According to the World Health Organization, addressing the mental health care gap for adolescents, especially in low-resource contexts, is a priority. Evidence-based assessment is crucial for selecting treatment strategies and for quality management.

To develop a digital platform for evidence-based assessments and implement it in different low-resource settings.

The project operates according to the principles of digital development (https://digitalprinciples.org/), including designing with the user, user testing, understanding the ecosystem, resusing software and being open source, think about sustainability and addressing privacy and security.

Different implementation contexts (in Tanzania, Kosovo and Chile) will be presented.

The learned lessons will be presented to the audience.

MHIRA is a promising tool that helps bridge the gap regarding adolescent mental health in low-resource settings. Challenges include the clinicans attitude towards evidence based assessment, sustainability of the project and integration with the existing information technology eco-system and regulations.

No significant relationships.

Community Perinatal Mental Health Services (CPMHS) have been established in the UK, however, there is limited research around their real-world effectiveness. Post-Partum Psychosis (PPP), a severe episode of affective psychosis usually occurring soon after birth, has known risk factors. CPMHS offer assessment and interventions for women with risk factors for PPP, with a view to reducing the risk of its occurrence, as well as, where necessary, to proactively manage the illness to minimise the impact on the mother-infant dyad, as well as associated risks to self and/or others.

To review the rate of PPP in women with established risk factors, who were referred and managed by our CPMHS between September 2019-September 2021. This rate will be compared with the known rates of PPP reported in the literature. Rates of non-psychotic relapse, acute hospitalisation, children social care supervision and mother-infant separation as a result of postnatal relapse will be (amongst others) secondary outcomes. Perinatal interventions offered to reduce the risk of PPP and contingency planning will also be reviewed.

This will be a retrospective case review study involving women referred and cared for by our CPMHS from October 2019 to October 2021, with known risk factors for PPP. Women identified as high risk for PPP receive consultant led-care in our service, therefore cases will be identified via the individual caseloads. Subsequently, electronic case notes will be reviewed to determine the primary and secondary outcomes, as well as the perinatal interventions that were offered.

To be reported.

To be reported.

No significant relationships.

The COVID-19 pandemic presented a global public-health crisis that demanded healthcare to adapt at an unprecedented pace. While challenging, it also created opportunities for the advancement of novel electronic-treatment-modalities. Telepsychiatry has emerged as an effective method to ensure continuity of care and ensure social distancing.1 Studies indicate that mental-health patients have higher rates of noncompliance to follow-up,1 thus finding means to increase compliance is critical.

The objectives of this study are to determine the impact of telepsychiatry on compliance to follow-up and to identify numbers of psychiatric/medical emergency-room visits, most common contributing factors for admission, and compliance in terms of diagnosis.

This IRB approved study is a retrospective chart-review, that aims to study children/adolescents (5-18 years) who presented to the Child&Adolescent-Psychiatry Outpatient-clinic from July-December 2020 and engaged in telepsychiatry, compared to a group of patients presented in July-December 2019-Pre-Covid19-Pandemic. A review of clinical characteristics including diagnosis, demographic information, medication, and treatment compliance will be compared as well as admissions to inpatient-psychiatry/emergency-room visits.

Our total sample (N=252) included patients from 2019-Pre-COVID19 (N=111) and 2020 Telehealth during COVID19-Pandemic (N=141). Our data analysis using SPSF and T-test has shown that Telehealth has significantly increased follow-up compliance (Two-tailed P-value=0.04); 2019-Pre-COVID outreach mean=0.06, 2020-Telehealth-during COVID outreach mean=0.02); significantly decreased ER/CPEP visits (P-value=0.02), and decreased In-patient-unit admissions (P-value=0.02).

According to the presented study, the incorporation of telepsychiatry has increased the compliance to psychiatric-care in outpatient and decreased the emergency-room visits and inpatient admission. Sufficient resources and steps need to be taken to further strengthen telehealth services.

No significant relationships.

Functional neurological disorders (FNDs), also known as “conversion disorder”, consist in the appearance of neurological symptoms that do not correspond to any medical condition and produces an impairment in social, occupational and other areas in the patient’s life. This disorder can represent up to 30% of neurologist’s consultation. We introduce the case of a 23-year-old man who attended the emergency services due to fainting and was finally diagnosed with FND.

To summarize the difficulties of making a diagnosis of FND and the importance of a multidisciplinary approach.

A narrative review through the presentation of a case.

The patient presented many absence seizures during his stay in the hospital. These episodes were characterized by non-reactivity, dysarthria, tremors, tachycardia and hyperventilation. The neurological examination and imaging tests didn’t show any pathological findings. During the psychiatric interview he revealed he had lived a severe conflict with his brothers the previous week and he was being excluded within his family. Furthermore he didn’t have any social support besides his mother in the city he was living, leading this situation to an incrementation of anxiety. Due to the absence of any abnormalities in the examination and recent psychological conflict that was affecting him, FND diagnose was made.

Very frequently the absence of a clear psychological trigger and the presence of neurological alterations can hinder the study of the patient. This makes necessary a multidisciplinary approach and the knowledge of signs that can help to carry out an accurate diagnosis.

No significant relationships.

The major clinical outcomes of COVID-19 in the brain are associated with its deleterious neurological and mental health actions.

Today, there are limited findings concerning the studying of neuropsychiatric action for SARS-Cov-2 in humans after COVID-19 disease.

The aim of the present study was to compare the efficacy of SSRIs (escitalopram, sertraline and fluoxetine) for 6 months therapy on the affective profile of man and women with the clinically confirmed Major Depressive Disorder (MDD) or Generalized Anxiety Disorder (GAD) cases following COVID-19 disease.

. For the assessment of affective profile in man and women (30-55 years) with the initial clinically confirmed MDD or GAD cases after COVID-19 disease, we used the different tests: Montgomery-Asberg Depression Rating Scale (MADRS) and anxiety scale (ShARS Scale). The hormonal and monoamines levels in the serum blood were measured by ELISA tests before and after SSRIs therapy.

After 6 months of SSRIs therapy, MADRS Scale showed a incomplete disappearance of the depressive/anxiety manifestations in both men and women with the initial clinically confirmed MDD case after COVID-19 (p<0,05). We found that SSRIs were able to reduce depression/anxiety levels only on 20% in man or on 30% in women with the initial MDD case after COVID-19 before treatment.

SSRIs treatmet alone failed to produce the decrease of depression/anxiety in the patients of both gender with the initial MDD or GAD diagnosis after COVID-19. The further randomized clinical trials involving new pharmacological therapies for psychiatric pations after COVID-19 disease are needed.

No significant relationships.

Multiple chemical sensitivity (MCS) is a chronic condition characterized by adverse health effects due to exposure to common chemicals which may lead to disability. The pervasive nature of stigma associated with MCS and similar conditions, including that which exists among providers, creates unbearable barriers to healthcare access.

The main objectives of this study are: (1) to describe the symptoms associated with MCS, (2) determine whether environmental exposure has an impact on psychological well-being of patients with MCS.

The qualitative phenomenological study consisting of 42 individuals presenting with medically-unexplained symptoms was conducted using semi-structured interviews.

The symptoms experienced by participants with MCS are diverse, with common symptoms being migraine, paresthesias, seizure-like attacks, allergic reactions, respiratory symptoms (e.g., SOB, swollen throat), GI distress, muscle pain, chronic fatigue and persistent insomnia. These symptoms always develop in response to low level exposures to various toxicants, recur reproducibly and improve when toxic agents are removed. Finally, the adults with MCS are more likely to experience significant affective and PTSD-like reactions. The participants stated the stigmas and misconceptions against those with toxicant sensitivities affected their mental wellness.

Multiple clinically significant behavioral and psychological symptoms are associated with MCS. Our data suggested that diagnostic overshadowing is pervasive in the healthcare system. This study also highlights the importance of psychological interventions and doctor–patient relationship in the management of MCS in various settings. Public education to increase knowledge around environmental illness is paramount.

No significant relationships.

The spectrum of suicidal behavior is a core factor of the prognosis and care of Borderline Personality Disorder (BPD).

Identify possible BPD specific personality traits that could act as protective factors of nonsuicidal self-injuries (NSSI).

We performed a cross-sectional, observational and retrospective study of a sample of 134 BPD patients aged from 18 to 56. We assessed the presence or absence of suicidal behavior and NSSI as well as different sociodemographic variables. Millon, Zuckerman-Kuhlman and Structured Clinical Interview for DSM personality questionnaires were also applied. The analysis of the association between variables was carried out with a multivariate negative binomial logistic regression model.

A statistically significant association between NSSI and suicidal behavior was found. Elseways, statistically significant differences were also found in the association between NSSI and the SCID variables for Narcissistic Disorder, which appears as protective variables. These results provide an idea of the dynamic relationship between NSSI and suicidal behavior in a BPD population with particularly severe characteristics.

The role of narcissistic personality traits appears to be important in identifying protective factors for NSSI and suicidal behavior in BPD patients and could be the subject of further research projects.

No significant relationships.

The social defeat hypothesis of psychosis posits that an outsider status or subordinate position is a common denominator of several psychosis risk factors, leads to elevated striatal dopamine function and thereby to an increased risk for the disorder. The purpose of this paper is to examine whether this hypothesis offers a good explanation for the increased psychosis risk for migrants from developing countries. Method: Review of literature. Results: The outsider status and subordinate position of many migrants from developing countries in Europe, and of Africans in particular, is evident. It is also clear that racism contributes to this situation. An interpretation of racism as psychotogenic is supported by findings of increased risks for other discriminated groups, such as homosexuals, individuals with a low IQ or a hearing impairment. The single study that examined dopamine function in migrants reported indeed elevated stress-induced dopamine release and dopamine synthesis capacity (Egerton et al., 2017). Recently, we examined the time course of the RR of treatment for psychosis for all migrants to the Netherlands (Termorshuizen & Selten, submitted). Contrary to our expectations, the RR for migrants from sub-Saharan Africa was already increased in the year of arrival (RR=2.5; 2.0-3.1), particularly for those aged 10-20 years (RR=6.1; 2.9-12.6). Conclusion: The social defeat hypothesis accords well with a psychotogenic effect of racism, but replications of the dopamine study are needed. The finding of an increased risk for Africans in the year of arrival suggests that racism is not the single cause of their increased risk.

No significant relationships.

Adult attention deficit hyperactivity disorder (ADHD) is associated with reduced work performance. Online interventions increase accessibility of services to clients by removing barriers such as physical distance, which may prevent care.

This study aimed to assess the efficacy of an innovative functional metacognitive intervention for work-performance improvement of adults with ADHD.

This study used a wait-list control group design, with a study and a comparison group (total 46 adults, mean age of 35.65 years). All participants had been diagnosed with ADHD, worked at least 3 months at the same place, and were willing to improve their work performance. Intervention sessions were provided mostly online and focused on the adults’ occupational goals in a workplace context. The intervention’s efficacy was evaluated with a focus on participants’ work performance (Canadian Occupational Performance Measure) executive functions (Behavior Rating Inventory of Executive Function-Adult), organisation in time (Time Organisation and Participation Scale), and quality of life (Adult ADHD Quality of Life Questionnaire).

Participants’ work performance, executive functions, organisation in time and quality of life significantly improved following the intervention. Their achievements were maintained through to the 3-month follow-up.

The online metacognitive functional intervention for work-performance improvement of adults with ADHD was found to be efficient and suitable for clinical use among this population. Future studies with larger samples and additional objective measures are needed to further validate these findings.

No significant relationships.

-Anxious Distress Specifier is one of the newly added specifier in diagnosis and managment of bipolar disorder.This unique item may paly a role in not only the symptoms severity but also the degree of adherence to the psychotropics. -DSM5 Anxious distress specifier is not well studied in the 1st manic episode of bipolar disorder.

1-To study the role of DSM5 Anxious Distress Specifier in the symptoms severity of 1st diagnosed manic episode 2-To investigate its role in medication adherence in thses patients

1-DSM 5 Anxious distress specifier interview which includes 5 items : a- Keyed up or tense b-Restlessness c-Impaired concentration. d-Sense of foreboding e-Loss of control 2-The Young Mania Rating Scale (YMRS) is one of the most frequently utilized rating scales to assess manic symptoms. The scale has 11 items and is based on the patient’s subjective report of his or her clinical condition 3-Drug Attitude Inventory:consists of a questionnaire that is completed by the patient, pertaining to various aspects of the patient’s perceptions and experiences of treatment.

1-There is a positive correlation between the mean score of Young mania Rating scale in 1st episode manic patients and the mean score of DSM5 Anxious Distress specifier Interview 2-The presence of high score of DSM5 Anxious Distress Specifier Interview is positively correlated to the mean score of Drug Attitude Inventory during the follow up visits after controlling the 1st episode mania

The presence of high levels of Anxious Distress in the 1st episde mania affected the symptoms severity and medication adherence

No significant relationships.

Bullying is a serious problem in schools because of the negative impact on a child’s educational outcomes, especially academic achievement. However, the underlying mechanisms and causes are unknown.

To evaluate the educational outcomes, and psychiatric comorbidities in children and adolescents who are victims of bullying

We used 2018–2019 Nationwide Survey of Children’s Health (NSCH) dataset for the study. The participants were children and adolescents (age: 6-17 years, n = 42,790). Data was stratified into two groups: 1) never bullied 2) bullied more than once. Prevalence of different educational outcomes were compared between the groups.

In the never bullied group 21,015 participants were included, and in the bullied more than once group 21,775 participants were included. More females were in the bullied group compared to never bullied group (50.4% vs 47.5%, p=0.006). More White non- Hispanic individuals were in bullied group in contrast to never bullied group (56.7% vs 43.9%, p< 0.001). Individuals whose health status was fair, or poor were bullied more (2.4% vs 1.4%, p=<0.001). Individuals in bullied group were more likely to be repeating the grades compared to the never bullied group (7.1% vs 5.9%, p:0.039). Individuals who were missing >=11 school days, and sometimes or never engaged in school were observed more in bullied group compared to never bullied group (5.9% vs 3.2% and 20.3% vs 10.6% p < 0.001).

Our findings suggest that bullying victimization could be a risk factor and associated with decreased academic outcomes.

No significant relationships.

Postpartum and peripartum depression are debilitating disorders that impact the mother and their ability to care for their children’s emotional, social, and physical needs. Current treatments include psychotherapy, pharmacotherapy, and electroconvulsive therapy. These treatments are moderately effective or come with side effects that can negatively impact mother and child. As a result, many mothers view some treatments as unacceptable while pregnant or breastfeeding. Over the last decade, repetitive transcranial magnetic stimulation (rTMS) has shown promise as an effective and safe treatment option for postpartum and peripartum depression. However, little is known regarding people’s knowledge and attitudes towards this emerging technology, with no research assessing this in Canada.

We aim to identify gaps in knowledge and to assess attitudes toward rTMS as a treatment for postpartum and peripartum depression in mental health professionals, patients, and the general public living in Canada.

A mixed methods study design will be employed. The qualitative portion will consist of individual semi-structured interviews. An inductive thematic analysis will be completed. The quantitative portion will consist of an anonymous, self-administered survey shared through REDCap. Focus groups with rTMS experts will be conducted to inform survey creation.

No resulst at this time.

Understanding gaps in knowledge and attitudes toward rTMS is the first step toward ensuring that everyone is well informed and able to access safe and effective treatments. With limited treatment options available to a postpartum and/or peripartum depression patients being well informed on all treatments is crucial towards accessing treatments that best suit their needs.

No significant relationships.

Increase in affective and somatic complaints during pandemic is considered as related to experienced stress (Wang et al., 2020, Roy et al., 2020, Robillard et al., 2020). Expression or suppression of emotions related to pandemic could affect the vulnerability of people to stressful situations (Gross, Thompson, 2007, Roberts et al., 2008).

The aim was to reveal a role of suppression / expression emotions regarding pandemic in the changes in somatic and affective complaints in people without coronavirus during lockdown.

In May 2020 110 people 18-65 years old (61.2% females) without coronavirus appraised their strategy of dealing with different emotions regarding pandemic on the 1-5 scale from emotional expression to hiding and suppression (Cronbach’s alphas) and 26 somatic and emotional symptoms including sleep-related symptoms, daytime functioning, affective symptoms, general physical condition (Cronbach’s alphas .81-.90). In December 2020 they reappraised 26 complaints.

There were no statistically significant changes in somatic and affective complaints during May-December 2020 (p>.20). Increase in sleep-related complaints (β=.23, p<.05, ΔR2=5.0%) and complaints regarding general physical condition (β=.32, p<.05, ΔR2=10.0%) were more pronounced in those reporting higher expression of emotions related to COVID.

People with higher emotional reactivity to pandemic situation tend to report increase in sleep-related problems and general worsening of their physical condition during lockdown. Research is supported by the Russian Foundation for Basic Research, project No. 20-013-00799.

Research is supported by the Russian Foundation for Basic Research, project No. 20-013-00799

We have been using LAB (Buvidal) in Cardiff after its pandemic use was funded by Welsh Government.

We wished to review the benefits of introducing LAB (Buvidal) into treatment during the pandemic.

This service development review of the first 73 patients treated with LAB (24mg/96mg rapid titration Welsh protocol) was analysed using Kaplan-Meier survival curves.

43 (58%) male, 30 (41%) female. <25years=1, 38 (52%) aged 25-40, 34 (47%) 40-55. Prior to LAB 14% (10 people) using Espranor, 8% (6) Buprenorphine, 28% (20) Methadone. 50% (36) illicit opiates (mainly Heroin). We had continuous data for patients for up to 9 months of LAB. Two stopped for non-discontinuation reasons: One wanted to detox, one died of natural causes (LAB-unrelated). Both were excluded from discontinuation rate analysis. 55 people have data for over a month. Of these, 11 discontinued treatment. 80% remained on LAB for 1 month or more [95%CI 67-90%]. Kaplan-Meier plots showed similar discontinuation rates when comparing different OST programmes or none prior to LAB, and comparing by age, sex and initial illness severity (CGI severity). These rates all far exceeded data for traditional OST. CGI scores dramatically improved, even at one week. By month 2 all scores “much improved” or “very much improved”.

Buvidal (LAB) has 80% retention rates, regardless of underlying prescribed/illicit opioid /demographics. The commonly held belief that those on heroin are further from Recovery than those more stable on OAD may be incorrect. LAB may be a more acceptable and useful first line therapy that other OSTs

Dr Melichar has provided consultancy work, presentations, training and chaired panel discussions for all the companies in this area in the UK and some outside the UK. Recent work includes Althea (UK), Britannia (UK), Camurus (UK and Global), Martindale (U

Functional neurological symptom disorder (FND) is characterized by the ideogenic neurologic presentation deriving from unconscious stressors or conflicts. The symptoms of FND usually begin with a psychiatric illness—most commonly depression, but with the release of the latest version of International Classification of Diseases-11 (ICD-11), a new favoring factor comes to our mind: prolonged grief disorder (PGD), the newcomer to psychopathology.

The purpose of this case-report is to highlight the several key differences between PGD and depression, and the role of PGD in the onset of FND.

The authors report the case of a 22 years old woman with a history of frequent seizures with loss of consciousness and the absence of stimulus-response, which started soon after the death of her 31 years old brother. Psychologically, the patient presented sustained interest in the deceased, self-blame, confusion, emptiness and low mood. On a physical exam, the patient showed periocular hyperpigmentation.

The emergent symptoms and signs were resistant, failed to resolve with medication alone and continued to persist across all settings. The neurological dysfunction remained present and interfered with the patient’s functioning, until applying grief-oriented psychotherapy, which was the most efficient approach.

In conclusion, PGD represents a favoring condition for the onset of FND and it is most often mistaken with depression. Therefore, it is crucial to distinguish between these two disorders, as there is solid evidence that treatment for depression is far less helpful than targeted grief treatment.

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.

Working at Covid-19 frontline may threaten physical and mental health healthcare workers (HCWs). Assessing perceived Stress in HCWs is important to prevent serious mental illness

Assess the association between perceived stress and risk perception among healthcare workers working in the Covid-19 unit.

We conducted a cross-sectional study among healthcare workers working in a COVID-19 unit between March and July 2021 through a self-administered questionnaire. The Perceived Stress Scale (PSS-10) was used to assess perceived stress. The perceived risk of getting infected was assessed by a 5-item Likert Scale. The perceived risk of family members’ infection was evaluated by a Scale from 0 to 10.

A total of 85 participants were included. The mean age was 31±6 years. About 87% of participants lived with their families. Seventy-six per cent of HCWs rated their health status greater than or equal to 8/10. A percentage of 18,8% of HCWs have been infected with the Covid-19. Our population consisted of 44.7% technicians and 24,7% nurses, and 80% of the participants reported direct contact with COVID-19 confirmed patients. The level of the perceived risk of getting infected was high to very high in 95% of the HCWs. The mean score of the perceived risk of family members contracting the virus was 5.7 and 27,1% rated it greater than or equal to 8. The PSS-10 showed moderate and high perceived stress in 82,3% and 7,1% of participants, respectively. Only 10,6% of HCWs presented low-stress perception.

Frontline healthcare providers have high perceived stress and are at risk of mental health disorders

No significant relationships.

Exposure to alcohol causes imbalances in neuroimmune function and impaired brain development.

Alcohol activates neuroimmune molecules, expressed and secreted by glial cells in the brain, alter neuronal function and stimulate alcoholic behavior.

The study involved women aged 25-41 years-did not drink alcohol 1 month before and during pregnancy – 1-st group; women with I-II degree of alcoholism 3-13 years – 2-nd group. Embryonic material were obtained 8-15 weeks of igestation. 2-nd group were divided into subgroups. Group Alcohol (A)-alcoholic women,s embrious, included 2 subgroups: A1-embryos 8-9 weeks, A2-10-11 weeks of gestation (n=12). The Control group (K) includ control samples K1-8–9, K2-10-11 weeks (n=14). The analysis of changes in morphometric parameters was used to identify quantitative changes among glioblasts, correlation between the degree of differentiation components and the degree of influence of alcohol. For this, the program AxioVision 4.8 was used Parameters of GABAA/benzodiazepine receptors were studied by the radio-receptor assay of [3H]-flunitrazepam with synaptoneurosomes.

Changes in glioblasts tof human brain embryos and fetuses were revealed under conditions of chronic prenatal alcoholization with an increase in gestational age compared to the control subgroups: a significant increase in the average number of glioblasts, the length of the perimeters of the presynaptic terminal, postsynaptic density, presynaptic terminal areas were significantly less (p<0, 01) in the study group than in the control. Exposure to ethanol reduces the affinity of GABAA/benzodiazepine receptors, which affects neuronal plasticity associated with the development of glioblasts and neuroblasts during embryogenesis.

Changes in microglial cause disruption of the neuronal activity

No significant relationships.

Psychiatric illnesses are related with a reduced life expectancy and an increase of mortality rates (around 60%) mainly associated with cardiovascular diseases [1]. The high prevalence of obesity, metabolic syndrome, diabetes mellitus and tobacco use among these patients undoubtelly predispose to the impairment in physical health and mortaility increase. Regular physical activity in the general population is associated with a decrease in cardiovascular risk but litle is know about iss influence in some chronic and severe mental disorders like schizophrenia [2].

To quantify the physical activity performed by a sample of subjects with psychosis, borth males and female, compared to a control group.

A sample composed of 141 patients with schizoprenia was compared to 103 healthy subjects as a control group. The International Physical Activity Questionnaire - Short Form (IPAQ) scale was applied to all participants. The time (minutes) of physical activity performed in a week (METs) was collected by each participant [3].

The differences in the total physical activity Mets for the patients with schizophrenia were highly significant (p = 0.001), showing a lower degree of physical activity compared to the control group. A higher and significant percentage of sedentary lifestyle among the psychiatric group (64.5%), compared to 35.5% in the control group was found.

The group of pateints with Schizophrenia showed a significant higher sedentary lifestile including less physical activity. This finding could be highly related with a higher risk of cardiovascular disease and deterioration of the physical health.

No significant relationships.

Late onset stress symptomatology (LOSS) is a relatively new concept in combat veterans, which includes repeated but not intrusive thoughts about combat-related experiences, irritability, or nightmares that do not cause impairment of daily functioning.

The objectives of this study were to identify the LOSS phenomenon in geriatric combat veterans and to establish a correlation between LOSS and cognitive deficit ± major stressors.

The electronic database was searched for the last 2 years from starting the study with the hypothesis that the LOSS phenomenon has been diagnosed with sleep, anxiety, trauma-related, or impulse control related disorders. Records were examined for trauma-related symptoms, excluding major symptoms of trauma-related stressors. The veterans were assessed objectively using LOSS, PCL-5 (PTSD checklist for DSM-5), social readjustment rating scales, and MOCA (Montreal Cognitive Assessment scale) for cognitive screening.

We reviewed 1329 patient records and identified 35 potential LOSS subjects. Four veterans were diagnosed with PTSD not otherwise specified, 2 with anxiety disorder unspecified, and 1 veteran with nightmare disorder. The majority (85%) of the veterans scored >40 in PCL-5, and only one veteran fulfilled the criteria for LOSS, who scored 67 on the LOSS scale. All the veterans scored ≤25 on MOCA with a significant deficit in recent recall.

Our study shows new onset stress-related symptoms are strongly associated with significant cognitive deficits and higher individual stress levels. The onset of PTSD symptoms in older combat veterans might have been correlated with the onset of cognitive deficits, as suggested by several other studies.

No significant relationships.