The validity of the Seasonal Pattern Assessment Questionnaire (SPAQ) in diagnosing Seasonal Affective Disorder is questionable. In 2004 the Seasonal Health Questionnaire (SHQ) was proposed as a more appropriate screening instrument for depression with a seasonal pattern.

To compare the performance of the SPAQ, the most commonly used tool for assigning a diagnosis of SAD, with the SHQ, which uses the DSM-IV criteria for recurrent depression with seasonal pattern.

Two samples of approximately 200 medical students in Tromsø, Norway (69° north) and Ferrara, Italy (44° north), filled in both questionnaires. Prevalence of recurrent depression with seasonal pattern was calculated according to gender and latitude of living, with both instruments. Using SHQ diagnosis as the gold standard, sensitivity and specificity of the SPAQ as a diagnostic instrument was ascertained.

The prevalence of depression with seasonal pattern measured by SPAQ was 12% in Norway and 14.5% in Italy, the difference was not significant. Prevalence was highest in females in both countries (Norway: males 4.2%, females 14.7%, Italy: males 2.3%, females 18.8%), but the difference was only significant in Italy (p = 0.007). According to SHQ, the corresponding figures in Norway 5.9% and 7.1% (p = 0.77) and in Italy 3.9% and 3% (p = 0.75). The specificity of the SPAQ was 88.8% and the sensitivity was 47.3%.

Compared to a DSM-IV diagnosis of depression with seasonal pattern as measured by the SHQ, the SPAQ seriously overestimates the prevalence of seasonal depression, especially in women, and the sensitivity is far too low.

Anxiety and depression disorders are common in patients with chronic pain. Studies using clinical interviews in patients with chronic pain report prevalence rates ranging between 30–54% for depression and 17–29% for anxiety. This is the first study using contacts with a hospital psychiatric ward to investigate prevalence of depression and anxiety in patients with chronic pain.

Estimate the prevalence of anxiety and depression in patients with chronic pain referred for interdisciplinary treatment.

To increase the knowledge about mental disorders and chronic pain in secondary health care.

All chronic pain patients referred to and treated at an interdisciplinary pain clinic at Odense university hospital, Denmark from 1 Jan 2005–13 Nov 2015 were included as participants. The Danish National Patient Register was used to collect information on contacts with a hospital psychiatric ward 10-year prior to the first contact at the pain clinic due to depression (ICD-10: F32-F33) and/or anxiety (ICD-10: F40-F41).

In total, 7204 patients (64% women; mean age: 48.2) were included. Altogether, 17.8% (95% CI: 16.9–18.7) of patients had contact to a psychiatric ward. The prevalence of unipolar depression were: 6.1% (95% CI: 5.5–6.6) and anxiety: 2.1% (95% CI: 1.8–2.5), while 0.7% (95% CI: 0.5–0.9) had both depression and anxiety.

The prevalence rates of depression and anxiety noted in this study were lower than those reported in previous studies. A hospital-based diagnosis seems likely to be less frequent than interview-based measures, yet, might have a higher validity due to the clinician-based assessment.

The authors have not supplied their declaration of competing interest.

Young adult woman was admitted to our department with symptoms of depression. The patient had a history of sexual abuse in her childhood. After her admission she received antidepressive treatment with a selective serotonin reuptake inhibitor (sertraline) as well as supportive therapy.

After a four months treatment the patient suddenly disappeared from her hometown. Some days later she was found by the police in a city hundreds of miles away. She had no memory of her previous life and identity and named herself with a new name. The patient was diagnosed as having dissociative fugue. For five months after the diagnosis was made the patient remained amnesic for her identity and autobiographical memory. No pharmaceutical medication was administered; only psychotherapy. The patient begun to have suicidal thoughts which led to her hospitalization.

A course of electroconvulsive therapy (ECT) as well as SSRI medication (venlafaxine, initially 75mg and then 150 mg) was administered. Following the fifth course of ECT the patient recalled all of her past memory.

The electroconvulsive therapy has not been shown to be an effective or appropriate treatment for dissociative disorders; some authors have indicated that it may be important in relieving an associated depression.

There are no reports on the use of ECT for dissociative fugue.

This patients paradoxal recall of memory following a course of ECT treatment forced us to this announcement.

Assessment of suicide risk is of paramount importance for proper prevention.

To examine the association between gatekeeper training and suicide-related knowledge among a diverse set of health care workers (psychiatrists, nurses, psychologists, and educators) and students enrolled in medical and psychological schools who took part in the world suicide prevention day 2015 conference.

Among 223 participants who completed the assessment, 204 provided complete data for analyses. Participants were administered the applied suicide intervention skills training (ASIST), a 13-item survey questionnaire to assess participants’ knowledge about suicidal behavior and comfort dealing with suicidal clients. There were 62 psychiatrists; 23 nurses, 51 psychologists, 11 educators, and 57 university students.

Among participants, 57.1% of the sample had experiences of suicide a patient (students were excluded from these analyses). Those who reported a suicide among patients (compared with others) less frequently answered that suicide risk is more alarming in older adults than youths. They also less frequently disagreed with questions asking if they had the training to deal with suicidal patients. Students more frequently answered correctly on the association between depression and suicide risk, and less frequently chose the correct answer on the seriousness of suicide intent in borderline personality disorder. Students also more frequently disagreed with questions asking on their suicide assessment skill.

Our study highlights that differences exist when it comes to knowledge and skills related to suicide risk assessment both among health professionals and students. Our results also indicate that suicide awareness among these groups should be promoted.

The authors have not supplied their declaration of competing interest.

There is limited research on the interaction of both positive and negative daily-life environments with stress-related genetic variants on psychotic experiences (PEs) and negative affect (NA) across the extended psychosis phenotype. This study examined whether the FK506 binding protein 51 (FKBP5) variability moderates the association of positive and negative experiences in the moment with PEs and NA in participants with incipient psychosis and their nonclinical counterparts.

A total of 233 nonclinical and 86 incipient psychosis participants were prompted for a 1-week period to assess their day-to-day experiences. Participants were genotyped for four FKBP5 single nucleotide polymorphisms (rs3800373, rs9296158, rs1360780, and rs9470080).

Multilevel analyses indicated that, unlike the risk haplotype, the protective FKBP5 haplotype moderated all the associations of positive experiences with diminished PEs and NA in incipient psychosis compared with nonclinical group.

Participants with incipient psychosis showed symptomatic improvement when reporting positive appraisals in the interpersonal domain, which suggests that these act as a powerful coping mechanism. The fact that this occurred in daily-life underscores the clinical significance of this finding and pinpoints the importance of identifying protective mechanisms. In addition, results seem to concur with the vantage sensitivity model of gene–environment interaction, which poses that certain genetic variants may enhance the likelihood of benefiting from positive exposures.

The intentional use of drugs before or during sexual intercourse (chemsex) is a phenomenon of special importance in the MSM (men who have sex with men) population due to its impact on mental, physical and sexual health. Sexual health issues related to chemsex practice have been described such as difficulties in achieving sober sex, erectile dysfunction or problems with sexual desire.

To describe the sexual health interventions (including sexual counselling and sexual therapy) for patients with chemsex practices in the NGO Apoyo Positivo in Madrid. We describe the main sexual problems.

Descriptive analysis.

The main sexual problems were dissatisfaction in sexual intercourse without substance and difficulties with sexual desire activation (70%); compulsive sexual behaviour (70%), difficulties with sexual orientation and non normative gender expression, difficulties in erection (34%), premature ejaculation (7%) and delayed ejaculation (10%).

Chemsex is a phenomenon that needs a multidisciplinary approach and mental and sexual health must be taken into account. “Sexo, Drogas y Tu” is a model of collaborative approach which is a pioneering intervention developed by an NGO in Spain.

National siege mentality, underlying the national threat, is surely socially and politically determined. However, we assumed that certain social attitudinal constructs and psychological predisposition might underlie a belief system such as the concept of national siege mentality is.

We tried to answer whether national collective narcissism, anomie, and psychopathic syndrome we developed may prove valuable in understanding the appearance and development of national siege mentality.

The aim of this research were: (1) To develop valid measure instruments that could be useful and efficient tools for assessing attitudinal and psychological tendencies in political-psychological and psychiatric research. (2) To find out the effects of national collective narcissism, anomie, and psychopathic syndrome on national siege mentality.

Confirmatory factor analysis (CFA) were performed to explore factorial and construct validity of the scales used in this research. A questionnaire was administered to randomly selected adults (N=544). Using structural equation modeling, this study examined the effects of exogenous variables in expressing national siege mentality.

Structural model indicated that national collective narcissism, anomie, and psychopathic personality syndrome showed significant effects on national siege mentality (RMSEA=0.07, SRMR=0.05, CFI=0.96, NNFI=0.95).

The scales used in research proved to be reliable and valid measures of the attitudinal and personality constructs. Given the amount of variance of national siege mentality explained by exogenous variables (46 per cent), it is reasonable to assume that collective frustrations, political mistrust, and psychopathological predisposition may be underpinning the belief system labelled national siege mentality.

Infliximab is a tumor necrosis factor-alpha (TNF-α) inhibitor commonly used in the treatment of autoimmune disorders such as rheumatoid arthritis and ankylosing spondylitis. An increased risk of opportunistic infections, malignancy, and neurodegenerative diseases have been widely documented as adverse effects of IFX therapy. Few reports exist serving the notice of new-onset psychiatric symptoms linked to IFX treatment, such as suicidal behaviors in adults and elderly patients, as well as psychosis in an adolescent. Psychiatric side effects while under IFX treatment are reported to be rare.

Here, we present a case of a female with bipolar disorder who developed a long-standing depressive episode with suicidal thoughts after her fourth infusion of infliximab for her ankylosing spondylitis

Retrospective life chart was created, including infliximab infusion.

Montgomery Asberg Depression Scale was applied at time of hospitalisation and discharge.

The Naranjo Adverse Drug Reaction Probability Scale was applied.

A 55 year old female with ankylosing spondylitis and bipolar disorder was treated with IFX for 8 months. During this period, a total of 4 infusions were administered and AS symptoms were well responding to the treatment. Patient describes the onset of depressive symptoms such as anhedonia and insomnia after the infusion of third IFX infusion, gradually progressing to loss of function and suicidal thoughts and hospitalization in a psychiatry clinic.

The patient had a history of bipolar disorder for 10 years with recurrent manic and depressive episodes, 4 hospitalisations and 1 cure of ECT.

Patient was on sertraline, maprotiline and diazepam at the time of hospitalization. We started treatment with aripiprazole, quetiapine and valproate, followed for 4 weeks as an inpatient, consulted with rheumatology treatment options and neurology for demyelinating disorders, no pathology was discovered. Rheumatology suggested the continuation of IFX infusion under psychiatric control. Fifth dose of IFX infusion was administered and patient was discharged after euthymic mood was established and insomnia and suicidal thoughts were deteriorated. Upon follow up, depressive symptoms recurred and lamotrigine was added for augmentation.

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Although there is very scarce evidence that IFX causes psychiatric symptoms, there are few clinical trials too, showing evidence that TNF-alpha inhibitors may improve depressive symptoms. While we need more information and evidence to support the ideas of TNF alpha inhibitors effects on human neuropsychology, it is of great importance for especially patients with psychiatric history to be closely watched while administering the product, at least to minimize unintended adverse events.

None Declared

To identify the different factors associated with postpartum blues and its association with postpartum depression, from a large French cohort.

We conducted an analysis of the Interaction Gene Environment in Postpartum Depression cohort, which is a prospective, multicenter cohort including 3310 women. Their personal (according to the Diagnostic and Statistical Manual, fifth edition [DSM-5]) and family psychiatric history, stressful life events during childhood, pregnancy, and delivery were collected. Likewise, the French version of the Maternity Blues Scale questionnaire was administered at the maternity department. Finally, these women were assessed at 8 weeks and 1 year postpartum by a clinician for postpartum depression according to DSM-5 criteria.

The prevalence of postpartum blues in this population was 33%, and significant factors associated with postpartum blues were found as personal (aOR = 1.2) and family psychiatric history (aOR = 1.2), childhood trauma (aOR = 1.3), obstetrical factors, or events related to the newborn, as well as an experience of stressful life events during pregnancy (aOR = 1.5). These factors had a cumulative effect, with each additional factor increasing the risk of postpartum blues by 31%. Furthermore, adjustment for sociodemographic measures and history of major depressive episode revealed a significant association between postpartum blues and postpartum depression, mainly at early onset, within 8 weeks after delivery (aOR = 2.1; 95% CI = 1.6–2.7), but also at late onset (aOR = 1.4; 95% CI = 1.1–1.9), and mainly if the postpartum blues is severe.

These results justify raising awareness among women with postpartum blues, including reassurance and information about postpartum depression, its symptomatology, and the need for management in case of worsening or prolongation of postpartum blues.

International experience convincingly shows the prevalence of mental disorders secondary to COVID-19, the pathogenesis of which includes biological and psychosocial factors, which characterizes this area of research as relevant and timely.

Analysis of the structure of the most common forms of psychopathology within consequences in COVID-19.

The study involved 45 patients with depressive episodes of varying severity (F 32.0, 32.1, 32.2) and 37 ones with anxiety disorders (F 40, 41). The average age of the examined groups was 39.42 ± 5.68 and 31.54 ± 4.36 years respectively. Clinico-psychopathological, psychodiagnostic, statistical methods were used.

Significantly more patients with depressive disorders before the first clinical manifestations of the disease experienced COVID-19 in mild and moderate form (31.82% and 68.18% of individuals, respectively) (p <0.05), while patients with anxiety disorders were more affected to some stressors of the SARS-COV-2 pandemic (including threatening information background (83.78% of people), quarantine measures in the form of self-isolation (75.66% of people), uncertainty of the impact of coronavirus infection on the socio-economic situation) (62.16% of people)) (p < 0.05). It was found that the examined patients with a history of coronavirus COVID-19 are more likely to have depressive and asthenic syndromes in the clinical picture (p < 0.05), while patients with psychogenic effects of the pandemic - anxiety-phobic and somato-autonomic syndromes (p < 0,05).

Data on the influence of coronavirus disease COVID-19 and stressors of the SARS-CoV-2 pandemic on the formation of mental disorders of various genesis will allow to develop prevention algorithms and personalize therapeutic programs.

No significant relationships.

Catatonia is a psychomotor syndrome frequently observed in disorders with neurodevelopmental impairments, including psychiatric disorders such as schizophrenia. The orbitofrontal cortex (OFC) has been repeatedly associated with catatonia. It presents with an important interindividual morphological variability, with three distinct H-shaped sulcal patterns, types I, II, and III, based on the continuity of the medial and lateral orbital sulci. Types II and III have been identified as neurodevelopmental risk factors for schizophrenia. The sulcal pattern of the OFC has never been investigated in catatonia despite the role of the OFC in the pathophysiology and the neurodevelopmental component of catatonia.

In this context, we performed a retrospective analysis of the OFC sulcal pattern in carefully selected homogeneous and matched subgroups of schizophrenia patients with catatonia (N = 58) or without catatonia (N = 65), and healthy controls (N = 82).

Logistic regression analyses revealed a group effect on OFC sulcal pattern in the left (χ2 = 18.1; p < .001) and right (χ2 = 28.3; p < .001) hemispheres. Catatonia patients were found to have more type III and less type I in both hemispheres compared to healthy controls and more type III on the left hemisphere compared to schizophrenia patients without catatonia.

Because the sulcal patterns are indirect markers of early brain development, our findings support a neurodevelopmental origin of catatonia and may shed light on the pathophysiology of this syndrome.

The FP7-European funded project TRIMAGE is run by a European consortium of 7 research institutes and 4 SMEs. It started in December 2013 and has a duration of 4 years. It is coordinated by the Department of Physics 'E. Fermi” of the University of Pisa (Italy),

TRIMAGE aims to create a trimodal, cost-effective imaging tool consisting of PET/MR/EEG. It uses cutting edge technology with performance beyond the state of the art. The tool is intended for broad distribution to enable effective early diagnosis of schizophrenia and possibly other mental health disorders.

The goals of this project will be achieved by the scientific and technological developments in both the clinical and technological fields, as detailed by the following three strongly correlated S&T sub-objectives:

1. a) Find new biomarkers and define a suitable multimodal paradigm with already available PET, MR, EEG and PET/MR systems thus providing clinical evidence on the feasibility of early schizophrenia diagnosis.

2. b) Construct and test an optimized cost-effective trimodality imaging instrument (brain PET/MR/EEG) for diagnosis, monitoring and follow-up of schizophrenia disorders.

3. c) Validate the trimodal imaging device built by this Consortium with regard to the results and the clinical data obtained from sub-objective a).

This presentation will describe the outlines of the project and will present an update after the first year of running.

Worldwide, stress and burnout continue to be a problem among teachers, leading to anxiety and depression. Burnout may adversely affect teachers’ health and is a risk factor for poor physical and mental well-being. Determining the prevalence and correlates of stress, burnout, anxiety, and depression among teachers is essential for addressing this public health concern.

To determine the extent of the current literature on the prevalence and correlates of stress, burnout, anxiety, and depression among teachers

This scoping review was performed using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). Relevant search terms were used to determine the prevalence and correlates of teachers’ stress, burnout, anxiety, and depression. Articles were identified using MEDLINE (Medical Literature Analysis and Retrieval System Online), EMBASE (Excerpta Medica Data Base), APA PsycINFO, CINAHL Plus (Cumulative Index of Nursing and Allied Health Literature), Scopus Elsevier and ERIC (Education Resources Information Center). The articles were extracted, reviewed, collated, and thematically analyzed, and the results were summarized and reported.

When only clinically meaningful (moderate to severe) psychological conditions among teachers were considered, the prevalence of burnout ranged from 25.12% to 74%, stress ranged from 8.3% to 87.1%, anxiety ranged from 38% to 41.2% and depression ranged from 4% to 77%. The correlates of stress, burnout, anxiety, and depression identified in this review include socio-demographic factors such as sex, age, marital status, and school (organizational) and work-related factors including the years of teaching, class size, job satisfaction, and the subject taught.

Teaching is challenging and yet one of the most rewarding professions, but several factors correlate with stress, burnout, anxiety, and depression among teachers. Highlighting these factors is the first step in recognizing the magnitude of the issues encountered by those in the teaching profession. Implementation of a school-based awareness and intervention program is crucial to resolve the early signs of teacher stress and burnout to avoid future deterioration.

None Declared

RGH-188 is an orally active, potent dopamine D3/D2 receptor antagonist/partial agonist atypical antipsychotic for the treatment of schizophrenia and bipolar mania.

RGH-188 displayed high affinity to human D3 receptors (Ki: 0.085 nM) and approximately six- and thirty-times less affinity to human D2, and 5-HT1A receptors. In various in vitro and in vivo assays RGH-188 behaved either as an antagonist or as a partial agonist on dopamine D3 and D2 receptors.

RGH-188 displayed potent antipsychotic activity (0.1-0.8 mg/kg) in rodent models such as apomorphine-induced climbing, amphetamine- and phencyclidine-induced hypermotility, conditioned avoidance response. It significantly improved the learning performance of rats (0.02-0.2 mg/kg) impaired by scopolamine in a water-labyrinth learning paradigm. RGH-188 showed no EPS liability as it produced no catalepsy up to 100-fold therapeutic range.

In a nonhuman primate positron emission tomography (PET) study using 11C-raclopride RGH-188 occupied striatal D2/D3 receptors in a dose dependent and saturable manner with an ED50 of 7 μg/kg iv. In healthy male subjects multiple administration of 1 mg RGH-188 resulted in over 70% D2/D3 receptor occupancy and the displacement showed correlation with RGH-188 and metabolites plasma levels.

After single administration to healthy volunteers, Tmax for RGH-188 was 3-4 hours and the terminal disposition half-life was 5-6 days. Over the dose range of 0.5-2.5 mg AUC of the parent drug was approximately dose-proportional. Systemic exposure to the pharmacologically active metabolites, desmethyl- and didesmethyl-RGH-188 was 20-30% and 50-200% of that to the parent, respectively.

Goal attainment scaling (GAS) is a method to assess the patient experience of whether a treatment is successful and capture outcomes across a diverse range of goal areas. However, this approach has not yet been used in assessing the treatment of Major Depressive Disorder (MDD) in Japan. GAS was first developed by Kiresuk and Sherman in the 1968, it is increasingly recognised as a sensitive method for recording patient-centred outcomes throughout the course of treatment.

To demonstrate the effectiveness of vortioxetine on patient’s goal achievement and depressive symptoms, emotional, cognitive, overall function and quality of life.

VGOAL-J is a prospective, multi-center, observational cohort study of outpatients initiating vortioxetine treatment for MDD in Japan. Patients with a diagnosis of MDD according to DSM-5 who are 18 to 65 years will be enrolled from 20 sites in Japan and followed for 24 weeks. A total number of 120 patients is planned for enrolment. Primary outcome measures are GAS-D, WPAI, secondary outcome measures include Montgomery – Åsberg Depression Rating Scale (MADRS), Sheehan Disability Scale (SDS), Perceived Deficits Questionnaire-Depression 5-item (PDQ-D-5), Oxford Depression Questionnaire (ODQ), EuroQol-5 Dimension (EQ-5D). Safety will be also assessed with Adverse Events collected during the study.

The results will be disseminated in late 2022 and provide new insights on GAS-D as an effective strategy to assess MDD treatment in Japan.

We expect to observe patients treated with vortioxetine achieving their treatment goals as assessed by GAS-D and improvements on patient- and clinician-reported measures in real-world settings.

Prof. K. Watanabe reports consultancies undertaken for Eli Lilly, Otsuka Pharmaceutical, Sumitomo Dainippon Pharma, Taisho Toyama Pharmaceutical, and Takeda Pharmaceutical, honoraria received from Daiichi Sankyo, Eisai, Eli Lilly, GlaxoSmithKline, J

The conceptualization of negative symptoms (NS) in schizophrenia is still controversial. Recent confirmatory factor-analytic studies suggested that the bi-dimensional model (motivational deficit [MAP] and expressive deficit [EXP]) may not capture the complexity of NS structure, which could be better defined by a five-factor (five NS domains) or a hierarchical model (five NS domains as first-order factors, and MAP and EXP, as second-order factors). A validation of these models is needed to define the structure of NS. To evaluate the validity and temporal stability of the five-factor or the hierarchical structure of the brief negative symptom scale (BNSS) in individuals with schizophrenia (SCZ), exploring associations between these models with cognition, social cognition, functional capacity, and functioning at baseline and at 4 years follow-up.

Clinical variables were assessed using state-of-the-art tools in 612 SCZ at two-time points. The validity of the five-factor and the hierarchical models was analyzed through structural equation models.

The two models had both a good fit and showed a similar pattern of associations with external validators at the two-time points, with minor variations. The five-factor solution had a slightly better fit. The associations with external validators favored the five-factor structure.

Our findings suggest that both five-factor and hierarchical models provide a valid conceptualization of NS in relation to external variables and that five-factor solution provides the best balance between parsimony and granularity to summarize the BNSS structure. This finding has important implications for the study of pathophysiological mechanisms and the development of new treatments.