Although a large number of studies have shown brain volumetric differences between men and women, only a few investigations to date have analyzed brain tissue volumes in representative samples of the general elderly population.

We investigated differences in gray matter (GM), white matter (WM) and intracranial volumes (ICVs) between sexes in individuals above 66 years old using structural magnetic resonance imaging (MRI).

Using FreeSurfer version 5.3, we automatically obtained the ICVs, GM and WM volumes from MRI datasets of 84 men and 92 women. To correct for interindividual variations in ICV, GM and WM volumes were adjusted with a method using the residuals of a least-square-derived linear regression between raw volumes and ICVs. We then performed an ANCOVA comparing men and woman including age and years of schooling as confounding factors.

Women had a lower socioeconomic status overall and fewer years of schooling than men. The comparison of unadjusted brain volumes showed larger GM and WM volumes in men. After the ICV correction, the adjusted volumes of GM and WM were larger in women.

After the ICV correction and taking into account differences in socioeconomic status and years of schooling, our results confirm previous findings of proportionally larger GM in women, as well as larger WM volumes. These results in an elderly population indicate that brain volumetric differences between sexes persist throughout the aging process. Additional studies combining MRI and other biomarkers are warranted to identify the hormonal and molecular bases influencing such differences.

Proactive coping helps to reduce stress “in advance” – by possible stressors’ anticipating (Greenglass & Fiksenbaum, 2009). Does it helps to reduce distress in hazardous work environment with extremely high uncertainty level – like in healthcare professionals’ work at the beginning COVID-19 pandemic? Data showed the lover level of proactive coping in healthcare professionals in comparison with non-medical group (Pearman, Hughes, Smith & Neupert, 2020). The acute issue is to investigate proactive coping among medical professionals with different stress level.

Specialists of Moscow public dispensaries (doctors, n=209; nurses, n=131) were checked during pandemic breakout (April 2020) - in order to compare proactive coping and job stressors’ subjective evaluation in groups with high and low chronic states.

The diagnostic set included: the job stress survey (Spielberger, 1994); the proactive coping inventory (Greenglass, 2002); the chronic stress and fatigues inventories (Leonova, 2012).

Cluster analysis by combination of stress-fatigue scores extracted equal 22% of professionals in risk subgroups. Surprisingly no proactive coping differences were found in nurses; among doctors preventive coping is significantly lower in risk subgroup (t=7.05; p=0.009). Revealed job stressors in risk groups for nurses are quite typical; but for doctors they are unusual: extreme workload (t=33.97; p<0.001), low coworkers support (t=48.94; p<0.001), lack of positive feedback (t=62.29; p<0.001).

Despite the undeniable workload increase, well-to-do professionals perceived no high job stressors. In risk subgroup with lack of preventive coping, perceived stressors are likely connected with inability to predict strain increase and to minimize the impact of its negative effects (Moore, 2017).

Social Physique Anxiety is defined as an emotional response that reflects individuals’ concerns regarding the way their body may be observed or judged by others.

To explore the relationship between physical activity and social physique anxiety.

A literature review haw been made through pubmed database.

Social Physique Anxiety is negatively related to participation in physical activity and commitment to exercise. Studies examining the relationship between motivation and social physique anxiety have shown that external motivations, such as improving muscle tone and body attractiveness, are directly linked to social physique anxiety. In addition, social physique anxiety is negatively related to self-efficacy. Individuals who believe that they will be judged by others to be ineffective are less likely to be engaged in physical activity programs. Social Physique Anxiety has been linked to negative effects on mental health such as low self-esteem, smoking and eating disorders.

Given all the negative effects of social physique anxiety, as it is responsible for a wide range of health-related behaviors, it is important to identify physical activity-related motivational mechanisms in order to reduce the impact of social physique anxiety.

No significant relationships.

More than 92% of people in Bangladesh are deprived from any sort of mental health care due to severe scarcity of mental health professionals, widespread stigma, lack of awareness, the inability to travel from remote area to Dhaka and maintaining the cost of travel and clinics. Moreover, the COVID-19 crisis made the scenario worse. To solve this problem we designed, developed and implemented “Monerdaktar”.

The process development Monerdaktar- website and mobile application started with the initial idea and concept by TRS followed by extensive literature review and naturalistic observation of the mental health care service delivery from two tertiary hospitals in Bangladesh. We conducted 3 focus group discussion with the patients, their care givers, mental health professions. Based on the user feedback and technical suggestion of the mental health professional and IT professionals we developed the prototype of the Monerdaktar mobile application and website. After piloting for two months, the final version of the mobile application and website was finalized incorporating the feedback of the patients and experts.

Monerdaktar created the unique opportunity to connect with the most the reputed mental health professional both psychiatrists and clinical psychologists online. Moreover, monerdaktar delivered the service free of cost to more than 700 clients during the peak of COVID crisis in Bangladesh.

The COVID-19 crisis has potentiated the acceptance and adaptation of the Moenrdaktar solved the long-standing crisis of access to mental health care in Bangladesh and ensure the evidence-based care from anywhere.

The Monerdaktar website and mobile application was design and developed by under the leadership of Dr. Tanjir Rashid Soron. Though the initial support was delivered free of cost, the consulting expert psychiatrist and Clinical Psychologist may take their

Research has shown that ethnic/racial minorities have a higher risk of homelessness, involvement with the criminal system, psychiatric misdiagnosis, treatment delay, and being prescribed first (versus second) generation antipsychotics.

To investigate if the disparities found in the community are replicated in incarcerated patients.

Systematic review on PubMed for articles that fulfilled criteria for 4 domains: prison, psychosis, race/ethnic, and treatment.

Forty-one articles matched the search criteria. Of those, 24 were irrelevant; 2 were inaccessible. Fifteen articles were considered; most highlighted the interplay between the criminal system, homelessness, mental disorders, and ethnic/racial minorities. Five articles highlighted differences in treatment. One stated that African-Americans and Asians were less likely than Whites to have access to mental health services. Concerning treatment for substance use disorders, one study found Hispanic inmates were more often engaged in treatment, followed by Caucasians and lastly, African-Americans; a different study reported the percentage of Whites and Blacks receiving treatment was similar, while Latinos were under-represented. Whites were most likely to have mental health counseling/substance use treatment as part of their sentence. A study from New-Zealand stated that treatment for mental disorders was less common for Maoris, in whom suicidal thoughts were often unrecognized. The last study reported a higher risk of self-harm for foreign patients, coupled with non-recognition/misinterpretation of symptoms.

Racial/ethnic inequalities show that disparities in healthcare are pervasive in all settings. More studies are needed to better understand the complex nature of this problem.

No significant relationships.

Discharge summaries are the mainstay of intra and inter-departmental communication, ensuring continuity of care. Local instructions fail to provide clear guidance to foundation doctors to ensure standardised discharge summaries.

The audit aimed to assess the inclusion of information within discharge summaries at Mount Carmel Hospital, Malta. A secondary objective was to update the current online discharge summary framework.

Stratified random sampling was used to select 120 discharge summaries, issued between October 2018 and September 2019. These were chosen out of a total of 956 discharge summaries issued during the period. The inclusion of information was analysed against the National Standard for Patient Discharge Summary Information issued by the Health Information and Quality Authority, Ireland. Data was collected and grouped into seven categories each containing multiple data points.

Patient details were present in all discharge summaries while no details relating to the primary care healthcare professional were documented. The average information inclusion rate regarding admission, discharge and medications was 85%. Average clinical information was documented in 50% while that of future management and person completing discharge summary was found in 41% and 28% respectively (as per Table 1). Encouragingly, discharge summaries contained mandatory information more frequently than conditional or optional information.

This audit has identified deficiencies in current discharge summary practices and gives recommendations for the development of local guidelines.

No significant relationships.

Huntington’s disease (HD) is a progressive neuropsychiatric and degenerative disorder that shows an autosomal dominant inheritance pattern. The principal symptoms of HD are progressive movement disorders, cognitive deterioration, dementia, and certain psychiatric manifestations, which may occur in many different forms, such as depression, psychosis, personality changes.

In this presentation, two female HD patients with psychotic components complicated with suicidal and homicidal thoughts will be reported to better illustrate psychiatric components of HD.

Hospitalization records of these two patients with genetically verified HD diagnosis indicated that their psychiatric health precipitously deteriorated in the last decade.

While the first patient suffered from severe depression, anxiety, suicidality; persecution ideas, suspiciousness, hostility were noted more prominently in the latter. Moreover, both cases had a positive family history for psychiatric diseases which is one of the hallmarks of HD. Anti-psychotic drug olanzapine, which has minor side-effects on EPS, was found to be highly effective on our HD patients, alleviating the behavioral and psychiatric symptoms of the disease.

In conclusion, HD should be one of the differential diagnoses if patients with psychiatric complaints have accompanying neurological findings such as movement disorders and impaired memory, and great attention should be paid to the extrapyramidal system (EPS) sensitivity of the chosen treatment regime when treating the HD patients,

Neurosciences evolved very rapidly in last few years and helped the establishment of Liaison Psychiatry as a fundamental part of the general hospitals functioning. However, the use of this department by the other specialties still needs to be refined, as it is common to find wrong assessments in the referral of the patients.

We aim to study the concordance between the referral motives and the assessment by the psychiatry team.

Data was collected through the informatic registry. Contains patient data observed by a liaison psychiatrist in the period between 1st of July and 30th of September of 2020. In this period there were 80 requests, of which, 6 were refused for various reasons. We decided to study the concordance when one of these symptoms were in the request: anxious symptoms, depressive symptoms, psychotic symptoms and psychomotor agitation. 46 requests met this criteria.

The mean age was 63,3yo and 46% were older than 65yo. Most were women (54%) and 68% had history of psychiatry disorder. About 50% were requests from the Medicine wards. The concordance between the medical request and the psychiatry assessment was higher for psychomotor agitation (n=11; 64%) and depressive symptoms (n=23; 57%), but it was lower in anxious symptoms (n=3; 33%) and in psychotic symptoms (n=9; 33%). Most common diagnosis was delirium.

Non-psychiatrist doctors appear to have more difficulty when assessing anxious and psychotic symptoms. Those concordance percentages are in line with recent research. Actions should be taken to improve this, like academic training and standardization of referral.

No significant relationships.

How traditional cultural healing works is difficult for biomedical science to understand. Outcomes do occur that defy the conventional logic of materialistic, reductionistic cause-and-effect.

We aimed to understand how participants understood what happens in traditional cultural healing.

We identified 26 cases of results in which improvement occurred beyond what biomedicine would expect from a placebo response. We interviewed the healers and their clients to understand their experience and how they saw what had happened.

Seven cases involved resolution of cancer; 2 cases, musculoskeletal disorders; 9 cases of rheumatological disorders; 8, other disorders. Each person spoke about the importance of spiritual transformation and described such an experience. They spoke about an attitude of the cultural healer that involved what could best be translated as radical empathy coupled with non-judgmental listening without interpretation. Many of healers had been initiated into their healing roles via a life-threatening illness that resolved when an extra-ordinary being(s) (a spirit or god, or God) entered their life world and became an integral part of their being. This was also a common description given by the participants for what had happened. The healers often described themselves as a hollow bone, a conduit through which spiritual forces flow.

Traditional cultural healing remains important to psychiatry because it defies explanation in our usual paradigm. Spiritual transformation and radical empathy may be necessary, though not sufficient components. For the person who undergoes a profound spiritual transformation, extensive changes in self and world view may occur.

No significant relationships.

Impairment of conventional perception is one of the key dysfunction in patients with schizophrenia even in absence of psychotic symptoms.

Possibility of improvement of conventional perception by add-on treatment with ipidacrine in patients with schizophrenia in long-term remission.

26 (13 females) patients, mean age 40.4 (SD 11.7) with episodic schizophrenia in remission more than one year, receiving stable antipsychotic therapy were included into the open label study. As add-on treatment ipidacrine was administered once per day in dosage 20 mg for two months. Positive and Negative Symptoms Scale (PANSS) was used to assess clinical symptoms and projective psychological method (Rorschach Test) was used to assess conventional perception.

The study showed that ipidacrine in a low dosage, added to standard antipsychotic treatment, was effective in relation to negative symptoms (PANSS negative subscale score before 22,4 (SD4,7) and after beginning of the study 19,7 (4,5), p=0, 001). Of all the indicators of the Rorschach test, there was significant improvement in the index X+%, which is responsible for the degree of conventionality in reality recognition. The decrease in conventionality was associated with both high individualism and perceptual disorders. The value of of X+ % did not reach the standard one (70%) to the end of the study, but the improvement showed the switching from severe (52,4 (SD 12,2) to moderate (60,6 (SD10,4) impairment level (p=0,039).

Ipidacrine in a low dosage as add-on treatment has positive effect on conventional perception of stable patients with schizophrenia even in short-term trial.

No significant relationships.

The prevalence of chronic liver diseases (CLD) is over 30 million people worldwide, they are associated with significant health care costs, loss of productivity of patients, and has a significant impact on the quality of life associated with health.

The research objective was to determine current views on the psychological state of patients with CLD.

A qualitative and quantitative analysis of the content of scientific Ukrainian and English literature published from 2014 to 2020, which sets out different views on the psychological state of patients with chronic liver diseases using the PubMed and Google Scholar databases. Only concept analysis, meta-analysis, and systematic reviews published in English, presented in the scientific literature were included.

The information on the peculiarities of the psychological state of patients with CLD was generalized. Based on the research, we can conclude that this group of patients is characterized by low mood, chronic fatigue, low level of social adaptation, increased anxiety, and reduced efficiency.

Studies by different scientists from different countries agree that patients with chronic liver disease are characterized by the above symptoms. Some emphasize psychoneurophysiology and associate these symptoms with chronic inflammation, which occurs as liver damage progresses. Other researchers suggest that it is due to the quality of life of these patients and the severity of the disease. However, the scientific community has yet to find out what exactly caused this.

The Covid-19 pandemic has a profound impact on all domains of day to day life, forcing individuals to make substancial change in the way of living. Such change is known to cause an important psychological distress, and in some persons evidencing silent disorders among apparently functional individuals. Good coping mechanisms and resilience can be the key to overpass this difficult period.

The aim of this study is to evaluate the coping mechanisms and resilience that Romanian psychiatric trainees used during Covid19 pandemic.

We developed an online questionnaire. We included questions about different socio-demographical variables and about coping mechanisms (using COPE scale), resilience (using Connor-Davidson Resilience Scale) and quality of life (using QoL Scale).

The preliminary data show that staying busy, seeking social support and having a positive minset are emotion-focused coping strategies present in individuals who overpass easier this period.

The Covid-19 pandemic is creating significant distress and impairment in functioning, but individuals who have good psychological mechanisms and who are more adaptable are less vulnerable during Covid-19 pandemic. Future research should build upon these findings to better understand coping mechanisms during crises and also social policies should be developed to acknowledge the variable needs in adults.

Bipolar female patients have clinical and evolutionary features wich involve different factors related to the women specifities.

Establish clinical and evolutionary features in a population of bipolar female patients attending to Gabes psychiatry department.

A retrospective descriptive and analytical study was undertaken including female patients referred to psychiatry department of Gabes regional hospital, for the first time in a 6-year period (January 1st, 2010 to December 31, 2016) and who were already diagnosed with bipolar disorder (BD). Sociodemographic, clinical and evolutionary data were assessed. Patients were divised into two groups according to gender. The collected data were compared between the two groups. The statistical analysis was executed on the software SPSS (20th edition).

From the 193 bipolar patients, 103 were women. The mean age of the disorder’s onset amongst Female patients was 32.4 years old [14 - 63]. The mean duration of the disorder was 7.6 years [2 - 30]. The polarity of the first episode was a depressive one in 74.7% of cases. It was associated to psychotic features in 43.7% of cases. Seasonal pattern was noted in 10.6% amongst female patients and rapid cycling bipolar disorder in 6.2% of cases. Analytical study showed that women began the BD more often with a depressive episode (p=0.004) and were more frequently diagnosed with BD type 2 (p<0.001). Men had significantly more auditory (p=0.002) and visual hallucinations (p=0.019).

There were clinical specifities of women with BD from which important to be considered.

The outbreak of COVID-19 has disrupted the lives of countless people worldwide. The pandemic has imposed a sense of uncertainty and anxiety, as the world could not predict or prepare for this crisis. It is important to study risk factors, including employment, marital status, and pre-existing medical or psychiatric conditions to effectively handle this pandemic’s mental health impact.

We aim to evaluate factors contributing to the suicides and mood disorders during the coronavirus pandemic.

We examined MeSH terms “COVID-19” in the context of “Mood Disorders,” “Suicide,” “Suicidal Ideation,” “Assisted or Suicide, Attempted or Suicide,” “Risk Factors.” We identified eight case studies for the qualitative synthesis per the PRISMA guidelines, searching Medline, PubMed, PubMed Central, and PsychInfo databases until August 2020.

We identified that the population of all age groups and sex are at risk of stress and mental illness due to the pandemic. Several factors are attributed to the increased risk of mood disorders and suicide. Not having pre-existing psychiatric or medical condition is not a protective factor, since suicide was attempted or committed due to external factors such as economic and social.

The pandemic has increased the risk of mood disorder and suicides in the population. Focus should be on the behavioral and psychological first aid to curb stress.

Although cyberchondria was suggested as a separate phenomenon (Starcevic, Berle, 2013, Starcevic, 2017), it is by definition related to both health anxiety, general hypochondriac beliefs and behavior and Internet use (Baumgartner and Hartmann, 2011, Eastin and Guinsler, 2006, Singh and Brown 2014).

The aim was to reveal relationship between cyberchondria in adult Internet users, Internet use and hypochondriac beliefs and behavior.

126 adults (18-70 years old) filled The Cyberchondria Severity Scale (CSS, McElroy, Shevlin, 2014), checklist of activities about health online, Scale for Assessing Illness Behavior (Rief et al., 2001), Cognitions About Body and Health Questionnaire (Rief et al., 1998).

Compulsion, Distress, Excessiveness, Reassuarance Seeking scales are related to various health-related activities online including both specialized (medical web-sites) and non-specialized (Wikipedia) ones (r=.25-.48, p<.01). Compulsion is closely related to surfing in social networks (r=.41, p<.01), excessiveness – to viewing of illnesses-related pictures (r=.48, p<.01) and reassurance seeking – to reading of online reports (r=.47, p<.01). Cyberchondria is related both to health anxiety (r=.37), hypochondriac behavior (r=.19-.41), beliefs about autonomic sensations, bodily weakness, intolerance to sensations and somatosensory ampliphication (r=.25-.31).

In general population, different aspects of cyberchondria seem to reflect health anxiety and hypochondriac beliefs but are differently related to different forms of online behavior including use of more or less specialized web-sites. Research is supported by the Russian Foundation for Basic Research, project No. 20-013-00799.

There has been an increasing amount of research examining the addictive nature of self-harm (non-suicidal self-injury). One such area of research has examined if themes related to addiction are present in self-harm board postings on imessages. Recent research from the UK suggests that such themes are evident.

The present aim was to build on previous research to examine if themes of addiction are present in other cultural contexts.

A sample of 254 online postings from a self-harm discussion forum on a Russian Internet message board were translated, extracted, read, and re-read before being coded using inductive content analysis to identify themes.

Five themes were extracted and labelled: “Relationships with Family and Friends”, “Self-Blame and Hatred”, “Ongoing Battle”, “Positive affect”, “Other Mental Health Problems Difficulties”. These themes are somewhat similar to those found within messages in a UK based self-harm forum.

The present findings, obtained from Russian respondents, provide further evidence demonstrating that repetitive self-harming seems to have addictive aspects.

Clozapine is the most effective antipsychotic for treatment resistant schizophrenia but adverse reactions to clozapine include neutropenia. Patients with COVID-19 infection frequently experience lymphopenia, but not neutropenia.The impact of clozapine treatment in the presence of COVID-19 is unknown

Show 2 cases of neutropenia in patients treated with long-term clozapine during COVID-19 infection.

Subjects: 48 admitted patients to a long-stay psychiatric unit. COVID-19 infection confirmed by positive nasopharyngeal swab for viral ribonucleic acid of SARS-CoV-2. Hematological controls between March and April 2020.

16 patients (33%) treated with clozapine.18 patients (37’5%) had COVID-19 infection, of which 5 (10’4%) were treated with clozapine; 2 presented neutropenia. 1- 56-year-old woman diagnosed with schizophrenia on clozapine since 2009. Begins to have a dry cough and fever with positive COVID-19 swab (day 0). Slight leukopenia without neutropenia was observed on day 1. On day 7, neutropenia was observed with an absolute neutrophil count (ANC) of 1100. We decided to suspend clozapine and to initiate daily hematological controls. The ANC on day 8 was 970. Over the next few days the ANC will progressively improve until neutropenia resolved (day 22). 2- 55-year-old woman who required a transfer to a general hospital because of respiratory complications from COVID-19. She presented significant leukopenia (1’01x 10^3/uL) and neutropenia (ANC 100). Clozapine was not withdrawn. She was treated with granulocyte colony-stimulating factor.

An urgent full blood count will be required to exclude neutropenia with appropriate action. Further research will be needed to clarify the possible relationship between COVID-19, clozapine and neutropenia.

No significant relationships.

No significant relationships.

The COVID-19 pandemic has had an unprecedented influence on the global economy and population health. Vigorous, well-designed studies with complete, long-term follow-up of high risk groups including COVID-19 patients, their families and frontline workers are imperative for a comprehensive understanding of the mental health impact of the pandemic. The Nordic-Baltic national registries and biobank resources provide a unique opportunity to gain critical insight into the interplay between mental and somatic health during the COVID-19 pandemic. The COVIDMENT consortium leverages an extensive research experience and infrastructure from ongoing collaborations between four Nordic countries and Estonia, including national registry resources (est. >24 million individuals) and new COVID-19 cohorts with questionnaire data (est. > 220.000 individuals), to significantly advance current knowledge of mental morbidity trajectories in the COVID-19 pandemic. This program will address the following specific aims: 1) The role of preexisting psychiatric disorders in subsequent risk and progression of a COVID-19 infection. 2) The impact of COVID-19 on short and long-term psychiatric sequel among COVID-19 patients, their families and frontline workers. 3) The impact of the COVID-19 pandemic on population mental health by the varying mitigating responses and corresponding COVID-19 related mortality rates across 4 Nordic countries and Estonia. These data sources and research plan, along with preliminary results will be presented.

No significant relationships.