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.

Medication is primary tactics in schizophrenia treatment. First and second generation antipsychotics (FGA and SGA respectively) affect on core symptoms. Unfortunately, it causes side effects. Metabolic syndrome one of them and includes large number of affections like body mass index changes, lipidemias, hypertension and others.

To study the role of polymorphic variants FTO gene in metabolic syndrome in schizophrenia patients.

We were investigated 480 patients. Main criteria for inclusion in study was using antipsychotics, verified diagnosis of schizophrenia and metabolic syndrome. Mean age was 42,1±1,4 years. The metabolic syndrome was assessment based on clinical data. Standard phenol-chloroform protocol for DNA isolation was used. Genotyping was carried out on six SNP’s of FTO gene with real-time PCR. Statistical analysis was carried out with R 3.6.2 with basic functions and SNPassoc package.

The distribution of genotypes for variants rs7185735 and rs9939609 was not in according to Hardy-Weinberg equilibrium (a p-value less than 0.05) and excluded from further analysis. Patients with schizophrenia were divided into two groups: patients with metabolic syndrome and patients without it. We did not identify any statistically significant associations between genotypes and alleles of FTO gene and metabolic syndrome.

We did not find any associations of alleles and genotypes of FTO gene with metabolic syndrome in schizophrenia patients from Siberia region. Metabolic syndrome needs more further studies with larger number of samples and different populations. Conflict of interest. The authors declare no conflict of interests. Supported by Grant of RSF 19-75-10012.

Psychiatric emergency visits have with associated with seasonal pattern that reflect psychosocial factors. Its knowledge could proving valuable insight about help seeking behaviour of patiens suffering with mental illness.

Our aim was to analyse weekly and monthly seasonality

Daily urgency visits were extracted from electronic medical records of Hospital Universitario La Paz from 1st January 2019 to 31st December 2019. A poisson multivariate model was performed with day of the week and month as covariates. Predictive margins were estimated

Psychiatric emergency visits were less frequent in Saturday and Sunday (5.5 visits per day) than weekdays (7.5 visits per day). Not differences were observed among months.

A weekly season pattern was observed with less psychiatric emergency visits during weekends.

No significant relationships.

DSM-V includes near-psychotic symptoms as new criteria in borderline personality disorder (BPD). This change makes more difficult the differential diagnosis between considering psychotic symptoms as part of the BPD or as part of a comorbid psychotic disorder.

Recognize the difficulty of the differential diagnosis in clinical practice between BPD and comorbid diagnosis of BPD with psychotic disorders, and how it can affect the patient’s outcome.

Patients’ data is obtained from medical history and psychiatric interviews carried out during their hospitalizations.

32 year-old female patient with previous diagnosis of BPD, psychotic episodes and cannabis abuse, was admitted due to paranoid ideation and aggressiveness, with massive borderline defense mechanisms (frequent displays of anger, high impulsivity, low frustration tolerance, self-destructive behavior…). Psychotic symptoms ceased two weeks after admission, and considering the patient’s individual characteristic it was believed BPD fitted more with this clinical case, although different psychotic disorders were considered. 30 year-old female patient began intensive psychiatric treatment with previous diagnosis of BPD, psychotic disorder and cannabis abuse. It was observed that the paranoid ideation and bodily experiences she suffered lasted months and were characterized by a strong belief. These two reasons were put into consideration when it was decided to judge this clinical case as a comorbid diagnosis of BPD with a psychotic disorder.

It is necessary to assess the difficulty of the differential diagnosis in these patients, and offer them specialized treatment depending on the diagnosis, as it can affect the patient’s outcome.

The bipolar disorder is characterized by instability mood. It normally happens in the middle-aged. In elderly patients with a first manic episode, you have to dismiss organic pathology.

To present an elderly patient with a first manic episode

A descriptive study of a clinical case and literature review

A 67-year-old man, married. Consulted Mental Health 5 years ago, about low mood after his early retirement. With no psychiatric treatment. Somatic antecedents: Acute myocardial infarction, hypertension and dyslipidemia. Came to the hospital accompanied by his son-in-law presenting rapid speech and thinking, bright clothing, risky behaviour, irritability, grandiosity deliration ideas and less sleep; being necessary a hospital admission. Blood and urine analysis: with no abnormalities. No toxics in the urine. Asenapine 20mg and Lorazepam 3mg were prescribed with clinical improvement. Brain CT: with no abnormalities. After that, Lithium 400mg per day was prescribed to avoid the induction of depression. Clinical judgement: manic episode. Bipolar disorder Type I

After dismissing somatic causes, the symptomatic treatment of a manic episode in older patients is on the same lines as the treatment for mania in young adults. 8-10% of psychiatric inpatients over age 55-60 years are diagnosed with bipolar disorder. Since there is an increase in the number of individuals living longer, an expected increase in the number of older adults who will be diagnosed with bipolar disorder. Older adults with bipolar disorder will increase in absolute numbers as well as the proportion of the general populations.

No significant relationships.

In the U.S. approximately11.4 million misused prescription pain relievers; 2.1 million had an OUD in 2017. The Addictions Nursing Subspecialty was created to address this epidemic by expanding a workforce trained in OUD/SUD screening, treatment, and prevention. A curriculum was developed that included integrated/telehealth health care settings in medical and mental health provider shortage areas during their last nine months of training. Courses were developed and taught by aninterprofessional team of university faculty and informed by evidence-based guidelines/clinical competencies for effective OUD/SUD screening/prevention, assessment, treatment, and recovery. Courses were also offered as electives for nursing, clinical-counseling, social work, and other health science disciplines emphasizing an interdisciplinary approach to healthcare.

Expand the OUD/SUD trained workforce in areas with high OUD/SUD mortality rates and high mental health provider shortages emphasizing team-based integrated care and telehealth settings.

Program curriculum was informed by evidence-based guidelines/clinical competencies for effective OUD/SUD screening/prevention, assessment, treatment, and recovery using integrated care. Competencies included: Core Competencies for Integrated Behavioral Health and Primary Care that have been set forth by the Center for Integrated Health Solutions, telehealth competencies outlined in the recommended competencies by the National Organization of Nurse Practitioner Faculties (NONPF), and Core Competencies for Addictions Medicine by the American Board of Addictions Medicine.

Approximately 11 students enrolled in courses received additions integrated/telehealth health care settings. Students responded positively to evaluations regarding timely feedback, unique approach (i.e. intrative content, short videos and discussions).

The Addictions Nursing subspecialty will continue to be offered allowing enrollment for nurses twice a year.

Gayet Wernicke Encephalopathy (GWE) is a diagnostic and therapeutic neuropsychiatric emergency due to thiamin deficiency (vitamin B1).

The purpose of our work is to recall some clinical situations suspecting GWE, along with radiological and evolutionary profile.

We conducted a retrospective study concerning patients who were hospitalized in the neurology department of Habib Bourguiba Hospital between 2013 and 2020 for management of GWE.

The median age of 7 patients was 39.57 years with sex ratio (H/F):1.33. The most common risk factor found is incoercible vomiting (5 patients), followed by chronic alcoholism (3 patients). Confusional state was the most frequent symptom found in 4 patients. The characteristic clinical triad of confusion, oculomotor disorders and ataxia was only found in 2 patients. Neuroimaging showed a typical aspect in 3 patients. The serum levels of thiamine were low in five patients and normal in two patients. After receiving parental than oral thiamin supplementation, three patients were independent after one month with a mRS score <3.

GWE is an acute neuropsychiatric emergency. Chronic alcoholism is recognized as its most common cause. The clinical triad is not constantly present. MRI shows typically bilateral symmetrical hyperintensities in periaqueductal area, periventricular region, thalami and mammillary bodies. Thiamin level can be normal since it does not accurately represent body thiamine status or in case of mutations in a thiamine-transporter gene. Thiamine therapy is warranted if any component of the GWE triad is present in an appropriate clinical setting to prevent irreversible neurological sequelae.

Electroconvulsive therapy (ECT) is a current, relevant treatment for severe mental illness. In this article we describe our experience on ECT in a public hospital in Chile.

Describe a 34 patients’ cohort who received ECT and their outcomes.

Data was extracted from ECT records between 2018-2020, patients’ evaluations before and after ECT, and case files. Data was then analyzed and described.

ECT was received by 18 males and 16 females. Age ranged from 19 to 73 years (41 average). More than 75% had 12 or more years of education. Patients’ diagnoses and indications for ECT are shown in Figures 1-2

The CGI-SI scale was applied to subjects before treatment, and 85% had a score of 5 or more. On average, patients received 8.7 ECT sessions. Right unilateral electrode placement (RUL) was preferred initially for 94% of patients. Brief pulse width (0.3ms) was most commonly used (76%). Seizure duration averaged in 29 seconds. Adverse reactions presented on 32%, most being mild. One treatment had to be stopped due to confusional symptoms post ECT. After ECT, 91% of patients improved according to CGI-GI scale. 55% were assessed CGI-GI 1 “very much improved”. MoCA scale was also evaluated, showing a 2,1 point gain.

Schizophrenia and psychosis were the most frequent diagnosis and indication for ECT. RUL and brief pulse width were the preferred settings. This cohort suggests that ECT had an impact on markedly ill patients, based on CGI and MoCA scales.

The PDSS-24 is a Portuguese short version of the Postpartum Depression Screening Scale (Beck and Gable, 2002). Items were selected on the basis of exploratory factor analysis (those with loadings >.60). The PDSS-24 proved to be superior to the 35-items PDSS in reliability, validity and screening ability (Pereira et al. 2013).

To analyze the psychometric properties (construct validity using Confirmatory Factor Analysis, discriminant validity and reliability) of the Brazilian preliminary version of PDSS-24

After confirming the items semantic equivalence and slightly adapt two adjectives from European to Brazilian Portuguese, 350 pregnant women (Mean age: 30.01±5.452; Mean gestation weeks=25.17±6.55), with uncomplicated pregnancies, completed the PDSS-24 and the Brazilian recently validated versions of Profile of Mood States-25 (PoMS; Barros et al. 2021). SPSS and AMOS software were used.

After some errors were correlated the multidimensional second-order model of PDSS-24 presented an aceptable fit (χ2=3.448; RMSEA=.099; CFI=.817, TLI=.886, GFI=.886). The PDSS Cronbach’s alpha for the total was α=.90. Cronbach alpha was .90 for the total and >.75 for the dimensions. Appling the Portuguese validated cut-off score for Major Depression/DSM-5 (>42) to this sample 224 (64.0%) participants presented clinical relevant depressive symptoms.

The Brazilian PDSS-24 has acceptable validity and reliability. The percentage of women with high depressive symptomatology is three times higher than the figures reported in Portuguese Studies. This can be partly explained by the fact that data collection was done during the COVID19 pandemic. It is important to determine the PDSS cut-offs to screen for perinatal depression in Brazil.

All persons whose memory consultations at CMRR Limoges were cancelled during the period of confinement (17 March to 11 May 2020) were contacted by telephone by the nurses or psychologists at CMRR.

The experience of the confinement episode as well as the deconfinement are studied. The survey records the clinical changes in patients and the medical/medical-social events that occurred during this period. The impact of the aids maintained and the place where people live is studied.

Confinement is an exceptional measure that makes it possible to reduce the risk of contagion in the event of an epidemic, at the risk of harmful consequences for people weakened by a NCDs. In the event of an epidemic episode in the future, this study could help to define the arrangements to be put in place to better protect people suffering from NCDs and their family caregivers.

No significant relationships.

Suicide is one of the major public health concerns worldwide, currently listed as the 15th most common cause of death. Mental illness stigma may contribute to suicidality and is associated with social isolation and low self-esteem among people with affective disorders.

The aim of the present study is to assess, in a sample of people with affective disorders, whether high levels of internalized stigma are associated to suicidal thoughts and behaviours.

60 outpatients diagnosed with depression or bipolar disorder according to DSM-5 have been recruited. Suicidal behaviours and ideation were assessed through the Columbia Suicide Severity Rating Scale (C-SSRS); internalized stigma through the Internalized Stigma of Mental Illness (ISMI) scale. Socio-demographic characteristics have been collected through an ad hoc schedule.

62.9% of the sample was female, with a mean age of 45.7 (±14) years. About half of the sample had a diagnosis of major depression (54.8%). Patients with suicidal ideation reported higher score at ISMI “alienation” subscale (p<0,05), compared to those without suicidal ideation. Patients with a previous history suicide attempts reported higher score at “alienation” and “social withdrawal” ISMI subscales (p<0,05). Moreover, “alienation” ISMI subscale significantly correlated with suicidal ideation and behaviours (p<0,01).

These results are in line with the available literature, highlighting that stigma and suicidality are strongly correlated. This underline the importance of interventions at addressing internalizing stigma, in particular to those with previous suicidal attempts and with an active suicidal ideation.

No significant relationships.

The first description of syphilis was made in Europe around the year 1493, and although perceived as a disease relegated to its historical importance, recent studies demonstrate that the prevalence of these infections is on the rise. Spanning decades after initial infection, 30% of affected individuals without treatment may develop tertiary syphilis, which includes neurosyphilis. Its notoriously “chameleon-like” presentation implies the necessity to not overlook neurosyphilis as a differential diagnosis in psychiatric settings.

Case report study and discussion.

The authors present a case of affective and psychotic symptoms (including auditory and visual hallucinations and persecutory delusions) of rapid onset in a 61-year old woman without prior psychiatric history. A clinical investigation was conducted, which subsequently revealed a positive Venereal Disease Research Laboratories (VDRL) test. A lumbar puncture was performed and cerebrospinal fluid analysis confirmed neurosyphilis.

Steady improvements in initial psychopathological manifestations were noted after completing recommended treatment for neurosyphilis. After discharge, the patient was medicated with an antidepressant and antipsychotic, demonstrating a complete return to baseline mentation and functionality on follow-up.

This case demonstrates the vital importance of considering syphilis in our differentials, especially due to the wide range of manifesting psychiatric symptoms. Although considered a disease of the past, this case reminds us that syphilis remains present in our society and its timely diagnosis and treatment can ameliorate the debilitating psychopathological manifestations of the disease. Due to the potential difficulties in identifying this great imitator, routine screening tests are still recommended in the psychiatric setting.

Globally, governments have enforced protective measures of social distancing to prevent COVID-19 spread. The lifestyles of public have essentially transformed due to these actions. This study evaluates the effects of COVID-19 on connections and behavior/life adaptations.

Changes in life style and behavior in COVID-19-Pandemic

We conducted a global cross-sectional study via survey on phone apps and social media platforms in population aged ≥ 16, including questions regarding demographic data and lifestyle changes. We also searched databases APA PsycNet, PubMed, PsycINFO, and Medline; reviewed 40 articles and included 3 in this review, a cross-sectional online survey1, a planned questionnaire2, and a study on 600 adolescents, age 10-19 in Palestine3

Our survey data showed total of 1002 responses, 31.7% decreased sleep, 42.1% increased appetite, 70.6% bulk-buying, and 50.2% weight gain. 43.1% less socialization than before, 78.7% increased screen time, 53.5% excessive hand washing/wiping surfaces, 45% reported social distancing facilitated in overpowering the fear of contracting infection, 29.4% negative impact on relationships, 80.7% noticed changes in behavior including shaking hands/hugging/speaking with a mask on, 49.5% adopted new hobbies, 34.9% showed increase in meditation. The literature review revealed that since COVID-19, there is an increase in screen time, weight, appetite, sleep, and a decrease in physical activity1-3, and greater adherence to the Mediterranean diet in younger population2

COVID-19 induced quarantine has caused increased screen time, appetite, weight gain, adoption of new hobbies, bulk-buying, hand washing, meditation, reduced sleep, and negatively impacted interaction/relationships. COVID-19 pandemic is ongoing and our data needs further assessment in more population studies.

No significant relationships.

For more than a decade, digital health has held promise for enabling a much broader population to have access to health information, education and services. However, the increasing number of studies on the subject show mixed results and currently, there is a certain disillusionment regarding its benefits. And yet, the Covid-19 crisis has revealed the importance of developing digital-based complementary support to existing resources.

Factors associated with higher utilization rates among the target audience need to be investigated.

In 2018, 41 French cities enrolled in an intervention program aimed at promoting StopBlues®, a digital health tool that helps prevent mental distress and suicide among the general population. After two years of experimentation, a Multiple Correspondence Analysis (MCA) was performed using quantitative and qualitative data collection methods from institutional sources, questionnaires and web analytics tools.

Finding trends show that higher utilization rates were associated with the involvement of general practitioners (GPs) in the promotion of StopBlues and the use of digital marketing channels. Context-specific characteristics also played an important role in the adoption of the tool.

The local context has a strong influence on how digital tools are locally promoted and accepted. Further research is needed to understand how local actors and specifically GPs can be involved in suicide prevention. More broadly, the challenge today is to ensure acceptance of digital health technology among targeted populations by adapting the digital offer to their needs and promoting the available tools.

No significant relationships.

Huntington’s disease (HD) is a progressive neuropsychiatric and degenerative disorder that shows an autosomal dominant inheritance pattern. The principal symptoms of HD are progressive movement disorders, cognitive deterioration, dementia, and certain psychiatric manifestations, which may occur in many different forms, such as depression, psychosis, personality changes.

In this presentation, two female HD patients with psychotic components complicated with suicidal and homicidal thoughts will be reported to better illustrate psychiatric components of HD.

Hospitalization records of these two patients with genetically verified HD diagnosis indicated that their psychiatric health precipitously deteriorated in the last decade.

While the first patient suffered from severe depression, anxiety, suicidality; persecution ideas, suspiciousness, hostility were noted more prominently in the latter. Moreover, both cases had a positive family history for psychiatric diseases which is one of the hallmarks of HD. Anti-psychotic drug olanzapine, which has minor side-effects on EPS, was found to be highly effective on our HD patients, alleviating the behavioral and psychiatric symptoms of the disease.

In conclusion, HD should be one of the differential diagnoses if patients with psychiatric complaints have accompanying neurological findings such as movement disorders and impaired memory, and great attention should be paid to the extrapyramidal system (EPS) sensitivity of the chosen treatment regime when treating the HD patients,

Pandemic are known to generate traumatic events, such as job losses or violence [1]. Several studies have shown that epidemics and related health measures (quarantine, confinement) lead to an increase of acute stress disorders (ASD), post-traumatic stress disorders (PTSD), anxiety and depression in the adult population [2]. In the pediatric population, few studies have been carried out on the psychiatric outcomes during and after epidemics and associated measures [3].

The aim of this study was to explore ASD symptoms during stay-at-home and Covid 19 pandemic and its impact on children and adolescent mental health.

Sixty participants (53% girls and 47% boys; mean age= 9 years 5 months) were included in this longitudinal study [4]. The measures consist in an emergency semi-directed interview designed to assess symptoms of ASD according to the age of children.

Patients’ age modulated psychiatric outcomes. Children under the age of six shown more developmental regressions and more restlessness than older ones. Children from 6 to 12 years were characterized by more oppositional behaviors than adolescents. Finally, adolescents were characterized by more social isolation than younger ones. Other symptoms appear to be more stable across ages: sleep disturbance, fear behavior and somatization.

Young children experienced more externalized symptoms (opposition and agitation) and developmental regressions than older children [5]. Thus, it appears necessary during pandemic to take into account the psychiatric consequences of confinement to reduce psychosocial long-term outcomes in particular in younger patients who appeared to develop specific and age-related psychiatric disorders.

No significant relationships.

The global health crisis due to Coronavirus Disease 2019 (COVID-19) and related containment measures have led to changes in daily life and, therefore, social and psychological impacts on the population.

To explore the psychological and social impact of COVID-19 in the general population of Bolivia.

Cross-sectional study was implemented using an anonymous and self-administered online questionnaire. Adult people were invited to participate through social networks between May to June 2020. The questionnaire included sociodemographic information, coping strategies, changes in income and working conditions and psychological distress (K10 Scale).

A total of 878 adults living in Bolivia answered the questionnaire. Most people considered COVID-19 as a quite/very serious health problem that affects the entire population, without distinction. 65% reported to accomplish lock down measure, however, one of the main reasons for non-compliance is the need to go out to work. Half of participants (50%) reduced worked hours and 18% modified their employment contract. However, 70% reduced household income. A considerable percentage (62%) reported psychological distress (46% with moderate or severe). It was higher in women, young people and among those with lower household income. In addition, social networks and watching series and movies were the main coping strategies reported.

The COVID-19 pandemic has a considerable impact on psychological and social level. The negative impact was greater in some population groups such as women, young people, and those with a lower socioeconomic level, which may further increase inequities.