The article is devoted to the study of adaptation to the covid-19 pandemic conditions in Russian men and women in the first part of 2020. Respondents assessed the degree of potential danger of various types of social threats caused by the pandemic, as well as the level of their adaptation to changed living conditions during the first lockdown.

The purpose of this study was to identify key differences in adaptation to pandemic conditions in groups of men and women.

The author’s methodology was developed to assess the level of adaptation to COVID-19. The questionnaire included 6 scales on different aspects of life during the lockdown (for example, physical and emotional state, communication, employment during the pandemic, etc.). The sample was N = 80 (residents of Russia age 18-37).

Men significantly higher estimated the potential danger of an epidemic threat to themselves than women. The level of adaptation to conditions caused by the COVID-19 pandemic also differed in two gender groups according to t-test on the scale “Employment in a pandemic”: men were better adapted to work or study in conditions caused by the COVID-19 pandemic than women.

This can be interpreted from the point of view of the stereotype existing in Russian culture which postulates the performance of household duties and child care is more perceived as a woman’s responsibility. The adaptation of women to remote work during the lockdown was forced to be combined with an increased workload in the family and household sphere.

No significant relationships.

The discovery of second-generation antipsychotics represented an authentic breakthrough for the management of psychotic disorders. Nevertheless, they still don’t adequately manage some aspects of these disorders, such as negative symptoms (NS), cognitive impairment, or extra-pyramidal symptoms (EPS). New-generation antipsychotics present different pharmacological mechanisms and have been reported to ameliorate these aspects. Among them, cariprazine acts as a D2/D3 partial agonist with variable affinity with serotoninergic receptors, and many studies show its efficacy for preventing and treating positive symptoms as well as for the management of NS and EPS.

To report a case of a patient diagnosed with schizophrenia with highly invalidating antipsychotic-induced EPS that remitted after switching to cariprazine, while maintaining clinical stability. To review literature about cariprazine and its relationship with NS and EPS.

We describe the case of a 66-year-old woman diagnosed with schizophrenia and under treatment with three-month injectable paliperidone 175mg. During her follow-up at outpatient clinic, she presented a progressively highly invalidating non-trembling parkinsonian syndrome attributable to medication. Paliperidone plasmatic levels were within therapeutic range. An antipsychotic switch was agreed, and cariprazine was started.

The switch from a second-generation antipsychotic to cariprazine entailed the remission of a highly invalidating EPS while improving some of the NS and maintaining psychopathological stability.

Assessing and differentiating NS and EPS is of an utmost importance during the follow-up of patients under antipsychotic treatment. Cariprazine is an interesting alternative when treating patients diagnosed with psychotic disorders that present mostly NS and antipsychotic-induced EPS.

No significant relationships.

Despite the efficacy of antipsychotics, up to about 30% of schizophrenia patients do not respond adequately to treatment and are called treatment-resistant schizophrenia (TRS) patients. The treatment of choice in these patients is clozapine, which is used last due to the adverse effects it can cause. However, it has been shown that half of TRSs are also resistant to clozapine, leading to ultra-resistant schizophrenia.

We present a clinical case corresponding to a 33-year-old man, single, residing in a community residence, undergoing psychiatric follow-up from the age of 7, receiving during this period the diagnoses of schizotypal personality disorder and paranoid schizophrenia.

As of 2015, he began to make autolytic attempts, the last being this year, 2021. Moment in which he manifests for the first time presenting imperative, sporadic auditory pseudo-hallucinations, which incite self-harm. These sensory-perceptual alterations appeared from 2015, together with the worsening of the negative symptoms.

The patient has been treated with numerous antipsychotics, without complete remission, so since 2019 treatment with Clozapine 200mg was started. As the symptoms did not subside, the dose was increased to 400mg, at which point some of its side effects began to appear; urinary incontinence, sedation, sexual impotence … so the patient abandoned the treatment, suffering a relapse of his mental pathology.

Despite the arrival of atypical antipsychotics, it remains a challenge that there is a complete remission of symptoms in some patients with schizophrenia, for which we consider that psychopharmacological research in this group of patients is of the utmost importance.

No significant relationships.

The differential impact of depression across different periods in life on mortality remains inconclusive. We aimed to examine the association of depression that occurs at different age with all-cause mortality, and to explore the roles of dementia, as well as genetic and early-life environmental factors, in this association.

From the Swedish Twin Registry, 44,919 twin individuals were followed for up to 18 years. Depression was ascertained using the National Patient Registry and categorized as early-life (<45 years), midlife (45–64 years), and late-life (≥65 years) depression according to the age of the first diagnosis. Deaths were identified through the Cause of Death Register. Generalized estimating equation, generalized structural equation, and conditional logistic regression were used for unmatched, mediation, and co-twin matched analyses, respectively.

In unmatched analyses, the multivariate-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of mortality were 1.71 (1.46–2.00) for depression at any age, 1.72 (1.36–2.17) for early-life, 1.51 (1.19–1.90) for midlife, and 4.10 (2.02–8.34) for late-life depression. Mortality was significantly higher in individuals with late-life depression than those with earlier-life depression (p < 0.05). The mediation analysis showed that 59.83% of the depression-mortality association was mediated by dementia. No significant difference in ORs between the unmatched and co-twin matched analyses was observed (p = 0.09).

Depression is associated with an increased risk of all-cause mortality, and dementia mediates approximately 60% of the impact of depression on mortality in late life. Genetic and early-life environmental factors may not play a significant role in the depression-mortality association.

Emotional intelligence is a term coined by Salovey & Mayer and is defined by these authors as a form of social intelligence that involves the ability to perceive and identify emotions, to discriminate among them and to use the information to improve cognitive processes, and manage one's and others’emotions. There are also mixed models of emotional intelligence that imply a broader concept of intelligence, including mental abilities and personality characteristics.

To discuss the relevance of emotional intelligence in Psychiatry. To review recent studies of emotional intelligence in psychiatric disorders.

Review of the literature. MEDLINE and PubMed databases searches for peer-reviewed studies, published between 2000 and 2010, using combinations of the Medline Subject Heading terms emotional intelligence, trait emotional intelligence, ability emotional intelligence and psychiatry, mental disorders, schizophrenia, bipolar disorder, social phobia, eating disorders.

There are few studies in the literature addressing this topic. Emotional intelligence is a complex concept, with different theories defending distinct conceptualizations. The studies reviewed showed lower levels of emotional intelligence across different psychiatric disorders.

The field of affective neuroscience is of major importance in Psychiatry and has added important clues to the understanding of psychopathology. Although emotional intelligence is a recent and understudied topic in Psychiatry it can help to understand mental disorders and bring new insights to the comprehension of psychopathology.

Gynecomastia refers to the abnormal development of breast tissue in males, often posing a concerning symptom. Often, gynecomastia is associated with multiple factors, including the use of various drugs, notably certain atypical antipsychotics. Gynecomastia is a significant side effect that affects the quality of life of male patients taking antipsychotic medications. Among these, risperidone and paliperidone have been identified as the most prone to causing gynecomastia, although aripiprazole has garnered attention for its superior profile in controlling prolactin and gynecomastia. The relationship between these drugs and the development of gynecomastia lies in their ability to elevate prolactin levels, a hormone that regulates reproductive function and is involved in milk production. Several studies have shown that prolactin levels are more commonly elevated with risperidone and paliperidone prescription, thus triggering gynecomastia.

The study aims to investigate the management of gynecomastia in male patients receiving antipsychotic medications.

This research employs a retrospective analysis of patient records to examine the association between specific antipsychotic drugs, prolactin levels, and the development of gynecomastia, while also evaluating the effectiveness of aripiprazole as an alternative treatment.

We present the case of a 21-year-old male with no prior medical history who initiated treatment with oral paliperidone and later switched to 100 mg of long-acting injectable paliperidone once monthly during his initial admission for psychotic symptoms. After six months, he developed gynecomastia, which was ruled out as breast tissue and was determined to be an increase in adipose tissue. Since his hospital discharge, he has gained 25 kg (30%) in body weight, and his baseline prolactin level has decreased. This weight gain, a common side effect of several antipsychotics, was linked to gynecomastia. However, a promising approach for gynecomastia antipsychotic-associated treatment is aripiprazole, which has a milder impact on prolactin levels. In this case, during the next appointment, a switch to 400 mg of long-acting injectable aripiprazole once-monthly was made, which led to weight loss, a reduction in breast size and blood prolactin levels in the following weeks.

The detection and management of gynecomastia in these patients are crucial to improving their quality of life and treatment adherence. This management encompasses changes in medication, hormonal therapy, or surgery in severe cases. Physicians must be aware of this potential complication when prescribing antipsychotics and closely monitor at-risk patients. In summary, antipsychotic-associated gynecomastia in men represents a medical challenge that requires careful attention and an individualized treatment strategy for each affected patient.

None Declared

The autonomic nervous system (ANS) plays a key role in maintenance of the homeostasis and adaptability of the body to different stimuli. The disturbances of ANS, especially sympathetic dysregulation in stress response, are associated with various disorders.

Thus, we aimed to study the sympathetic arousal in response to negative emotional stress and during recovery using heart rate variability (HRV) nonlinear analysis (symbolic dynamics parameter 0V%) and skin conductance level (SCL) as sympathetically-mediated indices in healthy students.

Seventy students (age: 23.1±0.2yr., 39 females) were examined during complex stress response: baseline – negative emotional stress – recovery. RR intervals (for HRV analysis) and electrodermal activity were continuously recorded during each period lasting six minutes. Evaluated parameters: HRV nonlinear analysis - symbolic dynamics index 0V% as cardiac sympathetic index, skin conductance level (SCL) as sympathetic cholinergic index.

Regarding electrodermal activity, the parameter SCL significantly increased in response to negative emotional stress (p<0.001) and remained higher after stress (recovery phase, p<0.001). Symbolic dynamics index 0V% was without significant changes.

Our findings revealed increased sympathetically-mediated index SCL in response to negative emotional stress and in recovery phase indicating higher sympathetic arousal during complex stress response in young people. Surprisingly, cardiac sympathetic index 0V% was not sensitive to detect discrete changes in sympathetic arousal to negative emotion. We suggest that detailed knowledge about complex sympathetic regulatory mechanisms to emotional stress in healthy probands represents the first step for understanding of pathomechanisms leading to abnormal stress response in mental disorders.

This study was funded by the Slovak Scientific Grant Agency under grants VEGA 1/0044/18; VEGA 1/0190/20 and Ministry of Health of the Slovak Republic under the project registration number 2018/20-UKMT-16.

Bipolar disorder (BD) and borderline personality disorder (BPD) appear as prevalent psychiatric conditions, with both being associated with increased morbidity and elevated suicide rates.

Borderline personality disorder is characterized by emotional instability and impulsivity, and patients are susceptible to dangerous behaviors such as unsafe sexual behavior, eating disorders and substance abuse. On the other hand, mania in BD patients contributes to impulsivity, hypersexuality and poor judgment, as well as a lack of inhibition. In both cases, individuals are at a higher risk of committing suicide due to emotional dysregulation and impulsive behaviours.

The symptomatic overlap in BPD and BD is prone to discussion and may lead to misdiagnosis. Some studies suggest that BPD and BD may lie on a spectrum, while others advocate them as separate entities that may coexist.

To explore the clinical challenges associated with both the differential diagnosis and the comorbidity of BD and BPD.

We performed a non-systematic review of the literature using the database PubMed and the following keywords: bipolar disorder borderline personality disorder comorbidity

Patients with borderline personality disorder seem to have significantly greater odds of a previous bipolar misdiagnosis, but no specific borderline criterion was shown unique in predicting this outcome.

Nonetheless, research studies have reported that approximately 20% of BPD were also diagnosed with BD and, similarly, 10% of people with BD I and 20% with BD II were diagnosed with BPD.

Comorbid BPD and BD are associated with marked psychosocial disability, with patients being more impulsive and aggressive than those with BPD and BD alone. They are also highly susceptible to anxiety disorders like obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and somatoform disorders. Studies have shown that comorbid BPD has a negative impact on the clinical course of Bipolar Disorder, as the patients have an unfavorable illness trajectory, with earlier onset of mood symptoms,higher likelihood of hospitalization, longer treatment duration and worse response to treatment. They are also at higher risk for depression and persistent unemployment, increased risk drug abuse, higher suicide risk, and greater utilization of ECT, compared to patients with BPD or BD alone.

A careful review of the patient’s history must be done to properly distinguish between BPD and BD and to make the right diagnosis. Further studies are needed to clarify the risk factors associated with the comorbidity between these two disorders, in order to develop effective clinical strategies for optimal outcomes for patients with both disorders, improve their clinical course and prevent the increased risk of suicidality.

None Declared

Anorexia nervosa (AN) is an eating behavior disorder characterized by intense fear of gaining weight or persistent behavior that interferes with weight gain, with caloric intake restriction and secondary loss of body weight. It can affect up to 4% of women during their lifetime and is responsible for one of the highest mortality rates from psychiatric disorders.

Review of the literature and exposure of a case report of AN in a woman with high level of stress at work.

Case report and nonsystematic review using databases such as PubMed and UpToDate.

Caucasian woman, 31-year-old, PhD in biology, who works in a multinational company. No personal or family history of psychiatric disorder. She was observed in the psychiatry emergency department, due to low weight, caloric restriction and intense physical exercise, maladaptive personality traits related to perfectionism and control were found. She began follow-up with a multidisciplinary team, but there was a need for hospitalization due to clinical deterioration with BMI of 11. After 6 months, she continued to follow up at the consultations and, despite refusing psychotropic drugs, she maintains psychotherapy and presents clinical improvement (BMI - 17).

Eating behavior disorders are chronic and difficult to treat diseases that are more frequent among people subject to high levels of stress. This case represents a restrictive AN in a woman with multiple risk factors: athlete, perfectionist, with stressful work and life events and restricted interpersonal and affective relationships.

No significant relationships.

Peer relationships play a critical role in the development of adolescents, not only for the acquisition of social skills but also for the sense of personal identity and competence. Thus the quality of peer relationships influences actual and future mental health of the adolescent.

SEYLE (Saving and Empowering Young Lives in Europe) is a randomized controlled trial, funded by the EU, evaluating interventions for mental health promotion and suicide prevention. The study comprised 12,395 high-school students from 11 European countries.

We investigated the differences on psychological problems between students with poor and good peer relationships.

1,195 adolescents (mean age 15.3 ± 0.6; 68% females) from the Molise region constituted the Italian sample. Adolescents were identified as with poor peer relationships if they never or just sometimes get along with people of their age, feel that peers like having them in the group and feel that peers were kind and helpful. Psychometric measures were used to assess mental health problems such as depression (Beck Depression Inventory II), anxiety (Zung Self-Assessment Anxiety Scale), well-being (WHO-5) and suicidal ideation (Paykel Suicide Scale).

Adolescents who reported poor peer relationships scored significantly higher (p < .005) on the scales assessing depression, anxiety and suicidal ideation and significantly lower (p < .001) on the WHO-5.

Particularly in adolescence peer relationships may influence psychological well-being and vice versa mental health influences the openness to the others. So promoting mental health and contemporary improve social skills could lead adolescents to a better life.

This study aimed to determine the effect of Electroconvulsive Therapy (ECT) on serum serotonin level of patients with major depressive disorder (MDD).

In this experimental study, 36 patients (age: 20–65 years old) with MDD were allocated to ECT group (n = 21) and non-ECT group (n = 15). Serum serotonin level of the ECT group was measured before ECT, 15 minutes and two, six, and 24 hours after the first session, and 24 hours and 30 days after the last ECT session. Measurements were performed at the time of admission and one month after hospitalisation in the non-ECT group. Data analysed with t-tests, repeated measures analysis of variance by SPSS16.

The mean serotonin levels of the two groups were significantly different 24 hours and 30 days after the last session of ECT (P = 0.048 and P = 0.04, respectively). The difference of mean serotonin levels in the ECT group before & 15 min after ECT (P = 0.044) before & 6 hour after ECT (P = 0.015), before & 24 hour after ECT (P = 0.007), before & 24 hour after last ECT (0.002) was meaningful.

Altogether, our results showed that serum serotonin levels significantly increase following ECT in MDD patients.

Prevalence estimates of childhood and adolescent mental health disorders appear to vary between 20 to 30% worldwide. It is therefore unsurprising that studies have yielded inconsistent findings in regards to the trends of prevalence of mental health disorders. Some reasons for the discrepancy in findings include use of survey data and its associated attrition and selection bias.

First, to determine and compare the prevalence of mental health disorders derived from a survey and a population cohort. Second, to evaluate trends of mental health prevalence over time.

As population data (i.e., linked health records) may be used to overcome the issues presented by survey data, we compared the prevalence estimated from a prospective survey cohort (the Western Australian Pregnancy Cohort (Raine study) to another estimate from a prospective population cohort (linked population data; data from the Hospital Morbidity Records and Mental Health Registration).

As expected, the Raine cohort yielded a larger estimate of prevalence when compared to the linked population data. However each cohort also revealed opposite trends of prevalence, where the Raine cohort showed the prevalence of mental health disorders to decrease as children age.

We therefore recommend that estimates of prevalence be interpreted with the type of cohort in mind, as estimates from survey cohorts will provide different information to that from population cohorts.

No significant relationships.

Mental distress among medical students is often reported. Social phobia is a highly prevalent yet often overlooked psychiatric disorder that can cause severe disability but fortunately has shown responsiveness to specific pharmacotherapy and psychotherapy. The aim of this work was to study the prevalence of social phobia problem and potential risk factors that may be associated with social anxiety among medical students.

The present study was designed to identify the manifestations and correlates of social phobia among medical college students. The sample for this investigation consists of 321 (170 female and 151 male) students aged 19-26 years. For detection of social phobia among the studied sample, we used Social phobia inventory which is a self rating scale that capture the spectrum of fear, avoidance and physiological symptoms. It demonstrates good test-retest reliability, internal consistency, convergent and divergent validity.

The sample consisted of participants from all medical stages (this was a proportionate representative sample from each classes), 56% were from higher income groups, nearly 45% had their residence in hostel, 21.5% of the students had a SPIN score of 19 and more, mean social phobia was present in almost 22% of the population. There was no statistically significant difference in prevalence of social phobia with respect to gender, family income or type of residence.

Social phobia has a high prevalence and marked impact on life, early identification and adequate treatment by college counseling centers will successfully help in reducing the burden of this common condition.