No significant relationships.

Although numerous effective antidepressant (AD) strategies are available for the treatment of major depressive disorder (MDD), many patients do not achieve satisfactory treatment response.

The aims of the present European, cross-sectional, multicenter, naturalistic study were (1) to determine the proportion of patients suffering from primary MDD who received additional psychotherapy to their ongoing psychopharmacotherapy and (2) to identify the associated socio-demographic and clinical patterns.

Patients receiving both treatments were compared to those lacking concomitant additional psychotherapy that was manual-driven psychotherapy (MDP) in all cases.

While 68.8% of a total of 1279 MDD patients received exclusively psychopharmacotherapy, 31.2% underwent a psychopharmacotherapy-MDP combination. The latter patient population was rather younger, higher educated, employed, exhibited an earlier mean age of MDD onset, lower severity of current depressive symptoms with lower odds of suicidality and higher rates of melancholic features, and comorbid asthma and migraine, and was generally treated with lower daily doses of their first-line ADs. Whereas agomelatine was more commonly dispensed in these patients, selective serotonin reuptake inhibitors were more often prescribed in MDD patients lacking additional MDP. No significant between-group differences were detected in terms of treatment outcome.

The fact that the employment of additional MDP was not related to better treatment outcome in MDD represents our major and clinically most relevant finding. Generally, MDP was employed in a minority of our patients who experienced rather beneficial socio-demographic and clinical characteristics. This might reflect an inferior accessibility of these psychotherapeutic techniques for patients who are more severely ill and less socio-economically privileged.

References Bartova L, Fugger G, Dold M, Swoboda MMM, Zohar J, Mendlewicz J, Souery D, Montgomery S, Fabbri C, Serretti A, Kasper S. Combining psychopharmacotherapy and psychotherapy is not associated with better treatment outcome in major depressive disor

Timely and accurate information is foundational to moderating and curing the COVID-19 for both the public and the scientific community, while repeated media exposure to crisis-related information raises stress and anxiety among general population.

The main goal of the current study was to evaluate the associations between the COVID-19-related information sources and anxiety levels.

An online web-survey recruited participants who were ≥18 years old and lived in Romanian through an online campaign in May 2021. Participants were asked whether they received COVID-19-related information frequently from the following sources: the Internet, traditional media, medical staff in health care settings or from friends, co-workers, or family members. We also assessed participants’ level of anxiety with Zung Self-Rating Anxiety Scale (SAS) and the cut-off point for anxiety index was set at 45. The associations of each information source with anxiety were examined using multiple regression analyses to control for sex, age, education and other demographic characteristics.

In total, the data of 1559 respondents (1224 female; mean age = 37.03 years and standard deviation (SD)=12.90 years) were analysed. The mean index score for SAS were 44.28 (SD=10.6). The major source of information on COVID-19 was the Internet (59.20%) and medical stuff (58.27%), almost in equal measure, followed by traditional media (48.17%) and friends, co-workers, and family members (30.72%).

Receiving COVID-19 information from the Internet and traditional media was positively correlated with anxiety level (p=0.01), while receiving COVID-19 information from medical-stuff was associated with low levels of anxiety (p=0.03).

No significant relationships.

Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is an autoimmune limbic encephalitis, where psychiatric symptoms are often the initial presentation dominant initially. These patients are mainly admitted to psychiatric wards, due to first episode psychosis (FEP).

Multiple studies analysed whether anti-NMDAR antibodies were present in the sera of schizophrenic patients, but results have not verified this hypothesis. It is possible, however, that unknown autoimmune antibodies play a role in FEP, similarly to anti-NMDAR antibodies.

40 patients with FEP and 30 healthy controls have been recruited to the study. Patients with affective psychosis, drug-related psychosis and patients with diagnosed encephalitis were excluded. The sera were tested with immune fluorescent assays for anti-NMDAR antibodies. A non-specific method was used to test anti-brain antibody activity on monkey-cerebellum and rat-hippocampus slices.

Neither the samples from the 40 patients, nor the samples of healthy controls contained anti-NMDAR antibodies. 14 of the patients’ and only 6 of the healthy controls’ serum showed positive reaction of the neuroendothelium. These results suggest that there is a difference between the groups, although the results are not significant.

None of the 40 patients proved positive for anti-NMDAR antibodies in agreement with previous studies. However, a higher proportion of samples from the FEP group showed activity in the neuroendothelium of non-specific immune fluorescent assays compared to healthy controls. Based on literature and on our experience, it is possible, that unknown autoimmune antibodies play role in FEP.

No significant relationships.

Fetal or neonatal hypoxia (FoNH) is a known risk factor for schizophrenia. It has been hypothesized that FoNH induced expression of schizophrenia susceptibility genes (Schmidt-Kastner et al. 2012, Giannopoulou et al. 2018).

To test this hypothesis, we explore the effects of FoNH and some genetic variants on age at onset (AAO) of schizophrenia.

The study included 1670 patients (women 1021 (61.1%), mean age 34.6 (SD 13.6), mean age at disease onset 25.4 (10.5) years) with ICD-10 diagnosis of schizophrenia or schizoaffective psychosis. The effects of FoNH in interaction with sex, family history (FH) and genetic variants on AAO of schizophrenia were evaluated. Polymorphisms rs2514218 DRD2 (n=943), Val66Met BDNF (n=820) and VNTR AS3MT (n=804) were genotyped.

Among all patients studied 179 (10.8%) had experienced FoNH. Regression model showed that FoNH, sex and FH of schizophrenia contribute significantly (p=0.000) to AAO. In the FoNH group, AAO was lower compared to the group without FoNH (20.7 (6.2) vs 25.5 (10.) years). When comparing men and women, there was a difference between FoNH and non- FoNH subgroups only in women (p=0.000). No interaction between FH and FoNH was observed though positive FH had an effect on AAO. There was the interaction effect of VNTR AS3MT and FoNH on AAO. In the FoNH group, carriers of 2 repeats had younger AAO compared to the carriers homozygous for 3 repeat variant (19.6 (4.9) vs 22. (7.6) years).

We demonstrate the interaction effects of FoNH and VNTR AS3MT polymorphism on AAO of schizophrenia.

No significant relationships.

Firesetting is a behavior, arson is a crime, and pyromania is a psychiatric diagnosis. Arson is a criminal act in which a person or group of persons willing fully and maliciously sets fire or aid in firesetting to cause harm to property, people, and infrastructure. The likelihood of an arson offender having schizophrenia is 20 times greater than that in the general population. Here, we describe the case of a male in his 50’s, a first-time arsonist, who suffered from schizophrenia since his late teens prior to the onset of random firesetting behavior.

To understand the association between Arson and Schizophrenia.

A case report, as well as a review of the literature, was conducted.

The patient is a male in his 50’s carrying a diagnosis of Schizophrenia with over 50 inpatient hospitalizations. He was observed standing on the threshold of a neighbor’s apartments where he allegedly set fire to a pile of clothing. These charges are based upon allegations that he attempted to set fire to a 14-storey apartment building. At the time of his assessment, he was floridly psychotic. He was found not fit to stand trial. He was restarted on Clozapine and Depakote which is the medication he had the most success with.

Literature shows that Arson and firesetting behaviors are quite commonly seen in patients with mental disorders. Arson often has sequelae that negatively impact the community. The strong correlation between firesetting behavior and mental disorders needs extensive, detailed collaboration between psychiatry, legal expertise, and fire services.

No significant relationships.

Being the parent of a child followed for a chronic pathology can require different resources and coping skills.

to determine the adaptation strategies of the parents of children monitored for adrenal insufficiency in the face of their children’s pathology

We conducted a descriptive cross-sectional study carried out with parents of children with Adrenal Insufficiency followed at the pediatric outpatient clinic in Taher Sfar Mahdia University Hospital between February 2019 and April 2020. We used a pre-established questionnaire collecting sociodemographic data and the strategies of coping using the Brief-COPE Board.

A total of 38 parents of children with adrenal insufficiency and 38 control parents participated in the study. The Brief-Cope board’s study of Coping strategies revealed that the strategies most used by parents of children with Adrenal insufficiency were, in descending order: religion (92.1%), support emotional (73.7%), distraction (63.9%), behavioral disengagement and acceptance (57.9%), instrumental support (52.6%), expression of feelings (50%), positive reinterpretation (39.5%), blame (38.9%), denial and humor (36.8%), active coping and planning (36.1%). On the other hand, those used by the control population were in descending order: religion (94.4%), distraction (84.2%), blame (78.9%), acceptance (72.2%) %), emotional support (69.4%), humor (63.9%), behavioral disengagement (61.1%), active coping (47.2%), expression of feelings (44 , 7%), planning (41.7%), instrumental support (30.6%), positive reinterpretation (22%), denial (19.4%).

Psychological support for the parents of children with chronic illnesses would be necessary to prevent parental burnout and improve their ability to adapt to their experiences

No significant relationships.

The COVID-19 pandemic has a huge impact on the provision of mental health care. Particularly the limitations of face-to-face contacts and the access to treatment facilities can be expected to have significant negative effects on the practice of psychiatric treatment and outcomes. To date the extent and the severity of these effects in people with severe mental illnesses are rarely investigated in Germany.

We investigated the impact of the COVID-19 pandemic on mental health and service use of people with severe mental illness in Germany.

As part of a pragmatic randomized trial on the effectiveness of an integrated community mental health care program that started immediately after the first COVID-19 wave in June 2020, 1000 people with severe mental illness from different regions in Germany have been asked for the effects of the COVID-19 pandemic on their mental health care and on their general living conditions. Multivariate regression models were computed to estimate the effects of the patients’ COVID-19 experiences on the outcome parameters empowerment (EPAS), psychosocial impairment (HoNOS) and unmet needs (CAN).

Using prospective data in a large sample of people with mental illness, we will be able to examine the extent to which the pandemic has affected participants’ mental health, their social lives, but also the use of mental health care services.

The data will help to examine the impact of the pandemic on people with severe mental illness in a comprehensive way and will provide evidence where immediate action is needed to reduce further burdens and inequities.

No significant relationships.

Resilience is the ability to bounce back or cope successfully with stress. Fostering resilience is a promising way to mitigate the negative effects of stressors and prevent burnout.

Study the level of resilience among Tunisian medical interns and residents.

We conducted a cross-sectional descriptive study between March 1 and April 15, 2021. Medical interns and residents were invited to complete an online self-questionnaire. We used the Brief Resilience Scale (BRS) to assess the level of resilience.

The total number of participants was 56 of which 28.6% were male. The average age was 26.76±2.52 years. Most of the students had studied at the Faculty of Medicine in Sfax, 58.9%. 64.3% of the participants were residents, 55.4% of them in a medical specialty. 75% of participants were working in a medical department. The average years of practice was 2.27±1.23. The number of working hours per week exceeding 40 hours was found in 60.7% of participants. The number of shifts per month exceeding 4 shifts was found in 67.9%. 46.4% of the participants wanted to change their profession and 44.6% regretted choosing medicine. The mean score by BRS was 2.79±0.48. The level of resilience was high in 42.9% of the participants and normal in the rest of the respondents.

The level of resilience was normal to high in Tunisian medical interns and residents. Assessing the presence of burnout and the coping strategies used could provide insight into the quality of work life.

No significant relationships.

Definitions used for suicide attempts and self-harm have been discussed for many years and is used differently in European countries, sometimes even interchangeably. Therefore, it is difficult to compare relevant rates across nations.

This study aims at estimating the rate of suicide attempts and self-harm in chosen European countries in the more recent years when distinguishing between applied definitions.

A systematic search for relevant articles published between 2010-2020 will be performed in databases such as PubMed, Embase, PsycINFO, and Web of Science. Only articles in English or Danish will be included. Data will be collected for all age groups above 15 years of age. The prevalence of suicide attempts and self-harm will be calculated by a random effect model. Subgroup analyses will be performed to compare the rates according to age.

from the performed systematic review and meta-study will be presented at the conference.

The conclusion will be presented when results have been analysed.

No significant relationships.

Psychiatry is not immune to the effects of trends and fads, which are ideas that elicit short-lived enthusiasm, are quickly adopted, and abandoned when they fail to live up to expectations. Trends meet a deeply felt need to explain, or at least name, what would alternatively be unexplainable human suffering.

The authors aim to explore the trends and fads that have occurred in psychiatric diagnostic and treatment throughout history and assess if any modern trends can be identified as well as assessing the effects or consequences of these.

The authors conducted a non-systematized literature review with focus on those articles most pertinent to the topic in question.

The literature demonstrates that fads and trends not only plague fashion and diet, but also psychiatry. Trends in psychotherapeutic options can be observed by the swing from psychoanalysis to psychopharmacological focus. Overdiagnosis is one of the consequences of these trends, and can be seen from hysteria, schizophrenia, multiple personality disorder, attention-deficit and hyperactivity disorder to gender identity disorder. These trends impact the way diagnosis are made and the treatments implemented.

Fads in psychiatry have occurred not only on the edge, but in the very mainstream of theory and practice. A balance is called for, with caution needed in order not to fall into the temptation of the fad, however, an open mind should also be maintained when cutting-edge treatments and theories emerge. The sensible antidote to falling for fads and trends in psychiatry is commitment to evidence-based medicine.

No significant relationships.

Magnocellular deficit in visual perception and impaired emotion recognition are core features of schizophrenia, however their relationship and the neurobiological underpinnings are still unclear.

The aim of our research was to investigate the oscillatory background of perception and emotion recognition in schizophrenia and to examine the relationship between these processes.

Thirty-nine subjects with schizophrenia and forty healthy controls subjects were enrolled in the study; the two study groups did not differ in age, gender and education. In the visual paradigm the participants viewed magnocellular biased low-spatial frequency (LSF) and parvocellular biased high-spatial frequency (HSF) Gabor-patches and in the second paradigm happy, sad and neutral faces were presented, while 128-channel EEG was recorded.

Significantly weaker theta (4-7 Hz) event related synchronisation (ERS) was observed in patients compared to controls in the LSF condition, whereas in the HSF condition there was no difference between the two groups. Event related changes in theta amplitude were also found to be significantly weaker in patients compared to healthy controls in the emotion recognition task, which difference was disappeared after correction for ERS to LSF condition. In the correlational analysis theta activity in the magnocellular biased stimuli correlated significantly with theta activity in the emotion recognition task, while theta to parvocellular biased stimuli showed no similar correlation with emotion recognition.

In schizophrenia, emotion recognition impairments are closely related to the dysfunction of the magnocellular system, which supports the bottom-up model of schizophrenia.

No significant relationships.

The author demonstrates the psychodynamic understanding of schizophrenia and describes the ensuing personality-structural psychotherapy. Schizophrenia from a psychodynamic understanding is a disease in the core of the identity with disturbances of the personality functions of identity, ego-demarcation, aggression, fear, narcissism, perception, cognitive abilities and the body- ego. It is the concern of the author to investigate how schizophrenically structured patients and their family members experience the group dynamic field in which the patients grew up and its relations to the illness. The following five topics: contact and experiences within the family of childhood, body care and physical contact, kindergarden and school life, puberty, and contacts outside the family have been investigated.

The aim is to show how the family settings and backgrounds are conducive to developing schizophrenia

The author chosed for her investigation the method of biographical interviews, introduced by Witzel (1985). This method of interviewing is problem centered, object and process oriented. The analysis of the exhaustive tape-recorded interviews was made by using the method of qualitative analysis based on the grounded theory.

Schizophrenia from psychodynamic understanding is a disease in the core of the identity with disturbances of the personality functions of identity, ego-demarcation, aggression, fear, narcissism, perception, cognitive abilities and the body- ego.

It is the concern of the author to investigate how schizophrenically structured patients and their family members experience the group dynamic social energetic field in which the patients grew up and its relations to the illness

No significant relationships.

The overall goal was to determine the degree of mental, neuromuscular and statodynamic functions disorders resulting from toxic effect of mercury and its compounds, to study relationship between the degree of loss of professional ability to work as a result of occupational disease with the presence of complications due to concomitant diseases.

The relevance of studying the degree of violations of the main indicators of vital activity due to the toxic effect of mercury and its compounds is due to the persisting high level of loss of professional ability to work, and in some cases, and disability of this contingent. Analysis of indicators of primary and repeated disability due to occupational diseases showed that a sufficiently high number of persons recognized as disabledю

We studied the dynamics of psychopathological disorders: violation of the emotional sphere, thinking, perception, attention, volitional activity and cognitive functions. The functional and metabolic activity of segmented neutrophils in the peripheral blood of 42 patients, men and women aged 43 to 64 years, and 22 healthy donors were studied.

Long-term exposure to chronic industrial mercury intoxication led to persistent disorders of mental functions, suppression of phagocytic activity of neutrophils up to 42.3+-4.7 per cent and inhibition of the reaction with nitro blue cytosol 4.2+-0.1 per cent..

The revealed violations of the emotional-volitional sphere and cognitive mental functions are possibly associated with the suppression of nonspecific cellular reactions of microphages. Violations of neuroimmune interactions in mercury intoxication require further study.

No significant relationships.

Hearing music inside our heads is frequent, however some hear it more vividly, constantly and involuntarily. Musical Hallucinations (MH), first described by Baillarger in 1846, are a complex type of auditory hallucination characterized by perception of melodies, music, or songs.

This work aims to review the literature considering MH.

Pubmed and Google Scholar search using MeSH term “musical hallucinations”

MH occurs in 0.16% of the population. They´re usually perceived as frightening or annoying. Proposed mechanisms include spontaneous activity triggered by sensory deprivation from hearing impairment, like in visual hallucinations in Charles Bonnet syndrome, and some authors even include MH as a subtype of this syndrome. Indeed, 60% of all patients with MH have hearing impairment or deafness. Other less frequent causes include focal brain lesions involving the auditory pathway and cortex, temporal epilepsy, metabolic or drug intoxication. Psychiatric conditions are uncommon but not impossible, especially in affective disorders. MH most frequently consist in familiar tunes, sometimes of personal significance, religious songs (especially in older patients), childhood songs, folk and popular songs from the radio - suggesting that musical perception is never unlearned but represents a “parasitic memory”, an unchangeable memory feature which can be experienced by relevant neuronal circuit stimulation. Most patients with MH were reported to have no extraordinary musical skills.

MH are rare and strongly associated with hearing loss, though investigation of other causes should be sought. Treating the underlying cause is important but remission is not guaranteed.

No significant relationships.

Adolescents patients presenting with mood disorders, including disruptive mood dysregulation disorder (DMDD), often present with the comorbid disorders such as oppositional defiant disorder (ODD) and attention-deficit hyperactivity disorder (ADHD).

1) Evaluate the association between suicide in adolescents and various mood disorders. 2) To study the impact of comorbid conditions in DMDD on suicide ideation and attempt in adolescents.

We used 2016-2017 National Inpatient Sample dataset to select patients with mood disorders. Rao Scott adjusted Chi-Square test used to compare the groups with SPSS v26.

In this study, 15195 patients were in the DMDD group (Mean age:12.1,F: 38%) and 219205 in the ‘other mood disorders’ group (Mean age:14.4,F:67%). The odds of SI/SA were two times more in patients with the ‘other type of mood disorder’ (OR:2.07, 95%CI: 1.77-2.14). Patients with the primary diagnosis of DMDD sub-classified into four groups (Group 1: DMDD only (n=5160), Group 2: DMDD+ADHD (n=7240), Group 3: DMDD +ODD (n=700), and Group 4: DMDD+ADHD+ODD (n=2095). SI/SA was prevalent in 30.8%, 26.0%, 22.9% and 26.3% in Group 1, 2, 3 and 4 respectively (p: 0.03). SI/SA was more prevalent in females compared to males (31.3% vs. 25.2%). An increase of 1 year in age was associated with a higher SI/SA (OR:1.05, 95%CI:1.01-1.08, 0.01). The SI/SA odds were 5% more in female patients (OR:1.27, p:0.01).

The study reveals that the risk of suicide ideation or suicide attempt is almost twice in the adolescent with mood disorders without DMDD compared to the DMDD group.

No significant relationships.

Chronic hand eczema (CHE) , inflammatory dermatitis, can lead to physical and psychosocial disability altering the quality of life of these patients.

The objective of this study was to examine the quality of life in patients with chronic hand eczema

Descriptive study collating patients who consulted for CHE, at the Dermatology Department of the CHU Hédi Chaker Sfax, during 3 years (2018-2020). A socio-demographic, clinic , and the Quality of life Questionnaire (DLQI) were administered in this study.

Our study included 12 patients (8 men and 4 women). The mean age was 46.8±11.6 years. The patients were in professional activity in 86.8% of the cases. No patient was in early retirement or disability status. The average duration of the disease was 4.5 years (1- 9 years). All patients were in remission. The intensity of pruritus at the last attack was mild (25.77%), moderate (72.23%), and severe (2%). The impact of pruritus on sleep was noted in 100%. The mean total quality of life score (DLQI) was 6.8±5.5 which means a moderate impairment of quality of life

This work highlights the importance of the impact of this dermatitis on the quality of life of these patients. Therefore, multidisciplinary dermatological and psychiatric management is considered necessary

No significant relationships.

It is important to determine those clinical factors that imply a greater risk of rehospitalization in psychotic patients

To determine the rate and predictors of rehospitalization in psychotic patients after their first hospitalization

We include all Psychotic patients admitted for first time in their life in our Psychiatric Unit between 2009 and 2019 (N=359) , including all diagnosed according DSM-IV of Schizophrenia or other Psychotic disorders -Multiple clinical, sociodemographic and biological variables of the basal hospitalization were recorded With the SPSS program we compared the variables between patients who needed any hospitalization in the follow-up until 31th December 2019 and those who do not. We use the Chi square ( qualitative variables) and the Student T ( quantitative variables)

109 psychotic inpatients had at least one rehospitalizations (30,4%). The qualitative variables significantly associated with rehospitalization were : cannabis in urine at admission (P<0.03), and treatment with risperidone (P<0.014). Instead treatment with long acting paliperidone was associated with absence of rehospitalization (P<0.005) .The quantitative variables relationed significantly with multiple rehospitalization were : lower age (P<0,015) lower HDL cholesterol levels (P<0.02) and higher years of follow-up after discharge (P<0.000)

1-More of 30% of psychotic patients need rehospitalization after their first hospitalization in a mean of follow up of 5,8 years 2-Lower age, longer follow-up period and treatment with risperidone are significantly associated with rehospitalization , instead treatment with long acting paliperidone are significantly associated with absence of rehospitalization

No significant relationships.

Aggressive behavior is frequently associated with acute psychiatric admission. Several studies highlight the increased risk of aggression in certain psychiatric disorders.

The aim of the study was to explore the extent of aggressive behavior, its various manifestations, and its association with gender, age, and diagnosis among patients admitted to an acute psychiatric ward.

Patients admitted to our acute psychiatric ward in a three months period were included and the Dynamic Appraisal of Situational Aggression - Inpatient Version (DASA-IV) questionnaire was administered in the first seven days after admission for all patients.

A total of 290 patients, 153 men and 137 women, with a mean age of 46.9 years (SD=17.5) participated in the study. Men were overrepresented among patients who showed aggressive behavior (p=.008). There was no correlation between age and DASA-IV score (p=.259). 40% of patients (N=116) did not show aggression, while 60% (N=174) experienced some form of aggression. Of those who exhibited some form of aggressive behavior, 94% had only low, 4% had high, and 2% had extremely high levels of aggression. Aggression was most common in patients with intellectual disabilities, dementia, and bipolar disorder.

According to our findings the majority of the acutely admitted psychiatric patients shows no or only low level of aggression. There were also differences in the forms and extent of aggressive behavior between the diagnostic groups. Risk assessment is important because it provides an opportunity for early detection and prevention, and the development of personalized treatment plans.

No significant relationships.

No significant relationships.