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 intentional use of drugs before or during sexual intercourse (chemsex) is a phenomenon of special importance in the MSM (men who have sex with men) population due to its impact on mental, physical and sexual health. Sexual health issues related to chemsex practice have been described such as difficulties in achieving sober sex, erectile dysfunction or problems with sexual desire.

The objective of this study was to understand the impact of chemsex on sexual health and sexual response by the participantes of a sexual health program for chemsex users in two Substance Use Disorder Clinics in Madrid.

Qualitative research approach. We analyze an anonymous survey with chemsex users with open answer questions about the impact of chemsex practice on sexual response and sexual health. Data analysis was based on thematic analysis of content.

Several differences were identifed between chemsex and sober sex. In sober sex it can take longer to feel aroused, sexual desire is more context-dependent and more easyly controled. They connect easily with other people needs when they had sober sex. They described difficulties with consent with some sexual practices when they were on drugs. Shame and guilt was associated with chemsex. They describe more arousal, more independent of the erotic context, longer sexual intercourse and delayed ejaculation when they had sex under the influence of drugs.

Chemsex is a phenomenon that needs a multidisciplinary approach and mental and sexual health must be taken into account including sexological perspective. Interventions that provide sexual counselling and sexual therapy for chemsex users must be developped.

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Healthcare workers (HCWs) are on the front line in the management of the COVID-19 pandemic. They are at higher risk of acquiring SARS-CoV2 infection and might transmit the virus to other person or their family members. All these gave rise to stigma toward society, family, and HCWs.

to measure social and professional stigma and guilty feelings among HCWs in a Tunisian hospital.

A cross-sectional study using a questionnaire (sociodemographic and professional characteristics and three questions (yes/no) related to social and professional stigma and guilty feelings) was conducted from September 1 to December 31, 2020, at Charles Nicolle hospital of Tunis. The survey was distributed among HCWs consulting the department of occupational health after a COVID-19 infection.

A total of 259 HCWs were included in the study. The mean age was 41±10 years with a sex ratio of 0.25. The HCWs were married in 66.8% of cases. The professional categories were represented mainly by nurses in 33.5% of cases followed by technicians and physicians in 26.2% and 17.4% of cases respectively. The average professional seniority was 13 years (min=1 year; max=13 years).

The social stigma was reported by 30.5% and professional stigma by 20.1%. The stigmatized population was predominantly female (86%), and the proportion of married people was 63%. The predominant professional category was nurses (36%) followed by senior technicians and workers (25% and 16% respectively). The average length of employment was 13 years. Guilt was felt by 57.1% of the cases.

Based on the results of this study, the social and professional stigma during COVID-19 among HCWs was significant as well as the feeling of guilt. This may have an adverse impact on HCWs’ mental health.

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Alzheimer’s disease (AD) is the most prevalent form of age-related dementia in the world. The body of evidence suggesting that its main pathological features consist of amyloid-β (Aβ) plaque deposits and neurofibrillary tangles formed by hyperphosphorylated tau protein is robust. The drugs currently on the market have no effect on disease progression and provide only partial symptomatic relief, which creates a large unmet medical need. Anti-Aβ monoclonal antibodies (mAbs) have been shown to reduce amyloid plaques. Therefore, passive immunization is a major hope for treatment of AD.

This review aims to summarize the up to date knowledge and experience with Anti-Aβ mAbs with positive clinical or biomarker effects in long-duration trials.

A narrative review was conducted based on a search in Google Scholar and Pubmed, using the following terms or combinations “anti-aβ protofibril antibody”; “early alzheimer’s disease”; “immunotherapy for Alzheimer’s disease”. Peer-reviewed literature published between 2016 and April 2022 was screened on full-text for this purpose.

Aducanumab surpassed a successful Phase 1B trial demonstrating a dose and time dependency for Aß reduction with a beneficial impact on some clinical measures after 1 year of treatment. Two large Phase 3 clinical trials were initiated and already discontinued based on futility analysis done and not based on safety concerns. Further analyses including participants exposed for longer periods of time at higher doses indicated that aducanumab reduced brain amyloid and decreased the rate of decline.

Lecanemab (BAN2401) completed a Phase 2 trial (2018) with evidence of amyloid reduction and slowing of cognitive decline and has now entered Phase 3. Aducanumab and BAN2401 showed significant efficacy on both clinical and biomarker outcomes.

Crenezumab Phase 2 trial results suggested efficacy in mild AD; a Phase 3 program was recently halted due to futility. This mAb is currently being assessed in a prevention trial involving a Colombian kindred with autosomal dominant AD.

Gantenerumab showed significant biomarker effects, with no clinical efficacy reported to date and is being assessed in Phase 3 trials after a trial in prodromal disease stopped for futility suggested that higher doses might be efficacious. Gantenerumab and solanezumab showed no drug-placebo differences in clinical outcomes of specific studies included in this review.

Therapies with anti-Aβ mAbs have been developed successively and conducted in clinical trials signaling a promising new era for AD drug development and providing compelling evidence for the prominent role of neurotoxic soluble amyloid oligomers in the pathogenesis of AD and as therapeutic targets. Lessons learned from these studies may also be a bridge to more efficacious, safe drugs in AD.

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Donepezil is an acetylcholinesterase inhibitor approved by the Food and Drug Administration for the treatment of dementia in Alzheimer’s disease. While it is not curative for Alzheimer’s disease, donepezil has been shown to improve symptoms and slow disease progression; however, cases of rare psychiatric adverse effects, including hallucinations, mania, and increased confusion, have been reported. This report presents a case of donepezil-induced psychosis, which quickly resolved following cessation of the offending medication.

To illustrate a unique case of donepezil-induced psychosis

The patient is an 81-year-old male with a history of late-onset Alzheimer’s disease, mild depression, hypertension, hyperlipidemia, gastroesophageal reflux disease, and myocardial infarction. The patient was prescribed oral donepezil 10mg twice daily to manage his late-onset Alzheimer’s disease. Subsequently, he began developing persecutory delusions, increased agitation toward his family, and auditory hallucinations. His symptoms were worse at night after taking the donepezil, and he regularly requested to have a firearm for self-defense in the late hours of the night. His symptoms progressed for several weeks before his family brought him into the geriatric psychiatry clinic to address his psychosis. The family recognized that these new symptoms started shortly after the patient began taking donepezil and had already started decreasing the dose to half of what was originally prescribed.

This patient experienced symptom remission from psychosis immediately upon discontinuation of donepezil. The patient and his family reported significant improvement with no continuation of hallucinations or paranoia. There was also reported improvement in mood and irritability, and the patient appeared significantly better upon follow-up with geriatric psychiatry. Due to this immediate improvement, the suspected causative factor in the precipitation of psychosis in this patient is the anticholinesterase activity of the donepezil. Although the prescribing information of donepezil details inadequate data proving an association between donepezil and psychotic symptoms, two other published case reports (Yorston GA et al. J Psychopharmacol 2000;14:303-4, Pozzi FE et al. Case Rep Neurol 2022; 14:359-365), along with this one, provide evidence of a causal relationship between the two. The patient was switched to memantine therapy and has remained free of psychotic symptoms thus far.

This case demonstrates the caution required among clinicians when prescribing donepezil for the treatment of Alzheimer’s disease. There needs to be a more focused risk evaluation of potential psychiatric adverse effects in patients treated with donepezil.

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Gaining competitive advantage is essential to modern organizations, for which it is fundamental that workers are engaged with their work. Perceived age discrimination in the workplace is a factor that may influence workers’ engagement.

The present study aimed to analyze the moderating role of emotional regulation in the relationship between perceived age discrimination and work engagement.

This empirical study included a sample of 452 Portuguese workers of various age groups, between 18 and 65 years-old and used the questionnaire as data collection method.

Results show that perceived workplace age discrimination negatively impacts work engagement. Further, results suggest that emotional regulation exacerbates the negative relationship between perceived age discrimination and work engagement.

Age management strategies to address perceived age discrimination and work engagement, particularly due to the increasing proportion of older workers, are discussed.

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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).

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Over the past decades, the digital landscape has been rapidly changing worldwide, and the number of social media users has been constantly increasing. social media usage is widespread among the age groups going from Adolescents (aged 16-24 years) to young adults (aged 25-34 years) the vast majority of Tunisian students (98.4%) reported using social media platforms, with Facebook being the most widely used (94.3%), followed by YouTube (90.5%) and Instagram (65.0%) (Feten Fekih-Romdhane et al., 2021)

We aimed to compare Facebook addiction between low and high schizotypal individuals

the final sample included in this study was comprised of 700 students. Based on the Schizotypal Personality Questionnaire (SPQ) total scores, the sample was classified into two groups of low (the lower 10% of a standardization sample) and high (the upper 10%) schizotypy(Raine, 1991).

From the overall pool of 700 students (67.6% females, mean age of 21.5 ± 2.5 years), 74 identified as belonging to the low schizotypy group and 70 were classified as having high schizotypal traits .

Students of the high schizotypy group displayed significantly greater scores on Facebook (p=.001) addiction scales, as compared to those of the low schizotypy group

High schizotypal participants spent in average 7.4 hours on on social media use per day, as compared 3.9 hours on social media in their low schizotypal counterparts

Our study showcases that schizotypy is related to a certain level of addiction to social media. These results can be used as a way to help this at risk population by making social media into a safe space where we can provide help lines and protection

None Declared

Long-term schizophrenia, even in remission, is necessarily accompanied by residual symptoms that may be quite pronounced and may significantly affect many aspects of the patient’s life, requiring exploration of specific therapeutic approaches. The alleviation of residual symptoms is an important factor in the patient’s better adjustment.

Assessment and study clinical characteristics long-term schizophrenia.

Clinical, statistical, psychometric. A total of 90 patients, mean age 66,6±13,3 years, 26 males, 64 females were examined.

Negative symptoms were predominant in patients with long-term schizophrenia (17,8±6,7). It was represented by: abstract thinking disorders (2,8±1,0), stereotyped thinking (2,7±1,1), passive-apathetic social isolation (2,6±1,2), avolition (2,6±0,8), flattening of affect (2,5±0,8). It manifested as lack of expressiveness in facial expressions and gestures, deficit of communicative gestures as well as emotional indifference (2,4±1,1), limitation of contacts with people, and spontaneous and fluent speech impairments. Positive symptoms were rare, mainly represented by suspiciousness (2,2±1,2), sometimes rising to delirium (1,8±1,4). Conceptual disorganization was detected in 1,9±0,7. Agitation and aggression were generally not characteristic of those surveyed. Depression/anxiety was quite pronounced in patients with long-term schizophrenia. Depression (1,8±0,8) was represented by low mood, hopelessness and loss of social interests. Anxiety (2,9±1,2) was even more prominent and predominant amongst all symptoms.

The authors expanded our understanding of the clinical characteristics of residual symptoms of long-term schizophrenia to allow timely identification and provision of medical and rehabilitative care.

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Addiction is a chronic disorder resulting in physical, psychological, and/or social harm following the repetitive, compulsive consumption of a substance. In Morocco, there are few data on female addictive behavior, apart from those concerning the prevalence of consumption of products based on surveys of the general population.

Report the current epidemiological, clinical, and therapeutic peculiarities of female addiction according to a heuristic approach (based on proven scientific evidence).

A questionnaire was distributed to patients followed at the addiction center in Tetouane and the Ar-razi psychiatric hospital in Tangier. We also carried out a systematic review of the literature, focusing on about ten articles. The main search engines are PubMed, Medline, Science Direct.

The substance use disorder concerns cannabis in 68% of cases, tobacco in 52.1% of cases, alcohol in 40.33% of cases, benzodiazepines in 33.61%, cocaine in 15.96%, opioids (7.5%), and inhalants (1.6%). 73.8% of residents have psychiatric comorbidities, of which 42.9% suffer from depression, 13.40% from bipolar disorder, 10% from generalized anxiety disorder, 4, 20% have panic disorder, 1.7% have social anxiety, 0.8% have post traumatic stress syndrome and 0.8% have bulimia. 58.8% of patients had a personality disorder, 36.1% attempted suicide, 16% suffered physical violence, and 20.20% of patients were victims of rape.

International literature shows the growing interest in gender issues in the field of addictions (whether they involve the consumption of legal or illegal products or behaviors such as gambling, food, purchases, sexuality, etc.), apart from those concerning the prevalence of consumption of general population survey products, shows the growing interest in gender issues in the field of addictions. This problem has been recognized as being of crucial importance and has been posed as a priority objective

Minimum levels of consumption among women tend to obscure the impact of gender relations on female addicts. Through this research, we hope to identify the differences between male and female addictions. The overdetermination of certain forms of psychiatric suffering and/or certain living conditions makes women more vulnerable to the problematic use of psychotropic drugs. On the other hand, women have to gain from being able to benefit from specific responses within the framework of front-line or support and care systems.

None Declared

Childbirth is a period of transition for women, which can have several physiological and psychological repercussions on their lives.

To estimate the prevalence of postpartum post-traumatic stress disorder in a sample group of Tunisian women.

This is a longitudinal prospective descriptive study carried out among women who were hospitalized for childbirth in the obstetrics gynecology department and those who consulted the outpatient perinatal consultation of the Tahar Sfar Mahdia hospital during a period of 7 months from March 15, 2020 to September 15, 2020. Data collection was based on a pre-established questionnaire determining the different socio-demographic and clinical characteristics.

The women’s psychometric assessment was conducted using a PCLS psychiatric scale for screening for post-traumatic stress disorder.

We collected 120 women with an average age of 28.3 ±5.3 years. Among our sample, two women had a history of depression (1.6%) and three participants had a history of an anxiety disorder (2.5%).Thirty-five patients (29.1%) had a pathological obstetric history. However, fifteen patients (12.5%) were hospitalized during their pregnancies. Eighty-seven patients (72.5%) expressed their anticipated fear of childbirth and one hundred two patients (85%) had a good marital relationship with good social support. 48.3% of deliveries were vaginal and 27.5% were by emergency cesarean section. Level three pain was expressed in 73.3% of deliveries. Psychometric assessment revealed a prevalence of PTSD at 5.8% with PTSD symptomatology in 18.4% of women.

Postpartum post-traumatic stress disorder is a major public health problem that affects the healthy development of the newborn and the mental and physical recovery.

None Declared

During the war, the rehabilitation of combatants after injuries of varying degrees of complexity has particular importance. The effectiveness of rehabilitation of athletes-war veterans can be assessed by the level of physical performance, functional properties and state of all body systems. The reduction of functional asymmetry, accuracy of the sensorimotor response and dynamic muscular endurance (DME) of hand movement by the tapping test are effective and objective indicators of physical rehabilitation.

The aim of this study was to evaluate functional asymmetry, accuracy of sensorimotor response and dynamic muscular endurance of hand movement by tapping test during the rehabilitation of amateur field-and-track athletes after battle traumas.

10 war veterans (amateur field-and-track athletes, right-handed male aged between 28 and 60 years) took part in the study. To determine the state of psychophysiological functions and the maximum tempo of movement of the hand Diagnostic complex “Diagnost-1” (Ukraine) was used. We analyzed indicators of the tapping test, indicators of a simple visual-motor reaction (SVMR) and a reaction of choosing one of three signals (RCh1-3) separately for the right and left hand, indicators of a reaction of choosing two of three signals (RCh2-3). Non-parametric statistics methods (Spearman’s rank correlation coefficient) were used to process data.

The accuracy of the sensorimotor reaction (according to the SVMR indicators) corresponded to the average level in the majority of athletes (60%). The indicators of the simple response of the choice of RCh1-3 were below the average (20%) or at a reduced level (50% of the examined). DME of the dominant hand was high or medium in 40% and 60% participants respectively. In 90% of the surveyed athletes, asymmetry in terms of the tapping test is moderately expressed. Results showed the significant correlation between the stability index of the simple visuomotor reaction (SVMR) and the dynamic muscular endurance (DME) indicators for the dominant and subdominant hand (r = 0.75, r = 0.71, p<0.05, respectively) - the greater DME corresponded to the lower stability of the SVMR. Latency periods of simple visuomotor reaction and their components (motor components of SVMR, RCh1-3, RCh2-3 reactions and the time of central processing of information in choice reactions) were not associated with tapping test indicators.

Therefore, it can be assumed that motor components of a simple visuomotor reaction, choice reactions and the time of central processing of information in choice reactions were not related to dynamic muscle endurance. The revealed interrelations between the stability of the sensorimotor response and the dynamic muscular endurance of the hand movement can be indicators of the successful rehabilitation of amateur athletes after injury.

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At the global level, women are more likely than men to misuse pharmaceutical drugs, particularly pharmaceutical opioids and tranquillizers. By contrast women are three times less likely than men to use cannabis, cocaine or amphetamines and one in five people who inject drugs are women.This mainly reflects differences in opportunities to use drugs owing to the influence of social or cultural environments, rather than intrinsic gender vulnerability. The scientific literature shows that processes of drug use initiation, social factors and characteristics affecting people who use drugs, biological factors and progression to the development of drug use disorders vary considerably between men and women. In this presentation we will present the main characteristics at bio-psycho-social level, including mental (i.e, Depression, Post- Traumatic Stress disorder) and physical comorbidities (i.e. HIV, HCV) of women with illicit drug use disorders. Finally, there will be a reflection on the different difficulties that women who use drugs have in accessing treatment.

M. Torrens Consultant of: MT has been a consultant/advisor and/or speaker for Gilead Sciences, Camurus, Servier, Adamed, Lundbeck, Otzuka, Angelini, Molteni

Working in a care setting is characterised by an increased mental and physical load. During their professional life, personnel in this sector can develop essentially degenerative pathologies, which could influence their professional career as well as their psychological balance.

We aimed to evaluate the impact of chronic pathologies on the prevalence of anxiety and depression among this group.

We conducted a cross-sectional study in hospitals in Sfax using a self-administered questionnaire. This questionnaire evaluated socio-demographic, professional, and clinical characteristics as well as an evaluation of the degree of anxiety and depression by the HAD questionnaire.

Our population consisted of 120 participants. The average age was 37 years, with a female predominance (a sex ratio of 0.69). The chronic pathologies found in the participants were mainly diabetes (18%), high blood pressure (4%), and rheumatic disease (6.7%). The average anxiety score was 8.18± 3.5 and that of depression was 9.02± 3.5. Certain depressive and anxious signs were found in 28.4% and 23.6% of participants, respectively. Although the average scores for anxiety and depression were higher in the subgroup of personnel with chronic pathologies (respectively, 9.8 versus 9.04 and 9.3 versus 8.46), these differences were not statistically significant (p > 0.05).

Physical and mental health are both important to ensure a balanced life. Having good control of somatic illness can improve mental health.

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Electroconvulsive therapy (ECT) is a procedure performed under general anaesthesia involving triggering an intentional brief seizure through small electrical currents through the brain. The anaesthetic depth should be adequate prior to shock and measured with BIS, a processed electroencephalogram (EEG) monitor. Adjusting the hypnotic dose allows to decrease the ictal threshold and thus improve the response to treatment and decrease side effects.

Our goal is detecting elements such as spontaneous epileptiform activity after ECT without tonic-clonic activity with the spectral density matrix (SDM).

Our patient: an 87-year-old woman, diagnosed with F20.2 catatonic schizophrenia and under antipsychotic treatment since her youth. She has required multiple hospital admissions due to psychopathological decompensations until starting monthly maintenance ECT sessions in 2014. Since then she no new hospital admissions have been required.

Images 1D and 1E shows the SDM, a spectrogram of the EEG. The X axis show time (minutes), the Y axis shows the frequency (Hz) and the Z axis shows the energy or intensity of that electrical activity in the frequency bands replaced by colors: warm colors (red) reflecting high intensity electroencephalographic activity and cool colors (yellow, blue and green), low activity. Images 2 and 3’s EDM shows spontaneous epileptiform activity after electroconvulsive therapy without tonic-clonic activity. We observed an initial EDM of an awake patient, with warm colours in practically all frequency bands, including the beta band (13-30 Hz), characteristic of waking states. Around 9:50 anaesthetic induction occurs, activity increases in slow frequencies (red colours in alpha, theta and delta), plus an increase of cold colours in beta, reflecting the disappearance of brain activity in that frequency. The asterisk reflects the EEG response to the electrical discharge, followed by a postcritical state with brain activity exclusively in slow waves and high amplitude (delta and some theta) and absence of activity in other frequencies (blue colour in the beta and alpha bands) around 9:57. At about 10:00 there is an abrupt appearance of high intensity brain activity (warm colours) in beta and alpha and delta, mainly, reflecting spontaneous epileptiform activity after treatment and clinically reflected as a patient absent and disconnected from the environment, but without tonic-clonic activity. New postcritical state in which blue colour predominates, reflecting little brain activity, and warmer colours reappear in all frequency bands, including beta, reflecting the progressive recovery of wakefulness.

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Image 2:

Image 3:

Psychiatric pathology can be reflected in the SDM, which allows to observe changes in the EEG, correcting the electrical stimulus of the shock and the dose of anesthetic appropriate to the patient to trigger an intentional brief seizure under general anesthesia.

None Declared

Schizophrenia patients are at an increased risk for severe SARS-CoV-2 illness. Recent studies indicate that vaccines reduce morbidity gaps between schizophrenia patients and the general population; nonetheless, the ongoing emergence of COVID-19 variants and the increased frequency of breakthrough infections might lead to changes in these risk profiles.

In this study we aimed to bridge this gap by assessing the risk of COVID-19 infection, hospitalization, and mortality among vaccinated individuals with schizophrenia, as compared to vaccinated individuals with no schizophrenia, matched for age, sex, and vaccination coverage (first, second, and booster) throughout the first year of the vaccination plan.

The study included 50,958 vaccinated individuals: 25,479 individuals with schizophrenia and 25,479 without schizophrenia. Data were derived from the databases of Clalit Health Services, the largest healthcare organization in Israel.

Findings indicated that differences among vaccinated schizophrenia patients and controls were non-significant after adjusting for infection (HR = 0.93, 95%CI 0.84-1.03, p = 0.14) and mortality rates (HR = 2.18, 95%CI 0.80-5.90, p = 0.12). Nonetheless, differences in rates of hospitalization remained significant even after controlling for demographic and clinical factors (HR = 2.68, 95%CI 1.75-4.08, p<0.001). A longitudinal assessment of relative risk indicated that the rate ratio of differences between the groups increased during the fourth infection wave of the B.1.617.2 (delta) variant across all parameters, with schizophrenia patients demonstrating higher relative risk of hospitalization (RR = 4.19, 95%CI 2.41-7.23) and mortality (RR = 7.61, 95%CI 0.93-61.89) during the relevant periods.

These findings suggest that vaccination coverage is effective in narrowing overall morbidity and mortality gaps; nonetheless, individuals with schizophrenia are still at risk for severe COVID-19 outcomes.

None Declared

The Severe Acute Respiratory Syndrome Coronavirus (COVID-19) pandemic not only impacted on physical but also mental health of the patients. We investigated the prevalence and associated factors of depression, anxiety among hospitalized patients with COVID-19. Rajavithi hospital is a supra-tertiary hospital which was the frontline in the first wave and gets referral SARS CoV-2 cases from other parts of Thailand.

We investigated the prevalence and associated factors of depression, anxiety among hospitalized patients with COVID-19.

A cross-sectional study was designed to evaluate prevalence of depression, anxiety and associated factors among 93 hospitalized COVID-19 patients between 1 July 2020 – 31March 2021. Depression and anxiety were measured with Thai Hospital Anxiety and Depression (Thai HADS).

Prevalence of depression was 5.4 %, prevalence of anxiety was 2.2 % Depression was associated with age greater than or equal to 60 years old (p-value = 0.028) and requiring supplemental oxygen therapy (p-value = 0.021).

This study shows low prevalence of depression and anxiety in hospitalized patients with COVID-19. Depression was significantly related with elderly and supplemental oxygen therapy. Elderly is vulnerable to depression during treatment and patients who require supplemental oxygen therapy. Severity of the disease might affect neuroinflammatory responses which can relate to depression. Furthermore, severity of disease puts patients in more isolation or guilt that might lead to depression.

None Declared

A pandemic can have significant effects on people’s emotional wellbeing. Infection control measures such as social distancing can lead people to feel isolated and to increased feelings of fear, anxiety, anger, and sadness. Recent research showed a worrying increase in depression and anxiety disorders, general distress, and sleep disorders. People who already suffer from a mental illness may be more vulnerable to stress caused by the pandemic and may experience a deterioration of already preexisting symptoms of anxiety and depression.

The purpose of the present study was to assess the pandemic’s psychological impact on people with preexisting mental illness, to investigate their COVID-19-related fear, anxiety, and depression in association with various variables and to explore their behavioral responses regarding the measures against the pandemic.

A cross-sectional study was conducted from March to May 2022 in the outpatient mental health clinic of a provincial hospital in Greece. Participants were patients, who were not fully disorganized and have been diagnosed with a mental illness before the COVID-19 pandemic. Among the 50 adult patients, 11 lived in assisted living facilities. The study included sociodemographic questions, questions about fear of COVID-19, negative feelings, safety measures and behaviors, disease progression, and compliance with their therapists. DASS-21 scale was used to measure the 3 subscales of emotional states.

Sadness was reported as the most unpleasant emotion of the lockdown, following by hopelessness and denial. Several participants (36%) reported high levels of COVID-19-related fear, mainly patients living in the community and not in assisted facilities (40.1% vs 18.2%) and males compared to females (42.1% vs 32.3%). The majority (70%) declared high compliance with the therapy. A moderate to severe deterioration in disease progression during the pandemic was observed in 28%, mainly in females compared to males (38.7% vs 10.6%). Based on DASS-21 the mean scores ranged from moderate to severe symptoms in depression (16.2/42), anxiety (14.3/42), and stress (18.4/42) without a statistically significant correlation with age, gender, and living situation. However, 34%, 22% and 56% screened positive for severe and extreme severe depression, anxiety, and stress, respectively.

The study revealed a substantial proportion of patients with mental disorders to experience unpleasant emotions and increased levels of psychological distress and highlights the need for supportive mental health services to address the increased mental health symptoms in people with pre-existing mental illnesses during a pandemic.

None Declared

Subjective memory complaints remain a relevant aspect to be considered in patients with mild cognitive impairment. Likewise, their association with depressive symptoms, quality of life and cognitive performance is also an objective to be studied in such patients.

Our clinical case represents just one opportunity to study how memory complaints are related to depressive states and how they affect the quality of life of patients with mild cognitive impairment.

We conducted a bibliographical review by searching for articles in Pubmed.

PERSONAL HISTORY: Male, 73 years old, separated, residing alone in Valladolid. He has home help, a person comes to help him with the household chores. Little social and family circle.

He has a history of an admission in 2013 to this Short Hospitalization Unit for ethanol detoxification. Since then, he has been followed up in the Mental Health Unit. According to the reports, he has been diagnosed with depressive disorder and cluster B personality disorder.

Current psychopharmacological treatment: diazepam, olanzapine, duloxetine 60 mg, quetiapine.

Toxic habits: history of chronic ethanol consumption. Smoker. He denies other toxic habits.

The patient presents a worsening of his mood of 15 days of evolution, coinciding with a voluntary decrease of his psychopharmacological treatment that the patient has carried out on his own. He walks with the aid of a crutch. Hypomimic facies. Slowed language, circumstantial, with speech focused on current discomfort.

On assessment, he reports initial improvement after reducing his medication, but in recent days he has experienced a decrease in initiative accompanied by feelings of emptiness, sadness and loneliness. He refers to memory complaints for which he is awaiting evaluation by Neurology. The patient explains that at other times in his life he has presented self-harming ideas that he has been controlling. At this time he expresses desire for improvement and adequate future plans, and accepts plans to attend a memory workshop. He also reports visual hallucinations with no affective repercussions and preserved judgment of reality.

Treatment adjustment: Duloxetine 60 mg, 2cp/day. The patient is recommended to lead an active lifestyle and attend a day center or memory workshop.

In numerous patients with mild cognitive impairment, we have observed that memory complaints are closely related to depressive symptoms and to the patient’s functioning in daily life.

In one study memory complaints were a negative predictor of quality of life in these patients.

Therefore, in addition to considering the importance of treating depressive symptoms, it is also important to address quality of life in patients with mild cognitive impairment.

None Declared

Steroids are a necessary treatment for hypoxic respiratory failure; however there are many side effects that should be taken into account. A 44- year-old-woman with asthma and no past psychiatric history was admitted due to COVID-19 pneumonia and Respiratory syncytial virus (RSV) infection, presenting hypoxic respiratory failure. After two days of intravenous methylprednisolone administration, the patient presented acute psychosis and agitation.

It has been previously described that steroid use can cause effects such as mania, anxiety, agitation, delirium and psychosis amongst other. However they are a necessary treatment in respiratory illnesses and are sometimes unavoidable.

The aim was to examine the appropriate medical response to steroid induced psychosis in patients with acute hypoxic failure.

A bibliographical review was done in PubMed database searching recent cases of steroid induced psychosis using the words (“Steroid”, “Psychosis” and “COVID-19”).

According to literature, it has been shown that partial or complete reduction of steroid use and/or use of psychotropic has been successfully used to treat steroid induced psychosis. Following the research it was decided to reduce intravenous methylprednisolone dose from 20mg/ 8h to 20mg/12h and start oral haloperidol 5mg/8h the first 24h and reducing the dose progressively as the patient recovered. After the first 24 hours the patient presented adequate response to steroids as well as partial response to antipsychotic treatment; presenting no further agitation, absence of hallucinations and partial persistence of the persecutory delusion. A couple of days later there was complete remission of the psychotic symptoms and the patient was on the way to recovery from COVID-19 and RSV.

There is evidence that suggests that medications such as steroids used to treat COVID-19 and other respiratory illnesses can lead to psychotic episodes. It is very important to pay attention to possible side effects when treating with steroids and evaluate the patient history as well as suggest having a follow up visit after the hospital discharge.

None Declared