Schizophrenia is one of the most disabling diseases affecting the patient’s ability to live independently, to be socially active and to work or study1,2. Therefore, identifying predictors of functioning in the first stages of the disease is important to prevent a negative progression of functional outcome in these patients3.

To identify the factors associated with real-world functioning in patients with recent onset of the disease.

Secondary analysis of a cross-sectional, naturalistic study. 84 patients with Schizophrenia (F20), aged 18-71 in their first five years of the disorder under maintenance treatment. Assessments: PANSS, CDS, CGI-S, CAINS; functioning: PSP, cognition: MATRICS. Statistical analysis: student-t test, ANOVA, Pearson correlation and lineal regression.

Mean age (SD): 31.30 (10.08); men: 62.8%. Statistical significant differences (p<0.05) were found in work status, benzodiazepines and antidepressants use. Furthermore, significant correlations (p<0.05) were found with depressive, positive and negative symptoms (avolition, anhedonia, alogia and affective flattening) and cognition. A significant predictive model was obtained that explains the 72.1% of the variance [F(5,74)= 20.952; p< 0.001]. This model included depressive symptoms (B= -0.940; p= 0.001), negative symptoms (B= -1.696; p< 0.001), avolition and anhedonia (B= -0.643; p= 0.001), affective flattening and alogia (B= 1.197; p= 0.003), and visual learning (B= 0.202 p= 0.039).

Negative and depressive symptoms are the main determinants of real-world functioning in patients with recent onset of schizophrenia. Visual learning also contributes to this outcome. On the other hand, the positive relationship between expressive domain and functioning needs furthermore investigation.

No significant relationships.

Psychiatry is fundamental interdisciplinary medical science with essential importance for enormous health-problems of humanity. Creation of integrative-psychiary in context of multidimensional&holistic medicine, founded by HIPPOCRATES-GALENUS-HUA T’UA-AVICENA-PARACELSUS is necessary to counteract disastrous human health-situation. Psychiatry needs new integrative therapy-models considering application of psychopharmacotherapy as well as practices of psycho-somatic (Th.v.UEXKÜLL) and somato-psychic theories (Y.IKEMI). Emperor AKIHITO during Opening-Ceremony of ICPM-2005-Kobe appointed to consider “total symptoms of mind-body, seeking ways of holistic care”.

REFERENCES. PSYCHIATRY: EPA-2020-virtual/Madrid, Eur.Psychiatry 63S, EPP0834/5+EPV0581/1470; EPA-2019-Warsaw, Eur. Psychiatry 56S,S689; EPA-2018-Nice, Eur.Psychiatry 48/S1, S623&567&662. WPA-2019-Lisbon, E-Poster WCP19-2137, -1822, -1839; 2018-Mexico-City, Abs.-Book WCP18-0584/-0625/-0643/-0654. 2011-Buenos-Aires,AB:PO1.200. PSYCHOLOGY: EFPA-2019-Moscow, Abs.-Book 1529,1530,1549. IUPsyS-2012-Cape-Town, IntJPsychol 47:407; -2008-Berlin, 43/3-4:154, 248,615,799; -2004-Beijing, AB:49,587. PSYCHOSOMATICS: ICPM-2017-Beijing, AB:ID: 648493,648895,648749,648878; -2005-Kobe, J.Psychosom.Res. 58:85-86.

Evaluation of psychic-“polar-attitude-list”/physiological-parameters: heart-rate, blood-pressure,etc. from patients/probands after training by occidental/oriental practices (Music-/Yogatherapy/others) (ref.).

Observations demonstrate strong positive influence after music[1], respiratory[2], hatha-yoga[3] therapies. Items of psycho-physiological (relaxed), emotional (tranquil/happy), cognitive (few/ordered thoughts), voluntary (active/spontaneous), social (open/assertive), consciousness (clear/sleepy) categories are significantly positive changed 25-50%. The 3-therapies have specific psychic-effects,e.g. items “relaxed/tranquil” after respiratory- (+45/50%) and music- (+20/5%), also item “open” after music-therapy (+25%) are positive, but negative after respiratory-therapy (-20%). Psychic-effects are correlated with positive physiological-ones,e.g. heart/respiratory-frequency decreased 25-30%, voluntary-apnoea prolonged 55%. Mountain-altitude (>2000-3000m), hypothermia (<20 to 0°C) influenced positively psychic/physiological-parameters,e.g. heart-rate/blood-pressure decrease (n=125,P<0.05-0.01).

Different methods of integrative psychiatric therapy are with preference,e.g. for depression is suitable respiratory/physical-training, also hypothermia&high-mountain therapy (activation-euphoria), for mania:music-therapy (inhibitory-effect). Systematically research about single/combined therapies is necessary,e.g. for epilepsy: Respiratory-therapy/hypothermia,etc. could help patients (hypo-/hypercapnia: inhibitory/excitatory effects on CNS-structures).

Eslicarbazepine Acetate, a novel anti-epileptic drug has been approved as monotherapy in focal onset seizures, with/without secondary generalization in adults. Eslicarbazepine has many advantages over older anti-epileptic drugs and is useful in patients of new onset focal epilepsy.

Aim of our study was to determine the efficacy and safety of Eslicarbazepine Acetate, observe its well-tolerated use and monitor adverse effects in newly diagnosed patients of focal epilepsy.

Study was done at Department of Psychiatry, Teerthanker Mahaveer University, Moradabad. A total of 30 newly diagnosed cases of focal epilepsy between 18-60 years of age were studied for 6 months, using a Semi-structured Interview and Liverpool Adverse Events Profile.

Majority of patients were males (58%), between 21-30 years. Patients with partial/focal seizures (63%) were more common than those of generalized seizures (37%). Majority of the participants had 1-2 episodes of focal seizures weekly(48%), while some had almost daily(32%). Majority were on Eslicarbazepine Acetate 800 mg in two divided doses daily (64%), while the others received 1200 mg in three divided doses(32%). The mean Liverpool Adverse Events Profile score initially was 28.34 ± 6.28 which significantly improved after 4 weeks treatment to 22.80 ± 4.35 (p < 0.05). The improvement in newly diagnosed focal seizures patients was significantly more than other patients (p < 0.05). No major side effects were observed.

Eslicarbazepine Acetate as a monotherapy is effective in treating focal epilepsy. Better results of this drug are found in newly diagnosed focal epilepsy patients.

No significant relationships.

In 2005 Elizabeth Parker and fellow researchers described the first case of Hyperthymestic Syndrome, a woman going by initials AJ. Thereafter, a handful more of such cases have emerged. Older descriptions of extraordinary memory in medical literature mainly considered semantic and working memories. Jorge Luis Borges in his 1930s short story ‘Funes, his Memory’ writes about his, presumably fictitious, encounter with a man named Ireno Funes who possessed an extraordinary memory and a knack for keeping track of briefest of passing moment. Among many qualities that Funes and AJ share are their extraordinary memories, obsession for keeping track of time, and their problems with abstraction. After describing his extraordinary memory, Borges says of Funes, ‘I suspect nevertheless, that he was not very good at thinking. To think is to ignore (or forget) differences, to generalize, to abstract.’ Similarly, AJ has been described to have impaired abstraction, hypothesis formation and conceptual shifting. Moreover, both Funes and AJ see their capability as a burden rather than a gift. “My memory, sir, is like a garbage heap.” Says Funes.

A brief exploration of Jorge Luis Borges’ works in the context of autobiographical memory.

The comparisons between Borges’ description of his character’s autobiographical memory and findings of modern research techniques will be done qualitatively.

Effort is made to undersatnd Borges philosophy in context of mordern memory research.

An in depth look into Borges’ philosohies linking perception of time, coding of memory, abstration and language can inform further line of research regarding autobiographical memory.

No significant relationships.

No significant relationships.

Mental health challenges are common among medical students. Data shows that that they are less likely to use mental health services, regardless of experiencing frequent mental health issues.

The aim of our study was to evaluate first year medical students’ mental health state and attitude to seeking help.

The target group was the first year medical students in Vilnius University. Anonymous questionnaire created by authors was used to evaluate socio-demographic data, self-perceived emotional state level, attitudes and accessibility to mental health services. The study involved 152 first year medical students: 97 of them were local and 55 international students.

The majority of students (71.7%) reported that their studies negatively impacted their emotional condition. 14.5% of all students thought that they needed a consultation by mental health specialist, but decided not to seek help. 11.2% of students reported having used psychotropic drugs which had not been officially prescribed by a psychiatrist. 18.4% of all students thought that seeing a mental health specialist could negatively affect their future career as a doctor. 30.9% of students reported that they had used alcohol to improve their emotional state, 11.2% of students had used cannabis, 4.6% of students had used other drugs (e.g. LSD, amphetamine, cocaine) for this purpose.

1. Majority first year medical students think that the begining of studies have negative impact on their emotional well-being. 2. A large number of medical students unwilling to see mental health specialist. 3. Significant number of students use psychoactive substances to improve their emotional state.

No significant relationships.

The influence of personality on how people deal with stressful situations has long been discussed. In bipolar disorder, these two entities seem to have a role in the outcome of the disease.

To study the relationships between coping strategies in stressful situations and personality dimensions in euthymic bipolar patients.

This is a cross-sectional, descriptive and analytical study of 30 patients followed for bipolar disorder in remission, at the psychiatric outpatient clinic at the Hédi Chaker Uuniversity Hospital in Sfax. We used a socio-demographic and clinical data sheet and the Ten Items Personality Inventory (TIPI) to evaluate personality dimensions and the Ways Of Coping Checklist (WWC) for the assessment of coping.

The mean age of the patients was 43.77 years, the sex ratio was 0.5. Bipolar I disorder was diagnosed in 93% of patients. WCC : -Coping focused on the problem : 70% of the patients. -Emotion-centered coping : 20% of patients -Coping focused on seeking social support : 10% of patients. TIPI : Conciousness was the most represented trait of personality (36.7%), agreableness (30%) and extraversion (20%). Extraversion was associated with coping focused on the problem: (p=0.015). Agreableness was associated with coping focused on seeking social support:(p=0.033).

Our study showed that conciousness is the most common trait of personality in bipolar disorder patients. The coping focused on the problem is the most frequent strategy which correlated with extraversion, so, personality dimensions appear as a target for cognitive interventions.

No significant relationships.

Hospital discharge is a significant transitional phase with varying levels of needs and risks to be managed as lapses in communication commonly happen between secondary/tertiary and primary care.

Our aim was to look at inclusion of delirium diagnosis in discharge summaries based on standards set by: 1. Health Information and Quality Authority (HIQA) National Standard for Patient Discharge Summary Information 2. NICE Guidelines on Delirium: prevention, diagnosis and management (CG 103)

All inpatients referred to Liaison Psychiatry from 9thJuly 2019 till 5th January 2020 were included, n = 729. Compared discharge summaries diagnoses to the internal Liaison Psychiatry ICD 10 consensus diagnosis and also HIPE coded diagnosis specifically for delirium.

Delirium diagnoses and inclusion of delirium-specific information on discharge summary

Hospital discharge summaries are essentially the main communication link between hospitalists and general practitioners to ensure continuity and future care of patients. Delirium diagnosis is not always recorded in discharge summaries. This is a risk to be managed. Education is vital to ensure awareness, prevention, early recognition and to ensure recording of diagnosis of delirium.

In many countries, depressed individuals often first visit primary care settings for consultation, but a considerable number of clinically depressed patients remains unidentified. Introducing additional screening tools may facilitate the diagnostic process.

This study aims to examine whether Experience Sampling Method (ESM)-based measures of depressive affect and behaviors can discriminate depressed from non-depressed individuals. In addition, the added value of actigraphy-based measures was examined.

We used data from two samples to develop and validate prediction models. The development dataset included 14 days of ESM and continuous actigraphy of currently depressed (n=43) and non-depressed individuals (n=82). The validation dataset included 30 days of ESM and continuous actigraphy of currently depressed (n=27) and non-depressed individuals (n=27). Backward stepwise logistic regression analyses were applied to build the prediction models. The performance of the models was assessed with the goodness of fit indices, calibration curves, and discriminative ability (AUC, the area under the receiver operating characteristic curve).

In the development dataset, the discriminative ability was good for the actigraphy model (AUC=0.790) and excellent for the ESM (AUC=0.991) and combined-domains model (AUC=0.993). In the validation dataset, the discriminative ability was reasonable for the actigraphy model (AUC=0.648) and excellent for the ESM (AUC=0.891) and combined-domains model (AUC=0.892).

ESM is a good diagnostic predictor and is easy to calculate, and, therefore, holds promise for implementation in clinical practice. Actigraphy shows no added value to ESM as a diagnostic predictor, but might still be useful when active monitoring with ESM is not feasible.

No significant relationships.

Although suicide showed an association with personality disorders, few studies focused on narcissism. This association is interesting, especially in what authors called a “narcissism epidemic”, considering narcissistic wounds to which subjects could be subjected.

To systematically review studies investigating the association between narcissism and suicidal risk.

We focused on the association between narcissism (NPD, narcissistic traits) and suicide (Suicidal Ideation (SI), Non-suicidal Self-Injury (NSSI), Deliberate Self-Harm (DSH), Suicide Attempt (SA) and Suicide (S)). Studies were identified through a PubMed-based search. Reference lists were examined to extract additional articles. This review was performed according to PRISMA Statement.

We included 33 studies. Most studies evaluated narcissism through DSM, showing heterogeneous results. NPD was associated with low impulsivity and high planning, but also with a higher number of SAs. Studies evaluating narcissism as a trait were more coherent. SI, NSSI and DSH showed an association with vulnerable narcissism. These associations were explained by mediation and moderation models including shame and dissociation. The grandiose component was associated with severe repetitive NSSIs and S in high suicidal risk samples. Impulsivity showed no effect.

It is possible to develop hypothesis, even if not causal relationships, on the association between narcissism and suicidal risk. Grandiose narcissism seemed to be protective for suicidal outcomes with low intent to die, while vulnerable narcissism seemed to be associated. However grandiose narcissism seemed to be a risk factor for suicidal outcomes with high intent to die, showing low impulsivity and high planning and severity. New studies, differentiating between narcissistic components, are needed.

Climate change is a major global public health challenge that will have wide ranging effects on human psychological health and wellbeing through the increased incidence of acute (e.g., storms, floods, wildfires), sub-acute (e.g., heat stress, droughts, lost agricultural yields) and long-term stressors (e.g., changes to landscapes and ecosystems). Children and adolescents are particularly at risk because of their rapidly developing brain, vulnerability to disease and limited capacity to avoid or adapt to climate change-related threats and impacts. They are also more likely to worry about climate change impacts than any other age group.

To produce a new conceptual framework that describes climate change-related threats to youth mental health from a developmental life course perspective.

We critically review and synthesis literature documenting the pathways, processes and mechanisms linking climate change to increased mental health vulnerability.

We show that climate change-related threats can additively and interactively increase psychopathology risk from conception onwards, that these effects are already occurring and that they constitute an important threat to mental health and therefore human capital worldwide. We then argue that birth cohort studies are uniquely positioned to examine climate change-related threats and that incorporating relevant measures into existing and planned birth cohorts is a matter of social justice and crucial long-term investment in mental health research.

Climate change is affecting the healthy psychological development of children and these risks are increasing worldwide. New theoretical and empirical work is urgently needed so that threats can be tracked and mitigated.

The development of an extrapyramidal syndrome (EPS) is assumed to be a potential and important consequence of organophosphate poisoning (OP). Even though its causal relationship is firmly established, the information available in the literature regarding the orientation to be given is scarce, and its approach remains shrouded in a significant degree of uncertainty. Catatonia, as a neuropsychiatric condition, may present a marked overlap with the set of extrapyramidal symptoms developed after OP. Does the overlap between the symptoms seen in catatonia and in EPS make differential diagnosis fundamental or does it have no relevance in relation to the approach to be established?

To discuss the therapeutic approach to be implemented in the extrapyramidal symptoms resulting from OP and reflect on the overlap between catatonia and EPS.

Presentation of a clinical case and review of the literature.

A 50-year-old woman with major depressive disorder developed a condition marked by exuberant extrapyramidal symptoms 3 weeks after OP. Significant stiffness, tremor, dysphagia and facial hypomimia were some of the symptoms observed. Therapy was started with amantadine 100mg daily, with complete resolution of the symptoms after 5 days. Follow-up revealed reversal of extrapyramidal symptoms, in the absence of any neuroimaging changes or any other neuropsychiatric manifestations.

The possible overlap between catatonia and EPS is remarkable. The two conditions, regardless of their differentiation, may benefit from an identical approach using dopaminergic drugs. The use of amantadine, even in low doses, may be an option in the rapid reversal of extrapyramidal symptoms resulting from OP.

No significant relationships.

It’s established that aesthetic dysfunctions can be associated with psychiatric conditions. In present times, considering the exponential growth of minimally invasive and accessible techniques, alongside with ideals of beauty present in everyday life through exposure in social media, the importance of early detection of mental illness and its impact on the respective outcome should be emphasized.

To review evidence regarding psychiatric disorders in people searching for aesthetic treatments and their impact on the outcome.

Literature review using Medline database.

Around 50% of individuals seeking aesthetic procedures fulfill the diagnostic criteria for psychiatric disorders. The prevalence of Body Dysmorphic Disorder (BDD) can vary from 5-15%, with some studies showing a prevalence of more than 50%. Patients with heightened BDD symptoms are less satisfied with the outcomes of aesthetic procedures which could result in exacerbation of said symptoms. With regards to eating disorders, evidence suggests the initial satisfaction following aesthetic procedures, when observed, is usually transitory, not leading to long-term changes in self-perception relating to body image, nor improving prognosis or quality of life. There’s also some evidence suggesting that personality disorders may be a predictor of poor satisfaction with the results of aesthetic treatments.

Awareness should be raised in this matter, since psychiatric conditions are more common in patients seeking aesthetic treatments and early identification can lead to a better prognosis by providing patients with the mental health treatment they need; this could also reduce the probability of dissatisfaction and subsequent aggravation of psychiatric symptoms following aesthetic interventions.

Converging evidence substantiates a negative impact of the COVID-19 pandemic on the mental health of frontline workers. Nonetheless, there is paucity of research on paramedics.

To estimate the prevalence of stress, anxiety and depression in frontline paramedics in the Athens region, Greece, and to investigate the coping skills that are associated with less favourable mental health outcomes

A total of 100 ambulance paramedics participated in the study. The online questionnaire encompassed the DASS-21 for assessing mental health outcomes and the Brief-COPE for measuring coping skills. Information about socio-demographic characteristics and personal/relatives’ vulnerability to COVID-19 was also gleaned.

The prevalence for moderate to severe cases was found to be 7.2% for stress, 9.4% for anxiety and 11.3% for depression. Multiple linear regression analysis indicated that men demonstrated significantly higher stress [B = -2.28, 95%CI = -3.88 - -0.68] and depression compared to women [B = -1.69, 95%CI = -3.19 - -0.19]. Similarly, the use of denial was found to be associated with higher stress [B = 0.69, 95%CI = 0.11 -1.37] and anxiety [B= 0.55, 95%CI = 0.13 – 0.98]. Moreover, emotional support was linked to heightened anxiety [B= 0.71, 95%CI = 0.36 – 1.06] and self-distraction to depression [B = 0.60, 95%CI = 0.16 – 1.04]. Personal or relatives’ vulnerability to COVID-19 did not impinge on mental health outcomes.

Healthcare initiatives should be tailored at the mental health needs of frontline paramedics, especially men. Psychosocial interventions should target maladaptive coping, especially the use of denial.

Eating Disorders (ED) have increased both in number of cases and diagnoses in recent years, partly due to the ease of searching on the Internet. This “community” as they call themselves has a proper language, which makes them easier to connect.

To know the search frequency of Pro-Ana and Pro-Mia terms in Spanish in the Google search engine.

A manual screening was carried out based on the word analysis of Pro-Ana and Pro-Mia blogs to obtain their search frequency in Spanish. Using the Google Trends tool, a total of 19 word combinations related to ED and their advocacy were reviewed in the time period from 01/01/2019 to 01/12/20. Some of them such as: “carrera de kilos” (kilos race), “princesa de cristal” (glass princess), “princesa de porcelana” (porcelain princess) and “dieta ABC” (ABC diet) among other terms.

From 2019 to 2020 there has been an increase in the searches related to Eating Disorders (41.63%), ABC diet (9.72%), porcelain princess (25.52%) and kilos race (38.53%). There has also been a decrease in the search for thinspo ana (30.9%), tips ana (4.15%), blog mia (13.09%) or blog ana (0.79%).

Search trends change over time as they meet the evolving needs. In several media we can find a clear increase in ED during this 2020 due to the confinement related to COVID-19. This is something that we can also relate to this increase in searches for some terms.

No significant relationships.

The illusion of invulnerability has been linked to lower perceived risk and increased engagement in risky behaviors among youth. Therefore, it has been purported to influence young people’s poor adherence to public health measures aiming to contain the COVID-19 pandemic. Concomitantly, beliefs about the virus and mental health may also shape public health behaviours.

To investigate the role of beliefs, perceived invincibility and mental health status in explaining frequency of hand-washing and hours outside the house among youth in Greece

A total of 1.899 students, aged between 18-29 years old, were recruited from the main universities of the country. An online questionnaire entailing: (i) popular beliefs about COVID-19, (ii) the DASS-21, (iii) the Adolescent Invincibility Tool and (iv) queries about health behaviours, was distributed during the lockdown period.

Most participants reported washing their hands rarely/never within a day (78.6%) and spending 2-6 hours outside the house (68.1%). Handwashing was largely influenced by mental health [OR = 0.94, 95%CI= 0.91 – 0.98 for stress; OR = 0.96, 95%CI = 0.93-0.99 for anxiety and OR = 1.05, 95%CI= 1.02-1.08 for depression]; while hours outside the house by perceptions that the virus is out of control [OR=0.76, 95%CI = 0.61-0.95], manufactured [OR=1.21, 95%CI = 1.53, 95%CI =1.21 – 1.93] and airborne [OR= 0.78, 95%CI = 0.64-0.95].

Addressing stress and anxiety as well as health education interventions should be prioritized to foster young people’s adherence to public health measures amid the pandemic.

No significant relationships.

No significant relationships.

No significant relationships.

In Taiwan, residents of mental health halfway houses (MHHH) receive psychiatric rehabilitation services, aiming for independent living and community integration. Research is yet to investigate how MHHH may effectively assist residents’ discharge in this cultural context.

To examine the processes of assessment, preparation, assistance, and appraisal of discharge from MHHH staff’s perspectives.

Semi-structured in-depth interviews were conducted with 11 halfway house staff members. Verbatim transcripts were analyzed with dimensional analysis procedures of the grounded theory methodology.

Successful discharge is a personalized process with integrated approaches addressing three essential factors: (a) regular community involvement, (b) the residents’ capacity to work, and (c) the family’s acceptance and support. Staff supported individual residents’ community involvement by attending to residents’ personal interests, resource availability, financial concerns, and transportation. Moreover, staff provided rehabilitation trainings to develop work capacity. However, residents’ motivation and functioning as well as job opportunities might affect their employment. Finally, in Taiwan, residents were rarely discharged without their family members’ consent because residents tended to co-reside with their family after discharge or rely on family support while living separately. Staff worked to engage families, which was influenced by family relationship quality, past traumatic events, financial concerns, capacity to assist the resident, and/or the resident’s ability to assist with family affairs.

To achieve successful discharges, MHHH staff need to assist each resident by developing an integrated plan to enhance conditions of the aforementioned factors, including strategies for different familial situations to garner family support in this cultural context.

Conventional psychiatric services are not always acceptable to indigenous communities and people.

To present successful models of interactions of psychiatrists with indigenous patients and communities based upon our work with five communities in Maine.

We reviewed the strategies that worked for community interaction from our project for supporting indigenous communities to implement medication-assisted treatment and we reviewed the literature to see what other strategies are reported successful.

Psychiatrists working in these communities may need to share more personal details than to what they are usually accustomed to be accepted. They may need to acknowledge local culture and spirituality and work with traditional knowledge holders to create collaborative healing approaches. As part of this, a narrative approach appeared to work best in which the psychiatrist worked within the stories and beliefs of the community which required taking the time in dialogue to learn those stories and beliefs. Specifically, we address the challenges of flying into northern, rural, and remote communities, of academic physicians consulting to tribal-based opiate treatment programs, of modifying usual counseling techniques such as motivational interviewing to an indigenous population, and of the changes made in practice styles when taking into account the critiques made by indigenous people about medicine in general and psychiatry in particular.

We propose that participatory action-based approaches can improve service delivery to indigenous people. Indigenous cultures share a collectivist mindset in which the needs of the group supersede the needs of individuals, a reliance upon stories, and commitment to a biopsychosocial and spiritual approach.