The pandemic caused by the SARS CoV-2 virus (COVID-19) has a profound effect in the health care system (HCS). The therapeutic effect of communication skills is well known. Psychiatric patients are a vulnerable population and remote care via telephone was one of the first implemented measures during the lockdown.

The aim is to highlight the potential benefits and risks of remote follow up, according to the scientific evidence currently available.

Non-systematic review of the literature with the selection of scientific articles published in the last year. The search was performed in Pubmed database with the following Mesh terms: “COVID-19”, “psychiatry”, and “health communication”. Complementary references were also included.

For those with a stable psychiatric condition, remote appointments may guarantee the adequate follow up in a safe way throughout the COVID-19 pandemic. However, telephonic appointments are associated with a limited ability to perform psychopathological examination. A better assessment can be achieved if video call is used. Also, data protection and the ability of giving informed consent by psychiatric patients should be addressed. Additional training should be considered. A subgroup of patients with severe mental illness may require face-to-face visits.

COVID-19 pandemic is an unprecedented crisis and telemedicine is now emerging as an alternative. Remote consultation has advantages and, in some situations, it may replace or complement the in-person visits. Since social isolation is one of the most effective measures, digital means constitute a window of opportunity for the HCS.

Internet provides wide opportunities not only for development, but also for developmental risks including information about drug consumption, advocacy for weight loss and suicide (Livingstone et al., 2011).

The aim of this study was to compare user activity and online risks in Russian adolescents and parents according to three population studies, 2010, 2013, and 2019.

Using EU Kids Online methodology (Livingstone et al., 2011), the data of 1219 parents of adolescents 12-17 years old and 1553 adolescents 12-17 years old from 15 regions of Russia in 2019 were compared with the data of 1203 adolescents 12-17 years old and 1209 parents in 2013, as well as the answers of 685 couples “parent - teenager 12-16 years old” in 2010.

Compared to 2010, in 2019 adolescents are more frequently disappointed or worried about something online (41.5% versus 33.6%, χ2=12.44, p<.01, CC=.07). Contemporary adolescents rarer report having seen sexual images (χ2=339,48, p<0,01, CC=0,36) online but more frequently report having seen rude actions online (χ2=69,93, p<0,01, CC=0,16). They more frequently see information about drugs and suicides (χ2=37,11, p<0,01, CC=0,12 и χ2=85,04, p<0,01, CC=0,17, respectively) and report an experience of cyberaggression (χ2=80,85, p<0,01, CC=0,19) and fraud (χ2=17,75, p<0,01, CC=0,09).

In Russian sample online risks in adolescents closely related to mental health and risky behavior in 2010-2019 increase suggesting necessity of social programs of risk prevention. Study is supported by Russian science Foundation, project 18-18-00365.

Study is supported by Russian science Foundation, project 18-18-00365.

Galactorrhea wiht antidepressants SSRIs or SNRI is a rarely adverse effect. Some authors believe that the risk of galactorrhea in women who use SSRIs is 8 times higher than in patients treated with other types of drugs. Serotonin is believed to be a potent physiological stimulator of prolactin release.Prolactin stimulates the growth of the mammary glands and the galactorrhea. The SSRIs would activate the serotonergic pathways, these in turn would stimulate the release of prolactin directly in the pituitary and in the hypothalamus, inhibiting the release of dopamine and increasing the release of stimulating factors. The main inhibitor of prolactin secretion is dopamine.

The objective is to reveal this rare complication through the report of a clinical case

A 45-year-old woman with a diagnosis of mixed anxiety-depressive disorder. Treatment with 20 mg of escitalopram was started, with a good therapeutic response, but with breast pain and swelling. She was switched to duloxetine 60 mg, with a good response and adequate tolerance. At 6 months of treatment, she begins to present breast pain and yellow-green breast discharge, with elevated prolactin levels and normal cranial MRI.

She was diagnosed with functional hyperprolactinemia, and treatment with vortioxetine was started. Finally, the Prolactin levels normalize.

Galactorrhea is a very rare and annoying side effect that can lead to discontinuation of treatment and requires a change in the therapeutic strategy.

No significant relationships.

The Italian law 81/2014 has given a strong push to the design of therapeutic-rehabilitative paths for psychiatric patients who are offenders. This innovation requires a constant organizational effort on the part of mental health services to enforce the law. The rehabilitation team is represented by different professionals like psychiatrists, psychologists, nurses, psychiatric rehabilitation technicians, educators, social workers and others. They must be able to work in an integrated way among them and with private social sector.

It is in our interest to reach an agreement between different professionals working in the rehabilitation-forensic field about good practices.

We have prepared a survey to identify good practices in the field of psychosocial rehabilitation of the offender psychiatric patient, involving different professionals who have expertise.

This audit revealed, in everybody’s opinion, that these offending citizens have received a security measure capable of having greater control over their actions in a therapeutic-rehabilitative perspective but it is fundamental to educate them also to exercise their own safety for a social shared culture. Ensuring the safety of the offender during the therapeutic-rehabilitative path is as important as responding to a society’s need for social security.

Satisfying a society’s need for security, established by the Judge and the Law, all this cannot separated from the active exercise of security of the offending psychiatric patient towards himself, through psychoeducation. The safety towards others and towards oneself can constitute a good practice in the field of psychosocial rehabilitation.

No significant relationships.

When New York City became an epicenter of the COVID-19 pandemic, healthcare workers from an array of specialties were deployed to work on general medicine units with limited time for clinical retraining.

This study assesses the subjective experience and perceived preparedness of a cohort of non-internal medicine clinicians who were deployed to assist with inpatient management of patients with COVID-19 in the Spring of 2020.

An online survey was distributed to clinicians (residents, fellows, attendings, nurse practitioners, and physician assistants) who cared for patients in roles outside their usual specialties during the pandemic at the Montefiore Health System in the Bronx, NY.

85/169 (50.3%) clinicians responded. 16.5% reported strong feelings of preparedness prior to deployment (≥7/10 Likert scale). ‘Access to appropriate and efficient review materials prior to deployment’ was ranked as 6/10, overall level of stress as 8/10 and concern for contracting COVID-19 while deployed as 8/10. Responses regarding ‘general feelings of preparedness’ had a weak negative association with ‘feelings of frustration about one’s circumstance’ (r= -0.39, p<0.001). Weak negative associations were found between feelings of ‘access to adequate review materials’ and ‘overall stress levels’ (r= -0.31, p<0.001). A moderate positive association was found between ‘feelings of access to adequate review materials’ and ‘feeling on top of one’s work responsibilities’ (r= 0.40, p< 0.001).

The majority of respondents did not feel adequately prepared to care for patients with COVID-19 prior to deployment and had both high stress levels and fear of contracting COVID-19 in the first wave of the pandemic.

No significant relationships.

Previous study has identified increased antithrombin III (ATIII) in patients with major depressive disorder (MDD), supporting ATIII as a potential biomarker for depression diagnosis.

This study aimed to reveal the alteration of ATIII after occipital repetitive transcranial magnetic stimulation (rTMS), and illuminate its power to evaluate and predict the curative effects in MDD treatment.

A total of 90 MDD patients were recruited and further intervened with rTMS in occipital for individualized, standard or sham treatment for five days. Those of 74 patients underwent entire detection, including clinical assessments, blood collection and protein measurement.

After treatment, decreased ATIII were detected in both the individualized and the standard group (p=0.000 and 0.001, respectively) instead of the sham one. Especially, the reduction in ATIII in the individualized group was associated with improvements in several neuropsychological assessments. Besides, ATIII at baseline in the standard group and after the individualized rTMS showed high performance to evaluate or predict the response to the 5-day treatment (AUC=0.771, 95%CI, 0.571-0.971; AUC=0.875, 95%CI, 0.714-1.000, respectively) and the remission in follow-up (AUC=0.736, 95%CI, 0.529-0.943; AUC=0.828, 95%CI, 0.656-1.000, respectively). Furthermore, both baseline ATIII and change in ATIII involved in the prediction of 24-item Hamilton Depression Rating Scale in the follow-up study with significant predictive values (p=0.0240 and 0.0233, respectively).

This study detected a reduction in ATIII after occipital rTMS, further revealed the relationships between change in ATIII and therapeutic response, and ultimately provided evidence for the potential of ATIII as a biomarker for the evaluation and prediction of antidepressive effect.

No significant relationships.

Seasonal changes, climatic factors such as temperature, sunlight intensity and precipitations as well as temporal factors seem to have an influence on suicidal behavior.

Our study aimed to analyse the association between seasonal changes, climatic variations, temporal factors and suicide attempts.

A retrospective descriptive and analytical study was undertaken including all patients consulting for the first time at Gabes psychiatry department from the 4th March 2009 to the 25th September 2020 for suicidal attempt. Sociodemographic and clinical data as well as suicidal attempts’ characteristics were assessed. Meteorologic data, related to the years 2009 through 2020, were obtained from the official weather website of Tunisia.

278 patients were collected, including 217 female. Mean age was 26. Suicidal patients were unmarried (75.9%), childless (79.1%) and unemployed (47.5%). Results showed that suicidal attempts occurred most frequently in summer (32.5%) specifically in June and July (10.9% for each). Regarding the distribution of suicide attempts over the days of the week, the highest rate was observed on Monday (22.5%) and the lower one on Friday. There were a correlation between high temperature and suicide attempt by hanging (p=0.006), between days of sunlight and manifestations preceding the suicidal attempt (p=0.04) and between rainfall and anxiety disorder leading to suicidal attempt (p=0.03).We finded also an association between the summer and risk behavior such as runaways (p=0.024).

A better identification of seasonality, climatic and temporal factors in suicidal behavior could allow a better prevention in suicidal attempts and a reduction in death by suicide

Neuropsychiatric symptoms may be the first and only manifestation of brain tumours, while classic neurological symptoms and signs may be minimal or absent at first. These patients will often receive psychiatric treatments for prolonged periods before correct diagnosis.

To report the case of a patient with olfactory groove meningioma presenting with neuropsychiatric symptoms as a basis for discussion.

Retrospective review of clinical notes, neuroimaging results and house photos. Literature review.

A 66-year-old woman was brought by police to the psychiatric emergency department Her neighbours had notified authorities of a bad smell, and police found the house was loaded with garbage. The patients reported depressive symptoms in the last 6 months, including apathy, anhedonia, social isolation, decreased appetite and insomnia; loss of basic skills such as cooking or cleaning; she also reported dizziness and two episodes of urinary and faecal incontinence in public. The patient had a history of being medicated for depression between 2000 and 2006. Currently she was taking only alprazolam 1 mg daily. During evaluation she was conscious, oriented and cooperative, with evident hypomimia, psychomotor inhibition and indifferent attitude. Cranial nerve function was preserved except for anosmia. Cranial CT and MRI showed a solid extra-axial tumour of 5.2x3.5x4.9 centimetres compatible with meningioma of the olfactory groove, and she was referred to Neurosurgery for surgical intervention.

This case illustrates the importance of a thorough organic evaluation, including neuroimaging, in the differential diagnosis of patients with atypical symptoms before making a psychiatric diagnosis and instituting treatment.

An important aspect of depression relapse prevention programs is identifying personalized warning signals (PWS). These PWS are typically defined as depressive symptoms. Yet, no study has investigated to what extend PWS fit within the diagnostic classification framework, and how this compares to a more transdiagnostic, integrative approach towards depression.

To examine how well PWS reflect depressive symptoms, describe the remaining PWS, and examine how well PWS can be assigned to domains of an existing transdiagnostic and integrative framework, the positive health concept.

162 PWS of 66 individuals with a history of depression were labeled as one or more symptoms of depression or to a residual category. The same process was repeated for labeling the domains of the positive health model. Labeling was done by three independent reviewers (inter-rater percent agreement: symptoms: 0.83 & positive health domains: 0.73). Disagreements were resolved by discussion.

The three most commonly reported depressive symptoms were insomnia/hypersomnia, anhedonia and fatigue/loss of energy. However, sixty-five percent of the PWS were not depressive symptoms, but other symptoms (e.g. irritability, rumination) or aspects of functioning (e.g. withdrawing, managing time). The positive health domains captured all the PWS. However, 44% of PWS were labeled as multiple positive health domains, whereas labeling as symptoms of depression resulted in almost no such overlap.

A more transdiagnostic and integrative approach seems necessary to capture PWS. Depending on one’s purpose, one may consider expanding the definition with other symptoms and aspects of functioning, or using the positive health concept.

Affective flattening is one of the main symptoms in Schizophrenia, several studies highlighted the importance of social skills training in improving negative symptoms. However, Covid-19 pandemic is changing our life with limitations in social contacts and in psychosocial rehabilitation; pre COVID-19 strategies should be implemented with new ones.

To evaluate the practicability of a narrative method in improving affective flattening, general social skills in stable outpatients with a diagnosis for schizophrenia during Italian lockdown in March – April 2020

Outpatients with a stable psychopathology have been involved in a narrative project during lockdown. We asked to patients to write daily a story telling about their experience and emotions and send us their diary. Every week the diary has been used to discuss their story telling in group in a web conference. At end of the experience we administered a survey about the enjoyment and the subjective benefits.

From ten people with a known psychopathology we recruited six patients. All participants completed the project and all of them referred for a subjective benefit as to feel more reassured by the contact with their psychiatrist. Four patients explicated initial discomfort about share their experiences in group. One patient started to share his own thoughts about mental disease on social media.

Narrative Psychiatry might be a pragmatic opportunity to implement conventional strategies to contrast affective flattening and negative symptoms in Schizophrenia. Sharing digital story telling is a useful method in lockdown and general social restriction condition.

Artificial intelligence algorithms are increasingly used to highlight refined qualifiers of pathologies and to build treatment protocols based on them. These possibilities open up new perspectives for personalized interventions in psychotherapy. The affective neurosciences that link psychopathological phenomena to the hypersensitization of emotional systems are an excellent field of application of deep learning algorithms

In this contribution we present the standardization of a psychodiagnostic test that can be analyzed with a deep learning algorithm for the development of personalized treatments for depressive disorders in a perspective of precision psychotherapy

Previously we have constructed a psychodiagnostic test that correlates the psychopathological characteristics to the emotional systems described in affective neuroscience. The construction of this test was carried out with the use of a neural network that discriminated 161 items from a pull of 300 psychopathological and character descriptions. In the present work, the 161 selected items were compared, in a sample of 600 subjects, with the measurement of sadness described in the Panksepp model. Comparation was performed with linear and non-linear statistical analysis methods.

The items emerging from the statistical analyzes as strongly indicative of a hypersensitivity of the sadness system outline a psychopathological profile for which it is possible to adapt specific psychotherapeutic treatment protocols.

In future prospect, neurobiological and psychophysiological variables such as heart rate variability, skin conductance and activity of the areas of the cortex, measured with a scanner of the near infrared photons, will be correlated to these descriptors of psychopathology.

On August 4th 2020, a massive port explosion shook Beirut, killing at least 200, injuring more than 6,000 people and leaving more than a quarter of a million living in unfit homes. Various factors can participate in the severity of mental health outcomes of a disaster including the number of injuries, the degree of property destruction, unexpectedness of the occurrence of the event, and the type of the disaster.

The main aim of this study is to assess the prevalence of post-traumatic stress disorder (acute stress disorder) and major depression at 1 and 6 months following the Beirut explosion. The secondary aim is to determine predictors of PTSD incidence among civilians and relief workers affected by the disaster.

This is a cross-sectional study with data collected via an online survey through convenience sampling. People will be recruited via social media platforms. To achieve a power of 80% and a two-sided significance of 5% and because gender differences will be explored, assuming a design effect (deff) of 2.5, a minimum sample of 960 participants would be needed. The survey will include sociodemographic data, questions about exposure levels to trauma and a psychiatric symptom inventory. Pearson’s Chi Square test will be used to examine the association between categorical variables and regression models will be run to examine the associations while controlling for confounders, including age, gender and others.

The results from both rounds of data collection (months 1 and 6) will be available in late March 2021.

to follow based on results

No significant relationships.

Wernicke’s encephalopathy is a potentially fatal neurological emergency caused by thiamine deficiency. Although it is often associated with chronic alcoholism, it can also occur in all situations that lead to a thiamine deficiency such as undernutrition and exclusive artificial feeding.

In this work, we propose to study the clinical and treatment concerns of Wernicke’s encephalopathy complicating catatonic schizophrenia.

We retrospectively report the case of a patient who developed a Wernicke’s encephalopathy in the aftermath of catatonic schizophrenia.

Mr H.L, a 47-year-old-male has been followed in psychiatric hospital since the age of 27 for catatonic schizophrenia. He has been hospitalized in July 2020 because of oral intake refusal, social isolation and lack of self-care with a poor compliance to treatment. Examination of the patient revealed catalepsy, mutism and negativism. He was treated with antipsychotics drugs, benzodiazepines and parenteral nutrition. About six weeks after his hospitalization, the patient developed horizontal nystagmus and ataxic gait. Magnetic resonance imaging was consistent with Wernicke encephalopathy. Vitamin B1 dosage was 32nmol/l. Parenteral thiamine replacement therapy was initiated with clinical improvement

Catatonic schizophrenia can be associated with severe malnutrition and thus with thiamine deficiency and Wernicke’s encephalopathy. An early intervention by supplying prophylactic thiamine given parenterally in high-risk patients is crucial to avoid Korsakoff syndrome, as well as cardiovascular and neuropsychiatric complications associated with thiamine deficiency.

In these unprecedented times, the medical workers particularly at the frontlines of the pandemic are vulnerable to psychological trauma rooted in the new demands of their work, as well as the prevailing sense of insecurity and safety concerns for themselves and their loved ones.

To explore the mental health impact of the covid-19 pandemic on the front-line health care workers in a tertiary care hospital in Rawalpindi, Pakistan

Frontline healthcare workers will include all doctors, nurses and paramedical staff performing duties that involve dealing directly with known or suspected cases of COVID-19 at triage clinics, ICUs and isolation wards. Depression Anxiety and Stress Scale (DASS) and Impact of events scale-revised (IES-R) were administered to them to assess the mental health of these frontlines.

A total of 94 frontlines were included in the study. 76(80.9%) had no significant depression while 18 (19.1%) had presence of significant depression. 62 (66%) had no significant anxiety while 32 (34%) had significant anxiety. Female gender and degree of contact with high clinical suspicion cases were significantly related with presence of anxiety and depression among the study participants. Being female, single, a nurse or a paramedic and degree of contact with high clinical suspicion cases was significantly related with presence of stress among the frontlines. People working in ICU or corona isolation unit had more chances of having trauma as compared to other frontlines.

Depression, anxiety, stress and trauma were common among the front liners fighting in this pandemic

The epidemic caused by the SARS-CoV-2, which began in Wuhan city in December 2019, quickly spread to various countries around the world. The first case in New York State was confirmed on March 1; three weeks later (on March 22, 8 p.m.) the entire population was sheltered in place (SIP). By March 27, the USA had already become the first country in the world for the number of infections. 56% of known domestic cases were confined to New York State.

The study aims to evaluate the immediate psychological effects on sheltered in place persons aged between 18 and 70 years old and living in New York State (USA).

This study is based on a cross-sectional online survey conducted anonymously in the period between the tenth and twenty-third day of SIP. Zung Anxiety Self-Assessment Scale (ZAS scale), Insomnia Severity Index (ISI) and Perceived Stress Scale 4 (PSS4) were used to evaluate anxiety, insomnia and stress respectively.

We collected data on 354 individuals (189 females, 34.9 years). MANOVA evidenced that anxiety was significantly related to marital status (higher for divorced/widow participants as compared to married/civil partnership and single), it decreased significantly with age, it was higher for females and for persons having an history of psychiatric disorders and sleeping problems.

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

No significant relationships.

The context of infodemic and necessity of preventive behavior (Roy et al., 2020) demands for studies of the role of news in compliance including health priming (Gibbons, 2003, Pechmann, 1999). Especially important is a topic the effect of news about traditional and alternative medicine (Furnham, Forey, 1994) their impact on subjective compliance.

The aim was to study the relationship to medicine and subjective compliance in people with hypochondriac beliefs after priming by negative news about traditional and alternative medicine.

122 healthy adults (56 males, mean age 40.7±13.6) were randomized to conditions (control, negative news about traditional medicine, negative news about alternative medicine); then they read and appraised four news (in two experimental groups one of them was about medicine); filled changes in emotions after reading (PANAS, Carver et al., 1989), Cognitions About Body and Health Questionnaire (Rief et al., 2018), checklist of relationship to medicine and compliance.

Moderation analysis indicates that in people with higher hypochondriac beliefs negative news about alternative medicine lead to lower readiness to use these methods but also to comply with any medical recommendations (p<.01). In people with higher hypochondriac beliefs negative news about traditional medicine decrease readiness to use it but not alternative medicine (p<.01).

Negative news about formal medicine situationally decrease readiness to use it while negative news about alternative medicine situationally decrease any readiness for treatment. Research is supported by the Russian Foundation for Basic Research, project No. 20-013-00799.

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune disorder characterized by neuropsychiatric symptoms before progressing to seizures, complex movement disorder, autonomic dysfunction and hypoventilation.

Presenting a review of the psychiatric manifestations of anti-NMDAR encephalitis.

Search on Pubmed® and Medscape® databases with the following keywords: “psychiatric”, “anti-NMDA receptor encephalitis” and “anti-NMDAR encephalitis”. We focused on data from systematic reviews and meta-analyzes. The articles were selected by the authors according to their relevance.

Studies show that 77% to 95% of patients with anti-NMDAR encephalitis initially present psychiatric manifestations. Age and sex distribution are young women, and the frequency of cases is lower after 40 years of age. The most common psychiatric symptoms are agitation (59%) and psychotic symptoms (54%). The psychotic symptoms more common are visual (64%), auditory (59%) hallucinations and persecutory delusions (73%). Catatonia is described in 42% of patients. Antipsychotic treatment induces an adverse drug reaction (33%), the neuroleptic malignant syndrome represents 22% of the cases. Delays in distinguishing this disease from a psychiatric disorder can have serious complications, with a mortality of up to 25% in patients receiving limited or delayed immunotherapy.

It’s important to consider anti-NMDAR encephalitis in the differential diagnosis of patients with an acute onset psychosis or unusual psychiatric symptoms. Antipsychotic treatment should be use with caution when suspected or confirmed anti-NMDAR encephalitis. Without appropriate treatment, patients may suffer a protracted course with significant long-term disability or death. A clinical index of suspicion is required to identify patients who would benefit from cerebrospinal fluid testing and immunotherapies.

No significant relationships.

The COVID-19 pandemic has significantly impacted the delivery of mental health services globally. Within Australia, the COVID-19 pandemic and subsequent containment measures have led to reduced face-to-face attendances. To maintain access to mental health consultations, new telehealth services were introduced by the Australian Government in late March 2020.

We aimed to quantify the impact of the COVID-19 pandemic on patterns of mental health attendances in Australia using an interrupted time series model.

To characterise patterns of mental health service utilisation, monthly mental health attendances between January 2016 and June 2020 were extracted from the Medicare database, stratified by clinician type: general practitioner (GP), psychiatrist, and allied health. We used triple exponential smoothing to model attendances between January 2017 and December 2019. Observed and predicted attendances between January and June 2020 were compared with 95% confidence (p<0.05).

Our models showed decreased mental health attendances in March and April, consistent with all healthcare services during this time. While uptake of telehealth was significant, it only partially covered the reduction in mental health attendances.

Our modelling highlights the significant impacts of the COVID-19 pandemic on mental health services in Australia, with telehealth only partially compensating for the reduction in face-to-face attendances. These results suggest that telehealth services may not be suitable for all individuals (e.g. those without reliable internet access). Given that telehealth will likely remain a feature of mental health service provision, outreach and face-to-face services should be considered for vulnerable groups

No significant relationships.

Digital Mental Health holds strategic potential in fulfilling populations’ mental healthcare unmet needs, enabling convenient and equitable access to mental healthcare. However, despite strong evidence of efficacy, uptake by mental healthcare providers remains low and little is known about factors influencing adoption and its interrelationship throughout the Digital Mental Health adoption process.

This study aimed at gaining in-depth understanding of factors influencing adoption and mapping its interrelationship along different stages of the Digital Mental Health adoption process.

This work adopted a qualitative approach consisting of in-depth semi-structured interviews with 13 mental healthcare professionals, including both psychologists and psychiatrists. The interviews were transcribed and analysed thematically, following Braun and Clarke’s method.

In this communication, we will describe how digital technology is currently used by clinicians to deliver mental healthcare. We identify potential factors influencing Digital Mental Health adoption and characterize the different identified stages inherent to this appropriation process: i) Pondering appropriate use; ii) Contractualizing the therapeutic relationship; iii) Performing online psychological assessment; iv) Adapting and/or developing interventions; v) Delivering Digital Mental Health interventions; and vi) Identifying training unmet needs. A discussion on how different factors and its interrelationship impact the adoption process will also be performed.

By characterizing mental healthcare providers journey throughout the Digital Mental Health adoption process, we intend to inform ecosystem stakeholders, such as researchers, policy makers, societies and industry, on key factors influencing adoption, so policies, programs and interventions are developed in compliance with this knowledge and technology is more easily integrated in clinical practice.

We present the case of an 82-year-old patient who was treated by our liaison psychiatry unit after a suicide attempt through prescription-drug overdose. The patient had been diagnosed with Parkinson’s disease (PD) ten years prior to his admittance and was being treated with carbidopa/levodopa and non-ergot dopamine agonists.

Impulse control disorders and depression are the most prevalent neuropsychiatric manifestation of PD. According to several sources, this symptomatology is underdiagnosed and undertreated, causing helplessness and distress to patients and their caregivers. Likewise, the accumulated evidence suggests that certain drugs can contribute to the appearance of the aforementioned symptoms.

A case report is presented alongside a review of the relevant literature regarding the neuropsychiatric manifestations in the context of PD and the diagnosis and treatment of these symptoms.

During his treatment, ropinirole was removed while quetiapine was progressively administered (up to 150mg/day). Carbidopa/levodopa regime was increased causing visual hallucinations and delusional jealousy. A careful balance between antiparkinsonian and antipsychotic medication needed to be achieved before discharge.

Neuropsychiatric manifestations in the context of PD are more prevalent than what was thought in the past. Certain medications, particularly non-ergot dopamine agonists could potentially contribute to the onset of these symptoms. Moreover, these manifestations can be underdiagnosed due to the stigma or social burden imposed upon family and / or caregivers. It is important that recent advances in the understanding of non-motor symptomatology of PD could permeate clinical practice to achieve an adequate identification and treatment of these symptoms.