Deficits in social cognition have been associated with the onset of emotional and behavioural problems, but the biological mechanisms underlying this relationship remain unclear.

This study examined whether diurnal cortisol patterns, systemic inflammation, or both, explained the association between social cognition difficulties and subsequent emotional and behavioural symptoms.

The sample consisted of 714 individuals from the Avon Longitudinal Study of Parents and Children (ALSPAC) with valid data on cortisol measures (age 15 years) and emotional or behavioural problems (age 17 years). Social cognition abilities were measured at 8, 11, and 14 years old. Inflammation was measured using serum levels of interleukin 6 (IL-6, age 9 years) and C-reactive protein (CRP, age 9 and 16 years). Bayesian structural equation modelling was used to investigate the mediating effect of cortisol or inflammation on the association between social cognitive difficulties and emotional or behavioural problems.

Children with social cognition difficulties were associated with later emotional and behavioural problems. Flattened diurnal cortisol slope was associated with the hyperactivity/inattention problem two years later. Mediation analyses revealed that lower morning cortisol significantly mediated the associations between social communication difficulties at 8 years with hyperactivity/inattention and conduct problems in adolescence, with the adjustment of inflammation and all covariates. Systemic inflammation was not related to social cognitive difficulties or future emotional and behavioural problems.

The finding suggests that social cognition is related to cortisol activities longitudinally. It also expands the evidence that adolescents with behavioural problems are characterised by hypoactivity of the hypothalamic-pituitary-adrenal (HPA) axis.

No significant relationships.

No significant relationships.

Mental health remains key comorbidity in the transgender population. There are more grave consequences on mental health if there is long-term incarceration history of a transgender person. 21% of transgender women are incarcerated in their lifetime, compared to <3% of the US general population. Incarcerated, transgender women are typically at risk for verbal, physical, and sexual assault that has been cross-sectionally linked to poor mental health in transgender patients. Childhood traumas and Adverse childhood experiences like sexual abuse may attribute to gender dysphoria as well as the externalizing and internalizing behaviors of the child in later part of life.

Better understand Gender Dysphoria and Incarceration.

A case report and review of the literature.

X is a 56-year-old transgender female, admitted for Major Depressive disorder with Psychotic features, and substance abuse disorder. She was disoriented to person place, or time, believing she was at the “Federal Penitentiary.” She was also selectively mute and socially isolative as well as unable to perform ADL’s. She has an extensive legal history, which started in 1985 when she burglarized a pharmacy store for estrogen. Patient was started on Sertraline, Mirtazapine, and Risperidone. She was still socially withdrawn but was soon oriented to person place, and time and was able to complete her daily tasks.

In this poster we discuss the challenges of managing an acute patient with extensive legal and substance abuse history, while also addressing the features of gender identity disorder and highlighting the difficult path of both the patient and physician in managing these challenges.

No significant relationships.

According to recent research violations of the oxidative-antioxidant balance may play an important role in the pathogenesis of schizophrenia, by changing generate, conduct and reproduce a nerve impulse. Antibodies with oxidoreductase activity may be involved in protection against oxidative stress in schizophrenia.

The study was to compare the superoxide dismutase (SOD) activity of IgG in patients with acute schizophrenia and during remission.

The study included 20 patients with acute schizophrenia (mean PANSS total score 94,3±14), 18 people with schizophrenia during remission (mean PANSS total score 54,7±9), and 10 healthy individuals. All participants signed informed consent for the research. Isolation of IgG from blood serum was performed using affinity chromatography on Protein-G-Sepharose columns. The homogeneity of the substances is confirmed by the SDS PAGE method. SOD activity of IgG was carried out spectrophotometrically. Statistical processing was conducted with Statistica v.10.

IgG of schizophrenia patients and healthy individuals have a SOD activity and studied activity is proved to be antibodies intrinsic property. The activity of antibodies in acute schizophrenia was 1.7 times higher than in healthy individuals (p<0.05). In patients with schizophrenia during remission SOD activity of IgG was 2.4 times higher than in healthy individuals (p<0.05).

We can assume that in the conditions of oppression antioxidant activity in schizophrenia patients, antibodies partially take over the function of protecting the body from patients with generalized oxidative stress. This work is supported by the Russian Scientific Foundation, grant # 18-15-00053P.

No significant relationships.

Ovocystatin has beneficial properties for cognitive function in young rats and might prevents aging-related cognitive impairment in older animals, as well as reduces memory decline in APP/PS1 mice model.

Our study aimed at assessing the impact of ovocystatin on microglia activation and neurogenesis.

Immunoactivation: Mouse wild type microglia were stimulated with ovocystatin at dose of 100 micrograms/ml. The effect of ovocystatin on nitric oxide production and interleukin 1 beta secretion were determined. Neurogenesis: Primary rat hippocampal neurons of H19-7 cell line was used. The impact of ovocystatin on proliferation, nitric oxide production, and expression of markers of neurogenesis: microtubule-associated protein 2 (MAP2, isoforms A/B and C/D) and Synapsin 1, were determined.

It was shown that ovocystatin does not stimulate microglial cells to produce inflammatory mediators. Whereas, no toxic effect of ovocystatin (1-100 ug/ml) on H19-7 cells viability, and dose-dependent down-regulation of proliferation were demonstrated. It was also shown that in primary hippocampal neurons of H19-7 cells incubated with ovocystatin (100 micrograms/ml), the expression level of MAP2 C/D (75kDa) - characteristic form of immature neurons is unchanged. However, the increased expression of MAP2 A/B protein (280 kDa) – characteristic for mature neurons was observed after 6 and 24h incubation with ovocystatin. Relatively to MAP2 A/B, increased expression of synapsin 1 was observed.

The ovocystatin might be a potential activator of molecular mechanisms in primary hippocampal neurons, participating in regulation of neurogenesis. Nevertheless, further studies are needed.

No significant relationships.

The Covid pandemic has mental health consequences. This study examined service user suicides for thirteen months during the pandemic and “lock down” restrictions in Ireland .It compares variables from this group with a previous 2016 study examining service user suicides conducted in Ireland. Despite a previous trend of improving suicide there was an increase in people who were involved with mental health services completing suicide during the pandemic.

To hypothesize that social disequilibrium caused by the Covid pandemic and its control measures may remove the benefit of protective factors in suicide.

The 2016 study used the Suicide Support and Information System- Psychological Autopsy Model as its methodology.The Rosenberg criteria were used to make a determination of suicide. This 2021 study used an anonymous clinical record review to repeat some key variables identified in the SSIS-PAM work. Statiscal comparisons were made.

The pandemic group had a different pattern of suicide with low levels of significance between four variables. The majority were female, in a relationship, had jobs, no history of self-harm, no family history of mental illness, less addiction problems and in-patient care. Like the 2016 group they did have diagnoses of mental illness, were in regular contact with services and were prescribed medication. Their suicides were predominantly hanging and drowning.

During the pandemic suicide increased. Protective factors such as relationships and employment were increased in pandemic suicides who also had less vulnerability factors such as addiction problems and self-harm. “Real time” suicide data collection such as a suicide observatory model might identify more significant trends.

No significant relationships.

The Inventory of Academic Sources of Stress in Medical Education (IASSME) evaluates the presence and intensity of the main sources of academic stress for Portuguese Medicine students in five dimensions: Course demands/CD, Human demands/HD, Lifestyle/LS, Academic competition/AC, and Academic adjustment/AA.

To further validate the ISSME using Confirmatory Factor Analysis and to analyze[ATP1] the psychometric properties of a new version including additional sources of stress.

Participants were 666 Portuguese medicine (82.6%) and dentistry (17.4%) students (81.8% girls); they answered an online survey including the ISSME and other validated questionnaires: Maslach Burnout Inventory – Students Survey (MBI-SS) and Depression Anxiety and Stress Scales (DASS).

Confirmatory Factor Analysis showed that the second order model composed of five factors (the original structure by Loureiro et al. 2008), but excluding item 11 (loading=.371), presented good fit indexes (χ2/df=3.274; RMSEA=.0581, p<.001; CFI=.917; TLI=.904, GFI=.919). The Cronbach’s alfas were α=.897 for the total and from α=.669 (F2-HD) to α=.859 (F1-CD) for the dimensions. The expanded version, including two additional items related to lack of interest in medicine/dentistry (F6, α=.543) and two additional COVID-19 stress-related-items (F7, α=.744) also showed acceptable fit indexes (χ2/df=3.513; RMSEA=.061, p<.001; CFI=.88.; TLI=.866, GFI=.892). This new version’s α was of .896. Pearson correlations between ISSME and the other measures were significant (p<.01) and high: >.55 with DASS and >.50 with MBI-SS. Girls presented significantly higher ISSME scores. F6 score was significantly higher in dentistry students.

This further validation study underlines that IASSME presents good validity (construct and convergent) and reliability.

No significant relationships.

Dysfunctional breathing is experienced as a feeling of “difficulty in inhaling” and shortness of breat , which may be similar to the symptoms of coronavirus infection (Gavriatopoulou et al., 2020). The conditions of the COVID-19 pandemic create an increased level of anxiety and attention to respiratory sensations, which becomes a favorable ground for the occurrence of dysfunctional breathing.

To examine the relationship of ideas about the pandemic with the occurrence of dysfunctional breathing in the Russian population during the COVID-19 pandemic.

The Naimigen Questionnaire (Van Dixhoorn, Duivenvoordent, 1985) and the author’s socio-demographic questionnaire were used, which included questions about personal experience of the pandemic. The study was conducted online from April 27 to December 28, 2020. It was attended by 1,362 people from all regions of Russia, including 1,153 women and 209 men aged 15 to 88 years (38.3±11.4).

It was found that respondents who are more confident in the danger of coronavirus have more respiratory difficulties (N=517;NQ=19±10.6) compared to those who consider its danger exaggerated (N=454,NQ=15.9±9.2,p=0.000). Respondents who are completely convinced of the absence of a condemnation for COVID-19 disease have less pronounced dysfunctional breathing (N=331,NQ=15.26±9.5), compared to those who sure about it (N=88,NQ=19.16±10.05, p=0.007). Respondents who have relatives ill COVID-19 (N=430) have a higher score on NQ (18.6±10.5), compared with those dont have (N=932, NQ=17.1±9.7, p =0.011).

The dysfunctional breathing is associated with the respondents’ beliefs about the danger of coronavirus and the expectation of stigmatization in COVID-19 disease, as well as with the experience of COVID-19 disease among relatives.

Research is supported by the Russian Science Foundation, project No. 21-18-00624.

Post-traumatic stress disorder frequently alters the quality of life.

Assess the quality of life in midwives who have post-traumatic stress disorder.

We conducted a cross-sectional study among midwives in a single university hospital centre using a self-administered questionnaire. We screened post-traumatic stress disorder using the Impact of event scale and the quality of life using 5 items Likert scale.

Our response rate was 82%. Out of 42 midwives who answered us, 18 had post-traumatic stress disorder symptoms (42.8%). They were all female. Their mean age was 45.6± 10.3 years. The traumatic event occurred mainly at work and was related to the death of a mother or a baby. Symptoms of post-traumatic stress disorder symptoms were severe in 5 midwives. The quality of life was altered in 38.8% of participants. Both post-traumatic stress disorder symptoms and alteration of the quality of life were more frequent in patients who don’t have leisure activities.

In conclusion, midwives are vulnerable to developing post-traumatic stress disorder. Encouraging sports and other leisure activities may protect them from having severe repercussions on their life.

No significant relationships.

16-year-old female who starts psychiatric follow-up due to episodes of anxiety crises with dizziness and tremors.

To expose a case in which it is essential to rule out organic pathology in cases where there is anxiety and physical symptoms.

Case report and literature review

The patient explains that she was in a situation of conflict with her ex-partner, commenting that he did not accept the breakup. Sertraline was prescribed in ascending doses up to 100 mg per day with complete remission of anxiety. 8 months later, she went to the emergency room for loss of consciousness and tremor of the lower limbs. She was diagnosed with conversive disorder and was prescribed lorazepam up to 3 mg per day. Since then, there has been a worsening in the frequency of syncope occurring up to 10 times a day, limiting her academic and social life. She was evaluated by a cardiologist who diagnosed Pots Syndrome (postural orthostatic tachycardia syndrome) and started treatment with ivabradine and mineralocorticoids. With this treatment, the episodes were drastically reduced and spaced out to 1-2 per week. The dose of lorazepam is decreased until its withdrawal without worsening of the anxious symptomatology.

This disorder consists of an involvement of the autonomic nervous system in which there is a sudden drop in blood pressure together with an abrupt increase in heart rate. Its treatment is based on increasing blood volume with drugs such as corticosteroids as well as postural measures with adequate water intake.

No significant relationships.

COVID-19-related stigma has been raised as a crisis since the beginning of the pandemic. We intended to develop a valid and reliable questionnaire to measure COVID-19-related stigma, attributed by the non-infected general population, and applied it in Tehran from September to October 2020.

This study measures the COVID-19-related stigma attributed by the non-infected general population using a valid and reliable questionnaire specific to COVID-19-related stigma.

A preliminary questionnaire with 18 items was developed. The score ranged from 18 to 54 while the higher score indicating a higher level of COVID-19-related stigma. Out of 1064 randomly recruited Tehran citizens without a history of COVID-19 infection, 630 participants, who completely responded to the questions on a phone call, entered the study.

The content validity was established with a scale content validity index of 0.90. Item CVI and Item content validity ratio were higher than 0.78 for all items. Internal consistency was confirmed with Cronbach’s alpha of 0.625. Exploratory factor analysis revealed seven latent variables, including “blaming and penalty-seeking behavior”, “social discrimination”, “dishonor label”, “interpersonal contact”, “spreading rumors and myths”, “overvalued idea”, and “apathy toward the patients”. The mean (SD) of the score was 25.1(4.71) in our study. 86.8% of participants reported a low level of stigma with a score below 31. 13.2% of them demonstrated a moderate level of stigma, and none of the participants showed a high level of stigma.

we found a low level of stigmatizing thoughts and behavior in Tehran, which may be due to social desirability bias.

No significant relationships.

Cultural psychiatry is an area of psychiatry that has been growing in importance recently. According to the new definition, mental health requires harmony with the universal values of society (Galderisi et al., 2017). Faith is considered an important factor in culture. Theology can enable a better understanding of psychiatric problems and distinction between spiritual and mental issues. “Pastoral theology aims at constructing models of redeeming activity of the Church which are current in these days, and will be current in the nearest future” (Przygoda, 2013). This discipline must recognize and evaluate the impact of contemporary sciences, including psychiatry, on theology and ecclesiastical activity.

This study aims to prepare a modern concept of pastoral psychiatry, which will be used to prepare a textbook, teaching aids and teaching plan for this discipline.

Textbooks and articles in psychiatry, psychology and related disciplines, and pastoral theology monographs were analyzed. This was followed by the conceptualization of areas of interest and methodological standards.

Textbooks on this problem were published several decades ago (Gabriel, 1933; Bless, 1949; Polish edition issued in 1980, translated with amendments by Kaczmarek). Since then, knowledge has advanced considerably. Textbooks of psychiatry and psychology only selectively consider the Christian perspective.

“Pastoral Psychiatry” should be helpful for priests, theologians, believers, doctors, psychologists. It requires the work of authors with theological and psychiatric competence. It will create ways of agreement, facilitate understanding of different perspectives, increase competence: theologians, priests – to better understand modern psychiatry; psychiatrists, psychologists – to better help religious patients.

No significant relationships.

Cannabis is among the most widely used substances in the world. it is associated with several mental health problems.

To assess self-esteem among a group of young Tunisian users of cannabis.

The total study sample was composed of 137 participants, who took part of a transversal descriptive study during two months (January and February 2020).

In our study population, the cannabis consumers were young adults aged between 18 and 35 years old, with a male predominance of 71%. Among those users, 65.9% were single and 29.7% dropped out of school or experienced academic failure. On a socio-economic level, we concluded to a rate of 5.8% (lower class), 60.9% (middle class) and 33.3% (upper class). Besides, 40.8% were employed. In total, 23.2% had a psychiatric history. Furthermore, the use of other substances was also prominent and frequent as follows: alcohol 72.5%, tobacco 74.6%, ecstasy 41.3% and 25.4% cocaine. The use of cannabis was considered as a means of indulgence and pleasure for 66.7%, as an anxiolytic for 26.8% and as a sedative for 23.9%. Self-esteem, among those cannabis users, was very low in 20% of cases, low in 38% of cases, medium in 15% of cases and high in 25% of cases.

These results lead us to question the relation between cannabis and self-esteem. The question that is evolved about the use of cannabis is the following: Is it used as a remedy or is it the cause of self-esteem deficiency?

No significant relationships.

Lithium is commonly administered to patients in an outpatient department (OPD) setting. Regular monitoring of lithium levels and renal function in accordance with published guidelines is required. In our unit, this is usually performed at OPD review. During the COVID-19 pandemic, reviews were either postponed or done remotely.

1. To devise a system to ensure that patients receiving lithium had appropriate blood test monitoring in the absence of traditional OPD appointments. 2. To assess the efficacy of this intervention by recording blood test dates and comparing with pre-COVID compliance.

All outpatients receiving lithium, identified from the hospital database, received (1) a letter summarising the monitoring guidelines and (2) prospectively dated blood request forms. Patients at higher risk of contracting COVID-19 were advised to attend their primary care setting. Others were encouraged to attend primary care or our phlebotomy department. Compliance was measured by accessing the hospital’s laboratory enquiry computer based system and compared with pre-COVID-19 figures. Information was anonymised, as per General Data Protection Regulations.

57 patients receiving lithium were identified. Prior to the first Irish lockdown in March 2020, 16 (28%) were overdue testing. Three months into the pandemic, 15 patients (26%) were overdue testing.

In the absence of routine outpatient appointments during the COVID-19 pandemic, the provision of written guidelines and completed blood request forms for patients receiving lithium was effective in ensuring monitoring of lithium levels and renal function. This system can be utilised as an alternative/adjunct to OPD review benefitting patients and health service delivery.

No significant relationships.

Acute Confusional Syndrome (ACS) is the most common neuropsychiatric complication in COVID-19 infection. Its management is still a challenge because the data and recommendations based on the evidence are limited.

To describe the differential characteristics in the management of ACS in patients with COVID-19 pneumonia compared to ACS secondary to other causes.

We present a descriptive study that is has been carried out in 62 patients with ACS (26 of them diagnosed with COVID 19 pneumonia), who have required assessment by the liaison psychiatry service of Hospital del Mar between February and April, 2020. The sample was divided in 2 groups (with and without COVID 19 pneumonia). Chi square and Fisher’s tests were used to comparisons.

Dexmetomidine (26 vs 0) and olanzapine (13 vs 3) were significantly more frequently used in COVID-19 patients (p< 0 001). A greater number of different antipsychotic drugs were used in COVID 19 patients (2.40± 1 323 number of drugs), (p<0.0001). Further neuroimaging tests were requested in COVID 19 patients and they received less family support (4) compared to non COVID-19 (22), (p<0.005).

ACS associated with COVID-19 pneumonia in the patients in our sample is more difficult to manage than ACS associated with other pathologies, similar to which described in other series. It is associated with a longer duration of confusional symptoms and difficulties for control it.

No significant relationships.

Difficulties in the diagnosis of bipolar disorder (BD) are associated with a lack of understanding of the mechanisms of its pathogenesis. Identification of proteins involved in the pathogenesis of BD will bring us closer to an understanding of its mechanisms and can help in diagnosis.

The search of proteomic biomarkers of bipolar disorder.

We performed a proteomic analysis of the serum of 16 healthy people and 33 patients with BD. Patients were hospitalized in an acute state of the depressive phase, and they did not receive therapy for more than 6 months. Blood was collected before the start of therapy. Serum was purified from major proteins by affinity chromatographyandseparatedby1D-electrophoresis. After trypsinolysis, the proteins were identified by HPLC/mass spectrometry. The ELISA kit was used to determine the amount of zNMDAR1.

We identified a protein that does not occur in healthy people: a subunit of the glutamate NMDA receptor zeta-1 (zNMDAR1). As a result, we found a statistically significant (p = 0.037) almost fivefold increase in the concentration of this protein in the serum of patients with bipolar disorder (0.64 [0.18; 0.78] ng/ml) compared with healthy individuals.

Thus, in bipolar disorder NMDAR is damaged, which can lead appearance of their subunits in the serum, and which indicated a violation of glutamatergic neurotransmission. Then this protein claims the role of markers of bipolar disorder. Mass spectrometric analysis was carried out of the “Human Proteome” Core Facility of the Institute of Biomedical Chemistry Moscow. RSW project, state registration number AAAA-A19-119020690013-2.

No significant relationships.

Long-acting injectable antipsychotics (LAIs) have emerged as a new therapeutic option to treat patients suffering a psychotic disorder. To date, there is a lack of studies regarding safety and clinical use pattern of LAIs in pregnant women.

Provide evidence and real world clinical data of pregnant women with schizophrenia who have been treated with long-acting aripiprazole monohydrate (aripiprazole once monthly [AOM] condition) during their pregnancy.

Descriptive real-world clinical experiences of pregnant women in treatment with AOM. The information was obtained by reviewing electronic medical records and by direct clinical observation management.

The first six case-series describing the pregnancy course of women with schizophrenia treated with AOM. All of them remained psychopathologically stable through pregnancy, and their infants became healthy with normal developmental milestones (Table 1).

Table 1.

Clinical characteristics of six case-reports.

The favorable results in this case-series suggest that despite the lack of evidence on reproductive safety and treatment with AOM during pregnancy, this therapeutic option should be considered in pregnant women with schizophrenia. However, further research on the use of long-acting antipsychotics in pregnant women is needed.

No significant relationships.

No significant relationships.

More often, cardiac surgery patients (CSP) receive systematic psychological aid after surgery. However, their need for psychosocial interventions in the perioperative period is underestimated.

The goal is to determine the stages of psychosocial interventions for CSP that could cover the whole period of their treatment and rehabilitation.

Analysis of scientific papers and practical experience gained in cardiologic clinic allowed dividing the system of psychosocial interventions for cardiac surgery patients into periods in accordance with actual stages of medical aid for CSPs.

According to the principles of personalized approach, we determined six consecutive semantically different stages of psychosocial interventions: out-of-hospital pre-surgery, in-hospital pre-surgery, early post-surgery, in-hospital post-surgery, post-surgery rehabilitation, and out-of-hospital rehabilitation. They have different duration and cover the whole period of treatment and rehabilitation of CSPs beginning with the moment of indication to surgery up to the complete rehabilitation and full adaptation to their post-surgery somatic condition. Each stage has its own goals, main objectives and expectations. Duration of the stages is conditional and can change depending on the nature of every clinical situation.

Determination of clinical stages in the process of psychosocial interventions for CSPs gives ground for selecting optimal psychological methods and techniques for each stage and sets exact goals, achievement of which becomes possible only through a properly organised work of an interdisciplinary team of specialists.

No significant relationships.

Because of different phenotypic approaches, data on depression prevalence is variable and controversial.

The aim was to evaluate the prevalence of different depressive phenotypes in the Russian population (DSM criteria based self-report vs HADS questionnaire).

The data was from the on-line survey of 5116 clients of Genotek Ltd. (males - 50,63%; age - Me=35 (Q1-30;Q3-42)). The survey included questions on sex, age; sel-report adapted major depression DSM-V criteria questionnaire and depression subscale of Hospital Anxiety and Depression Scale.

DSM Major depression phenotype was detected with moderately-high prevalence - 17,67% (N=904). The DSM depression phenotype was more prevalent in women (22,72%) compared to men (12,74%, p<0,001) and in younger individuals (10,18%, p<0,001) compared to older ones (6,16%). HADS-D clinical depression phenotype (score>11) was less prevalent (3,4%) with no significant differences for sex and age. However, the prevalence increased with HADS-D subclinical scores (>8) - 14,97%. HADS-D scores were higher in DSM-depression phenotype individuals compared to ones without DSM phenotype (5,822(3,221) vs. 3,893(2,437), p< 0,001).

Our results showed variable prevalence of depression with different phenotypic approaches. The differences could be associated with the clinical severity of the symptoms and the life-time evaluation in DSM compared to only current symptoms for HADS. Further research is needed to understand the factors affecting the phenotyping approaches and providing the most effective and valid instrument for depression prevalence evaluation. Research is supported by an RSF grant №20-15-00132.

Research is supported by an RSF grant №20-15-00132.