The study of gender-related peculiarities of vertebral pain syndrome course in order age patients appears to be highly relevant.

Study population included 46 female patients and 38 male patients in the age between 60 and 75 years old; mean age was 67,4±6,6 years old.

Pain syndrome intensity was assessed using the visual analogue scale (VAS), vegetative disfunction was assessed using A.M. Wayne Questionnaire; the Toronto Alexithymia Scale

The conducted comparative study showed that the male patients perceived the pain syndrome as more intense as compared to the female patients in lumbar spine: 4,5 ±0,8 vs 3,6±0,5 scores (р <0,001) and in thoracic spine: 4,1 ±1,0 vs. 3,4±1,0 (р <0,05). On the other hand, in vegetative dysfunction assessment, the male patients demonstrated generally lower score: 43,3±7,5 scores vs. 59,6+10,3 in female patients, р <0,001. The results of correlation analysis pf interrelations between alexithymia and pain intensity revealed the differences between the study groups in emotion recognition accuracy (Mann-Whitney U-test = 109,00, р = 0.09): female patients showed lower scores (60,7 ±3,5) as compared to the male patients (74,2 ±2,1).

Therefore, the vertebral pain syndrome tends to be more pronounced in older age male patients as compared to the similar population of older age female patients. Therefore, vertebral pain syndrome correction requires multidisciplinary approach, including psychotherapeutic support.

With the spread of the coronavirus pandemic, there has been the dissemination of an enormous amount of information, through multiple channels, from different sources and with an often unverifiable basis (infodemic). In recent years, there has been debate in the literature about the possibility that different information channels (social media vs traditional media) can determine a more or less extensive emotional contagion regardless of the severity and direct exposure to the stressful event and more precisely through a ‘secondhand’ exposure to events.

We want to investigate whether the information channel or the amount of time dedicated to the update is associated with greater psychological sequelae.

This study is based on a cross-sectional online survey conducted anonymously in the period between the tenth and seventeenth day of shelter in place in Italy. We used Zung Anxiety Self-Assessment Scale and Perceived Stress Scale 4. SPSS 21.0 was used for data analysis.

We collected data on 1047 individuals. In our sample, the Internet was the primary health information channel (55%) followed by TV (36%). Most TV and internet users spend about 1-3 hours a day for the update. There was no correlation between the time spent or the information channel used and higher levels of stress and anxiety.

In our opinion, this relationship between the time spent receiving information or the most widely used information channel and psychological disorders is not clear. Is it the news channel causing an emotional contagion or are the most anxious people looking for news anywhere and anytime?

No significant relationships.

The outbreak of the Covid-19 epidemic in Tunisia has led a total confinement startingfrom March 23rd, 2020. Remote interventions of psychiatrists and psychologists have been set up to help tunisiancitizens. The requestsconcerned panic attacks, acute stress disorder, sleepdisorders and relapse of some patients followed for mooddisorders, obsessive compulsive disorder or anxietydisorders.

We propose to present 3 types of interventions by apsychiatrist in response to the request of 3 Tunisiancitizensin this first experience.

We will summarize three interventions with the history of each patient and his or herrequest as well as the short term evolution of the presenteddisorder.

As a first experience, weresponded to numerousrequestsfrom people of all ages and living all over Tunisia. The first intervention concerned a lady whowasvolontarilyvomiting in order to maintainhercurrentweight.Shewasafraid of having the covid infectionrelated to a sore throat. The second situation is a gentleman whodid not toleratehome confinement because for 20 yearshe has been going out for adailywalk at exactly 4 pm. The thirdrequest came from a father living in a rural area who chose to self isolate in his room and refused to go out and seehischildrendespitetheir pressing demand. We offered active listening, reassurance and behavioural psychotherapy techniques.

Duringthis first experience in Tunisia, wefoundthatcitizens haveadhered to new communication techniques. Anxiety, stress and relapse of priormedical conditions were the mostfrequent diagnoses. Several interventions have proven to be effective despite obstacles related to teleconsultation.

No significant relationships.

As Dame Cecily Saunders said, “How people die remains in the memory of those who live on.” For Muslim people, funerals and burial procedures are crucial moments that help them come to terms with the loss of a loved one. The COVID-19 pandemic has disrupted usual experiences of grief since funerals and burials are held without the presence of family. Approaches to support grief are needed to be adapted to these particular circumstances.

Describe the lived experiences of grief of the Muslim Tunisian family for patients who died due to COVID -19.

This was a qualitative study with a phenomenological approach. Data of patients who died due to COVID -19 were collected. One family member or more of each deceased was contacted. Semi directive interview was conducted to help participants to describe the lived experience.

30 persons participated in this study. The reactions of participants towards death were crying, being sad, and being choked. The reactions of grief were influenced by several factors. These included: the circumstances of the deceased, relationship with him, the hospitalization in an intensive care unit, doctors’ expectation, and the average length of stay in hospitals before the death. Islamic religious beliefs influenced the way family experienced grief, mainly toward the management of the dead body and the imposed funeral protocol.

This study describes the devastating impact of COVID-19 toward lived experiences of grief of Muslim Tunisian. In light of these results, grief therapies should be adapted and evaluated in this population.

No significant relationships.

The emergence of COVID-19 changed the lifestyle of individuals through the appearance of lockdown. This period seems to have potential effect on some health determinants related to behaviors such as drug addiction.

Compare the prevalence and behavior of drug consumers before and during the lockdown.

A cross-sectional study was carried out on 1001 Moroccan addict between April and July 2020, using two international questionnaires: The global drug survey “Special Edition on COVID-19” and the survey on impact of COVID-19 on patients and families.

before lockdown, tobacco use (80.2%), alcohol (70.9%), cannabis (46.3%). During lockdown: tobacco consumption remains unchanged (80.7%), alcohol and cannabis consumption reduced significantly, respectively (39.6%) and (40.8%). Results show also the weaning of hallucinogens and solvents. 76.3% decreased their use, the raisons behind these changes were: 39.8% worried about health issues, 26.6% have less opportunities to consume, 23.7% think that the current life style make it difficult to use, 23.4% think they have less ability to obtain drugs.

The lockdown seems to be an opportunity for addicts to reduce drugs consumption. However, setting up support services with targeted interventions is the best chance to decrease psychological stress and avoid the consequences of this reduction.

We present the case of a 56 year old woman with a diagnose of Complex Partial Seizures since her teenage years, with a history of multiple hospitalizations in the psychiatric ward of our hospital and a challenging clinical evolution.

To review the different kinds of psychotic disorders that may arise in relation to epilepsia.

Literature review of scientific papers and classic textbooks on the issue, including references in both Spanish and English languages.

From 2008 to 2011 our patient was hospitalized with episodes of different clinical features leading to different diagnoses (in 2008 the episode was compatible with a maniac phase and led to a diagnosis of possible Bipolar Disorder, in 2010 dissociative-like symptoms became more prominent and led to a diagnose of Dissociative Identity Disorder and in 2011 the symptoms pointed to an interictal depression), and a subsequent symptomatology that made clinicians consider a diagnose of unspecified schizophrenia. From 2015 to 2020 our patient suffered multiple decompensations resulting in up to six new hospitalizations, with psychotic symptoms in the shape of auditive hallucinations being consistent and affective symptoms varying widely. This evolution suggests a plausible diagnose of interictal chronic psychosis with bipolar-like affective episodes.

An extensive review of the available scientific literature shows, as so does this case, that along the course of an epileptic disease both schizophrenia-like psychosis and affective psychosis may arise, and that those might be divided along the categories of peri ictal and inter ictal disorders.

No significant relationships.

Persons with substance use disorders (SUD) smoke at strikingly high rates and tobacco use cessation rates are notably low in this population. Contingency Management (CM) is effective to promote substance abstinence, including tobacco, in a large range of populations. CM is scarcely implemented in clinical settings mainly due to barriers at the therapist and organizational levels.

The study sought to examine the additive effectiveness of CM on Cognitive-Behavioral Therapy (CBT) over long-term smoking abstinence in persons undergoing SUD treatment.

A total of 54 smokers (75.9% males, Mage=46.19, SD=9.21) were randomly assigned to CBT (n=30) or to CBT+CM (n=24). Interventions consisted of eight weeks of group-based therapy. Participants were instructed to gradually reduce their nicotine intake by 20% weekly. The CM arm was voucher-based, and the primary outcome was biochemically verified tobacco abstinence (CO≤4ppm, and urine cotinine≤80ng/ml).

A total of 42/54 (77.78%) participants completed the treatment (73.33% in CBT and 83.33% in CBT+CM; p=.380). At the end of treatment, participants in CBT+CM showed higher 24-hour smoking abstinence (50% vs. 20%, p=.032); however, both treatment conditions show equal abstinence rates in the remaining follow-ups (CBT1month= 13.33% vs. CBT+CM1month= 25%; CBT2months= 10% vs. CBT+CM2months= 16.66%; CBT3months= 10% vs. CBT+CM3months= 16.66%; CBT6months= 10% vs. CBT+CM6months= 8.33%; all p-values ≥ .244).

CM facilitates early abstinence outcomes in smokers with SUD more than CBT only does. However, no additive effects of CM were observed at long-term, suggesting the convenience to intensify CM schedules or using technology platforms for incentives delivery.

No significant relationships.

Clinical studies had shown a correlation between mindfulness and changes in the immune response. Other studies had observed an interaction between sensory neurons and neuropeptide-mediated immune response.

This research aims to provide theoretical support to carry out a clinical study based on psychoneuroimmunology.

For this, An epistemological analysis of the concepts of autopoiesis and evocative body was carried out to explain the self-conformation of the organism.

The result of this analysis indicates that the autopoietic process of the organism can be experienced from the three levels proposed by the concept of the evocative body (preontological, ontological and logical). It is posible to generate a nexus between the preontological and the logical in the autopoietic process through the ontological level. Mindfulness is the tool through which it is possible to access the ontological and thus express the preontological in the logical, thereby generating the theoretical possibility of being able to influence our therapeutic process.

This analysis supports the concept of the self-management in health as a measurable therapeutic tool in a clinical study.

No significant relationships.

Preeclampsia is a new-onset hypertension with new-onset proteinuria after 20 weeks gestation. Scarce evidence regarding psychiatric effects of preeclampsia is available.

To describe a case of a pregnant 24 year-old patient with a premature cesarean section in context of severe preeclampsia and dissociative symptoms.

Patient referred to a third-level hospital for cesarean section due to a severe preeclampsia at week 32, in whom magnesium sulfate, labetalol perfusion and betamethasone are started. In the puerperium period only labetalol up to 300 mg/6h is maintained.

Due to the appearance of pulsating headache and photophobia, a computerized tomography is conducted, showing bilateral insular and occipital hypodensity related to vasogenic edema. High blood pressure is maintained (177/121 mmHg) despite antihypertensive treatment. A magnetic resonance imaging and an ophthalmologic exam do not show significant abnormalities and blood pressure is stabilized with treatment. However, the patient refers new-onset auditory imperative hallucinations and suicide thoughts, being referred to our Acute Psychiatric Ward for clinical assessment and intervention. Treatment with risperidone 2 mg is started. The day after her admission, she does not refer psychotic symptoms, explaining depersonalization symptoms in the previous 5 days, seeing herself having to choose a knife to commit suicide. After discharge, she maintains reiterative dreams in which she falls down from a building, not presenting dissociative symptoms during the day.

Further evidence regarding psychiatric effects of preeclampsia is needed in order to study the consequences of edema and pharmacological treatment. Blood pressure and psychiatric symptoms monitoring after preeclampsia should also be considered.

No significant relationships.

It is necessary to consider the religious worldview and spiritual needs of patients with mental illness in the course of psychotherapy and rehabilitation.

The explication of value-meaning formations (VMF) in mental patients with a religious worldview.

G. Kelly’s methodology of personal constructs (Method of Triads, Hinkle’s laddering technique, the assessment repertory grid by F.Fransella&D.Bannister) and statistical analyses were applied.

1. The structure of the value-meaning formations (VMF) of patients with religious worldview was characterized by its integrity, which is prerequisite for coping. 2. Opposite, patients with absence of religious belief had substantial destruction of integrity and plurality of relationships between VMF. 3. The content of the VMF of mental patients with religious worldview and healthy believers had similarities. 4. In the content of VMF meta-values were: 1. active aspiration to God and the realization of own existence; 2. material well-being in the earthly world; 3. “unselfish” ability to get along without causing harm; 4. feeling of inner confidence.

Mental disease affects VMF of believers and unbelievers in different way. In unbelievers, the structure of VMF in the course of disease significantly changes. In believers, the disease does not destroy the basis of VMF and allows to keep safe the key elements. The stability of VMF in the believers may be explained by the meaningfulness of life. The concepts of “health” and “disease” are included in the worldview of believers, in the general context of their spiritual, psychic and physical life.

No significant relationships.

Europe’s drug situation is facing an increasing trend.

To compare the psychoactive substance use pattern in Romania and Hungary.

Data was collected from the electronical databases of the 3rd Psychiatry Clinic of Cluj County Emergency Hospital, Cluj-Napoca, Romania and from the Psychiatry Department of Kenezy Gyula Hospital Debrecen, Hungary. We included adult patients who had at least one hospital admission for mental and behavioral disorders due to psychoactive substance use between 01/01/2013 and 31/12/2016.

96 patients from Romania (80.2% males, mean age 27.8 years (18, 82)) and 816 from Hungary (71.93% males, mean age 47 years (18, 90)) were included. Romanian patients consumed more opioids (31.52% vs 4.34%, p<0.05 Chi-square Test), cannabinoids (66.3% Ro vs 13.04%, p<0.001 Chi-square Test), and synthetic drugs (declared 73.91% vs 8.21%, p<0.001 Chi-square Test), an underlying personality disorder (52.08% vs 34.06% p=0.001 Chi-square test) was more often diagnosed. Hungarian patients consumed more alcohol (89.46% vs 30.43%, p<0.001 Chi-square Test), a comorbid bipolar disorder (18.75% vs 5.2%, p=0.001 Chi-square Test), a major depressive disorder (40.8% vs 16.6% p<0.001, Chi-square Test) or an anxiety spectrum disorder (55.26% vs 7.29%, p<0.001 Chi-square test) were more often diagnosed. Overall, more than 85% had a dependence use pattern, more than 65% having multiple admissions.

Romanian drug users are younger, prefer opioids, cannabinoids and synthetic drugs and have more often a comorbid personality disorder than Hungarian patients, who consume more alcohol and have a comorbid affective disorder.

Sport trauma is a stressful situation demanding not only physical but also psychological rehabilitation (Clement et al, 2015, Ardern et al, 2012) including prevention of mental health symptoms. Revealing coping strategies that are related not only to rehabilitation effectiveness but also to well-being of athletes is important for rehabilitation programs (Crowther et al, 2017, Hamson-Utley, Vazquez, 2008, Johnston, Carroll, 1998).

The aim was to reveal coping strategies that are related to better well-being in athletes after trauma after adjusting for trauma perception.

61 athletes (15-25 years old, 31 males) rehabilitating after sport trauma filled COPE with specific instruction about trauma (Carver et al., 1989), Illness Perception Questionnaire (Moss-Morris et al., 2002) modified for trauma situation, Satisfaction with Life Scale (Diener et al., 1985), Scale of Positive and Negative Experience (Diener et al., 2009).

After adjusting for subjective trauma representation humor related to trauma predicted better satisfaction with life (β=.43, R2=43.7%). Active coping with trauma was related to more positive emotions (β=.31, R2=9.8%) while emotion venting, substance use and lower instrumental support are related to negative emotions (β=.39, β=.24, β=-.29, respectively, R2=30.5%), although these effects eliminate after adjusting for trauma representation.

Humor, active coping and instrumental support as well as control of emotion venting and substance use could be helpful strategies of promotion of better well-being in athletes after sport trauma. Research is supported by the Russian Science Foundation, project No. 19-78-10134.

Research is supported by the Russian Science Foundation, project No. 19-78-10134.

No significant relationships.

Synthetic Cannabinoids were recognized as drugs of abuse since 2008, they are sold under various names (Kush, K2, Spice).

The Patient N., 17 years old male was admitted to the hospital with a first-time psychotic episode. He is fond of extreme sports (ski jumping, gymnastic and acrobatic elements).

The patient was fully examined.

Then he was taken to the admission department. About a week before admission he fell, injuring his leg and head. After that he did not sleep, became excited, aggressive, “said strange things”. During the admission patient showed disorganized behavior, agitation, paranoid ideation, beliefs that others were inserting thoughts into his head (“thought insertion”) and that his thoughts could be read by others (“thought broadcasting”), imperative “voices”, bizarre delusional thoughts. The UDT showed positive K2 analysis. The patient was prescribed Diazepam, Zuclopenthixol, Valproic acid. No improvement observed. Haloperidol was prescribed next day. Then Haloperodol was changed to Quetiapine, and after 10 days of treatment no improvement was observed. The patient started to show catatonia symptoms such as elective mutism, mild rigidity, signs of cog-wheeling or clasp-knife rigidity. He experienced anxiety, fear, did not take care of himself. Every day he started to be aggressive, impulsive, started to experience auditory hallucinations. Due to that fact it was decided to prescribe Haloperidol, Chlorpromazine, Phenazepame, Diphenhydramine.That treatment improved behavior.

Thus, the intensive treatment with antipsychotic medications in combination with benzodiazepines and diphenhydramine is much more preferable for the management of the cases of oneiroid catatonia due to the usage of Spice.

Despite innovative treatments, the impairment in real-life functioning in subjects with schizophrenia (SCZ) remains an unmet need in the care of these patients. Recently, real-life functioning in SCZ was associated with abnormalities in different electrophysiological indices. It is still not clear whether this relationship is mediated by other variables, and how the combination of different EEG abnormalities influences the complex outcome of schizophrenia.

The purpose of the study was to find EEG patterns which can predict the outcome of schizophrenia and identify recovered patients.

Illness-related and functioning-related variables were measured in 61 SCZ at baseline and after four-years follow-up. EEGs were recorded at the baseline in resting-state condition and during two auditory tasks. We performed Sparse Partial Least Square (SPLS) Regression, using EEG features, age and illness duration to predict clinical and functional features at baseline and follow up. Through a Linear Support Vector Machine (Linear SVM) we used electrophysiological and clinical scores derived from SPLS regression, in order to classify recovered patients at follow-up.

We found one significant latent variable (p<0.01) capturing correlations between independent and dependent variables at follow-up (RHO=0.56). Among individual predictors, age and illness-duration showed the highest scores; however, the score for the combination of the EEG features was higher than all other predictors. Within dependent variables, negative symptoms showed the strongest correlation with predictors. Scores resulting from SPLS Regression classified recovered patients with 90.1% of accuracy.

A combination of electrophysiological markers, age and illness-duration might predict clinical and functional outcome of schizophrenia after 4 years of follow-up.

In adolescents, both non-suicidal self-injuries (NSSI) and previous suicidal attempts (SA) represent significant risk factors for future suicide. Thus, the search for EEG markers of these forms of auto-aggressive behavior seem to be an actual task.

The aim of the study was to reveal the differences of baseline EEG features in depressive female adolescents with auto-aggressive behavior such as NSSI or SA.

The study included 45 depressive female in-patients aged 16–25 years. 21 of them showed only NSSI (NSSI subgroup), 24 patients had a history of SA (SA subgroup). Subgroups did not differ in clinical and social-demographic parameters. Baseline EEG spectral power (SP) and its asymmetry were measured.

SA subgroup had higher parietal-occipital alpha-2 (9-11 Hz) SP than NSSI subgroup. Its focus was located in the right hemisphere, and alpha-3 (11-13 Hz) SP was higher than alpha-1 (8-9 Hz). In contrary, in NSSI subgroup alpha-1 SP was higher than alpha-3; and foci of alpha-2 and alpha-3 SP were localized in the left hemisphere.

Spatial distribution and the ratio of EEG alpha frequency components SP in the SA subgroup reflect greater activation of brain cortex, especially of the left hemisphere that is more typical for EEG of individuals with increased risk of suicide. In NSSI subgroup, the right hemisphere is relatively more activated that is more typical for EEG in depression without SA. The study supported by RBRF grant No.20-013-00129a.

No significant relationships.

Bipolar disorder in children and adolescents is distinguished by a variable and complex clinical expression. Mood is difficult to assess, mood symptoms are often masked and signs of disorganization may be in the limelight. This can be more difficult when adolescents have intellectual disability (ID).

This work aims to describe diagnostical and therapeutical features of bipolar disorder in adolescents with ID.

Case reports about five patients who have been diagnosed with bipolar disorder associated to ID, all seen and treated in child and adolescent psychiatry department of Razi Hospital, in Tunis.

The study focused on three girls and two boys, all with mild to moderate ID. Four patients had psychiatric family history of bipolar disorder and ID. Only one patient was followed since childhood for mixed ADHD. The average age of onset of bipolar disorder was 14 years. Four cases were inaugurated by manic access; the fifth was a depressive disorder followed by a manic shift under sertraline. Only one case was rapidly favorable, under 10mg of Olanzapine, without any recurrence or relapse during 18 months of follow-up. Another case was slower but also favorable, under 10mg of Olanzapine. We found resistance to usual treatments for 2 patients; these did not evolve well under conventional thymoregulators, or different antipsychotic molecules, nor with combinations of two thymoregulators + an antipsychotic. One of them benefited from a combination of clozapine and lithium with excellent response.

Bipolar disorder comorbid with ID in adolescents is a difficult diagnostic entity and particularly hard to manage.

No significant relationships.

Care givers of patients with severe mental disorders have been shown to be under heavy stress burden that reflect itself through various heterogenous psychiatric symptoms that may mimic PTSD with associated negative impact on interpersonal relations and work performance

to assess the prevalence of PTSD symptoms among care givers of patients with severe mental illness

70 patients care givers of sevely mentally ill patients compred to control 70 care giver of patients with chronic debilitating medical illness were recruited from outpatient of the university hospital outpatient facilities, random selection. Severe mental illness was defined by Global assessment of function GAF score above 50 and duration exceeding 2 years. Both groups were subject to Zarit burden interview to assess stress burden and post traumatic stress diagnostic scale PDS to assess PTSD symptomats

43% of care givers of severly mentally patients showed moderate to severe burden on the Zarit scale compared to only 10% among care givers of medically ill patients, this difference was statistically significant (p<0,001). Among care givers of severly mental patients showed moderate to severe score on post traumatic stress diagnostic scale compared to 0% among those taking care of medically ill patients. this difference was statistically significant (p<0,001)

Stress burden among care givers of patients with severe mental illness is high and may manifest symptoms of post traumatic disorder. This highlight the importance of particular psychological support and assessment among care givers of patients with sever mental illness

No significant relationships.

Rape resulting in pregnancy warrants special attention due to the associated psychosocial and physical adversities. There are no guidelines for the management of teenage pregnancies resulting from rape in Sri Lanka.

This case series aims to describe the experience of four teenagers who became pregnant as a result of rape in Sri Lanka.

This is a case series of 4 pregnant teenagers who became pregnant as a result of rape

This case series highlight the deficiencies in services in Sri Lanka such as lack of legal framework to terminate pregnancy following rape, delay in legal procedure leading to prolonged institutionalization of pregnant teenager, not giving the teenage mothers the choice of breastfeeding and lack of awareness about the psychological consequences of rape and teenage pregnancy.

Formulating a national guideline on managing rape related pregnancy in teenagers in Sri Lanka, with the involvement of all stakeholders is a need of the hour.

No significant relationships.