Marijuana is widely used among people, recreationally and medically. However, recent studies have shown that Marijuana has negative effects on brain structures and functions.

To discuss the effects of Marijuana use on brain development in adolescence.

The method that is used in this study is literature review, through analyzing and summarizing the data that were collected from PubMed, epidemiology articles from BNN and CDC, and other online journals to understand the effects of Marijuana on the brain development in adolescence. There were 25499 articles that were filtered and screened resulting in 10 articles that were used as data of this literature review.

Marijuana effects on the brain are divided into structural changes and functional changes. Structural changes are seen in the brain hemispheres, amygdala, hippocampus, and nucleus accumbens. While functional changes are seen in behavioral and cognitive changes in everyday life and even psychotic disorders.

Marijuana use has shown negative effects on the human body, organs that are rich in cannabinoid receptors, especially the Brain. Therefore, Marijuana use among adolescents may disrupt their developing brain, and cause adolescents to have structural and functional changes in the brain.

No significant relationships.

Empathizing with others’ pain appears to recruit the whole pain matrix, including a collection of frontal regions involved in the affective, motivational, cognitive, and attentional dimension of pain.

This research explored how the modulation of interoceptive attentiveness (IA) can influence the frontal (dorsolateral prefrontal cortex -DLPFC- and somatosensory cortices) activity related to the emotional regulation and sensory response of observing pain in others.

22 healthy participants were required to observe face versus hand, painful/non-painful stimuli in an individual versus social condition while brain hemodynamic response (oxygenated [O2Hb] and deoxygenated hemoglobin [HHb] components) was measured by functional Near-Infrared Spectroscopy (fNIRS). The sample was divided into experimental (EXP) and control (CNT) groups and the EXP group was explicitly required to focus on its interoceptive correlates while observing the stimuli.

In the individual condition, higher brain responsiveness was detected for painful confronted to non-painful stimuli, and a left/right hemispheric lateralization was found for the individual and social condition, respectively. Besides, both groups showed higher DLPFC activation for face stimuli displayed in the individual condition compared to hand stimuli in the social condition. However, face stimuli activation prevailed for the EXP group, suggesting the direct interoceptive phenomenon has certain features, namely it manifests itself in the individual condition and for pain stimuli.

We can conclude that IA modulation promoted the recruitment of internal adaptive regulatory strategies engaging both DLPFC and somatosensory regions towards emotionally relevant stimuli (painful faces displayed in the individual condition). Therefore IA could be trained for promoting emotion regulation and empathic response.

Holiender and Hirsch defined hysterical psychosis in 1964 and, while hysteria has a contemporary equivalent in somatoform/dissociation disorder, hysterical psychosis remains set adrift in the nosological understanding of psychiatric disorders.

To present a case report of a hysterical psychosis and to review this nosological construct.

Clinical interview, consultation of clinical records and review of literature using the Pubmed platform.

The authors present a case of a 38 year-old woman, admitted in a psychiatric emergency department for bizarre behavior, restlessness, auditory (pseudo)hallucinations and emotional lability, starting 1 week after a personal development retreat. This is the second episode of this nature, the first being a 15-day hospitalization 7 years ago, with rapid stabilization, extensive examination and restitium ad integrum. The patient initiated Olanzapine and was referred to an outpatient clinic, with rapid stabilization and restitium ad integrum throughout follow-up. Given the episode and patient characteristics, a hysterical psychosis diagnosis may be accurate, taking into account the acute onset and course, the pleomorphic nature of symptoms and the presence of a disturbing life event. The authors propose reviewing the concept of hysterical psychosis regarding its clinical implications and debating its therapeutic and prognostic utility.

Hysterical psychosis may not be a mere historic footnote and encompasses an entity with distinctive diagnostic, prognostic and therapeutic characteristics. While its etiology may not be understood, its clinical implications ensure the need for future research.

No significant relationships.

The relationship between alcohol use and dementia is complex. There is a J-shaped relationship between alcohol use and cognitive impairment and evidence shows that one-quarter of the dementia population have alcohol related problems. It is estimated that alcohol-related dementia (ARD) contributes for about 10% of all cases of dementia, especially early-onset dementia, but is largely overlooked or seen as a comorbid factor.

To clarify the relationship between alcohol use, alcohol-related brain damage and dementia; to review the clinical features, neuropathology, nosology and neuropsychology of ARD and alcohol-induced persisting amnestic syndrome (Wernicke-Korsakoff syndrome- WKS).

We performed a review of systematic reviews from the last 10 years. A total of 28 systematic reviews were identified.

Heavy alcohol use has been shown to be a contributory factor and necessary factor in the development of multiple brain diseases. It may cause brain damage in multiple ways: direct neurotoxic effect of acetaldehyde; thiamine deficiency. It is also a risk factor for other conditions, such as hepatic encephalopathy, epilepsy and head injury.

Clinical observation favors the diagnosis of ADR as a distinct entity, but broader evidence reflects significant commonality between ARD and WKS, tough neuropsychological studies have largely attempted to differentiate these syndromes. Repeated episodes of WKS may cause cognitive deterioration. In contrast to other common causes of dementia, the decline in cognitive functioning in ARD is relatively non-progressive if abstinence is maintained, or even partially reversible, as supported by neuroimaging evidence. Given the increase in per capita consumption, it is expected a disproportionate increase in ARD.

Patients with depression are likely to eventually develop Cardiovascular disease(CVD) and have a higher mortality rate than general population. In addition, anxiety disorders, especially Generalized Anxiety Disorder (GAD), may be associated with mortality and other adverse cardiac outcomes.

Evaluation of depression and anxiety control in Greek patients with Major Depressive Disorder (MDD) with/without GAD and CVD, under 6 months of treatment with citalopram, and/or quetiapine, and/or pregabalin.

565 patients with MDD with/without GAD, enrolled in this observational, study (NCT03317262). The subgroup of 133(24%) patients had CVD. Severity of MDD and GAD symptoms was evaluated using the HAM-D and HAM-A Scores at baseline (V1) and after 6 months (V3) respectively.

Mean HAM-D score in patients with CVD without GAD, at V1 and V3 was 23.94±7.51 and 8.14±4.65 respectively (p<0.0001). Similar results were observed in patients without CVD without GAD (HAM-D score 26.67±8.79 at V1 and 7.44±4.40 at V3). Mean HAM-A score in patients with CVD and GAD at V1 and V3 was 25.64±6.38 and 8.98±3.93, respectively (p<0.0001). Same magnitude reduction in HAM-A score was observed in patients without CVD and GAD, 26.27±8.16 at V1 and 9.28±6.48 at V3 (p<0.0001). Patients’ depression symptoms with/without CVD and GAD showed also a significant reduction between V1 and V3.

MDD patients with CVD without GAD, had a marginally lower baseline HAM-D score versus patients with GAD. After 6 months of treatment with citalopram, and/or quetiapine, and/or pregabalin the improvement of depressive and anxiety symptoms was almost equal between MDD patients with/without GAD regardless of the presence of coexisting CVD.

Employee of ELPEN Pharmaceutical Co. Inc.

Psychotherapy of patients suffering from schizophrenic disorders remains controversial. There are promising descriptions of psychothereputic interventions in combination with pharmacological treatment. Some empirical studies show that different forms of psychotherapy are effective. However, there are few models to combine different psychotherapeutic strategies in a comprehensive way.

We here propose a model of integrative psychotherapy that is based on the therapeutic alliance and the general principles of understanding and communication. It comprises interpersonal, behavioral, psychodynamic, and existential elements.

Theoretical principles of different psychotherapeutic schools are applied hermeneutically to a case of schizophrenia. Thus, general methods of psychotherapy gain contextual meaning by the analysis of an individual narrative. The patient himself assessed and approved his case report.

After remission of the acute symptoms, integrative psychotherapy played the major role in the recovery of a young musician. It is shown how the therapeutic alliance and communication in a general sense interacted with behavioral, cognitive, psychodynamic, and existential techniques. It is demonstrated narratively how recovery was facilitated, adjunct to pharmacological treatment, by method-integrative psychotherapy. Basic cognitive-behavioral techniques ensured at first the stabilization of the patient. Then psychodynamic remembering, repeating, and working through became possible. Finally, existential topics and creative solutions dominated the sessions.

Psychotherapeutic method-integration is necessary to treat patients with various mental disorders especially schizophrenia. We propose an ABCDE-Model that comprises the following principles: Therapeutic alliance (A); behavior change (B); cognitive reflection on dysfunctional meanings and beliefs (C); psychodynamic remembering, repeating, and working through (D); and existential understanding and communication (E).

Mindfulness-based cognitive therapy (MBCT) is a third wave cognitive-behavioral therapy (CBT) that incorporates meditation exercises in the classical, structured intervention. Mindfulness has been associated with psychological well-being, and certain symptoms that occur in major depressive disorder (MDD), e.g. worries, ruminations, ideas of incapacity or self-devaluation, are considered potential targets for MBCT.

To evaluate the current level of evidence for the MCBT efficacy in MDD.

A literature serach was performed in the main electronic databases, targeting clinical trials that evaluated in a randomized manner the efficacy of MCBT versus active comparators or placebo in patients with MDD.

MBCT was efficient in a 10-week randomized controlled trial (RCT) versus standard treatment, and it decreased ruminations, increased patients quality of life, mindfulness abilities, and self-compassion. In another randomized, 8-week RCT, MBCT prevented relapses in MDD, with similar rates when compared to psychoeducation and standard treatment. A 26-month follow-up study evidenced the persistence of symptoms improvement detected after 12 months of the trial, when compared to active control group and treatment as usual. MCBT was compared to cognitive therapy in a randomized 8-week trial, and both treatments had similar efficacy in MDD relapse prevention.

MCBT may be an useful adjuvant to the current treatment in acute MDD, but it may also decrease the risk of relapse after psychotherapy termination.

Suicidogenic effects COVID-19 pandemic are expected to reveal themselves not immediately, but within a longer period.

To evaluate the prevalence of suicidal tendencies in university students during the COVID-19 outbreak and specify the psychosocial characteristics of the students with a low anti-suicidal barrier to mitigate their suicide risks.

The research was done via an on-line survey, which covered 536 students of both sexes (aged 21.46±2.95), who studied in Russian universities and who filled in a structured questionnaire during their distance learning due to COVID-19 outbreak.

We revealed that 11.38% of the respondents (57.47% of whom are males) with a low anti-suicidal barrier showed suicidal tendencies by allowing the possibility of committing a suicide in a certain situation. Among them were more Russian students than international ones (p=.0272). They also certainly exceeded the students with the developed anti-suicidal barrier in taking alcohol (p=.0126), in underestimating their own health (p=.0053), in expressing happiness (p=.0001), and in degree of religious belief (p=.0001). They perceived the situation associated with the COVID-19 outbreak with a more strongly manifested anxiety due to the fear of their own infection with coronavirus (p=0.0347). At the same time, they acted less responsibly in following personal restrictive measures aimed to reduce the risk of infection (p=.0002).

Students with suicidal tendencies during the COVID-19 outbreak present a risk group in COVID-19 spread and infection. The pandemic can intensify anti-vital sufferings and enhance the risk of committing suicide in individuals with suicidal tendencies, which should be taken into account in prevention programs.

Family caregivers of psychotic patients are exposed to violence and stress. However, associated psychological outcomes are poorly characterized in this population.

The aim of this study was to clarify the relationship between violence directed towards caregivers of patients with psychosis and developing post-traumatic stress disorder (PTSD).

Participants were family caregivers of psychotic patients (n=95). They completed a questionnaire assessing sociodemographic characteristics. Sociodemographic and clinical data of patients were collected from medical records. We used the perceptions of prevalence of aggression scale (POPAS) to measure the frequency and severity of aggression directed at the respondent in the past and the Impact of Event Scale-Revised (IES-R) to evaluate PTSD.

A rate of 75.8% of caregivers reported experiencing moderate to severe levels of aggression. Decreased contact with patient (p=0.00), male gender (p=0.00), older age (p=0.00) and parent relationship (p=0.01) of caregivers, diagnosis of schizophrenia or schizoaffective disorder (p=0,00) and poor adherence to treatment (p=0,00) in affected relatives were associated with experiences of moderate–severe aggression. More than a half of caregivers (54.7%) reported potentially significant levels of PTSD which correlated with the level of aggression (p=0.00).

Our findings suggest that a large proportion of family caregivers of patient-initiated violence in psychosis reported experiencing a great distress and a high level of PTSD symptomatology. So, more attention should be paid to the support needs of caregivers who are faced with potentially life threatening aggressive behaviour by psychotic family members.

In the midst of a global pandemic with a rising death toll, the children´s mental health can be easily overlooked in the country’s response. But this overlook would have devastating consequences for years to come.

The objective of this research is to compare children’s physical and mental development before, during and after the situation of social isolation caused by the pandemic of COVID-19.

The parents/guardians of 100 children aged between 0 and 5 years and 11 months old were asked to answer questions based on the ASQ-3 (Ages and Stages Questionnaire III), containing questions related to Communication, Gross Motor, Fine Motor, Problem Solving, and Personal-Social and ASQ- SE (Ages and Stages Questionnaires Social-Emotional) addressing issues of self-regulation, compliance, social-communication, adaptive functioning, autonomy, and affect. In addition, behavioral issues related to children’s mental health will be included, such as: aggressiveness, insomnia, lack of appetite, apathy, sadness, tiredness, lack of interest, hyperactivity, manias, tantrum, morning among others. Child development data will be collected before and during quarantine / isolation and later, in a second stage, after the end of social isolation.

The data will be analyzed in order to characterize child behavior before, during and after the period of social isolation, correlating the different areas of child development, especially mental health.

As argued, socially isolated children are at increased risk of health problems in adulthood. Furthermore, studies on social isolation have demonstrated that a lack of social relationships negatively impacts the development of the brain’s structure.

No significant relationships.

Bipolar disorder is presumed to involve difficulties in emotion regulation. However, little is known about the specific emotion regulation profile associated with this disorder.

To study emotion regulation in bipolar patients in remission phase and to determine the factors correlated with it.

A cross-sectional, descriptive and analytical study of 30 patients followed for bipolar disorder in remission, at the psychiatric outpatient clinic at the Hédi Chaker University Hospital in Sfax. We used a socio-demographic and clinical data sheet and the Cognitive Emotion Regulation Questionnaire (CERQ) which assesses cognitive strategies (maladaptive and adaptive) for regulating emotion.

The mean age of the patients was 43.77 years, the sex ratio was 0.5. Bipolar I disorder was diagnosed in 93% of patients. A good adherence to treatment was found in 86.7% of cases and a good social integration in 40%. The mean total score of the adaptive CERQ was 66.73 and the most used adaptive strategy was acceptation (mean score =13.87), while the mean total score of the maladaptive CERQ was 36.7 and the most used maladaptive strategy was self blame (mean score =9.47). Adaptive cognitive emotion regulation was predominant in 93.3% of patients. It was significantly correlated with good adherence to treatment (p = 0.047) and good social integration (p = 0.026).

Our patients with euthymic bipolar disorder showed a satisfying level of adaptive emotion regulation strategies. A cognitive remediation seems important to embetter this capacity and improve the income of the disease.

No significant relationships.

Quality of life should be an important issue to everyone. In the general population and in various medical disciplines, this topic has been studied extensively. In forensic psychiatry, this topic has received little attention so far.

Within this project a questionnaire that measures the quality of life in forensic hospitals was developed.

As a basis the questionnaire measuring the quality of prison life (MQPL) by Liebling et al. (2011), which was designed only for using in prisons, was used. First, this questionnaire was translated, then adapted to the living conditions in forensic hospitals and supplemented by questions regarding therapeutic support. For the psychometric evaluation of the instrument, a one-time survey was conducted at 13 forensic hospitals in Bavaria. A total of 255 patients took part, 25 of whom were female. In summary, the reliability of the MQPL can be rated as very good.

The factor structure was checked with a confirmatory factor analysis and was confirmed. There are significant differences between the 13 Bavarian forensic hospitals in the subscales admission to a forensic hospital, equal treatment, quality of accommodation and therapeutic services.

The great importance of the quality of life in the penal system is shown by the fact that a good quality of life contributes to reduced psychological distress of inpatients.

No significant relationships.

No significant relationships.

Teenagers’ Internet addiction can be supported by a wide variety of Internet content.

To study the structure of the content consumed by Siberian adolescents with Internet addiction.

200 (69 boys and 131 girls) Internet addicted adolescents aged 11-18 years and living in the urban area of Central Siberia (Krasnoyarsk) were surveyed. Content consumption was studied using Game Addiction Scale for Adolescents and The Social Media Disorder Scale.

19.0% of adolescents were addicted to Internet games, 22.5% of adolescents were addicted to social media. A combination of both types of addictions was found in 23.5% of adolescents. Other types of content addiction was found in 35% of adolescents. Boys prefer Internet games (62.3% of boys vs. 32.1% of girls), while girls prefer communication on social media (55.0% of girls vs. 29.0% of boys), p <0.001. Combined addiction is observed equally in both sexes (23.2% and 23.7% respectively). For older adolescents, there is observed a decrease in the interest to Internet games (from 48.4% at 11-14 y.o. to 37.6% at 15-18 y.o.) and to social media (from 49.5% to 43.1%). At the same time, interest to other types of content is growing (from 27.5% to 41.3%).

Boys with internet addiction are more likely to be addicted to internet games, while girls are more likely to get engaged in social media. Older adolescents show a decrease in the interest both to Internet games and social media, while their interest to other types of content increases. The study was funded by RFBR project № 18-29-2203218.

The study was funded by RFBR project № 18-29-2203218.

The immediate antidepressant effect of Ketamine has become a breakthrough in the treatment of depression. Cytochrome CYP3A4 and 2B6 primarily metabolize Ketamine.

The present study explores potential pharmacokinetic and pharmacodynamic interactions of Lamotrigine and Ketamine.

A literature search was conducted using (“ketamine” OR “Lamotrigine” AND Interactions in PubMed, Embase, and PsycINFO. Our literature search resulted in 72 hits and result in qualified five studies.

We found five studies: one RCT study, a RCT, a crossover design, Two case reports, and one murine model study. In the first RCT conducted on 16 healthy normal volunteer subjects. lamotrigine significantly decreased ketamine-induced perceptual abnormalities (P < 0.001), positive (P < 0.001) and negative symptoms (P < 0.05), and learning and memory impairment (P < 0.05) which shows the counter effect of ketamine. Another study revealed Ketamine evoked increases in all the BPRS subscale scores, and all scores were lower after lamotrigine pretreatment. A case report from 2014 reports the failure of ketamine anesthesia in a patient with lamotrigine overdose. Another case report mentions that Lamotrigine reduced the craving in a patient with ketamine use disorder. A murine model study with lamotrigine showed improved PPI (Prepulse inhibition) ketamine-induced disruption. These results suggest that Lamotrigine may exert this effect via a glutamatergic system.

The literature review suggests that Lamotrigine interferes with glutamatergic neurotransmission reducing the effect of Ketamine. It is not clear how this may impact Ketamine’s antidepressant action. Future large scale and well-designed RCTs are required to confirm these findings.

No significant relationships.

There is an ongoing debate about the impact on mental health associated with Covid-19 pandemics. Some studies have shown an increase in depressive and anxious symptomatology in general population. It has been noted that young people might be among the highest risk populations due to various enviorenmental and developmental influences.

To estimate the impact of Covid-19 related restrictions on mental health measures among Latvian adolescents and young adults (14-24).

We conduct a survey on social media, recruiting 500 participants among the 14-24 age gropup. The survey consists of three parts: 1) sociodemographics; 2) quantitative mental health self-evaluation form; 3) open ended questionaire about the needs and expectations. For statistical analysis we use Excel software and use a regression analysis.

483 participants participated in our survey. The average age was 17.2, 62% was female, 36% male, 2% identified as trans. 52.3% reported decline in their mental functioning and wellbeing in one or several mental health domains (depression, anxiety, addictive behaviours) out of which 13.4% reported significant impairment in a major life area. The support and needs defined by respondents can be divided in three clusters: socialising outside immediate family, psychosocial services, recreational needs.

Confirming to findings in other EU countries, majority of adolescents and young people in Latvia have experienced clinically significant mental health decline during the Covid-19 pandemic. These results can help policy makers in establishing appropriate, needs oriented support in tackling this problem.

The need for preventive mechanisms in psychiatric pathology has been raised, therefore authors talk about primary, secondary and tertiary prevention. However, this emphasis on those preventive aspects has tended to ignore an essential part: quaternary prevention.

Reflecting the importance of avoiding ignoring iatrogenic forms of psychopathology by studying a clinical case and reviewing available literature.

We will present a clinical case of a patient with residual schizophrenia who undergoes an escalation of pharmacological interventions that lead to functional deterioration after initiating behavioral alterations. We will also review available literature about quaternary prevention.

M. is an institutionalized patient who was taking a combination of three neuroleptics, anxiolytics and stabilizers for the treatment of behavior problems such as heteroaggressiveness. When the patient was referred to psychiatry consultations after being hospitalized, he could not move, had lost sphincter control and had serious communication problems. However, treatment was suspended and only one neuroleptic was maintained. The patient regained sphincter control and kept a residual but communicative delusional speech.

It is important to see how sometimes we can get into therapeutic escalation without correcting the underlying problem by focusing on a symptom, because behavioral alterations will persist regardless of pharmacological treatment changes. Sometimes clinical fluctuations make us confuse basal state and decompensation, ignoring the fact that we lack the way to modify the course. Authors believe that a rational approach to treatment should take into account the balance between potential benefits and side effects applied to an individual patient.

No significant relationships.

Every year in the month of September, National Suicide Prevention Week is celebrated. The goal of suicide prevention week is to inform the public about suicide prevention, primarily the warning signs of suicide. However, the impact of this month on the general population is unknown. The Google trends show how frequent web searches have been performed for a particular search-term, which provide an approximation of the people’s interest.

To evaluate public interest in suicide prevention by analyzing the google trends of “Suicide Prevention” search-term.

We estimated the interest in such topics by running the google trends data of the last decade by using the filter [Search Term:“Suicide Prevention”, Locations: “United States” and Time Ranges “ 2010 to 2020”].

During this specific interval, people have searched “Suicide Prevention” most frequently during the month of September (month of National Suicide Prevention week). Conversely, in the other months, interest in “suicide prevention” fluctuated between little to none. The only other time people have shown interest in Suicide prevention, other than the month of September, was with suicide news in the media, such as the death of a celebrity by suicide, or suicide-related TV shows. [Figure]

Although it is not definitive, it gives some idea that National Suicide Prevention week has a considerable impact on population interest. Since we did not observe sufficient public interest in other months, there should be frequent and systematic efforts to spread suicide prevention awareness among the general population.

Discontinuity in child and adolescent mental health services (CAMHS) and adult mental health services (AMHS) constitutes an important challenge in mental health care. In the last decade, efforts have been made to better define the transitioning population and build consensual models for CAMHS-AMHS’ transition.

We aim to present our protocol and transition consultation results on the scope of published literature.

Description of protocol and casuistic of 18 months’ transition consultation at Centro Hospitalar Barreiro-Montijo. The literature found on PubMed was published from 2008 to 2020 and was reviewed using the keywords: transition, CAMHS, AMHS, adolescent, mental health service, young people. Articles with full text available written in English and French were selected. The included clinical studies focused on populations with neurodevelopmental disorders, psychotic disorders, non-suicidal self-harm and suicidal attempts.

Forty-four articles were included, published from 2008 to 2020. 4 articles were excluded on basis of language and diagnosis criteria (eating disorders). Twelve were reviews, 24 were clinical studies and 4 were opinion articles. There are cultural and referral issues that explain the loss of patients in this transition gap. Individuals with history of severe mental illness were more frequently referred than those with neurodevelopmental disorders. Optimal transition is defined as adequate transition planning with a flexible age cut-off and continuity of care following transition.

For the vast majority of service users, transition from CAMHS to AMHS is poorly planned, executed and experienced. Improving transition models is essential to the patients autonomy’ promotion and a stronger adult mental health.