In France about 10,000 suicides/year are recorded. General practitioners (GPs) have an important role in prevention, with consultation rates between 20% and 76% the day preceding suicide. StopBlues is an application/website for primary prevention of suicide in the general population. Its promotion was supported by municipalities and involved GPs.

To evaluate how the involvement of GPs in the promotion of StopBlues had an impact on its utilization.

StopBlues was promoted in 25 French municipalities randomly assigned to a ‘basic’ promotion group organized by municipalities only or an ‘intensified’ promotion group that also includes promotion in GPs’ waiting rooms. StopBlues users were asked how they found out about StopBlues. After two years, an ad hoc questionnaire was sent to all GPs (N=2,111).

StopBlues users from those municipalities (N=885) were 16% to learn about StopBlues from GPs, 93% of them living in municipalities with ‘intensified’ promotion. In the ‘basic’ group, where no GPs have heard about StopBlues, 15% would like to know more about it/will have a look at it and 8% will use it and recommend it to colleagues. Half of GPs from the ‘intensified’ group had heard about the program, with 24% who recommended StopBlues to some patients. 21% of GPs agreed that they will use it and recommend it to colleagues.

Involving GPs in the use of e-health tools is of major interest to improve their utilization. Our results show that GPs are in need of those in dealing with patients with psychological pain/distress.

No significant relationships.

No significant relationships.

Psychiatric Patients Admissions in Mental health Service of Treviso (Italy) were compared from 2013 to 2017. Trends of Admissions take onto consideration, the presence of Menthal Health Service for Outpatients Care.

To point out the distribution of Diagnosis made in Different Years for different patients ages.

For every patient has been considered the following date : Sex, Age, Marital State, Profession, Psychiatric Diagnosis, Days of Admission, Geografic Origin and KInd of Admission (Voluntary / Involuntay).

It is noticeable the different percentage of Psychiatric Diagnosis in 2013 rather than in 2017. In 2017 it happened a more amount of Psychiatric Admission of Subjects with Substance Addiction Related Disturbs (Alcool included) and Atypical Depression Sindrome and Borderline and Cluster B Perrsonalòity Disorders. Lower amount instead was verified for Diagnosis of Schizofernia, Neurosis and Oligofrenia. Beside it was noticed, an earlier onset of Psychotic Sindrome in Young people often related with Substance Abuse. In the 2017 besides was lower the amount of Involuntary Admission (T.S.O. in Italy) compared with 2013.

Different distribution of Diagnosis is explained by the Evolution Diagnosis Orientation (from D.S.M. IV to I.C.D. 10) About the increased Diagnosis of Substance Addiction Disturbs and Younger age of same subjescts seems caused by a different treatment’s Strategy with brief selective Admissions. Furthermore lesser Involonary Admission seems due to best knowledge of every patients. The most of Theese were indeed already known by Ambulatory Outpatient Mental Health Service.

22q11.2 Deletion Syndrome (22q11.2DS) represents a congenital syndrome with several clinical features. It entails a 25% risk of psychotic onset in lifespan. 22q11.2DS is a reliable model for biological vulnerability to schizophrenia.

With the hypothesis of similar impairments in schizophrenia and 22q11DS, to investigate a possible correlation between Social Cognition (SC) and Interpersonal Functioning (FU).

Sample consists of 1735 adults: 893 schizophrenic subjects (SCZ); 18 with 22q11.2DS and psychosis (DEL_SCZ); 44 22q11.2DS individuals (DEL); 780 healthy controls (HC). SCZ and HC data come from a multicentric study by Network for Research on Psychoses. SC was assessed with The Awareness of Social Interference Test (TASIT, consisting of three sections: T1= Emotion Recognition; T2=Minimal Social Inference; T3=Social Inference Enriched). The Specific Levels of Functioning (SLOF) interview was employed.

DEL_SCZ (p<0.001) and SCZ (p<0.001) showed impairments in each TASIT sections compared to HC. Significant deficits in interpersonal functioning area were found in SCZ (p<0.001) compared to HC. The interpersonal functioning domain showed a positive correlation with SC in HC (T1: r=0.097; p<0.001; T2: r=0.120; p=0.001; T3: r=0.121; p=0.001); DEL (T1: r=0.380; p=0.024; T2: r=0.466; p=0.005) and SCZ (T1: r=0.113, p=0.001; T2: r=0.110, p=0.001; T3: r=0.134; p<0.001).

SC deficits both in subjects with 22q11.2DS and in people with schizophrenia suggest a role of endophenotypes. SC is directly correlated to interpersonal functioning in 22q11.2DS without psychosis and people with schizophrenia. DEL_SCZ may suffer from deeper cognitive and symptomatic conditions that both impact differently on FU.

Inflammation is now known to be a key factor in the development of schizophrenia. In this regard, the study of the pathogenic role of inflammation in the early stages of schizophrenic process is of particular importance, making it possible to assess its activity and to predict the development of the disease.

To compare the dynamics of inflammatory markers in blood of first-episode psychosis (FEP) patients and people at risk signs for schizophrenia in the course of the treatment. Juvenile depression (JD) with attenuated symptoms of schizophrenic spectrum (ASSS) was investigated as a risk group.

The patients aged 17-25 years (20 people, of which 10 FEP patients (F20) and 10 JD with ASSS ones (F32.1-2, F32.38, F32.8)) were examined at admission to the hospital and at discharge. The controls consisted of 10 healthy volunteers. Symptom severity was collected using PANSS, SOPS, SANS, HDRS. The inflammation markers (TNF-α, IL-6, IL-10, leukocyte elastase (LE), CRP, α1-proteinase inhibitor (α1-PI), anti-S100-beta antibodies) were determined in blood.

An increase of inflammatory markers in both groups compared to controls was found (p<0,05). The highest values of IL-6, LE, CRP, α1-PI and anti-S100-beta antibodies in FEP patients were revealed (p=0,03). After the treatment, the positive trend of inflammatory markers in FEP patients (p<0,05), but not in JD with ASSS patients was detected (except LE activity, p<0,05).

The results confirm the pathogenic role of inflammation in the development of endogenous mental disorders. The inflammatory markers studied reflect the activity of the pathological process in the early stages of schizophrenia.

No significant relationships.

Preliminary results indicate that COVID-19 lockdown measures could lead to an increase in eating disorder pathology. However, some patients could be more vulnerable to experience such an increase than others. The reason why some patients are more susceptible to the impact of lockdown measures is still not known.

To analyze the impact of the Belgian COVID-19 lockdown measures on the surroundings, social context, negative affect (NA), positive affect (PA) and binge eating frequency of patients with bulimia nervosa (BN).

The data of 15 female patients with BN from an ongoing experience sampling method study were analyzed. Mixed effects models compared surroundings, social context, NA, PA and binge eating before and after the implementation of the lockdown measures.

After the implementation of the lockdown measures, significant changes in surroundings and social context were found as well as an increase in NA (p < 0.001) and decrease in PA (p = 0.015). Patients who experienced an increase in binge eating frequency also experienced a stronger increase in NA (p = 0.012) and decrease in PA (p = 0.026) after the lockdown measures were implemented.

Future research should also look at changes in surroundings, social context, affect and how these interact with factors such as personality traits and coping styles when investigating why some patients are more susceptible to the negative effects of lockdown measures than others.

Much has been written about psychosocial treatments (psychoeducation) in schizophrenia. However, for the psychiatric hospital as an organization wishing to create a service guided by an international wave of research there is a need for solutions which are practical and effective in addressing the gender issues and women patients’ needs.

This paper looks at and describes the process employed to develop a guidance document to enable the psychoeducation to provide information and to offer support to its women patients (pre- and post- menopausal age) in dealing with schizophrenia. Essential to this project was the understanding that the guidance would be easy to understand and practical whilst maintaining its strong foundation of research and good practice.

Women patient profile in a schizophrenia group hospitalized at the Moscow-based Psychiatric Hospital was analyzed.

Females of pre- and post- menopausal age actually outnumber males. Such women patients are unique in their needs and demands for health services. This is important subgroup, and some psychosocial interventions should be developed for them. Mental health professionals should be familiar with the unique health problems of these women, and the potential that psychoeducation have to increase their health awareness (information on menopause and aging, oestrogens and depression, on other somatic and psychological influences around menopause, on effects of physical activity etc.).

The implications of this guidance document to enable the psychoeducation for mental health promotion are discussed, in particular the gendered nature of perception of psychosocial treatments in schizophrenia.

The familial financial situation and its perception can be an important factor in the subjective well-being of adolescents, affecting their physical health and psychological state.

To identify the correlation between the perception of the familial financial situation, the physical health and various aspects of the psychological state of adolescents were self-assessed.

The study involved 506 adolescents (217 males and 289 females) aged 14 to 18 years (M=16.46; SD=1.07). We analyzed the relationship between participants’ assessment of their family’s financial situation, its changes over the past three years, and the adolescents’ self-report on their physical health, stress experiences, and feelings of happiness.

Perception of the financial situation (r=0.316;p<0.001) and assessment of its changes (r=0.217;p<0.001) are directly related to the self-assessment of physical health for the entire sample, as well as separately for boys and girls. For the entire sample, there were no links between the perception of the financial situation and the experience of stress and happiness. However, the study of relationships with gender as an independent variable showed that in boys, the financial situation score is associated with feeling happy (r=0.189;p=0.005), and in girls, an inverse relationship was found between the perception of a worsening financial situation and the experience of stress (r=-0.242;p<0.001).

The perception of the financial situation by adolescents affects the self-assessment of physical health by both boys and girls, but affects different aspects of the psychological state, depending on gender. The research was supported by the Russian Science Foundation, with the grant 15-18-00109.

Burnout syndrome concerns 27.8% of the general working population against 37% among doctors.

This study aimed to report the prevalence of burnout among health care professionals in medical oncology in Tunisia.

This was a cross sectional study including health care professionals in medical oncology working in public hospitals in Tunisia. It was carried out from 15 January 2019 to 15 June 2019. Health profeessionals were asked to answer the Maslach –Burnout Inventory Test. Three scores allowing to locate the burn-out state of the person: the Score of emotional exhaustion (SEE), the Depersonalization score (SD) and the Score of personal achievement at work (SAP).

Le taux de participation était de 58,3%. La combinaison d’un SEE élevé, d’un SD élevé et d’un SAP bas définit le syndrome de Burn-out. Le SEE était élevé chez 44 travailleurs (63%), indiquant un épuisement émotionnel sévère. Un SD élevé a été trouvé chez 37 répondants (53%). La majorité des participants (59%) avaient un PAS faible. Le burnout est défini par l’association chez la même personne d’un épuisement émotionnel élevé, d’une dépersonnalisation élevée et d’un faible rendement personnel. Cela a été trouvé chez 15 des participants (21%). Selon l’étude analytique, le sexe féminin était significativement associé à un SEE élevé, un SAP bas et un épuisement global. Le travail de nuit était significativement associé à un degré élevé de dépersonnalisation et à un degré élevé d’épuisement général.

Burnout is linked to an increasingly ergonomic load. Health care professionnel, particularly in oncology, are frequently faced to this syndrome.

The data on gender differences in mental health make the investigation of the specific impact of the pandemic and of the stay-at-home orders on men and women relevant.

The study focuses on the quality of the relationship in couples and mental health in men and women during the COVID-19 pandemic.

The study was conducted through an online survey a few weeks after the pandemic was declared and the stay-at-home order was introduced in Russia. 274 participants (50 men and 224 women) engaged in long-term relationships aged from 18 to 62 (M=34.2; SD=9.1) took part in the research. The instruments included the Warwick-Edinburgh Mental Well-Being Scale, the Perceived Relationship Quality Components, and the Depression Anxiety Stress Scales.

Women show a considerably higher level of stress (t=3.805; p<0.001), depression (t=3.76; p<0.001) and anxiety (t=2.959; p=0.003). The quality of relationship for women is significantly connected with mental wellbeing (r=0.423; p<0.001) and negatively correlated with the stress level (r= -0.60; p<0.001), depression (r= -0,381; p<0,001) and anxiety (r=-0,313; p<0,001). Meanwhile for men, the quality of the relationship is connected to mental wellbeing (r=0.280; p=0.049), opposed to stress levels (r= -0.316; p=0.025) and is neither connected to depression (r= -0.210; p=0.144) nor to anxiety (r= -0.126; p=0.383).

During the pandemic, a favorable partnership has a positive effect on the mental health of both men and women. However, while the relationship quality affects all investigated indicators of mental health in women, in men the relationship quality is only connected to the level of mental wellbeing and stress. The reported study was funded by RFBR, project number 20-04-60174.

No significant relationships.

Converging evidence substantiates a negative impact of the COVID-19 pandemic on the mental health of frontline workers. Nonetheless, there is paucity of research on paramedics.

To estimate the prevalence of stress, anxiety and depression in frontline paramedics in the Athens region, Greece, and to investigate the coping skills that are associated with less favourable mental health outcomes

A total of 100 ambulance paramedics participated in the study. The online questionnaire encompassed the DASS-21 for assessing mental health outcomes and the Brief-COPE for measuring coping skills. Information about socio-demographic characteristics and personal/relatives’ vulnerability to COVID-19 was also gleaned.

The prevalence for moderate to severe cases was found to be 7.2% for stress, 9.4% for anxiety and 11.3% for depression. Multiple linear regression analysis indicated that men demonstrated significantly higher stress [B = -2.28, 95%CI = -3.88 - -0.68] and depression compared to women [B = -1.69, 95%CI = -3.19 - -0.19]. Similarly, the use of denial was found to be associated with higher stress [B = 0.69, 95%CI = 0.11 -1.37] and anxiety [B= 0.55, 95%CI = 0.13 – 0.98]. Moreover, emotional support was linked to heightened anxiety [B= 0.71, 95%CI = 0.36 – 1.06] and self-distraction to depression [B = 0.60, 95%CI = 0.16 – 1.04]. Personal or relatives’ vulnerability to COVID-19 did not impinge on mental health outcomes.

Healthcare initiatives should be tailored at the mental health needs of frontline paramedics, especially men. Psychosocial interventions should target maladaptive coping, especially the use of denial.

The mental health impact of the COVID-19 pandemic is well documented. Portugal entered the emergency state on 19th march due to rising numbers of infected patients. The emergency state introduced regulatory measures that restricted people’s movements, applied a curfew, and closed most non-essential spaces and activities, such as shops and religious celebrations.

To evaluate the rates of suicides during the emergency state in Portugal.

We obtained the number of probable suicides during 19th march and 2nd may 2020, 2019 and 2018 from SICO/eVM (Real Time Mortality Electronic Surveillance). This system is used for health planning in Portugal and provides provisory data which is updated every 10 minutes. ExcelÒ was used for the statistical analysis.

During the Emergency State in Portugal there were 57 probable suicides. Comparing to the same period in 2018 and 2019, there were 62 and 70 probable suicides, respectively. Social isolation, anxiety, fear of contagion, chronic stress, and economic difficulties may lead to the development or exacerbation of depressive, anxiety, substance use, and other psychiatric disorders. Literature on suicides due to COVID-19 mention not only fear of infection, but also social isolation and distancing and economic recession as causes for suicide attempts and completions.

During the emergency state there was not an increase of probable suicides, compared to previous years. The greater vigilance of people’s movements may have deterred many attempts. However, policymakers and health care providers must be alert as the current psychosocial predispose to an increase in suicide rates.

No significant relationships.

Original compound ortho-fluorobenzonal, a barbiturate derivative, is shown to reveal strong anticonvulsant activity by means increasing GABA-mediation. Disturbance of GABA(A) -receptors functions play an essential role in both alcoholism and epilepsy pathogenesis.

Taking into account the presence of GABA(A)-receptors on the lymphocytes surface and involvement of immune system in alcoholism pathogenesis, we investigated ortho-fluorobenzonal effects on the immune and nervous systems functional activities in mice with chronic alcohol exposure to find new perspective pharmacological substances in the treatment of alcoholism.

(CBAxC57Bl/6) F1 male mice with 6-month 10% ethanol exposure were undergoing intragastric administration of original compound ortho-fluorobenzonal for 10 days. Animal’s alcohol consumption, behavior and immune parameters were estimated.

It was found that ethanol daily consumption decreased sharply starting from 2 days of ortho-fluorobenzonal administration and led to the cessation of ethanol consumption by the 4 day in mice with chronic alcohol exposure. Pronounced changes in motor and exploratory activities in “open field” test was registered in long-term alcoholized mice after 10- day course ortho-fluorobenzonal administration. The above behavioral changes were recorded against the brain cytokines synthesis modulation. We have shown also the modulation by ortho-fluorobenzonal of immune system functional activity, in particular, significant cellular and humoral immune response stimulation, estimated by the relative number of antibody forming cells and reaction of delayed-type hypersensitivity respectively.

Original compound ortho-fluorobenzonal has a positive neuroimmunomodulation effect that manifests itself in the correction of iimmune and behavior disorders caused by the chronic ethanol exposure, therefore, this compound is promising in the therapy of alcoholism

No significant relationships.

For treatment of CP patients multidisciplinary approach is often promoted. But it is not cost-efficient to involve all medical staff and variety of diagnostic/intervention tools for every patient.

Having knowledge on pivotal manifestations of CP and what are they related to would ease multidirectional approach in practice. It will shorten a search of pathologies only to those related to main manifestations related to quality of life.

611 children aged 2 to 18 years (mean age–6y5m) with CP(G80.0-G80.9): examined by 3 independent doctors. 56%males, 44%females. Randomized blinded assessment. Fine hand function assessed by “9-hole peg”,“Box and Blocks” tests, dynamometry. Intellectual functioning assessment was done using Raven Matrices. Quality of Life(QoL) assessment according to Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD). The intraclass correlation coefficient(ICC) was used for finding out discrepancies between observers. Inferencial statistics including 95%CI and P-value.

ICC coefficient between observers was highly reliable–0.93(95%CI:0.89–0.95). The mean QoL score for children GMFCS levels I and II was 58.5(SD 16.6), for GMFCS III, IV and V children–22.4(SD13.4). QoL was more related to fine hand functioning(r=0,344) than to cognition(r=0,295). There was a strong correlation bond between fine hand functioning and cognition (r=0,663). In case fine hand function improved positive changes in cognition were observed in 74% of subjects(p<0,05). Correlation between grasp power and IQ was weak(r=0,184). Grasp power improvement was slightly related to QoL(r=0,102).

Fine hand functioning improves QoL even more that cognition.So training of fine motor skills should be given a priority in case of limited rehabilitation resources.

No significant relationships.

Catatonia, a complex psychomotor syndrome and psychiatric emergency, is encountered across various psychiatric disorders. Most findings have been derived in the context of schizohrenia, warranting more comprehensive understanding in affective disorders.

To evaluate the longitudinal course of affective disorders presenting with catatonia and factors influencing the same.

Medical records of 439 patients presenting with catatonia to the psychiatry emergency from 2014 to 2017 were reviewed till June 2020. 135 patients with a final diagnosis of affective disorder (67 bipolar and 68 unipolar) were identified. Poisson regression and survival analysis were used for longitudinal data.

77.6% of bipolar patients were initially diagnosed under psychotic spectrum disorders compared to 3% in unipolar. Bipolar patients had a significantly younger age of first catatonic episode, earlier illness onset, and longer duration of illness. Survival analysis showed no significant difference between groups in time to recurrence of mood episode, readmission or catatonia relapse, with both groups demonstrating a greater likelihood of catatonia relapse in first 20 months. Poisson regression showed that bipolar patients had fewer catatonic relapses longitudinally over 2.5-6.5 years (RR: 0.64, CI: 0.43-0.96), but warranted more electroconvulsive therapy sessions for catatonic relapses (RR: 2.33, CI: 1.49-3.50), with fewer episodes resolving with lorazepam (RR: 0.62, CI: 0.40-0.95) compared to unipolar patients over same time period.

Bipolar disorders appear to have an earlier onset but fewer episodes of catatonia over illness course. Poorer lorazepam response and higher number of ECT sessions for catatonia resolution longitudinally suggest a differential treatment response of catatonia in bipolar disorder.

No significant relationships.

In bipolar patients cognitive deficits are an important feature. Persisting neurocognitive impairment is associated with low psychosocial functioning.

The aim of this presentation is to discuss potential cognitive, clinical and treatment-dependent predictors for functional impairment in bipolar patients.

In a first study (1) at the Medical University of Vienna 43 remitted bipolar patients and 40 healthy controls were assessed testing specifically attention, memory, verbal fluency and executive functions. In a randomized controlled trial, patients were assigned to two treatment conditions as add-on to state-of-the-art pharmacotherapy: cognitive psychoeducational group therapy over 14 weeks or treatment-as-usual. At 12 months after therapy, functional impairment and severity of symptoms were assessed. In a second, ongoing study, in-patients from a defined catchment area in Vienna (12th, 13th and 23rd district) were assessed via SCIP (Purdon S. 2005. The screen for cognitive impairment in psychiatry: Administration and psychometric properties. Edmonton, Alberta, Canada: PNL Inc.). The SCIP was performed before and after cognitive remediation. The effects of treatment on functioning were measured with the clinical Global Impression Scale (CGI).

Compared to controls, bipolar patients showed lower performance in executive function, sustained attention, verbal learning and verbal fluency. Cognitive psychoeducational group therapy and attention predicted occupational functioning. In the second study, SCIP and CGI values showed improvement after treatment.

Our data support the idea that cognition affects outcome. Bipolar patients benefit from cognitive psychoeducational group therapy in the domain of occupational life. (1) Sachs G et al. Front. Psychiatry, 23 November 2020 | https://doi.org/10.3389/fpsyt.2020.530026

No significant relationships.

For individuals with mental disorders and their families, religion and spirituality may have a significant influence over how these conditions are understood, managed and treated. Family can act as a moderator in which psychotic patients interpret and explain internalized events. However, they can have a negative impact when discouraging diagnosis and treatment adherence.

Explore the impact of family religious and spiritual beliefs on clinical outcomes among a schizophrenic patient. Investigate the psychiatrist’s role in addressing barriers to treatment adherence.

Data retrieved from clinical interview. Subsequent non-systematic review of the most relevant literature on the topic.

We report a case of a 30-year-old single catholic woman, living with her parents. She had a past history of psychotic symptoms that were interpreted in a context of a depressive episode. After some months she fulfilled the criteria for Schizophrenia and anti-psychotic was prescribed. Family always demonstrated doubts about the disease and negatively influenced the treatment adherence. They believed she was possessed by demons and she was submitted to exorcisms and spiritual therapies. After a 2-year follow-up with erratic treatment regimens and worsening symptoms they accepted her hospitalisation. The majority of symptoms were controlled allowing complete adherence to the same treatment proposed before.

The disease acceptance is a complex process, influenced by multiple beliefs that play different roles in each patient and family, that can adversely influence clinical management. It is essential to understand the family sociocultural environment, by gauging the most influential elements aiming to enhance their compliance with treatment.

No significant relationships.

Euthymic patients with bipolar I and II disorder (BD) often have comorbid insomnia, which is associated with worse outcome. Cognitive behavioral therapy for insomnia (CBT-I) is rarely offered to this population, though preliminary research indicates CBT-I to be safe and helpful to improve sleep and mood stability.

The present study investigates if CBT-I for euthymic BD patients is feasible and acceptable when offered in a group format.

14 euthymic bipolar disorder I or II participants participated in a 7-session group CBT-I with BD-specific modifications (CBT-I-BD), preceded by one individual session. Feasibility and acceptability were assessed by recruitment, treatment drop-out and participants’ and therapists’ evaluations, while sleep quality, mood and sleep medication were assessed at baseline, end of treatment, 3 and 6 months later.

31 of 539 patients with bipolar disorder were referred, 14 were included and one dropped out of treatment. Group CBT-I-BD was acceptable as shown by high session attendance and good homework compliance. Participants highly appreciated the treatment, the group format and learning effect. Insomnia severity decreased significantly between baseline and post-treatment. Group CBT-I-BD did not cause mood episodes during treatment and although not requested, the total number of nights with sleep medication decreased.

Group CBT-I-BD seems to be a feasible, acceptable and therefore viable treatment for euthymic patients with bipolar disorder suffering from persistent insomnia. The small sample size, resulting in small CBT-I-BD groups was a main limitation of the study.

Clozapine is a member of the dibenazepine class of antipsychotic drugs and has been designated an atypical antipsychotic drug. Clinical studies have shown that clozapine is effective in ameliorating the core symptoms, as well as the negative symptoms, in severe psychotic disorders and is therapeutically effective in treating about 30% of schizophrenic patients who are resistant to standard antipsychotic drugs.

The goal is to review pharmacology, efficacy, and clinical use of clozapine, such as its side effects, and the benefit-to-risk ratio of this antipsychotic drug.

Non-systematic literature review based on scientific databases such as PubMed, using key words such as “clozapine”, “efficacy”, “side effects” and “resistant schizophrenia”.

Clozapine was developed as the first atypical antipsychotic with activity for both the negative and positive symptoms of schizophrenia. The primary indications for clozapine are treatment-resistant psychotic disorder, defined as persistent moderate to severe delusions or hallucinations despite two or more clinical trials with other antipsychotic drugs, and patients who are at high risk for suicide. Concerns over a number of safety considerations are responsible for much of the underutilization of clozapine, such as agranulocytosis, metabolic side effects and myocarditis. These side effects can be detected, prevented, minimized and treated, but there will be a very small number of fatalities.

Awareness of the benefits and risks of clozapine is essential for increasing the use of this lifesaving agent.

No significant relationships.

Both original Big Three Perfectionism Scale (BTPS; Smith et al. 2016), and the Portuguese version validated with a sample of university students (Lino et al. 2018) evaluates three second-order factors (rigid, self-oriented and narcissistic perfectionism) and ten facets.

To confirm the BTPS three-factors-ten-dimensions’ structure in a sample of Portuguese adults from the general population.

A sample of 467 adults (70.7% females; Mean age=38.44±12.27; range: 25-82) answered the BTPS Portuguese version and other validated perfectionism measures (Multidimensional Perfectionism Scales from Frost and Hewitt & Flett; Self-Presentation Perfectionism Scale). To study the temporal stability a sub-sample of 132 participants completed the BTPS again after approximately five weeks. SPSS and AMOS software was used.

The second order model presented an acceptable fit (X²/df=3.115; TLI=.811; CFI=.825; RMSEA=.067). There was also evidence of a general factor comprising all the 45 items (X²/df=3.127; TLI=.809; CFI=.823; [JA1] RMSEA=.068). The Cronbach alphas of the three factors ranged from a=.88 to a=.92; and facets had a>.70 showing a total of a=.94. Total and dimensional scores showed significant positive and moderate to high correlations with the other perfectionism measures and their test-retest correlation coefficients were r=.85 (p<0.001).

This study confirms the validity and reliability of the Portuguese BTPS underlying three-factors structure. Additionally, we found, for the first time, that BTPS can also be validly and reliably used to measure a global perfectionism construct. It is our intention to develop a shorter version the Portuguese BTPS in the near future.