The COVID-19 pandemic has had an unprecedented detrimental impact on mental health in people around the world. It is therefore important to examine factors that may buffer or heighten the risk of mental health problems in this context.

The current study explores the buffering effects of different flows of compassion (for self, for others, from others) and the magnifying effects of fears of compassion on the impact of perceived threat of COVID-19 on indicators of mental health and psychosocial wellbeing.

4057 adult participants collected from the general community population across 21 countries from Europe, Middle East, North America, South America, Asia and Oceania, completed self-report measures of perceived threat of COVID-19, compassion, fears of compassion, social safeness, loneliness, depression, anxiety, stress, posttraumatic stress and growth.

Self-compassion moderated the impact of perceived threat of COVID-19 on depression, anxiety and stress, whereas compassion from others moderated the effects of fears of COVID-19 on social safeness. Fears of compassion moderated the impact of perceived threat of COVID-19 on psychological distress. Only fears of compassion from others moderated the effects of fears of COVID-19 on social safeness. Furthermore, social connection (compassion and social safeness) predicted higher post-traumatic growth and traumatic stress, whereas social disconnection (fears of compassion and loneliness) predicted increased traumatic symptoms only. Social connection heightened the impact of perceived threat of COVID-19 on post-traumatic growth, while social disconnection weakened this impact. Social disconnection magnified the impact of the perceived threat of COVID-19 on traumatic stress. The effects were consistent across countries.

Our findings highlight the universal protective role of compassion and social connection in promoting resilience and buffering against the harmful effects of the COVID-19 pandemic on mental health and psychosocial wellbeing. Furthermore, our results reveal that fears of compassion have a magnifying effect on the damaging impact of the COVID-19 pandemic on mental health.

None Declared

Contemporary evidence has established that stunted vitamin D levels are associated with depression, poor mood and other mental disorders.Vitamin D supplementation might play a significant role in depression.

To assess the role of supplementation of Vitamin D on depression scores among rural adolescents

It is a Cluster Randomized Control Trial carried out for a period of two years. 10 Government rural schools were taken as clusters and sample size was calculated using previous literature.(Libuda.et al:EJN. 2020; 27:1-0) 150 was the final sample size in each group. Adolescents aged 11-18 years were included and with any pre-existing mental health illness, renal abnormalities and confirmed neurological disorders (Epilepsy) were excluded. Intervention group received 2 months of 2000 IU per day for 9 weeks and Control arm received 500 mg of Calcium and low dose (250 IU) of Vitamin D. To assess socio-demographic status a pretested semi structured questionnaire was used. To assess depression, Becks Depression Inventory (BDI-II) was used. Venous Blood was taken by experienced lab technician and analyzed in Central Diagnostic Laboratory Services, Biochemistry Department, SDUMC, SDUAHER, Kolar, Karnataka, India. Study was started after Central ethics Committee approval. This study is intramural funded project (Rs.6,12,000/). Clinical Trials Registry number: CTRI/2021/07/034654: REF/2021/03/042355. All the data collected entered in Microsoft excel and analysed using SPSS v 22(IBM corp,USA). Pre-intervention and post intervention difference assessed with t-test summarized as Mean and Standard deviation (SD) with statistically significant difference defined with p value less than 0.05. Both Intention-To-Treat analysis and Per Protocol analysis done and reported separately.

Comparing Becks Depression scores before and after intervention, Vitamin D arm showed statistically significant reduction in Becks Depression scores. Intention to treat analysis showed that Vitamin D arm had statistically significant reduction in Becks Depression scores.

Vitamin D supplementation had reduced Depression scores among rural adolescents significantly. Vitamin D toxicity was not noted inspite of High dose of Vitamin D supplementation

P. Satyanarayana Grant / Research support from: SDUAHER Intramural research , R. Suryanarayana: None Declared, S. TY: None Declared, S. Reddy: None Declared, N. AG: None Declared

The Covid-19 pandemic has exacerbated mental health problems in many countries, yet little evidence has focused on older adults.

The aim of this study was to qualitatively explore the impact of the pandemic on the mental health and well-being of older adults living in Uganda

Semi-structured interviews with older adults, family carers, and people living with dementia, plus focus groups with care professionals were conducted remotely via the telephone. Data were collected at two time points between March and July 2021. Non-professionals were asked about their experiences of the pandemic and their mental well-being. Data were analysed using thematic analysis. All transcripts were also translated into English and a selection were second-coded by the another team.

A total of 30 interviews were conducted with older adults, people with dementia, and unpaid carers participating at baseline (n=30). Using inductive thematic analysis, we generated three overarching themes: Mental health needs overridden by need for basic necessities; Social isolation; Increased worry about restrictions and pandemic in dementia. For most people, limited access to basic necessities, including food, featured more prominently in responses than any direct acknowledgement of how the pandemic has affected their mental well-being. Participants were upset and worried about being socially isolated, with carers concerned about the welfare of many people with dementia and often feeling emotionally exhausted.

Older adults, carers, and people living with dementia in Uganda not only require support to cope with the mental health impact of the pandemic, but most importantly require improved financial governmental support to be able to access sufficient food and other basic necessities, as a group their health is poor and associated risk of deterioration high

None Declared

Tuberculosis (TB) is a bacterial infection caused by Mycobacterium tuberculosis and is a major public health problem in Morocco. The World Health Organization (WHO) recommends a four-drug combination therapy for two months (isoniazid (INH), rifampicin, pyrazinamide and ethambutol), followed by two drugs (INH and rifampicin) for 4 months, as first-line treatment for newly diagnosed pulmonary TB in children and adults. This regimen is generally considered effective, safe, and cost-effective. However, adverse effects and drug interactions often complicate the treatment of TB. Isoniazid is associated with 32% of adverse events, of which 1.9% are psychiatric.

focus on drug-induced etiologies of acute psychotic symptoms make the diagnosis of isoniazid-induced psychosis report the literature on the management of this condition. focus on drug-induced etiologies of acute psychotic symptomsmake the diagnosis of isoniazid-induced psychosis report the literature on the management of this condition.

The patient and guardians were interviewed to obtain information after their consent. Data from the patient profile forms and laboratory test reports were evaluated. Causality assessment was done by the WHO scale and the Naranjo scale. Oral informed consent was obtained from the patient and parents.

We report a case of acute psychosis in a child with a temporal sequence strongly in favor of INH-induced psychosis. Treatment with risperidone at an appropriate dose improved the symptomatology while waiting for the end of the antituberculosis protocol. As soon as the isoniazid was stopped, there was a clear return to the child’s premorbid state.

The acute onset of psychotic symptoms in a patient taking isoniazid should lead to suspicion of this psychiatric side effect and prompt intervention, involving discontinuation of isoniazid and/or a trial of an antipsychotic.

As protective measures, the authors suggest adjusting the dose of isoniazid to weight, possibly performing a genetic test if slow acetylation is suspected, and closely monitoring patients with a favourable background.

The acute onset of psychotic symptoms in a patient taking isoniazid should lead to suspicion of this psychiatric side effect and prompt intervention, involving discontinuation of isoniazid and/or a trial of an antipsychotic.As protective measures, the authors suggest adjusting the dose of isoniazid to weight, possibly performing a genetic test if slow acetylation is suspected, and closely monitoring patients with a favourable background.

None Declared

Crohn’s disease is a chronic inflammatory bowel disease of multifactorial etiology. Its association with psychiatric disorders has frequently been reported, mainly with depressive or anxiety disorders.However, its association with schizophrenia remains exceptional.

we will try to discuss this association.

In this regard, we report the case of a young patient, aged 24, diagnosed 5 years ago with Crohn’s disease, evolving by remission flares, currently treated with Azathioprine, after failure of corticosteroid bolus.

The patient was admitted to psychiatry for aggression towards his parents.In view of the history of the disorders as reported by the family and the psychiatric interview, the diagnosis of schizophrenia was retained and the patient was put on amisulpride.

Schizophrenia and Crohn’s disease are relatively frequent diseases, generally occurring at a young age, whose etiopathogenesis, multifactorial, involves in both cases genetic, environmental and immunological factors.Their association does not seem fortuitous and arouses both etiopathogenic and therapeutic interest, but studies involving a large number of patients would make it possible to elucidate the link between these two diseases.

None Declared

Previous researches have not distinguished between-person effects from within-person effects when exploring the relationship between self-esteem, coping styles, and anxiety symptoms among adolescents.

To address this gap, this study investigated reciprocal associations among self-esteem, coping styles, and anxiety symptoms in a three-wave longitudinal panel survey, using an analytical strategy that disaggregates within-person and between-person variance.

The data was drawn from the Longitudinal Study of Adolescents’ Mental and Behavioral Well-being Research study conducted in 10 public schools in the Guangdong province of China. All participants had a baseline visit (N = 1957, age 13.6, grades 7 and 10) and follow-up interviews at one-year intervals for 3 years. A random intercept cross-lagged panel model combined with mediation analysis was performed.

At the within-person level, following results were observed. (1) Low self-esteem and anxiety symptoms bidirectionally predicted each other. (2) Low self-esteem and negative coping style bidirectionally predicted each other. (3) Anxiety symptoms predicted subsequent negative coping style but not vice versa. At the between-person level, we obtained the following main results. (1) Significant predictive effects on the random intercept were found among all three study constructs. (2) There were sex differences regarding the association between self-esteem and anxiety symptoms and the correlation strength of females was greater than that of males. (3) Self-esteem mediated the reciprocal relations between coping styles and anxiety symptoms.

These results could be an important advance by elucidating the reciprocal relationships among self-esteem, coping styles, and anxiety symptoms at the within-person level, suggesting that interventions targeted at promoting self-esteem and cultivating positive coping style may help reduce adolescent anxiety.

None Declared

Mental illness is characterized by a major emotional, cognitive, and or behavioral impairment of an individual. It is usually accompanied by distress or functional impairments in important areas.

Mental illness affects 48.9% of the Moroccan population. This makes it a major public health issue but one that is still unrecognized and underestimated in the general population. Because of certain cultural aspects considering mental illness as a taboo or privileging traditional healing.

to evaluate the time between the initial symptomatology and the first psychiatric consultation Identify the course of action to be taken in the face of the first symptoms of the illness; Determine the factors responsible for the diagnostic delay;

We conducted a cross-sectional study to assess the duration between initial symptoms and diagnosis and to identify the responsible factors of diagnostic delay. This study included 200 patients followed at the psychiatry department of the University Hospital Arrazi of Salé, and evaluated by an hetero questionnaire.

The average age of our patients was 29 years, male gender was predominant (84%). The mean diagnostic delay was 46 months. Data analysis showed some significant results: - The Diagnostic delay was longer in male patients. - The diagnsotic delay conditioned response to treatment and therefore the prognosis.

In conclusion, public awareness of psychiatric problems, treatment availability, and educational efforts to overcome the social stigma are essential to reduce diagnostic delay and improve the prognosis of schizophrenia.

None Declared

In Japan, the effectiveness of health checkups for children aged 5 years has attracted attention as the basis for a support system for early detection and support of children with developmental disabilities. However, these have not yet become statutory health checkups, and their assessment has not been standardized. This study employed the Strength and Difficulties Questionnaire (SDQ) in examining the health of a 5-year-old child. This study aims to demonstrate the scores’ distribution and obtain the standard land and cutoff values of the SDQ.

From 2010 to 2012, children reaching 5 years of age in Kanie-cho, Aichi Prefecture, Japan, underwent a health checkup. Of the 888 children for whom parental consent was obtained, 884 responses without missing values (453 boys: 51.2%, 430 girls: 48.6%) were included in the analysis.

SDQ and medical questionnaires for 5-year-old children were sent to the parents with a formal request for approval for the child to participate in the study. Further, the parents were asked to respond to the questionnaire. The Ethics Committee of the Graduate School of Education and Developmental Sciences, Nagoya University approved this study (No.298).

A confirmatory factor analysis using the maximum likelihood method revealed a factor structure almost identical to that of Goodman (JCPP 1997; 38 581-586). Nonetheless, items 3, 10, 11, 13, 14, and 22 showed high loadings on factors different from those in the original version. Similar to the original version, we set our criteria so that Some and High Needs would be approximately 10% each. Furthermore, we calculated the percentage of children who fell into these categories and found that the scores that fell into the Need category differed from those in the previous study(Table 1).

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Although the five-factor structure of the SDQ was generally accepted, as pointed out in previous studies (Matsuishi et al. Brain Dev 2008;30 410-415 : Iida et al. 2014; 33-41), differences in expression between English and Japanese and cultural differences may have influenced the results. Therefore, it is necessary to be careful in interpreting the results. Additionally, the differences in the Need classification indicated that the difficulty level tends to be slightly lower in the 5-year-old children’s health checkups and that boys may be more likely to recognize the “Hyperactivity/inattention” problem. Based on these results, it is necessary to consider more effective ways of using the SDQ in 5-year-old children’s health checkups, such as evaluating the SDQ scores in combination with the actual condition of the children at the time of the checkup.

None Declared

The recent approval of euthanasia in the Spanish legal code and its posible extension to psychiatric patients opens an unprecedented scenario in the Iberian country. We analize the experience of the Netherlands, a country where euthanasia has been in practice for over two decades, in order to foresee epidemiological trends that could be replicated in Spain.

To review the legislation on euthanasia in Spain and the Netherlands, as well as the epidemiological data regarding euthanasia applicants affected by mental health conditions in the Netherlands, to predict future epidemiological trends in a similar population in Spain.

We studied the legislation on euthanasia in Spain and the Netherlands, as well as the directives of the Regional Commisions for Euthanasia in the Netherlands to analize differences and similarities between the legal codes on both countries. We also sought epidemiological data regarding the application of euthanasia on psychiatric patients in the Netherlands, gathering data from seven articles in English language obtained through a search in PubMed using the MeSH terms “Euthanasia” AND “Netherlands” and “Psychiatry”.

Euthanasia on psychiatric patients in the Netherlands has been a practice on the rise during the last decade, despite the elevated proportion of rejected applications and the high survival rate of this patients in later longitudinal studies. Affective disorders and personality disorders stand out as major psychiatric causes between the applicants. The Spanish legislation bears important resemblance to its Dutch predecessor, but also significant differences.

The available data on the application of euthanasia on mental health patients in the Netherlands show an in increasing trend regarding the execution of this practice, specially on patients who gather distinct clinical features. The data provided by the Dutch experience could have some replication in Spain, as well as anticipate possible future ethical conflicts regarding the application of this service.

None Declared

MDD is a chronic illness characterized by complex patterns of persistence, remission and relapse. Personality disorder (PD) is a negative prognostic marker MDD and its chronicity, and dynamics of STPD and BPD in adolescence occurs most severely.

The purpose of this study was to study the effect of STPD and BPD on the course of MDD in comparative groups in youth.

Clinical psychopathological interview and follow-up assessment, SCID-II, Hamilton Depression Rating Scale (HDRS). Sample: N=102 male and female with MDD in STPD and BPD into two equal groups of 51 people respectively. MDD was assessed in each of both PD groups in two time frames: current and during depressive the last 12 months in adolescence; three and more years later during adolescence. Outcome predictors included: clinical characteristics of MDD, duration of current episode, relapse rate. The average age of first MDD in both groups was 18.9±3.2 years.

The first MDD with both PD in adolescence characterized by psychopatological variety due to type PD and age factor. Depressive was more variability of affect, and shorter duration (less then 6 months N=28 (55%)) in group BPD as opposed to the sustained mood problems seen in STPD – (6-12 months N=19 (37%); 12 months and more N=21(41%)) with MDD (p=0,004; χ2= 14,997). During the subsequent follow-up assessment among patients with BPD had the highest percent recurrences once every 6 months or more (N=36 (71%)) and those with STPD significantly rarer recurrences, every 6 to 12 months (N=21(41%)), Less than once a year N=17 (33%)), (p=0,001; χ2= 23,252). Diagnosis of PD in adolescence is based on pathological traits, and impairment in the affective disorder is measurement separately. When measuring impulsivity in the BPD group, significantly higher rates BIS-11 scale were noted (74±1) than in the SPD group (61±1).

Diagnosis of PD in adolescence is based on pathological traits, and impairment in the affective disorder is measurement separately. It has been confirmed that PDs are a negative prognostic marker of the manifestation of a MDD in adolescence, and the presence of BPD is a serious prognostic predictor of its persistence.

None Declared

Autism spectrum disorder (ASD) is a disorder with social, communication and behavioral disturbances that start from early childhood. There are many difficulties in diagnosing people with ASD. The diagnostic criteria are in terms of behavior descriptions, and as methods of intervention the most used is the applied behavior analysis (ABA). Although, the treatment of autism is not based on drugs, there are a number of reports that sustains the vitamin supplementation. For example, the deficiency of vitamin D (VD) was often outlined in the serum of the ASD people. Nowadays, zebrafish (Danio rerio) plays an important role in the modeling era; being one of the main organisms used in animal studies.

In this study, we aimed to describe the influence of VD in autistic people, and the possibility of vitamin investigation through animal models studies.

For analyzing this subject specific scientific databases were screened using certain keywords as: ”autism spectrum disorder”, ”vitamin D”, ”treatment”, ”deficiency”,”animal models” and ”zebrafish”. Inclusion criteria were studies that (1) investigated a behavioral intervention, (2) used animal models for ASD modelling, (3) reported vitamin D results, and (4) were published within the last 20 years.

The majority of the studies supported the importance of an adequate level of VD in the body, mainly due to its implication during pregnancy and early brain development. The few existing data bring information about the positive impact of its administration in ASD children; in which a considerable improvement in typical symptoms was observed. For further knowledge about VD activity in ASD it was suggested the animal modelling, especially zebrafish organisms due to its numerous advantages (high similarity of its genome with the human one).

VD deficiency during pregnancy and early brain development is a real risk factor besides genetic predisposition. Moreover, the use of animal models for investigating the effect of VD is required for a better understanding of the vitamin mechanism in ASD people.

Acknowledgement: *R. M.-A. and B. M.-I. are supported by the Project POCU/993/6/13/153322 ”Suport educațional și formativ pentru doctoranzi și tineri cercetători în pregătirea inserției în piața muncii” of the European Social Fund through the Human Capital Operational Program.

M. Robea Grant / Research support from: Project POCU/993/6/13/153322 ”Suport educațional și formativ pentru doctoranzi și tineri cercetători în pregătirea inserției în piața muncii” of the European Social Fund through the Human Capital Operational Program., M. Balmus Grant / Research support from: Project POCU/993/6/13/153322 ”Suport educațional și formativ pentru doctoranzi și tineri cercetători în pregătirea inserției în piața muncii” of the European Social Fund through the Human Capital Operational Program, M. Nicoara: None Declared, A. Ciobica: None Declared

Mixed states in bipolar disorder (BD) are characterized by the simultaneous occurrence of both manic and depressive features. Growing evidence suggests that they are associated with longer duration of illness, increased relapse risk, and higher prevalence of comorbidities. Suicide risk among BD patients is up to 20–30 times greater than in the general population, although there is not a univocal consensus in whether mixed states should be considered as a high-risk state for suicide.

The objective of this study was to identify whether depressive and hypo/manic episodes with mixed features, are associated with more frequent suicidal behavior or ideation when compared to pure hypo/manic and depressive ones. We hypothesized that suicidal ideation or behavior would be more common in those experiencing mixed symptoms. We subsequently also tested whether gender or bipolar subtype moderated the relation between mood and suicidality.

In a naturalistic study, 903 adult BD outpatients participating in the Stanley Foundation Bipolar Network were followed longitudinally across 14,213 visits for 7 years. The scores at the Inventory of Depressive Symptomatology–Clinician-Rated Version (IDS-C) and at the Young Mania Rating Scale (YMRS), administered at each visit, were used to define the mood episode. Given partial overlap of items between these scales, analyses were also conducted by removing overlapping items. The presence of suicidality was evaluated through the 18th item of the IDS-C (Suicidal Ideation).

During the observation period, up to 60.7% of subjects had at least one visit with suicidal ideation or behavior, broadly defined as a score ≥ 1 at the 18th item of the IDS-C. The distribution of suicidality among visits in different mood states is reported in Figure 1 (N° of visits in which suicidality was detected by mood state at the time of visit). Depressive symptoms were associated with suicidal ideation and behavior either during mixed depression and hypo/mania (p < 0.0001). Hypomanic or manic symptoms appeared to be related to suicidality only during hypo/mania, either pure or mixed (p 0.007). When overlapping items between the two psychometric scales were removed results seemed to confirm these hypotheses. Moreover, male gender appeared to have a protective role against suicidal ideation when hypo/manic (p 0.002).

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The primary role of depressive symptoms in predicting suicidal risk was confirmed by our results, which however suggest that mixed symptoms relate to suicidal ideation and behavior more intensely than pure hypo/manic symptoms. More importantly, hypo/manic symptoms did not appear to have a protective role during mixed episodes. Future studies considering also deaths by suicide are required in order to better clarify the role of mixity on suicidality.

None Declared

The COVID-19 pandemic has strongly impacted mental health outcomes of healthcare workers (HWs). In spite of the large literature reporting on Post-Traumatic Stress Disorder (PTSD) symptoms, only a few studies focused on potential positive aspects that may follow the exposure to the COVID-19 pandemic, namely post-traumatic growth (PTG) among HWs.

In a large sample of Italian HWs, we aimed to investigate the prevalence of PTSD, its correlates and whether PTG dimensions independently affect the risk of PTSD during the first COVID-19 wave.

An online self-report survey was submitted to HWs throughout physicians’ and nurses’ associations, social networks and researchers’ direct contacts, between April 4th and May 13th, 2020. Sociodemographic data, information about possible COVID-19 related stressful events, Impact of Event Scale-Revised (IES-R) and PTG Inventory-Short Form (PTGI-SF) scores were collected. IES-R and PTGI-SF scores were compared between subjects based on main sociodemographic, work- and COVID-19-related variables using the Student T-test or the one-way ANOVA where appropriate. Post-hoc comparisons were conducted using the Tukey test. Participants with total IES-R score >32 were assigned a provisional PTSD diagnosis and binary logistic regression analysis was conducted to investigate the contribution of each variable to the provisional PTSD diagnosis.

Out of 930 respondents, 256 (27,1%) reported a provisional PTSD diagnosis. Female sex (p<.001), separation from cohabiting family (p<.001), family members infected with (p<.05) or deceased due to (p<.05) COVID-19, increased workload (p<.05), relocation to a different work unit (p<.05) and unusual exposure to sufferance (p<.001) were significantly associated with higher IES-R mean scores. The median PTGI-SF score was 24. Factors associated with greater mean PTGI-SF scores were female gender (p<.001), being a nurse (p<.05), being older than 40 years (p<.05), and increased workload (p<.05). The logistic regression model showed that previous mental disorders (OR=1.65; 95% CI= 1.06-2.57) working in medical (OR=2.20; 95% CI=1.02-4.75), or service units (OR=2.34; 95% CI=1.10-4.98) (compared to frontline unit), relocation to a COVID-19 unit (OR=1.90; 95% CI=1.06-3.36), unusual exposure to sufferance (OR=2.83; 95% CI=1.79-4.48) and exposure to a traumatic event implying threat to self (compared to other work-related events) (OR=2.07; 95% CI=1.10, 3.89) significantly increase the risk of receiving a provisional diagnosis of PTSD, while the availability of personal protective equipment (OR=.61; 95% CI=.40-.94) and moderate or greater scores on PTGI-SF, particularly in the spiritual change domain (OR=.552; 95% CI=.35-.85), were found to be protective factors in relation to the PTSD diagnosis.

Our results shed light on possible protective factors against PTSD symptoms in HWs facing COVID-19 pandemic.

None Declared

Schizophrenia is a severe mental illness but especially important in terms of its impact on the subject. The stigmatization of these patients is major, leading to a significant decrease in their quality of life. This is partly due to the media coverage of the rare cases of hetero-aggression.

The aggressiveness of schizophrenic subjects remains poorly known and little studied.

The objectives of our study are to determine whether the prescription of second-generation antipsychotics is associated with lower levels of aggression than the prescription of first-generation antipsychotics and to identify aggravating factors.

Materials and methods: We used an anonymous questionnaire based on, in addition to individual status and conditions, a self-administered questionnaire to assess the degree of aggression (the Buss and Perry Aggression Questionnaire (BPAQ)).

Our study demonstrated superiority of second-generation antipsychotics in preventing aggression in subjects with schizophrenia, as well as an association between increased aggression and low insight, low compliance and low social support. In addition, younger age, male gender, and lower education were associated with increased aggression.

The prevention of aggression would then begin with the management of psychotic symptoms and comorbid disorders, as well as work on the compliance and insight of these patients. However, the aggressive dimension persists in some of them.

None Declared

Late-life depression (LLD) is currently a hot topic for neuroimaging studies, while an increasing number of imaging modalities are now available for the characterization of brain structure and function. Changes in brain volumes, including hippocampal volume, have been observed in LLD, although results are inconsistent. Vascular lesions are more consistently associated with LLD and may constitute factors of poor prognosis. More recent MRI modalities, including fMRI and DTI, also show interesting results, notably to assess treatment response in LLD. Molecular Imaging also has the potential to improve our understanding of the pathophysiology of LLD, using imaging such as PET-FDG and Amyloid PET. Finally, there are emerging studies with novel neuroimaging modalities such as Ultrasound to measure subtle mechanical properties in the brain of patients with LLD. Finally, we contend that neuroimaging has the potential to provide markers for the identification of subcategories of LLD (vascular depression, amyloid depression, etc.) as well as prognostic values and markers for treatment response.

None Declared

The use of hallucinogens has accompanied the human being throughout history. In the 1970s, studies focused on the therapeutic potential of hallucinogens were blocked due to their misuse in the young population. At present, psilocybin is re-emerging as the center of attention due to its possible therapeutic potential in different psychiatric pathologies such as depression, anxiety or substance use.

The main objective of this work has been to review recent studies on the therapeutic potential of psilocybin in drug-resistant depressive disorder.

For the search for articles, the search strategy “psilocybin AND depression” was established in PUBMED. Regarding the inclusion criteria, it was established that they were recent articles, in Spanish or English and that the full text was freely accessible. On the other hand, those articles whose studies did not focus on humans and resistant depressive disorder were excluded. A total of 19 articles were obtained to review.

Focusing on Drug-Resistant Depressive Disorder, multiple studies have agreed that the administration of one or two microdoses (10-25mg) of psilocybin accompanied by psychotherapy improves the clinical picture for at least 6 months. These results make us feel optimistic in the search for new treatments in the field of mental health.

Psilocybin microdoses associated with psychotherapy improves depressive symptoms in a patient resistant to common antidepressants.

The psilocybin response in terms of improvement of the depressive symptoms persists after 6 months of evolution.

One or, in some two cases, two microdoses of psilocybin (10-25mg) are enough to obtain statistically significant results in the improvement of the depressive symptoms.

None Declared

Burnout is prevalent in residents and coping is one of the important modifying factors.

This study aimed to investigate coping strategies, burnout, and their relationship among residents.

A cross-sectional descriptive study was conducted among residents from October 2019 to April 2020 in Thailand. The Brief COPE Inventory Thai version and The Maslach Burnout Inventory Thai version were used, and the associations between coping strategies and burnout were examined.

The number of 280 residents replied the questionnaire (response rate 41.5%). The most favored copings were self-distraction and acceptance and the least common were denial and substance use. Most residents had high level of emotional exhaustion (n = 113, 40.4%) and moderate level of reduced personal accomplishment (n = 99, 35.4%). However, low degree of depersonalization was reported predominantly (n = 164, 58.6%). The coping of venting, behavioral disengagement and self-blame independently predicted emotional exhaustion and depersonalization. Behavioral disengagement was the only predictor of burnout in all dimensions, whereas positive reframing is the only strategy that had independent and protective effect against burnout in all dimensions.Table 1

Multivariate analysis of factors associated with emotional exhaustion

A large number of residents had emotional exhaustion. Behavioral disengagement and positive reframing were the most influential coping strategies related to burnout. This study might inform residency training program of some specific approaches for burnout prevention.

None Declared

Bipolar Disorder (BD) is considered a serious mental disorder characterized by a changing mood that fluctuates between two completely opposite poles. It causes pathological and recurrent mood swings, alternating periods of exaltation and grandiosity with periods of depression. We talk about rapid cyclers when four or more manic, hypomanic or depressive episodes have occurred within a twelve-month period. Mood swings can appear rapidly. Approximately half of the people with bipolar disorder may develop rapid cycling at some point.

Presentation of a clinical case about a patient with Bipolar Disorder with rapid cycling and poor response to treatment.

Review of the scientific literature based on a clinical case.

33-year-old male, single, living with his mother, under follow-up by mental health team since 2012. First debut of manic episode in 2010. The patient has filed multiple decompensations related to consumption of toxics (alcohol and cannabis). Currently unemployed. He attended to the emergency service in June 2022 accompanied by his mother, who reported that he was restless. The patient refers that he has interrupted the treatment during the vacations, having sleep rhythm disorder with abuse of caffeine drinks. Currently the patient does not recognize any consumption.The patient reports that during the village festivals he felt very energetic, occasionally consuming drinks rich in taurine and sugars, even having conflicts with people of the village. Finally, the patient was stabilized with Lithium 400 mg and Olanzapine. In September, the patient returned to the emergency service on the recommendation of his referral psychiatrist due to therapeutic failure. The only relevant finding we observed in the analytical determinations were low lithium levels (0.4 mEq/L). The transgression of sleep rhythms and the abuse of psychoactive substances required the admission of the patient to optimize the treatment (Clozapine, Lithium, Valproic Acid). At discharge, he is euthymic, has not presented behavioral alterations and is resting well. Finally, it was decided that the patient should go to the Convalescent Center to continue treatment and achieve psychopathological stability.

Bipolar disorder is an important mental illness, having an incidence of 1.2%, being responsible for 20% of all mood disorders. Therefore, it is important to perform an adequate and individualized follow-up of each patient. Treatment with mood stabilizers tries to improve and prevent manic and depressive episodes, improving chronicity and trying to make the long-term evolution as good as possible, being important psychoeducation and psychotherapy.

None Declared

Antipsychotic-related hematological abnormalities have been reported in the literature, but remain a rare complication of some second-generation antipsychotic drugs. It has been suggested that risperidone is the preferred alternative when adverse hematological effects have been induced by conventional antipsychotic drugs. Blood dyscrasia adverse reactions have been reported rarely with risperidone.

We aims to call attention to leukopenia as a potential side effect of during treatment with risperidone.

We report a case in which a patient developed leukoneutropenia during treatment with risperidone

A 46-year-old man was admitted to psychiatric department for aggressive behavior. The patient had a history of right bundle branch block and has been diagnosed with schizophrenia at age of 36 years. This patient had only one psychiatric hospitalization in 2021 where he developed persistent leuko-neutropenia. A viral cause was retained. The patient was discharged on risperidone 4 mg and had been poorly compliant with his antipsychotic medication for the last year.

Currently, the patient was excited, very talkative and refused medication. He received an intramuscular injection of haloperidol 10 mg and chlorpromazine 50 mg. Under these doses, the patient became sedated and his balance sheet showed a leukoneuropenia amounting to 1960 cells/mm3. Then, it was decided to stop chlorpromazine and Haloperidol and put the patient on Diazepam. A complete blood count was done the next day showing that his white Blood Cells (WBC) count went up to 4360 cells /mm3 (neutrophils rate = 62,4 %). The reintroduction of haloperidol with diazepam caused the WBC to fall back to 2000. Haloperidol stopped as a possible cause of the leucopenia. The patient started taking risperidone orally 1 mg daily, which was gradually up titrated to 4 mg daily. Two weeks later the WBC went up to 4680 cells/mm3 (neutrophil rate = 60,4%) three week after stopping haloperidol. However, three days after increasing the dose of risperidone to 5 mg the leukoneutropenia recurred, (WBC = 2960 cells/mm3, neutrophil rate = 41%). When risperidone was reduced to 4 mg, his WBC count remained stable for two weeks (WBC = 2970, neutrophil rate = 48,9%). Clinically , the patient is no longer excited.

Risperidone-induced leuko-neutropenia (RILN) is very unusual and its incidence rate is unknown. Currently, there are no evidence-based alternative antipsychotic recommandations for RILN. For the case presented here, we achieved stabilisation of RILN by dose reduction.

Routine monitoring of the WBC level of patients on risperidone treatment, regardless of their hematological baseline, might be good practice for all psychiatrists. We recommend extending this practice to inpatient and outpatient services.

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Treating mental health problems adequately is of paramount importance given the tremendous burden it places on the individual and on society. Knowing and realizing there is no one size-fits-all-solution, some methods do yield better results. The yardstick as such can be interpreted with scores on questionnaires, subjective accounts and/or having the need for further future follow-up treatments.

Within the Yes We Can Clinics, based in the Netherlands, we provide a very intensive 10-week residential treatment program where clients learn to acknowledge their problems and get to the root of these problems. The program is centered around confrontation in group sessions from counselors and peers, a well-thought out activity program from early morning till late evening, multiple psychotherapeutic sessions on a daily basis and if possible, minimize the use of medication.

Different Routine Outcome Measurement tests were applied.

Here we measured willingness to participate in the program, which fluctuates from average to low at the start, reaching a significant low motivational point after 2/3 weeks, in accordance with the quintessential confrontational aspect, but following the principles of the program in combination with reconnecting with parents and family (systems-approach), a tremendous increase in willingness and commitment towards the program, but also towards life and facing mental health struggles in general, arises.

Herewith confirming the effectiveness of our intensive, immersive, confrontational and protocolized 10-week residential program for youth with mental health problems

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