Diagnostics of Apocalyptic variant of end-world Delusion with Religious Content (ADRC) in schizophrenia is related with insufficient exploration and recognizability, despite the severity of the state, social risks and resistance to psychopharmacotherapy.

To define psychopathological and phenomenological features of ADRC in schizophrenia, to identify the clinical dynamics of delusional disorders due to specifics of the delusional behavior, and to develop diagnostic and prognostic criteria.

28 patients with ADRC in schizophrenia were examined (ICD-10: F20.0, F20.01, F20.02). Clinical-psychopathological and statistical methods were applied.

Delusional ideas of end-world, Apocalyptic variant, occurred in the structure of affective-delusional state (acute sensual delusion with fantastic content). Two types of ADRC were identified: with the predominance of acute sensory delusions of perception and with the predominance of visual-figurative delusions of the imagination. These types differed in the severity and depth of psychotic manifestations and in the specifics of a delusion formation, were characterized by the mono- or polythematic delusional disorders.

Cases of ADRC differ both in the clinical-psychopathological specifics of delusional constructions, and in the socio-behavioral aspect. Among these cases, there is a high risk of delusional destructive behavior, with auto-aggressive, suicidal attempts and hetero-aggressive behavior. In cases with ADRC the strong persistence of delusional pseudo-religious beliefs occurs, with the refusal of any medical and psychological assistance, as well as implication of socially dangerous acts associated with the spread of delusional ideas and their induction of religiously inclined persons, which leads to the emergence of pathological pseudoreligiosity (distortion of traditional canonical religious views).

No significant relationships.

Internet is an important sphere of activity in children 7-11 years old (Finkelhor et al., 2014; Li et al., 2015; Nasi, Koivusilta, 2013) creating a sphere of possible mental health risks (Livingstone et al., 2011). Neurocognitive deficiency could increase these risks online due to control and change replies and activities online.

The aim was to study relationship between neurocognitive functioning in children 7-11 years old and their self-appraisals online and offline.

50 children 7-11 years old (primary school in Russia, 25 males and 25 females) participated in neuropsychological observation (Akhutina, 2016) and filled Dembo-Rubinstein scales of self-appraisals both for Internet and offline (used descriptors: healthy, happy, clever, kind, confident, independent, Cronbach’s alpha=.63-.65).

Difficulties in the functions of programming and control, serial organization, auditory-speech processing are related to better self-appraisals online (r=.30-.35, p<.01) but not offline. Difficulties in functions of the right hemisphere are more strongly related to online self-appraisals (r=.51) than to offline self-appraisals (r=.31). Adjusting for offline self-appraisals, serial organization, auditory-speech processing and functions of the right hemisphere predict difference in offline and online self-appraisals (ΔR²=6.6-13.0%, p<.05).

Neurocognitive deficiency in children 7-11 years old could lead to unrealistic appraisals of themselves online but not offline increasing probability of problem behavior in the Internet. Study is supported by the Russian Foundation for Basic Research, project 19-29-14181mk.

Study was supported by the Russian Foundation for Basic Research, project 19-29-14181mk. There are no other significant relationships.

The coming out of depressive disorders seems to be associated with severity of schizophrenia’s disease and with poor quality of life (QoL).

The aim of our study was to assess the relationship between depression and QoL in patients with schizophrenia.

This is a cross-sectional and analytical study including stabilized patients with schizophrenia or schizoaffective disorder followed up in the outpatient psychiatry department at Hedi Chaker hospital university of Sfax (Tunisia), between August and October 2019. We used the Calgary Depression Scale (CDS) to evaluate depression and the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q-SF) to assess QoL.

We recruited 37 patients with a mean age of 49.14 years and a sex ratio of 4.66. Seventy-three (73%) of patients were followed for schizophrenia and 27% for schizoaffective disorder. They were married in 43.2% and 35.1% of patients had a regular work. According to CDS, 18.9% of patients had depression with a mean score of 2.27 (SD 2). QLESQSF mean score was 65.51. Depression was negatively correlated with Quality of Life Enjoyment and Satisfaction (r=-0.59, p<0.001). We did not find a significant difference in depression according to the socio-demographic characteristics of the respondents or the clinical features of the disease.

It is clear that depression in patients with schizophrenia is associated with significant functional disability. Strategies to overcome the burden of depression may instil hope for functional recovery.

Schizoaffective disorder is a psychotic disorder of controversial nosological entity. Affective symptomatology and psychotic features of varying intensity coexist simultaneously in him throughout evolution. The lack of consensus on the existence of this entity determines its diagnostic delay and the absence of specific treatment guidelines.

To review the diagnostic criteria for schizoaffective disorder and the published scientific evidence on the efficacy and safety of the different therapeutic options available. To analyze the efficacy of a multidisciplinary treatment plan implemented in an intensive follow-up program, presenting the evolution of a clinical case.

To review the psychiatric history and psychopathological evolution of a patient diagnosed with schizoaffective disorder from the beginning of an intensive follow-up program in a day center to the present. Review the existing scientific evidence on the usefulness of the treatments used in this nosological entity.

This is a longitudinal and retrospective study of a clinical case in which the areas for improvement are analyzed before implementing a multidisciplinary therapeutic program and the favorable results obtained today. Currently, the patient is euthymic and attenuated and chronic positive and negative symptoms persist that do not interfere with his functionality.

From the implementation of an individualized, personalized and multidisciplinary maintenance treatment plan, an overall improvement in psychopathological stability and functional recovery is observed. Among the psychopharmacological options in this patient, Paliperidone Long Acting Injection (PLAI) stands out for its long-term efficacy and safety.

The dark triad is composed by the personality traits Machiavellianism, narcissism and psychopathy (MNP). Their complexity can make them difficult to interrelate. Artificial intelligence (AI) could help in this endeavour.

To investigate whether AI could predict MNP from themselves.

Data from 210 questionnaires were analysed using an AI. The short Dark Triad questionnaire (SD3) was used to assess MNP. Two of the MNP scores were employed to predict the third one and the procedure was repeated for all of them alternatively. The AI was conservatively tuned to maximize the one-way random intraclass correlation coefficient (ICC) between predicted and real values. Pearson’s r was calculated too. The free and open source programming language R was used for all the analyses. Dataset source: Borráz-León, Javier I. (2020), “Dark triad, attractiveness, mate value, and sexual partners”, Mendeley Data, V1, doi: 10.17632/87vx6jfnrp.1

Machiavellianism, narcissism and psychopathy predictions obtained ICC of 0.593, 0.335, 0.505 and Pearson’s r of 0.608, 0.346, 0.548 respectively. The results were indicative of fair performance, mainly for Machiavellianism and psychopathy.

AI might be useful to predict MNP. This could be utile in many situations, such as dealing with missing data or deciding whether to formally test someone. Finally, the AI used in this study is freely available, allowing anyone to experiment.

No significant relationships.

Psychological problems are common among the pediatric population suffering from a chronic illness, especially compared to the normal population. Stressful life events, such as social distancing measures implemented to counter the COVID-19 pandemic emergency, can strongly influence their epidemiology.

The aim of this study was to assess the prevalence rate of depressive and anxiety symptoms among an Italian pediatric population affected by chronic illness and already under a Children Hospital psychological follow-up program during COVID-19 lockdown.

We conducted a cross-sectional study among 54 Italian children and adolescents affected by chronic illness (mean age: 15y; range: 8.9-18y) during the COVID-19 epidemic period. We assessed depressive and anxiety symptoms with the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorders (GAD-7) questionnaire during scheduled follow-up checks or teleconsulting.

Preliminary results showed an elevated prevalence of depressive and anxiety symptoms (51% and 48% respectively) among chronically ill children during the COVID-19 outbreak. When compared with a non-ill pediatric population (Zhou et al. 2020), rates are + 7.3% higher for depression and + 10.6% for anxiety.

Chronic ill pediatric patients are a vulnerable group and require careful consideration. For this reason, the healthcare system should be able to implement and guarantee adequate mental health support programs and continuity of care. Further research is necessary since the COVID-19 outbreak could be repeated.

No significant relationships.

Altered fear learning processes could be mechanistically linked to the development and/or maintenance of obsessive-compulsive disorder (OCD). From a clinical perspective, the first-line psychological treatment for OCD is cognitive-behavioral therapy (CBT), which is based on the principles of fear learning. However, no previous functional magnetic resonance imaging (fMRI) studies have evaluated the predictive capacity of regional brain activations during fear learning on CBT response in patients with OCD.

We aimed at exploring whether brain activation during fear learning in patients with OCD are associated with CBT outcome.

We assessed 18 patients with OCD and 18 healthy participants during a 2-day experimental protocol where brain activation and skin conductance responses (SCR) where assessed during fear conditioning, extinction learning, and extinction recall within the fMRI scanner. Following the protocol, patients with OCD received CBT.

We found non-significant between-group differences in SCR during fear learning. Patients with OCD showed significantly diminished activation of the dorsal anterior cingulate cortex and the right insula during fear conditioning. Importantly, our analyses revealed a significant negative association between clinical improvement after CBT and activity at the right insula during fear conditioning (x = 39, y = 12, z = -11; t = 5.64; p<0.001; k = 928). This finding is displayed in Figure 1 below.

Patients with OCD may require less fear-conditioned brain responses to achieve the same level of psychophysiological fear conditioning as healthy participants. Interestingly, insula activations during fear-conditioned responses may represent a potential predictor biomarker of response to CBT for OCD.

No significant relationships.

The dual diagnosis among patients with primary psychotic disorders is frequent and causes diagnostic and treatment challenges. In clinical practice, differentiating between substance-induced psychoses and independent (primary) psychoses when the patient is actively using drugs of addiction, is difficult, especially in the acute phase of the psychosis.

The aim of the study is to identify clinical data relevant for differentiating between primary psychoses triggered by addictive drug misuse and substance-induced psychoses, using psychometric scales.

The study was conducted on 111 patients divided in four samples: 28 dual diagnosis psychotic patients (DD), 27 bipolar patients (BD), 25 schizoaffective patients (SCA) and 31 patients with schizophrenia (SCZ). The subjects were assessed using scales for the severity of psychiatric symptoms, cognitive functions and social acuity (theory of mind): BPRS-E (Brief Psychiatric Rating Scale – Expanded), MoCA (Montreal Cognitive Assessment), CBS (Cambridge Behavioral Scale), and RMET (Reading the Mind in the Eyes Test). The tests were performed when patients were in the remission phase of the psychosis.

BPRS-E scores showed significant differences between DD subjects and patients from the other three samples (primary psychoses). CBS revealed significant differences between the DD subjects and patients with schizophrenia spectrum psychoses (SCA and SCZ). RMET identified significant differences between DD and BD patients.

Although differentiating between substance-induced and primary psychoses remains a difficult task, social acuity assessment performed in remitted patients may be helpful in guiding the clinician to establish a more accurate diagnosis.

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.

Parent training is an evidence based and highly effective intervention for conduct disorders in children. Traditionally, only the parents participate in behavioral trainings, implementing the new skills in their homes on their own between the appointments. In some cases, this turns out as not intense enough.

Therefore, we recently implemented the German version of the PCIT Parent Child Interaction Training in our clinic in Zurich, Switzerland.

PCIT is an evidence-based and highly effective intervention for children aged 2-7 years with conduct disorders (Zisser & Eyberg, 2010; Briegel, 2016). Parents visit the clinic weekly with their child and are directly supported in their interaction by the therapists. A special treatment room was set up for this intervention.

We will present our first experiences with this approach in the highly international and urban population of Zurich.

Parents appreciate to work with their child while being directly coached by the therapists. Almost all parents achieved considerable progress in their skills and the conduct problems reduced over time.

COVID-19 as a pandemic has disproportionately affected older adults, including those with dementia. The effects on health and social care systems has necessitated a rapid-response approach to care planning and decision-making in this population, with reflexivity and responsiveness to changing individual and system needs at its core. In light of this, a decision-making tool to help families of persons with dementia was developed using a combination of qualitative data and evidence synthesis.

To develop a decision-aid using a combination of assessment and evidence-gathering methods for families of persons with dementia.

Semi-structured interviews with helpline staff from national end-of-life and supportive care organisations formed the basis of the tool design. Co-design with people living with dementia, current and former carers and experts in general practice and social care shaped the next stage. Simultaneously, a rapid review of current evidence on making decisions with older people at the end of life was undertaken.

Output from interviews covered many topics, including trust, agency and confusion in making decisions in the context of COVID-19. The rapid review of existing evidence highlighted the need to consider both process and outcome elements of decision-making.

Combining different sources and forms of evidence was efficient and valuable in creating a novel decision-making tool for persons with dementia and their families within the context of COVID-19. The decision-aid covered care planning, caregiver support systems, access to information and contingency considerations. Upon publication, the tool was adopted by NHS England and other leading healthcare organisations.

No significant relationships.

No significant relationships.

No significant relationships.

In First Episode Psychosis (FEP), Suicidal Behaviours (SB), Violent Behaviours (VB) and substance use are frequent respectively 10% to 30%, 34.5% and 50% (Pompili et al., 2011), (Tournier et al., 2013). The role of substance use in facilitating SB and VB is described (Large et al., 2011).

We aim to evaluate the impact of substance use in FEP patients. Our hypothesis is that substance use is associated with more SB or VB before first admission.

First admission files of 45 patients diagnosed ICD10 F20 to F29 during the 2013-2018 period were retrospectively studied. SB, VB and substance use (Cannabis, alcohol and opiate/cocaine) before admission were collected. Correlation between SB and VB were tested with cannabis, alcohol, opiate/cocaine use with chi2 Pearson independance test.

The frequencies of suicidal behaviours and violent behaviours were 25 % and 22.7 %. The frequencies of cannabis use, alcohol use, opiate/cocaine use were 56.1 %, 10 % and 16.3 %. A strong significant correlation was found between opiate/cocaine use and violent behaviour, p = 0.011 Chi2 was 6.471 DF 1. No other significant correlations were found.

Suicidal behaviours and violent behaviours are known to be more frequent in psychotic patients with addictive comorbidity. Our french rural hospital retrospective study confirms that violent behaviours in first admission psychotic patients are strongly associated with opiate/cocaine substance use comorbidity.

The course of affective disorders varies significantly in clinical practice. There are many symptoms that are not related to affective disorders that cannot be described in other nosologies. In the present study such pathopsychological phenomena similar to psychotic symptoms and related to symptoms of “schizophrenia risk” were designated as positive thought disorders (PTD). These symptoms are understood as manifestations of delusional and hallucinatory register.

Aim of the study is to identify and validate the differences of neurocognitive functions among patients with positive thought disorders and at high risk of schizophrenia and patients without thought disorders.

In the research there were 17 patients with high risk of schizophrenia dominated by PTD (affective disorders, personality disorders, schizophrenic spectrum disorders) and 18 patients without thought disorders (affective disorders, personality disorders) in the research. Patients aged 17-25 years.

According to the results of the The Complex Figure test, the group with a high risk of schizophrenia had significantly low results on the “simultaneity” scale and points for copying the figure (p-value 0.04 and p-value 0.03). According to the results of the Verbal fluency test, the main group had significantly lower indices on the “loss of instruction” scale and on the number of repetitions (p-value 0.021 and p-value 0.009).

In the group of patients with a high risk of schizophrenia with positive thought disorders there are neurocognitive features in the form of reduced inhibitory control and a lack of simultaneity. The most sensitive methods are the Complex figure test and Verbal fluency Test.

The reported study was funded by RFBR, project number 20-013-00772

In the literature, service users and informal caregivers have been critical towards psychiatric inpatient care. However, little is known about their fears related to hospital care.

We describe service users’ and informal caregivers’ experiences of fear in psychiatric hospital settings.

The data were collected from seven mental health associations located in six Finnish cities. Focus group interviews (f=8) were conducted (2015–2016) with service users (n=20) and informal caregivers (n=15), and were guided to focus on violence and challenging situations in psychiatric care. In a secondary analysis, experiences of fear were extracted from the transcriptions and analyzed using inductive content analysis.

Both groups’ experiences of fear focused on themes related to staff, treatment and fellow patients. Additionally, service users had experiences of fear related to the hospital environment. Fears related to staff involved intimidating personnel using force or acting in threatening ways. Participants also described staff seemingly being afraid of patients and care givers. Three types of fears related to treatment were described: fear of not being admitted to hospital even if needed, fear of being admitted to hospital, and fear of coercive methods used in care. Fear of fellow patients involved being afraid of aggressive, unpredictable behaviors, which could cause, e.g., a lack of sleep at night for service users. Fears related to the environment itself were also discussed.

Being hospitalized can be a difficult experience for service users and informal caregivers. These results can help psychiatric healthcare staff acknowledge areas in care that may potentially cause feelings of fear.

No significant relationships.

The intentional use of drugs before or during sexual intercourse (chemsex) is a phenomenon of special importance in the MSM (men who have sex with men) population due to its impact on mental, physical and sexual health. Sexual health issues related to chemsex practice have been described such as difficulties in achieving sober sex, erectile dysfunction or problems with sexual desire.

To describe the sexual health interventions (including sexual counselling and sexual therapy) for patients with chemsex practices in the NGO Apoyo Positivo in Madrid. We describe the main sexual problems.

Descriptive analysis.

The main sexual problems were dissatisfaction in sexual intercourse without substance and difficulties with sexual desire activation (70%); compulsive sexual behaviour (70%), difficulties with sexual orientation and non normative gender expression, difficulties in erection (34%), premature ejaculation (7%) and delayed ejaculation (10%).

Chemsex is a phenomenon that needs a multidisciplinary approach and mental and sexual health must be taken into account. “Sexo, Drogas y Tu” is a model of collaborative approach which is a pioneering intervention developed by an NGO in Spain.

Goffman defined stigma as an “attribute that is deeply discrediting” and in the last two decades research on this subject grew substantially.Opioids were ranked as the second most common form of illicit drug used worldwide and there is consensus in the literature that opioid substitution therapy (OST), methadone or buprenorphine, are the most effective treatments, although remain underutilized. People with an history of substance use disorders (SUD) are widely stigmatized, a significant barrier to detection and treatment efforts. Care workers were cited as the second most common source of stigma.

The aim is to do a review of the literature of stigma as a significant barrier to OST and present several potential strategies to reduce stigma.

Non-systematic review of the literature with selection of scientific articles published in the last 5 years; by searching the Pubmed and Medscape databases using the combination of MeSH descriptors. The following MeSH terms were used: Opioid Use Disorder; Stigma; Opioid Substitution Therapy

OST providers should actively bring up the topic of stigma in clinic appointments to determine whether the patient is experiencing stigma, and if so, whether it is adversely affecting their ability to continue in the treatment. More active measures need to be taken to help reducing the stigma through public awareness campaigns at local levels, continuing education of health care providers regarding substance OST, and greater incorporation of family members into the program.

In conclusion, further research is required to understand and address this issue.

No significant relationships.

Bipolar disorder (BD) is a chronic, recurring illness that can lead to serious disruptions in functioning.

To evaluate functionning in this population and to explore the relationship with socio-demographic and clinical features of BD.

This is a descriptive and analytical cross-sectional study including patients with BD (DSM V) in euthymia, followed on an ambulatory basis to the Mood Disorders Unit of the Psychiatry A Department at Hedi Chaker Hospital University of Sfax between January and April 2019. Patients were considered euthymic if they scored less than 7 on the Young Mania (YMRS) rating scale and less than 8 on the Hamilton Depression scale (HDRS-17). The Short Function Evaluation Test (FAST scale) was used to evaluate functionning. Global functional impairment is defined by a total FAST score>11.

We recruited 62 patients with a mean age of 45.65 years (SD=13.3) and a sex ratio of 1.13. 88.7% of patients were followed for BD I and 11.3% for BD II. The mean age of onset was 29.37 years (SD=11.6). The mean numbers of manic and depressive episodes were respectively 3.73 (SD=3.8) and 2.48 (SD=2.9). The mean FAST score was 28.97 (SD=15). Overall impairment was observed in 85.5% of patients. Impaired functionning was significantly more frequent in patients with a history of surgery (p=0.046), in those with a higher number of depressive episodes (p<0.001) and in subjects with partial remission (p=0.01).

Thus, the treatment should target not only the improvement of symptoms but also the reduction of the incapacity of patients.