No significant relationships.

Premenstrual dysphoric disorder (PMDD) is included for the first time in the last edition of DSM within affective disorders. It is necessary that 5 of a list of 11 symptoms (lability, irritability, depressed mood, anxiety, lethargy, being out of control or physical symptoms among others) appear in the majority of menstrual cycles but must be only present during the week before menstruation improving after its onset. It has a prevalence of 1,8-5,8% and it is associated to significant functional impairment. SSRIs are indicated as first-line treatment in severe symptoms.

To review about premenstrual dysphoric disorder and its psychopharmacological treatment.

We carry out a literature review about premenstrual dysphoric disorder, accompanied by a clinical description of one patient treated with sertraline.

44 years old female referred to our outpatient mental health service due to anxious and depressive symptoms. She had presented abdominal pain, anxiety, obsessive thoughts, sadness, emotional lability, apahty, anergy, uncontrolled impulse, irritability and vociferous attitude with verbal agressiveness only the week before menstruation during several years. These symptoms interfered negatively in her relationships. We started sertraline treatment with ad integrum clinical recovery after two menstrual cycles. 6 months later we indicated to take sertraline only the week before menstruation, maintaining stability.

1) It is important to consider premenstrual dysphoric disorder as a possible diagnosis in women with premenstrual discomfort symptoms. 2) It might be consider as a depressive disorder. 3) Antidepressant treatment should be considered in women with disabling symptoms.

No significant relationships.

While alcohol-induced psychotic disorder (AIPD) is a well-recognised clinical disorder, relativery little is known about aspects such as epidemiology, course and treatment of the condition. Current evidence suggests AIPD can be clinically distinguised from alcohol-withdrawal delirium and schizophrenia. AIPD is associated with high comorbidity with other psychiatric disorders, high re-hospitalization and mortality rate, namely suicidal behaviour.

The objetive of the study was to examine the correlates, clinical features, psycopathology, and short-term response in an inpatient sample with alcohol-induced psychotic disorder, predominant hallucinations (ICD-10 F10.52) admitted to Centro Hospitalar Psiquiátrico de Lisboa.

We collected retrospectively data from all admitted patients to our Alcohol Unit between January 2010 and January 2020 with the diagnosis of AIPD. The exclusion criteria were: presence of preexisting psychotic disorder, delirium, or other substance use disorders. We characterized our sample in Demographic categories, Clinical categories, Treatment and Short-term course.

A total of 113 subjects were included in the study. The prevalance of alcoholic hallucinosis was found to be 1.3% of all patients who received inpatient treatment. Most individuals reported auditory hallucinations, that iniciated when they decrease their alcohol intake, and 1 in 4 had past episodes of AIPD.

There are specific challenges in studiyng AIPD, such as the relatively rarity of the disorder, its often transient nature and high levels of comorbidity. A high degree of recurrence and morbidity indicates a need to prevent, and intervene early with an abstinent-oriented management goal.

No significant relationships.

Antipsychotics are the mainstream treatment of delusional disorder. However, limited therapeutic effect was recognized due to side effect and lack of insight.

This article presents a case with Ekbom’s syndrome, also known as delusional parasitosis, who has significant response with Brexpiprazole.

A 58-year-old female developed her very first episode of psychosis 3 weeks before she visited our emergency department. Delusion of spiders laying eggs and bitsy spiders crawling over her body was claimed, followed by depressed mood and insomnia. The patient denied any substance use in recent months. Examination including biochemical studies, complete blood count, vitamin, and endocrine during admission were all normal. Brain image revealed senile cortical atrophy without apparent acute infarction. Cognitive abilities screening instrument (CASI) revealed total score 75, indicating borderline cognitive function. Ophthalmologist and dermatologist were consulted, and no specific abnormality was found.

Brexpiprazole 2mg was prescribed. After 3 weeks of treatment, the delusion improved with less parasitosis content. We discharged the patient, and kept following her at outpatient department with Brexpiprazole 2mg for 2 months. We tried to taper Brexpiprazole to 1mg at clinic, but her delusional parasitosis relapsed within 1 month. Therefore, we titrated the medication back to 2mg, and kept some dosage for 4 months. No more relapse of psychosis or significant movement dysfunction was observed. The total treatment course was 7 months.

Brexpiprazole, with its D2 partial agonism, shows impressive antipsychotic effect to Ekbom’s syndrome. Little side effect was observed in clinical practice, making Brexpiprazole a worth-trying psychopharmacological management of delusional parasitosis.

No significant relationships.

Epidemiological studies suggested that antidepressant usage amongst pregnant women increased by 3- to 7-fold in the past 2 decades and that up to 13% of fetuses are exposed to antidepressants. There are concerns regarding the impact of prenatal antidepressant use on the offspring.

We aim to review more recent evidence of antidepressant use during pregnancy and the risk of autism spectrum disorder (ASD) in the offspring.

Non-systematic review based on the PubMed® database.

A recent meta-analyses suggested children of mothers who used antidepressants during their pregnancy may be at a higher risk of ASD, compared to mothers who do not use these medications. Other suggested that the use of any antidepressants in the first 2 trimesters was related to significantly risk of developing ASD. Despite higher risks with the use of antidepressants, the absolute risk appears to be low. In addition, confounding factors should be considered while interpreting the results. Studies concluded that the comparator group selection strongly influences the observed antidepressant-ASD relationship. Associations derived from general population studies might have been mediated by unmeasured maternal psychiatric burden or transdiagnostic genetic liability. The observed increase in risk may also be associated with depression, not its treatment.

The findings of these studies have important implications, and often result in drug discontinuation with a significant impact on maternal and infant health. Future research should include investigation of the severity of depression in this association, assessment of antidepressant dose and use of antidepressants in pregnant women with other pathologies.

No significant relationships.

Bipolar disorder is related with functional impairment in euthymia. The contribution of biological functions such as sleep, sexual functioning; or the presence of obesity on this loss remain understudied.

The aim of this work was to study the influence of biological determinants in context with clinical and demographical determinants of functioning in a 3-year cohort of euthymic BD patients.

In this multicentric study 67 euthymic adult bipolar outpatients were followed during three years. Functioning was assessed with FAST, insomnia severity with Oviedo Sleep Questionnaire (OSQ) and, sexual functioning with Changes on Sexual Functioning Questionnaire (CSFQ-14) and obesity was expressed as body mass index (BMI). The basal effect of sleep, sexual functioning and obesity (Time 0) on FAST (Time 3) was analyzed with a mixed ordinal regression model including time effect, age, sex, number of manic and depressive episodes, euthymia length, and comorbidity with personality disorder. Change in functioning (Time 3 to 0) was analyzed in another mixed model also considering the difference in biological determinants (Time 3 to 0) and the presence of mood episodes during the period.

A basal worse sexual functioning, a higher severity of insomnia and a higher BMI predicted a worse functioning at three years (p=0.005, p=0.043, p=0.05 respectively). Regarding FAST difference from Time0 to 3, only having a manic episode related to an impairment on functioning (p=0.027).

Sexual functioning, quality of sleep and BMI are predictors of functioning in euthymia in BD. Manic episodes in the following contribute to impairments on functioning more than depressive episodes.

No significant relationships.

PTSD is a chronic, debilitating condition with limited treatment efficacy. Accessing traumatic memories often leads to overwhelming distress, impacting treatment process. Current approved pharmacological treatments have exhibited small to moderate effects when compared with placebo. Evidence suggests 3,4,-methylene-dioxymethamphetamine(MDMA)-assisted psychotherapy as a viable option for refractory PTSD.

Comprehensive review of early clinical research, proposed mechanisms, safety and emerging therapeutic models.

Eligible studies will be identified through strategic search of MEDLINE.

Pre-clinical and imaging studies suggest memory reconsolidation and fear extinction as candidate psychological and neurological mechanisms, involving MDMA’s combined effects of increasing serotonergic activity, as well the release of oxytocin and brain-derived neurotrophic factor in key memory and emotional circuits. Resulting reduction in amygdala and insula activation and increasing connectivity between the amygdala and hippocampus may create a “tolerance window” of neuroplasticity for emotional engagement and reprocessing of traumatic memories during psychotherapy. Early clinical trials report impressive and durable reduction in PTSD symptoms, with a safety profile comparable to that of SSRIs. A recently completed randomized, double-blind, placebo-controlled phase 3 trial reported full remission of PTSD symptoms in 67% of patients at 2 months, with no increase in suicidality, cardiovascular events or abuse behavior. Emerging treatment models underline the importance of unmedicated therapeutic sessions for preparation for the experience and subsequent integration as essential for full benefit and safety of the clinical context.

The psychological impact associated with the COVID-19 pandemic is an reminder of the emotional and economic burden associated with PTSD. MDMA-assisted therapy may be a breakthrough approach meriting further multidisciplinary investment and clinical research.

No significant relationships.

Borderline Personality Disorder (BPD) is a pervasive pattern of impulsiveness, emotional dysregulation, and difficult interpersonal relationships. Several studies showed that its onset depends on the combination of biological and psychosocial factors, particularly between biological vulnerabilities and traumatic experiences during childhood.

We aimed to explore the mediators of the effects of childhood trauma in BPD vulnerability.

We conducted a literature review using “PubMed” database and keywords “borderline personality disorder”, “childhood trauma”, “hypothalamic-pituitary-adrenal axis”, “stress”, adverse childhood experiences”.

Several studies showed that a diagnosis of BPD is associated with child abuse and neglect more than any other personality disorders, with a range between 30 and 90% in BPD patients. All types of abuse and neglect happen to be significantly associated with BPD features. Besides, the exposure to multiple types of maltreatment through multiple development periods increased the severity of BPD. Several studies highlighted the role of alterations in Hypothalamic-Pituitary-Adrenal axis, in neurotransmission, in the endogenous opioid system and in neuroplasticity in the childhood trauma-associated vulnerability to develop BPD. Besides, morphological changes in several BPD brain areas and in particular in those involved in stress response have also been incriminated.

Our findings regarding the role of childhood trauma in the development of BPD would help identify and develop early intervention services for a vulnerable population. The critical role of psychotherapy in treating individuals with early life stress may partially explain why the prevailing empirically validated treatments for BPD are psychotherapeutic.

No significant relationships.

Adolescent´s subjective well-being (SWB) can be improved through the training of emotional intelligence (EI).

The goal of this study is to determine the general link between EI and SWB in adolescents, to analyze the affective (AWB) and cognitive components (CWB) of SWB, and to investigate the moderating effect of EI models on both types of SWB.

We searched PsycINFO and WOS from inception to December 2020. Eligible studies reported an association between EI and SWB in adolescents aged from 10 to 19 years using instruments that directly measure SWB. Two meta-analyses were conducted, one for the relationship between EI and AWB and the other for EI and CWB.

A total of 41 studies were included, of which 37 were pooled in the meta-analyses. We obtained a significant positive relationship between EI and AWB (estimated effect size = 0.35) and between EI and CWB (0.29). Concerning EI models, self-report ability showed an estimated effect size of 0.33 for AWB and 0.28 for CWB. For the self-report mixed model, we found an estimated effect size of 0.42 for AWB and 0.38 for CWB.

Establishing a quantitative relationship between SWB and EI makes it possible to implement both clinical and educational prevention measures. Introducing EI training in educational and clinical settings can increase SWB, which could significantly impact the prevention of emotional disorders in adolescents.

No significant relationships.

Social intelligence (SI) and creativity (Cr) are resources to develop adaptive coping strategies and positive emotions that can help combat feelings of fragility and vulnerability caused by uncertainty during primary career self-determination as the developmental task in late adolescence.

The aim of the study was to compare SI and Cr of students with high and low level of tolerance for uncertainty (TU) during two last years in the middle school.

Participants were 200 students (15-17 years old). The level of TU was estimated by Budner’s scale (Kornilova, 2010). Social intelligence was assessed by O’Sullivan & Guilford’s Tests, creativity was measured by CAP. In addition, we estimate career adapt-abilities applied to present and prospective future career decisions.

Two contrast clusters based on TU level were analysed. The level of SI and Cr were various within each group. There appears to be an association between TU and career adapt-abilities (at r ∼ .37, p < .05). Mostly female students with low level of TU and above average scores on SI and Cr demonstrate the effective coping strategy dealing with stress (at r ∼ .45, p < .01) emotionally focus on nearest professional future, seek social support. Coping strategy of students with high TU, SI and Cr is focusing on nearest and distant professional future, on task-oriented content and the social status of the future profession. They are open to new career experience and flexibility in the use of future professional skills (at r ∼ .56, p < .001).

Employing their SI and Cr give new opportunities to understand and prevent the development of stress and provide age-specific support to prospective students during primary career self-determination.

Research is supported by the Russian Humanitarian Research Foundation, project No. 18-013-01067.

Today, a number of researchers consider the problem of addictive behavior as one of the most global problems for Kazakhstan and Russia. Some scientists consider CBT to be the most effective way to work with addictions. In our country there are no scientific works devoted to the study of addictive beliefs, so we decided to conduct such a study.

The Objective of the study was to identify the characteristic addictive beliefs of drug addicts with different type of addiction: opioids and synthetic cathinones (designer drugs called “salts”, “bath salts”).

Questionnaire of addictive beliefs by A, Beck, questionnaire of beliefs about cravings by A. Beck and F. Wright, clinical interview. Descriptive statistics and chi-square test were used for data processing.

People with opioid addiction are more likely to believe that their lives will become more depressive if they stop using drugs (p= 0.0347); that drug use is the only way to cope with pain in their life (p= 0.0347) and that they cannot cope with anxiety without drugs (p=0.009). Respondents who use synthetic psychostimulants endorse to believe that addiction is not a problrm for them (p= 0.0358).

Having categorized these beliefs in accordance with A. Beck’s classification, we came to the conclusion that “relief-oriented beliefs” are more typical for people who use opiates. The motive for use is often the desire to alleviate a negative emotional or physical state. For people using psychostimulants “salt”, “anticipatory beliefs” are more characteristic - the desire to experience euphoria and pleasant experiences.

No significant relationships.

Beyond living longer, it is increasingly important to live with more and better health during aging (1). Sexual well-being (SWB) was found to contribute to health and well-being in old age and is highly under-researched in the older population (2).

This study aims to analyze SWB in a cross-cultural way through older Portuguese and Slovenian older samples.

We interviewed 136 older participants with an average age of 71.6 years old. Participants were Portuguese and Slovenian and lived in the community. Participants were subjected to semi-structured interviews and these were subjected to a content analysis process.

The content analysis indicated nine themes related to SWB: self-reported good health; demonstrations of love; non-sexual joint activities; overall well-being and quality of life; partner support; positive self-image; being independent and active; sexual compatibility; and masturbation. Portuguese older adults experience their SWB associated mainly with self-reported good health and demonstrations of love, while Slovenians older adults associate their SWB mainly with non-sexual joint activities and overall well-being and quality of life.

The themes found in this study are fundamental evidence for cultural interventions and guidelines outlining in the context of sexual health in aging, mainly due to the scarcity of knowledge of SWB among older adults. 1.von Humboldt S et al. Sexual expression in old age: How older adults from different cultures express sexually? Sex Res Social Policy. 2020;1-15. 2.von Humboldt S et al. Are older adults satisfied with their sexuality? Outcomes from a cross-cultural study. Educ Gerontol. 2020;46:284-293.

No significant relationships.

Employee of Gedeon Richter Plc.

Electroconvulsive therapy, also known as seismotherapy or electroshock therapy, consists of passing an alternating current of variable intensity between two electrodes placed on either side of the patient’s skull to create a generalized convulsive seizure with therapeutic effects.

To evaluate the knowledge of the nurses of the neuropsychiatry pole of the Military Hospital of Tunis in seismotherapy.

Descriptive study, carried out in February 2021 in the pole of neuropsychiatry of the Military Hospital of Tunis (Services of psychiatry, neurology and neurosurgery). We developed for this study a form gathering sociodemographic questions and technical questions on seismotherapy (indications, contraindication, monitoring parameters …).

Thirty-nine (39) nurses agreed to answer the questionnaire. The average age was 37 years, 12 men and 27 women, with a sex ratio of 0.44. The majority (62%) of the participants had no idea about seismotherapy, 92% had never attended a session, 90% had no specific training, 87% thought that seismotherapy was indicated for all psychiatric illnesses. Seismotherapy was feasible on an empty stomach for 13% and after free and informed consent of the patient for only 33%.

Although included in the nursing curriculum, the knowledge in seismotherapy of the nurses of the neuropsychiatry pole seems limited. A specific training program is indicated in anticipation of the establishment of a seismotherapy unit at the Military Hospital of Tunis.

No significant relationships.

Cognitive function may be impaired in COVID-19 patients, especially in executive functions such as phonemic fluency. Among risk factors, inflammation during hospitalization is related with worse cognitive performance in the long term. On the other side, it has been shown that cognitive reserve (CR) protects against cognitive impairment associated with brain damage, psychiatric disorders and neurodegenerative diseases.

Our aim is to study the protective role of cognitive reserve in phonemic fluency to inflammation after SARS-CoV-2 infection.

We enrolled a cohort of 102 severe SARS-CoV-2 survivors after Intensive Care Unit (ICU) discharge and 58 agreed to participate in this 6-month follow-up study. Patients with previously known cognitive impairment were excluded. Demographic, clinical and laboratory data were collected. To assess the phonemic fluency, we used the Controlled Oral Word Association Test (COWAT) controlling the effects of age and education. Inflammation was recorded according to the number of days with high CRP. ANCOVA analyses were used to test the effect of interaction between medical variables and cognitive reserve on phonemic fluency.

The COVID-19 inflammation interacted with CR in phonemic fluency (F= 6.47, p= 0.01), with worse performance in patients with low CR (mean 16.7 (10.2-23.3)) than those with high CR (mean 37.7 (34.3-41.2)) in function of number of days with high PCR during ICU stay.

The role of the cognitive reserve is important to reduce the cognitive impairment related with COVID-19 inflammation in post-ICU patients.

No significant relationships.

Football is the world’s most-watched and played sport. Even though sports psychiatry is steadily gaining importance, the stigma on mental illness in sports, especially football, and the limited number of articles on this topic means there is a pressing need for more study in this area. This narrative review begins to fill this gap. This review summarises the work on addictive disorders in sports, with a close focus on football, as well as mentioning some initiatives that are advancing our understanding of how mental illnesses in sports can be addressed.

This view also contributes to understanding the reasons behind mental illness and sports, and raises awareness.

This review was conducted by searching for the keywords ‘addiction’ and ‘football’ on three different database search engines, namely, PubMed, Cochrane Library, and Medline. We found 26 articles based on this literature search with these keywords from 2005 to 2020. After data extraction, we cited 10 of them considering the specificity of addiction disorders in the football industry. 16 additional articles found by backwards citation chaining are also included in this review.

The articles reviewed here investigate addictive disorders within the football sector by looking at the incidence of particular addictive disorders, their underlying reasons and their consequences. This piece concludes by showing the need for more research and new initiatives regarding addictive disorders within the target group of footballers.

A holistic, multidisciplinary and biopsychosocial approach is essential to provide long term solutions considering different factors contributing to addictive disorders in the football sector.

No significant relationships.

Maintaining remission, preventing from future episodes, better treatment adherence and improving the quality of life are main aims of long-term treatment in bipolar disorders (BD). In recent years, new generation long-acting injectable (LAI) antipsychotics have been frequently used in maintenance treatment for bipolar disorders.

We aimed to review socio-demographic and clinical characteristics of bipolar patients taking LAI treatment for maintenance treatment.

Clinical records of 44 bipolar patients who are on LAI treatment and followed in Mazhar Osman Mood Clinic (MOMC) of Selcuk University Medical Faculty were evaluated.

Nearly half of the patients were male (n:24, 54%). 43,2% of the patients were married. The mean age was 36.6±11.9 years and the mean duration of education was 11.5±3.9 years. All of the patients were diagnosed with bipolar 1 disorder. Most of the patients (65.9%) was on aripiprazole LAI while remaining was receiving paliperidone LAI for maintenance treatment. Ten of the patients discontinued the treatment due to the side effects and extrapyramidal side effects was the most common side effect. Relapse was observed in 25% of the patients and there was no difference between aripiprazole and paliperidone in terms of relapse rate.

LAI new generation antipsychotics are taking place in long-term treatment of bipolar disorder via improving treatment adherence. Side effect profile of aripiprazole and paliperidone are different. However, we could not find any difference between two drugs in terms of side effects and relapse rates. Small sample size and shorter duration of follow-up should be considered as limitations.

No significant relationships.

Drug poisonings is a continuous public health problem in Russia and worldwide.

The objective of the study was to provide characteristics of lethal drug poisonings in a northern Russian region.

The data on deaths from drug poisoning that occurred between 2018 and September 2021, systematically collected by the Regional Center on the Organization of the Narcological and Psychiatric service of the Khanty-Mansi Autonomous Okrug of Russia, was analyzed.

Among 220 cases of fatal drug poisoning the overwhelming majority (90.4%) occurred among males. The number of cases increased annually from 27 in 2018 to 71 in 2020. The average age of death increased from 33.6 years in 2018 to 38.2 years in 2021. Over two thirds of deceased (70.9%) had complete secondary or vocational secondary level of education, almost one third (30.0%) were skilled workers, and slightly less than half (44.1%) were unemployed. The most common causes of death were methadone poisoning (34.5%), poisoning with other opioids (21.8%), other synthetic drugs (17.3%), other unspecified drugs (11.8%), and psychostimulants (10.0%). Alcohol intoxication was identified as a concomitant cause of death in every fourth case (26.0%), of which 98% were among males. Most often, alcohol was present in the blood at a concentration of 120 mg/ml and above. Every fourth deceased (23.6%) was registered with narcology health service for drug addiction.

Fatal poisonings with narcotic drugs and psychotropic substances is a growing public health problem in a northern industrial region of Russia, which affects predominantly working-age males and requires comprehensive multisectoral response.

No significant relationships.

Telepsychiatry is the best-documented e-Mental Health application. It refers to the use of videoconferencing in the provision of mental health services. During the COVID19 pandemic, in response to physical distancing, mental health services worldwide have turned to online consultations. For the vast majority of clinicians, it was the first time they use telepsychiatry, and very few have received training in how to do it.

- to present the main objectives and messages of the WPA Global Guidelines for Telepsychiatry related to competencies & skills, educational & legislative needs, and international collaboration.

A structured review of the main challenges, innovations, and settings in the first Global Telepsychiatry Guidelines, published by WPA in February 2021.

The benefits of increased access to telehealth services are apparent for telepsychiatry, but benefits can only be realized if the tools are used by clinicians who have the appropriate training and guidance. With proper preparation and thoughtful risk management, telepsychiatry can be an invaluable tool for allowing greater access to care. However, certain prerequisites must be fulfilled to achieve the desired goals. These prerequisites are e.g. choice of the technology, settings, patient/provider preferences as well as competencies and skills described in this document.

The need for training among health care professionals is the highest priority. The urgent need for clinical training and skills building around e-mental health inclusive telepsychiatry, will determine the influence that psychiatry can have in addressing the mental health sequelae of the COVID19 pandemic via competent practice and increased international collaboration.

I am the main author of “WPA Telepsychiatry Global Guidelines”

Ekbom Syndrome (ES) is a condition characterized by the fixed, delusional belief that one’s body is infested by parasites or other vermin, in absence of supporting clinical evidence. Literature suggests antipsychotic treatment for the management of behavioural and psychotic symptomatology, long-acting-injectable (LAI) antipsychotics for poor compliance.

A case report of a 70-year-old woman with an ES diagnosis treated with LAI palmitate paliperidone was followed-up for an 8-months period, resulting in a confirmed diagnosis of secondary ES to Lewy Body Dementia (LBD).

Patient was admitted to the local psychiatry ward presenting with new-onset visual and tactile hallucinations and social withdrawal. She was diagnosed with ES in a context of executive functions impairment. She was initially treated with risperidone, then switched to LAI Paliperidone due to poor compliance. Subsequently she was monitored monthly for 8 months by administering PANSS, MOCA, GAF, BPRS, PSP, complete neurocognitive assessment and neuroimaging studies

After 8 months a progressive cognitive deterioration and worsening of motor impairment confirmed a secondary ES to a LBD. Meanwhile, a significant reduction of psychotic symptomatology (delusions and somatic hallucinations) was observed at BPRS and PANSS positive scale, even after treatment discontinuation due to the onset of extrapyramidal symptoms of the underlying condition.

LAI Paliperidone treatment induced a complete remission of psychotic symptoms, with no relapse even after discontinuation of treatment. Moreover, close observation during follow-up allowed early diagnosis of LBD, which has been associated with a more favorable course.

No significant relationships.