HIV-positive patients with schizophrenia spectrum disorders experience burden of double stigma. Comorbid pathology may alter structure of stigma and shall be considered in development of individual destigmatization programs.

Study of psychiatric stigma features in HIV-positive and HIV-negative patients with schizophrenic disorders.

ISMI (Ritsher et al., 2003), PDD (Link et al., 1991) – to study stigma in 70 patients divided into three groups with respect to their diagnosis (I — F20.x, II — F21.x, III— F2x+HIV); BPRS (Overall & Gorham, 1962) – to assess psychiatric status, RSAS (Eckblad et al., 1982) – to assess anhedonia. Dispersion analysis (Kruskal and Mann–Whitney tests), Spearman and Pearson correlation were used.

Patients with comorbid HIV-infection showed increased level of perceived stigma, although they resisted the stigma internalization better than others did (Table 1).

Patients with schizotypal disorders and patients at early stages of HIV infection experienced the most alienation and frailty to internalization of stigma (Tables 1, 2).

Correlation relationship between social anhedonia and perceived stigma (r=0.5, p<0.05) observed in patients with HIV infection.

Comorbid HIV infection in psychiatric patients contributes to the psychiatric stigma structure. Differentiated approaches in rehabilitation of HIV-positive mental patients should be used.

Vitamin D modulates the biosynthesis of neurotransmitters and neurotrophic factors, thus influencing mood and its alterations. Decreased blood levels of Vitamin D are involved in many psychiatric disorders, in particular, affective disorders. As regards bipolar disorder (BD), an association between vitamin D deficiency and severity of illness has been found.

In this observational study, we assessed calcium homeostasis imbalance in a sample of patients with BD; in particular, we explored whether serum levels of PTH, Vitamin D and calcium influence the clinical presentation of BD and its symptom severity.

All patients were administered with validated assessment instruments to assess psychopathology, affective temperaments and global functioning. Vitamin D and PTH levels were assessed in all patients. An-ad hoc schedule was administered for socio-demographic and clinical characteristics.

The total sample consisted of 199 patients (females: 51%; mean age: 47.1 ± 13.2 years). Levels of serum PTH were directly correlated with the total number of hospitalizations (p< 0.01), and of depressive (p< 0.0001), manic (p< 0.001) and hypomanic episodes (p< 0.01). Serum levels of Vitamin D were positively associated with age at first psychiatric contact and were inversely correlated with the total number of depressive episodes (p< 0.05) and cyclothymic temperament (p< 0.05).

Increased levels of PTH and Vit D correlate with a worse clinical outcome of patients with BD. Our results highlight the importance to routinely assess PTH, Vit D and calcium levels in BD patients. Moreover, vitamin D may represent a valid add-on treatment for these patients.

No significant relationships.

Cyberaggression including the most wide-spread variants of flaming (O’Sullivan, Flanagin, 2003; Voggeser et al., 2017) and trolling (Buckels et al., 2018) is affecting mental health of adolescents and youth although it could be (Kowalski, 2014; Wright, Wachs, 2020).

The aim was to study prevalence of flaming and trolling experience in Russian youth and adolescents and its relationship to general aggression and tolerance.

525 adolescents 12-13 years old, 1029 adolescents 14-17 years old, 736 youth 18-30 years from 8 Federal regions in Russia appraised their experience of flaming or trolling online (as initiators, victims and observers) using vignettes. 1105 parents of adolescents appraised whether their children experienced flaming or trolling online. Then they filled Aggression Questionnaire (Buss, Perry, 1992) and Tolerance Index (Psychodiagnostics…, 2008).

More than one-half of adolescents (51-58% in 12-13 years old and 64% in 14-17 years old) and youth (45-69%) reported experience of flaming and trolling online, mostly as observers (32-65%). Parents accurately appraised flaming experience in their children but underestimated trolling experience (p<.05). Adolescents and youth observing flaming online report higher hostility, anger and physical aggression (F=17.8-28.3, p<.01, η²=.02) while lower social tolerance (F=4.27, p<.05, η²=.01). In adolescents observing trolling online these effects are stronger than in youth observing trolling online (interaction: F=5.68, p<.05, η²=.01).

Observing trolling and flaming online is related to higher aggression and low tolerance in adolescents and youth and for adolescents the relationship is stronger. The reported study was funded by RFBR, project 20-013-00857.

The reported study was funded by RFBR, project 20-013-00857.

Suicide is an international public health problem and a leading cause of death for youth and adults, worldwide. Prevention efforts in health care systems create opportunities for identifying medical patients with occult suicidality. Detecting suicide risk among patients in medical settings can be a challenge, but successful suicide risk screening programs have been demonstrated in hospital settings.

This presentation will discuss how a suicide risk screening tool that was developed for the pediatric emergency department was tested and then implemented in other medical settings in order to leverage healthcare providers as partners in combating the public health crisis of youth suicide..

Implementation and quality improvement projects in various medical settings that have adapted the ASQ will be described. Effective management of pediatric patients that screen positive for suicide risk and how mental health clinicians can best be utilized in efficient ways will also be discussed.

Average time to administer the ASQ was 20 seconds. Positive screen rates across ED, inpatient and outpatient settings ranging from 2-14% equating to one additional psychiatric consultation per week. The ASQ Toolkit was developed to help medical providers implement screening including scripts for nurses, flyers for parents and a brief suicide safety assessment (ASQ BSSA) to operationalize next steps for patients at risk.

The medical setting is a key venue for youth suicide risk detection and linking patients with effective interventions. Mental health clinicians have a role in guiding non-mental health providers in the identification and management of patients found to be at risk.

No significant relationships.

Social withdrawal, or hikikomori, is one of Japan’s most serious psychosocial issues. The concept gained international attention around 2010 and widespread psychiatric epidemiological studies have since been conducted.

With an understanding of the extensive range of hikikomori circumstances as a spectrum, we aimed to quantitatively measure the severity of hikikomori in adolescent subjects, an age group considered particularly susceptible to the condition, and to identify factors associated with its severity.

We selected population demographics, socioeconomic data, and psycho-behavioral characteristics as factors related to hikikomori and explored their associations with hikikomori severity using cross-sectional analysis. Subjects were a patient group of middle school students examined as outpatients at a psychiatric clinic during adolescence for a chief complaint of hikikomori and a control group of middle school students matched for sex and age. Subjects’ parents completed a questionnaire pertaining to their child’s hikikomori symptoms and living environment along with the Child Behavior Checklist (CBCL). The data collected was then statistically analyzed.

T-test results demonstrated that scores for all CBCL syndrome scales were significantly higher in the patient group, but no scores fell within the clinical range. Multiple regression analysis revealed that being anxious/depressed, somatic complaints, lack of communication between parents, and overuse of the Internet were statistical predictors of hikikomori severity.

It may be possible to prevent hikikomori from becoming severe if the above predictors are used to identify high-risk individuals requiring active intervention while hikikomori is at an early stage.

No significant relationships.

Growing evidence studying pathological online behaviour has shown an increasing rate of internet addictions in younger populations across the globe.

The current study aims to investigate the prevalence of smartphone internet addiction of youths in Hong Kong, and its associations with gender and depression.

A total of 1,164 participants’ preliminary data were extracted from the Hong Kong Youth Epidemiological Study of Mental Health, a territory-wide, household-based study of mental health in youths aged between 15-24. Internet usage behaviors, socio-demographic and psychosocial characteristics of the participants were assessed. The Chen Internet Addiction Scale was modified to measure smartphone internet addiction (SIA). Symptoms of depression were assessed using the Patient Health Questionnaire. Mann-Whitney U tests were used to examine (i) SIA across gender and (ii) depressive symptoms between high and no to low SIA groups. Linear regression model was used to evaluate the association between SIA and depression.

The prevalence of smartphone internet addiction was 27.8% using the cut-off scores of 67/68. Women had higher SIA scores than men (U=144239.50, p=0.001). Participants with high SIA were associated with a higher severity in depression than those with no-to-low SIA (U=89187.00, p<0.001). Regression analysis revealed a significant positive correlation between depression and SIA after adjusting for confounding factors (B=0.099, t=9.138, p<0.001).

Our findings suggest a gender difference on online behaviour using smartphones. Further investigations are needed on whether SIA may exacerbate severity of common mental disorders.

No significant relationships.

Studies on large samples agree on the negative impact of maternal perinatal depression (PD) on child’s cognitive development. Early experience with insensitive maternal interactions appears to be predictive of poorer cognitive functioning. These children present a higher risk for the onset of socioemotional development, nutrition, growth and sleep disorders. Research on Covid-19 pandemic suggests that families, particularly mothers, may be at increased risk of psychological distress.

This study evaluates the effect of perinatal depression on child development and the impact of distress caused by the Covid-19 pandemic.

We designed a case-control study comparing, during Covid-19 pandemic, a group-A of children of mothers with PD (n=19), with a group-B of children of healthy mothers (n=21). The age of the children recruited was 4-35 months. Participating mothers underwent DP3-Interview and the socioemotional and adaptive-behavior Bayley’s scales by telephone and completed an online survey (IES-R).

We found significantly lower scores on the Bayley socioemotional scale and in all the DP3-scales, in group-A. There is an inversely proportional correlation between the age of these children and overall development score of the DP3. On the IES-R scale, the medium scores in both groups show no psychological distress as a consequence of the Covid-19 pandemic, although mothers with PD show borderline total scores and higher hyperarousal scale values.

This study confirms that PD is a risk factor for the onset of disorders in all areas of the child’s development. Mothers with PD are less likely to manage psychological distress secondary to the pandemic.

No significant relationships.

Clinical pathways (CPWs) are tools used to guide evidence-based healthcare. They translate clinical practice guideline recommendations into clinical processes of care within the characteristics of a healthcare institution. There are few studies about the impact of CPW in the field of Psychosis in terms of adequacy to their recommendations and clinical outcomes.

PSYCHSTAGE project has been designed to study the adjustment of psychosis clinical care to a CPW based in a Clinical Practice Guideline according to a clinical staging model in a network of psychiatric services covering 580.000 inhabitants in a University Hospital in Madrid.

Retrospective and observational study in a sample of 1780 subjects 18 years old or above, diagnosed with schizophrenia and other psychosis. Socio-demographic and clinical variables were collected from clinical records, including ICG, GAF and DAS at the time they were included in the study. Clinical stage was established according to McGorry model at the same time. CPW was analysed in 1,391 subjects with 15,254 care events using a Process mining method. Process discovery, process checking and process enhancement analysis have been used.

Patients were grouped according the clinical stage. 9,2% were in stage 2; 18,5% in 3a; 47% in 3b; 22,1% in 3c and 4,1% in 4. A different CPW is represented for each clinical stage in routine practice. Then, every pathway is compared with the recommendations in the established Psychosis CPW.

Process mining can be a useful tool for the study of CPW in the field of psychosis

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.

No significant relationships.

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.

Sleep disturbance specifically insomnia, non-restorative sleep, and hypersomnia are common symptoms of major depressive disorder (MDD). As it alleviates major depressive disorder, transcranial magnetic stimulation (TMS) may improve associated sleep disturbances, and may also have inherent sedating or activating properties.

To examine the impact of TMS on sleep disturbances in adults with treatment resistant depression in a clinical setting, we retrospectively reviewed de-identified data from naturalistically-treated MDD patients undergoing an initial acute course of TMS therapy at St.Louis Park MinCEP Clinic.

Adults with treatment-resistant depression received daily TMS treatments. 9-item Patient Health Questionnaire (PHQ-9) total scores were used to calculate % change at endpoint (relative to pretreatment baseline); response on both measures was defined as 50% reduction in scores, with remission defined as a final total score 4 on the PHQ-9. Insomnia was measured with a 3-item subscale of the Inventory of Depressive Symptomatology Self Report (IDS-SR). Hypersomnia was measured with a single IDS-SR item. Pairwise comparisons were performed using Student’s T-test. Categorical variables were compared using Fisher’s Exact test. Continuous outcome measures were tested with an analysis of covariance, using baseline PHQ-9 score as a fixed effect covariate.

TMS appears to have differential modulatory effects on insomnia and hypersomnia in adults with treatment resistant depression.

These results may provide the basis for further investigation into therapeutic applications of TMS in addressing sleep disturbances in treatment-resistant depression. Measures that separate hypersomnia and insomnia should be implemented in future work addressing effects of TMS in treatment-resistant depression.

No significant relationships.

Psychiatry is fundamental interdisciplinary medical science with essential importance for enormous health-problems of humanity. Creation of integrative-psychiary in context of multidimensional&holistic medicine, founded by HIPPOCRATES-GALENUS-HUA T’UA-AVICENA-PARACELSUS is necessary to counteract disastrous human health-situation. Psychiatry needs new integrative therapy-models considering application of psychopharmacotherapy as well as practices of psycho-somatic (Th.v.UEXKÜLL) and somato-psychic theories (Y.IKEMI). Emperor AKIHITO during Opening-Ceremony of ICPM-2005-Kobe appointed to consider “total symptoms of mind-body, seeking ways of holistic care”.

REFERENCES. PSYCHIATRY: EPA-2020-virtual/Madrid, Eur.Psychiatry 63S, EPP0834/5+EPV0581/1470; EPA-2019-Warsaw, Eur. Psychiatry 56S,S689; EPA-2018-Nice, Eur.Psychiatry 48/S1, S623&567&662. WPA-2019-Lisbon, E-Poster WCP19-2137, -1822, -1839; 2018-Mexico-City, Abs.-Book WCP18-0584/-0625/-0643/-0654. 2011-Buenos-Aires,AB:PO1.200. PSYCHOLOGY: EFPA-2019-Moscow, Abs.-Book 1529,1530,1549. IUPsyS-2012-Cape-Town, IntJPsychol 47:407; -2008-Berlin, 43/3-4:154, 248,615,799; -2004-Beijing, AB:49,587. PSYCHOSOMATICS: ICPM-2017-Beijing, AB:ID: 648493,648895,648749,648878; -2005-Kobe, J.Psychosom.Res. 58:85-86.

Evaluation of psychic-“polar-attitude-list”/physiological-parameters: heart-rate, blood-pressure,etc. from patients/probands after training by occidental/oriental practices (Music-/Yogatherapy/others) (ref.).

Observations demonstrate strong positive influence after music[1], respiratory[2], hatha-yoga[3] therapies. Items of psycho-physiological (relaxed), emotional (tranquil/happy), cognitive (few/ordered thoughts), voluntary (active/spontaneous), social (open/assertive), consciousness (clear/sleepy) categories are significantly positive changed 25-50%. The 3-therapies have specific psychic-effects,e.g. items “relaxed/tranquil” after respiratory- (+45/50%) and music- (+20/5%), also item “open” after music-therapy (+25%) are positive, but negative after respiratory-therapy (-20%). Psychic-effects are correlated with positive physiological-ones,e.g. heart/respiratory-frequency decreased 25-30%, voluntary-apnoea prolonged 55%. Mountain-altitude (>2000-3000m), hypothermia (<20 to 0°C) influenced positively psychic/physiological-parameters,e.g. heart-rate/blood-pressure decrease (n=125,P<0.05-0.01).

Different methods of integrative psychiatric therapy are with preference,e.g. for depression is suitable respiratory/physical-training, also hypothermia&high-mountain therapy (activation-euphoria), for mania:music-therapy (inhibitory-effect). Systematically research about single/combined therapies is necessary,e.g. for epilepsy: Respiratory-therapy/hypothermia,etc. could help patients (hypo-/hypercapnia: inhibitory/excitatory effects on CNS-structures).

Porencephaly is a neurological condition that can develop before or after birth, characterized by cysts located in any place inside the brain parenchyma, which generally are covered by plain walls and encircled by an atrophic crust. It generates a very variable clinic appearance, with severe cases of high disability and slight cases with a light neurological involvement, which also can go unnoticed until adulthood. The prevalence is unknow and the inheritance is autosomal dominant Male patient of 45 years diagnosed with porencephaly with cerebral palsy that affects left half and cognitive disability. His father reports an emerging defiant behavior, mutism and decrease of appetite from a week ago. No triggering stress factors are reported.

Show the importance of include in the differential diagnose hypoactive confusional syndrome.

On urgent medical visit, male comes with ataxic gates which wasn’t shown before. Inhibited attitude, semiflexed staring at floor, with sparing and monosyllabic speech answers, verbalizing discomfort and personal concern. Sleep-wake rhythm disruptions.

Blood tests and drug screening shows no abnormalities Cranial CT: Without acute lesion Urinary infection observed.

It is important to make complementary test to exclude organic frames which could justify acute-subacute psychopathology. In this case, diagnosis was acute confusional syndrome, however, most known presentation is the hyperactive one which include motor hyperactivity, inappropriate behavior or disorganization and alterations of sensory perception. Hypoactive must always be considered, which is the concluding diagnosis in this case.

No significant relationships.

According to psychoanalytic theory performing circumcision on a boy in phallic phase may aggravate this fear and cause sexual dysfunctions later in life. However this hypothesis is an unverified common-view rather than a scientifically proven conclusion.

We hypothesized that being circumcised during phallic phase is not a risk factor for sexual dysfunction. We also took a peak at how the experience of circumcision is being perceived and its psychological effects. Our secondary hypothesis was, sexual dysfunctions are more frequent among men who had a traumatic circumcision experience.

For this cross-sectional study, a total of 2768 sexually active, circumcised and voluntary men were recruited from 20 different urology outpatient clinics around Turkey.

There was no significant difference for PEDT and IIEF scores between participants who were circumcised at different ages (Graph-1,2). When participants were divided into 3 groups according to their circumcision age in accordance with psychoanalytic theory (before, after and during phallic phase) mean IIEF and PEDT scores did not differ. PEDT scores did not differ either by which emotion the participant describe their experience of circumcision or how vividly he remembered it. However participants who remembered their circumcision experience more vividly and had who describe their circumcision experience with fear/anxiety had a higher IIEF score (Graph-3).

The age of circumcision does not affect the risk of PE. This is one of the very few studies that challenges psychoanalytic theory with a scientific method. Remembering the circumcision experience with fear or anxiety did not increase the risk of sexual dysfunctions.

The COVID-19 pandemic has highlighted a need for engaging online resources to enrich psychiatry training for undergraduate medical students. Podcasting is a well-established digital communication platform utilised daily in a myriad of capacities, including education. A group of medical students were tasked with creating their own educational podcasts covering specific aspects of psychiatry.

Each pair was set a sub-topic of psychiatry and utilised software to produce educational resources. The objective of this project was to reflect upon production as well as explore the efficacy of podcasting as a tool within undergraduate training.

The medical students conducted research and contacted experts within the field to contribute to their podcasts. The majority of the students then conducted reviews of the literature surrounding podcasting within medical education, which informed the production of their own podcasts. From this, it was discussed how this project could impact future practice, and indicated that podcasts may become crucial asynchronous learning tools in medical education.

Literature review and first-hand experience of podcast production enabled the students to appreciate the advantages of podcasting and the potential for its widespread future applications. Their wider reading revealed that podcast-using study participants outperformed or matched their peers in assessments, and overwhelmingly enjoyed using podcasts over traditional teaching methods.

The use of podcasting can complement traditional psychiatry training and appeal to a generation of digital natives that prefer this learning style. Podcast production is also an excellent revision method, highlighting the advantages of peer-to-peer education in both learning and increasing engagement with psychiatry.

No significant relationships.

The COVID-19 pandemic has enforced the restructuring of inpatient psychiatric services. In the UK, the South London and Maudsley NHS Foundation Trust has introduced a triage ward system to ensure all patients have a COVID test prior to admission to the general ward with the aim to reduce COVID transmission amongst psychiatric inpatients.

To characterise the flow of patients through a COVID-19 psychiatric triage ward and the protocol of assessment and management used.

Descriptive analysis of patients admitted to a COVID-19 triage ward since its creation.

The caseload of patients admitted to the COVID-19 triage ward since its inception will be presented. This will include the profile of patients admitted, their status (formal/informal) and their acceptance of COVID-19 tests. The protocol followed at this COVID-19 triage ward will be presented, and the challenges faced and suggestions to overcome them will be discussed.

This presentation aims to share the workflow and protocols adopted at a COVID-19 triage ward in the UK, discussing challenges experienced as well as good practices.

No significant relationships.

No significant relationships.

No significant relationships.