This is a case aboout a 12-year-old girl, lives with her mother, father and younger brother. Parents originally from Peru, the patient was born in Spain.

She started follow-up by Mental Health in May 2022 due to low self-esteem after school bullying. The parents report that she has always been a shy child with many insecurities; she has always been insecure and suspicious in her relationships with peers, but during the last school year she was more nervous and insecure with everything that had happened to her; this situation was the reason for requesting a consultation at an Infant-Juvenile Mental Health Center when the school year was about to end.

In October she went to the emergency department accompanied by her parents because she seemed different in the last few days. A few days ago, while the patient was returning on the school bus, the patient began to write to her mother commenting that her classmates were imitating her, and that she noticed strangers not only in her classmates but also in her teachers, and in her own parents, thinking that they were imitating her. She had not slept well for several days.

In the interview alone with the patient, she was distrustful, hypervigilant, referring that the therapists were imitating her. She verbalized delusional ideation of harm and auditory hallucinations with high distress and emotional repercussions. She also presented slightly disorganized speech and formal thought disorders. In the last few days she had also been aggressive towards her younger brother and mother.

She had presented a febrile condition two weeks ago that subsided with antibiotics.

As a family history, she has a father’s aunt diagnosed with paranoid schizophrenia.

Due to the seriousness of the situation and the impossibility of performing an outpatient approach, it was decided to perform an urgent admission to the Infanto-Juvenile Brief Inpatient Unit with the objectives of performing a diagnostic affiliation, organic screening and evolutionary follow-up.

Due to the febrile picture that had presented two weeks ago, and the recent onset of symptomatology, it was decided to request the following tests: abdominal ultrasound, cranial MRI and electroencephalogram. All tests were normal.

Due to the normality of the complementary tests requested, it was diagnosed as F29 Non-organic psychosis without specification. Treatment with Risperidone was started.

Two months later, the patient has had a good evolution, but still continues to present psychotic symptoms, such as auditory hallucinations and delusional ideation of harm, but with less impact than at the beginning.

The evolution of the case points to a possible diagnosis of Schizophreniform Disorder, due to the persistence of psychotic symptoms, less than 6 months after the debut.

Due to the age of the patient, we would be facing a diagnosis of VEOS (Very Early Onset Schizophrenia).

None Declared

The hormonal mediators of the stress response, such as glucocorticoids and catecholamines, have both protective and damaging effects on the body. In the short term, they are essential for adaptation, maintenance of homeostasis, and survival; but chronic exposure to stress or abnormalities in the modulation of the stress response can become maladaptive, leading to a broad range of physical and mental problems.

Allostatic load refers to the activation of physiological regulatory systems in response to stress and “the cost” of the effects of these systems on the body. Results from isolated biomarkers and allostatic load measures based on the stress response system (hypothalamic-pituitary-adrenal axis, autonomic nervous system and immuno-metabolic biomarkers) and its relationships with clinical outcomes, such as cognition, in a clinical sample of major depression patients will be presented. The usefulness and relevance in the clinical practice of those biomarkers and the allostatic load concept will be discussed. The integration of several biomarkers translating the biological and psychological impact of stress on depression development and its clinical trajectories could contribute toward understanding how to prevent and improve outcomes in major depression.

V. Soria Grant / Research support from: Instituto de Salud Carlos III and the Bellvitge Biomedical Research Institute

As much as one fifth of hospitalized patients with dementia may have sleep disturbance which may impair daily functioning, cause lower quality of life, chronic stress and consequently even deterioration of physical health. We hypothesized that multimorbidity may be one of many causes of higher incidence of sleep disturbances in hospitalized patients with dementia. Multimorbidity may be defined as having two or more chronic medical conditions. In 2018, the U.S. Academy of Medical Sciences declared studies on multimorbidity a global priority, noting the lack of research and the clinical importance and complexity of the problem.

To assess the association of chronic physical multimorbidity (CPM) with the quality of sleep, in population of hospitalized patients with dementia.

We performed a cross-sectional study at University Psychiatric Hospital “Sveti Ivan”, Zagreb, Croatia. We selected a consecutive sample of patients diagnosed with mild or moderate dementia. The outcome was quality of sleep assessed by the Pittsburgh Sleep Quality Index. We recoded the number of chronic medical conditions from the hospital electronic health records, and defined multimorbidity as ≥ 2.

After the adjustment for possible confounders: age, gender, duration of hospitalization, dementia severity and treatment, patients having a CPM had 2.5 times higher odds for sleep disturbance than patients with no, or with only one chronic medical condition (OR=2.51; 95% CI 0.60-4.41; p=0.011). This association between CPM and sleep disturbance was markedly stronger in women (OR=3.42; 95% CI 0.40-6.45; p=0.029) than in men (OR=1.73; 95% CI -0.66-4.14; p=0.145). In patients with three, and four chronic medical conditions the odds for sleep disturbance growth rapidly (OR=3.65; 95% CI 0.53-6.77; p=0.023; OR=4.71; 95% CI 1.40-8.03; p=0.007, respectively).

Chronic multimorbidity is associated with sleep disturbance in patients with mild or moderate dementia.

None Declared

Positive psychiatry is broadly defined as the science of understanding and promoting well-being through interventions that involve positive psychosocial characteristics (PPCs) in people suffering from, or are at high risk of developing mental and physical illnesses (Jeste et al. JCP 2015; 76 675-683). Over the past 3 years, as the pandemic tested the limits of what our minds and bodies can handle, there has been an upward trend in the incidence of mental health conditions, including overdoses, suicide, and substance use (Czeisler et al. MMWR 2020; 69 1049-1057). COVID-19 has highlighted the relationship between the environment and individual mental health, most notably as people have faced increased social isolation, loneliness, and stress (Jeste. SB 2022; 48 533-535). The tools of positive psychiatry can be utilized to further address and target these deteriorations in mental health in hopes of improving outcomes.

To educate about the modality of positive psychiatry and how it can be an especially critical tool in treating mental health in the post COVID-19 era. To advocate for the incorporation of positive psychiatry practices into the training curriculum of mental health care providers.

A literature review was conducted using Google Scholar and Pubmed databases with the term “positive psychiatry” in the title. The search showed 26 results, including 6 systematic reviews and 1 clinical trial. Subsequent searches of “COVID-19” and “mental health” were conducted to create formulations and recommendations for the post COVID-19 era.

Growing evidence shows that PPCs are modifiable constructs that may be associated with improved mental and physical health outcomes. Research during the pandemic has demonstrated that PPCs such as resilience and optimism moderated the trajectory of OCD, depression, and anxiety, and that those with more resilience and optimism displayed lesser decline in their function (Hezel et al. JPR 2022 150 165-172). Beyond mental health, various PPCs, such as social support, have also shown positive outcomes in medical conditions such as hypertension and cardiovascular disease, and ultimately improved well-being (Jeste et al. JCP 2015; 76 675-683).

Based on our literature review, practices of positive psychiatry in conjunction with traditional psychiatry can serve as an invaluable modality in treating patients with various psychiatric conditions and improve mental health outcomes. These positive factors have historically been under-recognized among individuals with or at-risk for mental illnesses. As social distancing, fear of the “unprecedented” and loss of agency became more prevalent over the past couple years, the need for tools to target these notions increases. Further research into optimal incorporation of positive psychiatry into routine clinical practice can help address the trends in mental health brought on by the pandemic.

None Declared

Not only children with autism spectrum disorders (ASD) need specialized care, but the whole family as a whole. The family is seen as an important resource in the treatment and rehabilitation process.

To identify coping strategies for parents of children with ASD after psychoeducation.

The study involved 75 families (75 mothers and 68 fathers aged 27 to 38) raising children with ASD (age range from 3 to 5 years). All children were diagnosed under subheading F84 “Pervasive developmental disorders” according to ICD-10 (F84.01; F84.02; F84.11; F84.12). Diagnosis period for a child: from 6 months to 1 year.

The main instrument was “Ways of Coping Checklist” (R. Lazarus & S. Folkman) (in Russian adaptation by L.I. Wasserman et al.).

Psychoeducational work was carried out with all parents, including:

- attitude and acceptance of the child’s illness;

- awareness of the disease and ways of helping a child with ASD;

- compliance with the recommendations of specialists working with the child (psychiatrist, psychologist, speech therapist, social pedagogue);

- skills of interaction with the child in the conditions of the house and society;

- emotional experiences of parents (anxiety due to insufficient information about the child’s illness);

- emotional acceptance of the child.

After completing the psychoeducational program, the parents’ scores on the “positive reappraisal” scale increased, which may indicate that parents, in spite of everything, are looking for positive aspects in the situation of raising a child with ASD and focus their attention on their own personal growth. Thus, mothers of children often undergo training in programs for working with children with ASD, begin to conduct educational webinars, blogs, and share their experience in solving problems with other parents. There is also an increase in scores on the “confrontation” scale, as well as a decrease on the “distancing” scale.

Conducting psychoeducation with the parents of underage patients allows us to come closer to solving one of the main issues of psychosocial rehabilitation - the socialization of a child with ASD and the whole family as a whole.

None Declared

We have observed an increase in the number of patients detained under s136 of the Mental Health Act (MHA) within our emergency department. Patients are often transferred to the emergency department as an alternative place of safety. Many of these patients are provided very little information about the detention and the process of assessment. Best practice states that all patients should be provided written information. Currently, there is no such written information available with our emergency department or within the psychiatric liaison team in St Mary’s Hospital.

We aim to produce a user friendly information leaflet which will be distributed to all patients bought into the A&E department under s136. We aim to improve provision of written information from 0% to 50%.

We aim to complete this project in three stages:

Stage 1: involvement of service users using the trust Expert by Experience Forum. We will co-produce a clear and user friendly leaflet detailing information pertaining to s136 and the process of assessment.

Stage 2: Once the leaflet is finalised, we will involve colleagues within the emergency department to ensure that there is an effective system which will ensure adequate distribution of the leaflet.

Stage 3: Once the leaflet is incorporated into our clinical practice, we will audit its distribution.

We will upload the finalised leaflet. We will also assess a random selection of notes from November 2022 to March 2023 to assess % of patients provided with written information.

This project will result in co-production of an information leaflet for patients detained under s136 of the MHA. As such, we will aim to inform and improve the process for patients presenting to St Mary’s Hospital under the MHA.

None Declared

Many different long-term neuropsychiatric sequelae of the novel Coronavirus have been described after the pandemic outbreak. One of the most common symptoms in the months following infection is related to “brain fog”. This condition includes several signs of cognitive impairment like mental slowness, deficits in attention, executive functions, processing, memory, learning, and/or psychomotor coordination, which can be perceived on a subjective level and further confirmed by objective data. Since this kind of mental status has been documented in previous viral infections, and the SARS-COV-2 has been characterized by a worldwide diffusion, investigation into this condition in post-covid individuals is warranted. Currently, several hypotheses on its pathophysiology have been put forward, mostly hypothesizing a direct effect of the virus on the central nervous system or indirect consequences of the inflammatory response.

The aim of our research is to analyze brain correlates of subjective cognitive complaints in Covid-19 survivors using multimodal brain imaging.

We performed a voxel-based morphometry (VBM) and a resting state functional connectivity analysis on 60 post-COVID-19 individuals recruited from the San Raffaele Hospital in Milan, that underwent a 3 tesla MRI scan. We assessed the perceived cognitive impairment both after the infection and at the time of the MRI scan through the PROMIS Cognitive Abilities scale. The difference of the two scores (delta PROMIS) was calculated as a measure of cognitive improvement over time.

We found the perceived amelioration of cognitive abilities (delta PROMIS) to be positively associated to grey matter volumes in the bilateral caudate, putamen and pallidum (pFWE: ˂0.001). Moreover, in the resting state fMRI analysis, subjective cognitive status at MRI was found to be associated with functional connectivity between the right putamen and pallidum, and two clusters belonging to the attentional (pFWE: ˂0.001) and salience (pFWE: 0.02) networks.

This is one of the first studies investigating brain correlates of subjective cognitive impairment after COVID-19 infection; our main finding is the convergence of structural and functional results on brain areas located within the basal ganglia, implying their possible role in the pathophysiology of the condition. Moreover, this research could be interpreted as the first step toward understanding a very complex condition, with potential implications for the development of treatment and neurorehabilitative strategies.

None Declared

Admission to hospital is a stress-inducing experience for children. Informing children helps to reduce anxiety according to their developmental stage.

To explore the associations between Greek teenager patients’ characteristics and their desired information during the perioperative period.

Eighty children (52 boys, 28 girls; median age: 12 years old) admitted for surgery into a large Greek paediatric hospital self-completed a 40-item questionnaire on Children’s Desire for (perioperative) Information (CDI). The respondents’ desire for perioperative information was calculated by summing responses (‘I really have to know’ plus ‘I might want to know’) to all 40 items. Ethical issues were addressed. We used multiple linear regression to explain the relationship between participants’ characteristics (demographic, attitudes, coping strategies) and their desire for information when facing surgery. A p value of less than 0.05 was considered statistically highly significant. SPSS 21.0 was used for statistical analysis.

The 40/80 (50%) Greek teenager patients admitted for surgery had a CDI score more than 33 out of 40 score. Their desired perioperative information was positively associated with their fear of surgery [β=0.59; 95%CI:0.10-1.08; t=2.39; p=0.020] as well as their being raised in a single-parent household [β=3.9; 95%CI:0.13-7.65; t=2.06; p=0.043]. Their desire for perioperative information was negatively associated with their missing friend support network [β=-1.10; 95%CI:(-2.12)-(-0.08); t=-2.16; p=0.034]. The revealed statistically significant associations explained almost 30% (R-square=0.29) of Greek teenager patient desire to be informed perioperatively.

The high CDI score of Greek teenagers facing surgery in paediatric hospitals implies that they have a proven right for perioperative information. Identification of what influences the perioperative information desired by teenager patients would play a vital role in planning effective perioperative intervention programmes.

None Declared

People presenting to hospital in a crisis of mental ill-health usually present via Emergency Departments, and are often admitted for brief interventions. Unlike drug treatments, the evidence base for brief non-pharmacological interventions has not been systematically evaluated.

1. To describe brief non-pharmacological interventions used in Emergency Departments and inpatient psychiatric units, for those in a crisis of mental ill-health, and evaluate the study types and outcome measures used to evaluate them;

2. To conduct a systematic review of this evidence

We searched the Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, DARE, Embase, MEDLINE, PsycINFO, and relevant government and non-government organisation websites for peer reviewed journal articles, including both qualitative and quantitative articles. Interventions were sorted into Categories and Types to manage heterogeneity.

We found 47 studies. Interventions were highly varied, and we created a taxonomy to understand this heterogeneity. Most studies were quasi-experimental trials (n=26; 55%) or qualitative studies (n=13; 27%) and only 8 RCTs (17%). Twelve were high quality (26%). Interventions were mostly found to have no effect on measured outcomes, though outcome measures may not have been best suited to expected domains of change.There was a broad range of outcome foci reflecting inconsistency in goals of interventions. No interventions were found to reduce the incidence of self-harm on the inpatient ward. One study suggests that inpatient safety planning may reduce readmission rates. Aggression-related outcomes for inpatient sensory modulation rooms were equivocal. Brief admissions with psychotherapy may reduce suicide attempt repetition and re-hospitalization, whereas brief admissions without psychotherapy may improve function but not re-hospitalization rates. Face-to-face psychoeducation for panic in the ED was associated with a reduction in ED presentation rates, but brochure-only psychoeducation may increase ED presentation rates.

This review found little evidence to guide much of what clinicians do for people in crisis in hospital. There is a need to develop a framework for brief non-pharmacological interventions, address the quality and size of studies, and identify consistent outcome measures for non-pharmacological interventions. The data is insufficient to make clear recommendations for appropriate brief non-pharmacological interventions for people in crisis in Emergency Departments and Psychiatric Inpatient Units. Multiple promising interventions are available for further study, however there is a dearth of research and more rigorous testing is needed.

None Declared

Social network addicts may differ significantly from non-addicts in terms of personality traits, such as agreeableness, neuroticism, and conscientiousness. Addicts may be prone to negative emotions and unpleasant experiences, which may be associated with a higher level of neuroticism. Addicts often fail to cope in the real world, often experience negative emotions, quickly give up their goals, see themselves and others in a negative light, and escape into virtual reality. The virtual world is devoid of the anxiety that an individual faces in real life interactions, hence the tendency for addiction among people with higher levels of neuroticism. The primary cause of Internet Addiction may be innate temperamental traits (i.e., impulsiveness of behavior and impulsiveness of decisions) that influence the susceptibility to functional and chemical addictions. According to the concept of addictive personality, people who have this problem are prone to addiction as such, regardless of what they are addicted to.

The purpose of this study was to generally assess the degree of women’s dependence on social networking sites on the example of Facebook, taking into account personality traits according to the five-factor model of personality, the so-called Big Five by Costa and McCrae

The study included 556 women. This survey-based study was carried out using the questionnaire technique. The following research tools were used to analyze behavioral addictions in adult women: the Bergen Face- book Addiction Scale (BFAS), the NEO Five-Factor Inventory (NEO FFI) and the author’s questionnaire.

Among the surveyed women, 69.6% were average Facebook users, of whom 16.4% had scores indicating possible Facebook addiction, and 14.0% had scores indicating addiction. The higher the neuroticism, the more serious the Facebook addiction (r = 0.26; p < 0.001; R2 = 6.7%). A weak negative correlation was obtained for the agreeableness subscale e (r = -0.08; p < 0.05; R2 = 7.2%). A weak negative correlation was also obtained for the subscale of conscientiousness (r = -0.16; p < 0.001; R2 = 2.6%). There was no statistically significant correlation between the log10 score obtained on the BFAS and the score on the NEO-FFI subscales of extraversion (r = 0.04; p = 0.40) and openness to experience (r = 0.04; p = 0.30).

The personality types of the studied women indicated relationships in terms of behavioral addictions. Women characterized by neuroticism showed stronger addiction to Facebook. Women characterized by high conscientiousness were at lower risk of behavioral addictions, while agreeableness as a personality trait significantly protected the surveyed women against Facebook addiction.

None Declared

In recent research, psychological disorders have been increasingly defined as complex dynamic systems in which symptoms are interconnected and influence each other, thereby forming symptom networks. This paradigm shift calls for the analysis and interpretation of relationships between symptoms that are complex, potentially non-linear, and dynamic. Dynamic Time Warping (DTW) is used to measure similarity in temporal sequences, and has recently been found effective in modelling psychopathology symptom networks.

We aim to demonstrate that DTW could also be used to model the network structure in Ecological Momentary Assessment (EMA) data.

355 participants of the Netherlands Study of Depression and Anxiety (NESDA), of which 100 with and 255 without current disorder, completed EMA assessments of 20 symptoms (e.g., feeling sad, tired, satisfied) five times a day for two weeks. DTW analysis was performed on the group level, comparing participants suffering from mood disorders to healthy controls. DTW distances were visualized as an undirected symptom network, in which we adjusted for the average symptom severity per item per person.

DTW analysis of close to half a million symptom scores yielded six symptom dimensions based on their aggregated similarity of changes over time within the participants. Surprisingly, negative affect symptom networks were found to be less strongly connected in those currently suffering from mood disorders than in controls, whereas the network density of (reverse-coded) positive affect symptoms was more closely connected in this group. This is contrary to the results of previous studies, where negative affect-related symptom networks of those with mood disorders were found to be more strongly interconnected.

DTW is a promising new technique for analyzing EMA data and modeling dynamic symptom networks at both the individual and group levels. Using EMA data, symptom networks and dimensions can be modeled with great structural and temporal detail. Incorporating the temporal symptom dynamics may highlight the importance of the independent trajectories of negative mood symptoms.

None Declared

Addiction has long been recognized as a disease that may have a dramatic influence on the addicted individual’s family members, manifesting as stress or trauma-related physical and psychological symptoms, resulting in increase in the usual family’s use of health-care services. There is little research available to identify and explore problems of families associated with such patients. In this study, we will evaluate stress among family members of substance abuse patients and try to focus on how these family members are dealing with these stress factors. The study will also compare different types of coping mechanisms among family members of patients taking licit and illicit substances.

To identify stress among families of patients abusing licit and illicit drugs and assess and compare their coping mechanisms.

175 family members of patients with licit substance abuse cases and 175 family members of patients with illicit substance abuse were taken for study after informed consent. Stress among participants was evaluated using Symptom Rating Test and The Depression Anxiety and Stress Scales (DASS). Coping Questionnaire (CQ) and Breif COPE was used to assess coping among them.

The study demonstrated that the total number and severity of symptoms, including psychological and physical symptoms, are found lesser in caregivers (participants) of patients abusing licit substances than in patients abusing illicit drugs. These symptoms among family members grow as the patient’s age rises. Symptoms in participants are more if their patient is female as compared to male. And also, total symptoms are more if they are living in nuclear family (Table 1). In our results, total coping and engaged coping mechanisms in family members are found to be not significant as per drug type and remains the same for both licit and illicit drugs abusing patients’ families. Avoidant coping mechanisms in family members are more if their patient is female and in nuclear family.Table 1

In our study, it was clearly noticed that the total symptoms, both physical and psychological, were found more in family members of patients abusing illicit drugs. Impact of substance abuse related problems is found more in female members compared to male members of family.

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Digital technologies and advances in computational methods have become key drivers of innovation in many medical fields. In precision psychiatry, accurate and reliable measures of mental health are critical for informing patient care and clinical research. There has been growing concern over the limitations of traditional mental health assessments that are typically grounded in nosology defined by the DSM and are based on interviewer-led assessments or patient self-report questionnaires. Whereas such gold-standard clinical assessments can be cost-prohibitive, insensitive to change, and prone to subjective biases, the use of digital technologies provides an opportunity to improve the practical feasibility as well as the inter-rater and test-retest reliability of repeated mental health assessments. The key promise of this approach is to unlock the clinical potential of digital technologies in ways that foster research of high clinical relevance and impact on clinical care. I will discuss these promises and challenges for the future use of machine learning approaches for predicting and monitoring post-traumatic stress and resilience.

None Declared

Sexual dysfunction (SD) is a prevalent side effect of antipsychotic drugs (AP), and it impairs patients’ quality of life. Because of the distress caused by it, it should be borne in mind when prescribed since it is responsible for treatment nonadherence or discontinuation. SD affects about 45- 80% of males and 30-80% of females that take it. In SD, all phases of the sexual response cycle may be compromised.

This non-systematic review of the literature aims to better understand the antipsychotic-induced SD and its management to better compliance of AP-treated patients without compromising their quality of life.

A semi-structured review on PubMed linking SD as a side effect of AP drugs.

All AP drugs can cause SD. It seems related to their mechanism of activity at receptors D2, 5-HT2, α1, H1, and M, which are also involved in sexual function. They do it by diminishing arousal, decreasing libido by blocking motivation and reward system and orgasm indirectly, provoking erectile dysfunction by vasodilatation, and decreasing woman lubrification. Hyperprolactinemia is a significant cause of sexual dysfunctions. Haloperidol, Risperidone, and Amisulpride (prolactin elevating AP) are more likely to cause SD than Olanzapine, Clozapine, Quetiapine, and Aripiprazole (prolactin sparing AP). Although psychotic disorders (Schizophrenia and other psychotic disorders) can impact sexual functioning, according to evidence, there is no denying the role of AP in this issue. Aripiprazole, a D2 partial agonist, has been associated with lower rates of SD and seems to reduce the rates of SD in patients previously treated with other AP. Other AP with the same potential dopamine agonist activity, such as Cariprazine and Brexpiprazole, can probably have the same effect. The management of SD induced by AP drugs should include measuring serum prolactin and modifying risk factors like hypertension, smoking, hyperglycemia, and hypercholesterolemia. In that regard, waiting for spontaneous remission, reducing the dose of the AP prescribed, or switching to Aripiprazole are all viable strategies, if possible. Although the evidence supporting the addition of symptomatic therapies is weak, adding dopaminergic drugs (amantadine, bromocriptine, cabergoline) or drugs with specific effects on sexual functioning (such as phosphodiesterase inhibitors or yohimbine) may be helpful in selected cases.

Although all AP drugs can cause sexual dysfunction, it is difficult to determine its true prevalence accurately. AP-induced sexual dysfunction can adversely affect compliance and is one of the factors that must be considered when selecting treatment. In summarizing, Aripiprazole has shown to be the AP with the most favorable profile concerning SD. Cariprazine and Brexpiprazole, being also D2 partial agonists, may cause less SD.

None Declared

Depression, anxiety and suicide are serious psychiatric conditions that affect Mexican youth (Institute for Health Metrics and Evaluation, IHME, 2022), with depression showing a prevalence greater than 16%. Suicide ranks as the second most important cause of deathin this age group, (6/100,000 deaths), the first being violent deaths by firearms (15/100,000 deaths;IHME, 2022).

To identify factors related to age of onset of pediatric depression.

A cross-sectional study was carried out during 2018-2020 in two Children’s Psychiatric Hospitals in Mexico City. Data were collected using a survey method. All participants signed an informed consent form. We applied Cox hazard analysis, with the hazard event being the onset of psychiatric symptoms.

Data from 400 patients were analyzed, 148 girls (37%) and 252 boys (63%). Mean patient age was 12 years, and mean age of symptom onset was 8 years. The most common diagnoses were hyperkinetic disorder (51%), depression (34%), and anxiety (7.8%). Age of depression onset was significantly reduced in association with male sex (HR=1.46), family history of psychiatric disorder (familial depression HR=2.34; hyperkinetic disorder HR=2.67; psychoactive substance abuse HR=5.09), and certain medical comorbidities (asthma HR=6.41; enuresis HR=3.03). These same covariates were not associated with age of onset of hyperkinetic disorder or anxiety.

These analyses indicate that a subgroup of pediatric depression has an early onset and is associated with familial hyperkinetic disorder and depression, the male sex, and certain medical comorbidities.

None Declared

There are about 10 million inmates in the world, of which 6 million are held in American prisons. While in Europe there was a 6.6% reduction in the detention rate, in Italy the number of prisoners is constantly growing. Due to the worldwide importance of the phenomenon in the field of public health, it is necessary to analyze the relationship between detention and prisoner health, as well as the change in the psychophysical state of a subject after a period of incarceration.

The analysis of the results deriving from the completion of forensic examinations was carried with the aim of assessing the compatibility of the health conditions of prisoners with imprisonment.

We report the results of a preliminary study on a sample of fifty prisoners held in Southern and Central Italy prisons.

The average age of the prisoners was 41. The prevalence of psychiatric disorders in the sample examined was about 39 %. 45 % of subjects with mental disorders made one suicide attempt in prison at least. We emphasize the pathogenic role of prison in the development or aggravation of psychiatric disorders. This happens particularly in subjects coming from degraded socio-family backgrounds.

In order to reduce the prevalence of psychiatric disorders and the risk of suicide, it is necessary to carry out careful medical and psychological evaluation at each new entry, so as to be able to frame the inmate’s state of health and plan periodic monitoring of diagnosed diseases. This evaluation should include a psychiatrist, so as to be able to set up an adequate drug treatment when it’s necessary. The correct management of psychiatric disorders is essential in order to improve the inmate’s mental health and prevent medico-legal consequences for health workers.

None Declared

Dry eye disease (DED) is a multifactorial disease of the tear film and ocular surface representing one of the most common problems in ophthalmological practice and significant public health problem. Characteristic symptoms of DED include gritty, sandy foreign body sensation as well as visual disturbances that have a negative impact on the patient’s daily activities and also affecting patient’s quality of life (QOL).

The objective of this research is to point out the importance of transdisciplinary approach to treatment of dry eye disease in patients with psychiatric disorders.

We reviewed all current available literature in Pubmed dealing with the topic of connection of dry eye disease and psychiatric disorders.

In recent years, the relationship between DED and psychiatric disorders has been gaining attention. A number of epidemiological studies have reported a possible association between dry eye and psychiatric disorders showing that the subjective symptoms of dry eye can be affected not only by changes of the tear film and ocular surface but also psychological factors such as anxiety, depression, schizophrenia, post-traumatic stress disorder (PTSP) and subjective happiness. Apart from psychiatric disorders, psychiatric medications are also considered as risk factors for DED due to their influence on the tear film status. The incidence of ocular side effects increases rapidly with the use of polypharmacy, a very common form of treatment used in psychiatry.

Mental health disorders may be one of considerable contributing factors for dry eye symptoms and undiagnosed mental health conditions can be an influencing element for unexplained levels of DED symptoms. Depression, anxiety, stress, hypochondriasis, neuroticism, sleep and mood disorders may be associated with the exacerbation of symptoms to degrees that are not consistent with the objective signs related to tear dysfunction as well as changes in the anterior surface of the eye.

There is often inconsistency between signs and symptoms of DED, where symptoms often are more related to non-ocular conditions including psychiatric disorders than to tear film parameters. Consequently, in many cases DED may be considered as a psychiatric as well as ophthalmological problem. Psychiatrists and ophthalmologists need to be aware of the potential influence of psychiatric disorders and medications on tear film stability.

A detailed medical history, thorough ophthalmological examination and referral to a psychologist or psychiatrist may be essential in the treatment of those patients. In treatment of psychiatric patients, an integrative and transdisciplinary approach will result in better functioning and higher QOL.

None Declared

The Government of New Zealand closed the borders and introduced a number of restrictions following the first reported case of Covid-19 in February 2020. Comprehensive measures to control the outbreak included a strict managed isolation and quarantine (MIQ) system and rolling lockdowns that restricted movement. There were concerns about the mental health impact on the population. This presentation will outline the approach to maintaining social cohesion and supporting the psycho-social needs of the population through the pandemic.

An overview of the Covid-19 response will be presented, including the Covid-19 alert systems and the strategies to support particular populations.

This will include:

1. The mental health support for the 229,000 people subjected to managed isolation and quarantine in government facilities

2. Psycho-social interventions for our Maori and Pacific populations

3. Specific approaches for people with severe mental disorders, including vaccination strategies and supporting people in the community with Covid-19

4. Interventions for homeless and socially vulnerable populations

Reflections and learnings from our apprach will be shared.

The government ended the Covid-19 Framework in September 2022 and retrurned to fully open borders in October 2022. There have been over 1.8 million cases and 2000 deaths during the period of restrictions.

None Declared

Negative symptoms represent a fundamental aspect of schizophrenia: they have a substantial impact on patients’ real-life functioning and do not respond satisfactorily to currently available treatments. Therefore, a better understanding of the pathophysiological mechanisms underlying these symptoms could favor the development of new treatments.

To date, the most validated pathophysiological hypothesis indicates an association between the Motivational domain (consisting of avolition, anhedonia and asociality) and alterations in the neuronal circuits involved in motivation. The Expressive Deficit domain (consisting of blunted affect and alogia) would be subtended by widespread alterations of cortical connectivity and associated with impaired neurocognition, social cognition, and the presence of neurological soft signs.

The aim of the present study is to examine the neurobiological correlates of the two domains of negative symptoms, starting from the brain areas that have been most commonly found in the literature to be associated with negative symptoms.

Resting-state (rs) fMRI data were acquired in 62 subjects with schizophrenia (SZ) and 46 healthy controls (HC). The two negative symptom domains were assessed using the Brief Negative Symptom Scale. In addition, the following assessment tools were used: the Positive and Negative Syndrome Scale for the assessment of positive symptoms and disorganization, the Calgary Depression Scale for Schizophrenia for depression and the St. Hans Rating Scale for extrapyramidal symptoms. The study of the possible relationships between rs-brain activity and the negative symptoms domains was conducted through partial correlations, checking for possible confounding factors (positive, depressive, extrapyramidal symptoms and disorganization).

The SZ, compared to the HC, showed higher rs-brain activity of the right inferior parietal lobule and of the right temporoparietal junction and lower rs-brain activity of the right dorsolateral prefrontal cortex, bilateral anterior dorsal cingulate cortex, bilateral ventral caudate and bilateral dorsal caudate. Furthermore, in the group of patients, the rs-brain activity of the left ventral caudate showed a moderate negative correlation with the Expressive deficit domain (r = -0.401; p = 0.003), but not with the Motivational domain.

The results of the present study, in line with the literature, demonstrated how the two domains of negative symptomatology are subtended by different pathophysiological mechanisms. Given the role played by the ventral caudate in neurocognitive processes, these results are in line with the hypothesis that Expressive deficit may have a common etiopathogenesis with cognitive deficits. A better understanding of the neurobiology of negative symptoms could foster the development of innovative treatment strategies targeting the two negative symptom domains.

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Undergraduate students encounter developmental challenges during their transition into adulthood. Previous studies have claimed that adults with later chronotypes usually manifest negative psychological effects: poor sleep quality, greater stress, depression, and cognitive dysfunction. However, knowledge about the relationship between chronotype, stress, and sleep quality among young adults is lacking.

The present study investigated the relationship between undergraduates’ chronotypes and perceived stress on sleep quality.

An online survey with a descriptive, cross-sectional design was conducted with a convenience sample of undergraduate students at a university in southern Taiwan. Those who were 20-25 years old and enrolled as a student were included; but who had been suspended or had deferred graduation were excluded. Students’ chronotype, stress, and sleep quality were assessed with three self-reported instruments: Munich Chronotype Questionnaire (MCTQ), Perceived Stress Scale (PSS), and Pittsburgh Sleep Quality Index (PSQI).

Of 161 undergraduates who completed the questionnaires, 51 reported using an alarm clock to wake and were removed from data analysis. One hundred and ten students’ mean age is 20.3 and perceived moderate stress. Sixty-one percent were poor-quality sleepers. The mean chronotype score was 5.7, and 85.5% had an intermediate chronotype, while 13.6% had an evening chronotype. Chronotype and perceived stress were positively correlated with sleep quality (p < .001). Social jetlag was positively correlated with chronotype (p =.036). Undergraduate’s later chronotype and higher stress perception predicted 30% of poorer sleep quality (p < .001).

Undergraduate students’ chronotype and perceived stress were positively correlated and acted as predictors of the sleep quality. The findings could help to develop health-promotion interventions for these emerging adults to adjust their daily routines; and reduce their social jetlag, stress levels, and sleep disturbance.

None Declared