When parents discover that their child has hearing loss, a new reality presents itself with frustration, a huge amount of work as special care, therapies, exams, etc. Adapting to this new situation is a huge challenge to the development of both parents and children who receive this diagnosis.

This study investigated how Brazilian parents of children diagnosed with hearing loss dealt with this situation from diagnosis to the present day.

In this study it was used the Bioecological Theory of Human Development, which considers the development of both parents and children over time. Two meetings were conducted using a focal group technique, with questions related to the diagnosis and how they faced the situation, prejudice, care of other siblings, etc.

Most parents discovered the diagnosis of hearing loss of their children right after birth. Only one mother said she did not care about the diagnosis of hearing loss while most reported having suffered a lot and glimpsed a life of difficulties. Even knowing the limitations imposed by the condition of the children, no one considered hearing loss as a sickness. Parents reported that the child suffered bullying because of difficulties in speaking and most parents say they worry about their children’s school life.

Parenting kids with hearing impairment is challenging, and involves dealing with prejudice, fear of future, long-term therapies and high costs. Nevertheless parents make great efforts to provide a good environment minimizing the risks of having such condition.

Neuropsychiatric symptoms (NPS) are common, disabling and burdensome core-features of dementia, with important diagnostic and prognostic value. However, their measurement remains challenging. The Neuropsychiatric Inventory (NPI) is the most widely used NPS measure. Nevertheless, it is also time-consuming and impractical in most clinical settings. Therefore, the Abe’s BPSD score (ABS) has been proposed as a brief score to facilitate the NPS assessment.

To explore the concurrent validity of the Portuguese ABS by comparing the 10 ABS items with the relevant NPI-12 domains.

A cross-sectional study was conducted with outpatients attending a gerontopsychiatric consultation. Patients were included if they were ≥65 years and had a reliable caregiver. NPS frequency rates (number of patients with a symptom) were estimated with ABS and NPI-12, and an agreement analysis was undertaken by calculating kappa-coefficients (k) and the respective 95% confidence interval [95%CI] between ABS items and relevant NPI-12 domains.

Overall, 107 patients were included. Kappa-values ranged from 0.277 to 1.000. Higher agreement was recorded for the ABS items eating/toilet problems (k=1.000), day–night reversal (k=0.976[0.925-1.000]) and depressive/gloomy mood (k=0.957[0.899-1.000]), with the NPI-12 appetite/eating abnormalities, night-time behavioural disturbances and dysphoria domains, respectively. The ABS item violent force recorded the lowest agreement (k=0.277[0.104-0.45]) with the NPI-12 agitation/aggression domain.

This exploratory analysis demonstrates good levels of agreement between most ABS items and relevant NPI-12 domains. Data add to the evidence that both measures capture a comparable broad spectrum of psychopathology, supporting the ABS use in clinical routine. Support: FCT(PD/BD/114555/2016), and National Funds through FCT-within CINTESIS, R&D Unit (ref.UIDB/4255/2020).

Although there are several empirical studies exploring the relationship between problematic Internet use and personality traits, few had considered perfectionism.

To explore the association between generalized problematic Internet use and perfectionism.

A sample of 433 Portuguese university students (Mage = 20.15 years, SD = 1.77, range = 18-25 years) completed the Generalized Problematic Internet Use Scale 2/GPIU and the Multidimensional Perfectionism Composite Scale – short version.

GPIU total score (rs=.16**), Mood Regulation (rs=.22**), and Deficient Self-Regulation (rs=.13**) were correlated with Positive Striving factor. GPIU total score (rs=.38**), Preference for Online Social Interaction (rs=.16**), Mood Regulation (rs=.28**), Deficient Self-Regulation (rs = .33**), and Negative Consequences (rs=.41**) were significantly correlated with Evaluative Concerns factor. A one-way between groups analysis of variance was conducted to explore the relation between GPIU and perfectionism. Subjects were divided into three groups according to their GPIU risk levels (Group1:low-risk; Group2:medium-risk; Group3:high-risk). There was a statistically difference at p >.05 level in Positive Striving scores for the three risk level groups: F (2,430)=4.39, p=.013, and in Evaluative Concerns scores, F (2,430)=28.83, p=<.001. Post-hoc comparisons using the Tukey USD test, for Positive Striving, indicated that the mean score for Group1 (M=39.21, SD=8.56) was significantly different from Group3 (M=43.69, SD=9.74). Considering Evaluative Concerns, the mean score for Group1 (M=39.86, SD=11.31) was significantly different from Group2 (M=46.91, SD=11.42) and from Group3 (M=51.75, SD=8.54).

GPIU is consistently related to maladaptive perfectionism. Future longitudinal studies are needed to clarify the bidirectional association between GPIU and perfectionism traits.

Pronoia is a neologism originally coined in 1982 to describe a state of mind that is, in essence, the positive counterpart of paranoia. It is characterized by feeling that the world is conspiring on behalf of the person experiencing pronoia.

Brief literature review.

The authors review the available literature on pronoia and present a broad overview of its description and defining characteristics. An initial search utilizing key health journal databases revealed a scarcity in available documents, therefore a generalized search utilizing the search engine Google Scholar was performed with the term “pronoia”. Relevant articles obtained from the respective bibliographic references were also consulted.

The primary outcome of this work is a summary of the available literature in order to build a more comprehensive understanding on pronoia. All relevant information was collated to form a cohesive description of the condition and its characteristics. We address a gap in the literature by offering a description of the lesser prevalent concept of pronoia.

Our results demonstrate a scarcity in the available literature describing the pronoia phenomenon when compared to its well-documented counterpart, paranoia. Further exploration into this topic is merited so as to close the gap on paranoia’s lesser-known positive counterpart. By signalling the existence of this concept, we strive to contribute to an increased identification of a concept that is many times underdiagnosed due to a lack of attention to its existence.

No significant relationships.

Adolescence is a life period with considerable biological, psychological and social changes. Quality of life is a complex and multifactorial construct that necessarily encompasses the adolescent’s mental well-being. Some life habits like sleep, sport practice and screen time can be either risk factors or protective factors, influencing the quality of life and mental health.

To investigate the role of sleep habits, sport practice and screen time in quality of life, and psychological distress in a Portuguese adolescent girl sample.

409 girls, mean aged 13.51±2.298, from public and private schools in Coimbra answered questions about sleep time, sport practice and screen time habits; the Portuguese versions of the Quality of Life Questionnaire (reduced version) and theAnxiety, Depression and Stress Scale. SPSS 26 was used.

Girls mentioned to sleep 8,2 hours/night during the week and 9,4 hours/night at the weekend. They spend 1,5 hours/day during the week and 1,8 hours/day at the weekend with Screens. They spend 2,1 hours/ week in Sport Practice. Quality of Life was positive correlated with Sleep Time and negative correlated with Screen Time, Anxiety, Depression and Stress (all p<.05). Multiple regression analysis showed that Screen Time, Anxiety and Depression were all significant predictors of Quality of life in girls (p<0,05).

Our findings show that Screen Time is related with poor Quality of Life in girls. These results suggest the importance of addressing Screen Time and Psychological Distress in adolescent girls during adolescent health care consults.

Multiple hospitalisations towards the end of life is an indicator of poor-quality care. Understanding the characteristics of patients who experience hospitalisations at the end-of-life and how they vary is important for improved care planning.

To describe socio-demographic and clinical characteristics of patients diagnosed with serious mental illness who experienced multiple hospitalisations in the last 90 days of life.

Data for all adult patients with a diagnosis of serious mental illness who died in 2018-2019 in England, UK were extracted from the National Mental Health Services Data Set linked with Hospital Episode Statistics and death registry data. Variables of interest included age, gender, marital status, underlying and contributory cause of death, ethnicity, place of death, deprivation status, urban-rural indicator, and patient’s region of residence. The number of hospitalisations and patient’s sociodemographic & clinical were described using descriptive statistics and percentages, respectively.

Of the 45924 patients, 38.1% (n=17505, Male=42.9%, Female=57.1%, Mean age:78.4) had at least one hospitalisation in the last 90 days of life. The median number of hospitalisations was 2(StdDev:1.64, Minimum=1,Maximum=23). Most of those hospitalised (n=11808, 67.5%), died in a health care establishment (e.g. Hospital or hospice). There were marked geographic differences in the proportions of hospitalisations.The North West region of England recorded the most hospitalisations (n= 2906,16.6%), compared to other regions.

Further analysis is needed to understand factors independently associated with hospitalisations in people with serious mental illness. Funding: This project is supported by the National Institute for Health Research (NIHR) Applied Research Collaborations (ARC) South London.

This lecture will present a therapeutic group that took place at a closed-unit in a psychiatric hospital. The members of this group were patients suffering from psychotic disorders

Patients suffering from psychotic disorders.

The patients had difficulty in organizing their thoughts as well as with the expression of their internal-world and emotions. Moreover, they were suspected of the units’ staff members. These circumstances led us to create a theme group that combines a verbal-affective metaphoric instrument - literature. Art, such as literature, represents the mind of its creator and when incorporated into the therapeutic process, can serve as a third-voice - a symbolic language that conveys an idea indirectly and arouses the patient’s personal associations and emotions. The use of literature, while relating to content that aroused from a poem or a short story, led to a connection or an identification with the emotion expressed in the writing stimuli or in opposition to it, and from there to a projection of the internal world of the patient.

Through the possibility of alternating between proximity and distance, regard the metaphoric instrument, patients could organize their associations and emotions and express them in a more beneficent way – “normalization” of the cognitive and expressive process.

The analysis of the different group’s sessions, points to the potential of using literature in a therapeutic group with patients in their acute state, at the closed-unit. Examples of verbal reports from different group settings, in which literature was used, will be presented.

No significant relationships.

It reveals a case that occurred in a patient with no previous history whose first manifestation was kinesthetic allucinations, subsequently appearing other psychopathological alterations

24-year-old male. Truck driver by profession. No prior mental health story. Good operation prior to the consultation. He comes accompanied by his parents for having a sensation of having bugs under his skin. It has come to throw gasoline on top to eliminate the possible infection.

Exploration: He is concius, oriented, with scratching lesions. He wears a cap soaked in gasoline to ward off critters. He does not present in the foreground other psychopathological alterations. CT with normal results, thyroid hormones, and normal biochemistry are requested. Treatment with aripiprazole is initiated in ascending doses, as it presents in the beginning a torpid evolution with the appearance of delusions of injury to its boss.

After that, he is currently psychopathologically stable and has returned to work with his father in the field.

Although not the most common, psychotic disorders can occur at the beginning with cenesthetic alterations. Organic screening should be performed and results treated accordingly.

No significant relationships.

Background: Little is known about the modifications in gambling patterns during the Covid-19 pandemic, which has shown signs of increase, particularly for individuals with preexisting gambling problems.

Our aim was to assess the behaviour of a cohort of patients in the Trentino Region.

A semi structured questionnaire containing Hamilton Depression Rating Scale as well as open-ended questions on gambling activities, specifically online gambling, was administred over the telephone. The survey was administred for two months over the lockdown period (april-june 2020) and took approximately 20 minutes to complete.

About 50 responsens were collected. Data are currently been analyzed and will be avaiable at the time of the Congress.

Will be show at the time of the Congress.

No significant relationships.

In the perinatal period, about 15-20 % of women will present a mental health disorder. These disorders, as with all sources of psychological and physical stress in early childhood, especially the poor quality of parent-child relationships, are widely involved in predicting poor mental health in adulthood. The economic cost of perinatal mental health, corollary of this human cost, evaluated in 2014 would amount to £GBP 8.1 billion per annual birth cohort according to a UK report. This report highlights another fundamental element: 3/4 of the costs are associated with the deleterious consequences of parental psychological disorders on child development. The mechanisms involved in the relationship between parental psychiatric disorders and child development are complex. On the other hand, the influence of parental characteristics on the future of children can vary depending on social determinants such as familial income level. During the perinatal period, parental mental health represents one of the keys to the infant development. Perinatal psychiatry allows a dual approach essential to deal with the complexity of perinatal psychiatry care, combining a curative aim (care of the parent) and a preventive one (preventing the risk of dysfunction in the process of becoming parents, in parent-child relationships and of impaired child developement). This intervention wil discuss how this interactive circle must be supported by perinatal mental health policies, of which the joint care of parents and infants (from parent-child psychotherapy to joint mother-baby hospitalisation) in perinatal psychiatry is a pivotal element.

No significant relationships.

Problems in sexual function associated with psychotropic drugs in adolescents with psychotic disorders are common in clinical practice. However, they are usually not taken into account in follow-up and are rarely reported by patients.

1. To analyze if there is sexual dysfunction in adolencents with antipsychotic treatment. 2. To assess the degree of sexual dysfunction.

Descriptive study in psychiatric outpatient clinics involving 14 men (aged 16 to 19) with antipsychotic treatment. Record prospectively through interviews between 2 and 4 months from the start of treatment. Sexual function was evaluated with the questionnaire SALSEX Informed consent.

Initially, no sexual dysfunction scores are obtained. At 4 months, records of sexual dysfunction were observed in 67% of the patients with less impact in those with aripiprazole as antipsychotic treatment, with a moderate intensity (mean score 8.2; SD 4.7). 33% of cases report the problem spontaneously. Breaking down the reasons for sexual dysfunction: 50% decrease in libido, 20% delay in ejaculation and 7% impotence. The global tolerance to sexual dysfunction was poor, 45% with ideas to abandon treatment.

In our experience, sexual dysfunction is one of the main causes that make young patients abandon treatment and even follow-up. For what we consider, it is very relevant to systematically evaluate and be able to quantify this vital aspect of our patients, which on many occasions is not addressed in the consultation. Likewise, it will be necessary in future studies to describe in detail the psychotropic drugs associated with sexual dysfunction for better management and dose adjustment.

The National Mental Health Survey of India 2015-16 (Gururaj et al., 2016) indicated a large treatment gap of 70-92% for mental disorders and a paucity of mental health specialists in the country. In order to address this treatment gap and develop human resources, the National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India, with impetus from the Ministry of Health and Family Welfare, Govt. of India, launched the online course of Diploma in Community Mental Health for Psychologists.

The course was designed with the objective of training individuals with a Master’s Degree in Psychology, in providing first-level psychological care in the community.

The course is a 3-month online programme comprising of approximately 25 hours of self-paced e-learning and 11 hours of live real-time interactive discussion via video conference. The course comprises of 6 modules, with an assessment at the completion of each module. Pre- and Post-Assessment is conducted to evaluate competencies achieved.

On successful completion of the course, trainees are expected to have achieved competencies to: Screen for and identify mental health problems in adults and children, and understand factors influencing them; Understand management options; Conduct interview-based functional developmental assessment for intellectual deficits; Conduct first-level brief psychosocial interventions; Make appropriate referrals to Mental Health Professionals and other health professionals.

This digitally-driven online course is a viable option for development of human resources on a large scale, in a resource-scarce (i.e. of mental health specialists) country such as India.

No significant relationships.

The Childbirth Expectations Questionnaire (CEQ; Gupton, A., Beaton, J., Sloan, J. & Bramadat, I.; 1991) evaluates the women childbirth expectation’s with 34 items organized in four dimensions: Pain and coping; Significant others; Nursing support and Interventions.

To analyze the psychometric properties (construct validity using Confirmatory Factor Analysis, discriminant validity and reliability) of the Brazilian preliminary version of CEQ.

350 women (Mean age: 30.01±5.452) in the second trimester of pregnancy (Mean weeks of gestation=25.17±6.55), with uncomplicated pregnancies, completed the CEQ. To analyze discriminant validity, thirty of these women participated in a workshop (12 hours, integrated in the GentleBirth, a specific perinatal education intervention program) and fill in the CEQ again after approximately 8 weeks.

After deleting seven items (1-3-20-24-33-34-35) and some errors were correlated the four-dimensional second-order model of CEQ presented good fit (χ2=2.496; RMSEA=.071; CFI=.845, TLI=.828). The CEQ Cronbach’s alpha for the total was α=.90; all factors presented good reliability: Pain coping (α=.87); Significant others (α=.66), Nursing support (α=.84), and Interventions (α=.76). The CEQ mean scores (total, Pain coping and Nursing support) were significantly higher after the workshop, indicating more positive expectations for childbirth (p<.05).

This additional validation study emphasizes that CEQ is an adequate measure of expectations of labour. It will be very useful to understand the correlates of childbirth expectations and also to access the efficacy of childbirth preparation programs.

. Self-isolation regime is an effective measure to contain the pandemic (Alfano, Ercolano, 2020), but the psychological factors predicting compliance with stay-at-home recommendations (CSHR) are understudied. We hypothesized that 1) defensive optimism and constructive optimism will have opposite effects on CSHR, 2) the effect of defensive optimism will be mediated through a decrease of anxiety (fear of infection).

. The purpose of this study was to assess the direct and indirect (through the fear of infection) effects of defensive optimism (belief that coronavirus problem is exaggerated) and constructive optimism (belief that people’s efforts help to prevent infection and spread of the virus) on CSHR, controlling for dispositional optimism.

. A longitudinal study (from 10/4/2020 till 2/6/2020) was conducted on a sample of 306 university students (89% women, MA=21.20, SD=4.54) using a single-item measure of CSHR, LOT-R (Scheier et al., 1994), the scales of defensive and constructive optimism (Gordeeva, Sychev, 2020), and anxiety in a pandemic situation questionnaire (Tkhostov, Rasskazova, 2020).

. During seven-week interval CSHR has decreased dramatically (Cohen’s d=0.66, p<0.001) while the other variables remained stable. Using SEM we have showed that CSHR at the end of study (T2) is predicted by the CSHR (T1) and through it by the defensive optimism (negative effect, p<0.05) and constructive optimism (positive effect, p<0.001). Negative effect of defensive optimism on CSHR is also mediated by the fear of infection (T2), reducing it. Dispositional optimism is associated only with constructive optimism.

. Defensive and constructive optimism/ pessimism are essential in explaining health-related behavior.

No significant relationships.

Dementia is a major cause of disability worldwide. About 25%-40% of patients with mild to moderate dementia are affected by sleep-awake cycle disturbances, including increased daytime sleepiness and insomnia. However, little is known about the specific impact of excessive daytime sleepiness on the cognitive decline of dementia patients.

To evaluate the impact of daytime sleepiness on the cognitive decline of dementia patients. Additionally, longitudinal associations with functional impairment and neuropsychiatric symptoms will be explored.

A longitudinal study will be conducted in a psychogeriatric consultation. Patients will be consecutively invited according to predefined eligibility criteria. Those aged ≥65 years, with dementia diagnosis or Mini-Mental State Examination (MMSE) <24, and with a knowledgeable caregiver, will be included. The exclusion criteria are: a caregiver <18 years, terminally ill, incapable to communicate or with a known diagnosis of insomnia, sleep related respiratory disorders, central hyperinsomnia, restless legs syndrome or sleep paralysis. Participants will undergo an assessment with a comprehensive protocol including: Montreal Cognitive Assessment (MoCA), Barthel and Lawton Index, Epworth Sleepiness Scale (ESS), Neuropsychiatric Inventory (NPI) and Global Deterioration Scale (GDS). Participants will be re-assessed 6 months after the initial evaluation. The Health Ethics Committee of Hospital Universitário de São João granted the study authorization (nº 260/2020).

Findings will be disseminated via publication in peer-reviewed journals and presentations at national and international scientific conferences.

This study will address key questions on the relation of daytime sleepiness and dementia outcomes, in order to undertake corrective and preventive non-pharmacological and pharmacological approaches.

A growing body of evidence in both chronic and first-episode schizophrenia report increased expression of pro-inflammatory substances in the blood and cerebrospinal fluid of patients. However, there is not much data in the literature on immune alterations in unaffected first-degree relatives (FDRs) of the patients.

We aimed to evaluate inflammatory aberrancies in patients with schizophrenia, their unaffected first-degree relatives (FDRs) and healthy controls.

50 chronic, stable schizophrenia patients, 42 FDRs and 40 healthy subjects with no family history (HCSs) were recruited to the study. IL-1β, IL-6, TNF-a and CRP levels were measured. Complete blood counts, fasting glucose and lipid levels were analyzed and neutrofil-lymohocyte ratio (NLR) were calculated.

There was a significant group difference in all cytokine levels after controlling for age, gender, smoking status, comorbid medical diseases, BMI and blood glucose and tyrigliseride levels (p<.001). FDRs showed significantly higher serum levels of cytokines than HCs, in the same way as the corresponding schizophrenia patients but a lower level. Pairwaise comparisions revealed that the differences were significant between each group after controlling for confounders (p<.001 for all comparisons). However, NLR and CRP levels were not different between groups.

Our results support the role of inflammatory aberrancies in the pathophysiology of schizophrenia. The finding of abnormal cytokine levels both in schizophrenic patients and FDRs indicates that such immunological alterations are not exclusive to the patients and can be possible endophenotypes for the disorder.

No significant relationships.

Autism spectrum disorder (ASD) is a multi-factorial disease characterized by impairments in social interaction, communication and repetitive behaviors. The necessity of developing an adequate treatment for ASD is essential. There is an increase in clinical studies assessing the positive effects of vitamins in ASD children. Vitamin C (vit. C) is implicated in biosynthesis of neurotransmitters and in protein metabolism.

This study evaluated the possible effect of vit. C on zebrafish sociability after a single insecticide mixture administration as inductor for ASD.

A single dose of insecticide mixture (600 μg L-1 fipronil and 600 μg L-1 pyriproxyfen) was administrated to zebrafish juvenile. Vit. C (25 μg L−1) was daily administrated during 14 days. A control group simulated the administration of insecticide mixture and vitamin. Each animal was tested in the experimental tank designed for the social interaction test. The trials were recorded and analysed using EthoVision XT 11 (NOLDUS, Netherlands). The locomotor activity parameters and the time spent next to the group were measured. Each trial had 4 minutes duration.

We have found no significant differences in the average levels between pre-treatment and treatment days (P< 0.05 ANOVA) regarding the locomotor activity parameters. Significant changes in sociability were observed for the group exposed to insecticide mixture and for vit. C group (P > 0.05 ANOVA). It was also found that 14 days vitamin administration can lead to sociability improvements after a single administration of mixture insecticide.

The results of the current study bring some positive insights for the future of ASD therapy.

This work was co-funded by the European Social Fund, through Operational Programme Human Capital 2014-2020, project number POCU/380/6/13/123623, project title

Forced displacement has been shown as a direct consequence of civil wars and armed confrontations, its effects on the victims are evidenced in the material, physical health and psychosocial effects (Mendoza, 2012; Pavas & Díaz, 2019; Ramos, 2018). It is common to identify in victims the presence of a post-offense emotional discomfort, which is recommended to work as a way of forgiveness for the achievement of personal restoration (Prieto & Echegoyen, 2015).

For this reason, the results of the study are presented, which has aimed to analyze the relationship between personal restoration and feelings of guilt with victims of forced displacement in the Colombian Caribbean.

A correlational study has been carried out with a sample of 40 (n = 40) subjects of which 52.5% are men and 47.5% women, the mean age is 57.52 (σ = 13.591), all with a history of forced displacement; to the data collection has been used the CAPER instrument of Rosales, Rivera and Garcia (2017) (α = .592).

There is a positive bilateral correlation between the variables studied (r = .000; p = .829), the greater the personal restoration, the greater the sense of guilt is also manifested.

For therapeutic work in personal restoration with victims of forced displacement, it is important to also include the feeling of guilt, which is presented as post-offense emotional distress.

No significant relationships.

The quality of life of patients with epilepsy, their social activity and functioning depends not only on the presence of epileptic seizures, but also on the level of cognitive decline.

The object of our study is impact of non-pharmacological methods on cognitive functions, decreasing of which deteriorates social activity in patients with epilepsy.

We have studied the features of clinical and psychopathological manifestations in patients suffering from epilepsy. The study covered 27 patients who were in inpatient care. The following psychodiagnostic techniques were used: the Toronto Cognitive Assessment TorCA, the MOCA and the MiniMult tests, Patient Social Functioning Questionnaire. Currently, a group of patients with cognitive decline cause by epilepsy is undergoing remote cognitive training on one of an online platforms, under our observation. Correction occurs throughout regular daily performance, assessment of cognitive functions is carried out on three indicators: attention, memory and thinking

The following results of the study were observed: initially decreased memory in 88,8 % patients and the level of cognitive decline were directly proportional to the duration of the illness, this category of patients has reduced activity and limited social contacts.The result of the use of cognitive training is an increase in all three indicators.

The results of the study indicate the need for further study of the features of cognitive disorders in epilepsy and the use of methods of psychotherapeutic correction.

Anti-NMDA-receptor encephalitis is a severe rare acute form of encephalitis caused by an autoimmune process with the synthesis of autoantibodies to the glutamate receptors. The average age of onser is estimated to be 23-25 years. A typical clinical picture consist of prodromal, psychotic, areactive, hyperkinetic phases, and a phase of gradual regression of symptoms. The disease usually lasts for a several weeks with spontaneous recovery or fatal outcome and caused by neoplastic process. Our case demonstrates that the course of anti-NMDAR encephalitis is possible at more mature age in the form of a long process with cultural features, without significant catadrome, inflammation and associated neoplastic process.

50-year-old Buddhist Buryat woman with complaints about hypomnesia, anosmia and dissomnia. The disease began with impaired consciousness, disorientation, seizures and memory loss 4 years ago. Then after a visit of Lama, the symtoms described above spontaneously reduced and schizophrenia-like psychosis developed (voice of Lama in the head, a belief in the existence of super-powers, disorganized behavior), mild neurological and severe neurocognitive symptoms, weight loss, intolerance to antipsychotics in minimal daily doses.

Examination included: CBC, metabolic panel, coagulogram, tumor markers, CSF, MRI, PET, specialists.

CBC, metabolic blood analysis, tumor markers - within the reference values. CSF: cytosis 9/3, glucose 5.5 mmol/l, Pandi++, Nonnet-Apeltau+, antibodies to the NMDA receptor - 8. MRI: signs of the consequences of encephalitis. PET: no signs of metabolic activity of the malignant process.

The diagnosis of anti-NMDA-receptor-encephalitis was confirmed by the laboratory and clinical criteria despite unususal course and age. The trigger role of herpes is possible, but not verified.

No significant relationships.