The concept of trema refers to an initial phase in the psychotic process that is characterized by intense anguish, an experience of hostility and a feeling of imminent catastrophe. This situation engenders in the patient a sensation of being in a tunnel than can only lead to something terrible but ineffable.

To illustrate the incipient phase of psychotic disorder though the presentation of a case.

A presentation of a clinical case.

A 29-year-old man attends the emergency department due to anxiety of one moth of evolution, that had debuted after a stressful event in the patient’s life such as loss of employment. He suffered from intense morning-predominance anguish, depersonalization episodes, insomnia, hallucinosis, cognitive blocks that occasioned him great anxiety and apragmatic behaviors. Besides, he had language alteration and autolytic ideation with previous autolytic gestures. After evaluation, he was diagnosed with psychotic episode. He was hospitalized, and treatment with olanzapine and lorazepam was started.

With the exhibition of this case, we intended to point up the importance of a differential diagnosis with different disorders marked by anxiety as the main symptom. In our case, panic disorder should be taken in account as a differential diagnosis. Furthermore, as the evidence shows, the identification of prodromic phases in schizophrenia allows an early diagnosis and early intervention, improving the prognosis.

No significant relationships.

Preservation of health, increase in life expectancy determine the need to improve the effectiveness of medical recommendations, which, despite the success of pharmacology, are insufficient for reasons related to the low level of compliance with these recommendations by patients.

Participants of the study-148 employees of medical institutions: 12 men, 136 women, their age ranged from 27 to 74 years.

Despite the absence of signs of decompensation of concomitant pathology, representatives of the subgroups took a different amount of concomitant therapy. Using the scale of assessment of drug compliance, it was found that compliance is most reduced in the subgroup of 41-50 years. In this subgroup, a comprehensive decrease in compliance across the “behavioral”, “emotional”, and “cognitive” domains was detected in 87.8% of cases, while in the younger subgroup partial non-compliance was 32.4%, in the older subgroup - 74.5%

An analysis of the states of cognitive functions in 52 representatives of the middle age subgroup with low compliance rates showed that, unlike other representatives of the same subgroup, their indices for a number of neuropsychological tests are close to the results of more adult participants in the study.Individuals demonstrating low compliance with quite favorable CNS resources are at risk for the formation of pathological aging.

Compliance is considered as Compliance is considered as a control mechanism for preventing normal aging into pathological by regulating risk factors that are dangerous for the brain and associated with the formation of dementia

No significant relationships.

Facing the COVID-19 pandemic, individuals are experiencing severe mental distress. Following social distancing and economic insecurity, significant increases in mental health concerns have developed.

The aims of this study was to report the levels of depressive and anxiety within active population in Romania, and to identify possible risk and protective factors for mental health.

Data collection occurred between February-March 2021. The online survey included questions regarding socio-demographic characteristics and Hospital Anxiety and Depression Scale (HADS). 620 responses were validated (331 students and 289 workers).

Among active population, risk of anxiety symptoms is lower in those who already were infected with SARS-Cov2 (p=0.026, df=2, Phi=0.109), while positive screening for anxiety or depression in this study was statistically significant associated with younger age (p=0.026, df=4, Phi=0.134) and female gender (p=<0.001, df=2, Phi=0.166). Even though anxiety and depression scores are similar among students and employees, there are different aspects regarding symptomatology between these two groups. Students have experienced more frequently tendency to worry and sudden feelings of panic (p=0.004, df=3, Phi=0.146). Also, their ability to laugh and see the funny side of things is affected (p=0.019, df=3, Phi=0.127) and they feel less enthusiasm about future (p=0.001, df=3, Phi=0.159). Participants living with someone else scored lower on anxiety and depression subscales and those are not influenced by the person with whom they are cohabitating or residing (p=0.020, df=3, Phi=0.138).

Findings from the current study offer initial insights into the rates of anxiety and depression within active population in Romania, one year after the onset of the COVID-19 pandemic.

No significant relationships.

Despite the large amount of research concerning the impact of COVID-19 on health care workers, to date few targeted MHWs. Moreover, none has investigated the vulnerability due to exposure to previous traumatic events among health care workers.

This study aimed to investigate the psychological distress in MHWs after the first lockdown imposed by the COVID-19 pandemic in the more impacted regions of the North of Italy, to understand which COVID-19, sociodemographic and professional variables as well as previous stressful life experiences, could have had greater negative effects.

The online survey occurred from 28-June to 10-August 2020. This included questions regarding sociodemographic factors, professional information, COVID-19 exposure. Moreover, three validated self-report questionnaires were administered: Life Events Checklist for DSM-5 (LEC-5), Impact of Event Scale-Revised (IES-R), Depression Anxiety Stress Scales-21 (DASS-21).

271 MHWs completed the survey. At least 20% had elevated levels of psychological distress with post-traumatic symptoms. Stratifying for professional roles, the nurses resulted the most affected, with significantly higher scores in terms of intrusive thoughts, hyperarousal and avoidance behaviors. Several variables affected psychological distress in MHWs, but stronger effects were done by age, professional roles, increased workload and worst working environment during COVID-19 pandemic, to had experienced the separation of family members, but also had experienced during their life of a severe human suffering (physical and/or psychological) on oneself or on a loved one.

Our data underlying the importance of recent but also previous severe stressful events as risk factors to develop post-traumatic symptoms reducing the resilience of the subjects investigated.

No significant relationships.

Evidence shows unemployment as a negative impact factor on a variety of health outcomes. Regarding mental health, unemployment is considered one of the most consolidated risk factors for morbidity. This relationship is considered bi-directional. Prevention and wellness promotion are essential guidelines for mental health providers.

To describe the work status in a sample of patients with anxiety disorders after two types of group mindfulness-based interventions in the MER-ACT project.

A descriptive analysis was conducted on work status before and 6 months after two types of mindfulness-based interventions. The group treatments were Acceptance and Commitment Therapy and a Mindfulness-based Emotional Regulation intervention, during 8 weeks, guided by two Clinical Psychology residents. The employment change was calculated (percentage of change from unemployed or temporary incapacity to employed).

The work status of participants of the sample (n = 40), before and 6 months after interventions, were employed: 55% vs. 60%; temporary incapacity: 12.5% vs. 12.5%; unemployed: 25% vs. 20% and others: 7.5% vs. 7.5%. In the same period, the unemployment rate in the Spanish general population was from 13.8% to 14.5%. After 6 months the percentage of change on work status was 25% (15% improved their employment situation).

Preliminary results show worse work status of participants compared to the Spanish general population. It is recommendable to include well-established risk factor measurements to establish the effectiveness of interventions in mental health. More research is required to determine the impact of interventions on the employment status.

No significant relationships.

Clozapine is widely known as the drug of choice in treating refractory schizophrenia. However, clozapine prescription requires close clinical and biological monitoring to prevent harmful side effects like agranulocytosis, neutropenia and myocarditis.

To show the benefits of lithium carbonate in the clozapine rechallenge of a patient with neutropenia under clozapine.

We present the clinical case of a patient who developed neutropenia under clozapine, we rechallenged with clozapine after lithium treatment to stimulate hematopoietic functions.

A 42-year-old man diagnosed with refractory schizophrenia, under clozapine for 11 years with a good clinical response at a dosage of 500mg per day (clozapine serum level 328ng/ml), developed a neutropenia (BCC at 840/mm3) within an interval of 2 months. Clozapine treatment was suspended and the patient presented a severe psychotic relapse requiring hospitalization. During hospitalization the patient remained symptomatic under haloperidol 15mg daily. At week 3 of clozapine cessation, neutrophil count reached 1510/mm3. After week 4 we introduced lithium carbonate and while reaching 500mg per day we observed an increase in the neutrophil count to 4850/mm3. We rechallenged with clozapine at week 12 after a poor clinical response, with incremental dosage to 150mg per day in 17 weeks. The blood cell count did not show any abnormalities and the patient had a good clinical response up to 11 months after the clozapine rechallenge.

Despite the lack of guidelines assessing clozapine rechallenge after neutropenia, the use of lithium carbonate may be considered to stimulate hematopoietic functions.

No significant relationships.

Childhood Apraxia of Speech (CAS) was declared as a motor speech disorder by ASHA (2007). Yet, until then it was mainly addressed as a phonological disorder and until these days, 14 years later, the treatment of CAS is yet to be motor based worldwide. Professionals finds it hard to diagnose it clearly due to comorbidity with communication and language disorders.

This non clarity might lead to non-accurate treatment since the essence of the syndrome is not addressed. An accurate treatment will integrate knowledge from several domains: communication, Language, Sensory, behavioural, emotional, cognitive and, the most important one for CAS, motor learning.

Motor learning is an area of knowledge which is learnt usually in sport academy, while Its main practical purpose is to improve training methods in sport. The use of motor learning knowledge doesn’t belong to the world of sport primarily but rather to the world of movement wherever it exists. One of the fascinating areas of movement is speech.

Speech in its basic form is motor based, before it being used as a motor tool for language and communication. It is the most complicated motor task in the human body since for every syllable we activate directly and indirectly over 100 muscles. The children who can’t acquire speech spontaneously due to severe deficit in motor planning, need to practice motor speech tasks repeatedly and accurately.

This lecture will present the use of 20 motor learning principles in the speech treatment via the VML method

I am the founder of the VML method while teaching it in various countries

International experience convincingly shows the prevalence of mental disorders secondary to COVID-19, the pathogenesis of which includes biological and psychosocial factors, which characterizes this area of research as relevant and timely.

Analysis of the structure of the most common forms of psychopathology within consequences in COVID-19.

The study involved 45 patients with depressive episodes of varying severity (F 32.0, 32.1, 32.2) and 37 ones with anxiety disorders (F 40, 41). The average age of the examined groups was 39.42 ± 5.68 and 31.54 ± 4.36 years respectively. Clinico-psychopathological, psychodiagnostic, statistical methods were used.

Significantly more patients with depressive disorders before the first clinical manifestations of the disease experienced COVID-19 in mild and moderate form (31.82% and 68.18% of individuals, respectively) (p <0.05), while patients with anxiety disorders were more affected to some stressors of the SARS-COV-2 pandemic (including threatening information background (83.78% of people), quarantine measures in the form of self-isolation (75.66% of people), uncertainty of the impact of coronavirus infection on the socio-economic situation) (62.16% of people)) (p < 0.05). It was found that the examined patients with a history of coronavirus COVID-19 are more likely to have depressive and asthenic syndromes in the clinical picture (p < 0.05), while patients with psychogenic effects of the pandemic - anxiety-phobic and somato-autonomic syndromes (p < 0,05).

Data on the influence of coronavirus disease COVID-19 and stressors of the SARS-CoV-2 pandemic on the formation of mental disorders of various genesis will allow to develop prevention algorithms and personalize therapeutic programs.

No significant relationships.

Digital mental health interventions, such as chatbots that promote mental health and wellbeing are a promising way to deliver low-threshold support 24/7 for those in need. According to current knowledge about the topic, health care professionals should participate in the design and development processes for digital interventions.

The aim of this presentation is to describe the interdisciplinary content development process of the ChatPal chatbot.

The content development process started in co-operation with mental health professionals and potential users to identify requirements. Content was created, evaluated and tested in international, multi-disciplinary group workshops, and online tools were used to allow the collaboration. Initial conversational scripts were drafted in English, and translated into Finnish, Swedish and Scottish Gaelic.

A multilingual chatbot was developed and the conversation scripts were structured and stored using a spreadsheet. The conversation scripts will be made freely available online in due course using this structured approach to formatting chatbot dialogue content. It will allow repurposing the content as well as facilitating studies that wish to assess the design of conversation scripts for mental health chatbots. Conversation design process also highlighted some challenges in turning empathetic and supportive conversations to short utterances suitable for a chatbot.

The ChatPal chatbot is now available in four languages. As literature about the topic is still scarce, it is important to describe and document the content development processes of mental health chatbots. Future work will develop a conversational UX toolkit that would allow health professionals to design chatbot scripts using design guidelines.

No significant relationships.

Schizophrenia is associated with disturbances in neurophysiological processes. However, the relation of EEG and ERP parameters to structural supragranular cortical abnormalities, observed in schizophrenia, remains unclear.

The purpose was to characterize EEG and ERP disturbances and their relationship to changes occurring in supragranular cortical layers in subjects with schizophrenia.

43 first-episode schizophrenia (FES) male patients and 43 matched healthy controls (HC) underwent background EEG and standard two-tones oddball ERP recording and structural MRI at 3T Philips scanner. MRI images were processed via FreeSurfer and MATLAB to derive two markers specific to supragranular thickness change: gyral-sulcal thickness differences (GSTD) and gyral-sulcal intrinsic curvature differences on pial surface (GSCD) (github.com/kwagstyl/schizophrenia_gyral_sulcal).

Theta rhythm spectral power was increased in FES while P300 amplitudes and latencies, N100 (to non-targets) amplitudes, alpha rhythm spectral power were not altered compared to HC. GSCD measures were increased in temporal, parietal and occipital cortices, whereas both GSTD and GSCD were increased in the right frontal cortex in FES. No correlations between altered EEG and supragranular thickness markers survived correction for multiple comparisons.

Presumably, theta rhythm has a widespread circuit of generators, including the cortical ones. However, we have not found correlations between EEG and supragranular markers in FES. Considering an absence of correlations between theta and hippocampal volumes (Lebedeva et al., 2020), a speculative interpretation is that the neurophysiological disturbances may be associated with a more complex patterns of more localized structural and functional impairments.

The work was supported by RFBR grant 20-013-00748.

ATR for children has successfully increase survival to adolescence. Health-related quality of life (HRQoL) is relevant to evaluate the impact of the disease on well-being in adolescents living with HIV (ALH). Kidscreen-52 questionnaire is validated in mexican adolescents to measure HRQoL

To evaluate health related quality of life in a sample of 22 mexican ALH

A sample of ALH in treatment at the HIV Clinic during 2021, were evaluated with Kidscreen-52 by a child psychiatrist. Statistics included non parametric tests and Cohen “d” and “r” size effect to compare T means between ALH and Kidscreen-52 standardized scores.

Mean age:14.4+2.5. Gender: 11(50%)boys, 11(50%)girls. ALH showed significantly lower scores in all domains. Girls reported lower scores in physical well-being(p=0.047) and autonomy (p=0.023). Orphan ALH had lower scores in mood and emotions (p=0.021)

- HRQoL were significantly lower in ALH. -Girls showed significantly lower scores in physical well-being and autonomy. - ALH orphans showed significantly lower scores in mood and emotions domain

No significant relationships.

Clozapine has proven to have a unique efficacy on treatment-resistant schizophrenia (TRS). Nevertheless, studies show that 47%-63% of clozapine-treated patients may fail to respond after around 12-years of treatment (CRS). Several augmentation strategies have been proven to be effective in CRS.

Hereby, we present two clinical cases of CRS successfully managed with brexpiprazole augmentation.

A 48-year-old man without comorbid substance use, treated with clozapine-brexpiprazole augmentation, and a 20-year-old man with comorbid substance use, treated with clozapine-brexpiprazole combination and subsequently with twice-injection aripiprazole (TIA). They were administered with the following assessments at t0, t1-3 (first month), t4-8 (monthly until 6-month follow-up): CGI, BPRS, PANSS, CDSS, Craving VAS, BARS, BIS-11, HRS-A, MADRS, YMRS, AIMS.

At 1-month follow-up, both patients showed a considerable improvement (respectively 75% and 55.9% reduction of PANSS total score). At 6-month follow-up, reached only with the first patient, we noticed a further improvement (an overall 37.5% reduction of PANSS total score from the baseline).

The present work is the first report describing combination treatment strategies with clozapine and brexpiprazole which appear to give promising results.

No significant relationships.

Patients treated for chronic mental disorders and who receive atypical antipsychotics are in most cases at risk of gaining weight, the excess of which is complicated in the long term by metabolic syndrome (MS). The management of these patients is effective if it includes Therapeutic Education.

Describe the therapeutic education program developed for patients on antipsychotics who have metabolic syndrome

In this work, we present the educational program that we have developed for patients undergoing psychiatric treatment with atypical antipsychotics, who have been stabilized for at least 3 months and who suffer from SM.

It is a program that starts with the inclusion consultation and educational diagnosis with the first step of clinical (weight, abdominal perimeter and BMI), biological (blood sugar, HbA1C, cholesterol, HDL, triglycerides) and psychometric (SF12, MAQR, food and physical activity diary) assessments. Our initial program includes 6 sessions and 2 maintenance sessions at 1 month and 3 months after the 6th session. The objectives were divided between information about DM, motivation to eat a balanced diet, physical activity and improvement of quality of life. We also included stress management and positive psychology activities. Assessments are repeated at the end of the initial program and at the last maintenance session.

Our program was developed according to the Geneva therapeutic education recommendations. We plan to apply it to groups of patients in our department

No significant relationships.

People with schizophrenia could be more substantially influenced by the emotional stress brought on by the COVID-19 pandemic, resulting in relapses or worsening of an already existing mental health condition because of the high susceptibility to stress.

This study aimed to assess the presence of relapse and its risk factors among patients with schizophrenia during the era of COVID 19 pandemic.

This study included 90 adults who met DSM-5 criteria for schizophrenia and were diagnosed by (SCID-I) Arabic version and who are following up at the outpatient psychiatric clinic, Zagazig University Hospital, Egypt, Positive and Negative Syndrome Scale (PANSS) measuring severity of symptoms, Compliance Rating Scale (CRS) and World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). scales were conducted on those patients before COVID-19 pandemic from January to April 2019 and repeated on September to November 2020 during COVID 19 pandemic to compare clinical parameters between those two periods as to detect any deterioration in their clinical state.

The mean score of compliance rating scale (CRS) was decreased after COVID-19 pandemic compared to before COVID 19 (P<0.001).The mean score of PANSS scale positive subscale (P) had increased after COVID-19 pandemic compared to before COVID 19 (P<0.001).

There was a deterioration of the clinical state of schizophrenic patients during COVID-19 pandemic especially the positive symptoms and following up the news about COVID-19 regularly, decreased level of family support, lower level of compliance with treatment, and having a family member with COVID-19 infection or death were the risk factors for relapse.

No significant relationships.

The municipality of Leganés has been very vulnerable to the effects of the crisis derived from the COVID-19 pandemic (both due to the incidence of the infection and the socioeconomic situation). Multiple studies show that children and adolescents, especially those with a psychiatric background, have been one of the most affected groups during the confinement.

Firstly, to describe the characteristics of clinical care at the Child/Youth Mental Health Centre of Leganés (Madrid) during the first lockdown (March-June 2020). Secondly, to present data on the clinical evolution of the patients along this period (n = 720).

Descriptive study and literature review.

Clinical care during the period of strict confinement was mainly by telephone, although the most serious cases were attended in person. In addition, referral to Intensive outpatient programs was interrupted. The results show 56% of patients remained stable. Anxious symptoms (35%) and behavioural disturbances (24%) were most frequently referred (Figure 1), It is noteworthy that the most critical cases (such as suicide attempts or domestic violence) were observed in adolescents and that at least 11% of patients increased their use of electronic devices.

The first confinement stage was particularly stressful for families and especially for children and adolescents, although most patients remained psychopathologically stable. However, other studies have found a significant increase in child and adolescent mental health problems during the following months (de-escalation stage).

No significant relationships.

Attachment style is defined by the American Psychological Association as “the characteristic way people relate to others in the context of intimate relationships”. Four attachment styles have been described: secure, fearful, preoccupied, and dismissing. While the effect of attachment style on psychotherapy was widely investigated, few studies have investigated its role in determining beliefs about medicines in patients with Major Depressive Disorder (MDD).

This study aimed to investigate the relationship between preoccupied attachment style and beliefs about medicines in patients with MDD.

27 patients admitted in the Psychiatric Unit of Careggi with diagnosis of MDD were enrolled. Working Alliance Inventory - patient version (WAI-P), Relationship Style Questionnaire (RSQ) and Beliefs about Medicines Questionnaire (BMQ) were administered. An ANCOVA model having BMQ total score as dependent variable and age, sex, RSQ preoccupied attachment subscale and WAI-P task subscale as predictors was considered. WAI-P task was intended to assess the role of agreement on therapeutic choices.

The overall model was significant (F(4,22)=9,571, P<0.001) and explained 66.8% of BMQ total score variance (R2=0.668). Both RSQ preoccupied attachment subscale (B=3.331, t(22)=3.907, p=0.001) and WAI-P task subscale (B=0.238, t(22)=4.565, p<0.001) showed a positive correlation with BMQ total scores. RSQ preoccupied attachment subscale explained 44.6% of variance of BMQ total scores (partial η2=0.446), WAI-P task explained 52.3% of variance of BMQ total scores (partial η2= 0.523). Age (B=0.059, t(22)=1.588, p=0.129) and sex (F(1,22)=0.035, p=0.854) had no significant effect.

These preliminary data suggest a possible influence of preoccupied attachment style on beliefs about medicines in patients with MDD.

No significant relationships.

Displaced refugee children with a history of war exposure are at risk of developing complex and severe forms of post-traumatic stress disorder (PTSD).

Search for the most relevant causal predictors of complex PTSD in a prospective cohort of Syrian refugee children living in informal settlements in Lebanon (N=1007).

A latent class unsupervised analysis was carried out to determine clusters with complex PTSD presentation at the follow-up assessment. A new exploratory causal discovering modelling approach was applied using 97 multilevel psychosocial variables as predictors (Biazoli et al., 2021). Associations between discovered candidate causal factors assessed at baseline with a presumed diagnosis of complex PTSD one year later were calculated using a multiple logistic regression model.

Several putative causal factors emerged: perceived social coherence of the neighbourhood (Positive Predictive Value increase: 1.22); impulsivity (1.25), self-efficacy (1.23) and depressive symptoms (1.15) at the parental level; positive home experiences (1.16) at the family level; and child-level factors such as being forced to work (1.22), being a victim of verbal or physical bullying (1.19), loneliness (1.17) and well-being (1.18). In further confirmatory multiple logistic regression analysis and after correction for multiple comparisons, verbal or physical bullying victimization (p=.005) and caregiver depressive symptoms (p=.0004) at baseline were associated with complex PTSD presentations one year later.

Our results support the need for a multi-level psychosocial care model to prevent psychological distress and promote mental health in refugee children. Specifically, our results suggest that programs tackling caregiver’s mental health and children’s exposure to violence might effectively prevent complex PTSD.

No significant relationships.

There are relatively fewer pharmacogenetic studies of antipsychotics in adolescents than in adult patients. The development of personalized pharmacotherapy is promising.

Identify the most significant pharmacogenetic predictors of antipsychotic safety in adolescents experiencing acute psychotic episodes

The study included 101 adolescents diagnosed with acute polymorphic psychotic disorder at the time of admission (F23.0-9 according to ICD-10). All patients were taking an antipsychotic as their main treatment for 14 days. Children’s Global Assessment Scale (CGAS), Positive and Negative Symptoms Scale (PANSS), Clinical Global Impression Severity (CGI-S) and Improvement (CGI-I), UKU Side Effects Rating Scale (UKU SERS), Sympson-Angus Scale (SAS), Barnes Akathisia rating scale (BARS) were used. All study participants underwent pharmacogenetic testing of pharmacokinetic and pharmacodynamic factors.

CYP2D6 “intermediate” metabolism increased the risk of developing an adverse reaction by a trend of significance (OR=2.616 (95% CI 0.950-7.203); p=0.063). Carriage of HTR2A rs6313 was associated with a lower score on the UKU SERS “Other Symptoms” subscale (Beta=(-0.289); p=0.003) and an objective score on the BARS akathisia severity scale (Beta=(-0.217); p=0.029). DRD3 rs324026 carriers had a lower BARS akathisia scale score (Beta=(-0.349); p=0.004); DRD3 rs6280 carriers had a lower SAS extrapyramidal symptom severity scale score (Beta=(-0.351); p=0.003). Carriers of ANKS1B rs7968606 were associated with a higher SAS scale score (Beta=0.237; p=0.017).

We proposed that genotyping of CYP2D6*4, *10, DRD3 rs324026 (C allele), DRD3 rs6280 (C allele), HTR2A rs6313 (TT genotype) and ANKS1B rs7968606 (T allele) will predict the high risk of intolerance to antipsychotics in adolescents with acute psychotic episodes.

No significant relationships.

Early detection of psychosis is a promising area in preventive psychiatry. The use of early intervention can prevent the first episode psychosis and improve outcomes.

Identification of premorbid features of depressive patients at clinical high risk for psychosis (CHR) comparing with depressive patients without CHR in order to improve early recognition of the psychotic process.

219 young depressive in-patients with CHR criteria for SOPS with attenuated positive and attenuated negative symptoms and 52 young depressive in-patients without CHR were examined. Presence of obstetric complications, neurodevelopmental deviance, neurological and psychiatric signs at the premorbid stage, and the level of premorbid functioning on the PAS were examined.

It has been established that depressive patients at CHR and without CHR had some obstetric complications (57.5% and 40.4%, respectively). Neurodevelopmental deviance in the first year of live was in 57.5% patients with CHR. At the age of 3-5 sleep disorders, ADHD and phobias were more common in patients at CHR than without it (58.8% and 32.7%, p=0.014). In pubertal, patients at CHR were more likely to show depression symptoms, obsessions, and aggression - 90.4% versus 76.9% (p=0.029). On the PAS scale, a decrease of the level of premorbid functioning has been observed in two groups of patients with and without CHR from the age of 12: from 12 to 15 years, 0.4 and 0.3 (p=0.004), from 16 to 18 years, 0.47 and 0.37 (p 0.001).

Premorbid functioning were worst in patients with CHR, which indicates the possibility of early clinical detection of psychosis.

No significant relationships.

Delusional idea disorders are a group of syndromes whose main or unique characteristic is the presence of consolidated delusional ideas that usually have a chronic character and do not fit into other diagnoses such as schizophrenia, affective disorder or other organic diseases. On the other hand, Charles Bonnet syndrome is an organ hallucinosis in whose context visual hallucinations may appear in patients with a visual deficit. Historically, it has been considered that the presence of another psychiatric condition is an exclusion criterion for the diagnosis of Charles Bonnet syndrome, although the presence of similar etiological and maintenance factors means that this situation of dignous exclusion must be reconsidered.

The objective of the present communication is to study the current state of the topics “delusional disorder” and “Charles Bonnet syndrome”. Another objective is to reconsider that the presence of previous or concurrent psychiatric pathology is an exclusion criterion for the diagnosis of Charles Bonnet syndrome..

A bibliographic review on “delusional ideas disorder” and “Charles Bonnet syndrome” has been carried out, as well as a discussion on the diagnostic and exclusion criteria, based on the etiopathogenic and maintenance factors.

Both in “delusional ideas disorder” and in “charles bonnet syndrome” advanced age, social isolation and deficiencies in sense organs constitute etiological factors that facilitate the appearance of these syndromes and make their treatment difficult.

Due to this, we consider that the appearance of another previous or present psychiatric illness should not be an exclusion criterion, both can appear in the same patient.

No significant relationships.