A 2020 study in Wuhan residents reported 70.2% of participants faced the COVID-19 pandemic using active coping strategies, and we wanted to explore its comparability in Chinese Health Care Workers (HCWs) across 7 regions in China 1 year after the initial outbreak.

The study analyzed coping strategies utilized by different Chinese HCWs under a stressful period like the COVID-19 pandemic and three psychological scales were used to assess its effect on five psychological outcomes such as depression, anxiety, stress, post-traumatic stress disorder and suicidal ideation.

A cross-sectional self-administered online questionnaire was conducted during the period of November 2020 and March 2021 and included sociodemographic information, work environment before and during the pandemic, experiences, fears and concerns about COVID-19 and three psychological scales including Depression, Anxiety and Stress Scale-21(DASS-21), Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) and Simplified Coping Style Questionnaire (SCSQ-20). Chi-square analysis was used to explore categorical association.

The findings demonstrated that 633 (52.5%) of the participants used passive coping strategies, while 600 (47.5%) used active coping strategies. Passive coping strategies with at least one mental health problem were positively correlated with participants having a previous chronic disease diagnosis, working days in a week during the outbreak, PPE availability, days in isolation for being suspected or a confirmed case of COVID-19, worries about infecting relatives and the pandemic affecting family’s financial situation.

Developing and creating intervention programs to strengthen active coping strategies will improve mental health outcomes in Chinese HCWs during the COVID pandemic.

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Every year at least one million people die by suicide, with major depressive disorder (MDD) being one of the major causes of suicide deaths. Current suicide risk assessments rely on subjective information, are time consuming, low predictive, and poorly reliable. Thus, finding objective biomarkers of suicidality is crucial to move clinical practice towards a precision psychiatry framework, enhancing suicide risk detection and prevention for MDD.

The present study aimed at applying machine learning (ML) algorithms on both grey matter and white-matter voxel-wise data to discriminate MDD suicide attempters (SA) from non-attempters (nSA).

91 currently depressed MDD patients (24 SA, 67 nSA) underwent a structural MRI session. T1-weighted images and diffusion tensor imaging scans were respectively pre-processed using Computational Atlas Toolbox 12 (CAT12) and spatial tract-based statistics (TBSS) on FSL, to obtain both voxel-based morphometry (VBM) and fractional anisotropy (FA) measures. Three classification models were built, entering whole-brain VBM and FA maps alone into a Support Vector Machine (SVM) and combining both modalities into a Multiple Kernel Learning (MKL) algorithm. All models were trained through a 5-fold nested cross-validation with subsampling to calculate reliable estimates of balanced accuracy, specificity, sensitivity, and area under the receiver operator curve (AUC).

Models’ performances are summarized in Table 1.Table 1.

Models’ performances.

Overall, although overcoming the random classification accuracy (i.e., 50%), performances of all models classifying SA and nSA MDD patients were moderate, possibly due to the imbalanced numerosity of classes, with SVM on FA reaching the highest accuracy. Thus, future studies may enlarge the sample and add different features (e.g., functional neuroimaging data) to develop an objective and reliable predictive model to assess and hence prevent suicide risk among MDD patients.

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Psychiatric diseases are often accompanied by medical comorbidities, and cardiovascular system disease is one of the most important causes of death in bipolar disorder (BD) and schizophrenia (SCH) [1]. The QRISK3 algorithm calculatesa person’s risk of developing cardiovascular disease over the next ten years and it has been used in psychiatric research in recent years [2].

In this study, we aimed to evaluate the relationship between cardiovascular risks (by using QRISK3 algorithm) and treatment options in patients of BD and SCH.

Thirty-six patients with bipolar disorder and thirty-two patients with schizophrenia recruited between the years 2016-2022. All of the patients were treated with long-acting injectable (LAI) antipsychotics. Sociodemographic information, clinical features and medical treatment agents of individuals were recorded. The risk of development of cardiac disease of the patients were evaluated by the QRISK3 algorithm. Descriptive and regression statistical analysis was performed with Statistical Package for the Social Sciences (SPSS).

More than half of the patients were male (n= 39, 57.4%) and single (n= 40, 58.8%). The mean duration of education was 9.2 ±3.5 years and the mean age was 39.7 ±11.9 years of the patients. Nearly half of the patients had a diagnosis of BD (n= 36, 52.9%) while others had SCH (n:32, 47.1%). Most of the patients were treated with LAI of aripiprazole (n= 36, 59.2%) and the rest of them were treated with LAI of paliperidone (n= 32, 40.8%). When demographic and clinical data of BD and SCH patients were compared, there was no significant difference in terms of age. However, SCH patients had a longer disease duration (t= 2.56, p= 0.013) and more hospitalization (t= 3.35, p= 0,002) than BD patients. Our findings showed positive correlations between age (r= 0.74, p<0.01), duration of disease (r= 0.57, p< 0.01), and duration of LAI use (r= 0.55, p< 0.01) with QRISK. A regression analysis to examine related factors associated with QRISK found that having a diagnosis of schizophrenia (β= 0.27, t= 2.58; p= 0.01) and a long disease duration (β= 0.67, t= 6.50, p< 0.01) were associated with the development of cardiovascular disease. However, there was no relationship between LAIs (paliperidone vs aripiprazole) used in the treatment and QRISK.

The significant correlation found between duration of disease and QRISK -that indicate the risk of development of cardiac disease- confirming the progressive nature of the BD and SCH. Moreover, the significant correlation between SCH and QRISK suggests that SCH is a chronic and severe disease that causes more cardiac dysfunction than BD. However, we could not find a significant difference between LAIs in terms of QRISK, these results can be changed by evaluating other variables such as comorbidities, other medical treatments and physical activities in future research.

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Weight gain and obesity are important health problems associated with psychiatric disorders and/or with psychotropic drug treatments. There is a high inter-individual variability in the susceptibility to drug induced weight gain and/or other cardiometabolic disorders.

To study the genetic, clinical and environmental risk factors for weight gain and onset of metabolic syndrome during psychotropic treatment.

Analysis in PsyMetab, a large (n>3000) ongoing longitudinal prospective cohort study investigating cardiometabolic disorders in psychiatric patients.

Aside from well-known clinical risk factors for metabolic worsening (e.g. young age, first episode status, rapid weight gain during the first month of treatment and/or low initial BMI), we recently identified additional risk factors, such as the socio-economic status, a low status being associated with increased worsening of cardiometabolic parameters. Results from ongoing studies on the moderate dose dependencies of the metabolic effects of antipsychotics will be shown, as well as the clinical consequences. An epigenome-wide association study (EWAS) performed in 78 patients before and after one month of treatment (Dubath et al., submitted) and a genome-wide association study (GWAS) in 1924 patients (Sjaarda et al. submitted) will also be presented, as well as the use of polygenic risk scores to predict patients at risks for dyslipidemia (Delacretaz-Reymond et al., in preparation)

Many factors contribute to the differences in weight gain and metabolic disorders induced by psychotropic drugs. The use of specific algorithms and/or polygenic risk scores can help to identify patients at risks. However, when starting a psychotropic drug at risk, a prospective monitoring of clinical (e.g. weight and blood pressure) and biochemical (fasting glucose, lipid levels) parameters is essential.

None Declared

Bipolar disorder or manic-depressive psychosis is a severe recurrent psychiatric disorder that, if left untreated, can lead to severe social harm, disability and neurotrophic changes in the brain. However, social and psychological factors play a key role in the onset and progression of the disorder. Therefore, a bio-psycho-social therapeutic approach in the form of an integrated model of “Collaborative Care” is recommended.

Determining the main factors interfering with the decision of fitness to work in bipolar disorders according to work requirements.

Clinical cases including health professionals (HP) was carried out. Cases were examinated at a specialized occupational health Clinics including HP between 2018 and 2022. Data was collected from medical records and by questioning patients directly in case of missing data.

Four HP were included in the study. All suffering from bipolar disorder. The average age was 37 years [28,49]. All were women. Two were divorced and one single. Two anesthesia technicians, a nurse and a cleaner. Two were smokers. Two were transferred to another department because non psycho-education of colleagues at work, dealing with patients, verbal and physical agressivness and cognitive disorders. The two anesthesia technicians were judged unfit for work because of their work responsability and the need for the integrity of all cognitive faculties in the workplace.

In order to decide the fitness to work, occupational physician must consider both bipolar disorder impact and workplace exigency. The adequacy between disease stability and others security is iteratively revised.

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Excessive daytime sleepiness is a frequent symptom in the general population. It may be fleeting, due to transient circumstances, or it may be related to certain pathologies. Indeed, following their infection with SARS-COV2, several healthcare workers (HCWs) have complained of excessive daytime sleepiness.

This study was conducted to assess excessive daytime sleepiness in the SARS-COV2-affected HCWs during the “OMICRON” wave.

Cross-sectional descriptive study, conducted among the HCWs of Charles Nicolle Hospital with COVID-19 during the period from 22 December 2021 to 31 January 2022. Sleepiness was assessed using the Epworth Sleepiness Scale administered during the return to work medical visit.

During the “OMICRON” wave, 58 HCWs joined our study. The average age was 39 +/- 10 years. The sex ratio (M/F) was 0.2. The participants had no previous history of sleep disorders. Excessive daytime sleepiness was found in 21 participants (36% of cases). Excessive daytime sleepiness was mild in 81% of cases, moderate in 14%, and severe in 5%. The category most affected was senior technicians in 57% of cases. Most of the HCWs suffering from daytime sleepiness were working in the gynecology department (19%) and the neurology department (19%).

Early and systematic screening for sleep disorders after any SARS-COV2 infection is necessary to ensure the good health of the HCWs and to reduce accidents and errors in professional procedures.

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Psychiatry is often perceived “different” by other medical professionals as well as by the general population. This perception of “difference” may give rise to stigma toward both patients with psychiatric disorders and mental health professionals.

The aim of this study was to investigate the attitudes of non-psychiatric and their perception of psychiatry and mental disorders.

It was a cross-sectional, descriptive and analytical study, conducted among Tunisian undergraduate and graduate non-psychiatric physicians. Data were collected during September and October 2022, through an anonymous online questionnaire, spread throughout social media (Facebook), using the Google Forms® platform. We used the “Attitude toward Psychiatry-30” (ATP-30).

A total of 168 participants completed the questionnaire. Among them, 81 (48,2%) were undergraduate and 87 (51,8%) were graduate doctors. Their mean age was 26,4± 4.4 years, with a sex-ratio (F/M) of 3.4.

Among doctors, 79,2% had overall favorable attitudes toward psychiatry but only 38,2% among the undergraduate considered psychiatry as a potential career choice.

Psychiatry was considered as an unscientific and imprecise specialty by 20,3%; while 35,7% considered it as the least exciting.

The total score ATP-30 increased significantly with age (p= 0.023). It was significantly higher in those with psychiatric history (p=0.01).

Our study showed a dissonance between favorable perception of psychiatry and the choice of psychiatry as a potential career. Therefore, it is crucial to identify factors that potentially account for this dissonance and enhance enthusiasm among undergraduate doctors as the shortage of psychiatrists may influence mental healthcare.

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Alcohol Use Disorder (AUD) is one of the most significant public health problems in Europe, being highly associated with several medical and psychiatric comorbidities. Sleep disturbances are in this interface and may include insomnia, alterations of sleep architecture and circadian rhythm abnormalities, breathing-related sleep disorders, and sleep-related movement disorders. Also, considering the three stages of the addiction cycle (binge/intoxication, withdrawal/negative affect, and preoccupation/anticipation) and since these domains are reflected in key regions of the brain, it is possible to map these nearly ubiquitous sleep disturbances.

This review aims to summarize the current literature related to the association between sleep disorders and AUD, with a focus on its clinical aspects and neurobiology.

Non-systematic research was made recurring to the PubMed database, with the keywords “alcohol use disorder”, “sleep”, “sleep disorder”. The most relevant articles were selected, focusing on articles published in the last decade.

In patients with AUD, the prevalence of insomnia ranges from 36-91%. A possible mechanism underlies in a mismatch involving maintained activity in wake-promoting structures during non-rapid eye movement sleep (NREM) and a blunted homeostatic drive. On the other hand, alcohol consumption also affects the normal sleep-wake cycle, due to a disruption in the underlying circadian rhythms, a mechanism compassed by the suprachiasmatic nucleus and by photic and non-photic cues. Considering this, it seems highly likely that insomnia and circadian abnormalities may coexist in some individuals. Moreover, AUD is implicated in initiation or worsening of breathing-related events in sleep, especially when having a history of snoring or sleep apnoea syndrome and in period limb movement disorder.

Simultaneously, sleep disorders in AUD can be incorporated into the three-stage addiction cycle. In the binge/intoxication stage, excessive alcohol intake leads to a faster sleep onset but poor sleep quality, explained by the effects on GABAergic systems. During the withdrawal/negative affect stage, there is a decrease in slow-wave sleep and limited rapid eye movement (REM) sleep recovery, which can be explained by the alcohol-positive allosteric modulation of GABAA receptor and other mechanisms. Lastly, during the preoccupation/anticipation stage, the glutamatergic system dysregulation contributes to persistent sleep disturbances, including insomnia, decrease in slow-wave sleep, and an increase in REM sleep.

The knowledge of sleep disturbances associated with AUD has grown and has suggested a bidirectional process that appears to play an essential role in the addiction process. Further studies investigating this association are warranted.

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Azerbaijan ranks among the top 3 countries with the highest rates of suicide in the Muslim world. Yet, research indicates an underestimate of risk due to cultural stigma related to suicidal behavior that may influence reporting and given that many Muslim-majority countries, where populations exceed 100 million, do not report any data on suicide rates. Violence against women also occurs at alarming rates in Azerbaijan and is a significant risk factor for suicide.

We examine perspectives towards suicide and violence against women and barriers to care among key stakeholders.

Thirty qualitative interviews and 4 semi-structured focus groups were held with female survivors of suicide and mental health professionals working with individuals at risk of suicide to assess for perspectives on suicide and violence against women, factors influencing help-seeking, and the nature of existing resources.

Most participants viewed suicide (83%) and violence against women (73%) as problems. Nevertheless, 33% reported negative stereotypes regarding suicide and 50% reported psychological treatment as unaccepted in Azerbaijan. Findings highlight that domestic violence is the strongly identified as risk factor for suicide among women in Azerbaijan. Stigma and related cultural values regarding gender norms are significant contributors to violence against women and suicide. Existing services are underrecognized and perceived of as unavailable or insufficient.

Employing a social determinants of health lens, multi-level programming is needed that spans micro (individual level supports), mezzo (family level supports), and macro (advocacy and outreach) levels to support a comprehensive strategy that beings with prevention and extends to address intervention, management, and capacity building to halt the increasing rates of suicide and deter violence against women.

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One of the great challenges still to be achieved in schizophrenia is the development of a staging model that reflects the progression of the disorder. The previous models suggested have been developed from a theoretical point of view and do not include objective variables such as biomarkers, physical comorbidities, or self-reported subjective variables (Martinez-Cao et al. Transl Psychiatry 2022; 12(1) 1-11).

Develop a multidimensional staging model for schizophrenia based on empirical data.

Naturalistic, cross-sectional study. Sample: 212 stable patients with Schizophrenia (F20). Assessments: ad hoc questionnaire (demographic and clinical information); psychopathology: PANSS, CDS, OSQ, CGI-S; functioning: PSP; cognition: MATRICS; laboratory tests: C-Reactive Protein (CRP), IL-1RA, IL-6, Platelets/Lymphocytes (PLR), Neutrophils/Lymphocytes (NLR), and Monocytes/Lymphocytes (MLR) ratios. Statistical analysis: Variables selection was performed with an ad hoc algorithm developed for this research. The referred algorithm makes use of genetic algorithms (GA) to select those variables that show the best performance for the patients classification according to their global CGI-S. The objective function of the GA maximizes the individuals correct classification of a support vector machines (SVM) model that employs as input variables those given by the GA (Díez-Díaz et al. Mathematics 2021; 9(6) 654). Models performance was assessed with the help of 3-fold cross-validation and these process was repeated 10,000 times for each one of the models assessed.

Mean age(SD): 39.5(13.54); men: 63.5%; secondary education: 59.50%. Most patients in our sample had never been married (74.10%), and more than a third received disability benefits due to schizophrenia (37.70%). The mean length of the disease was 11.98(12.02) years. The best SVM model included the following variables: 1)Clinical: number of hospitalizations, positive, negative, depressive symptoms and general psychopathology; 2)Cognition: speed of processing, visual learning and social cognition; 3)Functioning: PSP total score; 4)Biomarkers: PLR, NLR and MLR. This model was executed again 100,000 times applying again 3-fold cross-validation. In 95% of the algorithm executions more than a 53.52% of the patients were classfied in the right CGI-S category. On average the right classification was of 61.93%. About specificity and sensitivity the average values obtained were of 0.85 and 0.64 respectively.

Our staging model is a robust method that appropriately distributes patients according to the severity of the disorder. Highlights the importance of clinical, functional and cognitive factors to classify patients. Finally, the inflammatory parameters PLR, NLR and MLR have also emerged as potential biomarkers for staging schizophrenia.

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Freelancing can be analyzed through psychological prism of escapism, through the desire not to be involved in the systems of inflexible social ties that are accepted in group (career, family, classical education, etc.)

Freelancers have a non-standard self-attitude and self-description, which indicates their “isolation” from the real social world by these people.

Quantitive (Spyrman’s criteria and corellations) and qualitive analisys ( semi-structured interviews). N = 300, residents of ussia and Austria.

The hypothesis was rejected that freelancers do not have career and personal orientations, in contrast to individuals who are not prone to this type of career choice. The absence of a connection between goal setting and downshifting was revealed based on the analysis of the author’s questionnaire for goal setting.

The hypothesis was empirically confirmed that freelancers have more pronounced indicators such as global self-attitude, self-esteem, self-sympathy, expected attitude from others, self-confidence, self-acceptance in the affective component of the self-concept, in contrast to people choosing the traditional career path.

Freelancers have a less pronounced indicator of self-accusation, in contrast to people committed to careerism.

None Declared

Interest in possible clinical uses for psychedelic drugs has grown steadily over the past decade. Although impressive findings from small studies stimulated considerable speculation and provided a strong justification for further study of psychedelic treatments, until very recently there was a dearth of high-quality evidence for their efficacy, mechanisms of action, and appropriate treatment models for clinical use. However, during the past 2-3 years, there have been dramatic advances in the field. This presentation will focus on 5 publications in the field of psychedelic medicine that exemplify three important aspects of the recent progress in psychedelic research. (1) There has been a rapid increase in the number and size of controlled clinical trials of various psychedelic treatments. (2) Conceptual models for studying and potentially understanding the therapeutic effect of psychedelics have increased in sophistication and comprehensiveness. And (3) progress has been made toward developing models of treatment that would facilitate access to safe and effective psychedelic treatments, if and when they are approved by regulatory bodies. Although progress has been rapid, the field of psychedelic medicine is still in its infancy. Much more work on these and many other fronts will be necessary to discover what the study of psychedelics can contribute to healthcare and neuroscience.

None Declared

The use of alcohol, in particular its harmful use and alcohol dependence, represent a public health problem of interest to all age groups. Indeed, alcohol is responsible for a heavy burden of disease and a considerable socio-economic burden.

To determine the prevalence of alcohol use and the main factors associated with it in a sample of Tunisian students.

This is an analytical cross-sectional study carried out during the 2020/2021 academic year with a sample of Tunisian students. We used an anonymous self-administered questionnaire distributed online via social networks. Our questionnaire included a section focusing on socio-demographic characteristics and the AUDIT test (Alcohol Use Disorders Identification Test) to detect alcohol addiction.

Our study enrolled 772 students .The average age of the study population was 23.29 ±3.25.Two hundred ninety-nine students (38.7%) consumed alcohol. The mean age at first use was 18.44 (3.09). Fifty-two alcohol users (17.4%) presented a risk of alcohol dependence. The first consumption contexts were mostly “between friends” (57.4%) and “party time “(23.5%).The main effects sought were the effect of disinhibition (64.5%) and social integration (41.1%) were predominant responses. The determining factors of alcohol consumption were age (p<10-3), male gender (p<10-3), and the presence of grade repetition (p<10-3), wealthy socioeconomic level (p<10-3), and participation in community life (p<10-3).

Alcohol use and especially alcohol dependence may have harmful effects on student’s life. It is relevant to screen this addiction to better its prevention.

None Declared

Proper nutrition with fats has a protective effect on the functioning of the nervous system. However, a disturbed ratio of essential polyunsaturated fatty acids supply is nowadays a common phenomenon. A diet overloaded with saturated fats and a shortage of those essential ones in the company with possibly some unfavorable genetic endowment could lead to the release of psychosis from the framework of diet defined by nature for thousands of years.

The study aims to review the literature to assess the influence of supplementation with polyunsaturated fatty acids in the occurrence of psychotic disorders prevention, as well as their impact on remission prolongation.

Literature review in PubMed, Google Scholar, and Web of Science using the keywords [psychosis] OR [psychotic] OR [schizophrenia] OR [unipolar] OR [bipolar] OR [schizoaffective] OR [depression] OR [manic] OR [hypomanic] OR [mania] OR [hypomania] OR [first episode psychosis] OR [ultra-high risk] OR [UHR] AND [polyunsaturated fatty acids] OR [PUFA] OR [prostaglandin] OR [phospholipid] OR [phospholipase A2] OR [arachidonic acid] OR [linoleic acid] OR [alpha-linolenic acid] OR [omega-3] OR [omega-6] OR [nutrition] OR [diet]. The review included original articles, reviews, systematic reviews, meta-analyses, and case reports from 1977-2022 in Polish and English.

86 articles devoted to diet and nutrition in psychotic disorders were analyzed. Patients with schizophrenia, bipolar disorder, and schizoaffective disorders exhibit deficiencies in polyunsaturated fatty acids. Such results may indicate compliance with David Horrobin’s theory of the psychotic disorders development in predisposed individuals.

Supplementation with polyunsaturated fatty acids may be a chance for a selected group of patients to prolong remission but also hope to prevent the occurrence of psychotic disorders in particularly vulnerable individuals.

None Declared

Patients with amnestic mild cognitive impairment (aMCI) have a high risk of transition to Alzheimer’s disease. Analysis of potential biomarkers of conversion to dementia in this clinical group is crucial for prognosis and early intervention.

The aim of the pilot study was to compare whole-brain functioning characteristics (fMRI, spontaneous activity and local coherence) in aMCI converters and non-converters to dementia.

Nine aMCI converters to dementia of the Alzheimer’s type (mean age 69.2 ± 8.2; 9 females) and ten aMCI non-converters (mean age 65.9 ± 6.1; 8 females) underwent resting-state fMRI (3T). All patients were followed up for three years. Baseline whole-brain amplitude of low-frequency fluctuations (ALFF) and local coherence (LCOR) were compared between groups (CONN-fMRI toolbox 19.с, https://web.conn-toolbox.org/; p < .001 voxelwise, p(FDR) < .05 clusterwise). Age was included in the analyses as a second-level covariate.

As compared to non-converters, aMCI converters were characterized by higher ALFF and LCOR values in the cluster located in the frontal medial cortex and frontal pole bilaterally.

Frontal medial cortex and frontal pole are involved in a wide range of cognitive functions, including episodic memory and “hot” (motivational) executive control (Rolls. ProgNeurobiol 2022; 217; Friedman, Robbins. Neuropsychopharmacology 2022; 47(1) 72-89). Both increased and decreased LCOR/ALFF values in aMCI converters compared to non-converters were found, although in the other regions (Mondragón et al. Dement Geriatr Cogn Dis Extra 2021; 11(3) 235–249; Khatri, Kwon. Front Aging Neurosci. 2022; 14). It seems reasonable to clarify if the brain functional features revealed in our study are the markers of conversion to dementia in aMCI.

None Declared

Major depressive disorder (MDD) is a mood disorder that can last for weeks or even months, in which there is a depressed mood accompanied by anxiety, in addition to negative changes in cognitive functions, psychomotor movement and vegetative functions. Depression with psychotic features is a psychiatric syndrome that progresses with delusions as well as severe symptoms such as psychomotor retardation or agitation, depressive ruminations, deterioration in cognitive functions, and confusion. Compared to the subtypes without psychotic features, the symptoms are more severe, the age of onset is earlier, and the duration of the disease is longer. Feelings of guilt, worthlessness and suicidal thoughts and attempts at suicide are more common. The risk of exacerbation is greater. Diagnosis of bipolar disorder and schizophrenia is more common in first-degree relatives of these patients.

An 18-year-old female patient with somatic delusions and psychotic persistence that started after a sexual trauma and persisted for 1 month was consulted after organic exclusions were made. It is understood from the anamnesis that the patient had a manic episode about 6 months ago and that his mother was followed up with a diagnosis of bipolar disorder. The patient’s current clinical picture was evaluated as depression with psychotic features, and after hospitalization, the treatment was adjusted as fluoxetine 20 mg/g, olanzapine 5 mg/g, and lithium 900 mg/g. Self as context, cognitive defusion and acceptance interventions were applied to the patient.

When the Cognitive Fusion Questionnaire(CFQ), Self-as-Context Scale(SACS), Acceptance and Action Questionnaire(AAQ-II) completed by the patient during hospitalization and in remission periods were compared, it was observed that there was a significant regression in the patient’s psychological inflexibility during the period of remission. Written informed consent was obtained from the patient whose clinical picture was presented in order to contribute to the scientific literature.

Depression with psychotic features is another clinical picture in which psychological inflexibility increases, and it has been observed that interviews to increase psychological flexibility during the treatment process contribute positively to the treatment process. For this reason, the contribution to the healing process can be better clarified in further studies on interventions to increase psychological flexibility applied in addition to pharmacological treatments.

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Psychological inflexibility is an effort to control a person’s emotion, thought, behavior or experience in a dysfunctional way in the face of an undesired experience. It has been seen in studies conducted in recent years that; There is a significant positive correlation between high psychological inflexibility and somatization, depression, anxiety and other psychological disorders.

None Declared

Depressive disorders in adolescence and young adulthood have always been and remain an urgent problem due to their fairly high prevalence among the population, serious difficulties in diagnosis and untimely treatment. Timely diagnosis and adequate treatment can have a powerful impact on the future life of a person in a positive context. This process requires both standardized mechanisms, and an individual detailed study of each case, as the future of the individual depends on it.

A young adult M., 20 years old, a university student, from a socially prosperous family, approached us.

Main complaints: headaches that have been going on for almost 4 years. Pains did not depend on loads, both physical and mental, were of various characteristic and different localization. Non-steroidal anti-inflammatory drugs, as well as anti-migraine drugs, have little effect on the pathological experiences.

Our main method of examination was clinical interview. In the complex assessment detailed neurological and ophtalmological examination included.

The parents referred patient for a medical examination about a year ago, because they noticed persistent mydriasis in him. During the year, the patient underwent a detailed examination (consultations of a therapist, endocrinologist, neurologist, ophthalmologist, MRI, EEG, dopplerography). Doctors expressed various assumptions about the diagnosis, because all the studies did not reveal any pathology that could explain the indicated complaints and mydriasis.

During the initial interview, a high level of intelligence and knowledge was revealed, as well as a sufficient ability to learn. Examining the emotional-volitional sphere, a slight level of emotional instability, mild irritability, anhedonia and a slight degree of hypobulia (which can be explained by long-lasting and persistent pathological somatic experiences in the form of headaches) were found. Incomplete Protopopov’s triad was revealed.

The patient was referred for repeated neurological and ophthalmological examination. Specialists with a high qualification level discovered the A. Athanassio symptom in him.

He was diagnosed with recurrent depressive disorder, a current episode of severe depression with somatic symptoms, and appropriate treatment was prescribed.

1. 1. Depressive disorders in adolescence and young adulthood require special attention from specialists of all medical specialties.

2. 2. The need for a detailed medical examination and modern neuroimaging methods is beyond doubt.

3. 3. Psychiatric examination cannot be limited to assessment of mental status only, and assessment of Protopopov’s triad should be part of psychiatric examination.

4. 4. Neurological and ophthalmological examination must necessarily include an assessment of neuro-ophthalmological symptoms.

5. 5. Individual selection of treatment should be carried out by a psychiatrist.

Sorry to say, Professor Mykola Pityk died 27.12.2020

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Irish Travellers are an indigenous minority in Ireland with distinct history and culture, of which nomadism was traditionally an important feature. Travellers experience disadvantages in education, employment, housing and health. Suicide is a big problem in the Traveller community, their suicide rate is 11%: 6 to 7 times higher than the general population. 59.4% of Traveller men and 62.7% of Traveller women reported that their mental health has not been good for one or more days in the last 30. Despite the high rates of suicide, there is a paucity of clinical research into mental health of Travellers.

Aim was to improve the scientific knowledge of the mental health of Irish Travellers by addressing the gap in the scientific literature.

The objective was to conduct a qualitative assessment of Travellers who have experienced self-harm and suicidal thoughts themselves, or who have a family member who has experienced same, by exploring their personal experience of distress, adversity and illness.

We conducted semi-structured interviews exploring the following topics: self-harm, bereavement by suicide, experience of mental illness and of seeking treatment, stigma, discrimination and perceptions of research participation. Participants were recruited from community Traveller organisations in order to improve participation. Data were analysed using Nvivo software for thematic analysis.

Our participants aged from 22-62. 67% reported a personal history of self-harm, 83% had a psychiatric diagnosis. None were actively engaged with a Psychiatric team.

The main themes from the data were discrimination, identity issues, cultural understanding in healthcare settings, mental health and wider societal issues. Our findings showed that many Travellers who suffer from mental health problems and suicidal thoughts, find it hard to discuss problems openly within their families and communities due to stigma and shame, despite the high incidence of suicide. Many reported experiencing idenity crises, and a sense of not belonging in society, particularly since the introduction of legislation preventing them from aspects of their traditional lifestyles. Other common topics were literacy issues, womens and LGBTQplus rights.

Travellers are a marginalised group in our society with high rates of socioeconomic deprivation, which we know is a factor in mental illness and thoughts of self-harm or suicide. There is a need for improved education for mental healthcare workers into the culture of Travellers and for increased sensitivity and awareness of how to engage with patients with literacy issues. Stigma remains an issue within the Travelling community and more work needs to be done to improve engagement between Travellers and mental health services in order to prevent acute mental health crises and/or suicidal behaviour. Travellers remain a difficult to reach and under-researched group in our society.

None Declared

The coronavirus disease 2019 (COVID-19) pandemic has had an unprecedented impact on educational systems and the well-being of the university staff. The mental health of university staff can affect their ability to work.

Our study aimed to assess the association between the well-being of university staff and their workability during the COVID-19 pandemic.

We conducted a cross-sectional study among university staff in Sfax, Tunisia. We collected data between September and October 2021 using a self-administered questionnaire including socio-professional characteristics, the Work Ability Score (WAS) and the Arabic version of the Mental Health Continuum-Short form.

Our sample was composed of 62 university staff. The respondents’ mean age was 51.4±6.7 years and 67.7% were female. The average job tenure was 17.9 ± 8 years. The mean score of WAS was 7.5±1.8. The mean scores of emotional well-being, social well-being and psychological well-being were 8.5±4.2, 12.6±6.1, and 19.9±7.3, respectively. Sixty-one per cent of participants reported languishing to moderate mental health, and 39% % were flourishing. The workability of participants was significantly associated with their well-being (p = 0.04).

Having good mental health improves the worker’s ability to work. Taking care of mental health is crucial to guarantee better efficacy at work.

None Declared

Obsessive compulsive symptoms may occur at any age. It was studied extensively in the youth contratry to the elderly that usually suffer for other health issues leading to misdiagnosis.

We aim through this study to discover the particularities of OCD in elderly .

Our literature review was based on the PubMed interface and adapted for 2 databases: Science Direct and Google Scholar using the following combination ( obsessive compulsive disorder [MeSH terms]) OR (OCD [MeSH terms]) AND (elderly [MeSH terms]) OR (dementia [MeSH terms]).

Our review revealed 39 articles from which we selected 4 articles.

We found that in aged adults over than 50 years experience mostly somatic symptoms, religiosity, and moral scrupulosity as obsessive thoughts.

We also found that OCD can occur as a primary disorder in older women, whereas in men it either persists from, younger years or arises in the context of another psychiatric or medical disorder

The relationship between Obsessional illness, brain mechanisms and Cognitive disorders are not fully understood.

Indeed, we noted a relative Impairment in executive function in older adults with OCD stressing the link with cognitive impairment. Moreover, Obessive compulsive symptoms may worsen cognitive functioning .

Obsessive compulsive disorder presence in the elderly may be described as a primary health condition or be related to organic mental health issues in particular dementia. The physiopathology remains unclear therefore further studies are needed for better understanding and management.

None Declared