The Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) introduced severity indices for Eating Disorders (ED).

This study assessed in a male ED sample the DSM-5 severity indices for Anorexia Nervosa (AN), Bulimia Nervosa (BN) and Binge Eating Disorder (BED) and compared them to an alternative transdiagnostic drive for thinness (DT) severity category and a combined DSM-5/DT severity categorization

178 males with EDs were classified using: a.) a DT categorisation based on the EDI-2 DT subscale; b.) the DSM-5 severity categories for AN, BN and BED and c.) a combination of the DT and the DSM-5 severity categorisation. These severity classifications were then compared based on psychopathology and personality.

For the DSM-5 severity indices, the “mild” category was most prevalent for AN and BN, and the “moderate to extreme” group for BED. For the EDI-2 DT severity classification, the “mild” category was overrepresented in all subtypes. For the combined DSM-5/DT categorization, the “mild combined” severity group was the most prevalent for AN, while for BN and BED the “severe/extreme” combined group was most prevalent. Clinically significant findings were strongest for the DT categorization followed by the combined DSM-5/DT approach. Almost non-significant findings were revealed for the DSM-5 severity categories for all ED subtypes. These findings were most pronounced for AN and BN and almost non-existent for BED.

Our findings provide support for DT as an alternative transdiagnostic severity category for EDs in males that may be more meaningful than the DSM-5 severity indices for AN and BN, but not BED.

No significant relationships.

Psychiatric emergency visits have with associated with seasonal pattern that reflect psychosocial factors. Its knowledge could proving valuable insight about help seeking behaviour of patiens suffering with mental illness.

Our aim was to analyse weekly and monthly seasonality

Daily urgency visits were extracted from electronic medical records of Hospital Universitario La Paz from 1st January 2019 to 31st December 2019. A poisson multivariate model was performed with day of the week and month as covariates. Predictive margins were estimated

Psychiatric emergency visits were less frequent in Saturday and Sunday (5.5 visits per day) than weekdays (7.5 visits per day). Not differences were observed among months.

A weekly season pattern was observed with less psychiatric emergency visits during weekends.

No significant relationships.

No significant relationships.

Substance use disorders (SUDs) are estimated to affect around 30 million people worldwide, and are characterized by repeated use of a substance that leads to clinically significant impairment or suffering, making it a serious health problem, with high associated costs.

Understand and evaluate the impact of cannabis use on adherence to treatment in young patients with psychosis.

Narrative literature review by performing a search on MedLine for English-written articles. The query used was “(Cannabis) AND (Schizophrenia OR Psychosis) AND (Adherence)”.

About 70 to 80% of young people with SUDs have at least one concomitant psychiatric disorder and cannabis is involved in approximately 50% of psychosis or schizophrenia of those cases, so there is a growing concern about the deleterious medical and psychiatric consequences of the increase and early initiation of consumption of this substance. It is estimated that about 26% of patients with psychotic conditions do not adhere to the treatment plan established by the psychiatrist; however, especially during the inaugural phases of psychotic disorders, rates of non-adherence to therapy are high (above 50%), and are said to be higher in younger patients.

The risk of relapse after a first psychotic episode is high. As the use of cannabis is a potentially preventable risk factor, interventions aimed at improving therapeutic adherence in psychotic conditions must specifically target the use of this substance, since reducing its consumption can lead to a more favorable course of the disease and at less expensive costs in addressing these pathologies.

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,

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.

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

Efficacy of lithium is well documented in the literature, making it the gold standard treatment. However, its use declines with the advent of anticonvulsants. This raises the question about monitoring of mood stabilizers in practice.

The aims of this study were to determine the prophylactic lithium response in patients followed for bipolar disorder and compared to those of anticonvulsants and assess the mood stabilizers monitoring procedures in clinical practice.

A retrospective study was conducted, over a period of six months, with patients followed for bipolar disorder stabilized under the same mood stabilizer (lithium or anticonvulsant) for at least one year. The participants were divided into two groups according to the mood stabilizing treatment. The two groups were compared according to socio-demographic, clinical and evolutionary profiles as well as the prophylactic response to treatment.

Patients included were 64 in the study, 28 received lithium and 36 received anticonvulsants. The socio-demographic profile and clinical characteristics were similar in two groups, except for the average total number of mood episodes. Retrospective evaluation of the prophylactic response by ALDA scale showed a significantly higher mean total score in patients receiving lithium (5.9 ± 2.8 versus 2.58 ± 2.4, p = 0.025).). Ten of them were in compliance with the recommendations; while 19.44% received anticonvulsants had all the monitoring parameters within the recommended time frame.

Thymoregulators significantly modify the disease’s prognosis. Practitioners will attach particular special attention to distinguish the therapeutic efficacy of the side effects which are numerous and sometimes serious.

The rapid spread of coronavirus has forced the healthcare systems in Tunisia to reorganize its structures, thus mobilizing all caregivers. Their professional and emotional burden was put to the test.

To evaluate the level of anxiety and to study coping strategies among caregivers during this pandemic.

A cross-sectional descriptive and analytical study among150 caregivers in two hospitals in Sfax in Tunisia; during April 2020. We used anonymous questionnaire, the Spielberger State Anxiety Scale(STAI) to assess tension felt at anxiety-producing situations; and the Coping Inventory Scale for Stressful Situations (CISS): to assess coping strategies.

The average age was 30.33± 6,93 years and the sex-ratio M/W = 0,29. Caregivers followed the news of this pandemic with these means of communication: 96% Facebook, 80%TV. The increase of the time spent in front of media:84% Sleep disorders were present in 64.7%: insomnia (36%), chopped sleep(34%). Caregivers used sleeping pills in 12% of case. STAI: The mean ascore =48.85 and a high anxiety level was noted in72% of case. CISS: Task-oriented coping strategies : a mean score= 47.90 and Emotion-centered coping : a mean score = 40,49 High anxiety was correlated with: age>40 years old (p=0.042). The increase of the time spent in front of media, chopped sleep and use of sleeping pills are correlated respectively (p= 0,043, p=0,003, p=0,003) with an emotionally focused coping strategy.

Health professionals had a painful psychological experience with significant anxiety. Strengthening prevention strategies, management of health crises should be a priority of our health-system.

Lock-down restrictions were introduced in most countries of the world at the onset COVID-19 pandemic. It was associated with serious implications for healthcare delivery, with affectation of access to medical services for patients with chronic medical conditions. It is important to assess the impact of this on the subjective feeling of mental wellbeing in these patients.

This study aimed to assess the access to health care services during the lock-down as well the perceived affectation of the mental, physical and social wellbeing and their related factors in patients with chronic illnesses in Ilorin.

This study was a cross-sectional study, involving 166 patients being managed for different chronic medical conditions, attending the Medical Outpatient Clinics of the University of Ilorin Teaching Hospital. A socio-demographic questionnaire and a structured questionnaire designed by the researchers was used.

The mean age of all respondents was 49.5+18.5. 25.3% of respondents were being managed for heart-related conditions. 54 respondents(32.5%) reported a negative affectation of their mental wellbeing, which included changes in mood, sleep pattern and feelings of being overwhelmed and unable to cope properly. The age (p= 0.031) and employment status(p=0.015)of the patient were significantly associated with a subjective feeling of negative affectation of wellbeing.

The impact of the COVID-19 pandemic lockdown on the mental well-being of patients with chronic medical conditions is significant and calls for a more strategic plan for delivery of health care services during pandemic situations with focus on the mental well being of patients.

No significant relationships.

Depression and anxiety are recognized as common psychiatric complications of stroke, yet little is known about their clinical correlates and their impact on functional outcome.

To assess the prevalence of anxiety and depression during the first year post-stroke; To determine their relationships with clinical and functional variables.

We conducted a cross-sectional study, which included 147 patients, followed for stroke that had occurred over the past year. We used the HAD scale in its Arabic version for screening for anxiety and depression and the modified Rankin scale to assess the degree of disability due to stroke.

Anxiety was detected in 55.1% of patients and depression in 67.3% of them. These emotional disturbances were more common during the first six months post-stroke. Depression was more common among male gender (p=0.003). Older age and more than secondary educational attainment correlated with post-stroke anxiety (p respectively 0.013 and 0.002). Post-stroke anxiety and depression were significantly more common in case of infarcts involving the territory of the Sylvian and the anterior cerebral artery (p respectively 0.01 and 0.001). Depression was significantly associated with the presence of motor deficit on the initial neurological examination (p<0.001) and subsequent neurological sequelae (p<0.001). Anxiety and depression were significant predictors of functional disability during the 12 months post-stroke (p=0.007).

Anxiety and depression impair functional ability after stroke. These data may help identify the patients at greatest risk of poor emotional outcomes and thus help in planning appropriate interventions.

Recent studies reported very high cumulative risk for a patient who had cannabis-induced psychosis to be diagnosed with a schizophrenia spectrum disorder.

We aim to compare sociodemographic and clinical characteristics, treatment and discharge plan in cannabis-induced first psychosis episode (CI-FEP) vs. multiple cannabis-induced psychotic episodes (CI-MEP) inpatients.

Retrospective observational study of inpatient episodes with a discharge diagnosis of cannabis-induced psychosis between January 1st, 2018 and December 31st, 2019 in the Psychiatry Service of CHUSJ. Descriptive analysis of the results was performed using the SPSS software, version 26.0.

Our sample included 61 inpatients, 19 (31.1%) with CI-FEP and 42 (68.9%) with CI-MEP. CI-MEP group had a median of 1±0,234 previous hospital admissions. CI-MEP group has 10,0 higher odds of being discharged in outpatient compulsory treatment (CI 95% 1,21-82,50, p=0,013) and 6.0 odds of being treated with long-acting injectable antipsychotics (LAIAP) (CI 95% 1,79-20,31, p=0,002) when compared to CI-FEP group. Having multiple cannabis-induced psychotic episodes was associated with future admissions to psychiatry unit (OR 4,85 (95% CI 1,23-19,15, p=0,018). We found no statistically significant differences regarding the sociodemographic and clinical characteristics, use habits and discharge plan between the two groups.

Patients with multiple psychotic episodes due to cannabis use are more likely to have a LAIAP prescription, be discharged in compulsory outpatient regimen and be readmitted in to psychiatric inpatient unit. Considering the prevalence of CI-MEP and the risk of chronicity, we need integrative treatment programs to address the specificities of these patients.

The COVID-19 pandemic has become a major challenge for both the overall health system and the individual ability for health professionals to stress coping.

To find the link between the perception of danger from coronavirus and the severity of burnout syndrome in medical workers during the COVID-19 pandemic in Russia.

We used a socio-demographic questionnaire (20 questions), a Stress Perception Questionnaire (Linville, 1987; Ababkov et al., 2016), a Modified Pandemic Perception Questionnaire (Broadbent et al.,2006;Yaltonsky et al., 2017), and Maslach Burnout Inventory (Maslach et al., 1996; Lozinskaya et a. 2007). 249 medical workers (58 men and 191 women) took part in the online survey between April 27 and October 26 in Russia.

The severity of stress is positively correlated with the perception of pandemic as threatening (r=0.532, p=0.000) and unknown disease (r=0.297, p=0.000). Stress severity also correlates with all burnout parameters: exhaustion (r=0.737, p=0.000), depersonalization (r=0.342, p=0.000), and belief in personal achievement (r=-0.417, p=0.000). The perception of pandemics as threatening events is significantly associated with exhaustionm (r=0.458, p=0.000), depersonalization (r=0.133, p= 0.036), and belief in personal achievement (r=-0.152, p=0.016).The feeling of uncertainty from the pandemic is statistically significantly associated with exhaustion (r=0.242, p=0.000), while the feeling of control over the pandemic is positively associated with belief in personal achievements (r=0.129, p=0.042) and negatively associated with exhaustion (r=-0.161, p=0.011) and depersonalization (r=-0.125, p=0.049).

Uncertainty and a sense of threat from the coronavirus and the pandemic are significant factors of stress and emotional burnout for health workers. To determine the interaction between parameters such as signs of burnout, perception of the COVID-19 pandemic and the severity of stress, further construction of a structural model is required.

Suicide is one of the most common causes of death among young people worldwide. Adolescence is an important developmental period of life due to the increased risk of suicide and the prevalence of psychiatric disorders.

To explore the suicidal ideation, intentions and risk factors of adolescents.

A clinical case study presentation will be performed.

An adolescent female, aged of 16 years old, was admitted to the Department of Psychiatry for Children and Adolescents of a General Hospital, diagnosed with behavioral and emotional disorder and active suicidal ideation on ground of sexual abuse. During her hospitalization, she exhibited self-destructive behaviour by swallowing objects or causing extensive skin scarring as well as serious suicide attempts by hanging. Her emotional and behavioral status was unstable and unpredictable. The adolescent had repeatedly expressed her will to escape from an unbearable life.

The results of the presentation of our clinical case could contribute to the improvement of awareness regarding suicidal behavior in adolescence, which might have a significant effect on the prevention and treatment of this potentially lethal condition.

No significant relationships.

On February 26, 2020 the Greek government established measures against the spread of COVID-19, which eventually escalated to the entire social and economic ‘lockdown’ of the state on March 23. The main message was staying home and protect the eldest who are more vulnerable to the virus.

The aim of the present study was to test the effect of living with a vulnerable person to specific psychological factors in order to be able to create future interventions for psychological well-being of the population.

A convenient sample of 1,158 Greeks (280 males [24.2%] participated electronically during the ‘lockdown. A battery of questionnaires for stress resilience, acute stress, and satisfaction with life, well-being and effect on psychosocial health was used for the study. Analysis was performed with SPSS 24.

Individuals living in the same house with a vulnerable partner of parent were found to have statistically significant higher levels in acute stress disorder (Μ=39,4±15,4) than those living without (M=37.7±15.5) (t1156=2.125 p=0.03)The same happened with the effect on psychological health with the first Group having significantly higher score in the questionnaire (M=76.6±56,9) than the second group (M=69.1±55.1) (t1156=2.330 p=0.02). Stress resilience, satisfaction with life and well-being were not affected.

According to our data individuals living in the same house with a vulnerable person for COVID-19 are more likely to develop acute stress and psychosocial impact. Stress reduction programs are needed in order to help this population with managing the results of the lockdown.

No significant relationships.

The 2019 Coronavirus disease epidemic is a public health emergency of international concern and poses a challenge to psychological resilience.

To study the psychological repercussions in terms of anxiety and depression of the Coronavirus pandemic on the Tunisian population.

This was a cross-sectional, descriptive and analytical study. We used an online questionnaire on Facebook, on June 2020. The heteroquestionnaire included epidemiological data and two scales: the State-Trait Anxiety Inventory (STAI Form Y-1) to evaluate the anxiety level at the time of the study, and the Patient Health Questionnaire (PHQ 9) to detect a characterized depressive episode.

We included 121 participants. They had an average age of 36.52 years with a sex ratio (M/F) of 0.41. The mean STAI score was 43.12 while the PHQ score was 7.46, indicating that 30.8% of the participants suffered from depression. Both scores were correlated to female sex (p=0.01 for STAI and p=0.02 for PHQ), a history of anxiety (p<0.001) and depressive disorders (p<0.001) and to poor sleep quality (p<0.001). The STAI score was also associated with a family history of high blood pressure (p=0.004), while the PHQ score was correlated to a family history of diabetes (p=0.02), a widowed or divorced marital status (p<0.001) and to a single lifestyle (p=0.03). Furthermore, the two scores (STAI-Y and PHQ 9) were also associated (p<0.001; r=0.67).

The psychological impact of Coronavirus epidemic seems not negligible requiring psychological interventions to improve the mental health of vulnerable groups.

Recently, the seasonal pattern of bipolar disorder has been accepted, with the clinical, diagnostic, treatment and prognostic consequences that this entails. It is interesting to study its epidemiological characteristics, such as the influence of gender on this pattern.

To study the influence of gender in the Seasonal Pattern of Bipolar Disorder.

A systematic review was carried out by means of a bibliographic search in Ovid MEDLINE of articles published in the last ten years (2010-2020), using the following keywords: bipolar disorder, seasonal pattern and gender: Those studies carried out in patients who presented a seasonal pattern were selected, and the influence of gender on this was studied.

The initial search showed a total of 92 articles, of which 7 met the inclusion criteria. It was found that, indeed, gender influences both the clinical characteristics and the course, management and prognosis of the seasonality of bipolar disorder.

The diagnosis of the Seasonal Pattern in Bipolar Disorder continues to be an important challenge. Women more frequently present PE, associated with manic, depressive or mixed episodes, while men in depressive episodes. Men are more frequently associated with Bipolar Disorder type II and depressive episodes, and women with rapid cycling and eating disorders. Male manic episodes are associated with psychotic symptoms, and with greater severity in admissions. Women have a higher risk of Seasonal Pattern than men, with the clinical and prognostic repercussions that this entails.

The first description of syphilis was made in Europe around the year 1493, and although perceived as a disease relegated to its historical importance, recent studies demonstrate that the prevalence of these infections is on the rise. Spanning decades after initial infection, 30% of affected individuals without treatment may develop tertiary syphilis, which includes neurosyphilis. Its notoriously “chameleon-like” presentation implies the necessity to not overlook neurosyphilis as a differential diagnosis in psychiatric settings.

Case report study and discussion.

The authors present a case of affective and psychotic symptoms (including auditory and visual hallucinations and persecutory delusions) of rapid onset in a 61-year old woman without prior psychiatric history. A clinical investigation was conducted, which subsequently revealed a positive Venereal Disease Research Laboratories (VDRL) test. A lumbar puncture was performed and cerebrospinal fluid analysis confirmed neurosyphilis.

Steady improvements in initial psychopathological manifestations were noted after completing recommended treatment for neurosyphilis. After discharge, the patient was medicated with an antidepressant and antipsychotic, demonstrating a complete return to baseline mentation and functionality on follow-up.

This case demonstrates the vital importance of considering syphilis in our differentials, especially due to the wide range of manifesting psychiatric symptoms. Although considered a disease of the past, this case reminds us that syphilis remains present in our society and its timely diagnosis and treatment can ameliorate the debilitating psychopathological manifestations of the disease. Due to the potential difficulties in identifying this great imitator, routine screening tests are still recommended in the psychiatric setting.

Pandemic are known to generate traumatic events, such as job losses or violence [1]. Several studies have shown that epidemics and related health measures (quarantine, confinement) lead to an increase of acute stress disorders (ASD), post-traumatic stress disorders (PTSD), anxiety and depression in the adult population [2]. In the pediatric population, few studies have been carried out on the psychiatric outcomes during and after epidemics and associated measures [3].

The aim of this study was to explore ASD symptoms during stay-at-home and Covid 19 pandemic and its impact on children and adolescent mental health.

Sixty participants (53% girls and 47% boys; mean age= 9 years 5 months) were included in this longitudinal study [4]. The measures consist in an emergency semi-directed interview designed to assess symptoms of ASD according to the age of children.

Patients’ age modulated psychiatric outcomes. Children under the age of six shown more developmental regressions and more restlessness than older ones. Children from 6 to 12 years were characterized by more oppositional behaviors than adolescents. Finally, adolescents were characterized by more social isolation than younger ones. Other symptoms appear to be more stable across ages: sleep disturbance, fear behavior and somatization.

Young children experienced more externalized symptoms (opposition and agitation) and developmental regressions than older children [5]. Thus, it appears necessary during pandemic to take into account the psychiatric consequences of confinement to reduce psychosocial long-term outcomes in particular in younger patients who appeared to develop specific and age-related psychiatric disorders.

Major mental disorders have typically a complex aetiology where both genetic and environmental risk factors have been implicated. It has also been suggested that these risk factors could be interactive rather than just additional. In the last decade, large genetic studies have began to unravel the genetic architecture of several of these disorders. While the mechanisms of action of environmental risk factors are still unclear. At the molecular level, gene expression can be regulated at the epigenetic level, e.g. chromatin modifications or DNA methylation. Epigenetic modifications can be affected by both genetic variations as well as environment variations. In this presentation, we will review recent results either from literature or from own data on how several known environmental risks for mental disorders can be associated with modifications of epigenetic markers, especially in DNA methylation. We will for instance look at the modifications associated with smoking, alcohol, cannabis, childhood trauma or obstetric complications. We will discuss also the limits of these studies and how epigenetic modifications can be relevant for the onset of mental disorders and their treatment.

No significant relationships.