The Coronavirus disease (COVID-19) health emergency has led national states to adopt severe actions forcing many people to cope with new and unexpected challenges. Those constraints risked to jeopardized the mental health and subjective wellbeing (SWB) of individuals.

The present cross-sectional quantitative study explored whether and to what extent psychological and social aspects were determinants of parental SWB as outcome variable during the COVID-19 lockdown.

The sample was composed of 304 Italian parents (93% female, mean age 41.5, 91% from Lombardy). Data were gathered through Computer Assisted Web Interview (CAWI) four weeks after the beginning of the national lockdown. World Health Organization (WHO) wellbeing scale along with other self-reported measures of social support, feelings of abandonment, feeling of being equipped and adequacy of living spaces were administered. Data were analyzed by hierarchical regression models (Ethics Committee of Milano-Bicocca University approval N.0034537/20)

According to the WHO cutoff score, 37.7% of parents reported low well-being levels. The regression model (F=11.2, p<.001) suggested that the feeling of abandonment and the feeling of being equipped were the most important contributors to SWB. Other statistically significant (but with lower effect sizes) variables were the support received by the partner and the adequacy of living spaces.

The findings bear out the pivotal importance of subjective states (such as feelings of abandonment or perceptions of being poorly equipped) in relation to the levels of parental SWB during the COVID-19 lockdown. Implications for planning psychological interventions aimed at strengthening personal resources to face the emergency are discussed.

No significant relationships.

Cyberchondria involves excessive and uncontrollable online searching of information about a perceived illness. This behavior can cause or maintain distress.

Little is known about cyberchondria during the COVID-19 pandemic or how cyberchondria in one individual may cause distress in their significant other if they are self-isolating together; our study sought to fill these gaps.

We conducted a Qualtrics Panel survey with 760 cohabitating Canadian couples; in June 2020, participants retrospectively reported on their cyberchondria behavior, general anxiety, and COVID-19 fears during the month of April 2020, while adhering to stay-at-home advisories. Two separate actor-partner interdependence models (APIMs) used cyberchondria excessiveness and compulsion to predict generalized anxiety and COVID-19 danger/contamination fears in the actor and partner.

Both cyberchondria excessiveness and compulsion were associated with higher general anxiety and higher COVID-19 danger/contamination fears in the individual (actor effects). Partner cyberchondria compulsion was associated with higher general anxiety in the individual whereas partner cyberchondria excessiveness was associated with higher COVID-19 danger/contamination fears in the individual (partner effects).

Findings suggest that excessive and uncontrollable searching of information about COVID-19 on the internet during lockdown may contribute to distress in both the individual engaging in the cyberchondria behavior, and in their romantic partner. Moreover, different aspects of cyberchondria in the partner (compulsion vs. excessiveness) appears to contribute to general vs. COVID-19-specific anxiety/fears in the partner, respectively. Future research should examine mechanisms underlying the observed partner effects (e.g., co-rumination, social contagion) and reasons for the differential partner effects of cyberchondria components.

It is known that negative body image can cause significant emotional distress for an individual and thus lead to lower subjective well-being. Previous research has shown that both disordered eating and body mass are connected to negative body image.

To examine how disordered eating and BMI can predict different aspects of body image.

A sample of 180 healthy respondents (152 Female, 28 Male, mean age 22,62±7,35) were recruited in Moscow. Disordered eating was measured by Eating Attitude Test (EAT-26; Garner D. et al., 1982), body image was measured by Multidimensional Body-Self Relations Questionnaire (MBSRQ; Cash T. F., 1990). Body mass index (BMI) was calculated on the basis of self-reported data (height and weight). Multiple linear regression analysis was performed in IBM SPSS Statistics 22.0.

Regression model with both predictors determined self-classified weight (SCW; R2=0,569, p<0,0001), overweight preoccupation (OWP; R2=0,497, p<0,0001), body areas satisfaction (BASS; R2=0,259, p<0,0001), and appearance evaluation (R2 = 0,229, p<0,0001), but only disordered eating symptoms predicted appearance (R2 = 0,193, p<0,0001) and health (R2 = 0,036, p<0,05) orientation, and none of the predictors affected fitness or health evaluation and fitness orientation.

Symptoms of disordered eating and body mass index in normal population can predict self-evaluation of one`s appearance as less attractive, body size as bigger and weight as heavier. Only symptoms of disordered eating predicted higher extent of investment in one’s appearance and health. And neither IBM, nor disordered eating predicted self-evaluation of one`s health and fitness or the extent of investment in fitness.

Factors causing anxiety among healthcare professionals (HCP) are increasing, and psychosocial causes are the most common. During the COVID-19 pandemic, HCP are exposed to additional stressful factors.

The aim of this study was to assess the prevalence of trait-anxiety and its associated factors towards the COVID-19 outbreak among Tunisian HCP.

A cross-sectional descriptive and analytical study conducted among Tunisian HCP during November and December 2020. The data were collected by an online questionnaire including the sociodemographic information and the “General anxiety questionnaire of Spielberger” (STAI-Y-B) which was used to assess the trait-anxiety.

A total of 135 HCP participated in this study (47.4% female and 52.6% male). The average age was 31.98 years (SD=6.59). Of the participants, 3% were nurses, 8.1% were interns, 48.1% were residents, 34.8% were specialist doctors and 5.9% were generalist doctors. Concerning marital status, 61.5% were single, 36.3% were married and 2.2% were divorced. Of HCP involved in the study, 13.3% of the participants had a history of chronic somatic-disorder and 11.9 % of them had a history of a psychiatric disorder. The prevalence of trait-anxiety in HCP was 53.3%. The analysis showed that anxious HCP were more younger (p=0.002) and had history of a psychiatric disorder (p=0.017) compared to non-anxious HCP. However, no significant difference was found by gender, marital status and professional degree according to trait-anxiety.

In our study, we found that more than the half of HCP were anxious and these one were more younger and had history of psychiatric disorders.

No significant relationships.

No significant relationships.

Clozapine, the antipsychotic of choice for treatment-resistant schizophrenia, has a narrow therapeutic range and high interpatient variability in the dose-response relationship. Serum clozapine levels are essential both for therapeutic dosing and to monitor adherence. Use of venepuncture and prolonged result turnaround times with standard laboratory based methods for drug monitoring together contribute to the suboptimal use of clozapine.

A novel portable point-of-care (POC) device has been developed to measure whole blood clozapine concentrations using an automated homogenous immunoassay. It is as accurate and reliable as standard laboratory methods but only requires a drop of blood obtained by finger prick and can produce a result in minutes. We pioneered clozapine POC testing in the acute inpatient setting during the outbreak of the COVID-19 pandemic.

We report on the use of POC clozapine testing in the management of 4 acutely psychotic patients with treatment resistant schizophrenia.

POC testing offered a more practical, less invasive and quicker alternative to conventional methods for monitoring of clozapine levels. Near immediate availability of clozapine levels expedited clinical decisions and helped ensure safe clozapine prescribing to severely unwell patients in a time of crisis. By facilitating patients’ early safe discharge from hospital, clozapine point of care testing also reduced length of hospitalisation.

Point of care monitoring of other psychotropic medications in addition to clozapine brings about the prospect of personalised precision medicine for patients with severe mental illness, both in the acute setting and in the community.

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

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.

No significant relationships.

No significant relationships.

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.

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.

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

No significant relationships.

The outbreak of COVID-19 has disrupted the lives of countless people worldwide. The pandemic has imposed a sense of uncertainty and anxiety, as the world could not predict or prepare for this crisis. It is important to study risk factors, including employment, marital status, and pre-existing medical or psychiatric conditions to effectively handle this pandemic’s mental health impact.

We aim to evaluate factors contributing to the suicides and mood disorders during the coronavirus pandemic.

We examined MeSH terms “COVID-19” in the context of “Mood Disorders,” “Suicide,” “Suicidal Ideation,” “Assisted or Suicide, Attempted or Suicide,” “Risk Factors.” We identified eight case studies for the qualitative synthesis per the PRISMA guidelines, searching Medline, PubMed, PubMed Central, and PsychInfo databases until August 2020.

We identified that the population of all age groups and sex are at risk of stress and mental illness due to the pandemic. Several factors are attributed to the increased risk of mood disorders and suicide. Not having pre-existing psychiatric or medical condition is not a protective factor, since suicide was attempted or committed due to external factors such as economic and social.

The pandemic has increased the risk of mood disorder and suicides in the population. Focus should be on the behavioral and psychological first aid to curb stress.

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

Unpredictable risks of COVID-19 morbidity and mortality make people suffer from threats and fears. Are there any psychological personality traits that correlate with a decrement in such feelings?

To specify the relationship between psychological characteristics of time perspective, hardiness and COVID-19-related life threat.

We used Zimbardo Time Perspective Inventory, Maddi Hardiness Scale and a 17-point Attitude towards COVID-19 Questionnaire to question 327 Russian university students on social networks. The survey was carried out in the second half of May 2020 in the period of increasing COVID-19 morbidity and mortality rates. The mean age of the respondents was 21.24±2.84; most of them were females (61.16%).

The survey showed that every fifth respondent had a high level of COVID-19-related life threat (21.10 %). At the same time, every tenth of the respondents (10.09%) saw no threat to their life in the situation of a fast spreading dangerous novel coronavirus infection. According to the correlation analysis, decrement in feeling personal threat related to the spread of COVID-19 was directly associated (p<0.05) with low indicators on the scales of Negative Past (r=0.16), Hedonistic Present (r=0.13) and Fatalistic Present (r=0.17). Certain inverse relation was found between the level of COVID-19 related life threat and such indicators as psychological hardiness – commitment (r=-0.16), and challenge (r=-0.23).

Dispositional orientation to the present and future, as well as psychological characteristics of hardiness may mediate COVID-19 related life threat; therefore, these may be used as a possible basis for preventing stress and mental disorders in population.

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.

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.

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.