The study of attitudes towards death in patients of different nosological groups is an urgent task for modern science. It becomes especially relevant when working with adolescents with severe depressive disorder: for many of them, thoughts about death in various forms become the main reason for contacting specialists and the most subjectively painful symptom.

Revealing the characteristics of attitudes towards death in adolescents with severe depressive disorder.

The study involved 135 adolescents (12-17 years old) with depressive disorder, hospitalized in a psychiatric hospital. Participants completed the following methods: Hamilton Rating Scale for Depression, Columbia Suicide Severity Rating Scale, Death Attitude Profile-Revised, Fear of Personal Death Scale, Death Anxiety Scale.

The severity of depressive symptoms is significantly associated with the “death-as-flight” scale (r = 0.639, p = 0.000). The values on the “fear of death” scale are positively associated with the indicators on the scales “death anxiety” (r = 0.432 p = 0.025), “consequences of death for the individual” (r = 0.658, p = 0.000), “transcendental consequences of death” (r = 0.711, p = 0.000), “the consequences of my death for loved ones” (r = 0.496, p = 0.008). Indicators on the “active death search” scale are negatively associated with indicators on the “neutral acceptance of death” scale (r = -0.503, p = 0.007) and positively with the “fear of oblivion” scale (r = 0.432, p = 0.024).

The attitude towards death in adolescents with depressive disorder has a pronounced specificity, which can become one of the targets of psychotherapeutic work.

No significant relationships.

COVID-19 had direct and indirect impacts on both mental health and healthcare systems. Evaluating urgent psychiatric consultations may be useful to determine the effects of COVID-19 pandemic since it reflects the condition of psychiatric patients and healthcare systems

This study aims to determine the quantitative or qualitative changes in emergency psychiatry consultations after COVID-19 pandemic.

The socio-demographic characteristics and clinical features of two hundred thirty three patients were retrospectively collected and analyzed in order to compare the emergency psychiatry consultations before (between the dates 11th of March 2019-10th of March 2020) and after (between 11th of March 2020-10th of March 2021) the COVID-19 pandemic.

The ratio of patients consulted to psychiatry to total emergency department increase after pandemic (%0.03 vs %0.07). Among these patients, the diagnosis of ‘alcohol and substance use disorder’ (%6.1 vs. %15.4) (p=0.03) increased while the diagnoses of ‘obsessive compulsive disorder (5.3% vs. 0%)(p=0.01) and bipolar disorder (%21.1 vs. %20.5) (p=0.02) decreased. Hostility among patient during consultation increased (%19.1 vs. %30.8)(p=0.04). Suicidal thoughts decreased (%25.2 vs. %14.5) (p=0.04). Furthermore, voluntary inpatient treatment (%20.9-%34.2) (p =0.02) increased, transfer to another clinic (%25.2 vs. %12) (p=0.01) and outpatient treatment (%46.1 vs. %42.7) (p=0.01) decreased. An increase in oral treatments (%10.4 vs. %26.5) (p=0.02) and decrease in parenteral treatments (%71.3 vs. 54.7) ( p=0.01) were also reported.

Our findings confirmed that after COVID-19 spread the clinical features diagnosis, and treatment modality have changed among urgent psychiatric consultations.

No significant relationships.

Previous studies have shown that the month of Ramadan has a negative impact on the sexual life of fasters. Sexuality during Ramadan seems monotonous, rather poor, leaving little room for foreplay, sensuality and diversification of the sexual repertoire.

To examine the socio-demographic and religious factors associated with the change in the sexual lives of fasters

A cross-sectional study was conducted among married Muslim volunteers in Tunisia. The data was collected with an anonymous self-completed questionnaire, one week before Ramadan (W-1) and the fourth week of Ramadan (W4).

We included 100 participants in this survey.The analytical study found a negative correlation between age and the frequency of coitus during Ramadan (r= -0.2, p= 0.04). The lenth of the marriage was associated with less communication about sexual satisfaction during Ramadan (P=0.01). Rural origin was associated with less tenderness (p=0.03) and shorter foreplay (p=0.03). Wearing the veil was associated with sexual abstinence in women during Ramadan (p=0.038) and not wearing it was associated with the cessation of oral sex (p=0.04). The practice of prayer was correlated to a lesser diversification of sexual positions (p=0.01) and to the withdrawal of certain sexual positions: posterior vaginal (p=0.01), lateral (p=0.02), Andromache (p=0.004).

Changes in the expression of sexuality during Ramadan are not consistent with religious dictates. These findings suggest that the perception of sexuality and its practices are motivated by tradition and culture much more than religion.

No significant relationships.

No significant relationships.

Electroconvulsive therapy is a proven treatment for mood and psychotic disorders in adult patients. It is estimated that in children and adolescents this type of therapy is underutilised despite the fact that the most recent studies have supported the success of ECT in these patients. A case is described of a 15-year-old male patient diagnosed with psychotic disorder who was previously treated with several antipsychotics, including clozapine, and finally treated with electroconvulsive therapy.

Review of the clinical indications of electroconvulsive therapy in children and adolescents with psychotic or mood disorders through a clinical case of a patient admitted to a Psychiatric Short Stay Unit

Detailed psychopathological description of the case as well as the treatments used (psychotropic drugs and electroconvulsive therapy).

After the administration of electroconvulsive therapy, an improvement in both positive and negative psychotic symptomatology was observed, with a decrease in soliloquies and an improvement in affective flattening.

Electroconvulsive therapy is an effective treatment in adolescent patients with psychotic and mood disorders, which should be considered as indicated as an effective treatment.

No significant relationships.

Surrey and Borders NHS Foundation Trust’s AVATr (Augmented Virtual-reality Avatar in Training) is a unique ground-breaking Virtual Patient simulation system, which uses the Xenodu platform to train learners in essential clinical and complex communication skills. Over 30 patient scenarios have been developed after identifying learner-specific development needs, including exploration of overt psychosis, assessment of capacity, sharing bad news, and neglect in care home residents.

During the session, the trainee is projected on to a large screen, using a camera and video special effects, which results in a life-like interaction with the Virtual Patient. Trainees can view themselves interacting with the Virtual Patient in real-time, from a unique ’out-of-body’ perspective, immersed in a customdesigned interactive virtual environment. This is different to a first-person perspective used in virtual or augmented-reality systems in several clinical specialties. During the COVID-19 pandemic, we evolved the AVATr model to remote or hybrid sessions, where simulations were digitally enhanced, and have been run through Microsoft Teams. The simulation facilitator is connected to a multi-user video call, enabling the Virtual Patient to be projected as an attendee using Microsoft Teams.

To evaluate the feedback from Doctors in training taking part on the education sessions.

We collected qualitiative and quanttaive infromation from participants after the teaching session.

We received strongly positive reults in all parameters measured. the presenters will show a detailed breakdoen in the session.

The digitalised delivery of the virtual patient simulation, has been pivotal in limiting interruptions to communication skills training in mental health.

The NHS trust has co produced the simulation platform with a private software firm Xenadu Virtual Environments

The COVID-19 pandemic has disrupted numerous fundamental systems ranging from businesses to education system. The long-term consequences of the Pandemic, namely virtual learning and prolonged social isolation are coming to fruition in Child/Adolescent-Psychiatric Emergency-Rooms (CAP-ER). Discontinuity of in-person attendance of schools has poorly impacted the mental health of children and adolescents (C&A) of low-socioeconomic areas, who often rely on schools for meals, physical activity, and mental-health support. An increase in agitation, suicidal ideation, and a declining school performance has been observed in such situations.

The primary objective of this study is to explore the increase in these symptoms as the presenting complaint in the psychiatric ER.

Between April to June 2021 a cross-sectional quality improvement (QI) study was done on children presenting to CAP-ER BronxCare-Hospital NY with psychiatric complaints. Concomitant substance use disorder was determined using CRAFT questionnaire.

Our data comprised 209 patients (84 M/125 F) with 79 children and 130 adolescents. Ethnicity: 116 Hispanics (56%), 84 African Americans (40%), and 9 others. The most common presenting complaints were aggression (111, 53%), suicidal ideation/suicide attempt (50, 24%), acute exacerbation of chronic illness (7, 3.3%), accidental overdosage (5, 2.3%) and others (36, 17.4). Marijuana was the most used substance (34 patients).

There has been a surge in severity of presentation of psychiatric disorders among children and adolescents, aggression so far, the most prevalent. Further studies are needed to delineate the social links with this high emergent load and pandemic.

No significant relationships.

Since the emergence of the term “transsexualism” in the Ninth International Classification of Diseases (ICD-9), disciplines related to mental health have contributed to the perpetuation of stereotypical attitudes towards trans people. Recent years have shown the significant prevalence of mental pathology suffered by this group, and the need for specialized training to improve access to the health system.

The main objectives of this research are: (a) to find and analyse the scientific evidence published which assesses the attitudes of mental health professionals towards the trans community; b) to establish the main variables that modify these attitudes, paying special attention to gender, ideology, sexual orientation and previous training or experience

A systematic review of the literature was conducted following the PRISMA recommendations.

Tendency towards more positive and liberal attitudes among professionals than in the general population.

Higher values for extreme prejudice among those professionals who attributed gender diversity to a psychological, ethico-moral or religious cause.

Association of depathologising practices with belief in the psychosocial nature of diversity, clinical training and interpersonal contact with LGBT people. The following socio-demographic variables were related: being a woman, clinical psychologists, progressive political ideology, professionals who strive to know their own limitations and biases.

More positive attitudes than the general population but still insufficient Specific training in gender diversity and minority issues would be a key element in improving care for transgender people. The attitudes of professionals depend, in part, on the personal characteristics of the therapists.

No significant relationships.

The quantification of suicidal risk in specific populations is important for the adoption of prevention and risk reduction measures. This risk remains very high in patients with eating disorders compared to the general population.

The present study evaluates the prevalence of suicide among patients with eating disorders all seeking different suicidal risk factors in these patients.

A retrospective study of medical records of all patients with eating disorders, diagnosed according to DSM 5 criteria, at Arrazi hospital of Salé for the past 14 years, by assessing the prevalence of suicide attempts and care.

In our work, all patients are female, 17 years old on average, 18 patients out of 20 have anorexia nervosa, 4 of them have had bouts of bulimia, and only one patient was admitted for management of bulimia nervosa alone. The mean age of onset was 15 years with addictive comorbidity in 5 patients.

Thirteen patients had comorbid depressive disorder, one patient was schizophrenic and six patients had borderline personality disorder.

12 patients have made suicide attempts, planned especially in a depressive environment.

Preventive management of suicidal risk must be taken in order to improve the prognosis in this category of patients.

No significant relationships.

The involvement of informal carers (family and friends) in the care of people with severe mental illness (SMI) contributes to positive clinical outcomes, such as relapse prevention and symptom reduction. To date, the care pathway between inpatient and community care is not clearly defined impeding the smooth transition for patients, whilst carers are still barely involved in shared decision-making processes.

To investigate the views and experiences of patients with SMI, carers and clinicians regarding the transition from inpatient to community mental health services.

Four mixed focus groups were conducted with individuals with SMI (n=12), carers (n=10) and clinicians (n=9) across four different mental health catchment areas in England. Participants discussed their experiences and provided their views on facilitators, barriers and solutions for carer involvement during the transition between mental health services. Data were analysed using thematic analysis.

All stakeholders highlighted that factors that impede carer involvement are related to: confidentiality issues, unmet (structural and organisational) needs, and carer expectations. Patients with SMI, carers and clinicians agreed that carer involvement can be improved by providing psychoeducation to carers and training to staff, having accessible and transparent clinical procedures, and allocating specialised staff to carers.

The study findings emphasise that carer involvement is still overlooked, particularly when adults with SMI transition between services. The results provide guidance for practice emphasising the need for systematic involvement of carers across inpatient care, and for future research proposing effective ways of maximising carer involvement in mental health care.

No significant relationships.

Vascular dementia (VaD) accounts for approximately 15% of all cases of dementia. While there are many different definitions of vascular dementia, it is generally understood to refer to “disease with a cognitive impairment resulting from cerebrovascular disease and ischaemic or haemorrhagic brain injury”. Research suggests that 30% of patients with VaD also suffer from depression. The treatment of depression in VaD with pharmacological therapy is relatively well-established, with the first line drug being a selective serotonin reuptake inhibitor (SSRI). However, a relatively under-researched area is the use of brain stimulation and neuromodulation therapies for the treatment of depression in VaD.

This review aims to provide a critical analysis on the efficacy and safety of brain stimulation therapies in treating depression in VaD to determine whether it is an appropriate treatment option.

The databases used were PubMed and WebofScience. The available literature was analysed which resulted in three papers which met the inclusion criteria and were critically appraised.

In all three studies, depressive symptoms improved after ECT was administered, regardless of the specific tool used to measure the severity of depression. The side effects experienced were also only temporary and resolved independently which speaks to the safety of ECT as a treatment option.

The results of the study prove that ECT is a safe and effective option in treating depression in VaD. However, more research is needed for the medical community to fully understand the different treatment options and say with certainty which is the safest and most effective.

No significant relationships.

There are several case reports describing clozapine side effects such as agranulocytosis, constipation,tachycardia but rarely cases describing oesophagitis caused by clozapine were reported.

To report the first case in our country about clozapine induced oesophagitis.

We describe a case in which a patient who has no gastrointestinal past history,has developed an oesophagitis stage 2 of Savary and Miller Classification without any gastroesophageal reflux disease, few weeks after introducing clozapine at therapeutic dose.

A 25 years old male patient with resistant schizophrenia managed with clozapine,was admitted to reinitiate his treatment after weeks of stopping his medication.During hospitalization, our patient developed a sudden haematemesis in 10 days after commencement of clozapine. The patient had no history of gastrointestinal symptoms or disease. The clinical examination and blood tests did not find any signs of bleeding severity.A gastroscopy was performed, revealing esophagitis stage 2 of Savary and Miller classification and a cardiac polyp removed with biopsy forceps that showed no malignant lesions .The patient was treated with acid suppressant therapy.There was no further episode of haematemesis and our patient healed uneventfully within a week.As for clozapine, it wasn’t interrupted and we continued increasing doses very carefully with no further incident.

Although it is a rare side effect, oesophagitis may appear at therapeutic doses of clozapine, and this possibility should be taken into account when treating patients with resistant psychiatric disorders.

No significant relationships.

70-year-old male with previous diagnosis of bipolar disorder and poor adherence. In the past months, he showed incipient behavioral alterations, for which he entered psychiatry service. During adressment, frequent memory failures, isolation, apathy and mutism were identified, clasifying the case as a possible dementia. A CT-scan was performed, revealing bilateral, simetrical calcifications of the basal ganglia, compatible with Fahr’s syndrome.

Review of the available literature regarding Fahr’s syndrome, a rare condition witch can lead to a wide spectrum of neurological, motor and behavioral symptoms.

A bibliographic revision has been carried out. Sources used: Google scholar, PubMed.

Fahr’s syndrome is characterized by symmetric and bilateral calcification of the basal ganglia, as well as other areas related to motor functions, such as the cerebellum. It is believed that it has an autosomal dominant inheritance, and the symptoms appear between the ages of 40 and 60. The spectrum of clinical manifestations includes motor disorders such as parkinsonism or chorea. The appearance of dementia or psychiatric disorders, such as schizophrenia like psychosis or mood disorders, are also common. Also pyramidal symptoms, cerebellar dysfunction, speech difficulty or convulsive seizures can be identified.

Fahr’s syndrome is rare, with a prevalence of <1 / 1,000,000. Diagnose is based on a compatible CT-scan, with clinical features and exclusion of other medical conditions. Nowadays, treatment is limited to a symptomatic support. The goals of further research are to understand the genetics of this disorder which could lead to an effective method for treating and preventing Fahr’s syndrome.

No significant relationships.

While several studies have assessed the impact of the COVID-19 pandemic on sexuality and sexual behavior in the general population, very few studies have assessed sexuality after Sars-Cov 2 infection.

The objective of our study were to assess sexuality in women recovered from COVID-19 and to compare it to healthy controls.

This is a cross-sectional case-control study.

We randomly recruited women, from April 1st to 30th, 2021.The women in the case group have been infected with Sars-Cov 2, with a benign or pauci-symptomatic clinical form, and cured for one to two months at the time of the study without any post-COVID complications. Women included in the control group have not been infected with Sars-Cov 2. Sexuality was assessed by the Female Sexual Function Index (FSFI).

In total, we recruited 30 women in the case group and 30 women in the control group.The average age of the case group was 35.8 ±6.8 years versus an average age of 35.3 ± 6.33 years in the control group. The majority of coronavirus infections were symptomatic (83.3% (n=25)). An FSFI score <26.55 and corresponding to impaired sexual function was found in 63.33% of women in the case group (n=19), versus 53.33% of women in the control group (n=16) with a significant difference between the two groups (p=0.009)

COVID-19 is significantly associated with sexual dysfunction, even in mild or pauci-symptomatic clinical forms.

No significant relationships.

Paediatric and adult psychiatric emergency department (ED) visits decreased during the initial COVID-19 pandemic outbreak. Long-term consequences of the pandemic will include increases in mental healthcare needs especially among especially vulnerable groups such as children and adolescents.

This study examined changes in the number of overall and diagnosis-specific mental health ED visits among patients aged <18 years following onset of the COVID-19 pandemic in Madrid, Spain.

We used electronic health records to extract the monthly numbers of total and diagnosis-specific mental health ED visits among patients aged <18 years, between October 2018 and April 2021, to La Paz University Hospital. We conducted interrupted time-series analyses and compared trends before and after the day of the first ED COVID-19 case (1st March 2020).

In March 2020, there was a marked initial decrease of -12.8 (95%CI -21.9, -7.9) less monthly mental health ED visits. After April 2020, there was a subsequent increasing trend of 3.4 (95%CI 2.6, 4.2) additional monthly mental health ED visits.

After onset of the COVID-19 pandemic, there was an increase in paediatric psychiatric ED visits, especially due to suicide-related reasons. These data reinforce the crucial role of the ED in the management of acute mental health problems among youth and highlight the need for renovated efforts to enhance access to care outside of and during acute crises during the pandemic and its aftermath.

No significant relationships.

Long-Covid or Post-COVID-19 syndrome develops during or after an infection with COVID-19 and continues for more than 12 weeks. The signs and symptoms are not explained by an alternative diagnosis. Neuropsychiatric symptoms are usually manifested as cognitive impairment (brain fog, loss of concentration or memory issues, etc.), headache, sleep disturbance, peripheral neuropathy symptoms (pins and needles and numbness), dizziness, anosmia, symptoms of depression, anxiety and fatigue. Patients complain of reduced quality of life and impairment on daily functioning. Although the burden of disease is high there is until now very few data available, the etiopathology is still unknown and treatment strategies are not established.

The objective of this study is to gather standardized data of patients with long-covid syndrome who suffer from neuropsychiatric symptoms in order to better understand the complexity of this syndrome.

Patients were referred from the long-covid outpatient unit of the internal medicine department to our specialized outpatient unit, so that the previous infection was confirmed. A standardized psychiatric interview and a thorough neuropsychological assessment was conducted.

We will present preliminary data on psychiatric symptoms, neuropsychology and quality of life with patients with long-covid syndrome.

Potential treatment strategies to improve psychiatric and neurocognitive symptoms as well as improvement of quality of life will be discussed.

Daniela Roesch Ely and Matthias Weisbrod have a contract with Schuhfried GmbH (development of neurocognitive batteries and training programs)

Mixed states in mood disorders present significant clinical and prognostic challenges. Although the DSM-5 has broadened diagnostic criteria for mixed states with the development of the ‘mixed features’ specifier and its application to unipolar depressive disorders, some mixed episodes might still be overlooked.

to evaluate the frequency and the factors associated with mixed depression according to the broader Koukopoulos criteria in a sample of patients with a major depressive episode

We included 99 consecutive patients presenting for a major depressive episode of bipolar (n=10) or unipolar major depressive (n=89) disorder at our outpatient clinic. Major depression was ascertained using SCID- IV criteria, and mixed features were determined using Koukopoulos’ diagnostic criteria

Mean age of the sample was 35.5 years [14-58]. Women accounted for 63.6% of patients. Mixed features were found in 19.5% (n=19) of the sample, 80% (n=8) among patients with bipolar disorders (BD) and 12.3% (n=11) among those with major depressive disorder (MDD). Individuals with mixed features had more substance abuse (p=0.005) and more suicide attempts (p=0.01). Individuals receiving antipsychotics had a lower risk of mixed features (p=0.000) while antidepressant treatment did not have any affect. A family history of BD, psychosis, suicide and substance abuse were found in these patients. Mixed features in depression were more frequent in patients with BD than in MDD.

Our study showed a high frequency of mixed features in depression, especially bipolar depression when Koukopoulos criteria are applied. Special attention should be given to these patients given the association with substance use and suicidality

No significant relationships.

Studies assessing the psychological impact of COVID-19 have shown that patients with COVID-19 had significantly higher levels of depression, anxiety, and post-traumatic stress symptoms than healthy controls.

The objectives of our study were to assess depression in women recovered from COVID-19 and to compare it to healthy controls.

It was a cross-sectional case-control study.

We randomly recruited women, from April 1st to 30th, 2021.The women in the case group have been infected with Sars-Cov 2, with a benign or pauci-symptomatic clinical form, and cured for one to two months at the time of the study without any post-COVID complications. Women included in the control group have not been infected with Sars-Cov 2 .Depression was assessed by the Beck Depression Inventory (BDI).

In total, we recruited 30 women in the case group and 30 women in the control group.The average age of the case group was 35.8 ±6.8 years versus an average age of 35.3 ± 6.33 years in the control group. The majority of coronavirus infections were symptomatic (83.3% (n=25)).

The average depression score for the case group was 10.8 ±9.6 corresponding to moderate depression, while the average depression score for the control group was 6.1 ± 6.1 corresponding to mild depression. The presence of depression was more significant in the case group compared to the controls (p=0.003).

COVID-19 is significantly associated with depression, even in mild or pauci-symptomatic clinical forms.

No significant relationships.

No significant relationships.

Life expectancy of people with schizophrenia is reduced by 10-20 years compared to the general population. The excess mortality is part due to an increased prevalence of cardiovascular disease, prediabetes and obesity, which are in part due to antipsychotic treatment. Gaining weight is associated with reduced quality of life and also among the most frequently reported reasons for the discontinuation of treatment. Lifestyle changes have a time limited effect, and therefore, interest has focused on Glucagon-Like Peptide 1 receptor agonist treatment. Semaglutide, currently used to treat type 2-diabetes in doses up to 1.0 mg once-weekly, has shown promising results regarding weight loss in doses up to 2.4 mg once-weekly. It may also be able to reduce the risk of developing diabetes and cardiovascular disease.

The HISTORI Trial aims to reduce risk of developing diabetes and cardiovascular disease in people with schizophrenia, prediabetes and overweight and to investigate for an indirect effect of Semaglutide on psychotic symptoms and quality of life through a weight loss.

A 30 weeks randomized, placebo-controlled, double-blinded study with once-weekly injections of Semaglutide 1.0 mg. Primary inclusion criteria are age 18-40 years, schizophrenia, prediabetes, overweight and treatment with antipsychotics. Questionnaires and interviews regarding psychotic symptoms, quality of life, medication adherence and physical activity will be applied either monthly or every third month.

will not be ready for the congress. A poster outlining the feasibility challenges will be presented.

Perspective: Through weight loss, Semaglutide may indirectly be able to improve quality of life, medication adherence and psychotic symptoms.

No significant relationships.