The exposure to child maltreatment increases the lifetime risk for many psychopathological symptoms: depression, anxiety disorders, bipolar disorder, schizophrenia, post-traumatic stress disorder, personality disorder and dissociation. Besides, adopted children, especially those with a history of institutional living before adoption, are at greater risk for a range of developmental, behavioral and attachment concerns. The case report is of a 17-year-old male, with reactive attachment disorder (RAD). He suffered child maltreatment in his family of origin before the international adoption.

The aim of this study is to present a case-report illustrating the relationship between chil maltreatment, adopted children and the reactive attachment disorder.

A bibliographic search was performed about reactive attachment disorder. Information regarding the clinical case was obtained by consulting the patient’s file.

A 17-years-old male who was adopted at age of 9 from Spain. According to reports from the orphanage, the patient suffered severe maltreatment by his family of origin, with scars on his back. The patient presents impulse control disorder, with verbal and physical heteroaggressiveness in situations of frustration, hunger and sleep. He stopped attending the institute at the age of 12, with marked isolation and reversal of the sleep-wake cycle. His treatment plan are partial hospitalization, psychotherapy and pharmacotherapy.

Both child maltreatment and adoption are risk factors for the presence of psychopathology during the lifetime. Especially during the pre-adoption process and the first years after adoption, both the family and the child should be able to use specialized Mental Health services.

No significant relationships.

Social Media Misinformation During the COVID-19 Pandemic: Impacts on Public Mental Health

Some behavioral measures such as handwashing, masking or social distancing are among the most effective tools to combat COVID-19 pandemic.

Describe the extent to which major media outlets in the United States and Spain have tweeted about COVID-19 health related behaviors, and determine if differences exist between major media outlets in the two countries.

We analyzed contents posted on Twitter by 25 major media outlet’s (15 from USA and 10 from Spain) about COVID health related behaviors (HRB). News content were analyzed and classified as well as Twitter users’ reactions.

Masking and quarantine were the HRB that generated most of the tweets. However, we found differences between media outlets in the two countries. Twitter user´s engaged more with tweets posted by USA media. Most of the tweets describing HRB from the general population were consistent with CDC/WHO guidelines.

Understanding the public view of these HRB is necessary to design promotional strategies aimed at the appropriate population.

No significant relationships.

A variety of psychological determinants, such as vulnerability to stress, low levels of psychological well-being and several comorbidities, have been hypothesized to play a role in the development, and maintenance of Internet Gaming Disorder (IGD). However, evidence has been insufficient to sustain an overarching model of the causal pathways leading to IGD.

. This study aimed to depict a model of the causal links between vulnerability to stress, psychological well-being, and symptoms of common mental disorders (e.g., depression, generalized anxiety, phobic anxiety, obsessive-compulsive disorder, somatization, and hostility).

. A community-based sample of Portuguese gamers (N = 153; Mage = 21.92; 15.29% female) completed measures of IGD (IGDS9-SF), mental health (SCL-90-R), psychological well-being (EBEP), and vulnerability to stress (23QVS). A machine learning algorithm – Greedy Fast Causal Inference – was used to infer a model of the causal pathways linking those psychological determinants to IGD.

. Hostility and psychological well-being were directly involved with a subgroup of IGD symptoms (i.e., gaming used as escape, tolerance, withdrawal, and loss of control). Stress vulnerability and symptoms of mental disorders were only indirectly implicated in the causal pathways leading to IGD.

. It is likely that several psychological factors implicated in the causal pathways leading to IGD, have not been yet identified. Future research should directly test specific models of the causal pathways involved in the development and maintenance of IGD symptoms.

No significant relationships.

The uncertainty of contemporary social contexts fosters suspiciousness and anaclitic anxieties. In the context of interpersonal relationships this manifests in cognitive distortions and magical thinking, specially in the vulnerable populations.

To study the ability of understanding social causality and its relation to magical thinking and ambiguity intolerance in schizophrenia and controls.

Participants were 40 inpatients with paranoid schizophrenia and 40 controls. Understanding of social causality was measured by corresponding SCORS-S scale for Thematic Apperception Test, Magical thinking was measured by SPQ-74 and intolerance to ambiguity by the New Tolerance-Intolerance to ambiguity questionnaires.

The understanding of social causality was less developed in schizophrenia group (mean values 2.28 and 3.28, p<.001). They manifest omissions of psychological aspects, logical faults and inconsistencies in depicting social relationships. Magical thinking was higher in clinical group (4.32 and 2.33, p<0.001). Two measures were significantly (p<0.05) correlated in both groups. Regression analysis indicates that 37.7% of variance of dependent variable ‘understanding of social causality’ (R2=0,377) was predicted by ‘magical thinking’ (-0,398, p<0,001) and ‘tolerance to ambiguity’ (0,412, p<0,001). The overal level of tolerance of ambiguity was higher in control group (52.2 and 61.0, p<0.002).

Tolerance of ambiguity, being more characteristic for normal population, underlies the understanding of social causality. In contrast, the intolerance to interpersonal ambiguity is related to increment of anxiety, failures in cognitive elaboration of interpersonal relationships and leads to superstition and illogical beliefs. This relationship has a heuristic value for understanding what is happening to vulnerable individuals in the context of current COVID pandemic.

Emotion regulation is a key world to understand many human behaviors. Preschool children can exhibite disturbing behaviors that could interfeer with their integration, development and learning abilities. One way to understand these behaviors is their “immature” emotional regulation process. Helping children acquiring this ability can help to solve these disturbances’, which can lead to mental health problems.

To experiment with a new acceptance and committment therapy protocol in preschool children

It is a qualitative interventional study that relies on issues to enable the recognition and regulation of emotions. a protocol was implemented which consists of activities and techniques useful to help children recognize, regulate and accept their emotions, with the support of the educator.

All six selected children accepted to undergo the therapy till the end of the eight sessions. at fisrt, they were enable to recognise some emtions. it was the most difficult for them to recognise body expression of emotion. they had also difficulties find the different worlds to express them and to enact them.Throw different activities, we tried to help children visualize their emotions, imagine them under different faces and play with them. Children were introduced to mindfulness and emotional regulation technics. After One month of the intervention, children were still able to recognize emotions and to propose technics to regulate them. their score on the CBCL were below 70 one month after the intervention.

Even at an early age of 4 years, ACT seems to be possible and helpful for children.

The link between autism spectrum disorder (ASD) and anorexia nervosa (AN) firstly emerged in the 80’s. Given the overlap in behavioural and cognitive features between these two seemingly different disorders, AN has been hypothesized to be a female phenotype of ASD.

This report aims to describe a clinical case of an anorexic female patient diagnosed later in life with ASD, while presenting a bibliographic review on the subject.

After gaining consent, detailed information about the case history was collected and medical records were analysed and reviewed. A non-systematic literary review was performed on the Pubmed and Cochrane databases using the key words “anorexia nervosa”, “females”, “comorbidity” and “autism spectrum disorder”.

The current case report is of a 28-year-old female, whose extremely low body weight and complete food refusal for three days prompted her first hospitalization in a psychiatric unit with the admission diagnosis of anorexia nervosa. However, long-term impairments in social interaction and flexibility, emotional difficulties and sensory processing overload were acknowledged and the primary diagnosis of ASD was then considered.

As illustrated in this case, the diagnosis of ASD should always be considered in females with eating disorders, in particular AN, regardless of age. As this neurodevelopmental condition appears to present differently in females, they also seem more likely to go underdiagnosed. Also, due to poorer treatment outcomes in females with both ASD and AN, the importance of developing a specialized approach and prompt referral of these patients is highlighted.

No significant relationships.

The persistent and recurrent use of the internet to engage in games, often with other players, which leads to clinically considerable deficits and online dependency still lacks more research support its impact of attentional levels and Sleep Quality.

To assess levels of Online Gaming Dependency, its impact on attention levels and quality of sleep among online gamers.

The following instruments were used: a sociodemographic questionnaire, as well as the Video Game Behavior Assessment Scale (α = .842) and the Portuguese version of Color and Words Stroop Test. The sample consists of 66 individuals, 92.3% male and 7.7% female, with an average age of 23.1 (SD ± 4.07).

Mild levels of online gaming dependency were obtained. Male gamers presented higher motivation to play online games, and higher levels of Stroop interference. Regarding the association between gaming behaviors and quality of sleep, results show that individuals who have difficulty falling asleep show greater motivation to play online games, a greater degree of concern with daily life and a greater frequency of negative behaviors in relation to online gambling.

The results show the importance of an increase in investigations in this area, as well as to the development of psychological assessment instruments and psychological intervention strategies, based on scientific evidence, on the different variables under study, in order to improve the quality of life in of individuals.

Glucagon-like peptide-1 (GLP-1) is an endogenous peptide that stimulates insulin secretion and decreases glucagon secretion. The use of GLP-1 receptor agonists (GLP-1RA) showed efficacy reducing the weight and glucose levels in patients with and without type 2 diabetes. This effect was also associated with a decreased risk of major cardiovascular events.

Our aim is to review the role of GLP-1RA in psychiatric patients at cardio-metabolic risk due to antipsychotics treatment.

We reviewed articles published in PubMed using the keywords: “GLP-1” “glucagon like peptide” “antipsychotics” and “psychiatry”.

The number need to treat (NNT) to achieve clinical meaningful weight loss was 3.8. GLP-1RA treatment was also associated with greater reductions in body mass index, fasting glucose, HbA1c and visceral fat. This effect is true for antipsychotic treatment in general and for those on clozapine and olanzapine in particular. Overall, the GLP-1RA are well tolerated with nausea being the most common related adverse effect. Other variables such as age, sex, psychosis severity, nausea or any adverse drug reaction did not affect the weight loss.

Studies showed a promising role in the management of antipsychotics induced weight gain, particularly in clozapine and olanzapine treated patients. Although these promising results, the route of administration, with a daily or weekly subcutaneous injection, and the GLP-1RA associated financial costs, can be viewed as important factors which can limit the wide use of this type of treatment in psychiatric patients.

No significant relationships.

The relationship between epilepsy and depression has been recognized for a long time. In fact, the presence of depression could worsen the disease outcome.

we aimed to study the prevalence of depression in patients with epilepsy and to assess the determinant factors of its genesis.

54 patients with epilepsy, aged more than 18 years, attending the neurology department of Habib Bourguiba Hospital, Sfax, Tunisia, were enrolled for the study. All patients were administered Mini-International Neuropsychiatric Interview (MINI) for evalution of psychiatric comorbid disorders especially depression. Socio-demographic and clinical data were collected.

A total of 54 patients were included, of whom 63% (n =34) were men. Mean duration of epilepsy was 20.13 years. The most frequent type of seizure was generalized 72.7%. Depression was present in 7.3 % of patients. Alcoholism (p=0.027) was significantly associated with occurrence of depression. Drug resistence (p = 0.03) and longer duration of epilepsy (p = 0.046) were significantly associated with occurrence of depression. No significant association was found between type of seizure, seizure frequency, medication compliance and depression. Depression wasn’t associated with anti-epileptic drug. We didn’t find any association between depression and other psychiatric comorbidities.

Depression wasn’t frequent in our study contrary to literature. The possible explanations are the reduced simple size and the sensitivity of the used tool to assess depression in epilepsy. Pursuant to literature, we found significant association between Alcoholism, drug resistance and long duration of epilepsy.

Personality traits play are related to many forms of psychological distress, such as body dissatisfaction.

To explore the associations between appearance schemas and personality traits.

494 university students (80.2% females; 99.2% single), with a mean age of 20.17 years old (SD=1.77; range:18-20), filled in the Appearance Schemas Inventory-Revised, the NEO-Personality Inventory, and the Composite Multidimensional Perfectionism Scale.

A significant difference was found in Self-evaluation Salience scores by sex [females (M=37.99,SD=7.82); males (M=35.36,SD=6.60);t(489)=-3.052,p=.002]. Having conducted correlations separately, by sex, Self-Evaluation Salience was correlated with Concern Over Mistakes (r=.27), Doubts about Actions (r=.35), and Socially-Prescribed Perfectionism (r=.23). For females, Self-evaluation Salience was correlated with Concern Over Mistakes (r=.34), Personal Standards (r=.25), Doubts about Actions (r=.33), Parental Expectations (r=.24), Parental Criticism (r=.24), Organization (r=.11), Socially-Prescribed Perfectionism (r=.31), Self-Oriented Perfectionism (r=.32), and Neuroticism (r=.33). Concerning Motivational Salience, in the total sample (not separately, by sex), this scale/dimension significantly correlated with Conscientiousness (r=. 18), Personal Standards (r=.23), Socially-Prescribed Perfectionism (r=. 10), and Self-Oriented Perfectionism (r=.29).

Females seem to value more their self-appearance and, in females, the salience of appearance in life seems to be associated with maladaptive-perfectionism, as well as with adaptive-perfectionism. In males, the salience of appearance was only related with adaptive perfectionism. Males seem more concerned with their own standards, while for females other´s standards are also relevant. In females the level of salience of appearance in life seems to relate to the experience of feelings, such as anxiety/depression (neuroticism). The motivation to improve appearance seemed to be particularly related, in both sex, to adaptive perfectionism.

No significant relationships.

No significant relationships.

The intravenous (IV) is one of the main parenteral routes for drug administration. Rapid onset of action, precise titration, patient-specific dosing and bypass of liver metabolism are a few of its advantages, while hypersensitivity reactions, adverse effects, infection risk and a higher overall cost some of its most debated downsides. Unlike other areas of Medicine, IV has been significantly under-utilized in Psychiatry.

This systematic review analyzed the evidence for effectiveness and safety behind the use of IV medication used for the management of acute disturbance.

APA PsycINFO, MEDLINE, and EMBASE databases were searched for eligible studies. Studies were included if they used IV medication to treat acute disturbance, in English language, had participants aged >18. The quality of the included studies was assessed using the National Institutes of Health quality checklist.

17 studies were deemed eligible. Data analysis was limited to narrative synthesis since primary outcome measures varied significantly between each study. Findings showed strong evidence for efficacy and safety of dexmedetomidine, droperidol, midazolam, and olanzapine. These medications displayed a short time to sedation, reduction in agitation levels, or large percentage of patients adequately sedated with a low number of adverse events. Results did not provide enough evidence for the use of IV ketamine, haloperidol, diazepam, lorazepam, and promethazine.

This review supports dexmedetomidine, droperidol, midazolam, and olanzapine as safe and efficacious options for managing acute disturbance via the intravenous route, particularly in special clinical settings where trained staff, optimal monitoring, resuscitation equipment and ventilators are all at hand.

While prison inmates have an increased risk of mental illness, psychiatric services are often less accessible and insufficient for this group. A low level of awareness or a fear of becoming stigmatised could also influence the help-seeking behaviour of some inmates.

To study the knowledge and beliefs regarding mental health and mental illness as well as the help-seeking behaviour of inmates in Norwegian prisons.

We describe a study of help-seeking behaviour and mental health literacy of prisoners. This is a qualitiative study involving in-depth interviews with inmates in prisons in North Norway.

Recruitment and data collection is ongoing. Central topics in the interviews are inmates’ associations regarding positive mental health and how they can enhance their own well-being while in prison, and how other external factors can contribute to increased well-being. Furthermore, the inmates are asked about their attitudes, beliefs, and knowledge regarding mental illness, and what they think might be factors that can contribute to the development of mental illness. Moreover, we cover topics such as the inmates’ beliefs regarding the treatment of mental illness, strategies for handling such health problems, and sources of information regarding mental health and mental illness.

The study will increase knowledge about how prisoners think about mental health and mental illness and the help-seeking behaviours of prison inmates. In a next step, this understanding can be utilized in improving information about well-being, mental illness, and psychiatric services to prisoners.

First-episode psychosis (FEP) is a particularly high-risk period in which risk for suicide death is elevated by 60% as compared to individuals in later stages of psychotic illness. Clinical insight and cognition have been studied in schizophrenia in relation to suicide ideation and attempt, yet, less is understood within the context of early-phase of illness and FEP.

This study examined whether clinical insight and cognitive functioning served as a mechanism in the relationships between depression, positive symptoms, negative symptoms, and suicide ideation over time among individuals in FEP.

Data were obtained from the Recovery After an Initial Schizophrenia Episode (RAISE) project. Participants (n=404) included adults in FEP between ages 15 and 40. Structural equation modeling was used in Mplus8 to examine the proposed mediation model.

Clinical insight and working memory functioned as mechanisms in the relationships between depression, positive symptoms, negative symptoms, and suicide ideation. As depression decreased and positive and negative symptoms increased, clinical insight was shown to be poorer, which in turn related to decreased suicide ideation. As positive symptoms increased and negative symptoms decreased, working memory was shown to be stronger, which in turn related to decreased suicide ideation.

Implications surround the importance of cognitive testing and approaches aiming to strengthen cognitive functioning given the relationships between cognition and suicide ideation in FEP. Also, of importance, it is imperative practitioners have awareness of the insight paradox given the complex and dynamic relationships between clinical insight and suicide thoughts and behaviors.

Studied the role of self-esteem in the regulation of mental states in the educational activities of students.

The aim of the research is to reveal the interrelationships of states’ substructures (mental processes, experiences, behavior) with the level of self-esteem of students.

The study involved 69 students of the 1st and 2nd year, all humanities. The study was carried out in various situations of educational activity: at lectures, seminars, exams. Used the methods to study mental states, style of self-regulation and self-esteem.

Found that as the level of self-esteem increases, the intensity of mental states’ substructures also increases, and vice versa. As a result of ANOVA use, found that the regulatory properties “independence” (p <0.001) and “ability to program actions” (p <0.002) exert the greatest influence on the interaction of mental states and self-esteem. In lectures, seminars students with a low level of self-esteem mostly experience states of low intensity. Students with an average level of self-esteem are characterized by positive states of an increased level of intensity: from cheerfulness and anticipation to interest and fun. Students with high self-esteem experience mental states different in modality, intensity. As the level of self-esteem increases, the intensity of mental states’ substructures manifestation increases, and vice versa.

Average self-esteem is most optimal for the regulation of mental states. In the case of high self-esteem, the most optimal states are experienced when the subject is highly independent. Low self-esteem students, experience the least intense states. This work was supported by the RFBR grant № 20-013-00076.

No significant relationships.

Over the past decades, immunotherapy treatments have been a revolution to many chronic diseases with encouraging results in clinical outcomes and quality of life. The use of monoclonal antibodies has yielded a great variability in terms of clinical efficacy and tolerability although it’s believed the incidence of psychotic symptoms is low (0,1-0,4%).

To review the effects of monoclonal antibodies on psychosis.

Review of literature using PubMed database. A total of 16 studies were included.

The targeted molecules by monoclonal antibodies may determine the risk of psychosis. While those who target TNF-alfa seem to have a reduced risk of psychosis (such as Infliximab, Adalimumab, Certolizumab and Golimumab), monoclonal antibodies who modulate lymphocytes may have a greater risk of psychosis namely Natalizumab, Belimumab, Basiliximab and Daclizumab, which seems to correlate to evidence of alterations in lymphocyte subsets in groups of patients with first psychotic episode and schizophrenia. Some seem to have positive correlation with psychosis namely monoclonal antibodies who have a supressing effect on the immune system, especially those who target adaptative immunity and those who are used in autoimmune diseases (vs oncologic conditions). It is unknown if delusions prevail over hallucinations or vice-versa. Despite the paucity of evidence, these findings corroborate the variability regarding the psychiatric effects of immunotherapy.

The available literature reports a low prevalence of psychotic symptoms associated with the use of monoclonal antibodies but it highlights the importance in knowing the immune mechanisms involved in psychotic disorders. Greater research is needed to correctly assess that risk.

In order to prevent relapse and increase medication adherence, primary care physicians and psychiatric inpatient units should consider referring patients with delusional disorder (DD) to specialized outpatient clinics for treatment and follow-up.

This poster describes a sample of DD patients referred to a specialized unit for DD and documents rates of follow-up care.

Over a 2-year period, 29 individuals were consecutively referred to the Parc Tauli -Delusional Syndrome Working Group, which provides treatment and clinical care for patients with delusional disorders for a catchment area of nearly 450.000 inhabitants in Sabadell (Barcelona, Spain). Criteria for inclusion in the program are relatively flexible. Referred patients are evaluated at baseline and at 6 months following their first appointment. Treatment and case management are offered by a multidisciplinary team consisting of psychiatric, nursing, and social work personnel. Psychological interventions are also offered.

Of the 29 persons initially referred, 27 attended at least one scheduled appointment. Twenty-one out of the 27 patients received a confirmed diagnosis of DD (14 women,7 men), 2 suffered from schizophrenia and 4 were diagnosed with other psychiatric disorders and referred to other programs: primary care (n=2), affective program (n=1) and addictions unit (n=1). A breakdown of DD subtypes follows: persecutory (n=10,47.6%), jealous (n=4,19%), somatic (n=5,23.81%), mixed (n=2,9.5%). Three patients with DD (14.3%) were lost to follow-up. Attendance rates of the 21 DD patients: 80.4% (Women:77.67%, Men:100%).

For a traditionally difficult-to-engage population, adherence to multidisciplinary clinic appointments was relatively high. Loss to follow-up was lower than would have been expected.

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

In order to understand etiopathogeny of any mental illness, it is important to be aware of the sequential emergence of symptoms, having presentations, that appear before, after or simultaneously. We could understand mental pathology as the sumatory of different factors and vulnerable cerebral substrates. Adverse external factors influence over them, causing relapses, that would lead to the evolution of diagnosis through time. However,patients usually come when pathology is already developed. Interventions are delayed, what is insufficient to modify the course of the illness.

Proving that replacing classic clinical evaluation by an open access/multiintervention model, would determine a better prevention and reduction of relapse tendency.

We have arranged a prospective descriptive study of 124 users along 2 years. The idea was to test a first sample which let us check the viability of our project. We adopted a qualitative approach, linking practice and research, which have implied to perform a structured clinical process based on a dynamic reevaluation performed for different professionals in various stages using Rodman’s model.

MultiIntervention model reduces the prognosis factor of delayed treatment thanks to reaching a high risk group in the early stages. That model allows us to determine the way each factor relates to each other, what facilitates multiple-intervention that tries to eliminate the symptom and also the relapse.

Late adolescence and early adulthood are stages in which many mental disorders start, however treatment delays some years. Rothman’s model may be a useful tool, what means a multiintervention treatment that mixes biological and psychosocial interventions.

No significant relationships.

Vortioxetine has demonstrated sustained efficacy and favorable safety profile in multiple clinical trials.

This study aims to describe the effectiveness and safety of vortioxetine in real-world clinical practice.

RELIEVE is a prospective, multi-national, observational cohort study of outpatients initiating vortioxetine treatment for MDD at physician’s discretion and followed for 6 months. Data were collected at routine clinical visits. The primary outcome was functioning measured by Sheehan Disability Scale (SDS). Depressive symptoms measured by Patient Health Questionnaire 9-item (PHQ-9), cognitive symptoms measured by PDQ-5 and DSST were key secondary outcomes. Safety outcomes including adverse events were reported. This interim analysis presents results of 527 patients who completed the study and were followed for 6 months. Mixed models of repeated measures were used to assess improvements between baseline and month 6, adjusted for relevant confounders.

A total of 527 patients (mean age, 50.2 years, 65% female) were enrolled from US, Canada, France and Italy, and included in the analysis. Mean SDS total score, PHQ-9, PDQ-5 scores decreased by 8.6, 7.4 and 4.7 respectively from baseline to last visit. Mean DSST score improved by 6.5 from baseline to last visit. Patients’ overall functioning and quality of life significantly improved, sick leave days and underproductive days (both absenteeism and presenteeism) decreased over the entire follow up period. The overall incidence of adverse events(AE) was 25%, with the most common AEs being nausea and headache.

The results confirm the effectiveness and good tolerability of vortioxetine in a broad range of patients in routine clinical practice.

Dr. Mattingly has served as researcher, consultant or speaker for Akili, Alcobra, Alkermes, Allergan, Axsome, Boehringer, Forum, Genentech, Jansen, Lundbeck, Medgenics, Merck, Neos, NLS Pharma, Otsuka, Reckitt Benckiser, Roche, Sage, Shire, Sunovion, Supe