Most mental illness of adult life begin in late adolescence, affecting young people when they require transition to adult services. In <18 years old patients is more difficult to establish a definitive diagnosis, so diagnoses are often unstable and temporary. In young patients, understanding diagnostic stability may help in clarifying the course, developmental changes, and long-term prognoses of psychiatric disorders. Little research has explored the diagnostic adjustments that occur in child and adolescent mental health services, however previous studies reported that moods disorders and schizophrenia showed more stability than other diagnoses.

Understanding diagnostic trajectories is necessary to improve developmental psychopathology, in order to acquire more discrete diagnostic entities, and clinical judgements, regarding risk and prognosis.

as the evidence of diagnostic stability from childhood (child and adolescent mental health services) to adulthood (adult services) is limited, the aim of this study is to describe the clinical features in patients from child and adolescent mental health services in transition to adult services and to compare the main diagnosis of these patients made in both services.

all individuals, between 18 and 25 years old, admitted to our outpatient clinic specialized in prevention, diagnosis and treatment of mental illness in adolescents (ASST Grande Ospedale Metropolitano Niguarda, Milan), referred to our service between 2021 and 2022. Clinical Diagnosis were establish using ICD-10 criteria.

301 new patients were admitted in our outpatients service: 171 in 2021 and 130 in 2022 (until October). The mean age was 21,08. The 30.2% of patients come from child and adolescent mental health services (29,2% in 2021 and 31,5% in 2022). The main diagnosis of these patients were: first reaction to severe stress and adjustment disorders (F43), second specific personality disorders (F60) and thirst eating disorders (F50). The main diagnosis made in our services were: first specific personality disorders (F60), second first reaction to severe stress and adjustment disorders (F43), thirst other anxiety disorders (F41). 56,1% of patients have the same diagnosis in both services and 43.9% have a different diagnosis. There were not differences in sex (60,5% female and 39,5% male). Patients from child and adolescent mental health services were youngers (19,68 vs 21,69), not statistically significant.

Further research is required to understand diagnostic trajectories, especially longitudinal studies in minors during transition period to adult services, in order to find patterns of diagnostic adjustments.

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Anxiety and depressive disorders are major public health problems associated with multiple adverse occupational outcomes, including unemployment, reduced productivity, and absenteeism.

To study the socio-professional and medical characteristics of workers with mixed anxiety -depressive disorders and to evaluate their impact on work ability.

A descriptive and retrospective study conducted in the occupational medicine department at Charles Nicolle Hospital, involving all the medical records of workers suffering from mixed anxiety –depressive disorders that were referred for a medical opinion of fitness for work from January 1, 2014, to December 31, 2020.

The study included 62 females and 20 males diagnosed with mixed anxiety-depressive disorders with a mean age: 41.4± 8 years. The average professional seniority was 12.8 years±7.8 years. The most auspicious occupational sectors for these disorders were health (41%) and communication (30%). Most of these workers (62%) were fit for work with professional restrictions (10 workers to positions with a lower mental load and 20 exclusions from night shift work), though 12% were declared unfit for work temporarily. Twenty-one workers were fit to continue working and one worker was unfitted to work.

The overall prevalence of mixed anxiety –depressive disorders was found to be significantly elevated in female patients (p: <0.001).

The decision of medical fitness for work among workers with psychiatric disorders considers their physical and mental capacities as well as the conditions in which the work is carried out, aiming to annihilate the risk of psychic imbalance. Thus, an adjustment of workstations can be an important determinant in the prevention of psychosocial risks.

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Prolactin adenoma, called “prolactinoma” is a benign neoplasm, it is the most common secreting pituitary tumor, and represents up to 40% of all pituitary adenomas. More than 90% are small intrasellar tumors which rarely increase in size.

the problem of management lies in how to stabilize the patient on a psychiatric level without increasing the level of prolactin.

We report the case of a young woman who presented a comorbid schizophrenia with a prolactinoma. We will try through this clinical vignette to study the different pillars of management of such pathologies.

At the same time, we did a literature review. The main search engines used were Pubmed, medline, and Science Direct. The keywords Prolatinoma schizophrenia olanzapine

This is Mrs. N. Q., 39 years old She is single, an engineer but currently without a profession, from an average socio-economic level of a teacher father and a housewife mother. She is the 3rd of his siblings of 6 . She is currently hospitalized at Ar-razi Tanger hospital for treatment of decompensation of her chronic psychotic disorder. The patient would have been born following a premature delivery of 34 weeks. For her antecedent, she was followed for asthma since her childhood. Her mother and her maternal grandfather would have been psychotic. The history of the disease dates back to 2017. The patient suffered from headaches resistant to any treatment. The patient would have consulted a neurologist. Magnetic resonance brain imaging would have been requested, which objectified at the left latero-pituitary level a lesional process of 7 mm discretely intense in T2, hypo-intense in T1 and not enhanced by Gd reflecting a pituitary micro adenoma. The patient was put on Cabergoline (Dostinex®). So the psychiatric symptomatology dates back to the end of 2019, by behavioral problems, social withdrawal, she will have stopped all professional activity. At the same time, she will have stopped all medication (Cabergoline). In 2020, the patient would have been hospitalized for the first time at the Ar-razi Tangier psychiatric hospital. The diagnosis of schizophrenia was retained according to the DSM 5 criteria. After a stay of 5 weeks, the patient would be stabilized on olanzapine 20mg/d. Currently, and following non-compliance with treatment (because of adverse effects such as amenorrhea and galactorrhea), the patient has returned, suffering from a relapse, justifying her second hospitalization. During his stay, a check-up would have been requested to show hyperprolactinemia 3 times normal. We therefore switched to Aripiprazole.

We have proposed an approach to the management of patients with comorbid schizophrenia and prolactinoma, an approach that balances the benefits and risks of managing the psychiatric stability of the patient on antipsychotics with the management of prolactinoma and symptoms. of hyperprolactinemia.

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The clinical features of juvenile fibromyalgia were first described by Yunus & Masi in 1985. In the US, it is estimated that about 6% of adolescents between 15 and 19 years of age suffer from juvenile fibromyalgia. However, this entity remains “a poorly defined disorder”, being excluded from the main diagnostic classification systems.

The goal of our work is to present and discuss a case-based review of juvenile fibromyalgia.

We present a case of chronic pain in pediatric age, referred to a multidisciplinary chronic pain consultation. Through the analysis of this case, we review the concept of juvenile fibromyalgia and its pathophysiology, the risk factors, the diagnostic criteria, the recent evidence for the treatment of these cases and the prognosis of this disorder.

We describe the case of an 11-year-old female, who presented with widespread musculoskeletal pain, headaches, and sleep disturbances for a period over 3 months. At physical examination no significant alterations were found except for pain at palpation of the referred pain locations and at palpation of 11 typical fibromyalgia tender points. Complementary diagnostic exams were normal. The patient was referred to a multidisciplinary chronic pain consultation and was prescribed pharmacological therapy with antidepressants and a gabapentinoid and non-pharmacological therapy with a plan of physical exercises and psychotherapy.

This case report demonstrates the importance of considering juvenile fibromyalgia in the differential diagnosis of pain in pediatric age, showing also the complexity involved in the assessment and treatment of these cases. This case also highlights the importance of multidisciplinary collaboration in the management of chronic pain.

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Insomnia is a prevalent global health problem that affects 11.7% - 36% of the population (Grewal et al. Clinical Handbook of Insomnia Int 2017; 13 - 25). It is a risk factor for depression, poor quality of life, and accidents. Increasingly, insomnia has been identified as a suicide risk factor (Lin et al. BMC Psychiatry 2018: 18; 117) We present a case report of a 43-year-old male patient with insomnia-induced suicidal ideation (SI).

1. 1. Learn the mechanism of insomnia-induced SI

2. 2. Understand the current insomnia treatments

3. 3. Discuss the possible mechanism of ECT treating insomnia-induced SI

A 43-year-old single male with past psychiatric diagnoses of social anxiety, borderline personality disorder, chronic SI, and severe recurrent depression was admitted to inpatient due to intractable SI from insomnia. He failed trials on SSRIs/SNRIs, bupropion, trazodone, lithium, vortioxetine, quetiapine, zolpidem, and ketamine. The patient was initiated on electroconvulsive therapy (ECT) three times a week with 20mg vortioxetine and 100mg quetiapine for sleep initiation.

After 6-sessions, the patient’s mood, affect and sleep had improved considerably, and his suicidal ideations resolved. The patient was discharged with outpatient follow-up and ECT as rescue therapy. His sleep gradually improved to 4-6hrs/night and his mood was back at baseline.

ECT is an effective treatment for refractory insomnia-induced SI, likely due to persistent REM suppression and reduced dendritic arborization and excitatory synapses in the amygdala (Doghramji et al. Sleep 2000; 23 - S16 - S20; Lahmeyer et al. Sleep Respiratory 1989; 18 346). Possible mechanisms for insomnia-induced SI include impaired decision-making, abnormalities in 5-HT function, or HPA dysfunction leading to a hyperarousal state and cortisol release (Chatzittofis et al. Euro Neuropsychopharmacology 2013; Elmenhorst et al. Sleep 2012; 35 1615 - 1623; Keilp et al. Psychol Medicine 2013; 43 539-551; Novati et al. 2008 Sleep; 31 1579 - 1585). Current insomnia treatments address underlying medical/psychological problems and non-pharmacologic and pharmacologic strategies. The predominant non-pharmacologic approach is Cognitive Behavioral Therapy Insomnia (CBT-I), such as relaxation techniques, sleep hygiene education, cognitive structuring, and sleep restriction (Rossman et al. American Journal of Lifestyle Medicine 2019; 13 544 - 547). Pharmacologic options include benzodiazepines, non-benzodiazepine hypnotics, tricyclic antidepressants, trazodone, and antihistamines (Saddichha et al. Annals of Indian Academy of Neurology 2010; 13 94-102). ECT should be strongly considered for the treatment of refractory insomnia-induced SI, and its early application may avoid rapid deterioration improving the quality of life.

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The worldwide COVID-19 pandemic leads to the development of stress disorders, increased anxiety in the society. One of the strongest factors leading to the development of anxiety, stress in society during a pandemic is the Mass Media. The mechanisms of stressogenic effects of Mass Media remain not completely clear.

The aim of this study was to evaluate age-specific characteristics of gaze behaviour related to the perception of anxiety-provoking information.

189 volunteers took part in the study (164 participants aged between 17 and 22 years old (students, control group), 25 people aged between 59 and 71 (experimental group)). Participants were asked to fill in Psychological Stress Measure (PSM-25), Patient Health Questionnaire (PHQ-9), and Generalised Anxiety Disorder Assessment (GAD-7) questionnaires in order to determine their levels of stress, depression, and anxiety. The second stage of the research was an eye-tracking study of text perception - we analysed eye-tracking data during the text perception by using web-eye tracking (EyePass).

To identify the relevance of COVID-19 information, we compared the perception of positive, neutral and negative texts and detected rather a negativity bias than attraction to the positive or neutral stimuli: fixations positive vs negative (p-value < 0.01), positive vs neutral (p-value < 0.01), neutral vs negative (p-value < 0.01). Under the competitive conditions (higher relevance of negative information during Pandemic) the perception of negative text is characterized by attentional priority. Moreover, it should be taken into account that highly anxious participants showed a negativity bias than attraction to the positive stimuli, and this is typical during quarantine.

Therefore, participants showed a negativity bias than attraction to the positive stimuli, and this is typical during quarantine. There are significant age-related differences in gaze behavior while reading text with negative text elements. While the origin of these differences between older and younger adults remains unknown, further research may provide more evidence about the origin of this effect.

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Schizophrenia is a chronic psychiatric illness with symptoms in positive, negative and cognitive domain.The interplay of dietary folic acid intake with common genetic variants that influence folate metabolism, has potential implications for Schizophrenia pathogenesis and treatment.Therefore, it’s deficiency has been identified as a risk factor for Schizophrenia through epidemiologic, biochemical and gene association studies.

1-To assess the efficacy of folic acid supplementation on severity of symptoms and overall functional status of patients

2-To assess the correlation of serum folate levels with symptom severity and overall functional status of patients

A randomized control trial study was carried out in the inpatient department of a psychiatric tertiary care centre on 40 participants (29 males and 11 females)who were between the ages of 18 – 55 years,met diagnostic criteria for Schizophrenia (ICD 10) and had at least 2 years of illness duration while those with a co-morbid psychiatric illness, medical illness and substance abuse were excluded. The participants were then randomly allocated into two groups (experimental Group A which received 5mg folic/day along with anti psychotic drugs and control Group B which received only anti psychotic drugs) and followed up for 3 months. Blood sample for measuring serum folate level was obtained from the experimental group at the beginning and at the end of the study period. Scales applied were Positive and Negative Syndrome Scale(PANSS) for symptom severity and Global Assessment of Functioning scale(GAF) for overall functional status.

A significant difference (p value< 0.05) was observed in PANSS scores at the end of the study between experimental group and control group( table 1) and also in GAF scores between both the groups after 3 months(table 2). At the end of the study period,a strong negative correlation(r= -0.9) was found between serum folate level and total PANSS score in the experimental group (figure 1) while the correlation between GAF score and serum folate level was strongly positive (r= 0.8) (figure 2).Table 1

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Image 2:

Our study is among the few to use a randomized controlled study design for assessing the effect of folic acid supplementation on severity of symptoms and global functioning in Schizophrenia,strongly suggesting the use of folic acid as an adjuvant treatment for Schizophrenia.

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We previously demonstrated that the difference between 11 PM and 8 AM TSH response to protirelin (TRH) tests on the same day (∆∆TSH test) is an improved measure in detecting hypothalamic-pituitary-thyroid (HPT) axis dysregulation in depression. This chronobiological index is normalized after successful antidepressant treatment.

The present study aimed at assessing the effects of repetitive transcranial magnetic stimulation (rTMS) of the left dorsolateral prefrontal cortex (DLPFC) on the HPT axis activity in treatment resistant depressed inpatients (TRDs) (defined as having at least 2 treatment failures).

The ∆∆TSH test was performed in 13 TRDs and 14 healthy hospitalized control subjects (HCs). To be enrolled in this study, patients had to show reduced ∆∆TSH values (i.e., < 2.5 mU/L) at baseline (BL). After 20 sessions of rTMS (using daily theta-burst stimulation; 100% resting motor threshold; number of pulses/session: 900), the ∆∆TSH test was repeated in all inpatients. The 17-item Hamilton depression rating scale (HAM-D) was used to assess the severity of depression. Remission was defined by a final HAM-D score ≤ 8.

Compared to BL, HAM-D scores decreased and ∆∆ TSH values increased after 20 sessions of rTMS (both p< 0.05 by T-test). There was a relationship between the reduction in HAM-D scores from BL to endpoint and the increase in ∆∆TSH values (rho = - 0.64; n = 13; p = 0.018). At endpoint, 7 patients showed ∆∆TSH normalization (among them 6 were remitters), while 6 patients did not normalize their ∆∆TSH (all were non-remitters) (p < 0.005 by Fisher Exact test).

Our results suggest that after 20 sessions of rTMS, chronobiological restoration of the HPT axis activity is associated with clinical remission. Further investigation of the specific effects of rTMS on the HPT axis activity in TRDs is warranted.

None Declared

Pregnancy-specific anxiety is defined as a mental state of a pregnant woman whose concerns are specific to the pregnancy itself, such as fears regarding the pregnancy, delivery, and health of the child. In the perinatal period, anxiety disorders are relatively common and are more common than depressive disorders. These psychiatric concerns can lead to long-term negative effects on pregnancy outcome. On the other hand, when the pregnancy is complicated by the diagnosis of fetal malformations, these concerns are more detrimental to maternal health.

This study aimed to determine the association between pregnancy-specific anxiety in pregnant women and the diagnosis of prenatal fetal malformations, through our database of genetic counseling and prenatal diagnoses.

We conducted a retrospective study on 20 pregnant women who were referred to our genetic counselling. The consultation was piloted during a prenatal genetic exploration and counselling after the second trimester ultrasound diagnosis of syndromic and non-syndromic fetal malformations. Collection and characterization of the psychiatric concerns of the cohort were conducted using the self-reported feelings during the consultation. A conversion of these data using the Perinatal Anxiety Screening Scale was possible to assess the pregnancy-specific anxiety level of our patients.

Results of our study showed that pregnancy-specific anxiety is significantly associated with the discovery of fetal malformations during pregnancies. Depression, generalized anxiety, and post-traumatic stress disorder as well as a specific phobia from the malformed baby were constants as psychiatric concerns.

Health care providers should pay special attention to pregnancy-specific anxiety. The Arabic translated version of the PASS that has been shown to have adequate validity and reliability must be used in our institutions to screen for the new concept of pregnancy-specific anxiety among all pregnant women in the perinatal phase. Women who experienced the discovery of a malformed fetus and who are facing pregnancy termination due to fetal abnormalities need to have a particular psychological support. A specific scale may be crucial in pregnant women with a malformed fetus before and after termination of the pregnancy.

None Declared

Cri du Chat syndrome (CdCS) is a genetic disorder resulting from a variable size deletion of the end of the short arm of chromosome 5 (5p), including a critical region located at p15.2. It represents one of the most frequent chromosomal deletions, with an incidence in the general population of 1/20,000 to 1/50,000.

Through this observation we update the scientific news of this rare syndrome and present an observation of a Cri du Chat syndrome confirmed by metaphasic karyotype (46,XY,del(5)(p13) de novo) with autism spectrum disorder.

Description a case with cat cry syndrome seen in child psychiatry consultation in our institution

Discussion through articles published on pubmed, googlescholar and science direct

Typical features of CoCs present in the subject include intellectual disability, psychomotor acquisition delays, language delay, and dysmorphic features (e.g., wide and high nasal root, hypertelorism, and coarseness of features). Expected features of CoCs that are not present are: growth retardation, microcephaly, round facies, micrognathia, epicanthal folds and characteristic high-pitched cry. Behavioral features in this subject include symptoms of autism spectrum disorder.

The deletion of the short arm of chromosome 5, when it includes a critical region located at p15.2, is responsible for a well-characterized syndrome, Cri-du-Chat disease, including a characteristic craniofacial dysmorphia that evolves with age, the mental handicap in the characteristic form is very severe. Visceral malformations are relatively rare and not very specific.

None Declared

Up to 80 % of patients with alcohol use disorders (AUD) display cognitive impairments. Some studies suggested that cognitive functions could be worsened by hepatic damage, particularly cirrhosis. Cirrhosis is widespread in patients with AUD, indeed one third of them develop cirrhosis during their lifetime (Zhang et al. Alcohol Clin Exp Res. 2022). Currently, patients treated for cirrhosis do not benefit from a systematic assessment of alcohol related cognitive impairments. The Brief Screening Tool for Alcohol-Related Neuropsychological Impairments (BEARNI) is a specific tool developed to screening for those impairments.

The primary objective of this study was to compare BEARNI mean scores in a group of AUD patients with (AUD/C+) or without cirrhosis (AUD/C-).

We conducted a prospective, monocentric study at the Amiens University Hospital. Subjects were consecutively recruited from the hepato-gastroenterology department of Amiens University hospital and from the local substance abuse treatment department. All patients were assessed using BEARNI test, demographical (age, gender, number of years of scholarship), and clinical variables, using Child-Pugh scores and Alcohol use disorders identification test (AUDIT). The BEARNI mean score in the AUD/C+ group was compared to the mean score in the AUD/C- group using an Analysis of covariance (ANCOVA) with age and educational level as covariate. Between group comparisons were performed using post hoc analysis with Tukey HSD test.

107 patients (75 AUD/C+, 32 AUD/C-) were included in this study. AUD/C- patients were significantly younger than AUD/C+ patients (respectively, 45.5 ± 6.8 vs 59.3 ± 9.3; p<0.0001). There were no differences regarding gender and years of scholarship. Child-Pugh mean scores were 6.9 ± 2.4 in the AUD/C+ group. AUDIT mean scores were significantly lower in the group of patients with AUD and cirrhosis than in the group of patients with AUD without cirrhosis. After adjusting on age and educational level, we found that mean BEARNI total and cognitive scores in the group of patients with AUD and cirrhosis were significantly lower than in the group of patients with AUD without cirrhosis (respectively, 13.8 ± 0.7 vs 7.8± 0.4 F=46.8; p<0.0001 and 10.6 ± 0.6 vs 6.9± 0.3; F=30.1; p<0.0001). The mean subscores of delayed verbal memory, alphabetical ordination, alternating verbal fluency and ataxia subtests were also significantly lower in the group of group of patients AUD/C + (respectively, 1.8 ± 0.1 vs 2.8 ± 0.2, F= 13.9, p<0.0001; 1.8 ± 0.1 vs 2.6 ± 0.2, F= 10.6, p<0.0001; 2.4 ± 0.1 vs 3.6 ± 0.2, F= 13.4, p<0.0001; 0.9 ± 0.2 vs 3.1 ± 0.2, F= 30.6, p<0.0001).

In the present study, the patients with AUD and cirrhosis had more cognitive impairments than their counterparts without cirrhosis. Longitudinal studies are needed to investigate how cirrhosis can influence cognitive impairments.

None Declared

Covid -19 pandemic challenged health care personnel, especially frontline employees. The increased workload was unevenly distributed.

The aim of the present study is to assess potentially traumatic pandemic work-related events (PTEs), psychological distress and insomnia symptoms especially among employees who were in the frontline June 2020, after 24 -month follow-up.

Participants were recruited from the Helsinki University Central Hospital personnel on June 2020 and followed via electronic surveys for 24 months. Mental Health Index 5 (MHI-5) and Insomnia Severity Index (ISI) was used to assess psychological distress and insomnia symptoms. Potentially traumatic events related to pandemic work (PTEs) were asked. The study is described in detail elsewhere (R1, R2).

On May 2022, early frontline employees from June 2020 (N=1171) continued to report a greater frequency of PTEs compared to those not in early frontline (N=3623) (19.4% vs. 9.5%; OR = 2.29, 95% CI = 1.51–3.46). They did not report statistically significantly greater frequency of psychological distress (14.2% vs. 9.9%; OR = 1.5, CI = 0.96–2.35), nor sleep problems (8.9% vs. 5.8%; OR = 1.57, CI = 0.91–2.72). The difference was not quite significant for the continuously varying MHI-5 scores either (p = 0.058 in t-test and p = 0.064 for Kruskal-Wallis test), but the continuous ISI scores at the last follow up were still statistically significantly higher for the early frontline employees than for the non-frontline employees (6.82 vs. 5.51; p = 0.001 in t-test and p = 0.001 in Kruskal-Wallis test). Attrition from the study was higher among the early frontline personnel compared to others. The odds of no show at 24-month wave were 1.42-fold for those at the frontline (95% CI = 1.2–1.68). This effect was not fully explained by age, sex, profession or having experienced a potentially traumatic event at the baseline.

Early frontline employees who participated the 24 -month follow-up, did not report significantly more psychological distress than other employees. Subthreshold changes in insomnia scale are in line with a recent meta-analysis R3.

R1. Haravuori H, Junttila K, Haapa T et al. Personnel Well-Being in the Helsinki University Hospital during the COVID-19 Pandemic-A Prospective Cohort Study. Int J Environ Res Public Health. 2020 Oct 28;17(21):7905.

R2. Laukkala T, Suvisaari J, Rosenström T et al. COVID-19 Pandemic and Helsinki University Hospital Personnel Psychological Well-Being: Six-Month Follow-Up Results. Int J Environ Res Public Health. 2021 Mar 4;18(5):2524.

R3. AlRasheed MM, Fekih-Romdhane F, Jahrami H et al. The prevalence and severity of insomnia symptoms during COVID-19: A global systematic review and individual participant data meta-analysis. Sleep Med. 2022 Aug 8;100:7-23.

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Schizophrenia is a severe, chronic, mental disease. Its stability relies upon a multidisciplinary treatment, where pharmacological treatment is a key aspect. Long-acting injectable antipsychotics (LAIs) have proved efficacy in improving adherence, reducing hospitalizations and relapses, compared with oral treatment[1,2]. Paliperidone palmitate is a long-acting antipsychotic, approved by FDA in 2009 for acute and chronic treatment in schizophrenia. To date, long evidence exists regarding treatment efficacy of paliperidone palmitate 1 month (PP1M) and paliperidone palmitate 3 month (PP3M)[3]. In September 2021 a new long-acting medication was approved for schizophrenia treatment, that is, paliperidone palmitate 6 months (PP6M). This is the first LAI with 6 months duration of treatment, which means, only 2 administrations per year.

We here analyzed the factors explaining transitioning from PP1M and PP3M to PP6M treatment in a population previously described somewhere else[4].

To identify the variables explaining the transition from other long-acting formulations (PP1M and PP3M) to the new biannual formulation (PP6M) in our clinical practice.

123 patients, previously diagnosed with psychotic disorders, in follow-up in our clinical center Fundación Jiménez Díaz Hospital, was analyzed. Sociodemographic factors and clinical evolution were compared in order to identify factors predicting transitioning from PP1M and PP3M to PP6M.

In the PP1M group, patients transitioning to PP6M had more than 6 years of evolution of disease ans active consummation of drugs, compared with patients who stayed on PP1M. Other sociodemographic were similar in both groups. Only 1 patient was readmitted in hospital since transition to PP6M and no emergency visits were accounted for people transitioned.

In the PP3M group, the majority of people transitioning to PP6M were under polypharmacy of which, 42% were on clozapine treatment. The percentage of people with schizophrenia diagnosis was significantly less than in the no transitioning group, though it remained the principal diagnosis. No other significant difference was found with regard to sociodemographic variables. Additionally, no emergency visits nor readmissions to hospital were accounted in this group.

Finally, the PP3M transitioned to PP6M significantly more than PP1M group. Although no clear variable explained this situation.

With these results, we conclude that chronicity and drugs consummation were the main variables explaining transitioning from PP1M to PP6M. In the other hand, the main variable explaining transitioning from PP3M to PP6M was polypharmacy.

These results are preliminary and, therefore, should be taken cautiously. We will probably dilucidated future tendency in these treatment use in the upcoming months.

None Declared

From the beginning of the pandemic in Georgia, Covid clinics and Covid hotels were not ready to receive and manage people confirmed Covid 19 with pre-existing mental disorders, because of stigma. As a result of this, the Ministry of Health created special Covid-Psychiatric clinics.

Study the impact of stigma on people with pre-existing mental disorders during Covid 19 pandemic. Also clinical, and dynamic characteristics of Covid 19 infection in people with severe mental illness.

A retrospective statistical analysis of medical records of all hospitalized patients (total 301) at the specialized Rustavi Covid –Psychiatric clinic from November 23, 2020, to March 15, 2022, according to the following parameters: age, gender, mental disorder diagnosis, comorbid chronic illness, vaccination rates, degree of covid infections ongoing, and outcome.

57% of patients were men. Average age-44 years. 67% were asymptomatic or mild with covid symptoms, 25% with moderate severity and 8% were referred to the intensive care unit. 56% of referred patients were hospitalized already in serious conditions. 46% of patients had schizophrenia spectrum disorders. Among referred patients, 60% were women, and 25% had comorbid diabetes mellitus. 44% of patients transferred to the intensive care unit died. Most of the hospitalized patients with pre-existing mental disorders were in remission, and only 7% were referred to other psychiatric clinics for continuing their inpatient treatment.

The study showed that only due to the lack of readiness of the relevant structures, individuals with Covid 19 infection were hospitalized in psychiatric clinics because of their past mental history. Vaccination rates were extremely low than in the general population. The aforementioned indicates a high degree of stigma in the country that makes obstacles for people with mental disorders from receiving adequate and timely medical care. Comorbidities played a big role in degree of COVID infections ongoing, especially diabetes. Statistics also showed that the majority of hospitalized patients did not require inpatient treatment and covid infection did not aggravate the course of most severe mental disorders.

None Declared

Workplace violence (WPV)has been a persistent problem that is underestimated and generally disregarded by the public and professional organisations, and it has been noticed that the highest number of these assaults are directed towards healthcare workers.

The aim of the study is to determine the prevalence of workplace violence against nurses in psychiatry hospitals in Oman and to explore the determinants contributing to the workplace violence

This is a cross-sectional study was conducted at two tertiary mental health care hospitals (Al Masarra Hospital and Sultan Qaboos University Hospital) in Muscat, Oman between October, and December of 2021.Participants were asked to complete the Workplace Violence in the Health Sector to assess level of violence, as well as a sociodemographic survey.

This study included 106 participants with 80% response rate. The Majority of participants aged between 30-39 years. Of this study, 52.8% werefemale and most of the participates are Omani (73%) and working in inpatient (80%). The highest type of violence experiences was verbal violence 86.8%followed by physical violence 57.5%. Most physical violence incidents 26.4% took place during weekdays with highest incidences happened during morning shifts (34%) followed by afternoon shift (25.5%).

Current study revealed a relatively high prevalence of WPV among nurses working at psychiatric hospitals in Oman. Future studies needed to explore the predictors of violent among nurse. It is important to invest in the prevention of WPV by constant training of workers in mental hospital in Oman on how to respond to violent psychiatric patients.

None Declared

Childhood maltreatment (CM) is recognized to be a non-specific risk factor for the development of psychiatric disorders in adulthood. It has been consistently demonstrated that exposure to CM increases the risk of developing bipolar disorder (BD). In addition, CM has been associated with worse clinical presentation and course of BD. CM has been also linked to poorer responses to psychotropic drug treatments in different psychiatric disorders.

The aim of the current study was to explore retrospectively the impact of CM on the response to prophylactic treatment with lithium or anticonvulsants in a cohort of adult BD patients. Based on the reported literature, we hypothesized that BD patients with a history of CM would present a poorer response to both lithium and anticonvulsant treatments.

Participants were recruited from patients consecutively attending the outpatient facilities of the Psychiatric Unit of the University of Salerno. The following inclusion criteria were adopted: (1) diagnosis of BD type 1 or type 2 according to DSM‐5 criteria; (2) age ≥ 18 years; (3) willingness to participate in the study, expressed by written informed consent; (4) stable adequate treatments with mood stabilizers (at least 1‐year duration and, in the case of lithium, at therapeutic blood levels); (5) being clinically euthymic at the time of inclusion. Retrospective treatment response was evaluated by using the Alda scale. CM history was assessed by means of the short form of the Childhood Trauma Questionnaire (CTQ).

Thirty‐seven patients (24 with a history of CM and 13 without CM) were on stable lithium treatment while sixty (35 with a history of CM and 25 without CM) were on stable anticonvulsant treatment. Clinical response to drug treatment did not differ between BD with CM and those without CM in the whole sample as well as in the anticonvulsant‐treated subgroup. In the lithium‐treated subgroup, a significant negative correlation emerged between physical abuse and treatment response (ρ = −0.38; p = 0.03) and patients with CM showed a significantly reduced Alda score (p = 0.04).

In patients with BD, CM did not influence the clinical response of anticonvulsants, whereas it was associated with a poorer response to lithium with childhood physical abuse playing a major role in this effect.

None Declared

Hair loss is a common clinical complaint, resulting from a wide variety of causes, a variety of medications prescribed to treat mental diseases may contribute to hair loss.

As far as we know, no previously published reports of alopecia associated with quetiapine were identified in Morocco.

Through this work we will try to expose the first case having this undesirable effect in our context, next to the rare cases in the literature.

This article describes the experience of a 37-year-old male developing diffuse alopecia associated with use of quetiapin and recovering after cessation of the medicament is presented, besides presenting some rare cases that were found and described in other studies.

Among these psychotropic agents, this side effect is most often reported with the use of valproic acid and lithium It has been also reported with the atypical antipsychotic medicines olanzapine and risperidone, but only rare cases were reported in relation to quetiapine, In this paper, a 37-year-old male patient developing diffuse alopecia associated with use of quetiapine and recovering after cessation of the medicament is presented.

The results of this study are the first known in morocco, establishing a relationship between hair loss and the use of quetiapine will be taken in consideration while prescriping this medicine. These results confirm the relatively new idea of the impact of quetiapine on hair loss, unlike older studies which suggested good tolerance of this molecule.

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For many years, the question of the announcement of the diagnosis in psychiatry has been controversial. It is the starting point of a management allowing access to psychoeducation and to the patient’s recovery. In the case of schizophrenia, the cognitive impairment and the stigmatizing nature of the pathology jeopardize the announcement of the diagnosis. However, recommendations and legislation emphasize the need to inform the patient about his or her pathology. In Morocco, the law n° 131-13 of February 19, 2015 relating to the practice of medicine has made information about the diagnosis to patients an obligation for doctors and a right for patients

The interest of our work is to try to evaluate the current state of this practice, its ethics and its representations among psychiatrists.

This is a descriptive study on the announcement of the diagnosis of schizophrenia in a population of psychiatrists. The data collection was carried out by a questionnaire including: Socio-demographic and professional data, opinion on practice and training concerning diagnostic announcement in psychiatry, physicians’ representations concerning announcement: frequency, opinion on the importance of this practice.

31 participants responded to our questionnaire. More than 9 out of 10 participants would not benefit from training on diagnostic announcement. Only 22.6% of physicians reported being very or somewhat familiar with medical information laws and their content regarding the regulation of diagnostic announcement. All participants considered schizophrenia to be the most difficult pathology to announce, followed by personality disorders and bipolar disorder. 74.2 of the participants considered it “rather” or “completely” essential to inform the patient of his or her psychiatric diagnosis. 77.4% of the participants considered it necessary to announce the diagnosis of schizophrenia and 80.7 often or systematically announce this diagnosis. Three situations considered appropriate to announce a diagnosis of schizophrenia: 74.2% announce it in general when the patient or the family asks for information about the diagnosis, 42% advise the patient when he/she mentions schizophrenia on his/her own. The patient’s functional inability to understand the diagnosis (77.4%) and the fear of negative clinical and therapeutic repercussions (41.9 and 38.7 respectively) were reported to deter physicians from making the announcement. More than half of the participants (64.5%) thought that the announcement of the diagnosis improved therapeutic compliance. Conversely, 35.5% considered that the announcement had no impact on therapeutic compliance.

The announcement of the diagnosis of schizophrenia remains today a complex and evolving subject. Even if great progress has been made to inform patients as well as possible, practices remain disparate from one doctor to another and this information is not well traced.

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There is a paucity of population-based longitudinal studies examining the associations between childhood behavioural problems and alcohol use disorders in later life.

This study aimed to examine the association between hyperactivity/inattention problems in early adolescence and the risk of alcohol use disorders in young adulthood.

We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a population-based prospective cohort based in Bristol, United Kingdom. Hyperactivity/inattention problems at 11 years of age were measured using the Strengths and Difficulties Questionnaire (SDQ). Logistic regression analyses were used to examine associations. E-values (E) were calculated to estimate the extent of unmeasured confounding.

Hyperactivity/ inattention problems in early adolesce were associated with a 1.75-fold increased risk of any alcohol use disorders (OR = 1.75, 95% CI: 1.20-2.56; E= 2.90, CI: 1.69) and a 4-fold increased risk of severe alcohol use disorders at age 24 (OR = 4.35, 95% CI: 2.00 – 9.47; E= 8.17, CI: 3.58). We also found a 2.09 (OR = 2.09, 95 % CI: 1.24-3.53; E= 3.60, CI: 1.79) and 1.63-fold (OR = 1.63, 95% CI: 1.07 – 2.49; E= 2.64, CI: 1.34) increased risk of alcohol dependence symptoms and alcohol abuse symptoms at age 24 in offspring who had hyperactivity problems at age 11, respectively.

Hyperactivity/ inattention problems in early adolesce were associated with an increased risk of alcohol use disorder symptoms in adulthood, even when controlling for conduct problems. Associations did not appear to differ by gender and unmeasured or unknown confounders were unlikely to alter the observed associations.

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Anhedonia is a transdiagnostic psychopathological phenomenon, which is assessed as «core» for several diseases, first of all - schizophrenic and affective spectrum disorders. The problem of clinical features differentiation and identification of anhedonia’s neurobiological mechanisms in the structure of the affective and schizophrenic spectrum disorders is still topical and far from being resolved.

The aim of the study was comparative research of the relationship between the features of neurocognitive functioning and the manifestations of anhedonia among patients with disorders of the schizophrenic and affective spectra.

The sample consisted of 40 patients, 17 patients with schizophrenic spectrum disorders and 23 patients with affective spectrum disorders were examined. We used next psychometric techniques to research anhedonia: Revised Social Anhedonia Scale (RSAS), The Temporal Experience of Pleasure Scale (TEPS), Physical Anhedonia Scale (PAS). We used following methods to study neuropsychological features: Dynamic praxis; Color interference test; Arithmetic Tasks; Plot picture; Number of skips and impulsive errors; Reverse and straight rows; Verbal fluency; Number of repetitions; Rey-Osterritz figure.

Patients with schizophrenia spectrum disorders show lower scores of pleasure anticipation ability and ability to experience pleasure in the social sphere. Neuropsychological indicators of prefrontal cortex dysfunction demonstrate a positive relationship (p = 0.035) with the severity of social anhedonia and a negative relationship with the ability to anticipate pleasure. Thalamus and forehead dysfunction indicators mainly show a negative relationship with the ability to directly experience pleasure. Indicators of dysfunction of the parietal, occipital and temporal lobes have single connections with different parameters of anhedonia.

Manifestations of different parameters of anhedonia demonstrate their heterogeneity among patients with schizophrenic and affective spectrum disorders. Patients with schizophrenic spectrum disorders have greater difficulty with anticipation of pleasure and the ability to experience pleasure in the social sphere. The ability to anticipate pleasure is more strongly related to prefrontal brain function, whereas the ability to experience pleasure directly is related to subcortical brain function.

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