The emergence of COVID-19 changed the lifestyle of individuals through the appearance of lockdown. This period seems to have potential effect on some health determinants related to behaviors such as drug addiction.

Compare the prevalence and behavior of drug consumers before and during the lockdown.

A cross-sectional study was carried out on 1001 Moroccan addict between April and July 2020, using two international questionnaires: The global drug survey “Special Edition on COVID-19” and the survey on impact of COVID-19 on patients and families.

before lockdown, tobacco use (80.2%), alcohol (70.9%), cannabis (46.3%). During lockdown: tobacco consumption remains unchanged (80.7%), alcohol and cannabis consumption reduced significantly, respectively (39.6%) and (40.8%). Results show also the weaning of hallucinogens and solvents. 76.3% decreased their use, the raisons behind these changes were: 39.8% worried about health issues, 26.6% have less opportunities to consume, 23.7% think that the current life style make it difficult to use, 23.4% think they have less ability to obtain drugs.

The lockdown seems to be an opportunity for addicts to reduce drugs consumption. However, setting up support services with targeted interventions is the best chance to decrease psychological stress and avoid the consequences of this reduction.

Studies of the pathophysiology of mental disorders indicate the involvement of neurobiological processes, including the release of neurospecific proteins in biological substances.

The purpose of this study was to research the level of neuron-specific enolase in patients with alcohol use disorder and mood disorders during the therapy.

The studied groups included patients with alcohol use disorder (AUD, F10.2, ICD-10; n=41), patients with mood disorders (MD, F32, F33, ICD-10; n=39), patients with co-morbidity of AUD and MD (n=31) and 20 healthy controls. Severity of depressive symptoms was assessed with HDRS-17 and CGI-S scales. The concentration of NSE were measured in serum by enzyme immunoassay. Рarticipants of the study were examined with clinical scales and laboratory analysis at baseline and on the 28th day of treatment. For statistical analysis we used the SPSS software.

The results of the study showed that all patients are characterized by an increased level of NSE (p>0.005 compared with control). Patients with AUD characterized by changes in the concentration of NSE during therapy (p>0.005 compared with patients after therapy). In patients with MD revealed correlation between the level of NSE on the 28th day of antidepressive therapy and the HDRS-17 score before treatment (r=0,421; p=0,018). In patients with co-morbidity correlation between the level of NSE and the CGI-S score before therapy was found (r=-0,537; p=0,001).

The revealed correlations indicate the relationship between the severity of depressive symptoms and the level of NSE. Disclosure statement: This study was supported by the Russian Science Foundation, grant No. 19-15-00023.

Disclosure statement: This study was supported by the Russian Science Foundation, grant No. 19-15-00023.

Results about the effects of mindfulness training on the executive function of inhibition are mixed. Research about interventions in anxiety disorders is needed to exam the differential efficacy among men and women, and the factors involved in those potential gender differences.

To compare the effectiveness of Acceptance and Commitment Therapy (ACT) versus a Mindfulness-based Emotional Regulation (MER) intervention on inhibitory control according to gender.

This study was carried out in a Mental Health Unit in Spain (Colmenar Viejo, Madrid). Firstly, 80 adult patients with anxiety disorders were randomized according to the score on the Acceptance and Action Questionnaire-II (blocking factor), of whom, 64 patients decided to participate (mean age = 40.66, S.D. = 11.43; 40 females). Each intervention was weekly, during 8 weeks, guided by two Clinical Psychology residents. A 2x2x2 mixed ANOVA (pre-post change x intervention type x gender) was conducted, with Sidak-correction post-hoc tests. The dependent variable was the Interference score of the Stroop test.

Normality and homoscedasticity assumptions were met. No statistically significant differences were observed on age or gender between interventions. A statistically significant interaction effect was observed between pre-post change x intervention x gender on Interference [F(1, 52) = 5.004, p = .030; statistical power observed = 59.3%]. Improvement in interference was larger for women after ACT (p = .000) and for men after MER (p = .002).

These preliminary results show improvements in inhibition after the two interventions examined. However, each treatment maximizes improvement in different ways according to gender. Further research is required.

No significant relationships.

Paraphrenia is a classic diagnostic entity characterized by an insidious development of a vivid and exuberant delusional system, more or less systematized, hallucinations and confabulations.

Increase knowledge about paraphrenia, a classic diagnosis that no longer appears on international classifications.

Extensive research on the historical path of the paraphrenia diagnostic entity was carried out. Patient’s data is obtained from medical history and psychiatric interviews done during her hospitalizations.

68 year-old patient attended the hospital emergency service due to a demonic possession delusion that emerged when she was 44 year-old, when she first consulted a psychiatrist because she believed someone introduced the demon inside her body. She described kinesthetic hallucinations as “movements of her brain” and an intense headache, both originated by the demon; as well as other types of hallucinations and confabulations. However, there was no deterioration in her personaliy or her intellectual capacity, as it could have been seen in a case of schizophrenia. This clinical case is considered a paraphrenia phantastica as it presents the typical features raised by the classic authors (mainly Henry Ey): paralogical thought dominance, megalomania, confabulation and integrity of relation with reality.

Current internacional classifications do not consider paraphrenia as a differentiated diagnostic entity, as it also occurs with other classical entities. This causes a loss of important tools that would achieve a better approach to the patient’s condition.

No significant relationships.

Depression is a common complication of pregnancy and the postpartum period. Up to 70% percent of women report depressive symptoms during their pregnancy, and approximately 10-16% meet full criteria for major depressive disorder. Women with a history of perinatal or non-perinatal major depression are likely to relapse during pregnancy. Research shows that exposure to untreated depression and stress can have negative consequences on the birth outcome and child development. Given the harmful effects of this disease on both the mother and child, it is essential that all pregnant patients be screened for depression. Literature review did not reflect many studies that focus on depression screening in this population, let alone in pregnant patients with Human Immunodeficiency Virus (HIV). Our study focuses on the impact the mandatory screening tool had on the incidence of depression screening in pregnant HIV patients.

- Gain understanding of the Family Focused HIV Health Care Program for Women - Understand the importance of a mandatory screening tool for depression

Using standardized Quality Improvement tools Implementation of screening tool in notes & enforcing a hard stop in the medical records

We noted both qualitative & quantitative improvement in depression screening. Qualitatively the screening has been standardized by creating a universal workflow by the inclusion of screening tools (PHQ2 and PHQ9) in Electronic Medical records. Quantitatively there has been a 34.9% improvement in screening by the case managers in the post interventional quarter.

Significant improvement noted in the incidence of depression screening by implementation a mandatory screening tool

Video games are becoming increasingly popular among children (Lenhart et al., 2015). There is a lack of research that studies the impact of online games on children’s neurocognitive functions.

The aim is to study neurocognitive functions in children and adolescents playing and not playing online games.

The sample comprises 100 children aged 5-10 years and 100 adolescents aged 11-16 years. The following neuropsychological indexes (Akhutina, 2016) are studied: programming and control, serial organization of movements, auditory and visual memory, left and right hemispheric functions, and neurodynamic component of mental activity. Wexler’s Awareness and Comprehension Tests were used to study verbal functions. The game activity are measured by social-psychological questionnaire.

Children who play online games have a serial organization of movements (smooth switching from one component of the program to another) (F=14,46, p<0,01) and a neurodynamic component (F=13,07, p<0,01), which are worse developed than children who do not play online games. Adolescents playing online games have better analytical (left hemispheric) functions (F=13,37, p<0,01), mathematical abilities (F=3,47, p=0,063), and Awareness subtest (F=3,47, p=0,065) scores than nonplaying adolescents.

Children playing online games have lower results on neurocognitive functions directly related to motor development. Teenagers playing online games had higher scores in mathematical ability, analytical functions and awareness. The results indicate the need to develop an optimal time for digital gaming activities depending on the age of the child. The reported study was funded by RFBR, project No. 19-29-14181.

The reported study was funded by RFBR, project 19-29-14181.

Huntington Disease (HD) is an autosomal-dominant, neurodegenerative disorder, with a progressive course, that typically involves a triad of cognitive, motor and psychiatric disorders. Its pathogenic mechanisms are not fully understood, although a faultily encoded version of the protein huntingtin—resulting from a cytosine-adenine-guanine (CAG) trinucleotide expansion in the HTT gene—has been shown to cause intracellular toxicity in neural tissue. Patients usually presents with prodromic psychiatric perturbances, such as depression, delusions or personality changes. Occasionally HD gives rise to criminal behavior.

To understand HD clinical presentation and underlines the differencial diagnosis. We present a case of a 31-year-old male offender, whose mother was diagnosed with HD, and during his forensic-psychiatric evaluation, HD was considered, but not confirmed.

Case report.

A 31-year-old male offender was under a forensic-psychiatric evaluation due to a crime of domestic violence, after he discovers that his wife had an affair. He reports previous personality changes and depression, and compares himself with his mother, stating she was diagnosed with HD due to psychiatric prodromic disturbances. He shows concern about having a disease, and was waiting for genetic test result. After a clinical evaluation, and despite a family history of HD and genetic suspicion, it was important to consider differential diagnosis. The case refers to a passionate crime, which attempted to simulate a HD, considering his genetic background.

Psychometrically identifiable features in HD appear to be important in the context of analyzing circumstances occasioning criminal acts, but the medical history is the most important part of the examination.

No significant relationships.

Major depressive disorder (MDD) is complex and multifactorial, posing a major challenge of tailoring the optimal medication for each patient. Current practice for MDD treatment mainly relies on trial-and-error, with estimated 42%-53% response rates for antidepressant use.

We sought to generate an accurate predictor of response to a panel of antidepressants and optimize treatment selection using a data-driven approach analyzing combinations of clinical and demographic factors.

We analyzed the response patterns of patients to five antidepressant medications in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study and the Pharmacogenomic Research Network Antidepressant Medication Pharmacogenomic Study (PGRN-AMPS), and employed state-of-the-art machine learning (ML) tools to generate a predictive algorithm. To validate our results and confirm the algorithm’s external generalizability outside of its training groups, we assessed its capacity to predict individualized antidepressant responses on a separate validation and test sets consisting of 1,021 patients overall from both studies.

The algorithm’s ML prediction models achieved an average accuracy of 0.6416 (64.16%, SD 4.4) across the analyzed medications, and a cumulative accuracy of 0.6012 (60.12%), AUC of 0.601, sensitivity of 0.6034 (60.34%) and specificity of 0.599 (59.9%).

These findings support applying ML to accumulating data derived from large studies to achieve a much-needed improvement in the treatment of depression. By an immediate analysis of large amount of combinatorial data at the point of care, such prediction models may support doctors’ prescription decisions, potentially allowing them to tailor the right antidepressant medication sooner.

Dekel Taliaz is the founder and CEO of Taliaz and reports stock ownership in Taliaz. Amit Spinrad and Sne Darki-Morag serve as data scientists in Taliaz.

No significant relationships.

Triple Network Model (TNM), which considers the dynamic interaction between Default Mode (DMN), Salience (SN), and Central Executive (CEN) networks, explains clinical features in mental disorders from a neurophysiological perspective. Some studies highlight the increased connectivity in TNM in adults with Borderline Personality Disorder (BPD), but little is known about adolescents.

The aim of our preliminary study was to investigate TN functional connectivity (FC) in BPD adolescents with a history of traumatic experiences, and its correlation with dissociative symptoms.

15 BPD adolescents (DSM-5 criteria) with early traumatic experiences were compared to 15 healthy controls, matched for sex and age. Dissociation Questionnaire (DIS-Q) was administered. Eyes-closed resting-state (RS) EEG recordings were performed (19 electrodes; 10- 20 system) and analyzed using Exact Low-Resolution Electromagnetic Tomography software (eLORETA). FC was computed for all frequency bands and 9 Regions of Interest for TNM.

BPD adolescents showed a hyper-connection between CEN and DMN [dorso-lateral prefrontal cortex (dlPFC) and posterior cingulate cortex (PCC); PCC and left posterior parietal cortex (PPC)] and within the CEN (left and right PPC). The strength of PCC-dlPFC and left-right PPC connections was correlated with dissociative symptoms severity.

FC alterations can already be identified in BPD adolescents, supporting the need for early diagnosis. Normally DMN and CEN show opposite functioning. In our BPD adolescents, the absence of this “anti-correlation” reflects the typical confusion between internal and external mental states, which clarify their difficulties in metacognition or mentalization. Moreover, in dissociative symptoms, two CEN nodes are also involved, not only DMN as previously described.

No significant relationships.

Clinical studies had shown a correlation between mindfulness and changes in the immune response. Other studies had observed an interaction between sensory neurons and neuropeptide-mediated immune response.

This research aims to provide theoretical support to carry out a clinical study based on psychoneuroimmunology.

For this, An epistemological analysis of the concepts of autopoiesis and evocative body was carried out to explain the self-conformation of the organism.

The result of this analysis indicates that the autopoietic process of the organism can be experienced from the three levels proposed by the concept of the evocative body (preontological, ontological and logical). It is posible to generate a nexus between the preontological and the logical in the autopoietic process through the ontological level. Mindfulness is the tool through which it is possible to access the ontological and thus express the preontological in the logical, thereby generating the theoretical possibility of being able to influence our therapeutic process.

This analysis supports the concept of the self-management in health as a measurable therapeutic tool in a clinical study.

No significant relationships.

Of the many studies describing psychotic symptoms in schizophrenia, few have investigated their direct influence on prognosis.

We aimed to apply natural language-processing (NLP) algorithms in routine healthcare records to identify reported somatic passivity and thought interference symptoms (thought broadcasting, insertion and withdrawal), and determine associations with prognosis by an analysis of routine outcomes.

Four algorithms were thus developed on de-identified mental healthcare data from a large south London provider and were applied to ascertain recorded symptoms over the three months following first presentation to that service in a cohort of patients with a primary schizophreniform disorder (ICD-10 F20-F29) diagnosis. The primary binary dependent variable for logistic regression analyses was any negative outcome (Mental Health Act section, >2 antipsychotics prescribed, >22 days spent in crisis care) over the subsequent 2 years, adjusted for age, gender, ethnic group, neighbourhood deprivation, diagnostic group, and recorded paranoia, persecutory delusions or auditory hallucinations.

In 9,323 patients, final models indicated significant associations of this composite outcome with baseline somatic passivity (prevalence 4.9%; adjusted odds ratio 1.61, 95% CI 1.37-1.88), thought insertion (10.7%; 1.24, 1.15-1.55) and thought withdrawal (4.9%; 1.36, 1.10-1.69), but not independently with thought broadcast (10.3%; 1.05, 0.91-1.22).

Symptoms traditionally central to the diagnosis of schizophrenia, but under-represented in current diagnostic frameworks, were thus identified as important predictors of short- to medium-term prognosis.

No conflict of interest - past support from Janssen; GSK; Takeda; Induction Healthcare; Holmusk; the NIHR; SLaM NHS Trust; the MRC; KCL; the NIHR ARC; KCH NHS Trust; the Academy of Medical Sciences; The Wellcome Trust; BHF; Arthritis Research UK; the Roya

No significant relationships.

Lockdown resulting from the experienced pandemic has had a great influence on the emotional and social well-being of the general population. Specifically, it is known that those with an Autism Spectrum Disorder (ASD) and their caregivers had to overcome several challenges during this period. Moreover, this situation has influenced the professionals who work in this field.

The aim of this study is to describe the impact, the learnings and the challenges that have arisen for the patients with ASD, their families and professionals during the coronavirus outbreak through progenitors’ and professionals’ perceptions.

A qualitative research design using focus groups was selected to identify and discuss participants’ experiences, beliefs, perceptions and attitudes. The target population consisted on parents with children with ASD and professionals who work with them. Data was collected via two focus groups. A content was made using the program Atlas.ti to determinate the principal categories and themes that describe the COVID-19 impact.

Findings widely describe the problems faced and difficulties experienced by this population during lockdown and after it. As well as the challenges, opportunities and learning that this situation has offered.

Reflections derived from the study manifest the need of thinking about new models of intervention with children with ASD and their families. Greater attention must be paid to parents’ experiences in order to attend to the actual demands of patients and their caregivers contextualized within our current changing situation.

The year 2020 was marked by the COVID-19 pandemic that killed more than one million people. Scientists around the world are looking for prophylactic treatment against this virus.

The objective of our study was to assess the acceptability of prophylactic treatment against COVID-19 by paramedics.

Descriptive and cross-sectional study including paramedics (nurses, orderlies) from the military hospital of Tunis. Data collection was carried out by a clinical psychologist. We studied the acceptability of prophylactic treatment by paramedics, reasons for refusal and factors that may affect this choice.

A total of 161 paramedics agreed to answer our questionnaire. The average age was 37.73 years. The average number of years worked was 14.95 years. There were 85 women (52.8%) and 76 men (47.2%). Only 59 (36.6%) agreed to take prophylactic treatment for COVID-19. The main reason for refusal was fear of side effects 57 (34.7%). Sufficient hindsight was the main factor that could make them change their decisions. This refusal was definitive for 55 (34.2%) paramedics.

Fear of drug side effects exceeds the fear of COVID.19. An information and communication strategy on the value of prophylactic treatments during a pandemic must be developed.

Stigma, including beliefs about mental illness, can operate in different cultures in different ways, making Western theoretical bases considered “universal” on the stigmatization of theories not applicable to non-Western cultures; hence the need for international studies on this subject.

This work aimed to assess knowledge of mental illness, available treatments and recovery in a non-clinical sample of Tunisian university students.

In a cross-sectional descriptive study from October 1 to November 30, 2019, we evaluated 714 students from 3 Tunisian public universities using the Mental Health Knowledge Schedule scale (MAKS).

We found that 34.2% of students did not agree that drugs can be an effective treatment for people with mental health issues, while 76.4% agreed on the effectiveness of psychotherapy. In addition, 34.3% did not consider drug addiction as a mental illness and 21.9% did not consider depression as a mental illness. We objectified a significant correlation of the MAKS score with gender (p=0.019), living environment (p=0.001), high academic level of father (p=0.000) and mother (p=0.027) and presence of personal psychiatric history (p=0.013).

Awareness and information campaigns aimed at developing the general public’s knowledge of the scientific, medical and psychosocial causes of mental illness and the means of management should be established.

COVID19 outbreak had affected physical and mental health of individuals. Different adverse health behaviors had worsened and eating disorders had evolved. Health care workers were not spared.

To screen binge eating disorder among health care workers of regional hospital of Gabes (south of Tunisia) and its associated factors.

We conducted a cross-sectional, descriptive and analytical study, from April 19, 2020, to May 5, 2020 on 289 in Gabes regional Hospital. All healthcare workers were included (n=620). Workers who were on sick leave during the study were excluded. During this period, the total confirmed cases of COVID-19 exceeded 900 cases in Tunisia and around 20 cases in Gabes. We used a self-administered anonymous questionnaire containing sociodemographic and clinical data. DSM-5 diagnostic criteria were used to assess Binge-Eating Disorder.

Of the 289 responding participants, 85 were physicians (29%), 166 nurses (57.4%), 8 ambulance drivers (2.8%) and 30 health-related administrators (10.3%). A total of 100 participants (34.6%) were frontline health care workers directly engaged in diagnosing, treating or caring for patients with coronavirus disease. Nine percent of participants experienced binge eating disorder during the outbreak. Binge eating disorders were associated to past psychiatric history of eating disorder (p=0.001), social isolation (p=0.001), increased consumption of tea and coffee (p=0.02) and the fact of being a frontline care giver (p=0.009).

Binge eating disorders are usually associated with health problems: obesity and consequently severe form of coronavirus disease. Screening those disorders is important to alleviate its physical impact.

No significant relationships.

The H2020/PERISCOPE project, including 32 partners from European universities & agencies, began 1st November 2020 and will last 36 months. The overarching objectives of PERISCOPE are to map and analyse the unintended impacts of the COVID-19 outbreak; develop solutions and guidance for policymakers and health authorities on how to mitigate the impact of the outbreak; enhance Europe’s preparedness for future similar events; and reflect on the future multi-level governance in the health as well as other domains affected by the outbreak. During this session we will report about early lessons learnt from the mapping and assessments of the impacts of the COVID-19 outbreak on mental health at national and subnational level in the EU with respect to individuals, communities and societies. Further, we will comment on their comparability. The aim is to explore differences between countries regarding the occurrence of mental ill health, and especially the impact on vulnerable groups, and how this is related to exposure to SARS-CoV-2, differences in policies over time, and effects on the economy. We will reflect on the short- and long-term consequences on mental health and health inequalities, report on the ongoing development of holistic policy guidelines for health authorities & other authorities, and from the analysis of multilevel governance, at local, regional and national level, memberstate – EU-level, and EU - global governance level. PERISCOPE will continue collecting data and updating a common data ”Atlas”, which would lead the consortium to engage in modelling and experiments to provide “continuous nowcasting” of the outbreak.

No significant relationships.

Climate and weather have a great influence on the prevalence of depressive disorders. Selected physical parameters for instance light, temperature and pressure can be used to treat mood disorders.

The present mini-review aims at approximating the mechanisms by which selected, strictly controlled physical parameters in particular light, temperature, and oxygen pressure can help in the treatment of depression and determine their potential effectiveness.

Relevant literature was identified by searching the PubMed/Medline database, by combining the search strategy of free text terms and exploding a range of MESH headings relating to the topics.

Mechanisms that can modify the course of depression were briefly presented. Review of the literature showed the well-established position of bright light therapy (BLT) effective in treating seasonal (SAD) and non-seasonal affective disorders (non-SAD); safety and rapid-action of whole-body hyperthermia (WBH) and whole-body cryotherapy (WBC) were also demonstrated; the least data was available on hyperbaric oxygen therapy (HBOT), which had antidepressant properties only in people with concomitant neurological damages.

In addition to the well-established position of BLT in the treatment of depression, further research is needed on other methods, such as WBH, WBC, HBOT.

No significant relationships.