Oncological and palliative care patients face unique stressors which increase their risk of developing depression and anxiety. Cognitive behavioural therapy (CBT) and mindfulness has established success in improving this population’s mental health. Traditional face-to-face psychotherapy is costly, has long wait lists, often lacks accessibility, and has strict scheduling, each of which can make attending psychotherapy physically, mentally, and financially out of reach for oncological and palliative patients. Web-based CBT (e-CBT) is a promising alternative that has shown efficacy in this and other patient populations.

To quantify the efficacy of online CBT and mindfulness therapy in oncological and palliative patients experiencing depression and anxiety symptoms.

Participants with depression or anxiety related to their diagnosis were recruited from care settings in Kingston, Ontario, and randomly assigned to 8 weekly e-CBT/mindfulness modules (N= 25) or treatment as usual (TAU; N=24). Modules consisted of CBT concepts, problem-solving, mindfulness, homework, and personalised feedback from their therapist through a secure platform (Online Psychotherapy Tool- OPTT) Participants completed PHQ-9 and GAD-7 in weeks 1, 4, and 8. (NCT04664270: REB# 6031471).

Significant decreases in PHQ-9 and GAD-7 scores within individuals support the hypothesis of efficacy. At this time, 10 e-CBT/mindfulness and 12 TAU have completed the study. Decreases in PHQ-9 and GAD-7 scores within e-CBT group support the hypothesis of efficacy. Specifically, PHQ-9 scores decreased over the 3 repeated measures (ANOVA, 2 groups, 3 repeated measures and the decrease in GAD-7 scores was similarly large)

As hypothesized, the results suggest that e-CBT/mindfulness therapy is an affordable, accessible, and efficacious mental health treatment for this population. The virtual, asynchronous delivery format is particularly appropriate given the unique barriers.

N. Alavi Shareolder of: OPTT inc, Grant / Research support from: department psychiatry Queen’s University, M. Omrani Shareolder of: OPTT inc, A. Shirazi: None Declared, G. Layzell: None Declared, J. Eadie: None Declared, J. Jagayat: None Declared, C. Stephenson: None Declared, D. Kain: None Declared, C. Soares: None Declared, M. Yang: None Declared

Anabolic-androgenic steroids (AAS) are synthetic derivatives of steroids which are frequently utilized in order to increase muscle mass and strength. Estimates of AAS abuse vary according to different studies. However, a global lifetime prevalence of 3.3% has been reported. The increasing illicit use of AAS over the years has raised serious public health concerns.

To report a clinical case of AAS abuse and review the psychopathology associated with AAS abuse and its treatment.

The authors report a clinical case and conducted a non-systematic review on the Pubmed database with the terms “anabolic-androgenic steroids”, “abuse” and “psychiatric manifestations”.

A 25-year-old male patient with history of body dysmorphic disorder was admitted to the emergency services following severe psychomotor agitation and verbal and physical aggression towards his family members. He explained he had begun using AAS years prior in order to improve his physical appearance. Recently he had been administering AAS injections on a more regular basis and restricting his food and water intake. His sleep-wake cycle was disrupted and he began experiencing increasing anxiety and persecutory ideation. Additionally, increased aggression was reported and numerous conflicts with his family members took place in the weeks previous to his psychiatric observation. AAS abuse has been associated with psychiatric symptoms such as aggression and violence, mania and less commonly psychosis and suicidal ideation. Moreover, its prolonged abuse can lead to symptoms of dependence and withdrawal following suspension. A biphasic model of steroid dependence has been described. First there is a brief hyperadrenergic state with opoid-like withdrawal symptoms which is then followed by a prolonged period of depression and craving. During this phase symptoms such as fatigue, muscle and joint pain, insomnia, anxiety and depression may occur. There are no established guidelines for treatment. Acute care of agitation should follow a similar course as the one utilized in other forms of substance induced-agitation: firstly, the least invasive interventions should be implemented. If medication is required, haloperidol has been reported to be effective, although evidence is scarce. Benzodiazepines may be considered, although its use with AAS has not been reported. In regards to long term care, AAS discontinuation is vital in conjunction with proper management of withdrawal symptoms. If a patient presents symptoms of opioid-like withdrawal, treatment with clonidine may be initiated. The use of medically prescribed steroids has been suggested in order to alleviate withdrawal symptoms. Other treatment options such as human chorionic gonadotrophin and clomiphene have also been proposed.

AAS abuse is a serious public health concern. Clinicians should be aware of its serious psychiatric effects and possible treatment courses.

None Declared

Two emblematic clinical cases will be addressed in this poster. The purpose of the poster is to relate the aspect of how the artistic resources of psychiatric patients are useful to improve social cohesion.

Correlate psychotherapy work on superior defenses to social cohesion and clinical improvement.

Psychopharmacotherapy. Psychoanalytically oriented psychotherapy. Psychiatric rehabilitation.

Social jutice idex (Schraad-Tishler, 2015) and BES (Istat 2015) as sources of social cohesion indicators.

In the first case we have a man with ciclotimic personality disorder and substace abuse with psicotic episodes. Previously, the patient underwent repeated hospitalizations . Once the therapeutic relationship was hooked up and introduced in addition to pharmacological treatment, a psychotherapy also aimed at activating personal resources, the patient began to take an interest in the activity of a street artist. Over time and with the improvement of this activity, aspects of social cohesion have been highlighted in the social context. Social relations both linked to work and affective activity, as well as friends; improvement of the economic situation both through the economic return of this activity and through associative loans linked to this activity; an improvement of social inclusion and non-discrimination in the cities where the artistic activities were carried out; the use of fixed environmental spaces where the activity can be carried out. These aspects have favored a recovery that has reached the complete economic independence of the patient, the establishment of a family unit of their own, the progressive remission of the toxicophilic relapses and therefore the psychotic imbalances they induce.

In a second case, we have a 30-year-old patient with a severe depressive disorder, with narcissistic, paranoid and obsessive personality traits, graduated from the Academy of Fine Arts and with an artistic production both before and after the illness. In addition pharmacological therapy, the patient began psychotherapeutic interventions on the enhancement of superior defenses such as sublimation through artistic activity. So she began to rededicate herself to the artistic activity , she however progressively improved the recovery aspects for a long period of time up to living, working and emotional autonomy. During this path the aspects of social cohesion were also decisive, such an economic autonomy linked to the work activity of an employee in an art gallery, a progressive social inclusion, the conquest of spaces where you can exhibit your works and an increase in trust both towards the family and towards health workers and towards friends and work relationships.

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In this Clinical cases and others not reported exist correlation between psychotherapy work on superior defenses to social cohesion and clinical improvement.

None Declared

In this first session of our motivational interviewing workshop, we address the basic principles of how every therapeutic relationship should be established and the main differences for the right environment in which we can develop motivational interviewing tactics that can be used to precipitate enduring change.

None Declared

A heterogeneity in prevalence rates of functional and/or dissociative disorders is evidenced in primary care settings. At least one medically unexplained symptom is diagnosed in 40–49% of all primary care patients and 91% of all patients with a functional diagnosis are managed exclusively by general practitioners (GP) and nonpsychiatric specialists. It is therefore important that GPs identify these disorders so that individualized, multimodal treatment, with psychiatric collaboration, can be initiated promptly.

Our objective is to demonstrate the role of consultation-liaison (CL) psychiatrists in the management of patients with a functional diagnosis in primary care, as well as the potential impact of non-collaboration between GPs and psychiatrists.

Case report of Mrs. P., a 32-year-old patient, married for one year. Following a burnout that occurred two years ago, associated with anxiety-depressive symptoms, she developed gradually persistent dizziness, with balance disorders and asthenia. Mrs. P. consulted a psychiatrist for these symptoms and was treated first with an SSRI and then with an SNRI, which increased her symptoms of dizziness and vertigo. She stopped the psychiatric treatment, being disappointed by the proposed care, and asked her GP for help. No pathology was revealed by the neurological and ENT assessment requested by her GP. He referred her for a second opinion at the university center for general medicine.

After an initial GP assessment, a CL-psychiatric evaluation was performed (a first joint GP-psychiatrist session, 3 psychiatric sessions, and a feedback joint GP-psychiatrist session), during which a feeling of loss of control was noted in a patient with obsessive personality traits and controlling tendencies. A bidirectional relationship between anxieties, underlying uncontrolled internal conflicts, and dizziness was demonstrated. A dynamic work around the underlying conflicts according to the bio-psycho-social model allowed to identify the presence of a dissociative neurological symptom disorder, with vertigo or dizziness (6B60.2) of which the patient could become aware. This brief CL-psychiatric and psychotherapeutic intervention, proposed and accompanied by the GP, made it possible to explore and elaborate on the patient’s modes of functioning in her relationship to her body, to herself, and to others. At the same time, vestibular rehabilitation was performed by a ENT, with a favorable clinical and postural evolution. Thanks to this multidisciplinary treatment led by the GP, Ms P. was able to resume her professional and social activities after 3 months.

GPs have a central role in the detection of dissociative neurological symptom disorder, with vertigo or dizziness, and in the rapid organization of an adapted care network. Collaboration with CL-psychiatrist can offer optimal management of such disorders in primary care settings.

None Declared

Contemporary children practically live in cyberspace, constantly using various devices,and many of them have an addiction that leads to violations of their mental and physical formation.

Based on the mental and the physical examination of children suffering on cyber addiction with the sings of clinical manifestations determine the targets and form of ccmbined correctional rehabilitation system.

The clinical investigation based on psychiatric examination with the narrative motivation interview,psychological examination by Eysenck “extra/introversion”test and physical examination with special attention to the musculoskeletal system.

The randomized investigation of childhood population was performed.198 children of different age (7 – 14 years old) were examined.72 (36.4%) of them showed significant signs of cyber addiction with a narrowing of interests, a reduction in social ties, and a decrease in school performance. They spent from 3 to 10 hours on gadgets per day.140 (71%) of them, also showed signs of fubbing, that is, the priority of telephone communication over direct communication with the interlocutor.The significant results of Eysenck test examination were following: 126(64%) of them were introverts and 72(36%) of them were extraverts. During the physical examination,91 (46%) of these children had different spine and musculoskeletal disturbances.In the group of addictional children the vast majority of subjects, 87%, have characteristic defects of the musculoskeletal system. The most symptomatic in the diagnosis of cyberaddiction and phubbing of school-age children are: round back, stooping, scoliotic posture and types of lateroflexion.The severity of cyber addiction and the degree of musculoskeletal disorders were inversely proportional. The results served as the basis for the development of a combined system of psycho-physical rehabilitation. The psychotherapy based on CBT according to A. Beck, modified for children’s in concordance with specialized program “Vertebra-Dinamik” to correct defects of the musculoskeletal system. The basis of the corrective “Vertebra-Dinamik” technique includes a comprehensive approach to the use of isometric and statodynamic exercises of moderate intensity with elements of relaxation. Approbation of the developed system showed its high( 80%) and moderate(20%) efficiency.

To successfully overcome cyber addiction and its negative consequences, the most optimal system is the complex application of psychotherapeutic and physical rehabilitation methods.

None Declared

Early-onset schizophrenia (EOS) is a relatively uncommon disorder with psychotic symptoms emerging before 18 years of age. Although still under debate, EOS may be a more severe disorder relative to adult-onset schizophrenia (AOS), with worse prognosis. Cognitive deficits are a core feature of schizophrenia, accounting for a large part of the detrimental effect of the disorder and may reflect underlying neurodevelopmental disturbances. Some but not all previous studies show that the magnitude of cognitive deficits, including intelligence quotient (IQ), in patients with schizophrenia is dependent on the age of onset.

We aimed to assess IQ in adult patients with EOS and AOS, and healthy controls. We hypothesized that patients with EOS would show lower IQ than those with AOS, and both patient groups lower IQ than HC.

We included 136 adult patients with EOS (mean age: 24.7 (7.7) years, mean duration of illness: 9.3 (8.5) years, 50% women), 382 patients with AOS (mean age: 32.4 (9.5) years, mean duration of illness: 5.7 (6.6) years, 40.1% women) and 896 adult healthy controls (mean age: 33.2 (9.2) years, 47.1% women). We assessed current IQ with the Wechsler Abbreviated Scale of Intelligence (WASI) which yielded verbal (VIQ), performance (PIQ) and full-scale IQ (FIQ) scores. In a post-hoc analysis, we estimated premorbid IQ using the National Adult Reading Test (NART). We applied analyses of covariance (ANCOVAs) to investigate the putative differences in IQ scores and IQ change between patients with EOS, patients with AOS and healthy controls.

In sex-, and age-adjusted models, FIQ and PIQ, but not VIQ, were significantly lower in EOS than in AOS (p=0.03, p<0.001 and p=0.428, respectively) (Image). Patients with EOS had fewer years of education than patients with AOS (p<0.001); the PIQ but not the FIQ difference between EOS and AOS remained significant after adjustment for education years (p=0.016 and p=0.333, respectively). Both patient groups had significantly lower IQ scores than healthy controls (Image). Further, patients with EOS and patients with AOS did not significantly differ in estimated premorbid IQ (109 and 110 units, respectively, p=0.092), whereas patients with EOS had a significantly larger estimated IQ decline after the disease onset compared to patients with AOS (12 and 9 units decline, respectively, p=0.015).

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Our findings show that adult patients with EOS have significantly lower PIQ and FIQ scores, and significantly larger IQ decline after the disease onset, but not lower premorbid IQ, compared to patients with AOS. The adolescent onset of psychotic symptoms is linked, as expected, to fewer total years of education, which appears to explain the lower FIQ but only partially the lower PIQ in EOS, which may thereby be linked to the disorder per se.

T. Calkova: None Declared, L. Mørch-Johnsen: None Declared, R. Elle Smelror: None Declared, K. Nordbø Jørgensen: None Declared, S. Cervenka: None Declared, K. Collste: None Declared, A. Vaskinn: None Declared, A. Margrethe Myhre: None Declared, O. A. Andreassen Consultant of: HealthLytix, Speakers bureau of: Lundbeck and Sunovion, T. Ueland: None Declared, I. Agartz: None Declared, D. Andreou: None Declared

Serotonin syndrome is a potentially life-threatening condition due to increased serotonergic activity in the CNS. Its most well-known causes are the ingestion of large amounts of serotonergic drugs or the inappropriate combination of two or more serotonergic antidepressants. Rarer causes of serotonin syndrome have been reported in the literature.

The aim of this paper is to highlight, through case presentation, rarer causes of serotonin syndrome.

Case presentation (woman, 39 years old) who was hospitalized with clinical presentation of Serotonin syndrome, after pharmaceutical self-poisoning with a large amount of quetiapine (>20g). The search of the case data (clinical and paraclinical examination findings) was performed from the medical records and files of the 3rd Internal Medicine Clinic and the Liaison Psychiatry Department of our hospital. A literature search of similar cases (through PubMed) was performed.

A patient with a history of mood disorders, under treatment with venlafaxine, lamotrigine, quetiapine and aripiprazole, was admitted to the hospital ICU due to a decreased level of consciousness (GCS 11/15). Ingestion of approximately 100 tablets of Quetiapine 200mg was reported. The patient developed upper and lower limb myoclonus, supraventricular tachycardia (130bpm), nystagmus, bilateral mydriasis with normal photomotor reflexes, increased tendon reflexes, excessive sweating, upper limb muscle rigidity and abdominal flatulence with the presence of loud bowel sounds. Gastric lavage was performed and admission to the Internal Medicine department followed. Intravenous diazepam was administered, 30mg on the 1st 24 hour period and 20mg on the 2nd, with gradual tapering. From the very 2nd 24 hour period of hospitalization, her clinical condition showed significant improvement, with complete remission of symptoms and recovery of a satisfactory level of consciousness.

Serotonin syndrome can be effectively treated if early recognition of symptoms is made. Clinicians should be particularly alert and suspect the possibility of serotonin syndrome in a patient with compatible symptoms by clinical examination, especially in case of overdose of a drug, with or without a serotonergic mechanism of action.

None Declared

Most mental disorders, when examined individually, are associated with an increased risk of cardiometabolic complications. However, these associations might be attributed to a general liability toward psychopathology or confounded by unmeasured familial factors.

To examine whether the associations between psychiatric diagnoses and increased risk of cardiometabolic complications are attributable to a general liability toward psychopathology, or confounded by unmeasured familial factors.

We conducted a cohort study in Sweden and identified all individuals and their siblings born in Sweden 1955-1962 with follow-up through 2013. After excluding individuals who died or emigrated before 1987, the final sample consisted 672 823 individuals. We extracted ICD-coded diagnoses (recorded 1973-1987) for ten psychiatric conditions and criminal convictions when participants were aged 18-25 years, and ICD-coded diagnoses (recorded 1987-2013) for five cardiometabolic complications (obesity, hypertensive diseases, hyperlipidemia, type 2 diabetes mellitus, and cardiovascular diseases) when the participants were 51-58 years old. Logistic regression models were used to estimate the bivariate associations between psychiatric conditions or criminal convictions and cardiometabolic complications in individuals. A general factor model was used to identify general, internalizing, externalizing, and psychotic factors based on the psychiatric conditions and criminal convictions. We then regressed the cardiometabolic complications on the latent general factor and three uncorrelated specific factors within a structural equation modeling framework in individuals and across sibling pairs.

Each psychiatric conditions significantly increased the risk of cardiometabolic complications; however, most of these associations were attributable to the general factor of psychopathology, rather than to specific psychiatric conditions. There were no or only small associations between individuals’ general psychopathology and their siblings’ cardiometabolic complications, suggesting that the associations were not attributable to genetic or environmental confounding factors shared within families. The same pattern was evident for the specific internalizing and psychotic factors.

Individuals with mental disorders in early life had an increased long term risk of cardiometabolic complications, which appeared attributable to a general liability toward psychopathology. Sibling analyses suggested that the elevated risk could not be attributed to confounds shared within families.This highlights the importance of transdiagnostic and lifestyle based interventions to reduce the risk of cardiometabolic complications, particularly in patients with several mental disorders.

None Declared

Early detection and intervention are critical for improved outcomes in mental disorders, and this is particularly true for bipolar disorders. Understanding the risk factors involved in the onset of the disease and the subsequent relapses and recurrences may lead to better results as regards to functional outcomes, which are the most relevant for patients and their significant others. This presentation will review those factors and discuss which ones can be used as targets for early intervention. It has been argued that, most often, early intervention comes late, and it is therefore paramount to build on strategies aimed at effective detection of people at risk and situations that may lead to recurring episodes of illness. Treatments not only aimed at treating symptoms, but at improving illness trajectories are necessary, and pharmacological formulations and interventions improving treatment adherence are particularly relevant to avoid interruptions of effective therapies.

E. Vieta Grant / Research support from: Boehringer-ingelheim, Compass, Janssen, Lundbeck, Novartis, Consultant of: AB-Biotics, AbbVie, Adamed, Angelini, Biogen, Boehringer-Ingelheim, Celon Pharma, Compass, Dainippon Sumitomo Pharma, Ethypharm, Ferrer, Gedeon Richter, GH Research, Glaxo-Smith Kline, Janssen, Lundbeck, Medincell, Merck, Novartis, Orion Corporation, Organon, Otsuka, Roche, Rovi, Sage, Sanofi-Aventis, Sunovion, Takeda, and Viatris

The existence of a clinical entity on the spectrum of mood disorders characterized by the occurrence of manic episodes without major depressive episodes (Unipolar Mania, UM) is largely debated. Although not classified nosologically, the studies exploring this topic have suggested that UM might differ from bipolar disorder with a manic-depressive course (md-BD), in terms of several clinical characteristics. Individuals with UM might represent a subpopulation with specific clinical profiles and unmet care needs, requiring personalized treatments, as compared with those suffering from md-BD.

To identify clinical factors associated with UM, as compared with md-BD.

We performed a systematic review and meta-analysis of observational studies according to the MOOSE guidelines. We searched for articles indexed up to July 2022 in the main electronic databases. We conducted random-effects meta-analyses of the association between UM and relevant correlates, using odds ratio for categorical variables and standardized mean difference for continuous variables.

Based on data from 21 studies meeting the eligibility criteria, we found that individuals with UM, as compared with md-BD, were more likely to be males (p = 0.007) and to have an earlier age at onset (p = 0.020). Moreover, UM was significantly associated with a higher number of hospitalizations (p < 0.001), the occurrence of psychotic features (p < 0.001), as well as hyperthymic temperament (p = 0.012). Finally, subjects with UM were less likely to report a family history of depression (p = 0.006) and a personal history of suicide attempts (p < 0.001).

Our work supports the hypothesis that UM might represent a distinctive diagnostic construct, with peculiar clinical correlates. Additional research is needed to better differentiate UM in the context of affective disorders.

None Declared

Autism spectrum disorder is a heterogeneous group of disorders that affects virtually every population, regardless of their ethnic or socioeconomic origin. In recent years, the attention of researchers has been drawn to the participation of the oxytocinergic and vasopressinergic systems in the development of autism spectrum disorders. A relatively large number of studies have investigated the association of SNPs in these genes with the development of ASD, however, there is a lack of studies in the literature focusing on their actual effect on expression and on the effect of their expression on the risk of ASD.

The aim of this study was to assess the levels of expression of OXTR and AVPR1a genes and evaluate their links with both risk of ASD and genotypes of the most studied polymorphisms.

The study included 132 people, 77.5% of whom were male (n = 100). 113 participants (85.6%) were diagnosed with autism spectrum disorders confirmed by the ADOS-2 test conducted by a certified diagnostician. In this group, men constituted 76.1% of the population (n = 77). The remaining 28 people did not have a diagnosis of autism spectrum disorders, and in the ADOS-2 study they obtained the result below the cut-off level. The mean age in the whole group was 14.4 years (95% CI: 13.92-14.93).

Significant decrease in expression of the OXTR gene was found in case of rs53576 where presence of the alternative allele (G) was linked to the 20% decrease in expression (2^(-ΔΔCt) = 0.8). In case of AVPR1a alternative allele (T) of SNP rs10877969 was linked to the 20% increase in the gene expression(2^(-ΔΔCt) = 1.197). SNPs rs2254298 (2^(-ΔΔCt) = 0.97) and rs7294536 (2^(-ΔΔCt) = 0.97) did not influence expression of the appropriate genes in significant way. In comparison between the test and control group in participants with confirmed diagnosis of ASD 13% lower expression of AVPR1a was found (2^(-ΔΔCt) = 0.87).

Genotype of SNPs rs53576 and rs10877969 significantly influenced the levels of expression of the genes OXTR and AVPR1a respectively. In case of rs2254298 and rs7294536 observed effects were negligible. Presence of ASD diagnosis was linked to the 13% lower expression of AVPR1a. Abnormalities in AVPR1a expression seem to be more important for the development of autistic traits than the more attention-grabbing gene abnormalities for the oxytocinergic system.

None Declared

The term paraphrenia, as classically described by Kraepelin, characterizes a disorder that fits into the complex group of late onset psychoses and resembles schizophrenia, but with better preservation of affect and volition and less deterioration of personality. Over the last few decades, the concept has suffered several setbacks and is not currently recognised by the main manuals of mental disorders. However, there are several authors who argue that the diagnosis of paraphrenia has not lost its usefulness. In 1999, Munro and colleagues proposed a set of criteria to identify this entity and delimit it from the diagnoses of schizophrenia and delusional disorder.

Based on a clinical case, we intend to discuss the applicability of the criteria proposed by Munro and the usefulness of the concept of paraphrenia nowadays.

Case report.

A 71-year-old woman was taken to the emergency department for presenting a first psychotic episode characterized by auditory hallucinations, persecutory delusional ideation and Capgras delirium. The delirium was well structured and very dynamic, interfering in the patient’s social and family spheres. Affects were preserved and adequate and no volitional alterations, thought forms or cognitive deficits were found. Organic pathology was also excluded. Thus, it was possible to make the diagnosis of paraphrenia in light of Munro’s criteria.

The description of this case illustrates the definition and identification of paraphrenia, highlighting the usefulness of the proposed criteria and the importance of giving greater recognition to this entity in order to stimulate future research.

None Declared

The presentation will focus on elements of leadership that have been shown to be useful on local and more comprehensive levels. It will be based on experience gained in leadership positions in international and national organizations and during leadership and professional skills courses which were conducted in more than 40 countries over the past thirty years. Among the topics that will be addressed for discussion and further action will be the need to introduce leadership training in the course of postgraduate education and to provide career advice at the beginning and during early years of service.

None Declared

There are manic episodes to involve a challenge in treatment due to finding resistance or secondary effects with the drugs of choice, this situation oblige forcing us to seek alternatives in the data sheet.

To describe the complicated evolution of a case of acute mania difficult to threat with stabilizer drugs and antipsychotics of choice. We discuss the psychopharmacological approach.

Case summary. We have conduced a systematic review of the descriptions published to date, regarding this case.We presented a case, in a 48-year-old female, admitted to our hospital due to psychopathological descompensation of bipolar affective disorder, where we observed manic and psychotic symtoms.

In the first instance, we started treatment with Lithium and Olanzapine, in increasing doses, along with benzodiazepine support.

During more than four months of follow-up , multiple drugs have been tested sequentially: olanzapine, aripiprazole and quetiapine. We observed a good response but low tolerance issue to secondary effects consisting of severe akathisia, in progressive stiffness (spasticity) and hands tremor, it was very disabling problem for patient, even though the use of biperiden.

This situation forced us to search another option of treatment, different from non-pharmacological therapies (ECT). After checking the literature and publications about it, we decided to start treatment with Caripracine 3mg/24h, for which the therapeutic indication is the treatment of manic with mixed symtoms.

We propose, through a clinical case, the use of cariprazine as a first choice in the acute decompensation of bipolar affective disorder, without symptoms of mixed mania.

During the treatment, the patient presente multiple difficulties and finally, a good response is was obtained with the use of Cariprazine, althought this patient continued showing slight akathisia well tolerated, she was able to leave after four months of hospitalization in the acude mental health unit.

None Declared

A considerable number of patients with schizophrenia suffer from somatic passivity or delusions of control. So much so, that Schneider considered them as part of the first-rank symptoms.

In these cases, patients can think that feelings, impulses, thoughts, or actions are controlled or imposed by an external force.

The objective is to make a psychopathological description of this symptomatology, based on a case report with Anomalous bodily experiences.

In this study, we describe the case of a patient with disorder of self-experience. We have conducted a systematic review of the descriptions published to date, regarding this case.

We present the case of a 21-year-old patient who had gone to the emergency services three times for somatic pathology (described as dysesthetic and algic sensations in the throat, stomach and testicles).

In the psychopathological exploration, a delusional narrative is observed, as he refers that these sensations are being provoked by external people, with the aim of harming him.

The patient reports that these people are causing an increase in salivation in his salivary glands, for which he spits repeatedly.

He explains that these people can control his organs using an influencing machine, which in this case consists of a microchip implanted at the retroauricular area, from which they give orders and insult him at the same time.

In this case, a good symptom response was achieved with intramuscular Aripiprazole.

In the experiences of passivity, the patient experiences one event as if it were not his, but inserted into his self from the outside.

In the case of somatic passivity, there is a belief that there are external influences acting on the body. In this case, there was probably a kinesthetic hallucination coupled with an experience of passivity.

Similar to other published cases, this patient complained of being controlled and impaired by some form of contemporary technology. Delusions of control are often associated with delusional explanations about how thought or body can be controlled, in this case, through a microchip.

None Declared

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

Eating Disorders (EDs) as a public health concern were explored by numerous studies, where attention was drawn to further exploration of Anorexia Nervosa (AN) in non-western countries due to the existing gap in the area (Cummins et al., 2005; Javier & Belgrave, 2019). The studies emphasized the importance of exploring the perceptions and attitudes of healthcare practitioners in order to improve the quality of medical care for people who have AN (Atti et al., 2020; Colmsee et al., 2021; Costa-Val et al., 2019; Ghaderi et al., 2020; Jafar & Morgan 2021; Kohrt et al., 2020; Reas et al., 2021). Little research related to EDs in Central Asia has been found among previous literature. This study contributes to further research in this area taking into account societal and cultural specifics existing in Kyrgyzstan.

Healthcare practitioners are accessible for the majority of the population of Bishkek through the local primary healthcare (PHC) structure. Therefore, the perceptions of the local PHC workers were explored within the present study. The aim of the current research was to explore how primary healthcare practitioners perceive AN and people who have AN in Bishkek, Kyrgyzstan.

Six semi-structured interviews with six PHC workers who currently provide medical care for the local population were conducted in accordance with the Interpretative phenomenological analysis (IPA). The results were discussed in frames of the Social Constructionism theory.

The interviews uncovered major themes which show how the participants perceive AN and people with AN. According to the participants, AN develops due to stress. Families of AN patients carry the heavy burden of the disorder. The participants described how local and western socio-cultural standards influence the development of AN and seeking treatment process. AN patients do not want to be treated due to the stigmatization of mental health area within the local population and self-stigmatization of mental health disorders. However, the participants themselves have both positive and negative attitudes towards the mental healthcare.

The participants represent local societal perceptions and attitudes related to EDs and AN among medical professionals in accordance with the social constructionism theory. Overall, the PHC physicians in Bishkek have positive attitudes towards AN patients. They feel compassionate towards people who need their professional help. However, the participants feel like they are not able to provide the appropriate medical help for the population with AN due to the way PHC structure in Bishkek, Kyrgyzstan functions. Local PHC practitioners do not receive enough resources to provide medical care for people with mental health issues in general. The important discourse uncovered within the present study is the attention brought to the local PHC structure.

None Declared

Sexual life is affected by physiological, psychological and social changes during pregnancy. Therefore, pregnancy is considered as a stressor affecting sexual lives of women and as a period when sexual dysfunctions can easly appear.

The aim of our study was to explore the prevalence of sexual dysfunctions among pregnant womens.

we conducted a cross-sectional and descriptive study among Tunisian pregnant women. The questionnaire used was performed with Google Forms and posted on social media. It contained questions concerning personal and sociodemographic aspects and questions concerning obstetrical data such as parity, gestational age and complications during the current pregnancy. We used the Female Sexual Function Index to examine Sexual dysfunction. Total scores of 26.55 or less characterize deficiency of female sexual function.

Fifteen women (44.1%) were primiparous and 19 (55.9%) were multiparous with 29% being in the first trimester, 27% in the second, and 44% in the third. Half had at least one child. Most of participants reported better satisfaction with their sexuality before pregnancy than during pregnancy (76.5% vs. 26.5%). This difference in satisfaction was statistically significant (p=0.004). A sexual dysfunction was found in 70.6% of cases and we did not identify any correlations between the presence of sexual dysfunction and sociodemographic or clinical data of the current pregnancy.

The prevalence of sexual dysfunction among Tunisian pregnant women was high and not related tosocio-demographic characteristics.

None Declared

There is much evidence of grey matter alterations in subjects at clinical-high risk of psychosis (CHR). Although, to the best of our knowledge, no studies have analyzed both cerebral cortex and amygdala nuclei morphometry alterations in CHR individuals.

The aim of the study was to explore cortical thickness and amygdala nuclei morphometric characteristics in CHR patients.

Nineteen right-handed male patients (17-24 years, mean age 21.1 ± 2.1) fulfilling CHR criteria and 20 matched healthy controls (18-24 years, mean age 21.1 ± 1.8) underwent T1-weighted structural MRI at 3T Philips scanner. Images were processed via FreeSurfer 7.0. Cortical thickness (according to Desikan atlas) and volumes of 9 separate amygdala nuclei bilaterally were compared between groups. The morphometry data, SOPS, HDRS (Hamilton Depression Rating Scale) scores and chlorpromazine equivalents were included in correlation analysis.

Compared to healthy controls, patients showed decreased cortical thickness in the left [F(1, 36) = 10.8, p = 0.002; Cohen’s d = −1.1, 95% CI: −1.8 to −0.4] and right [F(1, 36) = 10.5, p = 0.003; Cohen’s d = −1.0, 95% CI: −1.7 to −0.3] postcentral gyri, and increased cortical thickness in the right posterior cingulate [F(1, 36) = 9.9, p = 0.003; Cohen’s d = 1.0, 95% CI: 0.3 to 1.6] and the right rostral anterior cingulate gyri [F(1, 36) = 12.2, p = 0.001; Cohen’s d = 1.1, 95% CI: 0.4 to 1.8]. No changes in any amygdala nuclei were detected. No correlations between altered cortical thickness, HDRS, SOPS or chlorpromazine equivalents were revealed.

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The current findings suggest that volumetric characteristics of amygdalar complex are unaffected in the CHR state. The results have some inconsistency with our previous findings (Tomyshev et al. Psychiatry Res Neuroimaging. 2019; 289 26-36), which revealed only a decrease in cortical thickness in CHR individuals. However, the cross-sectional design of the current study and the lack of correlations between cortical thickness and clinical symptoms do not allow to conclude definitely whether the revealed higher cortical thickness can represents some resilience mechanisms, which will be elucidated via further research.

This study was supported by RSFBR 22-15-00437

None Declared