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.

Diabetes is a major public health problem in Tunisia. Its prevalence increases with age. In addition, depression, at the top of mental disorders list, mainly remain undiagnosed, in particular in the elderly and consequently untreated.

The aim of this study was to estimate depressive symptoms and related factors in elderly diabetic patients.

This is a cross-sectional study, conducted among type 2 diabetic patients aged ≥ 60 years old, attending Mahdia’s primary health center, from January 2019 to March 2019. Depressive symptoms were assessed by using the Geriatric Depression Scale (GDS).

95 diabetic patients were recruited. The average age was 75 ± 7.4 years and the sex ratio was 0.9. In our sample, 68.4% of patients were categorized according to having depressive symptoms. The proportion of participants with mild and severe depression symptoms were 25.3% and 43.1%, respectively. Analytical results demonstrate many factors which were significantly associated with depressive symptoms: female gender, living alone, history of hypertension, presence of complication, and using insulin (p < 0.05).

Our study shows that depressive symptoms are common in elderly subjects with diabetes, and there have been many significant risk factors associated with it. So there is need for physicians to detect, confirm, and treat depression in elderly diabetic patients.

Autism-spectrum disorders (ASD) are characterized by deficits in social domains, associated with abnormal socioemotional perception. Although olfaction provides access to socioemotional cues, little is known about the perception of emotional odors considering their social meaning in ASD.

To investigate the subjective responses to emotional body odors (BOs) versus non-social, common odors (COs) in ASD.

Eleven ASD and 49 typically developed (TD) adults were asked to smell negative, positive, and neutral BOs (axillary sweat from healthy individuals exposed to fearful, happy, and neutral film-clips) and COs, and to rate each odor on perceived pleasantness, intensity, familiarity and arousal. Odors were presented for 5 sec. Analyses were performed with linear mixed-effect models with fixed factors (group × odor type × valence) and covariates (e.g., age; intensity for arousal/familiarity; familiarity for pleasantness). Post-hoc comparisons were Bonferroni-corrected.

Odors were perceived as significantly more intense (p=.044) and pleasant (p<.001) in ASD than TD. Distinct response patterns were found in ASD and TD. First, positive BOs and COs were similarly arousing and pleasant in ASD (p>.05), but not in TD (p<.001). Second, positive and neutral COs were equally arousing, familiar and pleasant in ASD (p>.05), but not in TD (p<.001). No differences were observed between BOs in ASD and TD (p>.05).

ASD is associated with abnormal subjective responses to emotional odors, which could contribute to the social communication difficulties characterizing ASD. Since emotional BOs elicit psychological responses in others, analyses on subjective and automatic responses will allow a better understanding of the role of olfaction in ASD.

No significant relationships.

Personality traits like neuroticism and trait-anxiety, as well as the predisposition to a greater sensitivity to pain, are risk factors for dental anxiety. Although perfectionism has been associated with both anxiety and pain, particularly when mediated by repetitive negative thinking/RNT (Macedo et al. 2015; Albuquerque et al. 2013), its role in dental anxiety has not yet been studied.

To analyze the role of perfectionism and RNT in dental anxiety.

A community sample of 552 adults (68.2% women; mean age=35.15±15.79 years) completed the Portuguese versions of:Hewit and Flett Multidimensional Perfectionism Scale–13, State-Trait Anxiety Inventory, Sensitivity to Pain Traumatization/SPT Scale, Fear of Dental Pain/FDP Questionnaire, Perseverative Thinking Questionnaire and Dental Fear Survey/DFS.

Trait-anxiety (r=.225), socially prescribed perfectionism/SPP (r=.177), SPT (r=.286), FDP (r=.509) and RNT (r=.274) were significantly (p<.01) correlated with dental anxiety (DFS total score). Serial mediation analysis using the PROCESS-macro 3.5 for SPSS (Hayes, 2020; Model 6) showed that even controlling for trait-anxiety and gender (as SPT, FDP and RNT mean scores were significantly higher in women, p<.01) SPP plays a significant indirect effect through SDT, FDP and RNT on dental anxiety, which are (isolated or sequentially) full mediators of this relationship (Total effect: .553, p<.001).

This study shows for the first time that negative perfectionism is a predictor of dental anxiety; its influence operates through the increase in levels of sensitivity to pain, DPA and RNT. We suggest that when intervening in this health problem it is important to evaluate perfectionism and try to mitigate its negative impact, namely diminishing RNT and the focus on pain and fear.

No significant relationships.

The COVID-19 viral pandemic has taken the world by surprise. The pandemic has caused a great impact on the mental health and wellbeing of pregnant women with mental health difficulties. Healthcare providers veered towards video-telemedicine to safely and swiftly provide services to its users.

To determine impact of Video-telemedicine on: 1. Access to Care 2. Ease of Use 3. Quality of Care 4. Difficulties of Use 5. Future Prospects of Video Telemedicine

We have decided to conduct a targeted survey to 100 pregnant women who are known to Perinatal Mental Health services to assess the new methods of contact that the viral pandemic has enforced upon healthcare providers.

Pre-pandemic: video-telemedicine was ranked as least preferred Post-pandemic it is ranked as second favourite. 70.4% of responders have confirmed that video-telemedicine significantly facilitated access to care. 23.3% of responders insisted video-telemedicine made the service better. 50% of responders thought it was much easier to use video options to access their care services needs 95.4% of responders felt that video-telemedicine alternatives should remain post-pandemic

Video-telemedicine options have significantly improved the access and quality of services provided by Community Health Services to pregnant women during the pandemic. Video options can also make it easier to reach critical care without negatively affecting the quality of wholistic care provided, in fact, it can sometimes improve it. It is important that the psychiatric field learn from this pandemic and implement these services permanently. Bigger and wider studies need to be done in the future to support these conclusions.

No significant relationships.

Obsessive compulsive disorder (OCD) is a disabling condition that affects the quality of life of both the patient and the caregivers. Similarly, in patients with physical medical illness, caregivers face a significant amount of stress.

This study aimed to assess and compare the caregiver strain index between patients of OCD and medical illness. Moreover, this study will also compare the care giver strain index in the patients of OCD and physical medical illness depending on the severity and duration of the illness.

Study was done at Department of psychiatry, Teerthanker Mahaveer University, Moradabad. In this Cross-sectional study 2 groups of caregivers were included. The group 1 included 30 caregivers of obsessive compulsive disorder patients and group 2 included 30 caregivers for physical medical illness. The Yale-Brown Obsessive Compulsive Scale was used for measuring the severity of OCD and the stress in caregivers were drawn from Caregiver strain index.

This study reported a high objective burden among caregivers of OCD compared with the physical medical illness (P-value=0.002). The age of the caregivers also showed to be significantly associated with the stress in both the groups. The severity of the OCD was shown to be correlated well with the stress of the caregivers (P-value=0.032). In contrast, in physical medical illness the duration of the disease showed no significant association with the caregiver’s stress.

This study showed that in patients with OCD caregivers face a higher strain compared with the physical medical illness.

No significant relationships.

The current pandemic has only confirmed the need for international collaboration and more extended use of telepsychiatry than before. Unfortunately, regulatory constraints and lack of standardization are posing significant barriers to the internationalization of telepsychiatry. A need for global guidelines and service standardizations is of utmost importance in this rapidly growing but not yet well-established field. By mastering telepsychiatry, the professionals also may enable the remote provision of other eMH approaches complementary to well-known, traditional service(s). However, first, one ought to become familiar with the basics of telepsychiatry. Globally standardized telepsychiatric service and uniform regulations are prerequisites for fruitful international cooperation.

- to present the main objectives and messages of the WPA Global Guidelines for Telepsychiatry.

A structured review of the main challenges, innovations, and settings in the first Global Guidelines for Telepsychiatry, published by WPA.

With proper preparation and thoughtful risk management, telepsychiatry can be an invaluable tool for allowing greater access to care. However, certain prerequisites must be fulfilled to achieve the desired goals. These prerequisites are e.g. choice of the technology, settings, patient/provider preferences as well as competencies and skills, all outlined in this document.

This WPA document may pave the way for the development of global regulations in order to break down the barriers of accessibility for both the professionals as well as for the patients worldwide. Further, it may help professionals in setting up a standardized telepsychiatry service(s) in addition to the existing mental health system(s).

I am the author of WPA Global Guidelines for Telepsychiatry but have no financial interest.

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

Female sexual dysfunction (FSD) can be overlooked. Different types of breast cancer surgery could have a different impact on the sexuality of women. Artificial intelligence (AI) could help to determine the relation between those conditions.

To investigate whether AI could predict FSD relying primarily on the time elapsed after treatment and the type of breast cancer surgery.

Data of age, time elapsed after treatment and type of surgery (breast-conserving therapy and mastectomy) were employed to predict FSD status in 128 subjects using an AI. Women with and without steady relations were included in the analysis. FSD prevalence was 27.3%. The AI was conservatively tuned to maximize the positive likelihood ratio considering predicted and real FSD statuses. The free and open source programming language R was used for all the analyses. Dataset source: Nowosielski, Krzysztof; Krzystanek, Marek; Kowalczyk, Robert; Streb, Joanna; Kucharz, Jakub; Głogowska, Iwona; Lew-Starowicz, Zbigniew; Cedrych, Ida (2018), “Data for: Factors affecting sexual function and body image of early stage breast cancer survivors in Poland: A short-term observation.”, Mendeley Data, V1, doi: 10.17632/948n98trm6.1

Predictions obtained a positive likelihood ratio of 5.314. The results were indicative of fair performance.

AI might be useful to predict FSD in women who undergo breast cancer surgery. Furthermore, the results of this study might indicate a moderate effect of age, time after treatment and type of surgery on the probability of FSD occurrence. Finally, the AI used in this study is freely available, allowing anyone to experiment.

Non-suicidal self-injury (NSSI) is a clinical condition defined as intentional, self-inflicted act causing pain or superficial damage without suicidal intents (12-35% of the adolescent community). Several findings show a high correlation between NSSI and impairments in the impulsivity control.

The goal of our study is to evaluate the role of impulsivity in NSSI adolescents, relatively to the inhibitory control, in order to investigate if it can represent a neurocognitive risk factor underlying maladaptive behaviours and which psychopathological dimensions can be associated with this neurobiological process.

30 NNSI inpatients (age range: 12 to 18 years), drug-free, were compared with an age-matched control group, using two behavioural paradigms for the study of inhibitory control: the Stop Signal task and the emotive go/Nogo. Psychopathological traits were evaluated by self-report questionnaires for impulsivity dimensions, suicidality and self-injurious acts. Statistical analyses were performed with SPSS program (p =0.05).

NSSI patients did not present impairments in the global inhibitory control but they had longer movement times in both paradigms and faster reaction times in the Go/no-go behavioural paradigm. Therefore, NSSI patients tended to be impulsive at an early stage of movement (rapid TR) and have to slow down in a second phase (TM slow) in order to have time to rework the cognitive processes underlying movement.

The impulsivity dimension is a complex construct that involves multiple interconnected factors. The study of neuro-cognitive and psychopathological aspects and how they are interconnected is necessary to draw new perspectives on the etiopathogenesis of NNSI.

Religious obsessions constitute an interesting component of the phenomenology of obsessive-compulsive disorder(OCD). Scrupulosity can be phenomenologically similar to other OCD subtypes but the ultimate feared consequence is religious or moral in nature.

To develop a reflexion about religion, belief and its interaction with psychopathology, focusing on a clinical case.

Review of the clinical case and literature.

37-year-old female patient with 4 prior psychiatric admissions. Stable until May 2020. After a brief online relationship patient develops subsequent guilt, anxiety and obsessive images with religious/sexual content. Abruptly, on the day of admission to the ER, the patient eats garlic in penitence and self-flagellate. At inpatient-unit she presented in mutism and total oral refusal, needing nasogastric tube for feeding and medication administration. She was medicated with diazepam and olanzapine, being added fluoxetine later on. In later interviews, a primordial idea based on the prevailing religious beliefs was found: “sex before marriage is a mortal sin”. This itself generated doubt “have I been forgiven” with compulsions of verification/purification (eg. repeated confession) and punishment, and this doubt almost reached a delirious character during the acute episode. Partial egodistonia, lived with suffering although with some continuity with her beliefs. At discharge patient showed insight for the unrealism of this dyad, though the primary idea remained immovable.

Although the pharmacological approach managed to control the most disturbing symptoms presented by the patient, it’s worthwhile to review and to reflect on this report in a wider perspective, within in the light of the relevance to the clinical practice.

No significant relationships.

The importance of ensuring the well-being of physicians is determined by the serious changes in medical organizations that transform the traditional “doctor - patient” relationship and set different indicators of the medical care quality (Melnyk et al., 2020; Sandy et al., 2019; Tawfik et al., 2019).

The main objective was to study the characteristics of the well-being of physicians working in public and commercial medical institutions. The difference in these “environments” is the degree of independence and responsibility in the course of diagnosis and treatment.

The study involved 102 people: 66 of them are employees at public hospitals, 36 –at commercial medical centers. The respondents were offered a methodic package aimed to diagnose: career orientations; the degree of satisfaction with various work aspects; severity of burnout symptoms; subjective assessment of their work.

The estimating factor analysis identified 3 factors (73% of the total variance of the data) –such as emotional acceptance of one’s work, stress and tension, intellectual workload. The indicator of emotional exhaustion among physicians of commercial centers is significantly higher than that of doctors of public hospitals, which indicates a greater emotional involvement in the situation of providing paid services (p≤0.007).

The main direction of psychological work with physicians of commercial institutions is teaching them to regulating the emotional state and to master communicative techniques. An important part of psychological support of physicians in public hospitals is to provide a favorable psychological climate that ensures the professional growth and adherence to humane principles of working with patients.

No significant relationships.

Shame and guilt are often discussed in their association with depression. However, there is a need in deeper understanding of relationship between these emotions and depressive symptoms in personality disorders, where affective patterns do not reach the level of clinical depression.

To examine the differences in shame and guilt levels in normal subjects and patients with personality disorders and their association with depressive symptoms.

In total, 28 patients (M=36.07, SD=11.87) diagnosed with personality disorders and 76 (M=29.67, SD=8.87) healthy individuals were recruited to take part in this study. Patients and healthy controls had equivalent educational level. Participants were given two standardized tests: Beck Depression Inventory and Test of Self-Conscious Affect (TOSCA) – 3.

There were significant differences in levels of guilt between patients with personality disorders (M=64.79, SD=6.78) and healthy individuals (M = 59.92, SD = 11.86), t (102) = 2.603, p = .011. Patients also demonstrated higher levels of shame (M=47.86, SD=9.70) than the participants without diagnoses (M = 43.38, SD = 14.96), however, these differences were not significant t (102) = 1.47, p > .05. It was found that depressive symptoms in normal population but not in patients significantly correlated with levels of guilt (r(76) = .124, p <.01) and shame (r(76)=.188, p<.01).

It might be assumed that shame and guilt play different roles in emotional sphere of healthy individuals and patients with personality disorders, being associated with depressive symptoms in norm and unrelated to depressive symptoms in personality disorders.

Its basic object of study is the understanding of the individual and the group, Scientific direction in the study of behavior is an important feature of psychiatry.

Adolescence is a stage of physical and mental development of human, usually listed between the stage of childhood and legal maturity. in the middle aged 13 and 18 years the sexual way begins.

Education is the primary category of pedagogical theory, which includes the concepts of education and teaching. Physical education is a subject taught in school to train students physically, to enable them to work and to defend themselves. The totality of spiritual, mental and physical qualities or qualities of family and society and learning and working.

By taking preventive measures to close educational institutions against the spread of the covid virus 19, it has affected the education system of students, teachers and parents because it has been physically disconnected from learning and has gone virtually ONLINE, where it has been a form of home isolation.

Parenting is a constant concern for our entire society today, for child and adolescent psychiatry specialists and education experts, especially for all young parents.

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.

The Watersports Inclusion Games is an annual event organised by Irish Sailing and partners that provides an opportunity for individuals of all abilities across the physical, sensory, intellectual and learning spectrums and those experiencing barriers accessing mainstream sport to partake in a range of watersports. 79 volunteers from the 2019 cohort responded to a pilot survey to assess the benefits for volunteers at the event.

This project aims to assess this data in the context of current knowledge about the benefits for volunteers in inclusive sport.

Literature review used the PEO keyword framework in medical and psychological databases, as well as grey literature. Data was collected using SurveyMonkey, quantitative data was analysed using Survey Monkey and SPSS, and qualitative themes were analysed using SurveyMonkey and Excel.

Only one article exploring the benefits for volunteers in inclusive watersports was identified during literature review. This pilot survey analysis is the first on this topic in Ireland, and the largest sample of volunteers in inclusive watersport that we are aware of internationally. Thematic analysis finds that volunteers at this event are primarily motivated by altruistic motives, while the benefits they perceive include both personal enjoyment and growth, and seeing the enjoyment of other participants.

This project demonstrates that inclusive watersports can have many benefits for volunteers. The findings of this study can contribute to the evidence base on the benefits of inclusive sport for all those involved, while also identifying an opportunity for further study on volunteerism in inclusive sport, particularly adaptive watersports.

Ms O’Flynn reports a scholarship from the Health Research Board for this project, Dr Barrett has nothing to disclose, Ms Murphy reports to be the Inclusion Games Office, and thus responsible for the organisation of the Watersports Inclusion Games.

There is a lack of knowledge on utilized pharmacotherapies for treatment resistant depression (TRD).

To investigate the courses of treatment of TRD.

All patients aged 16-65 years and diagnosed with depression in Finland during 2004-2016 were included (identified from nationwide registers for inpatient and specialized outpatient care, sick leaves and disability pensions). New antidepressant users were identified with six-month washout period and followed up for two years to observe the possible emergence of TRD, which was defined as initiation of a third treatment after having two failed pharmacological treatments with adequate duration. Pharmacological treatments were analyzed using PRE2DUP-method.

During follow-up, 177,144 persons had their first registered depression (mean age:39.5, 62.5% women). Of them, 10.9% (N=19,322) met TRD criteria. Among the TRD patients, most common first and second lines antidepressants were as follows: SSRIs (44.6%), mirtazapine (19.0%) and SNRIs (16.5%). As the third line of treatment, 44.2% of TRD patients had antidepressant monotherapy, 32.1% a combination of ≥2 antidepressants, 15.8% antipsychotic or mood stabilizer augmentation and an antidepressant, 4.9% both combination of antidepressants and an augmentation with a mood stabilizer or antipsychotic, 2.7% antipsychotic or mood stabilizer monotherapy and 0.3% ECT monotherapy. Of TRD patients, 36.2% (N=6985) progressed to the fourth line of treatment and most common treatments were antidepressant monotherapy (37.5%), antidepressant combinations (30.8%) and augmentation (20.3%).

Although antidepressant combination and augmentation strategies became more frequent, antidepressant monotherapies were still the most common third and fourth lines of depression treatment.

The study was funded by Janssen and SR is an employee of Janssen.

The presence of psychotic symptoms is highest during acute episodes of bipolar mania. There is no evidence base regarding the implications of psychosis in the prognosis of bipolar disorder, despite common assumption that their occurrence reflects greater disease severity.

We aim to compare sociodemographic and clinical characteristics of inpatients admitted for bipolar mania with and without psychotic features.

Retrospective observational study of inpatients admitted between January 1st 2017 and 31 October 2020 in a psychiatry inpatient unit of a tertiary hospital. Descriptive analysis of the results was performed using the SPSS software, version 26.0.

Between 2017 and October 2020 there were 103 admissions due to mania bipolar I disorder, 53.4% (n=55) with psychotic symptoms. When compared with mania without psychosis, psychotic mania was associated to male gender (71.1% to 39.7%; c2(1, N = 103) = 10,06; p = 0.02) and younger age (t(103) = -2.43; p = 0.017). The proportion of compulsory admissions and average length of stay were similar between mania with psychosis and mania without psychosis. Also, having a manic bipolar episode with psychotic symptoms was not associated to being prescribed a long-acting injectable antipsychotic.

The presence of psychotic symptoms in bipolar manic episodes were associated to male gender and younger age but not to indirect measures of illness severity.

No significant relationships.

Diabetes mellitus is one of the most frequent chronic diseases in Tunisia. Individuals with diabetes mellitus may have concurrent mental health disorders and are shown to have poorer disease outcomes.

The aim of this study was to determine the prevalence of depression and anxiety in diabetics attending the primary care setting.

This was a cross-sectional survey carried out over two months and including diabetic patients followed up at the consultation for chronic diseases at the primary care center of Hiboun, in Mahdia, Tunisia. The validated Hosiptal Anxiety and Depression scale (HAD) questionnaire was used as a screening tool for the symptoms of depression and anxiety.

A total of 64 patients (24 men and 40 women) was enrolled. The average age was 54.5 ± 7.2 years. The mean duration of diabetes was 8.2 ± 2.3 years. The average HbA1c level was 9.1%.Over 48% of patients were overweight. The prevalence of Depression and anxiety among patients with diabetes from our study was 29.6% and 40.6%, respectively. Depression was found to be significantly associated with marital status of widowed, HbA1c level of more than 8.5%, and a family history of psychiatric illness. anxiety was significantly associated with females, unmployement and HbA1c level of more than 8.5%.

Screening of high risk Type II diabetics for depression and anxiety symptoms in the primary care setting is recommended at regular intervals.