Coronavirus disease 2019 (COVID-19) modify voluntary admission rates to psychiatric wards in the early phases following pandemic onset. Older patients have higher COVID-19 distress scores because elderly people are at risk for COVID-19 infection.

The present investigation aimed at admission rates of elderly patients to a General Hospital Psychiatric Ward during the lockdown due to the COVID-19, compared to similar periods of 2018 and 2019.

Anonymized data on psychiatric admissions (n=55) from one general hospital psychiatric ward have been obtained and analysed. We compared admission characteristics between April and June of 2018 and 2019 with the same period of 2020 (lockdown).

During the COVID-19 lockdown, a significant reduction in psychiatric hospitalizations of older patients (aged >65 years) was observed in the lockdown (69.2%; χ2=4.823,df=1,p=0.028) in contrast with young patients (26.7% reduction). There was a reduction of 14% in admission due to suicidal behaviour (IRR = 0.57; 95% CI: 0.11-2.75; p=0.48), 25% in depression (IRR = 0.28; 95% CI: 0.64-1.25; p=0.09) and 50% in psychotic disorders (IRR = 0.33; 95% CI: 0.07-1.48; p=0.15). There was none admission by dementia during the lockdown.

Changes in the number of psychiatric admissions, particularly for older patients, were observed during the COVID-19 lockdown. During this period, their fear levels could modify their psychiatric admission rates. We suggest that the decrease of psychiatric admissions in the elderly was due to fear of contagion in hospitals.

None Declared

As the founder of modern psychology as a discipline Wilhelm Wundt came up with the theory of tridimensional feeling (Wundt. Grundriss der Psychologie 1922; Leipzig), which has evolved over time with different theories and is thought to be essential for human survival. A feeling is the conscious awareness of the emotion itself. Feelings are personal and biographical, emotions are social, and affects are impersonal.

We intend to understand how emotions can be explained through theories since the beginning of the modern psychology.

We performed a review of the published literature on the subject using Pubmed. We conducted a search using ‘feeling’ , ‘emotion’ and ‘affect’ as keywords.

Although there are many theories on emotions they conclude that for centuries emotions have various functions and they help us survive. In order to explain this we can make use of biopsychosocial perspectives.The history of study of feeling began with Wundt’s theory of tridimensional feeling and later on different theories such as structuralism, functionalism, evolutionary perspective, behaviorism and nowadays most famous theory neuropsychoanalysis were proposed. Affect can be described as the individual’s ability to participate in stimuli, events, memories and thoughts with an emotional response, on the other hand feelings are the subjective complements of sensations but do not originate necessarily from a sense organ. Moreover, emotion is the reflection of a feeling.

Based on our research, we conclude that for almost over a century there are still theories being developed on feelings and in this matter biopsychosocial perspective has a critical role on its advancement. Are emotions just telltale signs of homeostasis, as Damasio points out? (Damasio & Carvalho. Nat. Rev. Neurosci 2013; 14(2), 143–152.) Apart from their physiological functions, can there be emotions that were once experienced and then suppressed and pushed into the unconscious? If we explain the unconscious only with the functioning of procedural memory in accordance with the current findings of neuroscience, then some changes are needed in our understanding of psychotherapy and especially transference. Because “is the thing that helps change in psychotherapy, the expression of an idea, the verbalization of the experiences, or an emotional/affective exchange between the psychotherapist and the patient?” We must find the answer to the question. It is hoped that neuroscience in general and neuropsychoanalysis in particular will reach new findings and explanations on these issues in the near future.

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The treatment of the person with alcohol dependence allows the possibility of a self-determined alcoholic abstinence and reducing the consequences associated with alcohol-related problems at a personal, family, work and social level.

It is important to develop therapeutic strategies that complement the different approaches in the treatment of people with alcohol dependence, enabling them to use effective coping strategies that facilitate the maintenance of their self-determined alcohol abstinence.

In recent years, scientific evidence has emerged that justifies the adoption of mindfulness-based protocols as a complement to various treatments, both for the prevention of relapses and as a treatment enhancer.

To train people with alcohol dependence to use Mindfulness;

To promote psychological well-being and positive emotions;

To reduce anxiety;

To evaluate the effectiveness of a Mindfulness-based intervention program.

The Mindfulness-based intervention program was developed with 2 groups of people hospitalized for the treatment of alcohol dependence (the institution’s treatment protocol is comprehensive and based on self-determined alcohol abstinence). The 1st G (pilot) - 6 people; 2nd G - 5 people), total of 11 participants; 4 sessions (each group), duration 45-60 minutes.

The selection criteria of the participants were evaluated in an interview and defined as follows: being in the first week of the treatment program; self and allo psychic orientation; reduced to moderate anxiety (Zung Self-Assessment Anxiety Scale - EAAZ); existence of motivation for change.

Participants gave informed consent.

In the global assessment used instruments: Psychological General Well-being Scale for the Portuguese population (BEP); Short Version of the Portuguese Scale of Positive and Negative Affect (PANAS-VRP) in the first session (before intervention). In the last session (after the intervention), in addition to the BEP and the PANAS-VRP, the EAAZ was also used.

At the end of each session, an evaluation was carried out using a grid built for this purpose.

As for the general psychological well-being, the BEP, only one participant (pilot group) had a final score lower than the initial one.

With regard to PANAS-VRP, in both groups, there was an increase in positive affection and a reduction in negative affection at the end of program implementation.

With regard to the EAAZ, 7 participants showed a decrease in anxiety after the intervention.

The evaluation grid of each session revealed good participation, good adhesion and positive evaluation.

It is concluded that after the implementation of the Mindfulness-based intervention program there was: an increase in well-being (the higher the score, the greater the state of well-being); increase in positive affection (which remained or increased); decrease in negative affection and decrease in the level of anxiety.

None Declared

The University Clinic of Skopje – Skopje was part of two Horizon 2020 projects – IMPULSE and RECOVER-e that finished in December 2021. The advances in the field of community mental health in the capital of Skopje, the idea to combine the best aspects of the aforementioned projects and the need of continual implementation and research on an evidence-based community-based service delivery model for recovery-oriented care led to this study which aims to improve functioning, quality of life, and mental health outcomes for people with severe and enduring mental ill health, such as schizophrenia, bipolar disorder, severe depression.

The objectives of the study are: - to design, implement and evaluate recovery-oriented care for people with severe mental illness in community settings using a psychosocial digital intervention - DIALOG+;- to recognize the value of experiential knowledge through inclusion of peer experts as members of community mental health teams;- to develop scale-up plans for national decision-makers, as informed by the intervention’s implementation and impact, for sustained implementation and scale up after the research study’s timeline.- to improve the conditions of people suffering from psychotic disorders and to overcome financial barriers encountered in the treatment of psychotic disorders in N. Macedonia.

DIALOG+ represents an affordable and effective intervention which has already demonstrated positive outcomes in previous research. This study involves the use of the DIALOG+ intervention during home visits, so that patients themselves can decide which aspects of their life that they would like to discuss and work on improving. DIALOG+ lets them rate 12 domains that are related to quality of life, such as physical health, relationships and employment. Patient decide which of these they would like to discuss in detail during the meeting. There is then a 4-step approach to help improve this aspect of their life, using the principles of solution-focused therapy. Researchers will collect information about demographic characteristics, quality of life, and symptoms in patients taking part in the study through the administration of questionnaires and clinical scales.

The study is still in phase of completion. The results will be shown at the EPA Congress 2023.

Having the previous positive outcomes from IMPULSE and RECOVER-e, with this combined approach we expect even more improvement in functioning and better quality of life in patients suffering from severe and enduring mental ill health.

None Declared

The COVID-19 pandemic is a healthcare crisis, with unprecedented impact on healthcare services, notable morbidity and mortality of the public and healthcare workers, economic impact and significant psychosocial impact. Besides, this pandemic has had a profound negative effect on the mental health of people worldwide, particularly among those who are faced with combating the virus.

The aim of this research was to examine the impact of the COVID-19 pandemic on healthcare workers’ mental health (HCWs), as they are on the front line of the pandemic.

An internet-based questionnaire was created including the following scales: (1)Posttraumatic Stress Disorder Checklist (PCL-5), (2) Secondary Traumatic Stress Scale (STSS) (3) Quality of Professional Life (ProQOL) (4) Post-Traumatic Growth Inventory, (PTGI), (5) Brief Resilience Scale (BRS), (6) Brief Orientation to Problems Experienced Inventory (Brief Cope)], (7) Self-Compassion Scale (SCS-SF). It was distributed to 120 Greek health professionals, including nurses, doctors, midwives and physiotherapists.

Most of the participants were female with an average age of 46 years. HCWs had low levels of both primary and secondary traumatic stress . They presented post-traumatic growth in the dimension of relationship with others. They used predominantly the coping strategies of positive reframing, acceptance of the situation, venting, and instrumental support.

Females had statistically significant higher levels of post-traumatic growth, better quality of life, and used more positive coping strategies compared to males. Humor and acceptance were coping strategies used mainly by physicians. Nurses and midwives had worse quality of professional life potentially due to increased workload. HCWs with more functional ways of coping were more resilient and seemed to have better quality of life, such as higher compassion, satisfaction, lower burnout, and lower post-traumatic stress.

The experience of the COVID-19 pandemic highlights the need to implement some strategies to protect health care workers’ mental health and to take extensive prevention measures in highly stressful situations.Further research is needed to clarify the long-term negative and positive psychological effects of the pandemic on healthcare personnel’s mental health.

None Declared

Although in many countries in the meantime more women than men choose medicine and later psychiatry for their training, key positions in hospitals and research are still mainly held by men. The professional career of women is impeded not only by institutional, but also by psychological barriers such as gender role behavior and gender role stereotypes. Mentoring can help young women to overcome these barriers.

But usually mentoring starts too late. As studies have shown, important decisions about future career steps are taken already towards the end of medical studies. Therefore, gender sensitive teaching and mentoring should start already at university and should not only address young women, but also young men as potential partners and future colleagues - especially regarding their gender role behavior and stereotypes. Mentoring programs considering gender-specific needs should be implemented in the regular teaching during medical studies and in psychiatric training.

Furthermore, women should be coached during their further career steps since there is not only a “glass ceiling” that excludes young women from achieving leadership roles. When they finally have achieved such a role, women often face further difficulties stemming from gender stereotypes and traditional gender roles.

University teachers and employers should be addressed, as well as politicians. Otherwise, psychiatry not only loses a great potential of talents, but might also miss the chance of reforms towards a more gender-sensitive psychiatry and psychotherapy.

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Understanding the psychological meanings of a rigorous protocol for introducing a drug to patients is a challenge of emotional management for clinical professionals. Clozapine is an effective drug for patients with schizophrenia resistant to treatment with first and second-generation antipsychotics. This medication has agranulocytosis as an important side effect. The medication protocol requires frequent blood draws to monitor any effect on blood cells. Investigating patients’ emotional perceptions about the experience with this procedure was the triggering question of our study.

To interpret emotional/symbolic meanings attributed by patients with schizophrenia to the protocol of introduction of clozapine in follow-up at a specialized university service.

Clinical-qualitative design of Turato. Semi-directed interviews with open-ended questions in-depth were conducted face-to-face with participants using clozapine. Closed sample by the theoretical information saturation criterion described by Fontanella. Data were treated by Faria-Schutzer’s Clinical-Qualitative Content Analysis, employing psychodynamic concepts of the theoretical framework of Medical Psychology.

From the analysis of nine patients, three categories emerged: 1) “Anyway, I come here to stay alive”: frequent blood collections of the protocol seem to have a good impact on patient’s adherence to treatment; 2) To re-signify a psychiatric illness: the protocol reinforcing an embodiment of a medical diagnosis; 3) “It is a very big precaution”: the protocol as real and emotional support to deal with the possibility of serious side effects.

Although blood collection is a repetitive experience for patients, such a routine does not mean that the procedure brings symbolizations that are more charged than the disease itself. Patients can benefit from the commitment to attend blood collection frequently, as it removes them from possible social isolation, allowing social interaction; it brings the perception of emotional security due to the commitment to the clinical team. These benefits can lead the patient to develop new meanings for their life condition. Future qualitative research can be conducted to study the meanings of medical protocols in other diagnostic situations.

None Declared

Due to the exacerbation of psychotic processes in acute psychiatric services, patients may exhibit risky behaviors for themselves and others. Especially, psycho-motor agitation seen in schizophrenia may result in some harmful behaviors towards him/her self or other individuals in patient. Physical restrain, or chemical restrain with psychotropic drugs can be used for ensuring the safety of the patient with a tendency toward violent behavior and to prevent harm to himself and others. These restrain methods are usually applied when they showed aggressive or violent behaviors, that is after the observed warning signs or real violent behaviors.There is no system that can evaluate and notice agitation or tendency of violence before the obvious behaviors. By using a wearable sensor system to be able to measure some biological change and to evaluate of the sensors’ ability to obtain quantitative and objective data may help the health professionals to prevent the damage in advance.

The aim of this pilot study was to evaluate the changes in measurements of the four wearable sensors which applied to persons with schizophrenia.

Ten patients who restrained in the observation room, selected for this pilot study. On the first day (13:00), which meets the criteria for inclusion in the study and the end of the insulation process (the COVID test result is negative), the first measurement was before the noon treatment. The patients’ second measurements were taken on the day they switched from parenteral to oral treatment. For measurement, the sensor circuits developed at the Physiological Analysis and Wearable Systems Research Laboratory of Koç University were connected to various parts of the body to collect the non-invasive data detailed below. In addition, including the clinical status of the patient in the experimentation process, and a positive-negative syndrome scale was also used. The data from the patient was obtained under the supervision of the clinical chief nurse for 10 minutes. Sensors were electrocardiogram (ECG) photoplethysmogram (PPG), seismocardiography (SCG), body temperature.

Since some recording errors observed in two patients’ records, the data of eight patients were evaluated. Aside from one of the eight patients evaluated, the signal deviation and strength of other patients’ data increased in general. This result imply that signal deviations and strengths may be reduced during the psychomotor agitation. These deviations may suggest that this sensor system is capable to evaluate some biological changes in patients.

Considering the results of the pilot study, it is planned to carry out future studies with a larger sample size and longer records. With these studies, it is thought that psychomotor agitation in patients can be determined in an objective and measurable way without risk.

None Declared

Posttraumatic Stress Disorder (PTSD) consists of an intense, prolonged, and occasionally delayed reaction to a deeply stressful event. PTSD is associated with risk of suicide and chronic psychological impairment. The continued exposure to stress suffered by Healthcare Workers (HCWs) during the COVID-19 pandemic can be considered a mass traumatic event and contribute to higher rates of PTSD in this population.

To study the rates of PTSD in a sample group of healthcare professionals working in a Portuguese general hospital and its relationship with a number of individual variables considered to be relevant by the existing literature on the subject.

We devised a survey to assess the prevalence of PTSD among HCWs in a general hospital and its relationship with sex, social support, profession, work experience in healthcare, time spent caring for COVID-19 patients and place in which the COVID-19-related activities were carried out. PTSD symptoms were assessed using the PCL-5, Portuguese version.

A total of 226 HCWs were included in the study. Provisional diagnosis of PTSD was made based on the PCL-5 responses, considering DSM-5 criteria and the cutoff score of 33.

79 out of 226 (35.0%) HCWs had a provisional diagnosis of PTSD, and a significant association was found between PTSD and time spent working with COVID-19 patients and between PTSD and place of work, namely the COVID-19 Emergency Room and Intensive Care Unit.

Our results are in line with previous studies, highlighting the importance of a serious, wide, and honest discussion about mental health promotion among HCWs. The COVID-19 pandemic has been an undeniable source of stress for HCWs around the globe, and the consequences of this stress are beginning to manifest themselves. It is urgent that this reflection takes place, as it is of paramount importance that what we all have lived in the past years serves as a lesson, and not as a warning of a crisis doomed to repeat itself.

None Declared

Anorexia nervosa (AN) is a severe psychiatric disorder that usually begins during adolescence and is associated with a high risk of mortality and morbidity, its treatment is complex and often ineffective. Psychiatric comorbidity is common in patients with eating disorders (with the prevalence of 20–95%), namely 39% in AN.

The purpose of the authors is to review the most common areas of psychiatric comorbidity in AN, how it affects the course of both diseases and the potential treatment approaches.

A brief non-systematized review is presented, using the literature available on PubMed and Google Scholar.

The most common psychiatric comorbidities in AN are: Affective disorders in 24-38% (mainly unipolar depression which can appear in up to 75% of patients, compared to 11% in bipolar disorder); Anxiety disorders in 25.5% (11% with panic disorder, 20% social phobia/social anxiety disorder, 15% specific phobias, 10% generalized anxiety disorder, 13% post-traumatic stress disorder); Obsessive compulsive disorder in 12%; Substance use disorders at 17%; Personality disorders around 30%. Other pathologies occur less commonly but can have a significant impact on the patient, namely Autism spectrum disorder (predictive factor for unfavourable outcome) or Schizophrenia (there are reports of reciprocal relationships between the two pathologies).

Some of these comorbidities may increase mortality in AN, namely unipolar depression, personality disorders, alcohol and illicit drug use.

The profound impact that starvation has on mood and cognition is well known. It can condition symptoms that are confused with other psychiatric diseases and change their clinical presentation. As such, the specific clinical characteristics and the therapeutic approach will be presented for each of the psychiatric comorbidities.

Early diagnosis and treatment of psychiatric comorbidities in AN are essential to improve the prognosis of this eating disorder. The additional treatment of these pathologies will increase complexity of the already challenging treatment of AN, with the additional symptomatology often being perpetuated by an uncontrolled eating disorder and a poor compliance to treatment.

The limited evidence available for approaching these cases is based on the few studies available, most with insufficient samples.

None Declared

Catatonia due to cerebrovascular stroke is a rare condition that needs further observation and research.

To review the opinions of psychotic disorders experts worldwide as to this issue based on evidence and clinical experience and to consider strategies for future investigations.

This case shows a 64 years old female who suddenly developed wish for isolation, followed 10 days later by discontinuity of ideas, hallucinatory behavior and food refusal. She had verbal and physical aggression due to a fixed belief that family members are conspiring somehow to harm her.

On examination she was mute with waxy flexibility and negativism. Extensor plantar reflex was evident. MRI Brain showed small vessel disease and right basal ganglia acute ischemic infarction. On IV midazolam 7.5 mg, patient’s mutism, negativism and waxy flexibility improved. Lower limb Venous Duplex revealed acute right popliteal and left soleal veins thrombosis. CT angiography showed Bilateral pulmonary embolism with no pulmonary infarction. D dimer was positive.

Early diagnosis and intervention improves outcome if psychiatric teams gives attention and has enough awareness with warning symptoms and prompt necessary interventions.

None Declared

The investigation of alcohol use and its correlates during the ongoing COVID-19 pandemic is of utmost importance.

This study aimed to examine alcohol use during COVID-19 pandemic, while nationwide lockdowns were in effect in Greece, and its relationship with demographic, clinical, and psychosocial factors.

The study included 378 individuals (225 women) with a mean age of 30.22 years who completed an online questionnaire during the third wave of the pandemic while restriction measures were in effect (March to April 2021). Participants completed Alcohol Use Disorders Identification Test (AUDIT), Fear of COVID-19 Scale (FCV-19S), Depression, Anxiety and Stress Scale (DASS-21), Coping Orientation to Problems Experienced Inventory (Brief-COPE) and the Multidimensional Scale of Perceived Social Support (MSPSS).

According to the results, alcohol use was negatively associated with COVID-19 fear (p = 0.011), and positively associated with anxiety (p = 0.024), depression (p<0.001) and avoidance-focused coping strategies (p = 0.003). Furthermore, perceived social support emerged as a significant protective factor against alcohol use. Men presented higher alcohol use levels compared to women (p = 0.002). Additionally, individuals identified as problematic users, based on AUDIT scores, displayed increased levels of anxiety (p = 0.028) and depression (p = 0.017) and used avoidance-focused coping strategies to a greater extent (p<0.001). Of note, higher alcohol use was observed in participants who lived alone (p<0.001) and in those whose work status had changed during the pandemic (p = 0.004).

Our findings highlight the importance of identifying individuals with problematic alcohol use, as well as recognizing crucial psychosocial factors related to alcohol use especially during the pandemic.

None Declared

GnRh agonists are drugs used in various gynecological pathologies, among which is endometriosis. They act by stimulating GnRh receptors in the pituitary gland. This sustained and continuous stimulation of GnRh, will initially generate an increase in the release of luteinizing hormones and follicle-stimulating hormones, subsequently losing sensitivity to the receptors, internalizing them, and thus suppressing the release of these hormones, which would entail an ovarian suppression, thereby inhibiting the release of estrogens and progesterone. Psychiatric adverse effects have been described. Gonzalez-Rodriguez et al (Front Psychiatry 2020; 11:479), described this association with changes in mood, and the presence of a series of cases where the link between GnRh agonist and the possibility of presenting psychotic symptoms is observed. Wieck (Curr Top Behav Neurosci 2011;8:173-87), Frokjaer (J Neurosci Res 2020;98(7):1283-1292), Brzezinski-Sinai et al (Front Psychiatry 2020;11:693) reported that this association could be related with the relationship of the hypothalamic-pituitary-gonadal axis, hormonal fluctuation and its relationship with the dopaminergic regulation, a genetic component that would increase the predisposition to trigger psychiatric pathology in patients with greater sensitivity to hormonal fluctuations, and the loss of neuroprotection generated by the decrease of estrogens in the central nervous system. All of this in the context of multiple environmental and genetic factors that participate together in the appearance of the disease.

To describe the importance of detecting the risk factors that can precipitate a psychotic episode, including the use of certain drugs, such as GnRh agonists.

We describe a case of a 45 year old patient with endometriosis with multiple organ involvement who went to the emergency room due to behavioral changes in the context of a brief psychotic disorder with “ad-integrum” recovery.

A retrospective analysis of the case is conducted, observing an association between the introduction of GnRh agonists and the presentation of a first psychotic episode.

The importance of this case lies in the limited evidence of this association in the literature, and the implication of these drugs in the triggering of psychiatric pathology, being an aspect to be considered by psychiatrists in their patient’s follow-up.

None Declared

In Taiwan, National Health Insurance has been implemented for 27 years and continues to receive international recognition. People pay part of the quota at the time of medical treatment, and the rest of the medical expenses will be paid by the national health insurance. In this study, the researcher, a psychiatrist in the general hospital, investigated the correlation between service and revenue. He has started to work in this hospital since November 1st, 2021, without any other psychiatrist peers.

This study used proportion of PPF as performance indicator and aimed to observe the changes of PPF unit from November 1st, 2021, to January 31st, 2022, examining the trend of PPF growth. The purpose is to figure out an appropriate model to optimize medical services and performance outcomes.

Demographic data were collected through PPF projects, consisting of 17 inpatient ward items and 14 outpatient items from November 1st, 2021, to January 31st, 2022, and items with no performance or related to physiological examination has been excluded. In addition, items with a ratio of greater than 1.5% are presented in the bar graphs, as shown in Figure 2 and 3. The performance proportion of inpatient ward and outpatient were calculated separately.

Demographic data found PPF rises significantly over time (Figure 1). The 2nd month PPF unit (27.09%) was 2.5 times the 1st month PPF unit (10.70%), and the 3rd month PPF unit (62.21%) was 2.2 times the 2nd month PPF unit (27.085%). The highest proportion of PPF items were general hospital bed inpatient consultation fee for inpatient ward item (Figure 2) and psychiatric outpatient consultation fee for outpatient item (Figure 3). Furthermore, only the proportion of psychiatric outpatient consultation – more than two consecutive transfers increased continuously and the proportion of psychiatric outpatient consultation – adjusted by the hospital decreased, the other items has not changed significantly.

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In the first three months of the psychiatrist employment, the performance showed an increasing trend. These findings may suggest that the psychiatrist could be competent in a general hospital with patients’ confidence. In addition, under an optimal model of PPF and medical service, psychiatrists would more like to work in the general hospital, to serve acute psychiatric patients in need.

None Declared

Although evidence of cannibalism in humans dates back millennia, for most civilized societies, it is an unthinkable act of violence and strictly taboo. It is commonly relegated to the domain of horror films and literature, often associated with the likes of Jeffrey Dahmer or Hannibal Lecter. However, for some, this theme encompasses a pathological or sexual realm. Vorarephilia or sexual cannibalism is, at its simplest level, a psychosexual disorder characterized by the erotic desire to be consumed by, or to personally consume, another human being´s flesh.

The authors aim to review human sexual cannibalism as a concept and its eventual relationship to mental illness with recourse to the description of cases of human cannibalism documented in the literature.

A brief non-systematized literature review utilizing various databases including Pubmed and Google Scholar, as well as complimentary literature and case reports when pertinent to the theme was performed.

Although cannibalism is a common phenomenon in the animal kingdom, its expression in humans is assumed to be a minority occurrence and relegated to stories of a more primal past. Pathological cannibalism is an extremely rare occurrence and has been described in association with severe psychotic mental illness and extreme forms of significant paraphilia. Sexual cannibalism appears as a rarity in humans and although the majority with this paraphilia do not partake in actual human consumption, remaining a fantasy-based desire, cases of cannibalism have been reported and tried.

Eating the flesh of one’s own species is probably one of the few remaining taboos in modern human societies. In humans, cannibalism is a rare occurrence and has been associated with mental illness. Due to the rarity of this phenomenon, with few cases documented in the literature, the underlying etiology, as well as potential environmental and individual risk factors are still to be defined, indicating a potential for further study.

None Declared

The process of integrating technology into mental health pathways represents a social transformation that we are gradually getting used to. But does it represent a valid alternative to face-to-face care processes? In this paper we will consider telesychology as a tool for treating anxiety and depression and its validity. Anxiety and depression are harmful to individuals, suffering from these disorders, their caregivers, and the economy. Remote delivery of psychotherapy has been established as a viable alternative to traditional in-person psychotherapy for treating anxiety and depression. However, literature comparing and evaluating the variety of remote delivery modalities of psychotherapy has not yet been integrated.

This review examines the efficiency – to - practice and the limits of e-therapy and its mediums: telephone, video, and online-administered psychotherapy, for treatment of anxiety and depression.

A comprehensive literature search, conducted using PubMed and PsycINFO included systematic reviews, randomized controlled trials, and cost-analysis studies focused on a remote delivery method of e-psychotherapy for anxiety and depression

Overall, interventions delivered through telephone, video, and online modalities, have generally demonstrated good efficiency in treating anxiety and depression; also comorbid with other disorders. The literature also suggested that telehealth psychotherapy is accessible, convenient, and cost-effective.

In evaluating the reviews on the databases, it also emerged that among the many psychological therapies for anxiety disorders, delivered digitally (CBT, Attention bias modification, Exposure therapy, Applied relaxation, Bibliotherapy, Psychodynamic therapy, Mindfulness, Behavioral stress management, Counseling), the best digital therapy is internet-based cognitive behavioral therapy (iCBT), in particular for Social Anxiety Disorder (SAD).

Despite this, overall, the efficiency and practical benefits of remote psychotherapy interventions in treating anxiety and depression across a diverse range of patient groups suggested that it is an appropriate alternative for those who cannot access in-person psychotherapy.

Further research evaluating the efficiency and practical benefits of e-psychotherapy for anxiety and depression is much needed for patients with limited access to in-person psychological care. Moreover, it remains to evaluate the maintenance of therapeutic gains after the end of the treatments.

None Declared

The relationship between cyber video game addiction and impulsivity is controversial. Some studies have shown a significant link, others have found no association between the two behaviours.

To study impulsivity in adolescents with problematic use of internet video games.

This was a cross-sectional, descriptive and analytical study, conducted among a sample of adolescents randomly collected in 6 schools in the region of Sfax-Tunisia, during the month of February 2022. The rate of addiction to video games was assessed by the 20-item “Internet Gaming Disorder-20” (IGD-20) scale and impulsivity by the 30-item “Barratt Impulsivity Scale” (BIS-11). Both scales are validated in Arabic.

The study involved 360 secondary school students, with a mean age of 16.62 +/- 0.822 years. The sex ratio was 1.09.

A gaming addiction was found in 4.7% of cases.

Similarly, impulse control disorder was noted in 23.6% of adolescents.

Problematic internet game use was significantly related to motor impulsivity (p=0.025).

There was no significant association between cyber video game addiction and cognitive or non-planning impulsivity.

According to the results, impulsiveness is a factor to consider for understanding the development of addiction to internet video games. Thus, impulsiveness should be taken into account to explain problematic gaming behaviour as well as to design preventive and treatment interventions.

None Declared

After two years of pandemic with COVID-19 Europe is facing a war, which has already caused numerous death and injuries, mass displacement, and aggravated the economic and energy crisis and has left most countries completely unprepared and created a humanitarian crisis. The COVID-19 pandemics crisis pointed out the unpreparedness of the health (including mental health) sectors for the emergency situations. However, we also learnt some of the practices that proved effective – including the fast creation of collaborative networks on a larger scale that also allowed fast spread of good practices and practical organisation of help. The European Psychiatric Association as well as individual national psychiatric association have started an informal network of solidarity for Ukraine on February 28th, 2022 to respond to the needs of people in Ukraine as verbalized by the Ukrainian mental health professionals, but also to the need of surrounding countries where people from Ukraine fled to. Through this network several actions, including financial support, medical donations and education. The Croatian Psychiatric Association took the lead in the organisation of education for first line helpers and volunteers from Ukraine and countries surrounding Ukraine where displaced persons fled to, in collaboration with many partners.

None Declared

Mental pathology is relatively prevalent in the women, and there is often a need for treatment with psychotropic drugs, with an impact on women’s reproductive health. The use of contraception is widely spread among this population and the choice between these methods must be considered carefully.

This review aims to present the main interactions between contraceptive methods and psychotropic therapy and its impact on psychiatric disorders, in addition to the precautions to be taken in their choice.

Literature review of relevant articles on Pubmed. Query: Contraceptive+(psychiatric disorder, depression, anxiety, schizophrenia, bipolar disorder, psychotropic drugs).

Based on current evidence, no statistically significant differences regarding unplanned pregnancy rates or the psychotropic treatment outcomes were found when using combined oral contraceptives and antidepressants, benzodiazepines or atypical antipsychotics (being clozapine the exception). The impact of contraceptive methods on mood was unclear, as some articles showed an association between contraceptive use and a higher risk of beginning antidepressants and others showing no differences or even as a protective factor. Although the interactions of the aforementioned drugs are infrequent, there are cases where important interactions occur, such as clozapine, valproic acid, lamotrigine and carbamazepine, as some herbal products as the St.John’s wort. With clozapine, there is an increased serum concentrations, while the opposite occurs in the case of valproate and lamotrigine with a decrease of 32.6% and 23.4%, respectively. Treatment with valproic acid in women of childbearing age has been discouraged because of its association with polycystic ovary syndrome, elevated testosterone concentrations and menstrual irregularities, in addition to the risk of fetal malformations. In cases where this drug is prescribed, it is recommended to use highly effective methods such as subcutaneous implants or intrauterine devices. Lamotrigine and carbamazepine reduce the effectiveness of some contraceptive methods, such as oral contraceptives, transdermal patch and vaginal ring, in which case the placement of a subcutaneous implant or intrauterine device is indicated.

The magnitude of the impact between contraceptives, regarding depressive disorders, is unclear. The evidence shows that some women report the appearance and recrudescence of depressive symptoms, evidencing the need of further studies to identify the risk factors in these cases. The importance of clear and simple information and a shared decision on which contraception to choose is crucial, as clarification about their interactions with psychiatric treatment. The clinician must also be aware of the implications for reproductive health, in order to reduce the risks and side effects associated with some drugs.

None Declared

For over two decades, much has been written about the role of heritage buildings and historic places on individual and societal well-being. Numerous manuscripts have been devoted to study the relationship between built and cultural heritage and well-being and to decrypt their mental and physical health benefits at the personal and societal levels. Other studies have focused on the diverse types of heritage experiences that enable these health benefits, ranging from perceptions, to the individual and societal engagements through exposure, protection and conservation of historic places and environment. Social benefits encompass enhancing of collective memories and identities, sharing experiences, social interaction, creative opportunities, etc.

The objective of this research is to explore the relationship between personal and societal health and well-being, and cultural heritage. The main objective is to disclose international strategies and programs for assessing and promoting heritage-led wellbeing benefits.

We comprehensively reviewed the scientific literature using qualitative data-analysis methods to state, international frameworks for promoting heritage-led wellbeing benefits.

Our bibliographic review revealed that there has been rising recognition that the conservation of cultural heritage is not just about the preservation of materials, but rather about safeguarding and sharing heritage for the improvement of people’s lives. According to the WHO, culture and cultural heritage are recognized as fundamental determinants of what makes personal and social lives meaningful. Consequently, many countries such as the UK and Canada, have developed people centred approaches achieved by local authorities as a means of ensuring inclusivity and diversity, so that heritage is able to contribute to people’s wellbeing. Politically, few agendas promoting wellbeing and engagement with the historic environment included guidelines of community-oriented projects and management systems that benefit people with building the relationship between people and place, while demonstrating the public value of the historic environment.

All professionals, at the architectural and urban level, as well as health and psychology level should have awareness about the concept of heritage-led wellbeing benefits and strategic views of the value of cultural heritage as process, as participation, as mechanism, as healing, as place and as environment to raise the planned positive effects by local authorities when promoting the perception of the role of cultural heritage in health and wellbeing.

None Declared