Fibromyalgia is a chronic condition, with a high degree of psychiatric comorbidity and an insufficiently explained pathogenesis. Therefore, its therapeutic management is challenging, with both pharmacological and non-pharmacological approaches being suggested as treatment options.

To analyze the current level of evidence in favour of pharmacological treatment for fibromyalgia.

A literature review was performed through the main medical databases using the search paradigm “fibromyalgia” AND “pharmacological therapy” OR “antidepressants” OR “moodstabilizers” OR “anxiolytics”. All papers published between January 2000 and August 2020 were included in the primary analysis.

A gradually increasing interest for the treatment of fibromyalgia has been observed in the last decade, and the number of clinical trials for this indications has almost doubled in this period, when compared to the previous decade. Pregabalin, duloxetine, and milnacipran are the most supported by evidence pharmacological treatments for fibromyalgia, especially for the pain component. Amitriptyline, gabapentin, cyclobenzaprine, and tramadol have also been studied in various clinical trials, but tehre are less evidence to support their use. Cognitive dysfunctions, sleep disorders, and mood disturbances benefit from far less investigation in clinical trials, therefore no clear recommendation can be made regarding the superiority of an agent over another.

The pain component of fibromyalgia benefits from treatment with pregabalin, duloxetine, and milnacipran, while the affective component and the cognitive dimension still need more research from the psychopharmacological perspective.

Stigma is a major burden and impediment for treatment and recovery in serious mental disorders, especially psychotic disorders. Therefore, it has been proposed to replace the term schizophrenia by psychosis susceptibility or psychosis spectrum disorder.

We have assessed stigma in the media through a 10-year survey of Flemish daily newspapers (2008-2017) by comparing the way schizophrenia and autism are portrayed. We added the term psychosis for the years 2013-17 to assess its suitability as a less stigmatising alternative.

Via the websites of the seven Flemish newspapers, we searched for all articles published between 01 Jan 2008 and 31 Dec 2017 containing the keywords autism, schizophrenia, and related terms. The collected articles (n = 5,337) were then graded to their stigmatising content. We added the term psychosis for the years 2013-17.

In the collected articles the coverage of autism was mostly positive, whereas the coverage of schizophrenia was predominantly negative. The contrast was very substantial (p < 0.0001) and stable over the years. The portrayal of psychosis turned out to be mostly positive in the broadsheet newspapers and mostly negative in the tabloid papers.

The social stigma attached to schizophrenia and psychosis is poignantly reflected in the Flemish newspapers. The fact that a comparable disorder such as autism is depicted in a much more favourable way than schizophrenia indicates that a more positive image of schizophrenia is not only desirable but also achievable. Psychosis gives mixed results, a finding up for discussion.

A stroke represents a major cause of the disability of an adult with various biological, physiological and social implications. Excluding the characteristic neurological pathology, a series of complications may follow and if they are neglected they might compromise the success of medical rehab and the reintegration of the patient back into society.Recent studies have demonstrated that there is a higher rate of incidence of cancer among the survivors of a stroke in comparison with the general population.

The correlation between strokes and oncological disease.

We have effectuated a prospective study of 6 months at the Neurology Section of Emergency Hospital “Saint Andrei”, Galati, in which we’ve included a total number of 50 patients who were over 60 years old. In this timeline we’ve analyzed the correlation between strokes and the comorbidities of the patient and the influence of these over the plan of medical rehab and the period of recovery after the stroke.

Over these 6 months, of all 468 patients having suffered strokes, 50 of these had been secondarily diagnosed with neurocognitive disorders. 56% of them were male and 44% were female, 37% from rural areas and 63% from the urban areas.

The category of neurocognitive disorders includes the group of disorders in which the principal clinical deficit is located at the cognitive functions level and is usually acquired, not representing a disorder of development.

Novel, evidence-based treatments are required for treatment-resistant post-traumatic stress disorder (PTSD). 3,4-Methylenedioxymethamphetamine (MDMA) has beneficially augmented psychotherapy in several small clinical trials.

To review the use of MDMA-assisted psychotherapy in treatment-resistant PTSD.

Systematic searches of four databases were conducted from inception to February 2020. A meta-analysis was performed on trials which were double-blinded, randomised, and compared MDMA-assisted psychotherapy to psychotherapy and placebo. The primary outcomes were the differences in Clinician Administered PTSD Scale (CAPS-IV) score and Beck’s Depression Inventory (BDI). Secondary outcome measures included neurocognitive and physical adverse effects, at the time, and within seven days of intervention.

Four randomised controlled trials (RCTs) met inclusion criteria. When compared to active placebo, intervention groups taking 75mg (MD -46.90; 95% CI -58.78, -35.02), 125mg (MD -20.98; 95% CI -34.35, -7.61) but not 100mg (MD -12.90; 95% CI -36.09, 10.29) of MDMA with psychotherapy, had significant decreases in CAPS-IV scores, as did the inactive placebo arm (MD -33.20; 95% CI -40.53, -25.87). A significant decrease in BDI when compared to active placebo (MD -10.80; 95% CI -20.39, -1.21) was only observed at 75mg. Compared to placebo, participants reported significantly more episodes of low mood, nausea and jaw-clenching during sessions and lack of appetite after seven days.

These results demonstrate potential therapeutic benefit with minimal physical and neurocognitive risk for the use of MDMA-assisted psychotherapy in TR-PTSD, despite little effect on Beck’s Depression Inventory. Better powered RCTs are required to investigate further.

James Rucker has attended trial related meetings paid for by Compass Pathways Ltd.

Secure forensic mental health services have a dual role, to treat mental illness and reduce violent recidivism. Those admitted to secure forensic services have a significant history of violence and treatment needs in multiple domains including psychiatric illness, violence and other areas such as substance misuse and physical health.

The aim of this study was to ascertain if the units in a medium secure forensic hospital are stratified according to individual risks and needs. We also aimed to clarify if there were differences in the symptom level, risks and needs of those with and without community leave and to clarify the risks and needs of the female patients and ID patients.

This is a cross sectional study a cohort of patients (n=138) in a secure forensic hospital.

There was a total of 138 patients, the majority of whom were male (n=123, 89.1%). The most common diagnosis was schizophrenia (n=99, 71.7%). Placements in the care pathway of the medium secure forensic hospital were associated with level of symptomatology (PANSS positive), dynamic violence risk (F=26.880,P<0.001), DUNDRUM-3 therapeutic programme completion (F=44.067,P<0.001), and DUNDRUM 4 recovery (F=59.629,P<0.001). Patients with community leave had better scores than those without leave on violence risk (F=77.099, P<0.001), therapeutic programme completion (F=116.072, P<0.001) and recovery (F=172.211, P<0.001).

Stratifying secure forensic psychiatric hospitals according to individual risks and needs provides in-patient care in the least restrictive setting appropriate for individuals, however niche groups such as female forensic patients and ID patients may need special consideration.

No significant relationships.

Sport trauma is a stressful situation demanding not only physical but also psychological rehabilitation (Clement et al, 2015, Ardern et al, 2012) including prevention of mental health symptoms. Revealing coping strategies that are related not only to rehabilitation effectiveness but also to well-being of athletes is important for rehabilitation programs (Crowther et al, 2017, Hamson-Utley, Vazquez, 2008, Johnston, Carroll, 1998).

The aim was to reveal coping strategies that are related to better well-being in athletes after trauma after adjusting for trauma perception.

61 athletes (15-25 years old, 31 males) rehabilitating after sport trauma filled COPE with specific instruction about trauma (Carver et al., 1989), Illness Perception Questionnaire (Moss-Morris et al., 2002) modified for trauma situation, Satisfaction with Life Scale (Diener et al., 1985), Scale of Positive and Negative Experience (Diener et al., 2009).

After adjusting for subjective trauma representation humor related to trauma predicted better satisfaction with life (β=.43, R2=43.7%). Active coping with trauma was related to more positive emotions (β=.31, R2=9.8%) while emotion venting, substance use and lower instrumental support are related to negative emotions (β=.39, β=.24, β=-.29, respectively, R2=30.5%), although these effects eliminate after adjusting for trauma representation.

Humor, active coping and instrumental support as well as control of emotion venting and substance use could be helpful strategies of promotion of better well-being in athletes after sport trauma. Research is supported by the Russian Science Foundation, project No. 19-78-10134.

Research is supported by the Russian Science Foundation, project No. 19-78-10134.

Stigma is omnipresent in human societies, both globally and historically; while it is also discerned in other primates. On these grounds, it has been suggested to be the product of natural selection and therefore to protect against threats to effective group functioning. Nonetheless, in contemporary society, stigma raises fundamental ethical concerns, while it actually impinges on public health

To explore prejudicial attitudes and desired social distance from recovered COVID-19 patients, people with mental illness and refugees in Athens region.

A convenience sample of 360 residents of Athens region participated in the study, after being recruited from social media. The questionnaire was distributed online and encompassed: i) the Prejudicial Attitudes Survey, (ii) the Social Distance scale, (iii) the Interpersonal Reactivity Index and information about respondents’ socio-demographic characteristics and personal experience with the three population subgroups. The stigma measures were included three times, one for each out-group.

Repeated ANOVA revealed that negative attitudes were predominantly expressed for refugees. On the contrary, positive attitudes were predominantly expressed for people with mental illness. Interestingly, desired social distance was greater from people with mental illness (mean = 32.37) compared to refugees (mean = 25.47) and recovered COVID-19 patients (mean = 24.17).

Stigma towards people with mental illness and refugees is still prevalent in Greece. Anti-stigma efforts should target prejudices in the case of refugees and social distance in the case of mental illness. To date, no stigma attached to COVID-19 has been discerned in the country

No significant relationships.

Adaptive thinking demands a balance between manifestations of intrapsychic activity and reliance on requirements of the outer reality. Features of responses to Rorschach’s III card could provide information about subject’s ability to preserve the dialectical tension between the two poles of external and internal realities during solving tasks related to interpersonal relationships.

To compare reality-fantasy relations during Rorschach’s III card responding in patients with schizophrenia, neurocognitive impairment and normal subjects.

Participants were 12 young adult inpatients with schizophrenia, 14 students without mental disorders and 12 inpatients with neurodegenerative diseases of old age. Reality-Fantasy Scale (RFS) was applied to assess responses to Rorschach’s III card. RFS scale ranges from –5 (reality collapse into fantasy) to 5 (fantasy collapse into reality) (Tibon-Czopp et al., 2015).

Patients with schizophrenia (M= –3,38, SD= 1,9) demonstrated tendency to fantasy domination (and reality collapse) if compared with the students (M= –1,47, SD= 2,0, p<0,05). Patients with neurodegenerative diseases (M= 0,75, SD= 2,1), conversely, had difficulties to apply fantasy during solving Rorschach task (p<0,01).

Express Rorschach testing using III card could be useful to provide screening data of thinking tendencies related to situations of social interaction. Also it provides a mental pabulum regarding role of cognitive impairment in schizophrenia in relation to significance of affective dependence of their thinking process.

The reported study was funded by RFBR, project number 20-013-00772

The epidemic caused by the SARS-CoV-2, which began in Wuhan city in December 2019, quickly spread to various countries around the world. On march Italy had already become the second country after China in terms of number of infections and deaths and Emilia Romagna was the second region in Italy by number of cases after Lombardy. On 11th of March 2020 through the “Stay at home” decree, the entire nation was sheltered-in-place (SIP).

Main objective is to understand immediate psychological effects on sheltered in place persons living in Emilia Romagna.

This study is based on a cross-sectional online survey conducted anonymously in the period between the tenth and seventeenth day of SIP. We used Zung Anxiety Self-Assessment Scale, Insomnia Severity Index and Perceived Stress Scale 4. SPSS 21.0 was used for data analysis.

We collected data on 651 individuals. About 38% of the sample reported having sleep problems; 31% of the population has a minimal-moderate level of anxiety while 4% marked-severe; finally, 54% of the interviewees perceive a moderate level of stress while 31% high. The MANOVAs showed that anxiety is influenced by gender, age, level of education and occupational status. Greater levels of stress are shown by individuals who declared the fear of contracting the virus and the concern of financial loss.

Our results could be used as a “psychological baseline” meanwhile the outbreak of COVID-19 is still ongoing. Despite the few days of SIP, we found the presence of a significant incidence and pervasive prevalence of psychological distress.

Currently, the number of cases of pathological aging of the CNS, represented by a violation of cognitive functions, is increasing. But there is a social request to prolong the physical and mental activity of older people

The study of the dynamics of cognitive aging is timely and relevant. The article contains a report on a cohore non-repeating study of higher brain functions at various age periods

The average age was 45.1 + 5.7 years. Inclusion criteria: 1. Dextral. Non-inclusion criteria: 1. Clinically significant somatic diseases in their medical history. 2. Mental disorders in their medical history. •Applied neuropsychological, statistical research methods. The research tool was the neuropsychological rapid method including the subtests: •“Memorizing 9 words in three presentations (1st, 2nd, 3rd attempts)”, •“Sequential subtraction”, •“Test of Benton’s visual memory”, •“Solving an arithmetic problem”, •“Overlaid images”, •“Specified flow of associations in 1 minute”, • “Figure of 3 geometric figures”, • “Blind hours”, • “Graph-motor test”, “Delay word reproduction”

The first cohort 27–40 years old. The second cohort 41–50 years old.Third cohort 51 years old and older. A significant difference in the performance of the graphomotor test between the subjects of the age subgroup of 27-40 years and the subgroup of 41-50 years was statistically confirmed. In older people revealed a much greater number of errors, interruptions of the test than the representatives of the more “young” subgroup

The deterioration in the performance of the graphomotor test was the most age-specific

No significant relationships.

It has long been theorized that Obsessive-Compulsive Disorder (OCD) and Compulsive Buying Disorder (CBD) may share important characteristics, increasing the likelihood of the cooccurrence of these two psychiatric disorders. On the other hand, Hoarding Disorder (HD) were originally conceptualized to exist only within the context of OCD, despite hoarding symptoms presenting in less than 5% of OCD cases.

This study aims to provide an overview of impulsive-compulsive spectrum, regarding the similarities and differential diagnosis between compulsive buying and hoarding.

The authors performed a non-systematic literature review, using PubMed search terms “compulsive buying”, “hoarding” and “obsessive-compulsive spectrum”.

Obsessive-compulsive spectrum disorders are a group of similar psychiatric disorders characterized by repetitive thoughts, distressing emotions and compulsive behaviors. Compulsive buying is defined by a preoccupation with buying and shopping, by frequent buying episodes or overpowering urges to buy that are experienced as irresistible and senseless. These episodes are accompanied by relief and pleasure, but followed by remorse and guilt. A sub‐group compulsively hoard the items they have bought. Hoarding disorder is characterized by persistent difficulty discarding items regardless of value, urges to save items and distress associated with discarding, and the accumulation of possessions which compromise use of the home.

Empirical evidence suggests that both OCD and CBD display high levels of impulsivity and compulsivity. However, given the phenomenology, CB may not fit well in OCD related disorders. It may be also misleading to classify HD as part of OCD, since hoarding has the lowest specificity and predictive criteria for OCD.

No significant relationships.

The inter-critical phase in bipolar disorder may contain symptoms that do not meet the diagnostic criteria for a thymic episode. According to studies, these symptoms are common and usually associated with impaired psychosocial and family functioning.

Study the subsyndromal symptoms in remitted patients with bipolar disorder, and their functioning repercussions.

We conducted a cross-sectional, descriptive and analytical study, in the outpatient psychiatry department of the University Hospital in Sfax (Tunisia) among 30 remitted patients with bipolar disorder. We used: the Montgomery And Asberg Depression Rating Scale (MADRS), the Angst Hypomania Questionnaire and the FAST test to assess functioning levels.

The average age of our population was 44.37±15.45 years with a sex ratio (M/F) =0.66. Most of them lived in urban areas (60%) and half of them did not go beyond the primary school level. Most did not have a constant job (76.6%). The average number of previous thymic episodes was 2±1.33 times/year. A quarter of the patients (26.6%) had hypomanic symptoms in the intercritical phase and 20% had depressive symptoms. Hypomanic symptoms were correlated with tobacco use (p=0.035). Depressive symptoms weremore frequent in men (p=0.074). Functioninglevel was lower in subjects living in rural areas (p=0.065).

Our study suggests that residual symptoms were frequent with a significant functional impact. As a result, their identification and management are highly essential to improve the overall functioning of patients with bipolar disorder.

Social cognition has been associated with functional outcome in patients with first episode psychosis (FEP). Social cognition has also been associated with neurocognition and cognitive reserve. Although cognitive reserve, neurocognitive functioning, social cognition, and functional outcome are related, the direction of their associations is not clear.

The aim of the study was to analyze the influence of social cognition as a mediator between cognitive reserve and cognitive domains on functioning in FEP both at baseline and at 2 years.

The sample of the study was composed of 282 FEP patients followed up for 2 years. To analyze whether social cognition mediates the influence of cognitive reserve and cognitive domains on functioning, a path analysis was performed. The statistical significance of any mediation effects was evaluated by bootstrap analysis.

At baseline, as neither cognitive reserve nor the cognitive domains studied were related to functioning, the conditions for mediation were not satisfied. Nevertheless, at 2 years of follow-up, social cognition acted as a mediator between cognitive reserve and functioning. Likewise, social cognition was a mediator between verbal memory and functional outcome. The results of the bootstrap analysis confirmed these significant mediations (95% bootstrapped CI (−10.215 to −0.337) and (−4.731 to −0.605) respectively).

Cognitive reserve and neurocognition are related to functioning, and social cognition mediates in this relationship.

This work was supported by the Carlos III Institute of Health and European Fund for Regional Development (PI08/1213, PI11/ 01977, PI14/01900, PI08/01026, PI11/02831, PI14/01621, PI08/1161, PI16/ 00359, PI16/01164, PI18/00805), the Basque Foundation for He

OPEN is a structured intervention program for patients who present with untreated psychosis at an early stage, under the guidance of a case manager and a periodic evaluation performed by a multidisciplinary team.

The aim of the OPEN program is to create an individual care plan, promoting recovery, functionality, quality of life and prevent relapses. One year after implementation of the program, we present the first results.

We performed a retrospective review of the patients’ clinical profiles included in the OPEN program.

Nine patients were included in the program. The most frequent diagnosis was schizophrenia (n=5). By the time of inclusion in the program, 5 patients used cannabis frequently; one patient kept substance use. At the 6th month assessment, 4 in 5 patients showed an improvement in social functioning (Personal and Social Performance Scale; ± 16 points), and a decrease in symptom severity in all (Brief Psychiatric Rating Scale; ± 11 points). Due to COVID-19 pandemics, group interventions were suspended, and some visits were performed by teleconsultation. No patients lost follow-up.

We observed an overall positive result of the first months of this program, regarding both functionality and clinical outcomes. The main obstacle so far is the impossibility of performing group interventions since the start of the contingency measures regarding COVID-19 pandemics. We expect further results of the OPEN program with the inclusion of more patients.

Decades of neuroimaging research in attention/deficit-hyperactivity disorder (ADHD) have yielded a few apparently firm findings and many open questions. The long-term objective of these efforts is to uncover the underlying brain pathophysiology of the disorder, to reveal reliable biomarkers of prognosis and treatment response, striving for personalized medicine. Unfortunately, neuroimaging research in ADHD and other psychiatric disorders is still unable to inform clinical practice. This presentation will provide an up-to-date overview of neuroimaging in ADHD, highlighting the most promising results and current challenges of structural and functional research with magnetic resonance imaging (MRI). Evidence from large, multicentric studies and from highly-sophisticated resting-state functional MRI techniques will be presented; methodological and reproducibility limitations in current literature will be introduced, and the way forward to bring this area of research closer to clinical practice with patients with ADHD will be discused. Dr. Pereira-Sanchez is conducting original research using resting-state functional MRI to study potential correlates of treatment response to stimulants in children and adolescents with ADHD; he has also recently published two literature reviews of MRI studies in ADHD.

No significant relationships.

Social withdrawal is an early and common feature of psychiatric disorders. Hypothalamic-pituitary-adrenal (HPA)-axis activation through increased salivary cortisol (sC) and sympathetic activation through increased salivary alpha-amylase (sAA) may play a role.

We aimed to study whether the link between increased sC and sAA on the one hand and depression on the other hand is mediated by social withdrawal.

In this cross-sectional, observational study, sC and sAA measures were measured in seven saliva samples in 843 participants (231 psychiatric patients and 612 healthy controls). Social withdrawal was assessed through the Brief Symptom Inventory (BSI)-, the Short Form 36-, and the Dutch Dimensional Assessment of Personality Pathology social withdrawal subscales, and analyzed using linear regression and mediation analyses. On average, participants were 44.0 years old (SD=12.8; 64.1% female).

Basal and diurnal sAA were unrelated to any social withdrawal scale and depression. Certain sC measures were positively associated with the BSI social withdrawal subscale (i.e., area under the curve with respect to the increase, beta=0.082, p=0.02; evening sC value: beta=0.110, p=0.003; and mean sC value: beta=0.097; p=0.01). We found limited support for statistical mediation by social withdrawal (measured using a composite social withdrawal score) on the relationship between evening sC and depression.

Thus, although we found no support for a role of basal and diurnal sAA in social withdrawal, HPA-axis activation may partly aggravate social withdrawal in depressive disorders.

Parents of children with an autism spectrum disorder (ASD) are at higher risk of suffering from mental health problems (MHP) than parents of children with other developmental disabilities. Research on the general population documented that MHP in parents contributes as a significant risk factor for maladjustment outcomes in their offspring, while parental anxiety disorders in particular have been associated with a higher prevalence of anxiety disorders in the offspring. However, evidence concerning possible associations between parent-offspring psychological problems in the case of ASD-families is scarce and inconsistent.This study forms a part of a larger PhD study and some preliminary findings have been partially discussed in previous work.

To investigate any association between anxiety symptoms in neurotypical offspring (ASD-siblings) with parental MHP.

118 parent-child-dyads from ASD-families that fulfilled inclusion criteria participated in this study and answered a demographic questionnaire. Parents were administered the GHQ-28, while the children answered the STAIC-A-Trait. A hierarchical multiple regression was performed to test the hypothesis.

Participating parents demonstrating poorer mental health, with 53 (44.9%) of them considered as suffering from psychological distress according to the score of GHQ-28. Furthermore, hierarchical regression showed that STAIC-(A-Trait) total score of ASD-siblings was associated with parental anxiety (std beta=0.292; p=0.29;model 1) and this association persisted after demographics entered the model (std beta=0.300; p=0.029; model 2).

This study shows a significant association between parental psychological distress and anxiety in the neurotypical offspring in ASD-families, highlighting the need to provide all members of ASD-families with the appropriate services.

No significant relationships.

No significant relationships.

There is a growing literature suggesting disgust plays a major role in religiosity. Asceticism is a personality trait characterized by abstinence from sensual pleasures, often for the purpose of pursuing spiritual goals. Since few studies suggested that higher disgust levels may lead to greater fear of sin, contamination disgust may serve as effective mechanisms for inflated scrupulosity.

We aimed to investigate the role of contamination disgust on a specific religious belief in two clinical groups: eating disorders and anxiety disorders.

We enrolled 84 patients admitted in the Psychiatric Unit of Careggi with diagnosis of Anxiety Disorders (AD) and Eating Disorders (ED). We administered them: Disgust Scale Revised (DS-R) and Eating Disorders Inventory 2 (EDI-2)

A t-test for independent samples between AD patients and ED patients showed no difference in DS-R contamination disgust subscale (t=1.437, p=0.153), while significantly higher EDI-2 asceticism scores were detected in ED patients (t=2.452, p=0.010). An ANCOVA model having EDI2 Asceticism subscale as dependent variable, and DS contamination disgust subscale, diagnosis, and interaction between contamination disgust and diagnosis was estimated. The overall model was significant (F(1,136)=4.854, p=0.003) and accounted for 9.7% of variance of EDI2 Asceticism subscale (R2=0.097). The effect of contamination disgust was positive and significant (β=0.302, t=2.781, p=0.006), and accounted for 5.4% of variance of EDI2 Asceticism (partial η2=0.054). No effect was detected for diagnosis (F(1,136)=0.012, p=0.912) or interaction between contamination disgust and diagnosis (F(1,136)=1.346, p=0.248).

Contamination disgust may have a trans-diagnostic effect on asceticism and may be a possible driver for specific religious behaviors.

No significant relationships.