Body dysmorphic disorder (BDD) is a relatively common disorder characterized by a preoccupation with non-existent or slight defects in appearance. It was first described in 1886 by Morselli as dysmorphophobia.

This work reviews the current available data on BDD and its treatment options and describes a clinical case that reports an improvement in symptomatology after surgery.

Non-systematic review of the literature with selection of scientific articles published in the past 10 years; by searching Pubmed and Medscape databases using the combination of MeSH descriptors. The following MeSH terms were used: “body dysmorphic disorder”, “dysmorphophobia”. Clinical file consultation.

The usual treatment involves a combination of psychotherapy and pharmacotherapy. Antidepressant medication, mainly selective serotonin reuptake inhibitors (SSRIs) have been used. If the symptoms do not improve, a different SSRI can be considered or clomipramine, venlafaxine or second-generation antipsychotics can be useful.

The role of surgery remains controversial, several studies indicating that the symptoms typically worsen after an aesthetic procedure because the preoccupation shifts to a different body area. However a recent study reported 32 of the 41 patients that underwent surgery were highly satisfied with the outcome. In our clinical case, our patient, a 20-year-old female with non-delusional dysmorphic ideas about her nose initiated treatment with paroxetine with poor response and was, against medical opinion, submitted to a rhinoplasty. Three weeks after the surgery there was an improvement in preoccupation about her nose. More research should be made to clarify the role of surgery in this disorder that often lacks adequate therapeutical response.

No significant relationships.

No significant relationships.

There is a rapid increase in the use of mHealth apps to provide care and support to people with deminetia (pwd) and their caregivers.

Functionality as well as scientific evidence of mHealth apps were analysed from a Health Technology Assessment (HTA) perspective

mHealth apps for pwd and their caregivers were identified in the app stores and assessed for functionality and methodological quality of the underlaying scientific evidence. Functionality was assessed with the Mobile App Rating Scale-German (MARS- G), methodological quality of studies using the Critical Appraisal Skills Program (CASP) checklists.

A total of 20 mHealth apps for were identified via systematic search in the Apple App Store and the Google Play Store. The overall quality of the apps can be rated medium with a mean score of 3.38. Studies have been published for only 30% of the apps (n = 6). 13 studies were included in the assessment of methodological quality, but the app itself was the object of study in only 2 publications. In summary methodological weaknesses such as small group sizes, a short study duration and insufficient comparative therapy were frequent.

Our results demonstrate that the majority of apps is lacking reliable scientific evidence. To support pwd and caregivers as end users in their choice standardised HTA criteria has to be defined and applied for mHealth apps.

The Digital Dementia Registry Bavaria (digiDEM Bayern) is funded by the Bavarian Ministry of Health (No.: G42d-G8300-2017/1606-381).

PROSPERO Registration Number: CRD42021260309.

No significant relationships.

Antenatal depression and antenatal anxiety adversely affect several obstetric and foetal outcomes, and increase the rate of postnatal mental illness. Thus, to tackle these challenges the need for social support during pregnancy is vital.

This study examined the association between domains of social support and antenatal depressive and anxiety symptoms among Australian women.

Our study used data obtained from the 1973–78 cohort of the Australian Longitudinal Study on Women’s Health (ALSWH), focusing upon women who reported being pregnant (n=493). Depression and anxiety were assessed using the Center for Epidemiological Studies Depression (CES-D-10) scale, and the 9-item Goldberg Anxiety and Depression scale (GADS) respectively. The 19 item-Medical Outcomes Study Social Support index (MOSS) was used to assess social support. A binary logistic regression model was used to examine the associations between domains of social support and antenatal depressive and anxiety symptoms.

After adjusting for potential confounders, our study found that the odds of antenatal depressive symptoms was about four and threefold higher among pregnant women who reported low emotional/informational support (AOR=4.75; 95% CI: 1.45, 15.66; p=0.010) and low social support (overall support) (AOR: 3.26, 95%CI: 1.05, 10.10, p=0.040) respectively compared with their counterpart. In addition, the odds of antenatal anxiety symptoms was seven times higher among pregnant women who reported low affectionate support/positive social interaction (AOR=7.43; 95%CI: 1.75, 31.55; p=0.006).

Low emotional support and low affectionate support have a significant association with antenatal depressive and anxiety symptoms respectively. As such, targeted screening of expectant women for social support is essential.

No significant relationships.

Recent studies show that a vegan diet causes a deficiency of vitamins (especially B12) and minerals. This can lead to severe physical and mental illnesses. On the other hand, the vegan diet is recommended as a preventative measure against cardiovascular diseases and is a growing trend among young people in developed countries for ideological reasons such as animal welfare and climate protection.

To show the importance of anamnesis of nutrition and vitamin B12 status in treatment of varied mental and physical symptoms in an adolescent.

The poster shows the case study of an adolescent girl who sought psychological help for nightmares and symptoms of anxiety and depression, as well as physical symptoms in the form of disturbed menstruation, fatigue and weakness, lethargy, dizziness, undifferentiated abdominal pain with nausea, and weight gain. All of which affected her academic success at university and daily functioning. An anamnesis showed that she has been following a vegetarian diet for 4 years and a vegan diet for two months.

Laboratory tests showed a deficiency of vitamin B12 (130 pmol/L) and 25-Hydroxy-Vitamin D(D3+D2) (47 nmol/l) and slightly elevated TSH levels (4,2x10-3 IU/L). These tests can explain the patient’s symptoms. Other laboratory results were in the normal range. A treatment with psychological therapy and vitamin supplements was commenced. Discussion reviews, among else, recent literature findings on correlation of vitamin B12 deficiency and a vegan diet.

Nutrition and vitamin B12 status should be investigated during anamnesis of adolescent patients presenting with varied mental and physical symptoms.

No significant relationships.

The COVID-19 pandemic has led to an increased psychological strain on public mental health and may impact behavioural, mental, and physical health, presumably with effects on patients with severe mental disorders.

This study examines pandemic-related physical and mental health and (compensatory) behavioural changes, in patients with BD as compared to healthy control individuals.

Physical and mental health and self-reported changes in daily structure and behaviour due to pandemic were assessed using a self-constructed questionnaire and the brief symptom inventory (BSI) from outpatient clinics in Germany, Austria, and Denmark in individuals with BD and a healthy control group.

The present study included 118 individuals with BD and 215 healthy controls. Individuals with BD reported statistically significant higher physical risk burden, increased weight gain, more physical comorbidities, and a decrease in physical activity and they further reported higher rate of COVID-19 testing, had more worries concerning health and experienced more anxiety but less social distancing.

The COVID-19 pandemic seems to have a greater impact on physical health in individuals with BD than in healthy controls. Individuals with BD appear to be having more difficulties compensating their behaviour due to the pandemic which could amplify the effect of risk factors associated with poorer physical health. This highlights the necessity for optimising and targeting the overall treatment of both mental and physical health in patients with BD during periods with far-reaching changes such as COVID-19 pandemic.

No significant relationships.

The self-report version of the Panic Disorder Severity Scale (PDSS-SR) is a reliable and valid instrument to assess panic disorder, but is unavailable in French.

The aim of this study was to conduct a transcultural validation of the French-Canadian PDSS-SR and examine its psychometric properties.

This study is part of a pragmatic RCT of group transdiagnostic CBT for anxiety disorders, and includes 272 adults meeting DSM-5 panic disorder diagnostic criteria. At baseline, participants completed the Anxiety and Related Disorders Interview Schedule (ADIS-5), the French-Canadian PDSS-SR and self-report measures. Convergent validity was assessed with Spearman correlations, Cronbach’s α was used to analyse internal consistency, and confirmatory factor analysis (CFA) evaluated its factor structure. Sensitivity to change was assessed with paired sample t-tests in patients (n = 72) meeting DSM-5 criteria for panic disorder at baseline with posttreatment data.

108 patients met DSM-5 criteria for panic disorder, including 58 with agoraphobia. The majority were women (85.3%) and mean age was 37.1 (SD = 12.4). Internal consistency (Cronbach’s α) was 0.91. For convergent validity, the highest correlation was with the Beck Anxiety Inventory (r = 0.64). CFA suggested a two-factor model. Optimal threshold for probable diagnosis was 10. Analyses support sensitivity to change when comparing transdiagnostic group CBT and control conditions.

With its good psychometric properties in primary care patients, the French-Canadian self-report version of the Panic Disorder Severity Scale is an efficient and practical instrument for both clinicians and researchers working in the field of mental health.

No significant relationships.

Body Dysmorphic Disorder (BDD) is a severe and common disorder that consists of distressing or impairing preoccupation with nonexistent or slight flaws in one’s physical appearance. People with BDD typically describe themselves as looking ugly, unattractive, deformed, or abnormal, whereas in reality they look normal or even very attractive.

Case Study

Case Study

Mr. X is a 31 year-old male with history of Opiate (heroin, oxycodone) use disorder currently on maintenance (Buprenorphine-Naloxone) treatment. On admission, urine toxicology was positive for opiates and other drugs.CIWA score was 11. He was started on Lorazepam taper, Mirtazapine, Fluoxetine, and was started on Suboxone soon after. His cravings decreased and he was admitted for Rehab. He reports that anxiety associated with his “body image” related to ears, shape of head, eyebrows since he was in high school which made him “feel uncomfortable” going to school and concentrating in his classes. His coping mechanism was covering his head with hats, shaving eyebrows, substance use, and receiving an otoplasty.

According to Houchins et al (2019), alcohol is the predominant substance used in BDD. It is interesting to note that only 6% of BDD patients had Opioid Use Disorder, but as this case demonstrates, can be a debilitating comorbidity that raises the risk for suicidality or hospitalization. However, little research has been done on the treatment of OUDs in patients with BDD or on the treatment of BDD in patients with an SUD, and this is an area of research that could benefit the modern population greatly.

No significant relationships.

FFA received consultancy honoraria from Novo Nordisk and editorial honoraria as EIC from Wiley. The rest of the authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of

Clinical practice has shown that SARS-CoV-2 viral infection increases the likelihood of developing mental disorders.Clinical practice has shown that SARS-CoV-2 viral infection increases the likelihood of developing mental disorders.

To analyze clinical indicators of patients with COVID-19 with mental disorders and to identify predictors of adverse outcomes associated with mental state on its basis.

The study included 97 patients, 41 men and 56 women (62.3±15.3 years of age). During the observation period, 26 people died and 71 people recovered. Data collection was carried out using a questionnaire (109 variables). Binary logistic regression and Cox proportional hazards regression were used.

In the study group, death occurred on average after 11.5 days. In this group, the mental state of patients was more severe with a predominance of cases of delirium. With age, the probability of a fatal outcome increased by 1.03 with each year of life. The severity of mental disorder had a greater impact on the risk of death compared to age (p=0.003). Improvement of the mental state of patients during psychotropic therapy was associated with a reduction in the risk of an unfavorable outcome of coronavirus infection by 11.11 times. The greatest contribution to the unfavorable outcome was made by the severity of infection: the risk of death increased by 33.17 times.

A severe or extremely severe mental state increased the risk of death by 4.55 times. The most significant factor in predicting mortality was associated with the severity of the underlying disease.

No significant relationships.

Diabetes has been associated to affective disorders and mental health problems which complicate the management of the disease. Emotional intelligence (EI), or the ability to perceive, facilitate, understand and regulate emotions has shown to be a protective factor of emotional disorders in general population.

To evaluate the role of EI and EI training in the biological and psychological variables related to people with Type 1 and 2 diabetes.

A systematic review was conducted in PubMed and Scopus database without time limitations, for studies examining the link between diabetes and EI. A total of 11 eligible studies were selected according to the inclusion criteria.

We divided the results into four sections: 1) EI and HbA1c, 2) EI training effects, 3) Differences in EI between persons with diabetes and without diabetes, and 4) EI and psychological adjustment and well-being. The results showed negative correlations between EI and HbA1C, positive effects of EI training on quality of life, anxiety and glycaemic control, no differences in EI between people with diabetes and healthy individuals and, finally, negative correlations between EI and different psychological variables such as diabetes-related anxiety and distress, and positive correlations with quality of life, well-being and marital satisfaction.

EI appear to be a promising protective factor for biological and psychological variables in individuals with diabetes. This systematic review offers a starting point for a theoretical and practical understanding of the role played by EI in the management of diabetes. Limitation and future lines of investigations will be discussed.

No significant relationships.

Lithium has a narrow therapeutic window. Frequent monitoring of both serum levels and clinical signs of toxicity is warranted because toxicity may be present even when concentrations are within the therapeutic range. Persistent neurological signs and symptoms of lithium intoxication gained clinical attention in the 1980s and were named Syndrome of Irreversible Lithium-Effectuated Neurotoxicity (SILENT).

To review the long-term neurological sequelae of lithium intoxication (SILENT) to highlight their clinical presentation, assessment, management and preventive measures.

Non-systematic review of literature through search on PubMed/MEDLINE for publications up to 2021, following the terms syndrome of irreversible lithium-effectuated neurotoxicity.

Neurological manifestations of lithium poisoning may persist, even after effective removal of the drug – SILENT. The most frequent sequelae are cerebellum and brain stem dysfunction, extrapyramidal symptoms and dementia. They may last for weeks, months or years. Infection, dehydration, deteriorating renal function or the addition of other drugs may precipitate acute toxicity. Irreversible damage is difficult to treat. Some cases show spontaneous recovery that may be total, but in others, sequelae persist. Helpful measures include the avoidance of acute intoxications with lithium, long-term and continuous dose adjustment and serum level monitoring, stricter exclusion criteria for starting lithium, and aggressive treatment of acute neurotoxicity. Once the long-term neurologic sequelae have set in, the patient should be managed according to the impediment (physical rehabilitation, speech, cognitive training).

It is important to raise the awareness of SILENT so that clinicians are able to avoid it. There should be a low threshold for suspecting the existence of toxicity.

No significant relationships.

Negative symptoms (NS) are a core feature of schizophrenia. NS show heterogeneity proven by factor analysis, which revealed two distinct negative symptoms subdomains: diminished expression (DE) and avolition/apathy (AA) (Marder et al. 2017, Fleischhacker et al. 2019). Some studies showed the different effects of these subdomains on clinical features of schizophrenia that suggest different pathophysiological mechanisms for their development (Stanculete 2021). It has been also shown that the levels of peripheral interleukins (IL) specifically correlate with NS (Enache et al. 2021), in particular, increased IL levels were determined in patients with deficit syndrome compared to non-deficit schizophrenia (Goldsmith et al. 2018).

To search for the association of genes for IL-4, IL-6, IL-10 and C-reactive protein (CRP) with NS subdomains.

The total sample included 551 patients (women 51,4%, aged 18-72 years) with ICD-10 diagnosis of schizophrenia. NS were assessed by PANSS. PANSS-derived factors include AA (items N2, N4, G16) and DE (N1, N3, N6, G5, G7, G13). Genotyping was performed for the following polymorphisms: C-589T IL-4, C-174G IL-6, C-592A IL-10, G-1082A IL-10, CRP (rs2794521).

There are effects of C-592A IL-10 (p=0.017) and G-1082A IL-10 (p=0.012) on AA subdomain. Post-hoc Bonferroni corrected comparisons show that carriers of the haplotype AA (C-592A)- AA (G-1082A) have the highest AA score. A significant effect of CRP (rs2794521) on AA is identified (p=0.007). There is a trend towards the association of C-589T IL-4 and C-174G IL-6 with AA. No association of these polymorphisms with DE was found.

AA and DE may have different genetic background.

No significant relationships.

The tools used to evaluate mental health during pregnancy matter. Their efficacy in identifying symptom severity enables better predictions of postpartum mental health. The Mother & Youth: Research on Neurodevelopment & behaviour (MYRNA) cohort is an NIH funded longitudinal cohort from Sherbrooke, Canada studying the effects of pregnant women’s mental health.

We examine which mental health tools will better gauge depression and anxiety during pregnancy based on predicting postpartum outcomes. Our hypothesis is that an approach combining a clinical interview with self-report questionnaires may predict mental health in postpartum women.

Participants’ mental health is evaluated by the SCID-5-RV, a lifetime interview administered at 30 weeks and monthly questionnaires including PHQ-9 and GAD-7. Participants are in the depression/anxiety group if they either pass all the criteria in the SCID during pregnancy or have an average PHQ-9 or GAD-7 score greater than 7. The Edinburgh Postnatal Depression Scale (EPDS) and the Perceived Stress Scale (PSS) are the outcome variables.

PHQ-9 was correlated with EPDS, r(220)= .38, p< .01, and GAD-7 was correlated with PSS, r(213)= .56, p< .01. SCID results only had a significant effect on PSS, F(3,220)= 3.77, p= .01 and not with EPDS, F(3,219)= 1.08, p= .36. When the self-report measures and interview were combined significant effects were seen for both the EPDS, F(1,222)= 18.71, p< .01 and the PSS, F(1,223)= 34.94, p<.01.

Preliminary results show significant associations between measures administered during pregnancy and postpartum measures. Prediction models based on classification will be analyzed once more data is collected.

No significant relationships.

INTRODUCTION: Patients with autistic spectrum disorders may exhibit symptoms that can also appear in psychotic disorders, such as isolation and difficulties in social interaction. In addition, these patients may also present psychotic symptoms throughout their lives, sometimes difficult to differentiate from the patient’s own idiosyncrasies.

OBJECTIVES: To deepen the knowledge of the comorbidity of autism spectrum disorders, in particular psychosis, as well as the differential diagnosis in order to establish an adequate treatment plan and a multidisciplinary approach.

METHODS: A detailed description is given of two cases of adolescents diagnosed with Autistic Spectrum Disorder who have presented time-limited psychotic symptomatology in the last year. In addition, a literature search was conducted on the comorbidity of psychosis in patients with ASD.

RESULTS: Both patients have required several hospital admissions to psychiatric units when they have had psychotic decompensations and psychopharmacological treatment with antipsychotics has been initiated.

CONCLUSIONS: Patients with autistic spectrum disorders have a wide comorbidity. Psychosis can appear in these patients, often starting in adolescence, a time when social demands increase and patients can become decompensated. They require rapid, multi-level intervention.

No significant relationships.

As a part of continuous destigmatization of mental illness and paople with mental disorders significant importance has media reporting, especially in modern times.

Media reports about mental health (MH) are still an issue of a great discussion concerning their content especially in ethical matters. Many initiatives in different countries resulted in various changes in attitudes and influenced on this topic. But the image of mental illness as well as psychiatry in general are still burdened with the shadow of stigma.

To show development of one of initiatives in Bosnia and Herzegovina (BH) supported by policy makers through the creation and broad distribution of recommendations for ethical media reporting about mental disorders.

In 2019 Task Force appointed by both entities’ ministries of health in BH developed an publication with recommendation for ethical reporting about mental health topics with special highlights on specific mental disorders (schizophrenia, depression, suicide, addictions, etc.). It was widely distributed to media and health institutions in the country and was officially adopted as the recommendation of the national Regulatory Agency for Media. Trough five rounds of educational workshops in 2019 and 2021 more than 150 media and mental health professionals were introduced with the publication as well as practical implementation of this recommendations (as is exercises of giving statement).

In BH is developed very useful tool for more quality media reporting about MH topics as one of important ways for reducing the stigma and discrimination of people with mental disorders as well as promotion of good mental health

No significant relationships.

Stigma and discrimination can disrupt the lives of individuals with a mental illness, preventing their opportunities to become productive citizens. These Individuals must also face either an avoidant attitude by healthcare professionals or prejudices about their adherence to medications and the psychological nature of their physical symptoms.

Assess stigma in terms of explicit and implicit attitudes among medical school students and junior doctors. Evaluate academic factors and interfering with these attitudes.

A cross-sectional study was conducted among students from medical schools in Tunisia.

All participants were invited to complete a brief anonymous electronic survey administered on the google forms online platform.

Data were collected using self-administered questionnaires, Stigma Measurement, Mental Illness: Clinicians’ Attitudes (MICA).

The sample consisted of 1028 respondents. The respondents’ mean age was 24.54 years (SD=3.7). Post-clinical students scored higher than pre-clinical students in questions 2, 6, and 12 on the rating scale. A positive significant relationship was identified with specialization in psychiatry. Residents who were specialized in family medicine, emergency, and intensive care had a higher stigma level compared to other residents (Mean score>0.51). The completion of a psychiatry clerkship did not significantly reduce the level of stigma toward people with a mental illness ( p=0.8).

A combination of medical school experiences of psychiatry’s theoretical learning and clerkship are important factors that shape students. Awareness of this will enable educators to develop locally relevant anti-stigma teaching resources throughout the psychiatry curriculum to improve students’ attitudes towards psychiatry as a discipline and mental illness in general.

No significant relationships.

Severe COVID-19 survivors experience long-term neuropsychiatric morbidity, particularly those who developed delirium, with a negative impact on health-related quality of life (HRQoL).

To identify the cases of delirium in severe COVID-19 patients and to describe its association with post-hospital discharge HRQoL.

In the context of the longitudinal MAPA project, we included adult patients (≥ 18 years old) admitted with COVID-19 to the Intensive Care Medicine Department (ICMD) of a Portuguese University Hospital (October 2020-April 2021). Exclusion criteria were: ICMD length of stay ≤24h, terminal illness, major auditory loss, or inability to communicate at the time of assessment. Delirium during ICMD stay was ascertained based on patients’ clinical records. HRQoL was evaluated using the 5-Level EQ-5D questionnaire (EQ-5D-5L), at a scheduled telephone follow-up appointment on average 1-2 months after hospital discharge.

Overall, 124 patients were included with a median age of 62 (range: 24-86) years, being mostly male (65%). About 19% had delirium, 42% were deeply sedated and 43% required invasive mechanical ventilation. Most survivors reported problems on the EQ-5D-5L domains: usual activities (85%), mobility (73%) and anxiety/depression (65%). Patients with delirium reported more pain/discomfort (75%vs46%; p=0.011) and considerably anxiety/depression (83%vs60%; p=0.032).

These findings pointed that COVID-19 patients who experienced delirium reported worse HRQoL, regarding pain/discomfort and anxiety/depression. This study highlights the importance of not only prevention but also early screening of delirium during hospital stay, as well as the crucial role of the timely interventions at discharge, in order to minimize delirium long-term impacts.

No significant relationships.

There has been obvious in university education the importance of mental health and psychological well-being of students along with academic achievements (Lambert et al., 2019). M. Seligman, one of the founders of positive psychology, characterizes positive education as education aimed at acquiring happiness along with knowledge and skills (Seligman et al., 2009).

The current study aims to overview the positive education impact on mental health and psychological well-being.

Systematic analysis of research publications concerning positive education and its role for maintenance of mental health and psychological well-being.

While university administration collects student’s feedback on various aspects of the educational process, it almost never asks students for their opinion on what can be done for their psychological well-being. The promotion of psychological well-being among young people is becoming an increasingly popular topic, and positive education is increasingly emerging within education. Positive education can be seen as a general sphere of positive psychology and advanced practice in education that aims the development of students for both academic achievement and psychological well-being. Special attention in positive education is paid to the use of empirically proven methods and programs aimed at improving well-being, engagement in educational activities, optimism, positive emotions, life satisfaction and other positive experience.

A particularly promising direction for the development of positive education can be the use of information and communication technologies to improve mental health and psychological well-being. The reported study was funded by the Russian Foundation for Basic Research, project number 18-29-22049.

No significant relationships.

States compatible with “Delusional disorder” have been described since the XIX century. Esquirol mentioned “irrational ideas and actions that would develop via logical and plausible arguments”; Kraepelin referred to the condition as “paranoia” and considered that hallucinations could not be present– unlike Bleuler, who considered them to be a possible feature. The criteria for delusional disorder have suffered several changes in the last centuries.

We aim to review the evolution of the criteria for delusional disorder across the editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM).

Review of DSM editions.

Criteria for the diagnosis of “paranoia” (DSM III) or “delusional disorder” (DSM III-IV.V) underwent several changes. In the first editions hallucinations could not be prominent (DSM-III-IIIR) and in the DSM IV, only tactile or olfactory hallucinations related to delusions could be present. In DSM-V hallucinations of other modalities related to the delusional theme can be present. Regarding delusional themes, the first edition of the DSM III regarded persecutory delusions only – which was changed in the DSM-III-R, with the inclusion of grandiose, jealous, erotomaniac, and somatic. Only in the DSM-V did the occurrence of bizarre delusions become possible in delusional disorder. Across the editions, there is a consensus about the absence of negative symptoms, absence of disorganized speech, and that the behavior is not odd aside from delusional content.

The most debatable symptoms across centuries in the classification of delusional disorders were: presence of hallucinations, the nature of the delusional content, and inclusion of bizarre delusions.

No significant relationships.