There is a lack of longitudinal studies of patients with bipolar disorder (BD) or unipolar depression (UD) in terms of psychological well-being as measured by the WHO-5 and the correlation to symptom scores. It is of interest to investigate whether the WHO-5 is useful in monitoring patients with mood disorders over time, as a tool in measurement-based care, and as a supplement to other psychometric measures.

In this study we investigate the correlation at baseline between the depressive symptom scores according to the 6-item Hamilton Depression Score (HDS-6) and the WHO-5 scores in outpatients treated for BD or UD. Furthermore, in patients with BD we investigate correlations between manic symptom scores according to the modified Bech-Rafaelsen Mania Scale (MAS-M) and the WHO-5 scores. Lastly, in patients with BD or UD, we investigate the correlations between endpoint-baseline change in WHO-5 and change in MAS-M and HDS-6.

A longitudinal study of 200 outpatients diagnosed and treated for either BD or UD. Patients will be measured at baseline and at least four weeks later. Baseline data are presented as frequencies, means and standard deviations or medians with interquartile ranges as appropriate. All correlations are presented as scatter plots and a Spearman correlation analysis

The study is ongoing, but the results will be available for presentation at the EPA in 2021.

The WHO-5 may represent a relevant outcome measure in the treatment of BD and UD.

No significant relationships.

Forensic psychiatry is a specialty of psychiatry primarily concerned with individuals who have either offended or present a risk of doing so, and who also suffer from a psychiatric condition. These mentally disordered offenders(MDOs) are often cared for in secure psychiatric environments or prisons. However, the organisation of these services differs greatly between countries due to different traditions and legal frameworks. Some countries, e. g., require absent or reduced criminal responsibility (at the time of the index offence) in order to enter forensic services while others determine access on the basis of current need for treatment. Numbers detained in forensic services also vary significantly as does length of stay, raising significant economic and ethical challenges. This talk will present different legal concepts determining admission to forensic-psychiatric services, data on length of stay as well as approaches to risk assessment and treatment in Europe.

No significant relationships.

No significant relationships.

Metabolic disturbances are common in patients maintained on neuroleptics. These abnormalities significantly increase the physical comorbidity and mortality rates due to cardiovascular disease. We hypothesized that 5-HT receptor genes polymorphisms have associations with drug-induced metabolic syndrome development in schizophrenic patients.

To investigate the role of polymorphic variants of serotonin receptors genes in the development of antipsychotic-induced metabolic syndrome.

467 patients with schizophrenia receiving long-term antipsychotic therapy were investigated. The mean age was 40.0±11.6 years. The standard phenol-chloroform method for DNA isolation was used. Genotyping was carried out on eight SNP’s of genes HTR1A, HTR2A, HTR3A and HTR2C with the MassARRAY® Analyzer 4 (Agena Bioscience™) using the set SEQUENOM Consumables iPLEX Gold 96 on the base The Core Facility “Medical Genomics”, Tomsk NRMC.

The prevalence of metabolic syndrome was 26.1%. In the study sample, there were significantly more women with metabolic syndrome (56.6%) than men (43.4%) (p=0.002). The majority of patients with metabolic disturbances were aged >40 years (62.3%), versus 40.9% in the group without metabolic disorders (p<0.001). The duration of the disease was statistically significantly higher in the group of patients with metabolic syndrome (p=0.003). We did not find statistically significant associations of polymorphic variants of the studied genes with the development of the drug-induced metabolic syndrome.

Our results do not demonstrate any significant association between allelic variants of serotonin receptor genes and metabolic syndrome in patients with schizophrenia. Conflict of interest. The authors declare no conflict of interest. Supported by Grant of RSF 19-75-10012.

In 2019 national survey - personal examination of persons, living in residential facilities for mentally disabled people - was executed under the instruction of the Government by specialists of V.Serbsky National Medical Research Centre. For 2559 legally incapacitated residents the procedure of rehabilitation of full or diminished capacity was recommended. For 16132 legally capable residents the procedure for recognising their incapacity was recommended (Kekelidze ZI et al., 2020).

To compare the recommendations on legal capacity in two regions with different systems of inpatient social services.

Full-sized noncontrol observational descriptive screening study.

In table 1 the recommendations on legal capacity in two regions are presented.

Differences in quantity of residents, for whom rehabilitation of full or diminished capacity was recommended, depend on characteristics of the systems of institutional care in the regions. In the first region a complex system of rehabilitation and deinstitutionalization has been organised. In the second region such system is just organising. Among legally capable and those, for whom rehabilitation of capacity was recommended, there were residents, able to live independently or under community-based services.

No significant relationships.

No significant relationships.

Harm reduction (HR) approaches substance use disorders (SUDs) from a standpoint of humanism and tolerance, understanding the difficulty of terminating consumption in some cases, and instead promoting practices aimed at reducing risks inherent to substance use while granting accessibility to comunity based healthcare and contact with differentiated care, when needed, to patients who otherwise wouldn’t have access to it. The COVID-19 pandemic brought about an economic crises, impacting mainly people from lower classes, associated with an increased prevalence of heroine and crack cocaine use and exacerbating previous SUDs.

Describe changes in a HR population treated in HR context in Gaia, Portugal.

Data was retrieved from clinical files of patients undergoing treatment in a Harm Reduction setting on the HR team “GiruGaia” from Porto. Analysed data included number of patients admitted to treatment in the period between march the 1st and december the 30th 2020, their sociodemographic data, psychiatric and substance use history, psychiatric treatment and opioid agonist treatment when required. Gathered data was compared to the same time period in previous years.

The number of patients admitted to treatment drastically increased. Patients presented with poorer socioeconomic conditions, more psychiatric comorbidity and in need of more extensive treatment interventions.

Our findings suggest that the pandemic and it’s socioeconomic impact affected drug users in need of HR interventions worsening underlying psychiatric disorders, poverty and inacessibility to healthcare. Drug users are often a forgotten population, and our results indicate that more attention should be devoted to them.

No significant relationships.

Autism spectrum disorders (ASD) is one of the most common neurodevelopmental disorders. It is known that infants who have older siblings with ASD have a risk for development of this disorder. It is important to study the development of children at risk for ASD to reveal early markers for ASD.

The aim of this research was to investigate the neurocognitive abilities in children at risk for ASD at 14 months of age.

The experimental group included 21 infants at risk for ASD at 14 months (12 boys and 9 girls). The control group included 21 typically developing children. The children from groups were matched for gender and age. The Bayley Scales (3rd Ed.) were used to evaluate the neurocognitive abilities in children.

The results were evaluated by two-way ANOVA, with level of performance in five Bayley scales as dependent variable, with group and gender as between-subjects factors. We did not reveal the significant (p≤0,05) influence of the group and gender on performance in cognitive scale, receptive language, gross and fine motor. However, the infants at risk for ASD performed significantly (p≤0,05) more poorly than infants from control group on expressive language. No differences were found between female infants at risk for ASD and female infants from control group on expressive language.

The obtained results show that male infants at risk for ASD have deficit in expressive language at 14 months of age. It is possible that delay in development of expressive language can be early markers for ASD.

Delirium is a frequent and serious complication of cardiac surgery. However, the knowledge regarding pathogenesis of postoperative delirium is limited.

To investigate whether increased levels of monocyte chemoattractant protein-1 (MCP-1) and hyper-sensitive C-Reactive Protein (hsCRP) are associated with postoperative delirium in cardiac surgery patients.

Patients were examined and screened for major depressive disorder (MDD) and cognitive impairment one day preoperatively, using the Mini International Neuropsychiatric Interview and The Mini-Mental State Examination Test. Blood samples were collected pre- and postoperatively for hsCRP and chemokine levels. Following surgical interventions, the Confusion Assessment Method for the Intensive Care Unit and the Memorial Delirium Assessment Scale with the cut-off score 10 were used to diagnose delirium.

Postoperative delirium screening was found positive in 34% (61 of 177) of patients. Both, pre- and postoperative hsCRP, and preoperative MCP-1 levels were associated with postoperative delirium in univariate comparisons; p=0.001; p=0.0004; p < 0.001, respectively. However, according to a multivariate stepwise logistic regression analysis only MCP-1 concentration raised before surgery was independently associated with postoperative delirium, and related to advancing age of participants (Spearman’s Rank Correlation 0.192; p=0.0103). According to ROC analysis, the most optimal cut-off for MCP-1 concentration in predicting the development of delirium was 371.81 ng/ml with sensitivity of 77.0% and specificity of 58.6%.

The present study suggests that raised preoperative MCP-1 concentration is independently associated with delirium after cardiac surgery. Preoperative monitoring of pro-inflammatory markers combined with regular surveillance may be helpful in the prediction and early detection of postoperative delirium in this patient group.

The Coronavirus pandemic has been causing a significant psychological impact on the population, showing symptoms such as anxiety, depression, post-traumatic stress disorder, among others. In addition, health professionals, who are on the front line, need to act promptly seeking unceasingly to save lives, predisposing to psychosocial events due to the risk of contamination, family distance and frustration in relation to death.

To analyze the profile of the psychosocial care performed in workers of a Brazilian university hospital who sought care to control the anxiety-stress resulting from the pandemic

Cross-sectional observational study, using a questionnaire to survey psychosocial demands and evaluate the care of workers who sought assistance in this service (n=61). As a dependent variable, the sector of action was stipulated and as independent the sex, age and the demands that justified the need for assistance. The data were analyzed by Pearson’s correlation with 5% of significance through the statistical software SPSS.

There was a statistic difference between the groups in the variables age and psychosocial interventions for anxiety and stress management. The most part of the sample was composed of health professionals, women, with an average of 33 years old, motivated, technically prepared, scared and not overloaded.

Psychosocial care to health professionals for the management of anxiety and depression is indispensable either during or after the pandemic by seeking Mental Health interventions to minimize the suffering of these workers.

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.

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.

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.

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.

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

In China, the indications of paliperidone extended in schizophrenia adolescents (12-17 years) was approved by National Medical Products Administration (NMPA) in 2017. But, the utilization of paliperidone in this group needs to be further investigated.

To assess paliperidone utilization in schizophrenia adolescents.

The study employed the electronic medical records (EMRs) database from a psychiatry specialized hospital (PH) and a general hospital (GH), respectively. General information, including birth date, gender, visit date, diagnosis (inpatient and outpatient) with ICD-10 coding, drug characterize, prescription date and dosage, was de-identified and standardized for analysis. Schizophrenia adolescents (ICD-10: F20.x) received at least one prescription of paliperidone between 2018 and 2019 were included in this study. Index date was defined as the date of first identified paliperidone prescription. The patients were followed up until the end of 2019 with the last record, or upon reaching 18 years. The database was analyzed based on days of supply, administration frequency, and daily dose.

Overall, 112 and 117 eligible patients were included in the present study from PH and GH, respectively. The median drug supply was 179.0 days and 44.0 days, respectively, during which median number of prescriptions patients received was 6.0 and 3.0. Paliperidone was mostly initiated alone (57.1% and 88.9%) with frequency of once daily (97.3% and 88.9%), and the median of average daily dose during follow-up was 5.7 mg/day and 6.0 mg/day, respectively.

The duration of paliperidone usage was very different in two hospitals, but the dosages in both hospitals were generally agreed with prescribing information.

The Kennedy Krieger Institute Network for Early Childhood Tele-Education (KKI-NECT) is a federally funded ECHO project. Its hub consists of a child psychiatrist, developmental pediatricians and a behavioral psychologist. Its community partners are primary care providers(PCPs) in underserved areas. Its goal is to create local experts in early childhood behavioral, emotional and developmental disorders.

After attendance at this session, the learner will be able to: 1. report the rates of co-occurring developmental, behavioral and emotional disorders presented by primary care participants 2. explain the efficacy of case based learning and a structured curriculum as a mechanism for expanding the workforce. The goal of this presentation is to build awareness of and interest in ECHOs specifically targeted to child behavioral, emotional and developmental issues.

Dr. Leppert will discuss KKI-NECT, particularly the process of procuring funding, setting up an ECHO, and getting institutional “buy-in". She will describe the use of case based learning and a structured curriculum in a longitudinal CME program, report the comorbidities in cases that participants present for discussion, and demonstrate the impact on participants’ practice.

Data from four cohorts demonstrate that PCPs showed increased comfort levels, improved knowledge of behavioral, emotional and developmental disorders. PCPs expanded the scope issues they could address in their practice as a result of participation in KKI-NECT.

KKI-NECT is a viable response to the workforce shortage of child psychiatrists by confidently increasing the role of the PCP in treating childhood developmental and mental health disorders.

No significant relationships.

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

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

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

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

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

No significant relationships.

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

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

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

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

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

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

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

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

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

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

No significant relationships.