The psychopathological causes that advise against a bariatric surgical procedure include any state that puts at risk the modification of habits and beliefs regarding eating behavior, wich condition weight loss and health improvement.

To Study the psychiatric profile of patients rejected for bariatric surgery at the Complejo Hospitalario Asistencial de León (León, Spain).

Retrospective observational study. All patients for whom bariatric surgery procedure has been contraindicated for psychopathological reasons are included. 145 patients were evaluated in the context of the protocol for bariatric surgery. The following diagnostic scales were used as support: Salamanca Questionnaire, Plutchik Impulsivity Scale, Attitudes towards change in patients with eating disorders (ACTA), Bulimia Investigatory Test Edinburgh e, and European Quality of Life-5 Dimensions.

41 Patients were rejected for psychiatric reasons (28.28%). The most frequent diagnoses are impulse control disorder (39%), followed by eating disorder (27%). Other diagnoses found are: depressive disorder (10%), adjustment disorder (5%), personality disorders, intellectual disability and generalized anxiety disorder (3%) 78% of them are women.

Uncontrolled psychiatric pathology is a contraindication to bariatric surgery. Impulse control disorder and eating disorder are related to overweight and obesity, so a diagnosis and treatment are necessary prior planning surgical procedure. Psychopathological variables determine the success of bariatric surgery procedures and it is mandatory to consider them in the process.

No significant relationships.

Cognitive function may be impaired in COVID-19 patients, especially in executive functions such as phonemic fluency. Among risk factors, inflammation during hospitalization is related with worse cognitive performance in the long term. On the other side, it has been shown that cognitive reserve (CR) protects against cognitive impairment associated with brain damage, psychiatric disorders and neurodegenerative diseases.

Our aim is to study the protective role of cognitive reserve in phonemic fluency to inflammation after SARS-CoV-2 infection.

We enrolled a cohort of 102 severe SARS-CoV-2 survivors after Intensive Care Unit (ICU) discharge and 58 agreed to participate in this 6-month follow-up study. Patients with previously known cognitive impairment were excluded. Demographic, clinical and laboratory data were collected. To assess the phonemic fluency, we used the Controlled Oral Word Association Test (COWAT) controlling the effects of age and education. Inflammation was recorded according to the number of days with high CRP. ANCOVA analyses were used to test the effect of interaction between medical variables and cognitive reserve on phonemic fluency.

The COVID-19 inflammation interacted with CR in phonemic fluency (F= 6.47, p= 0.01), with worse performance in patients with low CR (mean 16.7 (10.2-23.3)) than those with high CR (mean 37.7 (34.3-41.2)) in function of number of days with high PCR during ICU stay.

The role of the cognitive reserve is important to reduce the cognitive impairment related with COVID-19 inflammation in post-ICU patients.

No significant relationships.

Clinical relapses in schizophrenia remain a frequent event. Long-acting injectable (LAI) antipsychotics enhance adherence, but low blood levels can sometimes be observed despite an adequate posology. Nonetheless, the evaluation of this parameter is uncommon in clinical practice.

To explore the potential advantages of therapeutic drug monitoring (TDM) of LAIs as a predictor of relapse in clinically stable outpatients with schizophrenia.

44 individuals who had reached the pharmacokinetic steady state of LAI treatment (paliperidone, olanzapine, aripiprazole) underwent an anamnestic and psychopathological assessment. LAI blood levels were measured using liquid chromatography-mass spectrometry and classified as “in range” or “under range” according to the Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP) guideline values. Individuals who relapsed during the one-year follow-up were compared to non-relapsers (Fisher’s exact test, χ2 or Mann-Whitney U). An exploratory binary logistic regression tested the role of other possible relevant predictors of relapse.

No differences were observed in baseline use of mood stabilisers (p=0.211), antidepressants (p=0.530), or prescribed LAI (p=0.563). Other comparisons are presented in the table: among these variables, in-range LAI levels were the only significant predictor of relapse (F=5.95, p=0.015; OR 0.04, 95%CI 0.02-0.56).

TDM of LAIs may optimise the clinical management of schizophrenia by highlighting a suboptimal dosage and a consequent higher relapse risk. Large-scale, drug-specific assessments are needed to confirm these findings.

No significant relationships.

The study of ideas about death and the mechanisms of their formation in adolescents with suicidal behavior is an important task for both diagnosis and psychotherapy. The parents’ notions of death, and the prohibition on discussing the topic of death in the family, can significantly distort the adolescent’s relationship with death.

Investigate differences in attitudes towards death in parents and adolescents who apply to the crisis care room of a child psychiatric clinic.

The study involved 90 adolescents with their parents who applied to the crisis outpatient care system. The following questionnaires were offered: Death Attitude Profile-Revised, Death Anxiety Scale, Experiences in Close Relationships-Revised, Multidimensional Scale of Perceived Social Support, GAD-7.

Significant differences were found for most of the scales in the samples of adults and adolescents, of particular interest to us were the scales “death avoidance” (W=317,500,z=3,089,p=0,002) and “perception of family support» (W=288,500,z=3,393,p=0,001). For the group of adolescents, there are higher indicators on the scales of anxiety (W=61,000,z=-2,546,p=0,011), anxiety in close relationships (W=83,000,z=-2,549,p=0,011), avoidance of close relationships (W=28,000,z=-3,870,p=0,000), and death as a means of escape (W=54,500,z=-3,076,p=0,002).

In families of adolescents with suicidal behavior, the severity of dysfunctional patterns of building close relationships and the presence of sharply opposite positions in relation to death in children and parents are observed without the possibility of discussing this topic.

No significant relationships.

Neuroscience advances open the debate on improving brain functionality and human behavior. Transhumanism advocates the use of biotechnology for the betterment of man, transcending into another nature. Neuroethics marks limits of the application and experimentation in neuroscience, also proposing an interdisciplinary philosophical reflection valuing the multidimensionality of human mind.

To analyze the transhumanist approach of domining human nature controlling cognitive and moral functions through technique. A critique from neuroethics in an interdisciplinary key to evaluate the complexity of mental functionality and the derived issues that go beyond the scientific scope, with the help of philosophy.

A bibliographic review on neuroscience and neuroethics is carried out, finding a core consensus in the warning of the biopsychosocial complexity of the set of realities that shape the human being, facing a reductionist vision of neuroscience.

Despite the advances in biotechnology and neuroscientific research, the transhumanist approach of brain enhancement transgressing human reality and reducing its nature to a mechanical question that can be controlled through psychopharmacological resources, becomes dystopian due to the lack of ontological continuity in the deconstruction of the human being in a set of neural circuits, and the lack of consideration of all the dimensions that configure the human mind and existence.

An interdisciplinary vision is necessary to analyze the human mind, avoiding falling into the brain reductionism of the neuroscientific paradigm, for an holistic understanding of the human mind and behaviors, beside the integration of a philosophical reflection to join neurobiology and moral dimensions, in a humanist return from transhumanism.

No significant relationships.

Impairment in decision-making capacity is a serious consequence of executive dysfunction secondary to serious mental disorders like schizophrenia. Functional mental capacity (FMC) refers to an individual’s ability to make and communicate legally competent decisions autonomously. Studies have shown that FMC is dependent on severity of psychosis and can improve with treatment.

To ascertain the correlation between the scores on a structured judgement tool, namely the Dundrum Capacity Ladders (DCL) with level of acuity of treatment setting and length of stay in a secure forensic hospital.

Sixty-two patients were interviewed using the DCL across three domains – healthcare, welfare and finances. Correlation between DCL scores, length of hospital stay and level of acuity of treatment setting was assessed.

As patients moved from higher to lower dependency wards, mean DCL score increased, indicating a higher level of capacity. Patients in high dependency wards were most impaired while those in the low dependency wards performed significantly better (rs=0.472, p<0.001). The longer the patients stayed in the hospital, up until five years, the higher the mean welfare domain score (rs=0.402, p=0.011) and mean DCL score (rs=0.376, p=0.018). Beyond five years of hospital stay, those who had lower DCL scores and did not improve had longer length of stay.

Patients’ FMC improve as they progress from high to low level of acuity of treatment setting. However, this is dependent on the length of hospital stay. FMC may be a measure of recovery in the forensic setting.

No significant relationships.

Domestic violence is a critical global and social phenomenon.

- To describe the socio-demographic and clinical characteristics related to the abuser in the context of domestic violence. - To study risk factors for acting out in the abuser.

We conducted a descriptive cross-sectional study related to male abusers of their wives who consulted the Forensic Medicine Department of Taher Sfar Hospital in Mahdia between January 2020 and October 2020 for a forensic examination.

We collected 67 cases of domestic violence out of a total of 688 female consultants. The age of the abuser exceeded 35 years in 84% of cases. The average age of the abusers was 33.8 years. Almost half of the abusers had a primary school education. In 43% of the cases, the abuser was unemployed or had a job with a salary below the minimum wage. We found an association between domestic violence and the unfavorable professional status of the spouse. Only in 6% of the cases did the abuser have a psychiatric disorder. He had a history of chronic alcoholism in 35% of the cases and the use of illicit substances (cannabis) in 9% of the cases. Approximately one out of every two abusers (48%) was under the influence of alcohol at the time of the violent act. Alcoholism was associated with all forms of domestic violence. He had a criminal history in 30% of cases.

Our results provide real areas for reflection regarding the adoption of specific therapeutic strategies with domestic violence abusers.

No significant relationships.

No significant relationships.

The number of children with developmental language delay is growing. But the isolated use of speech therapy doesn’t always help to improve the long-term prognosis. It was found that developmental language delay is almost never the only violation of a child.

To develop the prevention program of emotional and behavioral disorders in children with developmental language delay.

100 children with developmental language delay (70 boys; Mage= 26.9 months, SD = 5.5) and 50 children with typical language development were studied by clinical follow-up method. The clinical method was supplemented by the Bayley Scale, the Language Development Survey and the Child Behavior Checklist 1½ -5.

A comprehensive children examination revealed developmental language delay risk factors, the psychomotor profile of the children, and the types of emotional and behavioral impairments, which were determined by us as: emotionally labile, emotionally detached and oppositional. The presence of subclinical disorders symptoms in children makes it necessary to carry out preventive measures. The primary prevention consists of pregnancy planning, effective care in pregnancy and childbirth. The secondary prevention aims to early diagnosis of developmental language delay, risk factors assessment of emotional and behavioral disorders and effective methods application of language and psychomotor development correction. Tertiary prevention have to individualized solves the children problems in accordance with revealed types of emotional and behavioral impairments. But the most important part is psychoeducation (special courses for parents and children with developmental language delay).

The prevention program was developed to prevent numerous psychiatric problems in childhood and adolescence.

No significant relationships.

People with mental illness (MI) have a reduced life expectancy compared to the general population, mostly attributable to somatic diseases caused by poor physical health. Modifiable lifestyle factors are increasingly associated with the onset of somatic diseases in people with MI. Despite the increasing evidence for the efficacy of lifestyle interventions there is little change in routine clinical care. This discrepancy is referred to as the implementation gap and has caused a need for effectiveness and implementation research in real-world settings.

This study investigates the health outcomes and implementation of a multidisciplinary lifestyle focused approach in treatment of inpatients with mental illness (MULTI+).

This is an open cohort stepped wedge cluster randomized trial in inpatients psychiatric wards of GGz Centraal. Three clusters are randomly allocated to one of the three pre-defined steps to integrate MULTI+. MULTI+ can be tailored to fit individual psychiatric wards and includes 10 core components aimed at improving lifestyle factors. The primary outcome is to investigate whether there is a greater decrease in the QRISK3 cardiovascular risk score after receiving MULTI+ as compared to treatment as usual. Secondary outcomes include somatic and mental health outcomes, lifestyle factors, and implementation factors.

First results expected in 2022.

To our knowledge, this will be the first large-scale study evaluating the long-term effects of a multidisciplinary, multicomponent approach aimed at improving lifestyle factors. We expect that this approach will increase long-term sustainability and can serve as a potential blueprint for future implementation of lifestyle interventions to improve routine clinical care.

No significant relationships.

Although several studies preliminary supported the effects of using smartphone mental health application (app) in patients with bipolar disorder (BD), patients’ subjective experience deserves more attention.

The present study aimed to explore how the BD patient experienced while using the APP in detecting their mood relapse warning signs (MRW app) which has been developed by our team (Su et al., 2021).

The MRW app collects 2 passive (location and GPS removal distance) and 6 self-reported data (daily mood, wake and sleep time, the brief record of mood and life, voice pitch, speech tone and rhythm, facial expression, and weekly emotional scale). By using qualitative research design, 15 patients recruited from the psychiatric outpatient department in a medical center were in-depth interviewed.

Four themes were identified as their subjective experience to use the app as: including positive and negative experience, facilitators, price, and barriers. Interconnected relationship was found in each theme; and counterbalancing associations between positive vs. negative experience, facilitators vs. price and barriers were also demonstrated.

Such first-person experience of using the app in illness detection could unveil technological myths and present its impacts upon patients’ lives in the real world. Implication for practice and future studies were be discussed.

No significant relationships.

Internet-addiction (IA) is one of the most common non-chemical (or behavioral) addictions with genetic impact and substantial effects of psychological and personality characteristics, taking into account the childhood traumatic experience. Gene-environment interactions (GxE) may substantially impact on the risk of Internet-addiction (IA).

Aim: to test the associations between the functional polymorphism rs6265 (Val66Met) in brain-derived neurotrophic factor (BDNF) gene, affecting BDNF function, and childhood traumatic experience and their GxE interactions with IA risk.

In total 456 participants were screened with Chinese Internet Addiction Scale (CIAS) to cut a cohort on two groups: IA (CIAS total score ≥ 65, n=100) and controls (CIAS total score less 64, n=356). The Adverse Childhood Experiences International Questionnaire (ACE-IQ) was used to assess childhood traumatic experience using its main domains: parents (P), family (F), abuse (A) and violence (V). BDNF Val158Met polymorphism was detected by RT-PCR.

Logistic regression revealed associations of P scores with increased IA risk only after adjustment for sex and age (p=0.01, OR=1.166, 95%CI[1.038-1.309]) and V scores with decreased IA risk (p=0.000, OR=0.799, 95%CI [0,233;0,744] only before adjustment. No associations of F and A with IA risk were found. BDNF Val158Met per se was not associated with IA risk, but significant effect of interaction V score*BDNF rs6265 CC on IA risk in “protective” manner was revealed (р=0.039, OR=0.873, 95%CI[0.768-0.993]) in a model adjusted for sex and age.

Childhood violence experience interacts with BDNF Val158Met polymorphism and CC (ValVal) genotype may be possibly protective factor decreasing the internet addiction risk

This work was carried out with the financial support of the Russian Foundation for Basic Research: RFBR grant # 18-29-22079

The term “neuroprogression” imply that bipolar disorder (BD) progressively worsens for some patients and accompanying neuroanatomical changes. BD has indeed been associated with cortical and subcortical brain abnormalities. But cross-sectional studies cannot determine whether the observed brain alterations reflect static premorbid traits or whether they result from progressive changes during the course of illness.

The aims of this series of studies were to determine if progressive brain changes occur in bipolar disorder, and if so, what the drivers of these changes are.

We addressed these questions in the St. Göran cohort – a longitudinal study where patients and controls undergo structural magnetic resonance imaging (MRI) scans at baseline and after 7 years. We have also conducted a longitudinal multicenter study within the ENIGMA consortium including 307 patients and 925 healthy controls scanned at two time points.

We addressed these questions in the St. Göran cohort – a longitudinal study where patients and controls undergo structural magnetic resonance imaging (MRI) scans at baseline and after 7 years. We have also conducted a longitudinal multicenter study within the ENIGMA consortium including 307 patients and 925 healthy controls scanned at two time points.

BD is associated with some (accelerated ventricular enlargement) but not global progressive brain changes (change in cortical structures do not differ from controls). Occurrence of manic episodes is, however, associated with accelerated cortical thinning over time. These results highlight the importance of preventing the potentially toxic effects of manic episodes and might explain why some patients experience worsening cognitive function.

ML has received lecture honoraria (unrelated to this topic) from Lundbeck pharmaceuticals.

Tobacco-use is currently one of the major public health problems and is more common among patients with schizophrenia.

We aimed in this study to estimate the prevalence of smoking in a population of patients with schizophrenia, to assess tobacco dependence and to identify its correlated factors.

This is a descriptive and analytical cross-sectional study carried out on 50 outpatients at the Department of Psychiatry (Tunisia) over a period of two months. For the data collection, we used: a general questionnaire on sociodemographic characteristics and tobacco consumption and the Fagerström test for nicotine dependence.

All the patients were male with a mean age of 32.7±7.02 years and 84% of them were tobacco consumers. More than half of the sample were single (68%) and had a primary school level (52%). A professional irregularity and low socio-economic level were found successively in 84% and 78% of cases. Half of the patients (52%) were diagnosed with paranoid schizophrenia and 46% of them were treated by atypical antipsychotics. Cigarette dependence was strong or very strong in 82% according to the Fagerstrom test. A positive correlation was found between strong tobacco dependence on the one hand and low socio-economic level, professional irregularity, smoking in a first-degree relative and treatment with a typical neuroleptic on the other hand.

Our study and data from the literature show that subjects with schizophrenia constitute a population of highly dependent smokers. A smoking cessation assistance program for this vulnerable population is a priority to improve their quality of life.

No significant relationships.

Ekbom syndrome is a clinical term for delusional parasitosis, a condition characterized by the belief that one’s skin is infested by invisible parasites. Despite having no medical evidence, patients strive to prove their illness and interpret different sensations and symptoms as infestation with parasites.

Our objective was to present a case report of a patient with Ekbom syndrome with detailed clinical information and treatment complications.

We included patient’s history, psychiatric evaluation, complete diagnostic work-up, therapy and follow-up.

A 60-years old female patient was admitted to her first hospital treatment in our psychiatric clinic. Upon admittance, she was extremely tense, preoccupied with the idea that bed bugs have infested her body. She showed extensive medical documentation, including numerous dermatologic reports regarding her condition, interpreting them in accordance with her delusions. In attempt to help herself and “release” the bugs, she harmed herself causing multiple skin lesions across her body and face. The treatment was complicated with secondary skin infections, ulcers, cellulitis and oedemas. Initial treatment with olanzapine was switched to risperidone due to side-effects (sedation, increase of appetite, weight gain). Gradually, with pharmacological treatment, psychoeducation and support, remission was achieved, but poor insight to her previous condition and psychiatric symptoms remained.

Ekbom syndrome presents a serious disorder that can be complicated with secondary somatic complications, often requiring involvement of different medical specialists. Moreover, lack of insight into the need for psychiatric treatment can lead to therapy discontinuation and relapse of symptoms.

No significant relationships.

Drug poisonings is a continuous public health problem in Russia and worldwide.

The objective of the study was to provide characteristics of lethal drug poisonings in a northern Russian region.

The data on deaths from drug poisoning that occurred between 2018 and September 2021, systematically collected by the Regional Center on the Organization of the Narcological and Psychiatric service of the Khanty-Mansi Autonomous Okrug of Russia, was analyzed.

Among 220 cases of fatal drug poisoning the overwhelming majority (90.4%) occurred among males. The number of cases increased annually from 27 in 2018 to 71 in 2020. The average age of death increased from 33.6 years in 2018 to 38.2 years in 2021. Over two thirds of deceased (70.9%) had complete secondary or vocational secondary level of education, almost one third (30.0%) were skilled workers, and slightly less than half (44.1%) were unemployed. The most common causes of death were methadone poisoning (34.5%), poisoning with other opioids (21.8%), other synthetic drugs (17.3%), other unspecified drugs (11.8%), and psychostimulants (10.0%). Alcohol intoxication was identified as a concomitant cause of death in every fourth case (26.0%), of which 98% were among males. Most often, alcohol was present in the blood at a concentration of 120 mg/ml and above. Every fourth deceased (23.6%) was registered with narcology health service for drug addiction.

Fatal poisonings with narcotic drugs and psychotropic substances is a growing public health problem in a northern industrial region of Russia, which affects predominantly working-age males and requires comprehensive multisectoral response.

No significant relationships.

Subjects with eating disorders (ED) show a high prevalence of childhood trauma.

Aim of the study is to evaluate the emotional, biological and behavioral responses to an experimental acute psychosocial stress in subjects with ED with or without childhood maltreatment. Secondary aim is to evaluate the effects of different traumatic experiences (physical and emotional).

48 women with ED completed the Childhood Trauma Questionnaire (CTQ). 29 participants (14 with Anorexia Nervosa [AN] and 15 with Bulimia Nervosa [BN]) reported an history of childhood maltreatment, while 19 (11 with AN and 8 with BN) did not. Cortisol levels, anxiety and hunger perceptions have been assessed in all participants throughout the Trier Social Stress Test (TSST) as well as body dissatisfaction after stress exposure.

Subjects with childhood trauma showed higher emotional reactivity and body dissatisfaction and lower hunger throughout the TSST than those without childhood trauma. Higher cortisol levels were observed in patients with AN, regardless of the presence of childhood trauma, and in those with BN and history of emotional trauma. Emotional trauma was the childhood trauma explaining most of the observed differences.

Childhood trauma, especially emotional one, can lead to vulnerability to interpersonal stress in individuals with ED. The present study is the first that supports the “maltreated ecophenotype” hypothesis in subjects with ED through an experimental task and the evaluation of multiple levels of response. These data may provide new prospectives on the pathogenetic mechanisms of ED and novel therapeutic implications.

No significant relationships.

It’s well known the challenge of differential diagnosis between Obssesive compulsive disorder and autism since their symptoms (intrusive, recurrent thoughts and repetitive behaviours) often overlap.

We report a case of a 14 years old boy diagnosed of ASD who was hospitalized for the first time due to difficult management of repetitive behaviours that made him incapable of doing basic activities without help. To interrupt them led to anxiety, aggressive responses and to insistence on sameness behaviours. Only with this information and with the literature research we made, anyone could tell the problem was probably an ASD symptom. However, during his evolution it was difficult to know whether this behaviour was due to ASD or OCD: after adjusting the medication, and when he started trusting his therapists, he told us about a theory he believed so he could explain the uncomfortable ideas that crossed his mind more than often, so he used those behaviours as an anxiety-reduction technique. This new situation was the fuel to make the present review.

To report a case.

The results are included in the “conclusions” section.

Although there is an ongoing debate concerning the nature of the symptoms in ASD versus those observed in OCD, there are commonly used criteria to differentiate them according to the articles we reviewed:

No significant relationships.

The use of cannabis is likely to increase as regulations on its consumption are diminishing throughout the world.

to identify the prevalence of anxiety and depression symptoms in a group of cannabis users in Tunisia.

this a transversal descriptive study about 137 participants in the University Hospital Of Mahdia during 2 months.

In our study population , the consumers were young adults aged between 18 and 35 years old ,of whom 40.8% were professionally active, 23.2% had psychiatric history. Moreover, the use of other substances was regular among users as follows: tobacco among 74.6% of users, alcohol among 72.5% of users, ecstasy among 41.3% of users, cocaine among 25.4% of users. The use of cannabis was considered as a means of exultation for 66.7%, as an anxiolytic for 26.8% and as a sedative for 23.9%. Overall, the effect of cannabis use on anxiety and depression on the HAD scale showed the following results: probable anxiety in 53% of cases, probable state of depression in 72% of time.

The correlation between cannabis use, anxiety and depression remains unclear. Equally concluded, the assumption of self-medication by cannabis stills a topic of discussion.

No significant relationships.

COVID-19 pandemic has many psychological and physical effects. University students are among vulnerable population.

We aimed in this study to assess sleep effects of COVID-19 pandemic on university students in Saudi Arabia.

We conducted cross-sectional study to collect responses of 5,140 participations from Saudi universities, responders completed the demographic questions, psychological scales including insomnia severity scale (ISI) between 24th and 30th of April 2020.

About 41% of the sample suffered from moderate to severe insomnia. Mean ISI score was 12.9 (SD 6.62). Insomnia was associated with female gender, younger age, students from new universities, junior students, if a relative got COVID-19, having a chronic medical illness, and having a psychiatric disorder.

Covid-19 pandemic has clear effect on sleep among Saudi university students. Universities need to plan and implement protective and intervention strategies to deal with this important issue.

No significant relationships.