The coronavirus disease 19 (COVID-19) pandemic has prompted concerns regarding increased suicide rates and exacerbation of underlying mental illness symptoms. •There is evidence suggesting neurocognitive changes as well as immune response in COVID-19 infection may increase a patient’s propensity for suicidal ideation. • Patients who are diagnosed with COVID-19 may be affected by psychological factors of anxiety, stress related to having this novel virus as well as depression, post-traumatic stress disorder and sleep disorders throughout treatment and post-treatment of continued concerns. •The combination of psychiatric, neurological, and physical symptoms associated with COVID-19 may elevate suicide risk

We present a case of a female with no prior psychiatric history who impulsively attempted suicide after a recent COVID-19 diagnosis and subsequent quarantine. Will explore possible link between increase of suicidal ideation and COVID-19 infection.

A case report.

Link between increase of suicidal ideation and COVID-19 infection has not been clearly established but there have been reports, as in our case, of the possible vulnerability to mental illness and new onset suicidal ideation that COVID-19 survivors may experience. It may be useful to screen all patients for depressive symptoms after a COVID-19 infection. Early identification and treatment of depression in recovered COVID-19 patients will help to improve psychological impact on COVID-19 survivors and potentially reduce suicide rates.

As COVID-19 infection may trigger new onset mental illness, exacerbate symptoms of underlying mental illness, and may increase suicidal ideation, further research is needed to evaluate links between COVID-19 infection and depression with suicidal ideation

No significant relationships.

Clozapine is commonly associated with hematological side effects. However, little research is available on the impact of adding other psychotropic medication on inducing blood dyscrasias.

The aim of the study was to explore the impact of associating psychotropic medication to clozapine in producing hematological abnormalities.

Our study was a longitudinal, retrospective chart review of adult psychiatric patients receiving clozapine treatment at our clozapine consultation between January 2000 and September 2020.

Our sample consisted of 15 women (23.5%) and 49 men (76.5%), mean age was 41.34 ±9.32 years. Polypharmacy was found in 70.3% of the cases. Association of clozapine to other psychotropic agents was found in 67.2% of the cases. Most prescribed add-on medication was valproic acid in 27 cases, benzodiazepines in 21 cases, promethazine and hydroxyzine in 16 cases, lithium in 8 cases and haloperidol in 6 cases. We found blood dyscrasias in 21 patients (32.8%). Hematological abnormalities were as follow: 2 cases of agranulocytosis, 8 cases of neutropenia, 13 cases of thrombocytopenia, 5 cases of leukocytosis, 5 cases of eosinophilia and 3 cases of anemia. In our sample we did not find a significant association between psychotropic polypharmacy and blood dyscrasias.

Many psychiatric patients on clozapine require polypharmacy to better stabilize their condition. Such co prescriptions may carry the risk of inducing more side effects especially blood dyscrasias. In our study, we did not find a significant association between psychotropic medication added to clozapine and hematological abnormalities. But further research is warranted to better explore this association.

No significant relationships.

Available meta-analytic evidence suggests an increased risk of suicide among cancer patients, although most of the reports focused on the sole suicide death (SD) outcome and they are usually hampered by significant between-study heterogeneity.

The present meta-analysis aimed at assessing the prevalence and risk rates of SD, suicide attempt (SA), and suicidal ideation (SI) among cancer patients.

Systematic search up to April 2021 of observational studies documenting cancer and suicide outcomes associations. Pooled prevalence estimates, odd ratios (ORs), risk ratios (RRs), and hazard ratios (HRs) of SD, SA, and SI were computed according to the random-effects model. SD prevalence underwent cumulative and sub-group analyses for different variables. Risk estimates underwent sensitivity analysis for study design.

Overall, thirty-nine studies were included. A higher risk of SD based on HR, SA based on OR and HR, and SI based on each measure was recorded among cancer patients versus controls. OR and RR of SD were not significant. Pooled prevalence rates of SD, SA and SI among cancer patients were 1.9% (1.1-3.1%), 1.4% (0.3-7.1%), and 9.1% (5.8-14.0%), respectively. Although high between-study heterogeneity held upon sensitivity and sub-group analyses, the overall message brought by risk analyses likewise held true. Age, country, study design, cancer type, sample size, cases type and comparison affected SD prevalence estimates in cancer patients. SD prevalence decreased over time.

Cancer patients face higher risk for SA and SI versus controls. SD’ results were controversial. Cancer patients have higher prevalence rates of suicide outcomes compared to the general population.

No significant relationships.

The perinatal period constitutes a unique individual and family experience, involved in multifaceted transformations and adaptations at the physical, psychological, social, and emotional levels. This is the period in women’s life cycle where there is a higher risk for the development of mental illness.

To introduce the perinatal mental health programme of the Hospital do Espírito Santo de Évora. The main objective is to structure an intervention with the woman and her support network to promote healthy parenting.

Implementing secondary and tertiary intervention approaches in a general and public hospital in the Alentejo region of Portugal. The programme is composed of the following components and domains of intervention in the pre-conception, pregnancy, and post-partum periods: individual consultation; brief intervention consultation; mindfulness sessions in the immediate postpartum period; home-based interventions; empowerment interventions for hospital and community healthcare professionals.

It is expected that the project will result in a multidisciplinary approach to perinatal mental health, with significant impact, improved perinatal mental health of the women integrated in the project, as well as improved level of satisfaction in the provision of care in the woman/family.

Considering the prevalence and impact of mental health issues in the perinatal period, it is desirable to structure interventions with a holistic and multidisciplinary approach. Perinatal mental health should be prioritized during the entire process of pregnancy and postnatal period. A network of primary and secondary care systems may allow mitigating and/or overcoming vulnerabilities.

No significant relationships.

Mental health interventions for Italian (and European) prisoners with mental disorders remain a problematic issue, despite radical changes in general psychiatric care and a 2008 major government reform transferring mental health care in prison to the National Health Service. Indeed, according to the American Psychological Association, 64% of incarcerated individuals report mental health concerns.

The aim of this study is to describe the mental health intervention model implemented since January 2020 for prisoners allocated in the Parma Penitentiary Institutes (PPI). This approach is specifically based on specialized, “person-centered” and “person-tailored” therapeutic-rehabilitation plans in line with psychiatric treatments usually provided in community mental health-care centers of the Parma Department of Mental Health.

All the processes and procedures included in the PPI intervention model were first carefully described, paying special attention to the service for newly admitted prisoners and each typology of specialized therapeutic-rehabilitation treatment potentially provided. Additionally, a preliminary descriptive process analysis of the first six months of clinical activity was also performed.

Since January 2020, 178 individuals entered the PPI service for newly admitted prisoners. In total, 83 (46.7%) of them were engaged in the services of the PPI mental health-care team (35 with pathological addiction and 48 with mental disorders): 56 prisoners were offered an integrated mental health intervention and 27 exclusively an individual psychological or psychiatric treatment.

The results support the potential applicability of an integrated mental health intervention in prison, planning a person-tailored rehabilitation in close collaboration with the prisoners, their families and the local mental health/social services.

No significant relationships.

Understanding the predictors of the willingness to get vaccinated against COVID-19 may aid in the resolution of current and future pandemics.Understanding the predictors of the willingness to get vaccinated against COVID-19 may aid in the resolution of current and future pandemics.

We aim to investigate how the readiness to believe conspiracy theories and the three dimensions of health locus of control affect the attitude towards vaccination.

A cross-sectional study was conducted based on data from an online survey of a sample of Czech university students (n=866) collected in January 2021, using multivariate linear regression models and moderation analysis.

Sixty-six percent of Czech students wanted to get vaccinated against COVID-19. Forty percent of the variance of willingness to get vaccinated was explained by the belief in covid-related conspiracy theories and the powerful others dimension of health locus of control. One sixth of the variance of the willingness to get vaccinated was explained by health locus of control, cognitive reflection, and digital health literacy.

Health locus of control and conspiracy mentality and its predictors are valid predictors of a hesitancy to get vaccinated against COVID-19. Campaigns promoting vaccination should target groups specifically vulnerable to conspiracy theories and lacking health locus of control related to powerful others.

No significant relationships.

Bipolar disorder is a frequent and particularly severe psychiatric pathology that causes significant morbidity and mortality. The rapid cycling forms are more severe in terms of their expression, evolutionary course, therapeutic responses and associated comorbidities.

The aim of this study is to conduct a descriptive assessment of therapeutic characteristics in patients with rapid cycling bipolar disorder.

Our work involved a population of 97 patients followed for bipolar disorder diagnosed according to DSM5 criteria, including 37 patients meeting the specification “with rapid cycles”. The patients were divided into two groups: - Group of patients with bipolar disorder with rapid cycles (TBCR) - Group of patients with bipolar disorder without rapid cycling (TBNCR). We compared the therapeutic features among these two groups.

The dominant polarity was depressive in patients with rapid cycles. They required more mood stabilizers. A greater proportion of them had received treatment with serotonin reuptake inhibitor antidepressants. They were more likely to use hypnotics such as antihistamines and zolpidem.

Rapid cycling TB is a relatively common clinical modality that should be investigated and identified.The use of antidepressants is associated with this course of the disease. Their utilization in the treatment of bipolar depression must be thoughtful and well studied

No significant relationships.

Paraneoplastic syndromes (PS) result from indirect effects of neoplasms. In 50% of the cases the symptoms precede the diagnosis and run independently. PS may involve the peripheral or central nervous system, resulting in symptoms from sensory neuropathies to several neuropsychiatric manifestations.

To review the psychiatric manifestations of paraneoplastic syndromes affecting the nervous system.

Selective literature review via PubMed search, using the keywords “paraneoplastic syndromes”, “endrocrine paraneoplastic syndromes”, “neuropsychiatric manifestations”, “limbic encephalitis”.

The prevalence of PS varies with the type of cancer (<1% for breast and ovarian cancers; 3-5% for small cell lung cancer; 20% for thymomas). The general mechanisms behind PS are related to the production of substances by the tumor that directly or indirectly cause distant symptoms, the depletion of substances or the host response to the tumor. Frequently there are autoimmune phenomena involved, with the production of antineuronal antibodies that recognise various antigens at the nervous system. Paraneoplastic neurological disorders include limbic encephalits that can present subacutely with symptoms of depression, irritability, hallucinations, cognitive impairment associated with sleep alterations, confusion and seizures. Others include psoclonus-myoclonus ataxia syndrome, neuromyotonia and cramp fasciculation syndrome. Metabolic and endocrine paraneoplastic syndromes (hypercortisolism, carcinoid tumors, pancreatic cancer) can result from the production of cytokines and hormones by the tumor and produce mood disorders, confusional states and psychosis.

PS can be related to various neuropsychiatric manifestations affecting consciousness, cognition, mood and perception. The recognition of this association can alert for the possibility of a cancer diagnosis specially when facing a patient with unusual clinical presentation.

No significant relationships.

One of the most important factors that represents a threating both physical and psychological health in our lives is the individual’s risk behaviour. Though emotions exert a strong influence on risk decision-making, the literature studying the role of emotional abilities on the tendency to engage in risk behaviour is scarce.

The aim was to explore the relationship between emotional intelligence (Attention, Clarity, and Repair) and risk behaviour in its different domains (Ethical, Health, Financial, Social, and Recreational domains). We also examined whether there were gender differences in both variables.

A Spanish community sample of 1435 participants (Mage = 29.84, ranging from 18 to 70 years old; 61.9% women) were assessed in levels of EI and risk-taking by the TMMS-24 and DOSPERT-30 scales.

The result revelated that emotional intelligence was positive related with Social and Recreational domains, and negative related with Ethical and Health domains. Moreover, women showed higher scores for EI and Social risk-taking domain than men, and men showed higher scores for Ethical, Financial, Health, and Recreational risk-taking domains.

These findings show and support that EI is differentially related to risk behaviour depending on the risk domain studied. We suggest that higher levels of EI could be adaptive for risk behaviour regardless the directionality of the relationship. Considering the impact of health-related risky behaviours on public health and individual well-being, the development of effective risk prevention programs that train emotional abilities could reduce the incidence of these behaviours in our society.

No significant relationships.

The concept of motivation pervades our professional and personal lives. Motivation is almost impossible to be observed directly, it is a construct for the interpretation of a behaviour that “calls the attention”.

This work reviews the current available data on the phenomenological description of motivation and the abnormalities of motivation.

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: “motivation”, “psychopathology”, “phenomenology”.

Abnormalities in motivation may involve diminution or exacerbation. Anhedonia is the absence of pleasure in relation to usually pleasurable activities, it occurs in depression and schizophrenia where the pleasurable intrinsic motivation that acts as incentive for behaviour may be lost. In mania it may be increased so that mundane activities become unduly fascinating and rewarding.

Countless theories have been proposed to explain human motivation but each sheds light on specific aspects of motivation, neglecting others. This diversity creates confusion because most theories have areas of conceptual overlap and disagreement. To facilitate the development of studies, an agreement should be achieved on an operational definition of motivation.

No significant relationships.

Preterm infants are at high-risk of developing autism spectrum disorders (ASD). The underlying mechanisms that explain the link between prematurity and ASD are unclear. Perinatal environmental factors may disrupt the gut-brain communication, when the gut microbiome composition is established and brain programming occurs. Therefore, the disruption of the gut-brain axis communication in response to perinatal environmental events may shed light on the association between prematurity and ASD.

To describe a new research project protocol which aim is to develop a dynamic model of gut microbiota variation in response to environmental factors that modulate the ASD risk in preterm infants.

A two-year prospective observational study will be carried out, in which preterm infants will be assessed at birth, 40th postmenstrual week, at 6, 12, and 24 months of corrected age. Two-hundred preterm infants will be recruited. A comprehensive assessment will be conducted by collecting data on sociodemographic characteristics, medical history, family functioning, neurodevelopment, ASD screening, and diagnosis. Microbiome composition and microbial activity will be determined from feces.

The expected results are: i) to characterize ASD since its early manifestations in an at-risk population, allowing an early diagnosis and intervention to improve clinical outcomes; ii) to identify early microbiota biomarkers in order to find potential pathophysiological pathways; iii) to understand the protective and risk factors associated to ASD since perinatal period.

A two-year predictive model will be generated based on environmental and gut microbiota variables. This predictive model of ASD would allow prevention, early diagnosis, improvement of prognosis, and personalized treatments in preterm infants.

No significant relationships.

Ramadan is a holly month for Muslims. Able-bodied adults fast and abstain from sexual activities from dawn to sunset. These hasty lifestyle changes have a major impact on the sexual life of the Muslim community.

To assess the impact of Ramadan on sexual activity in a Tunisian community.

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

We included 100 person in this study. The sample consisted of 59 females and 41 males. The average age was 40.3 years. During Ramadan, sexual intercourse happened more often on weekends (p=0.009) and mostly during the second part of the night (p ˂0.001). Data suggest a disturbed sex life with less satisfaction about sexual life compared to W-1 (p<0.05). Monthly sexual intercourse frequency dropped from 5.76 coitus/month on W-1 to 3.27 on W 4 (p<0.05) and Duration of sex from 9.45 minutes to 6.85 minutes (p˂0.001). Couples communicated less about sex (p=0.004). Sexual abstinence was more frequent (p=0.016). Preliminaries were less performed (P=0.01) and were shorter (p˂0.001).Oral sex was less frequent as well as some sexual positions: fellatio (p=0.01) and cunnilingus (p=0.002), sexual positions of Andromache (P=0.002), posterior vaginal (P˂0.001) and lateral (P=0.001). The participants used less pornography (p=0.007).

This study demonstrated the deleterious impact of the lifestyles changes in Ramadan on the sexual life. Better sexual and religious education is recommended to prevent sexual dysfunctions.

No significant relationships.

The physical and mental health of women prior to conception can have a significant impact on pregnancy and child outcomes. Given the rising burden of non-communicable diseases, the aim of this analysis was to explore the relationship between mental health, physical health and health behaviour in women planning a pregnancy.

To investigate the association between indices of physical and mental health in a large population of women in the UK planning a pregnancy.

Responses to a preconception health digital education tool provided data on the physical and mental health and health behaviour of 131,182 women planning pregnancy. Logistic regression was used to explore associations between mental health and physical health variables. Multiple imputation by chained equations was implemented to handle missing data.

There was evidence for an association between physical and mental health conditions (OR 2.22; 95% CI 2.14, 2.3). There was also an association between having a mental disorder and physical inactivity (OR 1.14; 95% CI 1.11, 1.18), substance misuse (OR 2.4; 95% CI 2.25, 2.55) and less folic acid use (OR 0.89; 95% CI 0.86,0.92).

There is a need for greater integration of physical and mental healthcare for women in the preconception period, which could support women, including those who wish to conceive, to optimise their health during this time.

No significant relationships.

No significant relationships.

The association between somatic diseases and bipolar disorder (BD) have been described especially for auto-immune diseases.

Through a case study and a review of literature we are going to describe a comorbidity of BD and myasthenia.

Starting from a case report, we conducted a literature review on “PubMed”, using a key word “myasthenia and bipolar disorder”

The patient AJ, 57 years old, married, mother of 5 children; 4 sons and 1 daughter who also has BD. She is illiterate and a full-time mother. she has high blood pressure, a congestive gastropathy and hemorrhoids. She has been diagnosed with BD in 1987 (at 21 years old) and mainly had depressive episodes. She was put on Amitriptyline, carbamazepine, long-acting neuroleptics and benzodiazepines. Since 2006 the patient has been reporting persisting myasthenia even when she was euthymic. In 2009, she was hospitalized for persistent headaches, pain and a decrease in visual acuity in the right eye. An ophthalmoscopy, a cranial CT-scan and an MRI were performed with no anomalies. Then a fluctuant ptosis and an intense fatigability appeared. She then was hospitalized in a neurology ward where she was diagnosed with myasthenia. Changes in her treatment had to be made. Carbamazepine was switched to valproic acid, amitriptyline was switched to fluoxetine. And benzodiazepines were stopped.

It’s important to pay close attention to somatic diseases in our patients in order to insure appropriate medical care. Also, the association between somatic disorders and BD can be an interesting lead in elucidating the etiopathogeneses of BD.

No significant relationships.

No significant relationships.

The grey matter heterotopias are a relatively common group of conditions characterized by interruption of normal neuronal migration from near the ventricle to the cortex. Subependymal grey matter heterotopia, also known as periventricular heterotopia, is the most common form.

To search a link between bipolar disorder and grey matter heterotopia

A case report of a woman with grey matter heterotopia who is diagnosed as bipolar

A 34 year old woman was admitted at Razi psychiatric hospital 3 months after childbirth. She was agitated, logorrheic with multiple projects and insomniac. The diagnosis was a manic episod with a marked score of 28/44 at The Bech-Rafaelsen Mania Scale (MAS). The patient was treated with 4 mg of risperidone and 1000 mg of sodium valproate with partial remission after two weeks. One month after her discharge, she had depressive mood, asthenia, anhedonia and insomnia. She had a score of 19 at Hamilton Depression Rating Scale (HDRS). She was switched from risperidone to olanzapine 15mg/j with partial remission after two weeks. In front of persistent symptoms with labile mood, she took lithium 1000 mg/j. She was complaining of a headache and a fluctuating heaviness of the right upper limb. At brain imaging, she had periventricular nodular heterotopia. The patient was adressed to neurology department.

Grey matter heterotopia can cause a variety of neuropsychiatrc symptoms which can lead to diagnosis difficulties. Therefore, in front of atypical symptoms or drug-resistance, patients should be referred for brain imaging.

No significant relationships.

Racism is present in most aspects of our society, including healthcare. Differences in health outcomes, and in the quality of mental health treatment for people coming from ethnic minority groups have been demonstrated in the literature. Psychiatry trainees are required to understand the impact of structural inequalities and power differences within mental health services, and to be able to deliver clinical care that is equitable for all.

To provide psychiatry trainees with a space to reflect on unconscious racial bias in clinical work and to explore potential barriers when talking about such topics.

A Race and Equality Reflective Group for psychiatry trainees was organised as an opportunity to discuss unconscious racial bias. Due to an insufficient number of registrations, the session was cancelled. An anonymous feedback questionnaire was sent to all trainees to understand reasons behind this, and to explore potential barriers to participation. The results were analysed and were brought back to a regular Balint group for further exploration.

Twelve trainees filled in the questionnaire. The main themes identified included this topic being a sensitive issue (5; 41.7%), discomfort in trainees (5; 41.7%), insufficient time to participate (4; 33%) and timetable clash (3; 25.9%). Barriers to discussing unconscious racial bias and inequality were identified in further exploration with trainees. The tendency for groups to adopt a split position that was observed, mirrors the dynamics seen in institutional racism.

This work has highlighted the need for ongoing focused, facilitated educational spaces where these issues can be openly discussed and reflected upon.

No significant relationships.

Inhibition capabilities have been shown to be a strong predictor of social and educational life outcomes (Mischel & Ebbesen, 1970; Shoda et al., 1990). Inhibition capabilities have an enormous impact on attention and impulsivity (Bari & Robbins, 2013). These two executive functions are associated with numerous psychiatric disorders but are not well understood in terms of white matter (WM) connectivity (Puiu et al., 2018). Novel techniques and statistical approaches in neuroimaging bring us closer to a biologically sustained model.

This research aims to: 1) identify WM connections associated with attention/impulsivity performance and 2) characterize the differences in WM microstructure associated with the variation of the performance.

157 children (GESTE cohort, 8-12 years, 27 Dx ADHD, 2 Dx ASD) with b=1500mm2/s, 2mm isotropic dMRI acquisitions were included. Tractography was performed with TractoFlow pipeline (Theaud et al., 2020). Dimensionality reduction of diffusion metrics yielded two components : microstructural complexity (DTI Metrics, AFD & NuFo) and axonal density (AFD_fixel) (Chamberland et al., 2019). Attention/impulsivity were evaluated with the CPT3. Multivariate linear regression was performed in python.

Lower microstructural complexity was associated with poorer attentional performance on regions of the parietal lobe to the occipital gyrus (P-O, p=0.044, R2=0.14, Figure 1.) and the Broadman’s area 8 to area 6 (SF8-SF6, p=0.002, R2=0.12, Figure 1.). Lower axonal density was associated with a less impulsive pattern on SF8-SF6 (p=0.001, R2=0.13, Figure 1.). Results remained significant when removing children with an ADHD or ASD diagnosis.

We identified underlying difference in WM microstructure that may be associated with the variation in attention/impulsivity performance in school-aged children.

No significant relationships.

Post-partum depression may occur in the first year after childbirth in approximately 25% of women, at times presenting with psychotic symptoms and catatonic states. Catatonia is a psychomotor syndrome that occurs in association with various neuropsychiatric disorders and can be described according to the characteristics of its manifestation in types such as retarded or agitated.

We report the case of a patient with postpartum depression and catatonic syndrome who, after a session of electroconvulsive therapy, was infected with Sars-COV-2, suspended treatment, and had her condition aggravated with distinct clinical manifestations.

Clinical case report and non-systematic review of articles consulted in the PubMed platform.

A 24-year-old patient develops depressive symptoms and obsessive behaviour 6 months after delivery and deteriorates with mutism, stupor and motor immobility. She was hospitalised and medicated with lorazepam, with no improvement. One session of electroconvulsive therapy was carried out with improvement of the symptoms. Due to an inpatient Covid-19 outbreak, in which the patient was infected, treatment was suspended. During isolation, deterioration of the patient’s condition was observed with psychomotor agitation, bizarre behaviour, and perseverative speech. The patient resumed treatment with ECT, with total remission of the catatonic syndrome and improvement of the affective symptoms.

Catatonic syndromes are relatively rare, but its association with post-partum depression is not so uncommon. The occurrence of different presentations of catatonia, although described as possible in the same episode in the literature, were not found in any clinical studies reviewed, which leads us to conclude that it is an uncommon situation.

No significant relationships.