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

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

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

Burnout syndrome (BO), considered to be the final stage of stress, is a dynamic process resulting from the gradual loss of the employee’s ability to face psychosocial risk factors and the exhaustion of personal resources. This syndrome can affect all professional categories. It represents a major threat for the worker and has a high economic cost

To identify the professional factor associated with BO among agents of a service center of a telecommunications operator in the governorate of Sousse in Tunisia

Cross-sectional descriptive study, conducted from February 1st, 2020 to January 31st, 2021 among agents of a service center of a telecommunications operator in the agencies of the governorate of Sousse. The collection of data was based on an anonymous self-questionnaire. The evaluation of stress was done via validated measurement instruments, namely the questionnaires of Siegrist and Karasek and the evaluation of BO by the Maslach Burnout Inventory (MBI).

Ninety four actel agents were identified in our study, and 59 participants answered the questionnaire. The average age of our population was 43.93 ± 8 years. The female gender was predominant with a sex ratio of 0.48. The Karasek Job Content Questionnaire showed that 23.7% of the participants were in job strain. Furthermore, 28.3% of our total population had an imbalance between extrinsic efforts and rewards. The assessment of burnout by the Maslach Burnout Inventory showed that 64.2% of the workers were in occupational BO, and in 11.8% of these cases, BO was considered high. Our study showed that work-related organisational and environmental factors were significantly associated with BO, such as the number of customers seen per day: exceeding 50 (p = 0.048) and being a victim of verbal aggression (p = 0.038).

The results of this study showed that BO among agents of a service center of a telecommunications operator in Tunisia, was significantly associated with some professional factors. Therefor, in the future, it would be advisable to improve the working conditions of these agents by introducing collective and organisational preventive measures (primary prevention) and individual measures (secondary prevention) and by facilitating their professional reintegration (tertiary prevention) to avoid relapses.

None Declared

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.

None Declared

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.

None Declared

Eating disorders severely impair psychosocial functioning, physical health, and quality of life. In particular, Anorexia Nervosa has the highest mortality rate among all psychiatric diseases. Other Specified Feeding or Eating Disorders have the highest lifetime prevalence with weighted means of 7.64% for women. Eating disorders are considered hard-to-treat, and studies have indicated that people suffering from eating disorders prefer low-threshold interventions compared to traditional mental health care. International studies show promising results of internet-based interventions for Other Specified Feeding or Eating Disorders.

To test the effectiveness of an internet-based psychologist-guided cognitive behavioral treatment program (I-TREAT) to reduce eating disorder symptoms in Danish adolescents and adults with Other Specified Feeding or Eating Disorders.

This study is a randomized controlled trial with two arms: 1) an intervention group and 2) an active control group. Participants are adolescents from the age of 15 or above, as well as adults, diagnosed with Other Specified Feeding or Eating Disorders. The intervention group receives the I-TREAT program while the control group receives self-guided mindfulness exercises. I-TREAT comprises 12 text-based treatment sessions with psychoeducation and treatment-related tasks, based on cognitive behavioral therapy and elements of compassion-focused therapy. The treatment duration is approximately 12 to 36 weeks. Videos, pictures, and animations support the treatment content and the program is accessible by web-browser and app. A specialist in eating disorders guides the patient through treatment with task-related feedback and asynchronous written communication. Patients will answer questionnaires regarding eating disorder symptoms, quality of life, and motivational states before, during, and after treatment, with follow-up measures at 3, 6, and 12 months. We expect to include 63 patients to each group and commence recruitment in August 2023. Preliminary results from a feasibility study on I-TREAT show good evaluations from clinicians and patients (N=30).

No results have yet been obtained. The results will be submitted to international scientific journals and presented at conferences.

The internet-based cognitive behavioral treatment program I-TREAT may be a promising tool for effectively treating adolescents and adults with Other Specified Feeding or Eating Disorders in Denmark.

None Declared

Suicide is considered an important public health problem in contemporary society. Over 800,000 deaths by suicide are estimated each year and the mortality rate is 11.4 per 100,000 people.

In people with cancer, depression is a high-prevalence disorder that affects patients’ ability to cope with illness, decreases treatment acceptance, prolongs hospitalization, reduces quality of life, and increases the risk of suicide. In turn, the diagnosis of cancer is a serious stressor, with many physical and psychological consequences, and is thought to be a risk factor for suicide.

This study aimed to perform a literature review on the incidence and risk factors of suicide in cancer patients

the search for articles was carried out in the electronic scientific databases PubMed, ScienceDirect and Scopus. Variables studied included suicide rate, type of cancer, demographic characteristics, and signs and symptoms associated with suicide using the descriptors “suicide” and “cancer”.

42 articles were selected. As in the general population, the risk of suicide was higher in men with cancer than in women with cancer. Cancer patients aged 65 or older have a higher suicide rate than those under 65. Prostate, lung, pancreatic, bladder and colorectal cancers are the types most at risk for suicide. The first year after diagnosis carries a higher risk of completed suicide. Multiple risk assessment tools have been developed and are effective in identifying patients with depression or hopelessness, factors associated with a higher risk of suicide. However, there are no tools that can sensitively and specifically predict suicide.

The incidence of suicide in a person diagnosed with cancer is approximately double the incidence of suicide in the general population. Early detection of depression in particular cancer populations, such as older male patients, can help identify those most at risk for suicide.

None Declared

Some evidence converges to consider that suicidal behaviour could be a separate diagnosis and emphasizes the relevance to identify specific biomarkers. Identifying the neural substrates of suicide attempt is key to understanding the etiology of suicide and might be helpful in reducing suicide rates among psychiatric patients by promoting the development of novel therapeutic strategies based on behavioral neuroscience and brain stimulation. Neuroimaging studies have reported structural and functional brain abnormalities located in the prefrontal cortex, insula and striatal regions as well as in the connections between these brain areas. Based on task related and resting state functional MRI studies, we will discuss original data showing the role of the ventral prefrontal cortex in suicide vulnerability.

None Declared

IPV is a public health issue that is often linked to depression. Parity has often been mentioned as a protective factor against depression and suicide attempts. Despite this, parity in Latin America may not be related to positive outcomes for victims suffering from IPV as the stress of taking care of the children can result in a burden and worsen the symptoms of depression for the victim.

Determine the impact of Parity in victims suffering from IPV and Depression.

A descriptive observational study was conducted, at the main Gender Violence Prosecutor’s office: Florida, Guayaquil-Ecuador. UCSG pre-medical students collected the information using Beck test for Depression. The total sample was 239: 195 women, 44 men. It was classified by groups, gender, marital status, children and severity of depression.

The data analyzed showed a higher percentage of Depression from IPV when parity is present.

Severe Depression: Women with children 57 (29%), 8 men with children (18%). Women without children 22 (11%), men without children 6 (14%).

Moderate depression: Women with children 28 (14%), 4 men with children (9%). Women without children 5 (3%), men without children 2 (5%).

Mild Depression. Women with children 25 (13%), 7 men with children (16%). Women without children 6 (3%), men without children 2 (5%).

Although some studies report having children as a protective factor in depression, this did not happen in this study. Financial violence is very common, so the mother does not receive any economic support from the father and has to take care of the children on her own. Social and hormonal factors also play a role, especially in women as they have more children. We believe that mental health clinicians should pay more attention to victims of IPV who have several children, especially in Latin America.

None Declared

While pregnancy itself is a risk factor in the development of anxiety disorders, the COVID-19 pandemic has brought additional pressure on expecting women. Despite these two independent factors, no study regarding their cumulative effect on anxiety in soon-to-be Romanian mothers exists.

This study intends to address this deficiency by measuring the level of anxiety in a sample of pregnant women from the public healthcare sector in Romania.

Sociodemographic data and Zung Self-reported Anxiety Scores (SAS) were used to look at 121 pregnant women to get a fuller picture of anxiety in pregnant women during the pandemic.

Some of the main findings of the study are as follows: anxiety symptoms are more intense during the first trimester of pregnancy, especially in the psychological domain of the scale, as opposed to the third one. High BMI was weakly correlated with lower Zung Scale scores, while marital status and having other children were moderately correlated with less anxiety symptoms. While no association could be found between history of infection, vaccination and anxiety, surprisingly, unvaccinated women showed less psychological distress than vaccinated ones (moderate correlation), suggesting that less anxiety prone women are also less likely to get adequate protection. Getting one’s information from official sources also proved to be weakly correlated with higher Zung Scale scores.

Image:

Image 2:

In conclusions, the findings of this study can serve as a start for further inquiry regarding the impact of the COVID pandemic on the mental health of pregnant women.

None Declared

In contexts of chronic crisis, such as wars, the population is affected by prolonged traumatic exposure. In this type of context, it is sometimes difficult to provide psychological support to work through the trauma because the environment is neither stable nor reassuring. It is about finding care devices that despite the complexity of the situation, manage to bring relief and improve the ability to manage negative emotions and stress.

The objective of the intervention was to relieve people in distress, to help them contain their reactions to moments of anxiety so that they are more available and calm in their daily lives. Since the intervention could not provide long-term treatment for the potential traumatic stress, due to the abuses still in progress, it aimed to prevent the appearance and installation of the symptoms.

A group protocol based on emotional stabilization exercises was offered to children and adults from communities affected by the fighting in the civil war in the Central African Republic in 2021. In addition to giving elements of psychoeducation, participants could practice exercises aimed at stabilizing emotions and managing stress.

People could benefit from this psychosocial support with daily frequency for four consecutive days. At the beginning and at the end of the care device, psychometric scales were administered in order to be able to measure the improvement in well-being (WHO5) the reduction in symptoms of anxiety and depression (HAD) as well as traumatic symptoms in adults (PCL -5) and children (CPTS-RI).

Between February and April 2021, 1,200 adults and 400 children were able to participate in the emotional stabilization device. 90% of the participants showed an improvement in well-being and a reduction in stress and axiety reactions. The participants particularly appreciated the exercises for the ease with which they could be reproduced in daily life and transmitted to other members of the family and the community. Despite the fact that exposure to stress remained significant and daily, they expressed the feeling of having regained some control, at least over their own emotions and reactions.

In situations of chronic stress, where psychic traumatic symptoms cannot be treated sustainably, this emotional stabilization protocol can be an effective option to regulate the emotional states of exposed people and give them tools to cope with anxiety.

Two important points to emphasize are also the fact that this device can reach a large part of the population without a lot of means and that it can be provided by non-professionals in mental health, if properly trained and constantly supervised by experts.

None Declared

Nitrous oxide recreational use and abuse has significantly increased in recent years among youth. To our knowledge, no previous study investigated the frequency and characteristics of N2O use disorder.

To assess the frequency and the socio-demographic and clinical characteristics of nitrous oxide use disorder in a sample of health professions students.

An online survey was distributed to health professions students at Paris-Cité University, Paris-Sorbonne University, Paris-Saclay University, Lille University and Picardy University, France. The following data were collected: age, gender, frequency of nitrous oxid use, DSM-5 criteria for nitrous oxide use disorder, frequency (day/week/month/year/lifetime) of tobacco, alcohol, cannabis, cocaine, amphetamines, and hallucinogens use, Alcohol Use Disorders Identification Test scores (AUDIT), the Fagerström Tobacco Dependence Test scores, the Cannabis Abuse Screening Test scores, lifetime psychiatric or sleep disorders.

2067 participants (mean age 21.7±2.6 years, 75% female) completed the survey from September 2021 to May 2022. Among them, 38% (n=790) reported nitrous oxide lifetime use. Seven per cent of the subjects (n=137) fulfilled DSM-5 criteria for current nitrous oxide use disorder (114 mild use disorder, 16 moderate use disorder, 7 severe use disorder). In the group of patients with nitrous oxide use disorder, there were correlations between nitrous oxide use disorder and daily alcohol use (Chi2=24.2, p<0.0001), daily tobacco use (Chi2=25.3, p<0.0001), AUDIT scores >12 (Chi2=7.9, p<0.0001), lifetime depressive disorders (Chi2 =13.6, p=0.0001), anxiety disorders (Chi2 =13.2, p=0.02), or sleep disorders (Chi2 =14.4, p=0.006), compared to the group of subjects without nitrous oxide use or the group of subjects without nitrous oxide use disorders.

Nitrous oxide use and nitrous oxide use disorder were common among the health professions students included in the present study and correlated with daily alcohol or tobacco use.

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

The high recurrence rate and diagnostic stability are current problems in treating panic disorder. Because anxiety symptoms are often temporary, it is hard to evaluate anxiety behaviors objectively. In evaluating anxiety behavior, virtual reality is suitable tools that can help bridge the gap between where the symptoms are and where the treatment is given.

This study aims to develop VRABES, an anxiety behavior evaluation system for objectively assessing an individual’s anxious behavior, and to evaluate the feasibility of VRABES.

Patients with panic disorder (ANX group) and healthy controls (CON group) matched for sex, age, and marital status were recruited through outpatient clinics and public advertisements. VRABES consists of four modules; Baseline evaluation (module 0), Daily environment exposure (module 1), Relaxation (module 2), and Interoceptive exposure (module 3). Except for the Baseline evaluation module, the other three modules consisted of three steps, including 1) pre-evaluation, 2) virtual environment 1, and 3) virtual environment 2. In VRABES, subjective anxiety experience (AS) were collected for three times (pre, during, post) for module 1, 2, and 3. we conducted a repeated-measures analysis of covariance (ANCOVA) to explore any significant differences in self-rating anxiety scores among groups and repetition for each module controlling for age, sex, smoking usage, alcohol usage, and depression. Additionally, partial correlation coefficients were calculated on the relationships between measures in VRABES and Panic disorder Severity Scale (PDSS) in the ANX group to eliminate the effects of demographic variables (age, sex, smoking usage, alcohol usage), and other psychological assessment scores [Liebowitz Social Anxiety Scale: Self-Report Version (LSAS-SR), Generalized Anxiety Disorder Scale (GAD-7), and Hospital Anxiety and Depression Scale (HADS)].

Table presents the significant results of repeated-meausre ANCOVA. Figure shows the significant results among the paired t-tests for each group conducted as a post-hoc test for the interaction effect shown in Module 1 and Module 2.Table.Results of repeated-measured ANCOVA for self-rating anxiety scores in the two groups (ANX and CON) and different time (pre, during, and post) concerning each module.

There are no significant results found in partial correlation analysis between PDSS scores and self-rating anxiety scores from VRABES.

The results showed that the VRABES is a reliable and valid research tool.

None Declared

More than 700,000 people die by suicide in 2019 globally (World Health Organitation 2021). Mental health problems constitute a risk factor for suicidal behavior and death by suicide (Hoertel et al. Mol Psychiatry 2015; 20 718–726). Different mental disorders have been related to different forms of suicidal ideation and behavior (Conejero et al. Curr Psychiatry Rep 2018; 20, 33) (Quevedo et al. Compr Psychiatry 2020; 102 152194). However, little is known on comorbidity profiles among suicide attempters.

The aim of our work was to identify the psychiatric comorbidity profiles of individuals who were admitted a hospital emergency department due to a suicide attempt. Moreover, it intended to know their clinical characteristics according to comorbidity profile.

A sample of 683 attempters (71.30% female; M age= 40.85, SD= 15.48) from the SURVIVE study was used. Patients were assessed within the 15 days after emergency department admission. Sociodemographic (i.e., sex, age, marital status and employment status) and clinical data were collected. The International Neuropsychiatric Interview (MINI) was used to assess DSM-V Axis 1 mental health diagnoses and the Columbia Suicide Rating Scale (C-SSRS) to assess suicidal ideation and behavior. The Acquired Capacity for Suicide-Fear of Death Scale (ACSS-FAD), the Patient Health Questionnaire (PHQ-9) to assess the frequency of depressive symptoms during the past 2 weeks, and the General Anxiety Disorder-7 (GAD-7) scale to assess symptoms of worry and anxiety were also conducted. For the identification of comorbidity profiles, latent class analysis framework was followed considering diagnosis to each individual disorder as clustering variables. On the other hand, binary logistic regression was used to study the relationship between comorbidity profile membership and clinical factors.

Two classes were found (Class I= mild symptomatology class, mainly featured by emotional disorder endorsement; and Class II= high comorbidity class, featured by a wide amount of endorsed diagnoses) (see figure 1). Individuals from the High comorbidity class were more likely to be female (OR= 0.98, p<.05), younger in age (OR= 0.52, p< .01), with more depressive symptoms (OR=1.09, p<.001) and have greater impulsivity (OR= 1.01, p<.05).

Image:

We found two profiles of people with suicidal behavior based on the presence of mental disorders. Each of the suicidal subtypes had different associated risk factors. They also had a different profile of suicidal behavior.

None Declared

HIV-associated neurocognitive disorder has been less frequent in recent years due to the availability of anti-retrovials. However, in the Philippines, persons with HIV are diagnosed late resulting to cases of HIV-associated neurocognitive disorder. With higher incidence of depression and anxiety in this population, difficulty sleeping becomes a prominent symptom and diphenhydramine is a common non-prescription nighttime sleep aid being given.

To present a case of diphenhydramine-induced delirium after a patient with HIV-associated neurocognitive disorder.

This a case report.

Mr. JR., a 38-year-old person living with HIV and no past psychiatric history, presents with acute onset altered mental status, suicidal attempt, and jerking movements of the neck and extremities. He has been having bouts of diarrhea, fatigue, weight loss, and forgetfulness for a year before he was diagnosed with HIV-AIDS with CD4 count of 59 cells/mm3. At this time, he already had blurring of vision, poor sleep, weakness, poor concentration, and increasing severity of forgetfulness. He also started to have depressed mood and anhedonia but no suicidal ideations. He was eventually started on antiretroviral (ARVs) which are lamivudine, tenofovir, dolutegravir and antibiotics targeting opportunistic bacteria – Isoniazid, Moxifloxacin and Clindamycin. A few days after, he started to have jerking movements of the neck and extremities contributing further to poor sleep. Upon consult with a local clinic to address his sleep, he was prescribed with Diphenhydramine and after taking 50mg dose that evening, he started to have disorientation, paranoia, command auditory hallucinations resulting to a suicidal attempt, on top of the jerking movements, which prompted consult to the emergency room and subsequent admission. Initially assessed as central nervous system infection and focal seizure, CSF fluids studies and EEG were done showing normal findings. Started on Sodium Valproate + Valproic acid 500mg IV twice daily and Olanzapine 2.5mg twice a day, on top of his previously mentioned ARVs and antibiotics, the disorientation, auditory hallucinations, and myoclonic jerks mood resolved after five days. Five months on ARVs, he has no recurrence of myoclonic jerks, disorientation or psychosis, with memory and concentration improved, euthymic mood, and was able to resume work as an engineer.

Diphenhydramine is a common nighttime sleep aid. Due to its anticholinergic effect, cases of delirium were reported for doses 300mg to 1,000mg per day. For Mr. JR, the mere 50mg dose of diphenhydramine caused disorientation and psychosis as his co-occurring HIV-associated neurocognitive disorder made his brain “delirium-ready”. Diphenhydramine is a relatively safe drug however not getting a thorough medical history may inadvertently cause harm to patients who are medically ill and frail.

None Declared

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.

None Declared

Autism spectrum disorder (ASD) is a highly heritable neurodevelopmental disorder affecting 1-2% of the population worldwide. Recent large-scale whole-exome sequencing (WES) studies identified hundreds of rare, highly penetrant genetic variations associated with ASD. Many of these genetic variations underlie particular genetic syndromes characterized by a variety of congenital anomalies in addition to the core ASD symptoms. Recently, we reported about certain ultrasonography fetal anomalies (UFAs) associated with later development of ASD (Regev et al. Brain 2022).

To identify genetic mutations associated with UFAs in children with ASD.

We conducted a cross-sectional study of all children diagnosed with ASD registered at the Azrieli National Centre for Autism and Neurodevelopment (ANCAN) who have both fetal ultrasound and WES data. We used an integrative in-house bioinformatics pipeline specifically designated to identify gene-disrupting variants (GDVs) in a panel of >1200 genes associated with ASD according to SFARI gene database. Then, we compared the prevalence of GDVs in these genes between children with and without UFAs. Finally, we applied the Gene Analytics tool to disrupted genes in children with specific fetal anomalies to identify biological pathways associated with both ASD and these fetal anomalies.

Overall, 115 ASD children were included in this study, of which 49 (42.6%) of them had UFAs in their ultrasound scans (Figure 1). Children with and without UFAs did not differ in their sociodemographic and clinical characteristics except for a significantly lower proportion of males in the UFA group (63.4% vs. 84.8%, respectively; p=0.011). Notably, children with UFAs were more likely to carry GDVs in ASD genes than their counterparts even after adjustment to the sex differences between the groups (aOR=2.27, 95%CI: 1.05-4.93), and this association was the most prominent with GDVs in the most notable ASD genes (i.e., those with SFARI gene score=1). Also, the study shows higher prevalence of children with GDVs in most anatomical systems, with UFAs in fetal size (14.8% vs. 1.6%, p=0.012, cases vs. controls) and the head&brain (16.7% vs. 4.9%, p=0.040, cases vs. controls) being the most prominent (Figure 2). In addition, children with UFAs had significantly more co-occurring mutations, and the number of mutations in a single fetus was significantly correlated with the number of UFAs (r=0.20, p=0.035).

Image:

Image 2:

Our findings suggest distinct genetic mechanisms for ASD subtypes that are characterized by unique UFAs. These findings may form a basis for future prenatal screening approaches for ASD using both ultrasound and genetic testing. Our findings suggest distinct genetic mechanisms for ASD subtypes that arecharacterized by unique UFAs. These findings may form a basis for future prenatal screening approaches for ASD using both ultrasound and genetic testing.

None Declared

Despite a variety of pharmacological and psychotherapeutic interventions, treatment of schizophrenia can still be challenging, even more when certain comorbidities are present. Myasthenia gravis (MG) is an autoimmune disorder of the neuromuscular junctions caused by antibodies against acetylcholine and tyrosine kinase. While co-occurrence of schizophrenia and MG is rare, treatment can be complicated as specific treatment of one condition can lead to worsening of other (e.g. anticholinergic side effects of psychopharmacotherapy, psychiatric side effects of corticosteroids).

To discuss treatment difficulties in the case of a patient with schizophrenia and multiple somatic comorbidities, including MG.

A case report and a review of literature.

We report a case of a 50-year-old female patient who was admitted to psychiatric hospital due to psychotic decompensation presented with dysphoria, paranoid delusions, agitation, verbal aggression and hostility. Clinical presentation and psychopharmacological treatment were complicated with her comorbid disorders, MG, which was recently treated because of a relapse, and hypothyroidism, which worsened as she neglected her regular check-ups. Multidisciplinary approach was needed to control the symptoms of her comorbid disorders, which, especially MG, limited psychopharmacological options. Combination of antipsychotics (aripiprazole, haloperidol) and mood stabilizer (sodium valproate) led to clinical improvement of psychotic symptoms. However, poor insight remained- the patient insisted on demission and was not interested in suggested psychotherapeutic and sociotherapeutic programs.

In complex cases like this, multidisciplinary approach is essential for adequate treatment of both psychiatric and comorbid somatic disorders. Conditions like MS can prolong treatment or even worsen the symptoms of a psychiatric disorder, especially since they limit the use of psychopharmacotherapy. Due to this, psychotherapeutic interventions could be even more important to keep a stable remission with a good insight and adherence to both psychiatric and somatic treatment.

None Declared