Disengagement from care in early psychosis is frequent. In outpatient general psychiatric services rates range from 17 % to 60 %. In early intervention programs, rates range from 14 % to 33 % at two years. In Europe, a study reported an initial drop out rate at 48 %.

Measure intensity of care during two years after first hospitalization in a schizophrenia spectrum disorder population. Search for a difference between lost and maintained follow-up patients.

A monocentric retrospective study was conducted. All patients aged 16 to 30 with at least one hospitalization for schizophrenia spectrum disorder from January 2013 to December 2018 in CHAC were included. First hospitalization medical charts and all (social, nurse, psychologist, psychiatrist) outpatient appointments were assessed. A monthly mean of all appointments (MMA) was calculated for each patient. Lost or maintained groups at two years were compared with a Mann-Whitney test.

Among 48 patients, 52,1 % (N=25) disengaged from initial follow up within 2 years. The MMA for (N=46) patients was 1,45 (SD 1,35), 0,5 (SD 0,33) for psychiatrists. For lost patients, the MMA was 1,35 (SD 1,40) compared to 1,55 (SD 1,32) for maintained. No significant difference was found : U=229,50 p=0,45.

At two years, care appears more intensive for maintained patients than for lost ones, but no significant difference was found.

No significant relationships.

There is no consensus about whether late-onset schizophrenia(LOS) is a type of schizophrenia or a secondary psychotic disorder. One of the theories of the occurrence of late-onset psychoses is neurodegeneration caused by the imbalance of proteostasis.

To study the concentration and expression of alpha-synuclein in patients with LOS compared with controls.

The study involved 42 patients with the ICD-10 criteria of schizophrenia with the onset of the disease after 45 years and 104 controls with no dementia and severe somatic pathology, comparable in age and gender. The alpha-synuclein level was estimated in a lymphocytic cell fraction from patients with LOS N=42 and controls N=104 using the Human alpha-synuclein ELISA kit. The expression of the SNCA gene was studied in 22 LOS patients and 22 controls and determined by PCR using the SYBR Green Supermix kit and the CFX96 instrument in comparison with the referent genes using previously developed primers. LOS group underwent psychopathological examination including scales. Statistics: SPSS 12.0; the Mann–Whitney test; exponential regression analysis; data is given as median (min–max). The level of significance was set at p<0.05.

The alpha-synuclein level is higher in patients with LOS (9.21 (0.78-29.52)) compared to control (6,355 (0.46-35.44)), p=0.024. The mRNA level of the SNCA gene is higher in the LOS group (0.533 (0.089-1.406)) compared to controls (0.087 (0.016-0.266) , p<0.001.

Our study shows the relationship of alpha-synuclein with the manifestations of LOS. Obtained novel data can open up new targets for therapy and bring it closer to understanding the phenomenon.

No significant relationships.

The emotional state of university students is critical for their successful learning, efficient interacting with people around, and increasing the quality of life in general. The COVID-19 pandemic widely affected the mood and emotional state of student youth.

The study focuses on tracing the dynamics of positive and negative affects among students in the first few weeks after the announcement of the COVID-19 pandemic and one year later.

Positive and Negative Affect Schedule (PANAS, Watson, Clark, Tellegen, 1988) was applied in the research. The study involved 210 university students aged 18 to 23. The study was conducted online shortly after the COVID-19 pandemic was declared in spring 2020 (N = 105) and a year later (winter-spring 2021) (N=105). Given that the sizes of subsamples are comparable ANOVA was used for the periods under consideration (Levene Statistic > 0.05).

One-way analysis of variance ANOVA showed that evaluations of positive affect differ significantly (p <0.05) while estimations of negative affect do not differ (p> 0.05) during the periods of the COVID-19 pandemic (spring 2020 and winter-spring 2021 ). With Post Hoc Scheffe, it was also shown that the positive affect scores in spring 2020 were significantly higher than in winter-spring 2021 (p <0.05).

Thus, it has been shown that although the level of negative affect in students did not increase a year after the beginning of the COVID-19 pandemic, the level of positive emotions significantly decreased during this period. The reported study was funded by RFBR, project number 20-04-60174.

No significant relationships.

Tendency to experience inaccurate beliefs alongside perceptual anomalies constitutes positive schizotypal traits in the general population and shows continuity with the positive symptoms of schizophrenia. It has been hypothesized that the positive symptomatology of schizophrenia, and by extension, positive schizotypy, are associated with specific alterations in memory functions. Imbalance between memory generalization and episodic memory specificity has been proposed on several counts; however, the direction of the imbalance is currently unclear.

We aimed to contrast two competing hypotheses regarding the association between positive schizotypy, and memory alterations in a general population sample (N=71) enriched for positive schizotypy from a larger pool of individuals (N=614).

Positive schizotypy was measured with the short-version of the O-LIFE questionnaire, and memory specificity and generalization was captured by the well-established Mnemonic Similarity Task.

Distortions in the behavioural memory performance indices were found to correlate with positive schizotypy: individuals prone to unusual experiences demonstrated increased discrimination and reduced generalization (explaining 10% and 17% of variance, respectively). Associations were robust when controlled for the disorganized, negative and impulsive-asocial dimensions of schizotypy and associated psychopathology.

Our findings show that people who are prone to irrational beliefs and unusual experiences also show measurable alterations in memory and likely have difficulty grasping the global picture and rather be overpowered by fragments of information.

No significant relationships.

Psychiatric comorbidity is prevalent among patients with epilepsy. Post-ictal psychosis syndrome (PIP) is a recent entity important to know. It belongs to the group of epileptic psychoses. The clinical presentation is often atypical, and symptoms are usually related to seizures.

This work aimed to study the particularities of PIP.

It is a case report of PIP, involving a patient hospitalized in psychiatry department.

We report the case of a 45-year-old woman, with medical history of generalized epilepsy which was stabilized under antiepileptic treatment (phenobarbital 150 mg/day). The patient was hospitalized for psychomotor instability and inconsistent speech after having experienced a generalized tonic-clonic seizure in the context of discontinuation of treatment. Psychiatric assessment revealed a hostility, a reluctance , a persecution delirium and auditory and visual hallucinations. A series of examinations have been carried out ; Neurological examination revealed no anomaly , a computed Tomography Scan of the Brain was normal. A lombar puncture was normal. A covid-19 infection was eliminated. The usual antiepileptic medication was reintroduced to the patient (Phenobarbital 150 mg/day),in association to benzodiazepines (clonazepam 4 mg/day). After 72 hours of treatment, psychiatric symptoms improved. The patient returned to its baseline condition after 7 days. A similar episode was reported two months earlier in the same circumstances with a similar symptomatology and a spontaneous resolution within 7 days.

PPI syndrome, regardless of its good short-term prognosis, can potentially evolve into other psychiatric disorders of less good prognosis. Thus, this syndrome should be managed in collaboration with neurology and psychiatry.

No significant relationships.

Parkinson’s disease (PD) and its pharmacological treatment can be associated with a long list of neuropsychiatric complications.

The aim of our case report is to investigate through a case analysis the possible association of dopaminergic dysregulation syndrome and Othello syndrome

we carried out a case analysis and a review of the literature by searching the PubMed database

Case report We present the case of a 43-year-old man suffering from early PD since the age of 16, started on levodopa since the age of 19.

Since 2 years, the patient has resorted to a considerable increase in the doses of levodopa up to 2500 mg / day, the evolution was marked by the installation of disabling dyskinesias and by a change in his behavior and mood.

He was then hospitalized in psychiatry following aggressive behavior towards his wife. The admission examination found a patient who was motor unstable with an interpretative delirium of jealousy and persecution.

The diagnosis of Othello syndrome associated with SDD was retained.

Our therapeutic strategy has been to put the patient on quetiapine, reduce the doses of levodopa, add a dopamine agonist and involve psychoeducation of the patient and his family. Evolution has been marked by the reduction of delusions of jealousy.

This case reports a rare case of delirium of jealousy induced by the misuse of dopaminergic drugs in a patient with PD in its early form. These complications can have catastrophic consequences for the patient. Researching and recognizing these psychiatric manifestations should help avoid devastating consequences.

No significant relationships.

The COVID-19 pandemic has focused attention on the challenges and risks faced by frontline healthcare workers (HCW).

To describe the quality of management of HCW affected by the COVID-19.

This is a cross-sectional study enrolling all HCW of Farhat Hached Academic hospital who had been affected by COVID-19 during the period from september to December 2020.

During the study period, 267 HCW were affected with a mean age of 42.3 ±10 years and a ratio-sex of 0.25. The most represented category was nurses (33.3%) followed by technicians (26.1%). Gynecology department had the highest number of affected HCW (14.4%).The majority of participants (97.4%) reported a medical care. Twelve HCW (4.5%) were hospitalized with an average length of hospital stay of 7.55 ± 6.12 days. The average length of sick leave was 18.68 ± 10.99 days. During the lockdown, 38.6% of HCW took care of their children without any external help. All of the HCW were supported by phone calls from colleagues in 88.4% of cases, the hierarchy in 67.4% of cases, occupational medicine in 60.3% of cases.

The impact of COVID 19 is greater in HCW than in the general population. The affected staff should have a multidimensional management to avoid post covid sequelae in both physical and mental levels.

No significant relationships.

Exposure to early life stress (ELS) strongly predicts prevalent, impairing, and costly psychiatric illness throughout life including mental disorders. The reason, some individuals are more vulnerable to ELS whereas others remain resilient, is poorly understood. There is a need for better understanding of early biological changes triggered by ELS with responsibility to negative outcomes in health.

We stratify animals after ELS according to corticosterone levels. [1] Re-challenging the animals to a second stressor, chronic social defeat (CSD) [2], in adulthood was performed to understand individual trajectories depending on corticosterone exposure during early adverse conditions.

We performed ELS as previously reported [1]. Behavior of mothers was observed during ELS. Correlation between level of corticosterone and behavior observed in dams. ELS animals were exposed to a second stress in adulthood. A battery of tests for different behavioral domains was performed. Behavioral analyses was combined with assessment of litter HPA system reactivity and observed behavior in dams.

Stress dams where significantly higher in number of sorties over whole observation period, time dams spent outside the nest differed. We could correlate the number of sorties on p3 with corticosterone plasma level at p9. Control dams spent significantly more time outside in 9pm recordings than stress animals. We could show reduced interaction with social juvenile targets in sociability test for CSD mice. Light dark transition was significantly higher for control mice compared to CSD but lower for control vs ELS animals.

Behavior in dams during ELS correlates with chronic stress coping mechanisms in offspring’s adulthood.

No significant relationships.

Borderline personality manifests in female adolescence and youth by higher frequency of deviant behaviors and suicidal ideations. Psychological models suggests that both perception and relationship to physical pain (Joiner, 2005, O’Connor, Kirtley, 2018, Galynker, 2017) as well as psychological pain (Eisenberger et al., 2003) could increase the risk.

This study concentrates on the relationship between relationship to physical and psychological pain and reported deviant behavior in female adolescents.

204 female adolescents (13-21 years old) filled checklist appraising alcohol use, drug use, aggressive behavior, suicidal ideations and emotional difficulties (Cronbach’s alphas .67-.89), Interpersonal Needs Questionnaire (Van Orden et al., 2012), Discomfort Intolerance Scale (Schmidt et al., 2006), The Pain Catastrophizing Scale (Sullivan et al., 1995).

Elder females more frequently reported substance use (r=.23-.28) and less frequently aggressive behavior (r=-.19) while suicidal ideations were unrelated to age. Females reporting higher perceived burdensomeness and emotional difficulties also reported higher alcohol use (r=.25-.29), aggressive behavior (r=.37-.42) and suicidal ideations (r=.64-.84). Thwarted belongingness correlated with suicidal ideations (r=.50) and aggressive behavior (r=.26). Higher alcohol use was associated with catastrophizing of pain in the form of magnification and helplessness (r=.17) while suicidal ideations and aggressive behavior were related to ruminations, magnification and helplessness (r=.23-.33). Only correlations between aggression and pain catastrophizing remained significant after statistical control of psychological pain (r=.15-.22).

After control for psychological pain, only aggressive behavior is related to catastrophizing of physical pain. Study is supported by Russian science Foundation, project 22-28-01524.

Study is supported by Russian Science Foundation, project 22-28-01524.

Patients with schizophrenia usually demonstrate low compliance to medication. This could be a component of the disorder or a fact that they are not being properly cared.

To prevent this in, we tried to treat these patients with long term action antidiabetic agents, in order to achieve better compliance.

HbA1C measurements of patients suffering from schizophrenia and at the same time receiving oral antidiabetic treatment were conducted. 62 patients were found that fell under the criteria of non regulated type 2 diabetes and at the same time presented less than 70% complied with their antidiabetic pharmaceutical treatment. We modified the antidiabetic treatment of these patients, with the introduction of dulaglutide.

Without intervening with their nutritional habits there was a decline in HbA1C measurements from the average rate of 9,4% to the average rate of 7,6%, as well as an average 6,31% reduction of their body weight.

Due to the improvement of the general medical condition of these patients, the answer to the question whether these patients should be treated with a long term antidiabetic medicines, is positive. The arrival of new long term action antidiabetic medicines in the near future, promises to improve the life quality of schizophrenic patients furthermor.

No significant relationships.

Cognitive frailty has recently been defined as the co-occurrence of physical frailty and cognitive impairment. Late-life depression (LLD) is associated with both physical frailty and cognitive impairment, especially processing speed and executive functioning.

The objective of this study was to investigate the association between physical frailty and cognitive functioning in depressed older persons.

A total of 378 patients (>60 years) with depression according to DSM-IV criteria and a MMSE score of 24 points or higher were included. The physical frailty phenotype was examined as well as its individual criteria (weight loss, weakness, exhaustion, slowness, low activity). Cognitive functioning was examined in 4 domains: verbal memory, working memory, interference control, and processing speed.

Of the 378 depressed patients (range 60-90 years; 66.1% women), 61 were classified as robust (no frailty criteria present), 214 as prefrail (1 or 2 frailty criteria present), and 103 as frail (>3 criteria). Linear regression analyses, adjusted for confounders, showed that the severity of physical frailty was associated with poorer verbal memory, slower processing speed, and decreased working memory, but not with changes in interference control.

Physical frailty in LLD is associated with poorer cognitive functioning, although not consistently for executive functioning. Future studies should examine whether cognitive impairment in the presence of physical frailty belongs to cognitive frailty and is indeed an important concept to identify a specific subgroup of depressed older patients, who need multimodal treatment strategies integrating physical, cognitive, and psychological functioning.

No significant relationships.

Consultant to or receives honoraria: Alkermes, Allergan, Dainippon Sumitomo, H. Lundbeck, Indivior, Intracellular Therapies, Janssen Pharmaceutical, Johnson & Johnson, LB Pharmaceuticals, Merck, Minerva, Neurocrine, Novartis Pharmaceuticals,

Multifamily interventions have shown to reduce the risk of relapse of psychotic symptoms in first episodes of psychosis (FEPs) but are not frequently implemented in specific treatment programs. We have develop a pilot study for the implementation of the interfamily therapy in FEPs within a Mental Health Centre in the Community of Madrid.

The aims were to examine: relapses (measured as re-hospitalization), duration of re-hospitalizations and voluntary versus involuntary re-hospitalizations during participation in MFG compared with the previous year.

21 subjects participated in a MFG during 12 months, 11 participants with a diagnosis of psychosis and 10 family members. Interfamily therapy works as a new model of interactive psychoeducation among families where they share their own experiences and look for comprehension and solutions all together.

Our clinical experience in an interfamily therapy intervention over 12 months has led us to identify a high degree of participation and acceptance by users and their families, and we have observed a lower relapse rate, with fewer of psychiatric admissions and of shorter duration among patients during the year of participation in the MFG compared to the year before treatment.

MFG has been well accepted by both patients and their families, with a high degree of participation.The results observed in our experience of MFG treatment are consistent with the findings of previous studies that support the reduction of the relapse rate, the number of hospitalizations and their duration when family interventions are incorporated into treatment in recent-onset psychosis, especially in a multi-family group format.

No significant relationships.

Functional deficits, that is, problems in fulfilling appropriate social roles in daily life, are very common in people with a psychotic disorder. In recent years, Virtual Reality (VR) has emerged as a potential tool to improve SCT. Our research group has developed an immersive VR-SCT (‘Dynamic Interactive Social Cognition Training in Virtual Reality’: ‘DiSCoVR’).

To evaluate to effects of a VR-based social cognition training (SCT) for people with a psychotic disorder.

This intervention was compared the an active VR-control condition in a multicenter RCT. Both interventions contained sixteen individual 45-60-minute on-site sessions, administered twice a week. Main study outcomes are social cognition and social functioning in daily life assessed with experience sampling.

From baseline to post-treatment (n=72), none of the time*group interactions were significant, indicating an absence of treatment effects. A significant effect of time was observed for the SERS total score (b=9.84, 95% CI=3.81-15.87, p=.002), indicating overall improvement in self-esteem.

We did not find any significant treatment effects. An effect of time on self-esteem was found at post-treatment, but not follow-up, suggesting a temporary improvement in self-esteem in both groups. One way to interpret these results is that, contrary to other SCT interventions, DiSCoVR does not improve social cognition or social functioning. This could be due to characteristics of the treatment protocol. Another possibility is that, contrary to the premise of VR-SCT, our VR environments inadequately simulated reality. Adapting an established protocol to VR, could further elucidate the merit of VR as a training method.

No significant relationships.

Currently, there are known problems of assessing the severity of psychopathological states based on psychometric (rank) scales [1]. The main problem: ranks are non-numeric information that does not allow the simplest mathematical operations (summation, average) [2] and, as a result, the impossibility of constructing correct models for evaluating states

Development of algorithms for processing initial rank information about the severity of psychopathological states in order to obtain results in numerical form based on the Analytic Hierarchy Process (AHP) [2]

Clinical, statistical, algorithms of the AHP.

The problems of assessing the patient’s states are multicriteria. They are solved within the framework of AHP by constructing numerical intensity scales when measuring the dimensions of disorders. This means a correct transition from the rank scale to the scale of relations, in which the estimates are numbers that allow any mathematical operations. The implementation of AHP procedures is based on the application of the AHP normative approach [2], which uses expert comparisons of ratings of the rank scale.

The fundamental difference between the results based on AHP and rank results is due to the fact that numerical estimates of the severity of states are obtained, which can be used for any mathematical processing and the construction of correct models of communication and prediction of the state of patients from many factors, taking into account their weight. References: 1. Zimmerman M., Morgan T.A., Stanton K. World Psychiatry. 2018;17: 258–275. 2. Mitikhin, V.G., Solokhina, T.A. S.S. Korsakov Journal of Neurology and Psychiatry. 2019; 119(2): 49-54.

No significant relationships.

No significant relationships.

Parental Alienation Syndrome (PAS) was proposed by Richard A. Gardner in 1985. It is assumed to occur in some distressing marriage break-ups, when a parent “brainwashes” his children so they reject the other parent in an unjustified way. But, is it the result of a conscious act as Gardner suggests? Or could it also appear as part of a shared psychosis?

To assess the possibility of the appearance of PAS as a consequence of paranoid contagion or shared psychosis.

We present the case of a 45-year-old patient and her 9-year-old daughter, who is allegedly assaulted by her father during visits, according to both. Mother and daughter continually request attention in the emergency department for this reason, with no obvious injuries. A bibliographic review is carried out on the PAS and shared psychosis. We compare the existing data with our case.

A paranoid cognitive style is observed in the 45-year-old patient, and it is observed that her daughter stops rejecting the father when she spends time separated from her. The contagion of delirium is the nuclear mechanism of shared psychosis. It is known that children with PAS may have distorted memories and incorporate beliefs of others through suggestion. There is also an inverse relationship between the number of visits by the alienated parent and the undervaluation of the child. We have not found any studies linking shared psychosis with PAS.

The existing bibliography on PAS is scarce. The possibility of an existing paranoid contagion mechanism has not been addressed yet.

No significant relationships.

No significant relationships.

Eating disorders (ED) are associated with other mental illnesses, but the association of ED with pain is less well understood.

To study the association of ED with headache and abdominal pain in adolescent girls.

In 2015-2018, 917 girls aged 12-17 were examined using the Body Image and Eating Distress scale (Koskelainen et al., 2001) and questions about frequency of recurrent headache and abdominal pain over the past six months. Adolescents were divided into three groups: girls with eating disorders (ED, n = 20); subthreshold eating disorders (SED, n = 88); and a control group (CG, n = 809).

Headaches of varying frequency are were reported by 80% of girls with ED, 70.4% of girls with SED and 52.2% of CG girls. Frequent headaches (every week) were reported by 60% of girls with ED, 40.9% of girls with SED, and 29.9% of CG girls (χ2 = 20.21, p = 0.003). Recurrent abdominal pain was reported by 65% of girls with ED, 56.8% of girls with SED, and by 46.6% of CG girls. Weekly abdominal pain affected 30% of girls with ED, 20.4% of girls with SED and 12.9% of CG girls. Combined weekly pain were commoner in girls with eating distress (in 20% of girls with ED and in 12.5% with SED) than in CG (7.7%, χ2 = 3.92, p = 0.04).

Eating disorders in adolescents are often associated with pain, which can lead to late recognition of the disease, worsening its course and prognosis.

The study was supported by the Russian Science Foundation grant # 21-15-00033

A history of traumatic brain injury (TBI) is often associated with acquired epilepsy, which is associated with psychiatric co-morbidity, that when undetected might lead to misdiagnosis and mistreatment.

The objective is to present the case of a 47-years-old male with a history of TBI and undetected acquired epilepsy, with a subsequent treatment resident mood disorder that was lead to a full clinical remission once epileptic activity was controlled using anti-seizure monotherapy.

After compulsory admittion to our inpatient psychiatric unit because of suicidal ideation and persistent aggressive behavior with volatile mood swings, the patient was fully evaluated and his psychiatric and medical histories were recorded. A brain CT scan and EEG were performed. Laboratory tests excluded other medical co-morbidity.

The patient had a previous history of TBI and subsequent multiple episodes of mood disorders that failed to reach full remission even if treated with antidepressives and antipsychotics for adequate time and dosage according to current quidelines. EEG was positive for epileptiform activity with sporadic slow theta waves and right frontotemporal epileptic-like features while the patient was free of clinical seizures. Carbamazepine was initiated and titrated up to 1200mg daily leading to the full remission of the initial clinical symptoms along with the EEG findings’ improvement. The patient remained stable with his functionality at its utmost recovery during the two-years follow-up evaluations.

TBI induced epilepsy might be under-diagnosed in the absence of clinical seizures leading to the mistreatment of the associated psychiatric disorders that could be the only clinical presentation of the underlying pathology.

No significant relationships.