Newborn infants can suffer permanent brain damage as a result of birth asphyxia (ASP), a severe obstetric complication (OC). However, effects of OCs on cognitive abilities and brain structure in schizophrenia (SZ) are unknown.

The main goals of this study were to investigate putative effects of a history of OCs on adult cognition and brain structure in SZ.

We utilized prospective data from the Medical Birth Registry of Norway to identify incidences of severe OCs in adult healthy controls (HC; n = 622) and patients with SZ (n = 607). IQ was assessed, and a subset of participants (n= 414) underwent magnetic resonance imaging.

Severe OCs (27%) and ASP (14%) were equally common in SZ and HC. SZ patients with OCs had lower IQ than patients without OCs, a difference not found in HC (p = .023). Having experienced more than one co-occurring severe OC was associated with lower IQ in both groups, wherein 81% of co-occurring OCs involved ASP. ASP was related to smaller intracranial volume and brain volumes in both groups. Smaller caudate volumes were found in SZ patients with ASP compared to patients without ASP, a difference not found in HC (p = .009).

Our findings give support for an effect of birth ASP on brain development in both patients with SZ and HC. OC history specifically impacts IQ in SZ. Smaller caudate volumes might be particularly related to disease development. These results warrant replication in an independent sample.

No significant relationships.

Since the declaration of the national lockdown in Spain on March 14th until the publication of the SEPB recommendations on May 11th, most of the ECT-U closed or drastically reduced their activity.

To present our non-stop management of an ECT-U during the first two months of COVID-19 lockdown in Spain.

We retrospectively analysed the time between sessions, the clinical, pharmacological and electrical data records of maintenance patients (m-ECT) and compared them with their own records in the two-month period prior to COVID-19. We analysed the length of admission, clinical, pharmacological and electrical records in hospitalized patients (i-ETC) and compared them with patients from the entire year prior to COVID-19 paired by age, sex and diagnosis.

The ECT-m programme included 17 patients: we postponed the ECT in 8 patients; 1 patient was hospitalized and 8 patients continued normally. The time between m-ECT increased by 8.37±4.89 days (p=0.018) without relapse. During the COVID-19 period, we performed ECT-i in 14 patients without new infections. In i-ECT the duration of admissions increased by 22.1 ±1.2 days (p=0.006), the load increased by 81.53 ±87.8 mC (p=0.027) and the time of the electrical seizure decreased by 7.9 ±9.2 seconds (p=0.037).

The modifications that reach a statistical significance are explained by the readjustment of the ECT-U, with no clinical significance. With the appropriate measures, neither m-ECT nor i-ECT were discontinued. Thus we maintained adequate patient management.

No significant relationships.

Borderline personality disorder (BPD) is characterized by instability of interpersonal relationships, self-image, and emotions, and by impulsivity. Although patients with BPD are misdiagnosed, some of them receive mental health treatment. Even if the first-line treatment of this disorder is psycotherapy, the patients with BPD may be highly symptomatic and are often prescribed multiple medications in a manner unsupported by evidence.

The aim of this study is to study the available evidence about the pharmacotherapy for borderline personality disorder.

A review of the available literature about the management of borderline personality disorder and de pharmacotherapy for personality disorders was performed.

First-line treatment of the personality disorders is psycotherapy. The treatment plan for BPD may include individual and group therapy, medication, self-education, specialized substance use disorder treatment, partial hospitalization, or brief hospitalization during times of crises. Medications are generaly used only as adjuncts to psychotherapy and the adjunctive use of symptom targeted medications has been found to be useful. There is limited information to guide pharmacotherapy; preliminary evidence limits the practice of polypharmacy. Sympton-domain focused medication treatment is recommeded by some guidelines: cognitive-perceptual symtoms (low-dose antipsychotic drugs), impulsive-behavioral dyscontrol (mood stabilizers), affective dysregulation (mood stabilizers and low-dose antipsychotic drugs) and self-harm (omega-3 fatty acids).

BPD cause significant distress and impariment of social, occupational and role functioning. The first-line treatment for BPD is psychotherapy; however symptom-focused, medication treatment of BPD is generally considered to be an adjunct to psychotherapy. The data support the efficacy of low dose antipsychotic drugs and mood stabilizers.

Day care programs have been extensively used to treat people with acute psychiatric disorders. Day hospitals (DH) can act as an alternative to admission in patients with acute symptoms, shorten the duration of admission, be useful for rehabilitation and maintenance care or enhance treatment in patients with poor adherence to outpatient care. Few research has been conducted in delusional disorder (DD).

To investigate whether DH care increases adherence with psychiatric appointments in patients with DD. To describe functions of partial hospitalization in DD.

Comparative study including DD patients who attended a DH (Group 1:n=12) versus patients who did not receive DH care (Group 2;n=7). Patients attending DH were classified into 3 groups according to the program function at referral. Adherence with outpatient follow-up appointments (primary outcome) and pharmacy refill data (secondary outcome) were assessed after discharge over a 6-month period (DH) and compared with group 2. For statistical analyses, non-parametric tests were performed.

Program function (DH): alternative to admission (n=4); shortening of admission (n=5) and enhancing outpatient treatment (n=3). Patients receiving DH care were more frequently referred from the inpatient unit or emergency department compared to those who did not attend DH (commonly referred from primary care services). No statistically significant differences were found between both groups in adherence to psychiatric appointments. Patients who attended DH showed higher compliance with antipsychotics (89.29% vs.72.62, p<0.05).

DH care may be a useful alternative to increase adherence with antipsychotics in DD patients with poor awareness of illness.

AGR has received honoraria, registration for congresses and/or travel costs from Janssen, Lundbeck-Otsuka and Angelini.

The purpose of art in art-therapy, in this context, is not an exercise of the already acquired knowledge upon the artistic material, but a discovery of the yet unknown. “Multimedia technology, which has evolved into meaningful visual representations, incorporates the science behind human perception and knowledge…Contemporary visual arts bring together, in different degrees of relationship and fusion, fields of art that until now were understood and practiced more individually. The most suitable territory for this partnership is that of the physical and metaphysical environment, provided by the installationist and shareholder arts.” [1].

Art-based therapies, as nondirective methods, attempt to visualize past traumatic experiences and harmonize the individual with himself and with others.

In the preventive activities we include all activities involving nonverbal communication and holistic engagement. ”Beneficiaries can create their own images with which they want to interact, to arrange their environment…We experiment with art-specific ways to make interdisciplinary exchanges and cultural interferences using the universal language of visual arts along with intercultural elements and religious ecumenism … Sometimes, common themes with schools and higher education are addressed as an extra-curricular complement. Benefits are multiple, diverse and complex, appear on the paths that offer inter/pluri/transcultural learning opportunities and exchange of knowledge, making space and time connections between different cultures. [2]

The creative process and the interaction increases self esteem, courage, taking of risks, the learning of new skills.

New ideas, conceptions and ways of expression emerge, enriching the patient’s life according with the therapeutic purposes. [3].

REFERENCES [1] Chirila, Emilia (2011), PhD Thesis, Educaţie artistică şi art-terapie cu mijloace specifice ceramicii [Artistic Education and Art-therapy within the Specific Means of Ceramics], University of Art and Design, Cluj-Napoca, Romania, p. 390

Web Journal Club as a collaborative learning method, is an effective method to enhance the knowledge base of nursing students, their presentation skills, problem-solving skills and ability to critically appraise literature.

To describe the experience of a online journal club on education of MHN undergraduate students.

We implemented a journal club in the online classroom with a total of 24 portuguese undergraduate students enrolled in clinical training of MHN (sixth semester). Over a two-week period, five 2-hour online journal club sessions were conducted in April 2020. During each session, five journal articles were presented synchronously to a live online audience via the Zoom Classroom technology. After all sessions, students were invited by e-mail to complete an anonymous and voluntary online questionnaire via Google Forms.

All students were all very positive about the journal club sessions and found the opportunity to discuss and reflect on practice issues in depth very helpful. They found the sessions supportive, they helped to bond the group, they learnt a great deal from each others experiences, and they felt that they gained in confidence as a group. Survey results also indicated that few participants experienced technical difficulties during sessions.

This pedagogical practice enhances gains in the various actors involved: 1) in students, contributing to their learning process and acquisition of competences, articulating research and clinical practice; and 2) lastly, even more indirectly, in people receiving care, since a evidence-based practice ensures safe and quality of nursing care delivery.

Globally, depression affects millions of individuals. A third of depression patients meet the criteria for treatment-resistant depression (TRD). The N-methyl-D-aspartate receptor antagonist, ketamine, improved depressive symptoms in a span of 24-hours. Recently, the FDA approved esketamine, an enantiomer of ketamine for TRD.

To determine the effectiveness of ketamine and esketamine in TRD, and observe their role in suicidality.

Individual systematic searches were conducted on the PubMed database following the PRISMA protocol (Figure 1). Inclusion criteria included randomized clinical trials (RCT). Search strings were (i) “ketamine” OR “esketamine” AND “treatment-resistant depression” (ii) “ketamine” OR “esketamine” AND “suicide.” Eleven studies were included for depression and five studies for suicidality (Table 1). Comparison analysis for suicide appeared trivial because of only one inclusion eligible esketamine RCT. This review was submitted for registration at PROSPERO. Randomized odds ratios, 95% confidence interval (CI), and heterogeneity were obtained.

The comprehensive meta-analysis, version 3.0, was used for analysis. Ketamine improved TRD symptoms and reduced suicidality by a nine-fold and three-fold odds, respectively (OR 9.01, CI 4.89–16.6, p<0.001 and OR 2.9, CI 1.67–5.06, p<0.001). Esketamine also improved TRS symptoms (OR= 2.61, 95% CI= 1.56–4.37, p<0.001). The heterogeneity ranged from 11% to 60% between the three groups. Sensitivity analysis did not alter the results.

Findings must be cautiously interpreted as the primary endpoint differed. The primary endpoint was set at 24-hours and 28-days for ketamine and esketamine, respectively. Esketamine’s effectiveness over 28 days appears promising for TRD. Current aim should consist of structured guidance for clinicians in esketamine administration.

Neurocysticercosis is a parasitic infection of the central nervous system and caused by the pork tapeworm Taenia solium. Humans become infected after consuming undercooked food or water contaminated with tapeworm eggs, or through poor hygiene practices. The clinical manifestations of neurocysticercosis (NCC) largely depend on the number, type, size, localization, and stage of development of cysticerci, as well as on the host immune response against the parasite. Seizures are the most common manifestations of NCC (70–90%) of patients, followed by headache (38%), focal deficits (16%) and signs of intracranial hypertension (ICH) (12%), but psychiatric symptoms can also be seen.

Literature review on neuropsychiatric manifestations of neurocysticercosis, based on a clinical case.

Pubmed search using the keywords neurocysticercosis, psychiatric comorbidity, neuropsychiatric manifestations.

We present a clinical case of a 29-year-old male patient, with history of an epilepsy, that immigrated to Portugal with his family from Cape Verde for specialized medical care. He presented to the ER with an acute psychotic episode characterized by disorientation, persecutory ideation, psychomotor agitation and violent behavior. Brain CT scan showed multiple calcifications in cerebral parenchyma and CSF was positive for antibodies against T. solium.

The polymorphous symptomatology seen in NCC is mimicked only by neuro-tuberculosis and neurosyphilis in developing countries, and multiple sclerosis in the Western countries. Psychiatric symptoms are a part of the clinical presentation of infectious diseases. It is important to consider NCC in endemic areas presenting with psychiatric symptoms, especially those showing poor response to the standard treatment and in those with history of seizures.

No significant relationships.

Suicide attempts and suicidal ideation are peculiar aspects of several cluster b disorders, including Narcissistic Personality Disorder. Similarly, difficulty in regulating negative affects can play a role in the relationship between narcissist features and suicidal ideation. To date, it is still unclear which facet of narcissism is more related to the desire to die and which other factors are involved in this relationship.

To offer preliminary empirical evidences concerning the relationship between narcissism, emotion regulation and suicide ideation.

We administered Pathological Narcissism Inventory (PNI), Difficulties in Emotion Regulation Scale (DERS) and Beck Scale for Suicidal Ideation (BSI) to a sample of individuals with Suicide ideation (n= 68) and a sample of community participants (n=140).

Controlling for age and gender, we found that BSI scores correlated significantly with the vulnerable dimension of narcissism, but not with the grandiose one, and with all DERS dimensions. Nevertheless, emotion dysregulation moderates the relationship between vulnerable narcissism and suicidal ideation.

Suicide ideation seems to be deeply connected with the vulnerable dimension of pathological narcissism and the relationship between the constructs is partially mediated by emotion dysregulation. Future directions and clinical implications are discussed.

The study of voluntary attention is necessary to assess the effectiveness of therapeutic, psychotherapeutic and psychocorrective measures. Evaluation of the effectiveness of treatment by analyzing the dynamics of indicators of voluntary attention of adolescents with endogenous mental pathology is necessary for the development of personalized patient management

To analyze the dynamics of indicators of voluntary attention to memory in adolescents with endogenous mental pathology during treatment.

clinical-catamnestic, pathopsychological methods. We examined 153 patients aged 12-16 years (average-13.7 years) with diagnoses of F21.3, F21.4, F20.8xx3 (ICD-10). The comparison group consisted of 143 healthy peers. Methods children’s color train test, Schulte tables. All subjects were examined twice – at the beginning of therapy and at discharge from the clinic.

Analysis of the results of comparing the dynamics of attention in adolescents with endogenous mental diseases during the initial examination and during repeated examination showed that adolescents with diagnoses of F21.3, F21.4, as well as with a diagnosis of F20.8xx3 improve their attention indicators during repeated examination (at p< 0.01). Adolescents of the experimental group showed better results compared to the control group, which indicates that there is a positive therapeutic dynamics of attention in sick adolescents. Comparison of therapeutic dynamics of attention of adolescents with endogenous mental diseases depending on the diagnosis revealed significant differences. Adolescents from the F21 group performed better than the F20 group (at P< 0.01).

The Study showed the effectiveness of the choice of this methodological tool in assessing the therapeutic dynamics of patients.

Our Emotional Schemas dictate how we deal with our own emotions, therefore, how we interpret and face different events that occur in our everyday life. Maladaptive schemas have been proven to be at fault for the inability to face different challenges.

This study aims to find the differences in emotional schemas between subjects with history of psychiatric disorder and subjects without a psychiatric disorder.

We realized a case-control study matched for age and gender, and analyzed the answers of 28 subjects (14 women and 14 men) to Leahy Emotional Schema Scale (LESS); 14 of which have a personal history of psychiatric disorders, while the remaining 14 had no such history. The LESS evaluation was part of a bigger study and was addressed to the general population, over 18 years old. The test was applied online, with the informed consent of the subjects.

The mean age of the participants was 40.28±13.98. Out of the 14 subjects with a psychiatric diagnosis, 71,43% have a job, 21,43% are retired and 1% are still studying. There was a significant difference between the two groups regarding the Higher Values dimension of the Emotional Schemas (p=0.0419). Also, the question regarding the feeling of shame when it comes to their own feeling, showed significant difference between the two groups (p=0.0211).

As opposed to the subjects without a history of psychiatric disorder, those who do have a psychiatric diagnosis, feel more often devalued and ashamed, therefore having a lower self-esteem.

Some research suggests that mental health problems can be brought on by the stress of having unexplained symptom. In non-western cultures especially, psychological distress is often communicated through multiple somatic complaints. The biopsychosocial model takes into consideration all factors affecting health and disease, supporting the integration of biological, psychological and social factors in the assessment and treatment.

In our study we assess prevalence of alexithymia as a potential psychopathological attribute manifesting as unexplained somatic symptoms

196 patients aged 18 to 60 with unexplained physical symptoms for at least three months, after collection of demographic data, medical and psychiatric history, were subject to Arabic version of the following scales : patient health questionnaire PHQ-15 to assess severity of somatic symptoms, patient health questionnaire PHQ-9 to assess depressive symptoms, generalized anaxiety disorder GAD-7 to assess general anxiety disorder symptoms and Toronto Alexithymia scale TAS to assess alexithymia

90% of ours ample were female patients, 49,5% showed alexithymia, 27,6% were borderline alexithymic and 23% had no alexithymia. Patients with unexplained physical symptoms showed moderate to high depressive symptoms in 81,1% of the sample, moderate to severe anxiety symptoms in 73,5%. Severity of somatic symptoms as assessed by PHQ-15 were significantly highly correlated to scores for Alexithymia (TAS), depressive symptoms (PHQ-9) and anxiety symptoms (GAD-7) p<0,001

Alexithymia is prevalent among patients with unexplained physical symptoms. This later population has high prevalence of depressive and anxiety symptoms that go with the severity of somatic manifestations

Smart care in offices and industrials approach has the best way for the results of staying healthy in the transmission chain and this issue is not only a moral necessity but also it can be a successful plan where personal care centers start keeping the patients, employees, and experts of healthcare ward healthy by digital industries. In this project, the environment along with the individual`s body scan and accessing his /her biomarkers, the environment mechanism will be approached to the welfare level to disappear the disease, then change the air by antiseptic materials for air conditioning desirably.

Designing the self-care environment by accessing the smart elements decreases the pathogenic factors in the environment, by scanning the individual`s case and inquiring from health base, the features of the environmental elements will be optimized to normal situation.

Content analysis of environmental components of space and categorizing of sensors. Determining the basic model for programming Designing the architectural environment in accordance with the standards set in the previous section, preparation of the model with thermal, biological, biochemical,.sensors.

Designing the self-care environment by accessing the smart elements decreases the pathogenic factors in the environment, by scanning the individual`s case and inquiring from health base, the features of the environmental elements will be optimized to normal situation.

By a positive design in architectural changes in care units in the field of public spaces, offices and industrial parts, we can easily control individual behaviors in the face of pandemic diseases and decline their psychic side effects.

Our work experience requires investment to run on a real scale

The experimental research of visual perceptual processes in schizophrenia could shed a light on the psychological mechanisms of development of the illness.

To research the performance of visual perceptual tasks and its correlation with the symptom severity in patients with schizotypal disorder (SD).

40 patients with SD in ICD-10 (mean age 29.8±8.3 years) were enrolled to the study. The Positive and Negative Symptoms Scale (PANSS) and two series of visual-perceptual tasks (Figures of Witkin and Goldstein) were applied. In series I subject should make a decision whether a complex figure contains a simple one without any feedback from the experimenter (all 96 trials). In series II each trial included two complex figures presented simultaneously (all 96 trials) that increased the visual-perceptual load. Statistical significance was ascertained by Spearman’s rank correlation.

Negative correlations were established between the number of right answers in series II of visual perceptual tasks and emotional withdrawal (r=-0.78, p≤0.01), passive/apathetic social withdrawal (r=-0.53, p≤0.05). Time of performance of series I and series II had negative correlations with preoccupation (r=-0.55 and r=-0.53, p≤0.05, respectively).

The decrease in the productivity of visual perceptual tasks performance in case of additional load relates with reduced social and emotional dimensions of symptoms (social initiation, passivity, lack of sociality and inattention in daily activity, etc.) of patients with SD. Impulsivity in solutions (reduction of decision-making time) is associated with the increase of preoccupation with feelings, thoughts and autistic fantasies that lead to social and daily life disadaptation.

With the huge increase of life expectancy in developed countries, new needs for long-term care arise in order to guarantee an active ageing for an increasing older adult population. One way to promote emotional well-being and quality of life in elderly is through socio-educational interventions.

To test the effects of a socio-educational intervention in quality of life and mental health of institutionalized elderly.

This study employed a pretest-posttest design. Measures: Portuguese version of Mental Health Inventory (Ribeiro, 2001) and WHOQOL-OLD (Vilar, Sousa & Simões, 2009). Qualitative assessment was made using a logbook. Participants: 15 institutionalized elderly, 60% females, with mean age of 82.5 years (sd=8.5). The intervention ran for 2 months, with 12 group sessions, 60 minutes each, held twice a week. A nonparametric paired samples tests was conducted to evaluate the impact of the intervention.

After the intervention, results showed a significant increase of total value of mental health (p=.021). Concerning dimensions: significant increase of positive psychological well-being (p=.014), emotional ties (p=.050), positive affect (p=.004), behavioural emotional control (p=.018), and a significant decrease of depression (p=.043). Concerning quality of live, the results showed a significant increase of the mean values of the facets: social participation and intimacy (p=.005; p=.027, respectively).

Overall, the intervention implemented with institutionalized elderly had good results, with significant increase of positive psychological well-being and decrease of depression. Although there was no control group, the results suggest that the socio-educational intervention implemented can contribute to promote mental health in elderly.

There is a paucity of information on the exposure of children to violence in Nigeria. The current study aims, as part of a larger study, to explore the experiece of children to violence in their homes in Nigeria.

To determine the prevalence and pattern of violence exposure of children in Ilorin Nigeria.

Cross sectional survey of 1,554 secondary school students aged 11-18 years in Ilorin Nigeria using multistage random sampling technique with proportional allocation was done. Respondents completed the ICAST-CH questionnaire which covers childrens’ exposue to violence. Prevalence of violence exposure was computed.

63.4% (994/1554) of respondesnts had witnessed violence at home. Table 1: Pattern of violence exposure at home in the last 12 months Form Frequency Percentage*

A good number of children in Nigeria might be exposed to violence. There is thus a need for initiative to strengthen family life and control the exposure of children to violence given its potential to cause long standing mental health problems in victims.

No significant relationships.

Women from ethnic minorities who experience mental health problems during the perinatal period are disproportionately represented in involuntary care. They have poorer access to community care but have higher engagement with services once accessed. Their pathways to accessing perinatal mental health care remain underexplored.

To investigate the pathways to perinatal mental health services for women across different ethnic groups, including number of caregivers encountered and time elapsed between referrals.

Analysis of patient records and routine service data from community and inpatient perinatal mental health services in the United Kingdom. Use of an adaptation of the WHO’s pathway encounter form.

Women from ethnic minority groups experience increased levels of complexity on their journey to accessing perinatal mental health care. We will present a detailed analysis of patient and service characteristics.

Referral pathways to perinatal mental health services need to be optimised for women from underrepresented groups.

No significant relationships.

Schizophrenia pathogenesis is known to be associated with chronic low-grade inflammation. Inflammation can be caused by extracellular histones that are released from cells due to apoptosis dysfunction. It can also be accompanied by the formation of natural catalytic immunoglobulins that bind and hydrolyze histones.

To investigate the ability to hydrolyze various histones by polyclonal IgGs from serum of patients with schizophrenia.

We recruited 50 patients (28 men and 22 women) with a verified diagnosis of paranoid or simple schizophrenia and 25 healthy individuals (13 men and 12 women) in our study. IgG preparations were obtained by affinity chromatography and analyzed by SDS-PAGE and MALDI MS. Catalytic activity of IgGs were revealed by the degree of hydrolysis of five histones using SDS-PAGE. To prove that antibodies exhibit histone-hydrolyzing activity, we used rigorous generally accepted criteria. Statistical analysis was performed in Origin 2019.

IgGs of patients are shown to bind and hydrolyze various histones with high efficiencies. The IgGs histone-hydrolyzing activity level, depending on the type of histone (H1, H2a, H2b, H3, H4), was statistically significantly 6–20 times higher than that of healthy individuals (Fig. 1). However, only 21% of patients with schizophrenia had IgGs with very high activity. The IgGs activity level correlated with PANSS General scale.

Fig.1. Histone-hydrolyzing activity of IgG.

We suggest that histone-hydrolyzing antibodies may play a compensatory role in schizophrenia because removal of extracellular histones minimizes the inflammatory responses. Therefore, such IgGs may be the link between inflammation and humoral immunity, and also be a promising biomarker.

This work was supported by Russian Foundation for Basic Research under grant 20-015-00156. E.A.E. is the recipient of the fellowship of the President of the Russian Federation (SP-2258.2019.4).

Benzodiazepines (BZD) are frequently prescribed to patients with bipolar disorder. The use of this medication can become problematic in some cases or even lead to dependence mainly in patients with personality disorders.

To assess different personality traits in BZD-dependent patients with bipolar disorder

A cross-sectional descriptive and analytical study was conducted on euthymic bipolar patients (DSM-5) attending the psychiatric outpatient in Hedi Chaker university hospital of Sfax. We used the Benzodiazepine Cognitive Attachment Scale (ECAB) to determine dependent patients and the Ten Item Personality Measure (TIPI) scale to assess the five personality traits.

Among the 61 included patients, 34 were BZD-dependents (55.7%). Their mean age was 52.12 ± 12.87 years. The sex ratio (M/F) was 0.54. A comorbid personality disorder was found in 18% of patients and the most frequent was histrionic personality (45.45%). According to TIPI, the highest scores of personality traits were conscientiousness, agreeableness and extraversion, with mean scores of 9.8 ± 2.78, 8.21 ± 3.15 and 7.98 ± 1.77 respectively. Having a comorbid personality disorder was not associated with BZD dependence. Regarding the dimensional approach using TIPI, the dimensions of extraversion, agreeableness and emotional stability were significantly negatively correlated with BZD-dependence (p 0.024; 0.006 and 0.01 respectively).

This study demonstrates that personality characterized by less extraversion, agreeableness, and emotional stability may increase the risk of BZD-dependence among bipolar patients. Such psychological factors should be taken into account in the risk-benefit assessment made in the planning of BZD treatment.