Severe mental disorders experience premature mortality mostly from physical causes. When a patient with a history of bipolar disorder is admitted to the emergency room (ER) for psychiatric symptoms, these are routinely interpreted as a psychiatric disturbance. However, a careful history should be performed to correctly interpret key clinical information to rule out somatic etiology and establish adequate diagnosis.

To describe a patient whose presenting symptoms were misdiagnosed as psychiatric relapse, rather than serious somatic comorbidity debut.

A 70-year-old man, with a history of type I bipolar disorder and multiple cardiovascular conditions, was admitted to the ER for self-referred nervousness, depressed mood, insomnia, and suicidal thoughts. Symptoms had greatly worsened the previous week to his consultation with paroxysmal episodes of severe anxiety, feelings of strangeness, and sensations of unpleasant odors.

During observation, the patient was found lying down with loss of consciousness, urinary incontinence, and amnesia of the event. Generalized tonic-clonic seizures were observed by neurologists while mental status examination was being performed. After symptoms were oriented as having a neurological etiology, the patient suffered cardiac arrest and defibrillation was required. After admittance to the intensive care unit and inpatient cardiology care, the patient was discharged from the hospital with the diagnosis of ventricular fibrillation due to drug-induced QT prolongation. There was no evidence of mixed depression or seizures once the cardiac dysfunction was identified and treated.

The psychiatric symptoms were the clinical manifestation of a generalized seizure-like activities that were attributed to transient cerebral hypoperfusion secondary to ventricular fibrillation.

No significant relationships.

Wissam El-Hage reports personal fees from Air Liquide, EISAI, Janssen, Lundbeck, Otsuka, UCB and Chugai.

Bipolar disorder (BD) is characterized by episodic changes in affect, motivation, cognition and behavior. This severe mental disorder has a prevalence of at least 1% and a high heritability of 60%-80%. The pathophysiology is still poorly understood but evidence indicate that the disorder relates to disturbances in front-limbic networks relevant for emotion processing and regulation. New techniques have been used to study BD and showed aberrante white matter (WM) microstructure in the corpus callosum and from-limbic pathways. However, lithium, a mood stabilizier, it looks like has celular and neuromodulatory effects.

The authors elaborate a narrative literature review to identify the existing clinical evidence of lithium’s effect on the WM from BD patients.

Pubmed databased searched using the therms “bipolar disorder”, “white matter” and “lithium”.

Lithium is a bipolar medication that confers treatment and long-term prophylaxis and been reported as having neuroprotective effects.

Studies that used new techniques such diffusion tensor imaging measures to assess white matter integrity reported a positive effect of lithium on the integrity of WM of BD patients and suggest that response to lithium treatment in BD patients is associated with normalization of WM microstructure in regions associated with emotion processing.

Lithium appears to positively influence the evolution of the white matter abnormalities described in BD patients however further investigation is required to strongly reinforce this potential and safety.

No significant relationships.

Cardiorespiratory fitness (CRF) can be directly measured and assessed by the cardiopulmonary exercise test (CPET) or estimated from different field tests as the Modified Shuttle Walking Test (MSWT). The CRF in schizophrenia (SP) population may be altered due to sex, age, body composition and core symptoms variables. However, the extent to which each domain influences CRF in this pathology is still unknown.

To analyze the predictive value of body composition and core symptoms in SP for CRF.

Participants (N = 144, 41.7 ± 10.3 yr old) with SP were assessed with (1) body mass index and fat percentage; (2) upright bicycle ergometer using an incremental ramp protocol and the MSWT; and (3) positive and negative symptoms of the disease [“Positive and Negative Syndrome Scale” (PANSS) and “The Brief Negative Symptom Scale” (BNSS)]. In the Stepwise Multiple Regression analyses, those variables which correlated (Spearman’s Rho) significantly with each CFR scores were included

Lower negative symptoms (P<0.001) and positive PANSS (P=0.035) predicted V̇O2peak (L·min−1) (R2=28.3%). Lower negative symptoms (P<0.001), positive PANSS (P=0.006) and fat body mass (P<0.001) explained V̇O2peak (mL·kg−1·min−1) (R2=46.5%). MSWT was predicted (R2=58.9%) by lower negative symptoms (P=0.001), body mass (P<0.001) and total PANSS (P=0.004).

In patients with SP significantly higher CRF was detected in those with lower negative and positive symptoms, as well as lower body mass. Exercise interventions for improving CRF should be promoting in this population for a better control of core symptoms.

No significant relationships.

Major depressive disorder (MDD) often involves immune dysregulation with high peripheral levels of pro-inflammatory cytokines that might have an impact on the clinical course and treatment response. Moreover, MDD patients show brain volume changes and white matter (WM) alterations that are already existing in the early stage of illness.

The aim of the present review is to elucidate the association between inflammation and WM integrity and its impact on the pathophysiology and progression of MDD as well as the role of possible novel biomarkers of treatment response to improve MDD prevention and treatment strategies.

We conducted an electronic literature search of PubMed on studies that examined the role of inflammation in depression and that focused on WM integrity and pro-inflammatory cytokines as predictors of antidepressant response.

There is evidence for central effects of peripheral inflammation which could activate microglia which, in turn, might trigger a cascade of inflammatory processes leading to neurotransmitter imbalances. Numerous studies indicated that both altered levels of peripheral inflammatory markers, particularly TNF-α, IL-6, and CRP as well as WM integrity might predict antidepressant treatment outcome.

Despite mounting evidence on the impact of the immune system on WM microstructure, no study has yet addressed the interaction between the two factors in influencing antidepressant response. There is a lack of reproducible biomarkers predicting treatment response on an individual basis. The availability of such biomarkers would enable more efficient and personalized treatments with a faster treatment response and better prevention of treatment resistance.

No significant relationships.

No significant relationships.

No significant relationships.

This study revolves around self-esteem which is defined as a basic human characteristic related to self-awareness, emotions, cognitions, behavior, lifestyle, general health and socio-economic factors. This fundamental data of the personality is revealed from one person to another as well as from one period to another. Many studies point out that advancing adults do not necessarily imply a decline in sense of self-worth, although skill losses are very real in many areas of psychological activity. Therefore, it seemed interesting to us to further explore this point in Moroccan women.

Evaluate and compare self-esteem among different age groups of Moroccan women. Identify the different influencing factors.

This is a descriptive cross-sectional study using a questionnaire based on tow parts, the first based Rosenberg scale, and the second part to identify the presence of certain factors influencing self-esteem.

Our researches have shown a similar results to those of some previous studies. Indeed, we found out that women experience a significant rise of self-esteem simultaneously with the increase of age. Yet, this self-esteem starts to decline in middle-aged women. Several factors can affect it; we can note on the top, the impact of relationships, education and physical health.

This research contributes to our understanding of Moroccan women’s self-esteem and to the identification of factors that influence it.Self-esteem is a core identity issue, essential to personal validation and our ability to experience joy. Previous researchs also suggests that self-esteem might influence economic welfare and physical health.

No significant relationships.

Whether exist a potential association between schizophrenia spectrum disorders following past exposure to ionizing radiation and SARS CoV-2 infection is unknown.

To assess a possible role of double radiation-viral exposure in pre- and postnatal periods in schizophrenia spectrum disorders genesis.

Integration and analysis of information available with the results of own clinical and epidemiological studies.

The renaissance of interest to the viral hypothesis of schizophrenia is observing during the current COVID-19 pandemic. There is an increasing number of cases and case series reports on psychotic schizophreniform disorders following SARS CoV-2 infection diagnosed as COVID-19-asssociated brief psychotic disorder, first episode psychosis, acute and transient psychotic disorder. The prevalence rate of schizophrenia in A-bomb survivors in Nagasaki was very high – 6 % (Nakane and Ohta, 1986), and increased in those prenatally exposed to A-bombing (Imamura et al., 1995) and medical X-irradiation (Gross et al., 2018). We found a significant increase in the schizophrenia incidence in the Chornobyl exclusion zone personnel, as well as schizophreniform syndromes in Chornobyl clean-up workers (liquidators) irradiated by moderate to high doses (more than 0.30 Sv). The neural diathesis-stressor hypothesis of schizophrenia spectrum disorders was proposed (Loganovsky and Loganovskaja, 2000; Loganovsky et al., 2005). Recently we observed the clinical case of organic schizophrenia-like disorder in the liquidator who was ill with COVID-19.

The linkage between schizophrenia spectrum disorders following past exposure to ionizing radiation and SARS CoV-2 infection can exist that should be studied on the irradiated cohorts with following COVID-19.

No significant relationships.

Anxiety disorders are very common and burdensome mental illnesses worldwide, characterized by exagerated feelings of worry and fear. These disorders are highly comorbid with other conditions.

The aim of our study is to explore the physical and psychiatric comorbidities and their clinical correlates. The second objective is to identify the predictors of recurrence of anxiety disorders.

Our study concerned 436 outpatients who met DSM-V diagnostic criteria for anxiety disorders and were followed in the Department of Psychiatry of Monastir (Tunisia) between 1998 and 2017. Selective mutism and seperation anxiety were excluded for lack of cases.

Our results demonstrated that Generalized Anxiety Disorder (GAD) was significantly associated with cardiovascular comorbidity (OR=3.208). Social Anxiety Disorder (SAD) was significantly correlated to avoidant personality disorder (OR=17). Patients with suicide attempts are more likely to have a comorbid personality disorder (OR=11.606). Being married and having a later age of onset are predictors of having comorbid depressive disorder. Furthermore, being married, having an anxiety-anxiety comorbidity and a longer duration of untreated illness (DUI) are predictors of recurrence.

Our study highlights the fact that comorbidities (physical and psychopathological) call for a closer follow up due to the higher risk of recurrence, the higher risk of suicide attempts and the poorer treatment response.

No significant relationships.

The paper presents experiences in working with drug addicts in Ze-Do Canton after the outbreak of the COVID pandemic

The time frame in which the research was conducted was April 15, 2020 to April 15, 2021. Criteria for inclusion in the study were clinically and laboratory-proven dependence on psychoactive substances and participation in some of the types of treatment in our institution. Criteria for exclusion from the study due to population specificity were not defined

. The study was designed as a retrospective-prospective in which the following parameters were monitored: rate of retention in treatment, rate of relapse and overdose, deterioration of basic psychopathology, number of hospitalizations due to worsening addiction or comorbid psychopathology, suicide rate, incidence and prevalence of blood-borne hepatitis and HIV -a, incidence and prevalence of COVID in the addicted population and auto and hetero-destructive behavior of health care users.

The results of the study indicated an increased rate of abuse of substitution therapy, an increased rate of relapse, most often with stimulants, abuse of sedatives, antidepressants and anticholinergics, an increased rate of overdose but no deaths and an increased rate of hospitalization due to worsening basic psychopathology.

The study indicated a deterioration in the quality of health care of addicts to psychoactive substances caused by pandemic working conditions and a marked deterioration in basic psychopathology caused by social distancing and the impossibility of more frequent and direct contact with patients. continuous monitoring

No significant relationships.

No significant relationships.

Younger schoolchildren with psychological development disorders have low cognitive activity, insufficient development of basic school skills, and a low level of educational motivation. In accordance with the requirements of the educational program for students it is important to develop the ability to predict the results of their actions and deeds.

The study of predictive competence in primary schoolchildren with psychological development disorders.

The study involved 60 children aged 8-10 years with a psychological development disorder. To study predictive competence, the methodology “The ability to predict in situations of potential or real violation of social norms” was used.

The study revealed a low level of the cognitive and speech-communicative spheres of prognostic competence development in primary schoolchildren with psychological development disorders, as well as a deficit in prediction in the field of learning, which includes educational cooperation and educational communication of the child. Generalized statements, a passive position in future situations and pessimistic attitudes prevailed in the predictions of schoolchildren when constructing an image of the future. For schoolchildren the prognosis is presented by monosyllabic answers, with the observable poverty of speech utterances.

The features of prognostic competence revealed in the study make it possible to develop individual programs for the development of the prognostic abilities of schoolchildren with psychological development disorders, to teach how to predict the development of events in educational activities, to recognize the emotions of the participants in the events. This paper has been supported by the Kazan Federal University Strategic Academic Leadership Program.

No significant relationships.

The clinical and biological studies indicate the involvement of inflammation in the pathogenesis of endogenous mental disorders. The inflammation markers leukocyte elastase, α1-proteinase inhibitor, and autoantibodies to neuroantigens reflect the severity of the pathological process in the brain. Systemic endotoxemia is a pathological process caused by an excess of endotoxins in the systemic circulation, can be considered as one of the components of the inflammatory process in endogenous psychosis.

To evaluate the association between systemic inflammation markers and indicators of systemic endotoxemia in patients with endogenous psychosis.

The study included 25 patients aged 23-49 with endogenous psychoses (F20, F25) and 25 healthy people. The severity of symptoms was assessed using PANSS. We detected the activity of leukocyte elastase and a1-proteinase inhibitor, antibodies to neuroantigens, endotoxin (ET) concentration, and antibodies to endotoxin (aEТ) in serum.

In 24% of cases, an increase of inflammation markers activity, ET concentration, and aET deficiency were observed (p<0.05), which is an unfavorable factor that aggravates the clinical course of the disease. In 76% of cases, ET concentration remained within control values (p>0.05) but associated with different levels of aET, which is likely to be a consequence of previous endotoxin aggression. There were correlations between ET concentration and antibodies to neuroantigens S-100B and MBP. We also revealed the association between the activity of the inflammatory marker with the severity of clinical symptoms in patients.

Results suggest the relationship between systemic inflammation markers and indicators of systemic endotoxemia and their involvement in the pathogenesis of endogenous psychosis.

No significant relationships.

Lead as an industrial pollutant can be detected at all stages of the working and living environment. Lead, based on its properties, solubility and mobility, accumulates in the soil, so that the average concentrations of oil in the soil are between 15 and 25 mg/kg (Radojević at all., 1999). Due to increased human activity, the amount of copper in the air, soil and water has increased. Glutathione (GSH) is an essential cofactor of many enzymes, such as: formaldehyde dehydrogenase, glyoxalase, prostaglandin endoperoxide isomerase, dehydrochlorinase and others. GSH is a biological redox in the metabolism of erythrocytes, it also plays a role in the transport of amino acids. Reactive forms of oxygen cause oxidative biomolecules (lipids, proteins, DNA) (Freidovich, 1999; Massaad i Klann, 2010).

The aim of this research was to examine the protective role of supplements GSH in conditions of chronic intoxication with sublethal doses of lead acetate and copper II sulfate.

The preparation of biomaterials for testing and making homogenates of brain tissue of albino rats of Wistar strain was performed and the activity of acid and alkaline DNase was measured spectrophotometrically (Kocić i sar., 1998).

Lead otherwise “as soft Lewis acid” has a pronounced affinity for interaction with “soft bases” such as S-atoms of the thiol group in antioxidants, natural biomolecules and supplements in this case in glutathione.

It can be said that GSH is a desirable supplement and antioxidant in the detoxification of reactive oxygen species in rats exposed to lead poisoning.

No significant relationships.

Bipolar disorder can be a severe psychiatric disorder. The combined prevalence of bipolar I, bipolar II, and unspecified bipolar disorders according to DSM-IV is 1.8%. Mean age at first affective episode has been estimated to 20 years among out-patients in the United States (2).

We present the case of a 40-year-old patient, diagnosed with type I bipolar disorder. In her story, multiple admissions are recorded for both manic and depressive episodes. The patient showed a desire to be a mother and multiple therapeutic interventions were performed, de-escalation of stabilizers until she was withdrawn, which triggered generally manic episodes that required hospital admission.

Given the controversy in the decision to maintain or not drug treatment during pregnancy and the lack of clear criteria, in this case it was decided to try to gradually withdraw the treatment, which triggered several serious relapses. It was then decided to maintain the treatment at lower doses than usual or complete withdrawal, which in all cases precipitated relapses. Finally the patient reconsidered her wishes and abandoned the possibility of pregnancy.

Bipolar I Disorder

Although most studies have found similar lifetime prevalence rates of bipolar disorder between men and women, gender differences may be evident in the impact of reproductive life events on affected women. In addition to the controversy regarding the decision to maintain or not treatment during pregnancy, there is also the certainty that childbirth can be the specific trigger for a manic or hypomanic episode.

No significant relationships.

Electroconvulsive therapy (ECT) is proposed to exert an effect on white matter (WM) microstructure, but the limited power of previous studies made it difficult to highlight consistent patterns of change in diffusion metrics.

We initiated a multi-site mega-analysis and sought to address whether changes in WM microstructure occur following ECT.

To this end, diffusion tensor imaging (DTI) data (n=58) from 4 different sites were harmonized before pooling them by using ComBat, a batch-effect correction tool that removes inter-site technical variability, preserves inter-site biological variability and maximizes statistical power. Downstream statistical analyses aimed to quantify changes in Fractional anisotropy (FA), Mean Diffusivity (MD), Radial Diffusivity (RD) and Axial Diffusivity (AD), by employing whole-brain, tract-based spatial statistics (TBSS).

ECT increases FA in the right splenium of the corpus callosum and the left cortico-spinal tract. Both the left superior longitudinal fasciculus and the right inferior fronto-occipital fasciculus showed increases in AD. Increases in MD and RD could be observed in overlapping white matter structures of both hemispheres. Finally, responders showed significantly smaller FA values in the left forceps major and smaller AD values in the right uncinate fasciculus compared with non-responders.

This is the first and largest multi-site mega-analysis to demonstrate that ECT normalizes altered WM microstructure in important brain circuits that are implicated in the pathophysiology of depression. Furthermore, responders appear to present a more decreased WM integrity at baseline, which if replicated could serve as a biomarker for ECT response.

No significant relationships.

The appearance of inhibitory symptoms encompassed in what are known as negative symptoms is part of the usual symptoms of schizophrenia. Sometimes this inhibition reaches a significant severity, so it is essential to know its approach.

Case report and literature review regarding the treatment of resistant schizophrenia with a predominance of negative symptoms

We present the clinical case of a 28-year-old man diagnosed with schizophrenia at 23 years old, whose onset was characterized by delusional ideas of harm (poisoning) and delusions with a mystic-religious theme that lead him to reduce his intake until requiring a first admission for severe desnutrition. Subsequently, after two more admissions, the patient presents selective reduction in food intake, decrease in daily activity and apathy without positive symptoms.

Throughout the treatment, several lines of antipsychotic treatments have been tried at the maximum tolerated dose (haloperidol, oral paliperidone and depot, aripiprazole and clozapine up to a dose of 600 mg). Clozapine resistance required testing various augmentation strategies (Venlafaxine, Lamotrigine and Electroconvulsive therapy) with low results. Finally, to complement the treatment, the patient was transferred to a mid-stay unit where psychosocial treatment with a multidisciplinary approach was started. This has allowed more continuous follow-up and thus a partial improvement of the clinic.

Numerous studies describe numerous augmentation strategies for clozapine-resistant schizophrenia with negative symptoms. However, the results are still inconclusive, needing more research. Meanwhile, we want to highlight the importance of complementing the treatment with psychosocial approaches.

No significant relationships.

Post-traumatic stress disorder (PTSD), is a Mental Health condition due to a traumatic experience. There are four types of Gender Violence in Latin America: physical, sexual, psychological or patrimonial violence, when it occurs between intimate partners it is called intimate partner violence (IPV). PTSD is highly associated with IPV.

Determine the statistical index of IPV and PTSD in women and men in Guayaquil-Ecuador.

We carried out a descriptive cross-sectional study, the sample was collected at the Florida Prosecutor’s Office in Guayaquil-Ecuador by UCSG medical students in 2018. The sample was 239 individuals, 195 women, 44 men. Individuals were separated into groups by gender, marital status, children, age, habits and PTSD. We applied Beck test for Depression, Davidson and DSM-5 for PTSD.

In this study we observe a male population suffering from IPV. Complaints of IPV 195 women (81.59%), 44 men (18.41%). PTSD positive 159 women (81.96%), men 35 (18.04%). More prevalent in age ranges 25-34. PTSD with children 147 (76%) and without children 47 (24%).

Factors such as being a woman, having children and younger ages are linked in this study as predisposing to suffer from IPV and PTSD. We highlight a male population that reports suffering from IPV despite the lack of support, especially in Latin America. It is worth mentioning that the final consequence in many cases is femicide and homicide. Although IPV is serious and frequent, Medical professionals still do not focus on IPV diagnosis, therefore affected individuals don t receive support.

No significant relationships.

The pandemic of a new coronavirus infection can be considered as a long-term traumatic event. It is known that chronic stress is characterized by dynamics of emotional state caused by processes of adaptation and maladaptation.

Our study aimed to investigate the dynamics of depression, anxiety, and stress levels among Russian students during the COVID-19 pandemic.

Data were collected from May to July 2020 (the first pandemic wave) and from October 2020 to April 2021 (the second wave). A total of 170 non-medical university students participated in the study. We used the DASS-21 to determine levels of depression, anxiety, and stress.

We found that during the first wave of the pandemic, 57 % of students showed no symptoms of depression, 77 % had no symptoms of anxiety, and 76 % showed no signs of stress. In the second wave, 50 % of students showed no depression, 65 % no anxiety and 67 % no stress. Analysis of mean values showed that the second pandemic wave provoked higher levels of anxiety (M = 3.32±4.25 vs M = 4.71±4.71, p < 0.05) and stress (M = 6.50±4.50 vs M = 7.99±4.97, p < 0.05) .

The second wave of the new coronavirus pandemic provoked more severe emotional reactions among Russian students than the first. By these results we suggest that the duration of the pandemic harms the emotional state of the general population. Therefore, it is essential to develop and implement psychotherapeutic programs to restore the mental health of Russian citizens.

No significant relationships.