Psychogenic Nonepileptic Seizures (PNES) refer to the dissociative condition which resembles seizures but does not involve epileptic synchronous cortical activity (Huff, 2021). 20% of people visiting epilepsy clinics have PNES (Huff, 2021). Depression, anxiety, and personality disorders predispose towards PNES (Ekanayake, 2018).

To present a case of PNES in a patient with dependent personality disorder (DPD) and to discuss the sociocultural aspects.

A case study.

A 23-years old, married female presented with 20 days history of episodes of ‘falling down, rolling on ground, and involuntary movements of her head.’ The episodes typically lasted from 20-25 minutes. During the episodes, patient closed her eyes but remained conscious and expressed her distress with gestures, and tearfulness was also observed. Her condition improved when she was offered water. The clinical picture of these episodes evolved with time. Her EEG and serum prolactin levels following the episodes were normal. Accordingly, a diagnosis of PNES was made. No acute stressor was present. The patient also fulfilled the criteria of Dependent Personality Disorder (DPD) (American Psychiatric Association, 2013). During communication with the patient, it appeared that the patient and her attendants perceived the train of questioning as investigational rather than therapeutic. Efforts were made towards a more empathetic understanding of their point of view, and the tailoring of long-term management in accordance with their sociocultural context.

The socio-cultural context is important in the management of PNES and a sensitive, and collaborative approach is recommended. Assessment of personality should be considered in patients presenting with PNES.

No significant relationships.

The self-report version of the Panic Disorder Severity Scale (PDSS-SR) is a reliable and valid instrument to assess panic disorder, but is unavailable in French.

The aim of this study was to conduct a transcultural validation of the French-Canadian PDSS-SR and examine its psychometric properties.

This study is part of a pragmatic RCT of group transdiagnostic CBT for anxiety disorders, and includes 272 adults meeting DSM-5 panic disorder diagnostic criteria. At baseline, participants completed the Anxiety and Related Disorders Interview Schedule (ADIS-5), the French-Canadian PDSS-SR and self-report measures. Convergent validity was assessed with Spearman correlations, Cronbach’s α was used to analyse internal consistency, and confirmatory factor analysis (CFA) evaluated its factor structure. Sensitivity to change was assessed with paired sample t-tests in patients (n = 72) meeting DSM-5 criteria for panic disorder at baseline with posttreatment data.

108 patients met DSM-5 criteria for panic disorder, including 58 with agoraphobia. The majority were women (85.3%) and mean age was 37.1 (SD = 12.4). Internal consistency (Cronbach’s α) was 0.91. For convergent validity, the highest correlation was with the Beck Anxiety Inventory (r = 0.64). CFA suggested a two-factor model. Optimal threshold for probable diagnosis was 10. Analyses support sensitivity to change when comparing transdiagnostic group CBT and control conditions.

With its good psychometric properties in primary care patients, the French-Canadian self-report version of the Panic Disorder Severity Scale is an efficient and practical instrument for both clinicians and researchers working in the field of mental health.

No significant relationships.

Major Depressive (MDD) and Bipolar Disorder (BD) are chronic relapsing condition in which mood episodes are interspersed with periods of euthymia. Impairments in Executive Attention (EA) are a trait characteristic of mood disorder that persists also during remission. Similarly prefrontal dysfunctions are crucial in the genesis and maintenance of Obsessive-Compulsive Symptoms (OCS), which are highly comorbid in both MDD and BD.

The aim of this study is to test a model in which deficits in EA mediate the relationship between the OCS and the relapse in a cohort of patients with MDD and BD.

Sixty-four euthymic subjects with BD and MDD performed the Attentional Network Task Revised (ANT-R), that gauges EA in a standard conflict task. Here we adopted a drift diffusion model to measure the task efficiency as the drift rate in incongruent trials. Patients also completed at baseline the YBOCS, a questionnaire that evaluate the severity of OCS. All the participants have been followed-up for up to 5 years and relapses have been recorded.

The association between OCS and time in euthymia was fully mediated by the EA so that greater OCS were associated with poorer executive functions (beta=-0.341; p=0.006) that in turn predicted a sooner relapse (beta=0.349; p=0.005). This held true even when controlling for classic predictors of recurrence such as previous episode distance, the duration of illness and medications.

Treatment targeting executive functions could hence be crucial in preventing relapses in subjects with mood disorders experiencing obsessive compulsive-symptoms.

No significant relationships.

Gambling disorder (GD) is characterized by repeated problematic gambling behavior associated with unsuccessful and uncontrollable urges to keep gambling, which leads to considerable distress and impairment. Several types of interventions exist to treat GD, with cognitive behavior therapy (CBT) being one of the most widely used approaches.

To estimate trajectories of the gambling disorder (GD) severity for 12 months following a manualized cognitive-behavior-therapy (CBT) program, and to identify the main variables associated with each trajectory.

Latent Class Growth Analysis examined the longitudinal changes of n = 603 treatment-seeking patients with GD.

Five separate empirical trajectories were identified: T1 (n = 383, 63.5%) was characterized by the most highest baseline gambling severity levels and positive progress to recovery during the follow-up period; T2 (n = 154, 25.5%) featured participants with high baseline gambling severity and good progress to recovery; T3 (n = 30, 5.0%) was made up of patients with high gambling baseline severity and slow progress to recovery; T4 (n = 13, 2.2%) and T5 (n = 23, 3.8%) contained participants with high baseline gambling severity and moderate (T4) and poor (T5) progress in GD severity during the follow-up. Psychopathology, personality traits, poor compliance and relapses discriminated between trajectories.

These results show that treatment seeking patients with GD are heterogeneous. In addition, the obtained findings could be useful in the design of more efficient interventions for this behavioral addiction. Funding oftained from RTI2018-101837B-I00

No significant relationships.

Magnocellular deficit in visual perception and impaired emotion recognition are core features of schizophrenia, however their relationship and the neurobiological underpinnings are still unclear.

The aim of our research was to investigate the oscillatory background of perception and emotion recognition in schizophrenia and to examine the relationship between these processes.

Thirty-nine subjects with schizophrenia and forty healthy controls subjects were enrolled in the study; the two study groups did not differ in age, gender and education. In the visual paradigm the participants viewed magnocellular biased low-spatial frequency (LSF) and parvocellular biased high-spatial frequency (HSF) Gabor-patches and in the second paradigm happy, sad and neutral faces were presented, while 128-channel EEG was recorded.

Significantly weaker theta (4-7 Hz) event related synchronisation (ERS) was observed in patients compared to controls in the LSF condition, whereas in the HSF condition there was no difference between the two groups. Event related changes in theta amplitude were also found to be significantly weaker in patients compared to healthy controls in the emotion recognition task, which difference was disappeared after correction for ERS to LSF condition. In the correlational analysis theta activity in the magnocellular biased stimuli correlated significantly with theta activity in the emotion recognition task, while theta to parvocellular biased stimuli showed no similar correlation with emotion recognition.

In schizophrenia, emotion recognition impairments are closely related to the dysfunction of the magnocellular system, which supports the bottom-up model of schizophrenia.

No significant relationships.

Wilson’s disease is a rare (1:30,000) autosomal recessive disorder of copper metabolism that is caused by mutations in the adenosine triphosphatase copper transporting beta (ATP7B) gene, located on chromosome 13. The reported percentage of patients with psychiatric symptoms as the presenting clinical feature is 10%-20%.

To present and discuss a rare case admitted in the First Psychotic Episode Inpatient Unit (UIPEP) with pleiomorphic psychotic symptoms and low serum copper and ceruloplasmin and high 24h urine copper.

The data was collected through patient and family interviews, as well as from his medical record. We searched Pubmed using MeSH terms: psychotic disorders AND Hepatolenticular Degeneration.

A twenty-two years old male, without known psychiatric history presented in the Emergency Department with a myriad of psychotic symptoms: motor stereotypes/mannerisms, paranoid delusions and auditory hallucinations. He was admitted in UIPEP, started low-dose antipsychotic medication with good response. As part of the implemented protocol, he did a battery of exams, including Brain CT-scan, EEG, ECG and blood and urine analysis, in which low serum copper and ceruloplasmin stood out, leveraging the suspicion of Wilson´s disease. Therefore, 24h urine copper was done, with 140 mcg/d (reference range < 40 mcg/d). Brain MRI was normal and no Kayser–Fleisher rings were seen by a consulting ophthalmologist.

Without proper treatment, Wilson’s disease is a progressive and fatal disease. Therefore, it’s of upmost importance to recognize the clinical signs that raise suspicion of this disorder, especially recent onset in young adult of miscellaneous psychotic symptoms with movement disorders.

No significant relationships.

The problems of the attitude to success and failure are relevant at the present time.

study allows to describe and compare the indicators of emotional intelligence and the types of attitudes toward success and failure of a peer in adolescence and youth

110 students and 90 teenagers were studied. T.V. Beskova’s methods “Attitude to the success and/or failure of a peer” in adolescence and adolescence (adapted technique by T.V. Beskova), N. Hall’s method of evaluating “emotional intelligence” (EQ questionnaire).

The “Relationship to Peer Success and Failure” methodology showed differences between adolescence and adolescence in scales: “peer joy” U = 0.016 (p≤0,05), “desire to achieve the same” U = 0.008 (p≤0,01), U = 0.027 “envy” (p≤0,05) and “passive” U = 0.006 (p≤0,01). The EQ questionnaire showed statistically significant differences in scales as “managing one’s emotions” U = 0.007 (p≤0,01), “self-motivation” U = 0.006 (p≤0,01). There are age differences in the types of attitudes to peer success and failure and the specifics of emotional intelligence in older adolescence and adolescence. Spearman rank correlation coefficient (r = 0.48) there is a relationship between the type of relationship to peer success and failure and emotional intelligence in adolescence and adolescence

Thus, the study showed the features of personal factors in relation to the success and failure of a peer in adolescence and adolescence.

No significant relationships.

Brodalumab, an anti-IL17RA monoclonal antibody, is a treatment option for plaque psoriasis related to increased risk of suicidal ideation and behavior, including completed suicide.However, in the literature no causal relationship is reported, and the reported incidence of patients receiving brodalumab that committed suicide did not differ from the expected suicide incidence of the general population.

Our objective is to answer the followings:1) What is the probability of developing emotional disorders during treatment with brodalumab.2) What is the recurrence rate of previously diagnosed emotional disorders in brodalumab responders (Kaplan-Meier curve). 3) What is the relationship between suicide and/or suicidal ideation in patients receiving treatment with brodalumab.

The study will enroll patients with moderate to severe psoriasis (aged 18-70) that attend the outpatient dermatology, and who already receive or are eligible to receive treatment with brodalumab. Patients who are willing to participate in the study will be provided with the self-completing questionnaires PHQ-9, GAD-7, RASS, HRQoL. During follow-up, if a patient presents with a PHQ> 9, will be referred for an HDRS evaluation in which if score> 17 in at least 2 scores or an increase in the RASS scale is detected, will be referred for psychiatric intervention.

Assessments will take place a) before treatment , b) 2 weeks after initiation of treatment with brodalumab , c) every month for the first 3 months, and e) on a quarterly basis up to 52 weeks.

This study will focus on creating a protocol for the safe use of brodalumab in psoriasis patients with concomitant psychological/psychiatric comorbidities.

No significant relationships.

No significant relationships.

Studies have demonstrated that Ziprasidone use may be beneficial in children. Determining its potential risks and benefits when used in children is therefore important.

To examine the tolerability of Ziprasidone, an atypical antipsychotic, in children and adolescents.

We conducted a literature search of open label or randomized control trials that report on Ziprasidone use in children on three databases: Embase, PsychInfo and PubMed using the PRISMA guidelines of Systematic review and Meta-analysis. Out of 1690 articles, 11 studies met inclusion criteria. Outcome measures included adverse effects such as weight gain, increase in BMI, QTc prolongation, changes in metabolic parameters, sedation, and dizziness. We conducted a random effects meta-analysis and meta-regression of potential moderators. Publication bias was assessed with funnel plots.

Data from Eleven studies was meta-analyzed (Total n= 474, mean age=12.87 years, male= 68..37%) that reported the use of Ziprasidone in children and adolescents with Psychosis, Bipolar, Autism spectrum disorders and Tourettes syndrome. Mean Ziprasidone dose = 84.40 mg and mean study duration = 2.85 months). We found that Ziprasidone was not found to cause any significant weight gain (1.72, p>0.05) or change in BMI (0.58 , p>0.05). QTc prolongation was found to be significant (11.9 , p<0.05). Most common side effects were sedation (42.44%), Nausea(19.32%), Headache (22.92%), fatigue (16.67%) and Dizziness (16.96 %).

Results demonstrate that Ziprasidone does not cause significant weight gain, however QTc prolongation and sedation were found to be significant side effects of Ziprasidone use. Therefore, baseline EKG and thorough history must be obtained before prescribing Ziprasidone in children and adolescents.

No significant relationships.

Effective diagnostic and treatment pathways for ADHD are needed in prison settings due to the high prevalence of ADHD and comorbidities in the prison population.

In this presentation, we will describe two studies conducted in seperate London prisons in England. In the first study, the aim was to identify prisoners with ADHD with a focus on describing comorbidity. In the second study, using QI (quality improvement) methodology, the aim was to measure the practicability and effectiveness of a specialist ADHD diagnostic and treatment pathway for prisoners.

Two studies were carried out in two separate prisons in London. Firstly, data were collected to understand the prevalence of ADHD and the comorbidities. The second study used quality improvement (QI) methodology to assess the impact of a diagnostic and treatment pathway for prisoners with ADHD.

Of the prisoners, 22.5% met the diagnostic criteria for ADHD. Nearly half of them were screened positive for autistic traits, with a higher prevalence of mental disorders among prisoners with ADHD compared to those without. The QI project led to a significant increase in the number of prisoners identified as requiring ADHD assessment but a modest increase in the number of prisoners diagnosed or treated for ADHD.

Despite various challenges, an ADHD diagnostic and treatment pathway was set up in a prison using adapted QI methodology. Further research is needed to explore the feasibility of routine screening for ADHD in prison and examine at a national level the effectiveness of current ADHD prison pathways.

No significant relationships.

No significant relationships.

The ongoing global pandemic of Covid_19 had a huge pressure to accelerate the development process of Covid_19 vaccine. This acceleration of the vaccine appearance raised many concerns regarding the effectiveness and the adequate safety of the vaccine among general population.

The aim of the study is to determine the reasons behind vaccine refusal among general population.

Online questionnaire with the subjects’ agreement; The study included 61 participants aged between 18 and 40 years old. The study was effectuated in October 2021.

Most of the participants (n=60, 98.36%) declared that they knew some persons who have refused the Covid_19 vaccine. Moreover, a number of 29 participants (48.33%) declared that vaccine refusal among the people who refused the vaccine was due to personal believes.

The success of the vaccination programs mainly depends on the proportion of the population that receive the vaccine. It is crucial to implement new strategies to increase the acceptability of Covid_19 vaccine.

No significant relationships.

Since the outbreak of the 2019 coronavirus, healthcare workers found themselves on the front lines of an unprecedented battle. Being characterized by adversity, this experience represents a fertile ground for the study of resilience.

Our study aims to clarify the phenomenon of resilience through its influence on perceived stress level and its connection with coping strategies.

A cross-sectional study was conducted involving 254 healthcare professionals in the region of Sousse during the pandemic. In addition to socio-demographic and professional characteristics, Resilience, perceived stress, and coping strategies were assessed using the Connor-Davidson Resilience Scale (CD-RISC), the PSS10 scale, and the Brief Cope questionnaire, respectively.

The overall mean [±standard deviation (SD)] age of the participants was 32.9 ± 8.76 years with a sex ratio (M / F) of 0.51. The assessment of resilience among participants revealed a mean score of 64.99 ± 14.72. The majority of participants evinced a score> 50 (82.68%) and 39.76% had a score >70. Our results revealed that, on the one hand, problem-focused coping strategies were positive predictors of resilience (p<10-3), accounting for 3.6% of its variance. On the other hand, coping strategies (problem-focused strategies and avoidance strategies) are also an integral part of the process by which resilience significantly influences the level of perceived stress (mediating factor).

Despite its complexity, the relationship between resilience and coping strategies is undeniable and it is a part of an important line of intervention opening the way to better identifications and care.

No significant relationships.

Transhistorical psychiatry defends that a psychic alteration can be interpreted as a cultural, historical and personal construction, subject to incessant variations.

A journey through the history of the disorder and the successive pathomorphoses it has undergone could provide us with a better understanding of it and explain the reason for the epidemiological trend towards a decrease in its diagnosis; and bring us closer to a universal definition of the phenomenon.

Bibliographic review

The word hysteria and all its subsequent meanings, not only contain a particular conception of the pathology, but also reflect its different forms of presentation in specific periods of time. Hysteria is presented as a voluble material that can take on any form: from the wandering womb theory of classical Greece to the demonic possessions of the Middle Ages; from the neurological degeneration of Charcot (1825-1893) to the conversion and dissociation of Freud (1856-1939). With the entry of the 20th century, its dramatic clinic has been progressively overshadowed by somatoform disorders and emerging functional somatic syndromes. Today, it is practically unrecognisable and very difficult to diagnose, to the point of having disappeared as a term from the official classifications of our time.

Hysteria is an entity that has not always been the same, neither in its conception nor in its manifestations. Depending on the socio-cultural context in which it is framed, it will be interpreted and expressed in different ways.

No significant relationships.

Rapid cycling Bipolar disorder and mixed affective states are treatment resistant conditions. Standard treatments are ineffective. Homozygous polymorphism of DIO2 gene is associated 3.75-fold risk of bipolar disorder.

High Dose Levothyroxine combined with repetitive transcranial magnetic stimulation (rTMS) in Rapid cycling Bipolar disorder: Is it thyroid disease?

20 RCBPD with ICD-10criteria for bipolar disorder. All were severely symptomatic. TFTs and ECGs were monitored weekly with cardiology and endocrinology backup. Genetic testing was undertaken for DiO1/DiO2 status.

17 were female, average age 32.4 yrs. 19/20 had Single nucleotide polymorphisms (SNP) of either DIO1, DIO2 or both. All but two patients were treated with rTMS to induce cerebral neuroplasticity. Average pre-treatment fT4 was 17.0 pmol/L , and fT3 4.5 pmol/L Average post-treatment, fT4 was 59.7 pmol/L and fT3 5.3 pmol/L. Average fT4:fT3 ratio pre-treatment was 4:1, and post-treatment was 5:1. HDL range was 200-800 mcg daily for remission. Average dose 472 mcg daily. Discontinuation rate was 0%. All patients had ECG and cardiac review One patient required a dose reduction because of minimal side effects 12 patients needed one mood stabiliser All were in remission for a minimum of 6 months.

We speculate that BPD may be a form of cerebral hypothyroidism and that HDL helps to overcome the deficit while robust inactivating deiodinases in the periphery protect from systemic thyrotoxicosis. This is evidenced by findings of normal clinical examination and elevated rT3. rTMS exercises its well established neuroplastic effect, helping to achieve and maintain remission as an adjunct to HDL.

The London Psychiatry Centre (TLPC) has pending patents for the combined protocol of rTMS and/or Thyroid hormones depending on the territory: - Pending US Patent application: (and/or) US20200384279 - Pending European patent appl

It is important to determine those clinical factors that imply a greater risk of rehospitalization in psychotic patients

To determine the rate and predictors of rehospitalization in psychotic patients after their first hospitalization

We include all Psychotic patients admitted for first time in their life in our Psychiatric Unit between 2009 and 2019 (N=359) , including all diagnosed according DSM-IV of Schizophrenia or other Psychotic disorders -Multiple clinical, sociodemographic and biological variables of the basal hospitalization were recorded With the SPSS program we compared the variables between patients who needed any hospitalization in the follow-up until 31th December 2019 and those who do not. We use the Chi square ( qualitative variables) and the Student T ( quantitative variables)

109 psychotic inpatients had at least one rehospitalizations (30,4%). The qualitative variables significantly associated with rehospitalization were : cannabis in urine at admission (P<0.03), and treatment with risperidone (P<0.014). Instead treatment with long acting paliperidone was associated with absence of rehospitalization (P<0.005) .The quantitative variables relationed significantly with multiple rehospitalization were : lower age (P<0,015) lower HDL cholesterol levels (P<0.02) and higher years of follow-up after discharge (P<0.000)

1-More of 30% of psychotic patients need rehospitalization after their first hospitalization in a mean of follow up of 5,8 years 2-Lower age, longer follow-up period and treatment with risperidone are significantly associated with rehospitalization , instead treatment with long acting paliperidone are significantly associated with absence of rehospitalization

No significant relationships.

Refugees, especially minors, who often have experienced traumatic events, are a vulnerable group regarding poor mental health. Little is known, however, of their risk of suicidal behaviour as young adults.

We aimed to investigate the risk of suicidal behaviour for young adult refugees who migrated as minors. The moderating role of education and history of mental disorders in this association was also investigated.

In this register linkage study, all 19-30-year-old Swedish-born (n = 1,149,855) and refugees (n = 51,098) residing in Sweden on December 31st, 2009 were included. The follow-up period covered 2010-2016. Cox models were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). The multivariate models were adjusted for socio-demographic, labour market marginalisation and health-related factors.

Compared to Swedish-born, the risk of suicide attempt was lower for all refugees (HR 0.78, 95% CI 0.70-0.87), and accompanied refugee minors (HR 0.77, 95% CI 0.69-0.87), but estimates did not differ for unaccompanied refugee minors (HR 0.83, 95% CI 0.62-1.10). Low education and previous mental disorders increased the risk of suicide attempt in both refugees and Swedish-born, with lower excess risks in refugees. Findings for suicide were similar to those of suicide attempt.

Young adult refugees have a lower risk of suicidal behaviour than their Swedish-born peers, even if they have low educational level or have mental disorders. Young refugees who entered Sweden unaccompanied do not seem to be equally protected and need specific attention.

No significant relationships.

Haphephobia is a morbid fear of being touched or touching. The symptoms of Haphephobia are very similar to other specific phobias.

Presentation of a case of haphephobia due to childhood sexual abuse

Mrs. X., A 22-year-old Bangladeshi female, presents to the psychiatric consult service with an intense fear of being touched by her husband. She told that whenever her husband comes closer to her, her heart starts to pound fast, she feels discomfort in the chest, a burning sensation on her whole body, and loses control over the environment. Furthermore, she can’t sleep properly for the fear of being touched. Her in-laws’ parents concluded that some ‘evil spirits’ might cause the symptoms. So her husband brought her to a Psychiatrist. On an in-depth assessment session, ensuring all the confidentiality issues, she told the Psychiatrist that she has a history of brutal sexual abuse followed by the threat to kill her by her stepfather at the age of fourteen.

After a thorough medical workup and history gathering, her consultant psychiatrist could elucidate the source of the presenting picture and told her that she developed haphephobia, and suggested taking psychotherapy along with prescribed medicines.

Fear of being touched is a particularly difficult fear to cope with. Patients with haphephobia after sexual assault should be handled very cautiously by the experts keeping confidentiality issues in mind. Cognitive-behavior therapy, Exposure therapy, Virtual reality exposure therapy, practicing mindfulness, using daily coping strategies, and medications like beta-blockers, anxiolytics, antidepressants can help a person to overcome haphephobia.

No significant relationships.

It is critical to provide not only mental health services but also welfare services that meet the socioeconomic needs of people suffering from mental illnesses in order for them to recover. Case managers in the public sector who provide socioeconomic support to the low-income class, in particular, play critical roles in early detection of untreated mentally ill people, linking them to the mental health system, and providing various supports for their community integration. Positive working relationships are required to fulfill these roles.

This study aims to analyze the effects of human rights sensitivity of case managers on the working relationships with the persons with mental illness mediated by empathy.

We evaluated overall human rights sensitivity, level of empathy(cognitive, affective, behavioral aspects) and working relationships with the mentally ill of 291 public sector case managers(Mean age = 40.52, SD=7.96, female 78.2%, male 21.8%).

In research model analysis, the goodness-of-fit was evaluated to verify the effect of overall human rights sensitivity on the working relationships with the persons with mental illness mediated by empathy. Most of indices showed sufficient goodness-of-fit. In other words, the higher overall human rights sensitivity is, the higher the level of empathy is, and this has a positive effect on the working relationships with persons with mental illness.

To form positive working relationships with people suffering from mental illnesses, public sector case managers must be educated to increase their empathy by improving their overall human rights sensitivity.

No significant relationships.