Cyberchondria is a pathological behaviour linked to excessive online searching of health information.It is frequently associated with health anxiety. It may be regarded as an compulsive behaviour secondary to obsessions about a real or an imagined illness. The coronavirus pandemic of 2019 has brought about a fear of getting infected. In the absence of a definitive cure, the focus largely lies on stringent preventive measures and early diagnosis. Known to present with diverse symptoms, fear of coronaviral infection makes affected individuals search for symptoms on internet for reassurance. Added misinformation further increases stress,anxiety and confusion.

The authors attempt to describe cyberchondria and highlight its increased prevalence during the coronavirus pandemic.

5 cases from different backgrounds were seen in the outpatient clinic during the months of April-July 2020.Consent was obtained from subjects before the study.They were clinically diagnosed with obsessive-compulsive disorder and exhibited cyberchondria in the background of the pandemic.

All of the described 5 cases had prominent fear of contracting or having contracted coronavirus disease-19.All of them were found to have significant scores rang on Yale-Brown Obsessive-Compulsive Severity Scale(ranging from 25-35) and improved after a trial of selective serotonin reuptake inhibitors.

The emergence of cyberchondria during the coronavirus -19 pandemic warrants further introspection.Changes in policy-making to prevent misinformation and present health information in a simple way to prevent confusion in the lay public is a necessity to tackle this problem in the near future.

Huntington’s disease is typically an inherited neurodegenerative disorder with autosomal dominant transmission. Early disease symptoms can include depression and behavioral changes, while physical and cognitive symptoms become evident later. Suicide and suicidal ideation are more frequent in these patients than on the general population. We present the case of a 50-year-old female patient with a history of depression and suicidal intents previous to her diagnosis. The patient committed suicide approximately 20 years after the beginning of her psychiatric symptoms.

To report a clinical case of early psychiatric symptoms and suicide in Huntington’s disease; To raise awareness for these comorbidities and for an adequate intervention in suicide prevention.

The information was obtained by interviewing the patient and her family and by reviewing past medical reports. A brief literature review using the keywords “suicide”, “Huntington´s disease” and “psychiatric symptoms” was performed on PubMed.

The patient had a history of depression and five hospital admissions for suicidal intents during the ten years prior to the diagnosis. After the diagnosis and the beginning of physical symptoms, she maintained suicidal ideation until she committed suicide ten years later.

This clinical case underlines the importance of being alert for early psychiatric symptoms of Huntington’s disease, especially if considering the patients’ probability of developing it. It also reinforces the need for suicidal ideation regular assessment and for pharmacological and non-pharmacological targeted therapy. Further investigation should be taken to understand which factors increase the risk for suicidal behavior and which moments during disease progression are crucial for prevention.

No significant relationships.

Post-Intensive Care Syndrome (PICS) is a physical, cognitive, emotional and functional condition resulting from prolonged stays in ICU (Intensive Care Unit). In pathologies with clinical characteristics similar to SARS-CoV-2 pneumonia, most patients showed cognitive deficits after discharge from ICU. Further studies are needed on verbal fluency impairment among PICS patients.

To analyse the phonological verbal fluency in patients with PICS after COVID-19 infection in a Functional Rehabilitation Unit in Madrid (Spain) using the Spanish version of the Screen for Cognitive Impairment in Psychiatry (SCIP-S).

This study was conducted in the Hospital Central de la Cruz Roja, in Madrid (Spain). A sample of 17 PICS adult patients was included, with age ranging from 56 to 74 years old (mean = 68.35 years; 13 males). Patients were assessed around three weeks after referral from their reference hospital. The Verbal Fluency Test (VFT) of the SCIP-S was used as outcome. Descriptive analyses were conducted (mean and standard deviation) on standardized scores (z) based on age-adjusted general population norms. Significant impairment was set at z < -1.5.

Mean z-score on VFT was -.53 (S.D. = .74) from the total sample, with 11.8% of cases with significant impairment (mean = -1.60; S.D. = .00).

These preliminary results show low probable presence of impairment on phonological verbal fluency among PICS patients after COVID-19 infection, which is in accordance with previous empirical studies. Longitudinal studies, with larger samples, are needed where the premorbid cognitive level is considered.

No significant relationships.

The Strengths and Difficulties Questionnaire (SDQ) is one of the most widely used screening instruments in child and adolescent psychiatry. Studies have shown that the parent is a better informant than the adolescent, both for externalising and internalising disorders (Goodman et al, 1997, 2000).

Aim of this study was to examine the prevalence of parent and adolescent reported internalising problems in outpatient child and adolescent psychiatry setting using SDQ and examine the differences between parent and adolescent reports.

The study group was 101 adolescents (11-17 y.o.) and their parents, in 2 outpatient psychiatric care centres in Latvia. Internalising problems were assessed using SDQ parent and self-report version. When analyzing the score, 3rd and 4th band were defined as “high”.

The mean age of adolescent population was 14,04 years (SD 1,96) and N=54 were female. 60,4% of parents and 52,5% of adolescents reported high level of peer problems, 63,4% of parents and 51,5% of adolescents reported high level of emotional problems. Parent and adolescent report results were concordant in two thirds of cases. Adolescents reported high emotional and peer problems in 9% and 14% of cases respectively, when their parents did not. And on the contrary - 22% of parents reported high level of internalising problems when the adolescent did not.

More than half of reports showed high levels of internalising problems. Every fifth parent reported a higher level of internalising problems than their adolescent. This agrees with previous findings that single informant (parent) reports might be more informative than multi-informant reports.

Since COVID19 pandemic emergence, containment measure have been taken by the Tunisian government imposing a new lifestyle resulting in psychological repercussions and a change in behavior.

Highlighting changes of behavior and lifestyle of the general public secondary to the COVID19 pandemic and to confinement and to assess their levels of psychological.

This is a qualitative, descriptive and analytical cross-sectional study realized between April and May 2020 with the general public using an anonymous online questionnaire covering: socio-demographic data; behavior during confinement; epidemic psychological impact; Mental health status was measured using Depression, Anxiety and Stress Scale(DASS-21). Anger level was assessed by STAXI-10 items.

132 responses were received: 68.2% were women; the average age 32.01(±11.10); half were single; 77.3% were at higher education level; 41.7% were healthcare professionnels. Consumption increased by 26.5% in coffee, 8.3% tobacco and 1.5% alcohol. 33.3% of participants increased their religious practice. 56.1% experienced sleep disorder mostly women(p<0.05). 91.7% followed COVID19 evolution through media essentially Facebook. Partners relationship was deteriorated in1.7% and improved in 25%. Child abuse increased by 13.7%. During confinement: 15.9%depression (0.8%severe depression), 12.9%anxiety (0.8%severe anxiety), 5.3% stress and 27.3%feelings of anger. Depression, anxiety and anger were related to younger age(p<0.05). Stress wasn’t age related. Depression was observed in participants without children (p<0.05). No association founded between psychological impact and gender, profession and civil status.

The COVID19 pandemic and the containment had consequences on individuals behavior and mental health. A psychological listening unit was launched during the period of confinement to overcome psychological impact.

Treatment representation is an important factor of motivation and well-being during treatment (Horne, 2002).

The aim was to reveal the relationship between treatment representation and well-being in oncological patients first referred to chemotherapy.

40 oncological patients (10 males, 20-72 years old, mean age 50.49±13.75 years old, localizations included gastrointestinal tract and genitourinary system) first referred to chemotherapy filled Satisfaction with Life Scale (Diener et al., 1985), Scale for Positive and Negative Experiences (Diener et al., 2009), Hospital Anxiety and Depression Scale (Zigmond, Snaith, 1983) and Beliefs about Medication Questionnaire (Horne, 2002) that was slightly modified for the situation of chemotherapy. Disturbance of functioning was assessed in the interview as an opportunity to cope with job, home responsibilities or self-care (1-5-point Likert scale).

Cronbach’s alphas for Necessity and Concern scales were .69 and .76. Despite high appraisals of necessity of chemotherapy (mean 4.24±.53 on 1-5 Likert scale), concern about it was rather high (2.83±.82). Hierarchical regression analyses revealed that, after adjusting for disturbances in social functioning, concern about chemotherapy (but not its subjective necessity) predicted more severe negative emotions (β=.32, p<.05, ΔR2=10.0%). After control for general level of anxiety and depression, this relationship became weaker but marginally significant (β=.32, p<.10, ΔR2=8.4%).

Concern about chemotherapy in patients first referred to this treatment could be important predictor of well-being demanding for interventions aimed at stabilization of emotional reaction to chemotherapy regardless belief in its necessity.

Psychotic-like experiences (PLEs) are often referred to as psychotic experiences, such as hallucinations and delusions, in the absence of a psychotic disorder. PLEs as part of the continuum of psychosis suggested that healthy population can endorse PLEs without having significant distress or impairment which would warrant them a clinical diagnosis. While PLEs are usually associated with psychotic disorders, previous research has also shown the link between PLEs and many other mood symptoms.

The present study aims to identify PLEs in community youths and explore the underlying risk and protective factors.

This is an ongoing study in which young people aged 15-24 were recruited from community through a random stratified sampling method. Sociodemographic, lifestyle, functioning, and other psychosocial factors were assessed in a face-to-face structured interview. In particular, PLEs were assessed using the Composite International Diagnostic Interview Screening Scales (CIDI-SC). Six domains of lifetime PLEs were measured, including auditory and visual hallucination, thought insertion/ withdrawal, delusion of control and reference, and persecutory delusions.

To date, 746 participants were recruited and of these, 3.2% of them has endorsed lifetime PLEs. Results showed that significantly higher depressive, anxiety and stress scores were found in those who has PLEs (p<0.001), and additionally, these scores significantly predicted the presence of PLEs in regression models (p<0.001).

Our preliminary findings highlighted the inter-related phenomena between PLEs and mood symptoms. Further investigation is needed to examine the likelihood of PLEs in predicting psychosis over time.

Recently, several studies have implicated the social context during a traumatic experience in susceptibility to, and severity of, post-traumatic stress disorder (PTSD). Although the precise mechanisms through which the social context affects the development of PTSD are unknown, it has been suggested that the neuropeptides oxytocin and β-endorphin may play a key role in this dynamic through their effects on both the locus coeruleus and the mesocortical and mesolimbic dopamine systems.

This experiment aims to identify in how far a formal social position, endowed by a recognised authority, modulates the stress response in cadets at the Czech military academy during a highly stressful training exercise.

As part of survival training, 40 cadets partake in a simulation of an avalanche. Although the maximum duration of the experience (being buried under snow) is 15 minutes, most cadets do not last longer than a few minutes with a significant portion requesting termination after a matter of seconds. During the experience, participants are fitted with a heart-rate and heart-rate variability monitor and tested before and after for pain resilience (a common proxy measure for β-endorphin). Participants are randomly allocated to have their individual scores or the average of their collective scores (in small groups of 5) incorporated in their final evaluation of the exercise.

Not all data has been collected yet.

We expect to see a difference in resilience (measured in duration) between the two groups which is mirrored in the afore mentioned biomarkers.

No significant relationships.

No significant relationships.

Pathological kinking of the internal carotid arteries (PK ICA) is a controversial issue of angioneurology. Patients with PK ICA often present a variety of complaints, such as headache, dizziness, decreased concentration, memory impairment, and general weakness [1].

To study the prevalence of anxiety and depression in patients with PK ICA.

We studied 132 patients who had PK ICA (main group) and 86 patients without brachiocephalic artery pathology (control group). Hospital Anxiety and Depression Scale (HADS) was used to evaluate anxiety and depression, considering depression or anxiety if the score was ≥10. Statistical analysis was performed with SPSS software, p-value<0.05 was considered statistically significant.

The mean age of the patients in the main group was 38.4±5.2 years, in patients of the control group 41.2±4.8 years, respectively. Anxiety disorders were detected significantly more frequently in the main group of patients than in the control group (35.7% and 10.2%, p=0.017 respectively). The frequency of depressive disorders was comparable in both groups – 13.6% and 14.3%, p=0.061, respectively. The level of anxiety was also significantly higher in the group of patients with PK compared to the control group (14.2±4.3 and 9.7±3.1 points, p=0.019). patients with PK ICA with anxiety are more likely suffered from depression (10.2% and 5.8%, p<0.001).

Anxiety disorders were present in one-third of patients with PK ICA, while depressive disorders were not typical for this group. In patients with PK ICA, in addition to collecting complaints, anamnesis, and evaluating the neurological status, it is advisable to conduct neuropsychological testing. References:1.Medvedeva LA, Zagorulko OI.Korsakov Journal 2019

No significant relationships.

Psychiatric diagnoses are derived from expert opinion (1). Since no objective tests or markers are on the horizon, clinical psychiatry is anchored to “the patient’s altered experience, expression and existence, associated with suffering in self and/or others”(2). Many studies have examined diagnostic stability over time. In the last years investigators have been reporting prospective and retrospective consistencies of diagnoses between two time points, specially in first episodes of psychosis (3).

To examine the prospective and retrospective stability of diagnostic categories 2 years after the first episode of psychosis

Data were examined from the First Episode Psychosis Program of Navarra (PEPsNA), a prospective observational study of a cohort of patients with first-episode psychosis in Navarra (Spain). Diagnosis was assigned using DSM-IV-TR at baseline and 24 months later. Diagnoses were divided into 5 categories: Affective psychosis, Schizophrenia spectrum psychosis, Schizoaffective disorder, acute psychosis and other diagnoses. Diagnostic change was examined using prospective and retrospective consistency

A total of 78 first-episode psychosis cases with baseline and 24 months follow-up were identified. Table 1 shows the diagnosis movement matrix, and Figure 1 its graphical representation. Of cases, 71.8% (56/78) had the same baseline and 24 months follow-up diagnosis. Prospective and retrospective consistencies are shown in Table 2

The prospective and retrospective consistencies of Schizophrenia spectrum psychosis and acute psychosis were higher than others. Affective psychosis and Schizoaffective disorder show very variable consistencies

Suicidal behaviour and cognition: A systematic review with special focus on prefrontal deficits Introduction: Suicide is a major health concern worldwide, thus, identifying risk factors would enable a more comprehensive understanding and prevention of this behaviour. Neuropsychological alterations could lead to difficulties in interpreting and managing life events resulting in a higher risk of suicide.

Objective: Bibliographic review about the influence of neuropsychological deficits on suicidal behaviour.

Method: A systematic literature search from 2000 to 2020 was performed in Medline (Pubmed), Web of Science, SciELO Citation Index, PsycInfo, PsycArticles and Cochrane Library databases regarding studies comparing cognition of attempters versus non-attempters that share same psychiatric diagnosis. Results: 1.885 patients diagnosed with an Affective Disorder (n = 1512) and Schizophrenia/ Schizoaffective Disorder (n = 373) were included.

In general comparison, attention was found to be clearly dysfunctional. Regarding diagnosis, patients with Schizophrenia and previous history of suicidal behaviour showed a poorer performance in executive function. Patients with current symptoms of an Affective Disorder and a previous history of suicidal attempt had poorer performance in attention and executive function. Similarly, euthymic affective patients with history of suicidal behaviour had worse decision-making, attention and executive function performance compared to euthymic non-attempters.

Patients who have attempted suicide have a poorer neuropsychological functioning than non-attempters with a similar psychiatric disorder in attention and executive function. These alterations increase vulnerability for suicide.

Jessica Fernández-Sevillano is beneficiary of the Pre-PhD Training Programme of the Basque Government. Dr. Gonzalez-Pinto has received grants and served as consultant, advisor or CME speaker for the following entities: Almirall, AstraZeneca, Bristol-Myers

In Chiapas, Mexico, it is estimated that 1,356 million people suffer from depression; there are about 210 psychologists (1/24,847 people) and 4 psychiatrists (1/1,304 people). Collaborative task sharing, which engages nonspecialists in mental health care delivery, is essential to address the large global burden of mental illness. The collaborative care model (CoCM), a specific type of task-sharing strategy, incorporates a team-based approach with: a primary care provider (PCP); a behavioral health professional, who is the care manager (CM); and a consulting psychiatrist. CoCM has shown improved outcomes for both mental and general health, expanded access to care, and cost-effectiveness.

Our objective is to implement one of the arms of the phased model and CoCM, through supervision and training of health professionals not specialists in Mental Health, in different clinical spaces of community primary care, by specialists.

We implemented a training program taught by psychiatrists and psychologists for health workers in communities of La Sierra Madre in Chiapas, which includes: training of intern nurses, training and supervision of intern doctors and on-site supervision and training of community mental health workers (CMHW); all undergoing a process of monitoring, evaluation and quality.

Of the patients that were treated (202; 89% women), more than 80% had a diagnosis of anxiety and depression. The most notable clinical improvement (measured with the PHQ-9 depression scale) occurred in the intervention group of CMHW + interns (reduction PHQ-9 58%).

This strategy seems acceptable to address the large gaps in the availability of mental health providers in low-income countries.

No significant relationships.

It is known that children with computer game addiction have a risk for development of deficit in executive abilities. It is important to develop effective approaches for helping children with this addiction.

The goal of this study was to reveal effect of body-oriented therapy on executive abilities in children with computer game addiction. Particularly we compared the efficacy of two methods of treatment (body-oriented therapy for children vs. conventional motor exercises) in a randomized controlled pilot study.

16 7-year-old children with computer game addiction were included and randomly assigned to treatment conditions according to a 2×2 cross-over design. The body-oriented therapy included the exercises from yoga and breathing techniques. To assess the executive functions and attention in children we used 5 subtests from NEPSY (Tower, Auditory Attention and Response Set, Visual Attention, Statue, Design Fluency). Effects of treatment were analyzed by means of an ANOVA for repeated measurements.

The ANOVA has revealed (p<.05) that for all 5 subtests on executive functions and attention the body-oriented therapy was superior to the conventional motor training, with effect sizes in the medium-to-high range (0.42-0.80).

The findings from this pilot study suggest that body-oriented therapy can effectively influence the executive abilities in children with computer game addiction. However, it is necessary to do further research into the impact of body-oriented therapies on children with this addiction.

Though schizophrenia (SZ) and obsessive-compulsive disorder (OCD) are conceptualized as distinct clinical entities, they do have notable symptom overlap and a tight association. Graph-theoretical analysis of the brain connectome provides more indicators to describe the functional organization of the brain, which may help us understand the shared and disorder-specific neural basis of the two disorders.

To explore the static and dynamic topological organization of OCD and SZ as well as the relationship between topological metrics and clinical variables.

Resting state functional magnetic resonance imaging data of 31 OCD patients, 49 SZ patients, and 45 healthy controls (HC) were involved in this study (Table 1). Using independent component analysis to obtain independent components (ICs) (Figure 1), which were defined as nodes for static and dynamic topological analysis.

Static analysis showed the global efficiency of SZ was higher than HC. For nodal degree centrality, OCD exhibited decreased degree centrality in IC59 (located in visiual network) (P = 0.03) and increased degree centrality in IC38 (located in salience network) (P = 0.002) compared with HC. Dynamic analysis showed OCD exhibited decreased dynamics of degree centrality in IC38 (P = 0.003) compared with HC, which showed a negative correlation with clinical scores in OCD. While SZ showed decreased dynamics of degree centrality in IC76 (located in sensory motor network) compared with OCD (P=0.009), which showed a positive correlation with clinical scores in SZ (Figure 2).

These changes are suggestive of disorder-specific alternation of static and dynamic brain topological organization in OCD and SZ.

Suicides occur more often in the young and in the elderly. However, although several studies have been performed to evaluate the effect of suicide prevention in the young, no studies have explored this in the elderly. Somatic comorbidity is associated with elevated suicide risk, especially in case of pain, which occurs often in the elderly.

To explore if suicide prevention interventions might be applicable in the elderly and if somatic comorbidity might be relevant for their application.

Evidence synthesis of controlled studies evaluating suicide prevention interventions and of collaborative care trials for depressive disorder in patients with and without somatic comorbidity.

Elderly living alone and with multimorbidity are more prone to suicide risk. Hence interventions involving admission in a general hospital after a suicide attempt, short intervention and follow up might be well applicable in the elderly. In terms of outpatient interventions, and IPD analysis found that collaborative care for depressive disorder is effective in reducing suicidality, especially in the elderly. This effect is independent of somatic comorbidity.

There is potential to develop and evaluate suicide prevention interventions for the elderly. Such interventions should address depression, multimorbidity and social isolation and may be provided at general hospital and at outpatient level.

No significant relationships.

Even though cognitive impairment is considered a hallmark of schizophrenia, it has not been included as a criterion into major diagnostic systems.

To test whether a set of clinical-defined cognitive impairment criteria can have utility in the assessment of psychosis patients in clinical practice.

We assessed 98 patients with a psychotic disorder, diagnosed using DSM 5 criteria. We developed a set of cognitive impairment associated with psychosis (CIAPs) criteria following the format of current DSM criteria and based on previous literature. The CIAPs criteria include: A) criterion for evidence of cognitive impairment after the beginning of illness; B) cognitive impairment clinically evidenced, affecting functioning in everyday activities in at least two out of six cognitive domains; C) and D) exclusion criterion for either delirium or other neurocognitive disorders, respectively, as causal agents of the cognitive impairment. The psychosis patients dichotomized by the CIAPs criteria were tested regarding the neuropsychological performance in attention, speed of processing, verbal memory, visual memory, working memory, executive function and social cognition tasks. Also a Global Cognitive Index was calculated.

Forty-three patients with psychosis fulfilled the CIAPs criteria (43.9%). MANOVA profile analyses revealed a pattern of statistically significant deficits in all the cognitive dimensions except for social cognition in CIAPs+ patients regarding CIAPS-, with prominent deficits in processing speed and memory functions.

The CIAPs criteria could be an auxiliary method for clinicians to assess cognitive impairment. It may also permit clinical estimation of the influence of cognitive deficits on the ecological functioning of patients.

This work was supported by the Government of Navarra (grants 17/31, 18/41, 87/2014) and the Carlos III Health Institute (FEDER Funds) from the Spanish Ministry of Economy and Competitivity (14/01621 and 16/02148). Both had no further role in the study des

Multiple sclerosis (MS) is an inflammatory demyelinating illness characterized not only by severe neurological symptoms and somatic signs but also by psychiatric symptoms. Psychiatric comorbidity is common in MS. However, the incidence of psychiatric comorbidity remains understudied.

To discuss the relationship of psychiatric disorder to neurologic dysfunction in MS through a clinical case.

Presentation of a clinical case of bipolar disorder in a 45-year-old woman with MS, followed by a literature review.

We reported a case of a 45-year-old woman, who was followed in neurology for MS since the age of twenty-five. She was stable under monthly treatment. She was referred by her neurologist for psychomotor excitement, insomnia, feeling of well being, and sexual disinhibition. The symptoms were present for three weeks. At the interview, she was euphoric, disinhibited, she had logorrhea and did not verbalize delirium. An attack of multiple sclerosis was ruled out. The patient did not report any history of psychiatric illness, epilepsy, head trauma, or use of psychoactive substances. We retained the diagnosis of bipolar disorder (manic episode). Divalproex sodium and olanzapine were prescribed with significant improvement of symptoms.

This reported case is interesting since it highlights the possible association between multiple sclerosis and bipolar disorder. Further investigations are needed to identify potential shared risk factors between these pathologies to improve patients’ outcomes.