Working Alliance is defined as the emotional bond and the agreement on therapeutic goals and tasks between patients and therapists. Despite the wide use of the construct of working alliance in research on psychotherapy, few studies have investigated the role of working alliance in influencing adherence to pharmacotherapy, and drug attitude. A deeper knowledge of the interplay between working alliance and drug attitude could help to challenge low adherence to psychopharmacological treatments in Major Depressive Disorder.

This study aimed to investigate the relationship between working alliance and drug attitude in patients with Major Depressive Disorder.

27 patients admitted in the Psychiatric Unit of Careggi with diagnosis of Major Depressive Disorders were enrolled. Working Alliance Inventory - patient version (WAI-P), Drug Attitude Inventory (DAI) and Beliefs about Medicines (BMQ) were administered. Pearson’s correlation was used to assess relationships between variables.

A significant positive correlation was detected between BMQ total scores, DAI total scores and WAI-P task, bond, and goal subscales.

Such preliminary data suggest a relationship between Working Alliance and drug attitude. This could contribute to provide tools to challenge low adherence to psychopharmacological treatments in patients with Major Depressive Disorder.

No significant relationships.

Gambling Disorder (GD) is considered a multifactorial behavioral addictive disorder, leading to severe psychological, social and economic consequences. Previous studies have investigated genetic mechanisms underlying GD. Growing literature showed a possible link between addiction-related disorders and neurotrophic factors (NTF), involved in synaptic plasticity and neuronal survival. Thus, the study of NTF genes emerged as promising targets in the field of GD.

To evaluate genetic implications of the NTF family in the pathophysiology GD. We hypothesized the involvement of some NTF genes polymorphisms in the onset and progression of GD as potential biological risk factors.

The sample was composed by 166 individuals with GD and 191 healthy controls. 36 Single nucleotide polymorphisms (SNPs) from NTF (NGF, NGFR, NTRK1, BDNF, NTRK2, NTF3, NTRK3, NTF4, CNTF and CNTFR) were selected and genotyped. Linkage disequilibrium and haplotype constructions were assessed, related to the presence of GD. Moreover, regulatory elements overlapping the identified SNPs variants associated with GD was also analyzed.

6 SNPs were potentially associated to GD after the comparisons of allele frequencies between groups. Single and multiple-marker analyses showed a strong association between both NTF3 and NTRK2 genes, and GD.

This study suggests the implication of NTF genes in the development of GD, being the altered cross-regulation of some NTF factors signalling pathways, a potential biological vulnerability factor in GD. Fundings and Acknowledgements: Ministerio de Ciencia, Innovación y Universidades (RTI2018-101837-B-100) Delegación del Gobierno para el Plan Nacional sobre Drogas (2017I067, 2019I47), Instituto Salud Carlos III (ISCIII) (PI17/01167, PI20/00132) and CIBERObn, an initiative of ISCIII.

No significant relationships.

What does the physician think in his/her intimacy about clinical care for when his/her death would be near? Living Will is a type of advance directive with the aim to guarantee the testator’s autonomy when faced with death. Particularly oncologists are often faced with human finitude. Their delicate work does not protect them from the possible anguish of thinking and preparing for their own death. It is pertinent to know the psychic mechanisms normally present in the management of this expectation.

To explore symbolic representations of oncologists such as referred to the possible elaboration of their own Living Will.

Qualitative design. Eight participants, clinicians, sample closed by theoretical saturation of information. Semidirected interviews in-depth were conducted online during the pandemic, fully transcribed. Technique of Clinical-Qualitative Content Analysis used for data treatment to generate categories of discussion. The authors search for core meanings in the corpus of interviews, after free-floating readings.

Three categories emerged from the material: Living Will: postponing the decision in order to not anticipate death; From Rationalization Mechanism to Intellectualization: a more sophisticated defensive strategy; Loss of Autonomy: the doctor’s belief while to feel him/herself patient.

(1) Even with all scientific knowledge, respondents have archaic thoughts on defining advance directives as healthy individuals would mean rushing time of their death. (2) Resistance of these professionals to an imagined scenario of end reveals underlying anguish in writing of living will. (3) There is fear of losing autonomy when they do not know how their Living Will can be seen.

No significant relationships.

The Covid-19 pandemic profoundly affected delivery and accessibility of mental health care services at a time when most needed. The OPTIMA Mood Disorder Service, a specialist bipolar disorder service, adapted group psychoeducation programme for delivery on-line.

We report the feasibility of creating a digital psychoeducation programme.

The OPTIMA ten session group psychoeducation programme was converted into a ‘Digital’ intervention using video-conferencing. Sessions offered a range of key topics, derived from the initial Barcelona Group Psychoeducation Programme. At the time of writing, OPTIMA had fully completed two 10 session digital courses.

A total of 12 people (6 in each group) consented to be part of a service evaluation of the digital groups. Just over half of the participants were women (7/12; 58.3%) and one identified as being non-binary (8.3); remaining participants were men. Age of participants ranged from 25 years to 65 years (Mean=42.3; SD=13.1). Data showed a high level of engagement (77%) All participants reported some improvement with a mean Bipolar Self-Efficacy scale (BPSES) post-group score of 105.6 (SD=14.8). At group level, this change was not statistically significant (F (1, 15) = 0.71, p=0.41). At an individual level, two out of five showed a reliable change index >1.96.

Delivering a ‘digital’ group psychoeducation programme was possible due to careful planning and programme development. There was good uptake from service users suggesting it is a feasible approach with preliminary evidence of clinical benefit.

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.

Therapies focused on exposure like prolonged exposure (PE) or Eye Movement Desensitization and Reprocessing (EMDR) dominate the treatment of posttraumatic stress disorder (PTSD). There are many patients with PTSD who are not fully responding with exposure-therapies. or don’t want exposure therapies at all. Many patients don’t like to be confronted with elements of their traumatic experience. IPT has proven to be highly efficient in e.g. depression and bulimia and is promising as a treatment for PTSD while NOT using exposure. IPT aims to repair the damage trauma does to interpersonal trust and social functioning.

Learn more about IPT. Learn more about the way IPT is used in the treatment for patients with PTSD (adaptations).

Literature review focused on IPT for PTSD.

Among the consequences of PTSD are affective numbing, interpersonal hypervigilance, and social withdrawal (1). Numbness, an avoidance particularly of negative affect, makes it hard to read one’s interpersonal environment. Thus in adapting IPT for PTSD, we devote the early part of treatment to affective reattunement: helping patients to identify their emotions and to recognize them as helpful social signals. Once patients can read their feelings, they can put them to use to handle relationships better, deciding whom they can trust and whom they can’t. IPT for PTSD tends to focus on role transitions, which are usually inherent having been traumatized (2).

In the past there has been several kinds of research that show that group IPT and individual IPT reduce PTSD and depression in traumatized patients with PTSD.

No significant relationships.

The use of nasogastric-tube feeding (NGT) in the treatment of Anorexia Nervosa (AN) in children and adolescents is recommended by current guidelines. Nonetheless, the literature lacks studies assessing prognostic factors for modifications of AN-specific psychopathology treated with NGT.

To assess potential prognostic affecting improvement in AN-specific psychopathology in children and adolescents hospitalized for AN, treated with NGT.

Retrospective study assessing young inpatients with AN, treated with NGT. Considered outcomes (admission vs discharge) were AN-specific psychopathology (Eating Disorder Inventory-3 (EDI-3): Drive for Thinness (DT); Body Dissatisfaction (BD); Eating-Disorders Risk (EDRC)) and body-mass index (BMI). Considered potential predictors were demographics, duration of untreated illness (DUI), severity (admission BMI), diagnoses, early vs late (0-7 vs 8+ days after admission) start of NGT, drugs). Models for specific contributions of predictors related to outcomes were assessed with analysis of covariance (ANCOVA).

Fifty-three inpatients (F=53, mean age 15.1±2.0 years) were enrolled. Both higher DT (F(1,22)=15.07, p<0.001) and BD improvement (F(1,22)=7.73, p=0.011) were predicted by lower admission BMI. Higher BMI improvement was predicted by lower admission BMI (F(1,47)=10.39, p<0.001) and age (F(1.47)=6.12, p=0.011. AN subtypes, comorbidities, antidepressants, and different antipsychotics did not predict any outcome.

In this study, greater improvement in AN-specific psychopathology (DT and BD) and weight in patients treated with NGT was predicted by lower admission BMI. These results suggest that young patients with greater severity may highly benefit from NGT. These findings, if confirmed in wider and controlled samples, could help in optimizing the treatment with NGT in young inpatients with AN.

No significant relationships.

Bipolar disorder (BD) is a severe mental illness (SMI) with an estimated lifetime prevalence of around 1%, starting in young adulthood and progressing with acute episodes. Although there is no significant prevalence difference between the sexes, the course of the disorder may be more problematic in women, due to hormonal and reproductive factors. Moreover, hypersexuality and impulsive sexual behaviour can manifest as part of a manic or hypomanic episodes, with devastating effects on the physical and emotional health of these patients.

To highlight the pertinent issues related to sexual and reproductive health of women with BD.

A non systematic review of the literature from the last 10 years was carried out using the electronic databases, Pubmed and Google Scholar. The literature search was confined to papers written in English. The keywords ‘sexual health’, ‘reproductive health’, were combined with ‘bipolar disorder’ and ‘women’.

The literature points to an increased incidence of unsafe sexual practices (unprotected sex, multiple sexual partners, trading sex) as well as poor reproductive and sexual health (increased risk of sexually transmitted diseases, high risk of unwanted pregnancies and abortions, low use of contraceptives, menstrual and fertility problems). Female patients with BD are also more likely to report history of sexual abuse.

Attention and counseling regarding effective contraception, planning a pregnancy and risk of sexually transmitted diseases, among others, should be an integral part of health care received by all women with bipolar disorder.

No significant relationships.

Grief is a normal and not necessarily pathological psychological process that occurs after the loss of a family member or loved one with its psycho-affective consequences, external manifestations and rituals. Although mourning processes can be associated with losses of different types (employment, housing, baseline situation, housing), we will refer to mourning for the loss of a loved one. For some people, social networks facilitate the expression of feelings and experiences of grief, connecting with the emotional support of other friends and loved ones. However, the presence of accounts belonging to these deceased persons, the persistence of photos and memories that periodically appear on the screen without the person being able to choose them, can make it difficult to process the mourning.

The aim of this paper is to consider the beneficial and detrimental factors of social media during a grieving reaction after the loss of a loved one.

For the preparation of this work, a bibliographic review on the subject has been carried out. Likewise, the clinical information provided by patients during our evaluations has provided critical views on what has been published in this regard.

Support through social networks can help to feel more affectionate, but there are other harmful factors that must be taken into account: permanence of photos, appearance of memories and reminder of the deceased person’s birthday.

Social networks can have favorable but also detrimental factors in the elaboration of a grief and should be considered in the psychiatric exploration and intervention.

No significant relationships.

Internet gaming has become a topic of interest since it has positive but also negative effects.

To explore the relationship between internet gaming, aggression and psychological distress in young adults.

229 Portuguese subjects (55.5% females), with a mean age of 21.13 years old (SD = 2.075, range: 18-29) filled in the Internet Gaming Disorder Scale-Short Form, the Buss-Perry Aggression Questionnaire, and the Depression, Anxiety and Stress Scales-21.

The total score of internet gaming was of 15.90 (SD=6.32), 79.9% (n=183) of the sample used to play videogames and 24.5% (n=56) spent more than ten hours playing a week. Internet gaming was correlated with physical aggression (r=.23**), anger (r=.31**) and hostility (r=.35**); and with depression (r=.36**), anxiety (r=.28**), and stress (r=.31**). A Mann Whitney U test revealed significant differences in internet gaming disorder levels of males (Md=130.75, n=102) and females (Md=102.35, n=127), U=4871.000 z=-3.232, p=.001, r=4.49.

Internet gaming disorder is associated with aggression and psychological distress, and males presented higher internet gaming disorder levels. Future studies are needed to explore the bidirectional relationships between gaming disorder, aggression and psychological distress.

No significant relationships.

GABAa-receptors proved to be the molecular targets of ethanol on immune and nervous cells, potentiating alcohol influence. ortho-Fluoro-benzonal is known to be a circular urea derivative and an artificial ligand of GABA/BD-receptor and thus a potential candidate drug for alchoholism treatment.

We have shown the alcohol motivation decrease under ortho-fluoro-benzonal influence in experiment. The investigation of molecular mechanisms and functional targets of this substance is an important step in understanding of molecular pathogenesis and approaches to managing alcohol addiction.

Splenocytes from male (CBAxC57Bl/6) F1 mice in a state of alcohol dependence owing to 6-month 10% ethanol exposure were aseptically obtained and cultured in presence of GABA, ortho-fluoro-benzonal and mitogens (LPS or concanavalin A). Proliferative activity of immune cells in vitro was estimated by means of radioactive 3H-thymidine incorporation.

The intact animals’ splenocytes revealed increased spontaneous proliferation, increased T-mitogen stimulated and decreased B-mitogen stimulated proliferation in the presence of ortho-fluoro-benzonal. The immune cells from alcoholized animals, demonstrating increased spontaneous proliferative activity and weaken susceptibility to the mitogens, showed normal response patterns, except B-mitogen response case, under ortho-fluoro-benzonal inluence. Addition of GABA into the cultures didn’t cancel most positive effects of ortho-fluoro-benzonal inluence, proving existence of their GABAaR-independent pathways, mediated by other barbiturate receptors in addition to GABAaR-dependent ones.

Immunomodulating properties of artificial GABA receptor ligand, ortho-fluoro-benzonal, in vitro has been shown. The compound may correct immune cells dysregulation caused by chronic ethanol exposure, so the original anticonvulsant has promise in the treatment of alcoholism.

The authors have not supplied a conflict-of-interest statement.

Cognitive behavioural therapy for psychosis as an adjuvant to pharmacological treatment has been been shown to be one of the most effective interventions for schizophrenia with benefits noted in even treatment resistant schizophrenia. Benefits have been mostly registered in the positive symptoms domain of schizophrenia. Acceptance and commitment therapy is a third generation Cognitive-Behavioural Therapy, empirically supported for a range of symptoms and conditions, including psychosis, with quickly increasing data. It targets experiential avoidance, which seems to be closely related with psychopathology. Its ability to also target affective symptoms can be an important advantage in the adjuvant treatment of psychosis.

To critically review the evidence of acceptance and commitment therapy in psychosis.

Non-systematic review of the literature with selection of scientific articles published in the past 10 years; by searching Pubmed and Medscape databases using the combination of MeSH descriptors. The following MeSH terms were used: “schizophrenia”, “acceptance and commitment therapy”.

Very few studies have been published on ACT and psychosis, with even less controlled trials and systematic reviews. So far there is convincing evidence for ACT reducing the frequency of hallucinations, increasing the outcomes of traumatic events associated with psychosis and having measurable effects on anxiety and help seeking behaviour.

As Acceptance and Commitment therapy evolves and more evidence arises a new kind of therapy with possible effects on both affective and positive symptoms in schizophrenia can emerge, allowing us to know what works for patients with psychosis and through what mechanisms and permitting the improvement of treatment strategies.

No significant relationships.

TRD is a highly disabling condition, often responsible for chronic clinical course, high number of relapses and elevated suicide risk. Intranasal esketamine is currently the only available pharmacological therapy specifically indicated for TRD, as add-on therapy to antidepressant treatment with SSRI or SNRI.

The purpose of the study was to evaluate the safety and efficacy of intranasal esketamine associated with CBT in a complex clinical case of TRD, over a six-month follow-up.

A 67-year-old patient with TRD was selected for treatment with intranasal esketamine+CBT as add-on to antidepressant therapy. Before each treatment session the HAM-D rating scale was administered. The patient underwent weekly CBT sessions throughout the 6 months follow-up. The effect on physical well-being and social functioning was evaluated by means of Short-Form-Health-Survey-36.

After the first two administrations of intranasal esketamine the total score on HAM-D decreased by 10 units (from 26 to 16). After 6 weeks of treatment decreased from 26 to 12 with the disappearance of suicidal ideation present at T0. After 6 months the total HAM-D score decreased from 26 to 8. Treatment was well tolerated, with mild adverse effects, confined to the first two hours post-administration. In particular, mild sedation, dizziness, slight transient blood pressure rise were reported, never required medical intervention and resolved spontaneously during the observation period.

Intranasal esketamine add-on therapy + CBT was an effective and safe treatment allowing to achieve and maintain symptomatic remission in a complex case of TRD, improving quality of life, social functioning, and reducing suicidal ideation over a six-month follow-up.

No significant relationships.

There are sufficient amount data on the immune cells and their biologically active products leading role in the pathogenesis of depression, which allows viewing modulated immune cells as model objects for developing new approaches to depression immunotherapy.

We first demonstrated the ability of immune cells modulated outside the body by caffeine to edit depression-like behavior and showed the central cytokines-mediated mechanisms of this effect. Considering theimportant role of the peripheral immune system in the pathogenesis of depression, we investigated the main parameters of its functional activity after transplantation of modulated immunocytes.

(CBAxC57Bl/6) F1 depressive-like male mice, developed under the long-term social stress, were undergoing the transplantation of syngeneic immune cells with in vitro caffeine-modulated functional activity. Recipient’s behavior and immune systems functional activity parameters were studied.

We showed earlier significant positive psychoneuromodulatory effect of caffeine-treated immune cells in depressive-like recipients which manifests itself in the behavioral editing (anhedonia reduction, stimulation of exploratory behavior and activity in forced swimming test); hippocampal neurogenesis stimulation against the background of increased BDN and modulation of brain cell’s cytokines production. Transplantation of caffeine-modulated immune cells in syngeneic depressive-like recipients also leads to positive changes in the immune system functional activity as evidenced by enhanced immune response, splenocytes proliferation stimulation on the background of modulation of cell’s cytokines production and decreased tryptophan catabolism, reducing systemic inflammation.

Results demonstrated that in vitro caffeine-modulated immune cells caused positive psychoneuroimmunomodulating effect in depressive-like recipients. So, its may be considered as a potential therapeutic agent in the treatment of depression.

No significant relationships.

Some projects have described post-disaster psychosocial services and planning across Europe. However, little is known about the real psychosocial disaster responses such as low-intensity initiatives after a terrorist attack

This study aims (1) to describe psychological support (PS) in the immediate (<48 hours), post-immediate (48 hours – 1 week) periods and more than one week after a terrorist attack among terror-exposed people, and (2) to identify factors associated with a lack of short-term PS among those who suffered from mental health disorders.

This study used data from a longitudinal survey of 189 civilians exposed to the January 2015 terrorist attacks conducted 6 months after the attacks. Factors associated with lack of PS after the attacks was identified using a Robust Poisson regression in three separate models (for the 3 periods).

Among participants who suffered from PTSD (n=34), depression (n=74), or anxiety (n=59) 6-9 months after the terrorist attacks, respectively, 9%, 18% and 12% did not received psychological support. The lack of immediate PS was associated with geographical distance, type of exposure, and support in daily life. The lack of post-immediate PS was associated with geographical distance, peri-traumatic reactions and past psychological follow-up. The lack of PS after one week was associated with geographical distance and social isolation.

Characteristics of exposition and social support seem to play an important role in lack of PS after a terrorist attack and highlights the need to use strategies to reach out to people regardless of the type of exposure.

No significant relationships.

Mental health care is considered to be one of the main sources of mental illness stigmatization. Detailed information about these stigmatization experiences is needed to reduce stigma in mental health practices.

The study aimed i) to identify the most relevant stigmatizing situations in mental health care encountered by users and families, ii) to characterize the relative importance of these situations in terms of frequency, experienced stigmatization and suffering, and iii) to identify individual and contextual factors associated with these experiences.

In a focus group, users were asked to select the 15 most relevant stigmatization situations among those they elicited and those that were taken from the literature. An online survey was then conducted among users and family members to characterize these situations and identify predictors.

A total of 235 participants were included: 59 participants with schizophrenia diagnosis, 96 with other psychiatric diagnoses and 80 family members. The results revealed 15 situations with different levels of frequency, stigmatization and suffering. Participants with a diagnosis of schizophrenia experienced more situations of stigmatization and with a higher frequency. Moreover, factors such as recovery-oriented practices and measures without consent were the best predictors of experienced stigmatization.

These original stigmatization situations could be targeted to reduce stigmatization and associated suffering in mental health practices. Results strongly suggest that recovery-oriented practice should be fostered to fight stigma in mental health care.

No significant relationships.

Psychosocial functioning is an an important issue in the follow-up processes of patients with bipolar disorder. Potential predictors of functional impairment in bipolar disorder may give a chance to improve functioning in this group of patients.

We aimed to assess the differences between patients with bipolar disorder and healthy controls due to childhood traumas, attachment styles, dysfunctional attitudes, affective temperaments and to assess which of these factors may significantly predict the overall functional impairment in patients with bipolar disorder.

63 remitted patients with bipolar disorder and 61 healthy controls were enrolled in the study. Asessment was conducted using a sociodemoghraphic and clinical questionnaire, Hamilton Depression Rating Scale 17-item version (HAM-D-17) and the Young Mania Rating Scale (YMRS), Childhood Trauma Questionnaire(CTQ-28), Relationship Scales Questionnaire (RSQ), Dysfunctional Attitudes Scale (DAS), Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS-A) and Functioning Assesment Short Test (FAST).

In the patient group scores of childhood traumas, dysfunctional attitudes, cyclothymic, depressive and anxious temperaments, all domains of functional impairment scores except financial issues, and overall functional impairment scores were significantly higher than the control group. Besides this, secure attachment scores were significantly higher in the control group. In the regression analysis anxious temperament and subclinical depressive symptoms significantly positively predicted functional impairment and hyperthymic temperament significantly negatively predicted functional impairment in patients with bipolar disorder.

In the assessment of functioning of patients with bipolar disorder subclinical depressive symptoms, hyperthymic and anxious affective temperament styles might be taken into consideration.

No significant relationships.

Postoperative cognitive disorders are an emerging public health problem because of its related socio-economic impact.: Postoperative cognitive disorders are an emerging public health problem because of its related socio-economic impact.

To determine the incidence and risk factors of cognitive disorders after endoscopic resection in urology.

This is an observational, descriptive and analytical study carried out in the urology department of Sahloul University Hospital during a 3 month period, and enrolling patients scheduled for endoscopic resections. Collected data included socio-demographic characteristics and parameters related to the operative management. Cognitive disorders were assessed by the MOCA Test one day before the intervention, then, during the first postoperative day. Patients developing TURP syndrome were excluded.

During the study period, 104 patients were enrolled with a mean age of 67.76 years. The sex ratio was 33.6. Main interventions were transurethral resection of bladder tumor and transurethral resection of the prostate.The incidence of cognitive disorders was 45.2% after endoscopic resection. Main Risk factors in multivariate analysis were age (p <10-3), low educational level (p <0.001), sedentary (p <0.001), smoking (p = 0.029), an age gap with spouse> 10 years (p <0.001), high blood pressure (p <0.001), myocardial infarction (p = 0.005); chronic bronchitis (p = 0.002), sleep disorders (p <0.001), preoperative concentration disturbances (p = 0.005), poor quality of patient information (p <0.05), and the type of anesthesia (p = 0.012).

The incidence of cognitive disorders after urologic endoscopic surgery is considerable. Patients with risk factors require preventive measures, regular screening and optimal management.

No significant relationships.

Structural variations of DNA, such as copy number variations (CNVs), are important contributors to risk for human diseases. Several CNVs have been associated with an increased risk of early-onset neurodevelopmental disorders (NDD), adult-onset psychiatry disorders and physical comorbidities. While in Pediatrics the microarray is the first-line genetic analysis technique in the study of child onset NDD, its use in psychiatry care of young/adult onset NDD has been limited to research purposes.

Review of the diagnostic yield of the use of microarrays analysis in psychiatric clinical practice of severe mental disorder care in adults, according to the concept of a neurodevelopmental continuum.

An exploratory literature review on the topic in PubMed, including the terms: “copy number variants/CNVs” AND “neurodevelopmental delay/disorders, congenital anomalies/malformations, ADHD, autism/ASD, learning disabilities, epilepsy, Tourette, schizophrenia, bipolar, behaviour”.

The prevalence of carriers of pathogenic or likely pathogenic CNVs among the different NDD phenotypes investigated by microarray analysis ranged from 3-22.5%. The majority of studies in adult psychiatric populations examined schizophrenia. Intellectual disability, autism spectrum disorders, dysmorphic features and multiple NDD/psychiatric diagnoses were described as predictors of an increased diagnostic yield of microarray testing.

While CNV testing is frequent in early-onset NDD; microarray analysis has not been established in psychiatric clinical practice despite the evidence of a high prevalence of findings in adult-onset NDD. The potential benefits in the detection of CNV are associated with physical comorbidities detection, understanding of pathogenesis of disease or genetic counseling. High-quality research designs are required before a routine clinical use.

No significant relationships.

Since June 2018, multi-site overdose prevention education and naloxone distribution has been available in the County of Skåne, Sweden. Among the participants there are individuals who have used naloxone to reverse overdose on multiple occasions (three times or more). Situations of overdose management are characterized by different conditions which inevitably lead to different decisions and outcomes.

To investigate the complex interaction of individual, social, and environmental factors of opioid overdose management, how these overdose situations affect responders´ lives, what impact prior experiences may have on engagement in future overdose situations and if needs of support to deal with these situations are met.

Qualitative study employing semi-structured interviews with individuals trained at needle exchange programs within the region who have used naloxone on more than two occasions to reverse opioid overdose. Interviews will be conducted during Q4 2021 and analysed thematically during Q1 2022.

Preliminary clinical observations point to the ambivalence between positive consequences of empowerment and pride in saving lives, and negative feelings of prior decisions and the burden to engage in future overdoses, in addition to insufficient access to support when dealing with these negative consequences.

Not yet available.

No significant relationships.