No significant relationships.

A major increase in mental health issues was noted since the outbreak of the covid-19 pandemic even in patients with no history of mental health illness, specifically brief psychotic disorders.

Establish the covid-19 pandemic circumstances as precipitating factors of psychosis independently from other stressors

This is a cross-sectional and descriptive study carried out in the psychiatric department of the University Hospital of Mahdia including two groups of patients over a period of 15 months: From October 2018 to December 2019 are pre-covid cases, and the second group consists of the ones admitted between June 2020 and August 2021. We have collected the data of patients diagnosed with brief psychotic disorder according to DSM-5. We have focused on two clinical characteristics of the psychotic episodes (theme of delusions, stressors).

We have collected 19 patients, 12 among them during the pre-covid period. In our pre-covid period, brief psychotic disorder presented mostly with marked stressors (33.3%) whilst in the middle of the pandemic, marked stressors are present in only 14.3% of the cases. Which could suggest that this state of alarm can singlehandedly trigger psychosis. For the theme of delusions, in the pre-covid period, the religious theme appeared to be the most frequent (58.3%), whilst during the pandemic, persecution became the most prevalent (71.4%), showing how living in fear of contracting the virus could manifest itself in delusional content.

Living in a prolonged state of alarm is, in itself, a marked stressor, theoretically capable of increasing the psychosis rate and altering its characteristics.

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.

Menstrual psychosis was first described in the 18th century. Brockington defined its characteristics: acute onset; brief duration with full recovery; confusion, stupor and mutism, delusions, hallucinations, or a manic syndrome and periodicity in temporal association with the menstrual cycle.

Description of a clinical case of menstrual psychosis and review of the literature.

Description of a clinical case. Non systematic review of the literature, searching the terms “psychosis”; “menstrual”; “catamenial” in the databases Pubmed, Medline and Cochrane.

Female, 39-year-old patient. No psychiatric history until the postpartum period of a traumatic vaginal birth, when she developed stupor and mutism which lasted for two days. During the following 2 years, she progressively presented with sadness, asthenia, anhedonia, insomnia and incapacity for self-care. She was prescribed paroxetine and olanzapine, with partial recovery. Subsequently, she had at least 6 episodes with about 3-day duration of asthenia, food refusal, insomnia, incapacity for self-care, disorganization of thought and behavior and mystical and persecutory delusions, coincident with the beginning of menstruation. She was hospitalized in two of them and received treatment with venlafaxine 75mg and paliperidone 6mg, with psychotic symptoms remission after a week.

This case presents the characteristics of menstrual psychosis. This is a rare condition, with only 30 reported cases worldwide. According to current classification systems, this condition fulfills diagnostic criteria for brief psychotic disorder. Nonetheless, studying in more detail this disorder could be interesting, with the goal of deepening the knowledge of the neurobiology of psychosis, particularly the effects of estrogen on this disorder.

No significant relationships.

Research data indicate the necessity of efficient human functional states’ (HFS) self-regulations for successful work execution, and not only for those professionals, who work under extreme work conditions; efficient HFS self-regulation is discussed as one of the key professional competences in socionomic jobs as well (Friedman, 2003; Landy & Conte, 2021). Moreover, ability of efficient HFS self-regulation could be viewed as a differentiative competence for separation of professionals with normal and high work achievements (Spencer L. & Spencer S., 1993).

The empirical study was targeted to investigate HFS self-regulation efficiency as a predictor of work success under long-term innovation stress.

The longitudinal research was conducted in college teachers (n=50) during the period of organizational innovations. The empirical data were obtained by the diagnostic set of methods for self-assessment of attitudes towards innovations as a factor of long-term work strain, coping strategies and self-regulation means, chronic fatigue and burnout as the main consequences of long-term stress manifestations (Hobfoll, Dunahoo, Ben-Porath & Monnier, 1994; Leonova, 2012).

The significant diversity in the level of HFS self-regulation efficiency in teachers with different work success has been found (p<0,05). Teachers with the highest level of work results have a well-developed system of self-regulation means, which allows them to cope with innovation stress.

The empirical data revealed patterns of effective self-regulation means, which are adequate to situational requirement, professional norms and rules of organizational behavior. Obtained results formed the basis for the elaboration of training course for HFS self-regulation skills development.

No significant relationships.

The 22q11.2 deletion syndrome (22q11DS) defines a set of developmental abnormalities due to a loss of genetic material. Phenotypic expression is highly varied. The immunological alterations that present as a severe combined immunodeficiency and the neurodevelopmental alterations stand out, especially the psychotic symptoms. It is the best described genetic alteration for the development of psychosis, presenting up to 30% of patients with compatible symptoms, with various hypotheses that justify it.

General objective:

1. Justify that SD2q11 can be used as a model for human research on the origin of psychosis.

1. Describe the pro-inflammatory state present in SD2q11.

2. Describe differences at the immunological level in SD2q11 among those patients with presence of psychotic symptoms of those who do not present them.

3. Describe possible biomarkers.

A systematic review of the literature in the last 5 years using electronic resources (PubMed and WOS) until June 2021 following the PRISMA recommendations.

Three original articles were reviewed. There is a very marked pro-inflammatory state in 22q11DS patients with psychotic symptoms. They present an increase in subpopulations of CD4. The IL-17 is important in the formation in primitive stages of the hippocampus, its ease of breaking the blood-brain barrier (BBB). The neutrophil / lymphocyte ratio is presented as a possible biomarker to predict patients at high risk of developing psychosis.

There is sufficient evidence that patients with 22q11DS can be used as a research model regarding possible hypotheses about the genesis of psychosis.

No significant relationships.

The combination of cognitive behavioral interventions and art therapy provides a unique tool for image transformation as a strategy for managing distress in extremely stressful situations. Previous studies offer evidence of the effectiveness of cognitive behavioral- and art-based (CB-ART) interventions in reducing stress related to community crises such as wars and earthquakes.

This study aimed to extend current knowledge by investigating the effectiveness of CB-ART interventions in the Covid-19 context, and the mechanisms underlying them.

Online CB-ART interventions were implemented during the first national lockdown in Israel with 15 women. The intervention included drawing three pictures related to: (1) Covid-19-related emotions and thoughts; (2) resources that may help them cope with the pandemic outcomes; and (3) integration of the stressful image and the resource picture. To examine the intervention effect, participants’ Subjective Units of Distress (SUDs) values were measured using a pre-post design.

Participants’ initial distress levels decreased on completion of the intervention. Another key finding is the reduction of the initial size of the stressful image and enlargement of the resource images within the integrated drawing. This may be the proposed mechanisms underlying the reduction of the SUDs values.

The new perspective derived from the compositional transformations performed by the participants may have increased their sense of control and competence, enabling them to perceive the Covid-19-related stressors as less threatening. The described art-based tool can be easily implemented online by mental health professionals with diverse populations in times of community crises.

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.

The challenge for psychiatrists is keeping up to date with the latest clinical trial data in managing major depressive disorder (MDD) and psychiatric emergencies.

We evaluated whether an online educational video lecture directed at psychiatrists, could improve knowledge and confidence regarding management of psychiatric emergencies associated with MDD.

Educational effect was assessed using a 3-question repeated pairs, pre/post assessment survey. A paired-samples t-test was conducted to assess overall number correct and confidence change. A McNemar’s test was conducted to assess question-level significance. P values < 0.05 are statistically significant. Cohen’s d test was used to estimate the magnitude of effect of education. The activity launched on 8 April 2021, and preliminary data analysed as of 24 June 2021.

807 psychiatrists participated in the programme, of which 150 completed the pre- and post-assessment test. An average overall correct response rate of 44% pre- increased to 74% post- (67% relative increase, P<0.001; Cohen’s d = 0.91). Knowledge on the burden of suicide and MDD improved from 38% pre- to 85% post- (124% relative increase,P<0.001). Knowledge regarding clinical data for novel therapies for use in psychiatric emergencies improved from 47% pre- to 68% post- (45% relative increase, P<0.01). Knowledge regarding signs of suicidal intent in patients with MDD improved from 49% pre- to 71% (45% relative increase, P<0.001) following education.

This study demonstrates the positive effect of online medical education on psychiatrists’ knowledge in contemporary management of psychiatric emergencies associated with MDD in Europe.

The results of this study were from an educational programme that was developed through independent educational funding from Janssen Neuroscience.

Good quality parenting in early childhood is reliably associated with positive mental and physical health over the lifespan.

The hypothesis that early parenting quality has significant long-term financial benefits has not been previously tested.

Design: Longitudinal study with follow-up from 2012 to 2016; UK multicentre study cohort. Participants: 174 young people drawn from 2 samples, one at moderate risk of poor outcomes and one at high risk, assessed aged 4–6 years then followed up in early adolescence (mean age 12.1 years). Measures: The primary outcome was total costs: health, social care, extra school support, out-of-home placements and family-born expenditure, determined through semistructured economic interviews. Early parenting quality was independently assessed through direct observation of parent–child interaction.

Costs were lower for youths exposed to more sensitive parenting (most sensitive quartile mean £1,619, least sensitive quartile mean £21,763; p < .001). Costs were spread across personal family expenditure and education, health, social and justice services. The cost difference remained significant after controlling for several potential confounders. These included demographic variables (family poverty, parental education); exposure to child abuse; and child/young person variables including level of antisocial behaviour in both childhood and adolescence, IQ and attachment security.

This study is the first showing that more sensitive early parental care predicts lower costs to society many years later, independent of poverty, child and youth antisocial behaviour levels and IQ. The findings provide novel evidence for the public health impact of early caregiving quality and likely financial benefits of improving it.

No significant relationships.

Concerns about health and fitness during lockdown may serve as a trigger for eating disorders in vulnerable individuals. Other risk factors may also include increased use of social networks and comparison with beauty ideals. Isolation, loneliness and problems with emotional regulation may lead people to reduce food intake by giving them a greater sense of control.

Emphasise the relevance of the increase in the incidence of Eating Disorders (ED) cases during the pandemic.

Review of the scientific literature based on a relevant clinical case.

14-year-old female, residing with her mother. She reports that from the beginning of COVID-19 confinement she became obsessed with leading a healthier life, starting to restrict food, limiting fats and carbohydrates, and having also started compulsive physical activity (approximately 4 hours of aerobic exercise per day), without associated purging behaviours. She also acknowledges eating small amounts (although she minimises this aspect) and controlling all calories, stating that food and practices aimed at “staying healthy” now dominate her life. Her previous BMI was 18, with a current BMI of 11.7.

Patients suffering from ED, who often have poor knowledge of their illness and find social-emotional communication difficult, may delay seeking help. Studies suggest the relevance of identifying specific vulnerability factors among ED patients in confinement in order to develop preventive strategies and personalised treatment approaches.

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.

Prior literature has indicated low socioeconomic status (SES) and regional differences as epidemiological risk factors for disability pension (DP) due to mental disorders.

Our studies aimed to examine these associations and differences in greater detail, with separate consideration of the risk factors for mood disorders (F30–39) and non-affective psychotic disorder (F20–29) DP.

Subjects (N = 36 879) were all those granted DP due to a mental disorder for the first time between 2010 and 2015 in Finland. All the subjects were matched with three controls. Education, income and occupational status were used as measures of SES. Conditional logistic regression models were used to study SES differences. Negative binomial regression analysis was used to study the levels of DP risk in the Finnish hospital districts.

DP recipients had low educational and income levels and often lived alone. The risk of DP was greater in white-collar occupational groups compared with blue-collar workers. Students had the greatest risk of DP for all mental and mood disorders. Significant differences in the regional mental disorder DP risks did not appear to follow the traditional Finnish health differences.

We found evidence of SES factors and regional variation associating with mental disorder-related severe loss of working and studying ability in a disorder-specific way. The increased risk of white-collar worker DP could be related to the psychosocially demanding contemporary working life. Regional variation in DP may at least partly relate to differences in regional mental health service systems.

No significant relationships.

Invasive vagus nerve stimulation (VNS) is an adjunctive long-term treatment option for chronic and recurrent difficult-to-treat depression (DTD).

In this prospective observational open-label case series we report on the effects of invasive VNS on depression severity, medication load and the need of maintenance electroconvulsive therapy (ECT) and esketamine treatment after 12 months.

Patients were treated with invasive VNS according to clinical indication. All patients were included in the Restore-Life-Study. The assessment of depression severity (MADRS) and concomitant treatment was performed at baseline and in 3-months intervals postoperatively over a 12 months period.

Twelve patients were treated with adjunctive VNS due to unipolar (n=10) and bipolar (n=2) depression. The majority of patients were female (n=9). The mean age at baseline was 53.8 years (range 38-66). Patients were severely affected by a variety of depression symptoms which was reflected in high MADRS Scores (median 29, mean 28) at baseline. All patients received at least 2 or more psychotropic drugs at baseline. After 12 months of VNS a clear reduction of MADRS Scores (41 % on average) was seen (12-months MADRS Score median 17, mean 18). After 12 months, one patient each was discontinued from maintenance ECT and esketamine, respectively. The median of drug load was reduced from 4,56 to 4,06 after 12 months.

Invasive VNS is an effective treatment option in the long-term management of DTD to reduce the need of concomitant drug dose and maintenance treatment.

E Kavakbasi received speaker fees from Livanova. BT Baune received speaker and advisor fees from Livanova. The patients were included in the Restore-Life Study sponsored by LivaNova.

Covid-19 pandemic put parents under great pressure, and the most vulnerable parents may have become too overwhelmed to find appropriate ways to be supportive caregivers and to address children’s fears and insecurities.

Assess the level of parental stress experienced by mothers during the COVID-19 pandemic and compare it with that experienced by fathers.

This was a descriptive and comparative analytical study, shared on social networks during the period from 8 to 20 April 2021, targeting mothers of children aged 2 to 18 years. The mother answered the questionnaire for herself and her child. The level of stress experienced by the mother in the parent-child relationship during the COVID-19 pandemic was assessed by the brief version of the Parental Stress Index (PSI-SF).

The total number of participants was 65 mothers. Parental stress level in mothers was high in 58.5%, the average PSI score was 94.25; the mean score of the parental distress subscale was 34.06; the mean score of the dysfunctional child-parent interaction subscale was 27.86; and the average score of the child difficulty subscale was 32.32. The mean scores of the parental distress subscale, the child difficulty subscale, as well as the mean PSI total score were significantly higher in mothers than in fathers, with p= 0.010; p= 0.022 and p=0.017 respectively.

Our results highlight a higher level of stress in mothers than in fathers. This can be explained the parental, marital and professional responsibilities imposed on women, underlining the urgent need to provide mothers with adequate support.

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.

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.

The co-occurrence of mental illness and somatic comorbidities is a major cause of increased morbidity and mortality within psychiatric patients, compared to the general population. This may be caused by an unhealthy lifestyle, side effects of psychotropic drugs and systematic barriers in healthcare provision. The underlying mechanisms remain under-investigated.

We systematically investigated relevant barriers and risk factors to the utilization of primary care among severe mentally ill outpatients.

In a cross-sectional analysis, the psychiatric as well as somatic diagnoses of inpatients of a German psychiatric community hospital were identified. Furthermore, somatic and psychiatric medication, blood values (HBA1C) and sociodemographic data of the patients were analyzed. The frequencies of the somatic diagnoses were presented according to psychiatric diagnoses. By a Chi-Square goodness-of-Fit Test the distribution of somatic diagnoses and drug classes were verified according to the total cohort as well as for each psychiatric diagnosis and in respect to sex.

Our results provide an overview of common comorbidities with regard to the psychiatric diagnosis. The medication, in relation to the recorded somatic comorbidities, as well as the blood values, allow a conclusion to be drawn about the extent and success of the treatment.

For the first time, real-life data on the somatic diagnoses and treatment of patients with a severe mental illness in a German hospital is presented. Our results will be used to create low-threshold interventions for the most relevant somatic comorbidities and to improve primary care of psychiatric patients through linking the care systems.

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.

In daily life an alert or relaps prevention plan can be a helpful tool in preventing patients with severe mental illness (SMI) from relapse. However, patients often find it hard to keep the paper version close by. A smartphone version could be a solution. “MySolutions” is a webapplication providing the possibility to add e.g. pictures or music to the alert plan, which could be helping in time of need.

To describe the lived experiences of patients with (SMI) with the webapplication ‘MySolutions’ and get insight in the helping and hindering characteristics of the application.

Qualitative research in a fenomenological framework. Eight interviews were held with outpatients with SMI. All interviews where methodically analyzed using the steps of Colaizzi (1978).

In general, users were enthousiastic about the look and feel of the application. Using the application was considerd easy. Lived experiences of participants displayed the following themes: Autonomy, Acceptance, Frustration, Self confidence, and Reassurance. By practicing and adding photos and music, they perceived the webapplication to be a personal aid tool for experienced problems related to mental vulnerability in daily life. Participants also reported more difficulties in using the application in times of dysregulation.

The webapplication can be a valuable addition to the alert plan for people with SMI due to the possibility of personalization and the fact it is always available on a mobile phone. The application seems particularly suiting for people in a stabile phase. Future research should focus on phase of recovery in relation to use of the application.

No significant relationships.