Histamine intolerance (HI) is a disorder associated with an impairment of ability to metabolize ingested histamine. The incidence of HI in general population is 1-3%. Clinical manifestation of HI contains nonspecific predominantly gastrointestinal, but also extraintestinal symptoms. HI could be primary with genetic predisposition, or secondary with lower activity of diaminooxidase (DAO) without positive genetic screening.

This study aims to evaluate the prevalence of HI by patients with anxiety disorders. HI can imitate anxiety symptoms, therefore we predict higher prevalence HI in patients with anxiety disorders than in general population.

It is observational cross-sectional study on cohort of anxious patients for detecting the prevalence of HI. Patients were screened by scale for histamine intolerance questionnaire. Patients with positive questionnaire were examined for serum DAO and genetically examined.

113 patients fulfilled the HI questionnaire. From this cohort 35.4% (40 subjects) were positive at screening. Biomarkers of HI were screened only in case of positivity in this questionnaire. Table No. 1: Results of our study from cohort with positive screening, 35.4 % (40 subjects).

This pilot study shows that the prevalence of HI could be higher in group of patients with anxiety disorders than in general population. For further confirmation other studies with control group and larger cohort should be done.

No significant relationships.

There is now compelling evidence that migrant groups in several countries have an elevated risk of developing psychotic disorders.

To identify risk factors for psychosis in immigrant population.

case report and Computerised literature search of MEDLINE and PUBMED and PsycINFO databases was performed using the keywords: immigration, psychosis, schizophrenia.

Mrs AM is 22 years old, Ivorian, without any personal or family psychiatric history, married and mother of an 11 months old baby.

Because of the poor socio-economic conditions, she immigrated illegally to tunisia 3 months ago, accompanied by her husband, leaving her child in her native country. since then, she has been working in cleaning jobs with very low salaries and several conflicts in the workplace, which pushed AMto leave the job. One month before her admission, according to her husband, she became isolated, distrustful, she often watches herself in the mirror, refuses to take a shower, with some bizarre behaviors and persecutory words, then she became aggressive with her husband andneighbors, hence her admission.

The interview revealed a dissociative and delusional syndrome, vague and poorly systematized, with hallucinatory and intuitive mechanisms. In view of the subsequent evolution, the diagnosis of schizophrenia was retained. After stabilization under antipsychotic drugs, the patient asked to be repatriated to join her child.

The evidence is still thin, and there is a clear need for further research to replicate and extend findings linking specific aspects of the social environment and risk of psychosis in migrant groups.

No significant relationships.

The research was carried out in Poland between 7-19 March 2021 with the help of online questionnaire on a group of 183 male aged 18-20. The subjects were divided into two age groups: 18-29 and 30-40. The second division are chemsex and non chemsex users.

Objective of this research was to test whether attachment styles, ways of coping with stress and feeling of sense of life influence the risk of overusing chemsex in MSM groups aged 18-29 and 30-40.

Online questionnaire composed of demographics and 3 psychological tests: Ways of Attachment Questionnaire (Polpa 2008) Ways of Coping Questionaire (polish adaptation by P. Szczepaniak, J. Strelau, K. Wrześniewski) Life Attitude Profile - Revised (polish adaptation by R. Klamut)

Examinated chemsex users, based on life attitudes analysis, tend to lead a strongly oriented life, are convinced of having clear and well-defined goals. In terms of dealing with stress they are presenting focused-on-task style, they exhibit lowered levels of avoidant style than normally characteristic for addicts. The research did not reveal any connection between chemsex users and attachment styles.

The research did not allow to clearly point out any connections between risk factors and chemsex usage. During data analysis some weak links occurred, nevertheless too weak to state any risk factors. As results of carried out research it was possible to determine some models, which marked some specific values, obtained on given scales, and following connections between heightening and lowering chance of chemsex usage.

No significant relationships.

Daydreaming is a normal, very common experience in childhood and adulthood. However, a new phenomenon – termed ‘Maladaptive Daydreaming (MD)’ – which takes daydreaming to an extreme form, is currently being investigated. Maladaptive Daydreaming is not listed as an official disorder in the ICD-10 or DSM-5 presently.

To review current literature on MD and explore whether MD could be acknowledged and classified as a real psychiatric disorder.

Data gathered via academic papers found through reliable sites, such as, Ovid, PubMed and Cochrane; through articles, videos and online forums to gather patients’ perspectives.

There is enough information and literature available to create specific criteria to qualify a diagnosis of MD in patients. Possible aetiologies of Maladaptive Daydreaming have been identified. There has also been exploration into treatment options.

There is sufficient evidence for Maladaptive Daydreaming to be classified as an official disorder. Being included in the ICD-10 and DSM-5 would motivate research, expand identification of this disorder in patients, and advance access to help and support for patients.

No significant relationships.

The consequences of schizophrenia stigma are numerous and highly damaging to individuals, their families, the health care system and society. Mental health professionals (MHP) are considered to be one of the main sources of stigmatization.

To identify the characteristics of MHP stigma in schizophrenia in comparison with other psychiatric disorders, the specificities of MHP compared with other social groups, and associated factors.

Following PRISMA guidelines, we systematically searched multiple electronic databases for articles: (i) reporting original data published in English in peer-reviewed journals, (ii) reporting quantitative data with statistical analysis, (iii) assessing stigma in a broad sense, and (iv) including samples composed only of MHP.

A total of 38 articles published from 1999 to 2019 and involving 10926 MHP fulfilled our inclusion criteria. Studies showed that schizophrenia is the most stigmatized mental illnesses in MHP, despite recent results suggesting that borderline personality disorder and substance abuse may be more stigmatized. In comparison with other social groups, MHP reported less dangerousness beliefs and more positive beliefs regarding pharmacological treatment. Nevertheless, results were less consistent regarding prognosis and desire for social distance. Age, education level, type of mental health profession, or length of practice were associated factors that showed inconsistent relations with stigma. Work setting and biological causal beliefs were more clearly associated with MHP stigma.

These findings provide strong support for the need to conduct specific research on schizophrenia stigma in MHP and the importance of controlling for several variables to identify predictors of stigma.

No significant relationships.

Bipolar disorder (BD) is considered a risk factor for developing Parkinson’s Disease (PD) because of an altered dopamine activity in both entities. Comorbidity may delay diagnosis and difficult therapeutic management.

To describe the case of a patient with both BD and PD and to determine the appropriate diagnostic and therapeutic approach for patients presenting both entities.

We present the case of a 58-year-old woman attended in our neurology unit due to the initial presence of visual hallucinations as a core symptom.

Psychotic symptoms as hallucinations and off-times, frequently observed in PD, may be misdiagnosed with a worsening of depressive polarity of BD. Thus, overlap between symptoms may lead to a challenging differential diagnosis. Moreover, there is no consensus about the therapeutic management of the comorbidity, due to the bidirectional worsening of symptoms when treatment is adjusted. In our case, a diagnosis of dopaminergic psychosis was made so antipsychotic treatment with quetiapine 50 mg/d was initiated. A worsening of symptoms was observed, presenting the patient a stuporous status, mutism and generalized rigidity. Neuroimaging and lumbar puncture were performed showing no alterations; electroencephalogram showed diffuse slowing. Final diagnosis was an off-episode of PD and a multifactorial encephalopathy resulting in visual hallucinations.

Coexistence of PD and BD may lead to a diagnostic and therapeutic delay and therefore a worse prognosis. Although these diseases are well-known, it is still challenging to manage patients presenting both entities. Further research is needed to clarify the proper diagnostic and therapeutic approach for these patients.

No significant relationships.

Obsessive-compulsive disorder (OCD) is a chronic, prevalent, and highly impairing psychiatric illness. While its aetiology remains unknown, several infectious agents have been associated to obsessive-compulsive symptoms, including herpes simplex virus 1 (HSV-1) and Toxoplasma gondii.

To evaluate the serostatus for HSV-1 and Toxoplasma gondii in sample of patients with OCD, as well as its clinical and brain imaging correlates.

Twenty-six patients with OCD and 30 healthy controls recruited in Lisbon were assessed for sociodemographic and clinical characteristics using the Yale-Brown Obsessive-Compulsive Scale-II (YBOCS-II) and the Beck Depression Inventory-II (BDI-II). Seropositivity for HSV-1 and Toxoplasma gondii was assessed in serum using ELISA, and volumes of cortical and subcortical structures were assessed using T1-weighted magnetic resonance imaging.

YBOCS-II and BDI-II scores were significantly higher in patients, while age, sex, smoking status, and seropositivity for HSV-1 and Toxoplasma gondii were similar between the two groups. Among OCD patients, those seropositive for HSV-1 had significantly lower volumes of total white-matter, total grey-matter, left and right putamen, while for HSV-1 seropositive healthy controls, only the last two were significantly smaller. In multiple regression analyses to control for age, associations between HSV-1 and brain volumes were conserved, while the effect of age was not significant. No significant differences were found in brain volumes of patients with OCD according to seropositivity for Toxoplasma gondii.

Our preliminary results suggest that in patients with OCD, seropositivity to HSV-1 is associated with smaller volumes of total white- and grey-matter in the brain.

No significant relationships.

The assessment of social and emotional wellbeing (SEWB) among Aboriginal people in Australia and elsewhere is complex and challenging task. A culturally appropriate tool for screening SEWB among Aboriginal adults known as the Here and Now Aboriginal Assessment (HANAA) has been developed and evaluated. The HANAA is based on exploring key domains of Aboriginal concept of SEWB and is based on a yarning process aimed to initiate a semi-structured interview that covers each domain. Over the last ten years the HANAA has been widely used by Aboriginal mental health service providers around Australia and elsewhere.

There have been multiple requests by service providers for a similar tool to be developed for young Aboriginal people. The aim of this study was to develop a youth version of the HANAA.

A Working Group was established to guide the development of the youth HANAA. This work included discussion of assessment domains, prompt words and other adolescent specific considerations that were needed. The evlauation process was also discussed.

The adult version of HANAA was well accepted by participants. Reliability was good with kappa agreements between Aboriginal and non-Aboriginal interviewers ranging from 0.5 to 1.0. Agreement between interviewers and treating clinicians on ecommended course of action was good.

Based on the previous field test results, it is expected that the youth HANAA will also be a culturally appropriate and useful tool which can be used by a range of service providers with differing levels of mental health training to assess SEWB among young Aboriginal people.

No significant relationships.

Professionals in the inpatient care of burdened children and adolescents are confronted with high demands in their daily work. The job satisfaction can be affected negatively, if these professionals do not have the necessary resources to carry out their work.

In a study as part of the accompanying research of an online course called “Trauma informed Care”, the connection between the personal resources action competence, emotional competence, self-efficacy and self-care and job satisfaction were investigated on a sample of N = 543 professionals working in the (inpatient) care of children and adolescents.

In order to quantify the connections between the personal resources action competence, emotional competence, self-efficacy and self-care and job satisfaction, correlations and a multiple regression were calculated.

Moderate to strong correlations were identified between personal resources and job satisfaction among the professionals. The regression model revealed self-efficacy to be the most important predictor of job satisfaction. Self-care was also identified as an important predictor. Less importance could be ascribed to emotional competence. Action competence showed no effects in the regression model.

The results indicate the importance of personal resources for job satisfaction an their targeted promotion in order to increase job satisfaction and thus counteract the tendency of fluctuation and shortage of professionals in the area of child and youth welfare.

No significant relationships.

Early stages of autoimmune encefalitis (AE) often present cognitive and neuropsychiatric symptoms such as personality change, irritability, axiety, depression, behavioral disorders, hallucinations, disorientation, sleep-wake cycle reversals, …). Thus often these cases are first treated as psychiatric disorders.

A literature review throughout a case report presentation.

We present the case of a 25-year old female with a medical history of iron-deficiency anemia who arrives at the emergency service. She presents the following one week of evolution clinical picture: complex auditive hallucinations, behavioral disturbances, sleep disorder and short term memory impairment. Neurological examination, LP and craneal CT are all normal. CSF analysis has no abnormalities. Thus she entered the psychiatric ward. There she was treated with neuroleptics with no improvement of symptoms presenting a severe psychomotor agitation and language impairment. After neurology interconsultation AE is suspected.

She was performed an EEG (left temporal epileptiform activity), CSF (inflammatory pattern), MRI (bilateral temporal lobe hyperintensity). Suspecting limbic encephalitis the presence of anti-NMDAR antibodies was tested , which turned out to be positive. First she was treated with corticotherapy with mild results. Then she was treated with intravenous immunoglobulin improving significantly.

Anti-NMDAR encephalitis is usually a multistage illness. Early in the course of disease psychiatric manifestations are not rare. Therefore the proper diagnosis and approach of AE may requiere a highly organized assessment, starting with detailed history and physical examination and an appropriate testing to exclude other possible relevant pathologies.

No significant relationships.

Cultural differences influence understanding and therapeutic adherence of migrant patients, therefore it is very important to acquire cultural competence.

The objective of this paper is to study, from the following case, the effect of cultural competence in approach to psychosis in migrant patients.

A bibliographic search was performed from different database (Pubmed, TripDatabase) about the influence of culture on psychosis and its resolution. A 25-year-old Moroccan man who came to Spain two years ago fleeing his country and suffered violence in different countries until he arrived. He lived on the street until they offered him a sheltered house with other Moroccans. He felt lack of acceptance and loss of his roots. In this context, he developed a first psychotic episode in which he described “the presence of a devil”.

He distrusted antipsychotic treatment and believed “that devil” was still inside him, being convinced that he needed a Muslim healer to expel him. We followed up with the patient and a cultural mediator, better understanding his cultural reality, uprooting and traumas, and he could feel understood and trust us. During the process, he decided to go to the Muslim healer who performed a symbolic rite for which he felt he “expelled the devil”, while accepting antipsychotics. With all this, the psychotic symptoms and their acculturation process improved.

It is very important that psychiatrists have cultural competence to understand the context of migrant patients, and to be able to provide them with the best treatment.

No significant relationships.

The mild encephalitis (ME) hypothesis of severe mental disorders, ME to be caused by infections, autoimmunity , toxicity and trauma ( Bechter 2001, updated Bechter 2013), is now emergingly supported from neuroimaging and CSF and postmorten findings.

Review about the present status of ME hypothesis and autoimmune psychosis and remainig challenges to assess and categorize mild neuroinflammation.

expert review

Autoimmune Encephalitis presenting with exclusive psychiatric symptoms and all cases of Autoimmune Psychosis (international consensus criteria in Pollak et al, Lancet Psychiatry, 2020) match the proposed ME criteria ( Bechter 2001 & 2013). Majority of these cases of an autoimmune type of ME are well treatable with immune modulatory treatments. It remained unclear, whether CNS antibodies are causal or contributive by shaping the observed clinical syndrome. The increasing evidence of mild neuroinflammation present in considerable subgroup of schizophrenia or psychosis spectrum cases from ongoing clinical studies, including CSF ( Bechter et al 2010, Endres et al 2018, 2020, aso.) and neuroimaging plus the observed clinical improvement with immune modulytory therapies, strongly support ME hypothesis, potentialy even in considerably larger subgroup of SMDs,supported by brain biopsy (Najjar et al ,several papers) and post mortem studies (Bogerts et al group ,Weickert et al group, several papers).

Beyond ME even more refined categories of mild neuroinflammation, including parainflammation ( proposed by Medzhitov 2008) and neuroprogression ( proposed by Berk et al 2010/11) need to be considered in further research on the possible role of mild neuroinflammation in SMDs (Bechter 2020, Frontiers Psychiatry).

No significant relationships.

No significant relationships.

I am an advisor to Compass pathways and Beckley Psytec two companies that are developing psychedelics for depression and other psychiatric indications. Several members of my research group receive support from these companies and also from Small Pharma.

Vitamin D modulates the biosynthesis of neurotransmitters and neurotrophic factors and it is involved in the modulation of inflammatory responses, with a potential impact on clinical status of patients with severe mental disorders. Moreover, available evidences report that decreased blood levels of Vitamin D are associated to a worse course of psychotic and affective disorders.

We assessed calcium homeostasis imbalance in a sample of inpatients and outpatients, referring to the Department of Psychiatry of University of Campania “Luigi Vanvitelli” in order to explore levels of Calcium, PTH and Vitamin D and their influence in clinical severity among this different subgroups.

All patients were administered The Brief Psychiatric Rating Scale (BPRS) to assess different domains of psychopathology. Vitamin D, Calcium and PTH levels were assessed in all patients. An-ad hoc schedule was administered for socio-demographic and clinical characteristics.

The total sample consisted of 152 patients (75 males and 77 females with 47.3 ± 14.4 age at admission, 74 inpatients and 78 outpatients). Patients with lower level of Vitamin D are more likely to present higher number of relapses (p<0.05) and to be inpatients (<0.01). Finally, serum levels of Vitamin D were negatively correlated with all the BPRS subscales (p < 0.01).

Lower levels of Vitamin D correlate with a worse clinical outcome of patients with different psychiatric diagnosis. Our results highlight the importance to routinely assess PTH, Vit D and calcium levels, especially in inpatients. Moreover, Vitamin D may represent a valid add-on treatment for these patients.

No significant relationships.

Traumatic brain injury (TBI) may alter dementia progression, although co-occurring neuropsychiatric symptoms (NPS) have received less attention. The mild behavioral impairment (MBI) construct relates NPS to underlying neural circuit disruptions, representing an important area of inquiry regarding TBI and dementia.

(1) to examine the influence of prior TBI history (preceding study enrollment) on MBI incidence in all-cause dementia (prior to dementia diagnosis, i.e. MBI’s original definition) and (2) to utilize MBI domains as a construct for examining the influence of TBI on related NPS across the course of dementia onset and progression.

Using National Alzheimer’s Coordinating Center data, individuals progressing from normal cognition to all-cause dementia over 7.6±3.0 years were studied to estimate MBI incidence and symptom domains in 124 participants with prior TBI history compared to 822 without.

Moderate-severe TBI was associated with the social inappropriateness MBI domain (ORadj.=4.034; p=0.024) prior to dementia onset, and the abnormal perception/thought content domain looking across dementia progression (HRadj.=3.703, p=0.005). TBI (all severities) was associated with the decreased motivation domain looking throughout dementia progression (HRadj.=1.546,p=0.014).

TBI history is associated with particular MBI domains prior to onset and throughout progression of dementia. Understanding TBI’s impact on inter-related NPS may help elucidate underlying neuropathology.

No significant relationships.

Patient who comes to the Hospital accompanied by the Emergency Services from the Santa Justa train station, coming from Madrid, after being repatriated from Bangladesh.

There he was serving a five-year sentence for drug trafficking.

He is a patient who has had several hospital admissions at UHSM and clinically prosecuted as a paranoid schizophrenic. In prison, the first years he had no antipsychotic medication and recognizes the presence of auditory pseudohallucinations.

psychopathological stabilization

case report

In the psychopathological assessment upon arrival, the patient was hostile and suspicious, even refusing to take food and medication because he was demanding his freedom. He also relates this point to delirious interpretations of passers-by who approached him at the Madrid airport.

During the admission, the patient was referred to Internal Medicine for a global evaluation and analytical tests of his organic situation, finding normocytic anemia without other findings and with good response to the treatment established.

The patient’s psychopathological evolution is very favorable. Progressively more approachable and critical of the phenomena of psychotic nature. Interventions are carried out with Social Work for his overnight stay.

We have the odyssey of one of many patients with a mental illness where their life journey leads them to marginal situations and where elements of a legal nature are intermingled; either by the stay in prison itself or by the need for an admission against their will for psychopathological stabilization and to redirect this shipwrecked life course.

No significant relationships.

The aim of this study is to investigate mobbing in the Hospitals of Etoloakarnania, Greece. Additionally, this research aims to find out which coping strategies are used by health care professionals who have suffered mobbing and how their quality of life has been affected.

This research aims to depict mobbing phenomenon’s extent and investigate the coping strategies and quality of life of working staff, victims of mobbing.

The research methodology was based on two questionnaires: LIPT scale and the scale of assessing bullying management strategies, as well as demographic data, which were answered by 130 people. A sufficient sample for the needs of this study to produce comparable results with the existing literature.

Mobbing is observed to a large extent of 83.8% , which, however, seems to be at lower levels in relation to corresponding researches abroad. In addition, the majority of respondents who appear to have been harassed at work are mostly women (78.5%), which seems to be in line with global studies. Τhe consultants and the supervisors take advantage of their position of power and impose or change duties on other staff (45.3%), in order to punish their subordinates, exacerbating the phenomenon of mobbing, also. Finally, the participants recognize the phenomenon and look for the majority of positive ways of action (65%), while they do not resort to non-constructive ways of solving the problem.

Mobbing is a serious phenomenon that affects working staff’s mental health and quality of life. Policies should address effectively this deleterious aggressive behaviour.

No significant relationships.

In the last two years, Prof Vita received, directly or indirectly, support for clinical studies or trials, conferences, consultancies, Congress presentations, advisory boards from: Angelini, Boehringer Ingelheim, Innovapharma, Janssen-Cilag, Lundbeck,

Depressive symptoms are common in patients with Fibromyalgia (FM), a chronic and disabling pain syndrome. Psychological interventions are mostly focused in negative thinking and behavioural activation. However, several studies suggest that personal identity is also affected by FM.

We aimed to examine the effects of Personal Construct Therapy (PCT), an idiographic approach that emphasizes identity features and interpersonal construal, on depressive symptoms in women with FM.

In the context of a multicentre parallel randomized trial (Trial Registry: NCT02711020), 106 women with FM and presenting depressive symptoms were randomized either to either Cognitive Behavioural Therapy (CBT; n = 55), taken as a gold standard comparison, or PCT (n = 51). In total, 69 patients completed the treatment and the six-month follow-up assessment (CBT = 32 and PCT = 37). Both treatments were applied on case formulation premises.

Linear mixed-effects models were performed to compare depressive symptoms between treatment conditions. Anxiety and pain measures were treated as secondary outcomes. Participants in both conditions significantly reduced their levels of depression and anxiety as well as the impact of FM but no significant between treatment differences were found. Analysis of clinically significant change for depressive symptoms and pain was also similar between both conditions.

PCT resulted equally effective in the treatment of depressive symptoms in women with FM when compared with CBT, both offered in a modular format. Thus, PCT with tis focus on identity issues can be considered as an alternative treatment for these patients.

No significant relationships.