Schizophrenia (SCZ) is a common and disabling psychiatric condition. Its diagnosis is entirely clinical. Many researchers have looked into electroencephalogram (EEG) power spectrum analysis for SCZ to find specific abnormalities.

The objective of this study was to analyze the EEG of patients with SCZ using power spectral density and to compare them with those of healthy controls, in order to look for specificities.

This was a cross-sectional, descriptive, and analytical case-control study conducted with patients followed for SCZ in the psychiatry "C" department at the Hedi Chaker hospital in Sfax. Healthy controls were included. Patients were assessed by the Positive and Negative schizophrenia scale (PANSS). All participants benefited from an EEG at rest condition at the service of the functional exploration at the Habib Bourguiba hospital in Sfax. We have measured the powers of each band using Welch power spectral density method called absolute power (AP). Statistical analyses were carried out.

Fifteen schizophrenics and 15 controls, all male, were included. The average age of schizophrenics and healthy controls was 40 years ±12.72 years and 47.93 ± 15.61 years respectively. There were no significant differences in age between patients and controls. Schizophrenics had a mean PANSS of 64.6±22.7.

At the quantitative EEG, differences appeared to be insignificant. There was an overall decrease in AP for the alpha band particularly in the parietal and occipital lobes in schizophrenics (53,16 ± 48,83 μV2 and 75,17 ± 56,28 μV2 respectively) compared to controls (335,15 ± 994,73 μV2 and 400,24 ± 1109,95 μV2 respectively). There was also an overall decrease in AP for the different frequency bands in schizophrenics compared to controls. However, values persisted high in the temporal lobe for all frequency bands.

In conclusion, this decrease in AP for the alpha band in the parietal and occipital lobes in schizophrenics can be a sensitive biomarker for diagnosing SCZ.

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The World Health Organization (WHO) declared the outbreak of a new coronavirus disease to be a Public Health Emergency of International Concern. The situation now in Egypt, through the efforts done by the General Secretariat of Mental Health and Addiction Treatment (GSMHAT) which is governmental body following the Ministry of Health and Population: Establishment of 2 Hot lines for psychological counseling and Psychosocial support to working 24 hours/ 7 days a week. In the last year, the Mental Health platform is a main objective to be dedicated for Egyptian population, the national mental health platform is another milestone in the innovative digital remote MH services that is planned to be provided.

Evaluating the effectiveness and feasibility of different mental health services provided by hospitals affiliated to General Secretary of Mental Health and Addiction Treatment, Ministry of Health during the COVID-19 pandemic outbreak including evaluation of remote delivery of mental health service and digital health solutions.

Observational Cross-sectional study. All patients seeking the hotline service & National Mental Health Platform, Evaluating the effectiveness and feasibility of services delivered over 12 months.

The platform’s statistical results since its launch showed that the number of visitors to the site is 44,105 and the number of registered users is 17,153. The number of self-requests conducted by users reached 16,318 and the number of virtual treatment sessions reached 2,797. The results also showed that the number of female users is 31%, compared to 69% of male users. The statistics showed that most of the age groups used for the site are between 15-20 years old, and that the users of the site are from all governorates, but most of the users are from the capital, Cairo. The statistical results also showed that general psychiatry with all its diseases is the most visited by the user of the site, followed by child and adolescent psychiatry subspecialty, then addiction.The GSMHAT, through the hotline, has provided services to the public represented by a number of calls ranging from April 2020 to March 2021 (8618) calls, and the GSMHAT hope that the hotline service to continue providing psychological counseling and support to those who wish, while continuing providing the service in hotline with the corresponding technical development and community needs.

it is crucial to reallocate resources in order to serve for psychological and social needs and liaison psychiatry and digital as well as defining the barriers for providing a convenient service delivered by healthcare providers to people who are in need.

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Patients with Borderline Personality Disorder (BPD) require a significant amount of time and effort on the part of general practitioners and psychiatrists, resulting in longer visits and complex medical records, with a poor resolution of both physical and mental symptoms.

These patients are likely to express feelings of anger and violence, compared to other patients which makes it difficult to deal with them.

To determine attitudes toward patients with BPD among psychiatry and family medicine residents in Tunisia. To understand in addition the challenges that these professionals encounter in their everyday practice

An online anonymous questionnaires was distributed through social networks to psychiatry residents and family medicine resident.

The attitudes of health professionals towards people with BPD was used to assess clinicians’ attitudes towards people with BPD.

Thirty three clinicians were in the study. A high proportion of respondents (81.8%) were females .The age of the participants ranged from 25 to 34 years, with an average age of 28 years and 3 months (SD = 2.23).In our study 34% reported that they often see patients with borderline personality .The half of the participants (51.5%) reported a feeling being on guard when meeting borderlines while 36.4% were empathetic and neutral. The feeling of anger and frustration was reported with 12.1 % of the participants.

The most frequent cause of these feelings was the difficulty of taking care of patients with BPD.

The majority of the participants (51.5%) reported avoiding working with them. However, only 39.4% reported asking a colleague to replace them in their follow-up.

The results of Attitudes of health professionals towards people with BPD Scale indicate that clinicians generally present a positive attitude towards patient BPD with a mean score 94.94(SD=18.60)

Working with patients with BPD can be challenging. Professionals’ attitude can create obstacles to effective communication and successful treatment.

Therefore, all clinicians should receive more specific training to be able to deal with this condition.

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A new interpretation of the normalised “Wayfinding” design task offers the opportunity to become an important element of the larger clinical and architectural project for a new “core” expansion of a large regional psychiatric hospital in the South-East of the UK. We call this new approach Waymaking, as it goes beyond signage, leveraging our deep-set knowledge and understanding of the entire project at all scales.

Waymaking at the Rivers Centre for Mental Health (Rivers) begins with the exploration of movement narratives into and around its larger site. It turns a classic design task into a design opportunity on all scales, starting with an urban design and planning perspective, through to the architectural and landscape design decisions outside of the building and into the specific on-ward atmospheres in a manner integrated with the detail interior design decisions of colour, built-in-furniture and others.

Rivers has been carefully composed out of existing structures as well as smaller new-build and extension buildings. These are all set within a large, sloping site of noteworthy natural beauty. As such, Rivers can well be understood as a hillside village or campus of health - rather than as a traditional “hospital.” As a health village, Rivers provides spatial sequencing as the landscape design directly introduces a series of smaller, more human scale spaces built and natural all of which together aid in orientation and identity across the site. This will help support the daily use of the buildings by all stakeholders.

This strategy has been “baked-in“ to the architectural design as well, strategically distributed retreat/recovery spaces allow for space for de-escalation or relaxation. These can be found in the form of regular niches in the hallways and “porch” entrance spaces, usually with built-in benches and bespoke lighting elements. In addition to creating orientation affordances, these also provide opportunities for neurodivergent persons (ie. ASD, learning disabilities, etc.) to better understand and master independent movement around the Centre.

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The Portuguese Plan for Mental Health envisaged the development of teams dedicated to the support of “difficult” patients. However, it was not clarified who these patients were, nor in which dimensions they could be supported. In this regard, there is a need for an objective and pragmatic definition to understand who these patients are.

To characterize the “difficult” patient with Schizophrenia.

Through the hospital’s IT services, all acute inpatient episodes at Centro Hospitalar Psiquiátrico de Lisboa were collected since 2017, with the diagnosis of Schizophrenia (ICD10: F20 – n: 1448). Cluster analysis was performed, regarding number of previous admissions (PA) and days of admission. Descriptive analysis of these patients was made, regarding age, gender, destination at discharge, and to the “difficult to treat” patients, whether they attend a medical consultation prior to admission, if they were complying with the therapy and if they were using psychoactive substances.

Cluster analysis identified 3 clusters: (G1) a larger, uncharacteristic one; (G2) one of users with many PA; and one with a high number of days of admission (G3).

The average age is similar (46 years old), as well as gender (male). Regarding hospitalization days, G1 and G2 presented similar average values (16 days), higher for G3 (60 days). Comparing PA in G2, 47% of patients have between 6 and 10 PA and 25% have between 11 and 20 PA. For the same intervals, G3 has values of 10% and 2% respectively. About the destination after discharge, about 2/3 of both groups were referred for follow-up consultation; in G2, 5% were discharged by abandonment and in G3, 5% were referred to a Rehabilitation service and 6% integrated in Residential homes. Approximately 2/3 of the patients in G2 and G3 did not go to a medical consultation in the three months prior to their admission. Regarding the therapeutic plan, in G2 73% were not following it and in G3 this rate was 66%. Only 5% of G2 and 2% of G3 were in involuntary treatment. Injectable medication was used by 42% of patients in G2 and 23% in G3. Regarding substance use, alcohol was present in 9% of G2 and in 6% of G3; cannabinoids in 18% of G2 and in 11% of G3; and other psychoactive substances were present in 8% of G2 and in 4% of G3.

The findings of this study allow us to outline two profiles of “difficult to treat” patients with Schizophrenia. On the one hand those with multiple relapses (G2), on the other those with prolonged hospitalizations (G3). Both have poor adherence to consultations and are erratic in therapeutic compliance. Injectable medication, although present in G2 and in a lower percentage in G3, and the infrequent involuntary treatment in both, may be considered as possible intervention points. An assertive multidisciplinary approach, focused on current treatment and relapse prevention (including social structures and rehabilitation centers), will be the key to their treatment.

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Bipolar Disorder (BD) is a common psychiatric disease. It has been demonstrated a long time ago that bipolar patients are more painful than the healthy subjects. Substance use disorder is a frequent comorbidity in BD, but also in painful patients. The aim of our study was to analyze if bipolar patients with a painful expression have more substance use disorder than bipolar patients without pain.

The aim of our study was to analyze if bipolar patients with a painful expression have more substance use disorder than bipolar patients without pain

We included all bipolar patients from the FACE-BD cohort which is a prospective cohort of French outpatients with BD enrolled at the 12 advanced Centers of Expertise in Bipolar Disorder (CEBD). Pain has been evaluated by the “pain item” of the EQ-5D scale and we divided subjects in four categories: “no pain”, “slight pain”, “moderate pain”, “severe or extreme pain”. A multivariate analysis was performed to identify differences between each pain’s groups according to the kind of substance use disorder, psychiatric comorbidities and clinicals data.

The cohort enrolled 1897 bipolar patients, 970 had no pain (51.1%), 507 had slight pain (26.7%), 298 had moderate pain (15.7%) and 122 had severe or extreme pain (6.4%). We found significant differences according to age, comorbidities and clinicals data with older, more anxious, and more severe patients more represented in the more painful groups. Painful bipolar patients had also more frequently lifetime substance use disorders (alcohol, opioid, sedative, marijuana) and we were able to characterize different profiles in bipolar patients.

Bipolar patients with a painful expression had more risks to have a lifetime substance use disorder, an anxiety disorder, and a higher score on MADRS. Interestingly, subjects seemed to prefer substances with anxiolytic or antalgic effects during the acute intoxication as alcohol, marijuana, opioid and sedatives.

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Childhood family income is a powerful predictor of academic achievement and mental health. Here, we ask whether children living in poverty–those whose family incomes are not sufficient to meet their material needs–who beat the odds by succeeding academically are subsequently either protected from, or more at risk for, internalizing disorders. Prior research indicates that children in poverty with better academic performance and more depressive symptomatology tend to have higher temporal coupling between lateral frontoparietal network (LFPN; supports executive functions) and Default Mode Network (DMN; supports internally-directed thought) than lower-performing children in poverty, in direct contrast to the pattern observed for children above poverty. Thus, an open question is whether this pattern of connectivity adaptive for children in poverty has maladaptive long-term consequences, particularly for mental health.

In this pre-registered study, we analyzed concurrent data from 8,091 children (1,307 in poverty) in the ABCD study at baseline (ages 9-10y). We performed linear mixed effects models to investigate whether both higher LFPN-DMN connectivity and grades are linked to more internalizing symptoms concurrently, and whether this differs for children above and below poverty.

We performed linear mixed effects models to investigate whether both higher LFPN-DMN connectivity and grades are linked to more internalizing symptoms concurrently, and whether this differs for children above and below poverty.

We found that higher grades were associated with fewer internalizing symptoms for both children above and below poverty; this association was stronger for children below poverty. In addition, LFPN-DMN connectivity showed a significant negative correlation with internalizing symptoms at this age. However, when looking at internalizing symptoms separately - that is, anxiety/depression, withdrawal/depression, and somatic symptoms - we found that higher LFPN-DMN connectivity for children below poverty was associated with higher withdrawal/depression symptoms, but fewer somatic symptoms, pointing to a dissociation in what pattern of brain connectivity is most adaptive for the development of internalizing symptoms vs. physical health. These somatic symptoms highlight potential maladaptive consequences of resilience for children growing up in unequal structural conditions.

This research has important implications for supporting children in poverty by illuminating mechanisms for, and potential maladaptive consequences of, their resilience in academic contexts.

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Traditional psychotherapeutic interventions show small to moderate effect in treating psychotic symptoms. Virtual reality (VR) assisted treatments has the potential of advancing current psychotherapies for psychotic symptoms by creating virtual environments that can elicit responses (e.g., thoughts, feelings, behaviours) mirroring real-world settings. This presentation will highlight the current research initiatives using virtual reality-based interventions targeting positive and negative symptoms in patients with psychosis.

Main findings from the pilot-studies and randomized clinical trials on computer-based and immersive VR-interventions demonstrate preliminary evidence of VR-based psychotherapy for treating auditory hallucinations and paranoia with large effect sizes (Cohens d= 0.75-0.80). Additionally, pilot data has provided indications as to VR-psychotherapy being feasible and acceptable in treating negative symptoms and may have a large effect on participants achieving their goals and potentially in reducing negative symptoms. No adverse effect has been found related to the VR-interventions.

The promising findings on VR-based interventions for psychosis calls for large-scale randomized clinical trials consolidating the evidence for the effect in treating positive and negative symptoms in psychotic disorders. Cost-effectiveness of these short-term VR-based interventions are essential to inform scalability and implementation. Finally, most of the studies target patients in more chronic/treatment resistant phases of psychosis highlighting the need to investigating the effect in earlier phases of psychosis, that is, first-episode and potentially clinical high-risk states.

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The outbreak of COVID-19 has long-term negative effects on mental health. This study shows the negative mental health effects of studying under pandemic limits involving distance learning and social isolation.

The specialized studies carried out after the emergence of the Coronavirus revealed the impact of the measures implemented during the period of restrictions and after the outbreak of the pandemic, as well as the way in which these measures were felt by the general population.

Qualitative analysis of students’ answers regarding the stress felt after the outbreak of the pandemic.

Social and individual anxiety remains a subject of investigation among female students, who are in the process of emotional maturation and professional training.

Students remain a vulnerable population category, in the conditions in which society is in full post-pandemic adaptation process.

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Patients with long COVID experience a wide range of physical and psychological symptoms. Mental health disturbances include cognitive impairment, memory loss, anxiety, depression sleep disorders…

We aimed to determine to assess mental repercussions in long COVID, especially sleep disturbances and depression.

This is a prospective cohort study including 84 adults Tunisian COVID 19 inpatients who had been discharged alive from hospital. Each enrolled patient was asked about the period before SARS COV2 related hospital stay, and the 6-9 month-period after hospital discharge, using the validated Arabic version of the Patient Health Questionnaire (PHQ)-9 and the Insomnia Severity Index (ISI).

The mean age of patients was 57,59 ± 12,84 years with a sex ratio (H/F) 1,2.

As compared with baseline, all assessed outcomes (ISI and PHQ) significantly impaired after the covid-19 infection (p<0.001 for the two cases).

The prevalence of depressive symptoms doubled after the infection (25% to 58,3%).

The prevalence of insomnia was multiplied by 5 after the covid-19 infection (5,95% to 30,95%). ISI score was correlated with the PHQ score (p<0.001; r=0.738).

Our study highlighted the association between COVID-19 infection and the impairment of mental health outcomes. Thus, patients who have experienced COVID-19 illness should be screened for long psychological disturbances even a few months after the infection, in order to guarantee a better quality of life.

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Approximately 15% of all pregnant women experience emotional changes that increase the risk of anxiety and depression, which can in turn adversely affect their health and their developing foetuses. There are literature reports indicating a significantly higher prevalence of anxiety and depressive symptoms in pregnant women during the COVID-19 pandemic than before the pandemic; however, their exact prevalence is currently unknown.

The aim of this study was to analyse and assess the prevalence of COVID-19 anxiety symptoms and to investigate the attitudes towards COVID-19 vaccination among pregnant women in Poland.

The study included 288 women at different stages of pregnancy as the study group and 307 women of reproductive age (18-49 years) as the control group. A total of 595 women participated in the study. The study used a diagnostic survey method with a web-based questionnaire consisting of the author’s survey questionnaire and the following standardised tools: the Scale to Measure the Perception of SARS-CoV-2 Vaccines Acceptance (VAC-COVID-19 SCALE), the Fear of COVID-19 Scale (FCV-19S), the Drivers of COVID-19 Vaccination Acceptance Scale (DrVac-COVID19S) and the Coronavirus Anxiety Scale (CAS).

According to 25% of the study group and 42% of the control group, vaccination was safe and necessary, while 10% of pregnant women and 8% of women of reproductive age believed that the vaccine was dangerous. We found statistically significant differences between the groups for CAS (p = 0.025), DrVac-COVID19S (p = 0.00) or VAC-COVID-19 (p = 0.00). From the results, it can be seen that pregnant women scored significantly lower. Furthermore, both pregnant women and controls showed a high level of vaccine acceptance and positive attitudes towards it. The mean VAC-COVID-19 score was 44.26 in the control group and 41.44 in the study group, while the mean DrVac-COVID19S score was 51.25 for pregnant women and 55.85 for women of reproductive age. The mean CAS score was 0.61 in the pregnant group and 1.03 in the control group, respectively, suggesting a low level of anxiety associated with COVID-19. Other results on the severity of anxiety and fear of coronavirus were obtained using the FCV-19S. The mean score oscillated around 15 out of a possible 35, indicating moderate anxiety.

Pregnant women generally showed moderate COVID-19 anxiety, but the results varied depending on the tool used. VAC-COVID-19 and DrVac-COVID19S scores confirmed the high level of vaccine acceptance among the women surveyed and positive attitudes towards it. There was a strong positive correlation between VAC-COVID-19 and DrVac-COVID19S. Insufficient knowledge of the effects or complications of the vaccine in the foetus were the most common reason for COVID-19 vaccine refusal among pregnant women.

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Perry syndrome is a rare neurological disorder, characterized by atypical parkinsonian symptoms, sleep disturbances, central hypoventilation, weight loss, and psychiatric symptoms, especially apathy or depression. This syndrome is due to a TDP-43 proteinopathy as a result of a mutation in the DCTN-1 gene.

To present the case of a patient with a mutation in the DCTN1 gene, related to Perry syndrome, who debuted with several depressive episodes, with apathy and weight loss.

A non-systematic literature review was conducted on PubMed database on depressive episodes related to Perry´s syndrome. The clinical case report was prepared through the review of the clinical record of the patient.

The authors present the case of a 49-year-old man, who contacted psychiatry for the first time 10 years earlier due to depressive symptoms, suffering multiple episodes. These episodes consisted of hypothymic mood, apathy, anhedonia and marked irritability, together with suicidal ideation, leading to several drug overdoses. He also presented disruptive behaviors, such as abusive drinking and aggressiveness. These episodes responded to antidepressants at medium doses, although maintaining several relapses. Given this, it was decided to introduce valproic acid as a mood stabilizer, with good tolerance.

In parallel, the patient’s mother, who had also suffered from depressive episodes, began with dementia symptoms, after which it was decided to request a genetic study. In this context, a mutation, similar in both patients, was observed in the DCTN1 gene, related to Perry syndrome.

In the case of the patient presented, no other associated alterations were found, neither in the neurological examination or in the rest of the tests performed (polysomnography without notable alterations, functional imaging tests without pathological findings).

Neurological diseases as Perry syndrome can show depressive symptoms and other behavioral changes at the beginning, developing the rest of the symptoms (parkinsonism, weight loss or central hypoventilation) several years after the onset of the symptoms. It must be taken into account in patients with a family history of mutations or atypical depressive symptoms. It should also be assessed in terms of genetic counseling.

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International guidelines recommend that prospective organ transplant patients receive a psychosocial assessment to optimise outcomes. There is limited consensus regarding the criteria for psychosocial evaluation. The Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT) tool was developed to enhance the pre-transplant psychosocial workup. The Mater Hospital is the National Centre for heart and lung transplantation in Ireland. The consultation-liaison psychiatry (CLP) service provides screening of pre-transplant candidates using a biopsychosocial assessment, SIPAT and cognitive screening tools. Post-transplant patients are reviewed on a referral basis.

To identify the psychosocial needs of heart and lung transplant recipients and CLP service input over a one year period.

A review of all heart and lung transplant recipients between January 1st and December 31st 2021 was conducted. The following data were recorded: demographics, pre-existing mental illness, SIPAT scores, and referral to the CLP service within six months of transplantation.

Twenty-eight individuals received a heart/lung transplant in 2021 (7 heart, 19 lung, 1 heart &liver, 1 heart & lung). Prior to transplant 50% (14/28) had a pre-existing mental health diagnosis, 7% (2/28) had attended a psychiatrist, and 28.6% (8/28) were on psychotropic medication. SIPAT scores were available for 20 patients. The overall mean SIPAT score was 10.8 (SD 6.1). The subscales were as follows: Patient Readiness, mean 3.2 (SD 1.7); Social Support System, mean 2.1 (SD: 1.8); Psychological Stability & Psychopathology, mean 1.6 (SD 2.7); and Lifestyle & Substance Misuse, mean 3 (SD 1.5). Based on SIPAT scores, 20% (4/20) were excellent candidates, 75% (15/20) were good candidates and 1 (1/20) was minimally acceptable. Pre-existing mental illness was associated with higher total SIPAT scores (p=0.013) and higher scores on the psychological stability subscale (p=0.032). Post-transplant, 50% (14/28) were referred for psychological support and 21.4% (6/28) were referred to the CLP service. A further 10.7% (n=3) were attending CLP prior to transplant. Referrals to CLP occurred (median) 13 days (range 1-275) post-transplant surgery. The reasons for attending CLP were anxiety (5/9), delirium (3/9) and mood (1/9).

SIPAT can be a valuable tool for use in the pre-transplant workup to help identify those that will require intensive psychosocial support post- transplant.

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The role of the interaction between the serotonin-transporter-linked promoter region (5HTTLPR) and stressful condition in determining the vulnerability to depression has been widely investigated. Nevertheless, empirical research provides contrasting findings. Recently, the differential susceptibility to environment model proposed a conceptual shift respect to the classical interpretation of 5-HTTLPR: viewing the short (s) and the long (l) allele not as associated to different traits of vulnerability (respectively vulnerable or not), but determining different plasticity levels (respectively, more and less plasticity) and, thus, different susceptibilities to the environment (respectively, high and low susceptibility).

As 5-HTTLPR is involved in plasticity, the main goal of the present study is to demonstrate that the interaction between the polymorphism and stress emerges when assessing its effects according to temporal factors in a dynamic process perspective.

We explored our hypothesis, exploiting a meta analytic approach. We searched PubMed, PsychoINFO, Scopus and EMBASE databases and 1096 studies were identified and screened, resulting in 22 studies to be included in the meta-analyses. We applied the DerSimonian and Laird random-effects model to estimate crude odds ratios for risk of depression according to 5HTTLPR and we assessed heterogeneity using the I² and Cochran’s Q statistic. We stratified the staties according to (i) stress duration (i.e., chronic vs. acute stress) and (ii) time elapsed between the end of the stressful condition and the assessment of depression (i.e., within one year vs. more than one year).

When stratifying for the duration of stress, the effect of the 5-HTTLPR x stress interaction emerged only in the case of chronic stress (OR 1.43, 95%IC 1.16-1.77, I²= 52%, Q=25.25; Figure 1), with a significant subgroup difference (p=0.004). The stratification according to time interval revealed a significant interaction only for intervals within one year (OR 1.23, 95%IC 1.03-1-46, I²= 67%, Q=39.35), though no difference between subgroups was found. The critical role of time interval clearly emerged when considering only chronic stress: a significant effect of the 5-HTTLPR and stress interaction was confirmed exclusively within one year (OR 1.53, 95%IC 1.17-2.02, I²= 45%, Q=10.94; Figure 2) and a significant subgroup difference was found (p=0.01).

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Image 2:

Our results show that the 5-HTTLPR x stress interaction is a dynamic process, producing different effects at different time-points, and indirectly confirm that s-allele carriers are both at higher risk and more capable to recover from depression. Overall, these findings expand the current view of the interplay between 5-HTTLPR and stress adding the temporal dimension, resulting in a three-way interaction: gene x environment x time.

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The global toll of chronic kidney disease (CKD) is significantly rising and unevenly distributed. In Indonesia, CKD is primarily managed by hemodialysis (HD) because limited resources rule out the possibility of renal transplantation. HD patients are commonly accompanied by caregivers but most studies show neglected the physical and mental health of caregivers.

This work aims to know the relationship between anxiety and depression with systolic blood pressure (SBP) in HD caregivers at Soehadi Prijonegoro Regional Public Hospital.

A cross-sectional study design was conducted to assess the population. This research took place in Soehadi Prijonegoro Regional Public Hospital Sragen Indonesia, at the Hemodialysis department in November 2022, with 31 participants. We assessed their SBP using a sphygmomanometer, and then we interviewed the caregivers using Hamilton Depression Rating Scale (HAM-D or HDRS) and Hamilton Anxiety Rating Scale (HAM-A).

We found that 38,8% of caregivers have hypertension with SBP above 140 mmHg. Around 93.5% and 6.5% of caregivers were found to be mild and mild-moderate anxious. Also, 22.6% were found to have mild depression, while the rest showed the normal result. There is a relationship between SBP and anxiety (p=0.037), while depression is not (p=0.302). However, there is a strong relationship between anxiety and depression (p<0.05), with a correlation coefficient of 0.69.

One-third of the caregivers were found to have hypertension, which is significantly related to anxiety. Furthermore, depression could occur in a patient with anxiety. Thus, caregivers need to maintain their physical and mental health.

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Rapid increase in the number of elderly patients in the world who need dialysis treatment. High age with dementio depression and anxiety negatively affects the outcome of hemodyalisis patients on (HD).

The goal is that patients get the ability to choose by themselves will they start HD treatment or not. The old population is often exposed doctors, family or guardian’s descisions that are against their wishes, either due to a lack of communication or lack of knowledge of working methods and procedures. Procedures can leave mental and physical consequences (suffering), no matter they were all done professionally.

We analyzed old (70-75 years) and very old patients (over 80 years). Cross-sectional analysis of survival of patients at the Hemodialysis (HD) Center with standard methods.

For patients who started hemodialysis at the age of 70 or more, the average survival was: 20.27±18.62 months, those who died 15.54±17.35, and living ones 30.29±17.85. 35% of the patients survived up to one year, two years 18%, and 3 or more 8%.

Most of old people that started dialysis treatment afterwards complained and concluded that it wasn’t necessary mostly because of the lack of communication, or simply it wasn’t their own decision.

Based on these facts, and knowing that these procedures can leave mental and physical consequences subjective assessment about starting dialysis treatment should respect, in the first place, patient’s decision.

The plan for medical procedure involves great ethical, legal and psychological engagment. It often occurs in people who, for some reason, are not in contact and do not adequately test reality.

We are of the opinion that it is, therefore, important that every person, while in mental, physical and social well-being, makes a decision about his medical treatment and communicates it to his family, but it is also very difficult because it touches on his own mortality and helplessness.

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Studies of criminality among women are relatively poor because of its lower rate compared to men and its frequent association with mental illness.

The aim of this study is to determine the characteristics of female offenders referred for forensic psychiatric examination.

We studied the medical files of all the offenders referred to the forensic psychiatry unit in the Razi hospital for an examination between January 2010 and October 2020.

The number of people who have undergone a forensic psychiatric examination was 256. The offenders were female in 4.29% (11) of the cases. Their average age was 35 years with a range of 17-73 years. They were mostly single (54.5%) with no education (54%). Fifty four percent of the studied population were unemployed and 63% of them lived with their families.

One third of the studied population had a neurological history. Family history of psychiatric disorder was found in one case and only two had suicide attempts history.

Two women had personality disorder: a borderline and a histrionic personality disorder. An average number of one hospitalization was found in this group.

A criminal record was found in 47% of the cases with an average number of two offenses per person. The mean age of the first offense was 24 years old. The main crimes were: homicide (18.2%) and theft (18.2%).

Three offenders were found of intellectual disability, two of them personality disorders, one of schizophrenia, one of dementia and one of depression. No psychiatric disorder was found in the rest of the cases.

No drug abuse was found in this population.

The criminal and psychiatric profile of female inpatients differs from their male counterparts, which has important involvements in case management and validates the need of further searches in this field.

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We present the case of a 19-year-old patient who experienced a nonexisting moving sensation, increasing size and painful sensation on tongue, jaw and skull bones. Likewise, the patient showed high anguish, psychomotor restlessness and low mood, in relation to somatic symptomatology; which severely interfered in his life, dropping his university studies and his social life. He also presented thoughts of being victim of a complot of his classmates.

To present a case report and to review the literature of coenesthetic schizophrenia.

Literature review of scientific articles searching in EMBASE and Pubmed. We considered articles in English and Spanish.

Treatment with oral aripiprazole and sertraline was started, with progressive clinical improvement, decreasing somatic sensations until they disappeared, as well as mood improvement and remission of anxiety and psychomotor restlessness.

Coenesthetic schizophrenia was first described in 1957 by Gerd Huber. It is characterized by bodily sensations often combined with affective disturbances. Other symptoms that occur frequently are affective, vegetative, motor and sensory alterations. Typical schizophrenic symptoms are limited to brief psychotic episodes.

We consider knowledge of this entity important, given the differential clinical characteristics regarding to other presentations of schizophrenia, as well as the need to do a differential diagnosis with other disorders such as body dysmorphic disorder or hypochondriasis.

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Despite replicated cross-sectional evidence of aberrant levels of peripheral inflammatory markers in individuals with major depressive disorder (MDD), there is limited literature on associations between inflammatory tone and response to sequential pharmacotherapies.

To assess associations between plasma levels of pro-inflammatory markers and treatment response to escitalopram and adjunctive aripiprazole in adults with MDD.

In a 16-week open-label clinical trial, 211 participants with MDD were treated with escitalopram 10– 20 mg daily for 8 weeks. Responders continued on escitalopram while non-responders received adjunctive aripiprazole 2–10 mg daily for 8 weeks. Plasma levels of pro-inflammatory markers – C-reactive protein, Interleukin (IL)-1β, IL-6, IL-17, Interferon gamma (IFN)-Γ, Tumour Necrosis Factor (TNF)-α, and Chemokine C–C motif ligand-2 (CCL-2) - measured at baseline, and after 2, 8 and 16 weeks were included in logistic regression analyses to assess associations between inflammatory markers and treatment response.

Pre-treatment levels of IFN-Γ and CCL-2 were significantly higher in escitalopram non-responders compared to responders. Pre-treatment IFN-Γ and CCL-2 levels were significantly associated with a lower of odds of response to escitalopram at 8 weeks. Increases in CCL-2 levels from weeks 8 to 16 in escitalopram non-responders were significantly associated with higher odds of non-response to adjunctive aripiprazole at week 16.

Pre-treatment levels of IFN-Γ and CCL-2 were predictive of response to escitalopram. Increasing levels of these pro-inflammatory markers may predict non-response to adjunctive aripiprazole. These findings require validation in independent clinical populations.

None Declared

Suicide, was defined as the act of intentionally taking one’s own life, understanding the lethal consequences of the act committed. The global suicide rate is 10.5 cases per 100,000 inhabitants, being lower in America, where it reaches values of 7.3 deaths per 100,000 inhabitants.

The Embera ethnic group is a Latin American indigenous people, of Chocó ethnolinguistic origin, which is located in the countries of Panama, Colombia and Ecuador; Particularly within the Embera ethnic group, a phenomenon of suicide in waves has been documented in journalistic media, which has been called “The Epidemic of the ropes”.

The data was collected in 2020, within the Río Salaquí-Isletas indigenous reservation (Riosucio-Chocó), in which multiple cases of suicide have occurred in the new millennium, without knowledge of previous cases.

To calculate the suicide rate and its trend over time in the Río Salaquí indigenous reservation, among 1999 and 2019 and compare the suicide rate and its trend with official data from Colombia, determining differences between the two.

A descriptive study with an analytical component will be carried out. The data was collected in 2020, within the Río Salaquí-Isletas indigenous reservation (Riosucio-Chocó-Colombia). The information was taked from no structurated interviews conducted with individuals from the community.

The validation of the cases and the selection of duplicate cases was carried out through checklists created by the researchers. When calculating the specific suicide rates, the estimated population in the community is obtained from official censuses and local authorities.

Statistical analysis to determine whether the suicide rate; It was carried out with the SPSS program, using a confidence interval on the rate, which would allow estimating its variability with 95% reliability.

Data of deaths by suicide were collected in people of any age, residents of the Río Salaquí Indigenous Reservation (Isletas), between the decade of 1999 and 2019, as well as the total population of the community for the calculation of suicide rates. suicide.

Among the 10 years evaluated, 22 deaths by suicide were found, of which 13 (59%) corresponded to men and 9 (41%) to women. The suicide rate in Río Salaquí for this decade was 88.8 cases per 100,000 inhabitants 95% CI (68.7-375.8), with peaks in some three-year periods analyzed and no deaths by suicide before 2001. On the other hand, the The national suicide rate in Colombia for this decade was 4.56 cases per 100,000 inhabitants 95% CI (4.18-4.87).

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During the development of the study is evident that in the indigenous reservation in the Salaqui river the suicide rate is significantly higher than in the national rates, it is even higher than the worldwide rate of suicide since the year 2001.

None Declared