Alterations in a variety of immune parameters, including abnormal cytokine levels, are known to be found in schizophrenia. These changes can be useful in identifying patients with the most severe immune abnormalities.

To develop approaches to stratification of schizophrenia patients based on cytokine levels using cluster analysis.

We recruited 53 patients (25 women/28 men) with a verified diagnosis of simple or paranoid schizophrenia and 37 healthy individuals (19 women/18 men) in our study. Serum levels of IL-1β, IL-2, IL-4, IL-6, TNFα, INFα, BAFF, GM-CSF, NGFβ, NRG1, and GDNF were determined using a MAGPIX multiplex analyzer (Luminex, USA). Statistical analysis was performed in Statistica 10.

Principal component analysis and partial least-squares discriminant analysis showed that the combined multi-cytokine profiles of the studied groups differ. The results of the k-means cluster analysis are presented in Table 1 The most reliable results are obtained by a combination of 4 variable: IL-1β, IL- 4, BAFF and GDNF. Table 1 Percent of individuals classified in different clusters depending of number of parameters using for classification.

A subgroup (сluster 1) of schizophrenic patients with severe immune abnormalities was identified using data on the levels of IL-1β, IL-4, BAFF and GDNF. Anti-inflammatory therapy is recommended for this subgroup of patients. Support by Grant of RSF № 21-75-00102.

No significant relationships.

Cardiovascular events (CVE) are infrequent adverse effects in patients receiving electroconvulsive therapy (ECT). Nonetheless, it constitutes a threat for patient’s life and may compromise continuing ECT.

To describe a case of acute-onset atrial fibrillation under combined therapy with ECT and venlafaxine.

We present a 76-year-old man diagnosed of delusional disorder and without any previous CVE, who was hospitalized in our acute psychiatric unit by major depressive episode with psychotic symptoms resistant to pharmacological treatment (valproic-acid 100mg/d, haloperidol 6mg/d, venlafaxine 300mg/d). ECT was initiated presenting atrial fibrillation after first session of ECT, requiring amiodarone and anticoagulant treatment for stabilization. Second session of ECT was delayed for three-weeks, worsening the psychiatric symptoms. Haloperidol was discontinued initiating lurasidone with better cardiovascular profile.

CVE occur in 2% of the patients receiving ECT, being acute arrhythmia the most frequent one. Among them, few cases of atrial fibrillation (AF) under ECT have been reported. It has been hypothesised that initial vagal response followed by catecholamine surge secondary to ECT could facilitate the development of AF. In addition venlafaxine, an antidepressant drug, may also predispose to arrhythmia in high-risk individuals. High doses of venlafaxine (>300mg/d) combined with ECT have been related with an increment of CVE.

Although clinically effective for the treatment of major depression disorder, combined therapy of ECT and venlafaxine could precipitate the start of a CVE in genetically susceptible individuals. Therefore, identify and clarify potential risk factors other than previous history of CVE is critical to reduce morbidity and mortality in these patients.

No significant relationships.

Late life depression is a major global health issue, with an estimated 7% of older adults suffering from this mental disorder. Depression is one of the most important predictors for suicide in the elderly. However, it is often difficult to recognize and manage, making treatment-resistance a common occurrence. Treatment-resistant depression itself is also a known risk factor for suicide. Recently, non-invasive neuromodulation techniques have been used as a new treatment for depression and suicidality with promising results.

This study aims to investigate the effect of adTMS (accelerated deep Transcranial Magnetic Stimulation) and tDCS (transcranial Direct Current Stimulation) on the suicidality of elderly, therapy-resistant depressed patients. The hypothesis is that suicidal ideation and risk of suicide will decrease after a treatment with adTMS and tDCS.

In this randomized double-blinded sham-controlled clinical trial, geriatric therapy-resistant depressive patients will receive adTMS treatment (See: Figure 1). Suicidality will be assessed before and after the active or sham treatment, through the Columbia Suicide Severity Rating Scale (C-SSRS) and Beck Scale for Suicide Ideation (BSI). After one week of rest, all patients will receive an at-home tDCS treatment for 3 weeks. Likewise, the suicide risk will be estimated before and after the tDCS. During the screening period, the severity of the patients’ depressive symptoms will be determined by using the 17-item Hamilton Depression Rating Scale (HDRS-17). In total, the trial will last for 5 weeks, and suicidality will be examined at five different time points (during screening, at T0, T1, T2 and T3).

Not applicable

Not applicable

No significant relationships.

Many studies have searched for an association between violence and psychiatric diagnoses, without providing a confirmative result.

We have sought to deepen this topic, analysing different aspects of aggressivity, focusing on a specific diagnosis and its particular phases of illness, and looking for a correlation between psychiatric co-diagnoses and outpatients’ visits adherence.

We studied 151 bipolar type I inpatients presenting complaint, past medical and family history; we collected information about lifetime hetero/self-aggressive behaviours, irritability, agitation, suicide attempts, alcohol, or substance abuse.

The overall aggressivity in our sample resulted in 11.92% of cases, while the number of aggressive episodes during euthymia decreased to 2.64%, close to the population without psychiatric disorders. Personality disorders and alcohol abuse appeared to be the main risk factors for irritability [Fig. 1]; substance abuse for both irritability and hetero-aggressive behaviour [Fig. 2]. We observed that subjects who displayed better compliance to follow-up visits exhibited a significant lower aggressive behaviour than less adherent subjects. Moreover, our data disconfirm the common conception that correlates the presence of psychotic features to violence.

Studying aggressive in a bipolar population, we observed that the rare episodes of aggressiveness were condensed in active phases of illness and mainly related to alcohol or substance abuse, while violent acts during long periods of wellbeing appear in line with those of the general population. We are confident our data might be helpful in deconstructing the stigma that a psychiatric diagnosis equals to violent behaviour.

No significant relationships.

Medical students have higher rates of depression, anxiety and suicidal ideation over the general population. The onset of these disorders can be a risk factor with unfavorable impact in both medical care and their lives during the years of clinical specialization

To assess the prevalence and factors involved in depression, anxiety and suicidal behavior in medical students of the University of Valladolid (Spain). The results are compared with a previous study conducted 5 years earlier

We used an online self-administered questionnaire that included demographic variables, academic information, sanitary data, Beck Depression Inventory (BDI), Generalized Anxiety Disorder 7 (GAD7), and MINI International Neuropsychiatric Interview for suicide. Chi-Square Test was used for categorical variables, Student`s t-test for quantitative variables and Spearman’s Coefficient to evaluate correlations between variables

362 students of all courses enrolled in Medicine at the University of Valladolid completed the survey. There were no differences between male and female students, both with high rates of moderate-severe depression (27% vs 30,4%), anxiety (42,9% vs 54,5%), and moderate-severe suicide risk (14,2% vs 10,7%). Previous study (n=584) also showed no differences between sexes but with lower rates of moderate-severe depression (14,3% vs 16,3%). 11% reported suicidal thoughts in the past month (11,6% previous study). There was a significant inverse correlation between medical career satisfaction and BDI scores

Five years later, rates of depression and suicide risk could have increased in medical students at the University of Valladolid. We urgently recommend the implementation of mental health prevention programs in this population

No significant relationships.

Self-harming behavior is a frequent problem seen at patients admitted to closed wards in psychiatric hospitals. People who self-harm have al higher risk of other forms of aggressive behavior as well. Little is known about prevalence and characteristics of this behavior, the preceding triggering factors and the relation with other aggressive behaviors.

To gain insights in the self-harming behavior of patients admitted to a closed ward in a psychiatric hospital.

From September 2019 till January 2021 information on self-harming incidents and aggressive behavior towards others or objects, of 27 patients admitted to the closed department of the Centre Intensive Treatment (Centrum Intensieve Behandeling), has been gathered. The Self-Harm Scale and Social Dysfunction and Agression Scale were used to gather the data.

Twenty of 27 patients examined (74%) showed self-harming behavior. Head banging (41,9%) and self-harming using straps/ropes (30%) occurred most. Tension/stress as triggering factor was mentioned most (19,1%), followed by reliving (13,5%) and team interaction (11,8%). Self-harming behavior occurred more in evenings then during the rest of the day. No significant difference was found in the degree of aggressive behavior towards others or objects between the group of patients harming themselves and the group that didn’t.

This study delivers insights in self-harming behavior of patients admitted to closed psychiatric departments that can be used for prevention and treatment.

No significant relationships.

Childhood trauma is associated with an increased risk of anxiety and depressive disorders, but its association with anger, irritability, and related constructs has received less attention.

We aimed to investigate (1) the relationship between childhood trauma and anger constructs in adulthood, and (2) which types of childhood trauma is most predictive.

In the Netherlands Study of Depression and Anxiety (NESDA), childhood trauma at baseline was assessed with a semi-structured interview. Childhood trauma was analyzed in relation to the Spielberger Trait Anger Subscale (STAS), the Anger Attacks Questionnaire, and the cluster B personality traits part of the Personality Disorder Questionnaire 4 (PDQ-4), measured at 4-year follow-up, using analysis of covariance (ANCOVA) and multivariable logistic regression analyses, adjusting for sex, age, level of education, BMI, smoking, alcohol dependency/abuse, disorder status.

Participants were on average 42.1 years (SD = 13.1), and 66.3% (n = 1.508) were female. Childhood trauma showed a dose-response association with all anger constructs. Zooming in, emotional neglect, and psychological, and physical abuse were associated with all anger constructs, independently of depression or anxiety. Additionally, sexual abuse and childhood life events were associated with trait anger and borderline personality traits, and trait anger and antisocial personality traits retrospectively.

Childhood trauma is linked with anger in adulthood. Childhood trauma may cause not only anxiety and depression, but also anger, and tailored interventions (at both childhood trauma and anger itself) might help to improve unsatisfactory relationships and prevent violent behaviors.

No significant relationships.

Imposing quarantine as a measure to manage the coronavirus pandemic is a stressful event that is often associated with negative psychological effects. Eating habits seemed to be significantly affected during the quarantine, while strong negative emotions were triggered as the feeling of loneliness increased at the same time.

This study aims to investigate the eating habits of individuals during quarantine and the role of positive and negative emotions and loneliness in shaping these habits.

An online cross-sectional study was performed using 3 validated scales, EAT-26 (3 subscales: Dieting, Bulimia and Food Preoccupation, Oral Control), Modified Differential Emotions Scale and UCLA Loneliness Scale. Data was collected between April and May 2021 mainly from social media platforms. Statistical analyses included linear regression and mediation analyses.

Abnormal eating habits were detected in 25% of the participants (N= 450, ages 18-74) while the majority reported medium rates of negative/positive emotions and loneliness. Female sex is associated with abnormal eating habits (p=0.010) and mainly dietary behaviors (p=0.029). Negative emotions (p=0.032) and loneliness (p=0.001) seem to be predictive factors of eating habits in general and bulimic behaviors. Negative emotions correlate directly with eating habits. However, we found a significant mediation of loneliness (p=0.032). Furthermore, the observed association between negative emotions and bulimia is partly mediated by loneliness (p=0.018).

Negative emotions and loneliness seemed to play an important role in shaping eating habits during quarantine. Multilevel public health interventions are needed to address the negative effects of quarantine and pandemic in general.

No significant relationships.

No significant relationships.

Reflection on the impact of this law on people with a Mental health disorder is required. It is a complex issue, in which it must be considered that these disorders are very prevalent, can greatly affect the quality of life and are often resistant to treatment.

Explore the first request of this type and review aspects to consider in patients with mental health disorders.

Collection of data from the first patient who requests it and review related aspects.

This is a patient with a personality disorder who presents significant suffering, in a chronic context, but at the same time makes the request in a moment of crisis as an impulsive gesture.

Pending evolution, we consider that it is difficult to assess compliance with the requirements of the law in patients of this type and we recommend caution.

No significant relationships.

Deep Brain Stimulation is an increasingly viable, well-established treatment for medication refractory obsessive-compulsive disorder. Yet, its neuromodulatory effects on the brain have led to varying and opposing neuroethical debates about its potential influence on a range of phenomena such as human agency, sense of nonauthenticity and identity.

Establish the importance of maintaining the psychotherapeutic alliance in a long-term DBS patient who reported minimal device side effect and no brain-technology interface interpersonal issues; yet struggled with a paradoxical phenomenon of psychic distress surrounding issues of agency and identity, not through device implantation, but through morphology of cognitions from negativistic interpersonal dynamics and spousal victim-blaming due to the necessity for such a device.

Case-report of a 60+-year-old gentleman with a history of childhood-onset, treatment refractory OCD with a 15-year history of bilateral DBS lead placed via a ventral caudate/ ventral striatum trajectory through the anterior limb of the internal capsule to the nucleus accumbens.

Years later he was only minimally improved above baseline; yet now with a few-years increasing degree of distress over a perceived atrophy of his capabilities that he felt was validated through what he described as his failure of artificial bionics. Extensive device setting re-optimization did not improve efficacy and with supportive therapy, the DBS device was weaned, and turned off.

The following year the therapeutic foci were on interpersonal identity, existential acceptance of breakthrough symptoms, and engagement of spouse into marital counseling leading to subsequent resolution of distress with improved quality of life.

No significant relationships.

Cultural barriers and prejudices of mental healthcare professionals may promote inequalities in the provision of care to immigrant population and have a negative impact in provided service quality.

To identify barriers and facilitators of immigrants’ accessibility to mental health services.

A literature review has been made through PubMed database.

Immigrants’ accessibility to mental health services may be related to social insurance problems, inadequate knowledge about their health rights, inadequate knowledge of the local language, as well as the bureaucracy of Greek State which may complicate mental health examination and treatment. The challenges faced by mental healthcare professionals in terms of diagnosis and treatment of migrants include communication difficulties due to linguistic and cultural differences as far as verbal presentation of symptoms and illness behavior is concerned. Culturally competent mental health professionals should work to erase racism and prejudice, to be familiar with cultural issues and have adequate knowledge related to cultural groups, to learn the life story of each patient separately and encourage patients to explain how their illness affects their lives, promoting a trustful communication environment in the context of healthcare provision.

Exploring the specific needs of migrants as well as assessing the degree of satisfaction from their access to healthcare services are essential to providing integrated mental health care for people from different culture.

No significant relationships.

ADHD is a neurodevelopmental disorder that frequently persists throughout adulthood. Binaural Beats (BB) are auditory perceptions occurring when two soundwaves of slightly different frequency are carried separately to the ears; they might modulate brain activity and performance.

To evaluate BB efficacy on studing performance, mind-wandering, and core symptoms of a sample of adult ADHD outpatients

In this randomized-controlled trial we recruited a sample of University students in pharmacological treatment for adult ADHD. A track with 15 Hz BB (415 Hz to right and 400 Hz to the left ear) was delivered to the intervention group; whereas, a placebo track consisting of two identical frequencies (400 Hz) was administered to control group. The RCT consisted of a baseline assessment (T0) and two fortnightly follow-ups (T1-T2). Each time, the patient filled the ADHD-RS-5 (ADHD Rating Scale-5) and the MEWS (Mind Excessively Wandering Scale) and executed an online version of SART (Sustained Attention to Response Task). The effect of self-administered acoustic stimulation during individual studying sessions was estimated by a subjective studying performance (SSP) evaluation questionnaire.

A significant improvement of SSP from baseline assessment (T1) to the last observation (T3) was detected in BB group only (mean differences= 2.7, p<.001). A significant between-group contrast for SSP was also found at T3. No other significant changes were detected for ADHD-RS, MEWS and SART at p<.05 level.

BB seem to improve subjective studying performance and ADHD symptoms severity. These preliminary findings must be confirmed in larger sample.

No significant relationships.

Over last decades convincing evident data was accumulated about the positive correlation of religious involvement and better mental health in depression, substance abuse, suicide, stress-related disorders and dementia. The studies of the impact of religion on patients with schizophrenia and schizoaffective disorders are still insufficient and controversial.

To investigate the impact of the religious coping strategies in patients with schizophrenia and shizoaffective disorder with focus on resolution and quality of remission in schizophrenia and schizoaffective disorder.

The pilot 1 year study covers 68 orthodox (group 1) and 55 unbeliever (group 2) outpatients with schizophrenia and schizoaffective disorder in remission on the maintenance therapy in FSBSI MHRC. The groups matched in age (18-60 y.o.), gender, treatment. The orthodox group received religious coping therapy. Number of relapses, remission quality (PANSS), quality of life (QLS), compliance (MARS) were measured 3 times (baseline visit, 6, 12 months). Statistical analysis (regression and correlation) was applied.

Religious coping strategies proposed by Paragment K. (2013) were applied considering the peculiarities of value-semantic structures and selected religious values of the patients as important rehabilitation resource (Kopeyko et al, 2016). Group 1 demonstrated statistically significant better remission at 12-months point – better subjective well-being, social/functional outcomes, higher adherence to medication, less relapses, less psychotic symptoms.

Religion contributes to acquire adaptive functions as the meaning of life, sense of hope, spiritual comfort, supports the overcome the disease burden. Religious coping is an important tool for rehabilitation and preventing the relapses in patients with schizophrenic disorders.

No significant relationships.

The behavioural variant of frontotemporal dementia (bvFTD) is a devastating neurodegenerative syndrome with its peak in the early sixties at about 13 per 100,00. The diagnosis of bvFTD relies on clinical assessment as patients present executive and behavioural deficits, like apathy, loss of motivation and personality changes. Current diagnosis criteria lack specificity and symptomatic overlap between bvFTD and primary psychiatric disorders (PPD) pose a diagnostic conundrum, with half of bvFTD patients previously receiving a psychiatric diagnosis.

The goal is to discuss the syntomatic overlap of these two entities.

Brief non-systematic literature review on the topic, illustrated by a case-report presentation.

A 69 year old men, retired and single, is committed for thought and behavior disorganization and insomnia. He presented expansive mood but also temporal and spatial disorientation and periods of incongruous speech. This patient’s clinical presentation could both entice a diagnosis of bvFTD but also of an affective disorder, especially since it has been reported that neuropsychiatric presentations, like late-onset psychosis or mania, can be the initial presentation of this form of dementia, particularly in patients with C9orf72 mutations, who often display persecutory or grandiosity delusions.

This clinical case exemplifies the difficulty that lies in differentiating cases of bvFTD from late-onset idiopathic mood or psychotic disorders. It is important to consider that on cognitive assessment patients with bvFTD score significantly worse on executive function tests that PPD patients No disease- modifying therapies are available for patients with bvFTD, therefore drug treatment should focus on the most disruptive or taggable behaviours.

No significant relationships.

Valproic acid is an antiepileptic drug used in different fields of Psychiatry. It is known mostly for its use in managing patients with bipolar affective disorder. In psychiatry of addiction, there is still no approved indications for its usage, but it is widely prescribed in treating alcohol and cocaine abuse, due to the existence of studies in these addictions.

This review aims to clarify the relation between valproic acid and dependences, particularly cocaine.

Non-systematic literature review using a PubMed search, using the following key words: “valproate”; “cocaine use”.

Cocaine dependence can decrease GABA levels in humans. Valproic acid has multiple mechanisms that favour the synthesis of GABA, potentiating its release and postsynaptic GABAergic response. Because of this, valproic acid was found effective in promoting abstinence and in reducing the use of cocaine. There are studies that support the valproic acid’s use in alcohol and cocaine dependences. Valproic acid has been shown to be promising in relapse prevention. It has also showed efficacy in the management of impulsivity and irritability, what makes it useful in managing patients with borderline personality disorder – patients at higher risk for alcohol or substance use disorders.

Cocaine addiction involves different phenomena and may respond to distinct pharmacologic approaches. Although some studies need to be confirmed by larger clinical trials, valproic acid seems a promising agent as one of some potential treatments for cocaine dependence. Further studies are required in this field to come to more reliable conclusions.

No significant relationships.

No significant relationships.

The VML method was developed and designed to treat Apraxia of speech focusing on the Autistic population. After experiencing over 2000 children in many countries around the world, we have developed an algorithm which represents the VML analysis process. The algorithm includes almost 1000 conditions and was found reliable with copying the in-person VML evaluation. The algorithm generates a treatment program with 95% accuracy of the elected treatment topics.

The objective of the VML software is to enable the VML analysis and treatment at low cost to wide population around the world, at home. The program includes main treatment topics, detailed exercises, picture and videos demonstrating the proposed treatment and general guidelines. The software users are supported by the VML experts around the world.

Based on the algorithm, we have developed a software which can produce a highly detailed motor speech treatment program. The software is web based, available now in English, Mandarin and soon in other languages as well. The user is required to fill in the speech data using the software interface.

The uniqe sofetware was tested and found to have 90% reliability rate in comparison to a VML expert treatment program. In addition it was found to have the ability to over come mild evaluation mistakes while producing an effective treatment program.

The MYVML evaluation software is innovation in the field of speech treatment, striving to share the knowledge and give the treatment tool to as many practitioners and families as possible.

I am the developer of the VML software described in the abstract

Sleep is essential for an adequate neurobiological functioning, being implicated in several cognitive functions. Even in healthy individuals, sleep deprivation can lead to a number of psychopathological changes, including perceptual distortions, hallucinations and delusions. Thus, the resulting clinical picture may be similar to a psychotic disorder.

To present a clinical case of psychotic symptomatology induced by sleep deprivation.

Patient’s clinical file consultation and literature review using the search engine Pubmed® and the keywords: “sleep deprivation”, “sleep loss” and “psychosis”.

We present the case of a 41-year-old woman with a history of an episode of mood changes with psychotic symptoms that was preceded by a period of total insomnia. No psychotropic drugs since then and no relapses. In May 2020, she was admitted in psychiatry department due to clinical picture composed by significant psychomotor slowing, drowsiness, slowed speech, verbal visual, tactile and auditory hallucinations accompanied by grandiose delusions. These symptoms were preceded by total insomnia with one week of duration. In the hospital was administered quetiapine 100mg and lorazepam 2.5mg to aid in the recovery of sleep deprivation and concomitantly aripiprazole 15mg was prescribed. The patient presented a rapid and significant clinical improvement. Currently, it is without any type of medication and without psychopathological changes.

The clinical picture present in this case report was triggered after a significant period of sleep deprivation. Thus, it illustrates the role that sleep has in the development of psychiatric symptomatology, sometimes difficult to differentiate from psychiatric disorders.

No significant relationships.

Thyroid dysfunction such as hypothyroidism, is connected with numerous neurological and psychiatric disorders. However, the importance of assessing the interaction between brain, psyche and thyroid in clinical practice is often underestimated, and this has a direct impact on the planning of therapeutic interventions and treatment efficacy in patients with primary hypothyroidism.

We examined 132 patients with primary hypothyroidism.

Assessment of the presence and severity of psychopathology was performed using the technique SCL-90-R (questionnaire severity of psychopathology).

The results showed the highest scores on the scales of somatization (3,75 ± 0,12), depression (3,64 ± 0,13), interpersonal anxiety (3,45 ± 0,19), phobias (3.25 ± 0,31). High rates of somatization scale showing a violation of bodily dysfunction of various body systems-cardiovascular, gastrointestinal, respiratory and headache, muscular discomfort and other unpleasant sensations in different parts of the body and manifest themselves in a complaint of patients. Scale depression revealed the presence of dysphoria, anhedonia, low affect, loss of vitality and interest in life. Relatively high on a scale of phobias indicate the presence in these patients persistent fear responses to certain situations and objects that are irrational and inadequate and lead to avoiding behavior. General index of severity of symptoms (GSI) and the index of an existing symptomatic distress (PSDI) were significantly higher in the following patients than in hypothyroid patients without mental disorders.

Thus, these results should be taken into account when determining treatment strategy both in psychopharmacotherapy and different methods of psychological correction.

No significant relationships.