The COVID-19 pandemic has positioned health professionals around the world in an unprecedented situation, having to work in extreme conditions.

The reactions of healthcare personnel that concern us most are the negative psychological effects of the pandemic, such as exhaustion, moral injury, acute stress reactions, anxiety, depression or post- traumatic stress disorder.

To assess the impact of the COVID19 crisis on mental health of Spanish health professionals during the start of the pandemic.

A descriptive, cross-sectional study is carried out, in which the population sample to be studied was the health professionals who responded to the online questionnaire designed to assess the emotional impact caused by the COVID-19 health crisis.

The questionnaire collects sociodemographic and labor data, which correspond to the independent variables of the study. The dependent variables correspond to the two scales used in the questionnaire (SAS and SASRQ scales)

The population sample was 473 people.

Analyzing the results of the SAS scale, 26.5% of the sample had anxiety symptoms in a normal range, 44.3% had mild-moderate anxiety levels, 24.4% marked-severe anxiety and 4, 9% had extreme anxiety levels.

The SARQ questionnaire assesses the presence of an acute stress disorder. In our study, 31.6% of those surveyed had this type of disorder.

Immediate interventions and support for health professionals are essential to improve psychological resilience and avoid the appearance of mental health problems.

No significant relationships.

Italy was the first European country to face up with COVID-19 pandemic, which posed challenges to National Health System (NHS), including the need to adapt mental health services/infrastructures and implement digitalization.

Despite telepsychiatry (ie., delivery of psychiatric care remotely through IT), is extensively used in non-European countries, only during the COVID-19 pandemic, became a convincing alternative to face-to-face modality for many psychiatrists in their clinical practice. Our aim was investigating Italian psychiatrists’ opinion about telepsychiatry.

A questionnaire, disseminated during the third Italian phase, constituted by three sections (socio-demographic, opinions and personal experience about/with telepsychiatry) was build by adapting the 42-item questionnaire by Schubert (2019) and CAMH’s Client Experience Survey from the psychiatrist’s perspective.

90 questionnaires were collected from a sample of 54 women (60%) with an average age of 43(SD=11.4). Mostly were psychiatrists (85.6%) working in NHS (66.7%) with an average working years of 13.7(SD=11.5) and a previous experience in telepsychiatry (71.1%). Overall, participants do not believe that telepsychiatry is comparable with face-to-face modality. A significant positive opinion was reported among younger psychiatrists compared to those more experienced, regarding efficacy, feasibility and mental health access (p<0.05). No significant differences were reported in psychiatrists’ opinion, according to the level of telepsychiatry use in their clinical practice.

Overall, sufficient digital skills and knowledge of technological tools are evident among younger psychiatrists who also appeared to be more prone to implement telepsychiatry in their clinical practice.

No significant relationships.

On January 2021 the Department of Psychiatry became the only unit exclusively dedicated to COVID patients with severe mental illness in acute decompensation. Only patients in risk of rapid medical deterioration were excluded and forwarded to intensive care.

Discussion of this unprecedented experience.

Analysis of 28 patients hospitalized during 3 months with both an acute psychiatric disorder and an SARS-CoV-2 infection; description of the multidisciplinary intervention made.

Our sample was characterized by a majority of patients with an acute psychotic episode derived from a schizophrenia spectrum disorder (42%) or a bipolar affective disorder (21%). Only 3% of the patients had a diagnosis of severe major depressive disorder. And 10% of patients developed severe respiratory symptoms requiring oxygen or urgent transfer to COVID medical wards. Most patients presented periods of psychomotor agitation, lack of impulse control and self-aggression. Psychopharmacological and psychotherapeutic interventions had to be adapted to these unusual conditions. Most of them had already gone through a period of isolation in the buffer ward created to exclude false negatives, which promoted atypical deliriums and symptoms of post-traumatic stress. The psychiatric team was faced with the emergent need to adapt an intervention model based on trust to a model that had to prioritize physical safety.

The pandemic experience was transformative for all who lived through it. From the challenge perspective, it may have been enriching. But the maintained confrontation with the antithesis of therapy, defined by “caring, supporting, communicating, approaching”, was devastating in ways that we consider essential to be debated.

No significant relationships.

Schizophrenia is a chronic psychiatric illness with periods of remission and relapse. Patients vary in the frequency and severity of relapse, time until relapse and time in remission. Discontinuation of antipsychotic medication is by far the most important reason for relapse. A possible method to optimize medication adherence is to treat patients with long-term, depot medication rather than oral medication.

Primary objective is to compare all cause discontinuation rates in patients with schizophrenia randomized to either one of the two depot medications (aripiprazole depot or paliperidone palmitate) with patients randomized to either one of the two oral formulations of the same medication (aripiprazole or paliperidone) over an 19 month follow-up period.

Pragmatic, randomized, open label, multicenter, multinational comparative trial consisting of a 19 month treatment period. Patients aged 18 years or older, having experienced the first psychosis 1-7 years ago, currently meeting DSM-IV-R criteria for schizophrenia. Patients are randomized 1:1:1:1 to paliperidone palmitate, aripiprazole depot, oral aripiprazole or oral paliperidone. The primary outcome is all cause discontinuation.

In the Intent to Treat sample (n=511), no difference was found in time to ACD between the combined oral and combined depot treatment arms, nor between the four individual treatment arms.

Even though the scientific evidence comparing oral and depot medication has been inconsistent, most studies were conducted in rigorous clinical settings, which may have biased those results. In contract, given the pragmatic, open label design of the current trial, the results may be more representative of common daily practice.

No significant relationships.

Transition of educational institutions to distance learning in pandemic was found to be associated with students’ complaints about difficulties, decrease in effectiveness, interest and well-being (Herbert et al., 2021, Almomani et al., 2021, Puljak et al., 2020).

The aim was to reveal psychological predictors of decreased academic satisfaction, competence, and engagement among students in the digitalization of education during a pandemic.

In December 2020 220 students 18-33 years old were asked about their learning difficulties, academic satisfaction, competence and engagement before the pandemic and now (Cronbach’s alphas .66-.90), well-being (Diener et al., 1985, Diener et al., 2010), educational motivation (Sheldon et al., 2017), pandemic anxiety (Tkhostov, Rasskazova, 2020).

There was a decrease in academic satisfaction, subjective competence and engagement, with moderate learning difficulties (F=60.4-63,3, p<.01, η²=.22). More pronounced learning difficulties during a pandemic were found in students with higher level of negative emotions, lower integrated learning motivation, higher anxiety due to the transition to distance learning and due to a violation of security online (p<.01). The decrease in academic satisfaction, competence and engagement were maximal among students with a lower level of positive emotions, higher level of amotivation, anxiety due to the transition to distance learning and violation of privacy and security online (p<.01).

Students with higher negative emotions and distance learning anxiety regardless of their skills were more vulnerable to the changes in learning in pandemic. The study was funded by Russian Science Foundation project № 18-18-00365.

The study was funded by Russian Science Foundation project № 18-18-00365.

Hydroxychloroquine an antimalarial medication has been approved in March 2020 by FDA for treatment of hospitalized patient with COVID-19 infection. Even thus, its efficacy has been controversial, it still being used worldwide. This medication also causes some serious side effects. Here we present a case of a woman with a very long history of treatment resistant schizoaffective disorder, on clozapine, who develops QT prolongation after receiving hydroxychloroquine for the treatment of COVID-19 infection.

Despite the controversy, this case aims to shed light on the importance of monitoring QTc via EKG in patient receiving hydroxychloroquine7. More importantly to avoid antipsychotic while patient is receiving this medication since both hydroxychloroquine and most antipsychotic can increase QTc.

This case report was written by reviewing chart of the patient and also via direct interaction and interviews with the patient.

This case report showed and increased in QTc interval after receiving hydroxychloroquine, which is also reported by others including Moussa Sleh et al in their article on Effect of Chloroquine, Hydroxychloroquine, and Azithromycin on the Corrected QT Interval in Patients With SARS-CoV-2 Infection4. The increase in Qtc could have been worse if Clozapine was not stopped during this time.

COVID-19 pandemic has caused more than 700000 deaths around the globe and more than 150000 deaths in the United States of America. Psychiatric patients are also getting hospitalized and receiving treatment with hydroxychloroquine. Holding anti-psychotics and monitoring of QTc via EKG resulted crucial in limiting the adverse effect of QT prolongation of both medications.

No significant relationships.

The use of “operational criteria” in DSM-III was proposed as a solution to low reliability among psychiatrist’s diagnosis. It is considered a turning point in the psychiatric classification and diagnostic process, furtherly adopted in ICD. However, the utility of using such criteria in everyday clinical practice is still not clear.

To measure agreement between prototypical and ICD-10 categorical diagnosis.

In IPUB’s outpatient clinics, psychiatry residents work in a real-life clinical scenario, attending patients from Rio de Janeiro/RJ-Brazil. Although regularly trained in ICD criteria, it is not usual to check every criterion in their daily practice. Thus, patients are diagnosed with a prototype-based disorder, not necessarily strictly attached to ICD criteria. We propose a cross-sectional study, where psychiatry residents check their clinical diagnosis according to ICD criteria and compare its agreement with kappa statistics.

Three of thirty residents joined the study, providing diagnosis for 146 patients under their care. Forty-five diagnoses were obtained before and 51 after ICD-10 criterion application. Diagnoses were grouped under 8 groups (Organic, Schizophrenia Spectrum Disorders, Bipolar Affective Disorder, Depression, Anxiety-Related Disorders, Personality Disorders, Neurodevelopmental Disorders), and kappa agreement obtained using ICD-10 diagnosis as the gold standard against prototypical diagnoses. Overall kappa was 0.77 (IC - 0.69 - 0.85), ranging from 0.58 (Personality Disorders) to 0.91 (Schizophrenia Spectrum Disorder). These findings also were reflected as high sensibility, specificity, Positive Predictive, and Negative Predictive values in all groups.

Prototypical diagnostic elaboration, while probably based on previously learned, but not applied operational criteria, was equivalent to diagnostic obtained through ICD-10 categories.

No significant relationships.

Early life stress (ELS) is a significant risk factor for major depressive disorder (MDD) in adults. Functional magnetic resonance imaging (fMRI) studies using face emotion processing paradigms have found altered blood-oxygen-level-dependent (BOLD) responses in the cortico-limbic network both in individuals exposed to ELS and in patients with MDD. Thus, early life stress may have a long-lasting impact on brain areas responsible for the processing of socio-affective cues.

By applying a facial emotion recognition (FER) fMRI paradigm, we examined the long-term effect of childhood adversity on brain activity in MDD patients with and without ELS.

MDD patients without ELS (MDD, N=19), those with ELS (MDD+ELS, N=21), and healthy controls (HC, N=21) matched for age, sex, and intelligence quotient underwent fMRI scanning while performing a block design FER task with faces expressing negative emotions. The severity of ELS was assessed with the 28-item Childhood Trauma Questionnaire.

Both MDD and MDD+ELS patients were slightly impaired in recognizing sad faces. Statistical analysis of brain activity found that MDD+ELS patients had significantly reduced negative BOLD responses in the right anterior paracingulate gyrus, subcallosal cortex accumbens compared to HCs. Moreover, the MDD+ELS group had a significantly increased negative BOLD signal in the right postcentral and precentral gyri relative to the HC group. MDD+ELS patients had reduced negative BOLD response in their anterior paracingulate gyrus compared to the MDD group.

Our results support that adult MDD patients with significant ELS are impaired in facial emotion recognition and they display functional alterations in the frontostriatal circuits.

This work was financially supported by the Hungarian Brain Research Program (2017-1.2.1-NKP-2017-00002)

Chronic schizophrenia patients are experiencing persistent and severe illness for more than 15-20 years and are usually suffering from long-term negative symptoms. Cariprazine, a novel D3-D2 partial agonist has been proven to be effective in the treatment of acute schizophrenia, however its ability to treat chronic patients has not been assessed yet.

The primary aim of the present post-hoc analysis is to assess the efficacy of cariprazine in treating patients with chronic schizophrenia (late-stage and residual schizophrenia patients).

Data from 3 phase II/III 6-week, randomized, double-blind, placebo-controlled trials with similar design in patients with acute exacerbation of schizophrenia were pooled and patients with more than 15 years of schizophrenia were analysed (late-stage patients). Furthermore, schizophrenia patients experiencing predominantly negative symptoms from a 26-week, randomized, double-blind, active-controlled, fixed-flexible-dose trial with an ICD-10 code of F20.5 were analysed post-hoc (residual patients).

Altogether, 414 late stage (286 cariprazine and 128 placebo) and 35 residual (23 cariprazine and 12 risperidone) patients were identified. The pooled analysis evaluating mean change from baseline to week 6 in the PANSS total score indicated statistically significant difference in favour of cariprazine in the late stage (LSMD -6.7, p<0.01) subpopulation compared to placebo. The mean change from baseline in patients with residual schizophrenia in the cariprazine arm was -9.6 on the PANSS-FSNS scale, while -7.9 in the risperidone arm.

Based on the results, it seems that cariprazine might be a good treatment option for patients with chronic schizophrenia. Nonetheless, further studies are needed to confirm this.

I am an employee of Gedeon Richter Plc.

Patients with Schizophrenia Spectrum Disorders (SSD) often lead unhealthy lifestyles with higher prevalence of obesity and unfavourable cardiometabolic parameters with less life expectancy and often worse quality of life compared with general population.

Evaluate the effectiveness of a combined intervention of exercise and psychoeducation in 48 SSD outpatients with metabolic syndrome (MetS), treated with second-generation antipsychotics and also aimed to explore if the effect persisted in a long-term follow-up of 24 months.

The intervention included a 12-week aerobic exercise program and a session of lifestyle psychoeducation. Effectiveness was measured in terms a wide range of outcomes involving physical and psychological health, functioning, quality of life, physical activity and changes in motivation to exercise in the context of the self-determination theory.

The active intervention group showed benefits after Bonferroni correction over clinical global impression, identified motivation to exercise and changes of physical activity pattern. Maintenance of effects after 24 months of follow-up was observed for identified regulation to exercise and also for negative symptoms of psychosis (Table). Table. Effects assigned-group/time-over *p≤0.05 **p≤0.01.

A combined intervention on SSD outpatients with MetS showed effectiveness over several clinical parameters and functioning. Therefore, should be considered an essential part of the integral treatment in mental health services for SSD patients.

No significant relationships.

The Covid-19 pandemic has caused multilevel changes worldwide. Everyday life of all people has been altered drastically. Children with ASD seem to face difficulties due to their heightened sensitivity to unpredictable and complex changes in their lifestyle. Our presentation aims to reveal the effects of Covid-19 on school-age children with Autism Spectrum Disorders.

The main thematic areas of this research, concerning the social workers’ questionnaire, focused on the routine, psycho-emotional field, school performance, sociability and school environment of children with ASD.

Between June 22nd and August 16th, 2021, social workers (n=38) and parents (n=25) administrated a questionnaire -through google form platform- which investigated issues around routine, psycho-emotional field, school performance, sociability, school, and family. Descriptive statistics were used for statistical analysis of the data.

The routine and psycho-emotional conditions of children with ASD were found to have a negative shift. Moreover, the degree of change on school performance was moderate, while sociability change was minimal. The significance of the school’s contribution and the impact of the Covid-19 pandemic on the family functionality was highly observed. Another interesting finding was that children with ASD did not display discomfort for the mandatory social limitations or fear for the virus transmission.

Lastly, it is important to implement appropriate practices for the protection of children with ASD, through the mobilization of the responsible parties and thus, social policy transformations are vital for this vulnerable population.

No significant relationships.

Since March2019, successive waves of the COVID-19pandemic have challenged the mental health of frontline healthcare workers, who have been shown in numerous studies to be at increased risk for characterized psychiatric disorders. However, healthcare professionals who were not directly involved in the care of patients withCOVID-19 were often not investigated. In Morocco, the literature dealing with the psychological impact of the pandemic on backline health professionals is still scarce.

The purpose of our survey is to assess the stress, anxiety, and depression of health workers who were not on the front lines of care forCOVID-19 patients.

It is a survey developed on googleforms and disseminated via social networks targeting groups of health professionals in Morocco, during June2020. We used the DASS21 scale(depression, anxiety and stress scale with21 items). The results were analyzed using the JAMOVI application.

out of80 participants: 54%are men, 56%are aged between 31 and 40years old, 38%have been in practice for less than 5years of exercise, 66%are married, 41%are specialists 36%are residents and 21%are nurses, 44% work in psychiatric ward. Psychiatric symptoms: 64%have worries, 64% tired, 63% irritability, 59% sadness, 53% insomnia and 51% somatic complaints. 6.3%report substance use. DASS-21: 50%of participants have depression (7.5%mild, 26.25%moderate, 11.25%severe, 5%extremely severe), 48.75%have Anxiety (7.5%mild, 25%moderate, 8.25%severe, 7.5%extremely severe) and 30%report Stress (8.75%mild, 15%moderate, 6.25%severe, 0%extremely severe).

The high level of job stress during the early months of the pandemic exposed health workers who were not on the front line of care forCOVID-19 patients to an increased risk of psychological decompensation.

No significant relationships.

. Cluj-Napoca in Transylvania, Romania, has a historically multiethnic population who maintain their language-based cultural identities. In order to harmonize interethnic relations in our multicultural society, art-therapeutical methods depend on the need to establish a sensitive relationship between the cultural horizon of individuals, thus increasing self-confidence, tolerance, resilience.

The objectives are : to develop social skills, which facilitate the social and professional integration of children and adolescents belonging to ethnic groups living together, including those with disabilities.

Clinical art therapy have unfolded within interdisciplinary teams: a neuropsychiatry doctor, a psychologist, a pedagogue, a social worker, an art therapist– each one having a specialized role. A medical project was transformed into an artistic project: E xperimenting with complex relationships: shape of the human body – shape of man-made objects and the creation of personal shapes conduct to harmonize interethnic relations in a multicultural place.

Focus on several objectives: - practicing the abilities to express one’s feelings - the consolidation of self-respect and of confidence - the training of empathy - the development of personal problem and conflict solving strategies -the breaking through the emotional blockages - the improvement of cognitive abilities -the release of tension, frustrations, anxieties, stress -the development of social skills

Benefits arise from experiences based in artistic creativity: materializing ideas and coping with unexpected outcomes.

No significant relationships.

Despite the high interest in affective aspects of endogenous depression, the question of overvalued ideas remains unclear.

To determine the clinical features of depression with overvalued ideas in the context of slow progressing schizophrenia.

The study involved 102 people, including 62 women and 40 men diagnosed with slow progressing schizophrenia, with moderate or severe depression, with the predominance of overvalued ideas (F21 in ICD-10). The control group had 110 people with similar distrubution by sex and age all diagnosed with a depressive state formed in the context of slow progressing schizophrenia, without overvalued ideas. Research methods were mainly clinical-psychopathological and clinical-catamnestic.

In the majority of observations (62.5%) in the comparison group, showed a uncomplicated form of depression, only limited to affective level. In the (37.5%) left, depression was characterized by a structural polymorphism, in addition to affective disorders, there were other psychopathological syndromes observed. In the main group, an inverse relationship was observed: uncomplicated depression in 29.2% of cases, while the overwhelming majority of cases (70.8%) experienced atypical depressions, disharmony of the affective triad, as well as an increase in the concomitance of neurotic and psychopathic symptoms were observed.

The cohort of patients with slow progressive schizophrenia with depression is heterogeneous, while the features of the course of the disease correlate both with the presence or absence of overvaluated formations in the picture of depression, and with the features of the modification of the overvaluated ideas during the disease.

No significant relationships.

There are some patients that remain resistant to treatment for major depressive disorder - who were treated with two or more different medications, and did not demonstrate any improvement in their mental-state. These patients can be treated with a new treatment – Esketamine. The recommended Esketamine treatment protocol includes 8-treatment sessions, each session lasts about two hours. In our clinic, we added a therapy group after each treatment. The therapy group is led by two co-therapist and lasts 30 minutes. The patients are invited to share their experiences from the session.

We will present a case report of a 44 year old man, that suffers from a major-depression for years, with symptoms such as loss of energy, recurrent thoughts of death and a decrease in functioning. He was treated with different medications, but there was no improvement in his mental state.

For the last six months, he was treated with Esketamine and also participated in the therapy group.

According to content that he raised in the sessions of the therapy group and following conversations with him and with his close environment, we observed a clinical improvement in his condition – a positive mood, a decrease of the thoughts of death, an increase in his function at work and at home.

He reported that the improvement is more significant because of the therapy group – he found a peer group, a place to process his treatment experience and to share his feelings and thoughts. We will present vignettes to demonstrate.

No significant relationships.

As publications on social media have become an important regulator of group opinions, moods and psychological well-being during the spread of COVID-19, it seems necessary to study the contribution of various information as a source of preserving the psychological resources of the population.

To analyze the content in communities created during the spread of the COVID-19 pandemic in order to assess the image of health professionals on social media.

Using datamining methods, we analyzed publications about medical staff in a large community ‘StopCoronavirus.RF’ which unites more than 400 thousand users.

More than 700 thousand entries were ‘liked’ in the community from March 2020 to March 2021; more than 125000 thousand posts were shared, about 290 thousand comments were written, and all community publications were viewed more than 3 billion times. Publications about medical staff working in the ‘red zones’ in Russia are distinguished by the largest number of ‘likes’ (more than 5000) and comments (more than 300). In the publications and comments, the model of modern heroes saving human lives is emphasized. This type of information contributes to the reduction of anxiety and promotion of psychological safety in case of COVID-19 contraction through establishing confidence in the competence of medical staff and their involvement in the fight against the pandemic.

These results suggest that the image of a doctor on social media during the pandemic has acquired special value for the population. Publications on the work of medical staff in the ‘red zones’ help to cope with anxiety associated with the COVID-19 pandemic. The study was funded by RFBR, project number 20-04-60174.

No significant relationships.

Self-Harm (SH) is any act of self-injury carried out by somebody irrespective of motivation. SH most commonly functions to relieve negative affect (NA). Tentative evidence suggests reward processing is altered in SH. NA may trigger reward hypersensitivity and therefore SH. Whether NA influences reward processing in SH remains unclear.

To investigate whether self-harmers differ in motivation to obtain SH stimuli than healthy controls (HCs) following NA induction.

After NA induction, SH participants will have a significantly shorter reaction latency (RL) and greater reaction accuracy (RA) than HCs in the SH condition of the Incentive Delay (ID) task.

16-25-year-old SH (n=35) and HC (n=20) participants were recruited online and underwent the Trier Social Stress Test, to induce NA, followed by the ID task, where participants were cued to respond to a target as quickly as possible. On responding, an image of either a SH act (SH Condition), people socializing (Social Condition) or money (Monetary Condition) appeared. Each condition included control trials showing a neutral image. RA was the percentage of trials responded to within the target’s presentation time. RL was the time (seconds) between target appearance and participants’ response.

There was no significant main effect of group, condition or group x condition interaction for RL. There was a significant main effect of condition (p < 0.05) but not of group nor a group x condition interaction for RA.

Reward processing did not differ in the SH group compared to HCs post-NA induction. Future studies could investigate reward processing in longitudinal and larger SH samples.

No significant relationships.

The COVID-19 related restrictions such as social distancing forced the search for feasible alternatives to the provision of care for patients with severe mental illness (SMI), with services opting for teletherapy as an substitute of face-to-face treatment.

To examine the implementation of teletherapy (telephone, videoconference) with patients with SMI during the COVID-19 first wave, and explore its associations with reduced hospitalisations after the first wave was over.

We performed a retrospective assessment of 270 records of patients visiting fifteen outpatient mental health services across Spain during 2020. We retrieved sociodemographic and clinical data, including modality of received therapy (in-person, telephone, videoconference) in three time points (before, during and after the first COVID-19 wave) and hospitalisation rates two, four and six months later.

During the first wave, services implemented teletherapy (telephone and videoconference) extensively, whilst they reduced face-to-face therapy, though this returned to previous levels after the first wave. Hospitalisations two months later did not differ between patients who received teletherapy, and those who did not (p=.068). However, hospitalisations were lower for the first group of patients four (p =.004) and six months later (p <.001). Multilevel analyses suggested that receiving teletherapy by videoconference during the first wave was the factor that protected patients most against hospitalisations six months later (OR=0.25; p=.012).

Our findings suggest that teletherapy plays a protective role against hospitalisations, especially when face-to-face therapy is not feasible. Therefore, it can be considered a valid alternative to ensure continuity of care to patients with SMI.

No significant relationships.

Schizophrenia is socially significant mental disorder characterized by early onset and high time and financial expenditure on treatment. Antipsychotics (APs) are highly effective against positive and negative symptoms, but at same time have a wide range of adverse drug reactions (ADRs). APs efficiency and safety are variable and depend on characteristics of genetically determined mechanisms (transportation, biotransformation, and elimination).

Investigation role of pharmacogenetic testing (PhGT) on example of clinical case of severe ADRs in 47-year-old woman with schizophrenia.

Patient’s medical history analysis; clinical observation; biochemical serum analysis; therapeutic drug monitoring; PhGT.

The clinical case of a woman with schizophrenia who has been noted to be unresponsive to APs for some years after schizophrenia onset. She was found to be homozygous for nonfunctional SNVs CYP2D6*4 and CYP2C9*2, heterozygous for CYP1A1*2A, which was reason for complete shutdown of isoenzymes 2D6, 2C9 and 1A1 activity and development of ADRs in use of initial doses of several APs, as well as for an increase in severity of ADRs with schizophrenia positive symptoms aggravation with an even slower titration of APs daily dose not only with polytherapy, but also with monotherapy. So, not recommented APs for patient: aripiprazole, haloperidol, zuclopenthixol, cariprazine, quetiapine, paliperidone, risperidone, thioridazine, sertindole, asenapine, alimemazine, chlorpromazine, etc. (CYP2D6); haloperidol, clozapine, olanzapine, perphenazine, promazine (CYP2C9); carefully: haloperidol, olanzapine, perospirone (СYP1A1).

This rare case demonstrates PhGT importance before APs therapy, because the patient had very high risk AP – induced ADRs. She needed PhGt before APs use, but not after severe ADRs during 12 years.

No significant relationships.

Social intelligence (SI) and creativity (Cr) are resources to develop adaptive coping strategies and positive emotions that can help combat feelings of fragility and vulnerability caused by uncertainty during primary career self-determination as the developmental task in late adolescence.

The aim of the study was to compare SI and Cr of students with high and low level of tolerance for uncertainty (TU) during two last years in the middle school.

Participants were 200 students (15-17 years old). The level of TU was estimated by Budner’s scale (Kornilova, 2010). Social intelligence was assessed by O’Sullivan & Guilford’s Tests, creativity was measured by CAP. In addition, we estimate career adapt-abilities applied to present and prospective future career decisions.

Two contrast clusters based on TU level were analysed. The level of SI and Cr were various within each group. There appears to be an association between TU and career adapt-abilities (at r ∼ .37, p < .05). Mostly female students with low level of TU and above average scores on SI and Cr demonstrate the effective coping strategy dealing with stress (at r ∼ .45, p < .01) emotionally focus on nearest professional future, seek social support. Coping strategy of students with high TU, SI and Cr is focusing on nearest and distant professional future, on task-oriented content and the social status of the future profession. They are open to new career experience and flexibility in the use of future professional skills (at r ∼ .56, p < .001).

Employing their SI and Cr give new opportunities to understand and prevent the development of stress and provide age-specific support to prospective students during primary career self-determination.

Research is supported by the Russian Humanitarian Research Foundation, project No. 18-013-01067.