Benzodiazepines (BZDs) and related drugs (BZRDs) are widely used to reduce agitation, anxiety and sleep disturbances in the elderly, despite concerns raised about their modest efficacy for such indications and risk of severe adverse effects, including acute consequences on cognition. Recently, some studies have also raised concerns about the long-term effect of BZDs, suggesting their association with an increased risk of cognitive decline and dementia.

To review published synthesis studies on the risk of dementia development due to BZDs/BZRDs use.

An electronic search was conducted in PubMed. Meta-analysis, systematic and non-systematic reviews examining the association between BZDs/BZRDs and subsequent dementia were included. No language nor publication date restrictions were applied. Search results other than synthesis studies were excluded. Studies were screened for relevance based on predefined inclusion and exclusion criteria.

Overall, 246 results were obtained. After initial screening, nine studies were included. From these, three were systematic reviews with meta-analysis of observational studies (cohort and/or case-control), one was a systematic review from observational studies and five were non-systematic reviews. Most studies found an association between BZDs/BZRDs and subsequent dementia, with meta-analysis studies reporting an increased risk (OR) between 1,38 and 1,78, even after controlling for protopathic bias. However, difficulties in establishing a causal relationship are reported due to the considerable clinical and methodological heterogeneity of the primary studies.

Most studies suggest an association between the use of BZDs/BZRDs and dementia risk, highlighting that their prescription should be cautious, prevented or reduced to attenuate this risk.

The acts of violence committed by adolescents are becoming increasingly more common, generating problems of a diverse nature.

To study the main characteristics of violent adolescent examined in a forensic psychiatric assessment.

This is a retrospective study which examined the expert files of the subjects aged between 14 and 20 years charged with violence, which were examined in the context of criminal psychiatric expertise in the psychiatry department of Hedi Chaker University Hospital in Sfax (Tunisia), between January 2002 and December 2018.

Our study included 34 forensic psychiatric assessments. The male sex was predominant (94,1%). The mean age was 19,2 years. The perpetrators were unmarried (100%), with a primary school level or less (55,9%), and low socioeconomic level in all cases. They had personal criminal records in 20,6% One-fifth had experienced emotional deprivation in childhood. The father was described as violent in 20,6% of cases. The most common diagnosis were antisocial personality disorder (55,9%) and mental retardation (29,4%). The main offences were homicide and attempted homicide (47.1%), assault and battery (26,5%) and sexual offences (20,6%). The experts had concluded to a “non-criminal responsibility” in 38,2% of cases.

The knowledge of epidemiology of violence perpetrated by adolescents highlights the need for targeted research, policy and programming responses for its prevention.

No significant relationships.

The inclusion process allows children with special educational needs to be included in a normative environment. A large group consists of children with intellectual disabilities and behavioral disorders, hey need medical and pedagogical rehabilitation due to their low learning ability, neurotic disorders, and mental distortion.

Study of psychophysical characteristics of children with intellectual disability and behavioral disorders.

140 children with intellectual disabilities who have impairments in the neuro-psychological sphere (2017-2020 г.г.). Methods: medical and pedagogical, observation, examination, assessment.

Variants of the child’s psychophysical development: Option 1. (75%): children with a predominance of violations in behavior, emotional and volitional sphere. There is aggressiveness, inconsistency and impulsiveness of actions, lack of distance with an adult, and difficulties in complying with accepted norms and rules. Option 2 (25%): children with the following manifestations: timidity, tearfulness, distrust, fears, lack of initiative. All children have difficulty sleeping, eating disorders, and frequent psychosomatic illnesses.

Children with intellectual disabilities in an inclusive practice need comprehensive assistance, taking into account different variants of their psychophysical characteristics. The studied children were found to have neurotic and neurosis-like disorders, as well as pathological personality development. All children have: low performance, lability of the nervous system, lack of voluntary regulation, impaired activity, learning difficulties. There are behavioral and mental disorders that require medical, psychological and pedagogical rehabilitation.

COVID-19 has been declared as a pandemic by the World Health Organization on March, 2020. Opioid substitution therapy (OST) for opioid-dependent patients is an evidence-based, effective outpatient (OPD) based treatment maintained on medications(, buprenorphine-naloxone combination). These are difficult times for patients with addictive disorders. Authors came up with an idea of implementing “walk through” out patient model inspired by “Drive through” model of Mc Donalds in which Doctor and Nurses run open space OPD near to Medical record section to reduce the waiting time of patient, quick delivery and minimize droplet exposure.

To study the efficacy of Mc Donald’s model of OST in OST centre in Tarn Taran, india.

This was a restrospective-comparative study. We studied records of our patients using streatment as usual from September 2019 to March 2020 and using Mc Donald’s model (From April 2020 to October, 2020) for a period of 6 months during and before lockdown.

The average number of patients attending OST clinics during Covid lockdown was 352.8. The compliance rates significantly improved (57.82%), The drop out rates were much lower (20.78%), using Mc Donald’s model than usual treatment.

As per our knowledge, this study is first of its kind to study the efficacy of OST drug deliverance in pre Covid and Covid times and suggest, the new findings which can be inculcated in the other OSTs.

CONTEXTUALIZATION: Palliative sedation is a resource used to control symptoms of terminal patients in general. It is considered that it should be discussed by the professionals involved in the process, based on the competence of each one, as well as with family members and patients when possible.

AIM: To understand symbolic meanings attributed by nursing professionals who provide assistance to the terminal patient regarding to the act of the palliative sedation.

Strategies: Clinical-qualitative design, semi-directed interview of open questions in depth. Nine oncologist nurses participated in the study; sample closed by the criterion of theoretical information saturation. Interviews were audio recorded, transcribed fully, categorized by qualitative content analysis. The results were discussed by colleagues of the Laboratory of Clinical Qualitative Research at the University of Campinas.

FINDINGS: The treatment of the data led to 6 emerging categories: (1) death maintains its ambivalent values in our culture; (2) serving the death symbolically on a tray; (3) the act of sedation and its “unfortunate coincidences”; (4) palliative sedation: agent of a pious death; (5) late sedation: cause for distress to the professional; (6) the professional’s self-comfort considering certain psychological strength from the patient and family.

Final considerations: palliative sedation takes a general and individual meanings for the professional and even in case of experienced professionals regard to palliative sedation, the death phenomenon conduct them to expresses multiple and peculiar emotional issues, not ever perceveid.

No significant relationships.

Suicide attempts are common and constitute a serious problem for public health.Thus, it is very important to evaluate risk factors for suicidal behavior.

The purpose of this study was to explore the socio-demographic and clinical profile of attempted suicide patients consulting in the psychiatry department in Gabes (southern of Tunisia).

It was a retrospective descriptive and analytical study covering all patients who had attempted suicide during the period from the 1st of May, 2009 to September 25th, 2020 and who were referred to the psychiatry department in the regional hospital of Gabes. Sociodemographic and clinical data of the patients as well as characteristics of the suicide attemptswere assessed.

Socio-demographic profile of the suicidal consultant in psychiatry department corresponded to a single (73.4%) female (78.8%), with a mean age of 26 years, from an urban area (46%). Suicide attempts were most often by the intentional drug ingestion (67.8%), committed between March and August in 54% of cases. At most of the time, the suicidal person was alone (85%) at home (94%) when he committed his suicidal attempt. He did not communicate his intention to commit suicide in 46% of the cases and only 22 cases (7.9%) notified a person before the suicide attempt and 12.6% afterwards. Suicide behavior was impulsive in 79.5% of the cases and a verbal expression of a desire to die was only noted in 24.5% of cases.

Our results suggest a systematic and specific psychiatric evaluation of any patient who attempts suicide.

No significant relationships.

No significant relationships.

It is not known with certainty how different phenotypes are transmitted in groups of families divided into three generations.

Having meticulously searched for terms of psychopathogic lexicon that best translated the sterile categorical diagnosis, we obtained three dimensional groups for all six families in the three generations.

We calculated the frequencies and percentages of the three dimensional groups for the three generations of families based on sex.

The chi-square TEST attests a p-value = 0.049, statistically significant for the dimensional group “A”. (Tab. 3)

The genetics, and above all the epigenetics, of the phenotypes are periodically transmitted in group “A” and group “C” in the female and male sex. (Graphs 2.1.1 and 2.3.1) Different phenotypes indicate that the complexity of the interactions of the regulatory mechanisms of genes with the environment is extremely significant for the group with the most severe psychiatric pathology.

As in many areas of life, the covid-19 epidemic has had a great impact on psychological counselor training. Although studies and practices on online counseling are increasing every day in the world, there has not been a psychological counseling method preferred by experts in Turkey, which comes from community culture and, where physical contact is important, until the pandemic.

The examination of the opinions of the students studying in the last year of the psychological counseling and guidance undergraduate program during the pandemic regarding online counseling, where they perform their first psychological counseling experience.

The study was conducted with 10 counseling students, 9 women and 1 Man. The age range of the students is 22-24 and the average age is 20.6. The students’ opinions are taken with open-ended questions such as “Can you share your views on online counseling before online counseling?“ The reflection letter that the students responded to was subjected to content analysis.

The findings of the study show that there are four themes: Emotions before the counseling process, Thoughts before the counseling process, Therapeutic relationship, Online counseling in professional life. For example; in online counseling, negative emotions such as anxiety, excitement, fear, anxiety, stress, anxiety, as well as feeling comfortable and safe are among the positive feelings they experience in their therapeutic relationships.

As a result, although students have a positive view of online counseling, they mainly prefer to do it face-to-face. The findings were discussed taking into account Turkish culture.

No significant relationships.

The improvement perceived by the patients is a subjective measure of the psychic state, while the clinical evaluation corresponds to an objective evaluation of the psychopathological improvement performed by a psychiatrist. It is therefore relevant to evaluate whether these parameters evolve in a common way after patients have undergone an intervention in Day Hospital focusing on first psychotic episodes.

Study the relationship between subjective improvement and clinical evaluation.

This is a prospective study, which includes consecutive patients admitted to the Day Hospital during 2018. Their objective clinical improvement was assessed by means of the PANSS and GAF scales at admission and discharge. Subjective clinical improvement was assessed using an anonymous Likert scale with a score between 1 and 7. Sociodemographic data and other satisfaction parameters were also collected. A statistical analysis was performed using Pearson’s correlation.

A total of 73 patients were included. The perception of improvement on the part of the patients is very high presenting average values close to the maximum in almost all the evaluated items. The correlation between subjective improvement and PANSS variation presented a Pearson value 0.008; p = .957 and with the GAF variation presented a Pearson correlation of -0.066; p = .578 which indicates that there is no significant correlation between the variables.

Clinical evaluation and subjective perception of improvement are independent parameters.

One of the most perplexing and characteristic symptoms of the schizophrenia (SZ) patients is hallucination. The occurrence of hallucinations to be associated with altered activity in the auditory and visual cortex but is not well understood from the brain functional network dynamics in SZ.

To explore the brain abnormal basis of hallucinations in SZ with the dynamic functional connectivity (dFC).

Using magnetic resonance imaging for 83 SZ patients and 83 matched healthy controls and independent component analysis, 52 independent components (ICs) were identified as nodes and assigned into eight intrinsic connectivity networks (Figure 1A). Subsequently, we established dFC matrices and clustered them into four discrete states (Figure 1B) and three state transition metrics were obtained. To further explore the changes in the centrality of each component, eigenvector centrality (EC) was calculated and its time-varying was evaluated.

Compared to controls with FDR correction, we found that patients had more mean dwell times and fractional time in state 1 (P=0.0081 and P=0.0018), mainly with hypoconnectivity between auditory and visual network and other networks and hyperconnectivity between language and default-mode network (DMN). While, patients had less dwell times and fractional time in state 3 (P=0.0018 and P=0.0009), and decreased FC between visual network and executive control network (ECN) and increased FC between ECN and DMN than controls (Figure 2).

EC statistics showed that SZs displayed increased temporal dynamics in visual-related regions (Figure 3).

SZ was mainly manifested as altered dFC and temporal variability of nodal centrality in auditory and visual networks.

No significant relationships.

Nowadays the cyberspace penetrates all the spheres of our lives: work, leisure and learning activity. However, uncontrolled presence in the virtual reality can form Internet-addictive behavior. Young people seem to be in increased risk of Internet-related problems.

The research aim is to study the motivational shpere of the students with different level of Internet dependency.

The research methods are: Chen Internet Addiction Scale (CIAS), Internet Perception Inventory, Learning Motivation Diagnostics Inventory, Test of Motivation of Success or Fear of the Failure. The sample consists of 37 students of the medical university in the age from 21 to 24 years. According to the results of the CIAS 3 groups have been marked out: Group 1 - with the highest level of Internet-related problems, Group 2 – the risk group of forming the Internet addiction, Group 3 – students who have not demonstrated proneness to Internet-addictive behavior.

The motivational sphere of the students with a low risk of Internet addiction seem to be more differenciated comparing with the one of the rest students. The motives of creative self-realization; communicative, social and learning motives have been demostrated. However, we have not found a significant differance between the groups in motivation for success. The motives of professional self-realization are equally important for all the research participants.

The obtained data can be implemented when designing Internet addiction prevention programs. We assume that including the motivational component into such programs can make them more effective.

No significant relationships.

The concepts of spirituality and religiousness has not been investigated so far in patients after stroke.

The aim of this study is to explore whether self-reports in two questionnaires measuring the personal experience of spirituality and religiousness can influence quality of life and estimations of rehabilitation in male older adult patients and their wives when compared with control dyads.

Fifteen male stroke patients and their wives participated one year after their hospitalization for stroke. The mean age of the patients and their wives was 75.58 years (SD = 7.50, range 61-90), level of education 15.47 years (SD = 3.82). In addition to that, fifteen married couples with similar demographics, were also measured. Depressive symptoms of the participants were assessed with the 15-item Geriatric Depression Scale. Family dyads consisting of an older adult and one family member, in all cases the wife, also responded to the Daily Spiritual Experience Scale, the Systems of Belief Inventory (SBI-15R), and the Satisfaction with Life Scale (SWLS). A 5-point Likert scale question was also administered examining the opinion of rehabilitation achieved.

indicated that there was a statistically significant difference between the two groups regarding the levels of spirituality, religiousness and quality of life in both partners, with the stroke patient dyad showing lower scores, but positive stronger correlations.

Although spirituality, religiousness and quality of life are lower in the stroke patient dyad, they show significantly statistical positive correlations in older adults suffering from stroke as well as their wives.

According to numerous studies, the origins of most endogenous mental diseases, in particular, autism, lie in early childhood. This concept is based on the classical theories of diathesis.

The purpose of this study was to clarify the phenomenology of mental disorders in children with an assessment of the prognostic significance of symptoms that preceded the development of the disease for future mental health.

The clinical material was collected during the survey of a child population. Selected for prospective observation was 40 children (1-3 years old) from the high-risk group for schizophrenia with functional disorders of the endogenous spectrum. All patients were examined by clinical methods and pathopsychological, neurophysiological. Psychometric scales PANSS, CARS were used. The results were mathematically evaluated using the Statistica 7 program.

The clinical picture of the mental state of young children, in children with autistic disorders in 1,5-3 years, was determined by a specific complex of disorders, which were reduced to a general deficit, especially in the emotional sphere, vegetative dysregulation, most often, the sleep-Wake rhythm. Motor skills, as a rule, did not lag significantly behind the age standards. The onset of actual autistic disorders was noted older than 1 year of life. Сhildren received medication and corrective therapy. The detailed clinical picture of violations developed gradually. Dynamics of psychopathological picture in (80,0%) children was regressive.

The study shows the importance of preventive measures in people related to ASD, sparing individual approach in education and therapy.

The dual diagnosis among patients with primary psychotic disorders is frequent and causes diagnostic and treatment challenges. In clinical practice, differentiating between substance-induced psychoses and independent (primary) psychoses when the patient is actively using drugs of addiction, is difficult, especially in the acute phase of the psychosis.

The aim of the study is to identify clinical data relevant for differentiating between primary psychoses triggered by addictive drug misuse and substance-induced psychoses, using psychometric scales.

The study was conducted on 111 patients divided in four samples: 28 dual diagnosis psychotic patients (DD), 27 bipolar patients (BD), 25 schizoaffective patients (SCA) and 31 patients with schizophrenia (SCZ). The subjects were assessed using scales for the severity of psychiatric symptoms, cognitive functions and social acuity (theory of mind): BPRS-E (Brief Psychiatric Rating Scale – Expanded), MoCA (Montreal Cognitive Assessment), CBS (Cambridge Behavioral Scale), and RMET (Reading the Mind in the Eyes Test). The tests were performed when patients were in the remission phase of the psychosis.

BPRS-E scores showed significant differences between DD subjects and patients from the other three samples (primary psychoses). CBS revealed significant differences between the DD subjects and patients with schizophrenia spectrum psychoses (SCA and SCZ). RMET identified significant differences between DD and BD patients.

Although differentiating between substance-induced and primary psychoses remains a difficult task, social acuity assessment performed in remitted patients may be helpful in guiding the clinician to establish a more accurate diagnosis.

In the early stage of schizophrenia (first 5 years), the most important clinical target besides symptom control is relapse prevention as each relapse significantly decreases the possibility of preferable long-term outcomes. Early discontinuation of antipsychotic medication due to intolerable side-effects is one of the most common causes of relapse.

This poster aims to present cariprazine’s tolerability in the early stage of schizophrenia.

Data from 4 randomized, double-blind, placebo-controlled trials (NCT00404573, NCT01104766, NCT01104779, NCT00694707) with similar design (1 week of wash out period, 6 weeks of treatment and 2-4 weeks of follow-up) were pooled. For the post-hoc analysis, patients with early stage of schizophrenia (defined as having a disease duration of less than 5 years) were extracted from the whole safety population, and approved doses of cariprazine (1.5-6.0 mg/day) were combined. Treatment-emergent adverse events (TEAEs) and discontinuation rates were analysed versus placebo.

Overall, 169 placebo- (PBO) and 322 cariprazine-treated (CAR) patients were identified as having schizophrenia for less than 5 years. 67.7% cariprazine- and 56.2% placebo-treated patients reported at least one TEAE; most frequently insomnia (10.9 % CAR; 12.4% PBO), akathisia (9.6% CAR; 2.4% PBO) and extrapyramidal symptoms (9.3% CAR; 1.8% PBO). Discontinuation due to adverse events was reported in only 8.4% of cariprazine- and 14.8% of placebo-treated patients. Relapse occurred in 3.1% of cariprazine- and 5.3% of placebo-treated patients.

Cariprazine was generally well-tolerated in the early stage of schizophrenia; given the limitations of this analysis, additional research is warranted.

Studies were funded by Gedeon Richter Plc. and Allergan Plc (prior to its acquisition by AbbVie). Dombi, Acsai, Dr. Barabássy, Dr. Sebe, Dr. Laszlovszky, Dr Vass, Dr. Szatmári and Dr. Németh are employees of Gedeon Richter Plc., Dr. Earley and Dr. Patel a

The reform of the Moscow psychiatric service began in 2011 and was aimed at its optimization, reducing the inpatient level, actively introducing psychosocial rehabilitation, multidisciplinary teams of specialists and developing community-based forms of care. In 2016, the number of beds in day care hospitals in Moscow had doubled to rich 3500.

Analyze the dynamics of characteristics of day hospital patients and propose measures to improve the quality of medical rehabilitation care provided.

Clinical and psychopathological, clinical and statistical, psychological, statistical of 337 schizophrenia patients discharged in 2010 and 2016.

A comparative analysis of the results obtained in 2010 and 2016 indicates a change in the clinical, socio-demographic and psychological characteristics of patients treated in the day hospital. In 2016, the proportion of early stage disease patients with endogenous mental disorders (F20-F29, according to ICD-10) increased; the age of patients and the proportion of patients with disabilities decreased; the proportion of patients with preserved working capacity increased, demonstrating low rates of compliance and motivation for treatment, but higher rates of neuro-cognitive functioning. In 2016, only a fifth of patients received complex psychosocial therapy.

The modernization of the psychiatric service has improved the continuity between its inpatient and out-of-hospital units. To improve the quality of care in the day hospital and to prevent relapses of the disease, it is necessary to combine pharmacotherapy with complex psychosocial treatment followed by a long-term personalized management of patients with the patient’s families involvement.

Previous studies have demonstrated that night-shift work is associated with adverse effects impacting physical and psychological health, including the Shift Work Disorder (SWD). SWD is a circadian rhythm disorder characterized by sleepiness and insomnia, resulting from working a shift other than the traditional daytime-shift. Armodafinil, a modafinil longer-lasting R-isomer, is approved for SWD treatment. Due to its pharmacodynamic profile, it may result in more sustained wakefulness during night-shifts than Modafinil.

To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing the efficacy of Armodafinil vs Modafinil and/or placebo on reducing SWD excessive sleepiness.

Will follow PRISMA guidelines. A systematic search will be conducted on PubMed, Web of Science, Scopus and ClinicalTrials.gov databases. RCTs comparing Armodafinil with Modafinil and/or Placebo for SWD treatment will be included. No language nor date restrictions will be applied. Outcomes of interest are prespecified as follows: the primary endpoint will be objective sleepiness; secondary endpoints will include subjective sleepiness, adverse effects, awareness, reaction time, memory and cognition. Retrieved studies will be independently screened for eligibility by two reviewers. Disagreements will be solved by consensus or by a third reviewer. Primary studies methodological quality will be assessed and data extracted independently using a standardized extraction-form.

Data will be described and reported as narrative text and summary tables. Heterogeneity of the included studies will be assessed and, if possible, a meta-analysis will be conducted.

It is expected that this systematic review and meta-analysis favours Armodafinil over Modafinil and placebo in the treatment of SWD.

No significant relationships.

The implementation of Intensive Home Treatment (IHT) aims to decrease the pressure on acute inpatient services that could lead to prevent hospitalization and reduce the number of hospitalization days and, ultimately, reduce cost in the mental health services. Although there are studies assessing the effectiveness of IHT, there is a shortage of research studying the cost-effectiveness.

The aim of this study is to present an cost-utility analysis of IHT compared to care as usual (CAU)

Patients between 18 and 65 years of age whose mental health professionals considered hospitalization were included. These patients were pre-randomized in either IHT or CAU and followed up for 12-months. For this study, the base case analysis was performed from the societal and healthcare perspective. For the cost-utility analyses the Euroqol 5D was used to calculate quality adjusted life years (QALYs) as a generic measure of health gains.

Data of 198 patients were used. From a sociatal perspective, the cost-utility analysis resulted in an incremental cost-effectiveness ratios (ICERs) of €58 730, and a 37% likelihood that IHT leads to higher QALYs at lower costs. The probability of IHT being cost-effective was >50% if there was no willingness to pay more for extra QALY than in the current situation under CAU.

Professionals working in crisis care are able to offer IHT with the same effect as other crisis care interventions at lower costs. IHT seem to be cost-effective compared with CAU over 52 weeks follow-up for patients who experience psychiatric crises.

No significant relationships.

Children with conduct problems (CP) exhibit problematic externalizing behaviors that violate the rights of others and/or societal norms, are likely to present with comorbid psychological problems, engage in high-risk behaviours during adolescence and in turn, display poorer prospective health in adulthood. However, little known about their adolescent quotidian behaviors, such as their sleep behaviours, which may contribute to these poorer outcomes.

Using a sample designed to assess the longitudinal consequences of CP, the current study examines how histories of CP and comorbidity with depressive symptoms and/or attention-hyperactivity problems are associated with sleep difficulties during adolescence.

744 participants from an ongoing longitudinal study in Québec, Canada were assessed for CP and comorbidities when they were 6 to 10-years-old. They were classified as without CP, CP only, CP and depressive symptoms, CP and attention-hyperactivity problems, or CP, depressive symptoms and attention-hyperactivity problems based on parent and teacher-reported indices. Sleep difficulties were assessed 7 years later, using self and parent-reported indices. Regression analyses controlling for sex, age, family income, maternal education and medications were conducted.

demonstrated that youth and parents from all CP groups reported more sleep difficulties than youth without histories of CP. Participants from the CP, depressive symptoms and attention-hyperactivity problem group reported more sleep difficulty than all other groups, while their parents did not.

These findings suggest that histories of CP, regardless of comorbidity, predispose youth to future sleep difficulties and highlight the importance of incorporating self and parental indices of sleep as well as examining the effect of comorbidity.