Substance abuse is a pattern of compulsive substance use that is accompanied by repeated substantial interpersonal, social, professional, or legal negative effects, such as repeated absences from work or school, arrests, or marital issues.

The study aims to show the influence of psychological factors among the consumption of alcohol in the general population.

A retrospective study that was conducted at the “Elisabeta Doamna” Psychiatry hospital of Galati, Romania. The study shows the fluctuations in hospital admissions of patients with alcohol related disorders in the period November 2020 till September 2022.

The study was conducted to show the difference in the number of admissions before and after the date of 1st March 2022, which is the date when the authorities in Romania have lifted the restrictions that were implemented to reduce the spread of Covid_19 virus. The number of total cases in the period between the 1st of November 2020 and 28th of February 2022 were 672 patients, from which 518 patients were males from Urban areas. In the period between the 1st March 2022 and the 1st of September 2022, the number of patients that were admitted due to substance use were 232 cases. This shows a significant decrease in the number of admissions that can be related to the decrease of psychological stressing factors that were accompanied with the restriction measure of the pandemic.

Overall, the results of this retrospective study suggest that the prevalence of adult substance use has declined with the decrease of the restriction measures that were imposed by the authorities. Monitoring and ongoing surveillance of substance use will be necessary over the years following the pandemic.

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Panic disorders (PD) are associated with suicidality. The link between PD and suicide has been suggested to be depression; however, this remains controversial. Comprehensive research on the history of suicide attempts (SAs) in patients with PD is scarce.

This study investigated the characteristics and pharmacological short- and long-term treatment responses of patients with PD, with or without SAs. Moreover, a network analysis was conducted to investigate the central symptoms and their connection to suicidality among SA-related variables with and without SAs.

We investigated the characteristics of SAs in patients with PD using PD-related scales, magnetic resonance imaging, and network approaches. A total of 1151 subjects were enrolled, including 755 patients with PD (97 with SA and 658 without SA) and 396 healthy controls. Suicide and PD-related scales were also administered.

Our results revealed that the scores of all symptom severities were significantly higher in the PD+SA group than in the PD-SA group. Multiple linear regression analysis revealed that short- and long-term pharmacological treatment responses were significantly poor in the PD+SA group. Network analysis showed that fear of cognitive dyscontrol (FCD) was the strongest central symptom among strength, expected influence (1 and 2 step), randomized shortest path betweenness, and eigenvector centrality measures in PD+SA, whereas depression was the central symptom in PD-SA.Table 1.Results of multiple regression analysis to predict treatment response for patients with panic disorder.

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Our results suggest that SA history could be associated with high symptom severity and poor pharmacological treatment response in patients with PD and that FCD is the central symptom in the PD+SA network.

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Various psychiatric disorders were reported during the long COVID. The most frequently cited by physicians included the insomnia, the anxio-depressive disorders and the post-traumatic stress disorder. These symptoms would have a negative impact on the quality of life as well as on the socio-professional and economic efficiency.

The aim of this study was to determine the associated factors to anxio-depressive disorders during long COVID.

A cross sectional analytic study was conducted at Taher Sfar university hospital of Mahdia over a period of one year (from March 2020 to March 2021). It included patients consulting within at least 1 month after a COVID-19 documented infection. We used the Hospital Anxiety and Depression scale (HAD) to screen for anxio-depressive disorders.

We recruited 137 patients in the study. The median age was situated at 60 years, ranging from 17 to 82 years. The sex ratio M/F was 0.073. The median HAD score was 19 [8, 33]. Anxio-depressive disorders were present in 61% of cases. There was no statistically significant association between anxio-depressive disorders and post COVID symptoms except arthralgia and myalgia (38.6% vs 13.5; p=0,006 and 26.8% vs 5.4%; p=0.007, respectively). After the multivariate analysis, only arthralgia during long COVID was associated with the anxio-depressive disorders (95% CI 1.489 to 30.25, p=0.01).

Arthralgia is a frequent symptom sometimes underestimated and in others overtreated. As it seems to be significantly associated with anxio-depressive disorders in the post covid period, physicians should pay attention to the history of a viral documented or probable infection and to psychiatric symptoms’ screening. Our results should however be confirmed by multicenter studies with larger sample size.

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Previous studies have shown an association between high Body Mass Index (BMI) and worse cognitive performance in obese patients and the general population. Cognitive deficits and overweight are important challenges in the clinical treatment of psychosis but scarcity of studies have investigated this relationship. Moreover the effect of sex in the psychosis research has been neglected since recent years and there is still a lack of studies taking into account the sex differences

To determine the effect of overweight and its interaction with sex on cognitive performance in First Psychotic Episodes (FEP)

We included 159 FEP out-patients (mean age 23.1 years 33.3% females ) in their first year of antipsychotic treatment attending to the Early Intervention Program of the Institut Pere Mata, in Reus. At study entry participants underwent to a comprehensive clinical, biometric and cognitive assessment by standardized neurocognitive battery (MATRICS Consensus Cognitive Battery; MCCB). T scores were converted to standard equivalents (z-scores) based on data from a healthy control group from the same geographical area.

Overweight was defined as BMI≥ 25 according to WHO standards. Two-way ANCOVAS were performed to determine the interaction effect between overweight and sex on the cognitive tests. Ethical approval was obtained by the Committee for Ethical Clinical and Pharmacological Investigation of the Pere Virgili Research Institute

At study entry 85% of participants were on antipsychotics for less than 6 months with a median dose of 300 (200-450) chlorpromazine equivalents (CPMZ) in mg/day. 37.7 % of participants were overweight without differences between men (41.5%) and women (30.2%) (X2 = 1.47; p = 0.22). There were no clinical and treatment differences between overweight and normal weight participants. With regards sex differences, females presented statistically significant higher scores in Calgary depression scale and lower doses of antipsychotics. No differences were found in cognitive performance regarding weight status but we found a significant interaction between sex and overweight in verbal learning memory ( F=6.09; p=0.01). When controlled for depressive symptoms and CPZM equivalents differences continued to be significant. Overweight females performed worse -1.09 ( SD 1.18) than normal weight females -0.23 (SD 1.10); (t= 2.57;p=0.02) in verbal learning memory whereas that difference was not found among overweight and normal weight males (t= -1.10; p=0.27)

Our results provide evidence for sex-differences on cognitive function depending on weight status. Advances in the study of sex differences in FEP would help to target specific treatment strategies

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In prenatal clinical consultations, what do adolescents talk about, in addition to physical and affective conditions and acquiring information about the general state of the evolution of pregnancy? The symbolic psychological elements that emerge during consultations are important for the handling of family guidelines with the clinical team.

To interpret emotional meanings attributed by pregnant adolescents, with the possibility of accessing public health care service in a Brazilian metropolitan city, about talking and listening about Family relationships with the clinical team in prenatal consultations.

Clinical-qualitative design by Turato. Semi-directed interviews with open-ended questions in-depth conducted online during the pandemic. Sample closed by theoretical information saturation according to Fontanella. Interview material, fully transcribed, was treated by Clinical-Qualitative Content Analysis of Faria-Schützer, with Balintian psychodynamic concepts from Medical Psychology to generate categories of discussion after free-floating readings. Findings were validated by peers from the Laboratory of Clinical-Qualitative Research, at the State University of Campinas.

The sample was closed with 10 pregnant adolescents. Three categories emerged from the analysis: (1) emotional meanings of the non-use the access to health service as a listening space: affective obstacles and social shame; (2) the relationship of complicity with the maternal figure in “competition” with a possible broad psychological relationship with the clinical team; (3) recurrence of teenage pregnancy in the family as a possible obstacle.

The finding so far that the adolescent’s personal reference is reported as the mother figure is also accentuated because the affective relationship with the doctor figure is more fragile. The bond of adolescents is established with the health institution and not with the reference health team.

There is a mismatch between the psychic maturation, still evolving, to the adult identity and the demands of social roles of the pregnant teenager already demanded as an adult. The teenager captures it, and the medical consultation becomes an act that occurs by inertial force. There is a perception of access to the health service and not access to the doctor as someone qualified for the adolescent to talk about relevant personal matters.

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Meta-analyses of functional magnetic resonance imaging (fMRI) studies have been used to elucidate the most reliable neural features associated with various psychiatric disorders. However, it has not been well-established whether each of these neural features is linked to a specific disorder or is transdiagnostic across multiple disorders and disorder categories, including mood, anxiety, and anxiety-related disorders.

This project aims to advance our understanding of the disorder-specific and transdiagnostic neural features associated with mood, anxiety, and anxiety-related disorders as well as to refine the methodology used to compare multiple disorders.

We conducted an exhaustive PubMed literature search followed by double-screening, double-extraction, and cross-checking to identify all whole-brain, case-control fMRI activation studies of mood, anxiety, and anxiety-related disorders in order to construct a large-scale meta-analytic database of primary studies of these disorders. We then employed multilevel kernel density analysis (MKDA) with Monte-Carlo simulations to correct for multiple comparisons as well as ensemble thresholding to reduce cluster size bias to analyze primary fMRI studies of mood, anxiety, and anxiety-related disorders followed by application of triple subtraction techniques and a second-order analysis to elucidate the disorder-specificity of the previously identified neural features.

We found that participants diagnosed with mood, anxiety, and anxiety-related disorders exhibited statistically significant (p < .05 – 0.0001; FWE-corrected) differences in neural activation relative to healthy controls throughout the cerebral cortex, limbic system, and basal ganglia. In addition, each of these psychiatric disorders exhibited a particular profile of neural features that ranged from disorder-specific, to category-specific, to transdiagnostic.

These findings indicate that psychiatric disorders exhibit a complex profile of neural features that vary in their disorder-specificity and can be detected with large-scale fMRI meta-analytic techniques. This approach has potential to fundamentally transform neuroimaging investigations of clinical disorders by providing a novel procedure for establishing disorder-specificity of observed results, which can be then used to advance our understanding of individual disorders as well as broader nosological issues related to diagnosis and classification of psychiatric disorders.

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The prevalence of overweight and obesity in youths has increased considerably and is related to several health and psychological issues. According to a study from Public Health Institute in Albania 7.7% of children are obese (Hyska et al., Albania Public Health Institute 2013), but there are no data for adolescents.

Recently a special attention is given to psychological consequences of obesity in youths. The aim of this study was to explore body image, self-esteem and psychosocial coping of obese adolescents.

The sample consisted of 200 obese Albanian adolescents aged 12-15 years old, 134 females and 66 males. BMI was considered as the obesity index. We used WHO growth references to determine body mass index (BMI) percentiles. Participants were students enrolled in grade 6 to 9. We used Rosenberg self-esteem scale and Body Shape Questionnaire by Cooper et al. which measures recent concerns about appearance feelings and is a widely used self-report measure of body shape dissatisfaction. Also, a self-constructed questionnaire related to social interactions, stigma and psychosocial coping was distributed to adolescents.

We found out an association between obesity in youths and self-esteem (77% of the sample had a low self-esteem), body image (72% reported moderate and strong concerns for their body appearance), as well as problems of social interaction. Low self-esteem was more prevalent in females (53%) compared to males (20%). There was no significant gender difference regarding body appearance concerns (p >0.05). The majority of the sample (64%) reported to be bullied, but they did not tell anyone about it.

Our findings reinforce the negative effects of obesity in early adolescence. Body image is closely related to self-esteem and this is noticeably manifested during early adolescence. Low self-esteem might be related with body shape dissatisfaction, but we didn‘t further explore the correlation. This sample of obese adolescents reported to be largely exposed to bullying (64%), still it is of great concern that none of the adolescents did confess it to family, teachers, school psychologist or friends.

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The Portuguese writer and Nobel prize winner José Saramago, is well-known for his sharp depiction and reflection of human condition. The recent events of the COVID pandemic juxtapose with his novel “Blindness” (1995) – original title: “Ensaio sobre a Cegueira”–, where the expression of fear of dehumanization in a globalized world where any contemporary society may lead to the obligation to follow what power structures define and establish. In his epidemic of blindness, an abandoned psychiatric asylum was chosen by the author as a quarantine ward and the centre of the plot. A question imposes: why an asylum? What is the focus of such a place in a cultural postmodernism message?

An historic background revision is proposed, glancing at the evolution of the architectural concept of asylum evolved until modern times, while setting a reflection towards today’s mental health services and European models.

A narrative review was performed, gathering points of view in the fields of Literature, Architecture, Philosophy, Politics and Economics.

Bertolt Brecht claims that “all art is political and the question is simply whether art attacks existing structures of power or refuses such attacks and thereby contributes to the continuation of those structures”. Regarding evolution of Asylum Architecture, and the principles which ought to control Modern Construction, In “Blindness”, the thematic of space appears above all through the reference of Marc Augé’s Non-Place. Initially extended to the city, gives way to the funneling of the space that leads to the “asylum” - a space that centralizes all the action. Through Saramago’s description, the floor plans were designed by Portuguese architect José Cardoso. As the first waves of blind people are imprisoned, it is characterized as a heterotopia, the embodiment of Foucaudian panopticism, as it is constituted as a prison whose role is to isolate, even if this attitude is motivated by despair of the government. A mental healthcare system assumes a multidisciplinary approach to psychiatric disorders. Evidence points to a balance between community-based and modern hospital-based care, with frontline services based in the community and hospitals playing a more specialized role. For most European countries, mental healthcare is financed in the same way as other healthcare services, using either national, regional or local budgets and four ways to purchase mental health services are looked at in depth. Therefore, general decisions about such financing may not be in line with mental health policy-maker or planner.

Where culture meets anthropology, social policies, legal boundaries and ethic reflections, a time for a joint dialogue arises. How to surpass the differences and heterogeneity between countries? Is there a place for a common system in mental health care?

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Risperidone is a benzisoxazole derivative and is an antipsychotic drug that is frequently used in psychiatric disorders with high binding to 5HT-2A, D2, α1-adrenergic and α2-adrenergic receptors. It is a second generation antipsychotic and the most common side effects are known as extrapyramidal symptoms, weight gain, sedation, hyperprolactinemia, dizziness, insomnia, anxiety and nausea. Edema has been reported in a few cases as a side effect of risperidone in the literature.

In this case report, we aimed to present a case of peripheral edema developed in a patient using escitalopram combined with risperidone and to review the literature on this subject.

A 48-year-old male presented to the outpatient psychiatry clinic with symptoms of difficulty in controlling his irritability and anger, damaging the things around him, depression, loss of interest and desire, sleep disturbance, fatigue, and feelings of worthlessness. The patient also applied to the psychiatry outpatient clinic with similar symptoms 5 months ago, and had been on sertraline 50 mg/day and quetiapine 25 mg/day since then. But it was learned that he did not benefit, so his treatment was adjusted as escitalopram 10 mg/day and risperidone 1 mg/day. The patient, who came to the outpatient clinic control after 1 month and did not describe a similar complaint before, described peripheral edema that developed approximately 2 weeks after he started using psychiatric medication. On examination, 3+ pretibial peripheral edema was detected. Since the patient had a previous history of escitalopram use, it was recommended to continue escitalopram 10 mg/day treatment, and risperidone 1 mg/day was discontinued and he was called for control.

It was observed that the edema completely resolved within 2 weeks following the discontinuation of risperidone treatment.

In conclusion, risperidone is an antipsychotic frequently used in clinical practice, and edema is a rare but important side effect and can be encountered even at low doses. Despite the low incidence, this side effect should be considered by clinicians. There is a need for controlled studies that explain the relationship between risperidone and edema, elucidate the mechanism of edema and investigate its incidence.

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What adolescents watch affects their body image. Smartphone is one of the most used tool in them today, allowing users to interact each other and share not only pictures but also sights.

The aim of this study is to evaluate the relationship between time/purpose (i.e. social media or the others) of smartphone usage and body image distortion revealed by weight control behavior. Differences in the effect of smartphone usage according to gender was also evaluated.

The cross-sectional study obtained data from the 2017 Korea Youth Risk Behavior Web-based Survey, a nationally representative survey targeting middle and high school students (N=62,276). We categorized the time using a smartphone into 4 groups: less than 1 h, 1-2 h, 3-4 h, and 5 h or more a day. The students were divided into two groups according to whether their main purpose of using a smartphone is social media or not. We defined that adolescents have body image distortion when they attempted to lose weight in the last 30 days, even though they were not obese (BMI < 95th percentile). We classified inappropriate weight control behavior as using: fasting for at least 24 hours, taking over-the-counter diet pills, taking laxatives or diuretics, vomiting, and eating only one food. We performed logistic regression analysis to evaluate the association between time using a smartphone and body image distortion expressed as all kinds of weight control behavior, adjusting for age, gender, residential area, family economic status, hours of sleep, current alcohol consumption, smoking and day time activity. Furthermore, we repeated logistic regression analysis to evaluate the association between time using a smartphone and inappropriate weight control behavior. Analyses were also stratified according to gender and main purpose of using a smart phone.

Smartphone usage time was significantly associated with body image distortion and inappropriate weight control behavior in total group and female adolescents (P <0.05). The association between inappropriate weight control behavior and smartphone usage time is significant even in male adolescent if they use a smartphone more than 5 hours a day. The association between inappropriate weight control and smartphone usage time is also significant when they are not obese. The odd ratio of inappropriate weight control behavior in not obesity group was higher when social media is the main purpose of using a smartphone than the others (OR 1.390 in total group, 1.491 in girls, P <0.001).

Using a smartphone and social media too much is associated with body image distortion and inappropriate weight control behavior in adolescents. It is necessary to reduce excessive smartphone use and educate media literacy for healthy body awareness.

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Diabetes mellitus is a chronic progressive disease, which has been associated with various mental and physical health problems, including sexual disorders. However, especially among female patients the potential effects of diabetes on sexual functioning have been understudied.

The aim of this study was to investigate the perceived sexual functioning in patients with diabetes mellitus compared to a group of healthy controls, as well as to explore its possible association with depression, anxiety, self-esteem, well-being and adult romantic attachement.

The study included 125 patients with diabetes and an equal number of healthy controls. All participants completed the following psychometric scales: Experiences in Close Relationships- Revised (ECR-R), Hospital Anxiety and Depression Scale (HADS), Rosenberg Self-Esteem Scale (RSE), Mental Health Continuum Short Form (MHC-SF), as well as Female Sexual Function Index (FSFI) and International Index of Erectile Function (IIEF) for female and male participants, respectively.

The results did not reveal a significant relationship between diabetes and sexual functioning, as no statistically significant differences emerged between patients and healthy controls neither among men nor women. However, in patients with diabetes, a positive correlation was found between perceived sexual dysfunction and depression, anxiety, and avoidant and anxious attachment, as well as a negative correlation with self-esteem and well-being.

The findings highlight the importance of investigating sexual functioning among individuals with diabetes mellitus, especially women, as well as its relationship with crucial psychological factors.

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Antipsychotic medications remain the mainstay of the treatment of various psychiatric disorders, particularly schizophrenia. However, this therapeutic class can induce a range of side effects. Although the treatment with second generation antipsychotics includes a lower risk for extrapyramidal symptoms as compared to first generation antipsychotics, there are numerous adverse events that can result from atypical antipsychotics. Since the introduction of clozapine, there has been increased awareness regarding antipsychotic-induced hematological side effects.

The objective of this case report is to highlight the importance of the management of antipsychotic-induced neutropenia.

We report a patient with history of schizophrenia who developed neutropenia induced by Haloperidol, Chlorpromazine, Olanzapine, Amisulpride and Aripiprazole.

We present a case of a 43-year-old male patient with a history of schizophrenia, admitted in our department for the management of a state of agitation in the context of a relapse of his condition. On admission, the patient experienced psychotic symptoms, including delusions and auditory hallucinations, in addition to negative symptoms, such as affective flattening, alogia, avolition and asociality. He was then started on 12 mg of Haloperidol and 200 mg of Chlorpromazine with a white blood cells count (WBC) of 5.98 x 109/L and absolute neutrophil count (ANC) of 2.52 x 109/L (WBC reference range: 4.0-10.0 x 109 /L; ANC reference range: 1.5-7.0 x 109 /L). The patient did not report adverse events on this medication.

15 days into hospitalization, a mild neutropenia was detected (WBC=3.92 x 109 /L and ANC=1.01 x 109 /L), leading to a discontinuation of the antipsychotic treatment. No signs of infection were found. After one month, the patient had a normal WBC and ANC. Aripiprazole was discussed as a first alternative and was begun at 5 mg/day and then at 10 mg/day. After one week of treatment with Aripiprazole, the patient’s WBC was normal, but the ANC decreased again leading to a moderate neutropenia (ANC=0.91x 109 /L). The antipsychotic treatment was once again discontinued and the hematological evaluation found no other identifiable cause. Afterwards, neither Olanzapine nor Amisulpride showed significant response to this adverse effect. Finally, the administration of Risperidone led to a positive outcome on the WBC and the ANC.

Awareness regarding the hematological side effects of antipsychotics should increase and clinical management of this type of adverse event should be a subject of interest among psychiatrists.

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The recent global pandemic has led, for many, to a period of enforced isolation. Anecdotally we are now seeing a “fourth wave” of morbidity. This is not a further wave of Covid infections but a surge of people presenting with depression. Given the potential importance of loneliness and isolation as risk factors for depressive symptoms, we sought to review the literature on this topic.

What is the impact of loneliness and isolation on the development and perpetuation of depression?

A search of the literature was carried out using Medline via OvidSP and Web of Knowledge core collection. Search terms used on Web of Science were ‘lonel*’ AND ‘depress*’, ‘isolat*’ AND ‘depress*’. OvidSP utilised search terms ‘lonel*’ AND ‘depression’, ‘isolation’ AND ‘depression’. MeSH terms were incorporated into the OvidSP search: these included ‘loneliness’, ‘social isolation’, ‘depression’, ‘depression, postpartum’. Papers were filtered first by publication year and article type, then manually through the review of titles and objectives. Full texts of relevant papers were obtained, reviewed and appraised to see if they could help to answer the study question.

Several key themes emerged across the papers reviewed.

Loneliness may be a risk factor for the development of depression and vice versa (Van As et al. International Psychogeriatrics 2022; 34(7) 657–69).

Equally, they may have a common aetiology for example shared genetic factors (Achterbergh et al. BMC Psychiatry 2020; 20(1) 1-23).

The experience of loneliness was shown to create a cyclical pattern in which feelings of loneliness worsen the deterioration of depression, which in turn worsens the proceeding loneliness. (Wahid et al. Child and Adolescent Psychiatry and Mental Health 2022; 16(1), 1-17). Loneliness has also been shown to increase the likelihood of reoccurrence of depression, as well as negatively predicting for recovery from depression (Gabarrell-Pascuet et al. Depression and anxiety 2022; 39(2) 147-155, Van As et al. International Psychogeriatrics 2022; 34(7) 657–69).

Fear of disclosing depressive symptoms to friends, due to fear of rejection and subsequent social isolation resulting in loneliness, was shown to lead individuals to withdraw from their relationships. This brought about social isolation: consequences of this isolation, such as loss of meaningful relationships, are in themselves risk factors for depression (Caputi et al. The Journal of Genetic Psychology 2017; 178(4) 207-216).

To prevent and improve recovery from depression, it is important to consider the importance of loneliness and isolation as risk factors. Consideration should be given to treating both using a biopsychosocial approach.

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Adult survivors of childhood sexual abuse (CSA) may experience psychological difficulties in adulthood. Such adverse experiences in the developmental years, sometimes for prolonged periods, could have an impact on their emotional, social and psychological resources. This impact is heightened in CSA adult survivors as the interpersonal nature of harm could reverberate throughout their adult relationships, with complex emotional responses to traumatic stressors. Despite the demonstrated effectiveness of trauma focused treatments in the West, culturally specific understanding of the needs and treatments for such survivors in South Asia is still in its infancy. This is important to address their meaning of presenting complaints in South Asia and offering them treatments suitable for them.

In this systematic review, we aimed to synthesize the findings of existing research on the impact of CSA on adult survivors in South Asia and the current approaches used to treat them.

We searched nine databases and ‘hand searched’ important peer-reviewed journals published in South Asian countries from inception until 3rd April 2022. Searches focused on adult survivors of CSA of South Asian origin residing in South Asia, different treatments offered and the efficacy and acceptability of these treatments.

We identified and screened 2608 records and included 56 articles in our full text screening. Out of those, we included 22 articles in the final review. Studies were from four out of the eight countries in South Asia; India, Sri Lanka, Nepal and Pakistan. Of note, only six of those studies focused exclusively on CSA whereas others included all forms of abuse and neglect. All except one article explored experiences of survivors. Only one article focused on their recovery process, within and/or outside of professional treatment with no published research on treatments for them in South Asia. Physical abuse and emotional abuse or neglect were more often reported in our included studies as compared to sexual abuse.

Our review suggests that even though the needs of adult CSA survivors in South Asia have been partly identified, there is very little research into the treatment of CSA adult survivors in this region. Perpetrators often come from their immediate or extended families, leading to their distrust of the familial and legal systems. Even when not diagnosed with a severe mental health condition, there are potentially serious implications for victims’ adult relationships and social functioning. There is a current lack of research and therefore, lack of evidence-based treatment for adult survivors of CSA in South Asia.

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The gut microbiome is one of our most prominent surfaces interacting with the outside world through the food we eat. It is influenced in terms of composition and diversity by our diets and life style habits and, in turn, affects us through the ‘gut-brain axis’. Cardiovascular risk, which is one of the main causes of death in Bipolar Disorder (BD), is affected by diet. The association between diet and microbiome in BD patients has not been studied.

We aimed to assess whether [1] dietary quality is associated with the microbiome’s diversity, and [2] what changes and interactions occur during in both the dietary quality and microbiome diversity during the subsequent year of onset BD.

39 recently diagnosed patients with BD of the ‘Bipolair Nederlands Cohort’ (BINCO) (mean age 36 years, 61.5% female) were included. Food Frequency Questionnaires (FFQ) and corresponding Dutch Healthy index (DHD-15) were analyzed at baseline and one year follow-up. Feces samples corresponding to the FFQ were analyzed using 16S rDNA gene amplicon sequencing to attain the Shannon Diversity index and the Chao1 diversity index. Multivariate regression analyses were performed.

The Shannon diversity index significantly correlated to the DHD-15 total score after adjusting for sex and age (beta = 0.451; P = 0.004). The Chao1 index showed the same trend, but did not reach significance (beta = 0.264; P = 0.11). These positive correlations seemed to be driven by the positive effect of fish, beans, coffee, fruits and nuts. There was neither a significant change in DHD-15 index nor in the diversity measures after one year.

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Diversity of the microbiome is positively associated with a healthy and varied diet in BD patients, which could have consequences on mood episodes and cardiovascular risk.

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In recent years, more evidence is emerging in favor of a new form of depression, aka “Modern-Type Depression” (MTD). It has also been theorized that MTD may have multiple relationships with other psychiatric disorders, including techno-addictions.

Our study aims at clinically characterizing subjects with MTD in a sample of individuals affected with Internet Gaming Disorder (IGD).

1,157 subjects were recruited from a sample of Italian young people (aged 18-35), and selected only if they declared to be video game players (48.6%, n=542). Video game players filled out the 22-item Tarumi’s Modern-Type Depression Trait Scale (TACS-22), Motives for Online Gaming Questionnaire (MOGQ), Internet Gaming Disorder Scale-Short-Form (IGDS9-SF), Problematic Online Gaming Questionnaire (POGQ), Multidimensional State Boredom Scale (MSBS), Symptom Checklist-90 (SCL-90). Subjects were classified as IGD+/IGD- and MTD+/MTD-. Descriptive analysis, Mann-Whitney’s U-test for independent data and Chi-square tests were carried out.

60.5% (n=328) of the sample were male. 21.7% (n=118) were positive to MTD. MTD subjects reported significantly higher scores at IGDS9-SF (p<0.001), POGQ (p<0.001), MOGQ (p=0.003), MSBS (p<0.001). Significant higher scores were found at the MOGQ subscales “reality avoidance” (p<0.001), “coping” (p=0.001), and “fantasy” (p<0.001) and at the SCL-90 subscales “interpersonal sensitivity” (p<0.001), “phobic anxiety” (p<0.001), and “psychoticism” (p<0.001).

MTD displayed a strong association with technopathies, particularly IGD. Therefore, further studies should evaluate whether MTD could represent a predictor to IGD onset and/or maintenance and adequately address this aspect from a preventive and treatment perspective.

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Charles Bonnet Syndrome (CBS) is an age-related disorder characterized by complex visual hallucinations in older persons with vision loss and underlying ocular pathology. The management of these symptoms is imprecise and combines psychological measures with psychotropic drugs.

to discuss the non-pharmacological management of Bonnet syndrome through a case report.

We report a case of atypical CBS in a 76-year-old male patient presenting with visual and auditory hallucinations that were improved by reassurance.

The past medical history was significant for diabetic retinopathy, difficulty hearing due to bilateral sensorineural hearing loss. He recognized these visions as unreal and felt distressed by them. No cognitive impairment was observed on several neuropsychological tests. He was reassured of the false nature of the visual experiences after explanations that he had no mental illness and that the problem could disappear. He was taught how to keep the images away by closing his eyes for sometimes and repeated blinking. After six weeks of psychological intervention, the visual experiences had disappeared without using any drug

In the management of CBS drug treatments remain partially satisfactory. Nonpharmacological interventions focus on the reduction of the visual pathway deprivation. This therapeutic alternative seems to provide positive benefits.

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Stressful experiences in utero can produce physiological changes which become embedded biological traces affecting fetal brain development and ultimately leading to increased vulnerability for psychiatric disorders.

We hypothesized that stressors as diverse as maternal obesity and maternal psychophysical stress might disrupt fetal programming resulting in long-lasting effects on offspring brain development by acting through shared oxidative stress (OS)-mediated mechanisms.

We compared a mouse model (C57Bl/6N) of maternal high-fat diet (HFD) consumption (13 weeks, until delivery) to prenatal restraint stress (PNS) repeatedly administered during the last week of pregnancy. To counteract the negative effects of both stressors, the antioxidant N-acetyl-cysteine (NAC, 1 g/kg) was administered to female breeders for 8 weeks until delivery. Emotionality was assessed in adolescent male and female offspring through the elevated-plus-maze (EPM). Moreover, hippocampal gene expression levels of Brain-Derived-Neurotrophic-Factor (Bdnf), Nuclear factor erythroid 2–related factor 2 (Nrf-2) and Kelch-like ECH-associated protein 1 (Keap-1) were measured, by qPCR, as markers of brain plasticity and antioxidant capacity.

Prenatal exposure to both HFD and PNS enhanced behavioral disinhibition, increasing time spent in the open arms of the EPM and decreasing the frequency of risk-assessment behaviors, especially in female offspring. Moreover, both prenatal stressors led to decreased Bdnf (in females) and Nrf-2 levels, and disrupted Keap-1 levels. Prenatal NAC was able to counteract these effects on the brain.

Our data support the hypothesis of a “funnel effect” model explaining how different prenatal stressors result in long-term negative effects on the adolescent offspring, increasing risk assessment behaviors and affecting brain plasticity and antioxidant defenses. The beneficial preventive effects of NAC suggest that OS may be a common mechanism, playing a pivotal role in fetal programming of mental disorders. ERANET-NEURON-JTC-2018-Mental Disorders-“EMBED” and Bando Ricerca Indipendente ISS 2021-2023; MOMINFLAM. Unique signatures underlying placental-fetal brain crosstalk in maternal obesity to F Cirulli.

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The human reaction to traumatic events is often marked by a dialectic alteration of two emotional states –a state characterized by intrusion, anxiety and hyperarousal, and a state of denial marked by dissociation and numbing. These two seemingly opposite states represent attempts to modulate stress, as gradual reduction of their intensity represents an adaptation to stress. Maladaptive reactions to trauma, however, reflect disrupted regulation capacities, manifested as persistent over-modulation or under-modulation of stress.

To demonstrate that these manifestations of disrupted regulation, as observed among individuals with posttraumatic stress disorder (PTSD) and borderline personality disorder (BPD) are also reflected in patterns of pain modulation.

Three studies using self-report questionnaires and psychophysical tests, assessing sensitivity to pain, as reflected by pain thresholds, and reactivity to suprathreshold noxious stimuli, as implicated in their rating

Study 1 Included 32 PTSD outpatients, 29 anxiety disorder outpatients, and 20 healthy controls. PTSD patients reported higher rates of chronic pain (83.3%) than anxiety patients (42.0%) and controls (5.0%). PTSD severity correlated with chronic pain severity (r = 0.61, p < 0.01). PTSD patients displayed a unique paradoxical pain profile, according to which their pain thresholds were significantly higher than those of the anxiety patients and controls (p < 0.01), but they perceived suprathreshold stimuli as being much more intense (p < 0.01).

Study 2 included 32 PTSD outpatients and 43 healthy controls. Findings replicated the paradoxical pain profile among PTSD patients. Pain thresholds were positively associated with dissociation level (b = 0.49; p < 0.05) and negatively associated with anxiety level (b = -0.63, p < 0.01). Pain ratings were positively associated with anxiety (b = 0.52, p < 0.05) and negatively related to dissociation levels (b = -.51, p < 0.05).

Study 3 included 46 women diagnosed with BPD and 47 healthy controls. Women with BPD reported higher levels of childhood trauma (p < 0.05) than the controls. They also demonstrated higher pain thresholds (p < 0.05). Among subjects with high levels of body dissociation, implicated by reduced body awareness, those with BPD demonstrated hyposensitivity to pain, manifested in higher pain thresholds, lower suprathreshold pain ratings, and pain evoked by higher temperature, than the controls. Among those with low levels of body dissociation, BPD subjects demonstrated increased reactivity to pain as manifested in higher pain ratings and pain evoked by lower temperature.

These findings demonstrate the association between over-modulation and under-modulation of stress and over-modulation and under-modulation of pain, respectively, among PTSD and BPD patients. These findings point to parallel processes of disrupted regulation among traumatized individuals.

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The proxies used to compose cognitive reserve (CR) in first episode of psychosis (FEP) have varied in the literature. The development of FEP is linked to the peripheral pathways of the central nervous system (Leboyer et al. Psychopharmacology 2016; 233(9) 1651-60) Furthermore, schizophrenia has been linked to the metabolic system, indicating that alterations in the levels of biological parameters, in particular high-density lipoproteins (HDL) (Gjerde et al. Eur Arch Psychiatry Clin Neurosci 2020; 270(1) 49-58) cause worse global functioning and cognitive impairment (Adamowicz et al. J Clin Med 2020; 9(2) 537). Despite this knowledge, no research has considered the introduction of biomarkers as proxies for CR.

The present study aimed to create a quantifiable and objective CR index that adjusts for the multifactorial nature of FEP.

We included 668 patients who had FEP and 217 healthy controls who were assessed for sociodemographic information and levels of biological parameters: waist circumference, hypertension and levels of HDL, triglycerides and glucose. The main analyses were multiple regression analysis, principal component analysis (PCA) and exploratory factor analysis (EFA).

Regression analyses showed that HDL was the top performing biological parameter in a model containing years of education and unemployment (F=11.80; p<0.001) while also outperforming other parameters in a correlation analysis with a composite of the same variables (r= 0.21; p<0.001). In EFA analyses combining all possible components, we found that the most optimal proxies for the composition of biological CR were years of education and HDL. The results using PCA indicated that biological CR would have a greater explanatory power for the phenomenon than classical CR, increasing 7.27% of the explanation for FEP patients and 16.08% for healthy controls.

This article proposes an objective and quantifiable method to measure CR, taking into account endogenous and exogenous factors. This index, introducing biomarkers as proxies could provide a more accurate CR score for FEP patients.

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