It currently remains unclear in how far supratherapeutic lithium serum concentrations can affect the cardiac conduction system. Prolonged QT interval, arrhythmias and cardiac death have all been anecdotally reported, but the systematic studies are few.

To examine ECG changes occurring with supratherapeutic lithium concentrations that have given rise to lithium toxicity.

We examined all episodes of lithium intoxication defined as serum lithium level (≥ 1.5 mmol/L). We analyzed ECG before, during and after intoxication and recorded ECG changes. These, we then assessed according to type of intoxications, clinical and other pharmacological characteristics. The study is based on 20-year data (1997-2020) from the retrospective cohort study (LiSIE) in the Swedish region of Norrbotten.

Of 1101 patients treated with lithium, 77 patients had experienced lithium intoxications. 12 patients had more than one episode of intoxication, yielding 91 episodes. 39 had ECG available both as reference and during lithium intoxication. We found no statistically significant prolongation of the QTc interval during lithium intoxication, compared to respective reference ECG (p = 0.364). Heart rate during lithium intoxication was significantly lower, mean 73 beats/min (SD 16,8, range 43 - 112), compared to the reference ECG, mean 79 beats/min (SD 15,3, range 48-112; p = 0.006). No patient died. All findings were independent of whether an intoxication was acute or chronic.

In our study, heart rate was significantly lower during episodes of intoxication. However, this decrease was of no clinical relevance in most cases. Lithium intoxication was not associated with prolonged QT time.

M. Ott: scientific advisory board member of Astra Zeneca, Sweden. U. Werneke: received funding for educational activities on behalf of Norrbotten Region; Astra Zeneca, Eli Lilly, Janssen, Novartis, Otsuka/Lundbeck, Servier, Shire, Sunovion. Others: None

The provision of mental health care should be promoted at the community level, in order to facilitate their recovery process. Thus, the people who care for these individuals go through a situational transition, as they have to play the role of Family Caregivers (FC).

a) to characterize the FC burden of the person with Mental Illness; and b) to correlate FC overload with the variables age, gender, cohabitation, degree of kinship and level of education.

A cross-sectional correlational study was conducted. The sample consisted of FC who went to consultations and to the inpatient psychiatric unit of a portuguese hospital. Data were collected through a questionnaire which included sociodemographic data, the Lawton-Brody Index and the Zarit Burden Interview (ZBI).

Of the 119 FC, 66.4% were female, with an average age of 53.8 years. 73.1% of FC cohabited with the person they care for, in which the majority was cared for by their child or spouse, 45.2% and 36.1%, respectively. It should also be noted that 71.4% felt the need for more support from health professionals. As for autonomy, 52% of the individuals cared for by FC were moderately dependent. It was verified that about 45% of the FC had an intense overload. Female gender has greater overload and that there are no significant differences between the level of education and cohabitation.

Considering the results, it is understood the importance of valuing FC, as a target and care partners, in order to reduce the burden, they feel when caring for people with MI.

DISCLAIMER The E-Lifelong Learning In Prevention of Suicide In Europe (ELLIPSE)-project is co-funded by the European Union’s Programme Erasmus+ (Project ID: 2019-1-SE01-KA203-060571). The EU Commission’s support for this project does not mean that the Com

With regard to glycemic control in type 2 diabetes (T2D), treatment with antidepressant drugs is a double-edged sword. Real-world, population-based data on the impact of antidepressant treatment on glycemic control in T2D is absent from the literature.

To estimate the impact of treatment initiation or termination with an antidepressant on HbA1c levels in individuals with T2D.

Population-based, within-subject, study design examining HbA1c levels in the 16 months leading up to - and the 16 months following - antidepressant treatment initiation or termination, respectively. All individuals with newly developed T2D between 1 January 2000 and 31 October 2016 were identified. Study population 1 consisted of individuals that initiated antidepressant treatment after incident T2D and age- and sex matched individuals with T2D and without antidepressant treatment. Study population 2 consisted of individuals with prevalent antidepressant use at the time of incident T2D, who terminated antidepressant treatment during follow-up, and age- and sex matched individuals with T2D and without antidepressant treatment.

Antidepressant treatment initiation was associated with a decrease in HbA1c levels (7.05% to 6.89%). The age- and sex matched individuals did not have a change in mean HbA1c levels after the matched date. Antidepressant treatment termination was associated with a decrease in HbA1c levels (7.05% to 6.73%). Age- and sex matched individuals did not see a change in HbA1c levels after the matched date.

These findings suggest that antidepressant treatment initiation is not associated with adverse effects with regard to glycemic control in T2D. Rather, the data are indicative of a beneficial effect.

Aarhus University funded the study. CR was supported by the Danish Diabetes Academy, funded by the Novo Nordisk Foundation, grant number NNF17SA0031406. The funders had no role in the study design, data analysis, interpretation of data, or writing of the

An increasing body of literature supports the hypothesis that immune imbalance towards a pro-inflammatory status in the brain plays an important role in schizophrenia. Anti-inflammatory drugs might compensate this dysregulation, ameliorating the symptoms of schizophrenia. N-acetylcysteine exhibits anti-inflammatory properties and may regulate various neurological pathways, including glutamate dysregulation, oxidative stress, and inflammation, becoming an interesting augmenting drug for schizophrenia treatment.

We aim to review the literature regarding the therapeutic effects of N-acetylcysteine in Schizophrenia.

We performed an updated review in the PubMed database using the terms “N-acetylcysteine” and “Schizophrenia”. The included articles were selected by title and abstract.

The literature suggests that N-acetylcysteine may be a useful adjunct to standard treatment for the improvement of schizophrenia symptoms, as well as the cognitive domain of working memory. Also, this augmentation therapy seems to be beneficial in all illness stages

N-acetylcysteine appears to be a promising agent for augmenting conventional pharmacotherapy in schizophrenia, however, further research is needed to consolidate the current findings.

Skin-Picking Disorder (SPD) is psychiatric condition characterized by recurrent and excessive picking of the skin. There are several attempts to stop the behavior and it causes negative consequences such as dermatological complications and functional impairment.

The aim of this study is to describe a case report of SPD.

Data was collected retrospectively from case notes.

A 30 year-old male, married with 2 children, currently on sick leave, was admitted to the Day Hospital at Centro Hospitalar Psiquiátrico de Lisboa (CHPL) with worsen skin-picking behaviour and functional impairment. During childhood the patient would “cut my toe nails the wrong way so that I could fix them”. By adolescence the patient suffered from acne and felt the need to “solve” them and take out the pus. Over the years the skin-picking behaviour spread to other areas of the body, mainly dorsal and chest areas. Before being admitted to the Day Hospital the episodes were daily and had 2-3 hours duration, using scissors and tweezers and evolving his family, asking his wife’s help with picking. He is being treated with fluoxetine 80 mg, risperidone 2 mg and N-acetylcysteine 1200 mg and Cognitive Behavioural Therapy. He is also participating in the Day Hospital activities that include occupational therapy, movement therapy, psychoeducation. After 2 months he has a few 20 minutes episodes per week, spends more time with his children and thinks about coming back to work.

SPD is a severe and debilitating illness that benefits from a multidisciplinary approach.

No significant relationships.

Social Media might represent an amazing and valuable source of information on mental health and well-being. Several researches revealed that adolescents aged 13 to 17 years old go “online” daily or stay online “almost constantly”.

The aim of this project is to identify distress in pre-clinical stages using Social media screening methods. The system can be modelled to centre on different several health-related topics.

We created a digital system able to analyse scripts written by adolescents on Twitter. InsideOut works using machine learning techniques and computational linguistic items to catch significant and sense of written messages and it improves its performances with iterations. The system is able to automatically identify semantic information relevant to different topics: in this case “distress in teenagers”.

The task of our system is considered correct when it is able to identify triples of Life Event, Sentiment and Experience of a tweet in agreement with the Gold Standard established among the annotators. The system has around 70% of accuracy in identifying triples. The analysis has been carried out both in Italian and English collecting over 4 million Italian tweets and 30 million English tweets. Comparative analysis with self-report questionnaires show that tweet analysis is able to suggest similar statistics.

This study analyzed contents of messages posted on Social Media Twitter meta-dating them with psychological and health-related information. Using InsideOut, we can plan clinical intervention in district and regions where high levels of uneasiness are revealed.

Executive dysfunction (ED) is an important clinical dimension that need to be evaluated in neurologic and psychiatric disorders, due to this factor’s impact over patients functionality, quality of life, and overall prognosis. Working memory, inhibition, set shifting, and fluency are the most widely accepted dimensions of ED. The evaluation of these aspects in clinical practive should be more frequently implemented, because they may offer an image about the patients ability to cope with new situations, stressful events, social challenges being included.

To determine the most appropriate methods of ED evaluation in psychiatric practice.

A literature review was conducted through main electronic databases, and papers published between January 2000 and August 2020 were included in the analysis.

Wisconsin Card Sorting Test (WCST), Halstead-Reitan Neuropsychological Battery, Cambridge Neuropsychological Automated Battery (CANTAB), Wechsler Adult Intelligence Scale (WAIS), and Controlled Oral Word Association Test (COWAT) have been the most frequently cited instruments for ED evaluation. The neuropsychiatric disorders in which ED was recommended in clinical trials were schizophrenia and other psychotic disorders, neurocognitive disorders, bipolar disorders, and major depressive disorders. An integrated approach, that combines initial evaluation and periodic monitoring of symptoms severity, global functioning, quality of life, and ED severity should be considered standard-of-practice for neuropsychiatric disorders.

ED is an important dimension of clinical evaluation in many psychiatric disorders that is useful because the results may correlate to the patients prognosis, quality of life, and overall functional evolution.

No significant relationships.

The relevance of this research is determined by the fact that an important scientific task of the modern clinical classification of mental disorders is the productive combination of the most valuable for the practical use of categorial and dimensional (in terms of the weight and depth of each dimensia) of the characteristics in in a particular clinical picture of a disease.

The goal of the research is to validate the new categorical-dimensional criteria necessary for the verification of schizotypal disorder.

The information base of the research included medical data on 150 patients with schizotypal disorder. Categorical characteristic used according to the systematics of schizotypal disorder (Kotsiubinskii A.P, 2018) published in the National Guide «Psychiatry», which includes the following syndromes: obsessive-phobic, dysmorphophobic, non-delusional hypochondria, heboid, histrionophoric, impulsive-dysfunctional, schizoaffective, dissociative-disintegrative, autistic, dismotivative, amotivative. Our systematics was used with following demensia: positive, affective, negative, cognitive, disordered behavior, dissociative and coenestesipatic. Guided by the principle of five-level representation of each dimensia (from «0» to «4») in accordance with DSM-V and the informative systematics of dimensia was developed with each of dimensia also has rate from «0» to «4».

This diagnostic approach made it possible to correlate the categorial and dimensional characteristics, both to each other and to the criteria of the condition of the patients’ state with the prototype of schizotypal disorder (in the range of «1» to «5»).

This has made it possible to more accurately diagnose non-psychotic forms of mental illness, in particular: differentiate schizotypal disorder «sui generis» and schizotypal personality disorder.

No significant relationships.

Fear of death is somehow a normal sensation. Though for those having a cancer, it could increase the burden of the disease and have negative psychological impacts. This death anxiety isn’t easily verbalized by patients, thus it’s important for caregivers to manage it to improve those patients’ quality of life.

Assess death anxiety in cancer patients and to identify factors that may influence it

Our study was a cross-sectional descriptive study with an analytical focus on quantitative specifications. It targeted patients hospitalized at the oncology department or consultant at the day hospital of the regional hospital of Gabes, Tunisia. Participants completed a questionnaire including sociodemographic and clinical data, using HADS scale for anxious and depressive symptoms and DAS scale for death anxiety.

One hundred and twenty patients were enrolled in the study. The average age of participants were 54, 9 ±11, 8 years. The majority of patients were married (68.3%) and had an average socioeconomic level (74, 2%). Our results showed that 43, 3% of patients had a high death anxiety score. Higher level of threat of death, were found in older patients(p=0.028), females (p=0.018) and for those having children (p=0,01). Death anxiety were also higher in patients having anxiety (p=0.007) and those having depression (p=0.033).

The degree of death anxiety among cancer patients seems important. Its assessment and resolution by the caregivers remains paramount. The identification of this death anxiety should optimize the overall care of the patient.

No significant relationships.

Faced with a possible overdiagnosis of bipolar disorder in children and adolescents, a new diagnosis has been created in the mental illness classification system. This new diagnosis is named Disruptive Mood Dysregulation Disorder.

We propose to carry out a bibliographic review on the new diagnostic category of Disruptive Mood Dysregulation Disorder.

We present the clinical case of a 10-year-old boy showing severe irritability symptoms.

Disruptive Mood Dysregulation Disorder refers to persistent irritability and frequent episodes of extreme behavioral disturbance in children up to 12 years of age. Onset must occur before 10 years of age and the diagnosis should not be applied to children under 6 years of age. The clinical course of these patients in adolescence and adulthood tends towards unipolar depressive disorders or anxiety disorders rather than bipolar disorders.

The new diagnosis of Disruptive Mood Dysregulation Disorder allows us to differentiate between the classic episodic presentations of mania from the non-episodic ones of severe irritability.

No significant relationships.

No significant relationships.

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.

Investigating family members’ causal beliefs regarding schizophrenia is an important step in the management of the illness; it may affect adherence to treatment of patients with schizophrenia.

To investigate the beliefs about the causes of schizophrenia among families of patients with schizophrenia.

We led a cross sectional descriptive study involving 32family members of patients suffering from schizophrenia who were followed in the psychiatry department of Hedi Chaker University Hospital in Sfax (Tunisia), between May to September 2019. Data was collected from the medical records and the questionnaire designed to the study.

The mean age of the relatives was 60.8 years, with a sex-ratio of 1.6. The relatives included 20 fathers (62.5%), six wives (18.8%), three mothers (9.4%), and three sisters (9.4%). Among them, 37.5 % were illiterate; 37.5% lived in rural area. Fourteen participants (43.8%) had cited at least two possible causes of schizophrenia. The most frequently cited causes were emotional shock (81%) and god’s will or fate (72%) followed by witchcraft (37.7%). The belief of God’s will and fate was associated with poor compliance to treatment (p=0.06). The belief of supernatural cause was correlated to rural origin (p=0.000) and advanced age of participants (p=0.000).Significant correlation was also found between family history of mental disorders and beliefs on hereditary causes (p=0.000).

These results suggest that family members of patients suffering from schizophrenia need to be better informed about its main causes to improve both compliance to treatment and social integration of this patients.

Psychotic disorders often cause a drastic change in the life situation of the affected individual. Personality is an aspect that can affect the symptoms and social function in psychotic disorders.

No study has examined stability of personality traits exceeding five years in patients with schizophrenia. The aim of this study was to investigate the stability of personality traits over a 13-year period among patients with psychotic disorder and healthy individuals and to evaluate case-control differences.

At three occasions during a 13-year period patients with psychotic disorders (n=28) and non-psychotic individuals (n=57) completed Swedish universities Scales of Personality (SSP). For all the individuals within- and between-subject analyses were performed at three occasions for all 13 subscales and the three overall factors of SSP. Correlations, means and SDs were calculated.

Tests of within-subject correlations showed differences in two subscales: Lack of Assertiveness, which were influenced by age and Physical Trait Aggression, where patients ratings were stable, whereas controls rated themselves less aggressive at higher age. Between-subjects correlations showed differences regarding any of the parameters diagnosis, time, age, gender or age x gender in nine of the 13 subscales as well as in factor Neuroticism.

Long term follow-up showed a generally high stability of personality traits measured with SSP, especially among patients. Between-subject analyses over the 13 years showed that patients differed compared to controls for the SSP factor Neuroticism as well as the subscale Detachment, which is in accordance with previous studies.

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.

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.

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

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.

An urgent problem all over the world is the growing number of adolescents with maladaptive (Internet addicted) Internet use.

To study the prevalence of various types of online behavior in adolescents in the southern regions of Siberia (Caucasians and Mongoloids).

4351 adolescents aged 12-18 in the city of Krasnoyarsk and the city of Abakan (Republic of Khakassia) were surveyed. Ethnicity is determined by the nationality of the mother. Online behavior was studied using the Chen Internet Addiction Scale (CIAS): adaptive internet use (API) – 27-42 points, non-adaptive (NPI) – 43-64 points and pathological (PPI) ≥ 65 points. The indicators were compared in 2 groups: Caucasians and Mongoloids. The program “Statistica 12” was used, the percentage of the share, the significance of the differences (p) and the values of the Pearson χ2 test were indicated.

Caucasians by their mothers accounted for 3663 (84.2%) and the share of Mongoloids reached 688 (15.8%). AIP was recorded in 44.0% of Caucasians and 7.9% of Mongoloids (p <0.0001; χ2 = 1474.99), NPI was recorded in 34.7% of Caucasians and 6.2% of Mongoloids (p <0.0001; χ2 = 1084.65), PPI was found in 5.5% of Caucasians and 1.7% of Mongoloids (p <0.0001; χ2 = 90.49).

Ethnic features of the prevalence of online behavior in adolescents in the southern regions of Siberia include a higher frequency of NPI and PPI in Caucasians compared to Mongoloids. The reported study was funded by RFBR according to the research project № 18-29-22032\18.

The reported study was funded by RFBR according to the research project № 18-29-22032\18.