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.

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Psychiatric symptoms of children and adolescents’ people whose families have joined the Islamic State of Iraq and Syria (ISIS) for various reasons, lived under the threat of terrorism in or outside Turkey, lost their parents or were separated for various reasons, are not clearly known.

This research aims to psychiatrically evaluate children and adolescents who are victims of various reasons due to their families joining the ISIS.

31 children and adolescents living with or without parents in Turkey, whose parents had joined ISIS, were included in the study. The sociodemographic data of the participants, the country they were in during their time in ISIS, the current situation of their parents, their exposure to terror attacks, their stay in prison were determined. Psychiatric diagnoses of the participants were determined according to DSM-5. Afterwards, the participants and caregivers were asked to fill out the Revised Child Anxiety and Depression Scale Child and Parent Form (RCADS-C, RCADS-P), Child Post Traumatic Stress Disorder Reaction Index Scale (CPTS-RI), Child and Youth Resilience Measure (CYRM) and Conners Parental Rating Scale Revised Short Form (CPRS-SF)

14 (45.2%) of the participants were boy and 17 (54.8%) were girl. The mean age of the participants was 10.55±3.79. The average age of the participants’ families at the time they joined ISIS was 4.81±3.37 years. The average age of the participants to return to our country was 8.87±3.99. All of the participants remained in Iraq. 25 (80.6%) of the participants stayed at home and 6 (19.4%) of them stayed in the camp. 19 (61.3%) of the participants were exposed to at least one conflict, 12 (38.7%) witnessed at least one terror attack, 5 (16.1%) were injured, 26 (83.9%) were not injured. It was found that 28 (90.3%) of the participants remained in prison and 3 (9.7%) did not. Participants’ RCADS-C scores were 23.42±15.96, RCADS-P total scores were 16.25±16.12, CPTS-RI scores 20.3±14.56. CYRM total scores were 46.65±9.04, and CPRS-SF total scores were 19.74±16.55.

It has been revealed that there are various psychiatric problems of varying severity in children and adolescents who are victims of ISIS in Turkey.

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Anhedonia is a loss of pleasure and interest in activities and a core symptom of major depressive disorder (MDD). Diffusion tensor imaging studies show evidence for white matter (WM) alterations in the superior longitudinal fasciculus (SLF) of patients with MDD, already in the early stage of illness. SLF fibers extend from the parietal lobe to prefrontal regions that are important for attention, motivation, decision-making and reward processing.

The present study focuses on the relationship between WM-integrity and anhedonia in patients with MDD. We hypothesize that WM-alterations are present in the SLF of depressed patients with motivational anhedonia.

Thirty-nine patients with MDD and 19 healthy controls matched for age and gender underwent diffusion-weighted magnetic resonance imaging. Voxel-wise statistical analysis of fractional anisotropy (FA) data was performed using FSL-Tract-Based Spatial Statistics (TBSS) software. Whole brain voxel-wise comparison in local coherence (LCOR), a measurement of resting state fMRI connectivity strength between a given voxel and the neighbouring areas in the brain, were compared between patients and healthy controls. We used the sum value of item 1 and 7 of the Hamilton rating Scale for depression (HAM-D) and the CORE non-interactiveness value to assess motivational anhedonia.

TBSS-analyses revealed reduced FA in the left SLF of depressed patients and we found a correlation with motivational anhedonia and LCOR in temporo-parietal regions of depressed patients.

These findings suggest that WM-alterations in the SLF might be associated with motivational aspects of anhedonia and predict motivation of reward in MDD.

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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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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.

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Young people are worried about climate change but the association between climate worry and current and past mental health has not been examined in population-based samples.

To examine 1) the prevalence of worry about climate change at age 23-years and its association with contemporaneous mental health symptoms, and 2) and adolescent mental health symptoms.

We used a Canadian population-based birth cohort (n=1325) to examine associations between 1) climate change at age 23-years and concurrent anxiety, depression, and suicidal behaviors, and 2) mental health at age 15 and 17 years defined as anxiety, depression, aggression-opposition, inattention-hyperactivity. We adjusted for participants’ socioeconomic status, childhood IQ, sex, and parental history of psychopathology.

Most participants were worried about climate change: 190 (14.3%) were extremely worried, 553 (41.7%) were somewhat worried, 383 (28.9%) were very worried, and 199 (15.0%) were not at all worried. Worry about climate change was associated with significantly elevated contemporaneous anxiety, depression, and suicidal thoughts. In longitudinal analysis, adolescent anxiety was associated with higher climate change worry at age 23-years while adolescent aggression-opposition was associated with lower climate change worry.

Worry about climate change is associated with contemporaneous mental health symptoms. However, longitudinal analysis suggests that this is largely explained by prior mental health, with adolescent anxiety symptoms linked with higher worry and aggression-opposition with lower worry. Future studies should aim to better define the dimensions of climate anxiety and track it alongside symptoms using prospective follow-up studies.

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Substance use during adolescence is linked to adverse biopsychosocial events, including poor mental health, cognitive deficits, low academic performance, and delinquency (Deas & Brown J Clin Psych 2006; 67 18; Armstrong & Costello JCCP 2002; 70 1224; Cox et al. JSH 2007; 77 109-115; Chassin JJSU 2008; 165-183). Identifying risks for these events is critical, given they are associated with adverse outcomes in adulthood.

Post-pandemic, rates of adolescent depression and anxiety have more than doubled (Racine et al. JAMA Ped 2021; 175 1142-1150). Adolescents often use substances, most commonly alcohol and cannabis, to manage mental health (Colder et al. JCCP 2019; 87 629).

Cannabis is increasingly viewed by adolescents as safe, while alcohol is viewed negatively (SAMHSA 2021). Non-disordered alcohol use (ND-AU), alcohol use below diagnostic criteria level, has adverse developmental impacts for adolescents, including increased risk-taking behavior and heavy substance use in adulthood (Marshall Alcohol Alcohol. 2014; 49 160-164).

With growing normalization of cannabis use, important questions still remain whether non-disordered cannabis use (ND-CU) among adolescents is linked to adverse life events.

Using data from the 2018-2020 National Survey on Drug Use and Health (NSDUH), an annual US representative survey on substance use and mental health, we compared associations among common adolescent substance use and adverse life events.

Responses from adolescents aged 12-17 (N=32,407) from the 2018-2020 NSDUH were analyzed. Logistic regression was used to evaluate associations between substance use disorder (SUD) diagnoses and adverse adolescent life events. Adjusted odds ratios (aOR) were obtained while controlling for age, sex, and race/ethnicity. Analyses included sampling weights to account for the US population. Adolescents in ND-CU and ND-AU groups were defined by either past-month or past-year use without their respective SUD diagnosis.

Approximately 5% of adolescents had any SUD, and 1.3% had more than one SUD (Table 1). All SUD variables, including cannabis use disorder (CUD) and alcohol use disorder (AUD), were significant for all adverse adolescent life events (Table 2). Adolescents with a SUD were nearly 3 times more likely to have major depression in the past year, 2.5 times more likely to have a C+ or below grade average, and 10 times more likely to be arrested, than controls. These risks increased with more than one SUD (Table 2). Adverse events were similar between ND-CU and ND-AU. (Figure 1).

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Given the biopsychosocial risks to ND-CU and ND-AU in adolescents, there may be reason to reevaluate whether the DSM adequately captures the population of youth affected by their cannabis and alcohol use. Clinicians can use these nationally representative data to stratify risks and direct to appropriate treatment.

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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.

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Studies show that patients diagnosed with residual schizophrenia are characterized by cognitive and emotional-volitional disorders that increase with age. They can be the main barrier to treatment, psychosocial rehabilitation, and cause disability.

To identify cognitive and emotional-volitional disorders in patients with residual schizophrenia.

The BACS and the abbreviated MMPI test were used; 20 patients with residual schizophrenia (ICD-10 F.20.5xx) receiving outpatient treatment (mean age 59.65±14.24 years) were examined. Exclusion criterion: scores more 4 on at least one parameter of positive symptoms according to the PANSS.

Patients with residual schizophrenia show an overall decline in cognitive function (BACS composite score = 31.56±14.24) compared with healthy individuals, as well as compared with patients suffering from other forms of schizophrenia spectrum disorders. The greatest deficiency was revealed in the speed of information processing (subtests “Symbol Coding”=28.01±10.06; “Verbal Fluency”=37.56±11.57) and auditory-speech memory (subtest “Verbal Memory”=33.25±6 .02). These parameters showed significant associations (r=0.56 at p≤0.01) with the disability of such patients. However, this deficit could be compensated by the relative preservation of planning processes and executive functioning (subtest “Tower of London” = 14.91±4.57). Among the emotional and volitional disorders, the most important is the subjective feeling of low mood and paranoid tendencies (MMPI scales “Dp” = 56.38±10.74T, “Pa” = 59.06±14.49T), which can reduce the compliance of patients with residual schizophrenia.

Methods for leveling cognitive and emotional-volitional disorders should to include in programs of psychosocial rehabilitation of patients with residual schizophrenia.

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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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The endeavor of practitioners of psychiatry and psychoanalysis has been to break the disciplinary silos and to re-think what practice is all about. There was a person who pioneered this aim of intradisciplinary and interdisciplinary synthesis. His name was Girindrasekhar Bose. He was a psychiatrist, psychologist, and psychoanalyst who challenged the Freudian universalism of the Oedipus complex.

We have forgotten that the texts emanating from the land of India were profoundly psychological and can inform psychiatric/psychoanalytic practice. Bose’s exchange of letters with Sigmund Freud is known by many but read by only a few. He gave us a path to think about the psychiatric and psychoanalytic practice from India. The paper looks at his exchange of letters with Freud and his works on the Bhagavad Gita, Puranas, Yoga Sutras, and the Vedas, which he claimed, were immensely beneficial for psychiatric/psychoanalytic training and can help us to work through the way we perceive medical practice.

This research used primary sources like books and articles to re-think the works of Girindrasekhar Bose in terms of today’s medical practice.

Can we imagine writing in our native language and being critically acclaimed for our work internationally? His writings in Bengali suggest that he was more decolonized in the 1920s than the Indian scholars of today. Keeping in mind the existential ground of the patient, a decolonized understanding of symptoms can revolutionize medical care.

Our aim in today’s times is to inform our practice where we could possibly reach an intradisciplinary and interdisciplinary unity. A re-discovery of Bose’s work can help us in this earnest endeavor.

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Stress related to high expectations towards students, a large amount of knowledge necessary to assimilate in a brief period of time, and peer pressure are an important factor in the deterioration of the mental state of medical students. As a consequence, it can lead to burnout and even the development of mental disorders such as depression. Mechanisms of coping with difficulties play an extremely important role in moderating this risk. For this reason, it was of the interest what strategies medical students adopt in the face of everyday stress and how it affects their well-being and functioning.

The objective was to determine how medical studies impact mental health of students and what coping strategies are used by them to mitigate the negative influence of stress associated with high expectations, peer pressure and overwork.

A cross-sectional study was conducted among students of polish medical faculties using an online questionnaire. Risk of depression was assessed using validated BDI inventory, aggression using STAXI inventory and evaluation of coping strategies was conducted with Brief-COPE inventory.

Study was conducted among 329 participants. The majority of respondents were female (71.4%; n=235) and average age in the whole population equaled 22.46 years (95%CI: 22.1-23.01). There was no statistically significant difference in age between females and males. Average outcome in BDI equaled 13.84 (95%CI: 12.8-14.8) with higher levels among females (13.84 vs. 12 p<0.05). 165 (49.6%) students had a score above threshold for the increased risk of depression while 32 (9.63%) for severe symptoms of it. In case of aggression average outcome of STAXI equaled 24.89 (95%CI: 22.6-27.1). There was a statistically significant correlation between STAXI and BDI (r=0.3; p<0.05). In terms of the coping mechanisms in terms of coping strategies, a clear advantage of approach strategies was observed (65.36% of respondents). In the multiple regression analyses coping strategies did not influence neither STAXI nor BDI outcomes.

What draws attention are the high level of depression among the surveyed students, where over 50% show results above the cut-off point for an increased risk of a depressive episode. The advantage of approach strategies is also interesting, especially in terms of planning strategies and positive reformulation. Interestingly coping strategies in the analysed population did not constitute a significant protective factor in relation to the severity of the depressive symptoms and agression. Meanwhile, the sense of satisfaction and contentment with the chosen direction was a very good protective factor in terms of the severity of depressive symptoms.

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Mental health problems among adolescents have been on the rise particularly among adolescents in sub-Saharan Africa (SSA) due to impoverished living conditions and a high burden of chronic diseases including HIV/AIDs. COVID-19 pandemic has further exacerbated the risk and placed additional stress on adolescents’ mental health. While the burden might be high, there are fewer mental health services in the region.

To evaluate the psychological and mental well-being of adolescents living in and co co-design with civil society organizations (CSOs) interventions aimed at enhancing mental health and psychosocial well-being.

Firstly, we conducted a formative phase to assess the burden of various mental health problems in Kenya. We conducted a cross-sectional survey in which we assessed the mental health status of 1541 adolescents using standardized tools. The participants comprised in and out of school adolescents, adolescents with disability, and those living with HIV/AIDS. Furthermore, we undertook a qualitative study through FGDs and KIIs to identify the factors contributing to mental health problems.

Secondly, we aim to adapt interventions that seek to promote mental health. Finally, we aim to implement effective mental health interventions targeting over 2000 adolescents living in Kenya’ informal settlements.

We found the prevalence of depression to be higher among out-of-school adolescents at 36.0% compared to school-going adolescents at 20.6%. Furthermore, out-of-school adolescents had statistically significantly higher anxiety scores as well at 27.7 % when compared to their school-going counterparts at 19.1%. In-school adolescents had a better quality of life scores, lower pandemic anxiety scores, and lower emotional scores compared to their out-of-school counterparts. Results from regression models indicated that being out of school, having a COVID-19 infection, having poor relationships with parents and peers, loneliness, and living in an unsafe neighborhood were factors associated with poor mental health outcomes. During the qualitative interviews, participants noted that COVID- 19 brought about financial stress, joblessness, led to early pregnancies, involvement in commercial sex work by adolescents, school dropouts, lead to stress, and depression among other issues.

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Adolescents, especially those out of school are at a high risk of poor mental health outcomes due to exposure to a host of psychosocial risk factors. We have identified two interventions that we are keen to implement: the Shamiri Wellness Intervention (https://www.shamiri.institute/the-shamiri-intervention) and the Mental Health Literacy Programme (http://mentalhealthliteracy.org/). We hope that by working with CSOs, the study will support the development of their capacity to offer mental health services that are sustainable, and contextually appropriate.

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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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Immunological mechanisms may contribute to the causation of mental illness. Autoimmunity is most convincingly shown for anti-NMDA-R encephalitis and Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS); disorders that overlap clinically with schizophrenia and OCD. Altered inflammatory cytokine production, glial activation and auto-antibodies have also been associated with schizophrenia and OCD. In these disorders, however, the treatment results with anti-inflammatory or immunomodulating drugs have hitherto been limited and inconsistent. Yet other targets within the immune system may still be effective and new options are warranted for treatment-resistant patients. Rituximab targets B-lymphocytes and is often used in autoimmune disorders such as rheumatoid arthritis, multiple sclerosis and anti-NMDA-R encephalitis.

We aimed to investigate whether rituximab is clinically effective, safe and tolerable as add-on therapy in markedly ill, treatment-resistant adult psychiatric patients with schizophrenia or OCD. We also wanted to identify putative mediating mechanisms in treatment responders, such as cytokine changes and functional connectivity (FC).

In an open pilot study, adults (18-39 years) with treatment-resistant schizophrenia and/or OCD were included. They received an intravenous infusion of rituximab 1000 mg, once at baseline, in addition to their regular psychiatric medication and were followed for 1 year. The main outcome measures were the Positive and Negative Syndrome Scale (PANSS) or Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Clinical Global Impression-Improvement scale (CGI-I) and the Personal and Social Performance scale (PSP). Treatment response was defined as ≥ 40 % decrease in PANSS or ≥ 35 % decrease in Y-BOCS, and much improved according to CGI-I. Resting-state fMRI was applied at baseline and after 5 months. Plasma cytokines were measured at 0, 3 and 5 months. Cognitive tests and the recently developed PsychoNeuroinflammatory Related Signs and Symptoms Inventory (PNISSI) were used to identify and measure symptoms related to neuro-inflammation and cognitive function.

Nineteen patients were treated with rituximab. 3-5 months after treatment, 6/9 patients with schizophrenia and 1/10 with OCD responded. One schizophrenia patient continues with rituximab every 6 months and has reportedly done well for almost 3 years. No severe side effects were reported apart from recurrent abdominal pain in a schizophrenia patient and one case of post-COVID-19 syndrome. Significant changes of FC were detected in responders only and correlated with PSP changes.

Aberrant B-cell activities may contribute to treatment-resistant schizophrenia and be amenable to treatment with rituximab. However, the results of this pilot study need confirmation in placebo-controlled trials.

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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.

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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.

None Declared

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.

None Declared

Maintenance electroconvulsive therapy (mECT) is an option in the treatment of affective disorders which progress is not satisfactory. It is certainly neglected and underused during the clinical practice.

To evaluate the efficacy of mECT in reducing recurrence and relapse in recurrent depression within a sample of three patients.

We followed up these patients among two years since they received the first set of electroconvulsive sessions. We applied the Beck Depression Inventory (BDI) in the succesives consultations for evaluating the progress.

The three patients were diagnosed with Recurrent Depressive Disorder (RDD). One of them is a 60 year old man that received initially a cycle of 12 sessions; since then he received 10 maintenance sessions. Other one is a 70 year old woman that received initially a cycle of 10 sessions; since then she received 6 maintenance sessions. The last one is a 55 year old woman that received initially a cycle of 14 sessions; since then she received 20 maintenance sessions.

All of them showed a significant reduction in depressive symptoms evaluated through BDI and clinical examination. In the first case, we found a reduction in the BDI from the first consultation to the last that goes from 60 to 12 points; in the second case, from 58 to 8 points; and in the last case, from 55 to 10 points. The main sections that improved were emotional, physical and delusional.

As side-effects of the treatment, we found anterograde amnesia, lack of concentration and loss of focus at all of them.

We find mECT as a very useful treatment for resistant cases of affective disorders like RDD.

It should be considered as a real therapeutic option when the first option drugs have been proved without success.

None Declared