Lockdowns and social distancing resulting from the COVID-19 pandemic have worsened population mental health and made it more difficult for individuals to receive care. Electronic cognitive behavioural therapy (e-CBT) is a cost-effective and evidence-based treatment that can be accessed remotely. The objective of the study was to investigate the efficacy of online psychotherapy during the pandemic.

The purpose of the present study was to develop and administer an e-psychotherapy program for patients with depression and anxiety d), affected by the COVID-19 pandemic . The program aimed to significantly reduce stress and psychological distress in patients, from pre- to post-intervention.

Participants (n = 59) diagnosed with MDD and/or GAD, whose mental health symptoms initiated or worsened during the COVID-19 pandemic. The online psychotherapy program focused on teaching coping, mindfulness, and problem-solving skills. Symptoms of anxiety and depression, resilience, and quality of life were assessed.

From the participants assessed for eligibility, n = 14 did not meet the inclusion and exclusion criteria and n = 7 declined to participate. As a result, n = 59 participants commenced the study. In total, 21 participants dropped out of the study (n = 11 from Weeks 1-3, n = 7 from Weeks 4-6, and n = 3 at Week 7), and 38 participants completed the study. The large majority of the total sample identified as women (n = 41, 69%). Two participants identified as Other and both dropped out of the treatment at Weeks 4 and 6, respectively. The average age of the sample was 32.26 (SD = 12.67). No significant differences were observed at baseline for any demographic variables or scores of treatment completers and dropouts . A significant difference was observed between the number of sessions completed by those who dropped out and those who finished the program (p < 0.001). On average, treatment dropouts completed approximately 41% of the treatment before dropping out.

Participants demonstrated significant improvements in symptoms of anxiety (p = 0.023) and depression (p = 0.029) after the intervention. Similar trends were observed in intent-to-treat analysis. No significant differences were observed in resilience and quality of life measures.

The evidence strongly suggests that online psychotherapy can supplement the current care model. Although no changes in quality of life or resilience were reported, these findings may be due to the persistent environmental challenges that are outside the normative levels observed pre-pandemic. While the efficacy of e-CBT has been observed across various populations, it is warranted for future studies to investigate the role of gender in treatment availability and help-seeking.

E. Moghimi: None Declared, M. Omrani Shareolder of: OPTT inc, A. Shirazi: None Declared, J. Jagayat: None Declared, C. Stephenson: None Declared, N. Alavi Shareolder of: OPTT inc

Psychotherapy is a treatment of proven efficacy in bipolar disorder (BD), but little is known about the molecular and cellular mechanisms that it produces in the brain. Brain-derived neurotrophic factor (BDNF) is thought to be important in neuroplasticity and could be increased by psychopharmaceuticals and psychotherapy in BD patients, but evidence in the literature is limited.

To analyze the scientific studies that relate psychotherapies with the increase in BNDF levels in patients with BD.

Systematic review with PRISMA recommendations in PUBMED and Web of Science in July 2022. The search was performed using the combination of keywords “bipolar disorder” AND (“BDNF” OR “Brain Derived Neurotrophic Factor”) AND “psychotherapy”.

With the initial search, 839 studies were obtained, finally 8 articles were analyzed. The available literature supports the role of psychotherapy in increasing BNDF in patients with BD.

BDNF could be a biomarker of therapeutic efficacy in BD. Psychotherapy increases BDNF levels. No differences were found between the different types of psychotherapies. More studies are needed to determine the mechanisms by which psychotherapies produce molecular changes in the brain.

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Culture and ethnicity are crucial to our identity and responsible for our health, values and thereby to our satisfaction from work.

To this end, this study focused on the minority groups of ultra-orthodox women in their work sphere and examined differences between women who work within the enclave, women who work both with ultra-Orthodox and other sectors of the Israel society and women who work mainly outside the ultra-Orthodox enclave on the different study variables. Moreover, a model which include main resources [family, community, diversity climate perceptions (in the job environment) and inclusive leadership] as potential explanatory factors of employees’ satisfaction from work and mental health.

Data were gathered from 304 ultra-Orthodox women who belong to various streams in this society, who were recruited by the Midgam research panel. The participants filled out self-reported questionnaires among which family quality of life, community sense of coherence, diversity climate, inclusive leadership, job satisfaction and mental health. The participants’ age ranged between 19-64 years (M=30.86 SD=8.71).

The explanation of the full model for jobs satisfaction was: 46% of the variance among women within the enclave, 60% among women who work in mixed environment, and 53% among women who work outside the enclave. As for mental health: 22% of the variance among women within the enclave, 17% among women in mixed environment, and 41% among women outside the enclave.

The results are analyzed through the lens of Bronfenbrenner’s ecological theory and show that in traditional societies such as the ultra-Orthodox one, the most important factors for job satisfaction and mental health are family and communal resources.

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Behavioral addictions (with related behaviors often conducted online) constitute new categories within the Diagnostic and Statistical Manual (DSM) and International Classification of Diseases (ICD). In both, gambling disorder is listed as a formal clinical diagnosis whereas disorders related to videogaming exist in the DSM (research criteria) and ICD (clinical criteria). However, a broader range of disorders related to other behaviors (e.g., shopping/buying, social media use, pornography use) have been proposed as possible behavioral addictions.

This presentation will provide insight in efforts by major organizations (e.g., the World Health Organization) to consider behavioral addictions and how best to screen for, assess and intervene to help people with these conditions. Empirical data influencing the classification of the behaviors and disorders will be presented. Changes in online behaviors during the COVID-19 pandemic will be considered with respect to mental health concerns.

Multiple methods ranging from results of neuroimaging studies, clinical trials, and longitudinal investigations will be presented.

Brain imaging results suggest similarities between specific internet-use behaviors (especially internet gaming disorder) and substance use disorders, supporting a classification as behavioral addictions. Multiple types of internet use increased during the pandemic, particularly during the onset. Different patterns of mental concerns in relation to internet use behaviors were seen during the pandemic. Consensus guidances regarding how best to avoid and address problematic use of the internet were developed and disseminated. Clinical trials support the efficacy of behavioral and neuromodulatory approaches, although no treatments have regulatory approval for behavioral addictions.

Multiple internet-use behaviors may form the basis of behavioral addictions. While considerable data exist for internet gaming disorder, other behaviors commonly performed on the internet also warrant consideration. Additional research is needed to develop, test and implement more effective prevention and treatment strategies.

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Impulsive personality Traits have been highly associated with both alcohol abuse and drug addiction, but have been accorded little attention in the context of food addiction.

To study the relationship between impulsivity and food addiction in school-aged adolescents.

It is a cross-sectional, descriptive and analytical survey, conducted in a sample of secondary school students, randomly collected in 6 schools in the region of Sfax during February 2022. A pre established form of 33 questions, including socio- demographic and family information was used. Impulsivity was evaluated by the Barratt Impulsivity Scale (BIS-11; Patton et al., 1995). The BIS is a 30-item questionnaire that measures impulsivity along the following dimensions: cognitive, motor, and non-planning. The validated arabic version was used. *

The 25-item Yale Food Addiction Scale (YFAS), validated in Arabic, was used to assess food addiction in adolescents.

Our sample consisted of 360 adolescents, with an average age of 16.62 years, being male in 52.2% and with a low to medium socio-economic level in 72.7% of them.

A total of 20% of the adolescents showed a tendency to impulsivity, 23.6% had impulse control disorder.

The food addiction score of our sample ranged from 0 to 56 with an average of 16.37 ± 12.380.

The average food addiction score for adolescents with impulse control disorder was 20.21 ±14.819 while the average food addiction score for adolescents without impulse control disorder was 15.18 ± 11.291.

Food addiction was strongly associated with impulsivity (p < 0.001).In particularly, Non-planning impulsivity was most strongly correlated with food addiction (p < 0.001, r ꞊ 0.252)

Impulsivity, commonly related to addictive substance use behaviors, may be a significant risk factor for food addiction. Early monitoring of impulse control disorder may help to reduce addictive food consumption.

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The use of selective serotonin reuptake inhibitors (SSRIs) has increased exponentially and worldwide in the last decade. Taking into account their tolerability and safety profile, they constitute the first line, in all age groups and in polimedicated population, for treatment of depressive, anxious, and phobic disorders, among others. Although safe, especially when compared to first generation antidepressants, they are not totally exempt of adverse effects, and may cause, especially in this context, some degree of cognitive impairment, which may or may not be completely reversible. On the other hand, and despite the controversy related to the subject, some studies suggest a possible protective effect of this pharmacologic class regard the development of cognitive disfunction, which, although not very consistent, should not be neglected.

To understand the cognitive impact of short- and long-term use of SSRIs, given the increasing use in an aging, polymedicated population.

Brief sistematic review of selected articles from Pubmed, Medline and Uptodate databases, with the keywords “SSRIs”, “cognitive”, “impairment”, “adverse effects”, “dementia”.

SSRIs are not entirely exempt from cognitive effects, despite their recognized safety profile. Some of the adverse effects typically related to the class, such as hyponatraemia, especially when insidious and silent course, as well as anticholinergic activity (typically associated with first generation antidepressants, but not exclusive) interfere with global functionality and may clinically present as mild cognitive impairment or even major neurocognitive disorders. Furthermore, given their potential to induce or inhibit the cytochrome P450 system, they are significantly implicated in pharmacokinetic drugs interactions that increase cognitive burden associated with other psychotropic drugs.

In the long term, and in certain patient populations, it has been hypothesized that they may exert some protective effect on physiological and pathological cognitive functions decline, by preventing neuronal death, acetylcholine decrease and amoyloidogenesis.

Despite their benign adverse effect profile, when compared with tricyclic antidepressants, SSRIs are not devoid of adverse effects on cognitive domains. However, and despite contradictory and inconsistent results, when well tolerated, SSRIs may confer benefits in terms of preserving global functionality, far beyond the affective symptoms resolution that motivated their introduction in the first place.

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A natural disaster like flooding causes loss of properties and evacuation and effective mental health. Resilience after natural disasters is a crucial area of research which needs attention.

To explore the prevalence and associated factors of low resilience a year after the 2020 floods in Fort McMurray.

A cross-sectional study was conducted in Fort McMurray using online surveys. The data were analyzed with SPSS version 25 using univariate analysis with the chi-squared test and binary logistic regression analysis.

The prevalence of low resilience was 37.4%. Respondents under 25 years were nearly 26 times more likely to show low resilience (OR= 0.038; 95% CI 0.004 - 0.384). Responders with a history of depression and anxiety (OR= 0.212; CI 95% 0.068-0.661) were nearly four to five times more likely to show low resilience. Similarly, respondents willing to receive mental health counselling (OR=0.134 95%CI: 0.047-0.378) were 7.5 times more likely to show low resilience. Participants residing in the same house before the flood were almost 11 times more likely to show low resilience (OR=0.095; 95% CI 0.021- 0.427), and support from the Government of Alberta was a protective factor.

The study showed demographic, clinical, and flood-related variables contributing to low resilience. Receiving support from the Government was shown to be a protective factor against low resilience. More robust measures must be in place to promote normal to high resilience among flood victims in affected communities.

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Knowing mental representations about the phenomenon of illness and medical care allows the clinical team to have better emotional handling of their patients, with gains in greater adherence to treatments. Graves’ Ophthalmopathy is an inflammatory disease with primary involvement of the extraocular muscles and orbit, being the most frequent extrathyroidal manifestation of Graves’ Disease. Many patients have psychological status changes even after successful treatment of hyperthyroidism, especially when the disfiguring signs of ophthalmopathy are predominant. An understanding of the symbolic aspects linked to this condition help doctors and nurses to have a relationship more harmonious with them.

To interpret emotional meanings in reports of patients with euthyroidism and with ophthalmopathy under follow-up at a specialized university endocrinology outpatient follow-up, discussing contradictions perceived between a stigmatized body and clinical-laboratory euthyroidism.

Clinical-Qualitative design of Turato. Data was collected using Semi-directed interviews with open-ended questions in-depth, carried out with patients at a university hospital specialized outpatient service in South-eastern Brazil. The interview material was audio-recorded and fully transcribed. The interviews were treated by Clinical-Qualitative Content Analysis described by Seven Steps’ Faria-Schützer. It is based on psychodynamic concepts from the Medical Psychology theoretical framework, whose main author is Michael Balint. The sample was closed by the Theoretical Saturation of Information studied by Fontanella and cols. The finding validation has occurred by peers at the Laboratory of Clinical-Qualitative Research, State University of Campinas, San Paolo.

The sample was composed by 10 patients. From the search of nuclei of meanings in the reports, four categories of analysis were constructed: 1) “No, this is not normal, I must have cancer”: psychodynamics of the doctor-patient relationship in Graves’ Disease; 2) Types of illness according to their manifestations and auto-perception: silent illness and non-silent ones; 3) “The eyes are everything”: the impacts of the disfiguring alterations of ophthalmopathy; 4) The contradiction perception between clinical and laboratory normality the stigmas of ophthalmopathy.

The patients with severe exophthalmos, maintained emotional distress despite being euthyroid, manifested by various emotional meanings reported in the interviews. The clinical-laboratory diagnosis of Graves’ Disease alone is not sufficiently capable of responding to the psychological demands of the patients. Proper listening to emotional symbolic meanings attributed by patients can help physicians and nurses in handling this setting

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Telepsychiatry (TP) uses communication technology to provide psychiatric consultation to patients unable to reach consultation services. Due to COVID-19 outbreak, many mental health services implemented TP. The University of Milan developed a patient-specialist video consultation service: the Cure Ospedaliere Domiciliari (Home Hospital Care system; COD20).

The aim of the study was to assess the digital skills of the mental health professionals and to assess both the confidence and the satisfaction with the COD20 platform, as well as their skills in handling certain degrees of technostress.

Mental health professionals of the outpatient clinics of the department were interviewed through an online anonymous survey. Data collected were sociodemographic, job position, educational level, digital skills, adequacy of devices in the workplace, satisfaction degree, ease of use of the COD20 tool, as well as main technostress score. Data were analyzed using SPSS v.27.

Among 95 subjects, more than 95% of the sample is familiar with the use of electronic devices, such as smartphones, tablets, and computers; 93% employs appropriate devices in the workplace. Only 12% had an ECDL certificate, while the majority of the sample (77%) learnt the use of electronic devices independently. The levels of the digital skills were considered intermediate-advanced for communication and information research. Despite all the respondents being aware of the use of COD20, only 50% received adequate training; 77% deemed it worthwhile to attend an individual or a group training (40% vs 43%). Telemedicine was used for clinical interviews by 80% of the sample: 41% of these used Telemedicine at least 10 times/year, 18% between 10 and 20 times/year, and 42% more than 20 times/year. With regard to the appreciation of the COD20 platform, 75% of the sample considered this tool useful, while 61% considered it easy to use. There is a significant correlation between the ease of use and a higher level of education (p<0,00). Among all categories, psychologists were more likely to use the platform compared to other workers ( p=0,016). The average score of technostress among operators was 22.78±6.84 (maximum score: 45).

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TP can improve mental health professionals’ working conditions. The COD20 platform represents a valid implementation in mental health care. It is necessary to provide training and updated programs for healthcare workers in order to facilitate the use of TP tools.

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There are serious adverse effects on the physical and mental wellbeing of patients with alcohol use disorders.

It is important to screen and provide brief intervention for these group of patients during their inpatient admission.

Prompt identification and treatment of patients with alcohol use disorders are contingent on the attitudes of healthcare workers towards them.

Non-psychiatric doctors and nurses might respond inadequately due to negative attitudes and beliefs.

We examined the attitudes of non-psychiatric workers in the medical and surgical wards.

The Alcohol & Alcohol-Problems Perceptions Questionnaire (AAPPQ) was administered to 128 doctors and 785 nurses from the medical and surgical disciplines in a tertiary hospital.

75.5% of doctors and 51.9% of nurses endorsed the domain of role legitimacy in the AAPPQ.

However both groups reported low-levels of role-adequacy (combined: 41.2%), role-support (combined: 36.9%), motivation (combined: 36.5%), task-specific self-esteem (combined: 25.1) and work satisfaction (combined: 20.5%) in the AAPPQ.

While non-psychiatric healthcare workers acknowledged the importance to initiating intervention for patients with alcohol-use disorder in daily work, there were low levels of therapeutic commitments towards patients with problematic alcohol-use.

It is vital to introduce in-house programmes to educate, empower and emphasise the importance of therapeutic contact with patients for alcohol intervention.

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The actual pandemic of COVID 19 is a very unusual yet real situation we are facing. It has affected people in both physical and psychological way. In fact,in such particular circumstances, so many people experience stress, anxiety and depression.Objective

The goal of our study is to emphasize theanxiety among patients who were tested positive with COVID 19 , using the HAD scale.

It is a retrospective study single-centerstudyPatients are collected from a database of the Sahloul emergency COVID unit. We include patients whose age is greater than or equal to 18 years old who has been infected with SARS-COV-2 according to the results of the PCR test. All patients lost to follow-up, refusing to participate in this study, having a psychiatric illness or having taken a psychotropic medication before randomization or non-cooperating (unable to respond to the evaluation test) were excluded. At 30 days follow up, anxiety was evaluated by HAD scale.

200 patients were included in this study.In our study, 98 patients had symptoms of anxiety (49%) after one month of their consultation in the emergency room; i.e. 39% have a doubtful symptomatology of anxiety and 10% have a certain symptomatology. Half (51%) of the patients had no signs of anxiety depression. The average age of the patients in whom the presence of definite anxiety symptoms was noted was 56.2 years; 63.7% of these patients were female. No difference was noted in relation to the pathological history. Patients in whom the symptoms of anxiety were certain presented a persistence of clinical signs for 10.7 days in average as opposed to 7.1 days in patients without anxious symptoms (p<0.001).

Anxiety is so common among COVID 19 patients and it has a huge influence on the evolution of their health state . This is why all health workers have to fight against COVID and its effects on both physical and mental health . Highlighting the fact that a psychological assistance is highly recommended in the management ofCOVID19 patients in order to improve their prognosis

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The co-construction of conjugality is influenced by the interactions established in the family as a whole. It manifests itself, therefore, as a relational model in the expression of affectivity and the management of conflicts.

In this clinical case report, the couple assumes relational difficulties focused on the significant reduction of time in individual leisure activities and, on the other hand, a 24-hour coexistence in the same space, in a period of compulsory confinement due to the COVID-19 pandemic.

This study is exploratory-descriptive, using the case study as an empirical approach.

The case described, reports to Couples Therapy, with the sessions taking place in 2022, in a total of seven. The couple, N, male, and J, female, have been married since 2020, shortly before the first confinement because of the COVID-19 pandemic. Regarding their marital relationship, they reported that it deteriorated due to the difficulty in expressing an adaptive reaction to the stressor confinement and the opposite position regarding their desire to become parents.

Integrative strategies were developed, with different theoretical and operative references. The couple took control of their relationship due to a greater empathic awareness and the establishment of a healthy and balanced communication system.

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Schizophrenia is characterised by a loss of contact with reality due to the presence in its symptomatology of a delusional and/or hallucinatory syndrome, also called positive symptoms and/or a dissociative syndrome, which reflects the negative component of the disease. Few studies suggest a probable link between testosterone and the symptomatic dimension of schizophrenia, but this subject remains poorly documented.

The purpose of this study was to describe Testosterone profile in male patients with schizophrenia who are naïve to antipsychotic treatment or have been off it for at least two months and to investigate the relationship between testosterone levels and disease severity.

This was a descriptive, cross-sectional study of fifty male patients hospitalized for a psychotic relapse who were naïve or discontinuing treatment for at least two months. Patients were assessed using a semi-structured questionnaire and The Positive and Negative Syndrome Scale (PANSS). A blood sample was taken to measure testosterone level.

The age of the patients included ranged from 17 to 65 years, with an average of 36.4±11.51 years. The PANSS score ranged from 50 to 195 with a mean of 116.76 +/- 31.817. Testosterone values ranged from 2.01 to 10.03 ng/ml with a mean of 4.74± 2.01 ng/ml. The majority had normal testosterone levels (94%) ; only 4% had high values and 2% had low values. A positive correlation was found between the positive component of PANSS and elevated testosterone (p=0.011). For the other subscales, no correlation with testosterone levels.

The present study is in favour of a testosterone aggravation of the mostly positive clinical signs of the disease in a significant way. Hormone assays could thus be a specific marker of certain patient profile with a particular evolution.

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Sexual dysfunctions (SD) are common in patients with schizophrenia. The link between schizophrenia and sexuality is complex. Studies have shown that SD can be linked to the side effects of antipsychotic medications, but also to symptoms of illness.

To identify the clinical and therapeutic factors associated with SD in outpatients with schizophrenia.

A cross-sectional and analytical study was conducted between Mars and September 2019. It included 53 outpatients with schizophrenia in clinical remission for at least two months.

We used the Positive and Negative Symptom Scale (PANSS) to assess clinical symptoms and the Arizona Sexual Experiences Scale (ASEX) to assess sexual functioning.

The average age was 42.28 ±10.49 years old. The sex ratio was 3.81. The mean age of onset was 27.09±5,46 years. The mean duration of illness was 18.11±9.29 years. First-generation antipsychotics were prescribed in 77.4% of cases, while second-generation antipsychotics were prescribed in 39.6% of cases.

The average ASEX score was 19.77±5.99, and 67.9% of participants had at least one SD. the analytical study revealed significantly higher average scores for the PANSS-negative subscale (p=0.006) and the PANSS total score (p=0.04) in patients with SD. SD correlated with first-generation antipsychotic treatments (p=0.02).

Our results show that SD are frequent in patients with schizophrenia and that they are related to the severity of the symptoms, in particular the negative symptoms of illness, and the prescription of first-generation antipsychotics.

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Machine learning (ML) approaches are a promising venue for identifying vocal markers of neuropsychiatric disorders, such as schizophrenia. While recent studies have shown that voice-based ML models can reliably predict diagnosis and clinical symptoms of schizophrenia, it is unclear to what extent such ML markers generalize to new speech samples collected using a different task or in a different language: the assessment of generalization performance is however crucial for testing their clinical applicability.

In this research, we systematically assessed the generalizability of ML models across contexts and languages relying on a large cross-linguistic dataset of audio recordings of patients with schizophrenia and controls.

We trained ML models of vocal markers of schizophrenia on a large cross-linguistic dataset of audio recordings of 231 patients with schizophrenia and 238 matched controls (>4.000 recordings in Danish, German, Mandarin and Japanese). We developed a rigorous pipeline to minimize overfitting, including cross-validated training set and Mixture of Experts (MoE) models. We tested the generalizability of the ML models on: (i) different participants, speaking the same language (hold-out test set); (ii) different participants, speaking a different language. Finally, we compared the predictive performance of: (i) models trained on a single language (e.g., Danish) (ii) MoE models, i.e., ensemble of models (experts) trained on a single language whose predictions are combined using a weighted sum (iii) multi-language models trained on multiple languages (e.g., Danish and German).

Model performance was comparable to state-of-the art findings (F1: 70%-80%) when trained and tested on participants speaking the same language (out-of-sample performance). Crucially, however, the ML models did not generalize well - showing a substantial decrease of performance (close to chance) - when trained in a language and tested on new languages (e.g., trained on Danish and tested on German). MoE and multi-language models showed a better increase of performance (F1: 55%-60%), but still far from those requested for achieving clinical applicability.

Our results show that the cross-linguistic generalizability of ML models of vocal markers of schizophrenia is very limited. This is an issue if our first goal is to translate these vocal markers into effective clinical applications. We argue that more emphasis needs to be placed on collecting large open datasets to test the generalizability of voice-based ML models, for example, across different speech tasks or across the heterogeneous clinical profiles that characterize schizophrenia spectrum disorder.

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Systemic inflammation has been increasingly related to bipolar disorder -BD- (Tanaka et al. Neurosci Res 2017;115 59-63). Intestinal bacterial translocation has been postulated as one of the causes of this inflammation (Nguyen et al. J Psychiatr Res 2018;99 50-61). A possible pathway is through the lipopolysaccharide, which is presented to CD14 through lipopolysaccharide binding protein (LBP) leading to a release of systemic inflammatory markers like C-reactive protein (CPR) (Funda et al. Infect Immun 2001;69 3772-81).

1) Describe gut permeability in patients with BD through the determination of intestinal inflammatory markers (LBP, sCD14) in plasma; 2) Analyze variables associated with intestinal inflammation.

Cross-sectional study of 38 patients with BD [mean age=45.50 (SD=10.93; range 23-68); males=15 (39.5%)], recruited from mental health outpatient clinics in Oviedo (Spain).

Assessment: Pro-inflammation biomarkers [CRP (mg/dL), Erythrocyte Sedimentation Rate (ESR) (mm/h), Neutrophil/Lymphocyte, Monocyte/Lymphocyte, Platelet/Lymphocyte and Systemic Immune Inflammation Indexes]. Indirect markers of intestinal bacterial translocation [LBP, soluble CD14 (sCD14)]. Dichotomous variables were created for LBP, considering LBP ≥15 μg/dL as increased gut permeability; and for CPR, considering CRP≥0.3 as systemic inflammation. Metabolic syndrome [ATPIII criteria: glucose, HDL, triglycerides (mg/dl), arterial pressure (mmHg), abdominal circumference (cm)], body mass index (BMI) (kg/m2), smoking, cannabis or alcohol use.

Statistical analyses: t-Student test, multiple linear regression analyses.

Average LBP was 14.60 μg/dL (SD=6.4) and 15 patients (39.5%) had increased gut permeability. Moreover, average CPR was 0.40 mg/dL (SD=0.58) and 16 patients (47.1%) showed systemic inflammation. There were no patients with increased levels of sCD14.

Associations were found between LBP and CPR (r=0.357; p=0.032), cannabis use in the last month (t=-2.293; p=0.029), BMI (r=0.433; p=0.008) and abdominal obesity (t=3.006; p=0.005); but no with age or sex.

Subsequently, a multiple linear regression model for LBP was calculated with variables previously mentioned, and age (based on expert criteria). The overall regression was statistically significant (R2=0.49, F=9.273, p<0.001). It was found that CPR, abdominal obesity, and cannabis use in the last month significantly predicted LBP levels (table 1).Table 1.Multiple linear regression analyses to LBP

More than one third of patients with BD had increased gut permeability. Almost 50% had systemic inflammation. Intestinal permeability was directly related to abdominal obesity and systemic inflammation, but inversely related to cannabis use.

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In this fourth session of our motivational interviewing workshop, we will go from theory to practice through simple and direct examples from clinical practice. The participants will be able to watch previously filmed clinical cases and participate in role plays, where they can practice using different motivational interviewing techniques that they had learned before.

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Fear of sleep (nyctophobia), has been attributed to myriad conditions ranging from benign nocturnal panic attacks and Morvan’s syndrome (Ekambaram, 2021). Positional dependent hyposmia as an origin of nyctophobia has not heretofore been described.

Increase awareness for correlation between nyctophobia and hyposmia in individuals with COVID-19.

This 52-year-old woman presented with sudden onset of loss of smell and taste with COVID-19, which returned to 85% of normal. Five months prior to presentation she was reinfected with COVID-19, and her smell and taste dropped to 20-50% of normal which improved. However, her symptoms worsened when she would lie down, to 30% of normal, but would improve with standing, moving and sitting. Even reclining for a short nap caused her sense of smell to drop, requiring her to stand for hours before her sense of smell would return leading to her nyctophobia that forced her to move around all the time. She altered her lifestyle and assiduously avoided lying down. When so overwhelmed by tiredness she would sleep sitting up. Prior to her chemosensory problems she slept well without any fear of lying down or sleeping.

Psychiatric exam: speech: coherent, relevant without circumstantiality, normal pace and volume. Mood: normal. Oriented x 3. Able to remember 7 digits forward and 5 backwards. Able to recall 3/4 objects without reinforcement. Interpretation of similarities: normal. Proverbs: normal. Calculation: normal. Neuropsychiatric testing: Clock Drawing Test: 4/4 (normal). Animal Fluency Test: 22 (normal).

Nyctophobia, fear of positional dependent loss of smell, highlights the importance of smell to narcissistic perception of self. More than just one of senses, olfaction is important for mood regulation, memories and quality of life. Associated with chemosensory dysfunction, this is associated with 96% incidence of DSM-IIIR Axis I or II diagnoses, with the most common Axis I diagnosis being generalized anxiety disorder and dysthymia (Hirsch, 1996). This can be understood that the olfactory lobe is anatomically part of limbic system (MacLean, 1973). Smell fascilitates socialisation as well as maintaining interelationships; sexual dysfunctioning is seen in 17% of the population with olfactory loss (Hirsch, 1998). Deposition of memory engrams are facilitated as manifest with olfactory evoked nostalgia seen in 84% of the general population (Hirsch, 1992). Quality of life is reduced in 68% of patients who demonstrate smell loss (Deems, 1991). The importance of smell is thus intrinsic to an individual’s wellbeing, and the threat of loss of such sensation with change in position with sleep, was the precipitating event leading to nyctophobia in this subject. Assessing for fear of loss of smell in those with nyctophobia, especially with past COVID-19 infection, allows for increased understanding of etiology and indicates potential treatment approaches.

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Dr. Pereira-Sanchez will discuss how the climate change emergency apeals psychiatrists and demands both personal and organized responses. Such responses are in the domains of awareness, research, education, and action. Dr. Pereira-Sanchez will present specific examples from his collaborative work at the World Network of Psychiatric Trainees, where a global forum about the topic for trainees was organized, and the World Psychiatric Association, where he assists the coordination of a Tri-Sectional initiative on the topic.

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The Coronavirus disease (COVID-19) pandemic affected the mental health of many individuals, especially vulnerable communities, who have experienced multiple traumas.

To examine the prevalence and associated factors of likely major depressive disorder (MDD) among inhabitants of Fort McMurray.

A study adopted a cross-sectional design, and questionnaires were distributed online. Sociodemographic, COVID-19-related, and clinical data were obtained. The Patient Health Questionnaire (PHQ-9) scale was used to assess likely MDD. SPSS version 25 used employed to analyze the data.

The prevalence of likely MDD among participants was 45%. Participants who desire mental health counselling are more likely to exhibit depression symptoms during the COVID-19 pandemic (OR = 5.48; 95% CI: 1.95–15.40). History of depression (OR = 4.64; 95% CI: 1.49–14.44) and hypnotics (OR = 5.72; 95% CI: 1.08–30.30) were more likely to experience depression symptoms during the pandemic than other participants without a history. Participants who received absolute support from the employer (OR = 3.50; 95% CI: 1.24–9.82) were protective against depression symptoms amid the pandemic.

Clinical factors and employer support are associated with depression symptoms during the pandemic. Communities that have experienced multiple traumas need to reduce any psychopathology, and governmental bodies need to implement holistic policies to increase support to individuals during traumatic eras like the CVID-19 pandemic.

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