Depression is a psychiatric disorder characterized by low mood and anhedonia. The diagnosis of depression and the initiation of treatment is important for improving quality of life and avoiding disability. Machine learning (ML), can be used for solving classification and regression problems.In this study, scores of multiple psychiatric scales were used to detect depression and different ML algorithms were used to study if they can help for diagnosing depression accurately.

The purpose of the study is to detect with high accuracy whether people are depressed or not by using widely used ML algorithms. It is also aimed to compare the algorithms used to predict depression with each other.

Data were collected from 96 university students. Beck Depression Inventory (BDI), Beck Anxiety Inventory, Neo Personality Inventory, Chronic Stress Scale (CSS), Perceived Stress Scale (PSS), Childhood Trauma Questionnaire, Post-Traumatic Stress Disorder Checklist (PTSD), SHAPS, Relationship Scales Questionnaire and Dissociative Events Scale were applied. 14 points from the BDI was accepted as the cut-off value as depressed. Total scores of each scale was used as the dependent variable in the Xgboost (XGB) to classify the depression. By XGB, the most important 4 of these surveys and scales were selected to use in the Non-Linear (NL) models such as XGB, Decision Trees (DT), Support Vector Machines (SVM), K-Nearest Neighbor (KNN). Lastly, a linear model as a Logistic Regression (LR) model was also used to compare with the NL algorithms. The success of the models was measured with the Cross Validation method, which is the gold standard in ML.

In the model in which all measurements are used as Independent Variables (IV), the XGB highlighted 4 scale scores: these are CSS, PSS, SHAPS and PTSD. All scale scores were used as IV, both XGB and DT classified depression with a success of 87.5%, while this score increased to 89.6% in both models when 4 prominent scales’ scores were used as IV. In the KNN, the classification made with prominent scales increased the success from 83% to 86%. The variance explanation rate of the LR model using 4 prominent scales remained at 58%.

With ML’s ability to solve NL relationships and dimensional reduction ability, models in which a large number of variables are input and there is no high correlation between dependent variables and IV can be classified with high success. Also, the success of the models was increased by choosing the most importants of the many IV and the variables that contributed negatively to the model could be excluded. The use of ML can yield promising results in fields such as psychiatry where linear relationships cannot be observed much.

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During the course of COVID-19 pandemic, the respiratory system is the most commonly affected while many neuropsychiatric manifestations of the disease have been observed.

Emphasize the importance of detecting psychiatric symptoms in patients infected with Covid 19.

Presentation of case report

A 44-year-old woman with no personal history of chronic diseases and with no psychiatric family history. About her experience with covid 19, her mother died as a result of covid 19 infection and our patient had been hospitalized for 17 days for pulmonary infection covid 19, during her hospitalization in COVID 19 unit she presented insomnia and anxiety without behavioural disorders. She had a good evolution of the respiratory symptoms and she was discharged under corticotherapy and anticoagulants.

She was admitted in our department after 45 days of her covid 19 infection for acute behavioural disorders.

On physical examination: she was hemodynamically stable and well oriented. Neurological examination was with no abnormalities. Cerebral CT scan was normal and lumbar puncture was indicated and the analysis of the CSF did not reveal any anomalies. At the psychiatric interview she was extremely agitated, anxious and hallucinated, she had disorganised speech with derailment and neologisms, she was disinhibited and her mood was exalted. She presented also a delusion of grandeur and delusion of persecution.

In individuals presenting with COVID-19 infection, consideration should be made for psychiatric manifestations because COVID-19 diagnosis predispose vulnerable patients to psychosis.

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Functioning in acute inpatient psychiatric units has been challenged by the Coronavirus disease 2019 (COVID-19). Patients with more severe mental health symptoms changed their rates of voluntary admission to psychiatric wards during the onset of the pandemic. Peritraumatic distress scores and increased likelihood of being psychologically affected by the COVID-19 pandemic can lead to a psychiatric admission. However, other factors could prevent hospitalization.

The present investigation aimed at admission rates of patients by depression, adjustment disorder or suicidal behaviour to a General Hospital Psychiatric Ward. We compared the lockdown due to COVID-19 in 2020 to similar periods of 2018 and 2019.

The data of one general hospital psychiatric ward admissions have been obtained and analysed. We compared admission characteristics of 237 patients between April and June of 2018 and 2019 with 79 patients in the same period of 2020 (lockdown).

During the COVID-19 lockdown, there was a 35.8% reduction in psychiatric admissions and a significant reduction in psychiatric admission was observed due to suicidal behaviour (IRR = 0.49; 95% CI: 0.26-0.89; p=0.002) and depression (IRR = 0.24; 95% CI: 0.08-0.68; p=0.007), but similar rates of adjustment disorders (IRR = 1.12; 95% CI: 0.58-2.15; p=0.73).

We suggest that patients with depression or suicidal behaviour avoided admission, for fear of contagion in hospitals. Also, greater family support could prevent self-injurious behaviours. By contrast, other disorders continued to require the same admission rate, since the social consequences derived from confinement could lead to the genesis or worsening of symptoms, such as adjustment disorders.

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Primary delusional infestation is a rare psychiatric condition in which patients mistakenly believe that their skin or other body parts are infested by small, living organisms, despite the fact that no organisms can be found upon investigation. The delusion occurs concurrently with abnormal cutaneous sensations. Therefore, they typically have a history of prior negative evaluations by dermatologists and general practice physicians. In addition, patients may have also received repeated courses of dermatologic and anti-infective therapies, despite the lack of an objective diagnosis.

To describe the clinical case of a patient who suffered from an undiagnosed primary delusional infestation for 12 years.

Description of a clinical case and a non-systematic review of the literature.

We describe the clinical case of a 65-year-old woman who spent 12 years being evaluated by multiple medical and surgical specialties for the following complaint: “sensation of something moving beneath the skin.” At the onset of the complaint, the patient believed that this “strange sensation” was due to a recent tooth procedure. However, as she felt the discomfort not improving, she believed it to be a consequence of a cutaneous anthrax infection. Thus, the patient started using tweezers to grasp the living organism that was bothering her and that behavior caused intense scaring in her face. Meanwhile, the patient was also submitted to 3 cutaneous biopsies (prescribed by a dermatologist) that refuted the hypothesis of any living organism underneath her skin. In addition, the patient was prescribed sertraline, bromazepam and lorazepam that, although improved her sleep and anxiety levels, were inefficient to treat the root of her suffering. Finally, after 12 years of dispersed medical follow-up, this patient was evaluated by a new psychiatrist and prescribed paliperidone that rapidly made the agonizing “strange sensation” disappear.

Even though primary delusional infestations are a rare psychiatric diagnosis, all medical doctors should consider it when their patients report bothersome dermatologic complaints associated with the belief of infestation and negative diagnostic examinations. It is incredibly important to consider this diagnostic, as the early treatment of this entity might prevent the patient from undergoing multiple years of suffering and discomfort.

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Culture is defined by the shared beliefs, attitudes, values, and practices of a particular group of people which can influence their behaviour and social interactions, including the use of substances.

The aim of this review is to identify the evidence of cultural competence in the treatment of people with substance use disorder (SUD) and encourage the professionals and organizations to take cultural context into account.

Narrative review about the topic, using PubMed/Medline database. MeSH terms: “culture”, “cultural competence”, “addictions”, “substance use disorder”.

Studies show that culture can either be a catalyst for SUD or play a protective role. However, other factors may also play a large role in client’s response substance use and the development of SUD. Acculturation and generational differences can also impact SUD treatment, especially when intergenerational conflict causes stress that leads individuals to engage in risky behaviours. Thus, treatment for SUD has to be sensitive to cultural differences and professionals should provide culturally based approaches. Culturally targeted practices have been linked to greater outcomes, better therapeutic alliance, less dropouts and consequent increased retention in the treatment. These practices include matching clinicians and clients on linguistic and cultural backgrounds as well as being mindful of the impact of culture on client’s experience of SUD. Providing therapy and materials in the client’s language, knowledge, understanding and appreciation for cultural perspectives, involving the family and community and training therapists, are some of culturally competent practices used. These strategies involve knowledge, creativity, and experience.

Cultural competence seems to be a valuable tool for healthcare professionals working in a multicultural context, particularly with people with SUD. Unfortunately, the lack of supporting evidence limits the validity of any particular model of cultural competence. Future methodologically research is necessary in order to provide quality cultural competence models for people with SUD.

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Social life has moved toward the digital world in many aspects. As the original inhabitants of virtual life, young people face several adversities while flirting and dating online. The anonymity of the online environment enables aggression without consequences. Cyberviolence has no boundaries as time or place. Thus it may cause psychological distress.

Young people frequently use online dating and social networking sites, which makes them vulnerable to cyber dating violence, sextortion, and revenge porn. Cyberdating violence usually targets young women and girls. It is mainly related to stereotypical gender beliefs: presented as controlling behavior and psychological violence. Survivors of cyber dating violence tend to feel anger, hostility, and loneliness. Sextortion is image-based sexual abuse, which includes threats with intimate pictures or videos. Perpetrators of sextortion can be hackers, ex-partners, or admirers. Exposure to sextortion is related to shame, fear, and helplessness. Former partners may use revenge porn to control one’s behavior. It is another kind of image-based sexual abuse. Perpetrators may use nonconsensual pornography to punish or humiliate their ex-partners.

Cyber victimization is as traumatic as real-life victimization. That results in depression, anxiety, and posttraumatic stress. Moreover, the absence of time and space restrictions can make cyberviolence even more debilitative. I aim to inform European psychiatrists about the current shapes of cyber psychological trauma in the context of online flirting and dating. So that psychiatrists can better understand its content and outcomes, especially while working with young people.

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Human trafficking is the trade of humans for the purpose of forced labor, sexual slavery, or commercial sexual exploitation for the trafficker or others. This may encompass providing a spouse in the context of forced marriage or the extraction of organs.

Research into the mental health impact of trafficking has consistently found high rates of mental health problems, most commonly depression, anxiety, and posttraumatic stress disorder (PTSD).

While there is some evidence that these factors can contribute the diagnosis of PTSD, exposure to trauma is the most important feature in the development of PTSD.

Other Mental Health Problems in victims of

Trafficking:

1. 1. Dissociative disorders

2. 2. Substance-related disorders

3. 3. Complex trauma

Although mental health problems among victims of trafficking have been shown to be high, recovery without treatment is rare, particularly in those who have developed PTSD.

Where there is comorbidity, recovery often does not occur even when rehabilitation has been attempted. This is unsurprising given the multiplicity of trauma that victims of trafficking have experienced, which often includes trauma prior to the trafficking situation.

Evidence-Based Therapeutic Treatment Options for PTSD:

Some evidence suggests that selective serotonin reuptakeinhibitors can effectively complement the psychotherapeutictreatment of PTSD as well as other anxiety and mooddisorders.

Cognitive-behavioral therapy

Exposure therapy

Eye movement desensitization and reprocessing

Narrative Exposure Therapy (NET)

In the absence of research pertaining to the mental health treatment of victims of human trafficking, mental health professionals working with this population must educate themselves on the evidence based research related to the treatment of common diagnoses and similarly marginalized populations to ensure proper provision of the best mental health care possible.

Among the most devastating mental health consequences for victims of any crime can be the destruction of basic life assumptions; that one is safe from harm, one is a good and decent person, and the world is meaningful and just. For victims of human trafficking, mental health problems can be compounded by the misconceptions about and limited understanding of the issue of human trafficking.

Additionally, lack of social support and stigmatization by friends, family, and social institutions can exacerbate victims mental health conditions.

Psychologically process the trauma they have experienced. However, until these studies are conducted and their results made available, mental health practitioners can base treatment options for this population on existing research findings and interventions found to be successful with other similarly victimized populations.

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Neuropsychiatric symptoms (NPS) are common during the course of neurocognitive disorders. NPS have been previously reported in early and late stages of Alzheimer’s Disease. However, our understanding of NPS in high-risk states for dementia such as mild cognitive impairment (MCI) and major depressive disorder (MDD) is poor.

To compare the frequency and factor structure of neuropsychiatric symptoms among individuals with Mild Cognitive Impairment (MCI), Major Depressive Disorder (MDD) in remission, and comorbid MCI and MDD (in remission) (MCI-D).

We used baseline data from the Prevention of Alzheimer’s Dementia with Cognitive Remediation Plus Transcranial Direct Current Stimulation in Mild Cognitive Impairment and Depression (PACt-MD) study, a multicenter trial across five academic sites in Toronto, Canada (clinical trial No. NCT0238667). We used ANOVA or χ2-test to compare frequency of NPS across groups. We used factor analysis of Neuropsychiatric Inventory Questionnaire (NPI-Q) items in the three groups.

We included 374 participants with a mean age of 72.0 years (SD = 6.3). In the overall sample, at least one NPS was present in 64.2% participants, and 36.1 % had at least moderate severity NPS (36.1%). Depression (54%, χ2 < 0.001) and apathy (28.7%, χ2=0.002) were more prevalent in the MCI-D group as compared to MCI and MDD groups. In factor analysis, NPS grouped differently in MCI, MDD, and MCI-D groups. A “psychotic” subgroup emerged among MCI and MCI-D, but not in MDD. Night-time behaviors and disinhibition grouped differently across all three groups.

Prevalence of NPS seems higher in persons with MCI-D as compared to those with only MCI or MDD. The factor structure of NPS differed between MCI, MDD, and MCI-D groups. Future studies should investigate the association of NPS factors with cognition, function, and illness biomarkers.

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Asthma is a common worldwide, chronic respiratory disease. It has been shown to impair a person’s health-related quality of life (HR-QoL), but the core influencing factors are not fully understood.

We aimed in this study to evaluate QoL of asthmatic patients and its main determinants.

A prospective single center study was held with asthmatics consulting in the Pulmonology Department a public hospital in Tunisia. A complete structured questionnaire concerning socio-demographic and clinical characteristics were determined. The assessment of asthma control during the last 4 weeks was based on the GINA 2022 report criteria. The quality of life was assessed by the Asthma Quality of Life Questionnaire (AQLQ) scale in its validated Arabic version.

A total of 109 asthmatic patients was included. Most of them were female (N= 73, 67%). Twelve (11%) were current or ex-smokers. The majority of patients (N=101, 92.6%) were active. Thirty-nine patients (35.7%) had comordidities. Asthma were controlled in 40.4% of cases.

The average of AQLQ was4.9±1.2. The most affected domains were environmental stimuli and symptoms with a mean value of 4.6 ± 1.3 and 5.0± 1.3 respectively.

Allergic and uncontrolled asthma and severe disease were significantly associated with the average of AQLQ in the study population with p respectively 0.001, <0.000 and <0.000.

Multivariate analysis demonstrated that factors independently associated with the HR-QoL were : the severity of asthma (OR-0.39, IC95% [-0.62,-0.15], p=0.001) and uncontrolled disease (OR=0.59, IC95%,[-0.87,-0.31], p=0.000).

These results suggest that uncontrolled and severe asthma significantly affect health asthma-related quality of life.

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On average, thirty percent of patients in internet based treatments do not complete the treatment program. The majority of studies predicting adherence have focused on baseline variables. While some consistent predictors have emerged (e.g. gender, education), they are insufficient for guiding clinicians in identifying patients at risk for dropout. More precise predictors are needed. More recently, studies on prediction have started to explore process variables such as early response to treatment or program usage.

To investigate:

1. i) How much variance in adherence is explained by baseline symptoms and sociodemographic variables?

2. ii) Can we improve the model by including early response and program usage as predictors?

3. iii) What is the predictive accuracy of the most parsimonious regression model?

Data will be extracted from the Danish ‘Internetpsychiatry’ clinic, which delivers guided internet based cognitive behavioural therapy for depression. Sociodemographic data is collected upon application, and symptoms of depression and anxiety are measured at the start of treatment. Further, symptoms of depression are measured between each session of the online treatment program. Early response to treatment will be conceptualized as the individual regression slope of depression scores for each patient, during the first four weeks of treatment. Program usage data will be collected from the online treatment platform (e.g. number of words per message to therapists, time spent on each session during the first four weeks, number of logins during the first four weeks).

Predictors for adherence will be examined in a hierarchical logistic regression. Models will be compared using ANOVA. The most parsimonious model will be determined using the Aikake Information Criterion. Receiver operating characteristic curve analyses will be used to classify the accuracy of the model.

Analyses have not yet been conducted. Results will be available for presentation at the conference.

Determining more accurate predictors for adherence in internet based treatments is the first step towards improving adherence. Research findings need to be translated into clinically useful guidelines that may inform clinical decision making. Findings from this study could potentially be implemented as a system that monitors patients’ program usage and symptom development and signals therapists if a patient is at risk for dropout.

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Research on life stress in bipolar disorder largely fails to account for the possibility of a dynamic relationship between psychosocial stress and episode initiation. The kindling hypothesis states that over the course of recurrent affective disorders, there is a weakening temporal relationship between major life stress and episode initiation that could reflect either a progressive sensitization or progressive autonomy to life stress.

To explore the concept of the Kindling model applied to bipolar disorder and to present a clinical case of a bipolar patient whose latter mood episodes were caused by adverse life events.

We performed a non-systematic literature review using the most relevant papers found on the database PubMed with the keywords “kindling effect”, “allostatic load”, “bipolar disorder” and “prevention”. Description of the clinical case report.

The phenomenon of kindling was first discovered by Goddard in 1967 who described it in epilepsy. Later, Post applied it to the bipolar disorder, arguing that the initial episodes of both unipolar and bipolar affective disorders are often precipitated by psychosocial stressors, but after multiple recurrences, not only do precipitated episodes continue to occur, but so do spontaneous ones as well. We present the case report of a 62 years old woman, divorced, diagnosed with type 1 bipolar disorder since she was 20 years old. She always have had poor adherence to her medication and follow-up with Psychiatry consultation, with a non-containing sociofamily environment that does not promote clinical stability. Over the time, her admissions on the Psychiatry ward were more frequent and precipitated by adverse life events, mainly caused by the deteriorated relationship with her children.

The kindling model clarifies aspects of the longitudinal course of episode development, recurrence, and progression to spontaneity, as well as further conceptual and theoretical rationales for intervention in order to prevent illness progression.

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Mindfulness refers to a process that leads to a mental state characterized by non-judgmental awareness of the present moment experience, including one´s sensations, thoughts, bodily states, consciousness, and the environment, while encouraging openness, curiosity, and acceptance.

The purpose of this paper is to review the ways in which cognitive and behavioural treatments for depression and anxiety have been advanced by the application of mindfulness practices.

Brief non-systematic literature on the topic.

Mindfulness has spread rapidly in Western psychology research and practice, in large because of the success of standardized mindfulness-based interventions, consequently research on mindfulness based interventions (MBIs) has increased exponentially in the past decade. The most common include Mindfullness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT), which incorporate the essence of Eastern mindfulness practices into the Western cognitive-behavioral practice. MBIs have showed efficacy in reducing the severity of anxiety and depressive symptoms in a broad range of treatment seeking individuals. MBIs have also been showed to perform with not so different results to cognitive-behavioral therapy (CBT).

MBIs have been showed to be important co-adjuvants to pharmacological treatment and psychotherapy of depression and anxiety. To prove this point without doubts and create adequate guidelines that include these forms of treatment more research needs to be done on the matter.

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Schizophrenia (SCH) and bipolar disorder (BD) are severe mental disorders which lead to psychotic, affective and cognitive symptoms and often cause a progressive functional deterioration of the individual. The current diagnosis of SCH and BD essentially depends on clinical observation that often leads to misdiagnosis and the introduction of non-specific treatments. Therefore, an early detection and intervention are determinant for a better prognosis. Improving outcomes of a First Episode of Psychosis (FEP) depends mainly on the identification of reliable and discriminatory biomarkers between both disorders.

Given that oxidative stress has been tightly involved in multiple metal disorders, the major goal of this work was to characterize oxidative alterations in order to identify potential biomarkers which allow the differential diagnosis in an early stage.

The study was carried out on samples from 49 subjects (14 women and 35 men), divided into four groups: a control group of 10 individuals not previously diagnosed with any serious mental disorder, 17 patients who had presented a FEP, 12 patients diagnosed with SCH and 10 patients diagnosed with BP. Biochemical analysis were conducted in erythrocyte fraction to characterize the cellular oxidative damage by measuring lipid peroxidation (LPO) levels and the antioxidant defense system by the evaluation of catalase (CAT) and superoxide dismutase (SOD) activities.

In the present work, we observed a significant increase in LPO levels in both SCH and BD disorders that was not neutralized by the antioxidant defense. It was found that SCH patients, despite exhibiting greater activities of SOD and CAT compared to BD individuals, also showed significantly higher levels of oxidative damage. The differential oxidative profile observed between SCH and BD individuals allowed to perform an individually analysis of patients diagnosed with FEP. Although it was not possible to identify the type of psychotic disorder of all the patients with FEP, the results obtained showed that while several individuals exhibited an oxidative prolife similar to that observed in SCH patients, other individuals presented a prolife very similar to that found in patients with BD.

The current work reveals that LPO is a potential indicator of worse prognosis after being differentially modified in both SCH and BD. Moreover, SOD and CAT have been identified, by presenting an opposite profile between patients with SCH and BD, as potential preliminary biomarkers for a discriminatory diagnosis in an early stage of the disorder.

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Mental health problems increase the risk for unstable career paths and often lead to early transition to disability pensions. Individual Placement and Support (IPS) is an evidence-based program integrated into psychiatric care helping individuals with serious mental illness to find competitive employment. It comprises personalized job search as well as individual in-work support for both the employee and the employer.

The Finnish Individual Placement and Support Evaluation Study (2020-2023) aims at investigating the implementation, feasibility as well as perceived benefits and outcomes of the IPS program implemented for the first time broadly in Finland. The present study focuses on the changes observed among program participants in employment status and psychosocial well-being during the 6- and 12-months follow-ups.

Both quantitative and qualitative data from different stakeholders have been and will be collected. The data collection will be finished at the end of 2022. The presentation focuses on findings from interviews (n=31) and from questionnaire data collected among program participants at baseline and at 6- and 12-months follow-ups. The total sample will comprise approximately 300 program participants (18−64 years of age) diagnosed with a severe mental illness.

Findings on changes in employment status as well as in psychosocial well-being (self-rated health and work ability, mental distress, positive mental health, self-esteem, satisfaction with life, social inclusion, and perceived social support) will be discussed at the congress. The preliminary findings of the study show that about half of the program participants have succeeded in getting employed at least once during the follow-up. However, becoming employed does not always result in increased psychosocial well-being. Work-related stress, meaningless or unsuitable job, problems at the workplace community or fear of being stigmatized may contribute toward decreased psychosocial well-being.

Meaningful work can play an important role in the process of recovery from mental illness. However, individuals with severe mental health problems need support with the working life related concerns and stress especially at the beginning of employment.

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Binge eating behaviors are associated with psychological, social, and biological factors, while it is suggested that they may be triggered by negative emotions, including depression and anxiety, and provide relief from them, which in turn may lead to reinforcement of such behaviors.

This study aimed to examine the eating habits and in particular the binge eating behaviors of a sample of adults during the COVID-19 pandemic, an unprecedented challenge for public health and communities worldwide with multi-level consequences on people’s lives.

The sample consisted of 196 individuals residing in Greece aged 18 to 64 years (76.5% women), who completed an anonymous questionnaire from June to July 2021. This included the following psychometric instruments: Fear of COVID-19 Scale to assess the fear related to COVID-19, Rosenberg Self-esteem Scale to assess self-esteem, Depression Anxiety Stress Scale-21 to assess anxiety, depression and stress, Binge Eating Scale to assess binge eating behaviors, UCLA Loneliness Scale for the evaluation of the perceived feeling of loneliness and Reflective Functioning Questionnaire for the assessment of reflective functioning (i.e., the ability to understand human behavior in terms of underlying mental states).

The majority of participants (86.7%) reported that during the pandemic their diet was less healthy than before the pandemic onset, while almost half (46.4%) of the participants stated that they had experiences an episode of binge eating during the past 6 months, and 36.2% that they had used self-induced vomiting in order to control their weight. Of note, the results of a multiple regression analysis revealed that higher levels of fear of the pandemic as well as of depression were independently associated with higher binge eating, with women presenting higher mean scores in the Binge Eating Scale than men. Conversely, higher self-esteem appeared to be independently associated with lower binge eating levels, thus acting as a protective factor, whereas the remaining psychometric factors were not found statistically significantly related.

In conclusion, the findings of the present study highlight the importance of identifying dysfunctional eating behaviors and related psychological factors that may potentially act as risk or protective factors, especially during the pandemic.

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Long COVID patients have experienced a decline in their quality of life caused, in part but not wholly, by its negative emotional impact. Some of the most prevalent mental symptoms presented by Long COVID patients are anxiety, depression and sleep disorders.

The objective of this study is to increase understanding of the affective state of people diagnosed with Long COVID, the evolution and associated factors.

Longitudinal study of three months of duration. The study population was 100 post-COVID-19 patients aged 18 years or older (80 women and 20 men). The main variable was the affective state through the Hospital Anxiety and Depression Scale (HADS) questionnaire. The rest of the collected variables were: Socio-demographic variables, number of residual symptoms, cognitive functioning using the Montreal Cognitive Assessment (MoCA), physical functioning variable measured by Sit to Stand Test and Sleep quality through the Insomnia Severity Index (ISI). A statistical analysis comparing baseline and 3months follow up measures were performed, using a Student T for related samples statistical. A lineal regression analysing associated factors to a reduction in HADS score was also performed. Ethics approval was granted by the Clinical Research Ethics Committee of Aragón (PI21/139 and PI21/454).

At baseline the score in anxiety, depression and total score were 9,10 (SD: 4,67), 8,25 (SD: 4,51) and 17,35 (SD: 8,43) respectively, and 74% of the participants were considered cases. At three months, there is a slightly decrease but not significative in the score of HADS, both in anxiety, depression and total score (pvalue 0,465; 0,236; and 0,216 respectively). 64,4% of the participants had a positive diagnosis of depression/anxiety. About the rest of the variables there were also a slight decrease but without being significant There was not a predictive model that explained the decrease in the HADS score.

The evolution of the people suffering long covid is very slow along the time, and also the affective state.

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Treatment-resistant depression (TRD) is considered one of the major clinical challenges in the field of psychiatry. At least 15% of all patients with MDD remain refractory to any treatment intervention. Repetitive transcranial magnetic stimulation (rTMS) is considered a treatment option for patients with TRD. Additionally, iCBT is an evidence-based psychotherapy for the management of TRD.

This study aims to evaluate the clinical effectiveness of adding iCBT to rTMS treatment as an innovative combined intervention, exploring the short and long-term outcomes on patients with TRD

This study is a randomized controlled trial. Participants diagnosed with TRD were randomized to one of two interventions: rTMS alone and rTMS+iCBT. Each group completed evaluation measures at baseline, discharge (6 weeks), and one & three months after discharge. The primary outcome measure was the mean change in the Hamilton depression rating scale (HAMD-17) from baseline to three months.

Preliminary results for the early outcome of the study showed that after adjusting for the baseline scores, there was no significant difference in the mean score of HAMD-17 from baseline to six weeks between the participants of the two groups, (F (1, 53) = 0.15, p = 0.70, partial eta square = 0.003). The result of the long-term effectiveness is underway, forecasting the potential synergism of the two interventions.

This study found the combined treatment of rTMS + iCBT not to be superior to treatment with rTMS alone, in the short term. We hope the long-term results would thoroughly address the effectiveness of the combined therapy in this randomized controlled trial.

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Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by social and communication deficits and restricted and repetitive or stereotyped behaviours. The prevalence of ASD has been thought to be higher in men, which may reflect aspects of the own aetiology of the disorder. Still, it may also be associated with misdiagnosis or missed diagnosis of females with autism due to specific phenotypic traits.

To explore the differences between sex/gender in autism’s clinical presentation.

Non-systematic literature review using the most relevant papers found on PubMed and Google Scholar using the following keywords: “autism spectrum disorder”, “gender differences”, and “autistic women”.

Autistic women seem to have a “camouflage” phenomenon, characterized by a high level of functioning, less unusual play or restricted interests, better socio-emotional reciprocity and coping behaviours. Therefore, women with ASD commonly have an anteriority of multiple diagnoses, which delays their access to the support and care they need.

Professionals must be aware of the sex/gender clinical differences to prevent the misdiagnosis or missed diagnosis of females with autism. Moreover, the current clinical criteria used to diagnose ASD may underserve the female population and deserve to be reviewed.

None Declared

Long COVID is a condition characterized by long-term health problems persisting or appearing after the typical recovery period of COVID-19. Physical symptoms such as respiratory, neurological and musculoskeletal complaints were initially described in the foreground. A little after, psychological disorders have been widely reported.

The aim of this study was to screen for somatic and anxio-depressive disorders of Long COVID.

A cross sectional descriptive study included the patients consulting within a minimum of 1 month after a COVID-19 infection. It was conducted at Taher Sfar university hospital of Mahdia over a period of one year from March 2020 to March 2021. A questionnaire and physical examination were used to look for physical symptoms and the Hospital Anxiety and Depression scale (HAD) was used to screen for anxio-depressive disorders.

We recruited 137 patients. The median age was of 60 years with a sex ratio M/F at 0.073. Obesity was the most frequent comorbidity (36%) followed by diabetes (35%) and hypertension (32%). More than a quarter of patients was hospitalized (30%) during the acute phase, while the others (70%) were confined at home. The median stay duration at home or hospital was of 10 days with extremes ranging from 0 to 21 days. The most frequent post-COVID symptoms were dyspnea, mood disorders, myalgia, arthralgia, dry cough, sleep disorders and anorexia in 45%, 30%, 30%, 20%, 16%, 15% and 14% of cases, respectively. Pulmonary auscultation was normal in 86% of our patients, for the others we noted crackles, ronchi and wheezing among 9%, 1% and 1% of patients. The median oxygen saturation was 97% with a range from 93 to 99%. The majority of our patients (120) had saturation more than 95% in ambient air. The median HAD score was situated at 19 [8, 33]. Anxio-depressive disorders were present 61% of cases. A severe depression was noted among 24% of patients. and a severe anxiety among 28% of them.

Our study highlighted a high prevalence of anxio-depressive disorders (62%) which exeeds the prevalence described in the literature. The systematic use of the HAD scale among consultants could be the explanation. Thus, psychological screening and support should be considered when managing patients having a history of COVID-19 infection. Citizens should comply with the relevant legal provisions making vaccination compulsory as it was found that COVID-19 vaccination reduced long COVID risk.

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A new mental health service specialising in intellectual disabilities in Ireland was set up in January 2022. Its current compliment of staff includes is a Consultant Psychiatrist, Trainee Psychiatrist, Social Worker and Administrator. The current National Directive in Ireland is to prioritize Mental Health of Intellectual Disabilities services.

The aim of the project is to establish the current baseline level of diagnostics and interventions within the new service. Our aim is to develop this service by implementing and following the gold standard guidelines and determine what extra resources does the service need.

The first fifty case notes of patients assessed by the new service were inspected. The reviewer looked for evidence of the following clinical descriptions:Diagnosis of Intellectual Disabilities and its severity; Mental Capacity; Psychiatric Diagnoses; Physical health diagnoses; Medications and evidence of a Positive Behavioural Support Plan to manage complex challenging behaviours.

The fifty patient audit contained 38 (76%) men and 12 (24% women) . One patient had Mild Intellectual Disabilities (ID), 39 (78%) had Moderate ID and 10 (20%) had Severe ID. All patents were very vulnerable and had limited or lacking Mental Capacity. Common diagnoses of the following were recorded in the following numbers and percentages; - Autism diagnosis 30 ( 60% ); Epilepsy 19 (38%); & Down Syndrome 9 (18%). A Formal Psychiatric diagnosis was identified in 26 (52%) of patients. Challenging Behaviour (severe and complex) was identified for 41 ( 82%) of the patients. The full breakdown of psychiatric diagnoses was ‘Psychotic illness’ – 9 (18%); Anxiety – 7(14%); Bipolar Affective Disorder 5 (10%): Depression – 4(8%); Attention Deficit Hyperactivity Disorder (ADHD) 3 (6%); Obsessive Compulsive Disorder (OCD) – 2(4%); Dementia – 2(4%): Post Traumatic Stress Disorder (PTSD) – 1 (2%); & Schizoaffective Disorder 1(2%). A Positive Behavioural Support plan (PBS) was available to support 33 (66%) of patients.

42 (84%) of patients were prescribed antipsychotic medication. 12 (24%) were prescribed more than one antipsychotic. 20 (40%) were prescribed an antipsychotic without a formally documented diagnosis of a psychotic disorder. 12 (24%).

The results of this first survey highlight areas in which the service can be improved. The service has requested funding for a Community Nurse and a Psychologist. Psychological evaluations and Positive Behavioural Support plans are essential for people with complex challenging behaviours. A Community Nurse should assist with Health Promotion and help supervise patients requiring Depot Antipsychotic medication or Clozapine. We also plan to set up a joint clinic with the Consultant Neurologist on a regular basis.

None Declared