Antipsychotics are psyschotropic medications that are indicated for the treatment of physchosis and mood disorders. Due to minimal side effects and their efficacy (affecting many receptors) compared to standard antipsychotics, today atypical antipsychotics are being used more and more as first-line treatment.

The aim of this study is to show the efficacy of asenapine and its tolerability as opposed to other atypical antipsychotics.

1. 1. What are the side effects identified?

2. 2. Side effects and efficacy of asenapine vs other atypical antipsychotics?

It is a comparative, regular, clinical study, an examination case of a 53-year old female diagnosed with Schizoaffective Disorder 27 years ago and treated outside of hospital with atypical antipsychotics, such as: risperidone, olanzapine, quetiapine, aripiprazole, amisulpride. The study covers the timespan of 2010-2022.

The results showed that asenapine sublingual 15 mg had fewer side effects than other atypical antipsychotics. They were mouth dryness, headache, fatigue.

The other atypical antipsychotics caused: metabolic disorders, like considerable weight gain, cholesterol and glycaemia increase, extrapyramidal side effects, hyperprolactinemia.

Asenapine sublingual 15 mg was not as effective in treating Schyzoaffective Disorder as risperdal 5mg, olanzapine 15 mg, aripiprazole 20 mg, amisulpride 600 mg.

The efficacy of asenapine sublingual 15mg was the same as quetiapine 400 mg.

This study showed that asenapine has minimal side effects but its efficacy in treating Schyzoaffective Disorder as monotherapy is lower than other atypical antipsychotics.

antipsychotics, schyzoaffective disorder, side effects, efficacy

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Science, Ethics, Solidarity… These three words are mottos of Psychiatric Association of Türkiye (PAT), since its foundation in 1995. In accordance, PAT has Code of Ethics for more than 20 years. There are many developments and changes both in practicing psychiatry and in the community in the last couple of decades. As a result, many new ethical questions, dilemmas and approaches arise for psychiatry. PAT had decided to update the Code of Ethics about two years ago and the updating process is almost on the edge of finalization.

In this presentation, main points of the updated and newly written principles will be summarized with special references to recent developments in the world and updated or newly written international Code of Ethics such as, EPA, WPA, and several national associations’ documents.

One of the most important outcome and benefit of such an updating process is modelling the project on a participatory base, having wide feedback and inputs from experts (as many as possible, enriched by diverse interests of related disciplines) and reaching as many colleagues as possible from different working conditions. A six step project with this perspective was prepared and implemented, and will be summarized in the presentation for international exchange of experiences.

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Anxiety disorders are a common type of mental pathology with severe social and medical consequences in the lives of people suffering from them. General population studies indicate their prevalence ranges from 1.7% to 4.7% of the population. According to data from a US national study among the population aged 15 to 54 years, only 2.7% and 4.7%, respectively, suffered from panic disorder, one of the common types of anxiety disorders, during their lifetime. At the same time, the features of the emotional structure of anxiety disorders and the effectiveness of their psychotherapy among the population of low-income countries, especially in countries in a situation of prolonged bloody war and environmental disaster, remain poorly studied.

The purpose of the study was to identify the features of the emotional symptomatic structure of anxiety disorder and evaluate the effectiveness of their psychotherapeutic correction. For this purpose, 180 patients with anxiety disorders who were hospitalized in Ukraine (during the period 2022 - 2023) were examined.

The basic method was group psychotherapy with elements of rational, positive, suggestive and family psychotherapy. Regarding emotional disorders, cognitive behavioural therapy (CBT) was used for phobic-depressive and anxiety-depressive syndromes.

Most patients experienced a decrease in the level of general anxiety and internal anxiety. Almost no spontaneous occurrence of fear was observed. During active interviewing, patients stated that their previous anxieties and fears had lost their relevance and acquired clear emotional overtones. There was also a significant decrease in the symptoms of the depressive cycle, and patients began to feel joy and optimism.

To correct emotional dysfunction in patients with episodic paroxysmal disorders, generalized anxiety disorders and mixed anxiety-depressive disorders, it is optimal to use a system of psychotherapeutic correction built on stepwise and multimodal principles.

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Psychiatryai.com was launched in 2021 and initial findings were published at EPA 2023. The portal is an advanced computing science project in Applied Data Science and Evidence-Based Healthcare for my MSc studies at the University of Oxford (Kellogg College). Artificial Intelligence (AI) and Data Science (DS) technology are utilised to analyse live Real-World Evidence (RWE) in Psychiatry and Mental Health from PubMed to provide CPD/CME online. A two-year review of the site and its performance will be presented to EPA 2024.

To develop and study an experimental real-time AI and DS platform in Global Mental Health and Psychiatry, to provide the latest RWE from PubMed for online education and training, and to report findings to EPA 2024 for peer review in Budapest. AI and misinformation are newly identified risks in healthcare (AI Safety Summit 2023). The site also aims to raise awareness about “Aiatrogenesis” to address this problem, with RWE and CPD/CME utilising AI and DS technology for the categorisation and meta-analysis of evidence, rather than the production of possibly misleading or false Generative AI evidence (Monteith et al. BJP 2023; 1-3).

As reported to EPA 2023 in Paris, a free open-code WordPress site was launched on the 22nd of November 2021 (Psychiatryai.com). The portal has been further developed and now features over 90k pages comprising 7GB of data with Cloudflare security and speed. Live evidence is collected into an open database and research articles are categorised into evidence nodes with AI. The results are presented in a real-time Evidence Matrix and Blueprint, creating 15-minute CPD/CME reflection modules. Data analytics from Psychiatryai.com with Google Analytics (G4A) along with platform insights from two years of development and research will be presented to EPA 2024. The site is conceptualised and designed to be viewed in an interactive VR headset.

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Psychiatryai.com has successfully developed a novel AI and DS platform that incorporates the latest research in mental health and psychiatry, providing real-world evidence (RWE) for psychiatrists and healthcare professionals worldwide, along with CPD/CME online. This enhances hypothesis testing in research by presenting a related Evidence Matrix and Blueprint (from the last 365 days) for each evidence node on the site (RAISR 4D). These matrices provide a real-time visual table (8 x 8 / 64) of global research related to the evidence node in the preceding year. The site is VR-ready and has a special focus on AI and Psychiatry, Disaster and Traumatology Sciences, and Youth Mental Health. This project is dedicated to the memory of Dr Denis O’Leary and Dr Navin Venkatraman.

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The intentional use of drugs before or during sexual intercourse (chemsex) is a phenomenon of special importance in the MSM (men who have sex with men) population due to its impact on mental, physical and sexual health. Group therapy has been included in several programs for chemsex users.

To describe and to compare the different group therapy treatments for problematic chemsex users in NGOs community treatment settings in Spain.

We conducted several interviews with key informants from 5 NGO in Spain. A qualitative analysis of the different group therapy treatments for problematic chemsex was performed.

Different models of groups were described including: psychoeducational, support, interpersonal process, harm reduction and mindfulness-based cognitive groups. Most of the group interventions developed were support and psychoeducational based. There were fewer interpersonal group and relapse prevention group therapy. The different models of group intervention were considered useful and necessary for deliver information in a culturally sensitive context and for reducing drug use, social isolation and loneliness.

Chemsex is a phenomenon that needs a multidisciplinary approach, including individual and group therapy. Group therapy for problematic chemsex has several advantages over individual model treatments, including the reduction of sense of isolation, loneliness, information and feedback from peers. More research is needed to analyze the implementation and efficacy of group therapy for chemsex users in different contexts.

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Numerous studies have established a heightened prevalence of anxiety and depression (A&D) in individuals diagnosed with Inflammatory Bowel Diseases (IBD) when compared to the general population. Research indicates that patients with active IBD exhibit a higher frequency of anxiety symptoms and depression symptoms compared to those with inactive disease. In patients with IBD, anxiety was linked to reduced medication adherence and an increased likelihood of undergoing surgery. Furthermore, associations were identified between depression and an elevated risk of disease relapse, as well as a poorer response to treatment in IBD patients. In both IBD and depression, there is evidence of disruptions in circulating miRNAs.

One facet of the ongoing project titled “The brain-gut axis linking inflammatory bowel disease with anxiety and depression: the inflammation-microbiome network” (CRP/ROU21-01) involves the exploration of circulating miRNA profiles in various patient groups.

These groups encompass IBD patients with symptoms of anxiety and/or depression (IBD+A&D+), patients lacking anxiety and depression symptoms (IBD+A&D-), a cohort of individuals without IBD but experiencing depressive and anxiety symptoms (IBD-A&D+), and a control group (IBD-A&D-). Thus far, our investigation has entailed screening a comprehensive panel of 179 miRNAs in the plasma of six IBD patients and 12 non-IBD patients (CTRL) to identify a subset of highly dysregulated miRNAs. MiRNA isolation was achieved using the miRNeasy Serum/Plasma Kit, and miRNA expression levels were assessed via quantitative reverse transcription-polymerase chain reaction (qRT-PCR) utilizing the Human serum/plasma focus, MIRCURY LNA miRNA Focus PCR panel (Qiagen).

Our statistical analysis revealed significant differential expression in 45 miRNAs (p<0.05). Specifically, we identified 29 miRNAs with elevated expression and seven miRNAs with reduced expression. Among these dysregulated miRNAs, 15 (miR-223-3p, miR-143-3p, let-7f-5p, miR-30b-5p, miR-26a-5p, let-7a-5p, miR-339-5p, let-7d-5p, miR-221-3p, miR-191-5p, let-7g-5p, miR-24-3p, miR-107, miR-26b-5p, miR-320b) were associated with depression and/or anxiety and were previously identified as dysregulated in the plasma of patients in other studies. These miRNAs will soon undergo evaluation in the plasma of IBD-A&D+ and IBD+A&D+ patients.

These initial findings provide us with a panel of circulating miRNAs that warrant further investigation in the aforementioned patient groups. The miRNA profile we obtained may either be unique to IBD or linked to the intricate phenotypes of IBD occurring concurrently with anxiety and depression. A more profound comprehension of these mechanisms will aid in the development of enhanced

diagnostic tools and disease monitoring strategies, as well as the exploration of innovative therapeutic approaches.

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The relationship between Autism Spectrum Disorders (ASD) and Narcissistic Personality Disorder (NPD), considering the dimensions of narcissistic grandiosity and vulnerability, represents an important differential diagnosis and potential ground of comorbidity, since both conditions show high grades of pervasiveness, a life-long course, ego-syntonic traits, and difficulties in building up and sustaining interpersonal relationships Although the co-diagnosis rates, according to the categorical criteria in use, are limited (0%-6.4%), it is common to encounter diagnostic doubts in clinical practice.

Here we aimed to explore both the dimensions of narcissistic vulnerability and grandiosity in a group of adults diagnosed with ASD without intellectual disabilities.

87 individuals with ASD completed the Pathological Narcissism Inventory-52 Items (PNI-52). The mean scores of our sample were compared with the normative distribution available in the literature. Participants also underwent a detailed sociodemographic and anamnestic interview, along with an assessment for autistic traits, comprising the “Ritvo Autism and Asperger Diagnostic Scale-Revised” (RAADS-R) and the Autism Quotient (AQ).

Individuals with ASD scored significantly higher than neurotypical controls at the Total Score and at the Vulnerable Narcissism subscale, but not at the Grandiose Narcissism subscales. Demographic features did not influence these results. Vulnerable narcissism was significantly associated with the RAADS-R subscale Social Relatedness.

Our findings could potentially be indicative of a greater comorbidity rate between the two disorders with respect to the one reported to date, possibly because DSM-5 criteria are mainly focused on the grandiose dimension. Potential explanatory links between ASD phenomenology and vulnerable narcissism, such as the personality dimension of neuroticism, are discussed, together with the possible role of narcissistic vulnerability in mediating internalizing symptoms (e.g., anxiety, depression) in individuals with ASD.

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Nonsuicidal self-injury (NSSI) is defined as deliberate and direct damage to one’s body tissues without any suicidal intent. NSSI is now recognized as a major risk factor for suicide and is prevalent among adolescents, with prevalence rates ranging from 7.5% to 46.5%, leading to increased interest in the pathophysiology of NSSI. This study aimed to examine cortical gyrification morphology, a neurobiological index of cortical folding and patterning, among unmedicated individuals with NSSI, which is prevalent in adolescents and young adults.

The main objective of this study is to compare cortical morphological abnormalities between individuals with NSSI and controls in terms of the local gyrification index (LGI), the ratio of the smooth cortical surface area at each vertex to the corresponding sulcal folds. In addition, we hypothesized that the LGI, a stable neurodevelopmental marker of cortical and subcortical circuit intergrity, would correlate with clinical measures in youth with NSSI.

A total of 101 individuals with NSSI and 100 age-, gender-, and handedness-matched controls completed self-report questionnaires and structural magnetic resonance imaging (MRI) data were acquired on a 3T Siemens scanner. A surface-based analysis was conducted using the Computational Anatomy Toolbox (CAT12) in Statistical Parametric Mapping (SPM12). Partial correlation analysis was also performed using R software to investigate the association between the LGI values extracted from the region of interest (ROI) and clinical symptoms, including depression, anxiety, emotion dysregulation, and anhedonia in individuals with NSSI.

Individuals with NSSI showed significantly increased LGI in the right insula sulcus and left superior temporal sulcus (STS), along with decreased LGI in the right calcarine and left superior parietal sulcus (SPS), compared to controls (5000 permutation correction, threshold-free cluster enhancement with a threshold of p < .05). In addition, higher LGI in left STS was correlated with greater scores of the Beck Anxiety Inventory (r = 0.22, p < .05) and of the Impulse Control Difficulties subscale of the Difficulties in Emotion Regulation Scale (r = 0.34, p < .001). Conversely, reduced LGI of the right calcarine was associated with a higher score on the Anhedonia subscale of the Beck Depression Inventory (r = -0.23, p < .05) within individuals with NSSI.

This study identified hypergyria in the right insular and left STS and hypogyria in the right calcarine and left SPS in individuals with NSSI. The former pattern was associated with anxiety and impulse control difficulties, and the latter was with anhedonia. This study is the first to alter distinct neurodevelopmental patterns of local gyrification and their correlations with clinical manifestations in individuals with NSSI.

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Despite major advances in research into the neurobiological basis of mental illness, there have been hardly any new developments in new drug therapies. As there are approximately 30% of affected individuals that do not respond sufficiently to available treatments, there is a significant unmet medical need for new therapeutic approaches. About 90% of novel substances that have shown promise in animal studies are not effective in clinical trials. Recent research on human induced pluripotent stem cells (hiPSC) could lead to the use of more human-tailored models in this field. IPSC-derived cell models and organoids may be very attractive for preclinical screening and bridge the gap between in vitro and in vivo studies, reducing animal testing. However, the next steps must first demonstrate the validity and reproducibility of the initial functional results from the hIPSC models of mental illness. In our own studies on neuronal cell models of patients with attention-deficit/hyperactivity disorder (ADHD) with rare PARK2 gene variants, we were able to show evidence of mitochondrial dysfunction and impaired energy metabolism. Additionally, we have first hints at a oxidative dysbalance which could be as well targeted by medication. In a model of cortical development of ADHD patients with common variants in the ADGRL3 gene, we found first evidence for altered neuronal maturation as well as abnormalities in calcium metabolism and glutamatergic functionality compared to cells from healthy controls. In summary, these first results are promising that hIPSC models can contribute new insights into cellular pathomechanisms of mental and neurodevelopmental disorders and the development of new, individualised therapeutic approaches.

S. Kittel-Schneider Grant / Research support from: The studies are funded by IZKF Wuerzburg and BBRF fund (to SKS and RMcN). SKS received speaker’s honoraria from Takeda, Medice and Janssen.

The Depression, Anxiety and Stress Scale (DASS-21) is recognized as being a widely used measure for the assessment of negative emotional states. While the DASS-21 has been widely used for assessing mental health in Pakistan, limited research has been done regarding its factor structure and measurement invariance.

To assess the factor structure and measurement invariance of the DASS-21 among young adults in Pakistan.

A large sample of 1361 Pakistani young adults had completed the scale during the current study comprising 666 males and 695 females with a mean age of 24.51 years.

Excellent internal consistency reliability was found for the overall DASS-21 and its three subscales (depression, anxiety and stress) ranging from r = .86 to .71 (Cronbach alpha). Moreover, the three subscales were strongly and significantly associated with one another. Additionally, the results showed a good fit of the three-factor model and the one-factor model of the DASS-21 aimed at assessing gender psychological distress. Strong measurement invariance was found regarding gender therefore showing that the DASS-21 is understood and interpreted similarly by males and females. However, little evidence was found regarding the three subscales (depression, anxiety and stress) for the measurement of three distinct constructs.

These findings confirm the utility of the DASS-21 for measuring mental health in Pakistan among young adults.

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Individuals diagnosed with Inflammatory bowel disease (IBD) often experience recurring and painful symptoms, which can significantly affect their daily life, while hospitalization and/or surgery may be needed when they present complications. During the course of the disease, IBD patients may experience feelings of anxiety and/or depression and present decreased well-being.

The aim of the present study was to investigate depression, anxiety, loneliness, well-being and self-esteem in patients with IBD in comparison to individuals without IBD (healthy controls), while taking into consideration demographic and clinical parameters

The study included 164 participants and in particular 98 patients with IBD and 66 healthy controls matched for sex and age. All participants completed Hospital Anxiety and Depression Scale (HADS) to assess depression and anxiety, UCLA Loneliness Scale to assess feelings of loneliness, Mental Health Continuum Short Form (MHC-SF) to assess well-being and Rosenberg Self-esteem Scale (RSES) to assess self-esteem, while socio-demographic and clinical data were additionally recorded.

According to the results, statistically significant differences were observed in all psychological parameters with IBD patients presenting higher depression (p<0.001), higher anxiety (p=0.002), higher loneliness (p=0.002), lower well-being (p=0.019) and lower self-esteem (p<0.001) compared to healthy controls. Among IBD patients, higher well-being was independently associated with higher self-esteem and lower anxiety, but not with depression, loneliness or patients’ sex and age.

The findings highlight the importance of investigating and timely detecting psychological symptoms among patients with IBD, with a view to providing them an integrative physical and mental health care.

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Schizophrenia has a heterogeneous range of possible outcomes. A portion of patients with schizophrenia significantly improves over the long term, with both clinical and functional remission. Recovery has been differently conceptualized by clinicians and service users, the former focusing on clinical and functional outcomes, the latter more underlying issues as the building a trail of personal meaning and subjective well-being. Besides the “clinical” and “personal” recovery, attention is now put on a wider perspective of “societal” recovery . The frequency of recovery achievement depends on which of these perspectives is considered. Many factors, demographic, clinical, contextual and treatment-related are involved in modulating the probability to meet these objectives. Both pharmacological and psychosocial interventions, and their integration, and attention to environmental and social circumstances could substantially improve the outcome of schizophrenia and achievement of specific recovery goals.

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Addressing mental and physical health problems and promoting wellbeing in educational settings is a global priority. Teachers present a high risk of stress and burnout, which negatively impacts their professional performance as well as their mental and physical health. Compassion-based interventions have been found effective in promoting psychosocial and physiological wellbeing.

The current paper presents preliminary findings of the impact of a 6-module Compassionate Mind Training intervention for Teachers (CMT-T) on immunological markers and the Conserved Transcriptional Response to Adversity (CTRA; a gene expression signature that involves a group of 53 genes: pro-inflammatory genes, type I interferon response and genes related to antibody synthesis).

A pilot non-controlled study was conducted in a sample of public-school teachers in Portugal (n=36). Participants were assessed at 4 time-points: 1) Extended Baseline Control_M0, in order to establish a within-subjects psychological and biophysiological baseline (8 weeks before the start of the CMT-T); 2) Pre-intervention_M1 (8-weeks after M0); 3) Post-intervention_M2 (8-weeks after M1); and 4) Follow-up_M3 (3 months after the CMT-T end). In all assessment moments, participants completed a set of psychological self-report measures and were assessed in immunological and epigenetic biological markers through the collection of blood. After M1, teachers completed the 8-week group CMT-T intervention and given access to its resources and materials. They were instructed to practice daily and incorporate the teachings in their personal and professional lives. All assessments and the CMT-T intervention took place at the schools.

Preliminary data on the impact of CMT-T on Immune Response Profiling revealed that teachers’ Natural Killer (i.e., NK) cells were decreased after the CMT-T intervention. In regard to the CTRA gene expression, results showed that type one interferon response genes (e.g., IFI16, IFI27L2, IFITM2, IFITM3, IFITM4P) were decreased after the intervention. In addition, we observed that the gene c-Jun, a pro-inflammatory gene, had a decreased expression after the CMT-T intervention.

These preliminary findings seem to corroborate previous studies involving the type one interferon response, the pro-inflammatory genes and antibody synthesis genes in a signature involving 53 genes previously described as the CTRA gene signature. Furthermore, our results suggest that cultivating compassion using a compassion focused intervention may have a positive impact on markers of the immune system response, associated with how our bodies respond to stress, infection and cancer, as well as, on reducing the expression of genes related to our bodies’ response to stress and inflammation.

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According to World Health Organisation (WHO), Extremely Low Frequency Electro-Magnetic Fields (ELF-EMF) include frequencies ranging from 0 to 300 Hz. They are widespread in our daily life and in the workplace. These fields have an impact on physical and mental health including depression and anxiety.

To assess the impact of chronic occupational exposure to ELF-EMF on Depression, Anxiety and Stress among workers in the Tunisian Electricity and GasCompany of Sousse, Tunisia.

In this cross-sectionalstudy, participants were enrolled into two groups: an “exposed group” including workers in a power plant and an “unexposed group” including administrative workers belonging to the same company. The Exposure to ELF EMFs was assessed by spot measurements using a portable magnetometer. Depression,Anxiety and Stress were assessed by the the Depression,Anxiety and Stress Scale(DASS-21).

This study included 77 exposed subjects and 88 unexposed subjects. The median age was 37 years for the exposed group and 43,5 years for the unexposed ones. Almost half of the exposed group were technicians and had a work experience of 9 years. The median value of EMF was 5,86 uT in the power plant[Min 0,1 Max 40,34 ut].The interpretation of DASS-21 showed that 24.7% of the exposed group and 3.4% of the unexposed group had depression (p<10-3). Anxiety was reported by, 23.4% of the exposed group and by none of the unexposed group. Stress was observed among 46.8% of the exposed group and by none of the unexposed group. After multivariate analysis, ELF-EMF exposure was significantly associated only with depression (p<10-3 ; OR=1,45 [1,17-1,81]) ).

Chronic occupational exposure to ELF-EMF increases the risk ofDepression, anxiety and Stress. Underlying mechanisms are not established yet suggesting the need of further studies.

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Chronic fatigue and psychiatric manifestations (depression, anxiety and sleep disturbances) appear to be key features of post-COVID-19 syndrome and increase significantly in prevalence over time (Lavienraj et al. J Neurol Sci 2022;434:120162). Several studies have suggested an association between altered levels of arginine metabolites and depression, anxiety and stress severity (Arisoy et al. J Psychiatr Res 2020;120:21-28). L-arginine supplementation has also been shown to improve walking performance, muscle strength, endothelial function and fatigue in adults with Long COVID (Tosato et al. Nutrients 2022;14(23):4984).

To study effects of L-arginine oral supplementation on chronic fatigue and depressive symptoms reported 3 months or more after acute COVID-19 onset in elderly outpatients without severe comorbid conditions.

This is a parallel-group, double-blind, randomized controlled trial conducted on 96 over 65 non-hospitalized patients suffering from Long Covid-related fatigue and depression. The first group included patients that received 1,66 g L-arginine twice a day in addition to a standard antidepressant therapy based on Selective Serotonin Reuptake Inhibitors (SSRIs), whereas the second group received antidepressant only. Severity of fatigue and depressive symptoms was evaluated at baseline and after 8 weeks of treatment using Fatigue Symptom Inventory (FSI) and Hamilton Rating Scale for Depression (HAM-D), respectively.

At baseline, 64 patients (66,7%) reported moderate fatigue (4-6) and the remaining 32 (33,3%) reported severe fatigue (7-10). In this phase the average HAM-D score was 12,85 ± 5,97; among patients, 57,3% experienced mild symptoms of depression, 32,3% experienced moderate symptoms and 6,4% experienced severe symptoms. After two months, patients treated with L-arginine supplementation exhibited a 30% greater improvement in fatigue-related symptom severity (p=0.008) and a significantly decrease in average HAM-D score (p=0.002) compared to the group treated with SSRI only.

According to our results, adding oral L-arginine to standard antidepressant therapy in elders with Long Covid-related fatigue and depression significantly decreases severity of both physical and affective symptoms. Further studies are needed to clarify the intriguing role of L-arginine in the treatment of Post Covid-19 syndrome and its potential effects in promoting geriatric patients’ health, wellbeing and quality of life.

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Wildfire disasters have become increasingly rampant. There is a critical need for all to fully understand the mechanism and impact of these disasters on humans, with a special emphasis on the mental health effects they pose on the affected individuals and communities. This article specifically presents a scoping review of the psychological reactions of children and adolescents post-wildfire disaster.

This review aims to synthesize currently available literature regarding the impact of wildfire on mental health, specifically the psychological reactions of children to wildfires.

We identified 8 research articles using 6 databases for this review. Data extraction was performed using a qualitative descriptive approach.

The results identified post-traumatic stress disorder (PTSD), anxiety, depression, stress, alcohol/substance misuse, hopelessness, low resilience, reduced quality of life, and self-esteem as the psychological conditions manifesting in children and adolescents post-wildfire disaster. PTSD was the most evaluated psychological reaction in the participants (7 out of eight studies).

This review highlights that deleterious mental health effects, such as PTSD, depression, anxiety, and suicidality, can persist in children for years post-wildfire disaster. Factors such as gender, direct exposure to the wildfire, re-traumatization, and resilience informed or ameliorated the severity of the impact of wildfire on children and adolescents. Our findings further emphasize the need for multi-year funding and programs to support children and adolescents’ mental health, including children with disabilities in the communities that have experienced wildfire disasters.

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Substance use disorders (SUDs) are a growing public health concern in the Arab world. To our knowledge, no previous study in Lebanon assessed the characteristics, management, and outcomes of patients with SUDs seen and managed by a consultation-liaisoin psychiatry (CLP) service.

This study explores the characteristics and management of individuals with SUDs who were referred to the CLP service in a tertiary care center in Lebanon.

As part of the Consultation-Liaison at the American University of Beirut (CLAUB) analysis, we conducted a retrospective record review of patients referred to our CLP service between February 2019 and May 2020. We assessed differences between SUD and non-SUD consults using Chi-square analysis, Fisher’s exact test, or Mann-Whitney U test, as appropriate.

Of 1475 patients, 278 (18.8%) received a diagnosis of SUD. They were mostly males (73.7%) with an average age of 38.8 years. The most used substances were alcohol (60%) and cannabis (28.4%). Compared to non-SUD consults, patients with SUDs were more likely to be males (odds ratio OR=3.18, p<0.001) and to get intubated during admission (OR=1.81, p=0.048). Predictors of intensive care unit admission in patients with alcohol use disorder included pulmonary or endocrinological disease, benzodiazepine use disorder, and days until CLP referral.

The results of this study highlight the high prevalence of alcohol use among individuals with SUD referred to the CLP service. Additionally, they underscore the limited treatment avenues available in this part of the world. The institution of a comprehensive CLP service is crucial to address the unmet needs of patients with SUDs who present to a general hospital setting.

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Neuropsychiatric disorders can develop following a group A β-hemolytic streptococcal infection, through autoimmune inflammation of the nervous system. Sydenham’s chorea and PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infection) are the two most well-known syndromes, primarily affecting children but rarely observed in adults.

Our aims are to contribute to the scientific understanding of adult PANDAS-like syndrome and provide a comprehensive literature review on the subject.

Case report using clinical records and a non-systematic literature review.

A 24-year-old female presented to the emergency department with profound emotional distress triggered by intrusive thoughts of existential dread, accompanied by compulsive praying. She reported that these symptoms had commenced five days earlier. Two days prior to the onset of her obsessions, she had experienced a high fever, odynophagia, cough, and chills and received an empirical diagnosis of tonsillitis following a physical examination. She was prescribed antibiotics with good response. She revealed that she had experienced two prior episodes of similar anxiety and obsessions when she was approximately seven years old.

She developed acute obsessive thoughts, including doubts about the meaning of her life, and engaged in compulsive prayer and seeking reassurance from relatives. Notably, there were no signs of affective, dissociative, or psychotic disorders during her admission to the ED or in the preceding months. She reported suffering from anxiety, insomnia, and loss of appetite in the past five days but did not express any suicidal ideation.

Physical examination indicated mild laryngeal erythema, and laboratory tests showed non-specific signs of infection with no further significant findings. Symptoms were alleviated within a week, aided by treatment with benzodiazepines (lorazepam 1 mg/8h), and she did not require further psychiatric counselling.

It is worth noting that adult patients can experience a PANDAS-like reaction after a streptococcal infection and may also undergo symptom relapse following new immunological challenges upon reinfection. The existence of a PANDAS spectrum has been postulated, encompassing various manifestations. Thus, when presented with acute obsessive symptoms, healthcare providers should consider this diagnosis, inquire about previous episodes, and conduct a comprehensive medical history and etiological assessment.

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COVID-19 is a multisystem disease affecting not only the respiratory, gastroenterstitial and vascular systems, but also the central nervous system, which leads to a wide range of neurological and mental complications. 3 years of experience in combating the pandemic has shown that elderly people burdened with chronic somatic diseases are the most vulnerable risk group for the development of severe course and complications of COVID-19.

To study the impact of COVID-19 on the onset and course of mental illness in elderly inpatients

We examined 67 inpatients aged 50 to 95 years with various mental pathologies, who underwent COVID-19 from February 2020 to December 2021. 46 people had previous history of mentall disease (PHMD), in 21 cases the disease developed for the first time. Statistical analysis was performed.

In the manifest group of patients, depressive episodes predominated (42.9%), including psychotic episodes (9.5%). In 28.6% of cases, organic disorders were diagnosed in the form of emotional lability, organic depression, mild cognitive impairment and delirium. In 23.8% of patients, neurotic disorders were observed in the form of depressive reactions, panic and generalized anxiety disorder. In one case (4.8%), acute polymorphic psychosis with symptoms of schizophrenia was diagnosed. The PHMD group includes affective disorders - 45.7%; organic disorders, including dementia 26.1%; schizophrenic spectrum disorders -19.6% and neurotic somatoform disorders - 8.7%. In the acute and subacute periods of COVID-19, acute psychotic states (APS) developed in both groups of patients (in 23.3% and 30.4%, respectively) in the form of delirium, psychotic depression, or polymorphic psychosis. APS were more common in PHMD patients with organic (50%) and schizophrenic spectrum disorders (33.3%) with a predominance of delirium. In the long-term period of COVID-19, PHMD patients more often than non-PHMD (60.9% and 38.1%) developed cognitive impairment (CI), especially in schizophrenia-like (77.8%) and organic (83.3%) disorders. CI developed twice as often after APS (89.5% and 39.6%, p<0.001), reaching the degree of dementia in 15.8% of cases. APS were significantly associated (p<0.05) with the development of CI (0.567733), the age of patients (0.410696) and the presence of previous cerebrovascular insufficiency (0.404916).

The age-related features of the mental consequences of COVID-19 are the occurrence of APS in the acute period of infection and the deterioration of cognitive activity at a remote stage. The PHMD patients, especially with disorders of organic and schizophrenic spectrum, were found to be more vulnerable to the effects of COVID-19. In them, the occurrence of APS was a risk factor for the development of dementia, while in primary diseased, and patients with affective and neurotic disorders, CI was reversible or had the character of a mild cognitive disorder.

None Declared

The literature indicates that parental reflective functioning (PRF) is crucial to a good parent-child relationship. Furthermore, genuine parental mentalizing also promotes adaptive emotion regulation in attachment relationships. However, no prior study assessed the relationship between parental mentalizing, emotion regulation and object relation in the early years.

We examined the relationship between PRF, cognitive emotion regulation and perception of the infant among parents of children up to five years old.

In our cross-sectional, non-clinical study, 136 parents completed the Parental Reflective Functioning Questionnaire, the Cognitive Emotion Regulation Questionnaire and the Mother’s Object Relationship Scale - short form. In our 12 moderator models, we chose the subscales of the parental perception of the infant (invasiveness and warmth) as dependent variables, the subscales of adaptive and non-adaptive strategies of cognitive emotion regulation as independent variables, and the three subscales of PRF (pre-mentalization, interest and curiosity, certainty about mental states) as moderators.

Warmth had a positive, weak correlation with adaptive strategies (r(134) = 0.27, p < 0.007), with certainty in mental states (r(134) = 0.24, p < 0.007) and interest and curiosity (r(134) = 0.23, p < 0.007); the correlation between interest and curiosity and non-adaptive strategies was moderate and positive (r(134) = 0.32, p < 0.007). None of the subscales of PRF moderated the relationship between the subscales of emotion regulation and the perception of the infant. The use of adaptive emotion regulation strategies was more likely to affect the perception of warmth (B = 0.05 (t = 2.0584, p = 0.0415), B = 0.04 (t = 1.7887, p = 0.0760)), and the use of non-adaptive strategies was more likely to affect the perception of invasiveness (B = 0.08 (t = 2.1333, p = 0.0348), B = 0.09 (t = 2.3164, p = 0,0221).

Our results suggest that cognitive emotion regulation plays a role in object relation; therefore, we recommend promoting adaptive cognitive emotion regulation strategies among mothers in the early years.

None Declared