At pathomorphological research of suicides reveal neurogenerative changes, which determines the relevance of the search for neuroimaging predictors (suicidal behavior) SB in dementia.

To study predictors of SB (in dementia, due to Alzheimer’s disease (AD), vascular (VD), mixed (MD) based on neuroimaging research.

We examined 213 patients with dementia in АD, VD, MD on a CT, which were divided by the factor of the presence of SB into the main and control groups.

At patients with SB at AD expansion of basal cistern is revealed of the brain (59%), but signs of chronic ischemia in the form of a decrease in the density of brain matter in the projection of the basal ganglia and white matter (67%), dilation of the ventricular system of the brain (51%), more typical for patients without SB. At VD with SB periventricular leukoareosis (67%), expansion of subarachnoid spaces (82%) and deepening of cracks of a brain (67%) are found. Patients without SB were characterized by a decrease in the density of brain matter in the projection of the white matter (73%). At MD with SB expansion of subarachnoid spaces (100%), basal cistern of a brain (87%), periventricular leukoareosis (87%), decrease in density of substance in the brain were registered in the projection of the basal ganglia (100%). Patients without SB with MD had deepening of the brain slits (40%).

Neuroimaging signs in the form of chronic ischemia and pronounced atrophic changes in the brain are factors in the anti-risk of SB in dementia.

No significant relationships.

Intergenerational programs involving children and the elderly promote intergenerational interactions and can positively affect physical and mental health, and the quality of life of the elderly.

To test the effects of an intergenerational intervention in social isolation, depressive symptoms and quality of life of the elderly.

This study employed a pretest-posttest design. Measures: Portuguese versions of Geriatric Depression Scale, Lubben Social Networks Scale and WHOQOL-OLD. Participants: 12 elderly, 75% females, with mean age of 80.8 years (sd=8.8) and 20 kindergarten children (65% female) with mean age of 4,1 years (sd=0.79). The intervention ran for 6 weeks, with 11 intergenerational group sessions, each range between 30 and 120 minutes. A nonparametric paired samples tests was conducted to evaluate the impact of the intervention.

After the intervention, when comparing elderly with and without depressive symptoms, results showed significant differences in the total value of quality of life (p=.048) and in the facets: 1) Sensory functioning, 2) Autonomy, 3) Past, present and future activities (p=.003; p=.018; p=.030, respectively). 12,5% of de elderly with depressive symptoms before the intervention no longer have depressive symptoms after the intervention. Regarding social networks, there were no significant differences (p=.576) between the mean values of the two assessments.

The implemented intergenerational program was effective in promoting quality of live and minimized depressive symptoms. After the intervention, the number of the elderly without depressive symptoms have increased and these presented a higher quality of life. Finally, longitudinal studies with a large sample are needed to consolidate results.

There is a need to study therapies that may contribute to the successful rehabilitation of veterans with traumatic brain injury (TBI) and increase their effective interaction with the stressful environment, reduce the severity of symptoms. Combined short-term therapies may have potential.

To analyze the clinical case of combined psychological treatment of TBI in a Ukrainian combat veteran with reduced resilience

The clinical case of Ukrainian combat veteran with TBI is presented. Montreal Cognitive Assessment (MoCA) was used to assess cognitive domains. Neurobehavioral symptom inventory (NSI) was used to assess neurobehavioral symptoms of TBI. CD-RISC was used to assess resilience. In addition to pharmacotherapy, the patient agreed to undergo a combined program of psychological therapy of 3 short-term positive intervention sessions and 3 cognitive training sessions.

MoCA result prior to treatment was 24 p., NSI – 38 p., CD-RISC – 44 p. (lower than in population). After the combined therapy, the results of the assessment with MoCA were 26 points, NSI was 17 points, CD-RISC – 47 points. Subjectively, the patient noted an improvement in emotional state, better resilience, and a significant reduction in the intensity of cognitive symptoms.

Combining positive interventions with cognitive training can have the potential to significantly improve the neurobehavioral and cognitive functioning of war veterans with traumatic brain injury, and also possibly increase resilience. Further research in this direction will be conducted to obtain more reliable results.

End-Stage Renal Disease (ESRD) patients have difficult and challenging lifestyle due to the burden of the disease that, leads to numerous psychological issues. Regardless, healthcare providers usually focus on the somatic side and don’t take care of the psychological dimension.

Determine the effect of psychological support on the wellbeing of patients with ESRD.

A survey sheet including sociodemographic and clinical data were distributed to two different groups. Psychological counseling was given to one of the groups, and wasn’t given to the other one.

Patients not receiving psychological support had higher levels of anxious and depressive symptoms and suicidal ideations compared to the group receiving psychological support that had lower levels of anxious, depressive symptoms and suicidal ideation.

ESRD patients are at risk of developing all sorts of psychological issues. Which underlines the importance of the psychological support associated to the appropriate somatic care.

No significant relationships.

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe cutaneous drug reaction characterised by both systemic and cutaneous clinical manifestation with a mean latency period of 3.9 weeks.

To underline the importance of an early diagnosis of DRESS SYNDROME.

We reported a case of carbamazepine induced DRESS syndrome with atypical chronology of manifestations.

A 43-year-old man with no previous known medical history was admitted in psychiatry. He experienced a relapse of schizoaffective symptoms. In the last three years, the patient was treated by Valproic acid as a mood stabilizer. Because of the unavailability of this molecule, carbamazepine was prescribed in combination with antipsychotics. Three days later, the patient developed a high fever, hypotension, a pruritus, a facial oedema, a skin rash associated to lymphadenopathy. Laboratory findings showed a lymphopenia, eosinophilia and elevated liver chemistries. In order to define the case, RegiSCAR scoring system was used, and our case is categorized as probable with a score of five. Carbamazepine was discontinued upon clinical manifestationsand the patient was treated with systemic antihistaminic treatment associated to methylprednisolone with a good outcome. After 3 weeks, clinical and biological improvement were noted.

Despite the absence of a delayed onset, typically between 3 weeks and 3months, we can diagnose dress syndrome 3 days after carbamazepine intake. This case highlights that psychiatrists should be aware of the risk of early onset dress syndrome associated with carbamazepine and they should monitor for warning symptoms from treatment initiation.

No significant relationships.

Pain, fatigue and anxiety are common features of fibromyalgia and ME/CFS and significantly impact quality of life. Aetiology is poorly defined but dysfunctional inflammatory, autonomic and interoceptive (sensing of internal bodily signals) processes are implicated.

To investigate how altered interoception relates to baseline expression of pain, fatigue and anxiety symptoms in fibromyalgia and ME/CFS and in response to an inflammatory challenge.

Sixty-five patients with fibromyalgia and/or ME/CFS diagnosis and 26 matched controls underwent baseline assessment: pressure-pain thresholds and self-report questionnaires assessing pain, fatigue and anxiety severity. Participants received injections of typhoid (inflammatory challenge) or saline (placebo) in a randomised, double-blind, crossover design, before completing heartbeat tracking tasks. Three interoception dimensions were examined: subjective sensibility, objective accuracy and metacognitive awareness. Interoceptive trait prediction error was calculated as discrepancy between accuracy and sensibility.

Patients with fibromyalgia and ME/CFS had significantly higher interoceptive sensibility and trait prediction error, despite no differences in interoceptive accuracy. Interoceptive sensibility and trait prediction error correlated with all self-report pain, fatigue and anxiety measures, and with lower pain thresholds. Anxiety mediated the positive-predictive relationships between pain (Visual Analogue Scale and Widespread Pain Index), fatigue impact and interoceptive sensibility. After inflammatory challenge, metacognitive awareness correlated with baseline self-reported symptom measures and lower pain thresholds.

This is the first study investigating interoceptive dimensions in patients with fibromyalgia and ME/CFS, which were found to be dysregulated and differentially influenced by inflammatory mechanisms. Interoceptive processes may represent a new potential target for diagnostic and therapeutic investigation in these poorly understood conditions.

No significant relationships.

Impairment of conventional perception is one of the key dysfunction in patients with schizophrenia even in absence of psychotic symptoms.

Possibility of improvement of conventional perception by add-on treatment with ipidacrine in patients with schizophrenia in long-term remission.

26 (13 females) patients, mean age 40.4 (SD 11.7) with episodic schizophrenia in remission more than one year, receiving stable antipsychotic therapy were included into the open label study. As add-on treatment ipidacrine was administered once per day in dosage 20 mg for two months. Positive and Negative Symptoms Scale (PANSS) was used to assess clinical symptoms and projective psychological method (Rorschach Test) was used to assess conventional perception.

The study showed that ipidacrine in a low dosage, added to standard antipsychotic treatment, was effective in relation to negative symptoms (PANSS negative subscale score before 22,4 (SD4,7) and after beginning of the study 19,7 (4,5), p=0, 001). Of all the indicators of the Rorschach test, there was significant improvement in the index X+%, which is responsible for the degree of conventionality in reality recognition. The decrease in conventionality was associated with both high individualism and perceptual disorders. The value of of X+ % did not reach the standard one (70%) to the end of the study, but the improvement showed the switching from severe (52,4 (SD 12,2) to moderate (60,6 (SD10,4) impairment level (p=0,039).

Ipidacrine in a low dosage as add-on treatment has positive effect on conventional perception of stable patients with schizophrenia even in short-term trial.

The coronavirus disease 2019 (COVID-19) pandemic created a situation of general distress. Although the focus has been initially more on the physical health during the pandemic, mental health concerns linked to the lockdown have quickly risen.

The aim of this study was to evaluate the impact of the first wave of COVID-19 pandemic on Tunisian women’s mental health.

An online survey was conducted during the first wave of COVID-19 pandemic using the Depression Anxiety and Stress Scales (DASS-21). We also collected sociodemographic information and mental health status.

A total of 751 women completed the questionnaire. More than half of the participants (57.3%) reported extremely severe distress symptoms, and 53.1% had extremely severe stress symptoms as per the DASS-21. Those who had a history of mental illness were found to have more severe symptoms of depression, anxiety and stress.

As this study was the first one to evaluate the acute impact of COVID-19 on mental health in Tunisia, Arab world and in Africa, it may be a sound basis for developing an effective psychological intervention aimed at women in these regions.

No significant relationships.

Psoriazis and major depressive disorder (MDD) have a high degree of overlap, and inflammatory citokines like tumor necrosis factor alpha, interleukins 1, 2, 6 and 10, and C-reactive protein have been involved in their common pathogenesis. The prevalence of MDD in patients with psoriazis has been reported to range between 28% to 67%.

To monitor the core symptoms evolution in patients diagnosed with psoriazis and MDD during antidepressant treatment.

Four patients diagnosed with psoriazis and MDD (according to the DSM-5 criteria) were monitored during 6 months using Physician Static Global Assessment (PSGA), Hamilton Depression Rating Scale (HDRS)-17 items, and Global Assessment of Functioning (GAF). All patients underwent specific psoriazis and antidepressant treatment (with flexible dose of sertraline 100-200 mg daily, n=2, or escitalopram 10-20 mg/day, n=2).

All patients significantly improved their depressive symptoms during sertraline or escitalopram treatment (-8.7 points on HAMD at week 24, p<0.001), while their global functioning increased (+24.7 on GAF, p<0.001). The PSGA score decreased and reached a level of signifiance at week 24 (-1.2, P<0.01). The duration of active periods of psoriazis was less longer during the 6 months of monitoring than in the 6 months previous to the antidepressant initiation (by self-report, -10.5 days). No treatment discontinuation due to low tolerability was reported.

Antidepressant treatment with selective serotonin reuptake inhibitors is efficient and well tolerated in patients with MDD and psoriazis. The duration of active symptoms of psoriazis tends to be less longer than previous to the antidepressant initiation.

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.

Medical students’ well-being is a concern that drawn interest.On March, 2020, WHO declared COVID-19 as a pandemic.Strict isolation measures and closing schools expected to influence the mental health of students.Online education introduced to adjust to new realities.These un-precedented circumstances create significant stress and challenges may lead to unfavorable effects on learning and the overall psychological health of students.

To explore the perception of stress and anxiety level among medical students in Saudi Arabia. To determine factors influencing perception of stress and anxiety among medical students in Saudi Arabia. To explore the association between perception of stress, anxiety and on-line learning.

An online survey will be distributed through students representatives targeting medical students from different levels. The survey will have 4 components: 1) Demographic data that will include: age, gender, level of education and region of residence. 2) Questions concerned the experience of online learning. 3) Perceived stress scale by sheldon cohen. The perceived stress scale (PSS) is a 10-question tool will be used to measure a person’s perception of stress over the past month and scored as low, moderate and high perceived stress. 4)Generalized Anxiety Disorder 7 (GAD-7) which is also a valid tool in detecting anxiety in the last two weeks by 7 items with Likert scale answers which scored as minimal, mild, moderate and severe

Currently under analysis

To be attached later

No significant relationships.

Primary hyperparathyroidism (PHPT), usually caused by a parathyroid adenoma, is characterized by a pathologically high secretion of parathyroid hormone and consequent hypercalcemia. PHPT has a high prevalence among elderly patients and might be responsible for neuropsychiatric symptoms.

We aim to report the rare manifestation of acute psychosis accompanying a PHPT diagnosis, and to discuss the neurobiological relationship between hyperparathyroidism, hypercalcaemia and neuropsychiatric symptoms.

We present a clinical case based on patient’s history and clinical data, along with a literature review on PHPT neuropsychiatric symptons.

We present the case of a 68-year-old man diagnosed with PHPT in November 2019. He was brought up to psychiatric evaluation for the first time in May 2020 upon behavioral changes (aggressiveness and bizarre rituals). The patient described the sensation of burns scattered throughout the body since January 2020, felling anxious and frightened, sleeping poorly and progressive social isolation. He presented delusional ideas of mystical and paranoid content. No significant cognitive impairments were found. The patient’s psychosis was partially responsive to atypical antipsychotics. He’s waiting for surgery. Hypercalcaemia might manifest as mood disorders, cognitive changes and rarely as acute psychosis. Although there is not yet a clear mechanism to explain it, high calcium levels seem to cause neurotoxicity and neurotransmission dysfunction. Restoration of normal calcium levels tend to resolve neuropsychiatric symptoms, but in PHPT parathyroidectomy is usually recommended.

Neuropsychiatric symptoms are responsible for great disability, and demand an organic in-depth investigation. A multidisciplinary team approach must always be considered in the management of such conditions.

Central to recovery-oriented approaches in schizophrenia are treatment integration and personalization, targeting key variables beyond symptom reduction. The Italian network for research on psychoses conducted a study demonstrating, using network analysis, the central role of community activities in bridging the effects of symptoms, cognition, functional capacity and service engagement on real-word functioning. A 4-year follow-up study was recently completed and the presentation will illustrate the findings. Network analysis was used to test whether relationships among all variables at baseline were similar at follow-up. In addition, the network structure was compared between subjects classified as recovered or non-recovered at follow-up. Six hundred eighteen subjects were assessed at both baseline and 4-year follow-up. Results showed that the network structure was stable from baseline to follow-up, and the overall strength of the connections among variables did not significantly change. Functional capacity and everyday life skills were the most central variables in the network at both baseline and follow-up, while psychopathological variables were more peripheral. The network structure of non-recovered patients was similar to the one observed in the whole sample, but very different from that of recovered subjects, showing few connections among the different nodes. These data strongly suggest that connections among symptoms/dysfunctions tend to maintain over time, contributing to poor outcome in schizophrenia. Early treatment plans, targeting variables with high centrality, might prevent the emergence of self-reinforcing networks of symptoms and dysfunctions in people with schizophrenia.

Armida Mucci has been a consultant and/or advisor to or has received honoraria from Gedeon Richter Bulgaria, Janssen Pharmaceuticals, Lundbeck, Otsuka, Pfizer and Pierre Fabre. None of these has any impact on this abstract and on the presented study.

No significant relationships.

Several studies link COVID-19 and the associated lockdown and social-distancing measures to adverse mental health outcomes. In order to address this increase in mental health problems, adequate training of mental health care professionals is of the utmost importance. Objectives: To measure the impact of the COVID-19 pandemic on psychiatric training in Europe and beyond. Methods: The European Federation of Psychiatric Trainees (EFPT) represents more than 20 000 trainees from over 30 European countries. Every year, country representatives, complete the ‘Country Report’, which contains detailed information on psychiatric training in every (member) country. Results: In July 2020, representatives of 34 European and 9 non-European countries completed the survey. In 73% of countries, psychiatric trainees were assigned to COVID-19 wards, in 43% to emergency wards. In 25% of countries, trainees did not receive any training on COVID-19 prior to their assignment. Compared to before the COVID-19 pandemic, trainees reported a decrease in clinical supervision in 65% of countries. In 51% of countries, (parts of) formal psychiatric training was cancelled. Psychotherapy training was cancelled in 25% of countries. In the majority of countries both formal and psychotherapy training were given online, however in 56% trainees experienced difficulties to attend. Conclusions: The COVID-19 pandemic has had an extensive impact on psychiatric training in Europe and beyond. The EFPT calls upon policy makers and supervisors to minimize the impact of COVID-19 on psychiatric training in order to provide psychiatric trainees with adequate skills to deal with the mental health consequences of the COVID-19 pandemic.

No significant relationships.

There is a limited literature available showing mental health burden among adolescents following cyberbullying.

Aim is to evaluate the association of low mood and suicidality amongst cyberbullied adolescents.

A study on CDC National Youth Risk Behavior Surveillance (YRBS) (1991-2017). Responses from adolescence related to cyberbullying and suicidality were evaluated. Chi-square and mix-effect multivariable logistic regression analysis was performed to find out the association of cyberbullying with sadness/hopelessness, suicide consideration, plan, and attempts.

A total of 10,463 adolescents, 14.8% of adolescents faced cyberbullying a past year. There was a higher prevalence of cyberbullying in youths aged 15-17 years (25 vs 26 vs 23%), which included more females to males (68 vs 32%).(p<0.0001) Caucasians (53%) had the highest number of responses to being cyberbullied compared to Hispanics (24%), African Americans (11%).(p<0.0001) There was an increased prevalence of cyberbullied youths with feelings of sadness/hopelessness (59.6 vs 25.8%), higher numbers considering suicide (40.4 vs 13.2%), suicide plan (33.2 vs 10.8%), and multiple suicidal attempts in comparison to non-cyberbullied.(p<0.0001) On regression analysis, cyberbullied adolescence had a 155% higher chance of feeling sad and hopeless [aOR=2.55; 95%CI=2.39-2.72], considered suicide [1.52 (1.39-1.66)], and suicide plan [1.24 (1.13-1.36)].

In our study, cyberbullying was associated with negative mental health outcomes. Further research is warranted to examine the impact and outcomes of cyberbullying amongst adolescents and guiding the policies to mitigate the consequences.

No significant relationships.

Coronavirus disease 2019, is now a global pandemic that has spread rapidly causing many deaths. Most countries have opted for compulsory confinement which had repercussions on mental health and well-being.

The purpose of this study is to assess mental health consequences during the confinement period.

This is a cross-sectional descriptive study of 360 Tunisians in April and May 2020. We used an anonymous E-questionnaire that included a socio-demographic fact sheet, The HAD questionnaire, and a Q-EDD questionnaire to explore eating disorders.

The subjects of our sample were mostly males with a mean age of 31. The body mass index was 25.5 (range 16.10 -46.24), 15% suffered from obesity. Half of the subjects were single and 6.7% spent the confinement time alone. 11.1% were smokers while 4.4% were alcohol users. The HAD-A and the HAD-D scores had an average of 9.1 and 8.48 respectively.A pathological threshold of anxiety and depression was found in 20% and 30% of the sample respectively.15% had an eating disorder: 76% had binge eating, 20% had bulimia and 17% had anorexia. In our study, we found an association between eating disorder and obesity, single marital status (p=0.007), living alone (p=0.001), history of depression (p=0.046), anxiety (p=0.049) and depression (p=0.038).

Reduced social interactions, decreased physical activity and increased stress are potentially harmful causes for our brain. Confining the population for several weeks has a negative impact on our physical and mental health. A crisis unit has been formed in Tunisia to help subjects overcome these psychological difficulties.

Development of an acute cerebral dysfunction in a form of delirium after cardiac surgeries is common general medical problem that associated with prolonged hospital stay after the surgery, risk of development of infection, risk of subsequent neurocognitive changes, and postoperative morbidity

To compare risk of development of postoperative delirium in elderly patients with and without hippocampal dysfunction

Selective observational longitudinal study of the same group of objects in pre and postoperative period

For the diagnosis of degenerative process in CNS on early stages Free and cued selective reminding test immediate recall (FCSRT-IT) was shown to be the most sensitive. Based on learning of verbal material and semantic cues with recalling, FCSRT-IT allows differentiating amnestic disturbances hippocampal type from secondary disturbances of memory due to neurodynamic changes

Hippocampal dysfunction is a factor of developing of postoperative delirium in elderly patients that requires using additional measures in patients with mild cognitive disturbance to prevent developing of postoperative delirium

No significant relationships.

No significant relationships.

The recognition of the conditioned-unconditioned stimulus (CS-US) association in classical conditioning is referred to as contingency awareness. The neural underpinnings of contingency awareness in human fear conditioning are poorly understood.

We aimed to explore the EEG correlates of contingency awareness.

Here, we recorded electroencephalography (EEG) from a sample of 20 participants in a semantic conditioning experiment. In the acquisition phase the participants were presented with sequences of words from two semantic categories paired with tactile stimulation followed by presentation of a neutral sound (US-) ((e.g., animals -> left hand vibration -> US-, clothes -> right hand vibration -> US-). In the test phase the association violated in 50% of trials which followed by a presentation of a loud noise (US+). The participants were only instructed to listen carefully. On the basis of self-reported contingency awareness, twenty participants were divided in aware (N=12) and unaware (N=8) group.

The aware group expressed a non-lateralized effect of alpha-beta (12-23 Hz) suppression along with a more negative CNV at central channels preceding presentation of the vibration (main effect of Group). Also, CNV was more negative in expectation of US+ comparing with expectation of US- in the aware group but not in the unaware group.

The results indicate that contingency awareness is accompanied by neural patterns reflecting expectation as can be seen in the suppression of somatosensory alpha-beta activity before expected presentation of the vibration as well as in CNV in expectation of an aversive event.