concerns associated with psilocybin’s psychedelic effects, all studies have used it in conjunction with at least 12 hours of intensive psychotherapy. This makes psilocybin-assisted psychotherapy (PAP) highly resource intensive and impedes scalability given limited resources and access to trained therapists in most jurisdictions. Studies in healthy volunteers have shown that psilocybin’s psychedelic effects are blocked by 5-HT2AR antagonists like risperidone and ketanserin. In a pre-clinical study using a mouse model of depression, administration of ketanserin followed by psilocybin had the same antidepressant effect as psilocybin alone. We propose to conduct the first study to test in humans whether the antidepressant effects of psilocybin are attenuated by 5-HT2AR blockade from risperidone.

Aim 1: To evaluate the feasibility and tolerability of administering psilocybin with risperidone in adults with TRD by evaluating recruitment, retention, tolerability, and safety.

Aim 2: To evaluate psychedelic effects (measured with the 5-Dimensional Altered States of Consciousness Rating Scale) in the three groups.

Aim 3: To evaluate antidepressant effects (measured with the Montgomery Asberg Depression Rating Scale; MADRS) in the three groups. .

A three-arm, 4-week, double blind, proof-of-concept RCT for patients with a DSM-5 major depressive episode that has failed to respond to at least two adequate trials of antidepressants. Participants will be randomized to: 1) psilocybin 25 mg plus risperidone 1 mg; 2) psilocybin 25 mg plus placebo; 3) placebo plus risperidone 1 mg. All participants will receive 12 hours of manualized psychotherapy.

Ethics approval for the proposed study has been obtained. We will present preliminary feasibility data at the meeting in March.

If the study demonstrates that psilocybin’s psychedelic effects are not necessary for psilocybin’s antidepressant effects, the combination of psilocybin and a 5-HT2AR antagonist, such as risperidone, could increase acceptability and access to the use of psilocybin to treat MDD and related conditions.

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

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

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

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

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

None Declared

There are no conclusive findings about the possible protective role of religion on students’ mental health during the COVID-19 pandemic. Therefore, more research is needed.

The purpose of this study was to assess the relationship between the level of emotional distress and religiosity among students from 7 different countries during the COVID-19 pandemic.

Data were collected by an online cross-sectional survey that was distributed amongst Polish (N = 1196), Bengali (N = 1537), Indian (N = 483), Mexican (N = 231), Egyptian (N = 565), Philippine (N = 2062), and Pakistani (N = 506) students (N = 6642) from 12th April to 1st June 2021. The respondents were asked several questions regarding their religiosity which was measured by The Duke University Religion Index (DUREL), the emotional distress was measured by the Depression, Anxiety, and Stress Scale-21 (DASS-21).

Egypt with Islam as the dominant religion showed the greatest temple attendance (organizational religious activity: M=5.27±1.36) and spirituality (intrinsic religiosity: M=5.27±1.36), p<0.0001. On another hand, Egyptian students had the lowest emotional distress measured in all categories DASS-21 (depression: M=4.87±10.17, anxiety: M=4.78±10.13, stress: M=20.76±11.46). Two countries with the dominant Christian religion achieved the highest score for private religious activities (non-organizational religious activity; Mexico: M=3.94±0.94, Poland: M=3.63±1.20; p<0.0001) and experienced a moderate level of depressive symptoms, anxiety, and stress. Students from Mexico presented the lowest attendance to church (M=2.46±1,39) and spirituality (M=6.68± 3.41) and had the second highest level of depressive symptoms (M=19.13±13.03) and stress (M=20.27±1.98). Philippines students had the highest DASS-21 score (depression: M=22.77±12.58, anxiety: M=16.07±10.77, stress: M=4.87±10.08) and their level of religiosity reached average values in the whole group. The performed regression analysis confirmed the importance of the 3 dimensions (organizational religious activity, non-organizational religious activity, intrinsic religiosity) of religiosity for the well-being of students, except for the relationship between anxiety and private religious activities. The result was as presented for depression: R2=0.0398, F(3.664)=91.764, p<0.0001, SE of E: 12.88; anxiety: R2=0.0124, F(3.664)=27.683, p<0.0001, SE of E: 10,62; stress: R2= 0.0350, F(3.664)=80.363, p<0.0001, SE of E: 12.30.

The higher commitment to organizational religious activity, non-organizational religious activity, and intrinsic religiositywas correlated with the lower level of depressive symptoms, stress, and anxiety among students during the COVID-19 pandemic, but taking into account factors related to religiosity explains the level of emotional well-being to a small extent.

None Declared

The media portrayal of mental health is relevant in shaping the population’s attitudes towards mental disorders. However, there is little information about the representation of children and adolescent mental health in the Spanish press, especially in the context of the COVID-19 pandemic. The general objective of this study was to analyze the tone and content of Spanish newspaper articles about mental disorders in youth during the COVID-19 pandemic.

We collected media articles from 10 news sources, comprising the digital editions of five online news websites and five printed newspapers over a 6 month period (January 2021-June 2021). These articles were coded for content using a standardized codebook, followed by a qualitative thematic analysis. A total of 205 news items were evaluated.

Results showed that the majority of the news items had an overall positive tone (68.3%), only 5.4% were stigmatizing and only 7.3% were related to violence. However, few articles offered help seeking information (6%), adolescents were rarely quoted (14%) and children were never quoted. Substantial differences are described in terms of age, gender and disorder, with adolescents, males and patients with psychosis or behavioral disorders most associated with stigmatizing content or violence. The thematic analysis led to three emergent themes: (i) violence and victimization; (ii) the COVID-19 pandemic; and (iii) technology and social media. The number of articles that described young people with mental health problems as victims of violence was prominent.

The Spanish media generally does not stigmatize mental health problems in children and adolescents. Furthermore, the COVID-19 pandemic may have promoted more positive discussion about youth mental health. However, there remains some room for improvement, as patients are seldom quoted, very few articles offer help-seeking information, and a narrative of victimization without appropriate discussion of resilience regularly occurs.

None Declared