Triple Network Model (TNM), which considers the dynamic interaction between Default Mode (DMN), Salience (SN), and Central Executive (CEN) networks, explains clinical features in mental disorders from a neurophysiological perspective. Some studies highlight the increased connectivity in TNM in adults with Borderline Personality Disorder (BPD), but little is known about adolescents.

The aim of our preliminary study was to investigate TN functional connectivity (FC) in BPD adolescents with a history of traumatic experiences, and its correlation with dissociative symptoms.

15 BPD adolescents (DSM-5 criteria) with early traumatic experiences were compared to 15 healthy controls, matched for sex and age. Dissociation Questionnaire (DIS-Q) was administered. Eyes-closed resting-state (RS) EEG recordings were performed (19 electrodes; 10- 20 system) and analyzed using Exact Low-Resolution Electromagnetic Tomography software (eLORETA). FC was computed for all frequency bands and 9 Regions of Interest for TNM.

BPD adolescents showed a hyper-connection between CEN and DMN [dorso-lateral prefrontal cortex (dlPFC) and posterior cingulate cortex (PCC); PCC and left posterior parietal cortex (PPC)] and within the CEN (left and right PPC). The strength of PCC-dlPFC and left-right PPC connections was correlated with dissociative symptoms severity.

FC alterations can already be identified in BPD adolescents, supporting the need for early diagnosis. Normally DMN and CEN show opposite functioning. In our BPD adolescents, the absence of this “anti-correlation” reflects the typical confusion between internal and external mental states, which clarify their difficulties in metacognition or mentalization. Moreover, in dissociative symptoms, two CEN nodes are also involved, not only DMN as previously described.

No significant relationships.

Australia has a universal health insurance scheme covering part costs for private mental health care and which supports the public system. The Medical Benefits Schedule (MBS) schedule provides a recommended fee for each service, the amount the Australian Government thinks the service should cost. Many patients still pay a gap fee for the service. Similarly a system for medications, the Pharmaceutical Benefits Scheme (PBS) subsidises the cost of medicines for most medical conditions. As new evidence emerges in the treatment of psychiatric conditions, it is important that the MBS and PBS are updated so patients receive subsidised best practice treatment.

To provide an overview of RANZCP efforts to expand treatment availability through evidence and advocacy to government.

The RANZCP made submissions to the independent Medical Services Advisory Committee (MSAC) requesting an MBS listing for repetitive transcranial magnetic stimulation (rTMS) for treatment of antidepressant medication-resistant major depressive disorder. Submissions were made to the independent Pharmaceutical Benefits Advisory Committee (PBAC) to request ability to prescribe quetiapine in 25mg ranges for maintenance therapy.

Following RANZCP submissions, the MSAC supported public funding for initial treatment with rTMS for adults with major depression who have tried antidepressant medicine or psychological therapy and remain unwell. The PBAC has recommended changes allowing prescription of 25mg quetiapine tablets for maintenance therapy for acute mania, bipolar 1 disorder and in the treatment of schizophrenia following RANZCP submission.

The RANZCP has achieved access to treatments to provide optimal symptom relief for people living with mental illness.

Psoriasis is a chronic inflammatory skin condition affecting diverse racial/ethnic groups throughout the world. It has a major impact on the patient’s quality of life, influencing career, social activities, family relationships, and all other aspects of life

To evalue the quality of life in patients with psoriasis

Participants were outpatients of Hedi chaker University Hospital Center in sfax, Tunisia, recruited between January and July of 2017, diagnosed with psoriasis. A Demographic questionnaire and the Quality of life Questionnaire (SF-36) were administered in this study.

44 patients were included in this study. They had with a mean age of 45.8 ±12.1. The majority of patients were married (70.5%), unemployed (40.5%), without medical heredity (84,6%). Psoriasis was in plaque (65.9%), guttate (20.5%) and pustular(13.6.5%). Its severity assessed by BSA, was mild to moderate in 72.7% of cases and associated arthropathy was noted in 29.5% of patients. The overall average SF-36 scale scores for all patients ranged from 4 to 98 with an average of 55.97. The quality of life of patients was impaired in 45.5% of casesQuality of life was significantly more impaired in patients with associated arthropathy (p=0.004). There is no significant differences for the different dimensions of quality of life regarding the clinical form of psoriasis.

Psoriasis certainly has an impact on patients’ quality of life.So, dermatologists should give special attention to this subgroup of persons in order to prevent future psychopathology.

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.

Craniocerebral injuries are serious traumatic situations

Aim of this study is to present cases of deppresive disorders after mild craniocerebral injuries in young females

8 cases are presented. Range of age between 15 and 30 years old. All of them reported depressive disorders during the post traumatic period after mild craniocerebral injuries mainly due to road traffic accidents.

All of them they receive appropriate neurological, psychiatric, psycological and rehabilitation support and treatment. They managed to have a good outcome after 12 months follow up.

The development of depressive disorders after such traumatic events remains a strong predictor of a variety of difunctions (social, personal, work etc). The emergence of depressive disorders in many cases remains unexplored and poorly understood. The effect into the the overall health remains a very important factor to investigate. The combination and collaboration of the various medical disciplines is essential in order to help young people.

No significant relationships.

The H2020/PERISCOPE project, including 32 partners from European universities & agencies, began 1st November 2020 and will last 36 months. The overarching objectives of PERISCOPE are to map and analyse the unintended impacts of the COVID-19 outbreak; develop solutions and guidance for policymakers and health authorities on how to mitigate the impact of the outbreak; enhance Europe’s preparedness for future similar events; and reflect on the future multi-level governance in the health as well as other domains affected by the outbreak. During this session we will report about early lessons learnt from the mapping and assessments of the impacts of the COVID-19 outbreak on mental health at national and subnational level in the EU with respect to individuals, communities and societies. Further, we will comment on their comparability. The aim is to explore differences between countries regarding the occurrence of mental ill health, and especially the impact on vulnerable groups, and how this is related to exposure to SARS-CoV-2, differences in policies over time, and effects on the economy. We will reflect on the short- and long-term consequences on mental health and health inequalities, report on the ongoing development of holistic policy guidelines for health authorities & other authorities, and from the analysis of multilevel governance, at local, regional and national level, memberstate – EU-level, and EU - global governance level. PERISCOPE will continue collecting data and updating a common data ”Atlas”, which would lead the consortium to engage in modelling and experiments to provide “continuous nowcasting” of the outbreak.

No significant relationships.

Schizophrenia is a chronic mental disorder that has a significant impact on quality of life satisfaction in patients with schizophrenia.

The objective of this study was to examine the impact of socio-demographic factors and psychotic symptoms on quality of life satisfaction in patients with schizophrenia.

Participants were outpatients of Hedi chaker University Hospital Center in sfax, Tunisia, recruited between January and July of 2019, diagnosed with schizophrenia or schizoaffective disorder. A Demographic questionnaire, the Positive and Negative Syndrome Scale (PANSS) and The Quality of life satisfaction and enjoyment Questionnaire (Q-LES-Q) were administered in this study.

50 patients were included in this study with an average age 40,80 ±9,7. The majority of patients were single (72%), unemployed (60%), without medical heredity (80%) and living with their families (92%). The average score of the positive symptom scale (PANS) was 17.46 (SD = 9.1), the negative symptom scale (PANS) was 12.35 (SD = 7.4) and the psychopathological scale (PANS) was of 27.83 (SD = 14.7). the higher the score of the positive symptom scales (p <10-3) the negative scale score (p <0.002) and the psychopathological scale (p <0.001) was high, more the quality of life satisfaction score has been altered.

Improving the quality of life satisfaction of these patients through these different parameters could be a goal of care complementary to the objectives of traditional care.

Substance use disorder, depression and sexual minority are well documented risk factors for suicidal behaviour, far less is known about behavioural addictions.

First, to explore associations between behavioural addictions (gaming, gambling, cybersex, internet, smartphone, work) at age 25 and the incidence and reoccurrence of suicide ideation (SID), suicide attempts (SAT), and suicide attempts among those with suicide ideation (SATID) at age 28. Second, to test whether these associations were impacted by adjusting for cannabis and alcohol use disorder, nicotine dependence, sexual orientation and depression.

Based on two waves of a prospective cohort study of 5,428 young Swiss men, nested models with and without adjustment for risk factors were used to regress SID, SAT and SATID on preceding behavioural addictions.

Without adjustment, each of the behavioural addictions at age 25 significantly predicted the incidence of SID and SAT at age 28. Gambling and cybersex addiction furthermore predicted SATID. When adjusting for other risk factors, associations with behavioural addictions were reduced, whereas depression and cannabis use disorder were the most important and consistent predictors for the incidence and recurrence of SID, SAT and SATID.

Among young Swiss men, behavioural addictions are important predictors of SID and SAT, however a large part of their association is shared with depression and cannabis use disorder. Treatment for addictive behaviors, especially cannabis use can open the door to larger mental health screening and targeted intervention. Crisis intervention among men presenting addictive behaviours with or without substance may therefore be key to preventing suicidal behaviour.

No significant relationships.

Emotion self-regulation relies both on cognitive and behavioral strategies implemented to modulate the subjective experience and/or the behavioral expression of a given emotion.

While it is known that a network encompassing fronto-cingulate and parietal brain areas is engaged during successful emotion regulation, the functional mechanisms underlying failures in emotion suppression are still unclear.

We analyzed facial-view video and high-density EEG recordings of nineteen healthy adult subjects (26±3yrs, 10F) during an emotion suppression (ES) and a free expression (FE) task performed on two consecutive days. An actigraph was worn for 7-days and used to determine sleep-time before each experiment. Changes in facial expression were identified and manually marked on the video recordings. Continuous hd-EEG recordings were preprocessed using standard approaches to reduce artifactual activity and source-modeled using sLORETA.

Changes in facial expression during ES, but not FE, were preceded by local increases in sleep-like activity (1-4Hz) in in brain areas responsible for emotional suppression, including bilateral anterior insula and anterior cingulate cortex, and in right middle/inferior frontal gyrus (p<0.05, corrected; Figures 1 and 2). Moreover, shorter sleep duration the night prior to the ES experiment correlated with the number of behavioral errors (p=0.01; Figure 3) and tended to be associated with higher frontal sleep-like activity during emotion suppression failures (p=0.05).

These results indicate that local sleep-like activity may represent the cause of emotion suppression failures in humans, and may offer a functional explanation for previous observations linking lack of sleep, changes in frontal activity and emotional dysregulation.

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.

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.

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.

The prevalence of adult Attention Deficit and Hyperactivity Disorder (ADHD) has been investigated in the general population by multiple studies. However, few studies have focused on identifying its prevalence in the military population, particularly among military parents of children with ADHD.

The aim of our study was to screen for adult ADHD among military parents of ADHD children followed-up at the child and adolescent psychiatry department in the Military Hospital of Instruction of Tunis, Tunisia.

This prospective study was carried among military parents (one or both parents belonging to the national army) of ADHD children. Children were diagnosed with ADHD based on the 5th Diagnostic and Statistical Manual ADHD criteria and the Conners Comprehensive Behavior Rating Scale. Whereas adult ADHD was screened for using the Adult ADHD Self-Report Scale-V1.1.

Fifteen children and twenty-nine parents were included in the study: sixteen of the parents were military members and thirteen were civilian spouses. Eight (50%) of the sixteen military parents, and four (30,7%) of the civilian spouses were screened positive for ADHD. Whereas 73% of these children had at least one parent screened positive for ADHD, and 53% had at least one military parent screened positive for ADHD. These results suggest a high prevalence of adult ADHD among this population.

ADHD occurs in childhood and may persist into adulthood. The findings of this study indicate that ADHD symptoms are not limited to the youth and are common in military population. Implications on screening, management, preventive measures and research should be discussed.

E-cigarette use has increased over the last years. Many studies have examined teenagers’ attitudes towards smoking, but did not examine adolescents’ attitudes towards e-cigarettes.

The aim of this study was to examine high school students’ attitudes regarding e-cigarette safety, addictive properties and social norms and to compare e-cigarettes perceptions among e-cigarette users and non-users in Tunisia.

A survey was conducted with a sample of 234 students in Mohamed Ali high school in Sfax, a town in South of Tunisia, in February 2020. Socio-demographic data and questions about vaping and attitudes towards e-cigarettes were used to evaluate students’ perceptions towards e-cigarettes.

Among high school students aged 15 to 20, 58,8% have ever used e-cigarette, 38,3% had done so within the previous 30 days and 20,5 % were regular users of vapes. 53.8% of students believed that e-cigarettes are harmful. 78.4% of them thought they were less harmful than regular cigarettes and 50.5% thought they could be addictive, 45.4% of students believed e-cigarette smoking decreased anxiety and a third thought it made them sociable (33.3%) and confident (30.6%).Adolescents who used e-cigarettes had significantly more favorable e-cigarette attitudes than non-users: they believed they were less harmful than tobacco (p=0,019), they were not addictive (p=0,005), they decreased anxiety (p=0,001) and they made the user sociable (p<0,001) and confident (p=0,01).

Our results suggest the need to provide teenagers with the correct information about e-cigarettes risks, and the balance risk-benefit of their use.

No significant relationships.

Burnout occurs in every stage of a medical graduation and career. In the first years of graduation, is affects 35-45% of medical and dentistry students. This has severe consequences, such as: higher levels of suicidal ideation, substance abuse, medical errors and medical neglect; lower levels of empathy and self-compassion - essential to the quality of healthcare. Students with certain personality traits (e.g., neuroticism and, particularly, perfectionism) are more vulnerable to emotional dysregulation when facing stressors of daily life. Our recent studies proved that mindfulness and self-compassion can attenuate the effect of perfectionism on psychological distress.

To present the rational, materials, methodology and preliminary results of our project COMBURNOUT, aimed to develop, implement and assess the efficacy of a mindfulness and self-compassion-based intervention to prevent burnout in medical and dentistry students.

Students with high levels of burnout, psychological distress and perfectionism will be randomly assigned to intervention (8 weekly sessions) or control groups. The sessions will be composed by psychoeducation about burnout, mindfulness and self-compassion practices, within and between sessions. The follow up will include three assessment moments until a year after the intervention.

We expect that the experimental group will present significantly lower levels of burnout, psychological distress and perfectionism, and higher levels of emotional regulation skills.

The facilitators training and the manualization are guaranties of standardization and sustainability. If the positive impact of COMBURNOUT is verified, we intend to provide the program to medical/dentistry students from all over the country.

N-acetylcysteine (NAC) is a precursor of cysteine and glutathione, widely known as an antidote to paracetamol overdose. Its role as precursor of an antioxidant and modulating agent of glutamatergic, dopaminergic, neurotropic and inflammatory pathways, raised interest in its application in psychiatric disorders. NAC emerges as a promising therapeutic agent in substance use disorders (SUD) and provides a treatment option in a field with limited and suboptimal therapies.

To describe the use of NAC in SUD (tobacco, cocaine, cannabis, methamphetamine and alcohol), its potential mechanisms and clinical application.

The literature was searched using the Pubmed database with the following keywords “N-acetylcysteine”, “Substance use disorders” and “Psychiatry”. Retrieved papers (2011-2018) were selected according to their relevance.

SUD results in disruption of glutamate system, in nucleus accumbens, a critical brain area in the rewarding system. NAC reestablishes glutamate homeostasis restoring function of the cysteine-glutamate exchange in glial cells and reversing the downregulated GLT-1 receptor. Concerning its properties, evidence suggests that NAC is able to decrease drive, craving or compulsion to consume, making it particular useful in relapse prevention after achieving abstinence.

NAC has revealed itself as a promising therapeutic agent in SUD and its safety profile and favourable tolerability, as well as being an over-the-counter medication, adds to its interest. Data is still preliminary for the use of NAC in psychiatry disorders, due to the relatively small number of trials and their heterogeneous methodology. Larger studies are needed to confirm efficacy, optimal doses, long-term tolerability and side effects.

Assessing mentalizing abilities is a complex issue. Only recently an instrument assessing mentalizing capacity as a whole, the Reflective Functioning Questionnaire (RFQ), has been developed.

To reach the purpose of our study, we investigated the psychometric proprieties of the Italian version of the RFQ.

The study was conducted on a sample including a group of violent offenders and a group of community participants. All subjects fulfilled the RFQ, the Personality Inventory for DSM-5 (PID-5) and the Aggression Questionnaire (AQ).

The theoretical model was defined and analysed by using Partial Least Squares–Path Modelling with high-order construct definition. Data showed good psychometric proprieties of the Italian version of the RFQ. Also, specific patterns of correlations were identified between the RFQ subscales and both PID-5 and AQ scores. Offenders significantly differed from controls only in relation to one subscale of the RFQ.

Data supported the factorial structure of the RFQ found in the original validation study. Results also support the existence of a second-order variable, mentalizing, resulting from the convergence of hypomentalizing and hypermentalizing.

Children in a prodromal state manifesting as truancy or social isolation (hikikomori) often complain of problems that are physical in nature and are subject to significant changes. We developed the Child Psychosis-Risk Screening System (CPSS) that incorporates childhood psycho-behavioral characteristics revealed through a retrospective survey of schizophrenia patients into its algorithm.

Our research aimed to test the risk identification of pediatric and psychiatric clinic outpatients using the CPSS.

We conducted an epidemiological study involving 204 outpatients between the ages of 6 and 14 years who had been examined at a pediatric or psychiatric clinic using the CBCL and clinical data from medical charts. Logistic regression analysis and T-tests were performed using each clinical data variable to clarify the risk of the CPSS calculated from the CBCL data and contributing factors.

The results of the logistic regression analysis demonstrated that the diagnostic category (physical illness or DSM-5 diagnosis) and chief complaint did not contribute to differentiate between the high-risk and low-risk groups. Meanwhile, the environmental factors of “abuse” and “social isolation” did contribute to the discrimination of the two groups.

The fact that the diagnostic category during childhood does not contribute to the discrimination of the high- risk group warrants attention. It is possible that the high-risk group only had a latent endophenotype that had not yet manifested during this period. The factors suggested to have an association with the high-risk group may be reflecting activators and the dynamic state of the critical period for psychosis.

No significant relationships.

Climate and weather have a great influence on the prevalence of depressive disorders. Selected physical parameters for instance light, temperature and pressure can be used to treat mood disorders.

The present mini-review aims at approximating the mechanisms by which selected, strictly controlled physical parameters in particular light, temperature, and oxygen pressure can help in the treatment of depression and determine their potential effectiveness.

Relevant literature was identified by searching the PubMed/Medline database, by combining the search strategy of free text terms and exploding a range of MESH headings relating to the topics.

Mechanisms that can modify the course of depression were briefly presented. Review of the literature showed the well-established position of bright light therapy (BLT) effective in treating seasonal (SAD) and non-seasonal affective disorders (non-SAD); safety and rapid-action of whole-body hyperthermia (WBH) and whole-body cryotherapy (WBC) were also demonstrated; the least data was available on hyperbaric oxygen therapy (HBOT), which had antidepressant properties only in people with concomitant neurological damages.

In addition to the well-established position of BLT in the treatment of depression, further research is needed on other methods, such as WBH, WBC, HBOT.

No significant relationships.

The identification of potential biomarkers is crucial to improve the management and treatment of mood disorders. Glycogen synthase kinase-3 (GSK-3) is a multifunctional enzyme with an important role in the etiology of mood disorders. Recent findings suggested GSK-3 as a putative biomarker in mood disorders.

The aims of the study are: - to evaluate GSK3 as potential biomarker for differential diagnosis (MDD and BD); - to analyze the regulation of GSK3 by psychopharmacological treatments.

Patients included fulfill the following criteria: (a) principal diagnosis of MDD or BD (DSM-5); (b) age ≥ 18 years; (c) drug-free for at least 4 weeks before the inclusion. For each patient included a healthy control is enrolled, matched by gender and age. All included subjects at the study entry point (t0) are assessed through: - semistructured clinical interview and clinical rating scales (Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale; Young Mania Rating Scale, Clinical Global Impression) - blood draw, to measure GSK-3 levels Patients with MDD or BD are assessed again after 1 week (T1) and after 2 month (T2) of specific pharmacological treatment.

So far, we enrolled 16 patients and 16 healthy controls. The enrollment is still ongoing.

We expect to find GSK-3 levels differently expressed between healthy controls, patients with DDM and patients with BD. This finding would be crucial as it could contribute to the improvement of differential diagnosis. Moreover, we expect to observe a change in GSK-3 levels after psychopharmacological treatments.