There is evidence that maternal perinatal depression is associated with adverse neurodevelopmental and mental health outcomes in children. No study has yet examined the association between maternal depressive symptoms during pregnancy and the postpartum period and the risk of oppositional-defiant disorder (ODD) in children and adolescents.

This study aimed to investigate whether there is an association between perinatal depressive symptoms and the risk of ODD in offspring from age 7 to 15 years.

We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a population-based prospective birth cohort study in the UK. Offspring ODD at the age of 7, 10, 13 and 15 years were assessed by using parental reports the Development and Well-Being Assessment (DAWBA). We applied Generalized Estimating Equation (GEE) modelling to examine associations across the four time points.

Maternal postnatal depressive symptoms were associated with more a two-fold increased risk of ODD overall. Third trimester depressive symptoms (measured at 32 weeks of gestation) increased risk of ODD by 72%. Offspring of mothers who had depressive symptoms both during pregnancy and in the first year of postpartum period have a four-fold increased risk of ODD over time (adjusted OR = 3.59 (1.98-6.52).

Offspring of mothers with perinatal depressive symptoms are at an increased risk of developing behavioural disorders.

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women, which in addition to medical aspects also affects the dimensions of women’s mental health such as stress.

The present study was conducted to determine The effect of online motivational interviewing on stress management in infertile women with PCOS

This randomized controlled clinical trial enrolled 60 Infertile Women with PCOS from the city of Sari-Iran in 2020. Participants were assigned to MI and control groups using block randomization. The intervention group received 5 weekly of MI online via WhatsApp. While the control group received only routine care. Stress management scores in these individuals were measured using health-promoting lifestyle profile II questionnaire (HPLP II) before and after the intervention. Then, the data were entered into the SPSS software, version 25 and were analyzed using descriptive statistics, chi-square test, t-test, and repeated measures analysis of variance.

No significant difference was observed between the two groups before the intervention mean The Stress management scores (p>0.05). After the intervention, mean (SD) of The Psychological Domains score was 22.5 (3.8) in the intervention group and 17.9 (4.1) in the control. The Stress management score was significantly upper in the intervention group compared to the control. (p<0.000). The effect size (1.1) was calculated. NNT (1.6) was calculated.

According to the results and the effect of motivational interviewing is one of the effective methods to manage stress in infertile women with PCOS.

No significant relationships.

Adolescent online behavior is an urgent public health problem in different countries of the world due to the possibility of developing Internet addiction.

To study the prevalence of different types of online behavior and Internet addiction in Siberian adolescents, depending on gender and age.

During the period from January to May 2019, 2950 adolescents aged 11-18 years living in the urban area of Central Siberia (Krasnoyarsk) were examined, of them 1348 boys and 1602 girls. The Chen Internet Addiction Scale (CIAS) with a cut-off level of 65 points was used. Internet users are divided into three groups: Adaptive Internet Users (AIU) (27–42 points); maladaptive Internet users (MIU) (43–64 points); pathological Internet users (PIU) (score ≥ 65).

The AIU group comprised 50.3% (55.9% boys and 45.6% girls, p <0.001). The share of adolescents aged 11-14 is 52.0%, the share of adolescents aged 15-18 is 48.4% (p = 0.04). The MIU group constituted 42.9% (46.3% were girls and 38.9% boys, p <0.001). The share of adolescents aged 11-14 is 42.1%, and those aged 15-18 is 43.8%, p > 0.05. The PIU group constituted 6.8% (5.1% boys and 8.2% girls, p <0.001). The share of adolescents aged 11-14 is 5.9% and those aged 15-18 is 7.8% (p = 0.04).

Among adolescents in Central Siberia the prevalence of AIU consist 50.3%, MIU 42.9%, PIU 6.8%. The prevalence of PIU is more common in girls. The increase in PIU was marked in the older age group. The study was funded by RFBR project № 18-29-2203218.

The reported study was funded by RFBR project № 18-29-22032\18.

According to the World Health Organization (WHO, 2017) depressive disorder continues to be the most widespread and growing mental illness in the world, also assumes that in 2020 depression will have a prevalence equal to one in six individuals. Studies of neuroanatomy have highlighted structural alterations in the hippocampus, striatal nuclei and prefrontal cortex in patients with mood disorders. This alteration in depressed patients is closely related to the secretion of neurotrophic factors, in particular there is a reduction in BDNF (Brain Derived Neurotrophic Factor).

The objective of this study is to demonstrate which treatments are effective in reducing depressive symptoms that allow the increase of BDNF and consequently the structural homostaticity of the brain.

We have selected data from the literature of the last decade, collected on major search engines such as: Google Scholar, Research Gate, PubMed, Ebsco. Articles collected by selecting the following Keyword: depression, BDNF (Brain Derived Neurotrophic Factor), neuroimaging cognitive behavior therapy.

The results show that in patients treated with a single drug treatment or vagus nerve stimulation, repetitive transcranial magnetic stimulation (Lang et al., 2008) or electroconvulsive therapy had improvements in BDNF levels, although compared to drug treatment there are problems of no responders, no compliance and lack of effectiveness in reducing vulnerability to relapse. In addition, the study has shown that patients treated with cognitive behavioral therapy have reported greater changes in the frontal and temporal cortex reducing both depressive symptoms and the risk of relapse.

Underlines the importance of an integrated approach

It is known that children with attention deficit disorder (ADD) have deficit in sustained attention. It is important to develop trainings for improving sustained attention in ADD children. It was shown that yoga exercises have positive effect on sustained attention in adults.

The gaol of this study was to reveal effect of yoga exercises on sustained attention in 7-8 years of age children with ADD. We compared the efficacy of two methods of treatment (yoga exercises vs. conventional motor exercises) in a randomized controlled pilot study.

18 children with ADD at the age of 7-8 years were included and randomly assigned to treatment conditions according to a 2×2 crossover design. Children from intervention group participated in 8 weeks of yoga exercises. To assess the sustained attention we used subtest from Luria’s child neuropsychological battery. This subtest is designed to assess visual sustained attention.. Effects of treatment were analyzed by means of an ANOVA for repeated measurements.

The ANOVA has revealed (p<.05) that for sustained attention subtest the yoga exercises were superior to the conventional motor training, with effect sizes in the medium-to-high range (0.39-0.77).

The findings from this pilot study suggest that yoga exercises have positive effect on sustained attention in 7-8 years of age children with ADD. However, it is necessary to do further research to reveal the impact of yoga exercises on the prevention and treatment of attention deficit disorder in children.

Pregnancy and delivery are considered to be an important transition stage in a woman’s life. Although this experience is emotionally rich, it varies from one person to another and each woman goes through it in her own way.

discuss the psychiatric outcomes after a childbirth with somatic complications.

case report

Mrs X is a 32 years old woman, she has no particular history of illness until she gave birth to her son. He is now three and a half years old and he is an outpatient at the child and teen psychiatry department in a Tunisian hospital. After her delivery, Mrs X had several physical and psychological complications. She was hospitalized in the cardiology department for cardiomyopathy of Meadows for three weeks among it one week in the medical reanimation ward because she needed respiratory assistance. Furthermore, she suffered of left femoral head’s necrosis for which she was operated, and a total hip prosthesis replacement was done. Psychologically, Mrs X. presented a postpartum depression which resolved in its own after 9 months. Ever Since the childbirth, the patient presents symptoms concording with post-traumatic stress disorder and symptoms that may be linked to a specific phobia (fear of birthchild or tokophobia).

In addition to the usual health care provided to women during pregnancy and after childbirth, looking for mental health disturbances and eventually referring them for psychiatric assessment is important specially for women who have experienced traumatic events during the pregnancy or the delivery

No significant relationships.

Autism Spectrum Disorder and Social Anxiety Disorder are mental illnesses characterized by a dysfunction in social behavior (SB); a phenomenon largely mediated by the medial prefrontal cortex (mPFC). Clinical studies have demonstrated that lysergic acid diethylamide (LSD), a partial agonist of the 5-HT2A receptor, can promote SB. However, its mechanism of action on SB is unknown.

To assess the effects of repeated LSD administration on social behavior in mice and to identify which mPFC receptors mediate LSD’s behavioral effects.

Eight-week-old C57BL/6J male mice received vehicle or repeated LSD (30 μg/kg/day i.p. for 7 days) as well the selective 5-HT2A receptor antagonist MDL, or the AMPA receptor antagonist NBQX. Twenty-four hours following the last injection, mice underwent the Direct Social Interaction Test and the Three-Chamber Test (TCT) to assess sociability and preference for social novelty. in vivo electrophysiological recordings were performed in mice treated with vehicle or LSD using multi-barrelled electrodes for microiontophoretic ejections of the selective 5-HT2A receptor agonist DOI or the selective AMPA receptor agonist quisqualate on mPFC pyramidal neurons.

Repeated treatment with low doses of LSD increased the interaction time in the DSI as well as sociability and social novelty indices in the TCT. These pro-social effects were blocked by the intra-PFC administration of both 5-HT2A and AMPA antagonists. LSD also potentiated, in a current-dependent manner, the excitatory response of mPFC neurons to 5-HT2Aand AMPA agonists.

Repeated, low doses of LSD increases social behavior via a mechanism of action that is mediated by 5-HT2A and AMPA in the mPFC.

Challenging behavior is a common reason for referral to psychiatric service. Psychotropic medications widely used to modify behaviors, even when no evidence of diagnosable mental illness. However, literature show little evidence that benefits outweigh the risks in their prescription. Monitoring using International guidelines may help improving the outcomes. We audit current practice against known standards.

- To assess adherence within the Qatar Mental Health Services to National guidelines on using medication to manage behavior problems in adults with a learning disability. - To identify strengths and weaknesses in current practice. - To Make recommendations to improve LD patient care

Patients with LD attending psychiatric clinic screened using selection and exclusion criteria and data collected and analyzed using format from the International standards.

102 patients screened, 85 selected and 17 cases excluded Age range 18 to 50 years. 27% mild, 29% moderate and 44% severe LD, Autism 40% Psychiatric Diagnosis 55% Challenging behavior 45% Antipsychotic prescribing: 79% Rationale documented in 74%, Capacity assessment in 81%, Review of side effects in 53% Safety of medication in 61%, Medication discontinuation in 66%, Reasons for discontinuation in 36%

Antipsychotics use (79%) is high with several combinations of IM and oral or more than 2 drugs. There is need for improvement across all standards. Rationalising the prescribing for LD patients to improve the outcomes for the safety of these patients. The audit indicate need for specialist service to monitor prescribing and apply standards of care in clinical service.

No significant relationships.

Suicide remains a major problem throughout society. Unfortunately, recommendations for the treatment of suicidal clients are often presented at a general level, without providing adequate detail that could guide the practicing clinician.

The review explains three main strategies that can be used to helpr educe the risk of suicide among depressed adults.

Method: The review identified three themes derives from an integration of 30+ years of clinical experience working with depressed outpatients combined with a comprehensive review of recent journal articles on depression and suicide.

First, clients may become suicidal when they focus on unfortunate events from their recent or distant past, resulting in tendencies for rumination and guilt. Therapy can help clients cultivate an attitude of contentment, promoting self-forgiveness and a sense of accomplishment. Second, suicidal clients often focus on their current struggles, frequently involving financial problems, interpersonal conflict, and social isolation. Therapy can help clients to embrace life through planned activities, reconnecting with loved ones, and repairing damaged relationships. Third, clients may struggle because of hopeless views of their future, feeling trapped in a desperate situation with no possible solution. Therapy can help clients look to the future with a more optimist attitude and a sense of control.

Clients can learn to search for realistic solutions to their problems, developing a renewed sense of optimism and empowerment. The risk of suicide can be reduced when therapy helps clients reduce guilt and worthlessness, increase meaningful social bonds, and instill realistic hope for the future.

No significant relationships.

Prof. Mucci has been a consultant and/or advisor to or has received honoraria from Gedeon Richter Bulgaria, Janssen Pharmaceuticals, Lundbeck, Otsuka, Pfizer and Pierre Fabre.

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.

After attendance at this session, the learner will be able to: 1. describe the history and expansion of the ECHO model worldwide, 2.name the components and structure of ECHO sessions, 3. discuss ECHO as a force multiplier.

Dr. Harrison will briefly present the history and expansion of ECHO. She will then describe the program, which consists of a “hub and spokes” model with “tele-clinics” consisting of a “hub” of specialists and “spokes” of clinicians in rural, underserved areas who present cases for discussion, generating treatment recommendations.

The ECHO model has been replicated in a variety of disciplines across the United States and internationally. Its success has been well documented. There are currently 920 active ECHO programs worldwide.

Project ECHO is a viable model to address the workforce shortage of child psychiatrists worldwide.

No significant relationships.

Psychiatric patients often are self-stigmatized and hardly involve in the treatment.

Associations of self-stigmatizing beliefs in psychiatric inpatients and their treatment motivation.

63 inpatients; ICD-10: F2–65%, F3–13%, F4+F6–14%, F06–8%; mean age 34±13, illness duration 12±11 years. Treatment Motivation Assessment Questionnaire (TMAQ), Internalized Stigma of Mental Illness scale (ISMI); K-mean cluster analysis; dispersion analyses; p≤0.05.

18 patients of cluster 1 (C1) demonstrated explicit self-stigmatization. In comparison with 25 subjects from cluster 3 (C3) stigmatized patients (C1) had higher levels of overall ISMI scores (2.9±0.3) caused by alienation (3.1±0.5), stereotype endorsement (2.5±0.5), social withdrawal (2.7±0.4), and discrimination experience (2.7±0.4). 20 patients of cluster 2 (C2) had an implicit stigma. They were more self-stigmatized (ISMI score 2.7±0.3) in contrast with subjects from cluster 3 (1.9±0.2) due to a lower level of stigma resistance (C2: 3.8±0.5 and C3 3.1±0.6 – reverse scores). Patients with implicit self-stigma (C2) had the lowest intensity of treatment motivation (Z-scores -1.2±0.6) compering with others (C1 and C3) due to the lowest TMAQ factor 1 (reliance on own knowledge and skills to cope with the disorder: -1.0±0.6) and factor 4 (willingness to cooperate with doctor: -0.9±1.0). Differences between explicitly and implicitly stigmatized patients manifested also in lower TMAQ factor 3 for the second group (awareness of the psychological mechanism of maladaptation: -0.5±0.9).

Despite alienation, stereotype endorsement, social withdrawal, discrimination experience some patients could sustain stigma due to cooperation with doctors and reliance on their own knowledge and skills to cope with illness.

For the first time in N. Macedonia we had the experience to include peer workers as an equal members in the newly formed community mental health teams. For the purpose of the RECOVER-e project we engaged 2 patients to be the new peer workers.

To evaluate the initial period of peer worker involvement in the community mental health teams and to identify the next steps for them.

Conducting interviews with the peer workers.

One important aspect that is worth mentioning is their motivation to continue their work in the community mental health teams and continue to improve. Another finding is their will to establish a user led organisation. A user led organisation in the field of mental health in our country is rare to be find, with only a couple of them functioning in N. Macedonia. So if our peer workers can make it, it would be a great step in the right direction.

Overall, taking into consideration all that the peer workers have achieved in the last period, including the ups and downs of being the first official peer workers in N. Macedonia, they are looking forward to improve their knowledge and continue building their practical experience. A great plus of it all is that they have a financial stability for this troubled pandemic period.

No significant relationships.

Starting with December 2019, the first cases of SARS-CoV2 virus appeared in the Wuhan region of China, which will become the COVID-19 pandemic and will have an impact on the bio-psycho-socio-cultural environment. Lockdown and social isolation measures have been imposed in an attempt to gain time and find a viable treatment and a vaccine, for this new infection. The media, in an attempt to promote these measures and information about COVID-19 symptoms, have further increased fear of the virus in population.

This presentation tried to observe the impact of the COVID-19 pandemic on patients confirmed positive with SARS- CoV2 infection, treated in hospitals, inpatients who died by suicide.

As methods a brief review of the literature was made, based on research in scientific articles published in PubMed, APA PsychNet, The BMJ, Who.int, using as keywords the terms “pandemic covid-19”, “inpatients” and “suicide”, published between January 2020 - October 2020.

Several studies conducted to assess the impact of the pandemic on mental health found a significant increase in dysphoria, unhappiness, irritability, anxiety, dominant thoughts related to the transmission of the SARS-CoV2 virus, a tendency to worry about their health and culminating with suicide in the medical unit.

Depending on the psychological structure of each person and the socio-cultural context, different behaviors were observed related to the impact of this pandemic on mental health. The most important is, however, the occurrence of a significant number of deaths by suicide in hospitals in the context of social isolation, patients without a psychiatric history.

As a result of the emergence of coronavirus disease 2019 (COVID-19) outbreak caused by acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the Chinese city of Wuhan, a situation of socio-economic crisis and profound psychological distress rapidly occurred worldwide.

This work aimed to comprehensively review the current literature about the impact of COVID-19 infection on the mental health in the general population.

A detailed review has been conducted in order to identify the main psychopatological consequences related to Covid-19 infection in the general population.

Various psychological problems and important consequences in terms of mental health including stress, anxiety, depression, frustration, uncertainty during COVID-19 outbreak emerged progressively. The psychological impact of quarantine related to COVID-19 infection has been additionally documented together with the most relevant psychological reactions in the general population related to COVID-19 outbreak.

The role of risk and protective factors against the potential to develop psychiatric disorders in vulnerable individuals with Covid-19 infection need to be carefully addressed in the clinical practice.

The recurrence of bipolar disorder due to poor treatment adherence can be explained by different factors.The poor awareness of the disorder seems to be the major cause.

To evaluate insight in patients followed for euthymic bipolar disorders and determine the factors correlated with it,mainly the self-esteem.

A cross-sectional descriptive and analytical study of 33 euthymic subjects with bipolar I and II disorders (DSM 5) and followed up at the psychiatric consultation in Hédi Chaker university Hospital of Sfax.Data collection was performed using a sheet exploring socio-demographic and clinical data. We used Birchwood insight scale to assess the quality of insight and Rosenberg’s Self-Esteem scale.

The average age of our patients was 44,52±12,99 years old.The sex ratio =0.32.Patients were followed for bipolar I disorder(60.6%).The first episode of the disease was depressive in(51.5%) of cases.The average number of depressive episodes was1.97±1.87.The last episode was depressive in(57.6%) or manic in(42.4%).There were no psychotic characteristics in(42.4%) of cases.The patients had good insight in(54.5%).The average of self-esteem score was27±7.85and it was low in 51.5% of cases.Factors correlated with good insight were bipolar II disorder(p=0.001), high number of depressive episodes(p=0.013) and absence of psychotic characteristics(p=0.003) during the last episode.In addition,good insight was significantly associated with low self-esteem(p=0.023).

Our study shows that a poor insight depends mainly on the clinical characteristics of bipolar disorders. Moreover,low self-esteem seems to be linked to it. For this reason, our attention should be focused on psychoeducation to improve insight, especially during episodes, in order to facilitate integration and increase patients’ self-esteem.

About 30% of individuals in ultra-high risk (UHR) of psychosis develop overt psychosis within 3 years, and about 40% of those who don’t will keep experiencing ongoing attenuated psychotic symptoms and persistent functional disability. During this prodromal period, it’s possible to prevent the transition to a first-episode psychosis.

To conduct a short review of literature on the role of cognitive-behavioural therapy (CBT) in preventing psychosis in ultra-high risk patients.

We performed a literature search on PUBMED, using the query: “Cognitive Behavioral Therapy” [Mesh] AND “psychosis” AND “prevention”. We focused on data from systematic reviews, clinical trials and meta-analysis published on last 5 years, either in English or Portuguese.

Some authors claim cognitive-behavioural therapy (CBT) as first-choice treatment in clients with ultra-high risk (UHR) for psychosis. CBT aims to normalize extraordinary experiences with education and to prevent delusional explanations. On a Japanese study, the total score of Positive and Negative Syndrome Scale (PANSS) significantly improved on post-intervention and follow-up assessments, with large effect sizes observed. Teaching families to apply CBT with their offspring may bolster therapeutic gains made in time-limited treatment. CBT showed an 83% probability of being more effective and less costly than routine care.

Patients with UHR for psychosis can be treated successfully with CBT to postpone and prevent the transition to a first-episode psychosis. CBT for UHR has been included in the European guidelines and awaits dissemination and implementation in mental health services.

A communication gap exists between psychiatry and indigenous people about views of mind and mental health, which often becomes an obstacle to optimal care and a source of distrust.

We aimed to explore the utility of the concept of two-eyed seeing for facilitating communication among traditional cultural practitioners (TCP) and conventional mental health practitioners (CMHP).

“Two-eyed seeing” is spreading across North America as a metaphor for explanatory pluralism. Albert Marshall, a M’iqmaq from Nova, Scotia, Canada, developed this traditional concept (eptuamptamuk in M’iqmaq) to speak to the idea that indigenous knowledge is as valid as contemporary science for conceptualizing phenomena. We taught the concept to 100 practitioners, equally balanced between CMHP’s and TCP’s, and obtained ongoing feedback about the results of their applying these ideas to their ongoing collaborations. Qualitative research methods were used to evaluate this feedback.

Using the two-eyed seeing concept allowed CMHP’s to better listen to TCP’s descriptions of their concepts of mind and of mental suffering. TCP’s felt more respected by CMHP’s. While concepts such as spirit visitation, the breaking of taboos, and intergenerational curses are inherently foreign to CMHP’s, the two-eyed seeing concept allowed them to bracket these ideas as interesting and to interact with the TCP in a more productive way, while allowing them to observe the effects of the TCP’s interventions in a less judgmental way.

Two-eyed seeing allowed a rich dialogue between CMHP’s and TCP’s that enabled each to appreciate the other’s perspectives, leading to greater cooperation and collaborative treatment. Outcomes improved.

No significant relationships.