Psychiatric intensive care units (or PICU’s) emerged to manage high acuity patients outside the justice system. Studies have sought to better understand characteristics of those admitted to forensic or civilian PICU’s. Few, in contrast, have explored the frequency and contributors to readmission. The following study was conducted on Apsley unit, a Forensic PICU based in Melbourne, Australia, and seeks to understand the differences which would allow early identification of patients likely to require readmission and the provision of targeted interventions.

Examine rates of and contributors to forensic PICU readmission over a 6-month period.

A retrospective audit was conducted to collect clinical, problem behaviour (and strategies to manage), forensic history and demographic information for consecutively admitted patients to an 8-bed forensic PICU between March-September 2019.

Data analysis is ongoing. Interim analysis found that 96 patients were admitted during the 6-month study period: 74 (77.1%) had a single admission; 22 (22.9%) required readmission. Almost all were admitted from prison (96.9%), most had a psychosis diagnosis (80.2%) and substance abuse history (96.9%), and many had a personality disorder (24.0%) and history of adolescent antisocial behaviour (46.5%). Patients requiring readmission were significantly more likely to have been previously under compulsory mental health treatment (95.5% vs 75.3%, p=.039) and have a Positive Behaviour Support Plan developed during admission (85.7% vs 54.8%, p=.010).

Interim analysis highlighted the multicomplexity for forensic PICU patients alongside the occurrence of problem behaviour during admission and history of compulsory treatment as indicators of increased risk for re-admission.

From the life cycle perspective, the aging is described as the strengthening of adaptive resources and the capacity for recovery or compensation for losses. These skills are grounded in the coping strategies that individuals apply in order to effectively adapt to diverse situations. Emotion-focused, passive coping strategies are considered to be maladaptive in the long term. These strategies are associated with affective disorders, being these phenomena of great impact in older adults.

Verify if there is a relationship between emotion-focused coping strategies and depressive symptoms

The sample was composed of 418 healthy older adults, aged between 60 and 89 years with an average age of 69.67 years and SD = 7.24, 63.6% of the participants are women and the remaining 36.4% are men. The Coping Stress Questionnaire was used to evaluate strategies focused on emotion (Sandín & Chorot, 2003). The Center for Epidemiological Studies-Depression Scale (Radloff & Teri, 1986) was used to evaluate depressive symptoms.

Depressive symptomatology showed significant associations with all emotion-focused strategies: negative self-focus (.339), open emotional expression (.279), avoidance (.202) and religion (113) with a significance level of 0.05.

Emotion-focused coping strategies are associated with depressive symptomatology. Thus, it is considered that the use of these types of strategies in times of change or challenge will not benefit adaptation in the older adult. It is necessary to develop more active coping strategies for prevention in mental health during aging.

No significant relationships.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease involving the production of autoantibodies with consequent involvement of multiple organ systems. Although not an uncommon condition, its pleomorphic neuropsychiatric manifestations imply consideration of SLE as a relevant differential diagnosis. As many as 50% of patients with SLE have neurological involvement throughout their disease course and it is associated with impaired quality of life, high morbidity and mortality rates.

Case report study and discussion.

The authors present a case of a 50-year old woman without previous psychiatric history presenting to the psychiatric department with suicidal ideation in association with psychotic symptoms of rapid onset. She presented with various somatic symptoms including butterfly rash, alopecia, nail dystrophy and generalized myalgia and arthralgia. After conducting a thorough clinical investigation with subsequent unveiling of various alterations including those in the antibody panels and abnormal magnetic resonance imaging results, a diagnosis of neuropsychiatric lupus was established.

Improvements in initial psychiatric symptoms were noted after completing pulse corticoid therapy for SLE with adjunct antipsychotic medication. On follow-up, the patient demonstrated a complete return to previous mental functioning with no reported relapses.

This case demonstrates the heterogeneous presentations that neuropsychiatric lupus can assume. The vast array of psychopathological signs and symptoms in SLE continue to exist as a significant diagnostic and therapeutic challenge. Timely identification resulting from a proactive approach in maintaining lupus as part of our differentials may prevent the significant morbidity and mortality commonly associated with the resultant central nervous system involvement in SLE.

No significant relationships.

Previous studies have shown that emotional eating is associated with binge eating disorder, body image disturbances and depression.

In this study we wanted to find out if there is a relationship between emotional eating and body image and life satisfaction in non-clinical sample.

The study involved 182 normal participants (153 Female, 29 Male, mean age 22,6 ± 7,3), which were recruited in Moscow, Russia. Emotional eating was measured by the opposite pole of Eating for Physical Rather Than Emotional Reasons subscale of Intuitive Eating Scale-2 (IES-2), body image was measured by Multidimensional Body-Self Relations Questionnaire (MBSRQ), Satisfaction with Life Scale (SWLS) was used to measure the corresponding construct. Correlation analysis was performed in IBM SPSS Statistics 22.0.

Emotional eating was associated with the following MBSRQ subscales: lower appearance evaluation (-0,431, p<0,0001), lower body areas satisfaction (-0,335, p<0,0001), as well as lower fitness evaluation (-0,208, p=0,005) and lower health evaluation (-0,182, p=0,014), but higher overweight preoccupation (0,279, p=0,0001) and overestimation of body weight (0,362, p<0,0001). It was also connected to lower satisfaction with life (-0,195, p=0,008).

The results of the study allow us to conclude that emotional eating may pose risks to psychological health of a normal individual. It was shown that emotional eating is connected to negative evaluation of one`s body appearance, fitness and health state, weight and shape concerns, and even to the lower level of satisfaction with one’s life.

Deficits in social cognition have been reported in people at ultra-high risk (UHR) of psychosis exclusively using socio-cognitive tasks and in adolescent and young adult mixed population.

Aim of this study was (1) to assess subjective experience of social cognition in adolescent help-seekers identified through UHR criteria, (2) to explore its significant correlations with psychopathology and functioning in UHR individuals; and (3) to monitor longitudinally its stability after a 24-month follow-up period.

Participants [51 UHR, 91 first-episode psychosis (FEP), and 48 non-UHR/FEP patients], aged 13–18 years, completed the comprehensive assessment of at-risk mental states and the GEOPTE scale of social cognition for psychosis.

In comparison with non-UHR/FEP patients, both UHR and FEP adolescents showed significantly higher GEOPTE total scores. After 12 months of follow-up, UHR individuals had a significant decrease in severity on GEOPTE “Social Cognition” subscore. In the UHR group at baseline, GEOPTE scores had significant positive correlations with general psychopathology, positive and negative dimensions. Across the 2-year follow-up period, social cognition subscores specifically showed more stable associations with general psychopathology and negative symptoms.

Social cognition deficits are prominent in UHR adolescents and similar in severity to those of FEP patients at baseline. However, these impairments decreased over time, presumably together with delivery of targeted, specialized models for early intervention in psychosis.

It is well-known that university students experience high levels of mental health problems (1). University life presents changes and challenges that can be stressful and may affect the mental health of its community (2,3). More than 20 years ago, the Social Affairs Service (SAS) of the University of Salamanca started a program that ensured the mental health care in their community. The Psychiatric Care Unit is part of this program and its objectives are: 1) to detect serious mental disorders; 2) treat mild mental disorders; 3) give information to prevent illness and promote mental health; 4) serve as support in patients with previous follow-up that has been discontinued due to the beginning of their studies; 5) liaise with referral psychiatrists.

To make known a Psychiatric Care Unit targeted in the university community

18 people between 19 and 52 years old (22% male, 78% female) were evaluated between November and December of 2020 in the Psychiatric Care Unit of the Social Affairs Service (PCU-SAS, University of Salamanca). The assessment consisted in an interview carried out by a psychiatrist, in the presence of a medical graduate. Every patient belong to the university community (students/ staff).

The most frequent diagnosis in the sample is Adjustment Disorder (F43.2). Substance use, eating disorders, low-self-concept, perfectionism and emotional dysregulation are very prevalent symptoms along our sample.

Universities should invest in creating environments that promote student and staff mental wellbeing. However, the current body of evidence is scarce and more research is needed to recommend what are the best strategies(4).

No significant relationships.

Childhood and adolescence sexual abuse (CSA) is a risk factor for psychological trauma and a strong predictor of lifetime psychopathology, including depression, anxiety, inappropriate sexual behavior, anger, guilt, shame and other emotional and relationship problems.

Describe a clinical case of a sexually abused adolescent admitted in a psychiatric unit for young adults and to correlate sexual abuse with trauma and sexual risk behaviors.

The data was collected through clinical and family interviews. The revision was made with the search terms “trauma”, “child and adolescence sexual abuse”, “sexual risk behaviors” in scientific databases.

16 year-old girl, high-school student, living with her nuclear family, was admitted in a psychiatric hospital with feelings of sadness and anxiety since the previous month, that lead to a voluntary medicine ingestion. She has been continuously sexually abused from the age of 12 to 16 by an older man, and once by her cousin and his friends. Since than, she refers feelings of anger, sadness, dissociative symptoms and intrusive images and nightmares related to the abuses, and continues to seek attention from older men. With medication and individual and family psychotherapeutic interventions, depressive, anxiety and dissociative symptoms have improved.

Literature concludes that there’s a strong correlation between CSA, trauma and sexual risk behaviors throughout adulthood. In fact, our patient met criteria for Pos-traumatic Stress Disorder and has sexual risk behaviors that must be worked through therapy. Due to it’s complexity, treatment of the adolescent and familial system after sexual abuse is multifaceted and requires a biopsychosocial approach.

No significant relationships.

The relationship of alexithymia with gambling addiction is not obvious, but it is present, as evidenced by the results of many studies. Alexithymia is likely to associate with gambling as a coping behavior to increase emotional arousal and avoid negative emotions, according to the affect dysregulation model. Alexithymic individuals experience the same spectrum of emotions as ordinary people, however, from the standpoint of psychology, psychiatry, unexpressed emotions are repressed into the subconscious, and their bodily manifestations accumulate.

We plan to conduct research to improve the medical and psychological support of patients with pathological gambling due to the presence of alexithymia.

A systematic search of the literature was run in the major reference databases including PubMed, Cochrane Database for Systematic Review, Web of Science, Scopus until 2019. All studies assessed alexithymia with the Toronto Alexithymia Scale while gambling problems were assessed mostly with the South Oaks Gambling Screen.

We assume that for pathological gamblers, specific psychotherapeutic techniques like body-centered psychotherapy could help them to differentiate feelings from bodily sensations.

The results highlight the importance of taking in the relationship between alexithymia and pathological gambling. Further studies are needed to widen the knowledge of this association.

After the first case of Covid-19 was emerged in Turkey on March 11, 2020, schools were closed distance education began. On March 21, curfew was declared for people who under the age of 20. Subsequently, the date of the nationwide university exam was changed twice.

This study has two aims. The first goal was to investigate the factors that affect the test anxiety of individuals who will enter the university exam during the Covid-19 outbreak. The second aim was to investigate whether the test anxiety levels of the participants vary according to the level of cognitive flexibility and self-regulation.

The study consists of 420 (284 women, 131 men and 5 others). The age range of the participants was between 18 and 21, with the mean of 18.33. Exam Anxiety Scale, Adolescent Self-Regulation Skills Scale and Cognitive Flexibility Scale were used to collect data.

The findings indicated that women’s level of test anxiety was higher than men. Those who do have concentration issues in distance education have high level of test anxiety. Test anxiety was higher for students whose household income decreased because of the pandemic. MANOVA results revealed that individuals with low test anxiety have higher ‘self-regulation successful’ scores and lower ‘self-regulation unsuccessful’ scores. Moreover, it was yielded that people with low test anxiety have higher level of cognitive flexibility.

Protective factors such as cognitive flexibility and self-regulation play an important role in individuals’ management of test anxiety.

No significant relationships.

ECT is a potentially life-saving treatment for patients with severe or treatment resistant depression. Cognitive function disturbances following ECT are generally transient, but could be of longer duration in some cases

To assess the cognitive side effects in patients with affective disorders treated with a course of electroconvulsive therapy (ECT).

Cognitive functions of patients who undergo ECT was assessed prior to start of treatment, midway of the course of treatment and after end of the course of treatment using Montreal Cognitive Assessment (MoCA). We did a retrospective analysis of MoCA scores of 15 patients who received bilateral ECT in 2017-2018. In order to assess the efficacy of ECT in the treatment of their illness, we did a retrospective analysis of Montgomery Asberg Depression Rating Scale (MADRS) scores of 18 patients who received bilateral ECT in 2017-2018

Only 7% of the patients who underwent ECT in our sample did have significant cognitive decline as per their MoCA scores. 28% of patients achieved complete remission in their depressive symptomes. 22% of patients continued on maintenance treatment. 95% of patients showed significant improvement in their symptoms following treatment with ECT where there symptoms reduced to either mild or minimal depressive symptoms.

Cognitive side effect was not a significant side effect in our sample of patients. We did see an improvement in cognitive function in a significant number of the sample of patients as they progressed with treatment, which coincided with improvement in their affective symptoms.

No significant relationships.

The aim of the present study was to investigate emotional regulation and attachment in adolescents with anorexia nervosa (AN).

Anorexia Nervosa (AN) is an eating disorder (ED) characterized by self-starvation driving by weight, shape, and eating concerns and extreme dread of food, eating, and normal body weight. Dysfunctional emotional processing and regulation play an important role in the development and maintenance of eating disorders (EDs). Difficulties with emotional awareness and regulation in EDs are hypothesized to have their origins in childhood attachment.

The study population (N=20) consists of two research groups of patients with AN (group A) and general population controls (group B), matched for gender and age. The age of patients was 12-18 years. All adolescents were female. This study examined the attachment states of mind, assessed by the Adult Attachment Interview (AAI), and emotion regulation difficulties, measured by the Difficulties in Emotion Regulation Scale (DERS).

Group A reported significantly higher attachment insecurity (82% vs 50%) than group B. Group A show higher DERS total (nonacceptance, goals, and impulsivity scores) than group B.

Study results show a crucial role of attachment insecurity and emotional dysregulation in the development and maintenance of AN. Developing interventions to improve emotional management skills in the treatment of patients with AN can be an important component in improving treatment outcomes.

Cultural differences exist among indigenous and mainstream peoples about the nature of mind and how one achieves mental health.

We aimed to determine what is important and different for indigenous communities from non-indigenous communities.

We assembled a focus group of 109 indigenous and non-indigenous mental health counselors who worked in indigenous communities to meet weekly for 90 minutes via an internet platform (Zoom) for 810weeks with asynchronous communication between meetings.

The metaphor of the Four Directions, represented with different colors, attributes, and animals, was important in indigenous communities. Participants emphasized the idea of relational, non-local mind which places identity in the relationships between people rather than an individual body. Illnesses were seen as conscious beings who visit people and bring teachings. The healing, participants said, comes from reaching within the suffering and the pain to find the answer from within which makes meaning from an illness. People are expected to make offerings and sacrifices to the spirit of the illness to move toward wellness. These sacrifices can include lifestyle changes that the person might otherwise not make. Using substances without the proper protocols and prayers was likened to sorcery or witchcraft which can become a powerful incentive to stop disrespecting these substances and to find meaning in setting them aside with the help of a supportive community.

What participants saw as important for indigenous populations was different from what is usual for non-indigenous mental health services. Participants stressed the importance of non-indigenous providers understanding this and not dismissing these ideas.

This systematic review and meta-analysis fills a lacuna in the existing literature on the prevalence of mental disorders (MD) among young people (YP) in Europe.

This study sets out to estimate the pooled prevalence (PP) of ASD, ADHD, Conduct Disorder (CD), Oppositional Defiant Disorder (ODD), Anxiety Disorder (AD), Depressive Disorder (DD), Eating Disorder (ED), Substance Use Disorders (SUD) and the PP of any of these MD, among 5-to-18-year-old YP living in Europe, based on prevalence rates established in the last five years (LFY).

A search strategy was created following the SPIDER model and conducted on three databases. Studies were also identified from reference lists and grey literature. Eligible studies were evaluated for bias. Trends of prevalence rates across countries, gender and level of education were analysed. The random effects pooled prevalence rate (REPPR) for each MD and for any MD was calculated.

The European REPPR for any mental disorder among YP is 15.5%, translating to almost 1 in 5 YP. ADs are the most common group of MDs with a REPPR of 7.9%, followed by ADHD, ODD, MDD and CD, with REPPR of 2.9%, 1.9%, 1.7% and 1.5% respectively.

A range of challenges towards good mental health are portrayed, including diagnostic limitations, poor awareness on MD, and socioeconomic inequality. It is recommended that these challenges are tackled, and routine screening and early intervention services are developed to improve early identification and prompt treatment. Achieving these goals may positively impact individuals and societies at large, both now and in the future.

The process of emotional regulation allows the patient to deal with various situations throughout life, since it includes the ability to create and control emotions, in order to guide action and interaction with others. However, people with alcohol use disorder (AUD) is not always able to give appropriate responses to surronding situations in the face of certain specific emotions.

We aimed to evaluate the use of emotional regulation strategies in people with AUD.

A descriptive and correlational study was conducted. A sociodemographic questionnaire, that included variables to assess aspects related to AUD, and the Emotion Regulation Questionnaire were used.

The sample had 25 participants, mostly male, average age of 46.68 years. 44% were married, and most cases had an withdrawal time larger than 3 months. Regarding emotional regulation strategies, it was found that the participants resort more to cognitive reassessment (M=26.59,SD = 7.54), compared to emotional suppression (M = 15.16, SD = 5.03). Statistically significant differences were found between genders in relation to cognitive reassessment (U = 29.00; p = 0.02). No correlations were found between withdrawal time, treatment time, cognitive reevaluation and emotional suppression.

Results show differences between gender, and the absence of a relationship between educational qualifications in cognitive reassessment, contradicting previous findings on general Portuguese population. This data points to the need to implement intervention programs in this population, taking into account the gender variable, and including the development of the ability to identify and express emotions, as well as of strategies to deal with emotional aspects.

The work presented in this talk was conducted during a PhD in computer science (funded by APHP and Paris 8 University, France). A company was funded by a PhD collaborator, dynamico.ch. The presenter does not have consultancy or financial connection with d

Empathy is generally viewed as a “positive” trait, while the Dark Triad traits are regarded as a “negative” side of a Dark personality. The perception of Risk is less univocal, as it plays a role in both courage and questionable behavior.

We posed the following research questions: 1. Is risk linked to empathy and the Dark Triad traits? 2. Which traits help distinguish between participants with contrasting latent profiles (determined cumulatively for the specified personality variables)?

Participants (n=250) completed three questionnaires: the Dirty Dozen, Personality Factors of Decision-making and the Questionnaire of Cognitive and Affective Empathy (QCAE). Correlation and Latent profile analysis (LPA) were performed.

Risk was linked to Machiavellianism, psychopathy, and decentration (positively) and to emotion contagion and affective empathy (negatively). Rationality was positively correlated with cognitive empathy. Machiavellianism correlated negatively with rationality and online simulation (a cognitive empathy subscale). Empathy subscales were linked to psychopathy (negatively) and to narcissism (positively). LPA established two latent profiles: the smallest BIC value was obtained for the model with two profiles (log-likelihood: -3204.013, df=77, BIC=-6833; VEE). Analysis of means revealed that Class 1 was characterized by significantly higher Dark Triad values and higher Risk, whereas Class 2 was characterized by lower Dark Triad traits, lower Risk, and higher Rationality (see Figure 1).

Figure 1. Latent profile analysis

The Dark Triad traits and Risk are the more discriminative variables, while Empathy subscales do not help distinguish between the two classes of participants. The study was supported by the Russian Foundation for Basic Research, project 19-29-07069.

Long-acting injectable (LAI) antipsychotics are related to proven compliance to treatment and more constant medication levels (hence the apparent lower side-effect burden).

To highlight the experience with LAI antipsychotic treatment during pregnancy.

Literature review.

Seven cases are reported. A 35year old with schizophrenia received zuclopenthixole LAI (mostly 200mg/monthly) during both her pregnancies (of healthy girls born at weeks 39 and 40). A 35year old with schizophrenia was under risperidone LAI (25mg/2 weeks) and gave birth to a healthy girl at week 37. Another 35year old (probably with schizophrenia) was on olanzapine LAI (300mg/month during the last quarter of her pregnancy) that led to the birth of a healthy girl at week 40. A 37year old with schizophrenia received paliperidone LAI (100mg/monthly, last injection at week 28) and gave birth to a healthy boy at week 39. Paliperidone LAI (50mg/monthly) was the treatment of another 34year old with schizoaffective disorder that gave birth to a healthy boy at week 40, as well as of a 26year old (263mg/3-monthly), mother of a healthy boy as well (born at an unspecified week of pregnancy). Finally, a 43year old with bipolar disorder was on aripiprazole LAI (300mg/monthly) during her pregnancy that led to the birth of a healthy girl at week 40.

All pregnant women on LAI antipsychotic treatment gave birth to (apparently) healthy babies. LAI doses were mostly low. Long-term follow-up could clarify eventual delayed aftereffects. Based on the literature, LAI antipsychotic treatment could be considered as an option for selected pregnant patients.

No significant relationships.

In the Danish social welfare system, few people are homeless solely for economic reasons. In fact, 38% of homeless people suffer from both substance use and a psychiatric disorder, making diagnostic assessment and treatment difficult. This patient group, with dual diagnoses, often fail to receive effective treatment, and the consequences are far reaching and detrimental. A more comprehensive grasp of the history and patterns of substance use in these patients may contribute to improve their treatment.

To identify the role and patterns of substance use in mentally ill, homeless people.

50 homeless, mentally ill patients are examined in comprehensive interviews, exploring the relationship between substance use, homelessness, and suffering from a mental disorder. The data are analyzed quantitatively as well as qualitatively using thematic analysis.

Preliminary results indicate that substance use in mentally ill homeless patients is a complex phenomenon. On the one hand, substance use seems to contribute to keep the patient homeless and makes it difficult for the patient to get the necessary psychiatric help. On the other hand, substance use also appear to play an important part in coping with life on the streets by offering some kind of social contact and some relief from a desperate situation.

It seems that the triad of substance use, mental illness, and homelessness somehow reinforce each other and simultaneously locks the situation. New approaches for disentangling this locked situation and avoiding this ‘Bermuda triangle’ is needed.

Coronavirus disease 2019 (COVID-19) pandemic has had a negative impact for mental health. ULS-Guarda in cooperation with Portugal National Health Service, provided the population of the district of Guarda with a mental health helpline (MHHL).

Provide a descriptive data analysis of the MHHL calls received between April 1st and September 20th of 2020.

The data was obtained through the filling out of questionnaires. It included fields for gender, age, the type of service provided, relation to COVID-19, symptoms displayed and the number calls made per patient. For the statistical analysis, Microsoft Excel TM was utilized.

MHHL received 191 calls. The largest volume was received during April, which saw 116 instances of patients seeking the MHHL. The number of calls then tapered progressively throughout the following months. The services provided were split between psychiatric assistance, psychologic assistance, and the renovation of medical prescriptions, in 44%, 31% and 19% of the cases, respectively. The 101 patients who resorted to the MHHL were unevenly distributed in gender, being 74 female and 27 male individuals. Their ages were mostly between 50 and 69 years old. The most common symptoms were anxiety, depressed humor and insomnia, in 35%, 16% and 11% of the cases, respectively.

The largest influx of calls coincides with the home confinement period, and decreased alongside the relaxation of the confinement measures held. The MHHL had enough adherence to warrant consideration of it being an alternative means of healthcare access, especially in situations where physical access to healthcare is restricted.