The formation of thinking in ontogenesis follows the line of progressive differentiation and integration of the representations of objects, events, and relationships. The same is true for the development of mentalization ability, conceived as a thought process in the area of social interactions.

The purpose of the study was to compare the particularities of thought processes when dealing with different types of material: physical objects (operational thinking) and social situations (mentalization).

40 inpatients with schizotypal personality disorder, 40 inpatients with paranoid schizophrenia and 40 controls took part in the study. The Objects Sorting Test was used to assess operational thinking. The mentalization ability was assessed using two SCOR-S scales for Thematic Apperception Test: Complexity of representations of people and Understanding of social causality.

The results of correlation analysis support the existence of the reverse links between the impairments of operational thinking and both the complexity of representations of people (r=-.36, р<.001) and the understanding of social causality (r=-.38, р<.001). It is supported by the qualitative analysis, where inpatients with thought distortions, characterized by arbitrary generalizations, are inclined to make similar errors in the reasoning about the mental states, ignoring the conventional explanations and relying on their own emotional impression and etc.

The limitations of the operational thinking as reflected in the inability to form adequate generalizations on the basis of socially predefined attributes of meaning are closely related to the ability of differentiation, integration and causal explanation of meaningful aspects or social situations.

Nowadays we know that autism spectrum disorders (ASD) and Schizophrenic spectrum (SS) are different types of disorders in their etiology, symptoms and prognosis, but the clinical distinction is often difficult to make due to comorbidity and similar symptoms.

With this project, the authors intend to explore the differential diagnosis between ASD and SS specially when we talk about critical ages of onset.

An analysis of articles searched on Pubmed (articles between 2010-2020) with the key words “adult autism”, “childhood onset schizophrenia”, “childhood psychosis”.

Early-onset schizophrenia (EOS) is defined as occurring before age 18 years. The condition share key diagnostic symptoms with adult-onset schizophrenia (AOS) but his prognoses and comorbidities differ. Autism spectrum disorder (ASD) is a common neurodevelopmental disorder characterized by difficulties since early childhood across reciprocal social communication and restricted interests and behaviors. ASD is a lifelong neurodevelopmental disorder, however there is a lack of answers and research for adults with ASD. There are shared aspects of odd thinking, rigid behaviors and impaired socialization in schizophrenia and ASD and COS seems to have a strong relationship with ASD, being comorbid in up to 50% of cases.

Usually the evaluation of the developmental history of the person, prodrome and onset, its course and the presence of positive symptoms of schizophrenia is enough to help us find a diagnosis. Unfortunately, in some ages the conclusion is not so easy to find. However is essential to determine whether the clinical manifestations belong to the autistic spectrum, the schizophrenic or result from comorbidity.

Stoke is a growing public health problem in the developed world resulting in more hospitalization and mortality. In young adults stroke is the third most common cause of death world wide and the fourth leading cause of disease burden.

The aim was to describe a case of recovery after two hemorrhagic strokes in a young adult patient.

It was presented a clinical case and review the current literature showing the pathway of recovery.

A 38-years-old man presented two episodes of hemorrahgic strokes with a lack of 6 months. With history of hypertension, smoking habits and consume of cannabinoid. The first hemorrhagic stroke had sequels of right hemiparesis. It was diagnosed with frontal arteriovenous malformation. In the second episode was submeted to frontoparietal craniotomy with total dissection of the arteriovenous malformation. After surgery he had convulsive crises that remited with valproic and levetirazetan. It did intensive rehabilitation and two months later he recovered totally. In this momente he is functional for daily lactivities, maintained the same treatment and cognitive stimulation.

It is necessary to accomplish for healthy habits in order to prevent strokes in young people. A better prognoses may be related to a urgent and prolonged intervention and reabilitation.

No significant relationships.

The COVID-19 outbreak poses a challenge for health care professionals due to a surge in care demands, overwork, fear of contagion and concerns on the availability of protective equipment, and coping with distress of patients and their families. Although there is emerging evidence on prevalence of stress and its predictors, less is known on the trajectory of stress symptoms and the differences between cohorts of health care professionals.

To sustain and restore health care professionals the Leiden University Medical Center has launched the Digital Stress Buddy, a mobile app, to assess psychological stress, depressive symptoms, anxiety and posttraumatic stress symptoms.

Participants fill in a 14-item questionnaire on stress and resilience resources, followed by a COVID-related questionnaire and finally a set of validated questionnaires on depression and anxiety (DASS-21), posttraumatic stress-symptoms (IES-R), burn-out (CBI) and resilience (RES).

To date, 959 health care workers have completed the stress monitor, of whom 223 (23%) showed relevant stress levels. Within this group, anxiety and posttraumatic symptoms were most prevalent (45%), followed by depressive symptoms (15%). Predictors of stress were being female, coping with distress of patients and their families, teleworking, and overwork.

By identifying vulnerabilities and resilience for psychological distress, we are able to tailor the support interventions for health care workers within our hospital. This is an ongoing study and future follow-up during the second wave of the pandemic will provide more insight on the trajectories of stress-related symptoms.

No significant relationships.

Violence against women is a public health problem worldwide. During humanitarian crises such as wars, violence expands mainly to the detriment of the most vulnerable groups.

This study aims to assess the effect of the COVID-19-related lockdown on gender-based violence.

This study was conducted using an online survey, between April 25 and May 6, 2020. Women were asked about sociodemographic information, lockdown conditions, history involving exposure to violence before and during the COVID-19 lockdown and its types.

The number of included participants was 751. The age ranged from 18 to 69 years. Violence against women increased significantly during the lockdown (from 4.4 to 14.8%; p < 0.001). Psychological abuse was the most frequent type of violence (96%). Almost 90% (n = 98) of those who experienced violence during the lockdown did not seek assistance. Women who had experienced abuse before the lockdown were at an increased risk of violence during lockdown (p < 0.001; OR = 19.34 [8.71–43.00]).

Strengthening strategies to protect women during periods of crisis is urgent. However, a change in mentalities would take more time to set up. Violence against women necessitates a fundamental long-term struggle and practical intervention strategies.

No significant relationships.

No significant relationships.

PPalliative medicine is aimed at achieving the best possible in a particular situation the level of quality of life of the patient.

The reaction of grief is one of the strongest and most painful human experiences.

There were 120 cancer patients observed. The reaction of grief consists of 4 stages: shock and protest - numbness, disbelief and acute dysphoria; absorption - acute longing, search and anger; disorganization - a sense of despair and acceptance of loss and decision.

The initial reaction of grief - shock, emotional numbness and disbelief. The excitement is most pronounced within about two weeks, followed by symptoms of depression, which reach its peak 4-6 weeks. Eventually, the former intense pain of severe loss begins to subside. In addition to the reaction of grief, there is a pathological, which is divided into suppressed (inhibited), delayed (delayed) and chronic. The role of the psychotherapist at this stage is to provide psychological support and assistance to both the patient and his environment to cope with this situation.

The principle of the concept of palliative care is the need to ensure the psychological comfort of the patient.

The COVID-19 pandemic has become a major challenge for both the overall health system and the individual ability for health professionals to stress coping.

To find the link between the perception of danger from coronavirus and the severity of burnout syndrome in medical workers during the COVID-19 pandemic in Russia.

We used a socio-demographic questionnaire (20 questions), a Stress Perception Questionnaire (Linville, 1987; Ababkov et al., 2016), a Modified Pandemic Perception Questionnaire (Broadbent et al.,2006;Yaltonsky et al., 2017), and Maslach Burnout Inventory (Maslach et al., 1996; Lozinskaya et a. 2007). 249 medical workers (58 men and 191 women) took part in the online survey between April 27 and October 26 in Russia.

The severity of stress is positively correlated with the perception of pandemic as threatening (r=0.532, p=0.000) and unknown disease (r=0.297, p=0.000). Stress severity also correlates with all burnout parameters: exhaustion (r=0.737, p=0.000), depersonalization (r=0.342, p=0.000), and belief in personal achievement (r=-0.417, p=0.000). The perception of pandemics as threatening events is significantly associated with exhaustionm (r=0.458, p=0.000), depersonalization (r=0.133, p= 0.036), and belief in personal achievement (r=-0.152, p=0.016).The feeling of uncertainty from the pandemic is statistically significantly associated with exhaustion (r=0.242, p=0.000), while the feeling of control over the pandemic is positively associated with belief in personal achievements (r=0.129, p=0.042) and negatively associated with exhaustion (r=-0.161, p=0.011) and depersonalization (r=-0.125, p=0.049).

Uncertainty and a sense of threat from the coronavirus and the pandemic are significant factors of stress and emotional burnout for health workers. To determine the interaction between parameters such as signs of burnout, perception of the COVID-19 pandemic and the severity of stress, further construction of a structural model is required.

The coronavirus disease 2019 (COVID-19) has a great impact on health care workers (HCWs) who are exposed to high levels of stress and trauma leading to negative mental health outcomes, including stress-related symptoms and depressive symptoms.

The aim of this study was to investigate the prevalence of depressive symptoms, anxiety and post traumatic stress symptoms related to to the COVID 19 pandemic in Cyprus.

In this cross-sectional study, we report on mental health outcomes among HCWs in Cyprus. Data were collected between May 3rd and May 27th, 2020, using an online questionnaire that included demographics, the 9-item Patient Health Questionnaire (PHQ-9), assessing depressive symptoms, the Impact of Events Scale Revised (IES-R) measuring PTSD symptoms and the 10 item Perceived Stress Scale (PSS) measuring stress.

424 Health Care Workers (HCWs) participated in the study. 79 HCWs (18,6%) scored in PHQ-9 above the cut-off for depression while 62 HCWs (14,6%) scored high enough in IES-R indicating a diagnosis of post-traumatic stress disorder. The prevalence of depression and PTSD symptoms were significantly higher among nurses compared to doctors and other HCWs. (20.7% versus 10.8%; adjusted prevalence ratio, 1.70 [95% CI, 1.06 to 2.73]), after adjustment for age and sex.

Even in countries like Cyprus with minimum impact of the COVID-19 pandemic, the impact on the mental health of HCWs is substantial with nurses being more vulnerable.

The situation of Covid-19 disease, associated with a high threat to life and uncertainty, had not only somatic, but also psychological consequences for most patients. Emotional reactions of patients to hospitalization and ways to cope with what is happening have become the subject of study in different countries.

To assess the severity of signs of depression and anxiety and to study the methods used to regulate the emotional state in patients with COVID-19 at the time of hospitalization.

The study volunteered 127 hospitalized patients with Covid-19 (67 men (52.8%) and 60 women (47.2%), aged 19 to 77 years, who completed the following methods: Sociological questionnaire, Beck Depression Questionnaire, GAD-7, F-SOZU-22, CERQ, Dembo-Rubinstein self-assessment scales. The study was conducted from 04/25/2020 to 05/31/2020.

A quarter of patients showed pronounced signs of depression and anxiety (25.4% and 24.13%, respectively), with women having higher rates of depression (M = 8.76 and M = 6.32, p<0.01). Anova showed no significant differences in the response to the disease situation in patients of different age groups. Factor analysis made it possible to identify 3 patterns of emotional coping with the disease: «positive decision oriented», «fixed on negative experiences», «accusers» (The resulting factor solution explains 69% of the dispersion). None of the identified patterns were associated with a significant reduction in signs of depression and anxiety.

Despite the duration of the pandemic, there is still no specific pattern of effective coping with these experiences for patients.

No significant relationships.

The tryptophan pathway along with its two branches of metabolism to serotonin and kynurenine seems to be affected in major depression. In depressed patients, peripheral levels of tryptophan, serotonin, kynurenine and their metabolite remain unclear.

Therefore, peripheral tryptophan and metabolites of serotonin and kynurenine were investigated extensively in 173 patients suffering from a current major depressive episode (MDE) and compared to 214 healthy controls (HC).

Fasting plasma levels of 11 peripheral metabolites were quantified: tryptophan, serotonin pathway (serotonin, its precursor 5-hydroxy-tryptophan and its metabolite the 5-hydroxy-indole acetic acid), and kynurenine pathway (kynurenine and six of its metabolites including anthranilic acid, kynurenic acid, nicotinamide, picolinic acid, xanthurenic acid and 3-hydroxy-anthranilic acid).

60 (34.7%) patients were antidepressant drug free. Tryptophan levels did not differ between MDE patients and HC. Serotonin and its precursor (5-hydroxy-tryptophan) levels were lower in MDE patients than HC. Whereas, its metabolite (5-hydroxy-indole acetic acid) levels were within the standard range. Kynurenine and four of its metabolites (kynurenic acid, nicotinamide, picolinic acid and xanthurenic acid) were lower in MDE patients.

This study uses the largest ever sample of MDE patients, with an extensive assessment of peripheral tryptophan metabolism in plasma. These findings provide new insights into the peripheral signature of MDE. The reasons for these changes should be further investigated. These results might suggest a better stratification of patients and different therapeutic strategies therapeutic strategies.

Clozapine is a second-generation antipsychotic indicated in treatment-resistant schizophrenia. Patients taking clozapine are likely to experience an increase in salivation or sialorrhea. Clozapine‐induced sialorrhea (CIS) may lead to sleep disturbances or aspiration pneumonia. Treatment options include locally administered anticholinergic medication with atropine ophthalmic drops applied sublingually.

To review the current evidence for the effectiveness, safety, side effects and dosage of sublingual application of atropine in reducing or resolving of CIS.

Systematic review. Data were obtained from PubMed/Medline, EMBASE, PsycINFO, Cochrane Plus, Trip Database, Science Direct and Scopus searches of English-language articles, without restriction for date of publication and study design, reporting the sublingual use of atropine in the treatment of CIS. Large clinical studies with appropriate statistical methods and recruited adults were preferred.

12 selected articles (of 458 references) consisted entirely of case reports and case series. A total of 29 patients with CIS were reported, of whom 24 responded favorably to sublingually administered atropine drops 1% (1-2 drops a day). One limitation of its utilization is the dose-related dry mouth, which can be addressed by lowering the number of drops administered. CIS can occur at different clozapine doses, in various stages of treatment.

The reviewed articles suggest that the use of sublingual atropine is a promising local treatment for CIS. Oral anticholinergic and alpha-2 agonist medications have been used to treat CIS with variable efficacy, but can cause systemic anticholinergic side effects. Further experimental research is needed.

No significant relationships.

Diabetic patients are asked to focus on their eating habits and calories intake. Together with individual factors, this could increase the risk of developing Eating Disorders (ED) associated with diabetes. A score of 20 points at the Diabetes Eating Problem Survey-Revised (DEPS-R) scale is considered as a valid threshold to identify Disordered Eating Behaviours (DEB) in diabetic patients. DEB can be considered as altered eating behaviours not fully meeting criteria for ED. As DEB are not formally recognised as specific ED in DSM-5, there is a great risk of not detecting them, thus underestimate their consequences.

To meta-analyse literature on ED and DEB, when in comorbidity with Type 1 and Type 2 Diabetes Mellitus, focusing on pathological medical consequences.

PRISMA guidelines were followed for this meta-analysis. Articles were identified in literature by searching into PubMed, PsycINFO and Embase.

1141 records were identified through database search. Figure 1 shows six studies comparing HbA1c % values for 2857 diabetic patients versus 752 diabetic patients with DEB. HbA1c % levels appear to be higher in patients with DEPS-R ≥ 20, compared to those with DESP-R scores below 20.

Routine screening for DEB using DEPS-R scale could favour early identification of diabetic individuals, at risk for progression into a proper ED. Clinicians should be vigilant about potential DEB when patients show poor long-term glycaemic control; similarly, patients with a DEPS-R score over 20 points may require more frequent glycaemic checks. This could help prevent serious medical complications.

Social Physique Anxiety is defined as an emotional response that reflects individuals’ concerns regarding the way their body may be observed or judged by others.

To explore the relationship between physical activity and social physique anxiety.

A literature review haw been made through pubmed database.

Social Physique Anxiety is negatively related to participation in physical activity and commitment to exercise. Studies examining the relationship between motivation and social physique anxiety have shown that external motivations, such as improving muscle tone and body attractiveness, are directly linked to social physique anxiety. In addition, social physique anxiety is negatively related to self-efficacy. Individuals who believe that they will be judged by others to be ineffective are less likely to be engaged in physical activity programs. Social Physique Anxiety has been linked to negative effects on mental health such as low self-esteem, smoking and eating disorders.

Given all the negative effects of social physique anxiety, as it is responsible for a wide range of health-related behaviors, it is important to identify physical activity-related motivational mechanisms in order to reduce the impact of social physique anxiety.

No significant relationships.

Autism spectrum disorder (ASD) is a common neurodevelopmental disorder. Its underlying causes and pathophysiologies remain unclear. Recent data support the potential involvement of neuroinflammation in the onset of this disorder.

The aim of our study was to investigate the potential link between ASD and inflammatory mediators.

This descriptive study was conducted among ASD outpatients followed-up at the child and adolescent psychiatry department in the Military Hospital of Instruction of Tunis. Blood samples were collected for inflammatory cytokines dosage, notably the interleukin 1β (IL-1β), interleukin 6 (IL-6) and the Tumor Necrosis Factor α (TNF-α) immunodosage.

Twenty-four patients were included in this study, aged between four and ten years old (mean age= 6,55 years; minimum=4; maximum=10 years). Our sample was mainly represented by male patients (95,6%). TNF-α plasmatic levels were high (>5pg/mL) among all of our sample with a mean of 11,6 pg/mL (minimum= 6,87; maximum=17,7 pg/mL; standard deviation= 3,52 pg/mL), suggesting abnormal peripheral blood mononuclear cells response. However, IL-1β and IL-6 plasmatic levels were relatively normal.

An immune response dysregulation was detected in our sample. Multiple clinical and experimental studies investigated the implication of inflammatory cytokines in neurodevelopmental disruption. Their results, however, remain controversial and limited by small samples. Further studies need to be done in order to investigate the neuroimmunological factors linked with ASD.

Obesity is one of the leading problems of today’s society. According to WHO, 650 million people worldwide are obese, which is 13% of total population (in Croatia 21.5%). There are various psychodynamic theories that interpret the psychological aspects of obesity.

The aim of this paper is to present psychodynamic and contemporary psychiatric concepts that explain the interrelated phenomena presenting in obese patients.

The review of the literature included the investigation of the existing studies in the field of modern psychiatry, as well as previous knowledge in the field of psychodynamics.

Obesity is associated with the emptiness of not recognizing one’s own emotions from hunger, and the need for constant replacement. The everyday life of the obese is filled with shame, an uncomfortable perception that is so intense that can be unbearable. The emptiness and shame which overwhelm and create discomfort cannot be fulfilled by constant food intake and are associated with pathological narcissism (grandiose or vulnerable), which in turn is associated with more regressive behaviour. Thus, obesity may sometimes be associated with addictive behaviours, and a cognition that a bad pattern of rewarding behaviour through food has been adopted in parallel with poor self-control.

Relationship between psychodynamic phenomena and obesity is complex and multidimensional. Further research is needed in order to ameliorate our understanding of these connections.

No significant relationships.

Posttraumatic stress disorder (PTSD) is common in survivors of acute life-threatening illness, but little is known about the burden of PTSD in survivors of stroke attack.

This study estimated the prevalence of PTSD in post-stroke in the elderly and to look for the factors which are correlated with it.

Participants were outpatients of Psychiatry B department in Hedi chaker University Hospital Center in Tunisia, over the age of 65, hospitalized in psychiatry for a major depressive episode, recruted between 2000 and 2015. The data was collected using a pre-established sheet containing socio-demographic information, the clinical and evolutionary characteristics of the depressive episode and the therapeutic data concerning the depressive episode.

30 patients were included in this study with an average age (69 Y) and sex ratio (0.66). More than half (53.3%, 16 patients) had a history of chronic somatic disease. The average length of hospitalization was 26 days. The most frequent reason for hospitalization is sadness of mood (43.3%) with cognitive impairment as the predominant clinical symptomatology (40%). 93.3% of the population received as treatment an antidepressant mainly Fluoxetine (50%).

clinicians should be mindful that PTSD can be a devastating mental health condition and should consider screening for PTSD in stroke survivors.

The Covid-19 pandemic has limited the classic psychotherapy treatment. EAP provided temporary recommendations for online psychotherapy in March of 2020 which brought new possibilities and limitations and contains rules, ethics and techniques. From the perspective of a psychodynamic therapist, the specificity of online group psychotherapy in the context of strong stressors is described.

During the “lockdown” period and the earthquakes that occurred simultaneously in Zagreb in March of 2020, the secure Internet platform enabled the continuity of the group’s work in a video link modality.

Online group had regular weekly meetings which lasted 1.5 hours. The classic rules of group analytical therapy were adapted to the new setting in virtual space. A risk assessment was also performed.

The six group members and therapist have connected online through more freedom, developed new levels of sensitivity, flexibility and creativity. They have also accepted limitations. The online group is able to provide holding, but deeper connections require a physical presence to exchange emotions that technology interferes with as well as the process of empathizing. Previous live sessions crucial to maintaining emotional connections have served as reservoirs for a period in which communication over the Internet was insufficient.

Internet technology can temporarily enable the continuity of a group psychotherapy. Technical and institutional support is recommended. The advantages of technology can be used if the technique is adapted, realistic goals set, and clinical limitations accepted. Many questions about the possibilities of “online psychotherapy” are open and unexplored.

No significant relationships.

Nonhuman primates (NHPs) are critical for translational research due to their close genetic, physiological, and behavioral similarity to humans. In particular, higher brain functions depend on brain regions and neural circuits that evolved differently between primates and rodents. Thus, NHPs are a strong translational model system to investigate the pathophysiology and relevant biological correlates of mental disorders. This talk will focus on translational approaches leveraging NHP models to advance our understanding of environmentally induced epigenetic changes in post-traumatic stress disorder (PTSD). Environmental factors including early life stress significantly contribute to risk and resilience for psychiatric disorders including PTSD. However, human studies are often confounded, and it remains challenging to identify robust epigenetic signals in clinical populations even in large studies. We investigate the natural spectrum of behavioral phenotypes in rhesus macaques to complement human studies with a focus on stress and fear. This talk will present data on epigenetic signatures of fear and the effects of early life stress in rhesus monkeys and their relationship to human studies.

No significant relationships.

Restraint theory (Herman and Polivy, 1975) suggests that human eating behaviour is under cognitive control and this leads to reduced sensitivity to internal cues for satiety, resulting in overeating in situations where cognitive control is under-mined (Johnson et al., 2012). In other words, restraint theory suggests that restraint (dieting) actually leads to leads to an excessive intake of food.

The present study sought to investigate the relationship between dieting, eating behaviours (uncontrolled eating, emotional eating, cognitive restraint) and rumination (repetitive negative thinking). The second objective was to determine whether rumination mediates the relationship between dieting and both uncontrolled eating and emotional eating.

The sample was composed of 188 women (Mage = 29.46 ± 8.94; MBMI = 23.16 ± 4.04). The Eating Attitudes Test, the Three-Factor Eating Questionnaire and the Perseverative Thinking Questionnaire were used in the present study.

Dieting for weight control (intentional weight loss) was associated with higher levels of uncontrolled eating, emotional eating, cognitive restraint and repetitive negative thinking. Mediation analyses showed that the relationship between dieting and inappropriate eating behaviours was mediated by rumination. The direct effect of dieting on both uncontrolled eating and emotional eating was significant, suggesting partial mediation.

Our findings support the relevance of rumination in linking dieting and eating behaviours among women. The current study may have clinical applications such as the potential integration of rumination for the prevention and changes in inappropriate eating behaviours.

No significant relationships.