Pregnancy loss (PL) – by induced or spontaneous termination of pregnancy – is common, although its consequences on women’s mental health are often neglected in clinical practice.

To understand the existence of psychiatric morbidity in women, associated with PL, as well as related risk factors.

Non-systematic review of literature through search on PubMed/MEDLINE for publications up to 2021, following the terms ‘pregnancy loss’, ‘psychiatry disorder’, ‘depression’ and ‘anxiety’.

After a PL, anxiety is the most frequent symptomatology in 41% of women. Depression occurs in 22-36% of women in the first two weeks after PL, declining over time. Symptoms compatible with Post Traumatic Stress Disorder (PTSD) are found in 25% of women with PL in the first month. Women who meet criteria for PTSD are more likely to present criteria for Depressive Episode. Substance Use Disorder and Prolonged Grief Disorder are also reported, the latter having, as predictors, previous relational difficulties, poor social support and absence of descendants. Risk factors associated with significant psychopathology within PL are, for example, nulliparity, infertility, previous PL, longer gestation time, lower marital satisfaction, previous psychiatric illness, and history of abuse.

In clinical practice, the risk of psychopathology in women with PL should be considered. This population should be actively questioned about the presence of symptoms, as well as their persistence and impact, requiring timely and appropriate pharmacological and psychotherapeutic intervention. Perinatal Mental Health interventions show important gains in the overall health of women and their offspring.

No significant relationships.

Chemsex refers to the intentional consumption of specific substances, Gamma Hydroxybutyrate/Gamma Butyrolactone (GHB/GBL), Crystal Methamphetamine and/or Cocaine to facilitate or enhance the sexual experience. However, there was a plethora of associated problems ranging in severity to complex, life-threatening situations. Since its inception in 2014, The Club Drugs Clinic Ireland, the first outpatient-based clinic for GHB/GBL Detoxification in Ireland, had evolved to include managing problematic chemsex.

The Chemsex Working Group Ireland is a collaborative response from governmental and non-governmental agencies. Details of current medical and psychiatric management along with preliminary outcome findings on detoxification, relapse risk and associated factors will be presented.

Data collected include socio-demographic variables, gender and sexuality, detoxification setting, relapse history and attendance for counselling or aftercare. Descriptive analyses were conducted on referral counts, drug trends, success of first treatment episode, subsequent relapse rate, and uptake of counselling and aftercare.

There have been over 200 referrals to the Club Drugs Clinic Ireland. A number of predisposing and precipitating factors, contributed to the relapse rate (up to 70%) both in Ireland and internationally. The salutogenic, biopsychosocial-based model of addiction recovery produced the best outcomes. This integrated Dual Diagnosis Psychiatry, Sexual Health Medicine, Emergency Medicine and external services for a more comprehensive care.

The pattern of referrals reflects population trends in chemsex, despite the COVID-19 restrictions. While detoxification is largely successful, the high relapse rate highlights the challenge of maintaining abstinence. In order to competently address problematic chemsex, service coordination across various medical professions and ongoing monitoring of the substances consumed is quintessential.

No significant relationships.

Coronavirus disease 2019 (COVID-19) is the current world issue, with huge impact on mental health. More specifically,we expect that it will have a naocif effect on the pregnant women’s mental health and their well being, since they are more likely to be hospitalized and require more intensive care units admission than non-pregnant women.

The aim of this work was to evaluate the evolution of depression symptoms in the time of pandemic and their associated factors.

In the current work, we conducted a comparative in field cross-sectional study. We compared depressive scores and prevalences before and after the COVID-19 outbreak in Tunisia in pregnant women.The sampling period was outside the lockdown period to avoid quarantine bias. The sampling period was from September to October 2020.

showed a significantly higher prevalence of depressive symptoms in expecting mothers during the pandemic. Multivariate analysis showed that the pandemic multiplied by 3 the risk of severe depression symptoms. The impact of the COVID-19 period on depression was independent of sociodemographic and obstetric changes related to the pandemic.

These results highlighted the emergency of preparing strategies to avoid post-partum psychiatric disorders and to enable a healthy development of born. Screening the post-partum depression and assessing the mother-children early interactions should be considered in the up-coming births.

No significant relationships.

The main scientific task of the study is at the intersection of two fundamental areas of psychology - self-regulation of human mental states and management of educational activities. In the context of these problems, we study the self-regulation of states in academic activities.

The purpose of the study is to show the patterns of mental organization of the person that ensure the regulation of states.

The theoretical basis of the study is the system approach. The typical methods and techniques of self-regulation of states, as well as the influence of mental structures on students’ self-regulation have been studied. To solve the problems, standardized psychological tests have been used (23 methods, 303 indicators). The research involved 206 students.

We have revealed the features of the relationship between the quality of students’ subject training, regulatory abilities and mental states. It indicates that the effectiveness of students’ mental states self-regulation significantly affects the productivity of the semester exam. It has been established the properties of the personality providing high efficiency of self-regulation (adequacy, awareness, independence and assertiveness). Students with high self-regulation efficiency use a wide range of regulatory means.

The study of the influence of the mental structures on self-regulation and regulatory abilities of students confirmed the hypothesis that characteristics of mental organization play the central role in the regulation of psychological states. The research has been carried out with the financial support of the RFBR, project No. 19-29-07072.

No significant relationships.

No significant relationships.

Sexuality is one of the basic needs in human life and its positive effects for the wellbeing are undeniable. People with dementia, despite cognition and functioning impairments, still pursue intimacy as part of their expression of basic human instincts.

We aim to address the subject of sexuality among patients with dementia, emphasizing the physiological, environmental and legal barriers.

We conduct a non-systematic review of recent evidence on dementia and sexuality, using PubMed/Medline database.

People with dementia face several difficulties expressing their sexuality. First, they struggle with physiological barriers to enjoyment of sexuality, such as ageism, apathy and limited free mobility. Secondly, either at home or in long-term care facilities, privacy is usually abolished. For care facilities, the Sexuality Assessment Tool supports the normalization of sexuality and self-audit policies that promote resident rights for privacy and assistance. Moreover, expression of sexuality in elderly can be misinterpreted as disinhibition, leading to unnecessary use of psychotropics to cease these behaviors. Additionally, legal barriers regarding consent arise when a partner loses the ability to consent sexual activity, questioning agreement and mutual desire. The Lichtenberg and Strzepek Decision Tree for Capacity to Participate in Intimate Relationships can be helpful to address this issue.

Sexuality in older people remains neglected in clinical intervention. Besides the urgent need to deconstruct stereotypes, families and staff must be sensitized to understand the changes in expression and perception of sexuality among people with dementia, rather than being indifferent or medicate what can be perceived as disinhibited/distorted expressions of normal needs.

No significant relationships.

Despite its good results and tolerability in adults, electroconvulsive therapy (ECT) is barely administered in children and adolescents, with scarce evidence in these patients.

We aim to summarize the data available to give a clearer view of how children and adolescents might benefit from ECT.

We’ve done a bibliographic review in PubMed and Cochrane Library searching for articles that include the terms “electroconvulsive therapy” and “adolescents” and/or “children” and their variations.

Current evidence supports the use of ECT in various indications as mood disorders, schizophrenia spectrum disorders, catatonia, neuroleptic malignant syndrome and self-injurious behaviours associated with autism, Tourette’s syndrome or intellectual disability. The efficacy and safety it’s comparable to adults and there are no absolute contraindications. Side-effect profile it’s also similar to the general population, reporting as the most frequent adverse effects headache, generalized body aching, and nausea or vomiting.

ECT is an effective and safe treatment for severe mental disorders in children and adolescents.

No significant relationships.

Obsessive Compulsive Disorder (OCD) is a psychiatric disorder associated with suffering and disability. The serotoninergic system is implicated in the neurobiological processes of OCD and serotonin reuptake inhibitors (SRIs) are the first-line treatment. However, clinical improvement after starting SRIs can take long and patients may not fully recover. Meanwhile, recent data suggests that activation of 5-HT receptors may exert a therapeutic action in obsessional symptoms. Some psychedelics are strong 5-HT2 receptor agonists and there is a growing research interest as they can be a promising therapeutic approach to OCD.

We aim to provide an overview on the current evidence on the therapeutic potential of serotoninergic psychoactive substances in the treatment of OCD.

Non-systematic review. Literature search in the PubMed database using the terms psychedelics and obsessive-compulsive disorder.

Although research is currently limited to a few small studies, the ones conducted so far showed clinically meaningful acute reduction of OCD symptoms after treatment with serotoninergic psychoactive drugs, as well as possible longer-lasting benefits, particularly with psilocybin and lysergic acid diethylamide (LSD). Furthermore, substance-assisted psychotherapy with psychedelics has been showing promising results, being suitable for OCD treatment. It is important to add that, to date, studies have indicated relatively good tolerability to these drugs.

These promising early findings highlight the role of psychedelics in OCD treatment and the need for further research into efficacy, therapeutic mechanisms and safety, in order to determine whether these drugs may be worthy options for OCD treatment in the future.

No significant relationships.

Clozapine is an atypical antipsychotic, which has been shown to have superior efficacy in the remission of positive and negative symptoms in patients with treatment-resistant schizophrenia, compared to other antipsychotics. However, its benefits have been limited by the lethal adverse effects that this drug can cause, the most common, agranulocytosis. Other less serious and more common adverse effects are sedation, hypersalivation, hypo and hypertension, weight gain and urinary incontinence. It is estimated that approximately 1% of patients treated with Clozapine suffer from urinary incontinence. Data that varies from 0.3% to 42% in the articles reviewed, being undervalued in some of these for many reasons; it is stigmatizing and the patient is ashamed to express it.

The objective of this study is to assess the percentage of urinary incontinence in patients in treatment with clozapine, taking into account the presence or absence of this side effect as the main variable, and the diagnosis, gender and dose of clozapine as secondary variables.

A retrospective observational study was carried out in which 40 patients belonging to the Adult Mental Health area of the Nuestra Señora del Prado Hospital, were collected, all of them diagnosed with some type of psychotic disorder and undergoing treatment with Clozapine.

Of the total of patients studied, 25% presented urinary incontinence as an adverse effect, and of these, 60% were with doses equal to or greater than 400 mg of Clozapine.

We must be careful and bear this side effect in mind in all patients taking Clozapine.

No significant relationships.

First psychosis programs have been developed during the past 30 years to influence the prognosis of a first psychotic episode by early integrative biopsychosocial interventions, with a focus on the processes that contribute to relapse. In the process of recovery, Navigate program emphasis on enabling a connection to what is important to the person (work, studies, relationships, intimacy), thus strengthening resiliency and quality of life and reducing self-stigma. Medication is part of any intervention program, however, there is a lot of ambivalence amongst the young person and family about its continuation and many will stop the medication altogether. Moreover, although evidence for the benefits of antipsychotic medication in short-term treatment is well established, there is an ongoing debate in the professional medical literature about the need and benefit of routine prophylactic long-term antipsychotics after first psychotic episode. There is also a significant uncertainty concerning the proportion of patients that will maintain remission without antipsychotics.

In this lecture, we will present some of the lessons that we have learned and are still learning from our clients, together with case examples.

In our Navigate Program, we have developed strategies based on literature and experience that enables the person/family to be part of the decision-making process, which at times presents dilemmas and risks but also promotes the potential for growth and transformation.

How do we talk about the medication issue? Who can continue without medication or with very low dosage? How can we taper antipsychotic treatment?

Are we willing to take the risk?

No significant relationships.

Experimental data from both clinical and preclinical studies have unequivocally shown positive correlations between stress and depression, stress, depression and epigenetic changes.

The aim of this research is to analyze clinical trials on coping mechanisms and their interaction with epigenetic mechanisms in patients with mood disorders. Generally, we studied the interaction between these two mechanisms and its effects on the onset, recurrence and progression of these disorders.

109 articles were analyzed, of which 37 were considered relevant. 72 studies were excluded based on titles and abstracts. Regarding the coping mechanisms, 10 longitudinal and cross-sectional studies were selected. Longitudinal studies are defined here by a follow-up period longer than 6 months.

There is a consistent association in the literature between the degree of methylation of the NR3C1 gene, stress and affectivity disorders. The analyzed studies showed that methylation of the NR3C1 gene is associated with both stress and mood disorders. FKBP5 influences glucocorticoid receptor sensitivity and stress response. SLC6A4 gene methylation has been systematically associated with stress and affectivity disorders. Higher BDNF methylation has also been found in people who report high levels of stress at work. The data collected suggest that SKA2 methylation may serve as a biomarker for certain features of depression, such as suicidal ideation, and is not directly involved in the etiology of mood disorders.

The results suggest that environmental stress and adversity in early childhood may change biological systems through epigenetic mechanisms and have long-term consequences, increasing the risk for unfavorable prognosis of mood disorders.

No significant relationships.

Individuals confirmed with COVID-19 were isolated or treated in medical and well-designated units; however, such a situation probably causing psychological and mental health problems that require prompt intervention.

The purpose of this study was to identify the knowledge and management of healthcare workers regarding psychosocial and mental health priorities and needs of individuals with COVID-19.

This is a cross-sectional descriptive study. The data collected conveniently at one single point in time from 101 healthcare workers in Jordan directly managing the health of individuals with COVID-19.

healthcare workers have moderate to a high level of knowledge of psychological distress related to COVID-19; mean ranged from 50-70% agreement and confidence. Healthcare workers had moderate to a high level of management of psychosocial and mental health needs. In general, healthcare workers were able to identify mental and psychosocial health needs and priorities at a moderate level. Healthcare workers’ knowledge had a positive and significant correlation with age (r = .24, p = .012) and years of experience (r = .28, p =.004), and a significant difference was found in their management towards using mental and psychosocial care between those who are trained on psychological first aids and those who are not (t = - 3.11, p = .003).

there is a need to train healthcare workers to integrate psychosocial and mental health care while managing psychological distress related to COVID-19.

No significant relationships.

High BMI has been associated with psychiatric rehospitalisation.

We aimed to replicate this finding in a large Swiss psychiatric cohort and to examine whether other metabolic disturbances are independently associated with psychiatric readmission.

Data on 16’727 hospitalizations of 7’786 patients admitted between January 1st, 2007 and December 31st, 2019 at the Department of Psychiatry of the Lausanne University Hospital, were collected. Metabolic syndrome was defined according to International Diabetes Federation definition. Generalized Linear Mixed Models were used to investigate the associations between psychiatric readmission and metabolic syndrome and/or its five components.

The readmitted population (N=2’935; 37.7% patients) had higher BMI, and were more likely to have central obesity, hypertriglyceridemia, and hypertension. Multivariate analyses confirmed that having a BMI ≥ 25 kg.m-2 was associated with psychiatric readmission (25 kg.m-2≤ BMI< 30 kg.m-2: OR = 1.88; 95%CI [1.55-2.29]; BMI≥30 kg.m-2: OR = 3.5; 95%CI [2.85-4.30]) when compared to patients with 18.5≤BMI<25 kg.m-2. Interestingly, novel factors associated with readmission were identified including metabolic syndrome (OR = 1.57, 95%CI [1.05-2.33]), central obesity (OR = 1.81, 95%CI [1.33-2.46]), hypertriglyceridemia (OR = 1.59; 95%CI [1.38-1.83]), HDL hypocholesterolemia (OR = 1.22; 95%CI [1.06-1.40]) and hyperglycemia (OR = 1.58; 95%CI [1.35-1.85]).

Metabolic syndrome, central obesity, hypertriglyceridemia, HDL hypocholesterolemia, hyperglycemia and obesity were associated with psychiatric readmission. Possible causes will be presented and discussed (e.g. reduced adherence to treatment in patients with metabolic disorders, multiple psychotropic treatments in non-responders increasing the risk of metabolic worsening).

No significant relationships.

Maternal attachment style plays a major role in the intergenerational transmission of psychopathology. Previous studies indicated that a secure attachment style is associated with higher levels of mindfulness and a higher quality of the parent-child relationship.

The aim of this study was to explore the relationship between the mothers’ attachment style, mindful parenting, and perception of the child.

Data was collected from 144 non-clinical mothers, who have a child below the age of 3 years. Mothers completed self-report questionnaires including the following scales: a demographic questionnaire, Attachment Style Questionnaire (ASQ), Interpersonal Mindfulness in Parenting Scale (IMP), and the Mothers’ Object Relations Scale (MORS-SF). Mediation analyses with Mothers’ Object Relations Scale warmth and invasion subscales as dependent variables, mother’s attachment style as an independent variable and, mindful parenting as a mediator were conducted.

In mediation analysis, the direct effects of the mothers’ attachment style on the perception of the child were not significant. However, indirect effects through mindful parenting were significant; higher levels of mindful parenting were associated with higher levels of MORS-SF warmth and lower levels of MORS-SF invasion.

These findings suggest that attachment styles are related to the perception of the child through mindful parenting. Mindfulness-based parenting training might be useful in case of attachment-related problems to improve the parent-child relationship.

No significant relationships.

Clozapine is a drug that can cause several side effects. Among the less commonly described is a drug-induced lung disease. Due to its non-specific clinical presentation, it represents a diagnostic challenge. The diagnosis is made based on: 1. Association of exposure to the agent and development of symptoms, 2. Pulmonary infiltration, 3. Exclusion of other causes, 4. Withdrawal of symptoms when the agent is excluded from therapy. To date, there have been only a few descriptions of this condition.

Case report of rare side effect of clozapine.

Case report

Case report: male patient (37) with schizophrenia, was hospitalized after a brutal suicide attempt. The PCR test for COVID-19 that was routinely performed on admission was negative. After the introduction of clozapine into therapy, the patient became febrile. There was a drop in oxygen saturation, a Lung CT scan showed inflammatory changes („ground-glass opacities“), and COVID-19 pneumonia was suspected. Due to the worsening of the mental state, the dose of clozapine was increased. The physical condition further deteriorated: febrile, sO2 declining. After repeated PCR tests for COVID-19 (all negative), interstitial pneumonia caused by clozapine was suspected, and clozapine was excluded from therapy. The physical condition started to improve. Quetiapine was introduced, and occasional episodes of agitation were relieved with intramuscular diazepam. In the following days, the patient’s mental state improved and he was discharged.

Despite its superiority over other antipsychotics, clozapine was with good rationale ranked third in treatment guidelines for schizophrenia.

No significant relationships.

Sexuality is a growing field in the context of the management of chronic diseases and cancer in particular. Cancer treatments and the traumatic nature of the cancer experience frequently elicit considerable sexual difficulties.

To assess the prevalence of sexual dysfunction (SD) in patients with cancer, and to determine the associated factors.

This was a cross-sectional study, conducted over 1 month, involving 100 cancer patients followed in the oncology department at the Habib Bourguiba University Hospital in Sfax (Tunisia). General, clinical and therapeutic data were collected using a pre-established questionnaire. Sexual function was assessed with the “Female sexual Function Index” and the “International Index of Erectile Function”.

These results showed that half of the patients were female, and 70% of them were married. Their mean age was 51.96, and 68% of them were unemployed. Unemployment in men and treatment with chemotherapy were statistically associated with erectile dysfunction (p=0.049 and p= 0.001 respectively). treatment with radiotherapy was statistically associated with decreased desire in men (p=0.048). Depression correlated with a decreased orgasm (p=0.032) and erectile dysfunction (p=0.043) in men, mean score of IIEF (p= 0.019) and with a decreased sexual arousal (p=0.006) in women.

Sexual dysfunction is common in cancer patients. They can be of iatrogenic or psychological origin and can depend on the dynamics of the couple relationship. Training to raise awareness of the importance of sexuality first among cancer patients should be considered given the lack of communication between doctors and patients regarding sexuality issues.

No significant relationships.

Mental illness is the single largest cause of disability in the UK, with one in four individuals suffering from a mental health problem. Despite this, only 13% of the NHS budget goes towards treatment of mental illness. It is thus unsurprising that addressing the parity of esteem of mental health has been highlighted as a major priority for the healthcare system, with the NHS Five Year Forward plan aiming to achieve this by 2020.

To explore the barriers to achieving parity of esteem of mental healthcare in the UK and develop recommendations for implementation.

Narrative review of literature and synthesis of findings

Three key barriers to achieving parity of esteem of mental health were identified: the current mental health investment standard (MHIS), medical sub-specialisation, and access to acute day units (ADU). The following recommendations were thus synthesised: to increase the time-period to measure MHIS increments, integrating mental health teaching into specialty training programmes, and increasing the availbility of ADUs to crisis referral teams.

Addressing the disparity between mental and physical health is a major priority for the NHS. This research provides an overview of current barriers and suggests recommendations for improvement. By prioritizing improvement in the MHIS, integrating mental health teaching into specialty training, and increasing access to ADUs, the NHS formulates an excellent founding to achieving the ultimate goal, parity of esteem of mental health.

No significant relationships.

Visual images and music have long been known as a means to optimize emotions (Galeev, 1976; Gotsdiner, 1993). Together (eg in audio-visual slide-films) they may help students and professional cope with the negative side of intensive workloads (fatigue, stress, anxiety).

Our study attempts a multi-level assessment of the relaxation effect of a slide-film as part of student education.

Sample - 46 psychology students. The 20 minute relaxation film was shown after lectures and discussion of a forthcoming examination. Measures: standard psychological and physiological functional state tests and a cognitive task before and after the film (Leonova & Kapitsa, 2003); an original questionnaire revealing individual associations and experiences felt during the film.

The results showed pronounced subjective discomfort and anxiety before the film. The relaxation film resulted in lowered blood pressure, increased subjective comfort, decreased fatigue and acute anxiety, and negative emotion scores, as well as higher productivity in performing the cognitive test (Student t-test, p<0.005-0.001). Concentration on the film subject, as well as the combination of the student’s thoughts and associations around the plot, showed a positive correlation with the amount of relaxation effect.

Our research showed that using the relaxation slide-film (with imagery and music) can provide positive effects on students’ functional state. It also revealed the importance of the relevance of individual experience to the subject of the film to obtain optimal positive effects.

No significant relationships.

Social phobia is frequent comorbidity in schizophrenia. It`s clinical correlates and consequencies for clinical practice in late-onset schizophrenia (LoS) are unclear.

The study aimed to compare clinical correlates and therapeutic options in LoS patient with and without social phobia.

16 LoS patients with social phobia (ICD-11 diagnosis, age 59,6±6,2, 25% males) were compared with 16 LoS patients without social phobia (69,9±10,9, 0% males). Results of clinical assessment (PANSS, HDRS-17), cognitive examination (MMSE, MoCA), CT data were analysed. Type of antipsychotics (conventional\conconventional) was registed, dose of antipsychotics and antidepressants was randed from 1 (low) to 3 (high). Mann-Whitney test and χ2statistic was used.

There was no group differences in age, age manifestation, illness duration, number of psychotic episodes, PANSS and HADRS scores, rates results of cognitive tests, atrophy scores, length of hospital state, types of received antipsychotics. LoS patients with social phobia received more frequently medium and high doses of antipsychotics than LoS patient without social phobia (χ2 (2)=6,432, p=0,040).

Increased doses of antypsychotics in patients with social phobia don`t correlate with severity of psychotic symptoms and nay reflect some treatment resistance as well as misinterpretation of symptoms of social phobia as insufficient retreat of the psychosis. Active detection of social phobia is significant for treatment optimization.

No significant relationships.

Although cancer is a debilitating experience, it can also increase meaning and satisfaction in one’s life.

To investigate the effectiveness of interventions that aim to develop posttraumatic growth among cancer survivors.

Seven databasis were searched for relevant articles published between 2000 and 2020. The findings of randomized controlled trials related to interventions to effect posttraumatic growth of cancer survivors were included. Hedges’ g and 95% confidence intervals were computed to estimate the effect.

The effect of the interventions on posttraumatic growth among cancer survivors were heterogeneous. The effect size was statistically significant (Tables 1,2).Table 1

Posttraumatic growth interventions significantly increased posttraumatic growth among cancer survivors. Health care providers as the main sources of cancer care should be more focused on the achievement of positive outcomes.

No significant relationships.