the relationship between hypothyroidism and mood disorder espacially depressive disorder is well described. However, there are few studies reporting psychotic symptoms (such as delusions, auditory or/and visual hallucination) in the setting of thyroid hormone defeciency.

this study highlights psychosis as a possible presenting symptom in hypothyroidism.

case report and review

we report the case of a female patient aged 36 years old with no family or personal psychiatric history, who presented with delusion, depressive disorder and auditory hallucination . the CT scan was without abnormality . the thyroid screening finds a severe hypothyroidism after 3 months of radiotherapy witn Iodine131 [FT4 = 2.49 ρmol/l, TSH 135.28 μUI/ml]

psychotic symptoms are an uncommun presentation of hypothyroidism and treatement choices are contreversial.

Even though it has begun to be investigated in recent years, studies of microRNA (miRNA) in anxiety disorders are limited. Our research is the first miRNA expression study in panic disorder, which excludes of drug use and additional psychiatric disorders.

We aimed to determine the availability of miRNAs as biomarkers in the serum levels of panic disorder and to demonstrate the changing expression of miRNAs.

In the research, 35 panic disorder patients and 35 healthy controls were administered a socio-demographic and clinical information form, SCID-I, PDSS. 2 tubes of peripheral venous blood were taken from each group for genetic evaluation. miRNA expression analysis was performed in those samples by the RT-PCR method.

Compared with the healthy control group, 8 miRNA expression levels were found different in panic disorder group. Five of them were up-regulated and 3 of them were down-regulated. There was no correlation between the level of miRNA expression and PDSS total score and PDSS sub-items. miR-1297 and miR-4465 expression levels were statistically significant between the two groups. Both miRNAs are also known to arrange the gene regions that affect GABAA receptor subtypes.

miR-1297 and miR-4465 regulate the GABAA gene that is thought to play a role in the etiology of panic disorder (Wong et al., 2014, Wang 2016). In panic disorder group, miR-1297 and miR-4465 expression levels were found to be up-regulated from the healthy control group.

The authors have not supplied their declaration of competing interest.

Commitment to sports is especially important for well-being in people with disabilities (Malm et al., 2019), although mental health problems are common among Paralympic athletes (Hunt et al., 2019). Importance of representations of and regulation in sport situations was supported for different kind of sports (Moran, 1993, Suinn R., 1982, Hardy et al., 1996) but Paralympic ones.

The aim was to reveal aspects of psychological regulation important for achievement and longer commitment to Paralympic sports comparing to non-Paralympic sports.

51 athletes from Paralympic sports (49.1% candidates and masters of sports) filled Questionnaire of Image Representations of Professional Activity of Athletes (Leonov et al., 2020) measuring general importance and self-appraisals of different aspects of image representation and regulation in sport activities: control of temporal, spatial, informational, technical and tactical, energetic aspects, game intelligence, motivational, emotional and social aspects (Cronbach’s alphas .61-.89). Data were compared to 399 athletes without disabilities (48.4% candidates and masters of sports).

Comparing to athletes without disabilities, Paralympic athletes higher appraise general importance and their capacities for emotion regulation during sport situation (t=2.26-3.35, p<.01). High-level Paralympic atheletes report marginally better emotion regulation (t=1.74, p<.10). Longer experience in sport in Paralympic athletes is associated with better representations of spatial and social aspects of sport situations and better emotion regulation (r=.25-.29, p<.05).

Data suggest that improvement of emotion regulation in sport situation in Paralympic athletes could be helpful for longer participation and better achievement. Research is supported by the Russian Science Foundation, project No. 19-78-10134.

Research is supported by the Russian Science Foundation, project No. 19-78-10134

Metabolic syndrome (MS) is an often co-occurring condition that occurs during antipsychotic therapy and impairs social functioning

We tried to conduct a self - evaluation of social adaptation in patients with schizophrenia and MS

We examined 150 patients with schizophrenia receiving antipsychotic therapy at the clinics of Mental Health Research Institute. The study was supported by a grant from the Russian Science Foundation 18-15-00011. The IDF criteria were used to diagnose metabolic syndrome. We used «The social adaptation self - evaluation scale» (SASS).

63 patients (42%) had MS and 87 patients (58%) did not. In the subgroup of patients with MS, 59 people (93.65%) had disabilities or were unemployed, in the group without MS - 82 (94.26%) patients. There were no statistically significant differences between the groups (p ≥ 0.05). In the patients with schizophrenia and concomitant MS, the median SSAS scores was 35 [29; 39], which corresponds mainly to a high level of self - evaluation of social adaptation. At the same time, in patients with schizophrenia and without MS, on the contrary, the self - evaluation of social adaptation was 30 [23; 38] points (p = 0.03914). Perhaps this is due to the great attention from relatives and doctors of general somatic practice and the primary medical network in connection with the risk of developing severe somatic pathology.

Patients with MS can give a higher assessment of social adaptation, despite a objectively low social status.

No significant relationships.

The aim of study was to evaluate the pharmacotherapeutic efficacy of NDGA in experimental paradigm of depression i.e. olfactory bulbectomy (OB) specifically targeting kynurenine pathway.

Depression like behaviours was induced in OB mice and evaluated by assessment of various behavioural (olfactory deficit test, forced swim test, splash test, open field test, sucrose preference test), biochemical (catalase, reduced glutathione, SOD, nitrite, MAO-A, MDA, corticosterone), inflammatory cytokines (TNF- α, IL-1β, IL-6, IFN-γ) levels and alterations in delta sleep was recorded using EEG. Kynurenine pathway metabolites were determined in plasma and brain using HPLC method. After 14 days post-surgery, olfactory bulbectomized (OBX) mice were administered nordihydroguaiaretic acid (5 mg/kg, 10 mg/kg and 25 mg/kg) daily i.p.

We have developed a new HPLC method for simultaneous estimation of monoamines and kynurenine pathway metabolites in plasma and brain samples of mice. Chronic treatment with nordihydroguaiaretic acid significantly restored all behavioural, biochemical and neurochemical alterations in OBX mice and increase in quinolinic acid and decrease in kynurenic acid point out the neurodegeneration hypothesis of depression.

Nordihydroguaiaretic acid showed potent neuropharmacotherapeutic effect in OBX mice by virtue of its strong anti-oxidant, anti-inflammatory, anti-stress and by restoring quinolinic acid levels.

Schizophrenia is associated with deficits in higher order processing of visual information, steady state visual evoked potential responses recorded over the occipital cortex in patients with schizophrenia suggest a dysfunction of lower level visual pathways, which was more prominent for magnocellular than parvocellular biased stimuli. The magnocellular pathway helps in orienting towards salient stimuli [1]. A magnocellular pathwad deficit could contribute to higher level visual cognitive deficits in schizophrenia dysfunction of the magnocellular pathway may also account for other well described aspects of neurophysiological dysfunction in schizophrenia, for example, the magnocellular pathway projects predominantly to dorsal cortical stream (i.e. parietal lobe), which codes motion perception and spatial localization [2].

30 schizophrenic patients were recruited randomly from Alexandria University Hosiptal. They scored 4 or higher on the Clinical Global Impression Scale for Severity CGI-S. Visual Evoked Potential VEP was done to them and compared to healthy control group.

In the right eye the mean P100 was 104.55 ± 5.62 and 95 ± 5.27 msec in schizophrenic and healthy control group respectively with statistical significant difference. A finding that has been replicated in the left eye where the mean P100 was 105.8 ± 5.41 and 95.85 ± 5.4 msec in the same respective groups

P100 in both right and left eyes are more prolonged in schizophrenic patients compared to healthy control groups.

Patient 10-year-old pediatrics sent from service due to history of frequent admissions for recurrent abdominal pain. In the bypass request indicate that this is a patient of perfectionistic traits; detect dysfunctional family dynamics highlighting the rivalry in the phratry, and with an equal difficulty in the field. From 2010 to 2016, he has made more than 30 visits to hospital emergency combined intervention of psychiatry and psychology and multidisciplinary service available with a pediatric surgery and pediatrics is performed.

From 2011 to 2016, it has made 44 blood tests, sonograms 9 full abdomen, abdominal renal scintigraphy without significant findings.

F45.5 pain disorder.

Symptoms due to a medical condition. Other symptoms substance-induced mental disorders: non-specific conversion disorder, pain disorder, hypochondriasis, body dysmorphic disorder, somatization disorder, simulation, factitious disorder, medical symptoms…

Psychosomatic disorders are one of the most common clinical forms of mental disorders in childhood and adolescence expression. Knowing the stages of development and operating characteristics. In clinical practice, mainly in primary care, tend to find an organic cause somatic complaints in children, so prevalence data and/or referral to specialized services vary depending on mental consulted sources is critical to understand the pathogenesis of these disorders.

The authors have not supplied their declaration of competing interest.

SSRI/SNRI and pregabalin are recommended therapies for the treatment of GAD, particularly in case of benzodiazepines refractory (BR) patients. The aim was to compare the use of anxiolytic treatments in BR GAD patients initiating treatment with pregabalin or SSRI/SNRI as add-on therapies.

BR outpatients with GAD (DSM-IV criteria) enrolled in a prospective, multicentre, observational cohort study were included in this post-hoc analysis. BR was defined as insufficient response with persistence of symptoms of anxiety (HAM-Anxiety scale ≥ 16) after a course of a standard dose of benzodiazepines, for 6 months. The use (% of users and dose) of pregabalin, SSRI/SNRI and benzodiazepines was evaluated during the 6-month study period.

128 subjects treated with pregabalin and 126 with SSRI/SNRI were analyzed. Both cohorts presented a similar pattern of anxiolytic drugs utilization at baseline: Alprazolam (33% pregabalin and 27% SSRI/SNRI), diazepam (20% vs. 11%) and lorazepam (17% vs. 30%) were among the most used benzodiazepines. At the 6 month visit, pregabalin treated patients showed a significant decrease in the % of users of alprazolam (16% vs. 27%; p = 0.032), lorazepam (14% vs. 27%; p = 0.013) or ketazolam (0% vs. 7%; p = 0.002) compared with SSRI/SNRI. 57% of patients in pregabalin group, compared with 87% in SSRI/SNRI, were still receiving a benzodiazepine concomitantly at the 6 month visit (p < 0.001).

Compared with SSRI/SNRI, initiating therapy with pregabalin reduced the use of concomitant anxiolotic treatment in BR outpatients with GAD in routine medical practice.

Schizophrenia still ranks among the first 10 leading causes of disability worldwide. Recent analyses show that there is a considerable treatment gap in schizophrenia in Europe and worldwide.

To provide evidence-based information and give a concise overview of what is needed to overcome the treatment gap in schizophrenia.

Using a combined approach of systematic review and health economics was used to assess the socioeconomic impact of medical interventions (or the lack of thereof) for schizophrenia.

The case study analysis demonstrates socioeconomic impact and health gains of best practices in specific healthcare interventions for schizophrenia in comparison with the cost burden of current care or non-treatment.

Unterstützung bei Symposien/Symposia Support

– Janssen-Cilag GmbH, Neuss

– Aristo Pharma GmbH, Berlin

– Lilly Deutschland GmbH, Bad Homburg

– Servier Deutschland GmbH, München

– Fakultätsmitglied/Faculty Member

– Lundbeck International Neuroscience Foundation (LINF), Dänemark

Views on the causes and psychosocial consequences of schizophrenia of the Italian population, patients’ relatives and mental health professionals can influence detection and outcome of these disorders.

To investigate the opinions on schizophrenia in a sample of 614 lay respondents, 465 mental health professionals and 709 key-relatives.

The survey was conducted in 30 randomly selected geographical areas with the Questionnaire about Opinions on mental illness (QO).

The results show significant differences among the three groups as regards opinions about patients’ civil rights and social competence of patients with schizophrenia. In particular, the belief that patients’ behaviors are unpredictable is maintained by 18% of mental health workers and by 35% of family members and the general public. As regards causes, 68% of relatives, 20% of mental health workers and 34% of general public believe that schizophrenia is caused by psychosocial factors only. Forty-eight percent of the relatives affirmed that they are fully convinced of the usefulness of pharmacological treatment compared to 28% of professionals and 25% of the Italian population. With respect to civil rights, about half of the relatives is fully convinced that patients with schizophrenia should not have children compared to 17% of mental health workers and to 19% of the general public.

These results underline the need to conduct sensitization campaigns about schizophrenia focused on specific aspects of the disease, such as unpredictability, civil rights and opportunities to recovery of patients, taking into account the target population to which they are addressed.

In parents of autistic children there are high levels of stress. For parents, counseling can help them face the world of autism through the many stressors they experiment.

To evidence a possible effect of the counseling intervention on parental stress.

The sample consisted of 24 parents (mean age = 38.7) of children diagnosed with autism spectrum disorder related to the treatment centre “Una breccia nel muro”. Parents’ group was randomly divided into two subgroups, the first (EG experimental group) consists in 12 parents, which were included in a counseling treatment of six months (one meeting of 2 hours every 15 days), while the other subgroup parents, (CG control group) were not included. We used parenting stress index–short form (PSI-SF) before counseling intervention (T0) and after (T1) with every parent. PSI values stress level in following scales: parental distress (PD), parent-child dysfunctional interaction (PCDI) and difficult child characteristics (DC). Figure 1 shows all the variables in each group at T0 and T1.

Then a 2-tail t-test was separately carried out for each group (Counseling Yes; Counseling No). Counseling Yes: PD (t22 = .70, P = .49); PCDI (t22 = .72, P = .47); DC (t22 = 2.23, P = .03); Tot Stress (t22 = 1.04, P = .3). Counseling No: PD (t22 = .82, P = .42); PCDI (t22 = 1.7, P = .09); DC (t22 = .59, P = .56); Tot Stress (t22 = .72, P = .48)

Our data confirm the positive effects of counseling especially on the difficulties related to children (DC scale).

The authors have not supplied their declaration of competing interest.

According to WHO data about 60–80 million people around the world suffer from infertility. This problem causes huge negative impact on family life. Forty percent of women with infertility experience various mental disorders.

Aims/objectives: Investigation of anxiety-depressive spectrum disorders in women with infertility. Assessment of impact of women infertility on self-esteem and certain aspects of life. Development of recommendations on mental health services for women, experiencing infertility problems.

Sixty women at the age of 21 to 36 years, experiencing infertility problems for maximum period of 60 months participated in the study. Anxiety, depression and stress rates were assessed using Depression, Anxiety and Stress Scale - DASS-21, the level of self-esteem was determined with Rosenberg Self-Esteem Scale.

Data was analyzed using SPSS 16.0.

Such factors as education, occupation, religious beliefs, and accessibility of proper medical services were determined to have significant impact on depression, anxiety and stress rates as well as on self-esteem and satisfaction with life of women with infertility.

Screening for early detection of mental health problems, psychological counseling and family therapy for couples encountering infertility problems was recommended.

To explore tolerability, safety and treatment response of flexible doses of paliperidone ER in adult non-acute patients with schizophrenia previously unsuccessfully treated with oral antipsychotics.

International prospective 6-month open-label study. Endpoints were the Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression-Severity Scale (CGI-S), patient satisfaction, adverse events (AEs), extrapyramidal symptoms (Extrapyramidal Symptom Rating Scale; ESRS) and weight change.

1812 patients were included (59.9% male, mean age 40.1±12.6 years, 75.8% paranoid schizophrenia); most were enrolled because of lack of efficacy (n=1026) or lack of tolerability (n=490) with prior antipsychotic treatment. The median mode dose of paliperidone ER was 6 mg/day. 70.7% of patients completed the 6-month study. Most frequent reasons for early discontinuation were patient choice (8.8%), lack of efficacy or adverse event (5.1% each) independent of the reason for switching. Mean total PANSS decreased significantly from 79.4±20.4 at baseline to 66.1±21.5 at endpoint (mean change -13.3±19.7; 95% confidence interval -14.2;-12.3, p< 0.0001). The percentage of patients rated mildly ill or less in CGI-S increased from 27.0% to 52.2% at endpoint, and the rate of patients with mild functional impairment increased from 15.8% to 34.9%. AEs reported in greater-than-or-equal-to 5% of patients were insomnia (9.2%) and anxiety (7.2%). Extrapyramidal symptoms in ESRS decreased significantly from 3.5±5.8 to 2.1±4.6 (p< 0.0001). Mean weight gain from baseline to endpoint was 0.3±4.8kg.

These data support results from recent randomized controlled studies that paliperidone ER is safe, well tolerated and effective in patients previously unsuccessfully treated with other oral antipsychotics.