Children with acute brain damage make up a large group of patients who require multi-stage rehabilitation. Rehabilitation requires the creation of special conditions for psychiatric care and psychological and pedagogical correction of the consequences of severe damage to the nervous system.

To identify the options for mental activity during the restoration of the level of consciousness in children after acute severe brain damage.

210 children under the age of 18 with severe brain damage (traumatic brain injury, hypoxia, hydrocephalus). Clinical-psychopathological, pedagogical methods were used; additionally diagnostic scales, questionnaires.

4 groups were formed: 1st 37 (18%) patients had manifestations of mental activity with physical, cognitive and social capabilities in the minimal consciousness “+” (a- / hyperkinetic mutism with emotional reactions, understanding of addressed speech); 2nd 67 (32%) - manifestations of physical and cognitive abilities with minimal consciousness “-” (a- / hyperkinetic mutism without reactions); 3rd 95 (40%) - only the manifestation of physical capabilities at the exit from the vegetative status. 4th 11 (10%) - a low manifestation of mental activity in the form of physical capabilities with a vegetative status.

4 variants of mental activity in children after acute severe brain damage have been identified: from minimal involuntary reactions or their absence in vegetative status to voluntary actions according to the instructions of an adult in minimal consciousness “+”. Taking into account the variability of mental activity helps to differentiate the methods of psychiatric and psychological-pedagogical assistance in the recovery of children already in the early stages of rehabilitation.

Mental health is no doubt a topical conversation at medical school. We noted that whilst many students appreciated the power in talking openly about challenges faced, it was a topic many found hard to approach. In response, we have implemented a peer-led training programme at Bristol Medical School. The aim of the programme is to improve confidence and enable students to recognise and respond to their own, a peer or patient’s distress in a more proactive, supportive and overall effective way. It utilised peer-led, discussion based workshops during the first few months of medical school to achieve this.

To evaluate the role of peer-led mental health training in undergraduate medical education.

The program was piloted in November 2019. T-tests compared 142 participating students’ baseline self-reported understanding and confidence and follow up, as measured on a likert scale (1-5). Qualitative feedback was also welcomed.

Students showed a significant improvement in their self-reported understanding (24%, P<0.05), confidence when supporting a peer (18%, P<0.05) and confidence if faced with a more acute situation (21%, P<0.05). Students expressed particular admiration for the fact that the session was peer led ‘as it emphasised the importance of mental health in…society’.

This programme may be beneficial in creating a stronger community of doctors who are equipped with the confidence and ability to better care for themselves, their colleagues, and patients. Further evaluation is required to determine whether this reduces rate or severity of mental illness in participants or the broader student population.

No significant relationships.

Human social interactions are rooted in the ability to understand and predict one’s own and others emotions. Individuals develop accurate mental models of emotional transitions (MMET) by observing regularities in affective experiences (DOI: 10.1073/pnas.1616056114) and a failure in this regard can produce maladaptive behaviors, one of the hallmark features in several psychiatric conditions.

To investigate whether MMET are stable over time and which emotion dimensions (e.g., valence, dominance) influence MMET over time.

We selected thirty-seven emotion categories (DOI: 10.1177/0539018405058216) and five different time intervals (from 15 minutes to 4 days). Sixty-two healthy participants rated the likelihood of transition between all possible pairs of affective states at each time interval.

As expected, we observed a trend toward uncertainty as the timescale increased. In addition, the probability of shifting between two affective states having the same valence (e.g., happiness and contentment) was rated higher than for emotions with opposite polarity (e.g., happiness and sadness). Even though this pattern becomes gradually noisier for predictions far in the future, it is still present for infradian intervals (Fig.1).

Our results suggest that MMET are informed by the valence dimension and moderately influenced by the timescale of the prediction. These findings in the healthy population may prompt the exploration of emotion dynamics in psychiatric conditions. Future studies could leverage the MMET approach to test whether specific psychiatric disorders (e.g., bipolar disorder) are associated with abnormal patterns of emotion transitions.

No significant relationships.

Seasonal changes, climatic factors such as temperature, sunlight intensity and precipitations as well as temporal factors seem to have an influence on suicidal behavior.

Our study aimed to analyse the association between seasonal changes, climatic variations, temporal factors and suicide attempts.

A retrospective descriptive and analytical study was undertaken including all patients consulting for the first time at Gabes psychiatry department from the 4th March 2009 to the 25th September 2020 for suicidal attempt. Sociodemographic and clinical data as well as suicidal attempts’ characteristics were assessed. Meteorologic data, related to the years 2009 through 2020, were obtained from the official weather website of Tunisia.

278 patients were collected, including 217 female. Mean age was 26. Suicidal patients were unmarried (75.9%), childless (79.1%) and unemployed (47.5%). Results showed that suicidal attempts occurred most frequently in summer (32.5%) specifically in June and July (10.9% for each). Regarding the distribution of suicide attempts over the days of the week, the highest rate was observed on Monday (22.5%) and the lower one on Friday. There were a correlation between high temperature and suicide attempt by hanging (p=0.006), between days of sunlight and manifestations preceding the suicidal attempt (p=0.04) and between rainfall and anxiety disorder leading to suicidal attempt (p=0.03).We finded also an association between the summer and risk behavior such as runaways (p=0.024).

A better identification of seasonality, climatic and temporal factors in suicidal behavior could allow a better prevention in suicidal attempts and a reduction in death by suicide

The COVID-19 pandemic has highlighted a need for engaging online resources to enrich psychiatry training for undergraduate medical students. Podcasting is a well-established digital communication platform utilised daily in a myriad of capacities, including education. A group of medical students were tasked with creating their own educational podcasts covering specific aspects of psychiatry.

Each pair was set a sub-topic of psychiatry and utilised software to produce educational resources. The objective of this project was to reflect upon production as well as explore the efficacy of podcasting as a tool within undergraduate training.

The medical students conducted research and contacted experts within the field to contribute to their podcasts. The majority of the students then conducted reviews of the literature surrounding podcasting within medical education, which informed the production of their own podcasts. From this, it was discussed how this project could impact future practice, and indicated that podcasts may become crucial asynchronous learning tools in medical education.

Literature review and first-hand experience of podcast production enabled the students to appreciate the advantages of podcasting and the potential for its widespread future applications. Their wider reading revealed that podcast-using study participants outperformed or matched their peers in assessments, and overwhelmingly enjoyed using podcasts over traditional teaching methods.

The use of podcasting can complement traditional psychiatry training and appeal to a generation of digital natives that prefer this learning style. Podcast production is also an excellent revision method, highlighting the advantages of peer-to-peer education in both learning and increasing engagement with psychiatry.

No significant relationships.

Schizophrenia is a chronic disease that deteriorates the functionality of patients, especially when forming a family and taking care of children. We are interested in analyzing the characteristics of mothers with schizophrenia and their degree of global activity when going from oral treatments to injectable treatments.

1 To assess the quality of life and functional level of mothers with schizophrenia receiving paliperidone treatment. 2. Compare quality of life and functional level when going from oral treatment to long-term injectables.

Sample: Mothers, 37-45 years old, diagnosed with schizophrenia in monotherapy with oral paliperidone who started treatment with Paliperidone Palmitate LD IM (200 - 300 mg / month). Retrospective data collection. QLS quality of life scale.

5 patients were included, caregivers of 1 child (80%), 2 children (20%) who met the inclusion criteria and completed the questionnaires. After its application and correction through non-parametric tests (N <30). During oral treatment, scores were observed in the QLS questionnaire of: mean intrapsychic functions 34.2, mean interpersonal relationships 19, mean instrumental role 8, mean daily activities 8. After 12 weeks of treatment with Paliperidone Palmitate IM, scores were obtained: functions Medium intrapsychic 36, medium interpersonal relationships 23, medium instrumental role 15, medium daily activities 11. A better functioning of the patients was observed in the instrumental and daily activities categories.

In our experience, injectable long-acting Paliperidone Palmitate is associated with the perception of better quality of life in mothers with schizophrenia and increases the ease of administration as well as planning in their daily life.

People with schizophrenia are considered to be within the most stigmatized social groups. Accurate and efficient detection of stigma and its correlates is essential in patients with psychosis.

The purpose of this study was to assess illness insight, stigma, social anxiety and quality of life in patients with a first episode of psychosis and their possible correlations

The sample of this study consisted of 90 patients with a first episode of psychosis that fulfilled inclusion and exclusion criteria. Tools used for the purpose of this study were Schedule for the assessment of insight-Expanded version, Internalized Stigma for Mental Illness Scale, World Health Organization Quality of Life Assessment - Greek version, Liebowitz Social Anxiety Scale - Greek version. Data were collected and analyzed with SPSS v26.

The study group had good insight (SAI-E score: 20.33±4.449), medium to high stigma values (ISMI score 50.93±7.854), a good enough quality of life (WHOQOL-BREF score: 86.08±10.010) and low levels of social anxiety (LSAS-Gr Fear score: 3.26±8.653; Anxiety score: 2,93±7,596). The results of this study show significant at the 0.01 level 2-tailed correlations as such: (i) a positive and significant relationship between ISMI and LSAS-Gr, (ii) a negative and significant relationship between ISMI and WHOQOL-BREF, and (iii) a negative and moderate relationship between WHOQOL-BREF and LSAS-Gr.

We report medium to high stigma levels, good insight and a good enough quality of life in a sample of first-episode patients with psychosis.

No significant relationships.

Understanding suicidal ideation and its association with childhood adversity is crucial for preventing suicide. Although the “healthy immigrant effect”, whereby immigrants are healthier than the native-born population, has been well documented across studies, little research has examined the presence of such effect on lifetime suicidal ideation (LSI) and its association to early adversity.

The aim of this study was to compare the prevalence of LSI between the immigrant and native-born population in Chile and explore the association between childhood adversity and suicidal ideation in immigrants.

Data from two cross-sectional health surveys: the Santiago Immigrant Wellbeing Study (STRING, n=1,091; 2019) and the Chilean National Health Survey (ENS2016, n=3,432) were used. Each study used multistage probability sampling and estimates were weighted to approximate the distribution of demographic variables in each population. Outcomes included LSI measured by WHO-CIDI and an adapted version of the Adverse Childhood Experience Questionnaire. Multivariate logistic regression was employed.

indicated that immigrants were less likely to report LSI compared with the native-born population. Moreover, male and female immigrants had lower risk of having SI than native-born counterparts. After controlling for socioeconomic status, social support, and health conditions, childhood adversities predicted an increased risk of LSI in immigrants. No gender differences were found in the effects of childhood adversity on suicidal thoughts.

Findings confirm the presence of a healthy immigrant effect in LSI and support a life course perspective, highlighting the importance of assessing early life disadvantages to understand suicidal ideation among immigrants.

The COVID-19 pandemic has significantly impacted the delivery of mental health services globally. Within Australia, the COVID-19 pandemic and subsequent containment measures have led to reduced face-to-face attendances. To maintain access to mental health consultations, new telehealth services were introduced by the Australian Government in late March 2020.

We aimed to quantify the impact of the COVID-19 pandemic on patterns of mental health attendances in Australia using an interrupted time series model.

To characterise patterns of mental health service utilisation, monthly mental health attendances between January 2016 and June 2020 were extracted from the Medicare database, stratified by clinician type: general practitioner (GP), psychiatrist, and allied health. We used triple exponential smoothing to model attendances between January 2017 and December 2019. Observed and predicted attendances between January and June 2020 were compared with 95% confidence (p<0.05).

Our models showed decreased mental health attendances in March and April, consistent with all healthcare services during this time. While uptake of telehealth was significant, it only partially covered the reduction in mental health attendances.

Our modelling highlights the significant impacts of the COVID-19 pandemic on mental health services in Australia, with telehealth only partially compensating for the reduction in face-to-face attendances. These results suggest that telehealth services may not be suitable for all individuals (e.g. those without reliable internet access). Given that telehealth will likely remain a feature of mental health service provision, outreach and face-to-face services should be considered for vulnerable groups

No significant relationships.

BipolarDisorders (BD) are regarded as a multidimensionaldiseaseinvolvingbothpsychological and physicaldeterminants. Althoughmood dimension andthymicinstability areconsidered as the « core » aspect of bipolardisorders, itis crucial to note thatsomaticproblemsfrequentlyoccur in BD,deeplyworsening the prognosis.

Herewedescribea case of atwentyyearshistory of psychiatricimpairment, diagnosedlaterwithcardiac malformation.

Female patient H.G has been admitted for the first time to psychiatric department ‘A’ of Razi Hospital,treated for type 1 bipolar disorder since 2004 with poor therapeutic compliance. We reviewed the clinical and paraclinical data.

The patient was hospitalized for a severe manic episode with psychotic features, without cardiac personal history. The patient was asymptomatic and physical examination showed no abnormalities. Following a routine electrocardiogram, an acute coronary syndrom was discovered (inverted T waves seen in V1 to V6). Cardiac troponins were not elevated. According to cardiology recommandations, ischemic heart disease could not be ruled out and extensive cardiovascular investigations were needed. Antipsychotics and mood stabilizors were contraindicated.Therefore, the manic episode could only be managed using benzodiazepines. Given contradictions between clinical, electrocardioagraphic and imaging findings,coronary angiography was necessary. Results showed no significant stenosis of coronary arteries and a myocardial bridging of the left anterior descending artery and we were able to put her on antipsychiotics and moodstabilizer, almost two months after her admission.

This case underlines the significant impact of somatic comorbidities in therapeutic management of bipolar disorders. Cardiovascular diseases in particular cause a delay in treatment initiation and an increase in patient length of hospital stay.

No significant relationships.

Since the declaration of the national lockdown in Spain on March 14th until the publication of the SEPB recommendations on May 11th, most of the ECT-U closed or drastically reduced their activity.

To present our non-stop management of an ECT-U during the first two months of COVID-19 lockdown in Spain.

We retrospectively analysed the time between sessions, the clinical, pharmacological and electrical data records of maintenance patients (m-ECT) and compared them with their own records in the two-month period prior to COVID-19. We analysed the length of admission, clinical, pharmacological and electrical records in hospitalized patients (i-ETC) and compared them with patients from the entire year prior to COVID-19 paired by age, sex and diagnosis.

The ECT-m programme included 17 patients: we postponed the ECT in 8 patients; 1 patient was hospitalized and 8 patients continued normally. The time between m-ECT increased by 8.37±4.89 days (p=0.018) without relapse. During the COVID-19 period, we performed ECT-i in 14 patients without new infections. In i-ECT the duration of admissions increased by 22.1 ±1.2 days (p=0.006), the load increased by 81.53 ±87.8 mC (p=0.027) and the time of the electrical seizure decreased by 7.9 ±9.2 seconds (p=0.037).

The modifications that reach a statistical significance are explained by the readjustment of the ECT-U, with no clinical significance. With the appropriate measures, neither m-ECT nor i-ECT were discontinued. Thus we maintained adequate patient management.

No significant relationships.

Day care programs have been extensively used to treat people with acute psychiatric disorders. Day hospitals (DH) can act as an alternative to admission in patients with acute symptoms, shorten the duration of admission, be useful for rehabilitation and maintenance care or enhance treatment in patients with poor adherence to outpatient care. Few research has been conducted in delusional disorder (DD).

To investigate whether DH care increases adherence with psychiatric appointments in patients with DD. To describe functions of partial hospitalization in DD.

Comparative study including DD patients who attended a DH (Group 1:n=12) versus patients who did not receive DH care (Group 2;n=7). Patients attending DH were classified into 3 groups according to the program function at referral. Adherence with outpatient follow-up appointments (primary outcome) and pharmacy refill data (secondary outcome) were assessed after discharge over a 6-month period (DH) and compared with group 2. For statistical analyses, non-parametric tests were performed.

Program function (DH): alternative to admission (n=4); shortening of admission (n=5) and enhancing outpatient treatment (n=3). Patients receiving DH care were more frequently referred from the inpatient unit or emergency department compared to those who did not attend DH (commonly referred from primary care services). No statistically significant differences were found between both groups in adherence to psychiatric appointments. Patients who attended DH showed higher compliance with antipsychotics (89.29% vs.72.62, p<0.05).

DH care may be a useful alternative to increase adherence with antipsychotics in DD patients with poor awareness of illness.

AGR has received honoraria, registration for congresses and/or travel costs from Janssen, Lundbeck-Otsuka and Angelini.

Different electrophysiological indices have been investigated to identify diagnostic and prognostic markers of schizophrenia (SCZ). However, these indices have limited use in clinical practice, since both specificity and association with illness outcome remain unclear. In recent years, machine learning techniques, through the combination of multidimensional data, have been used to better characterize SCZ and to predict illness course.

The aim of the present study is to identify multimodal electrophysiological biomarkers that could be used in clinical practice in order to improve precision in diagnosis and prognosis of SCZ.

Illness-related and functioning-related variables were measured at baseline in 113 subjects with SCZ and 57 healthy controls (HC), and after four-year follow-up in 61 SCZ. EEGs were recorded at baseline in resting-state condition and during two auditory tasks (MMN-P3a and N100-P3b). Through a Linear Support Vector Machine, using EEG data as predictors, four models were generated in order to classify SCZ and HC. Then, we combined unimodal classifiers’ scores through a stacking procedure. Pearson’s correlations between classifiers score with illness-related and functioning-related variables, at baseline and follow-up, were performed.

Each EEG model produced significant classification (p < 0.05). Global classifier discriminated SCZ from HC with accuracy of 75.4% (p < 0.01). A significant correlation (r=0.40, p=0.002) between the global classifier scores with negative symptoms at follow-up was found. Within negative symptoms, blunted affect showed the strongest correlation.

Abnormalities in electrophysiological indices might be considered trait markers of schizophrenia. Our results suggest that multimodal electrophysiological markers might have prognostic value for negative symptoms.

Physical abuse of children in schools is common in Nigeria, but its prevalence and forms are yet to be clearly studied.

To determine the prevalence and pattern of physical abuse of children in Secondary Schools in Ilorin Nigeria

Cross sectional survey of secondary school students aged 11-18 years in Ilorin Nigeria using multistage random sampling technique with proportional allocation was done. Respondents completed the ICAST-CI questionnaire which covers child abuse in educational institutions. Prevalence and pattern of child abuse was computed.

Table 1: Pattern of physical abuse in School in the last 12 months

Physical abuse of children is extremly commonplace in public secondary schools in Nigeria. it is neccessary to explore other ways of dealing with children in educational institutions.

No significant relationships.

Despite many signs and symptoms of depression get dismissed as normal physiologic changes associated with childbirth, depressive disorders are a common complication of pregnancy and postpartum period. The so-called “baby blues” have a minor functional impact and respond well to social support, whilst postpartum depression causes significant functional compromise, requiring more aggressive therapy. There is an extreme type of postpartum depressive disorder, postpartum psychosis, when patients present psychosis, mania, or thoughts of infanticide. It is imperative to promptly recognize and differentiate these entities, in order to minimize its impact on both mother and child. Antidepressant treatment may be necessary for some women, but risks and benefits should always be considered prior to institute pharmacotherapy.

To identify current approaches and evidence-based treatment options for postpartum depression.

Review of the most recent literature regarding postpartum depression. The research was carried out through the Cochrane, UptoDate, PubMed, MedLine, LILACS and SciELO databases, using the terms “postpartum depression”, “baby blues” and “postpartum psychosis”, until December 2020.

Since both depression and antidepressant medications confer risk upon the infant, when postpartum depression develops, psychotherapy is usually the first-line treatment. Antidepressant treatment may be necessary, but its use during pregnancy and postpartum must be weighed carefully.

In order to better prevent postpartum depression, recommendations include the use of screening instruments as a routine clinical practice during pregnancy and referral when necessary. Maternal depression has a severe impact on both mother and child, so mental health professionals have a very important role in reducing postnatal emotional complications.

No significant relationships.

Child abuse has deleterious consequences on its victims. Its occurrence is poorly documented in Nigeria.

To determine prevalence and pattern of physical abuse at home among children in Ilorin Nigeria.

Cross sectional survey of secondary school students aged 11-18 years in Ilorin Nigeria using multistage random sampling technique with proportional allocation was done. Respondents completed the ICAST-CH questionnaire which covers child abuse in its several forms. Prevalence of child abuse was computed.

Table1: Pattern of physical abuse at home in the last 12 months

Conclusion Physical abuse of children is extremely common in Ilorin Nigeria. There are no specific demographic determinants of occurrence; hence every growing child is at risk. The prevailing cultural norms and state laws appear to be chief drivers of this phenomenon. The current findings expand the available pool of knowledge about CPA in Nigeria and calls for more research. It also supports existing calls for the abolition of corporal punishment of children.

No significant relationships.

Growing evidence studying pathological online behaviour has shown an increasing rate of internet addictions in younger populations across the globe.

The current study aims to investigate the prevalence of smartphone internet addiction of youths in Hong Kong, and its associations with gender and depression.

A total of 1,164 participants’ preliminary data were extracted from the Hong Kong Youth Epidemiological Study of Mental Health, a territory-wide, household-based study of mental health in youths aged between 15-24. Internet usage behaviors, socio-demographic and psychosocial characteristics of the participants were assessed. The Chen Internet Addiction Scale was modified to measure smartphone internet addiction (SIA). Symptoms of depression were assessed using the Patient Health Questionnaire. Mann-Whitney U tests were used to examine (i) SIA across gender and (ii) depressive symptoms between high and no to low SIA groups. Linear regression model was used to evaluate the association between SIA and depression.

The prevalence of smartphone internet addiction was 27.8% using the cut-off scores of 67/68. Women had higher SIA scores than men (U=144239.50, p=0.001). Participants with high SIA were associated with a higher severity in depression than those with no-to-low SIA (U=89187.00, p<0.001). Regression analysis revealed a significant positive correlation between depression and SIA after adjusting for confounding factors (B=0.099, t=9.138, p<0.001).

Our findings suggest a gender difference on online behaviour using smartphones. Further investigations are needed on whether SIA may exacerbate severity of common mental disorders.

The mental health impact of the COVID-19 pandemic is well documented. Portugal entered the emergency state on 19th march due to rising numbers of infected patients. The emergency state introduced regulatory measures that restricted people’s movements, applied a curfew, and closed most non-essential spaces and activities, such as shops and religious celebrations.

To evaluate the rates of suicides during the emergency state in Portugal.

We obtained the number of probable suicides during 19th march and 2nd may 2020, 2019 and 2018 from SICO/eVM (Real Time Mortality Electronic Surveillance). This system is used for health planning in Portugal and provides provisory data which is updated every 10 minutes. ExcelÒ was used for the statistical analysis.

During the Emergency State in Portugal there were 57 probable suicides. Comparing to the same period in 2018 and 2019, there were 62 and 70 probable suicides, respectively. Social isolation, anxiety, fear of contagion, chronic stress, and economic difficulties may lead to the development or exacerbation of depressive, anxiety, substance use, and other psychiatric disorders. Literature on suicides due to COVID-19 mention not only fear of infection, but also social isolation and distancing and economic recession as causes for suicide attempts and completions.

During the emergency state there was not an increase of probable suicides, compared to previous years. The greater vigilance of people’s movements may have deterred many attempts. However, policymakers and health care providers must be alert as the current psychosocial predispose to an increase in suicide rates.

No significant relationships.

Quality of life is a broad and complex concept, but essentially refers to an individual’s well-being in a spectrum of life domains.

The aim of the present study was to investigate the relationship between spirituality, religiosity (S/R) and quality of life (QOL) among bipolar disorder (BD) patients.

Data were collected between July and December 2017.Participants were enrolled from the Mood Consultation of the Psychiatry (A) Department of the University Hospital HediChaker. We assessed symptoms of mania [Young Mania Rating Scale (YMRS)], depression [Beck scale], quality of life [World Health Organization Quality of Life-Brief Version (WHOQOL-BREF)]andquality of life aspects related to spirituality, religiousness and personal beliefs [World Health Organization Quality Of Life –Spirituality, Religiousness and Personal Beliefs (WHOQOL-SRPB)]

Our sample included 60 patients. It consisted of 55% of female and the mean age was 44.94 (SD=12.76). The sample included 68% of participant diagnosed with BDI and 32% with BDII The median score of quality of live was 3 (minimum=1; maximum=5).The median of physic, psychic, social and environmental quality of life was respectively (25, 31, 81 and 19) (Minimum=0; Maximum=100). The mean score of WHOQOL-SPRB was 14.82 (Minimum=4, Maximum=20). S/R were correlated to psychic, social and environmental quality of life (p=0.006, p=0.011, p=0.016). We did not find a significant association between physic quality of life and S/R (p=0.234).

Our study suggests that spirituality, religiosity have an important influence on most aspects of the quality of life among bipolar patients.