The question of violence and dangerousness is a central subject in psychiatry, since it is a source of stigmatization for many patients and represents a major element of medical, legal and social care. Violence being defined as: "the deliberate use or threat of deliberate use of physical force or power against oneself, against another person or against a group or community, which results in or is very likely to lead to trauma, death, moral damage, maldevelopment or deficiency”. The violent character of the mentally ill was among the precursors to the discussion around the first therapeutic measures for the mentally ill. A better knowledge of the risk factors for the passage to a violent act in mental disorders is therefore necessary for the development of therapeutic and preventive strategies.

The objective of our work is to determine the socio-demographic, clinical and criminological characteristics of forensic patients and to seek the predictive factors of violence in these patients.

This is a retrospective study spread over 10 years on a series of forensic patients who were hospitalized at the Ar-razi psychiatric hospital in Salé (Morocco). The collection of data was carried out from clinical observations, psychiatric expertise and an exploitation sheet.

Numerous studies have defined subgroups of patients at risk. Factors such as positive symptoms, poor treatment compliance, and comorbidities such as substance use disorders or antisocial personality traits have been described as predictive of violence.

The prevention of medico-legal acts must take into consideration these associated factors, in particular early management of the disorders, improvement of therapeutic observance and family care.

None Declared

According to Article 5 of the Maria da Penha Law, domestic and family violence against women constitutes any action or omission based on gender that causes her death, injury, physical, sexual or psychological suffering, and moral or patrimonial damage, within the scope of the domestic unit, the family or any intimate relationship of affection. In isolation, domestic violence is already considered by the WHO a public health problem. In the context of a pandemic, as was the case with COVID-19, the issue had the severity increase.

To investigate the rates of domestic and family violence against women in the city of São João Batista, State of Santa Catarina, Brazil, between January 1, 2019, and December 31, 2020, relating the data to the COVID-19 pandemic.

Descriptive cross-sectional study, operationalized by the technique of bibliographic and documentary research.

There was a reduction in the total number of crimes involving domestic and family violence against women in the city of São João Batista/SC, Brazil. While in 2019 there was a notification of 116 crimes, in 2020 the number dropped to 65. (Graph 1)

The most frequent crimes in both years were: threat and bodily injury. Together they accounted for 83% of cases in 2020. (Graph 2)

The apparent decrease in the number of notifications does not necessarily represent a decrease in cases of domestic violence, but rather, it may mean fear of leaving the residence to formalize the complaint, difficulty in carrying it out, or even the worsening of factors that increase the risk in these situations, such as reduction or total loss of income and support network.

Image:

Image 2:

The scenario presented shows the need for preventive public policies regarding the problem of domestic and family violence against women. The creation and strengthening of community and personal networks are fundamental.

None Declared

Several studies have shown that ketamine, an NMDA receptor antagonist, represents a promising alternative in treating depression and suicide. The intranasal or intravenous use of ketamine, currently used, has limitations in terms of cost and complexity. The subcutaneous (SC) route may be an affordable alternative for the treatment of depression and suicidality.

To evaluate the response of SC ketamine (0,5 mg/kg) applications on depressive, anxiety, and suicide symptoms.

A patient with unipolar depression and suicide attempt was submitted to 3 sessions of SC ketamine (0,5 mg/kg). The applications had 2 days of intervals. Clinical evaluations were measured by BDI, BSI, and BAI. The vital signs were monitored under 2 hours after injections and the potential side effects.

Changes in measurement instruments according to applications can be seen in Tab 1:

The average measurements of vital signs during 2 hours of monitoring for each application can be seen in Tab 2:

The use of SC ketamine showed remission in BDI, BSI and BAI, respectively demonstrated safety in use.

None Declared

With the projected increase in the number of older persons in both low and middle-income countries, the burden of Alzheimer’s and related dementia diseases (AD/ARDs) is projected to increase as well. However, the health systems are inadequately prepared to offer optimal care for patients with AD/ARDs, despite the growing disease burden.

The aim of this study was to assess the capacity of the health facilities to optimally manage Alzheimer’s and related dementia diseases in the Mukono district

We conducted a cross-sectional between August and December 2018. A survey of 32 facilities (3 hospitals, 2 health center IV (HCIV), 15 health center III (HCIII) and 6 health center II (HCII), and 6 Private health facilities) in Mukono district. We conducted a thorough assessment of medical records, interviewed heads of the facilities, and a questionnaire was administered to 46 health workers. The study assessed the service provision for AD/ARDs, Knowledge of AD/ARDs management, challenges, and opportunities.

Out of 32 health facilities assessed, 4 in 10 (42%) facilities reported managing (diagnosing/treating) clients with AD/ARDs, and the majority (90.2%) were run by Non-Physician Health Workers (NPHW). Only 2 in 10 had guidelines for managing AD/ARDs. Less than half (46.4%) had AD/ARDs medicines in stock (mainly Haloperidol) and all of the private facilities lacked essential medicine to treat AD/ARDs. All health center IIs lacked drugs for AD/ARDs. A significant knowledge gap in assessing and diagnosing AD/ARDs was observed among all the health workers. All health workers highlighted the need for additional training in AD/ARDs. A multitude of client and health provider challenges were observed in this study

Health facilities in Mukono district are inadequately prepared to offer optimal services for the management of AD/ARDs. AD/ARDs drugs, knowledge gap, and human resources for health presented a great challenge. In order to address the inadequately capacity to manage AD/ARDs, emphasis should be dwelt on strengthening the health facilities.

None Declared

The underlying neurobiology of early-life stress (ELS)-induced major depressive disorder (MDD) is not clearly understood. miRNAs, a subclass of noncoding RNAs, are estimated to regulate 20-90% of genes in the genome. Previous studies identify differences in miRNA expression following MDD and ELS, but there is limited research on a direct link between changes in serotonin signaling and miRNAs in response to ELS.

In this study, we used MS and environmental enrichment to study serotonin signaling in the PFC and its regulation by miRNAs. Because women are more likely to develop MDD, but there is no strong evidence of sex differences in the experience of ELS, we were interested to test for sex differences. We hypothesized that genes in the serotonin signaling pathway would be altered by ELS and potentially recovered by enrichment.

We used maternal separation (MS) as a rodent model of ELS and tested whether microRNAs (miRNAs) target serotonin genes to regulate ELS-induced depression-like behavior and whether this effect is sex dependent. We also examined whether environmental enrichment prevents susceptibility to depression- and anxiety-like behavior following MS and whether enrichment effects are mediated through serotonin genes and their corresponding miRNAs.

MS decreased sucrose preference, which was reversed by enrichment. Males also exhibited greater changes in forced swim climbing and escape latency tests only following enrichment. Slc6a4 and Htr1a were upregulated in the frontal cortex following MS. In male MS rats, enrichment slightly reversed Htr1a expression to levels similar to control rats. miR-200a-3p and miR-322-5p, which target SLC6A4, were decreased by MS, but not significantly. An HTR1A-targeting miRNA, miR-320-5p, was also downregulated by MS and showed slight reversal by enrichment in male animals. miR-320-5p targeting of Htr1a was validated in vitro using SHSY neuroblastoma cell lines.

Altogether, this study implicates miRNA interaction with the serotonin pathway in ELS-induced susceptibility to depression-related reward deficits. Furthermore, because of its recovery by enrichment in males, miR-320 may represent a viable sex-specific target for reward-related deficits in major depressive disorder.

None Declared

Intentional self-harm in adolescents and young people included both suicidal behaviors and nonsuicidal self-injury (NSSI) is a serious issue in mental health systems. However, the majority of studies on self-harm in adolescents and young people focused on quantitative methodology which might has limitations to explain this complex phenomenon of intentional self-harm.

This study aimed to describe the subjective experiences of adolescents and young people who presented with intentional self-harm in order to provide better understanding of this behavioral phenomenon.

This is an exploratory qualitative study used phenomenological processes and thematic analysis.

Twenty subjects aged 13-29 years were included in this study. The results revealed 6 themes regarding predisposing child - rearing environments and 9 themes regarding factors related to cessation of intentional self-harm.

- 6 themes regarding predisposing child - rearing environments

1. 1. Lack of emotional responsiveness/emotional neglect

2. 2. Negativity, criticism and harsh punishment

3. 3. High academic expectations

4. 4. Comparison with siblings

5. 5. Superficial responsiveness

6. 6. Enmeshment and over involvement

- 9 themes regarding factors related to cessation of intentional self-harm

1. 1. Negative perception to self-harm and desire to stop

2. 2. Increase of adaptive coping

3. 3. Finding life purposes

4. 4. Improvement of psychiatric symptoms

5. 5. Supportive relationships and verbalization

6. 6. Treatments / interventions

7. 7. Unwanted consequences of self–harm

8. 8. Situations related to positive feelings

9. 9. Behavioral control

Moreover, this study demonstrated the important functions of self-harm as an intrapersonal strategy for emotional regulation.

This study underscored the importance to view self-harm as a complex phenomenon and it is essential to understand the developmental pathways as well as the pathways to cessation of these complex behaviors. Moreover, various internal and external factors related to cessation of intentional self-harm were demonstrated and verbalization in safe and supportive atmosphere tended to be an important process to promote the cessation or decrease of intentional self-harm.

None Declared

Mental health problems have a substantial economic impact across the world. Those who have their problems detected may receive therapies (usually medication or psychological) or who packages of care (for example, early intervention or residential support). Some problems are transient while others will remain across the life course. Costs are closely associated with care received and it may be that costs need to rise in order to provide adequate support. Economic costs also occur due to lost opportunities such as work and leisure. This talk will summarise recent estimates of the cost of mental health problems in a number of countries.

Establishing total costs does not tell us how to use limited resources. This requires the use of economic evaluation methods such as cost-effectiveness and cost-utility analyses. There is a growing evidence base from such evaluations for many psychological and pharmacological interventions and recent key findings will be discussed. The need for long-term, life course approaches to economic evaluation of mental health interventions will be proposed.

None Declared

Occupational stress (OS) is one of the major health hazards of the modern workplace. Poor working conditions are major occupational stressors and have a great impact on employees’ well-being.

This study aimed to assess the associations between OS and working conditions.

We conducted an exhaustive cross-sectional study among workers in a shoe and leather company. We used the Job Demand Control model of Karasek to measure occupational stress. Workers were asked about their perception of working conditions such as the noise, heat generated by certain tools and machines, fabric smells and uncomfortable workspaces. Data were analysed using SPSS software.

The study involved 310 workers (58 men and 252 women) with an average age of 34.2 ± 10.3 years. Workers reported different concerns about working conditions. The noise was the major complaint reported by 73.7% of workers. Workspaces were uncomfortable according to 48.7% of workers. Job strain and isostrain situations were found in 56.5% and 44.5% respectively. Unpleasant smell from leather products was associated with job strain (p= 0.004, OR = 1.9, 95%; CI [1.2-3.1]) and isostrain (p= 0.043, OR = 1.6, 95%; CI [1.03-2.6]) situations. Heat generated by certain tools and machines was associated to isostrain situation (p= 0.009, OR = 2.7, 95%; CI [1.2-5.9]). Perceiving workspaces as uncomfortable was associated with isostrain situation (p= 0.004, OR = 1.9; 95%; CI [1.2-3.09]).

Working conditions have an important impact on workers’ mental health. Thus, improving job conditions is a key way to improve workers’ health and well-being.

None Declared

Phenibut is a synthetic γ-aminobutyric acid (GABA) agonist used to treat symptoms of mental disorders like anxiety and insomnia. The substnce is licensed and widely used in Russia. Its recreational use is increasing in many countries as it is easily accessible online. In a recent years, several case reports of phenibut intoxication and withdrawal have been published worldwide.

We present a case report of intoxication with phenibut in a patient with psychoactive substances use disorder on regular methadone substitution therapy.

A 40-year-old male was hospitalized for the first time in the psychiatrc ward due to intoxication with phenibut. Before admission, he was confused, with incoherent speech. Bradypnea and somnolence were observed. A urine screening test was positive for methadone and benzodiazepines, while there was no information on phenibut intake at that time. After receiving naloxone, the patient became, agitated and haloperidol was introduced.

The main symptoms of phenibut intoxication, which have also been described in other cases, are cardiovascular effects, insomnia, anxiety, agitation, hallucinations, and reduced level of consciousness. In our case, a more heterogeneous clinical picture of intoxication was observed, due to the simultaneous use of methadone and other PAS.

The availability of various synthetic substances available online is constantly increasing. Their use is most common in the population with substance use disorders, in patients on substitution therapy and in patients with mental disorders in general. The clinical picture of intoxication can thus be very diverse and atypical, which requires increased attention from clinicians.

None Declared

During the COVID-19 pandemic the internet has become an important medium for learning and communication for university students. Increased time spent online during the pandemic is a significant risk factor for the development of internet addiction (IA) in this population.

This study aimed to investigate the influence of pandemics on IA among Croatian university students and to evaluate the characteristics of IA during the pandemic in comparison to pre-pandemic time.

Two cross-sectional studies, one in April 2016 and another in April 2022 were conducted. As part of these studies, a validated, anonymous questionnaire that contained questions regarding demographic data, as well as Young’s Internet Addiction Test, was self-administered to a cross-faculty representative student sample of the University of Osijek in Eastern Croatia.

The study sample included 1602 university students (810 in the year 2016 and 792 in the year 2022), the median age was 21 years (interquartile range 20-22), 34.5% males, and 65.5% females. There was no statistically significant difference in the median age of the two students’ samples (p=0.234). The main reasons for internet usage were learning and faculty assignments (25.0%), social networking and entertainment (71.0%), and online gaming (4.0%), and there was no statistically significant difference between observed students’ samples (p=0.075). The overall prevalence of IA in 2016 was 41.4% and 39.8% in 2022 but this difference was not statistically significant (p=0.542). The proportions of students with mild, moderate, and severe IA in 2016 were 32.8%, 8.4%, and 0.1% respectively, while in 2022 they were 27.4%, 11.9%, and 0.5%, and observed differences were statistically significant (p=0.011).

The COVID-19 pandemic has changed the pattern of IA among Croatian university students where proportions of students with moderate and severe IA were significantly higher in comparison to pre-pandemic time. To successfully manage this important public health challenge during the pandemic and post-pandemic time specific preventive measures intended for this population should be developed.

None Declared

In Tunisia, tobacco control remains one of the main country’s health strategies. However, it seems that the scourge of tobacco is still a prevalent problem and it’s often associated with other addictive behaviours like alcohol use.

Evaluate the addictive behaviours of the employees of an Electricity company in Tunisia and their impact on their mental health.

We conducted a cross-sectional study in May 2022. A pre-established questionnaire was filled out during a sensitization campaign that took place in the company. We used the Fagerstörm test and the AUDIT questionnaire to evaluate tobacco and alcohol dependency respectively. Signs of depression and anxiety were evaluated by the Hospital Anxiety and Depression scale (HAD). Collected data were analyzed using IBM SPSS statistics version 23.0.

Our population consisted of 83 employees. The average age was 40.79±11.23. Males represented 65.1% of employees. The mean of seniority was 15.23±10.82 years. Forty-one per cent were overweight and 22.9% had obesity. The mean Body Mass Index (BMI) was 27.17±3.92. Twenty-five employees (30.1%) were active smokers and 7 (8.5%) consumed alcohol. All of them were males. The nicotine dependency test’s mean was 4.12±2.78 and 28% of smokers had a high to a very high nicotine dependency. The mean score of the AUDIT questionnaire was 9.71±10.76. Four alcohol consumers (57.1%) had harmful alcohol use and 2 of them (28.5%) had alcohol dependency. The evaluation of the HAD score showed that the mean anxiety score was 7.59±3.13 and the mean depression score was 6.44±3.71. Twelve per cent and 10.8% of employees had elevated anxiety and depression scores respectively. Bivariate analysis showed that depression is significantly associated with the female sex (p=0.023) and with a lower number of service years (p=0.019). Anxiety was significantly associated with a high BMI (p=0.027). Anxiety and depression were not associated with alcohol or tobacco consumption.

Smoking and drinking are common in our society. Sensibilization campaigns must focus on motivating workers to quit those addictive behaviours and promote a healthier lifestyle.

None Declared

Migraine often leads to reduction of social power and prestige of the patients, hence leading further emotions of shame.

Exploring the role of external and internal shame in people with migraines.

The sample consisted of 180 people, more specifically 140 people from the general population and 40 people who have been diagnosed with migraine and receiving treatment for migraine, who completed the following questionnaires voluntarily and anonymously: a) Migraine Experience Questionnaire and Headache Impact Test-6 (HIT-6), b) the Other As Shamer scale (OAS) c) the Experience of Shame Scale (ESS), and socio-demographic and self-reported questionnaire.

Patients scored higher level external Shame (OAS) rates (31.28 ± 6.98) than people from the general population who scored lower external Shame (OAS) rates (16.89 ± 10.00) with a statistically significant difference between them (p = 0.000). Also, patients scored lower-level internal shame (ESS) rates (45.58 ± 6.91) than people from the general population who scored higher internal shame (ESS) rates (53.36 ± 15.62) with a statistically significant difference between them (p = 0.003).

Patients with symptoms of migraine show statistically higher level of external shame and lower level of internal shame and further study is considered necessary.

None Declared

Traditional psychotherapeutic interventions show small to moderate effect in treating psychotic symptoms. Virtual reality (VR) assisted treatments has the potential of advancing current psychotherapies for psychotic symptoms by creating virtual environments that can elicit responses (e.g., thoughts, feelings, behaviours) mirroring real-world settings. This presentation will highlight the current research initiatives using virtual reality-based interventions targeting positive and negative symptoms in patients with psychosis.

Main findings from the pilot-studies and randomized clinical trials on computer-based and immersive VR-interventions demonstrate preliminary evidence of VR-based psychotherapy for treating auditory hallucinations and paranoia with large effect sizes (Cohens d= 0.75-0.80). Additionally, pilot data has provided indications as to VR-psychotherapy being feasible and acceptable in treating negative symptoms and may have a large effect on participants achieving their goals and potentially in reducing negative symptoms. No adverse effect has been found related to the VR-interventions.

The promising findings on VR-based interventions for psychosis calls for large-scale randomized clinical trials consolidating the evidence for the effect in treating positive and negative symptoms in psychotic disorders. Cost-effectiveness of these short-term VR-based interventions are essential to inform scalability and implementation. Finally, most of the studies target patients in more chronic/treatment resistant phases of psychosis highlighting the need to investigating the effect in earlier phases of psychosis, that is, first-episode and potentially clinical high-risk states.

None Declared

Oxidative stress is the main characteristic of several diseases including Bipolar Disorder (BD). The involvement of oxysterol derivatives has recently been reported. In this study, the involvement of oxidative stress in the alteration of cholesterol in PTB patients will be evaluated.

To assess the association of oxidative stress and oxysterol profiles in subjects with BD and compare them to healthy physical and mental controls.

This is a case-control study involving subjects with BD. Selected based on DSM-5 criteria, an assessment of positive and negative symptoms was performed using the Positive and Negative Syndrome Scale (PANSS). Controls included in this study were matched to patients by age and gender. For all patients and control. Eight parameters of oxidative status were assessed: plasma ferric reducing capacity (FRAP), carbonyl proteins (PC), protein products of advanced oxidation (AOPP), reduced glutathione (GSH), total thiols, malondialdehyde (MDA ), glutathione peroxidase activity (GSH-Px) and catalase activity (CAT) analyzed by colorimetric methods. In addition, six cholesterol derivatives: oxysterols are measured by ULPC MS/MS.

This study included 33 patients with BD and 40 controls. Plasma GSH levels were significantly reduced in patients compared to controls (p < 0.001). Moreover, MDA, AOPP, PC and GSH-Px activity were significantly increased in patients compared to controls (p=0.005; p=0.003; p<0.001 and p=0.05, respectively). Significantly higher levels were observed for cholestane-3β, 5α, 6β-triol, 27-hydroxycholesterol (27-OHC), and cholestanol in patients with PTB. The concentration of 24(S)-hydroxycholesterol (24-OHC) was significantly lower in patients compared to controls. 25-OHC was positively and significantly correlated with CAT and GSH-Px activities (p=0.035 and p=0.010). 27-OHC was negatively and significantly correlated with MDA (p=0.014). Binary logistic regression revealed an association between the parameters: 27-OHC, 24-OHC, PC and MDA and the occurrence of PTB (OR = 1.007, 95% CI= 1.002-1.013), (OR = 0.956; 95% CI = 0.927 – 0.986), (OR = 39.925; 95% CI = 1.101 – 44.483) and (OR = 4.238; 95% CI = 1.091 – 16.466), respectively.

Our data support the relationship between disruption of redox homeostasis and oxidation of lipids and cholesterol in BD.

None Declared

Long-acting injectable antipsychotics (LAIA) are used in diagnoses other than schizophrenia. Over the last two decades, LAIAs have been developed with less administration frequency, going from 2-weekly presentations to 6-monthly presentations. The 6-monthly paliperidone palmitate has recently been released, allowing a reduction in the frequency of administration compared to the 1-monthly presentation and the 3-monthly presentation. Descriptive studies based on real clinical evidence can be very useful to assess clinical outcomes.

The main objective of the study is to describe the use of 6-monthly paliperidone palmitate in patients with schzophrenia, providing variables that objectify the evolution such as the number of psychotic decompensations.

Retrospective descriptive study with a sample selected by non-probabilistic consecutive sampling, retrospective type, in a time interval of 10 month (n=80). The patients selected were all those who received 6-monthly paliperidone palmitate treatment from after 10 months of use at Hospital Universitario Infanta Elena. A descriptive analysis was performed. Mean and standard deviation were calculated for quantitative variables and N and percentage for categorical variables.

A total of 80 administrations of 6-monthly paliperidone palmitate were performed in the study. None of the patients presented adverse reactions related to the administration of the drug, not reporting local pain or inflammation of the puncture area, except for the characteristic discomfort of an intramuscular puncture. Regarding the efficacy of 6-monthly paliperidone palmitate, none of the patients presented a psychotic decompensation after its administration, maintaining psychopathological stability after the change. The switch to 6-monthly paliperidone palmitate was made from both 1-monthly paliperidone palmitate and 3-monthly paliperidone palmitate, both showing the same efficacy. Regarding tolerability, all the patients who were administered 6-monthly paliperidone palmitate were previously treated with the monthly and quarterly presentation of the same molecule, having presented good tolerability to it, maintaining said tolerability after treatment. change to 6-monthly paliperidone palmitate, with no adverse reaction being recorded after the change. The adherence presented by the patients was very good, performing 100% of the administrations.

6-monthly paliperidone palmitate may be an effective and well-tolerated treatment for the treatment of schizophrenia and other diagnoses such as bipolar disorder or borderline personality disorder. According to objective data, 6-monthly paliperidone palmitate could be an effective and well-tolerated treatment as an alternative to monthly and quarterly presentations of the same molecule. Longitudinal studies must be carried out to confirm this hypothesis.

None Declared

Anorexia Nervosa (AN) is an Eating Disorder (ED), being globally characterized by a low body mass index (BMI), intense fear of gaining weight, and distorted body image that motivates extreme food restrictions. The consequence is massive weight loss.

AN is the third leading cause of chronic illness among adolescents and the leading cause of death among psychiatric conditions.

Among patients with AN it is common the occurrence of psychiatric comorbidities, particularly depressive and anxiety syndromes.

Negative emotions are very common and represent either primary aspects of the disease or arise secondarily to psychopathological or organic processes.

The therapeutic options for AN are scarce and only work for a small percentage of subjects.

It is known that difficulty in emotional regulation is one of the defining characteristics of ED, being a core feature of AN psychopathology.

To highlight the importance of understanding the neurobiology of AN, how it is related to emotional processing and future directions for AN´s management.

Non-systematic review of the literature using Pubmed database. Papers were selected according to their relevance.

In recent literature, in purging AN-type (neurobiology similar to Bulimia Nervosa - BN), binge eating is a method of emotional regulation, while in restricting AN-type, food restriction is the way to deal with emotions, mainly negative emotions.

It is known that in AN, patients tend to eat less than usual in response to a negative emotion and more than usual in response to a positive emotion. In BN, the neurobiology works in a mirrored way, patients eat less than usual in response to a positive emotion and more than usual in response to a negative emotion.

In short, in the face of negative emotions, subjects with AN respond with dietary restriction and, subjects with BN respond with binge eating. On the other hand, more positive emotions seem to resolve the maladaptive eating behaviours inherent to both ED, with AN and BN subjects tending towards more balanced eating behaviours.

One of the brain areas most implicated in the neurobiology of AN is the left dorsolateral prefrontal cortex (L-DLPFC), since this region is recognized as being involved in decision-making process and emotional regulation, and is therefore the target of novel and experimental treatment strategies, namely those related with neuromodulation, particularly Transcranial Magnetic Stimulation (TMS).

Emotional regulation, particularly the processing of negative emotions, appears to be a key element in the neurobiology of AN.

With new neuromodulation techniques, specially TMS, it seems possible to modulate the neuronal circuits inherent to emotional processing, such as the L-DLPFC.

Future randomized clinical trials are needed in order to understand how neuromodulation can contribute to exploring the neurobiology of AN and to become more targeted and effective therapeutic options.

None Declared

Major depressive disorder (MDD)is one of the most common psychiatric disorders and a large number of patients present a poor response to treatment. Shortening of telomeres physiologically occurs after each cell division and their shortening is also associated with cell ageing. Studies are affirming that patients who suffer from mental illnesses have shorter telomeres in comparison with patients without such affections. 4 The effect of antidepressant medication on the biology of the telomeres was studied very little in humans and the current data suggest that the length of telomeres is a promising target regarding the prognosis and the response to psychotropic treatment.

To analyze the telomere length (TL) from peripheral blood DNA of patients with major depressive disorder (MDD) compared to healthy controls. A second objective was to compare the TL of patients in relation to antidepressant treatment.

We analysed the clinical data from 16 patients admitted to the Psychiatry Clinic of Timisoara with the diagnosis of MDD and 10 healthy controls. The collection of clinical data was carried out in a structured and standardized manner both on paper and electronically, and the Hamilton Depression Rating Scale (HDRS) was applied to assess the severity of depression. Also, blood samples were collected, and plasma and white blood cells (WBC) were separated by centrifugation. Patients’ samples were collected before and after 12 weeks of escitalopram antidepressant treatment, and a structured diagnostic interview and a standardized depression rating scale were done. DNA was extracted from WBC using the QIAamp DNA Mini Kit (Qiagen), and TL was determined by real time PCR using the Absolute Human Telomere Length Quantification qPCR Assay Kit (Sciencell Research Laboratories) according to the manufacturers’ specifications. The TL expressed as megabases/diploid cell (Mb/DC) were compared between cases and controls using a Mann-Whitney test, and between patients before and after treatment using a Wilcoxon matched-pairs signed rank statistical test.

The mean±SD telomere length for healthy controls was 0.3614±0.082Mb/DC, for treatment naïve patients was 0.4513±0.199Mb/DC, and for patients after treatment was 0.3476±0.070Mb/DC. There was no statistical significant difference in TL between patients and controls (p=0.266), nor between patients before and after treatment (p=0.055).

In this pilot project of limited sample size there was no difference in TL between MDD patients and healthy controls. Moreover, the TL of patients did not significantly change after 12 weeks of escitalopram antidepressant treatment.

None Declared

The accurate examination of attributional patterns and cognitive biases in delusional patients is relevant to explain the externalizing tendency in paranoid schizophrenia patients. In subjects with delusional disorder (DD), attributional styles and other cognitive bias have been poorly investigated.

Our main goal was to review the tendency to use external-internal attributions for negative events and the presence/absence of other cognitive biases in patients suffering from DD.

A systematic review was conducted in PubMed and ClinicalTrials.gov databases/registers up to September 2022 according to the PRISMA Guidelines. The following key-words were searched in the title and abstracts: (attributions OR attributional OR “cognitive” OR “cognition” OR “social cognition”) AND (“delusional disorder”). Additionally, references of included studies were manually examined to identify further studies.

A total of 144 records were identified (Pubmed, n=125; ClinicalTrials.gov, n=16; other sources, n=13), five studies met our inclusion criteria, reporting attributional styles (n=5) and other cognitive biases (n=2) in DD. (A)Attributional style in DD. Mainly excessive external attributions implying the ascribing of negative experiences to another person’s behavior or action. Other authors describe attributions of negative events to internal causes (n=2). (B)Cognitive biases: Jumping to conclusions bias or judgments made on inadequate evidence have been described in DD (n=2).

Findings in attributional patterns in DD are mixed. Several authors report external and stable attributions in DD, whereas others described internal attributes for negative events, suggesting that depressive vs. “pure” paranoid core dimensions may appear in DD.

None Declared

Bipolar Disorder (BD) is a common psychiatric disease. It has been demonstrated a long time ago that bipolar patients are more painful than the healthy subjects. Substance use disorder is a frequent comorbidity in BD, but also in painful patients. The aim of our study was to analyze if bipolar patients with a painful expression have more substance use disorder than bipolar patients without pain.

The aim of our study was to analyze if bipolar patients with a painful expression have more substance use disorder than bipolar patients without pain

We included all bipolar patients from the FACE-BD cohort which is a prospective cohort of French outpatients with BD enrolled at the 12 advanced Centers of Expertise in Bipolar Disorder (CEBD). Pain has been evaluated by the “pain item” of the EQ-5D scale and we divided subjects in four categories: “no pain”, “slight pain”, “moderate pain”, “severe or extreme pain”. A multivariate analysis was performed to identify differences between each pain’s groups according to the kind of substance use disorder, psychiatric comorbidities and clinicals data.

The cohort enrolled 1897 bipolar patients, 970 had no pain (51.1%), 507 had slight pain (26.7%), 298 had moderate pain (15.7%) and 122 had severe or extreme pain (6.4%). We found significant differences according to age, comorbidities and clinicals data with older, more anxious, and more severe patients more represented in the more painful groups. Painful bipolar patients had also more frequently lifetime substance use disorders (alcohol, opioid, sedative, marijuana) and we were able to characterize different profiles in bipolar patients.

Bipolar patients with a painful expression had more risks to have a lifetime substance use disorder, an anxiety disorder, and a higher score on MADRS. Interestingly, subjects seemed to prefer substances with anxiolytic or antalgic effects during the acute intoxication as alcohol, marijuana, opioid and sedatives.

None Declared

About the term cognitive-behavioral minority disease or rare disease are a group of diseases that affect between 6-8% of the populatio. It is estimated that there are more than 7000 in the world, the majority with a genetic basis and affect various organs and systems, they also present psychiactric comorbidities and cause a physical or mental disability. Given its definition, it is difficult to see a large number of these patients in our usual clinical activity, so their management can be complicated.

To evaluate the prevalence of psychiatric comorbidity and the prevalence of psyhcopharmacological treatment in children and adolescents whe present a minority disease.

This is a descriptive, controlled, retrospective cross-sectional study of a sample obtained by non-probabilistic sampling, which is representative of the study population.

The statistical analysis was made using the statistical program SPSS V22 (2013).

With a sample of 114 patients, of which 26,6% presented fragile X syndrome, secondly 25,3% presented Prader-Willi Syndrome and 48,1% other chromosomal abnormalities.

By subgroups (male:female): in Prader-Willi syndrome 6:14 (30%:70%), in Fragile X syndrome 12:9 (57,14%: 42,86%) and in other diseases 25:13 (75,69%: 34,21%).

The creation of clinical expert units makes the possibility to increase knowledge of diseases whose prevalence in the population, thanks to technological advances, is increasing and where scientific knowledge is still limited.

These units are also important, in order to be able to offer personalized intensive treatments in order to reduce polypharmacy. There is not a great difference between the minority diagnosis and polypharmacy, although there is less polypharmacy than expected, which may be the result of the success of the most intensive and personal psychotherapeutic intervention in the unit.

None Declared