The COVID-19 pandemic has affected millions of people worldwide. Among a large number of deaths, COVID-19 has caused significant health-related sequelae involving many systems of the body. Some results include increased anxiety, depression, insomnia, and other distress symptoms. Additionally, there are reports of sudden onset of psychosis in patients with no psychiatric history following COVID-19.

Emphasizing the importance of Covid 19 causing many psychiatric diseases, although its etiology is not yet known.

Report of a clinical case

We report a 68-year-old previously healthy woman with no personal or family history of mental illness who was hospitalized due to COVID-19 and then started to have psychiatric complaints. She had complaints such as refusal to speak, eat and drink, fear of death which started after her discharge from the hospital due to COVID-19.

On 14.07.2021, she applied to the psychiatry outpatient clinic of our hospital for the first time. In addition to the existing complaints, we have considered the preliminary diagnoses of dementia and psychotic depression due to the increasing fear of being alone, going out alone, confusion in the interim periods, and thoughts that someone will harm her and her family. We consulted the neurology clinic and she was admitted to the neurology service with a preliminary diagnosis of encephalitis. During her hospitalization, the patient’s EEG and MRI were taken, LP was performed, and no pathology was detected in the examinations. Her current psychiatric treatment (escitalopram 10mg/d, medazepam 2mg/d, and olanzapine 2,5mg/d) continued throughout her hospitalization in the neurology service, but her complaints did not change. She was fed formula with an NG tube, IV hydration was provided, and a urinary catheter was inserted.

After ruling out neurological disease on 12.08.2021, the patient was admitted to our psychiatry service with a prediagnosis of catatonic-psychotic depression. Electroconvulsive therapy was planned because the visual hallucinations and persecutory delusions persisted. Total of 7 sessions of ECT were received. The patient’s oral intake started with the current treatment, and her fluent speech began. Olanzapine dose was increased to 7.5mg/d, and escitalopram dose was increased to 20mg/d due to persistent depressive and psychotic symptoms. The patient was discharged on 02.09.2021 with the current treatment. Her complaints had improved before she was discharged.

COVID-19 remains an emerging disease with unknown psychological sequelae. Caution should be exercised regarding psychiatric symptoms and associated risks in patients with a recent diagnosis of COVID-19. Cytokine storm may also be involved in the etiology, in addition to many psychological factors such as fear of illness, uncertainty, and isolation. Potential risk factors and underlying biological mechanisms should be investigated.

None Declared

We present the case of a sixty-seven-year-old woman who is examined for the first time in the emergency room because of a nine-month clinical picture that involves psychotic symptoms. The patient exhibits persecutory delusions that started after she shared some private information on social media. These symptoms also entail emotional distress and behavioral disturbances. She has never experienced hallucinations, but she does present delusional interpretations of the environment. Her clinical history reveals abnormalities of premorbid personality, including paranoid and immature features.

(1) We will be carrying out a differential diagnosis of late onset psychotic symptoms. We will as well be exploring the concept of Paraphrenia and analyzing its differential features in order to stablish the most suitable diagnosis for the case.

(2) The relationship between abnormalities in premorbid personality and psychotic symptoms will be covered, reviewing the available literature on this matter, and relating it to the patient’s symptomatology.

A review of the patient’s clinical history will be carried out, considering her biography, the testimony of her family and the complementary tests performed during the hospitalization period.

A bibliographic review of the available scientific literature will also be developed involving disorders that could explain psychotic symptoms in the elderly, as well as the term Paraphrenia, which describes specific features in a psychotic episode but is not included in the diagnostic manuals.

(1) The symptomatology that our patient exhibits may be considered atypical given the late stage of its onset and its specific features.

(2) The case could be explained under the category of Delusional Disorder. From a psychopathological point or view, it could also fit under de diagnosis of Paraphrenia as described by Ravindran et al.

(3) Pathological personality traits were assessed in premorbid personality which included paranoid and immature features.

It could be useful to review the concept of the “paranoid spectrum” as proposed by some authors regarding some patient’s psychotic symptoms that don’t exactly fit any of the nowadays diagnostic categories. “Paraphrenia” could be understood as a distinct clinical entity for patients who show psychotic disorders but keep affective warmth and lack though deterioration and grossly disorganized behavior.

Most patients with late life paranoid psychoses have abnormal premorbid personalities, most usually of schizoid or paranoid type. There’s a decent amount of consensus in viewing the premorbid personality as having been abnormal as an early marker of impending psychosis.

Reformulating the way we approach diagnosis of psychotic symptoms of late onset could help us identify vulnerable patients on a premorbid stage and better classify and understand atypical entities.

None Declared

Emergency psychiatric consultation requests present certain specificities both in the situations encountered and in their management, due to a close relationship between the consultant and his environment. They do not only correspond to psychiatric emergencies, in the strict sense of the term, but also to psychological emergencies with their possible social dimension. They require an adapted response that can be decisive for the future

To determine the epidemiological and clinical characteristics of patients reconsultants in the emergency medical department.

This is a cross-sectional study, conducted over a period of 12 months, from 01 April 2020 to 31 March 2021, in the emergency medical department of Mahdia University Hospital.

During the study period, 162 reconsultations for psychiatric emergencies were recorded. the age ranged from 18 to 61 years with an average of 35 years. The level of education was primary or secondary in 78.8% of cases. The majority of reconsultants had single marital status (70%). The absence of professional activity and social security coverage was found in 72.3 and 49% of cases respectively. The presence of family and personal psychiatric history was noted in 29.8% and 91.5% of reconsultants respectively. Heteroaggressiveness followed by instability were the most frequently encountered reasons for consultations with 23.4% and 12.8% of cases respectively. The presence of a triggering factor was found in 63.8% of cases where problems with the main support group followed by those related to the social environment and those related to access to health services were the most reported with 49.23 and 13% respectively. The syndromic psychiatric diagnoses were, in decreasing order of frequency, psychomotor excitement (23.4%), delusional syndrome (17%), dissociative syndrome (12.8%) and somatic conversion (12.8). For reconsultants, relational approach and/or injectable treatment were the most used therapeutic means immediatly (49%). Neuroleptics and benzodiazepines were prescribed in 38% and 13% of cases, respectively. The decision to hospitalize in a psychiatric department concerned 45% of reconsultants.

Referral decisions favored the organization of ambulatory follow-up, with a decrease in the rate of hospitalization. These results make it possible to identify the evolutionary trends of the population consulting in emergency

None Declared

The neurobiology of gambling disorder (GD) is not yet fully understood. Although dysfunctional signalling involved in energy homeostasis has been studied in substance use disorders, it should be examined in detail in GD.

To compare different endocrine and neuropsychological factors between individuals with GD and healthy controls (HC), and to explore endocrine interactions with neuropsychological and clinical variables.

A case-control design was performed in 297 individuals with GD and 41 HC, assessed through a semi-structured clinical interview and a psychometric battery, adding 38 HC in the evaluation of endocrine and anthropometric variables.

Individuals with GD presented higher fasting plasma ghrelin (p<.001) and lower LEAP2 and adiponectin concentrations (p<.001) than HC adjusting for body mass index (BMI). The GD group reported higher cognitive impairment regarding cognitive flexibility and decision-making strategies, a worse psychological state, higher impulsivity levels, and a more dysfunctional personality profile. Despite failing to find significant associations between endocrine factors and either neuropsychological or clinical aspects in GD, some impaired cognitive dimensions and lower LEAP2 concentrations significantly predicted GD presence.

This study suggests distinctive neuropsychological and endocrine dysfunctions may operate in individuals with GD, predicting GD presence. Further exploration of endophenotypic vulnerability pathways in GD appear warranted, especially with respect to etiological and therapeutic potentials.

F. Fernandez-Aranda Consultant of: Novo Nordisk , Employee of: editorial honoraria as EIC from Wiley, I. Baenas: None Declared, M. Etxandi : None Declared, B. Mora-Maltas: None Declared, R. Granero : None Declared, S. Tovar : None Declared, C. Diéguez: None Declared, M. Potenza Grant / Research support from: Mohegan Sun Casino and Connecticut Council on Problem Gambling, Consultant of: Opiant Pharmaceuticals, Idorsia Pharmaceuticals, Baria-Tek, AXA, Game Day Data and the Addiction Policy Forum; has participated in surveys, mailings or telephone consultations related to drug addiction, impulse control disorders or other health topics; and has consulted for law offices and gambling entities on issues related to impulse control or addictive disorders, Employee of: patent application in Yale University and Novartis, S. Jiménez-Murcia: None Declared.

Our previous reports on rodent models suggested that chronic stress exposure could lead to cognitive impairments, gastrointestinal transit changes, and oxidative stress. Zebrafish (Danio rerio) models are nowadays gaining more attention due to their advantages, as well as their complete neurobehavioral, biochemical, and genetic description and great similarity to human.

The aim of this study was to describe and to identify possible interdisciplinary applications of the neurobehavioral and biochemical changes induced by chronic stress exposure in zebrafish.

The main scientific databases were screened for English-written studies describing chronic stress exposure effects in animal models. Inclusion criteria: (1) studies performed on zebrafish models; (2) reporting stress exposure effects on the animal behaviour, cognition, oxidative, and/or inflammatory status. Exclusion criteria: (1) studies not focussing on chronic stress exposure paradigm or (2) not using zebrafish models.

We found that chronic stress exposure was applied to larvae, juveniles, and adult zebrafish. The neurobehavioral effects were mainly suggesting memory deficits and socio-affective impairments (such as anxiety and depressive-like behaviours). Several studies found oxidative stress and inflammatory-related response in brain and gut. While our previous research experience in rodents thought us that chronic stress exposure could model functional gastrointestinal disorders of which mechanisms mainly address an impaired brain – gut interaction (irritable bowel syndrome), the data regarding the gastrointestinal status of zebrafish in similar experimental conditions are rather scarce. Some recent studies suggested that stress-exposed zebrafish showed impaired digestion and intestinal glucocorticoid receptors functions. Furthermore, it was reported that the zebrafish response to stress could be improved by probiotic administration and gut microbiota modulation.

Chronic stress exposure paradigm is often associated with cognitive and affective-like impairments. Several oxidative stress and inflammation-related changes were also reported. Further studies are needed to describe the brain – gut interaction-associated functional gastrointestinal impairments in zebrafish.

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

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

6-monthly paliperidone palmitate features an initiation regimen through 1-monthly paliperidone palmitate or 3-monthly paliperidone palmitate. Some patients don´t have sufficient adherence to treatment and it is necessary at the clinical level to start directly with 6-monthly paliperidone palmitte. There is une little clinical experience with these alternative initiations and throuht this work those that have been carried out for 12 months at the Rey Juan Carlos Hospital are exposed.

The main objective of the study is to describe the alternative initations performed with 6-monthly paliperidone palmitate in routine clinical practice, having opted for a regimen different from the standard for clinical reasons.

A retrospective selection of patiens will be made throuht non-probabilistic consecutive sampling, including all patients who have benn administered 6-monthly paliperidone palmitate with a stard different form the standard during the last 6 months. To do his, the electronic medical record will be used, first selecting the patients who have started 6-monthly paliperidone palmitate through the anonymized digital records and, later, including in the study only those who have followed and alternative initiation pattern. The variables studied will be the following: age, sex, diagnosis, dose of paliperidone palmitate, initiation regimen, consumption of toxic substances, absenteeism from 6-monthly paliperidone palmitate, visits to the emergency room and admissions.

The study included a total of 5 patients ( n:5). 80% of the patients were male and 20%were female. The mean age was 39.7 years. 80% of the patients had an associated substance use disorder. The following alternate sarting schedules were with biannual paliperidone palmitate: monthly paliperidone palmitate 150 mg together with semi-annual paliperidone palmitate both on day 1 ( n: 2) or monthly paliperidone palmitate 150 mg on day 1, monthly paliperidone palmitate 100 mg on day 5 and semi-annual paliperidone palmitate on day 12 ( n: 3 ).

A total of 0 visits to the emergency department and 0 admissions were observed after the 6-monthly paliperidone palmitate regimen.

Alternative initations with 6-monthly paliperidone palmitate may be a useful and safe clinical alternative in patients with very low adherence who, due to clinical needs, require startin 6-monthly paliperidone palmitate earlier in order to guarantee adherence .

None Declared

Digital treatment for neurodevelopmental disorders is being developed in order to treat patients online when possible, to reduce waiting lists and to improve efficacy and efficiency of treatment. In this presentation, experiences with the so called Start Program of the Super Brains app for adults with ADHD are presented. The Super Brains app has been developed by Rutger den Hollander, who himself has ADHD and owns an ICT company, together with the speaker of this presentation and Parnassia Groep in the Netherlands.

The Start Program is part of the Super Brains app, and meant for patients referred for treatment, who have to wait on often long waiting lists. Now they have no longer to wait, but can start immediately by preparing for diagnostic assessment by filling in questionnaires, and with psycho-education, lifestyle tips and support by experience experts, who welcome them in the app and show them around.

First data on the use of different parts of the Start Program, the activity of the patients in the app and the satisfaction of patients will be presented. We also aim to study whether the Start Program is effective in reducing severity of ADHD symptoms during the waiting time. Super Brains can be adjusted for use in other (neurodevelopmental) disorders easily (https://www.superbrains.nl/?lang=en).

None Declared

Suicide is a leading cause of death among young people and most deaths by suicide occur in low and middle-income countries. School is the best place where we can identify and respond to youth suicide risk. School-based interventions for suicide prevention in young people have been successful across US, Europe and Australia, but require adaptations to be acceptable and feasible in Pakistan.

To develop and test culturally adapted preventative interventions for suicidal behaviours among pupils in secondary schools in Pakistan. The qualitative component aimed at exploring the views of students, parents, teachers and general practitioners on cultural adaptation, experience of participation, areas of improvement and suggestions for scale-up of the school-based suicide prevention program (SEPAK).

A clustered randomised controlled trial. The four culturally modified interventions 1) Linking Education and Awareness of Depression and Suicide Awareness (LEADS) Training for pupils (students=260) 2) the Question, Persuade, and Refer (QPR) for teachers (students=203) 3) QPR for parents (students=445); 4) Screening by Professionals (Profscreen) (students=260) were compared against control intervention (educational posters) (students=227). Structured questionnaires were administered at baseline and 1-month post-intervention to assess suicidal behaviours, psychological well-being and quality of life. A total of 8 focus groups (FGs) were conducted at pre and post intervention stage with each stakeholders.

Patient and public involvement and Engagement (PPIE) was strongly embedded in the project to ensure meaningful benefits for participants. A total of 40 schools were recruited from 8 cities across Pakistan. A total of 243 students attended LEADS intervention, 92 teachers and 304 parents completed QPR training, and 9 general practitioners were trained in ProfScreen. The retention rate at follow-up was 99% that shows feasibility of delivering intervention package in Pakistan. All participants marked SEPAK as effective in identifying risk of and preventing self-harm and suicide in young people and in improving pathways to treatment. Interventions were perceived as helpful in improving knowledge about mental health, impact of mental health difficulties on functioning, reducing stigma, equipping stakeholders to identify and signpost at-risk people. Improvement in clinical and teaching practice as well as understanding others behaviors were also reported.

This study suggest feasibility of integrating a suicide prevention program in existing educational system and highlights positive role of creating awareness about suicide in youth, introduction of school-based mental health programs, parental counseling and strengthening of the health system by training general practitioners in early identification of suicide risk and promoting suicide prevention strategies

None Declared

Obsessive-compulsive disorder (OCD) is characterised by intrusive thoughts and repetitive behaviours that considerably impact general functioning. Recent evidence links the endocannabinoid system to OCD neurobiology, and several case reports describe significant improvement after using dronabinol (synthetic tetrahydrocannabinol) in patients with severe OCD. Nevertheless, to what extent this new information can change our perspective on pharmacological treatment in OCD is unclear.

We present the case of a patient with obsessive-compulsive symptoms triggered after increased long-term cannabis use. Our purpose is to emphasise the necessity of continuous research and a better understanding of the correlation between OCD and cannabis derivates before formulating treatment recommendations.

We used psychiatric assessments to evaluate the patient’s symptoms and evolution over time and exclude other possible causes that could have triggered the disorder.

Our patient is a 37-year-old man who has been frequently brought to the hospital by the police in the last 11 years for psycho-motor agitation after cannabis use. This year, he came to the hospital by himself, complaining about intrusive thoughts that required motor and mental repetitions to reduce anxiety. His obsessions were mainly about the need for symmetry and exactness and his checking compulsions about his mother’s health. The symptoms required more than half a day and caused functional impairment. A detailed history did not outline any obsessive-compulsive symptoms before the previous year. The patient denies using new drugs, and we did not identify other medical conditions that could better explain the symptoms. However, he admits to increasing the doses and frequency of cannabis use during the last year. After two weeks of cannabis abstinence and Sertraline treatment, his symptomatology improved significantly, with a reduction of more than 50% in the time spent daily on mental and motor compulsions, reduced anxiety, and a noticeable increase in overall functionality. In addition, the Yale-Brown Obsessive Compulsive Scale result decreased from 35 on the first day to 17 on discharge.

Recent studies support the use of cannabis derivates for treating OCD symptoms. However, this case report outlines that prolonged cannabis use could also trigger OCD. Therefore, further studies are necessary to identify not only the potential benefits but also the potential risks of using cannabinoids as a pharmacological intervention.

Nicolini H et.al.CannabisUseInPeopleWithOC.FrontPsychiatry.2021May10; 12:664228.doi:10.3389/fpsyt.2021.664228.PMID:34040556;PMCID:PMC8141625

KayserR.R. et.al.TheEndocannabinoidSystem:ANewTreatmentTargetforOCD? CannabisandCannabinoidResearch.Jun2019.7787.doi10.1089/can.2018.0049

GoodmanWK et.al.1989.YBOCS:Archives of General Psychiatry,1006–1011.doi10.1001/archpsyc.1989.01810110048007

None Declared

Nothing is taken more for granted than the feeling that we are in control of our own thoughts and actions. For those who experience thoughts insertion or delusion of control, known as first rank symptoms of schizophrenia, it becomes a luxury to rule their own thoughts. Kandinsky-Clerambault syndrome is characterized by pseudo-hallucinations, delusions of control, telepathy, thought broadcasting and thought insertion by an external force. The patient’s thoughts, emotions, perceptions or actions are under the control of a different agent, or sometimes he believes that the operator of control is inside his body.

Presentation of a clinical case of Kandinsky-Clerambault syndrome in a patient with treatment-resistant schizophrenia.

Case report

We present the case of a 38-year-old man, diagnosed with paranoid schizophrenia since 2014, who has followed several therapeutic plans, starting with Haloperidol followed by Risperidone, Paliperidone, Quetiapine, Clozapine. Since 2016 he had been under treatment with Xeplion injectable 150mg/month ambulatory, but the psychotic features never fully remitted. 10 days before admission he had last administration of Xeplion LAI. The patient reports the loss of control over his mental life and describes the triple automatism: ideo-verbal, sensory and motor. “There are some people in my body who control me, they move my limbs. I feel like my body is not mine.” He describes imperative and commentative auditory pseudo-hallucinations. The patient speaks intermittently in the 3rd person about himself, has circumstantial discourse, with elements of tangentiality, ideo-verbal and conceptual disorganization. He presents delusions of control, persecution and prejudice. The treatment received during admission – Riseridone 5ml/day, Amisulpride 600mg/day, Orfiril Long 1000mg/day.

After 14 days of hospitalization, the patient is discharged in an improved state, without mentioning spontaneously the delusional ideation. He affirms the intermittent presence of auditory pseudo-hallucinations, but with low intensity compared to the moment of admission. It is ironic how the loss of the self, along with the insertion of thoughts and auditory pseudo-hallucinations create a patient’s own reality, which at the same time is experienced as coming from the outside. From a phenomenological point of view, thought insertion is explained as an autoimmune disease. Thoughts are produced by our mind, but because we have lost the meaning of control and belonging to ourselves, those thoughts are attacked as foreign.

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Antipsychotics are among the most widely prescribed molecules in psychiatry. Their sexual side effects are frequent, generally underestimated by clinicians and subjectively poorly tolerated by patients. They contribute to the significant non-compliance reported in treated patients. Most antipsychotics are non-selective and have actions on a multitude of receptors, both central and peripheral. Among these, the anti-dopaminergic action could have a deleterious effect on sexual function including spermatogenesis.

The aim of our study is to report, according to the analysis of the collected data, the impact of the treatment with antipsychotic drugs on spermatogenesis and the counteraction of its consequences to a possible infertility in patients.

The studies related to the treatment of DMDD were collected and analyzed. This study retrieved related articles from PubMed, SpringerLink, ScienceDirect, NCBI, CAIRN, and GOOGLE SCHOLAR. Use keywords “antipsychotics” AND “spermatogenesis” AND “infertility” AND “male” OR " hyperprolactinemia" AND “spermatogenesis” OR “risperidone” OR “olanzapine” OR " haloperidol" OR " fluphenazine" AND “spermatogenesis” AND “infertility” OR “psychotropics” AND “infertility” OR “spermatogenesis”.

Antipsychotics are responsible, by blocking the secretion of dopamine in the central nervous system, for hyperprolactinemia, indirectly leading to hypogonadism. They are the pharmacological class most implicated in the occurrence of hyperprolactinemia. several studies have shown changes in the levels of sex hormones with alteration in the quality of the product of spermatogenesis, and others have demonstrated abnormalities in testicular architecture in rats after regular administration of doses of antipsychotics. thus, all antipsychotic molecules, whether classic or atopic, are likely to cause abnormalities in spermatogenesis.

Antipsychotics are molecules with multiple indications in mental health, yet their adverse effects can become disabling or even irreversible. Sexual dysfunction and infertility are widespread among patients under antipsychotic treatment. The mechanisms of the effects of treatment with these molecules on spermatogenesis are poorly elucidated, since the vast majority of prospective studies are carried out on rats. However, this undesirable effect seems to be obvious and real.

None Declared

Schizophrenia, a chronic and complex psychiatric pathology, can be isolated. However, it may have other comorbidities and thus be accompanied by addictive behaviors complicating their management.

to estimate the prevalence and identify the characteristics of addictive behavior among patients with schizophrenia.

A retrospective study of 151 patients with schizophrenia and hospitalized in the psychiatry department of the Taher Sfar university hospital in Mahdia from January 2017 to December 2021.

The mean age of the patients was 39.8 ± 11.23 years with a predominance of age group 36-45 years (38.4%). All of the patients were males . Three quarters of patients (75.5%) were users of psychoactive substances (PSA): nearly three quarters (72.8%) dependent on tobacco, more than a third (39.7%) dependent on alcohol, more a quarter (29.1%) dependent on cannabis and almost a quarter (26.5%) dependent on other SPA. In more than half of the cases (54.4%), the age at which SPA consumption began was between 16 and 25. SPA use preceded the onset of schizophrenia in 62.3% of case. The relationship with the entourage was marked by hetero-aggressiveness in 77.5% of the patients, a withdrawal from the entourage for 16.6% of the patients and a conflict for 5.3% of the patients. The impact on the relationship with oneself was marked by self-aggressiveness in 18.5% of patients. Regarding professional impact, three quarters of patients (76.1%) had to stop working. The majority of patients (84.1%) continued their usual treatment, while 15.2% of patients stopped it. In only one patient increased doses were necessary.

Subjects suffering from schizophrenia are particularly vulnerable to addictions, mainly to tobacco and alcohol. They are therefore a group at greater risk of harmful effects of psychoactive substances and at worsening the clinical course of their psychiatric illness. Screening and treatment measures their addictive behaviors early on, even before schizophrenia sets in, should be offered.

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Forced medication is one of the most frequently used coercive measures in acute mental health units. It is a practice that can lead to physical, psychological and psychopathological consequences. Therefore, it is necessary to implement measures to reduce its use. In this sense, it is interesting to study the variables that can be associated with its use, and thus take measures accordingly.

This study attempts to identify the number of forced medication episodes between July 2017 and December 2018 treated in the catchment area of the Mental Health Service at Jerez Hospital. As a secondary objective, it pursues to identify the factors that conducted to the use of forced medication with the intention of being able to reduce the use of these measures.

A descriptive and retrospective study has been developed reviewing the total number of episodes of forced medication. Patients admitted and discharged from hospital between July 2017 and December 2018 treated in the Mental Health Service at Jerez Hospital. Data were extracted from medical records.

The total number of episodes of forced medication identified was 330. In these episodes, the average age was 41 years, with a predominance of 74% of the male gender. The most used route in the episodes was intramuscular (94.8%), in addition, more than 50% needed the association of two drugs, the most used were haloperidol and olanzapine. The 32.7% of the episodes also required the use of mechanical restraint and 44.2% required the presence of security service.

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We present the descriptive analysis of a further study currently been conducted in hour hospital which means to stablish predictive factors for the use of forced medication. We therefore intend to create patient profile, as well as new measures specifically directed to these factors with which to diminish the use of forced medication.

None Declared

Despite being effective in schizophrenia, second-generation antipsychotics are potent histamine-H1 receptor antagonists associated with weight gain. Histaminergic agonists can potentially counteract the weight gain effects of antipsychotics. Betahistine is a centrally acting histamine-H1 agonist and, therefore, may reduce antipsychotic-induced weight gain, but it has never been examined in a meta-analysis.

This meta-analysis aims to examine the efficacy of betahistine in counteracting the weight gain effects of antipsychotics.

We searched PubMed, Scopus, Web of Science, and Cochrane Controlled Register of Trials (CENTRAL) for all relevant trials. We used Hedges’ g with its confidence interval as our effect size to correct for the small sample size. The primary outcomes of this study were changes in weight and body mass index (BMI). Changes in insulin resistance and lipid parameters were secondary outcomes.

165 studies were included in the title/abstract screening, and 5 studies with 217 patients were finally included. Betahistine led to statistically significant changes in weight (Hedges’ g -1.13, 95% CI [-1.66, -0.60], p < 0001), BMI (Hedges’ g -1.64, 95% CI [-2.39, -0.89], p < 0.0001), and waist circumference (Hedges’ g -0.98, 95% CI [-1.47, -0.49], p < 0001). Nevertheless, betahistine did not lead to any significant changes in fasting glucose (Hedges’ g 0.02, 95% CI [-0.41, 0.44], p = 0.94) or insulin levels (Hedges’ g -0.07, 95% CI [-1.78, 1.64], p = 0.94).

Betahistine is an effective add-on treatment for second-generation antipsychotics to counteract weight gain experienced with these medications. Further trials are recommended to examine its effect on blood lipids and side effects.

None Declared

Drug-Induced Liver Injury (DILI) is one of the most common causes of hospitalization due to liver failure and represents a considerable challenge in clinical practice. One risk factor is the long-term use of a drug. Antipsychotics are regularly prescribed over a long period of time. Therefore, potential hepatotoxicity is of particular importance here. However, DILI related to antipsychotics are still insufficiently understood.

Within a combined pharmacoepidemiologic and pharmacodynamic approach, we examined the association between DILI and the receptor affinity of various common prescribed antipsychotics.

Disproportionality analyses were used to calculate reporting odds ratios (RORs) for reports in which drug-related hepatic disorders were reported as an adverse reaction related to antipsychotics. MedDRA terms for Drug related hepatic disorders were used to identify cases. Data were extracted from VigiBase the WHO global database of reported potential side effects of medicinal products. For pharmacodynamic evaluation, we calculated Pearson correlation coefficients between affinity for various receptors and the corresponding RORs.

We observed a statistically significant (r (12) = -. 74, p = 0.002384) negative correlation between 5-hydroxytryptamine receptor 1A receptor affinity and drug related hepatic disorders. Furthermore, we observed a statistically significant (r (8) = -. 69, p = 0.02577) negative correlation between 5-Hydroxytryptamine receptor 2B receptor affinity and drug related hepatic disorders. No statistically significant association was found for other receptors.

In this exploratory pharmacoepidemiological and pharmacodynamic approach, no particular risk for increased hepatotoxicity related to affinity for a specific receptor was found. Interestingly, a negative correlation to two serotonin receptors was found. These findings are consistent with results from the animal model, in which improved liver function and reduced fibrogenesis were observed under 5HT2B antagonists.

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Borderline personality disorder (BPD) is a real source of suffering for people affected and for those around them.

The aim of this study was to describe the socio-demographic and clinical characteristics of out patients with BPD consulting the psychiatry department of Hedi Chaker hospital in sfax tunisia during the period between January 2022 and October 2022.

It was a descriptive study. The population study consisted of patients diagnosed with BPD (DSM 5) consulting the psychiatry department of the hospital Hédi Chaker of Sfax tunisia during the period from January 2022 to October 2022.

Sociodemographic and clinical data were collected using a predefined form.

All statistical analyses were performed using the SPSS software package v 18.

Among 700 adult patients referred to the psychiatric unit of hedi chaker hospital in sfax from january 2022 to october 2022, 35 patients (5%) were identified as meeting the criteria for BPD.

The average age was about 35 years, 54.3% of the patients were men. They were married in 40% of cases.Only 31.4% of the patients had a regular job.

The presence of a family psychiatric illness was noted in 48.5% of cases and 20% had a childhood psychiatric follow-up .

The rates of sexual abuse, physical abuse, psychological abuse and neglect were 17.1%, 65.7% and 68.6% respectively.

In our sample,48.6% of the patients had attempted suicide and 60% of them had committed self-harm.

The most common means of attempted suicide was phlebotomy.No prior thoughts of suicide were mentioned, all suicide attempts were impulsive. Negative feelings and family conflicts motivated the suicide attempt (37.5% ,56.25%).

Comorbid psychiatric disorder was mentioned in 54.3% and The most frequent comorbid psychiatric disorders was depression (20%).

Pharmacotherapie was used in 88.6% of cases.

The results emphasize on the comorbidities with mainly depressive episodes and a high proportion of suicide attempts and self-harm. Moreover, this study confirms the impact of family conflicts and abuse in the development of this disorder

None Declared

Mental health deteriorated worldwide during the COVID-19 pandemic. The healthcare sector recognises the role of nature in mental health. Passive and active interactions with nature reduce stress, anxiety, and depression. Theoretical frameworks for mental health benefits from nature interventions include medical, evolutionary, relational, eco-psychological and human activity perspctives.

To assess the usefulness of the nature-based interventions in relation to well-being improvement.

The six-month survey was carried out in a forest in the administrative district of the capital city of Warsaw.Over 70 adult volunteers took part in structured sessions of active nature-based interventions, lasting ca. 1.5 hour.The forest bathing methodology was based on the review literature. Participants anonymously filled in on-line semi-structured questionnaire containing GHQ-30, DASS-21 andlife satisfaction. questionnaire. Between sessions, participants were asked toassessment their mood profile and life satisfaction. After every session they assessed particular interventions in terms of usefulness on 5-point Likert scale.

The authors will present the results of the study and key findings.

It is expected that the study may provide a significant contribution to the knowledge’ development about the nature-based interventions. In particular, we can learn about the impact of several interventions (active exercise, visualization, mindful walking, mindfulness perception) on improving the well-being of participants.

None Declared

Persons with temporal lobe epilepsy due to hippocampal sclerosis (TLE-HS) have a high frequency of psychiatric disorders, namely depression and anxiety. In addition, poor quality of life (QOL) and impairments in psychosocial adjustment are frequently reported. Despite the increasing number of studies aiming to identify predictors of poorer QOL, the role of depressive and anxiety symptoms remains poorly understood.

This study aimed to evaluate: (1) if psychosocial adjustment predicts worse QOL; (2) the relationship between psychosocial adjustment and QOL by concurrently examining the role of depressive and anxiety symptoms.

Thirty-five persons with TLE-HS ranging from 18 to 60 years old (mean age 39.82 SD 9.05; 20 men 57.14%) followed in a tertiary outpatient center underwent neurologic and psychiatric assessments.

The psychiatry interview was performed using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (SCID). Psychosocial adjustment was assessed with the total score of the Social Adjustment Scale (SAS) (SAS Overall). The QOL was evaluated by the total score of the Quality of Life in Epilepsy-31 Inventory (Overall QOLIE-31), the most frequently used instrument in assessing QOL in epilepsy. The Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI-X) were used to assess depressive and anxiety symptoms, respectively.

Prediction analysis was performed to evaluate the impact of psychosocial adjustment on QOL (simple linear regression). Simple moderation models were used to examine the moderation effect of depressive and anxiety symptoms on the association between PA and QOL (Figure 1). We used SPSS (version 29 IBM Corp) and PROCESS Macro (version 4.1. for SPSS) to perform regression and moderation analyses (Figures 2 and 3), respectively.

Poor psychosocial adjustment (higher scores on SAS) impacted on poor QOL (lower scores on QOLIE-31) (R=0.39; R2=0.15; adjusted R2= 0.12; B=-0.39; t=-2.28; p=0.03). The severity of anxiety symptoms (Trait and State; coefficient=-0.64; t=-2.01; p=0.05 and coefficient=-1.17; t=-2.20; p=0.03, respectively), but not the severity of depressive symptoms (coefficient=0.77; t= 1.37; p=0.18), moderated the relationship between psychosocial adjustment and QOL.

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Psychosocial adjustment is a predictor of QOL in TLE-HS. Anxiety symptoms moderate this relationship between psychosocial adjustment and QOL. Consequently, higher anxiety symptoms are associated with worse psychosocial adjustment and quality of life.

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Schizophrenia (SCZ) is a chronic neuropsychiatric disorder possessing a multifactorial nature and dual facets of symptoms with a core underlying genetic mechanism that is still obscure. Lately, genomic studies revealed numerous single nucleotide polymorphisms (SNPs) that are non-coding and influence ribonucleic acid (RNA) expression, particularly its splicing.

Considering that next-generation sequencing (NGS) protocols focus upon long-read sequencing as opposed to conventional RNA sequencing methodologies once with the advent of Oxford Nanopore Technologies’ (ONT) MinION, we primarily aimed to gather and review all evidence into how this approach may deepen and further offer insight into SCZ still undiscovered domain.

The relevant literature searches were performed using distinct combinations of keywords including “schizophrenia” alongside „Nanopore”, “MinION”, and “Oxford Nanopore Technologies” on four databases (PubMed/Medline, ISI Web of Knowledge, Scopus, and ScienceDirect). We implied the entries to strictly “research articles” written in English as inclusion criteria.

By restricting the returned results starting with the year when the platform was officially launched, a total of n = 69 studies were displayed between the pre-established interval (2014 – 2022). If taken per database, n = 2 were identified in PubMed/Medline, n = 7 in ISI Web of Knowledge, n = 4 in Scopus, and n = 56 in ScienceDirect. In chronological order, n = 0 were published in 2014, n = 3 in 2015, n = 7 in 2016, n = 7 in 2017, n = 9 in 2018, n = 3 in 2019, n = 7 in 2020, n = 19 in 2021 and n = 14 in 2022. Finally, per the strategy applied, n = 49 were returned for “schizophrenia” + “Nanopore” from which n = 2 in PubMed/Medline, n = 5 in ISI Web of Knowledge, n = 4 in Scopus, and n = 38 in ScienceDirect. For “schizophrenia” + “MinION, there was a cumulative number of n = 5, from which we had n = 0 in PubMed/Medline, n = 0 in ISI Web of Knowledge, n = 0 in Scopus, and n = 5 in ScienceDirect. Finally, for “schizophrenia” + “Oxford Nanopore Technologies” were displayed n = 15, and the situation was n = 0 in PubMed/Medline, n = 2 in ISI Web of Knowledge, n = 0 in Scopus, and n = 13 in ScienceDirect.

We presently assist to a fulminant ascension in the literature, with applicability in other fields. Perhaps as cornerstone stands a recent publication in which the authors reveal the risk of the Calcium Voltage-Gated Channel Subunit Alpha1 C (CACNA1C) gene involved, being identified thirty-eight novel exons and two hundred and forty-one novel transcripts following RNA purification from six regions (cerebellum, striatum, and dorsolateral prefrontal cortex) among which targeted were cingulate, occipital and parietal cortexes.

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Post-traumatic stress disorder (PTSD) is a debilitating disorder affecting approximately 6% of the population. Current treatments have been shown to efficaciously reduce symptom burden between 30%-50%. However, due to the high intensity of treatment over a long period of time. drop-out rates are as high as 50%.

Assess the effect of one-time ketamine infusion in subanasthetic dosage on PTSD psychotherapy

Assess feasibility and effect of massed, four days, esposure focused psychotherapy for PTSd

Here, we tested the efficacy of a four-day exposure and processing-focused psychotherapy at reducing PTSD severity. Twenty-seven participants with chronic PTSD were randomized to two groups, one receiving a one-time infusion of ketamine in a subanesthetic dose (0.5mg/kg for 40 minutes), the other receiving midazolam. Both groups underwent four 90-120 minutes of daily psychotherapy sessions a day after infusion, followed by in-vivo exposure practice. The severity of PTSD was assessed with the PCL-5 before and at the end of treatment, and at 30 and 90 days follow-up. Brain reactivation to the trauma reminders was measured using fMRI

PTSD severity in both treatment groups decreased by 13, 16, and 15 points on the PCL-5 at the end of treatment, 30 days follow-up, and 90 days respectively, surpassing the minimum clinical difference of 7.9 points. There was no significant difference in symptom reductions between the treatment groups. However, brain reactivation to trauma stories differed between the groups, with the ketamine group showing a decline in the amygdala and hippocampus reactivation compared to the midazolam group, at the end of treatment.

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Our results imply comparable efficacy of this short-term intervention to standard trauma-focused psychotherapies, emphasizing its clinical usefulness as a short and effective intervention.

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