Patients with schizophrenia spectrum disorders (SP) demonstrate heterogeneity in executive functions (EF) associated with the quality of outcome. However, neurobiological mechanisms of this heterogeneity are understudied.

We aimed to identify features of resting-state functional connectivity (FC) within the frontoparietal network (FPN) that discriminate between SP and healthy individuals (HI) with better and worse EF.

Twenty-five SP (mean age 20.8±3.23, illness duration 1.3±2.1 years, all males) and twenty-six HI (mean age 25.17±3.46, all males) underwent EF assessment (4 verbal fluency tests and a modified Stroop task) as well as resting-state fMRI (3T).

We used k-means clustering based on EF scores to divide all participants into groups with worse (15 SP, 6 HI) and better EF (10 SP, 20 HI). These groups differed in productivity of all verbal fluency tasks and performance time of the Stroop task. Differences between four subgroups (HI/SP with worse/better EF) were revealed in FC between the cingulate and lateral prefrontal cortex in the left hemisphere (ANCOVA, p-uncorrected<.005, p[FDR]<.05; Fig. 1). SP and HI within each group demonstrated a similar FC pattern. SP with poorer EF had increased FC, compared to HI with higher EF. HI with poorer EF demonstrated increased FC, compared to HI and SP with better EF.

FC within FPN may be one of the neurophysiological underpinnings of EF heterogeneity in SP as well as in HI. Further machine learning fMRI studies are needed to clarify whether FC within FPN is a prognostic marker in schizophrenia.

The study was supported by RFBR Grant 20-013-00748.

Sleep and circadian disturbances have been widely studied in patients with bipolar disorder (BD) (Duarte Faria et al., 2015; Gonzalez, 2014). However, there is no clear evidence about the role of peripheral biomarkers of circadian cycle in this population.

This systematic review aims to identify potential endocrine biomarkers of circadian rhythm in blood and study their relationship with sleep problems in BD.

An electronic search of Pubmed and PsycoInfo databases were performed. It includes articles about the topic from 1991 to 2021. The search strategy was: (“Peripheral biomarkers” OR “biological markers” OR biomarker OR cortisol OR melatonin OR orexin OR hypocretin) AND (blood OR serum OR plasma) AND (“sleep-wake” OR “circadian rhythm” OR sleep OR insomnia) AND “bipolar”.

92 records were obtained after excluding duplicates. Only five studies met the inclusion criteria (n = 499; BD = 125; unipolar depression = 148; schizophrenia = 80; controls = 146). The endocrine parameters analyzed were: cortisol (3 studies), melatonin (1 study) and orexin-A (1 study). Overall, no significant associations between these biomarkers and sleep disturbances, assessed with subjective (psychometric evaluation) and/or objective (polysomnography) measures, were detected.

This systematic review highlights the lack of studies that explores the role of endocrine biomarkers related to circadian function in the pathophysiology of sleep disturbances in BD.

No significant relationships.

No significant relationships.

Dysfunctional breathing is a breathing patterns that do not correspond to the physiological needs of the body, provoke many poly-systemic symptoms. Dysfunctional breathing is experienced as a feeling of “difficulty in breathing”, which in the conditions of the COVID-19 pandemic may be similar to the symptoms of coronavirus infection (Taverne et al., 2021).

To examine the role of socio-demographic predictors in the prevalence of dysfunctional breathing in the Russian population during the COVID-19 pandemic.

The author’s socio-demographic questionnaire, the Naimigen Questionnaire (Van Dixhoorn, Duivenvoordent, 1985), the STAI (Spielberger et al., 1983) and the “Perceived Stress Scale-10” (Cohen,Kamarck,Mermelstein,1983) were used. The study was conducted online from April 27 to December 28, 2020. It was attended by 1,362 people from all regions of Russia (38.3 ±11.4 y.o.).

In men, the average values for NQ (11.19±7.74) are lower than among women (18.73±9.96, p=0.000). Persons with incomplete higher education have a higher score on NQ (N=103,NQ=20.44±11.8) than persons with higher education (N=1051,NQ= 17.40±9.63,p=0.048) and candidates/doctors of sciences (N=97,NQ= 15.34±11.20,p=0.005). There was also a connection between the severity of dysfunctional breathing and the level of income, which is associated with a negative correlation between income level and perception of stress (r=-0.215,p=0.000), state (r=-0.165,p=0.000) and trait anxiety (r=-0.127,p=0.000).

The severity of dysfunctional breathing is associated with gender, income levels and education, what can be used to identify a group of people who are most susceptible to the occurrence of dysfunctional breathing during the pandemic COVID-19. The study was supported of the Russian Science Foundation, project No.21-18-00624.

The study was supported of the Russian Science Foundation, project No. 21-18-00624.

The search for approaches to creating a precision personalized virtual reality for the treatment of mental disorders is urgent. (Belkasim, 2005; Park M.J. et all., 2019).

To develop a new approach to personalize the form of virtual reality content to the neurophysiological and anatomical parameters of the patient’s brain, to improve the quality of precision VR therapy for mental disorders.

The MRI study was carried out on a GE Optima 450w apparatus with a magnetic field induction of 1.5 Tesla. We used a radio frequency coil for the head. T1-weighted images were obtained with a field of view (FOV) of 24.4 x 14.8 cm and a slice thickness of 0.5 mm. Later, the images were built in three standard mutually perpendicular planes. Measurements were carried out using standard tools on an eFilm 4.0 WorkStation. FreeSurfer 4.5.0 was used to calculate the surface area of the cerebral hemispheres. To estimate the surface area of the room and the design of the shape in VR closed environment Autodesk AutoCAD 2018.

A new approach to personalization of the form of virtual reality content has been developed (Patent No. RU (11) 2 668 697 (13) C1, 2018;Patent No. RU (11) 2 753 234 (13) C1, 2020). It is based on the use a single morphometric indicator for a closed VR space and brain.

Research and applied analysis of the developed approach is required. The development of this area will make it possible to create precision products for the therapy and rehabilitation of mental disorders.

No significant relationships.

Ovocystatin has beneficial properties for cognitive function in young rats and might prevents aging-related cognitive impairment in older animals, as well as reduces memory decline in APP/PS1 mice model.

Our study aimed at assessing the impact of ovocystatin on microglia activation and neurogenesis.

Immunoactivation: Mouse wild type microglia were stimulated with ovocystatin at dose of 100 micrograms/ml. The effect of ovocystatin on nitric oxide production and interleukin 1 beta secretion were determined. Neurogenesis: Primary rat hippocampal neurons of H19-7 cell line was used. The impact of ovocystatin on proliferation, nitric oxide production, and expression of markers of neurogenesis: microtubule-associated protein 2 (MAP2, isoforms A/B and C/D) and Synapsin 1, were determined.

It was shown that ovocystatin does not stimulate microglial cells to produce inflammatory mediators. Whereas, no toxic effect of ovocystatin (1-100 ug/ml) on H19-7 cells viability, and dose-dependent down-regulation of proliferation were demonstrated. It was also shown that in primary hippocampal neurons of H19-7 cells incubated with ovocystatin (100 micrograms/ml), the expression level of MAP2 C/D (75kDa) - characteristic form of immature neurons is unchanged. However, the increased expression of MAP2 A/B protein (280 kDa) – characteristic for mature neurons was observed after 6 and 24h incubation with ovocystatin. Relatively to MAP2 A/B, increased expression of synapsin 1 was observed.

The ovocystatin might be a potential activator of molecular mechanisms in primary hippocampal neurons, participating in regulation of neurogenesis. Nevertheless, further studies are needed.

No significant relationships.

Almost 5 million people worldwide have lost their lives due to SARS-CoV-2 (source: WHO coronavirus (COVID-19) dashboard, data of 1.10.2021; https://covid19.who.int/) and therefore, globally, there is an increase of people in grief due to the death of a significant other.

To study psychological correlates of grief during the COVID-19 pandemic.

591 university students, with a mean age of 23.84±7.95 years (range 18-65 years; 76.8% women; 91.2% Portuguese) completed an online questionnaire during the second COVID-19 confinement (from 15.02 to 13.03.2021), with sociodemographic questions, the Pandemic Stress Index, the Mental Health Inventory, Insomnia Scale, questions on physical/ psychological health, and social isolation.

Students bereaving the death of a significant other (n=93, 15.7%; n=25, 26.9% reported cause was SARS-CoV-2; time since death: < 3 months to 1-year), compared to those who did not (n= 498; 84.3%), described poorer psychological health, higher psychological distress (depression, anxiety, lack of control) and sleep difficulties, higher levels of stress (higher impact of COVID pandemic in daily life, and higher behavior changes in response to COVID-19) and more social isolation.

COVID-19 pandemic-related stress is a source of additional stress for bereaved students. Grief is also associated with social isolation, poor mental health (depression, anxiety, lack of control) and sleep difficulties. Screening efforts, guidance, and counseling from professionals of mental health care, primary health care, and universities health care services during and after the COVID-19 pandemic could be extremely beneficial for bereaved students, particularly for those at higher risk of developing prolonged grief disorder.

No significant relationships.

Goal attainment scaling (GAS) is a method to assess the patient experience of whether a treatment is successful and capture outcomes across a diverse range of goal areas. However, this approach has not yet been used in assessing the treatment of Major Depressive Disorder (MDD) in Japan. GAS was first developed by Kiresuk and Sherman in the 1968, it is increasingly recognised as a sensitive method for recording patient-centred outcomes throughout the course of treatment.

To demonstrate the effectiveness of vortioxetine on patient’s goal achievement and depressive symptoms, emotional, cognitive, overall function and quality of life.

VGOAL-J is a prospective, multi-center, observational cohort study of outpatients initiating vortioxetine treatment for MDD in Japan. Patients with a diagnosis of MDD according to DSM-5 who are 18 to 65 years will be enrolled from 20 sites in Japan and followed for 24 weeks. A total number of 120 patients is planned for enrolment. Primary outcome measures are GAS-D, WPAI, secondary outcome measures include Montgomery – Åsberg Depression Rating Scale (MADRS), Sheehan Disability Scale (SDS), Perceived Deficits Questionnaire-Depression 5-item (PDQ-D-5), Oxford Depression Questionnaire (ODQ), EuroQol-5 Dimension (EQ-5D). Safety will be also assessed with Adverse Events collected during the study.

The results will be disseminated in late 2022 and provide new insights on GAS-D as an effective strategy to assess MDD treatment in Japan.

We expect to observe patients treated with vortioxetine achieving their treatment goals as assessed by GAS-D and improvements on patient- and clinician-reported measures in real-world settings.

Prof. K. Watanabe reports consultancies undertaken for Eli Lilly, Otsuka Pharmaceutical, Sumitomo Dainippon Pharma, Taisho Toyama Pharmaceutical, and Takeda Pharmaceutical, honoraria received from Daiichi Sankyo, Eisai, Eli Lilly, GlaxoSmithKline, J

Studies regarding environmental contributions on callous-unemotional (CU) traits in children have informed about the protective role of positive parenting. However, it has not been explored whether findings from these studies -mostly conducted in High-Income Countries- can be generalised to Low-Middle-Income Countries (LMICs). Exposure to community violence is common in LMICs and is associated with emotional and behavioural problems in children. Therefore, it may represent an environmental risk factor for CU traits.

This prospective study explores whether positive parenting has a protective role in relation to CU traits in young Colombian children whose families have been exposed to community violence.

We assessed 235 families with children at age 3.5 years, from three contrasting regions of Colombia, using observations of mother-child interactions and maternal reports of community violence at ages 3.5 and 5.0 years.

Hierarchical multiple linear regression models indicated that maternal positivity at 3.5 years was associated with lower CU traits at age 5.0 years only in children of families exposed to community violence (interaction term p= .001). In the exposed group maternal positivity explained 10% of the variance (β= -.34, p= .001) with low positivity associated with elevated CU traits and high positivity with low CU traits. Maternal praise was not associated with CU traits. However, maternal negativity during play was associated with elevated CU traits as a main effect.

Based on these findings, whether or not exposure to community violence is associated with elevated CU traits depends on maternal positivity, with low positivity creating vulnerability, and high positivity, resilience.

No significant relationships.

People with schizophrenia could be more substantially influenced by the emotional stress brought on by the COVID-19 pandemic, resulting in relapses or worsening of an already existing mental health condition because of the high susceptibility to stress.

This study aimed to assess the presence of relapse and its risk factors among patients with schizophrenia during the era of COVID 19 pandemic.

This study included 90 adults who met DSM-5 criteria for schizophrenia and were diagnosed by (SCID-I) Arabic version and who are following up at the outpatient psychiatric clinic, Zagazig University Hospital, Egypt, Positive and Negative Syndrome Scale (PANSS) measuring severity of symptoms, Compliance Rating Scale (CRS) and World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). scales were conducted on those patients before COVID-19 pandemic from January to April 2019 and repeated on September to November 2020 during COVID 19 pandemic to compare clinical parameters between those two periods as to detect any deterioration in their clinical state.

The mean score of compliance rating scale (CRS) was decreased after COVID-19 pandemic compared to before COVID 19 (P<0.001).The mean score of PANSS scale positive subscale (P) had increased after COVID-19 pandemic compared to before COVID 19 (P<0.001).

There was a deterioration of the clinical state of schizophrenic patients during COVID-19 pandemic especially the positive symptoms and following up the news about COVID-19 regularly, decreased level of family support, lower level of compliance with treatment, and having a family member with COVID-19 infection or death were the risk factors for relapse.

No significant relationships.

No significant relationships.

The discovery of second-generation antipsychotics represented an authentic breakthrough for the management of psychotic disorders. Nevertheless, they still don’t adequately manage some aspects of these disorders, such as negative symptoms (NS), cognitive impairment, or extra-pyramidal symptoms (EPS). New-generation antipsychotics present different pharmacological mechanisms and have been reported to ameliorate these aspects. Among them, cariprazine acts as a D2/D3 partial agonist with variable affinity with serotoninergic receptors, and many studies show its efficacy for preventing and treating positive symptoms as well as for the management of NS and EPS.

To report a case of a patient diagnosed with schizophrenia with highly invalidating antipsychotic-induced EPS that remitted after switching to cariprazine, while maintaining clinical stability. To review literature about cariprazine and its relationship with NS and EPS.

We describe the case of a 66-year-old woman diagnosed with schizophrenia and under treatment with three-month injectable paliperidone 175mg. During her follow-up at outpatient clinic, she presented a progressively highly invalidating non-trembling parkinsonian syndrome attributable to medication. Paliperidone plasmatic levels were within therapeutic range. An antipsychotic switch was agreed, and cariprazine was started.

The switch from a second-generation antipsychotic to cariprazine entailed the remission of a highly invalidating EPS while improving some of the NS and maintaining psychopathological stability.

Assessing and differentiating NS and EPS is of an utmost importance during the follow-up of patients under antipsychotic treatment. Cariprazine is an interesting alternative when treating patients diagnosed with psychotic disorders that present mostly NS and antipsychotic-induced EPS.

No significant relationships.

Emotional competencies such as attention to emotion and emotional clarity have been extensively studied in the literature. Depending on the context, their role shows different patterns of association with emotion regulation and psychopathological states.

In the current study, we aim to understand when and how attention to emotion and emotional clarity are related to the co-occurrence of anxiety and depression.

Data were collected on attention to emotion, emotional clarity, anxiety, and depression. A sample of 258 adolescents aged 12 to 18 years (M = 14.6, SD = 1.7, 54.5% girls) was examined to investigate the moderating role of attention to emotion and emotional clarity on the relationship between anxiety and depression after controlling for age, gender, and socioeconomic status.

showed that high levels of attention to emotion and low levels of emotional clarity were associated with increased risk for anxiety and depression. Balanced levels of attention to emotion and emotional clarity were also associated with increased risk for anxiety and depression. However, low levels of attention to emotion and high levels of emotional clarity showed no statistically significant association with the occurrence of anxiety and depression.

Overall, this positive imbalance of low attention to emotion and high emotional clarity appears to be the most favorable emotional states for coping with internalizing problems, suggesting less harmful effects of attention to emotion.

No significant relationships.

Autism is a lifelong complex neurodevelopmental condition that affects brain development and behaviour with significant consequences for everyday life (WHO, 2018). Despite its personal, familial and societal impact, there is still a European-wide lack of harmonised guidelines about the support needed from early stages, the most sensitive time to gain positive future outcomes (Berajamo-Martin et al, 2019).

The objectives were: 1. To analyse autistic children care pathway and patient/carer journey in three European countries: Italy, Spain and U.K. 2. To propose policy recommendations on how to improve this pathway.

To identify major barriers and treatment gaps, we conducted a rapid literature review of the care pathway in Europe and a survey aimed at parents or carers of autistic children ages 0 to 18 living in the three countries. The survey gathered information on screening, diagnosis, accessibility and support received before, during and after diagnosis. Members of the working group met to discuss results and propose policy recommendations.

1. Current care pathway analysis showed the following treatment gaps: Long waiting time from first concerns until screening visit and confirmed diagnosis. Delayed or no access to intervention once diagnosis has been confirmed. Overall limited information about autism and how to access early detection services. Overall deficient support to families. 2. Please see Box 1 for our proposed policy recommendations.

Box 1. Policy recommendations

Our findings and recommendations will inform policy harmonisation in Europe to shorten long waiting times, diagnosis process and intervention, and therefore, improve autistic people and their families’ journey experience and quality of life.

No significant relationships.

No significant relationships.

Transitional age youth (TAY), from 16 to 24 years old, are a particularly at-risk population in mental health. They have specific needs, not currently covered between child and adolescent mental health services (CAMHS) and adult mental health services (AMHS), mainly because of existing barriers.

This retrospective study was carried out to describe sociodemographic and clinical characteristics of 243 patients who attended a new TAY-tailored outpatient psychiatric program.

Outcomes related to trajectories of psychiatric care were analysed, such as leading symptom, consultation’s referral and requester, and final orientation.

The sample was mainly composed by female; the average age was 18.7 (± 2.0) years. Leading symptoms were divided into three dimensions: internalizing (67.5%), externalizing (21.8%) and psychotic (10.7%). Leading symptom differed according to sex (p<0.001), with internalizing symptoms more frequent in women, externalizing and psychotic symptoms more frequent in men. Patients presenting psychotic symptoms were significantly older than both those with internalizing (p=0.016) and externalizing symptoms (p=0.008). After first assessment, 81.5% of youth were followed-up in our specific outpatient program, without any difference according to sex (p=0.081) or leading symptom (p=0.092). Overall and final psychiatric orientation are showed in the flowchart.

This TAY-tailored psychiatric outpatient program represents an innovative contribution to reinforce CAMHS-AMHS interface in French-speaking Belgium. This study enlightens the importance to enhance clinical expertise in youth mental health. Classical boundaries, determined by artificial variables such as age or type of psychopathology, do not seem to be efficient criteria to achieve a good quality psychiatric evaluation and continuity of care in TAY.

The authors declare no potential conflicts of interest. The study was carried out as part of the University Chair “Psychiatry in Transition in a World in Transition” (Université Libre de Bruxelles - ULB) with the support of Julie Renson Fund, the Queen Fa

No significant relationships.

Catatonia is a neuropsychiatric disorder characterized by motor, behavioral and autonomic changes. It is associated with several psychiatric disorders, including dementia. Catatonia is an underdiagnosed syndrome, so it is important to draw attention to it. Here, we review a case of a patient admitted to our psychiatric department with a clinical presentation compatible with catatonia. After proper treatment, further assessment revealed dementia.

This work aims to describe a case of catatonia in a patient with dementia.

Bibliographic research using Pubmed®. Clinical file consultation and patient interviews.

Catatonia is a disorder that was already been described as part of several types of dementia. We present a 69-year-old female patient, admitted to our psychiatric department with clinical presentation compatible with catatonia. To admission, she presented some typical complications resulting from long immobility such as pressure ulcers and nutritional deficiencies. During the hospitalization, she developed a urinary infection and there was the need to tube feeding. She was treated with benzodiazepines and improved. Further assessment revealed dementia.

Catatonia in dementia is not uncommon, although it is an underdiagnosed syndrome, and when treated early and properly it has a good prognosis.

No significant relationships.

Occupational therapy (OT) offers evidence-based methods to address daily functioning improvement and better health promotion. However, many adults who are dealing with deficient daily functioning due to unrecognized Attention Deficit Hyperactivity disorder (ADHD) do not benefit from these developed methods. Thus, they are at risk of experiencing adjustment barriers and poor mental health.

The aim of this project is to develop a dissemination strategy in order to reach-out for this unrecognized ADHD population and grasp their attention in an early stage of life. The study following this project is measuring the possibility of this action to reach out to the individuals and make a small change in their daily functional capabilities.

The Laboratory for the Study of Complex Human Activity and Participation (CHAP) is a lab sited in the occupational therapy department at the University of Haifa. Its research address ADHD as part of further neuro-developmental challenges in the life span. The lab started a dissemination program including 4 OT researchers, and a group of former researchers for materials feedback.

In the presentation we will share the dissemination strategy and it implementation during 6 months. Moreover, we will present a theoretically map relevant virtual pathways that adults with unrecognized ADHD may cross since childhood.

This preventative program towards health promotion aims to help people achieve meaningful milestones in life and live more fully. Moreover, this strategy may serve as a prototype for similar approaches in other outreach processes.

No significant relationships.

Intriguingly, autism spectrum disorders (ASD) and symptomatic generalised joint hypermobility (S-GJH) (e.g. hypermobility spectrum disorders and Ehlers Danlos Syndrome) share several clinical manifestations including motor difficulties, sensory hypersensitivity and autonomic dysfunction. Moreover, many syndromic forms of ASD manifest a hypermobile phenotype. Despite the increased interest in the area, few systematic studies are available.

This large cross-sectional comparative study aimed to examine the association between S-GJH and ASD in adults.

We assessed GJH by physical examination using the Beighton Scoring System (BSS) and collected data on musculoskeletal symptoms and skin abnormalities amongst 156 adult patients with ASD and 413 adult community controls. A proxy for S-GJH was created by combining a positive BSS with at least one additional musculoskeletal symptom or skin abnormality.

The prevalence of S-GJH was significantly higher amongst patients with ASD than amongst controls (16.7% vs 4.8%, p< .001). A logistic regression model, adjusting for candidate covariates of GJH (age, sex, race), revealed a significant influence of ASD on S-GJH with adjusted odds ratio of 5.4 (95% CI 2.8-10.5, p< .001).

ASD and S-GJH are associated in adults. If recognised, musculoskeletal complications related to S-GJH can be relieved by physiotherapy. Clinicians should be familiar with that symptoms frequently occurring in GJH such as pain, fatigue and orthostatic intolerance may mimic or aggravate psychiatric symptoms (e.g. depression, anxiety). Knowledge about comorbidities may provide clues to underlying aethiopathological factors. Future research to clarify the mechanisms behind this association and to evaluate how comorbid S-GJH affects ASD outcome is warranted.

No significant relationships.