It has been well established that depressive disorders including perinatal depression are very heterogeneous, which partly explain the ineffectiveness of available treatments for many patients. Recent innovations in data science can help elucidate the nature of perinatal depression especially the heterogeneity in its presentation.

The present study aime to elucidate heterogeneous subtypes of PND and assess the effectiveness of a multicomponent cognitive behavioral therapy (CBT) across heterogenous subtypes of PND.

This study was conducted in 2005 in two rural areas of Rawalpindi, Pakistan. Out of a total of 3,898 women, 903 pregnant women were identifed with PND (using DSM-IV) and randomly assigned to intervention and control group. Baseline assessments included interviewer admininstered Hamilton Depression Scale (HDS) and social risk factors. Follow-up assessments were conducted at 6 months and 12 months post-intervention. Principle component analysis was run to reduce dimensionality of the HDS. Two step cluster analysis was then run to elucidate subtypes of PND using the dimensional scores. Thereafter, effectiveness of CBT was compared across these subtypes of PND using multilevel modelling.

Principle component analysis revealed a four component solution for the Hamilton depression rating scale. Using these dimensional scores, cluster analysis (average silhouette= 0.5) revealed a parsimonius four cluster soultion of participants with mild PND symptoms (n=326); predominant sleep problems (n=311) c) predominant atypical symptoms (n=80) and d) comorbid depressive and anxiety symptoms (n=186). CBT yielded moderate effect sizes across all these subtypes of PND (cohen’s d > 0.8).

Multicomponent CBT is effective across hetergeneous presentations of PND.

No significant relationships.

Intramuscular injections (IMI) remain a frequent practice in mental health. The available guidelines for IMI in mental health only focus on the technical side of the practices. Moreover, no recent update has been performed to improve practice of IMI in mental health

To assess a formalized consensus agreement regarding the best practice concerning IMI in mental health and to develop practice guidelines.

A two-round Delphi method was used. The scientific committee consisted in one psychiatrist, one orthopaedic surgeon, one infection control practitioner, one hospital pharmacist, one mental health nurse, one nurse exploring care relationship and one nurse educator. From literature review, each expert proposed specific recommendations. The panel experts were asked to rate the appropriateness and the applicability in current practice of each recommendation on a 9-point Likert scale. Panel members were recruited in five mental health institutions. The first round questionnaire was emailed to each respondent on February 2020 and the second one on June. Propositions were considered appropriate and applicable in current practice if the median was >=7. Agreement among experts were judged by the statistical measure of the Interpercentile Range

From the first round, 46 recommendations were retained by 49 nurses. 27 propositions were retained after this second round by 32 nurses. The scientific committee added 12 other recommendations because of their importance in the literature and clinical practice.

This study provides consensus-based recommendations on IMI in mental health. Nursing staff need to be educated about the new guidelines from both the theoretical and clinical perspectives

No significant relationships.

Depression is the mental disorder with the largest disease burden impact. That is due to its high prevalence, chronicty, early onset but also due to its impact on various aging-related somatic morbidities and mortality. This talk will describes to what extent depression characteristics are related to chronologial and biological aging patterns.

Data will be shown from the Netherlands Study of Depression and Anxiety (NESDA, www.nesda.nl). In this study, a large cohort of over 3000 individuals (18-65 years), among which over 1200 with a DSM-based major depressive disorder (MDD), are now followed for 9 years. The association between depression characteristics and chronological and biological age will be described. Biological age was determined at various biological system-levels, including telomere length, epigenetics, transcriptomics, metabolomics and proteomics.

Older persons with a current MDD do not differ in overall disease severity as compared to younger persons with a current MDD. However, older depressed persons do differ in the types of symptoms they experience (more neurovegetative, somatic symptoms and less mood symptoms) and in their chronic course (with twice more chronicity in the oldest depressed persons compare to the younges depressed persons). At all biological system-levels, there was evidence for more advaned biological aging among persons with depression. This was not differential across chronological age groups. Discussion: Findings suggest that depression characteristics are linked to both chronological and biological age. It will be discussed what this could mean for clinical practice and intervention.

No significant relationships.

It is known that the intensity of inflammation weakens with age, and therefore it is of interest to study the clinical features of schizophreniс process in relation to the level of inflammatory markers.

To determine the level of inflammatory markers (the activity of leukocyte elastase (LE) and α1-proteinase inhibitor (α1-PI), autoantibodies (aAB) to neurotrophin S100b and myelin basic protein) in plasma in different years old groups of patients with schizophrenia.

Two groups of patients with schizophrenia were examined: the 1st group - 19 women aged 60 to 78 years; the 2nd group - 24 women aged 19 to 42 years.

An increase in activity both of LE and α1-PI was found in young patients. This characterizes a balanced inflammatory response. Elderly patients showed a similar increase in the activity of α1-PI, however, LE activity did not exceed the control values. Insufficient LE activity probably characterizes a decrease in the functional activity of neutrophils. The negative correlation was revealed between the activity of LE and TotPsy (PANSS) in the group of elderly patients (r=-0.62, p<05) and positive correlation between aAB to S100b and TotNeg in both groups (r=0.56 and r=0.49, p<05 respectively). There is relationship between age, the activity of psychopathological symptoms and the rate of development of schizophrenia: the rapid course and variety of disorders at a young age, against the poverty of symptoms and a slow rate in the elderly.

There is relationship between the features of inflammatory reactions and clinical picture in elderly and young patients with schizophrenia.

Dangerousness is a state in which a person is likely to commit violent acts.

Describe the socio-demographic and clinical characteristics of psychiatric inpatients hospitalized in the locked unit and suffering from schizophrenia or other psychotic disorders and to assess their dangerousness.

This is a cross-sectional study carried out in the locked unit of psychiatric department of the University Hospital of Mahdia during one year. We have collected data of patients diagnosed with schizophrenia or other psychotic disorders according to DSM 5. Psychometric assessment was done using the BPRS, the PANSS, the VRAG and the HCR-20 scales.

We have included 173 patients. The average age was 36 years with a sex ratio of 9. The majority of our patients were unmarried and of a low economic level. Alcohol and cannabis consumption was found in 7.6% and in 5.7% of cases respectively. A history of incarceration was found in 79% of cases. Homicide was the infraction the most committed in 8% of cases. 71.2% of patients had an anterior hospitalization in the locked unit. Aggressiveness and instability were the main indication for hospitalization. The diagnosis was schizophrenia in 84% of cases. Patients were treated with classic antipsychotic drugs in 55.8% of cases. Non-adherence to treatment was reported in 33% of cases. The average score of psychometric scales were BPRS = 21.4; VRAG = - 4.87 and HCR-20 = 17± 0.87.

Our study showed comparable assessments for dangerousness with the literature. Evaluating dangerousness should represent the first step of the therapeutic process.

In the mental health area, the most problematic issues are the involuntary placement of the mentally ill in closed institutions, both under civil and criminal proceedings, and their involuntary treatment. Despite the international efforts of harmonizing measures, the nature and practice of the services still vary from country to country.

To analyse involuntary placement of persons with mental disorders in closed institutions under civil and criminal proceedings, which include both psychiatric hospitals and care institutions.

Review and analysis of regulations and practice of involuntary placement of a person with a mental disorder in a closed institution in the context of Estonian, Finnish, Russian, and English law, health care and social system.

Estonian, Finnish, Russian, and English law distinguish between criminal and civil proceedings regarding involuntary placement of a mentally ill person in a closed institution. However, specifics of the proceedings are different among the countries, e.g. judicial involvement, and deadlines. Also, the provision of forensic mental health services differ among these countries, e.g. in Estonia offenders and non-offenders are kept separately, whilst in England and Russia patients are not distinguished so strictly.

The distinction between involuntary placement of the mentally ill in criminal and civil proceedings is distinguished primarily for the reason that in one case the risk arising from the person is directly realized by committing an unlawful act and in the other case the risk arising from the person is directed at themselves or is not qualified as an unlawful act.

Research following the Covid-19 pandemics has shown that psychological reactions to the pandemic and its constraints can vary significantly depending on personality. One of the traits that has not been studied yet, but can play a harmful role in the COVID-19 psychological impact is perfectionism. This trait, characterized by setting excessively high standards of performance and striving for flawlessness, has increased in recent years and is considered a transdiagnostic process involved in several (mental) health problems (Curran & Hill 2019).

To analyze the role of Perfectionism in the levels of fear of COVID19 and of perception of infection risk by COVID-19.

234 adults (75.6% women; mean age=29.53±12.51) completed an on-line survey with the Portuguese validated versions of Covid-19 Perceived Risk Scale (C19PRS; Pereira et al. 2020), Fear of COVID-19 Scale (FC19S; Cabaços et al. 2020) and Big Three Perfectionism Scale (BTPS; Garrido et al. 2020). SPSS was used to perform correlation and regression analysis.

Perceived Risk and Fear of COVID-19 were significantly correlated with perfectionism (.243, .228, respectively) (both, p<.01). Perfectionism explains 5.5% (Adjusted R2) of the FC19S variance (Beta=.243, p<.001) and 4.8% of the C19PRS variance (Beta=.228, p=.01).

This study provides preliminary, but completely innovative evidence that perfectionism contribute to the psychological impact of Covid-19 pandemics. In the near future we will test the hypothesis that the nature of unpredictability and the limitations imposed by the global crisis may be exacerbating the already high levels of psychological distress that affect negative perfectionists.

Suicidal behavior has a great impact on world public health. The literature describes the possible existence of an association between neurobiological, clinical and cognitive factors in suicidal behavior.

To determine the possible relationship between clinical variables (history of abuse/maltreatment in childhood), psychopathology (impulsivity traits) and cognitive (decision-making) with a history of suicide attempt and/or current suicidal idea in patients with major depressive disorder.

Cross-sectional study in a sample of adult patients with major depressive disorder in which two types of comparisons are made. In the first case, two groups were compared based on the presence or absence of history of suicide attempt. In the second case, two groups were compared based on the presence or absence of suicidal ideation in the same sample of patients. Finally, sociodemographic, clinical and cognitive variables were evaluated in that population sample.

When the joint influence of sociodemographic, clinical and cognitive characteristics are present, it can be said that being single/divorced/separated, a history of sexual abuse in childhood and an alteration in decision-making, specifically a lower number of choices of deck D in the IGT test, are associated with a higher probability of a personal history of suicide attempt. While a higher score on the Barrat impulsivity scale is associated with a greater probability of presenting current suicidal ideation once the influence of sociodemographic, clinical and cognitive variables has been taken into account.

Different sociodemographic, clinical and cognitive factors are associated with the presence of a history of suicide attempt and/or current suicidal ideation.

No significant relationships.

Acute and Transient Psychotic Disorder (ATPD) is a group of rare psychotic disorders characterized by acute onset, symptom fluctuation and short duration typically followed by complete recovery. Throughout the time, there have been different attempts to classify these disorders (Bouffée Délirante, Cycloid Psychosis, etc.); nevertheless, in the current date, ATPD encompasses a broad spectrum of heterogenous clinical presentations with low diagnostic stability over time.

To describe a case of ATPD, highlighting the variability of its’ psychopathological phenomena and establishing a comparison with historical descriptions of this nosological entity.

Clinical case report and brief review of literature.

V, 20-year old male without psychiatric history, presents in the emergency room exhibiting fluctuant psychopathology over the preceding two weeks – initially with depressive mood, anhedonia, apathy, bizarre behaviors and soliloquies; afterwards, showing paranoid delusional ideation; total insomnia in the previous 2-3 days; finally, showing grandiose delusional ideation; and throughout the episode, revealing pseudohallucinatory verbal activity assuming multiple identities. Several stress factors were identified in close time-relation with the onset of these symptoms. V. started risperidone 2mg 2id and quetiapine 100mg id and was discharged 2 weeks later, fully recovering from these psychopathological phenomena. V. remains asymptomatic at 6 months of follow-up.

Historically, some classifications of this disorder focus on etiological factors, others on clinical evolution and course, and yet another group on separation from the Kraepelinian duality (schizophrenia and bipolar disorder). ATPD is a diagnosis with high clinical heterogeneity and low stability over time, which can have implications in follow-up and long-term outcome.

Bipolar disorder is a mental disorder that has one of the greatest risk of completed suicide (CS)

Determine the rate and the risk factors of CS in a cohort of Bipolar I patients followed after their first hospitalization

We choose all Bipolar I patients (DSM-IV) who were first time hospitalized in our Psychiatric unit between 1996 and 2016. We reviewed the charts of first hospitalization and recorded multiple baseline variables. In the follow-up we updated the database recording all patients who CS. We compared the different baseline variables between Bipolar patients who CS and the rest.

Of a total of 254 bipolar I patients 9 (3,5%) CS in the mean of 13 years of follow up (rate 40 times higher than General Population). The average age at CS was 41.1 years (range between 26 and 71 years old) so there was a 9 years gap on average between the first psychiatric hospitalization and suicide. CS was characterized by a violent act (8 out of 9 cases, 89 %). When we compared BP patients who CS with the rest, only history of suicide in first-degree relatives was detected as a risk factor significantly associated (P<0.01) with CS. Conversely baseline treatment with anticonvulsants (mainly valproate) was detected as a significantly (P<0.004) protective factor of CS.

1-Bipolar I patients after first hospitalization completed suicide 40 times higher than general population almost always by violent method 2-History of CS in first-degree relatives is predictor of completed suicide

No significant relationships.

Anorexia nervosa is often associated with the development of depressive disorders.

Skillful dissimulation of the true causes of fasting in adolescents leads to diagnostic errors and delayed adequate therapy.

The study design includes clinical psychopathological, somatic-neurological, and psychological methods for examination of 54 adolescent girls aged 12-14, with a recurrent depression, and factors determine disorders in alimentary behavior (anorexia nervosa) in teen-agers. The following psychological tests were performed: Children’s Depression Rating Scale Revised, Columbia - Suicide Severity Rating Scale, Mendelevitch - Yakhin Scale to establish a neurotic state.

in all adolescent girls with anorexia nervosa depressive disorders were present in prepuberty. Behavioral syndrome and aggressive vulnerability prevailed in the structure of depression. Cognitive component was represented in the form of unstable type of poor memory and decreased rate of sensorimotor reactions with episodic recurrent attacks of bulimia. Our model of therapeutic intervention included: behavioral intervention, intravenous administration of Cerebrolysin 10,0 with 0,9 % Sodium chloride 200,0 (No.15). Therapeutic neuroplasticity, multimodal effect, and a disease - modifying therapy effects in short terms provide regression of emotional-cognitivity.

In adolescent girls with a recurrent depression anorexia nervosa has specific features that require early differentiation, neurotropic and neurodegenerative therapy.

Resilience and cognitive flexibility are considered as pre-adaptive traits that help individuals to deal with environmental and social distress. Although they may alleviate emotional impulses and/or support volitional self-control (VSC), these cognitive mechanisms remain insufficiently explored.

To better understand resilience and flexibility, we built a mechanistic framework to explain variations in socially adaptive responses under distressing situations (cooperation dilemma) using economic and social decision-making paradigms.

Twenty-four university students (7 females) were enrolled. We used ego-resiliency (ER) and Machiavellian (Mach) questionnaires to measure resilience and flexibility, and applied third-party punishment (TPP) and ultimatum game (UG), as well as moral dilemma (MD) tasks to derive VSC-associated brain activity using 3T-functional magnetic resonance imaging. Mediation analysis was used to investigate whether these pre-adaptive trait levels explain cooperative decision-making (invested sum in TPP and acceptance rate of unfair offers in UG), together with VSC-associated brain activity during MD. The regions of interest included the orbitofrontal cortex (OFC), dorsolateral prefrontal cortex (DLPFC), and temporoparietal junction (TPJ).

Pre-adaptive traits were a statistically significant mediator for two different models. There was an indirect effect of 1) ER on the relationship between OFC activity strength and TPP scores, and 2) Mach on the relationship between DLPFC/TPJ and UG (p < 0.05).

Although recruitment is still ongoing, our results suggested that trait resilience and flexibility may help other-regarding and goal-directed motivation shifts. They may align self-interests with collective interests and support VSC, thereby adjusting peoples’ behaviors within social contexts and cultivating social intelligence.

No significant relationships.

Analytical-cathartic therapy (ACTA), a modern model of psychotherapy, the theoretical basis of which is the psychology of relations of V.N. Myasishchev. ACTA is intended for the treatment of emotional disorders; the study of the dynamics of clinical and pathopsychological characteristics has not been previously conducted.

To assess the dynamics of the clinical and pathological characteristics of patients with neurotic disorders, in whose clinical picture anxiety syndrome predominated, in the process of an individual ACTA.

A specially designed semi-structured interview, HARS, and the CGI (CGI-S - disease severity, CGI-I - improvement dynamics). The study group (N = 90) included patients with neurotic disorders, whose clinical picture was dominated by anxiety syndrome

AKTA course 12 sessions 3 times a week for 60 minutes. Psychopharmacotherapy during the period of psychotherapeutic treatment in patients was not carried out.

The study of ACTA was carried out before, after treatment and in the follow-up.

The overall decrease in the HARS score was 73.8% - the high success of the therapy in relation to the reduction of anxiety.

On the CGI-I scale - improvement from minimal to significant. On the CGI-S scale, no more than mild disease severity (p <0.01). The change in the CGI scale also indicates the success of the therapy.

As a result of the study, clinical indicators were determined, on the basis of changes in which in dynamics the success of the treatment can be assessed. ACTA allows to clearly reduce anxiety and improve the general condition of patients with neurotic disorders.

No significant relationships.

Obsessive compulsive disorder (OCD) affects 2-3% of the general population. The neurobiology of OCD has been linked to dysfunction of cortico-striatal circuits connecting the orbitofrontal (OFC) to the striatum. Recently, this loop has become an approved target for non-invasive neuromodulatory treatment of OCD.

To explore structural and functional connectivity of the OFC in OCD subjects and healthy controls.

14 OCD patients and 12 age/sex-matched controls underwent magnetic resonance imaging (MRI) (3T-Philips scanner) for diffusion tensor imaging (DTI) and resting state functional connectivity (rsFC). DTI images were brain extracted and corrected for movement and eddy currents. A diffusion tensor model was fitted to each voxel and used to generate Fractional Anisotropy (FA) maps. Voxel-wise statistical analysis of FA was performed using Tract-Based Spatial Statistics. RsFC images were preprocessed and seed-based correlation (SBC) analysis was performed using Data Processing Assistant for Resting-State fMRI.

We found decreased values of FA in the body of the Corpus Callosum bilaterally (MNI_coordinates: x= 16, y= -16, z= 33 and x= -19, y= -16, z= 42) and left superior longitudinal fasciculus in OCD patients (fig 1, left), as well as decreased rsFC of the right superior orbitofrontal seed with the left inferior frontal gyrus and left middle occipital gyrus (fig 2, right).

Using an exploratory multimodal approach we found evidence of abnormal structural and functional long-range connectivity of the OFC in OCD. If confirmed in a larger sample these connectivity abnormalities could be explored as potential predictors of response to OFC-targeted non-invasive neuromodulatory interventions.

No significant relationships.

Experience of bullying may be a significant risk factor for non-suicidal self-injury (NSSI).

This study had three aims: to systematically investigate the association between bullying and NSSI, to analyze the possible mechanisms underlying the two phenomena, and to evaluate any differences between bullying victimization and bullying perpetration with respect to NSSI.

A systematic search about the association between bullying victimization and perpetration and NSSI was conducted using specific databases (PubMed, Scopus, Science Direct). The following keywords were used in all database searches: “bullying” AND “NSSI” OR “peer victimization” and NSSI.

The searches in PubMed, Scopus and Science Direct revealed a total of 88 articles about bullying or peer victimization and NSSI. However, only 29 met our inclusion criteria and were used for the present review. Overall, all studies examined victimization; 4 studies also evaluated the effects of perpetration and 1 included bully-victims. According to the main findings, both being a victim of bullying and perpetrating bullying may increase the risk of adverse psychological outcomes in terms of NSSI and suicidality in the short and the long run.

To the best of our knowledge, this is the first review to systematically evaluate the relation between bullying victimization/perpetration and NSSI. The main results support a positive association. Future research should evaluate the possible role of specific mediators/moderators of the association between experience of bullying and NSSI.

No significant relationships.

Since the declaration of the COVID-19 pandemic, several studies have demonstrated its considerable psychological impact. The isolation and social distancing, the increased fear of being infected or infecting others and the insecurity generated by the economic impact, could contribute to an increase in the incidence of mental health issues, such as psychotic disorders.

The aim is to discuss four clinical cases in order to provide further evidence on this matter.

We report on three females and one male with no personal psychiatric history who were admitted to a tertiary hospital during the first three months after the declaration of the pandemic. The average age was 44,25 ± 14,97 years.

All patients met the International Statistical Classification of Diseases (ICD-10) criteria for acute and transient psychotic disorder. All of the episodes were triggered by the stress generated from the COVID-19. Complementary tests were unremarkable. They all tested negative for SARS-CoV-2. Rapid discharge with favorable response to relatively low doses of antipsychotics was possible with a mean length of stay of 7,25 ± 2,86 days. In two of the cases the delirious content was predominantly marked by the coronavirus itself.

It has been suggested that the intense psychosocial stress associated with a new life-threatening disease and national lockdown restrictions could be triggers for new-onset psychotic disorders. Some authors have reported cases similar to ours, which means that we could be experiencing and increase in the incidence of psychotic disorders due to the exceptional circumstances we are living around the world.

Bipolar disorder (BD) is one of the most burdensome psychiatric illnesses, being associated with a negative long-term outcome and high suicide rate. Although affective temperaments are considered possible mediators of outcome, their role on the course and outcome of BD remains poorly studied.

The aims of the present study are to describe the clinical characteristics of patients with BD more frequently associated with the different affective temperaments and to verify which affective temperaments are associated with a more severe clinical picture in a sample of patients with BD.

All patients with BD referring to the outpatient units of two Italian university sites have been recruited. Patients’ psychiatric symptoms, affective temperaments, and quality of life were investigated through validated assessment instruments.

199 patients were recruited. 54.8% of patients had a diagnosis of bipolar I disorder. 56.8% of the sample reported at least one episode of aggressive behaviours and 30.2% of suicidal attempt. Predominant cyclothymic and irritable temperaments predicted more frequent relapses, a poorer quality of life (p<;0.05), more aggressive behaviours and suicide attempts (p<;0.01). The predominant hyperthymic disposition was a protective factor for several outcome measures, including relapses and suicidality (p<;0.01), and was correlated with a less severity of psychiatric symptoms and later age at onset (p<;0.05).

Early identification of affective temperaments in BD patients can help clinicians to identify those who could show a worse prognosis. A screening of affective temperaments can be useful to develop early targeted integrated pharmacological and psychosocial interventions.

No significant relationships.

Currently, there are no ideal medications for treating anorexia nervosa (AN) and bulimia nervosa (BN). This is due to the variety of symptoms from the mental and somatic spheres.

Describe the modern methods of psychopharmacotherapy AN and BN.

Data from available publications on the topic of psychopharmacotherapy AN and BN, and long-term practical experience of research staff the Department of psychiatry and medical psychology RUDN University, Moscow.

Therapy includes antidepressants (AD) - serotonin reuptake inhibitors (SSRIs), antipsychotics and tranquilizers. AD groups of SSRIs reduce most of the symptoms AN and BN - depressive disorders, anxiety, obsessive and compulsive symptoms, episodes of overeating and purifying behavior, suicidal thoughts, and reduce the frequency of relapses. With severe and persistent dysmorphophobia, a high degree of impulsivity, and psychopathic behavior second-generation antipsychotics Quetiapine, Olanzapine, Risperidone and Aripiprazole are used. Benzodiazepine tranquilizers (Lorazepam) are used in small doses and as additional therapy. Data from the European national guidelines for the treatment of AN and BN very different, and the world Federation of societies for biological psychiatry (WFSBP) does not provide specific recommendations at all. There are many reasons for disagreement and lack of specificity regarding drug selection, including the lack of an equally solid evidence base, that reflects the modern state of research on the psychopharmacological treatment of eating disorders.

In General, therapy AN and BN should be comprehensive - psychopharmacotherapy, psychotherapy, diet therapy, social rehabilitation. Treatment should be carried out both in the hospital and on outpatient basis and should be decided individually.

No significant relationships.

More than 92% of people in Bangladesh are deprived from any sort of mental health care due to severe scarcity of mental health professionals, widespread stigma, lack of awareness, the inability to travel from remote area to Dhaka and maintaining the cost of travel and clinics. Moreover, the COVID-19 crisis made the scenario worse. To solve this problem we designed, developed and implemented “Monerdaktar”.

The process development Monerdaktar- website and mobile application started with the initial idea and concept by TRS followed by extensive literature review and naturalistic observation of the mental health care service delivery from two tertiary hospitals in Bangladesh. We conducted 3 focus group discussion with the patients, their care givers, mental health professions. Based on the user feedback and technical suggestion of the mental health professional and IT professionals we developed the prototype of the Monerdaktar mobile application and website. After piloting for two months, the final version of the mobile application and website was finalized incorporating the feedback of the patients and experts.

Monerdaktar created the unique opportunity to connect with the most the reputed mental health professional both psychiatrists and clinical psychologists online. Moreover, monerdaktar delivered the service free of cost to more than 700 clients during the peak of COVID crisis in Bangladesh.

The COVID-19 crisis has potentiated the acceptance and adaptation of the Moenrdaktar solved the long-standing crisis of access to mental health care in Bangladesh and ensure the evidence-based care from anywhere.

The Monerdaktar website and mobile application was design and developed by under the leadership of Dr. Tanjir Rashid Soron. Though the initial support was delivered free of cost, the consulting expert psychiatrist and Clinical Psychologist may take their

In the context of distance learning students have an increase in the level of stress, anxiety (Husky, Kovess-Masfety, Swendsen, 2020). There is also a problem with time management and, as a result, procrastination. The reported study was funded by RFBR according to the research project №20-04-60174.

To study the differences in the level of anxiety and procrastination depending on the type of learning.

A total of 290 students took part in the study. In the first study (before distance), 168 people took part, the average age was 19.8. In the second study (during distance) – 120 students, the average age was 19.2. The questionnaires: General Procrastination Scale, C.Lay; State-Trait Anxiety Inventory, Ch.Spielberger.

In the course of descriptive statistics, it was revealed that the level of procrastination and state anxiety have a middle score. However, the level of trait anxiety in conditions of distance learning is high, especially among 1st-year students. In a comparative analysis of the two studies, it turned out that the level of state anxiety is significantly higher (t=1,975;p=0,049) in conditions of distance learning. The correlation analysis revealed the relationship between procrastination and trait anxiety (r=0,414;p=0,0001).

These results can be used to create programs to optimize the stress manifestation in students, especially when taking online exams. The high anxiety of 1st-year students may be associated with their accumulated stress factors, such as uncertainty about the future and etc. It should be noted that the level of procrastination does not differ, which may indicate procrastination as a personality trait.