Women receiving a prenatal diagnosis of fetal anomalies are a high-risk population for psychological distress leading to mood disorders. Even so, to date we have no evidence of studies who investigated the levels of maternal anxiety and depression in pregnant women receiving a prenatal diagnosis of fetal CNS anomalies.

The aim of this study was to assess the prevalence of anxiety and depression levels in a pilot sample of pregnant women at the Prenatal Diagnostic Unit of the Bambino Gesù Children Hospital.

We collected data among 43 women who receipt fetal brain anomaly diagnosis (mean age: 35 yrs, SD ± 6.3, range 19-48 yrs; mean week at first access 26w, SD ± 3.9, range 18-33w). Prenatal diagnosis including: ventriculomegaly (37.2%), posterior cranial fossa (23.3%), choroid plexus cysts (11.6%), anomalies of CC (7%) and other (20.9%). Pregnancies with assisted reproductive technology were 14%. We use the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorders (GAD-7) questionnaires to assess anxious-depressive symptoms.

showed a rate of mild-to-severe anxious depressive symptoms by 60.5% and 48.8% respectively. In detail: 41.9% mild, 14% moderate and 4.7% of severe anxiety. Meanwhile, 41.9% mild and 7% moderate depression. The prevalence of comorbid depressive and anxiety symptoms was 39.5% among the entire sample.

Preliminary data showed a high prevalence of anxious depressive symptoms and comorbidity among pregnant with CNS fetal anomalies. Women receiving a fetal CNS anomaly diagnosis may need additional psychological support or counselling.

No significant relationships.

Tranylcypromine (TCP), an irreversible monoamine oxidase inhibitor (MAOI), is recommended for difficult-to-treat depression. Besides the requirement of a low-tyramine diet, there are concerns about the safety of TCP treatment during anaesthesia and electroconvulsive therapy (ECT). For safety reasons, many psychiatrists prefer to terminate TCP before ECT.

To assess the safety of tranylcypromine treatment during ECT series in patients with difficult-to-treat depression (DTD).

In this retrospective study we report on n=19 patients, who were treated with tranylcypromine during the ECT series. ECT parameters, clinical and safety data were obtained from our clinical database.

Mean age of patients was 51 years (range 29-77) at time of the first ECT sessions. 58 % (n=11) of patients were female. In total, 198 ECT sessions were analysed (mean 11, median 9,5 per patient). Mean TCP dose was 44 mg at time of first ECT (median 43). Concomitant TCP and ECT treatments were well tolerated during the entire ECT series. In one case TCP treatment was discontinued due to self-limiting bigeminus during the ECT session. In another case TCP and other drugs as well as the ECT series were stopped after the patient developed delirium. At the end of ECT series the mean TCP dosage was 37 mg.

Tranylcypromine appears to be safe during ECT series and does not necessarily have to be terminated prior to electroconvulsive therapy.

No significant relationships.

The incidence and severity of posttraumatic stress disorder (PTSD) is higher in women than men because of environmental and biological factors. Specific mechanisms in the PACAP-PAC1R (pituitary adenylate cyclase-activating polypeptide and its type I receptor) system may confer PTSD risk in women. Interestingly, while the PACAP (ADCYAP1) - PAC1R (ADCYAP1R1) system is expressed highly in the hypothalamus, no relationship has been described for this pathway in the hypothalamus with fear processing or in PTSD.

We studied whether the estrous/menstrual cycle at the moment of trauma predicts PTSD and the involvement of the PACAP neurons in the amygdala and hypothalamus during traumatic stress.

Mice: DREADDs, immunohistochemistry and behavior. Humans: fear-potentiated startle and questionnaires.

Here, we show that acute stress immobilization (IMO) produces fear extinction impairments in female mice. Also, IMO elicits Adcyap1 and Adcyap1r1 mRNA upregulation in the hypothalamus, PACAP/c-Fos downregulation in the medial amygdala (MeA), and PACAP/FosB/ΔFosB upregulation in the ventromedial hypothalamus dorsomedial part (VMHdm) after fear extinction. We also found that women with the risk genotype of ADCYAP1R1 rs2267735 SNP show impaired fear extinction. In mice, DREADD-mediated inhibition of the MeA neurons projecting to the VMHdm during IMO rescues both PACAP upregulation in VMHdm and the fear extinction impairment. We ruled out contributions from inherent hormonal states showing that the menstrual or estrous cycle phase at the moment of trauma does not result in a vulnerable phenotype.

Our data suggest that the PACAP-PAC1R hypothalamic system may be a novel candidate to treat and prevent PTSD symptoms including fear dysregulations.

No significant relationships.

Previous neuroimaging studies of individuals with nonsyndromic oral clefts have revealed subtle brain structural differences compared to matched controls. Additional studies strongly suggest that the higher incidence of neuropsychiatric issues observed in these individuals may be explained by these neuroanatomical differences. Currently there are no studies that have assessed the overall empirical evidence of the effect of oral clefts on the brain.

Our aim was to summarize available evidence on potential brain structure differences in individuals with nonsyndromic oral clefts and their matched controls. In the current presentation, we discuss the results of regional brain structural differences.

Five databases were systematically searched in September 2020 for case-control studies that reported neuroimaging in healthy individuals and individuals with nonsyndromic oral clefts. Duplicate study selection, data extraction, random effects meta-analyses of mean differences (MDs) and their 95% confidence intervals were performed in order to compare regional brain MRI volumes.

We have identified 245 records following the database searches, from which 12 records met the inclusion criteria. Quantitative data on brain structure were available in three studies.The cerebellum, occipital and temporal lobes were significantly smaller in the cleft group compared to controls (MD: -12.46, 95% CI: -18.26, -6.67, n=3 studies; MD:-7.39, 95% CI: -12.80, -1.99, n=2 studies; MD: -10.53, 95% CI: -18.23, -2.82, n=2 studies, respectively).

There may be structural brain differences between individuals with nonsyndromic oral clefts and their controls based on the available evidence.

No significant relationships.

Difficult working conditions could be associated with addictive behaviors.

To examine the prospective associations between atypical working hours and substance use, including sugar and fat consumption.

In the CONSTANCES cohort, a total of 47,288 men and 53,324 women currently employed were included from 2012-2017 for tobacco and cannabis outcomes, and 35,647 and 39,767, respectively from 2012-2016 for alcohol and sugar and fat outcomes, and they were then followed up annually. Atypical working hours were self-reported at baseline and considered three different indicators: night shifts, weekend work and non-fixed working hours. Generalized linear models computed odds of substance use and sugar and fat consumption at follow-up according to baseline atypical working hours while adjusting for sociodemographic factors, baseline depression and baseline level of consumption.

Night shifts increased significantly the odds of using tobacco in women (Odds ratios, ORs varying from 1.55 to 1.62) and cannabis in men (ORs varying from 1.80 to 1.95). Weekend work increased the odds of using tobacco (ORs varying from 1.51 to 1.67) and alcohol (OR of 1.16) in women. Non-fixed working hours increased the odds of using tobacco and alcohol in men and women (ORs varying from 1.15 to 1.19 and 1.12 to 1.14, respectively). Dose-dependent relationships were found for tobacco use in women (P for trends<0.0001). No significant associations were found for sugar and fat consumption.

The role of atypical working hours on substance use should be taken into account by public health policy makers and clinicians for information and prevention strategies, especially among women.

Nadine Hamieh was supported by a grant from “Direction de la recherche, des études, de l’évaluation et des statistiques”, DREES, Ministry of Labour, France.

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by symptoms including inattention, hyperactivity and/or impulsivity that commonly persists into adulthood. Suicide is a major cause of death in adult ADHD (aADHD) patients. Suicidality is higher in these patients, in possible relationship to various clinical and socio-demographic factors.

To review the current literature concerning potential risk factors for suicide in aADHD patients.

A research was made using the Medline database through the Pubmed search engine, with the following keywords: “adhd”, “suicide”, “risk factors”.

Comorbid psychiatric disorders (major depressive disorder, sleep disturbances, behavior disorders and addictive disorders) are powerful predictors of suicidal behavior in aADHD. Depression is the most frequent diagnosis among aADHD patients with previous suicide attempts. Subtype (mostly the combined type) and severity of ADHD were also associated with a higher number of prior suicide attempts. Impulsiveness, poor emotional self-regulation, recklessness, persistent hyperactivity, inability to relax, engagement in risk behavior (often found in ADHD), common personality traits in aADHD like low frustration tolerance, maladaptive coping and poor problem-solving, as well as interpersonal relationship problems, were associated with higher suicidality. Financial distress caused by unemployment is associated with higher suicidal behaviors. The suicidality is higher in females, mostly associated to self-concept, whereas in males is typically related to impulsivity.

Clinicians should be aware of the potential risk factors for suicide in aADHD patients because the early detection of these factors is fundamental to improve the patients’ quality of life and could contribute to the design of more effective treatments.

No significant relationships.

Given the negative social representation attributed to mental illness, it is urgent to reconfigure its representation, not as an individual problem, but also as a collective. Several solutions have been indicated to improve the skills and quality of life (QoL) of these individuals. Among these, psychosocial rehabilitation programs stand out to keep individuals inserted in society reaching a level of independent functioning.

This study aims to: - assess the level of QoL, social support, treatment adherence, mental health status and mental health literacy of Portuguese people with HIV integrated into a community intervention program “InPulsar - Giros na Rua” program [which aims to contribute to the improvement of the socio-sanitary conditions of people who use psychoactive substances and to their social and therapeutic referral, as well as promoting risk reduction by intervening in a public space]; - improve mental health literacy levels, adherence to therapeutic regimen and QoL in individuals with HIV, after 12 months of implementation of a psychosocial rehabilitation program [biweekly sessions].

We will perform a single-group pre-experimental study with pre- and post-intervention evaluation, supported by the participatory methodology in health.

This study has received ethical approval from the local IRB. Data collection will start in November 2021 and will be completed in November 2022.

Through a multidisciplinary approach, this study will allow the development of health interventions articulated with psychosocial interventions based on various educational and behavioural strategies, promoting literacy and adherence to the therapeutic regimen.

No significant relationships.

A psychotic episode might stem from various psychiatric disorders, such as Major Depressive Disorder, Mania, Autism Spectrum Disorder, it might lead to Schizophrenia, or it might be a single event.

The study aimed to assess the main comorbidities encountered in the onset of psychotic episodes in children and adolescents, who were hospitalized in a pediatric psychiatry department for at least one night. Furthermore, another objective was to establish whether a family history of mental illness or a poor socio-economic status have bigger impact on the evolution of these patients.

To analyze the objectives, it was used an observational study, based on patients with the onset of a psychotic episode and associated diagnosis according to ICD-10, evaluated in Child and Adolescent Psychiatric Department of “Prof. Dr. Al. Obregia” Hospital, between 2015-2019. Patients with psychotic episodes with onset related to Major Depressive Disorder and Mania or a personal history of Schizophrenia were excluded.

The most frequent associated comorbidity was Autism Spectrum Disorder. In terms of long-term evolution, patients with comorbidities have poorer outcomes, more relapses and hospitalizations. Family history of mental illness, low socio-economic status, the age of onset were found to be prognostic factors and have an important impact on the outcome.

This study compared patients with psychotic episodes with and without comorbid conditions associated, considering the length of hospitalization period, the evolution and the number of relapses. The presence and the type of comorbidities are important factors of evolution and prognostic for these patients.

No significant relationships.

Despite youth’s high Global Burden of Disease there is a substantial service delivery gap between this population’s urgent needs and their access to health services. Because attention has remained under-prioritized (Babatunde et al., 2019), youth typically do not receive the treatment they require, i.e., they present an unmet need (Barwick et al., 2013). This is particularly problematic given that untreated mental disorders (MD) are associated with short-term and long-term functional deterioration.

To determine the level of functioning of children who receive mental healthcare in the selected psychiatric hospitals of Mexico.

A cross-sectional study was conducted during 2018-2020. Sample of children who received mental healthcare at the time of the study. Questionnaire for the evaluation of disability WHODAS 2.0 (World Health Organization-Disability Assessment Schedule) was applied. T test and analysis of variance were applied to know the differences of means of the variables and indicators.

Sample (n= 397), 63% were boys. Mean (SD) for Age: 12 (3.6) and schooling: 5.8 (3.6). 51% (n =202) of children reported having a generic diagnosis for hyperkinetic disorders and 34% depressive disorder. WHODAS scores: significant differences in the functioning domains (Do). Mean and (SD) for Do5 Life activities domestic: 45 (26.7); Do6 Social participation:37 (20.6); and Do1 cognition: 36.6 (19.3). Figure 1.

The children with MD are more vulnerable due to the associated disability and it requires specific heath interventions adapted to their mental health care needs. References: 1) Babatunde et al. (2021). Glob.Soc.Welfare 8, 29–46. 2) Barwick et al. (2013). J.evid.based.soc.work, 10(4), 338–352.

No significant relationships.

The covid pandemic has become a unique phenomenon in world history with great impact on mental health.

A great growth of anxious depressive pathology in relation to the Covid situation has appeared with the need to increase the psychiatric approach in the general population

A 58-year-old woman with no personal medical story of interest is referred to the high-resolution Covid program due to severe depressive symptoms: intense apathy, abulia, anhedonia, weight loss, insomnia and important social distancing after the beginning of the confinement due to the Covid Pandemic. 4 psychotherapy sessions are performed, with a maximum duration of 45 minutes. It is necessary to add antidepressant medication with sertraline up to 100mg to improve psychotherapeutic work.

A complete recovery of symptoms is achieved even their severity with normalization of daily life.

Small psychotherapeutic interventions have been shown, even with critically ill patients, to be very effective in helping patients regain their baseline status.

No significant relationships.

In many countries, people face problems regarding access to care, 24/7 support and evidence-based support. Digital interventions and services, such as chatbots, can be one option to tackle these challenges. There is a lack knowledge regarding how mental health chatbots are developed and how to ensure that there is collaboration between mental health and digital technology experts and users.

This presentation describes the phases of the development for the ChatPal mental health and wellbeing chatbot.

Development process was conducted in five and with four different languages. First, using an electronic survey for mental health professionals (n =190) we screened how familiar they are with chatbots and how they evaluated their potential. Second, university students and staff, mental health professionals and service users (n=78) participated in workshops to design the chatbot content. Finally, the content and scripts of chatbot were written in multi-professional and multi-national collaboration.

ChatPal is based on the PERMAH model of positive psychology and on the idea that we all have mental health which needs boosting and support from time to time. ChatPal includes relevant mental health information, exercises, mood diaries and simple monitoring and self-care tools. Based on preliminary evaluations, the ChatPal chatbot offers an option to offer support in areas where other mental health services are lacking or are insufficient.

ChatPal is already freely available in application stores and first scientific trials are have started. Preliminary results of 4-week and subsequent 12-week in-the-wild trials will be in place at the time of EPA 2022 conference.

No significant relationships.

The exponential increase of the older segment of the population (1) is coinciding with the growing challenges of a digital society in different socio-cultural contexts (2).

This exploratory study aims to analyze older adult perspectives of how smart technology influenced their meaning in life during the Covid-19 Public Health Emergency period, using qualitative research at a cross-national level.

Three hundred and fifty one community-dwelling older participants aged 65-87 years were included in the study. Participants were Italian, Mexican, Portuguese and Spanish. All the narratives went through a process of content analysis.

Findings of content analysis produced six themes: Meaningful relations, rewarding activities, spirituality, health and safety-related support, self-growth, and physical activity. Smart technology was important in promoting significant relations for Mexican older adults (71.3%), rewarding activities for Portuguese older adults (57.1%), spirituality for Spanish older participants (71.6%), and physical activity for Italian older adults (29.5%).

This study indicated that smart technology during the Health Emergency period was important for the meaning in life of older populations, mostly by facilitating meaningful relations, rewarding activities and spirituality. Future interventions with older adults during pandemic periods should consider the diversity of themes associated with increasing older adult well-being, from a cross-cultural perspective. 1. von Humboldt S & Leal I. The old and the oldest old: Do they have different perspectives on adjustment to aging?. Int J Gerontol; 9:156-160. 2. von Humboldt S et al. Does spirituality really matter? - A study on the potential of spirituality to older adult’s adjustment to aging. Jpn Psychol Res, 56;114-125.

No significant relationships.

We need to live in harmony with our lifestyle rhythms to stay healthy. A problem in our time is that technical devices have no respect for rhythm.If we get caught up in the technique and start neglecting our natural body needs such as sleep, eat and exercise – it will affect our health negatively. Today, children have increasing problems with mental health. When analyzing the problem we find rhythmical problems, often associated to technology. Being a parent in our time is hard. Time has come for us to take active care of our natural rhythms, to stay healthy.

Increasing mental health problems among the young is a global issue in the industrialized world. We see a connection between digitization, the intro of smartphones 2007 and the increase of anxiety, depression and melt downs in children who are left with to little adult guidance. Their screen time becomes to long leading to impaired health due to long sedentary time. The result is not enough physical activity, obesity, introversy because of lack of IRL social contact etc. The problems are well known but why don´t we talk more about them and help our children to deal with it?

Read any statistics about mental helath among the young in the industrialized countries.

While studying the statistics in Sweden over time the results of the bad sustainability of living are clear.

The adult world needs a wake up call which I will give in my oral presentation. I will also present proposals of solution.

No significant relationships.

Despite decades of brain MRI research demonstrating atypical neuroanatomical substrate in patients with autism spectrum disorder (ASD), it remains unclear whether and to what extent disorder-selective neuroanatomical abnormalities occur in this spectrum. This, and the fact that multiple brain disorders report a common neuroanatomical substrate, makes transference and the application of neuroimaging findings into the clinical setting an open challenge.

To investigate the selective neuroanatomical alteration profile of the ASD brain, we employed a meta-analytic, data-driven, and reverse inference-based approach (i.e.; Bayes fACtor mOdeliNg).

Eligible voxel-based morphometry data were extracted by a standardized search on BrainMap and MEDLINE databases (849 published experiments, 131 brain disorders, 22747 clinical subjects, 16572 x-y-z coordinates). Two distinct datasets were generated: the ASD dataset, composed of ASD-related data; and the non-ASD dataset, composed of all other clinical conditions data. Starting from the two unthresholded activation likelihood estimation (ALE) maps, the calculus of the Bayes fACtor mOdeliNg was performed. This allowed us to obtain posterior probability distributions on the evidence of brain alteration specificity in ASD.

We revealed both cortical and cerebellar areas of neuroanatomical alteration selectivity in ASD. Eight clusters showed a selectivity value ≥ 90%, namely the bilateral precuneus, the right inferior occipital gyrus, left lobule IX, left Crus II, right Crus I, and the right lobule VIIIA (Fig. 1).

The identification of this neuroanatomical pattern provides new insights into the complex pathophysiology of ASD, opening attractive prospects for future neuroimaging-based interventions.

No significant relationships.

Melatonin is often prescribed to patients experiencing sleep disturbances, which has been linked to elevated risks of suicide. However, it remains to be assessed whether melatonin is associated with suicide and suicide attempts.

We aimed to investigate whether individuals in treatment with melatonin had higher rates of suicide and suicide attempt when compared to individuals not in treatment.

Using longitudinal data on all persons aged 10+ years living in Denmark between 2007-2016 were obtained. Data from the National Prescription Register was used to identify periods of being in treatment with melatonin based on number of tablets and daily defined dose. Suicide and suicide attempt were identified in hospital and cause of death registries.

Among 5,798,923 included individuals, 10,577 (0.18%) were in treatment with melatonin (mean treatment length 50 days). Out of 5,952 individuals who died by suicide, 22 (0.37%) were in melatonin treatment, while 134 (0.53%) out of 25,136 had a first suicide attempt. After adjustment for sex and age-group, people in treatment with melatonin were found to have a higher rate of suicide (IRR: 4.2; 95% CI, 2.7-6.4) and suicide attempt (IRR: 6.7-fold (95% CI, 5.7-7.9) when compared to those not in treatment.

Treatment with melatonin was associated with higher rates of suicide and suicide attempt. The association might be explained through mediators, such as psychiatric comorbidity and sleep disorders. Our findings indicate that attention towards these issues might be warranted.

No significant relationships.

Psychological vitality has a significant relationship with self-realization, mental health, positive emotions and self-motivation, life satisfaction, and optimism. Additionally, it reduces the possibility of exposure to anxiety, depression and stress. In the same line, work pressures drive teachers to suffer from some negative emotions such as anger and lack of motivation, which in turn influence their vitality, social relations with colleagues.

The present study designed a motivational counseling-based program to improve psychological vitality among teachers in Dhofar region schools

Participants were 60 teachers obtained the lowest degrees on the psychological vitality questionnaire. They were divided randomly into two groups: experimental and control. Qusai-experimental method with two groups design was adopted. The given program consists of 18 counseling sessions at the rate of 3 sessions per week ranging from 60 to 75 minutes.

indicated that statistically significant differences at 0.01 level were found between mean scores of both groups groups on the posttest of psychological vitality favoring the experimental group. Also, statistically significant differences at 0.01 level were detected between the pre-test and post-test (experimental group) mean scores favoring the post-test. Taken together those findings confirm the effectiveness of the counseling program in improving psychological vitality Posttest and follow up test did not significantly differ which prove the continuity of program effectiveness.

To conclude, motivational counseling plays an important role in enhancing psychological vitality of teachers. Further research might use the program in alleviating other psychological disorders.

No significant relationships.

Patients attending psychiatric specialist health services in Northern Norway have since 2015 had the opportunity to access their medical records online. Prior to implementation, there were some concerns in the professional field that patient accessible electronic health records might introduce some challenges.

In this study, we asked psychiatric providers in outpatient psychiatric care about the impact of patients’ online access to documentation practices and whether they felt the access impacted the provider-patient relationship. We also examined whether the providers sought to deny patients’ access to any information.

16 qualitative in-depth interviews were performed with mental health providers working in the specialist services in North Norway. Participants had different professional backgrounds, and included doctors, nurses, psychologists and others. The interviews were audio recorded and transcribed verbatim. The data were qualitatively analyzed by means of the framework method.

The providers varied in their encouragement of patients’ online access, but few expressed concerns. There had been little specific training on how to optimize the writing of notes to accomodate patients’ online acces, but several pointed out that there had been an increased focus on the importance of adapting the notes to promote understanding. Increased transparency was in general seen positively, but the service might not fit all patient categories. Very few patients were denied access. In most cases, the service could improve the patients’ understanding of the treatment and the provider-patient relationship.

While some voiced caveats, patients’ online access was in general seen as beneficial to the treatment and the provider-patient relationship.

No significant relationships.

It is critical to provide not only mental health services but also welfare services that meet the socioeconomic needs of people suffering from mental illnesses in order for them to recover. Case managers in the public sector who provide socioeconomic support to the low-income class, in particular, play critical roles in early detection of untreated mentally ill people, linking them to the mental health system, and providing various supports for their community integration. Positive working relationships are required to fulfill these roles.

This study aims to analyze the effects of human rights sensitivity of case managers on the working relationships with the persons with mental illness mediated by empathy.

We evaluated overall human rights sensitivity, level of empathy(cognitive, affective, behavioral aspects) and working relationships with the mentally ill of 291 public sector case managers(Mean age = 40.52, SD=7.96, female 78.2%, male 21.8%).

In research model analysis, the goodness-of-fit was evaluated to verify the effect of overall human rights sensitivity on the working relationships with the persons with mental illness mediated by empathy. Most of indices showed sufficient goodness-of-fit. In other words, the higher overall human rights sensitivity is, the higher the level of empathy is, and this has a positive effect on the working relationships with persons with mental illness.

To form positive working relationships with people suffering from mental illnesses, public sector case managers must be educated to increase their empathy by improving their overall human rights sensitivity.

No significant relationships.

In nightmare disorder, dysfunctional emotion regulation goes along with poor subjective sleep quality, which is characterised by pathophysiological features such as abnormal arousal processes and sympathetic influences. Dysfunctional parasympathetic regulation, especially before and during REM phases, is assumed to alter heart rate (HR) and its variability (HRV) of frequent nightmare recallers.

We hypothesised that cardiac variability is attenuated in participants experiencing frequent nightmares as opposed to healthy control subjects during less deep sleep stages and an emotion-evoking picture-rating task.

Based on the second-nights’ polysomnographic recordings of 24 nightmare disordered (NM) and 30 control (CTL) subjects, we examined HRV during pre-REM, REM, post-REM and slow wave sleep periods, separately. Additionally, ECG recordings of wakeful periods such as resting state before sleep onset and an emotional picture-rating task were also analysed.

According to our results, a significant difference was found in the HR of the NM and CTL groups in the nocturnal segments but not during resting wakefulness before sleep onset, suggesting autonomic dysregulation, specifically during sleep in nightmare disorder. However, despite the accelerated HR of NM subjects at night, they did not exhibit lower HRV. Regarding the emotional task, we also found a contrast between the NM and CTL subjects’ HR and HRV, which might indicate altered processes of emotion regulation in nightmare disorder, but the two groups’ subjective picture ratings did not differ.

In summary, our study suggests that there might be some trait-like autonomic changes during sleep, but also state-like autonomic responses to emotion-evoking pictures in nightmare disorder.

No significant relationships.

Biomarkers in CSF could provide etiological clues and diagnostic tools for psychotic disorders. However, an overview of all CSF findings in individuals with psychotic disorders compared to healthy controls is lacking.

To analyse CSF findings from individuals with psychotic disorders compared to healthy controls.

PubMed, EMBASE, Cochrane Library, Web of Science, ClinicalTrials.gov, and PsycINFO were searched November 3rd, 2021. Case-control studies including patients with non-affective, psychotic disorder compared to healthy controls measuring at least one biomarker in CSF are included. Standardized Mean Differences (SMD) and random-effects analyses were used.

141 studies, covering 192 biomarkers, were included. 161 biomarkers have not previously been included in meta-analyses. Most markers measured showed no significant differences, including the dopamine metabolites HVA and DOPAC. Patients with psychotic disorders showed increased CSF levels of noradrenaline (SMD, 0.53; 95% CI, 0.15-0.90), MHPG (SMD, 0.30; 95% CI, 0.05-0.55), 5-HIAA (SMD, 0.11; 95 % CI, 0.01-0.21), kynurenic acid (SMD, 1.58; 95% CI, 0.26-2.91), kynurenine (SMD, 1.00; 95% CI, 0.58-1.42), IL-6 (SMD, 0.58; 95% CI, 0.39-0.77), IL-8 (SMD, 0.47; 95% CI, 0.18-0.77), anandamide (SMD, 0.78; 95% CI, 0.53-1.02), albumin ratio (SMD, 0.53; 95% CI, 0.10-0.96), total protein (SMD, 0.31; 95% CI, 0.14-0.48), and glucose (SMD, 0.57; 95% CI, 0.08-1.06). Neurotensin (SMD, -0.67; 95% CI, -0.89 to -0.46) and GABA (SMD, -0.29; 95% CI, -0.50 to -0.09) were decreased.

These findings suggest that dysregulation of the immune and adrenergic system and blood-brain barrier dysfunction might play a role in the pathophysiology of psychotic disorders.

No significant relationships.