The objective of this poster is to show the importance of understanding the situation of the patient’s family in order to know the development and role that eating symptoms are occupying both in the patient and in the different members that make up the family

Highlight the triggering and sustaining factors of a case of anorexia nervosa

Case Report

Patient is a 14-year-old woman who begins to develop excessive concern about her body image initiating eating behaviors in the form of high restriction and counting of calories from food. Also she explains that she began to compulsively perform more than two hours a day of sports in order to lose weight Family genogram: she is an only daughter, whose parents have been separated for 4 years. Parents recognize conflictive relationship. The patient recognizes a very close relationship with her mother. When she talks about her relationship with her father, she explains how she felt very close to her father when she was young but that after the separation her father moved away. She describes that his father rebuilt his life a year ago and that he recently informed her that he is going to be a father again. She recognizes intense feelings of abandonment from her father. She acknowledges that the sense of control starting with anorexia initially helped her to feel confident about herself.

Understanding the origin of the symptoms and their function is essential for a better management of cases of anorexia

No significant relationships.

Electroconvulsive therapy (ECT) remains a valuable treatment for major depression with psychotic symptoms. However, it is necessary to pay special attention when there is a history of fractures.

Through the description of the following clinical case, we will emphasize the importance of screening for vertebral fractures within ECT and the different procedures that must be taken if that occurs.

We undertook a narrative literature review by performing a search on PubMed for English-written articles. The query used was “Electroconvulsive Therapy” AND “Vertebral Fractures”.

A 71-year-old woman was admitted with an episode of psychotic depression. Basic tests were performed and were all normal. After not responding to pharmacologic treatment, she was referred for ECT. The patient had a full recovery after 4 weeks of biweekly sessions. She was discharged and proposed for maintenance ECT. However, she started complaining of back pain after falling and did an X-ray and CT scan which revealed fractured L1 and L2. It was suggested conservative treatment with a Jewett orthosis. Within this period, the ECT was suspended and after a 4-week treatment, the fracture was consolidated. As there was no risk of neurological compression, the treatment was restarted with the same dosage of succinylcholine, and it was achieved complete muscular relaxation. The patient fully recovered without any orthopedic sequel.

Electroconvulsive therapy can be safely performed after conservative treatment of vertebral fractures, if special attention is provided to complete muscular relaxation. For this effect, the dosage of succinylcholine can be adjusted.

No significant relationships.

Suicides occur more often in the young and in the elderly. However, although several studies have been performed to evaluate the effect of suicide prevention in the young, no studies have explored this in the elderly. Somatic comorbidity is associated with elevated suicide risk, especially in case of pain, which occurs often in the elderly.

To explore if suicide prevention interventions might be applicable in the elderly and if somatic comorbidity might be relevant for their application.

Evidence synthesis of controlled studies evaluating suicide prevention interventions and of collaborative care trials for depressive disorder in patients with and without somatic comorbidity.

Elderly living alone and with multimorbidity are more prone to suicide risk. Hence interventions involving admission in a general hospital after a suicide attempt, short intervention and follow up might be well applicable in the elderly. In terms of outpatient interventions, and IPD analysis found that collaborative care for depressive disorder is effective in reducing suicidality, especially in the elderly. This effect is independent of somatic comorbidity.

There is potential to develop and evaluate suicide prevention interventions for the elderly. Such interventions should address depression, multimorbidity and social isolation and may be provided at general hospital and at outpatient level.

No significant relationships.

It is known that children with computer game addiction have a risk for development of deficit in executive abilities. It is important to develop effective approaches for helping children with this addiction.

The goal of this study was to reveal effect of body-oriented therapy on executive abilities in children with computer game addiction. Particularly we compared the efficacy of two methods of treatment (body-oriented therapy for children vs. conventional motor exercises) in a randomized controlled pilot study.

16 7-year-old children with computer game addiction were included and randomly assigned to treatment conditions according to a 2×2 cross-over design. The body-oriented therapy included the exercises from yoga and breathing techniques. To assess the executive functions and attention in children we used 5 subtests from NEPSY (Tower, Auditory Attention and Response Set, Visual Attention, Statue, Design Fluency). Effects of treatment were analyzed by means of an ANOVA for repeated measurements.

The ANOVA has revealed (p<.05) that for all 5 subtests on executive functions and attention the body-oriented therapy was superior to the conventional motor training, with effect sizes in the medium-to-high range (0.42-0.80).

The findings from this pilot study suggest that body-oriented therapy can effectively influence the executive abilities in children with computer game addiction. However, it is necessary to do further research into the impact of body-oriented therapies on children with this addiction.

It is known that negative body image can cause significant emotional distress for an individual and thus lead to lower subjective well-being. Previous research has shown that both disordered eating and body mass are connected to negative body image.

To examine how disordered eating and BMI can predict different aspects of body image.

A sample of 180 healthy respondents (152 Female, 28 Male, mean age 22,62±7,35) were recruited in Moscow. Disordered eating was measured by Eating Attitude Test (EAT-26; Garner D. et al., 1982), body image was measured by Multidimensional Body-Self Relations Questionnaire (MBSRQ; Cash T. F., 1990). Body mass index (BMI) was calculated on the basis of self-reported data (height and weight). Multiple linear regression analysis was performed in IBM SPSS Statistics 22.0.

Regression model with both predictors determined self-classified weight (SCW; R2=0,569, p<0,0001), overweight preoccupation (OWP; R2=0,497, p<0,0001), body areas satisfaction (BASS; R2=0,259, p<0,0001), and appearance evaluation (R2 = 0,229, p<0,0001), but only disordered eating symptoms predicted appearance (R2 = 0,193, p<0,0001) and health (R2 = 0,036, p<0,05) orientation, and none of the predictors affected fitness or health evaluation and fitness orientation.

Symptoms of disordered eating and body mass index in normal population can predict self-evaluation of one`s appearance as less attractive, body size as bigger and weight as heavier. Only symptoms of disordered eating predicted higher extent of investment in one’s appearance and health. And neither IBM, nor disordered eating predicted self-evaluation of one`s health and fitness or the extent of investment in fitness.

Horticultural therapy is used as alternative treatment option in rehabilitation programs for patients suffering from chronic mental disorders. In Greece, the Psychiatric Hospital of Thessaloniki was the first that organized a organized Rehabilitation Program approved by the Greek Ministry of Health, the “Green Unit - Monada Prasinou”.

The purpose of this study was to investigate the effect of horticultural intervention on the functionality of patients employed in the Green Unit of the Psychiatric Hospital of Thessaloniki.

The Mini-ICF-APP Social Functioning Scale was used to evaluate the functionality of the patients. Horticulture therapy included actual gardening and other agricultural activities. The sample consisted of two groups, 22 inpatient of the Green Unit and 22 patients of outpatient units as a control group. The majority of the patients suffered from Schizophrenia spectrum disorders. Both patients’ groups were evaluated over 12 months (May 2018- May 2019).

At baseline evaluation, the patients of the Green Unit patients presented higher scores only in the mobility and endurance subscale. A year later there was a statistically significant difference in all thirteen subscales. Shortly, the patients were rated as more consistent, organizational, social, flexible, responsible, more confident and enterprising, more adaptable and more able to take care of themselves.

The results suggest that horticulture as a therapeutic method had beneficial effects in all dimensions of patient functionality confirming the hypothesis that such programs should be a priority in the effort of psychosocial reintegration of patients suffering from chronic mental disorders.

Obsessive compulsive disorder (OCD) affects 2-3% of the general population. The neurobiology of OCD has been linked to dysfunction of cortico-striatal circuits connecting the orbitofrontal (OFC) to the striatum. Recently, this loop has become an approved target for non-invasive neuromodulatory treatment of OCD.

To explore structural and functional connectivity of the OFC in OCD subjects and healthy controls.

14 OCD patients and 12 age/sex-matched controls underwent magnetic resonance imaging (MRI) (3T-Philips scanner) for diffusion tensor imaging (DTI) and resting state functional connectivity (rsFC). DTI images were brain extracted and corrected for movement and eddy currents. A diffusion tensor model was fitted to each voxel and used to generate Fractional Anisotropy (FA) maps. Voxel-wise statistical analysis of FA was performed using Tract-Based Spatial Statistics. RsFC images were preprocessed and seed-based correlation (SBC) analysis was performed using Data Processing Assistant for Resting-State fMRI.

We found decreased values of FA in the body of the Corpus Callosum bilaterally (MNI_coordinates: x= 16, y= -16, z= 33 and x= -19, y= -16, z= 42) and left superior longitudinal fasciculus in OCD patients (fig 1, left), as well as decreased rsFC of the right superior orbitofrontal seed with the left inferior frontal gyrus and left middle occipital gyrus (fig 2, right).

Using an exploratory multimodal approach we found evidence of abnormal structural and functional long-range connectivity of the OFC in OCD. If confirmed in a larger sample these connectivity abnormalities could be explored as potential predictors of response to OFC-targeted non-invasive neuromodulatory interventions.

No significant relationships.

Schizophrenia is one of the most severe mental disorders. Haloperidol and other first-generation antipsychotics are widely used for schizophrenia treatment, but have prominent side effects, primarily extrapyramidal symptoms (EPS). The EPS severity is highly variable and may be underlied by genetic factors.

We performed a prospective study to test the association of DRD2/ANKK1 Taq1A polymorphism (rs18000497) and CYP2D6 phenotype, predicted from genotypes using 8 CYP2D6 alleles (*3, *4, *5, *6,*9, *10,*41, xN) with EPS severity during haloperidol treatment in schizophrenia spectrum disorders patients.

57 inpatients with schizophrenia spectrum disorders (42,1% females; mean age - 46,7±11,8 y.o (M±SD) of European ancestry were enrolled in the study. Abnormal Involuntary Movement Scale (AIMS), Barnes Akathisia Rating Scale (BARS), Simpson-Angus Scale (SAS) were used to assess EPS on two timepoints: day 1 and day 21 of haloperidol treatment.

TaqIA T-allele carriers in contrast to wild-type allele homozygous patients had higher scores of BARS (p=0.029) and SAS (p=0.024) on day 21. After stratification by CYP2D6 phenotype, these differences were observed only in extensive metabolizers (p=0.006 and p=0.001 respectively), although the CYP2D6 phenotype itself was not associated with EPS severity. The combined effect of TaqIA T allele with CYP2D6 extensive phenotype on BARS score on day 21 was confirmed by General Linear Model (p=0.013).

Our results show that minor TaqIA T-allele is associated with the severity of EPS after 3 weeks of haloperidol treatment only in CYP2D6 extensive metabolizers. That highlights the importance of using both pharmacokinetic and pharmacodynamic genetic markers in pharmacogenetic EPS risk assessment.

No significant relationships.

Nowadays, ‘Acute and transient psychotic disorders’ in ICD-10 and ‘Brief psychotic disorders’ in DSM-5 are both classifications of the same clinical entity. Over the years, several concepts have been formulated to define the same syndrome.

To explore the historical evolution of brief psychotic disorders and relate them to current nosologies.

Literature review, using the most relevant papers, with the keywords “brief psychosis”, “bouffée délirante”, “cycloid psychosis”, “psychogenic psychosis”, “atypical psychosis” and “holodysphrenia”.

Initially, in 1896, Kahlbaum coined the term ‘dysphrenia’, a group of severe form of psychosis that remitted without showing the typical sequence of disease states and without leaving a lasting alteration. Later, Kraepelin included this kind of disorder in manic depressive illness, which he first named as ‘periodic delirium’ and then as ‘delirious mania’. Magnan, in the pre-Kraepelinian era, created the term ‘bouffée délirante’, a sudden onset of delusional ideas with rapid evolution and intense symptomatology with complete remission usually followed after a short time. Later on, Henry Ey grabbed this entity and renewed it, contrasting it to the defined concept of schizophrenia. Other psychiatric schools have proposed numerous designations: ‘cycloid psychosis’ by Kleist from the German school, ‘psychogenic psychosis’ by Wimmer of the Scandinavian school and ‘holodysphrenias’ by Barahona-Fernandes from the Portuguese school. Cultural variants are also observed, as ‘amok’ seen in Malaysia or ‘shinbyung’ in Korea.

The intensity and polymorphism of brief psychosis present a clinical challenge. The historical evolution may be helpful on recognizing this entity in current clinical practice.

No significant relationships.

It is clear from the literature that depressive disorder is closely related to lifestyle, however the relationship between burnout and lifestyle remains unclear.

The aim of this study was to present a comprehensive overview of depressive symptoms, burnout and lifestyle over the years. Furthermore, this study looks at the relationship between burnout, depressive symptomatology and lifestyle and seeks to clarify the extent to which burnout can be explained by these variables.

Data collection took place in three waves. The first data collection was in 2014 (October/November), the second in 2017 (March) and the third in 2020 (March). The STEM/MARK agency conducted the data collection and collected answers from a representative sample of respondents using the CAWI method - computer-assisted questioning. These respondents were selected from the European National Panel. Because the target group was adults (18-65 years), an online survey was chosen. Internet penetration in this target population is sufficient and it was not necessary to use a combination of methodologies.

All 3 data collections identically show that for the model explaining burnout statistically significant variables are: age, depression and fatigue during the day. Other variables related to healthy lifestyles did not reach statistical significance.

Even though the variables regarding healthy lifestyles have not reached statistical significance, their importance should not be underestimated. Mental well-being is closely linked to physical health and therefore a holistic approach to health should be emphasized and the rate of burnout should be regularly monitored.

No significant relationships.

Tunisian revolution has been a major upheavel in the tunisian history and has brought many political, social and economic changes. Little were found about the revolution’s potential impact on the psychiatric demand.

Compare the clinical profile of all the new consultants in the out ward psychiatry department before and after the revolution.

The study had a retrospective descriptive design including all the new consultants in the outpatient psychiatry department in the general hospital Fattouma Bourguiba in Monastir, Tunisia before (during 2007) and after (during 2016) the revolution. We used a pre-established questionnaire including sociodemographic and clinical data.

After the revolution, an increase in the number of new patients (p<10-3) 438 to 451 were found. In 2016, there were more unemployed consultants(p=0.004), having criminal record (p=0.01) and having a problematic substance use (p<10-3). An increase also concerned patients consulting for anxiety(p=0.002) and suicidal ideation (p=0.022). Considering the clinical diagnosis, there were also a significant increase regarding anxiety disorders (p=0.001) and mood disorders (p=0.011) essentially major depressive disorder (p=0.002). Although a significant decrease concerned somatoform disorder (p<10-3).

Our study showed a change in the profile of consultants after the Tunisian revolution. A study in the general population could find specific etiological factors. Thus highlight the importance of implementing preventive measures in general population in crisis’ times.

No significant relationships.

Digital mental health, before, during and after the COVID-19 pandemic Over the last two decades the digital landscape of mental health care research and service innovation has gained momentum. This period is characterized by many successes’ stories but brilliant failures as well. Today, e-mental health is like a two-headed Janus. One side of his face illustrates the birth of innovative technologies that entered mental health service provision. In parallel, the evidence-base for the application of these new technologies, such as internet-based treatments for depression, has been established with effect sizes comparable to those of face-to-face treatments. The other side of his face shows, however, that eMental-health has not yet lived up to its’ full potential as its actual delivery, evaluation and implementation in routine care has proven to be a much longer and bumpier road than expected. The question addressed in this presentation will be ‘what does the future hold’? Acknowledging that futures are difficult to predict Heleen Riper nevertheless provides insights into how we may overcome some of these bumps by combining the best of two worlds, i.e. blending digital and face-to-face components into one integrated treatment approach. She will illustrate these new developments by virtue of the results of the H2020 European Comparative Effectiveness Study for Major Depression and current experiences with especially videoconferencing during the Covid-19 pandemic.

No significant relationships.

Anxious-depressive disorders are common among children with epilepsy. A recent Systematic Review and Meta-Analysis (Scott et al., 2020) reported that the overall pooled prevalence of anxiety disorders is 18.9% while of depressive disorders is 13.5%. COVID-19 pandemic has centralized the attention of governors and careers on the health emergency. As a result, the trajectory of the psychological care needs of this at risk population may have been neglected.

The aim of the study was to assess the prevalence rate of depressive and anxiety symptoms among children with epilepsy during COVID-19 pandemic. Children were hospitalized in- and out-patients under a neurological and psychological follow up program in an Italian Children Hospital.

We conducted a cross-sectional study among 38 hospitalized children and adolescents with epilepsy (21F; 17M, mean age: 14,5; range: 11-18) during COVID-19 pandemic. We performed face-to face interviews and assessed depressive and anxiety symptoms with the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorders (GAD-7) questionnaire during scheduled follow up checks.

Preliminary results showed a rate of mild-to-severe anxious depressive symptoms by 49.9% and 60.5% respectively. In detail: 21.1% mild, 15.7% moderate and 13.1% of severe anxiety, meanwhile 23.7% mild, 26.3% moderate and 10.5% of severe depression. The prevalence of comorbid depressive and anxiety symptoms was 39.5% among the entire sample.

Depressive and anxiety rates among hospitalized children with epilepsy during COVID-19 outbreak are very high. Pediatric services should deserve special attention to those patients’ mental health. Regular screening protocols and empowerment interventions in Hospital should be promoted.

No significant relationships.

Electroconvulsive therapy (ECT) is a current, relevant treatment for severe mental illness. In this article we describe our experience on ECT in a public hospital in Chile.

Describe a 34 patients’ cohort who received ECT and their outcomes.

Data was extracted from ECT records between 2018-2020, patients’ evaluations before and after ECT, and case files. Data was then analyzed and described.

ECT was received by 18 males and 16 females. Age ranged from 19 to 73 years (41 average). More than 75% had 12 or more years of education. Patients’ diagnoses and indications for ECT are shown in Figures 1-2

The CGI-SI scale was applied to subjects before treatment, and 85% had a score of 5 or more. On average, patients received 8.7 ECT sessions. Right unilateral electrode placement (RUL) was preferred initially for 94% of patients. Brief pulse width (0.3ms) was most commonly used (76%). Seizure duration averaged in 29 seconds. Adverse reactions presented on 32%, most being mild. One treatment had to be stopped due to confusional symptoms post ECT. After ECT, 91% of patients improved according to CGI-GI scale. 55% were assessed CGI-GI 1 “very much improved”. MoCA scale was also evaluated, showing a 2,1 point gain.

Schizophrenia and psychosis were the most frequent diagnosis and indication for ECT. RUL and brief pulse width were the preferred settings. This cohort suggests that ECT had an impact on markedly ill patients, based on CGI and MoCA scales.

International Classification of Diseases 11th Revision (ICD-11) has inserted complex post-traumatic stress disorder (cPTSD) as a clinically distinct disorder, different from PTSD. The diagnosis of cPTSD has the same requirements for the one of PTSD, in addition to disturbances of self-organization (DSO – e.g., disturbances in relationships, affect dysregulation, and negative self-concept).

This study aimed to explore suicidality in PTSD and cPTSD. We examined also the association between clinical dimensions of hopelessness (feelings, loss of motivation, future expectations) and other symptomatologic variables.

The sample, recruited at the Fondazione Policlinico Tor Vergata, Rome, Italy, consisted of 189 subjects, 132 diagnosed with PTSD, and 57 with cPTSD, according to the ICD-11 criteria. Participants underwent the following clinical assessments: Clinician-Administered PTSD Scale (CAPS), Impact of Event Scale-Revised (IES), Beck Depression Inventory (BDI), Symptom Checklist-90-Revised (SCL-90), Dissociative Experience Scale (DES), Beck Hopelessness Scale (BHS).

cPTSD showed significantly higher BHS-total (p = 0.01) and BHS-loss of motivation subscale (p <0.001) scores than PTSD. Besides, cPTSD showed significantly higher scores in all clinical variables except for the IES-intrusive subscale. By controlling for the confounding factor “depression”, suicidality in cPTSD (and in particular the BHS-total) appears to be correlated with IES-total score (p = 0.042) and with DES-Absorption (p = 0.02). Differently, no such correlations are found in PTSD.

Our study shows significant symptomatologic differences between PTSD and cPTSD, including suicidality. Indeed, suicidality in cPTSD appears to be correlated with the “loss of motivation” dimension, which fits well within the ICD-11 criteria of DSO.

No significant relationships.

Non-compliance is a common problem in diabetes despite of the potentially drastic consequences. The study of the factors of compliance in adolescents with diabetes is not only important due to the possible practical implementations in health care, but also may be threated as a model for understanding the age-specific aspects of compliance behaviours.

The study was aimed to evaluate various, primary family-related, factors contributing to compliance behaviour.

Participants: 71 adolescents (f=44, m=27, age: 13-17) with diabetes mellitus type 1, without insulin pump usage, and their mothers. Instruments: compliance was accessed with MMAS and “Degree of compliance” (for 15-17-olders only) scales. Paternal attitudes were assessed by (1) ADOR questionnaire, yielding scores for: Positive interest, directiveness, hostility, autonomy, inconsistency; (2) Family anxiety analysis questionnaire, with scales: guilt, anxiety, tension. Illness attitudes were assessed with the Concerns of the illness progression model questionnaire. Interview data were used to assess such variables as duration of illness, frequency of therapist consultations y etc.

Stepwise regression analysis suggested the best model for compliance being predicted (R2=.203) by family anxiety (beta=-.406, p<.001), duration of illness (beta=-.218, p<.05) and frequency of consultations (beta=.0212, p<.05). For 15-17-olders only compliance was better predicted (R2=.499) by concerns about illness (beta=.876, p<.001), distraction copings (beta=.501, p=0.001), negative thinking (beta=-.421, p<0.02) and frequency of consultations (beta=.274, p<.05).

Low family anxiety, shorter duration, and more frequent contacts with therapist, as well as productive copings, absence of frequent negative thoughts and fantasies about illness contribute to compliance. Negative emotions hamper compliance instead of fostering it.

Since the declaration of the COVID-19 pandemic, several studies have demonstrated its considerable psychological impact. The isolation and social distancing, the increased fear of being infected or infecting others and the insecurity generated by the economic impact, could contribute to an increase in the incidence of mental health issues, such as psychotic disorders.

The aim is to discuss four clinical cases in order to provide further evidence on this matter.

We report on three females and one male with no personal psychiatric history who were admitted to a tertiary hospital during the first three months after the declaration of the pandemic. The average age was 44,25 ± 14,97 years.

All patients met the International Statistical Classification of Diseases (ICD-10) criteria for acute and transient psychotic disorder. All of the episodes were triggered by the stress generated from the COVID-19. Complementary tests were unremarkable. They all tested negative for SARS-CoV-2. Rapid discharge with favorable response to relatively low doses of antipsychotics was possible with a mean length of stay of 7,25 ± 2,86 days. In two of the cases the delirious content was predominantly marked by the coronavirus itself.

It has been suggested that the intense psychosocial stress associated with a new life-threatening disease and national lockdown restrictions could be triggers for new-onset psychotic disorders. Some authors have reported cases similar to ours, which means that we could be experiencing and increase in the incidence of psychotic disorders due to the exceptional circumstances we are living around the world.

The suspiciousness of a paranoid patient could reach extremes.

To present the lessons learned after an interview with a similar patient.

Case report.

Fifty-two year old woman suffering from paranoid schizophrenia (F20.0). Symptoms almost identical to her previous (two) hospitalizations: delusions of thought reading and of being surveilled by electronic equipment in her house/neighborhood. This time, though, she was additionally convinced of being the object of medical experiments and of being electronically surveilled even within the ward. Treatment: risperidone 12mg/day, lorazepam 3.75mg/day, biperiden 2mg/day. Three weeks after admission, the author noted a slight tremor in her hands (most certainly of extrapyramidal origin). I asked her to place both hands in front of her, fingers wide open, to assess it better. The patient followed with the fingers attached, though. Consequently, I approached my hands to hers -to show how it should be done correctly-, touching them lightly. Then, a spark was generated between our hands. Evidently, it was an electrostatic discharge (I was wearing a wool sweater that day; static electricity could easily accumulate on wool). She became outraged: “what kind of experiments are you doing to me?”, “what electronic devices are you using?”, “this is the proof of what I have been constantly saying”.

The symptoms of psychotic relapses could evolve over time. A clinician should refrain from any strictly unnecessary physical contact with an exceedingly paranoid patient, particularly when the latter claims that is the object of “medical experiments”. The elaborative “ability” of such patients could be, simply, astounding.

No significant relationships.

Loss of routine, disengagement from peers and adapting to distant learning during the pandemic may lead to psychological distress in medical students. Psychological impact of the pandemic on medical students has not been assessed in Sri Lanka

To identify the psychological impact and coping strategies of medical students during the pandemic.

An online survey was done among 527 medical students in a state Medical Faculty in Sri Lanka. Depression Anxiety Stress Scale (DASS-21) was used to measure psychological impact.

The main worries among the students was upcoming exams (74.4%, n=389) and taking a longer time than expected to complete their undergraduate medical education (68.1%, n=356). 68.7% (n=362) of the respondents experienced difficulty in working up the initiative to do things and 62.6% (n=330) had tendency to overreact to situations. Depressive symptoms were present in 40.8%, anxiety in 34% and high levels of stress were seen in 24.7%. In 10.8% depression was severe and anxiety was severe in 10.3%. Depression (p<0.01), anxiety (p<0.05) and stress (p<0.01) were significantly higher in students with a past history of psychiatric disorders. Depression, anxiety or stress was not associated with the gender, ethnicity, family income or living circumstances. The main coping strategy of the participants was engaging more with family (73.4%).

Given the high levels of psychological distress, supportive strategies should be designed to minimize the psychological impact in this vulnerable group.

No significant relationships.