The current coronavirus pandemic (Covid-19) is posing new critical challenges on mental health due to widespread social alarm as well as long lasting “physical distancing” as a result of public health protection measures or voluntary conduct. In a period of uncertainty, certain rewarding behaviors, such as the use of the Internet, exercise among other coping strategies might have increased considerably. We will share the results of an international cross-sectional investigation on the impact of physical-distancing on such potentially addictive behaviours to mitigate the pandemic effects, while identifying the most risky patterns and vulnerable populations. The studied sample consists of 3161 participants from Italy (41%), Spain (16%), the UK (12%), Lithuania (12%), Portugal (11%), Japan (6%), and Hungary (4%). Results are currently being analysied.

COVID-19 pandemic and the related restrictions had a significant impact on the living and working conditions as well as the everyday behavior and mental health condition. Aim of the current analysis was to examine the impact of the input-deprived circumstances on the sexual life characteristics. An online survey carried out after a few weeks of the first nation-wide lockdown was enacted in Hungary. 1,755 persons participated in the first wave (50.4% males). Relationship and sexual life satisfaction, sexual intercourse and masturbation frequency were assessed with additional single-item questions about the subjective change (5-pont Likert scale; 1=“decreased significantly”; 5=“increased significantly) in these characetristics since the epidemiological restrictions had been introduced. Furthermore, several potential protective and risk factors were measured (depressive symptoms, perceived stress, loneliness, general well being, intolerance of uncertainty, sensation seeking, and COVID-19 related health anxiety). Linear regression models were calculated to assess which of the former variables predict the subjective changes of one’s sexual life. The analyses resulted in weak standardized coefficients. The subjective change in relationship satisfaction (mean 3.20, SD 0.94) and sexual satisfaction (mean 2.82, SD 0.73) were predicted positively by general well-being (β=.11–0.25, p<.01), and negatively by loneliness (β=-.14-0.19, p<0.01). Loneliness predicted negatively the subjective change in sexual intercourses (mean 2.75, SD 0.89) and masturbation frequency (mean 2.89, SD 0.84) (β=- .10–.12, p<.01), while sensation seeking had no effect (β=-.09, p<.01). The COVID-19 related health anxiety predicted negatively only the change in sexual life frequency (β=-.07, p<.05). The explained variances were rather small (1.7%-11.8%).

We face today the huge and very rapid worldwide growth of behavioural issues related to the use of Internet. The definition of Problematic Internet Use (PIU) refers to new behavioural patterns that can potentially affect in variable degree, from mild to extremely severe, both individual and social wellbeing. PIU is strongly increasing in people affected by different forms of mental disorders and personality disorders, often inducing substantial changes in their clinical phenomenology, with consequent emergence of new symptom and course profiles. On the other side, PIU represents itself with growing frequency as a factor with high potential of inducing progressive psychological and behavioural impairment, with possible negative outcome on personal and psychosocial wellbeing and adjustment, also potentially leading to the development of new specific forms of psychopathology. Among PIU patterns, Internet Addiction (IA) plays a central role, due to its wide diffusion and behavioural as well as interpersonal and social consequences. The worldwide COVID 19 epidemics induced limitations in direct social relationships, such as social distancing, appear to lead to changes of patterns of IA, for an increase of time spent in addictive behaviour and a further reduction of research of interpersonal contacts. Obsessive-compulsive and autistic-like behaviour are differently reinforced by the combined effect of compulsory self distancing and general health concern, but also possibly induced in previously not affected subjects. Anxiety and mood reactivity also contributes to maladjustment profiles. Further evidences and new guide-lines are requested to face this novel and multifactorial social and clinical phenomenon.

GAMIAN-Europe is a patient-driven pan-European organisation, representing and advocating for the interests and rights of persons with psychosocial disabilities.

While recovery is a deeply personal journey it is also a product of interaction facilitated or impeded through the dynamic interplay of many forces, such as among characteristics of the individual, of the environment and of the exchange. To move recovery forward, recovery-oriented systems in recovery-facilitating environments are needed. Mental health professionals can either facilitate or hinder this journey. Service users and families want to feel they are more than their medical concerns, more than ‘the suicidal’ in room five. Respecting individuals and their human rights, active and engaged listening, including patients in their own healing plan, promoting wellness and engaging with compassion build trust between patients and health care professionals, leading to willingness to follow through with care plans. At the same time, by creating emotional connections and environments, not only can frequent burnouts be prevented, but productivity can be increased.

Polyunsaturated fatty acids (PUFAs) are essential fatty acids which are provided to the body through the diet. The brain is one of the richest organs in the body and has a high need in PUFAs. There are 2 main families of PUFAs, n-3 (or omega 3) and n-6 (or omega6). While it is quite easy to find n-6 PUFAs in westernized diets, the need in n-3 PUFAs is poorly reached, leading to decreased level of docosahexaenoic acid (DHA) in the brain. In humans, poor levels of blood n-3 PUFAs and brain DHA are associated to a higher prevalence of cognitive disorders and depression. However, the mechanisms underlying the effect of DHA on brain functions are poorly understood. Using mice models of n-3 PUFAs dietary deficiency or supplementation, we revealed that in the brain, DHA regulate neuroinflammatory pathways, in particular through its effect on microglia, the main innate immune system cell in the brain. In addition, n-3 PUFAs are key actors of ndocannabinoid- dependent synaptic plasticity. While neuroinflammation and eCB-dependent synaptic plasticity are crucial to cognition and emotional behaviour alterations, our results bring to the clinical scene the importance of controlling dietary n-3 PUFAs to protect the brain from the adverse effect of stres or inflammation. Altogether, our work brings a better comprehension of how dietary n-3 PUFAs participate to brain physiology and protect from the development of mood and cognitive disorders. It opens new avenues for the use of these lipids in the protection and treatment of brain diseases.

Anorexia nervosa (AN) is one of the most common chronic disorders in adolescence with still high mortality rates. Knowledge on gut-brain interaction might help to develop new treatments, as severe starvation-induced changes of the microbiome in AN-patients have been demonstrated, which do not alleviate with weight gain. In our own pilot study alpha-diversity was increased in patients with AN after short-term weight recovery, while beta diversity showed clear group differences with healthy controls before and after weight gain. A reduction of taxa belonging to Enterobacteriaceae at admission and discharge and an increase in taxa belonging to Lachnospiraceae at discharge were typically found in patients with AN. The work plan of our European project comprises an observational study and two phase II RCTs with the application of omega-3-PUFA and a multistrain psychobiotic to both, humans and rodents. With the help of a well-established animal model for AN (activity-based anorexia, ABA), the effect of stool transplants from patients to rodents will be analysed. Longitudinal MRI will be conducted in rodents together with cellular and molecular brain analyses. In addition, immune response and circulating antibodies associated with the presence of certain bacterial strains and interaction with hunger and satiety hormones will be explored. We hope that by this translational research we may systematically investigate the role of an altered microbiome for the course of AN and to identify new therapeutic tools.

In October 2018, France became the first country to officially approve baclofen for alcohol use disorder (AUD), even if the French Drug Agency (ANSM) officially stated that the efficacy of baclofen in AUD could be not established at this stage, in the light of the available evidence. The decision of the ANSM comprised obvious political aspects, as baclofen approval followed a decade-long practice of off-label prescription, where doses used could reach 300 mg per day or more. This situation led to a prolonged and ferocious debate between those who questioned such a widespread and unevidenced practice, and those who defended the place of an “common sense” empirical medicine. The French story of baclofen echoes other similar controversial off-label prescribing practices in the country, from the pioneer use buprenorphine for opioid use disorder in the 1990s, to the more recent off-label use of hydroxychloroquine during the COVID-19 outbreak. In each case, similar “pros” and “cons” arguments were opposed, highlighting the difficult interpenetration between evidence-based medicine on the one hand, and on-the-ground practice on the other hand.

Late-onset bipolar disorder (BD), when symptoms emerge after the age of 50 years, has gained recognition in the past decades. Currently, BD of about one in ten older patients is considered to be late-onset. Since suicide risk is extremely elevated in BD, especially at the onset of the illness, patients that live to old age are generally considered a survivor population. Meanwhile, patients with late-onset BD did not have BD while living through life periods that could be associated with typical risk factors for suicidal behaviours. Moreover, the late-onset BD might have specific etiopathogenesis, as demonstrated by less genetic component and more life stressors, medical comorbidity and alcohol use. Clinically, patients with late-onset BD have more depressive episodes and more favourable treatment outcomes, yet clinicians generally fail to adhere to guidelines while treating these patients. In n=614 older age BD patients from FondationFondamental Expert Centers, late-onset BD patients reported less lifetime suicidal ideation and attempts compared to non-late-onset patients, while there was no difference regarding the last year suicidal ideation. Better verbal memory was associated with more suicidal behaviour reporting in both groups. Meanwhile, late-onset patients had lower affect intensity and less childhood trauma – factors that were strongly positively associated with last year suicidal ideation in patients with earlier, but not late-onset BD. Meanwhile, late-onset BD patients had higher arterial blood pressure, which was associated with lifetime suicide attempt history in them, but not in earlier-onset patients. Late-onset BD seems to have a distinct pathway to suicidal behaviours.

Some of the most direct and brutal effects of the COVID-19 pandemic are experienced by health care professionals who are working in demanding environments while having to deal with their own fears of infection and mortality. To assess the impact of COVID-19 on the practice and well-being of global mental health professionals, we designed a three-part, longitudinal, internet-based study. Here we present data from part 1, implemented in June-July 2020 in six languages to members of WHO’s Global Clinical Practice Network composed of 15,500 mental health practitioners. The study assessed COVID-19’s impact on: work circumstances; occupational well-being; use and transition to telehealth; and expectations, needs and recommendations. 2,505 mental health professionals from 126 countries responded to the study (47% psychiatrists). 93.7% of respondents were currently practicing and 70.9% continued to see patients in person. The impact on clinical workload varied in terms of direction and extent depending on type of service provided and country of practice. Most participants had started or increased their use of telehealth services, and we identified a need for training to support telehealth use. Overall, clinicians scored high on well-being indices. However, a subset scored above the cutoff for low well-being and reported a significant number of post-traumatic symptoms. Five factors affected work-related stress: fear of infection, severe COVID-related events, life disruption, lack of adequate protection and role disruption. Data from this study will provide information relevant for the design, development, and integration of mental health services in the continuing pandemic, and in similar future scenarios.

The COVID-19 outbreak has raised numerous challenges for mental health service system in China. The pandemic has many affects on clinical, research and teaching, due to the strict quarantine in china. Fight the COVID-19 became the most important thing in work. We outlined major mental health needs during COVID-19 outbreak from the exiting studies and challenges for mental health professionals, and how to manage these challenges in China. To reduce the risk of negative psychological outcomes associated with the COVID-19 pandemic, the Central Health Authority of China and different national academic societies have integrated mental health crisis interventions into the general deployment of disease prevention and treatment. The NHCC developed a mental health triage strategy to provide four levels of psychological crisis interventions. More than 20 specific guidelines and expert consensus for mental health services for the COVID-19 outbreak were disseminated by the end of February 2020 to provide timely guidance for frontline health care professionals. External mental health expert teams in other provinces were also established to provide emergency mental health services in Hubei province, China. In addition, widespread adoption of online public education, psychological counseling, and hotline services have been set up for those in need. Although the COVID-19 pandemic has been under control in China, we should take a proactive lead to share its protocol of emergency mental health services with other countries affected by the COVID-19 pandemic. Also international cooperation is urgely needed to control the COVID-19 pandemic worldwide. Large-scale epidemiological surveys should be conducted to examine the prevalence of mental health problems associated with the COVID-19 pandemic to inform the development of appropriate mental health services in future.

Since COVID-19 was declared a pandemic by the World Health Organization in March 2020, it has had different infection rates across the world. Russia had one of the largest numbers of infected cases during 2020, but with a lower overall fatality rate. Nevertheless, as in other countries, clinical practice within the mental health care system has faced many stresses and challenges. This concerned the need to organize a treatment of COVID-19 in psychiatric hospitals, as well as a transformation of outpatient care, including psychotherapy, which has largely switched to a remote format. To better understand the effects of the pandemic on mental health professionals, a large-scale study has been implemented through the Global Clinical Practice Network, one of the largest professional communities, which includes 969 members from Russia. The study assessed how COVID-19 affected clinical practice and well-being of clinicians. The first of three surveys was launched in June 2020, in six languages including Russian. Over 2,500 global mental health professionals participated in the study, including 205 clinicians from Russia. Current work circumstances, work-related stressors, and use of telehealth were evaluated. In Russia, the data collection period was characterized by generally improvement in the overall pandemic situation. Results to be presented include the proportion of clinicians that continued working, what kinds of services they provided, their well-being strategies, telehealth modalities and areas in which they had particular concerns about assessment, treatment, or monitoring of patients with mental disorders using remote technologies.

Depressive symptoms during long-term course of schizophrenia constitute an important and frequent clinical problem. They may occur either as stand-alone major depressive episodes (MDEs) or as part of the schizophrenic negative syndrome. Teatment resistant schizophrenia due to affective deficits results in high subjective burden of disease and a marked subgroup of schizophrenia patients die from suicide. International treatment guidelines strongly suggest offering cognitive behavioural therapy to all patients with schizophrenia. Within pharmacological approaches evidence in favour of second generation antipsychotics exist. The application of mood stabilizers lacks evidence from clinical trials, but is often used in clinical practice. Several antidepressive agents have been administered to depressed patients with schizophrenia and were effective in alleviating both affective and negative symptoms. Treatment outcomes, however, were often limited by side effects and pharmacokinetic interactions, which constitutes the necessity of more easily tolerable pharmacological interventions. Data regarding duloxetine, bupropion, vortioxetine and agomelatine are presented in more detail and discussed within the perspective of multimodal treatment of schizophrenia.

Research demonstrates that the prevalence of overweight and obesity in the general population is increasing rapidly worldwide and that the environmental changes that have provoked these increases have also affected people with severe mental illness (SMI). Of note, obesity is two to three times more common among people with SMI and it contributes to a significantly reduced quality of life and to an increased morbidity and mortality rate in this population. The most important factor related to weight gain in people with SMI is the use of antipsychotic medication. Weight gain often occurs within 6-8 weeks after the initiation of antipsychotic treatment and may continue for at least 4 years. This can lead to non-adherence and risk of relapse. Next to behavioural interventions several pharmacological approaches have been investigated to deal with antipsychotic-induced weight gain. They target different receptor systems including dopaminergic, glutamatergic, serotonergic, adrenergic, opioid, and glucagon-like peptide 1 receptors. This symposium will provide an overview of the effectiveness of different add-on medications to treat weight gain in patients with SMI.

COVID-19 pandemia means a special threat to elderly patients in nursing homes. Dementia sufferers, who make up most of nursing home clients throughout Europe, have been in a critical situation. They bear a higher risk of delirium when affected by the virus. They often do not understand and easily forget, how to use a mask and keep the distance required. In many institutions the elderly were isolated and could not even take their meals together. And finally they do not recognize and even fear nursing staff and other personnel, which has to wear “protective clothes”. Caregivers were told not to visit their loved ones any more.

Where available, modern techniques werde used. Skype and/or Zoom, Facetime telephone should replace face to face contacts. Some insitutions offered visitor rooms, where clients and visitors were separated by acrylic windows and microphones were applied. In some areas, physicians’ visits were reduced to a minimum.

Just recently, regular testing of staff and clients in nursing homes has been introduced. However, this is consuming staff time, which - again - is taken from the patients. We discuss, whether the elderly and their caregivers could set their own preferences.