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.

No significant relationships.

Ayahusca has potential therapeutic beneffits.

Expose the potential beneffits of ayahuasca from neuropharmacology and clinical existing evidence.

A literature review was carried out in the databases pubmed, clinical key and texts of scientific dissemination.

There´s scientific literature about the potential therapeutic use of ayahuasca in dependencies, anxiety symtoms and depression, near death experiences and terminal illnesses. Possible benefit is postulated in impulsivity and personality disorders. It induces an introspective state, triggered by thoughts, emotions and autobiographical memories, which promotes reflection on personal issues, allowing new perspectives on certain life issues. It is common for users to describe it as analogous to a psychotherapeutic intervention. 5HTA2 agonists stimulate the expression of genes that encode transcription factors such as c-fos, egr 1, egr 2 and brain-derived neurotrophic factor (BDNF), which influence neuronal plasticity and are associated with cognitive aspects such as memory and attention. MAOIs and 5HT2A agonism have anxiolytic and antidepressant effects. Sigma -1 agonism promotes neuroplasticity. Decrease and remission in the consumption of alcohol and cocaine has been reported in patients with abuse and dependence. There has been significant decrease in depressive symptomatology, in observational studies, cases and controls and double blind compared with placebo. Improvement in different domains measured with mindfulness scales, similar to those observed in meditators, suggests an association between mindfulness techniques and experiences with ayahuasca.

There is existing evidence about potential therapeutical uses of ayahuasca. More studies are needed with biger samples, to establish it´s clinical use.

No significant relationships.

It is knowed the relationship between psychological problems and cardiovascular disease. Pychological alterations can cause cardiovascular diseases, and a cardiovascular event can trigger psychological alterations.

The aim was to present a clinical case about a young man with cardiovascular alterations and depressive symptoms and to analyze the role played by cardiovascular drugs, psychoactive drugs, and their interactions.

We present the clinical case and search the relation between cardiovascular disease and depressive symptoms and treatment at scientific literature of last five years.

A 38-year-old man comes to the emergency room with symptoms of palpitations, fatigue and shortness of breath for 2 weeks. An electrocardiogram is performed showing premature ventricular beats. The patient reports that he is sadder recently due to the loss of work, for which he is prescribed sertraline 50 mg daily and is referred to cardiology. No medical history or consumption of alcohol, tobacco or other toxins. The cardiologist requests ergometry, echocardiography, and Holter monitoring, resulting in all normal tests, with no evidence of ischemia. Bisoprolol 2.5 mg daily is prescribed and sertraline 50 mg daily is maintained. After two months, the patient reports feeling better in spirit. The control electrocardiogram is normal and the patient reports disappearance of palpitations. You are referred to your family doctor.

Elevation of cortisol, platelet hyperactivity, and alteration in heart rate variability were found in depressives. The SSRIs would be the ones of choice. Dual serotonin and noraderaline reuptake inhibitors should be avoided. Other atypical drugs such as bupropion or trazodone should be considered.

No significant relationships.

Pharmacogenetics (PGx) studies genetic variance and related differences in drug outcomes. PGx guidelines for psychotropic drugs are available (PGx drugs). By executing PGx testing in a prospective or pre-emptive setting, dose adjustments or even change of treatment type can be applied prior to start of therapy to patients who carry a specific geno- or phenotype (i.e. actionable geno- or phenotypes). By doing so, increased efficacy of therapy or reduced risk of adverse events of treatment can be accomplished. In Denmark, broad implementation of PGx is currently still low.

The aim of this study is to classify the PGx profiles of Danish individuals with and without severe mental disorders (SMD), to be used in follow-up studies investigating PGx and drug outcomes.

This study made use of imputed genotyping data of the Danish iPSYCH sample, which includes 77,639 young individuals born between 1981-2005, with or without a diagnosis of one or more of five selected SMD (i.e. depression, attention-deficit/hyperactivity disorder, autism, bipolar disorder and schizophrenia). We investigated a panel of 48 genetic variants with known PGx applications (part of the U-PGx consortium, a Horizon2020 funded project on clinical relevant PGx in the EU).

Imputed data contains over 11 million SNPs of 77,639 individuals.

We expect results in the end of 2020.

We thank the iPSYCH consortium, in specific the iPSYCH PI’s (Merete Nordentoft, Anders Børglum, Preben B. Mortensen, Ole Mors, Thomas Werge and David M. Hougaard). The iPSYCH project is funded by the Lundbeck Foundation Denmark and the universities and un

Eslicarbazepine Acetate, a novel anti-epileptic drug has been approved as monotherapy in focal onset seizures, with/without secondary generalization in adults. Eslicarbazepine has many advantages over older anti-epileptic drugs and is useful in patients of new onset focal epilepsy.

Aim of our study was to determine the efficacy and safety of Eslicarbazepine Acetate, observe its well-tolerated use and monitor adverse effects in newly diagnosed patients of focal epilepsy.

Study was done at Department of Psychiatry, Teerthanker Mahaveer University, Moradabad. A total of 30 newly diagnosed cases of focal epilepsy between 18-60 years of age were studied for 6 months, using a Semi-structured Interview and Liverpool Adverse Events Profile.

Majority of patients were males (58%), between 21-30 years. Patients with partial/focal seizures (63%) were more common than those of generalized seizures (37%). Majority of the participants had 1-2 episodes of focal seizures weekly(48%), while some had almost daily(32%). Majority were on Eslicarbazepine Acetate 800 mg in two divided doses daily (64%), while the others received 1200 mg in three divided doses(32%). The mean Liverpool Adverse Events Profile score initially was 28.34 ± 6.28 which significantly improved after 4 weeks treatment to 22.80 ± 4.35 (p < 0.05). The improvement in newly diagnosed focal seizures patients was significantly more than other patients (p < 0.05). No major side effects were observed.

Eslicarbazepine Acetate as a monotherapy is effective in treating focal epilepsy. Better results of this drug are found in newly diagnosed focal epilepsy patients.

No significant relationships.

Psychodermatologic disorders are conditions involving an interaction between the mind and the skin. Dermatitis artefacta (DA), also known as factitial dermatitis, is a frequently unrecognized psychocutaneous illness, in which the patient creates skin lesions to satisfy the unconscious need to presume a sick role. It is more common in women and in patients with a diagnosis of psychiatric illness. This is an exclusion diagnosis and organic causes should be ruled out. Treatment of DA can be challenging and it needs to involve a multidisciplinary approach consisting of dermatologists and mental health professionals.

From a case report the authors intend to present a literature review of dermatitis artefacta.

Observation the patient and review the clinical file. Consultation published and referenced scientific articles on PubMed.

60 year old man, diagnosed with Bipolar Disorder, was admitted for manic decompensation of his pathology. During physical examination he had sparse erythematous lesions, more exuberant in the neck, scalp, belly and upper limbs. The diagnosis of artifact dermatitis was made after excluding other possible causes.

Treatment of DA can be challenging and it needs to involve a multidisciplinary approach. Dermatitis artefacta is a long-term disorder, and patients need regular follow up with a dermatologist and a psychiatrist because relapses are common. These doctors must be aware of this possible pathology in order to make a correct diagnosis and treatment of psychiatric disorders that sometimes coexist with skin lesions. The prognosis for most patients is poor leading to self-injury, scarring and poor cosmesis.

No significant relationships.

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

Transcranial alternating current stimulation (tACS) is a non-invasive brain stimulation technique allowing to induce changes in oscillatory activity. Theta activity has been reported to play a major role in maintenance of information in working memory (WM).

The current study had the initial goal to check the effect of theta tACS on accuracy and resting state EEG in a set of match-to-sample WM tasks.

In the first experiment, we tested 31 participants in the WM task after 20-min tACS applied at Fpz and CPz at 6 Hz, 1 mA.). In the second experiment, we compared the after-effects and online effects of the stimulation in a sample of 25 individuals. Five similar 25-min blocks filled with the same working memory task were distributed over 3 days. We assessed the same group of participants in all three sessions. On the Training day, the participants performed one block without stimulation. On the Sham-Verum day (SV), the first block with Sham stimulation followed by the second block with Verum stimulation. On the Verum-Sham day (VS), the blocks order reversed.

After-effects of the stimulation did not produce any significant changes either in behavior (accuracy in the task) or resting-state EEG (theta frequency band spectral power in the first experiment. In the second experiment, 6 Hz tACS delivered before the WM task was not able to produce any observable changes in working memory performance. The same hold true for online stimulation.

Theta frequency tACS applied to Fpz-CPz electrodes is not an efficient method to improve WM.

The first stage of interdisciplinary studying (EEG, IQ, immunology, psychology, neuropsychology) of cognitive development of children with IVF, conducting at the Mental Health Research Center (Moscow, Russia) is presenting. A small number of studies analyzing the cognitive development of children in a wide age range, determined the design of this study.

Assessment of the capabilities of the neuropsychological approach in qualifying the cognitive development of children with IVF.

20 children aged 7 to 15 years old, born with IVF, studying in school. Neuropsychological diagnosis according to A.R. Luria-L.S.Tsvetkova. All participants signed voluntary consent to participate in the study.

1. Neuropsychological approach and methods of neuropsychological diagnostics are effective in qualifying the neurocognitive development of children with IVF 2. The overwhelming majority of the examined children (90%) had energy factor dysfunction (at the level of brain stem structures in 65%, at the level of diencephalic structures in 82%, combined disorders at both levels in 52%) 3. Regulatory inhibitory control (impulse control - suppression of the dominant reaction) was impaired (functionally unformed) in 58% of the subjects 4. A gross violation of the kinetic factor was found in 46% of the examined children and adolescents IVF 5. The development of speech and visual memory is variable.

The conclusions are preliminary and require testing on a wider sample of children born because of IVF and other assisted reproductive technologies. It is necessary to study the functional state of other neuropsychological factors, to expand the number of participants.

The psychoses in patients with dependence of alcohol are in many cases polyethiologic, this is especially common in the elderly due to accumulation of various somato-neurological pathologies.

88 men, with alcohol withdrawal syndrome accompanied by delirium; the average age - 70,4 ± 3,9 years, duration of alcohol abuse - 27,4 ± 6,5 years.

clinical, psychopathological and statistical

The psychoses in patients with dependence of alcohol are in many cases polyethiologic, this is especially common in elderly due to accumulation of various somato-neurological pathologies. One of such factors is alcohol dependence syndrome and alcohol withdrawal. ICD-10 allows sharing out delirium with mixed etiology F05.8; this category can include patients when there is a severe alcohol withdrawal condition and somato-neurological pathology that can be an independent factor in the delirious syndrome. 88 elderly patients with were examined in state of alcohol withdrawal. All patients had delirious syndrome. Patients were divided into 2 groups: 1st – patients with a condition of alcohol withdrawal with delirium; 2nd - patients with a delirium of mixed etiology (the factor of the presence of dyscirculatory encephalopathy, was considered a competing factor in the onset of delirium). Some differential-diagnostic signs of the studied disorders were established. In the case of prolongation of psychosis, the clinical picture was similar in both groups, which was explained by exacerbation of the existing somatic pathology.

Estimation of the leading factor in the emergency of acute psychosis in patients with alcohol withdrawal syndrome is of great practical importance for selection of therapeutic tactics.

Cases of memory loss are rare phenomena. We present a case-study of common psychological and psychotherapy observation 14,5 years old girl with dissociative dysmnesia during 2 years. Teenager grew up in a small town near Moscow, her parents were divorced. A girl and her elder brother stay with mother. One day in New Year Holiday in January she had come to take out the trash and did not return home. When mother and her friends had found girl on the other side of town, she did not remember anything about her life and family. Goal: description the case of long observing adolescent with dissociative dysmnesia

Girl age 14,5 y.o.

Psychodiagnostics, Psychotherapy.

First period (1 months later initial episode) mother provided mane consultations to understand what has happened with daughter and what is illness. Psychiatrist made a diagnosis - dissociative dysmnesia, neurologists did not find any disturbances. Psychological diagnostics showed small gaps in knowledge, pronounced violations of autobiographical memory, decreased activity, and mood. Unusual results were obtained in projective drawing. She got to know her family and friends again, started an account on Internet, shares her stories. These 2 years she worked with individual psychotherapist with positive changes. In September 2020 she went to school, not yet caught up with program. She masters the guitar, continues to play in the theater studio, and makes plans for future.

After 2 year observation and work autobiographical memory has not restored. Girl’s personality hasn’t changed, according to the family. Her mood and communication look better.

No significant relationships.

No significant relationships.

CONTEXTUALIZATION: Palliative sedation is a resource used to control symptoms of terminal patients in general. It is considered that it should be discussed by the professionals involved in the process, based on the competence of each one, as well as with family members and patients when possible.

AIM: To understand symbolic meanings attributed by nursing professionals who provide assistance to the terminal patient regarding to the act of the palliative sedation.

Strategies: Clinical-qualitative design, semi-directed interview of open questions in depth. Nine oncologist nurses participated in the study; sample closed by the criterion of theoretical information saturation. Interviews were audio recorded, transcribed fully, categorized by qualitative content analysis. The results were discussed by colleagues of the Laboratory of Clinical Qualitative Research at the University of Campinas.

FINDINGS: The treatment of the data led to 6 emerging categories: (1) death maintains its ambivalent values in our culture; (2) serving the death symbolically on a tray; (3) the act of sedation and its “unfortunate coincidences”; (4) palliative sedation: agent of a pious death; (5) late sedation: cause for distress to the professional; (6) the professional’s self-comfort considering certain psychological strength from the patient and family.

Final considerations: palliative sedation takes a general and individual meanings for the professional and even in case of experienced professionals regard to palliative sedation, the death phenomenon conduct them to expresses multiple and peculiar emotional issues, not ever perceveid.

No significant relationships.

In 2005 Elizabeth Parker and fellow researchers described the first case of Hyperthymestic Syndrome, a woman going by initials AJ. Thereafter, a handful more of such cases have emerged. Older descriptions of extraordinary memory in medical literature mainly considered semantic and working memories. Jorge Luis Borges in his 1930s short story ‘Funes, his Memory’ writes about his, presumably fictitious, encounter with a man named Ireno Funes who possessed an extraordinary memory and a knack for keeping track of briefest of passing moment. Among many qualities that Funes and AJ share are their extraordinary memories, obsession for keeping track of time, and their problems with abstraction. After describing his extraordinary memory, Borges says of Funes, ‘I suspect nevertheless, that he was not very good at thinking. To think is to ignore (or forget) differences, to generalize, to abstract.’ Similarly, AJ has been described to have impaired abstraction, hypothesis formation and conceptual shifting. Moreover, both Funes and AJ see their capability as a burden rather than a gift. “My memory, sir, is like a garbage heap.” Says Funes.

A brief exploration of Jorge Luis Borges’ works in the context of autobiographical memory.

The comparisons between Borges’ description of his character’s autobiographical memory and findings of modern research techniques will be done qualitatively.

Effort is made to undersatnd Borges philosophy in context of mordern memory research.

An in depth look into Borges’ philosohies linking perception of time, coding of memory, abstration and language can inform further line of research regarding autobiographical memory.

No significant relationships.

Schizophrenia is a chronic disease that deteriorates the functionality of patients, especially when forming a family and taking care of children. We are interested in analyzing the characteristics of mothers with schizophrenia and their degree of global activity when going from oral treatments to injectable treatments.

1 To assess the quality of life and functional level of mothers with schizophrenia receiving paliperidone treatment. 2. Compare quality of life and functional level when going from oral treatment to long-term injectables.

Sample: Mothers, 37-45 years old, diagnosed with schizophrenia in monotherapy with oral paliperidone who started treatment with Paliperidone Palmitate LD IM (200 - 300 mg / month). Retrospective data collection. QLS quality of life scale.

5 patients were included, caregivers of 1 child (80%), 2 children (20%) who met the inclusion criteria and completed the questionnaires. After its application and correction through non-parametric tests (N <30). During oral treatment, scores were observed in the QLS questionnaire of: mean intrapsychic functions 34.2, mean interpersonal relationships 19, mean instrumental role 8, mean daily activities 8. After 12 weeks of treatment with Paliperidone Palmitate IM, scores were obtained: functions Medium intrapsychic 36, medium interpersonal relationships 23, medium instrumental role 15, medium daily activities 11. A better functioning of the patients was observed in the instrumental and daily activities categories.

In our experience, injectable long-acting Paliperidone Palmitate is associated with the perception of better quality of life in mothers with schizophrenia and increases the ease of administration as well as planning in their daily life.

COVID-19 pandemic affected not only physical health of individuals, and communities but also their mental health worldwide. Young physicians, who were providing care for patients during the outbreak in a global atmosphere of stress, anxiety and depression, were not spared.

To assess anxiety and depression among young medical resident exposed to COVID-19 in Tunisia and its associated factors

It was a cross-sectional, descriptive and analytical online-based survey, from April 19, 2020, to May 5, 2020 on 180 medical residents in training, via a Google-Form link. We used a self-administered anonymous questionnaire containing sociodemographic and clinical data. Hospital Anxiety and Depression Scale (HAD) validated in the Tunisian dialectal version was used to assess anxiety and depression.

Among 180 young doctors included, 70.2% were female, 16% were married, 81.8% worked in a university Hospital and 51.1% were frontline caregivers involved in primary screening. Our study revealed that 66.1% of young medical residents were suffering from anxiety (severe anxiety: 28.9 %) and 61.7% of them from depression (severe depression: 29.1%). Anxiety disorder was correlated to female gender (p=0.008), being married (0.001), worse quality of sleep (p<10-3) and increased consumption of tea and coffee (p=0.012). Depression was associated to worse quality of sleep (p<10-3), lack of physical activity (p<10-3), shortage of personal protective equipment (p=0,027) and anxiety disorder (p<10-3).

Our study indicated a high proportion of anxiety and depression among young doctors in training, needing systematic screening in order to prevent them.

Currently available psychotherapies and psychotropic drugs for post-traumatic stress disorder (PTSD) are poorly effective in a substantial proportion of patients. Dopaminergic dysfunction plays a prominent role in the pathophysiology of PTSD: intrusions, avoidance symptoms, anhedonia and emotional numbing. Dopamine reuptake inhibitors can be studied as novel drugs in PTSD treatment.

Explore methylphenidate as a promising drug in PTSD treatment.

Case report presentation based on the review of clinical notes and non-systematic review of the PTSD therapeutics state-of-the-art.

A 72-year-old Portuguese male, a veteran of the Angolan War, sought medical attention four years ago after the death of his brother, which had happened three years before the consultation. The clinical picture consisted of re-experiencing the war and the loss of his brother, flash-backs, nightmares, irritability, a fear of losing control, inner dialogues with occasional intra-psychic voices, emotional numbing with the impossibility of developing loving relationships with his relatives, feelings of unreality, an episode of dissociative fugue and complaints of episodic forgetfulness and time warp. He was diagnosed with PTSD with dissociative symptoms, based on DSM 5 clinical criteria. He was initially treated with SNRIs and risperidone, with little improvement. A year ago, he suffered a flare-up, with suicidal ideation. He was prescribed methylphenidate 36 mg, with progressive improvement, persisting mild PTSD residual symptoms.

There is enough evidence of the dopamine involvement in PTSD, although research on dopaminergic drugs is scarce. Methylphenidate may be promising in the treatment of at least some individuals that haven’t responded to current psychological and medical interventions.

One of the most complex and emotional aspects of nursing is the interaction between the nurse and the dying child. The attitudes of nurses towards death, affect the quality of care.

To investigate pediatric nurses’ attitudes towards death.

Methodology: 170 nurses, working in pediatric hospital departments completed a questionnaire which included sociodemographic characteristics and information related to their previous training and clinical experience regarding death issues in general and dying children’s care in particular.

68.6% reported that the death of a child affects them very much, while 44.7% of the participants didn’t feel well prepared to manage death issues. Pediatric nurses were greatly affected by children’s death, expressing mainly feelings of sadness (44%), compassion (22%), guilt (22%) and anger (22%). 73% of the sample wished the hospitalized child, died when they were not present. 53.5% had been trained regarding the care of dying patients and the management of death and mourning as part of their curriculum and 21.2% had attended a relative seminar / lecture. The importance of proper and adequate education becomes particularly apparent considering that the majority of our sample either did not feel sufficiently prepared in order to deal with death and mourning, even though more than 70% of our participants had been relatively educated.

The incorporation of the notions of death and care at end of life in the theoretical and practical fields of nursing will improve the quality of services offered at the end of life for patients and their families.

In the context of COVID-19 pandemic, first-line responders (FLR) are exposed to multiple stress factors, ranging from lack of adequate protective equipment to worries about family health due to work-related exposure to the new coronavirus. Therefore, FLR became themselves a vulnerable population that need prevention strategies for professional stress-related disorders (PSRD).

To explore the literature in order to find evidence-based prevention strategies for PSRD in FLR, strategies resulted from other epidemiological crisis situations (MERS-CoV, H1N1, SARS-CoV) that may be applied in the current pandemic.

A literature review was performed through the main electronic databases (PubMed, CINAHL, SCOPUS, EMBASE) using the search paradigm “professional stress-related disorders” AND “first line responders” AND “prevention”. All papers published between January 2000 and June 2020 were included.

Reported prevalence of post-traumatic stress disorder in FLR involved in epidemiological crises was between 10% and 33%. Evidence-based recommendations for PSRD prevention are lacking, and only general advices have been detected. These suggestions were clustered on institutional level (e.g., involving of medical personnel in administrative decisions, encouraging personal initiatives, longer pauses between shifts) and individual level (e.g., training of coping abilities, relaxation techniques, and peer-focused group support). Several guidelines for prevention of mental disorders in workplace exist, but they are not focused on FLR.

The need to elaborate guidelines for prevention of PSRD in FLR can not be overemphasized, especially in the pandemic period, in order to avoid the onset of stress-related complications, and to preserve a good quality of the medical activity.