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.

None Declared

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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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.

None Declared

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.

None Declared

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.

None Declared

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.

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Clozapine is considered to be the most efficacious antipsychotic drug for treatment-resistant schizophrenia (TRS). Despite this, up to 70% of patients with TRS have a poor response to adequate treatment with clozapine. In order to overcome clozapine-resistance schizophrenia (CRS), a number of adjunctive therapies, including pharmacological and non-pharmacological options, have been attempted.

The objective of this paper is to highlight the efficacy of the combined electroconvulsive therapy (ECT) and oral paliperidone as a successful treatment in clozapine nonresponders suffering from schizophrenia.

We present the case of a 22-year-old female, with four years psychiatric history, which was admitted to our clinic for psychotic behavior, psychomotor agitation, verbal negativism, auditory hallucinations. During hospitalization, the patient presented behavioral disorganization, auditory, visual and tactile hallucinations, ideo-verbal barriers, poorly systematized delusional ideation (of guilt, mysticism, contamination, possession), episodes of catatonic stupor, rigidity, waxy flexibility, bizarre postures, false recognitions. Corroborating evidence, we established the diagnosis of undifferentiated schizophrenia. We initiated treatment with clozapine up to 450 mg/day and amisulpride up to 600 mg/day.

Combined treatment strategy of clozapine and amisulpride for six weeks showed no amelioration in our patient, with additional side-effects. Also, in the last four years, she had been treated with several atypical antipsychotics, which had not achieved substantial improvement. Considering that our patient did not present an adequate clinical response and the catatonic symptoms were accentuated, we decided to progressively reduce the doses of clozapine by 50 mg/day until elimination, to initiate paliperidone 12 mg/day and to conduct ECT three times a week, performing a total of six sessions. The bilateral electrode placement and brief pulse stimuli (800 mA; 8 s, 30 Hz) were applied under analgo-sedation, with no sustained severe adverse events. After performing ECT, the patient presented a favorable clinical evolution, with a decreasing trend until the remission of psychotic symptoms.

TRS was diagnosed based on the poor response to more than two kinds of atypical antipsychotics and CRS was established after the combination of clozapine and amisulpride failed to decrease persistent positive symptoms, associated with worsening of the negative symptoms. Combined therapy with paliperidone and ECT proved to be greatly effective in improving symptoms for our patient. Switching from clozapine to a previously untried atypical might be of benefit in TRS. Also, adjunctive ECT can be efficacious in CRS. Augmentation with ECT may result in a faster response, which is particularly useful among patients with high risks of self-harm.

None Declared

Mental disorders, musculoskeletal diseases (MSDs) and their comorbidities are major threats to work and functional ability. The relationship between mental health and the common MSDs has not received enough attention

To study the socio-professional characteristics of workers suffering from work related MSD

To evaluate the association of work related MSDs with anxiety and depression disorders

A descriptive cross-sectional study conducted among workers with work-related MSDs who consulted the occupational medicine department of the Charles Nicolle Hospital between January 2022 and September 2022. A remote survey was conducted among these workers to screen for anxiety and depressive disorders using the Hospital anxiety and Depressive Scale

The study population consisted of 54 workers with MSDs with a sex ratio (M/F) of 0.74. The average age was 44.4 [27-61 years]. The average professional seniority was 14.9 years±7 years and the sectors with the highest prevalence of MSDs were the health sector (22%), the food industry (13%) and the textile industry (11%). The workers reported MSDs of the lumbar spine in 61%, gonarthrosis in 31%, followed by MSDs of the upper limb in 25%. The prevalence of anxiety and depressive disorders were respectively 46% and 38%. There was no significant association between socio-demographic factors and anxiety depressive disorders. The anxiety disorder was associated with MSDs of the lumbar spine (p: 0.05; OR: 0.32 CI95% [0.1-1.09]).

Anxiety and depressive disorders were common among workers with MSDs related to work. Interventions targeting psychological distress and work-related psychosocial characteristics may reduce their musculoskeletal pain.

None Declared

The question of violence and dangerousness is a central subject in psychiatry, since it is a source of stigmatization for many patients and represents a major element of medical, legal and social care. Violence being defined as: "the deliberate use or threat of deliberate use of physical force or power against oneself, against another person or against a group or community, which results in or is very likely to lead to trauma, death, moral damage, maldevelopment or deficiency”. The violent character of the mentally ill was among the precursors to the discussion around the first therapeutic measures for the mentally ill. A better knowledge of the risk factors for the passage to a violent act in mental disorders is therefore necessary for the development of therapeutic and preventive strategies.

The objective of our work is to determine the socio-demographic, clinical and criminological characteristics of forensic patients and to seek the predictive factors of violence in these patients.

This is a retrospective study spread over 10 years on a series of forensic patients who were hospitalized at the Ar-razi psychiatric hospital in Salé (Morocco). The collection of data was carried out from clinical observations, psychiatric expertise and an exploitation sheet.

Numerous studies have defined subgroups of patients at risk. Factors such as positive symptoms, poor treatment compliance, and comorbidities such as substance use disorders or antisocial personality traits have been described as predictive of violence.

The prevention of medico-legal acts must take into consideration these associated factors, in particular early management of the disorders, improvement of therapeutic observance and family care.

None Declared

Elevated blood levels of homocysteine have been associated with several psychiatric and neurodegenerative disorders such as schizophrenic disorders, Alzheimer’s disease, Parkinson’s disease and depression. The hypothesis is that genetic and environmental factors elevate homocysteine levels, which causes vascular diseases of the brain, and/or changes in neurotransmitters, which cause various mental disorders.

The objective of our work is to discuss the association between hyperhomocysteinemia and the characterized depressive disorder

we conducted our study through the discussion of a clinical vignette

We report here a case of hyperhomocysteinemia with vitamin B 12 deficiency in a 16-year-old female patient who presented with a characterized depressive disorder.

She was initially treated with a selective serotonin inhibitor combined with parenteral injections of vitamin B12. The patient’s clinical condition improved after the first week. The discussion will attempt to clarify the role of vitamin therapy in the improvement of the patient’s depressive symptoms and its relationship with hyperhomocysteinemia.

We report here a case of hyperhomocysteinemia with vitamin B 12 deficiency in a 16-year-old female patient who presented with a characterized depressive disorder.She was initially treated with a selective serotonin inhibitor combined with parenteral injections of vitamin B12. The patient’s clinical condition improved after the first week. The discussion will attempt to clarify the role of vitamin therapy in the improvement of the patient’s depressive symptoms and its relationship with hyperhomocysteinemia.

Statistical data, physiological and genetic aspects seem to point to the involvement of hyperhomocysteinemia in the development of characterized depressive disorder. However, the results remain variable, even contradictory, and several confounding factors must be considered in these studies: ethnic, geographical, cultural (in terms of diet) and age factors are all elements that seem to intervene and that do not always make it possible to know whether hyperhomocysteinemia is a direct cause of depression or the consequence of mechanisms linked to folate and B12 deficiencies.

None Declared

Schizophrenia (SCZ) is one of the most severe mental disorders. Several elements involved in pathogenesis have been characterized recently. However, tools for diagnosis and risk prediction are limited. Elucidation of the underlying genomic and molecular mechanisms of SCA remains a challenge.

In this study, we aimed to identify plasma biomarkers for SCZ using targeted metabolomics.

All enrolled patients were drug-free for at least 3 months prior to admission. Plasma from 31 SCZ patients and 70 matched controls were analyzed using the LC/MS- Api 4000 QTrap Sciex. A total of 188 targeted metabolites, including 21 amino acids, 21 biogenic amines and 145 lipids or lipid-related metabolites were analyzed. All data modeling and analysis is done using MetaboAnalyst 5.0

There was no significant difference in the studied groups regarding BMI. Plasma Triglycerides, LDL-C, total proteins levels were significantly decreased in SCZ compared to controls. Heatmap identified 2 clusters with 25 significantly differentially expressed metabolites (FDR <0.05) between the drug-naïve group and the matched controls. The OPLS-DA score plot showed that the groups are clearly separated according to plasma phospholipids concentrations. Among these differential metabolites, the expression level of very long chain Phosphatidylcholines (PC 36 – PC p42) and acylcarnitines were significantly decreased in SCZ compared to controls, whereas sphingomyelin (SM) and lysoPC were significantly lower in drug-naive patients.

In this study, we found that plasma phospholipids were significantly dysregulated in the SCZ patients and could be a promising pathway to explore SCZ.

None Declared

Women with schizophrenia require health interventions and safe spaces sufficiently different from those of men.

To describe units in two mental health outpatient services specialized in the treatment of women with schizophrenia and related disorders.

Two units in Spain projected to treat women with schizophrenia and related disorders - Community Mental Health Programs (CMHU Rambla, CMHU Sant Cugat) will be described. Recruitment, assessment, intervention, and evaluation and satisfaction measures will be characterized, and the need to build-in safety precautions (policy/structural).

Demographics:(Preliminary 2021 data on the two services).

Patients attending (CMHU): 3,393. Forty-five per cent diagnosed with severe mental illness. Schizophrenia and related disorders: 873 patients. 58% women.

Staffing projected: 2 psychiatrists, 2 nurses, 1 clinical psychologist, 2 social workers.

Physical structure: Safe spaces for women/children.

Programs (offered currently and in planning stages): 1)Therapeutic Drug Monitoring/Adherence, 2)Individual/group patient/family sessions, 3)Perinatal Mental Health (preconception, pregnancy, lactation, postpartum, parent training/support), 4)Collaborative programs (primary care, medical specialties especially obstetrics/gynecology and endocrinology, trauma specialists, addiction experts), 5)prevention/intervention of suicide risk, 6)social services (single mothers, family issues, domestic abuse, sexual exploitation) 7)home-based services, 8)peer support, 9)physical activity, 10)psychoeducation for patients and families.

Planned quality evaluation measures: diagnostic assessment (reliability, long-term validity);regular treatment effectiveness evaluation (individualization of treatment plans, assessment of adverse effects of drugs, screening for metabolic syndrome/ physical health, family intervention, psychoeducation (individual/group) assessment of suicidal ideation and global functioning.

Specific services for women with schizophrenia and related disorders represent an important resource to improve patient well-being and offer clinical care leading to individual recovery.

None Declared

Corticosteroids are certainly an efficacious treatment for several inflammatory and immunologic disorders. However, their abuse can lead to dangerous consequences such as psychiatric complications. Physicians and Psychiatrists should cooperate to treat and prevent, if possible, the deleterious adverse psychiatric effects of corticosteroids.

to describe a patient whose psychotic symptoms occured within 2 weeks of starting corticosteroid abuse, to review the literature and to suggest treatment.

To present a case of a female young patient suffering from corticosteroid-induced psychosis due to corticosteroid abuse and review case report data published during the past quarter-century on adverse corticosteroid-induced psychiatric effects.

The patient was investigated to exclude other causes of her psychosis and she was treated with chlorpromazine and Risperidone. Numerous cases investigating these psychiatric corticosteroid-induced symptoms were identified. Data on incidence, drug dose, onset of symptoms, course of illness and treatment were arranged.

Corticosteroid abuse should be put in the spotlight especially for young Tunisian females desiring to look plump. This misjudged abuse may have sever psychiatric complications. Thus we should establish strategies of prevention and cure to these psychiatric complications

None Declared

According to Article 5 of the Maria da Penha Law, domestic and family violence against women constitutes any action or omission based on gender that causes her death, injury, physical, sexual or psychological suffering, and moral or patrimonial damage, within the scope of the domestic unit, the family or any intimate relationship of affection. In isolation, domestic violence is already considered by the WHO a public health problem. In the context of a pandemic, as was the case with COVID-19, the issue had the severity increase.

To investigate the rates of domestic and family violence against women in the city of São João Batista, State of Santa Catarina, Brazil, between January 1, 2019, and December 31, 2020, relating the data to the COVID-19 pandemic.

Descriptive cross-sectional study, operationalized by the technique of bibliographic and documentary research.

There was a reduction in the total number of crimes involving domestic and family violence against women in the city of São João Batista/SC, Brazil. While in 2019 there was a notification of 116 crimes, in 2020 the number dropped to 65. (Graph 1)

The most frequent crimes in both years were: threat and bodily injury. Together they accounted for 83% of cases in 2020. (Graph 2)

The apparent decrease in the number of notifications does not necessarily represent a decrease in cases of domestic violence, but rather, it may mean fear of leaving the residence to formalize the complaint, difficulty in carrying it out, or even the worsening of factors that increase the risk in these situations, such as reduction or total loss of income and support network.

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The scenario presented shows the need for preventive public policies regarding the problem of domestic and family violence against women. The creation and strengthening of community and personal networks are fundamental.

None Declared

Prior evidence suggests that men and women might be differentially susceptible to distinct types of childhood adversity (CA), but research on gender-specific associations between CA subtypes and psychiatric symptoms is limited.

To test the gender-specific associations of CA subtypes and psychiatric symptoms in the general population.

Data from 791 twins and siblings from the TwinssCan project were used. Psychopathology and CA exposure were assessed using the Symptom Checklist-90 Revised (SCL-90) and the Childhood Trauma Questionnaire (CTQ), respectively. The associations between the total CTQ scores and SCL-90 scores (i.e. total SCL-90, psychoticism, paranoid ideation, anxiety, depression, somatization, obsessive-compulsive, interpersonal sensitivity, hostility, and phobic anxiety) were tested in men and women separately. The associations between the five CA subtypes (i.e. physical abuse, emotional abuse, sexual abuse, physical neglect, and emotional neglect) and total SCL-90 were tested in a mutually adjusted model. As exploratory analyses, the associations between all CA subtypes and the nine SCL-90 subdomain scores were similarly tested. The regression coefficients between men and women were compared using Chow’s test. All models were adjusted for age and family structure.

Total CTQ was significantly associated with total SCL-90 in men (B = 0.013, SE = 0.003, P < .001) and women (B = 0.011, SE = 0.002, P < .001). The associations with the nine symptom domains were also significant in both genders (P < .001). No significant gender differences in the regression coefficients of total CTQ were detected. The analyses of CA subtypes showed a significant association between emotional abuse and total SCL-90 in women (B = 0.173, SE = 0.030, P < .001) and men (B = 0.080, SE = 0.035, P = .023), but the association was significantly stronger in women (ꭓ2(1) = 4.10, P = .043). The association of sexual abuse and total SCL-90 was only significant in women (B = 0.217, SE = 0.053, P < .001). The associations of emotional neglect (B = 0.061, SE = 0.027, P = .026) and physical neglect (B = 0.167, SE = 0.043, P < .001) with total SCL-90 were only significant in men. The explorative analyses of SCL-90 subdomains revealed significant associations of emotional abuse with all nine symptom domains and of sexual abuse with seven symptom domains in women. Significant associations of physical neglect with six symptom domains and of emotional neglect with depression were also detected in men. No other significant associations between CT subtypes and total SCL-90 or symptom domain scores were observed in men and women.

CA exposure was associated with diverse psychopathology similarly in both genders. However, women are more sensitive to abuse, but men are more sensitive to neglect. Gender-specific influences of CA subtypes on psychopathology should be considered in future studies.

None Declared

SARS-CoV-2 is a virus with a multisystem effect, and it can cause numerous neuropsychiatric disorders, both in the acute phase of infection and in the period after the disease has passed. According to Nalbandian et al. (2021), post-acute COVID-19 syndrome is a condition of persistent symptoms and/or delayed long-term complications caused by SARS-CoV-2 infection lasting longer than four weeks after the onset of symptoms.

To indicate the possible role of the SARS-COV 2 virus in the development of long-term neuropsychiatric and cognitive consequences of COVID-19.

We undertook a search of the available medical literature in the period after 2020 with the keywords COVID 19 and neuropsychiatric complications

Results: Case report: Female patient, 40 years old, unemployed, married, mother of two children. She was admitted for the first hospital treatment at the Psychiatry Clinic of the UCC of Niš due to psychological disturbances in the form of experiencing her own body changes and changes in the environment, moodiness, anxiety, the conviction that she is suffering from incurable diseases, the experience of being centered and existentially threatened, insomnia. In 2020, one month after the recovery from COVID-19, she was treated at the Neurology Clinic of the UCC of Niš for a crisis of consciousness, diagnosis at discharge: encephalitis, encephalopathy. At the end of the treatment, cognitive-mnestic deficits remain. In April 2021, after reinfection with the SARS-COV2 virus, a depressive-interpretive syndrome developed, which is the reason for the current hospitalization. Depersonalization and derealization phenomena, time disorientation, hypochondrial delusions, ideas of self-accusation, cenesthetic hallucinations, impaired volitional-instinctual dynamism and deficits in cognitive-mnestic functioning are observed during hospitalization. NMR of the endocranium with contrast shows changes in the form of encephalomalacia, porencephaly, which indicates a condition after a cerebrovascular insult. She was treated with low doses of haloperidol (2 mg pd), antidementia and vasoactive therapy, which led to a reduction of psychotic symptoms as well as an initial improvement in cognitive-mnestic functioning.

This case report confirms the neurotoxicity of the SARS-CoV-2 virus and it is in accordance with the available literature. The neuropsychiatric and cognitive complications that accompany COVID-19 are different and have a significant impact on the health of people who recovered from COVID-19. It is necessary for the health system to recognize this problem in time and provide organized neuropsychiatric and cognitive monitoring to patients suffering from COVID-19.

None Declared