Proactive coping helps to reduce stress “in advance” – by possible stressors’ anticipating (Greenglass & Fiksenbaum, 2009). Does it helps to reduce distress in hazardous work environment with extremely high uncertainty level – like in healthcare professionals’ work at the beginning COVID-19 pandemic? Data showed the lover level of proactive coping in healthcare professionals in comparison with non-medical group (Pearman, Hughes, Smith & Neupert, 2020). The acute issue is to investigate proactive coping among medical professionals with different stress level.

Specialists of Moscow public dispensaries (doctors, n=209; nurses, n=131) were checked during pandemic breakout (April 2020) - in order to compare proactive coping and job stressors’ subjective evaluation in groups with high and low chronic states.

The diagnostic set included: the job stress survey (Spielberger, 1994); the proactive coping inventory (Greenglass, 2002); the chronic stress and fatigues inventories (Leonova, 2012).

Cluster analysis by combination of stress-fatigue scores extracted equal 22% of professionals in risk subgroups. Surprisingly no proactive coping differences were found in nurses; among doctors preventive coping is significantly lower in risk subgroup (t=7.05; p=0.009). Revealed job stressors in risk groups for nurses are quite typical; but for doctors they are unusual: extreme workload (t=33.97; p<0.001), low coworkers support (t=48.94; p<0.001), lack of positive feedback (t=62.29; p<0.001).

Despite the undeniable workload increase, well-to-do professionals perceived no high job stressors. In risk subgroup with lack of preventive coping, perceived stressors are likely connected with inability to predict strain increase and to minimize the impact of its negative effects (Moore, 2017).

M.Z. received scientific grants from the German Research Foundation and Servier. Speaker and travel grants were provided from Otsuka, Servier, Lundbeck, Roche, Ferrer and Trommsdorff.

Usually, Plato is not considered a philosopher that comprehensively treated the matter of suicide. By studying Plato’s work (especially Crito, Phaedo, the Republic and the Laws), we observe that Plato was concerned with the problem of suicide and that he gave an elaborate answer regarding the problem of suicide, laws against its practice as well as exceptions from them, customs and punishments.

This paper, in the light of a trial to overcome the monistic approaches of the matter of suicide, proposes the modest but fundamental goal to point out the resemblance between Plato’s position (especially from the Laws and the Republic) regarding the matter of suicide and the nowadays reasons invoked by the patients requesting assisted suicide.

Looking at the patients from the United States of America which requested assisted suicide, by analyzing the available annual reports (at the time of writing this abstract, only 6 out of 9 states that have a legal status that permits assisted suicide are publishing annual reports regarding the patients and their assisted suicide requests), we compare them with Plato’s attitude towards suicide.

We observe that the most invoked reasons (concerns and underlying illnesses), by the patients wich request assisted suicide, are also the cases in which Plato permitted suicide.

This comparison and insight into Plato’s philosophy does not resolve any particular issues of the medical praxis but is binging out the utility of a multidisciplinary, especially philosophical and ethical, approach to the practice of assisted suicide.

Several ADHD teenagers had difficult behavioral problems during countries closing down due to Covid-19 pandemic. One of these negative outcomes that parents cannot control children’s behavior toward desired unhealthy food and the impulsive consequences. It was a great opportunity to convention a teletherapy program as a tool of intervention seeking for help to reduce uncontrolled self- management and nutrition, which may affect all sorts of childhood growth, development, health and behavior. Furthermore, it can affects daily life and academic success.

We tried through our study to enhance the teletherapy as a therapeutic tool, during the first and second phase of Covid-19 pandemic, trying to help parents and patient to overcome the impulsive behavior by using a specific therapy technique based on nutrition and behavioral therapy

Our case study is a young girl aged 12:4 Yrs. In middle bilingual Arabic/ American School. The therapeutic program designed via teletherapy program using multi-media and thru multi phases sessions, to increase focus attention, emotional control and reduce impulsivity.

The outcomes of the enhancing nutrition and behavior teletherapy program, showed significant improvement for the specific goal. Sensible change in the girl’s impulsive behavior, more focusing, emotional control and more accepting about health nutrition habits.

The important finding that intensive, focused nutation and self-management techniques provided via teletherapy as solitary program brought benefits to individual’s, family and reduced impulsivity outcomes. In addition, family education to become an expert at learning simple techniques in daily life can brining a sense of pleasure for long life wellbeing.

No significant relationships.

The COVID-19 pandemic presents symptomatic heterogeneity, so the differential diagnosis is even more relevant and more in patients with mental disorders. COVID-19 is a new disease that is under study and affects people over 65 with the greatest severity worldwide. The most frequent psychiatric symptoms are behavioral disturbances and confusional syndrome among those affected.

The objective is to demonstrate the importance of differential diagnosis in patients with psychiatric symptoms and covid-19.

Patients aged 71 and 77, admitted to psychiatry. They present drowsiness that alternates with episodes of psychomotor agitation in which they verbalize fear of the coronavirus. Personal history: bipolar disorder and schizoaffective disorder. Psychopathological exploration: Spatial-temporal disorientation, uncooperative, fluctuating state of consciousness, verborrheic, salty and incoherent speech at times. Dysphoric mood. Psychomotor restlessness predominantly at night, verbal heteroaggressiveness. Negative to ingestion due to odynophagia. Sensory-perceptual alterations and nihilistic delusions “the virus has killed me, I’m already dead.” Upon admission, they present a cough and fever and are treated with azithromycin and dexamethasone for suspected COVID-19. Complementary tests: chest X-ray bilateral pleural effusion. Cranial CT: Diffuse cortical and subcortical brain parenchyma retraction pattern. PCR positive coronavirus.

After overcoming the infection and with psychopharmacological treatment the confusional syndrome remitted.

Confusional syndrome can present with different psychiatric symptoms, so the differential diagnosis is very important and even more so in patients older than 65 years who present somatic pathologies or acute infections. The differential diagnosis of confusional syndrome is key to adequate treatment and favor the prognosis.

Loss of routine, disengagement from peers and adapting to distant learning during the pandemic may lead to psychological distress in medical students. Psychological impact of the pandemic on medical students has not been assessed in Sri Lanka

To identify the psychological impact and coping strategies of medical students during the pandemic.

An online survey was done among 527 medical students in a state Medical Faculty in Sri Lanka. Depression Anxiety Stress Scale (DASS-21) was used to measure psychological impact.

The main worries among the students was upcoming exams (74.4%, n=389) and taking a longer time than expected to complete their undergraduate medical education (68.1%, n=356). 68.7% (n=362) of the respondents experienced difficulty in working up the initiative to do things and 62.6% (n=330) had tendency to overreact to situations. Depressive symptoms were present in 40.8%, anxiety in 34% and high levels of stress were seen in 24.7%. In 10.8% depression was severe and anxiety was severe in 10.3%. Depression (p<0.01), anxiety (p<0.05) and stress (p<0.01) were significantly higher in students with a past history of psychiatric disorders. Depression, anxiety or stress was not associated with the gender, ethnicity, family income or living circumstances. The main coping strategy of the participants was engaging more with family (73.4%).

Given the high levels of psychological distress, supportive strategies should be designed to minimize the psychological impact in this vulnerable group.

No significant relationships.

Adolescent suicide and suicide attempts (SA) present a complex and multifactorial problem that deserves special attention. Identifying particularities of suicidal behavior in this age group is essential in order to identify suffering adolescents.

To determine the characteristics of adolescent suicide attempts compared to those of adults.

It was a retrospective study carried out on a clinical population who consult in the psychiatry department at the Gabes regional hospital during the period from January 1st, 2020 to September 30, 2020. Sociodemographic and clinical data of the patients as well as their family dynamics, their education, their personal and family history, characteristics of the SA and psychiatric symptoms preceding the act were assessed. We compared two subgroups: patients aged 10 to 19, and those aged 20 and over.

278 suicide patients were included. 101 of them were adolescents (10 -19 years), of which 89 (88.11%) were female. Mean age of suicidal adolescents was 16.5 years. They were mostly living with their families (92.07%). Intentional drug ingestion was more common in adolescents (81.1%) than in adults (40%). Adolescent suicide attempts were correlated with a conflictual family environment (p=0.04), exposure to mistreatment (p=0.001), the absence of underlying mental disorders (p<10-3), the presence of academic difficulties (p<10-3) and the presence of a precipitating factor such as family conflict (p<10-3) or school failure (p= 0.004).

A good knowledge of the particularities of suicidal behavior in adolescents is preliminary to support an effective preventive measure targeting both family and school environment

Autism spectrum disorders (ASD), is a population that does not usually receive specific treatment.

The main objective of the present study is to evaluate whether specific interventions within the TAVA program (transition program to adult life for patients with ADS), produce significant improvements in the quality of life of young adults with ASD.

This is a prospective randomized clinical study of patients with ASD (according to DSM-5 criteria) seen in outpatient of the Parc Tauli University Hospital in Sabadell (Barcelona) since September 2017. We compared the quality of life, functionality, caregiver burden, and comorbidity of patients in TAVA program (beneficiaries of group therapy and specific medical and psychosocial interventions), with that of control patients (treatment as usual), after 2 years of intervention.

Our sample is composed of 12 patients with ASD. The average age is 18.4 years. 83% of the sample are men (n = 10). 5 of the patients belonged to TAVA and the other 7 were controls. Overall, TAVA patients presented improvement in the ZARIT and BAI scales compared to control patients. The control patients evolved less favorably in the AAA, SRS and RAAS levels compared to TAVA.

Specific interventions in adults with ASD, improve the caregiver’s feeling of overload and the patients anxiety, compared to the usual interventions. The lack of regulated interventions produces an unfavorable evolution of the core symptoms of autism. More studies are needed to specify efficient interventions to improve the quality of life of adults with ASD.

No significant relationships.

Reduced motivation in schizophrenia is expressed is as the reduction of activity and social functioning.

Assessment of motivation in patients with schizophrenia and development to their psychosocial treatment.

Clinical, psychometric (URICA, PSP, PANSS), statistical. Included 100 patients diagnosed with schisophrenia F.20-29(ICD-10) with various levels of deficit.

The analysis showed the connection between the intensity of negative disorders of the patients with the level of their motivations: in the group of patients with severe deficiency (pseudoorganic), a decrease in the level of motivation was found: the score of the «Precontemplation» stage of the URICA scale (56.20 ± 9.29) was higher (P <0.001). Patients with moderate deficit (diminished schizoid) changes were distinguished by high motivation, high scores on the «Action» (49.34 ± 8.22, P <0.005) and «Maintenance» scale (52.43 ± 10.51, P <0.005). A negative correlation was established between the indicators of patient motivation and the PANSS scale: will disorders (r = -0.75, P <0.01), social withdrawal (r = -0.64, P <0.01), blunted affect (r = -0.62, P<0.005), etc. High positive correlation found between motivation rating and PSP scores in socially activity (r = 0,74, P <0,005) and social relationships (r = 0,65, P <0,01). We have developed a comprehensive program of psychosocial treatment, including compliance therapy, motivational, cognitive and social skills training, destigmatization actions and an assessment of its effectiveness.

The developed rehabilitation program showed high efficiency: increasing motivation, reducing self-stigmatization, developing communication skills, improving social functioning and cognitive sphere in patients with schizophrenia.

Attention-Deficit/Hyperactivity Disorder (ADHD) and Obesity are frequently comorbid. The prevalence of ADHD rises from around 2.8% in the general population (adults) to about 27% among those with obesity. Although neurobiological mechanisms explaining the strong association between ADHD and obesity are still unclear, several hypotheses have been proposed to explain the high comorbidity, including common genes, dopaminergic neurotransmission, deficits in executive functions (planning, adherence to weight loss programs or protocols after bariatric surgery) and circadian rhythm dysregulation.

Review on the relationship between ADHD and Obesity, focusing on possible biological mechanisms driving their high comorbidity.

We conducted a search in PubMed and ClinicalKey with the terms: “Attention-Deficit/Hyperactivity Disorder”, “Obesity”, “Dopamine”.

Altered reward processing and impaired inhibitory control are key features of ADHD and are also related to obesity. The ability to resist the impulse to eat and an appropriate reward response require normal function of these dopamine circuits. Both ADHD and obesity are usually associated with reduced volume of putamen, known to be a fundamental player in inhibitory control functioning. Human and animal studies have also demonstrated that obese individuals have decreased dopamine D2 receptor availability in the striatum. Recently genetic analyses implicated specifically Dopamine-DARPP32 Feedback in cAMP Signaling in both ADHD and Obesity.

ADHD and obesity are often comorbid. Dysregulated dopaminergic neurotransmission seems to be a fundamental factor underlying the overlap between ADHD and obesity, probably involving DARPP-32 signaling and possibly through neurobiological features of putamen, namely inhibitory control. Further studies are necessary to explain the neurobiological correlation between these entities.

No significant relationships.

Alcohol abuse can be the cause for psychotic disorders. In the International Classification of Diseases (ICD10) they are coded F10.4-F10.9. One of the potentially life-threatening complications is the development of alcohol delirium. Mortality rates in patients with untreated alcohol delirium reach 15%. It is extremely important to identify the risk factors that contribute to the development of delirium in time to ensure the most effective treatment and to ensure the patient’s potential survival in the hospitalization and post-hospitalization phase.

To analyze and evaluate the risk factors that have coused alcohol withdrawal with the development of delirium in patients admitted at the department of Narcology of the Riga Psychiatry and Narcology Center in 2018.

This study is a retrospectively conducted cohort study based on data from inpatient medical records for patients diagnosed with alcohol-induced delirium at the Department of Narcology of the Riga Psychiatry and Narcology Center in Year 2018.

In the Riga Psychiatry and Narcology Center 113 patients were diagnosed alcohol caused delirium. That makes up to 8% of all inpatients in year 2018. Summary of the prevalence of the most significant risk factors in 2018 inpatients with alcohol delirium.

The study indicated that some easily determined parameters are potential clinical predictors for the development of delirium tremens.

No significant relationships.

The ICD-10 acute and transient psychotic disorders (ATPD, F23) without symptoms of schizophrenia are considered predominantly reactive psychotic disorders or affective pathology. However, negative symptoms of schizophrenia may be revealed in some of these cases after the psychotic reduction.

To investigate the association between the developmental characteristics of psychosis and the negative symptoms detection after the psychotic reduction of ATPD without symptoms of schizophrenia.

68 adult inpatients with ATPD without symptoms of schizophrenia (F23.0) were examined. Negative symptoms were assessed with the PANSS negative symptom subscale (PANSS-NSS). The sample was divided into two groups: with PANSS-NSS score>14 (n=12) and with PANSS-NSS score≤14 (n=56), respectively. Clinical-psychopathological, psychometric and statistical methods were applied.

The results of the study are presented in Table 1.

*p<0,001

The probability of negative symptoms detection in ATPD without symptoms of schizophrenia is relatively strongly associated with the family history of schizophrenia, poor premorbid social adaptation and functional decline prior to the psychotic onset.

No significant relationships.

The aim of this research is to study the five major personality traits in a sample of call center employees in the Rabat-Salé-Kénitra Region, Morocco.

Demonstrate the domination of certain personality dimensions over others in this population.

This is a cross-sectional epidemiological study that involved 121 individuals, including 59 men and 62 women with an average age of 31.74 ± 7.93. The personality traits were assessed using the Big Five test.

The results show that, (63.64%) of our sample has a more dominant extraversion pole, while (36.36%) of the participants have a more dominant introversion pole. (66.12%) of our study subjects have a dominance of agreeableness dimension, while for (33.88%) of the sample the disagreeableness dimension dominates. Almost parity is observed between those in our sample who have a dominance of the conscientiousness pole (50.41%), and those who have a dominance of the impulsivity pole (49.59%). 74.38% of the participants have a dominance of the neuroticism pole, while (25.62%) have a dominance of the emotional stability pole. (57.02%) has a dominance of the openness pole, while (42.98%) have a dominance of the closedness pole.

This study sample is characterized to a large extent by extraversion and agreeableness; moreover this study has shed light on the dominance of the neuroticism trait in this kind of population. However, considering this study concerned only one region, it would be interesting to widen the geography of the survey to acquire more exhaustive results.

Lock-down restrictions were introduced in most countries of the world at the onset COVID-19 pandemic. It was associated with serious implications for healthcare delivery, with affectation of access to medical services for patients with chronic medical conditions. It is important to assess the impact of this on the subjective feeling of mental wellbeing in these patients.

This study aimed to assess the access to health care services during the lock-down as well the perceived affectation of the mental, physical and social wellbeing and their related factors in patients with chronic illnesses in Ilorin.

This study was a cross-sectional study, involving 166 patients being managed for different chronic medical conditions, attending the Medical Outpatient Clinics of the University of Ilorin Teaching Hospital. A socio-demographic questionnaire and a structured questionnaire designed by the researchers was used.

The mean age of all respondents was 49.5+18.5. 25.3% of respondents were being managed for heart-related conditions. 54 respondents(32.5%) reported a negative affectation of their mental wellbeing, which included changes in mood, sleep pattern and feelings of being overwhelmed and unable to cope properly. The age (p= 0.031) and employment status(p=0.015)of the patient were significantly associated with a subjective feeling of negative affectation of wellbeing.

The impact of the COVID-19 pandemic lockdown on the mental well-being of patients with chronic medical conditions is significant and calls for a more strategic plan for delivery of health care services during pandemic situations with focus on the mental well being of patients.

No significant relationships.

Electroconvulsive therapy (ECT) remains a valuable treatment for major depression with psychotic symptoms. However, it is necessary to pay special attention when there is a history of fractures.

Through the description of the following clinical case, we will emphasize the importance of screening for vertebral fractures within ECT and the different procedures that must be taken if that occurs.

We undertook a narrative literature review by performing a search on PubMed for English-written articles. The query used was “Electroconvulsive Therapy” AND “Vertebral Fractures”.

A 71-year-old woman was admitted with an episode of psychotic depression. Basic tests were performed and were all normal. After not responding to pharmacologic treatment, she was referred for ECT. The patient had a full recovery after 4 weeks of biweekly sessions. She was discharged and proposed for maintenance ECT. However, she started complaining of back pain after falling and did an X-ray and CT scan which revealed fractured L1 and L2. It was suggested conservative treatment with a Jewett orthosis. Within this period, the ECT was suspended and after a 4-week treatment, the fracture was consolidated. As there was no risk of neurological compression, the treatment was restarted with the same dosage of succinylcholine, and it was achieved complete muscular relaxation. The patient fully recovered without any orthopedic sequel.

Electroconvulsive therapy can be safely performed after conservative treatment of vertebral fractures, if special attention is provided to complete muscular relaxation. For this effect, the dosage of succinylcholine can be adjusted.

No significant relationships.

Addictive behaviors on the workplace are a real public health problem because of its consequences not only on workers but also on productivity at work.

To explore the relationship between addictive behaviors and productivity at work among employees of a Tunisian oil rig.

A cross-sectional study was conducted in the first half of 2018. The assessment of work productivity was done using the validated WPAI-GH questionnaire. Smoking dependence was assessed via the Fagerström score and alcohol abuse by the FACE questionnaire.

It was 94 employees working in an onshore oil field with an average age of 41.1 years. Average job seniority was 14.3 years. Active smoking was noted in 34.7% of cases. Alcohol consumption was noted in 19.1% of cases. In the 7 days preceding the survey, the average percentage of absenteeism was 3.64 ± 21.7% and the presenteeism was 17.66 ± 25.58%. The average decline in productivity was 14.8 ± 43.7% and the average decline in daily activities was 20.21 ± 31.45%. These parameters were not correlated with smoking and alcoholism.

Addictive behaviors in the workplace still a denied reality.Increasing awareness and clarifying expectations can be a good first step in order to ameliorate employee functioning and decrease productivity problems.

The concept of paraphrenia was first introduced by Kraeplin and has since been a controversial issue. However, a group of patients still represent a diagnostic problem and many remind us of the initial description of Paraphrenia: “The uncertain group between paranoia and dementia preacox”.

Revisit paraphrenia and to transpose it to modern times.

Clinical report and literature review.

“M”., a 68 yo women with no psychiatric history was admitted in with depressive humor, anhedonia, asthenia and structured delusional ideas of guilt and persecution and auditory hallucinations. Antidepressant therapy improved the mood, but with worsening of the psychotic symptoms. With further exploration it was was clear that the mood disorder was secondary to the psychotic symptoms that arose in insidiously. The family described her as very reserved and suspicious and notice that she abandoned many of her daily tasks. MMSE was 26 points and the laboratory results and the Cranial Computed Tomography were normal. There was little response to antipsychotics and the patient is undergoing electroconvulsive therapy with positive results.

Initially thought to be a depressive episode, the psychotic symptoms were the primary manifestation. Although the insidious installation, structured delusional ideas and the preservation of the affects pointed to a delusional disorder, the presence of auditory hallucinations and gradual loss of functionality are characteristic of schizophrenia. Some authors rejected the classic definition of Paraphrenia, but accepted that schizophrenia in the elderly could assume a paraphrenic form. In this case, the clinical picture and evolution are close to the classical description of the disorder.

No significant relationships.

A meta-analysis from 2016 estimates prevalence of hepatitis C to be superior in people with severe mental illness than general population. In France, positivity for hepatitis C is estimated at 0,75% of general population and 0.3% with a detectable viral load. No recent study was conducted to determine seroprevalence of hepatitis C in population admitted in psychiatric institution.

The aims of this study are to determine seroprevalence of hepatitis C in population admitted in psychiatric institution and describe the profile of infected patients.

From january 2020 to october 2020, screening test for hepatitis C, hepatitis B and HIV was proposed to every patient admitted at the reception unit of Ravenel Hospital. In case of positivity, viral load was realised.

Between January 7th and Octobre 1st , 407 patients greed to the screening test. Among them, 17 (4,2%) were tested positive to hepatits C and viral load was detectable in 9/17 positives, which lead to a 2,2% seroprevalence of hepatitis C infection in the studied population. The patients with positive screening had a mean age of 40 years old. 82% of them were males. 16 admit using intoxicating substances and 10 were still current users at the time of the study. They were hospitalized for addictology purpose (5/17), psychosis (6/17), mood disorder (5/17), personality disorder (2/17), adjustement disorder (2/7). 10/17 had an alcohol use disorder.

This study confirms seroprevalence of hepatitis C infection in psychiatric population is seven times that of general population. This justifies a systematic screening of this population.

No significant relationships.

Knowing the leading patterns will help timely predict that addictive behavior is being formed.

To identify the leading patterns of addictive behavior in adolescents in Central Siberia according to the results of the CIAS test.

200 adolescents aged 11-18, 69 males and 131 females, with Internet addiction living in an urban area (Krasnoyarsk) were surveyed. The patterns of addictive behavior were assessed using the CIAS test, which includes scales of key symptoms: “Com” (compulsive symptoms), “Wit” (withdrawal symptoms), “Tol” (tolerance symptoms); and negative consequences scales: “IH” (intrapersonal and health problems), “TM” (problems with time management).

The mean results (M) of key symptoms were obtained at 14.56 on the “Com” scale, 15.27 on the “Wit” scale, 12.23 on the “Tol”. The mean indices of negative manifestations were obtained at 17.00 on the “IH” scale and 13.94 on the “TM” scale. When comparing the mean results of the scales of addicted behavior by the method of one-way analysis of variance (ANOVA), statistically significant differences between representatives of different sex and age groups were not revealed (p> 0.05).

The leading key symptoms of Internet-addicted behavior in Central Siberia adolescents include withdrawal symptoms: decreased mood, anxiety and irritation in the absence of access to the Internet. Symptoms of negative consequences include decreased social contacts, reduced communication with family members, and problems at school. When such symptoms emerge, one should suspect the formation of Internet addiction and carry out the necessary diagnostics for timely intervention. The study was funded by RFBR project № 18-29-22032\18.

The study was funded by RFBR project № 18-29-22032\18.