The perinatal period poses heightened vulnerability to bipolar affective episodes. Lithium serves as first line in the management of bipolar disorder, demonstrating efficacy in stabilizing mood episodes and preventing relapses. Therefore, it also a recommended treatment during the pregnancy period. However, its use presents potential risks for both the mother and the developing fetus. Given the prevalence of bipolar disorder in reproductive-age women, it is crucial to investigate the risks associated with lithium use during pregnancy, along with its subsequent obstetric and neonatal complications.

This report outlines a case of severe polyhydramnios in a 42-year-old primigravida patient, under long-term lithium and antipsychotic treatment. Additionally, a systematic search for similar case reports was conducted to provide an overview of the existing literature.

The patient’s medical history and perinatal medical care are documented in this case report. A systematic literature search on MEDLINE (PubMed) was conducted using Boolean operators.

The patient was diagnosed with bipolar disorder type I and had a history of lithium treatment for over 20 years, supplemented later with antipsychotics. During her pregnancy, she experienced a polyuria-polydipsia syndrome and a severe polyhydramnios. She also suffered renal impairment. Together, it is indicative of a nephrogenic diabetes insipidus (NDI), likely induced by prolonged lithium treatment. As the pregnancy progressed, she experienced premature rupture of membranes at 34 weeks and 5 days. The newborn needed medical support and was admitted to the neonatal unit, without further complications.

Systematic research showed three published case reports describing nephrogenic diabetes insipidus (NDI) and polyhydramnios associated to lithium treatment.

Chronic administration of lithium may contribute to the development of resistance to antidiuretic hormone (ADH), leading to polyuria-polydipsia syndrome and potentially severe obstetric complications. The co-administration of lithium and antipsychotics may exacerbate these effects. Further research is needed to elucidate their combined clinical impacts.

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Pregnancy and puerperium are two critical stages for women’s mental health due to the biological stress of pregnancy itself, as well as the emotional stress that surrounds this vital moment. (1) Debut and aggravation of psychiatric symptoms may occur, as well as relapse in women previously diagnosed with Severe Mental Disorder (SMD).

Symptoms of the anxious spectrum are the most frequent within the perinatal mental pathology, being impulse phobias an entity that appears in about 25% of women previously diagnosed with OCD and up to 10-15% of women without previous psychopathology (2)

Exposing the importance of Perinatal Mental Health from the presentation of a clinical case.

Review of the literature available in PubMed. Presentation of the pathobiography and evolution of the patient.

Our case is about a 37-year-old woman, 30 weeks pregnant with her first child and history of having required admission to Psychiatry with subsequent follow-up in Mental Health for anxious-depressive symptoms with the presence of self-injurious ideas who, after two weeks with multiple life stressors, came to the Emergency Department for the presence of impulse phobias focused on pregnancy with significant internal anguish and ideas of death as a resolution to it, which is why it was decided to hospitalize her. During admission, and taking into account the patient’s gestational state, treatment was started with diluted Mirtazapine and Aripiprazole solution at minimal doses, which in this case were sufficient for symptom control.

The latest guidelines addressing psychopharmacology during pregnancy and lactation point to sertraline among the antidepressants and Lorazepam among the benzodiazepines as the safest drugs during pregnancy (3).

• - The exacerbation of anxious symptomatology and the presence of gestation-focused impulse phobias are frequent during pregnancy and their intensity increases as the time of delivery approaches.

• - Sertraline, Lorazepam, Mirtazapine and Aripiprazole are safe drugs during pregnancy.

• - In these women, a close and multidisciplinary follow-up by Psychiatry and Gynecology is advisable.

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Eating disorders (ED) are serious mental and physical illnesses that involve complex and damaging relationships with eating, exercise, and body image. They emerge due to a multifaceted interplay of factors, including familial predispositions, personality traits, and cultural influences. While societal beauty standards are recognized as significant risk factors, it is hypothesized that the roles and responsibilities associated with adult womanhood may also contribute to their development. In particular, the unique challenges faced by women, especially in developing countries like Turkey, may lead to discontent with traditional gender roles.

This study aims to explore the connection between eating disorders, female identity perceptions, body attitudes, expectations regarding women’s roles within families, and their potential association with body dysphoria. We investigate whether eating disorders are linked to a form of sexual dysphoria and body dysmorphia related to femininity rather than solely driven by societal beauty ideals.

Data from 228 female college students, both undergraduate and graduate, were collected via online surveys. The survey instruments included a sociodemographic form, the Eating Attitude Test, the Gender Roles Attitude Scale, and the Multidimensional Body-Self Relations Questionnaire.

The average age of the participants was 24.41 (18-33) years. Regression analysis revealed that age (β=-0.155, p=0.015), the belief that physical appearance would be less important if they were male (β=0.292, p<0.001), and maternal criticism about weight (β=0.239, p<0.001) were influential factors in shaping eating attitudes. Surprisingly, no significant relationship was found between eating attitudes and traditional gender roles (β=0.072, p=0.246). However, we did establish a connection between aspiring to meet ideal thinness standards and perceiving women as disadvantaged in the workplace due to their traditional gender roles (t(226)=2.32, p=0.021), as well as with maternal criticism (t(225)=3.55, p<0.001).

Our findings suggest that the absence of a direct link between eating attitudes and traditional gender roles may be attributed to an individual’s perception of their environment rather than their self-assessment of masculinity within an egalitarian context. Notably, maternal influences specifically their criticism regarding their daughters’ weight and the roles assigned to mothers significantly shape these perceptions and, consequently, eating behaviors, aligning with existing literature (Ferreira et al., 2021). This underscores the need to consider eating disorders within a broader biopsychosocial framework, encompassing attitudes toward the world and one’s role within it.

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Chronic pain is a prevalent condition that is frequently complicated by concomitant mood and anxiety disorders. Very preliminary data indicate that female physiotherapists could have a better attitude towards psychiatric disorders.

Purpose of the present article is to identify eventual differences in the management of patients with chronic pain and anxiety/mood disorders depending on the physiotherapists’ gender.

An ad-hoc questionnaire was developed and sent to physiotherapists by e-mail. The two group identified by gender were compared by unpaired sample t tests for continuous variables and χ2 tests for qualitative ones. A binary logistic regression was then performed with factors resulted statistically significant at univariate analyses as independent variables and gender as dependent one.

Female physiotherapists (compared to male ones) resulted to be more confident in the prosecution of physiotherapy by patients with Generalized Anxiety Disorder (GAD)comorbidity (t=2.46, p=0.01) and by patients who had received a visit with a mental health professional (t=2.79, p=0.01). Furthermore, female physiotherapists versus male ones believed that pharmacotherapy was less associated with motor side effects (t=2.90, p<0.01) and more frequently recognized the importance of a training to identify affective disorders (t=2.65, p=0.01) and the need of more education in mental health (t=2.85, p=0.01). The binary logistic regression model confirmed that female professionals (compared to male ones) were less likely to work as freelance in private institutions (p=0.015) and were more confident in the prosecution of physiotherapy by patients with GAD comorbidity (p=0.05).

Female compared to male physiotherapists resulted to be more comfortable with patients affected by mental conditions and to be more aware of the need of training on mental health. Implementation of mental health education for male physiotherapists is probably necessary and further studies are needed to confirm the results of the present study.

None Declared

New technological trends and access to more information have generated an anxious disorder and the need to obtain everything that the consumer society has to offer, this has increased with the influence of neuromarketing in internet ads.

The objective that was raised in the present investigation was to analyze the influence of neuromarketing in the increase of anxiety reflected in compulsive purchases of women in the city of Santa Marta.

The field research design is non-experimental and cross-sectional, the sample taken was of 500 women with purchasing power of more than three Colombian minimum wages.

The IDARE Ch. Spielberger, R. Díaz Guerrero et al. (1966) checklist was applied; To review the relationship between advertising with neuromarketing, anxiety and compulsive purchases, a Likert-type scale instrument was designed and validated with the Alpha Cronbach Coefficient. Analysis of Covariance ANOVA, inferential statistics and SPSS were performed.

57% of the women meet the criteria for the IDARE clinic. The analysis of the questionnaire showed a goodness of fit of R² = 0.697. The result indicates that the more hours women spend on the internet with access to ads focused on neuromarketing, the more they feel the need to buy, and this generates anxiety processes.

The mental triggers used by neuromarketing accelerate the need in women to buy the solutions that they sell and the same need to buy is evident in the signs of anxiety that is reflected in the women under study. Training that educates women to spend less time connected to the Internet is recommended, but it is also essential that they understand that advertising and marketing exert pressure that increases their anxiety and need to purchase, so it is recommended the implementation of training in personal management and control.

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Tunisia marked a significant milestone in the fight against gender-based violence with the adoption of Organic Law No. 2017-58. This pioneering law in the region enhanced the protection of women and girls’ rights and introduced harsher penalties for perpetrators of sexist violence. However, the journey toward eradicating violence against women is complex and multifaceted.

Our aim is to explore how tunisian women perceive gender-based violence and their attitudes towards it.

A cross sectional online survey designed using Google Forms and distributed on social media platforms (Facebook, Instagram) was conducted from August 30th to September 25th 2023. The questionnaire, presented in the tunisian dialect, included questions about personal experiences with violence, knowledge of gender-based violence laws as well as their perceptions and attitudes towards gender-based violence. The sample consisted of women from various regions of Tunisia.

In our study, we analyzed a sample comprising 110 tunisian women, with 46.4% falling within the 20 to 30 age bracket and 36.4% belonging to the 30 to 40 age range. Half of the survey participants were unmarried, and the majority of them (97.3%) had attained a university-level education.

Our research revealed that 45.5% of the surveyed women reported instances of gender-based violence in Tunisia. However, only a minority of these individuals (22.2%) initiated legal proceedings, primarily citing a lack of confidence in the judicial system and fear of potential reprisals as their reasons.

A majority of the participating women expressed deep concern regarding the issue of violence against women in Tunisia.

When asked about their perceptions of the most prevalent types of violence in Tunisia, 76.36% believed that psychological violence was the most common, followed by sexual violence (21.3%). Economic and physical violence were perceived as less frequent (9.9%; 12.6%). These women attributed the primary factors contributing to violence against women in Tunisia to cultural norms and laws that they considered inadequately stringent. Indeed, 83.3% of them believed that the current legislation was not stringent enough to deter potential perpetrators, and 37.3% indicated that they were unaware of the existing legal framework.

Despite legislative advancements, gender-based violence remains a pressing concern in Tunisia. These findings underscore the importance of increasing awareness about available resources for victims, educating individuals about women’s rights and mental health, and building trust in the judicial system.

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Fatty acids omega-3 are irreplaceable. They stabilize cell membranes, nerve impulses, homeostasis, immune reactions, the birth process, the psycho-emotional state of the fetus-mother dyad. Correlations between adequate dietary intake of omega-3 and cognitive health have been described in detail. According to the literature, docosahexaenoic acid is associated with the synthesis of serotonin, dopamine, acetylcholine, glutamate, neuroprotective and anti-apoptotic action, has antidepressant effect. Omega-3 makes up 60% of neuronal membrane phospholipids. Under clinical aspect,according to publications, fish oil reduces the risk of preterm birth by 44%.

The aim is to study the risks and benefits of using omega-3 during pregnancy and lactation in patients with mental disorders.

Comparative analysis of evidence-based scientific publications for the use of omega-3 fatty acids in pregnancy and lactation.

The body level of omega-3 depends on the quantitative intake from food, as well as gene polymorphism and age. For pregnant and lactating women are recommended 200-300 mg per day or about 300 g per week from food. Deficiency of omega-3 (protectins) affects the processes of myelination, neurogenesis, synaptogenesis, the metabolism of neurotransmitters, cell differentiation, neuronal migration and inflammatory responses.

There are many probably mechanisms of action of omega-3, namely: Enhances peroxisomal oxidation, reduces the synthesis of triglycerides in the liver; inhibits plasma acyltransfrerase. Omega-3 acts on phospholipids of the cell membranes of the nervous system and retina, their adequate functioning, improve psychomotor development of newborns. It was found the effect of decreasing the levels of cytokines and depressive symptoms, as well the risk of food allergies and depression. In conclusion, in adequate doses, omega-3 fatty acids seems to be useful in deficiencies and for prophylactic purposes in pregnancy and lactation.

omega- 3 fatty acids, pregnancy, lactation, mental disorders.

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Fear of childbirth is attracting growing interest because of its impact on the experience of pregnancy and on the progress of childbirth and it seems that some women are more susceptible to fear of childbirth than others are.

Our objective is to identify pregnancy factors that predict the fear of childbirth.

We approached 350 pregnant women consulting at the Gynecology-Obstetrics department of the Hedi Chaker University Hospital of Sfax. We collected their sociodemographic and clinical data. Fear of childbirth was assessed using the French version of the Traumatic Event Scale (TES), adapted to assess fear of childbirth.

The mean age of the participants was 28 years (16-41) and the mean gestational weak was 36.27. Half of the participants (53.7%) were nulliparous, and eight reported a history of infertility. The pregnancy was not planned in 61% of cases. As many as 67% of the participants had regular checkups, 50.3% had exaggerated somatic symptoms and 34.3% had pregnancy-related diseases.

The mean score for the TES was 48.73 ± 13.72.

We found a positive correlation between the TES score and nulliparity (p=0.01), gestational age ≥ 40 weeks (p=0.01), planned pregnancy (p=0.002), exaggerated somatic symptoms (p=0.03), and pregnancy-related diseases (p<0.001).

Identification of women at risk for fear of childbirth could help in preparing them before or during pregnancy to improve their childbirth experiences.

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Violence against women is a public health problem worldwide and a violation of human rights. It affects women’s lives due to its potential short-, medium- or long-term physical and psychological consequences.

The aim of our study is to explore the link between violence against women and self-esteem.

A descriptive cross-sectional study was conducted from March to August 2023 among Tunisian women consulting in three health care centers in Sfax, Tunisia. We have included women victims of violence (psychological, physical, sexual, and economic). We have used a semi-structured interview and the Rosenberg scale to determine the quality of self-esteem.

Among one hundred interviewed women, fifty-four women who had reported being violence victims were included in our study. The mean age of the participants was 44 years with the majority being married (87 %). Only 29.6% had a high school level and 51.9% had a profession. A total of 29.6% had a low socioeconomic status.

We found that 79.6% are victims of domestic violence (57.4% being victims of spousal violence). Psychological violence seemed to be the most frequent type (59.3%).

Almost all those who were abused (90.6%) experienced psychological (emotional) violence.

The mean score of the Rosenberg self-esteem scale was 31.54.

Self-esteem was very low in 16.7%, low in 37%, medium in 18.5%, and high in 27.8% of the women.

A statistically significant association was found between being a victim of spousal violence and low self-esteem (p=0.032). The semi-structured interview demonstrates that women with low self-esteem are more likely to accept violence.

These results justify the implementation of screening and support programs for women victims of violence to improve their self-esteem.

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Postnatal depression is a common mental health condition that affects women across the globe. Lower education is frequently considered to be linked to an increased likelihood of postpartum depression. Nevertheless, inconsistent epidemiological evidence has been reported concerning the associations between education and postpartum depression risk. This study investigates the correlation between education level and postpartum depression in the Czech Republic.

The aim of this study was to examine whether there is an association between educational attainment and the risk of postnatal depression in women who have recently given birth in the Czech Republic.

Women aged 18-45, who spoke Czech and had an email address, and had given birth in the hospital were eligible to participate in the study. The research was conducted in the maternity unit, where a medical professional presented the opportunity to take part. All participants were screened using the Edinburgh Postnatal Depression Scale (EPDS), with the cut-off score of ≥10 showing increased of postpartum depression.

Education data was collected via self-reported questionnaires. Binary logistic regression was employed to calculate the odds ratio (OR) with 95% confidence intervals (CI) to assess the relationship between educational attainment and postpartum depression risk, with sociodemographic and health-related characteristics being stepwise adjusted.

Our study consisted of 3,739 postpartum respondents (mean age of 31 years). The prevalence of increased postpartum depression (≥10 EPDS points) was 22.7%. Compared to individuals with higher education (reference category), those with basic education had a higher risk of postpartum depression (OR 1.67; 95% CI 1.26–2.23; p<0.001), even after adjusting for all covariates (OR 1.55; 95% CI 1.08–2.22; p=0.017). Basic education was found to have the strongest association with an increased risk of postpartum depression, even when adjusted for covariates. The association between education and postpartum depression was explained by the covariates.

Having only basic education is a significant risk factor for postpartum depression. Interventions to reduce the burden of postpartum depression ought to focus on individuals with low levels of education.

None Declared

Firstly, we will speak on the violence against women from a Russian perspective. The selected reports from regional psychiatric services and police department reports of domestic violence cases will be presented.

Secondly, we will draw upon our work developing and providing a new educational program, «Women victims of domestic violence: Detection, clinic, help,» mainly based on teaching several modules, WPA International Curriculum for Mental Healthcare Providers on Violence Against Women.

In this present paper, we examine evidence-based practice from the starting points of research as illumination and psychiatry as a discipline with hermeneutic potential, to consider relationships between research and practice and the opportunities available within the current research agenda for psychiatrists and clinical psychologists working in clinical settings.

We contend that the quality of women’s mental health services will only improve when they can acknowledge the considerable impact that intimate partner violence and sexual violence, as well as social inequalities, especially those based on gender, have on women’s mental health. We do not underestimate the difficulty of providing practical help to women whose mental health has been profoundly affected by the violence, damage that is often further compounded by years of mistreatment and revictimization in services.

The paper provides commentaries and reflections on the steps that must be taken to create opportunities to foster dialogue, discussing and exchanging ideas on a diverse range of topics relevant to the advancement of the program in the broader context.

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Men and women with psychosis have different courses and presentations of symptoms. Men with psychosis have an earlier onset of illness, more negative symptoms, and worse premorbid functioning. Women, on the other hand, have better social functioning and less substance abuse. Despite these evident differences, there are few studies that delve into these distinctions, especially from a subjective perspective.

The aim of this study is to understand the differences in the perception of psychosis between men and women.

Five women and five men diagnosed with schizophrenia participated in the study. They were matched so that the age difference between them was no more than 5 years, with ages ranging from 40 to 56 years. Participants had not experienced acute decompensation of their underlying illness and had not required admission to an Acute Care Unit in the 6 months prior to inclusion in the study. Data collection was conducted through the Spanish translation of the Indiana Psychiatric Illness Interview, consisting of five parts: a narrative about their life, a narrative about the illness, questions related to how the illness has changed their life and what has not changed, the overall influence of the illness on their life, and lastly, expectations for the future.

Men expressed more concerns about work (4 men versus 2 women), while women expressed more concerns about not having become mothers (3 out of 5 women, compared to one man). All participants shared experiences of isolation in intimate relationships, including romantic relationships. Regarding stigma, three women believed that people treated them like children and dismissed their opinions. However, two of them viewed this behavior from their loved ones positively. Two women discussed the impact that psychosis and medications had on their bodies and how others had reacted to these changes

The concerns and stigma associated with mental illness differ between genders. These differences should be taken into account when developing specific biopsychosocial treatment plans.

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Violence is a global phenomenon, destroying the fabric of society and threatening the lives, health and prosperity of all. In recent years, there has been an upsurge in domestic violence in Tunsia. Unfortunately, few studies have focused on the relationship within these couples.

To describe the characteristics of marriage between Tunisian couples where domestic violence prevails.

Our study was descriptive and analytical cross-sectional, carried out with women victims of domestic violence examined in the context of psychiatric expertise.

An anonymous survey was asked to these ladies concerning the socio-demographic characteristics of the wife and spouse and the characteristics of the marriage.

Our population was made up of 122 couples. The average age of ladies was 35.66 years (from18 to 64 years). As for the spouses, their average age was 41.68, with extremes of 22 and 70.

92,6% of couples had at least one child.

Professionally, (6.6%) of the husbands were inactive and 51.6% (n= 63) of couples had an average socio-economic level.

43.4% (n=53) lived in rented houses, 41% (n=50) owned their own homes, 14.8% (n=18) lived in a room with their in-laws and 0.8% (n=1) were homeless.

The average duration of marriage in our study was 11.16 ± 9.12 years and extremes of 1 and 40 years.Judicial records were found in 28.7% of assailants (n=35).The majority of women surveyed, 92.6% (n=113), were victims of three types of violence at once (verbal, psychological and physical). Sixty-two women (50.8%) were victims of four types of violence simultaneously (verbal, psychological, physical and sexual).Various causes of violence were reported, dominated mainly by claims for money, sexual problems, drunkenness and infidelity, with prevalence rates of 38.5%, 23.8%, 22.1% and 21.3% respectively.The majority of women, 66.4% (n=81), had been assaulted by their spouses during the first year of marriage. Forty-seven ladies (38.5%) were subjected to violence on a daily basis.According to the survey, 86.9% of women have been assaulted at least once before, and 38.7% of them have reported previous assaults to the police.The first person contacted after the violence was the mother, with a percentage of 48.4% (n=59).53.3% of ladies were assaulted during pregnancy, 43% of whom suffered obstetrical complications of varying severity.

According to our results, there is no typical profile of a couple where conjugal violence can reign.

Neither the length of the marriage nor pregnancy prevented the woman from being a victim of domestic violence.

None Declared

Domestic violence is a universal phenomenon that destroys the fabric of society and threatens the lives, health and prosperity of all.

It can take different forms, including physical abuse. This is one of the most serious form of violence, as it can range from a simple shove to homicide.

To determine the prevalence and describe the various forms of physical violence perpetrated by husbands against their wives.

We contacted women who consulted at the psychiatric emergency of ‘Hedi Chaker hospital’,Sfax examined in the context of medical expertise on the period between May 2021 until January 2022.

A questionnaire regarding the violence was asked to responders. It included a section for collecting socio-demographic and clinical data on the woman, and a section for assessing the various forms of domestic violence.

122 women were surveyed. The average age of victims was 35.66 years with extremes of 18 and 64 years. 78.7% (n=96) of ladies were of urban origin. The majority of them (44,3%) had secondary level education.

The half of the population (51.6%) had an average socio-economic level and 43.4% (n=53) lived in rented houses.

All the women of our population were married: it was the first marriage in (89.3%) and the majority (86.1%) had children.

Almost all women (95.1%; n=116) were victims of physical violence.

Different types of physical violence were reported with decreasing prevalence: slap (65,6%), punch (58,2%), strangle (46,7%), kicking (38,1%), stabbing threat (28,7%), kidnapping (4,9%), and gun threat (3,3%).

Should be noted that some women experience different forms of violence simultaneously.

Our study showed a high prevalence of physical violence with different shapes.

These figures must be taken into account by the authorities given the gravity of physical and psychological consequences of this form of violence.

None Declared

Intimate partner violence (IPV) is a major source of perceived stress for the women who suffer from it. To cope, they tend to implement multiple coping strategies depending on a number of contextual factors including, among others, the severity and frequency of abuse, the duration of the relationship, and available resources such as social support and financial resources.

To study the coping strategies used by women who are victims of IPV.

To study the factors associated with coping strategies among these women.

We conducted a descriptive and analytical cross-sectional observational study, carried out over a 10-month period from March 2021 to December 2021, among female victims of IPV consulting psychiatric emergencies at UHC Hedi Chaker, Sfax, Tunisia for medical expertise at the request of the court.

The Brief-COPE is a 28-item self-assessment questionnaire designed to measure coping with a stressful life event. It can be divided into 3 subscales: problem-focused, avoidance-focused, and emotion-focused.

The total number of participants was 120 with an average age of 37.27 years. The majority had secondary education or less (62.5%), were professionally active (53.3%), and were financially dependent on their partners (26.7%). As for the women’s clinical characteristics, 19.2% were under psychiatric care and 15% had attempted suicide (SA). Almost all the women surveyed (99.2%) had reported at least one previous incident of IPV. These incidents were daily in 60.5% of cases. Emotional violence was severe in 75.8% of women.

The emotion-focused strategy was the most widely used, with a mean score (29.68) on the Brief cope scale. It was correlated with the absence of a personal psychiatric history (p=0.02), the absence of SA (p=0.036), and the occasional frequency of IPV (p=0.037). The scores for problem-focused coping and avoidance-focused coping are 19.3 and 17.24 respectively. Avoidance-focused coping was negatively correlated with the presence of severe emotional abuse.

The most used strategy by our population was the emotion-focused strategy, with a relatively high average score compared to the other strategies. Indeed, it may be an extremely effective strategy for recovering from a traumatic event, through actions designed to help these women manage and relieve their psychological distress and reduce its negative impact.

None Declared

When faced with perilous transmittable infections, individuals defend themselves or welcome them, such as the Samos Syndrome, a pathophilia (people attracted by illnesses). As borderline personality disorder (BPD), found in Samos Syndrome, becomes more common, so will people who reject primary protection from transmittable diseases and health behaviour as their choices. Pandemics would sinisterly draw pathophilies and persons with borderline personality disorder who migh surf pandemics risk as a parasuicidal behaviour.

To investigate why pandemics (HIV, COVID-19) cannot be stopped. We have conducted a long-term assessment of HIV-discordant couples where a female partner, HIV-negative, voluntarily chooses to decline any prevention during stable and consensual relationships with HIV+ve partners. We also explored sociodemographic data that could explain health behaviours and condom use in HIV serodiscordant couples at risk of pandemic diffusion, those where one of the partners, usually male, already has a transmissible disease.

We used a mix of naturalistic and ethnographic approaches to understand the dynamics of Samos Syndrome. We also utilised a questionnaire to extract salient points in the sexual prevention of HIV infection. We assessed 475 HIV-serodiscordant couples.

Pathophilia is defined as an excessive, abnormal desire to be sick, also known as nosophilia, from the Greek word ‘pathos’ indicating illness and ‘philia’, meaning attraction. Women diagnosed with BPD can become high diffusers during pandemics of transmissible diseases as suffering from pathophila, a form of parasuicidal behaviour. In the couples assessed, when the HIV-negative woman comes from a socially disadvantaged family, the couple uses condoms in 87% of cases (p<0.001); when she comes from a middle-high class, the couple uses condoms in 59% (p<0.001) of sexual relationships. Suppose the HIV-negative female partner has conflicting relationships with their parents. In that case, condom use is only in 40% (p<0.001) of cases, compared to 83% (p<0.001) of instances where she has a good relationship with parents. If the female partner with BPD has a higher level of education than the HIV+ve partner the frequency of use if 90% (p<0.001) of cases compared to 60% (p<0.001) of instances where she has the same level of education as the male partner.

The current study confirms that female persons diagnosed with BPD are at high risk of becoming high diffusers during transmissible diseases and pandemics. Parasuicidal behaviours and self-harm in BPD could increase the risk of entering into relationships with persons who are already infected by sexually communicable diseases or are at risk of diffusing viral infections (HIV and COVID-19).

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Women experiencing severe perinatal mental health problems require specialized services and care. Perinatal mental disorders are common and can contribute to maternal mortality, affecting neonatal, infant, and child outcomes. Home treatment can prevent hospital admissions and promote strategies within the patient’s support network.

Our aim is to describe a clinical case in perinatal psychiatry managed by a Psychiatric Home Treatment Unit.

We present a case of perinatal psychotic depression in a 26-year-old pregnant woman.

We describe the case of a patient with no prior history of mental health issues. She was 25 weeks pregnant when she first sought psychiatric help in July 2023 and was diagnosed with depressive disorder with psychotic symptoms. She reported symptoms such as low mood, psychomotor inhibition, delusional guilt thoughts, and auditory hallucinations beginning three weeks before her initial visit. Due to her clinical presentation, the patient was admitted to the hospital, where pharmacological treatment was initiated with Olanzapine 5 mg, Sertraline 50 mg, and Lorazepam 1.5 mg. She remained in the hospital for four days, during which she showed gradual improvement but did not achieve full recovery.

Considering the improvement observed, home treatment was proposed and accepted by the patient and her relatives. During home treatment, she continued to exhibit persistent depressive and psychotic symptoms, including low mood, inhibition, and delusional thoughts of ruin and catastrophe. Therefore, her treatment was adjusted, with Olanzapine increased to 10 mg, Sertraline raised to 100 mg, and Lorazepam reduced to 0.75 mg. Over time, significant improvement in her clinical symptoms was noted. Throughout the follow-up period, she reported no significant side effects from the pharmacological treatment. After a month of follow-up in our department, she was discharged with outpatient care provided by a specialized community perinatal psychiatric unit.

We illustrate the possibility of home treatment for perinatal psychiatric disorders. The potential benefits of remaining close to one’s support network and developing coping strategies can be advantageous during the course of illness. Further studies should be conducted to explore these potential benefits.

None Declared

Depression is a significant global mental health problem and is very common compared to how it is perceived. In 2020 alone, 264 million people globally suffered from depression and its different forms as per the World Health Organisation. It is a leading cause of disability in individuals, affecting their ability to perform their daily chores, work, study, and even maintain relationships. The impact of depression is deeper and affects families, the economy, health care systems, and so on.

In India, the problem is grave and leads to serious consequences, thanks to the stigma and unawareness attached to mental health disorders. It is estimated that India has one of the highest rates of depression in the world, but it is hardly acknowledged.

Post-Partum Depression (PPD) is the most neglected and unreported subtype of depression in India. Globally, 1 in every 7 women suffers from Post Partum Depression. India is such a diverse country in terms of prevalence varies from 15% to 25% based on region, population, cultural and social expectations, economic status, living standard, climate factors, and others.

The objective of the study is to spread awareness, identify the risk factors, root cause analysis of risk factors, possible solutions, and treatments.

This study is conducted to capture the awareness level of PPD in females across different ages, regions, income classes, cultures, working statuses, and societies. This is carried out using a detailed yet anonymous survey, it captures the demography, knowledge of signs and symptoms of PPD, personal experiences, attitudes, expected support for PPD, and awareness of possible healthcare options. The result of the study tries to understand and conclude the most common risk factors, groups at highest risk, a root cause analysis of the risk factors, and possible solutions and treatments.

PPD occurs in the postnatal period, typically within the first year after childbirth. This condition can have a significant impact on the new mother and the infant’s well-being. The mother’s ability to take care of the child and herself is hugely impacted, impacting the child’s development and family dynamics negatively. Pushing to the limits, certain communities that believe in superstition and taboo often take PPD as an excuse to blame the mother resulting in the extremities like suicides.

PPD occurs in the postnatal period, typically within the first year after childbirth. This condition can have a significant impact on the new mother and the infant’s well-being. The mother’s ability to take care of the child and herself is hugely impacted, impacting the child’s development and family dynamics negatively. Pushing to the limits, certain communities that believe in superstition and taboo often take PPD as an excuse to blame the mother resulting in the extremities like suicides.

None Declared

Pregnancy and the postpartum period involve several physiological adaptations crucial for offspring care. Recent research has highlighted reproduction-related brain plasticity in human mothers. Associations with aspects of maternal caregiving suggest adaptive changes that facilitate a woman’s transition to motherhood. However, the dynamic changes that affect a woman’s brain are not merely adaptive, and they likely confer a vulnerability for the mental disorders. To elucidate the pathophysiology of psychiatric problems that occur during the perinatal period, gaining insights into the physiological changes in brain function due to pregnancy is crucial.

Although it has been hypothesized that pregnancy enhances social cognitive functions in mothers to adapt to the offspring care, there are few reports to support this hypothesis. This study aims to investigate whether social cognitive functions change during the first pregnancy, with a focus on maternal adaptation to offspring care.

The study included a first pregnancy group and a never-pregnant control group. We conducted a prospective study comparing pregnant women between two-time points (T1, T2); at less than 21 weeks of gestation [T1] and those after 30 weeks of gestation [T2]. To assess the effects of pregnancy and gestational age (< 21 weeks or 30 weeks or more), both the control (never-pregnant) group and pregnant group were evaluated at two time points with similar intervals. The Emotion Recognition Task [ERT] of the Cambridge Neuropsychological Test Automated Battery (CANTAB) was performed to examine the emotion recognition of six basic emotions in facial expressions. We analyzed a cohort of 26 participants in the pregnant group and 25 in the control group. We performed a two-way repeated measures analysis of variance with pregnancy status and gestational period (T1, T2) as independent variables.

Significant interactions between group and time points (T1, T2) were observed only for Unbiased Hit Rate Anger (p<0.01); facial recognition accuracy for anger increased with the progression of pregnancy. There were no significant interactions for Unbiased Hit Rate Sadness, Happiness, Fear, Disgust, or Surprise.

This is the first study to demonstrate that facial recognition of anger enhances with the progression of pregnancy, utilizing never-pregnant women as a never-pregnant control group. The results of this study contribute to the physiological effects of pregnancy on the brain and cognitive function and have potential for further study of perinatal mental health problems.

None Declared

Rheumatoid arthritis (RA) is a chronic inflammatory disease that significantly impacts patients’ quality of life (QOL), affecting both physical and mental well-being. QOL is predictive of morbidity and mortality, making its consideration increasingly important in treatment decisions.

This study aims to assess the Quality of Life in Female Rheumatoid Arthritis patients.

The study included 87 female patients with confirmed RA, diagnosed by an experienced rheumatologist based on the ACR 1987 or ACR/EULAR 2010 criteria. Quality of life was assessed using the World Health Organization Quality of Life assessment, short form (WHOQOL-BREF scale). The scoring ranged from 0 to 100 for each domain. Disease activity was assessed using the Disease Activity Score (DAS28), and functional disability was evaluated using the Health Assessment Questionnaire (HAQ).

The study included 87 patients with a mean age of 54.7 ± 12.2 years and a mean disease duration of 12 ± 9.1 years. The majority of patients had a medium socioeconomic level (81.6%), and a low cultural level with 31% being illiterate, 6% attending university, and 76.9% unemployed. Regarding marital status, 74.7% were married. RA was erosive in 77% of patients, deforming in 68%, and 40% were seropositive (FR and/or anti-CCP). Extra-articular manifestations were present in 34.5% of patients. Sixty-seven patients (77%) were on disease-modifying antirheumatic drugs (DMARDs), with 67.8% on methotrexate. Eighteen percent were treated with biological agents. Corticosteroids were used by 47.1% of patients, while 12.6% used non-steroidal anti-inflammatory drugs, and 6.9% used both. Disease activity varied, with 9.2% having low activity, 43.7% moderate activity, and 24.1% high activity based on DAS28. The mean HAQ index was 1.1 ± 0.8, indicating moderate to severe disability for more than 60% of patients. The mean WHOQOL scores were substantially reduced in the physical health (43 ± 16.2), psychological health (50.3 ± 14.4), social relationships (51.5 ± 18.6), and environment domains (46.8 ± 15). There was a significant inverse correlation between HAQ and the physical health (r = −0.52, p < 0.001), psychological (r = −0.57, p < 0.001), social relationships (r = −0.37, p = 0.001), and environmental domains (r = −0.45, p < 0.001) of QOL. There was no correlation between any domain of QOL and DAS28.

Patients with RA experience reduced QOL across multiple domains, including physical function, mental health, and social relationships. Functional disability, as reflected by HAQ, is the most significant factor affecting QOL in RA. The WHOQOL-BREF should be considered a valid outcome measure for interventions aimed at improving the quality of life for people with rheumatoid arthritis.

None Declared