The Covid-19 pandemic has brought with it far-reaching consequences that affect the mental health of a significant population. Those suffering from somatic symptom disorder (SSD) present a significant focus on physical symptoms, with excessive thoughts and behaviours, to an extent that results in major distress and dysfunction. Aggravation of SSD could be associated with various stressors, including the current pandemic, and culminate in an increased severity of the base presentation.

The authors present the case of an elderly man with previous diagnosis of SSD which began to aggravate and evolve into a depressive psychotic state, precipitated by the beginning of the Covid-19 pandemic.

The authors conducted a non-systematized literature review with focus on those articles most pertinent to the topic in question as well as presenting a clinical case as compliment.

With the pandemic overwhelming the globe, the literature has demonstrated a significant correlation with aggravation of mental health and psychiatric cases. The patient in question was previously followed in consultation for SSD. With the pandemic acting as precipitating stressor, the patient demonstrated a significant aggravation in his base presentation with the development of psychotic depression. He was subsequently hospitalized with implementation of psychotherapeutic and psychopharmacological methods, with remission of the psychotic state, with poor response of the SSD.

External stressors are an important influence on psychiatric disorders. Whenever potential life stressors, especially those that exert influence on a global scale, the psychiatrist should be attentive to the possibility of significant aggravation of a stabilized clinical picture and offer support.

No significant relationships.

Refugees have been shown to be a vulnerable population with increased psychiatric morbidity and lack of access to adequate mental health care. By establishing cooperations between psychosocial centers and psychiatric clinics the state funded project refuKey by NTFN e.V. and DGPPN aims to improve access to and quality of mental health care for traumatized refugees pursuing a stepped-care model.

As part of a larger project evaluation study four focus-groups among experts were conducted to explore the impact of refuKey on refugees’ mental health care.

Data analysis was conducted using Mayring qualitative content analysis as well as an additional quantitative survey with state refugee reception centers’ employees.

The results indicate that refuKey faciliated the access to mental health care for refugees in terms of systematic identification of mental disorders, eased transitions and increased networking between the mental health care institutions and sectors. Planning and implementation of treatment is described as being more coordinated, solution oriented and sustainable due to multiprofessional collaboration and regular use of qualified interpreters. Reduced distress as well as increased transcultural expertise was found for professionals.

The persisting barriers for refugees in access to mental health care, especially to psychotherapeutic treatment and the emotional burden for professionals underlines the need for further support and research. The experts highly endorse the continuance of refuKey. Furthermore, they call for expansion of the project in terms of staff and new sites and changes of health policies to guarantee the access to adequate health care for traumatized refugees.

No significant relationships.

Almost all definitions of impulsivity include the notion of distorted time perception such as impaired awareness of the future or premature responses. Preclinical evidence suggests that stimulant drugs speed up the internal clock, making time pass faster than it actually is. However, stimulant-addicted humans, who are drug-abstinent seem to over-estimate long time intervals.

The present study aims to investigate time processing in actively using patients with cocaine use disorder (CUD). We hypothesise that active cocaine use will be associated with an under-estimation of long time intervals.

We recruited 48 men with a chronic history of cocaine use, meeting the DSM-5 criteria for CUD, and 42 healthy men without a history of substance use disorders. All participants completed a time reproduction task in which they were presented four times with six different time durations and were subsequently asked to reproduce them by pressing the space bar for the same time duration of the target interval they had just seen. Participants also completed the Barratt Impulsiveness Scale (BIS-11).

Overall precision in time reproduction was significantly reduced in CUD patients (F6,81=3.97,p=0.002), which was particularly evident for longer time delays. CUD patients’ estimated-to-target-duration ratios were marginally shorter for the 11000ms (F1,86=3.1,p=0.084) and significantly shorter for the 18000ms and 24000ms time intervals (both p<0.05). Time reproduction performance correlated with self-reported attentional impulsivity on the BIS-11 in both CUD patients and healthy controls (all p<0.05).

Consistent with preclinical work, the inner clock of humans with regular cocaine use seems to be accelerated.

No significant relationships.

No significant relationships.

Risperidone, a second generation antipsychotic, shows high affinity with serotoninergic and dopaminergic D2 receptors, but also adrenergic and H1 histaminergic receptors. Previous studies have shown an increase in eosinophile count associated with the second-generation antipsychotics through the histaminergic path.

The presentation of a case in which eosinophilia was associated with risperidone withdrawl which has not been described so far.

A 46-year-old woman with schizophrenia diagnosed at the age of 22 was admitted in our inpatient psychiatric clinic with psychotic symptoms relapse after she voluntarily discontinued risperidone. The patient was fully evaluated with full laboratory tests, a brain CT scan, EEG and her medical and psychiatric histories were recorded.

Risperidone was reinitiated but due to the persistence of symptoms it was switched to clozapine which lead to full remission. It was observed though, that while gradually decreasing risperidone dosage (Figure 1.), eosinophile count was raising and it was normalized after complete discontinuation. Eosinophilia was also present in other instances that the patient discontinued taking risperidone according to her personal history. Other causes of eosinophilia (allergic, inflammatory) were fully excluded.

Risperidone discontinuation could lead to an elevated eosinophile count. There is limited research in this topic and it is yet to be clarified whether the elevation is due to stopping one antipsychotic or switching between two different antipsychotics. It is important to run laboratory tests regularly with every treatment modification.

No significant relationships.

Dementia develops slowly and insidiously and causes cognitive impairment. The diagnosis is pivotal for relevant treatment and care. However, 50,000 people are estimated to have undiagnosed dementia in Denmark, while 36,000 are diagnosed.

The municipalities offers a home visit to the population at the ages of 75 and 80 years to assess the need of care and prevent sickness. These home visits are well established and might offer an unused opportunity to detect cognitive impairment and dementia.

To assess impaired cognition at home visits in order to initiate clinical examination for dementia.

A feasibility study with the use of Brief Assessment of Impaired Cognition Questionnaire (BASIC-Q) (sensitivity 0.92, specificity 0.97) at home visits. It is expected to include 1000 participants without a dementia diagnosis at the ages of 75 and 80 years. Participants will be included in a period of 12 moths (in the year of 2022), in a number of municipalities.

If the screening for cognitive impairment is positive, the participant is motivated for clinical examination at the general practitioner. Follow-up through registers and general practitioners.

Preliminary results will be presented at the conference.

Assessment of cognition might give an opportunity to start medication and social support early in the elderly with impaired cognition and undiagnosed dementia.

No significant relationships.

Lateralization is a complex process that evolves during the development of the child leading to the organization of the functional dominance with a body side. However, laterality is poorly examined.

The aim of this study was to explore the features of patients with a laterality disorder evidenced by a non-dominance affirmed of the handedness.

A retrospective review of 25 cases of patients (15 children of 8-9 years and 10 adults of 26-42 years old) presenting a laterality disorder. All patients were assessed with the standardized assessment of neuropsychomotor functions battery (NP-MOT).It enables physical assessment of muscular tone of limbs and axial tone (trunk), laterality (tonic, spontaneous gestural, psychosocial handedness, and usual with objects for hand, foot, and eye), body spatial integration (in relation to self, imitation, objects and map), auditory attention, and others motor functions.

The study findings revealed poor level of the dominant laterality for all the patients (< 2DS) regarding the proximal tonic laterality (elbows) and the psychosocial subtests of mimed gestures (tending to ambidexterity). In addition, it was found a hypotonic trunk and difficulties in body spatial integration and in asymmetrical bimanual tasks with slowness and failures, similar dexterity performance right/left.Strong correlations between all these features and the personal history match the difficulties to focus a long time an attention holding posture without to move, and associated to a fatigability.

A deep standardized examination of the laterality and tone may explain some components of the behavior in relation with hemispheric dominance impairment.

No significant relationships.

Dysfunctional breathing is experienced as a feeling of “difficulty in inhaling” and shortness of breat , which may be similar to the symptoms of coronavirus infection (Gavriatopoulou et al., 2020). The conditions of the COVID-19 pandemic create an increased level of anxiety and attention to respiratory sensations, which becomes a favorable ground for the occurrence of dysfunctional breathing.

To examine the relationship of ideas about the pandemic with the occurrence of dysfunctional breathing in the Russian population during the COVID-19 pandemic.

The Naimigen Questionnaire (Van Dixhoorn, Duivenvoordent, 1985) and the author’s socio-demographic questionnaire were used, which included questions about personal experience of the pandemic. The study was conducted online from April 27 to December 28, 2020. It was attended by 1,362 people from all regions of Russia, including 1,153 women and 209 men aged 15 to 88 years (38.3±11.4).

It was found that respondents who are more confident in the danger of coronavirus have more respiratory difficulties (N=517;NQ=19±10.6) compared to those who consider its danger exaggerated (N=454,NQ=15.9±9.2,p=0.000). Respondents who are completely convinced of the absence of a condemnation for COVID-19 disease have less pronounced dysfunctional breathing (N=331,NQ=15.26±9.5), compared to those who sure about it (N=88,NQ=19.16±10.05, p=0.007). Respondents who have relatives ill COVID-19 (N=430) have a higher score on NQ (18.6±10.5), compared with those dont have (N=932, NQ=17.1±9.7, p =0.011).

The dysfunctional breathing is associated with the respondents’ beliefs about the danger of coronavirus and the expectation of stigmatization in COVID-19 disease, as well as with the experience of COVID-19 disease among relatives.

Research is supported by the Russian Science Foundation, project No. 21-18-00624.

ATR for children has successfully increase survival to adolescence. Health-related quality of life (HRQoL) is relevant to evaluate the impact of the disease on well-being in adolescents living with HIV (ALH). Kidscreen-52 questionnaire is validated in mexican adolescents to measure HRQoL

To evaluate health related quality of life in a sample of 22 mexican ALH

A sample of ALH in treatment at the HIV Clinic during 2021, were evaluated with Kidscreen-52 by a child psychiatrist. Statistics included non parametric tests and Cohen “d” and “r” size effect to compare T means between ALH and Kidscreen-52 standardized scores.

Mean age:14.4+2.5. Gender: 11(50%)boys, 11(50%)girls. ALH showed significantly lower scores in all domains. Girls reported lower scores in physical well-being(p=0.047) and autonomy (p=0.023). Orphan ALH had lower scores in mood and emotions (p=0.021)

- HRQoL were significantly lower in ALH. -Girls showed significantly lower scores in physical well-being and autonomy. - ALH orphans showed significantly lower scores in mood and emotions domain

No significant relationships.

No significant relationships.

Working in COVID – 19 Health Care Units – Psychological impacts (PTSD, Depression, Anxiety Disorders) Working in the frontline during COVID-19 has put under extreme psychological and physical pressure the health care workers. The severe psychological symptomps can emerge on short, mid and long term as well. Our research is focusing on the psychological impacts of front line health care workers.

In our lecture, we summarize our reserach made in the National Traumatology Center, Budapest, Hungary among health care workers who worked in the front and in the second line during the most severe period of the pandemic in Hungary, and discuss probable risk factors for PTSD and chronic psychological distress related to COVID-19. Furthermore we make an overview on the most frequently used coping skills for dealing with the psychological stress caused by the pandemic among the health care workers. The sample taking was processed in July 2021, after 3 month the 3rd COVID – 19 wave officially ended in Hungary.

123 health care workers completed the online survey anonimously, included Beck Depression Inventory, Spielberger Anxiety State Inventory, PTSD Checklist, Lazarus Coping Scale.

23% of HCW reported symptomps of depression, nearly 25% dealing with sleeping disorders and 38% with chronic fatigue, 42,50 % HCW suffering from anxiety disorders, 22% HCW experiencing symptomps of PTSD.

With our results we would like to raise awareness of the challenges and severe psychological consequences that these colleagues, our national heroes we can say, are facing after working in COVID-19 Health Care Units.

No significant relationships.

Although autism is only twice more common in men than women in general population, in clinical samples women are underrepresented. This difference may be due to a poor sensitivity of current diagnostic criteria of autism related to females. We present a 13-year-old woman referred to the adolescent psychiatric unit for anxiety, self injuries and suicidal ideation. After careful assessment of current symptoms and neurodevelopmental milestones, deficits in emotional-comunicational reciprocity, nonverbal comunication and relationships emerged, as well as inflexible adherence to routines and restricted interests. The diagnose of autism spectrum disorder was made and the patient started a specific treatment.

To review the clinical features of autism spectrum disorders in adolescent females and its differential diagnosis.

Review of the literature on autism spectrum disorders in female and its specific features.

The “Female Autism Phenotype” is a group features that are more common in autistic women, as opposed to the classic symptoms of autism in men. Some of these differential characteristics are: fewer social impairments and higher levels of social motivation; more age and gender appropriate restricted and repetitive interests; more internalizing rather than externalizing symptoms; and a tendency towards camouflaging

- Autism in women is frequently underdiagnosed. - Females express autism in ways that not allways meet the current diagnostic criteria. - The “Female Autism Phenotype” has been proposed as an specific way of expression of autism in females.

No significant relationships.

Frontotemporal dementia (FTD) is common in presenile population. The overlapping symptoms with other psychiatric disorders can lead to wrong/late diagnosis which cause delays/difficulties regarding case-management. Especially, long-standing and/or late-onset depression can descriptively envelop bvFTD (behavioral-variant) and leads to unnecessary treatments and increased distress. It’s important to implement a descriptive diagnostic algorithm which will help clinicians to distinguish the phenomenology of these disorders.

This presentation aims to call attention of the clinicians/researchers to an elaborated effort concerning differential diagnosis of two common disorders with overlapping features through a case-study of a 59-year-old male patient.

One case from an inpatient unit of a psychiatric clinic in Lower Saxony, Germany will be reported.

Case: The patient was referred to our acute-psychiatric-ward from the day-clinic-unit because of treatment-resistant, severe and long-lasting depressive symptoms. He was depressed, desperate, hopeless, listless and had suicidal thoughts. During the first days of treatment, symptoms like apathy, bad hygiene, weird eating-behavior, urinary incontinence, lack of empathy, language disorders and other behavioral symptoms were evident. Brain-MRI yielded frontotemporal lobar atrophy. Trail-Making-Test and Frontal-Assessment-Battery showed pronounced impairment of executive functions. Mini mental state examination and DemTect yielded light to moderate memory dysfunction. Diagnostic Criteria for Probable bvFTD (International-Consensus-Criteria) were fulfilled.

The diagnosis of bvFTD enabled a rapid assignment of a legal representative and relieved the long-lasting discomfort of the patient and his family that was caused by multiple unsuccessful treatment trials against depression. The differential diagnostic frame between bvFTD and depression will be discussed in view of the current literature.

No significant relationships.

Cultural syndromes are pathologies that cannot be understood outside the cultural or subcultural context of the person who suffers from it, since both their etiology and symptoms are symbolized by the patient and by the environment in fields of significance inherent to their culture. The globalization process in which we are involved affects the presentation, understanding, diagnosis and treatment of cultural syndromes as they were traditionally understood.

The objective of this work is to review the current state of cultural syndromes, the evolution of incidence and prevalence in recent years, as well as whether the globalization process has affected their understanding.

A bibliographic review has been carried out on cultural syndromes and case reports in both endemic and foreign populations. Likewise, a reflection is made on the possible evolution of these syndromes.

Globalization has been understood as a natural process of integration of nations and their cultures, incorporating the diversity and specificity of the other without forgetting their own and traditional characteristics. Within the globalization process, positive advances in the health area are recognized, specifically in the fields of communication and biotechnology. However, the negative impact of globalization on the daily life and health of people worldwide is undeniable. Those that are economically most disadvantaged are particularly affected. The cases of cultural syndromes in distant countries, the misunderstanding of the symptoms as well as the difficulties of integration of migrant patients with mental suffering must be the object of debate and study.

Globalization affects the care and understanding of mental health

No significant relationships.

The Mental Health Home Care is a program whose main objective is to provide care to people with a Serious Mental Disorders with difficulties to maintain continuity of treatment and link between the different resources. It is a program that guarantees continuity of care and facilitates the link between the different rehabilitation resources. It carries out a multidisciplinary approach to the difficulties of the patient and the family.

Both analyze clinical, psychopathological and epidemiological characteristics of Serius Mental Disorders and review causes, incidence, prevalence, diagnostic, therapeutic tools and the importance of maintaining the treatment and rehabilitation in Serius Mental Disorders, because the abandonment of the treatment is a predictor of relapses.

Review of the impact literature for the last five years concerning Serius Mental Disorder: prevalence, incidence, pathogenesis and its relationship with other psychiatric disorders encoded in DSM-V.

The program is made up of a Psychiatrist, a Clinical Psychologist, a Mental Health Nurse and two Nursing Auxiliary Care, two Social Workers and two Occupational Therapists.The responsible professional presents the patient at the program meetings. The program’s multidisciplinary team proposes an individualized treatment plan for the patient and family in the patient’s environment.

The objective and areas of global intervention is to provide comprehensive psychiatric, psychological, social and rehabilitative support in patients with difficulty in linking to other resources, keeping the patient in a normalized community context, improving treatment compliance and making appropriate use of standardized mental health services.

No significant relationships.

Lack of awareness of the disease is one of the most frequent symptoms (<80%) of schizophrenia, and it is accepted to have different aspects: cognitive, related to compliance, specific symptoms, and temporary. The detection of those dimensions of insight affected, allows to select and prioritize the objectives and therapeutic strategies to improve it.

To develop a multidimensional scale for monitoring insight in schizophrenia patients

A scale with 9 insight dimensions has been developed: appreciation of symptoms, acceptance of the cause, clinical and functional repercussions, limitations and level of competence, expected evolution and prognosis, terapeutic, and other factors. risk of decompensation. Each dimension is weighted from 0-4 points, and the result is expressed numerically and graphically. The scale was administered to 60 patients with schizophrenia on three occasions. The initial one by two psychiatrists consecutively, and the third three months after stable treatment. Other clinical and sociodemographic variables were also collected.

In the analysis, reliability, internal consistency, and intra- and interobserver reliability, logical, content, criterion and construct validity were assessed, obtaining satisfactory results in Cronbach’s coefficients and Pearson’s correlation (> 0.7 and > 0.8).

The scale has good reproducibility, validity, sensitivity and utility characteristics, which allow its use in patients with schizophrenia.

No significant relationships.

COVID-19 pandemic has affected human communities around the world, and there is fear that people with chronic diseases such as Multiple sclerosis(MS) are more vulnerable to negative psychological effects.

The aim of the present study was to assess the quality of sleep in patients with (MS) in comparison with healthy controls(HCs), during the COVID-19 pandemic and to identify its associated factors.

This was a cross-sectional survey study conducted with patients followed at the neurology department of Hbib bourguiba university hospital in sfax(Tunisia), during the month of november2020. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index(PSQI). The PSQI is a questionnaire assessing participants’ sleep quality, sleep duration, and sleep disturbances and their severity during the past month.Participants with a PSQI ≤5 are classified as ‘good sleepers’.

Fifty two patients were included in the study. The mean age was 33.69 years(SD=9.21 years)and the sex ratio(F/H)was 4.77. Overall, our patients had higher scores of(PSQI)compared to HC and these différences were statistically significant(p < 0.05). The mean score of(PSQI)was 11.04(SD=3.003)and 11.53%were classified as ‘good sleepers’. Unemployment was related to a poor sleep quality(p=0.0001). Patients with high EDSS(r=0.7;p=0.0001), high number of relapses(r=0.58 ;p=0.0001)were more likely to have sleep disturbance. There was a positive correlation between a poor sleep quality and the duration of disease(r=0.38;p=0.005).

We identified that during the COVID-19pandemic patients with(MS)had a worse sleep quality. The COVID-19pandemic poses a challenge to psychological resilience. More studies are warranted to better understand the long-term consequences of the pandemic on mental health of vulnerable people.

No significant relationships.

Despite of the heightened risks and burdens of physical comorbidities across the entire schizophrenia spectrum disorders (SSD), relatively little is known about physical multimorbidity (CPM) in this population. The study’s main objective was to explore the differences in the CPM prevalence between SSD patients and the general population (GEP).

The primary outcome was to explore the difference in CPM prevalence in the younger SSD and GEP groups (<35 years).The secondary outcome was the number of psychiatric readmissions.

This nested cross-sectional study enrolled 343 SSD patients and 620 GEP participants.

Younger SSD patients had more than three-fold higher odds for CPM than GEP. We also demonstrated an association between the presence of CPM and the number of psychiatric admissions in the SSD population independently of possible confounders. We did not observe significant interaction of CPM and age in the prediction of clozapine use. Younger women with SSD had statistically significant, almost four-fold higher odds of CPM than women from GEP.

This study suggests that women with SSD are at increased physical comorbidity risk compared to men, particularly early in the course of psychiatric illness. Our results highlight the importance of addressing physical health from the first contact with a mental health service to preserve general health, and provide the best possible treatment outcome. Treatment of SSD must be customized to meet the needs of patients with different physical multimorbidity patterns.

No significant relationships.

COVID-19-related stigma has been raised as a crisis since the beginning of the pandemic. We intended to develop a valid and reliable questionnaire to measure COVID-19-related stigma, attributed by the non-infected general population, and applied it in Tehran from September to October 2020.

This study measures the COVID-19-related stigma attributed by the non-infected general population using a valid and reliable questionnaire specific to COVID-19-related stigma.

A preliminary questionnaire with 18 items was developed. The score ranged from 18 to 54 while the higher score indicating a higher level of COVID-19-related stigma. Out of 1064 randomly recruited Tehran citizens without a history of COVID-19 infection, 630 participants, who completely responded to the questions on a phone call, entered the study.

The content validity was established with a scale content validity index of 0.90. Item CVI and Item content validity ratio were higher than 0.78 for all items. Internal consistency was confirmed with Cronbach’s alpha of 0.625. Exploratory factor analysis revealed seven latent variables, including “blaming and penalty-seeking behavior”, “social discrimination”, “dishonor label”, “interpersonal contact”, “spreading rumors and myths”, “overvalued idea”, and “apathy toward the patients”. The mean (SD) of the score was 25.1(4.71) in our study. 86.8% of participants reported a low level of stigma with a score below 31. 13.2% of them demonstrated a moderate level of stigma, and none of the participants showed a high level of stigma.

we found a low level of stigmatizing thoughts and behavior in Tehran, which may be due to social desirability bias.

No significant relationships.

A 21-year-old woman diagnosed with bipolar disorder was hospitalized in the Mental Health Day Hospital of Salamanca during the Covid pandemic. The patient engaged with 4 different jobs and a master’s degree, beginning with verbose speech, dysphoria, global insomnia, grandiose delusions, extremely high energy and thinking she has the vaccine. She works the following objectives:illness insight, risk factors, psychopathological stabilization, social skills, slowing down of activities and taking responsibilities.

The objective is do a follow-up of the patient during her hospitalization in the Mental Health Day Hospital and to carry out a structured search in PubMed and Up-to-Date about psychotherapy and bipolar disorder.

3-month follow-up of a 21-year-old woman diagnosed with bipolar disorder during her hospitalization in the Mental Health Day Hospital in Salamanca and a structured search in PubMed and Up-to-Date in April 2021 in English, French and Spanish, including the last 10 years with the keywords “psychotherapy”, “psychotherapies” and “bipolar disorder “.77 studies were analyzed: 12 included, 65 excluded.

Several randomized trials highlight the efficacy of group psychoeducation and cognitive-behavioural therapy in relapse prevention, improving illness insight, medical adherence and less hospitalizations. Therapeutic alliance plays a significant role in the process. Our patient improved her knowledge of her illness and treatment, her social skills and reconnected with her relatives and slowed down her activity. She then was referred to her community mental heath center psychiatrist.

The insight in bipolar disorder plays an important role in medical adherence and prevention of relapses. Therapeutic alliance improves their insight, their functionality in their daily life and enables close monitoring. Medical treatment should be accompanied by psychotherapy for a complete approach of the treatment.

No significant relationships.