Oxidative stress is the main characteristic of several diseases including Bipolar Disorder (BD). The involvement of oxysterol derivatives has recently been reported. In this study, the involvement of oxidative stress in the alteration of cholesterol in PTB patients will be evaluated.

To assess the association of oxidative stress and oxysterol profiles in subjects with BD and compare them to healthy physical and mental controls.

This is a case-control study involving subjects with BD. Selected based on DSM-5 criteria, an assessment of positive and negative symptoms was performed using the Positive and Negative Syndrome Scale (PANSS). Controls included in this study were matched to patients by age and gender. For all patients and control. Eight parameters of oxidative status were assessed: plasma ferric reducing capacity (FRAP), carbonyl proteins (PC), protein products of advanced oxidation (AOPP), reduced glutathione (GSH), total thiols, malondialdehyde (MDA ), glutathione peroxidase activity (GSH-Px) and catalase activity (CAT) analyzed by colorimetric methods. In addition, six cholesterol derivatives: oxysterols are measured by ULPC MS/MS.

This study included 33 patients with BD and 40 controls. Plasma GSH levels were significantly reduced in patients compared to controls (p < 0.001). Moreover, MDA, AOPP, PC and GSH-Px activity were significantly increased in patients compared to controls (p=0.005; p=0.003; p<0.001 and p=0.05, respectively). Significantly higher levels were observed for cholestane-3β, 5α, 6β-triol, 27-hydroxycholesterol (27-OHC), and cholestanol in patients with PTB. The concentration of 24(S)-hydroxycholesterol (24-OHC) was significantly lower in patients compared to controls. 25-OHC was positively and significantly correlated with CAT and GSH-Px activities (p=0.035 and p=0.010). 27-OHC was negatively and significantly correlated with MDA (p=0.014). Binary logistic regression revealed an association between the parameters: 27-OHC, 24-OHC, PC and MDA and the occurrence of PTB (OR = 1.007, 95% CI= 1.002-1.013), (OR = 0.956; 95% CI = 0.927 – 0.986), (OR = 39.925; 95% CI = 1.101 – 44.483) and (OR = 4.238; 95% CI = 1.091 – 16.466), respectively.

Our data support the relationship between disruption of redox homeostasis and oxidation of lipids and cholesterol in BD.

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Patients with unipolar major depression often present with symptoms of anxiety. Presentations with high levels of anxiety, restlessness, and somatic correlates of anxiety can be clinically identified as anxious depression. The comorbidity of anxious and depressive symptoms is a marker of poor prognosis, with greater risk of relapse and increased suicidal risk.

Brief review of the role of pregabalin in the treatment of major depressive disorder (MDD), based on a case study.

Consultation of the clinical record and brief review of the literature on this subject.

We present the case of a 25-year-old woman, with no past psychiatric history, admitted to a psychiatric consultation with depressive symptoms, and marked anxiety and somatic complaints, such as restlessness, palpitations, gastrointestinal discomfort. She fulfilled diagnostic criteria for Major depressive disorder (MDD), and was initially treated with sertraline 50 mg, with partial response, but maintenance of prominent anxious symptoms with important functional impairment. Then, we raised the dose of sertraline to 100 mg and added pregabalin 50 mg, with up-titration to 150 mg per day, divided in three doses. We observed rapid response, particularly on the anxious symptoms, and subsequently on the patient functionality.

The anxiety symptoms can increase in the first days of treatment with a selective serotonin reuptake inhibitor, which is the first-line therapy for major depression. Those are particularly difficult to treat, resulting often in treatment resistance and functional impairment. Pregabalin has a proven rapid-onset anxiolytic effect, with less cognitive and motor effects and less risk for dependence than benzodiazepines. It has demonstrated efficacy for the treatment of generalized anxiety disorder, but the use for patients with MDD has not been clearly studied.

Although the evidence on this subject is sparse, pregabalin augmentation of antidepressants could be an adequate option for the treatment of depression, allowing a faster action on the anxiety symptoms, especially on the first weeks of treatment, without some of the risks of the benzodiazepines.

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Cognitive aging is defined as the cognitive decline during the aging process. Most cognitive skills deteriorate in old age; however, there are individual differences in the speed of the decline and severity of neuropsychological deficits.

The aim of the study was to delineate the associations of sociodemographic, clinical, and lifestyle factors with cognitive aging.

302 participants aged 60 years and above (mean age 69,6±7,2; range 60-92 years) were included in the study. Women were 69.9% of the group (N = 211). Subjects completed the questionnaire (sociodemographic and anthropometric data, chronic diseases), and depression intensity was assessed by Beck Depression Inventory (BDI). Cognitive functions were evaluated using MiniMental State Examination, Trail Making Test, Stroop test, and selected tests from CANTAB battery (Pattern Recognition Memory, Spatial Recognition Memory, Spatial Span, Spatial Working Memory).

Age influenced most of the studied cognitive functions. Higher education level and more frequent cognitive activities (e.g. reading and crosswords) had a protective effect on the performance of tests assessing working memory and executive functions. Working memory and attention assessed in the Stroop test in part B were most sensitive to the negative impact of age, lower education level, and lower frequency of cognitive activity. Higher body mass index (BMI≥28) and diabetes were associated with worse spatial working memory.

The results suggesting the association between lifestyle factors – cognitive activity and cognitive functions can contribute to the development of interventions aimed at the preservation of cognitive functions in older age.

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The prison environment and health of people who experience incarceration increase the risks of contracting COVID-19. Aside from the risks of infection and transmission, one should also examine the impact on their mental health state and identify their needs, since prison inmates experience already disadvantages and inequalities to a large extent.

The aim of the study was to explore the experiences of inmates with the pandemic and the restrictions, their insights into the pandemic and the impact of social distancing in prison on their emotional status and management.

We used in-depth interviews with 5 inmates and 6 prison employees of a state prison in Athens, to produce an analysis of the challenges that the inmates faced during the pandemic. The study took part from February till June 2022. Each participant was asked semi-structured questions and a thematic content analysis was performed.

The results of the interviews revealed several key themes, that have emerged from the COVID-19 pandemic. The challenges that the participants faced were in relation to communication, feelings of heightened isolation and detachment from family, friends, and the normal rhythms of life in and out of prison. Furthermore, our study has shown that COVID-19 pandemic resulted in higher levels of anxiety, lack of positive stimuli, of work and education, of day-to-day interaction, and of information.

This study highlights the dramatic reduction in opportunities for prisoners to rehabilitate themselves and build productive and meaningful lives. A decline in the emotional, psychological and physical well-being of the prisoners as well as resignation with their situation can be expected due to the lack in purpose. There is a need to improve the information and communication and support them with continuous psychological care, especially when prison services are confronted with additional health or other crises.

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Maintaining a good sleep-wake cycle is an important factor for the prognosis and management of bipolar disorder. However, studies on the to various technological advances including smartphoe usage affecting inter-episodic sleep quality are yet relatively less thoroughly investigated.

This study aims to identify the association between smartphone usage and inter-episodic sleep quality of bipolar patients.

A total 52 Bipolar I or II subjects who were euthymic for at lest 6 months were included in this analysis. Pearson correlation analysis was used to examine the association among psychological assessments, including the Pittsburgh Sleep Quality Index (PSQI-K), Smartphone Addiction Scale (SAS), Hamilton Depression Rating Scale (K-HDRS), Young Mania Rating Scale (K-YMRS), and Multidimensional Scale of Perceived Social Support (MDPSS). Significant results were then analyzed using a multiple linear regression analysis with PSQI-K as the dependent variable to assess the impact of clinical variables on sleep quality.

PSQI-K was positively correlated with SAS (r = 0.457, p < 0.001), K-HDRS (r = 0.447, p < 0.001), and negatively correlated with MDPSS (r = -0.336, p < 0.05). Smartphone use, depressive symptoms, and perceived social support seemed to explain 35.7% of sleep quality. After adjusting for confounders, more smartphone use and more severe depressive symptoms were associated with poor sleep quality (SAS: β = 0.383, p = 0.002; K-HDRS: β = 0.339, p = 0.006), but perceived social support did not reach statistical significance (MDPSS: β = -0.204, p = 0.086).

The results of this study show that the more a person uses a smartphone, the worse their sleep is. This effect is significant, even when other factors are taken into account. These results support the possibility that improving the degree of smartphone use could be an essential intervention target for improving sleep quality during the inter-episode period in patients with bipolar disorder.

None Declared

There is growing evidence on the existence and the clinical usefulness of the recently described Suicide-Specific Syndromes (SSS), such as the Acute Suicidal Affective Disturbance (ASAD) and the Suicidal Crisis Syndrome (SCS). Many researchers and clinicians agree that Suicide-Specific Syndromes, as a distinct diagnostic category should be included in the major diagnostic and classification systems, such as the Diagnostic and Statistical Manual of Mental Disorder (DSM) or the International Classification of Diseases (ICD). In addition to their novelty in symptomatic and nosologic classification, the recently developed Acute Suicidal Affective Disturbance Inventory (ASADI) and the Suicidal Crisis Inventory (SCI) also provide an opportunity to objectively measure the current suicidal emotional and mental state by validated tools.

To assess the clinical usefulness of the ASADI and the SCI compared to each other and to traditional suicide risk assessment tools based on classical suicide risk factors.

A self-administered questionnaire battery and a semi-structured interview were completed with 100 psychiatric inpatients consecutively treated with depressive disorders and/or suicidal behaviour in a university clinic in 2021. Besides the ASADI and the SCI, the self-administered battery included depression screening tools, such as the Beck Depression Inventory - Short Form (BDI-SF) and the Patient Health Questionnaire - 9 items (PHQ-9). Traditional suicide risk factors were assessed by clinical judgement and with the Brief Suicide Questionnaire (BSQ).

According to our preliminary results, the ASADI and the SCI recognize Suicide-Specific Syndromes as distinct diagnostic entities. Furthermore, ASADI and SCI detect suicidal behaviour as effectively as traditional suicide risk assessment tools, and may be more effective in assessing imminent suicide risk. There were no significant differences in detecting suicidal behaviour and in assessing suicide risk between the ASADI and the SCI.

Suicide-Specific Syndromes (ASAD, SCS) use well-defined diagnostic criteria for suicidal behaviour. The recently developed different tools for assessing Suicide-Specific Syndromes, such as the ASADI and the SCI may be helpful tools for the clinicians to assess suicidal behaviour and imminent suicide risk in their clinical practice.

None Declared

Presently, the concept of preparing youth for the labor market in the 21st century receives much attention because of the rapidly changing nature of work and the soft skills and hard skills required by employers. Therefore, graduates need to be competent at work skills necessary for the 21st century to be able to face challenges of work in the present age and to have new perspectives for facing challenges and changes of work. According to the Federation of Thai Industries, the estimated number of workers needed by 14 groups of manufacturing industries during 2013-2017 included 58 percent of high school graduates.

The current study aims to survey and assess essential skills development in high school students in Southern Thailand for the workforce in the 21st century.

The cross-sectional study was applied to 1,200 subjects consisting of 400 employers and 800 high school students. Data was analysed using means, standard deviation and t-test

The results revealed that communication, digital literacy, creativity, critical thinking, collaboration, and responsibility were the major skills development needs of high school students in the 21st century labor market. The results indicated that high school students’ levels of skills were lower than those required by employers in four skills: communication, digital literacy, critical thinking, and creativity at the statistical significant level of .001, as presented in table 1.Table 1.Means different for skills development need by sample group.

The high school students possess skills needs for work in the 21st century at lower levels than those needed by employers. This is the issue requiring attention from individuals involved in educational management as they must find ways to develop the teaching and learning methods that can upgrade students’ skills that are needed for work and seen by employers as highly important. These skills are communication, digital literacy, critical thinking, and creativity. The teaching and learning styles should be more active rather than passive to stimulate students to think, to be proactive instead of passively to respond to whatever happens, to propose their ideas or to express differing opinions and using the appropriate language or communicating tools. The fact that these skills are at a moderate level could result in limitations for young people’s development or employment as these skills are required for work in this century where analytical thinking and creativity are necessary for invention both in the workplace and in private life.

None Declared

Acute and transitory psychotic disorders comprise a polymorphous picture such as Leonhard’s cycloid psychoses, which alternate episodes of affective symptoms such as psychosis between two poles (anguish/happiness, incoherence/stupor, or akinesia/hyperkinesia).

To describe a case report of a 20-year-old man, in outpatient psychiatric follow-up, after debuting at age 18 with a severe depressive episode of endogenomorphic characteristics without psychotic symptoms, with subsequent complete remission. Two years after clinical stability, he required prolonged hospitalization due to polymorphous psychotic syndrome of abrupt onset in a context of previous continuous use of cannabis and cocaine. Suspicion towards parents, bizarre behaviors, rushing desires, unmotivated laughter, fixed gaze, bewilderment, anguish with a feeling of imminent death, alternates with euphoria and senseless purchases.

We present the case report of this patient with a mental examination of conscious, scattered attention with marked distractibility, confusion and experiences of strangeness, memory gaps, subjective sensation of well-being with tachypsychia, which fluctuates with thymic oscillations and alternates with episodes of marked indefinite anguish, intense anxiety with delusional fear of the death of him or his family. Little systematized ideas of reference and prejudice based on intuitions or delusional occurrences in their environment. Megalomaniac and religious-messianic ideation. No sensory perception disturbances. Disintegrated course of thought, with frequent illogical associations, ambivalence of thought, affectivity and psychomotricity. Motor restlessness and behavioral disorganization. Global insomnia. Judgment of reality and superior functions diminished. No auto/heteroaggressiveness.

Various psychoactive drugs were tested for two months, obtaining a response only with valproic acid 1500mg, pregabalin 450mg and olanzapine 15mg, presenting slow improvement in a situation of absence of consumption, with a predominance of symptomatic polymorphism, decreasing fluctuation between episodes of expansiveness and psychotic anguish, remitting disorganization and motility alterations, persisting poor awareness of the disease and cognitive complaints. He was referred for follow-up at the mental health center where his gradual recovery continued.

A differential diagnosis of polymorphous psychosis is proposed, compatible with a cycloid psychosis of the anxiety-happiness type with marked affective symptoms, precipitated by substance use.

Cycloid anxiety-happiness psychosis stands out for intense and fluctuating anxiety, oscillating with feelings of happiness, ecstasy, and placidity, mystical-religious delusions, and preoccupation with death, which may comprise a different psychotic debut.

None Declared

Climate change is increasing the frequency of extreme weather events – such as heatwaves, droughts, floods, and wildfires – and undermining the mental health and wellbeing of global populations, but the dimensions and scope of this burden remain under-studied.

To identify the distinct but overlapping mental health domains that are being impacted by climate change-related stressors and how these domains relate to and interact with one another.

A narrative synthesis of conceptual and empirical studies of climate change and mental health.

We find strong empirical evidence that climate change is already harming mental health across multiple mental health domains, including through increased rates of psychiatric disorders (e.g., PTSD, depression, anxiety), sub-clinical psychological distress, harmful substance use, self-harm/suicidal behaviors, and worry about the observed and anticipated impacts of climate change. Most of the mental health burden is likely to occur in the form of sub-clinical symptoms, including lowered resilience and subjective well-being, while negative psychological states (e.g., eco-anxiety) are likely to constitute a smaller proportion of the overall burden. We argue that the mental health burden can be helpfully conceptualised within a dual-continuum model that considers the presence/absence of psychiatric diagnosis on the one hand, and high/low psychosocial wellbeing on the other.

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Climate change is already harming the mental health of global populations across multiple functional domains. Defining and tracking the scope of this growing burden is essential so that effective preventive and adaptive action can be taken.

None Declared

During the COVID-19 pandemic, the need to adapt to rapidly changing external conditions has increased dramatically. Predictors of successful adaptation can be the degree of development of individual self-regulation and its profile. The emotional state depends on successful adaptation.

The study aimed to examine the individual self-regulation of behaviour and emotional reactions among patients living with HIV in Russia.

The data were collected from February to July 2021 using a Google form developed by us. Fifty-nine HIV-positive patients participated in the study. To diagnose the development of individual self-regulation and its profile, we used the Self-Regulation Style Questionnaire, to study depression, anxiety, and stress — DASS-21 adapted for use in Russia.

We found that 10 % of respondents had a low overall level of self-regulation, 53 % had an average level, and 37 % had a high level. The average individual profile was as follows: predominance of planning (M = 6.24±1.90) over modelling (M = 5.69±1.90), programming (M = 5.93±1.66), and evaluating results (M = 5.78±1.60), which were approximately at the same level. Flexibility (M = 6.58±1.90) and autonomy (M = 5.56±2.08) scores were in the average normal range. Only two correlations were found: modelling was negatively associated with depression (rxy = -0.336, p < 0.01) and anxiety (rxy = -0.275, p < 0.05).

Awareness and adequacy of perceptions of changes in external and internal significant conditions contribute to a favourable emotional status among people living with HIV.

None Declared

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by the deficit in communication and social interaction as well as restricted and repetitive interests and behaviors. In addition to the involvement of the environmental component in ASD, it is currently established the significant contribution of genetic factors such us the 16p13.11 duplication. We report the case of a patient carrying this anomaly in whom an ASD was diagnosed, the genetic study of the parents objectified the same anomaly in a clinically healthy father.

This case report aims to expand the clinical findings associated to this genomic abnormality and provide further knowledge of the pathogenic involvement of this duplication.

Our patient, aged 4 years and 10 months, presented developmental peculiarities from birth. The difficulties became more evident with the language delay, the deficit of social interactions and the appearance of motor stereotypies as well as sensory specificities. The diagnosis of ASD was confirmed by the passation of the ADI and the ADOS.

Further genetic exploration with a CGH-Array request was performed due to a normal 46 XY karyotype. She objectified a 16p13.11 duplication comprising 25 genes including NDE1. The assessment was completed by the search for potentially associated malformations, particularly cardiac and skeletal. We continued the family investigation with genetic samples for the parents and the siblings finding the same anomaly in the father who does not present any particular phenotype.

The 16p13.11 duplication is associated with a variable clinical spectrum including behavioral disorders, attention deficit/ hyperactivity disorder, intellectual disability, cardiac and skeletal malformation, epilepsy as well as ASD and language delay presented by our patient. Eight annotated genes are present in this region including NDE1, the candidate gene for the neurocognitive phenotype. This microduplication can be found in the normal population, but it is increasingly detected in patients with ASD, schizophrenia or presenting cognitive disorders due to incomplete penetrance that can explain the presence of the duplication despite the absence of any disorders in the patient’s father.

The link between the 16p13.11 duplication and ASD is increasingly recognized in the literature. The heterogeneity of its clinical expression and especially its incomplete penetrating make genetic counseling difficult. Collaboration between child psychiatrists and geneticists remains essential to detect, link their clinical evaluation and optimize care.

None Declared

Autism spectrum disorder is a neurodevelopmental disorder characterized by persistent deficit in communication and social interaction associated with repetitive, restricted interests, behaviors or activities. Regardless long-term care, sequelae may remain present particularly in cognitive patterns, social interactions and adaptive reactions, leading to personality disorder in adulthood.

In this study we aimed to explore personnality disorder comorbid with autism spectrum disorder .

Our study was based on the PubMed interface and adapted for 2 databases: Science Direct and Google Scholar using the following combination ( autism spectrum disorder [MeSH terms]) AND (personality disorder [MeSH terms]) covering the period from 2013 to 2022.

We initially reviewed 13 articles. At the end of the literature selection process, two articles were included.

The prevalence of personality disorders with ASD was estimated around 35%.

The personality disorders evoked mainly responded to cluster C associating an obsessive-compulsive and avoidant personality in respectively 32% and 25%.

Cluster A personality disorders, in particular schizoid personality, were found in 21% with a female.

Concerning cluster B, borderline personality disorder was the most frequent because of different symptoms overlapping . In fact, the prevalence of borderline personality disorder in ASD was 4% . Meanwhile the prevalence of ASD in borderline personality disorder was 3%.

Apart from other neurodevelopmental pathologies, ASD can be comorbid with personality disorder. However, the neurocognitive particularities of ASD reveal clinical manifestations similar to those found in personality disorders. Therefore, additional research using large sample sizes and validated diagnostic tools taking into account the specificities of this population remain necessary.

None Declared

Caring for individuals with intellectual disabilities is a passionate, but challenging profession. Whether working in residential homes or in occupational facilities, its staff deals with the ordinary issues of teamwork, but also with these clients behavioral comorbidities. It often includes self-harming and aggression towards others – namely towards the staff itself. This is particularly relevant since a high turnover of staff implies the loss of people who are familiar with the needs and specificities of those clients. The quality of care provided may also be affected.

To investigate whether, or not, formal caregivers are at greater risk of occupational health issues, and what their main determinants are.

Research in Medline for intellectual disability caregivers. Only the relevant articles, published in English, were considered.

Among formal caregivers of people with intellectual disabilities, job dissatisfaction and job strain were found to be especially relevant and were associated to the following variables:

• Younger workers or those with less professional experience

• Personality and individual maladaptive coping strategies

• Poor organizational support

• Conflicting, ambiguous, or overloaded professional roles

• Unclear work tasks

The incidence of Burnout Syndrome was also described as relevant among these workers and was associated not only to aggression towards the worker, but also to the fear of aggression.

Caring for people with intellectual disabilities, in a residential or in an occupational context, implies heavy emotional and physical demands and a high prevalence of job dissatisfaction, Job Strain and Burnout Syndrome. In addition to the high risks to the quality of life and health of caregivers, there are consequences for the quality of the care that is provided. For this reason, guaranteeing proper work conditions should be considered part of the Social Institutions main goals. Yet, we lack specific, controlled studies that properly evaluate what measures could indeed help institutions to prevent occupational (and mental) health distress among their staff.

None Declared

Autoimmunity mechanisms involve many cells that produce inflammatory cytokines which damage different organs, like the brain. There is a relationship between neuropsychiatric diseases, such as psychosis, and autoimmune diseases. In this article we try to demonstrate that treating autoimmune diseases appropriately improves clinical evolution of patients with a first psychotic episode.

The purpose of this article is to emphasize the importance of a multidisciplinary approach to a first psychotic episode. It is very important to perform autoimmunity tests to rule out secondary psychoses, even more so if the patient does not respond correctly to treatment with antipsychotics, to improve his/her prognosis and quality of life.

We performed a literature search of PubMed database using the following MeSH terms: “Autoimmune Diseases” and “Psychotic Disorders”. 134 studies were published between 2017-2022. We selected the original papers that analyzed the association between autoimmune diseases and first psychotic episodes. Finally, 18 were selected.

In secondary psychoses, early diagnosis and treatment of the underlying pathology can lead to rapid improvement.

A multidisciplinary approach is necessary from the first moment that a FPE is diagnosed, even more so in middle-aged women.

None Declared

Patients with autism spectrum disorder are characterized by high anxiety when facing social situations and dealing with interpersonal relationships on a daily basis. Although initially because of their rigid personality with the norm, and their tendency to social distancing, we do not have in mind this pathology as the most likely to develop a substance use disorder. However, it is observed in the literature a remarkable percentage of patients who resort to consumption, mainly alcohol, as an anxiolytic to be able to interact in society.

To show the case of a 19-year-old adult with a diagnosis of ASD who resorts to alcohol consumption in her daily life as a strategy to manage anxiety in social situations.

Case report and literatura review

This is a 19-year-old woman with a recent diagnosis of ASD. She is studying biotechnology and lives with her parents and 3 siblings. The patient reports difficulty in social relationships since early childhood, with experiences of school bullying. She expresses desire to relate with others, although she does it in an inadequate way, with difficulty in detecting nonverbal language, irony and anger when she does not understand a joke. The patient confesses that since she was 16 years old she has consumed alcohol to mitigate the anxiety caused by facing a group of people. She says that she feels that it relaxes her and facilitates interaction, making it more fluid and less tense. However, she recognizes that initially she used to drink 1 or 2 beers, but now she needs to drink up to 2 glasses of gin, recognizing this as something problematic.

The literature shows how patients with ASD can also present substance use disorder. It has been shown that about 10% of these patients have an abusive use of alcohol. Other samples show wider ranges (7-71%) of prevalence of alcohol consumption in patients with autism. In relation to cannabis, it is seen that around 3% of these patients consume it. These patients seek its anxiolytic effect and to reduce mental health symptoms. In addition, the purchase of alcohol does not involve high social interaction to obtain it, since it is a substance that can be purchased legally. It is important to explore alcohol consumption in consultation with patients with ASD to help them develop more functional anxiety management strategies.

Prevalence of psychiatric disorders in adults with autism spectrum disorder: A systematic review and meta-analysis. Lugo-Marín.J et al. 2019. Research in Autism Spectrum Disorders Volume 59, March 2019, Pages 22-33

None Declared

The majority of people with cardiovascular disorder meets the criteria of type D personality. Its prevalence, however, favours experiencing negative emotions and avoiding social connections [Kupper et al. Int J Cardiol. 2013;166(2) 327-33]. Cardiovascular disorders’ steady morbidity growth entitles to search for the factors, which have an impact on functioning, acceptance of the disorder and obeying doctor’s orders among patients with this diagnosis [Leu et al. J Formos Med Assoc. 2019;118(3) 721-729]. One of the factors, which largely determines mental efficiency, except for anxiety and depression symptoms, is cognitive functioning [Burkauskas et al. Cogn Behav Neurol.2016;29(2)91-9, Schiffer et al. Eur J Heart Fail. 2008;10(8) 802-10].

Evaluation of cognitive functioning, acceptance of the disorder, intensifying of anxiety and depression symptoms among people who suffer from cardiovascular diseases with type D personality and seeking for relationships between those parameters.

102 people took part in the study, including 63 men and 39 women, the average age amounting to 65,471 (SD±10,567). Patients were divided according to the presence of type D personality, gender and cardiological diagnoses. The DS-14 scale was used to assess the type D personality, the HADS scale to assess the symptoms of anxiety and depression, and also the AIS scale to assess the acceptance of the disease and MoCA 7.2 scale for cognitive functions. The original questionnaire was used to collect the necessary sociodemographic data, data on the type and course of the main disease, comorbidities and medications taken.

About 37% of respondents meet the criteria of type D personality. The AIS scores correlate negatively with age, disease duration, and with both components of the DS-14 scale (negative emotions-Ne and social inhibition-Hs). Both DS-14 subscales correlate positively with HADS-A and HADS-D, and the DS-14 (Ne) subscale is also positively associated with age. The results of the MoCA scale negatively correlate with age and duration of the disease. People without personality traits of type D have higher AIS scores, lower HADS-A (fig.1) and HADS-D scores (fig.2), and higher MoCA scores (fig.3) than those with type D personality. There were no differences between patients with ischemic heart disease and patients with ischemic heart disease and heart failure. In the subscale of social inhibition DS-14 (Hs), women obtained a higher result.

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1. People with D personality are more difficult to accept their illness, they are characterized by a higher level of depression and anxiety, and weaker cognitive functions.

2. Women are characterized by stronger social inhibition.

3. Younger people with a shorter medical history accept the disease more easily.

4. Heart failure is not a factor differentiating the studied group of patients.

None Declared

Although the role of pituitary gland in schizophrenia and psychotic disorders has been studied for decades, evidence on anterior pituitary hormones in the early phases of psychoses – without the influence of chronicity, comorbidities, and pharmacological treatment – is mostly unclear and inconsistent.

Our systematic review and meta-analysis was aimed at comparing the blood concentrations of adrenocorticotropic hormone (ACTH), follicle stimulating and luteinizing hormones (FSH and LH), growth hormone (GH), prolactin (PRL), and thyroid-stimulating hormone (TSH) between people with drug-naïve first-episode psychosis (FEP) and healthy controls.

We searched main electronic databases for articles indexed up to September 2022. We appraised the quality of data. We carried out random-effects meta-analyses, generating pooled standardized mean differences (SMDs) and estimating between-study heterogeneity. Moreover, we performed sensitivity and meta-regression analyses.

Twenty-six studies were included. People with drug-naïve FEP had higher ACTH (p<0.001; moderate-to-high heterogeneity) and PRL (p<0.001; high heterogeneity) concentrations, as well as lower TSH concentrations (p=0.001; low heterogeneity), than healthy subjects. Sensitivity analyses confirmed these findings. Data were not sufficient to perform meta-analyses on other hormones (FSH, LH, and GH).

People with drug-naïve FEP have abnormal ACTH, PRL, and TSH blood concentrations, supporting the hypothesis that anterior pituitary hormone secretion is altered in the first stages of schizophrenia and psychoses. Additional research is needed to clarify the complex interconnections between vulnerability, environmental factors, and pituitary hormones in FEP.

None Declared

Borderline personality disorder (BPD) is a severe mental disorder characterized by affective, behavioral and relational instability, along with interpersonal hypersensitivity and unstable affective relationships (APA 2013). Poor interpersonal functioning could be associated with critical deficits in the ability to mentalize in these patients, together with high levels of impulsivity. Although most studies have described hypermentalization deficits among BPD patients (Bora Psychol Med 2021;51 2541-2551), existing literature is still scarce on this aspect, as well as its relationship with the impulsive behavior.

1) to assess specific mentalizing deficits in BPD compared to healthy controls in a complex ecological mentalization task; 2) evaluate the relationship between mentalization and impulsivity in BPD.

63 patients diagnosed with borderline personality disorder and 31 control subjects were studied using the Movie for the Assessment of Social Cognition -MASC- (Dziobeck et al. J Autism Dev Disord 2006; 36 623-636) and the Barratt Impulsivity Scale -BIS-11- (Patton et al. J Clin Psychol 1995; 51 768-774), as well as other sociodemographic and clinical factors. The clinical research study was approved by the Clinical Research Ethics Committee of the Hospital Clínico San Carlos (Madrid, Spain).

The results showed significant differences in the scores related to correct mentalization, hypomentalization, and non-mentalizing responses between patients and controls, with BPD patients showing worse performance. A significant negative relationship was also observed between impulsivity scores and correct mentalizing responses in BPD patients.

The results showed a deficit in the ability to mentalize in BPD patients, compared to control subjects, characterized by a hypomentalization and an absence of mentalization. Likewise, this deficit in mentalization ability was related to greater impulsive behavior in patients. These results would be consistent with the hyperarousal hypothesis in BPD, which would reduce inhibitory control, causing mentalization deficits (Euler et al. J Pers Disord. 2021; 35 177-193). Future studies will try to associate specific impulsive behaviors associated with the characteristics of hypomentalization and absence of mentalization observed in our results.

None Declared

Attention Deficit Hyperactivity Disorder (ADHD) is characterized by a persistent pattern of inattention, hyperactivity, and impulsivity, which begins in childhood and often persists into adulthood. ADHD has a heterogeneous expression with diversity in behavioral symptoms, cognitive deficits, and comorbidities. So, it is possible to consider it a spectrum with different losses.

To describe clusters of multiple neuropsychological, attentional, and behavioral measures in adults with symptoms of ADHD. It could help to seek new directions to examine heterogeneity from a dimensional approach to ADHD.

120 adults between 18 and 52 years old (m= 29.5) with ADHD symptoms participated in this study. Performance indices on computerized neuropsychological tests of attention (voluntary, automatic, temporal, and sustained), behavioral self-report scales for ADHD (ASRS-18), impulsivity (BIS-11) executive dysfunction (BDEFS), and functionality, emotional and behavioral problems (Adult Self-Report - ASR of ASEBA) were analyzed. Cluster analysis processed the data to find subgroups based on the scores of instruments. The NbClust tested the best number of clusters that converge to a solution.

The 3 clusters solution was obtained by comparing Z scores for each indicator. In cluster 1, the ADHD symptoms were equivalent but expressed more hyperactivity than in other clusters. Also, higher levels of functional impairments and executive dysfunctions (motivation, emotional regulation, and anxiety/depression) were identified. In the attentional neuropsychological tasks, the indices express a lower level. Cluster 2 expressed a higher level of inattention and attentional, motor, and non-planning impulsivity, and functional impairments in the academic, professional, and legal risk areas. Cluster 3 was the subgroup with the lowest level of symptoms of ADHD.

This study identified differences in performances that contribute to understanding the cognitive, behavioral, and emotional expressions of ADHD. Three groups of different prejudices levels should be considered in the development of evaluative models in new studies to consider the spectrum of ADHD.

Financial support: FAPESP [grant 2019/20757-5, 2019/21773-4, 2020/14800-2]; CAPES Proex [grant 0426/2021, 23038.006837/2021-73]; Mackpesquisa; CNPq [grant 307443/2019-1]

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The COVID-19 pandemic has caused immense psychosocial strain worldwide. Excessive use of the internet during these psychologically trying times, fueled by physical isolation as a result of lockdowns, translated into dysfunctional behaviors. A growing body of evidence suggests an unprecedented increase in internet use and consumption of online pornography during the pandemic, and possibly even directly caused by it. This presentation will focus on the the statistics, variations in diagnostic criteria, clinical presentations and interventions for problematic online pornography use. Practical solutions will be offered to show how foresightedness with utilizing existing tools and therapies and exercising appropriate amounts of caution could go a long way in addressing the challenges that lie ahead in the post-pandemic era.

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