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.

Hiccups are an involuntarily powerful spasm of the diaphragm, followed by a sudden inspiration with a closure of the glottis. Hiccups lasting longer than one month is termed intractable hiccups. Intractable hiccups can be caused by structural or functional disturbances of the medulla, afferent or efferent nerves to the respiratory muscles or metabolic and endocrine disorders, drugs, general anaesthesia and emotional problems.

Authors present a case report about curing a patient of intractable hiccups using baclofen along with literature review.

A case report along with literature review forms the basis of discussion.

A 30-year female diagnosed with schizophrenia stable on 2mg risperidone for 3 years presented to the outpatient department with complain of intractable hiccups for 6 months. Frequency of hiccups was around 10-12 times per minute and continued throughout the day leading to significant socio-occupational distress. patient had been receiving medical treatment for last 4 months for the same including Metoclopramide, chlorpromazine along with trying breath holding and drinking cold water but symptoms persisted. Her ECG, chest X-ray, complete blood counts were unremarkable, CT scan of brain was normal. Patient was started on baclofen 10mg thrice daily. Within 1-week patient had dramatic response and complete remission was achieved in 2 weeks.

Beclofen is effective in hiccups because it is an analogue of GABA, that decreases excitability and inhibits the hiccup reflex, which reduces synaptic transmission. Baclofen is used to treat hiccups, and can be used either as a first-line treatment or if patient does not respond to other medications.

No significant relationships.

Thanks to advances in medicine, more diseases are being cured, but this benefit can become a problem when it causes a worsening of quality of life.

The objective of this paper is to analyze, regarding the following case, the convenience of treating or to limit the therapeutic effort (LTE) in psychiatric patients who are in situations at the end of life.

62-year-old woman begins with depressive symptoms from financial problems. In 4 months ago she makes four suicide attempts (drug overdose, cuts, self-stabbing, and precipitation), being hospitalized in ICU after latter because of multiple trauma and shock. During that time, she had a bad evolution with several complications that made LTE be evaluated. A bibliographic search was performed from different database (Pubmed, TripDatabase) about LTE and ethical implications.

Trying to prolong life by disproportionate means in a patient with a poor prognosis or poor quality of life is bad practice. We must assess the severity, quality of life, capacity and preferences of the patient to decide to treat or not, thus guaranteeing the principle of beneficence. It is also important to respect the principle of autonomy, accepting patients can refuse treatment. All this is equally applicable to psychiatric patients, whom we should not stigmatize but rather evaluate their ability to decide, as in any person.

In conclusion, in situations of high suffering and near death, it is necessary a complete evaluation of the patient (psychiatric or not) is carried out in order to act in the most ethical way.

Obsessive-compulsive disorder (OCD) and schizophrenia (SZ) are both severe psychiatric disorders. Though these two disorders have distinct typical symptoms, there are partial polygenic overlap and comorbidity between the two disorders. However, few studies have explored the shared and disorder-specific brain function underlying the neural pathophysiology of the two disorders, especially in the aspect of dynamics.

To explore the abnormal characteristics of the dynamic functional connectivity (dFC) in OCD and SZ as well as the association between dFC metrics and symptom severity.

The resting state functional magnetic resonance imaging data of 31 patients with OCD, 49 patients with SZ, and 45 healthy controls were analyzed using independent component analysis to obtain independent components (ICs) and assigned them into eight brain networks (Figure 1), then used the sliding-window approach to generate dFC matrices. Using k-means clustering, we obtained three reoccurring dFC states (Figure 2), and state transition metrics were obtained

In a sparsely connected state (state 1), SZ showed both increased fractional time and mean dwell time than controls (P=0.047 and P=0.033) and OCD (P=0.001 and P=0.003). In a state characterized by negative FC between networks (state 2), OCD showed both increased fractional time and mean dwell time than controls (P=0.032 and P=0.013) and SZ (P=0.005 and P=0.003). Moreover, the fractional time of state 2 was positively correlated with anxiety scores in OCD (r=0.535, P=0.021, FDR corrected) (Figure 3).

OCD and SZ patients showed distinct alternations of brain functional dynamics.

No significant relationships.

Cyberaggression including the most wide-spread variants of flaming (O’Sullivan, Flanagin, 2003; Voggeser et al., 2017) and trolling (Buckels et al., 2018) is affecting mental health of adolescents and youth although it could be (Kowalski, 2014; Wright, Wachs, 2020).

The aim was to study prevalence of flaming and trolling experience in Russian youth and adolescents and its relationship to general aggression and tolerance.

525 adolescents 12-13 years old, 1029 adolescents 14-17 years old, 736 youth 18-30 years from 8 Federal regions in Russia appraised their experience of flaming or trolling online (as initiators, victims and observers) using vignettes. 1105 parents of adolescents appraised whether their children experienced flaming or trolling online. Then they filled Aggression Questionnaire (Buss, Perry, 1992) and Tolerance Index (Psychodiagnostics…, 2008).

More than one-half of adolescents (51-58% in 12-13 years old and 64% in 14-17 years old) and youth (45-69%) reported experience of flaming and trolling online, mostly as observers (32-65%). Parents accurately appraised flaming experience in their children but underestimated trolling experience (p<.05). Adolescents and youth observing flaming online report higher hostility, anger and physical aggression (F=17.8-28.3, p<.01, η²=.02) while lower social tolerance (F=4.27, p<.05, η²=.01). In adolescents observing trolling online these effects are stronger than in youth observing trolling online (interaction: F=5.68, p<.05, η²=.01).

Observing trolling and flaming online is related to higher aggression and low tolerance in adolescents and youth and for adolescents the relationship is stronger. The reported study was funded by RFBR, project 20-013-00857.

The reported study was funded by RFBR, project 20-013-00857.

Depression is commonly present among HF patients and is associated with adverse clinical outcomes. However, research regarding its association with New York Heart Association (NYHA) class is still scarce.

To evaluate the presence of depression symptoms in HF outpatients and analyze its association with NYHA class.

This study is part of a larger research project (Deus Ex-Machina/NORTE-01-0145-FEDER-00026). HF patients were recruited from an outpatient clinic at a University Hospital. Exclusion criteria were: unable to communicate, severe visual acuity deficit or NYHA class IV. Sociodemographic data and NYHA class were registered. The Patient Health Questionnaire-9 (PHQ-9) was used to assess depression, with a score ≥10 indicating clinically relevant depression.

A sample of 136 HF patients was included, with a median age of 59 (range: 24-81) years old, where 66% were men. Almost half of the patients (49%) were in NYHA class II, followed by class I (36%) and class III (15%). The median score of PHQ-9 was 4(range:0-18), with 26% showing clinically relevant depression. PHQ-9 total score was associated with NYHA class (p=0.001), with higher median scores in worse NYHA classes [class I: 3 (IQR: 5.5), class II: 4 (IQR: 8) and class III: 8.5 (IQR:9.3)].

In this study, depression was present in 26% of HF outpatients and was associated with more severe HF symptoms. Consequently, preventing, monitoring, and treating depression in the management of these patients is recommended. Further research is needed for a deeper analysis of this association.

With increasing prevalence, eating disorders (EDs) constitute a public health problem. Access to treatment is limited and often delayed for the majority of patients. Such obstacles might be mitigated via the development of virtual treatments.

Conducted during COVID-19 lockdown, this pilot study aimed to explore the feasibility and preliminary clinical outcomes associated with treatment of EDs by means of a remote psychoeducational (PE) programme.

Eleven patients who fulfilled DSM‐5 criteria for anorexia nervosa, bulimia nervosa, or binge eating disorder completed assessments, including ED symptoms, anxiety and depression, as well as motivation to change measures at the beginning and end of the time-limited (4 weeks) specialized treatment. It consisted in receiving 4 PE documents by email (1 per week), which was completed by a 15-20 minutes phone call with each participant (1 per week).

Data showed significant improvements of several self‐reported eating disorder symptoms, including body dissatisfaction and intensity of bulimic episodes.

Our findings suggest that a time-limited remote PE intervention produces clinically meaningful changes in ED symptoms. Thus, it might be worth developing such interventions in a clinical context, especially when performed prior to higher level of care. Further research is required to evaluate optimised interventions using a more diverse sample from a plurality of treatment facilities and context of care, as well as research in a non-pandemic setting which may have impacted these exploratory study results.

No significant relationships.

Bulgaria has undergone a number of very significant political and social changes over the past 150 years that has also impacted on the delivery of mental health care. There has been a 40% reduction in the number of inpatient psychiatric beds in Bulgaria within the past 20 years leading to the current state of approximately European average bed numbers per 100 000 population. This does not appear to have been accompanied by an increased investment in ambulatory / outpatient mental health services.

Description of the advantages and disadvantages of mental health services in Bulgaria, available staff and distribution in the country. The project RECOVER-E and its activities in Bulgaria are described.

Sources of health statistics of Bulgaria are used and analyzed. Maps and tables were used for visualization.

Taking into account the situation described in this way and the EPA guidelines for change in the system, a mental health strategy has been proposed.

It has a long and significant legacy of underfunding of mental health services, which has undoubtedly caused significant economic damage to Bulgaria through surmountable results increasing health and social care costs, and surmountable loss of economic productivity. A significant increase in the budget allocated to mental health and related social care services.

No significant relationships.

A person who has gender dysphoria can experience some difficulties in his/her/their life (as we can see even in language). These difficulties are mostly because of the binary gender system. Especially in countries like Turkey, homophobia is very common. Because of that, a homosexual person can think that he/she/they is a transgender.

At this point, group psychotherapies are worthwhile, especially for differantial diagnosis. These individuals can share their experiences about the process. On this way, they can also explore themselves.

We have a monthly group psychotherapy for transgender and gender nonconforming adults in our clinic. We accept the individuals who have problems about gender identity. All trans adults who apply to us and are considered to be suitable are directed to the support group.

An individual, aged 20, who defines herself as a FtM trans has joined to the group for 4-5 months. She was in hurry and had decided to go under surgery for gender transition. She was referred to surgery by another clinic which didn’t have a group psychotherapy. So she applied to our clinic. During the group psychotherapy, she realized that she was homosexual and gived up gender transition.

Group psychotherapy is helpful for trans individuals to reduce psychological distress and manage their process. This study shows that it is not the only benefit of group support psychotherapy. It also helps the individuals to explore themselves, like our case. Its benefit can be as major as saving themselves from an irreversible step and its consequences.

Assessment of mental health in medical staff during the COVID-19 pandemic helps to prevent the delayed negative consequences of work under high risk.

The study compares the perceived stress and coping ability in medical staff caring for patients diagnosed with COVID-19 and in professionals, working with other patients.

Online survey involved 249 doctors and medical staff of a Moscow hospital aged 19 to 60 (80 men and 169 women). 135 people worked directly with COVID-19 patients and 114 specialists did not. The study was conducted with the Perceived Stress Scale (10-items) amidst the first wave of COVID-19 in Russia, in May 2020.

No significant differences were found in the stress levels between the two groups of healthcare providers. On average, the sample revealed an increased level of stress (15.4 with standard values of 12-13). The general indicator of perceived stress (F = 13.471; p <0.001), stress level (F = 12.333; p = 0.001) and stress resistance (F = 6.003; p = 0.015) in women is significantly higher than in men. In addition, women working with COVID-19 patients have a higher level of stress resistance than women working with other patients (F = 3.432; p = 0.045).

The perception of stress by healthcare staff during the COVID-19 pandemic increases independently on whether or not they work with infected patients. Although stress is higher in women, they are better at coping, especially in extreme situations. The reported study was funded by RFBR, project number 20-04-60174.

22q11.2 Deletion Syndrome (22q11.2DS) represents a congenital syndrome with several clinical features. It entails a 25% risk of psychotic onset in lifespan. 22q11.2DS is a reliable model for biological vulnerability to schizophrenia.

With the hypothesis of similar impairments in schizophrenia and 22q11DS, to investigate a possible correlation between Social Cognition (SC) and Interpersonal Functioning (FU).

Sample consists of 1735 adults: 893 schizophrenic subjects (SCZ); 18 with 22q11.2DS and psychosis (DEL_SCZ); 44 22q11.2DS individuals (DEL); 780 healthy controls (HC). SCZ and HC data come from a multicentric study by Network for Research on Psychoses. SC was assessed with The Awareness of Social Interference Test (TASIT, consisting of three sections: T1= Emotion Recognition; T2=Minimal Social Inference; T3=Social Inference Enriched). The Specific Levels of Functioning (SLOF) interview was employed.

DEL_SCZ (p<0.001) and SCZ (p<0.001) showed impairments in each TASIT sections compared to HC. Significant deficits in interpersonal functioning area were found in SCZ (p<0.001) compared to HC. The interpersonal functioning domain showed a positive correlation with SC in HC (T1: r=0.097; p<0.001; T2: r=0.120; p=0.001; T3: r=0.121; p=0.001); DEL (T1: r=0.380; p=0.024; T2: r=0.466; p=0.005) and SCZ (T1: r=0.113, p=0.001; T2: r=0.110, p=0.001; T3: r=0.134; p<0.001).

SC deficits both in subjects with 22q11.2DS and in people with schizophrenia suggest a role of endophenotypes. SC is directly correlated to interpersonal functioning in 22q11.2DS without psychosis and people with schizophrenia. DEL_SCZ may suffer from deeper cognitive and symptomatic conditions that both impact differently on FU.

A delusion of pregnancy in men has been rarely reported in psychiatric disorders. The literature on this delusion in male schizophrenia is limited. It was reported especially in medical conditions. In psychiatric disorders, it has been explained for a long time by psychodynamic theories.

To present a case of a pregnancy delusion in man associated temporally to neuroleptic-induced hyperprolactinemia and a review of literature of medical and psychological etiologies of this symptom

We presented a case of a pregnancy delusion in man associated temporally to neuroleptic-induced hyperprolactinemia and we elucidated through a review of literature of medical and psychological etiologies of this symptom.

Case report A 46-year-old man, unmarried, who had a mild intellectual disability and a 22-year history of schizophrenia. He was admitted to our hospital for psychotic relapse due to the interruption of his medication. This patient had been treated for years with long action injection medication. On admission he was disorganized, verbalizing a poorly-systematized fuzzy delirium. And he believed he was pregnant. Serum prolactin levels was 38 ng/ml (3-25ng/ml). He was put on Haldol decanoate 150mg/month, chlorpromazine 150mg/day, and diazepam 15mg/day.

The presentation of a delusion of pregnancy in man is rather infrequent. The delusion may have many social, psychological, and biological determinants to its genesis. This case highlights the importance of medical investigations notably the assay of prolactin in the assessment of patients who present with delusions of pregnancy.

No significant relationships.

Covid-19 intensified public demand for telehealth services in child psychiatry. The shift towards online services raised concerns related to safety and quality of services.

The objective of the study was to explore outcomes and perceptions regarding psychiatric telehealth services from the patients’ and professionals’ perspectives.

Survey and questionnaires were the main methods to collect feedback after 1129 sessions conducted by psychiatrists and psychotherapists for 559 young patients in 2020.

Overall, patients/caregivers were generally satisfied with the quality of services, despite some technical issues and limitations of the platform. The most common outcomes of the sessions were: psychotherapy, in-depth assessment, pharmacotherapy, in-patient treatment, referrals for in-person appointments with other specialists, parenting strategies. Professionals gave more positive feedback on telehealth services after a few months of practice and training. Psychiatrists preferred conducting telehealth appointments for the patients they have previously seen in-person. The most common diagnosis were various neurodevelopmental disorders (48,9%), as well as patients within F84.0-F84.5 27,9%, and F84.8 (19,8%). Identification challenges, confidentiality and safety maintenance were among the top concerns for mental health workers. Specific guidelines for caregivers helped to use the appointment time effectively, prevent some technical and organizational issues and decrease negative effects of limited communication capabilities during a telehealth appointment.

Telehealth services in psychiatry are meeting real needs of patients, caregivers and professionals, and require further development. Proper training for professionals and clear guidelines for caregivers are among the key factors that enhance the quality of services.

Handwriting disorder is commonly observed in Developmental Coordination Disorder (DCD) (87-88%) and is often noted in children with high Intellectual Quotient (HIQ).Two mainly pure DCD subtypes: ideomotor-DCD (IM), visuospatial/or visuoconstructional-DCD (VSC) and a mixed subtype (MX) were identified in the literature but nothing is known regarding IQ and dysgraphia.

To refine the specific clinical features of dysgraphia related to DCD subtypes regarding IQ levels.

Neurovisual, neuropsychological, neuropsychomotor functions, and handwriting performances of 38 children (6-to-12 years-old: mean 9y, SD 2.7) diagnosed with DCD (DSM-5 criteria) were collected. Two matched groups were analyzed according to their IQ: 19 (TC) typical children (IQ=90-110) and 19 HIQ children (IQ> 120).

IQ scores were not significantly associated with dysgraphia. There isa significant difference between TC vs HIQ with a lower rate of IM-DCD respectively 11% vs 5% (p=.035) and 68% vs 37% for VSC-DCD (p=.03) but 21% vs 58% in MX-DCD (p=.41). Dysgraphia was significantly more present in TC group with MX-DCD and in HIQ with VSC-DCD. A negative correlation between Kho’s’ cubes test failure (p=.006), visual-spatial memory (p=.05) and VSC-DCD was noted in HIQ group. The deficit of visual spatial memory was significantly related to dysgraphia in HIQ children (p=.01) associated to visual gnosis impairment (p=.03).

Dysgraphia was significantly found with VSC-DCD subgroup in FIQ>120 with specific features of visual perception disorders suggesting more involvement of the right cortex. These results suggest that VSC-DCD in HIQ could be a neurovisual impairment rather than a pure VSC-DCD.

Dhat Syndrome is a culture-bound entity frequent in the Indian subcontinent. It is characterized by somatic symptoms, together with depressive and anxiety features, specifically focused on the belief of losing semen through urine1.

To describe an atypical Dhat Syndrome case in European cultural context,and to determine the appropriate diagnostic frame and subsequent therapeutic approach.

We present the case of a 37-year-old Indian man attended in our psychiatric outpatient unit mainly due to somatic complaints (gastrointestinal, sexual dysfunction, weakness, and dizziness). He interpreted his problem as possibly due to diabetes and hypothyroidism, and specifically from sugar loss in urine. Organic diseases were excluded.

Although considered as culture-bound, Dhat syndrome has been classified as a subtype of depression, anxiety disorder, somatoform disorder2,3,4, and even a prodromal phase of schizophrenia5. Antidepressants and benzodiazepines are the most recommended pharmacological treatments1. Antipsychotic agents have been used when clear psychotic symptoms were present (auditory hallucinations,delusions)5. Nonetheless, paliperidone 6mg/d was initiated at baseline, with good response and partial remission of the symptoms at two weeks, despite the absence of clear psychotic features. Culturally-informed cognitive-behavioural therapy, as well as sexual education could be beneficial were planned and initiated1.

Data on Dhat Syndrome is scarce, yet agreement exist in considering the cultural context of the patient to avoid diagnostic delays. The adequate treatment remains uncertain. Antipsychotics may be a potential treatment. Further research is necessary to clarify the nature of this syndrome but European clinicians must be aware of culturally-mediated psychiatric manifestations which are increasingly prevalent due to globalization.

No significant relationships.

The mental health law is not universal. In Portugal the urgent compulsory regimen is based on the principles of the presence of severe mental anomaly and risk to themselves or others.

Characterization of patients admitted in compulsory hospitalization (CH) between 2018 and 2020, in the University Hospital Center of Algarve - Faro Department

Retrospective study from January/2018 to August/2020. Social, demographic, epidemiological and clinical data were evaluated.

Of 1191 patients who were admitted 36% occurred in CH. There was a predominance in male sex (58%), the average age was 43 years old. For 62% it wasn´t the first hospitalization and 58% had a recent prescription. Admission occurred most frequently because of the presence of psychotic symptoms (figure1) and according to the international classification of disease (ICD10) the most frequent diagnosis was unspecified nonorganic psychosis (figure2). At discharge 59% of the patients remained on compulsory treatment (CT), where the most frequent diagnosis was schizophrenia. Although most of these patients were discharged with oral and long-term injectable antipsychotics, there were higher rates of readmissions when compared to non-CT group, were the most frequent diagnosis was mental and behavioural disorders due to psychoactive substance use and most of the patients were discharged only with oral therapy.

Patients in compulsory regimen have a severe mental illness with higher rates of readmission. We highlight the use of long-term injectable antipsychotics in terms of compliance. These findings corroborate the need for specialized and multidisciplinary approach in terms of psychosocial rehabilitation in these patients.

Suicide is an intriguing act of the human being. The reasons behind the violation of an instinct for survival is far from being understood. Besides, the emergence of assisted dying is raising even more questions about the concept of rational suicide, defined as a well-thought-out decision to die by whom is mentally competent.

Understand the concept of rational suicide, in parallel with suicide, by exploring the views on this debate over the years and elucidating the relationship with mental disorders, mental capacity and patient’s rights.

Literature review performed on PubMed and Google Scholar databases, using the keywords “rational suicide”, “assisted death”, “suicide”, “phenomenology”, “mental capacity” and “responsibility for life”.

The theological condemnations of suicide – as sin or crime – were put aside with psychiatric development in the last century. Durkheim was the first important precursor of the contemporary view - suicide is a form of mental illness (psychosis or depression) not compatible with rational deliberation. With the increasingly open debate on assisted dying, this vision is being tested by cases of terminally ill patients subjected to experiences that many wouldn’t choose to tolerate. Moral right to self-determination and needless suffering are examples of arguments in favor of rational suicide.

The need for an open discussion about rational suicide is raising, specifically in relation to psychiatric disorders, mainly to resolve the conflict between the duty of care of psychiatrists and the autonomy of patients.

No significant relationships.

Schizophrenia patients with auditory verbal hallucinations (AVH) demonstrate impaired functional connectivity (FC) between brain regions, involved in executive functions and language. However, as most studies compare patients to healthy controls, the specificity of these findings either for schizophrenia in general or for AVH is unclear.

We aimed to compare whole-brain resting-state FC of main language brain regions between schizophrenia patients with and without history of AVH and healthy controls.

Schizophrenia male patients with (n=31; mean age 29,8±11,6) or without history of AVH (n=16; 29±12,4) and 39 healthy male controls (30±8,9) underwent resting-state fMRI on 3T Philips scanner. No between-group differences in age, illness duration, and severity of clinical symptoms except AVH were revealed. Regions of interest (ROIs) were taken from the independent fMRI study with conventional language localizer and included left inferior frontal gyrus (l_IFG) and superior temporal gyri (STG) bilaterally. Whole-brain FC of each ROI was compared between groups (ANCOVA; p<.005 voxelwise; p(FDR)<.017 clusterwise, corrected for number of ROIs) with post hoc tests.

Decreased FC between each STG (left and right) and anterior cingulate cortex (ACC) was revealed in all patients, compared to healthy controls. Patients with history of AVH, compared to other groups, showed decreased FC between l_IFG and ACC.

Disrupted fronto-temporal FC is non-specific for AVH and characterizes all schizophrenia patients. Patients with history of AVH have impaired FC between the l_IFG, underlying language production, and ACC, involved in differentiation between language production and comprehension. The study was supported by RFBR grant 18-013-01214.