Medication adherence by persons with bipolar disorder (BD) is inconsistent. This is disconcerting, as BD is treatment responsive, side-effects are few, and the impact of both hypo/manic and depressive mood episodes can be considerable (e.g., self-harm).

For this study, we computed a path model to identify both direct and indirect predictors of medication adherence. This included both clinical and psychosocial independent variables (e.g., BD symptoms, psychological well-being, alcohol misuse).

From the BADAS (Bipolar Affective Disorder and older Adults) Study, we identified a global sample of adults with the BD. Participants were recruited using microtargeted, Facebook advertising. This sample included persons living in Canada, U.S., U.K., Ireland, Australia and New Zealand (M = 55.35 years, SD = 9.65).

Direct predictors included perceived cognitive failures and alcohol misuse. Of note, medication adherence is inversely associated with number of prescribed antipsychotic medications. Neither symptoms of depression nor hypo/mania emerged as direct predictors of medication adherence. Similarly, psychological well-being appears indirectly associated with adherence (via BD symptoms).

Despite the wide age range of participants (22 – 73 years), age did not emerge as a predictor of adherence. Nor do cognitive failures appear significantly associated with age suggesting that both young and older adults with BD perceived cognitive loss.

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.

Trans-cranial magnetic stimulation (TMS) as a non-invasive method of altering brain activity (1) has widened the array of therapeutic options available for various psychiatric disorders.

Trans-cranial Magnetic stimulation (TMS) as a non-invasive method of altering brain activity has widened the array of therapeutic options available for various psychiatric disorders. •A large number of studies have shown therapeutic benefits in a wide range of patient population with majority of studies in adults. •TMS is used increasingly for the treatment of child and adolescent depression. •Yet, the scarcity of studies and lack of published guidelines for this population is notable. •As TMS use is expanding in this population, an overview of the use of TMS in children and adolescents with depression may provide much needed and timely perspective on this neuropsychiatric intervention.

We searched all published studies using PubMed database, on TMS use in depressive disorders in children and adolescents. A total of 13 studies were found to have reported use of TMS in depression in children and adolescents.

We found various case series, open label studies as well as sham controlled blind studies indicating that TMS has been effective in treating depression in children and adolescents. No significant side effects were found in our review.

Studies have shown that TMS is an effective treatment option for depressive disorders in children and adolescents. Initial studies look promising but implications in large pediatric population may be different and there is a need for more double blind, controlled trials with larger sample size.

No significant relationships.

No significant relationships.

ADHD is a neurodevelopmental disorder displaying inattention, hyperactivity, and impulsivity as core symptoms. It can affect several areas of life including sexual health. Clinicians have often made assumptions concerning the bound of specific ADHD symptoms affecting sexual desire by increasing its frequency and intensity. Yet, there is still a lack of knowledge about the comorbidity between ADHD, hypersexuality, and paraphilias. A recent literature review could show that some individuals who suffer from ADHD report about hypersexual and paraphilic fantasies and behaviors, but as far as we know, no clear empirical data has emerged supporting the idea that hypersexuality and paraphilias are more frequent in individuals with ADHD.

The present investigation aimed to compare several sexuality related aspects between individuals with and without ADHD.

Therefore, we designed an extensive online survey based on established questionnaires, such as the Hypersexual Behavior Inventory (HBI). The survey was implemented in a outpatient sample, ADHD specific fora as well as other general online channels.

In total, N = 238 individuals participated in the survey (n = 160 with ADHD). Thereby, individuals with ADHD reported significantly more often about a wide range of hypersexual fantasies and behaviors in comparison to individuals without ADHD. Furthermore, individuals with ADHD reported significantly more often about paraphilic fantasies and behaviors including fetishistic and sadistic sexual fantasies. No differences were found concerning other paraphilias. Further results regarding other facets of sexuality, such as sexual orientation, are to be presented and discussed.

The present study contributes to closing the knowledge gap regarding sexuality in individuals with an ADHD.

No significant relationships.

An infectious disease such as COVID-19 can have a great impact on mental health due to the fear of contracting it as well as the social isolation itself due to the containment measures. Such events are considered stressors, as they can be perceived as threatening or challenging, and can have cumulative effects that are harmful to mental health. Along with this scenario, anxiety can occur in association with stress, and it is defined as extreme concern and somatic symptoms that generate tension, hindering the proper functioning and development of basic life functions. In people with Autism Spectrum Disorder (ASD) and their families, such events can occur more intensely, as changing routine and adapting to different activities are usually challenging. The study examined stress, anxiety and coping strategies during the pandemic.

To analyze stressful events, anxiety and coping strategies in caregivers of children and adolescents with ASD and typical development.

Forty caregivers of children and adolescents with ASD and 40 of typically developing participated in the study. The assessment instruments used were: 1. RSQ COVID-19; 2. Semi-structured interview; 3. State–Trait Anxiety Inventory for Adults. For statistical analysis, analysis of variance (ANOVA) or chi-square were used.

Caregivers of children and adolescents with ASD showed greater stress and anxiety, in addition to using less adaptive coping strategies.

There is a great need to welcome families of children and adolescents with ASD, helping to develop coping or coping strategies.

No significant relationships.

Loneliness is a critical issue of adolescents that has grown severe during the last decade. Social media use is often regarded as negative factor of loneliness experience in connection with escapism. At the same time social media is an important part of adolescents’ communication sphere. The present study aims to explore positive functions of social media which can help adolescents cope with loneliness.

The present research studies features of loneliness representation in adolescents with different behavior in social media.

Multidimensional Inventory of Loneliness Experience; Cognitive Processing of Social Information in Internet Questionnaire; Method of unfinished sentences about loneliness and social media; Questionnaire about social media were used in the study with 44 adolescents, aged from 13 to 18.

Adolescents have a higher level of loneliness (M = 29.6) than the results in 2013 (M = 17.7) show. Context analysis of unfinished sentences shows that 21% of adolescents have a various representation of loneliness, 71% perceive loneliness as negative. General feel of loneliness tends to show negative correlations with adequate perception of information in social media (k = - 0.317; p = 0.038). Negative attitude to loneliness is negatively correlated with interpretation adequacy of social media content (k=-0.568, p<0,001). Adolescents with low levels of holistic social media perceptions have higher levels of loneliness. Use of social media can reduce feelings of loneliness (p = 0.002).

Social media expand adolescents’ representation of loneliness. Productive use of social media can help adolescent cope with loneliness.

No significant relationships.

Post traumatic stress disorder (PTSD) is a mental health condition that’s triggered by a psychotraumatic event .

The aim of our study was to investigate the clinical manifestations of PTSD in the pediatric population.

This is a descriptive cross-sectional study carried out on children over the age of 7 and victims of a traumatic event that had occurred at least one month before. They were recruited from August 2020 to April 2021, in child psychiatry department. The clinical manifestations were evaluated using the Clinician Administered PTSD Scale Child and Adolescent version for DSM 5 (CAPS CA5) in Tunisian dialect. The statistical processing of these data was carried out using SPSS 26 software.

We recruited 101 children who had experienced a traumatic event which was in 35.6% physical assault, 47.5% sexual assault and in 16.8 % exposure to death. The mean age was 10.7 years at the onset of traumatic event and 11.74 years at the interview. We noted in our patients a female predominance at 64.4%. Diagnosis of PTSD according to the diagnostic criteria of the DSM5 was retained in 54.5% of cases. Intrusive symptoms were present in 81.2%, with 66.3% of involuntary, intrusive memories. Persistent avoidance of stimuli was noted in 80.2%. 71.3% of cases suffered from negative cognition and mood. We found in 66.3% marked alterations in trauma-related arousal and reactivity. Resulting in clinicialy significant distress in71.3%.

Recognizing PTSD symptoms is essential for diagnosis to initiate specialized care and reduce impairment at this critical age.

No significant relationships.

Capgras syndrome is a disorder of personal identification characterized by the delusional belief that one or more persons close to the subject have been replaced by physically identical doubles.

To deepen our knowledge of the Capgras syndrome

A case report about a Capgras syndrome.

We report the case of a 46-year-old female patient who was admitted in February 2021 for incoherent speech and behavior disorder against her family members. Three years ago, she started to have hypochondriacal concerns. A week before her admission, she threatened her husband with a knife and she was convinced that her daughters were dead and that they had been replaced by clowns. She had a Capgras delusion with a hallucinatory and interpretative mechanism against her daughters, she reported olfactory and cenesthetic hallucinations. Biological explorations and brain CT were normal. The PANNS scale showed a positive scale of 36, a negative scale of 39, the general psychopathology scale of 53. She had a total score of 30/40 on The Penn emotion recognition test. The patient had difficulty in recognizing low intensity emotions (0 or 1) and 50% of the false responses were for the neutral emotion with responses tending towards anger first and then sadness.

Capgras syndrome remains poorly described in the literature and the hypotheses concerning its origin often oscillate between neuropsychological and psychodynamic. With the recent advances in neuroscience, it would be interesting to deepen its physiopathology in order to place it in a more modern nosological framework.

No significant relationships.

The Burnout syndrome occurs preferentially in individuals subjected to intense stress conditions. The nursing staff in Obstetrics Gynecology is an example of this.

To assess the prevalence of Burnout and its determinants in the obstetrics gynecology service - Mahdia.

We conducted an analytical cross-sectional study carried out with the medical and paramedical staff of the gynecology-obstetrics department of the Taher Sfar Mahdia hospital during a period of 3 months.We used a pre-established self-questionnaire containing 2 parts: a part exploring the socio-demographic data of the population and a psychometric part evaluating Burnt out using the “Maslach Burnout” scale inventory ”.

Our sample consisted of 122 medical and paramedical personnel.The sex ratio was 4.3 (99/23), the mean age was 30.5 with values ranging from 25 to 55 years.Of the participants, 59 (48.3%) were single .Nine (7.4%) of the participants were smokers and 2 (1.6%) consumed alcohol.The majority of the population (96.7%) did not have a psychiatric history, 88 (80.3%) reported an organ history.A high level of burnout was noted in 64.8% of our population with 14.8% severe burnout. The presence of burnout was significantly associated with the consumption of psychoactive substances (p = 0.05) and professional rank (p = 0.04) .Nurses, residents and senior doctors werethose most at risk of developing burnout. It was also significantly related to the absence of other professional activities such as research (p = 0.05) and training continuing medical care (p = 0.05).

Psychological intervention strategies with these suffering health promoters would be desirable.

No significant relationships.

The ongoing debate regarding the treatment efficacy for negative and cognitive symptoms in schizophrenia is a subject of continuous frustration among psychiatrists. These symptoms are reputedly hard to tackle therapeutically and their impact on long-term functional prognosis made them an important target for the maintenance treatment.

To review the literature in order to find the most adequate treatment options for negative and cognitive symptoms of schizophrenia.

A literature review was performed through the main electronic databases (PubMed, CINAHL, SCOPUS, EMBASE, www.clinicaltrials.gov) using the search paradigm “schizophrenia” AND “negative symptoms” AND “cognitive symptoms” AND “pharmacological treatment”. All papers published between January 2000 and August 2021 were included.

The efficacy of atypical antipsychotics over cognitive dysfunctions in schizophrenia decreases with time, without significant differences between the agents. Clozapine, amisulpride, olanzapine, and risperidone have superior efficacy over positive and negative symptoms, with small to moderate effect sizes. Meta-analyses show decreased severity of negative symptoms during treatment with atypical antipsychotics, especially with clozapine, amisulpride, olanzapine, zotepine, and risperidone. Atypical antipsychotics had a superior effect over neurocognitive domains when compared to the typical antipsychotics. Newer atypical antipsychotics, with partial D2/D3 agonism, are preferred to other atypical agents, although based on a low level of evidence. Antidepressants, especially mirtazapine, may be a solution for negative symptoms, while modafinil/armodafinil is also useful as an add-on.

Although new therapeutic options are explored, there is a paucity of encouraging results from the pipeline regarding the treatment efficacy over negative/cognitive symptoms.

No significant relationships.

Lithium can induce renal and neurotoxic effects, particularly if it is combined with a neuroleptic or if there is an intercurrent condition. The neurological sequelae may be irreversible.

To show the renal and neurotoxic effects of lithium and the risk of its association with haloperidol.

A case of irreversible lithium neurotoxicity wih renal sequelae.

This case report is about a 57-year-old patient with a bipolar disorder type 1. She was well stabilized on lithium.On December 2020, the patient had an increased level of creatinine, therefore her medication was stopped. She developed a manic episode then she was switched on Haldol 25mg and lithium. After 4 days, she had a neuroleptic malignant syndrome with renal and neurological sequelae.. She was referred to us after her discharge from intensive care. The patient was agitated, anxious, sad with a superficial contact and a well-structured speech. She had delusional ideas of prejudice about her husband. On physical examination, she had a parkinsonian syndrome, moderate organic renal failure with a clearance of 45.93 ml/min. On the cerebral MRI, she had a diffuse cotico-subcortical atrophy with bilateral frontal predominance and vascular leukopathy. The most probable cause was the iatrogenic effects of the association of lithium and haloperidol. We decided to stop all medications and the patient got better.

Recognizing the neurotoxic effect of lithium and making an early diagnosis is a crucial determinant in the evolution of the disease and its irreversibility. Polypharmacy and comorbidities appear to be important precipitating factors for lithium toxicity.

No significant relationships.

Few studies have explored ethnic inequalities in physical and mental health in women at preconception.

Explore inequalities in multimorbidity in women of reproductive age.

Data from Lambeth DataNet, anonymized primary care records of this ethnically diverse London borough, linked to anonymized electronic mental health records (“CRIS secondary care database”) were extracted on preconception risk factors including BMI, smoking, alcohol, substance misuse, micronutrient deficiencies and physical health diagnoses for women aged 15-40 with an episode of secondary mental health care (January 2008-December 2018) and no pregnancy codes (n=3,633) and a 4:1 age-matched comparison cohort (n=14,532) .

Women in contact with mental health services (whether with or without SMI diagnoses) had a higher prevalence of all risk factors and physical health diagnoses studied after adjustment for deprivation and ethnicity. Women from minority ethnic groups [79.5% of total sample] were less likely to be diagnosed with depression in primary care compared to White British women [adj OR 0.66 (0.55- 0.79) p<0.001] and Black women were more likely to have a severe mental illness [adj OR 3.41(2.63-4.43), p<0.001]. Black and Asian women were less likely to smoke or misuse substances and more likely to be vitaminD deficient. Black women were also significantly more likely to be overweight [adj OR 4.56(3.96-5.24 p <0.001] and have two or more physical health conditions [adj OR 2.98(2.19-4.07) p<0.001] than White British women after adjustment for deprivation and SMI diagnoses.

Our results highlight a need for culturally centered integrative models of care across primary and secondary mental health services.

Closing the Gap is funded by UK Research and Innovation and their support is gratefully acknowledged (Grant reference: ES/S004459/1). Any views expressed here are those of the project investigators and do not necessarily represent the views of the Closing

Depression is one of the most frequent mental health problems in older populations.1 To the best of our knowledge, the prevalence of depressive symptomatology (DS) among centenarians in Switzerland is unknown. Furthermore, the COVID-19 pandemic may have had a negative impact. As part of the study SWISS1002, we intend to provide key information on centenarians’ levels of DS.

To describe the DS of Switzerland’s centenarians during the COVID-19 pandemic.

Randomly selected centenarians from across Switzerland and their proxy relatives were invited to participate. Data are collected via telephone. The questionnaire includes the assessment of DS via the Geriatric Depression Scale (GDS)– 5 items.3 Preliminary data were analysed using descriptive statistics.

Telephone interviews were completed with 51 centenarians, and for 19 of them, proxy relatives also answered. The MAge of the centenarians was 101.41 (1.47) years, 34 (66.67%) were female and 27 (52.94%) lived at home. The mean score of the GDS–5 was 1.32 (SD=1.49). Considering a cut-off ≥2, 18 (36%) centenarians were screened positive for possible depression. Descriptive statistics indicated effects of gender (men: M=1.41, SD=1.46; women: M=1.27, SD=1.53) and living situation (private: M=1.07, SD=1.36; institution: M=1.61, SD=1.62). Centenarians’ and proxy reports were significantly related (ρ=0.56; p<.05).

Clinically relevant DS are highly prevalent among centenarians during the COVID-19 pandemic (36%), which is consistent with a recent study4 reporting a prevalence of 32% in a sample of younger older adults (MAge: 77.6, SD=6.9). To conclude, DS in centenarians should be screened systematically, especially in this time of unprecedented health crisis.

No significant relationships.

Although smoking prevalence has been decreasing worldwide, sustained tobacco cessation remains a challenging goal for many smokers. Nicotine replacement therapy (NRT) products remain among the most widespread type of cessation tobacco aids, along with the more recently introduced electronic cigarette, the efficiency of which is still a matter of debate in the public health community.

This study aims to contribute to the ongoing discussion about effective ways of encouraging tobacco cessation and in particular evaluating the role of the two aforementioned tobacco cessation aids with regard to lasting smoking abstinence in real-life settings.

The study is based on the French 2017 Health Barometer, a cross-sectional survey conducted by Santé Publique France. Two distinct outcomes related to tobacco cessation were used: smoking status at 6 months follow-up (yes vs. no) and the duration of smoking abstinence. These two study outcomes were examined respectively among N1 = 2783 and N2 = 1824 participants. All results were weighted based on inclusion probability weights and controlled for propensity scores via overlap weighting (OW), which is appropriate when exposure groups are disparate.

After adjusting on potential confounders, tobacco cessation at 6 months remains significantly associated with e-cigarette use (OR: 1.50 (1.12-1.99)) and e-cigarette use combined with NRT (OR:1.88 (1.15-3.07)). This association did not reach statistical significance in the long-term analysis, nor did the results of NRT use alone in both analyses.

Overall, while electronic cigarette use alone and combined with NRT is associated with an increase in the likelihood of smoking cessation, the long-term effects are probably limited.

No significant relationships.

Nurses may be particularly at risk of violence exposure at work which can cause psychological trauma and even develop post-traumatic stress disorder (PTSD), which is a serious mental health disorder.

The aim of this study was to determine the prevalence of PTSD among nurses in psychiatry and emergency departments and to identify the factors associated with it.

This was a cross-sectional, descriptive and analytical study. It concerned 60 nurses working in the psychiatry (35 nurses) and emergency (25 nurses) departments of the Hedi Chaker and Habib Borguiba University Hospital in Sfax. The screening of PTSD was carried out by the « post-traumatic stress evaluation questionnaire » (PTSQ).

Direct trauma exposure was reported by 93% of participants, of which 48.3% experienced the act of violence more than 4 times. According to the PTSQ, 48.3% of the nurses had PTSD with a mean score of 50.93. Hyper-arousal was the most frequently observed outcome in victims (85%), followed by re-experience (83%) and avoidance (80%) symptoms. The presence of PTSD was correlated with female gender (p=0.002), the young age of the nurse (p=0.04), and the absence of peri-traumatic reactions (p=0.001).

Our study shows that PTSD is a pathology frequently encountered in psychiatric and emergency nurses. Hence the need to put in place strategies against violence in hospitals and to apply them rigorously in order to better manage this phenomenon and manage its repercussions on health workers .

No significant relationships.

Analysis of the first-episode psychosis remission, including post-psychotic affective and primary negative symptoms as well as personality changes, is necessary to personalize therapy and rehabilitation.

We aimed to identify different trajectories of psychosis remission in young adults.

First-episode psychosis patients (n=56, mean age 19.8±2.5 years, all males) underwent psychopathological assessment at the stage of remission.

Three trajectories of remission were identified. The thymopathic trajectory (33.93%, 19 patients) was characterized by the gradual increase of subclinical affective symptoms and resulted with a high-quality remission. In 63.61% cases in this group persistent depressed mood was present after a psychotic episode. Some patients (36.84%) became prone to depressive reactions. The pathocharacterological trajectory (39.28%, 22 patients) was characterised by personality changes with increase of existing traits or the development of traits previously not present. Types with an increase of schizoid (14.29%), histrionic (19.64%), and anxiety-hypochondriacal (5.36%) traits were identified. Patients in this group had high- as well as low-quality remission. The destructive trajectory (26.79%, 15 patients) was characterised by residual positive or single negative symptoms. Patients in this subgroup had low-quality remission with poor functioning and signs of treatment resistance.

Analysis of trajectories of the first-episode psychosis remission allowed us to choose the most effective strategy for personalized supportive treatment.

No significant relationships.

Sexual assault constitutes a major problem in Tunisian society. There is no definitive typology of the characteristics of those who sexually assault. The great diversity of sexual assault behaviors and the different underlying motivations do not allow us to describe a typical profile of the sexual assailant. There may be cognitive, personality trait, lifestyle, and pathway distortions involved in the etiology and maintenance of deviant sexual behaviors.

To establish the socio-demographic and clinical profile of the perpetrators of sexual assault appraised in the psychiatric service of Mahdia.

This is a descriptive retrospective file-based study on all subjects assessed at the Taher Sfar Mahdia psychiatric department for sexual assault during the period from January 01, 2010 to December 31, 2020.

Our sample consisted of 18 interviewed subjects. The median age was 40 years with extremes of age of the accused ranging from 30 to 61 years. The entire population is male. He was essentially of average socio-economic level. A psychiatric diagnosis was retained in 50% of the perpetrators of sexual assault: bipolar disorder (27.7%), schizophrenia (11.1%), antisocial type personality disorders (5.5%) and mental retardation (5.5%). Indecent assault was the most common assault followed by rape. The minors were victims in 33.3% of the cases Among those arrested, 72% were considered responsible for their acts and only one is considered irresponsible.

The studies having focused on the characteristics of the sexual aggressors concluded with a profile of the young man, single and badly inserted which does not constitute in any case a typical profile.

No significant relationships.

Cancer is a disease that can cause traumatic experiences and disrupt the balance of life in individuals. The development of resilience in individuals is important in adapting to the cancer process and the difficulties that the process may bring.

To investigate the effectiveness of interventions for the psychological resilience of individuals with cancer.

The findings of randomized controlled trials related to interventions to effect resilience of individuals with cancer were included. Comprehensive Meta-Analysis software was used to analyze the data. Hedges’ g and 95% confidence intervals were computed to estimate the effect. Additionally, funnel plots were created to assess publication bias. The Preferred Reporting Items for Systematic Reviews and Meta‐Analysis was used.

The eight studies that demonstrated the effect of the interventions on resilience of individuals with cancer were heterogeneous. The effect size was 2.649 (95% CI = 1.325 - 3.973), was statistically significant (p < 0.001). Results of the subgroup analysis showed that the effects of sample size, cancer type, lenght of treatment, duration of intervention and gender were significant. According to the lenght of treatment studies lasting >90 min and >10 weeks were less significant impact on resilience. Studies in which the sample consisted of more than 100 participants, conducted participants with mixed type of cancer and the sample consisted of participants from both genders demonstrated statistically significant effects on resilience.

This study showed that supportive interventions are crucial in developping psychological resilience among individuals with cancer. However, the findings also underscore the need for further research.

No significant relationships.

Although defined heterogeneously within the literature apathy is classified as a multidimensional deficit with emotional, behavioral, and cognitive domains in which there is a decrease in self-motivated/goal-directed activity. Recently conceptualized as a syndrome but lacking a universal screening tool.

Review current knowledge on apathy and its best therapeutic approach.

Non-systematic review of literature through search on PubMed/MEDLINE following the terms “apathy”and“psychiatry”.

Apathy is amongst the most frequent symptoms of dementia and highly prevalent across different forms and stages of dementia, including mild cognitive impairment (MCI) as well as other neurodegenerative and psychiatric disorders such as Parkinson’s disease (PD), Schizophrenia, Depression and Brain Injury. Individuals with apathy have higher frequencies of cognitive impairment and are less likely to be compliant/respond to treatment for comorbid illnesses. Apathy reduces quality of life, increases mortality and leads to caregivers distress - often identified as the most burdensome symptom. Once treatment should favor dopaminergic neurotransmission, psychostimulants were considered. Methylphenidate showed encouraging results as well as dopamine agonists but both with limited evidence. Atypical antipsychotics(APs) seem beneficial compared to typical APs. Antidepressants did not improve symptoms and may even worsen them. Previously reported benefits of acetylcholinesterase inhibitors (AChEIs) were not replicated in recent studies except for rivastigmine in PD. Nonpharmacological interventions are also important.

Apathy occurs frequently in a broad range of neuropsychiatric conditions and considering its impact on patients´ quality of life more studies are needed to find an efficient treatment. A consensus regarding definition and screening tools would allow a better approach.

No significant relationships.