Functional cognitive disorders (FCD) denotes a complaint about memory function or, less commonly, another cognitive process, in the absence of relevant neuropathology and with evidence of inconsistency between symptoms reported and signs identified at assessment.

Increasing numbers of people with FCD are being identified.

Most are discharged back to primary care without a diagnosis or are given the label of mild cognitive impairment, which is not a synonym for FCD.

There is a multitude of terms in the clinic and in the research to describe this kind of complaints. Some terms seem to minimize and normalize the state, whereas others posit an underlying cause.

Given this lack of order, it is a challenge to diagnose it and give it the proper clinical guidance.

This literature-based review aims to fill this gap.

Data was obtained through an internet-based literature search, using the databases PubMed, Cochrane Library and NCBI. The World Health Organization was also utilized. Nine articles from the last two years were included.

It is listed a nosology in six categories and a selection of clinical features which may help with the discrimination of functional and neurological disease causes of memory disorders.

Patients presenting with complaints about memory function require standard psychiatric and neurological history and examination.

It should be emphasized that these conditions are not diagnoses of exclusion but have positive symptoms and signs that should become well-known.

Nevertheless, we remain uncertain about prognosis and treatments, both psychological and pharmacological. Its development would reduce the burden of patients in the healthcare systems.

None Declared

Curiosity toward the effects of psychedelic drugs on neural activation has increased due to their potential therapeutic benefits, particularly serotonergic psychedelics that act as 5-HT2A receptor agonists such as LSD, psilocybin, and MDMA. However, the pattern of their effects on neural activity in various brain regions in both clinical and healthy populations is still not well understood, and primary studies addressing this issue have sometimes generated inconsistent results.

The present meta-analysis aims to advance our understanding of the most widely used serotonergic psychedelics – LSD, psilocybin, and MDMA – by examining their effects on the functional activation throughout the whole brain among both clinical and healthy participants.

We conducted this meta-analysis by applying multilevel kernel density analysis (MKDA) with ensemble thresholding to quantitatively combine existing functional magnetic resonance imaging (fMRI) studies that examined whole-brain functional activation of clinical or healthy participants who were administered a serotonergic psychedelic.

Serotonergic psychedelics, including LSD, psilocybin, and MDMA, exhibited significant effects (α=0.05) on neural activation in several regions throughout the cerebral cortex and basal ganglia, including effects that may be common across and unique within each drug.

These observed effects of serotonergic psychedelics on neural activity advance our understanding of the functional neuroanatomy associated with their administration and may inform future studies of both their adverse and therapeutic effects, including emerging clinical applications for the treatment of several psychiatric disorders.

None Declared

In the global practice and in Russia, alcohol abuse in the population remains one of the main risk factors for disability and premature death of the able-bodied population

Systemic neuropsychological study of impaired mental functions caused by the toxic effects of alcohol.

The study was in the substance use unit. Patients over the age of 24 years, with a period of abstinence from alcohol of at least 7 days before the study. The experimental group included 24 patients diagnosed with “Chronic alcoholism” stage II, (including 23 men and 1 woman). The age of patients was 47.1±4.5. The research method was standardized neuropsychological technique by A.R. Luria

In the study group, a direct relationship was found between disorders in the mental functions (frontal lobe of the brain) and the age of patients suffering from alcohol dependence (r = 0.477; p<0.05). This indicates premature cognitive aging, which manifested in a decrease in the processes of processing new information and working memory. With age, such patients become emotionally labile, impulsive, with behavioral disorders, similar to what occurs in different types of dementia and is the result of damage to the prefrontal lobe of the brain

Because of the study, moderate and / or pronounced impaired of mental functions revealed in most patients: impaired of dynamic praxis in all processes deployed in the time; impaired of voluntary regulation of behavior and regulatory aspects of memory, attention, thinking, speech; impaired of orientation in space and in performing operations with spatial characteristics

None Declared

Autism spectrum disorder (ASD) is a disorder with social, communication and behavioral disturbances that start from early childhood. There are many difficulties in diagnosing people with ASD. The diagnostic criteria are in terms of behavior descriptions, and as methods of intervention the most used is the applied behavior analysis (ABA). Although, the treatment of autism is not based on drugs, there are a number of reports that sustains the vitamin supplementation. For example, the deficiency of vitamin D (VD) was often outlined in the serum of the ASD people. Nowadays, zebrafish (Danio rerio) plays an important role in the modeling era; being one of the main organisms used in animal studies.

In this study, we aimed to describe the influence of VD in autistic people, and the possibility of vitamin investigation through animal models studies.

For analyzing this subject specific scientific databases were screened using certain keywords as: ”autism spectrum disorder”, ”vitamin D”, ”treatment”, ”deficiency”,”animal models” and ”zebrafish”. Inclusion criteria were studies that (1) investigated a behavioral intervention, (2) used animal models for ASD modelling, (3) reported vitamin D results, and (4) were published within the last 20 years.

The majority of the studies supported the importance of an adequate level of VD in the body, mainly due to its implication during pregnancy and early brain development. The few existing data bring information about the positive impact of its administration in ASD children; in which a considerable improvement in typical symptoms was observed. For further knowledge about VD activity in ASD it was suggested the animal modelling, especially zebrafish organisms due to its numerous advantages (high similarity of its genome with the human one).

VD deficiency during pregnancy and early brain development is a real risk factor besides genetic predisposition. Moreover, the use of animal models for investigating the effect of VD is required for a better understanding of the vitamin mechanism in ASD people.

Acknowledgement: *R. M.-A. and B. M.-I. are supported by the Project POCU/993/6/13/153322 ”Suport educațional și formativ pentru doctoranzi și tineri cercetători în pregătirea inserției în piața muncii” of the European Social Fund through the Human Capital Operational Program.

M. Robea Grant / Research support from: Project POCU/993/6/13/153322 ”Suport educațional și formativ pentru doctoranzi și tineri cercetători în pregătirea inserției în piața muncii” of the European Social Fund through the Human Capital Operational Program., M. Balmus Grant / Research support from: Project POCU/993/6/13/153322 ”Suport educațional și formativ pentru doctoranzi și tineri cercetători în pregătirea inserției în piața muncii” of the European Social Fund through the Human Capital Operational Program, M. Nicoara: None Declared, A. Ciobica: None Declared

The prevalence of alterations of liver function tests in patients with schizophrenia and bipolar disorders is not well known. These alterations are often considered as side effects of medication

Our study aimed to evaluate and compare liver function before and after treatment in patients with schizophrenia (SCZ), schizo-affective disorder (SCA) and bipolar disorder (BD).

This was a prospective study among patients with SCZ, SCA and BD according to DSM-5 criteria. Patients, from the “C” psychiatry department of Hedi Chaker University Hospital in Sfax, were assessed during both acute and remission phases in their illness. The acute phase (T0) assessment was made in drug-free patients from june 2016 to july 2018. As for the remission phase (T1), it was made between november 2019 and march 2020. Blood tests were performed in the Laboratory of Biochemistry at Habib Bourguiba University Hospital in Sfax. Clinical and biological parameters of patients were compared with those of healthy controls. Biological assessment consisted mainly in Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT) and Albumine.

Thirty patients were included in our study. Their mean age was 35.83 ± 12.24 years and they were all males. They suffered from SCZ in 33.33% of cases, from SCA in 26.66% of cases and from BD in 40% of cases. Psychoactive substance use was common among 80% of patients. In the remission phase, 90% were polymedicated with use of antipsychotics in 83% of cases and mood stabilisers in 53% of cases. Table 1 shows the evolution of the studied liver function markers in our patients.Table 1:

evolution of some liver function markers in patients

Our results showed an improvement of liver function in patients with SCZ and BD after treatment. This suggests that liver function alterations are due to these diseases rather than the medication.

None Declared

We present the case of a 69-year-old patient who went to the emergency department due to an episode of aggressiveness and behavioral alteration, presenting irritability and nervousness, of about 2 days of evolution according to her family member. Given that the patient had previously presented chronic behavioral disorders and had previously been followed up in psychiatric consultations, psychiatry was notified after an initial evaluation by the emergency physician.

Somatic personal history: NAMC. HTA. Not DM, not DL. Former smoker of 20 cigarettes/day. Recurrent intracranial hemorrhage secondary to amyloid angiopathy and suspected amyloid vasculitis. Last admission to the neurology service in June 2022, also presenting symptomatic epileptic seizures and secondary behavioral alterations. Mastocytosis. Post-traumatic vertebral fracture. Non-anticoagulated paroxysmal atrial fibrillation. Surgical: Left ear surgery. appendectomy. Hysterectomy + oophorectomy.

Personal psychiatric history: In follow-up since May 2021 referred from neurology for emotional lability, episodes of anger and fear. Diagnosed with anxiety-depressive disorder secondary to a medical illness.

Current psychiatric treatment: Oxcarbazepine 800mg 0-0-1, trazodone 100mg 0-0-1, aripiprazole 10mg 1-0-0.

Current illness: The patient goes to the emergency room brought by her husband. During the interview she minimizes her aggressive behaviors or even does not remember them. She is disoriented in time, with very striking memory failures. Her husband comments verbal aggressiveness if he contradicts her in something, sometimes even presenting physical aggressiveness with her relatives. They report that in the last psychiatric consultation a little over 1 month ago, aripiprazole was withdrawn due to an increased risk of cardiovascular events.

After the examination of the patient, she was referred back to the emergency department for a new assessment and to rule out the organicity of the current condition, given that the patient had cardiovascular risk factors, due to the suspicion of a new episode of intracranial hemorrhage.

sychopathological examination: Vigil, conscious, disoriented in time, partially in space. Collaborative, calm during the interview. Coherent, structured speech, with obvious memory failures. Labile, irritable mood. Verbal and physical heteroaggressiveness at home, not during the interview. No structured or planned autolytic ideation at this time. Appetite and sleep preserved.

An urgent head CT was requested, with the result of a small intraparenchymal bleeding in the left frontal location, and she was admitted to the neurology department, with a diagnosis at discharge of: small left frontal haematoma, suspected amyloid vasculitis, and secondary behavioral alteration (vascular dementia).

None Declared

A septum pellucidum cyst is defined as a fluid collection between the lateral ventricles whose walls have a lateral curvature and are separated by 10 mm or more . Most of these cysts are benign and their clinical significance should be considered as a neurodevelopmental anomaly that may contribute to neuropsychiatric abnormalities . It is often of incidental finding, of little clinical significance. However, an association between this developmental anomaly and a mental disorder, such as schizophrenia and/or intellectual disability, has been reported

The objective of this study is to discuss the relationship between the septum pellucidum cyst and mental disorders, especially schizophrenia and intellectual disability.

We report in this study two clinical cases, diagnosed with schizophrenia comorbid with intellectual disability and in whom brain imaging has objectified a cyst of the septum pellucidum

multiple cases reports of patients with Schizophrenia and/or mental retardation revealed, on brain imaging, significant abnormalities in midline brain regions such as Septum Pellucidum. It is suggested that CSP, particularly if large, should be considered a developmental anomaly that may contribute to neuropsychiatric abnormalities.

Whether the CSP may serve as a risk factor for psychosis or is only a reflection of neuroanatomical changes in individuals with chronic psychotic disorders remains ambiguous. More studies and case reports will be needed to establish the veritable association of CSP and neuropsychiatric disorders in the future, and perhaps to acknowledge the CSP as an early marker and predictor of psychosis.

None Declared

We research new neurological viewpoints of psychiatric syndromes in social cohesion regarding, especially the problematic of lymbic system and amygdala in adults. Nowadays, the number of the problematic use of internet is higher than before the COVID-19 pandemic. The development of the digital techniques is impulsive, which can be the main reason of most neurological dysfunctions and the change of the social communication.

In this presentation, we review studies investigating the relationship among the new digital techniques, limbic system and development of psychiatric syndromes. We attempt to provide a summary of new theories and the areas currently being researched around the topic. Another aim of our research is to present the change of the social communication and emotion regulation, which are risk factors of problematic use of internet and behavioral addictive disorders. These appear in different ways in rehabilitation and social inclusion in Europe.

In order to learn about recent international results, we conducted a literature search in 4 databases ( PubMed , Medline , Web of Science, Google Scolar) using keywords (amygdala, psychiatric syndromes, adults, emotion regulation, problematic use of internet, social cohesion) over the past 5 years. From the obtained results, the English empirical journal articles were used to prepare the literature review.

The frequency of co-occurrence of amygdala dysfunction, problematic use of internet and behavioral addictive disorders are correlated. The studies examined the presence of symptoms of impulsivity and dopamine level of the brain primarily through cross-sectional studies. The social cohesion and inclusion regarding types are different in the regions of Europe.

The dysfunctions of lymbic system regulation cause maladaptive emotion regulation and are risk factors and make the person vulnerable to the development of psychiatric symptoms, problematic use of internet and behavioral addictive disorders. The differents of regions and areas in Europe with the new neurological viewpoints in psychiatric disorders can help with rehabilitation in the social cohesion regarding. These changes are particularly pronounced during adolescence, when the demand for self regulation across a variety of emotional and social situations may be the greatest.

None Declared

As the founder of modern psychology as a discipline Wilhelm Wundt came up with the theory of tridimensional feeling (Wundt. Grundriss der Psychologie 1922; Leipzig), which has evolved over time with different theories and is thought to be essential for human survival. A feeling is the conscious awareness of the emotion itself. Feelings are personal and biographical, emotions are social, and affects are impersonal.

We intend to understand how emotions can be explained through theories since the beginning of the modern psychology.

We performed a review of the published literature on the subject using Pubmed. We conducted a search using ‘feeling’ , ‘emotion’ and ‘affect’ as keywords.

Although there are many theories on emotions they conclude that for centuries emotions have various functions and they help us survive. In order to explain this we can make use of biopsychosocial perspectives.The history of study of feeling began with Wundt’s theory of tridimensional feeling and later on different theories such as structuralism, functionalism, evolutionary perspective, behaviorism and nowadays most famous theory neuropsychoanalysis were proposed. Affect can be described as the individual’s ability to participate in stimuli, events, memories and thoughts with an emotional response, on the other hand feelings are the subjective complements of sensations but do not originate necessarily from a sense organ. Moreover, emotion is the reflection of a feeling.

Based on our research, we conclude that for almost over a century there are still theories being developed on feelings and in this matter biopsychosocial perspective has a critical role on its advancement. Are emotions just telltale signs of homeostasis, as Damasio points out? (Damasio & Carvalho. Nat. Rev. Neurosci 2013; 14(2), 143–152.) Apart from their physiological functions, can there be emotions that were once experienced and then suppressed and pushed into the unconscious? If we explain the unconscious only with the functioning of procedural memory in accordance with the current findings of neuroscience, then some changes are needed in our understanding of psychotherapy and especially transference. Because “is the thing that helps change in psychotherapy, the expression of an idea, the verbalization of the experiences, or an emotional/affective exchange between the psychotherapist and the patient?” We must find the answer to the question. It is hoped that neuroscience in general and neuropsychoanalysis in particular will reach new findings and explanations on these issues in the near future.

None Declared

Psychiatry has been diagnosing its pathologies through the evaluation of the symptoms reported by patients, relying on a few complementary exams to exclude organic causes. Studies about transcranial magnetic stimulation and electroencephalography (TMS-EEG) are bringing, from a clinical point of view, crucial information to characterize the different pathophysiological biomarkers of the psychiatric diseases, leading not only to the evolution of diagnosis, but also to an improved, more individualized treatment.

Characterizing the state of the art of TMS-EEG and its use in psychiatric diagnosis and treatments of different diseases.

We undertook a narrative literature review by performing a search on PubMed for English-written articles from the last 10 years. The query used was “TMS-EEG”; “TMS-EEG” AND “Schizophrenia” OR “Major Depressive Disorder” OR “Bipolar Disorder”.

Transcranial magnetic stimulation (TMS) is a safe and reliable method of non-invasive brain stimulation that allows for the local activation of cortical areas through electromagnetic induction. When combining this method with electroencephalography (EEG), it enables the underlying mechanisms of brain diseases.

TMS is a powerful therapeutic technic in Major Depressive Disorder (MDD). The literature refers to an enhanced N45 and N100 amplitude, which indicates a baseline cortical inhibition that can indicate a depressed state, which can be used as a clinical biomarker to evaluate TMS treatments.

In Schizophrenia (SCZ), TMS-EEG reveals a decreased cortical inhibition and excitation. Indices of inhibition and excitation reductions were also related to cognitive deficits.

The current studies regarding Bipolar Disorder (BD) are not so consistent, revealing that there are shared neural pathways with MDD and SCZ. This is a pathology often misdiagnosed with MDD, so biomarkers would help to diagnose BD earlier and improve its prognostic.

TMS-EEG can be used to provide more accurate neural targets, leading to more powerful and personalized interventions in psychiatric disorders, as well as more accurate diagnoses.

As for future studies, it would be relevant to assess not only TMS treatment effects, but also pharmacological results in these different pathologies.

None Declared

Obsessive–compulsive disorder (OCD) is a chronic, prevalent, and highly impairing psychiatric illness. Although the pathophysiology of OCD remains unknown, pathways involved in oxidative stress (OS) have been implicated. However, the complete clinical picture has been rarely considered, and it remains unclear whether oxidative dysregulation is inherent to OCD pathophysiology, or whether it is a consequence of confounding factors such as age, body mass index (BMI) or smoking.

In this work, we aim to assess oxidant and antioxidant markers and its clinical correlates in a well characterized sample of patients with OCD and controls, to test the hypothesis that altered OS markers are associated with OCD, rather than to illness-related behavioral changes or comorbidities.

60 patients with OCD and 60 age and sex-matched control volunteers were recruited and assessed for sociodemographic and clinical variables using the Yale-Brown Obsessive-Compulsive Scale-II, the Beck Depression Inventory-II and the State-Trait Anxiety Inventory and Mini International Neuropsychiatric Interview. Three oxidant [8-hydroxy-2’-deoxyguanosine (8-OhdG), malondialdehyde, protein carbonyl] and three antioxidant [catalase, glutathione-peroxidase and superoxide dismutase (SOD)] markers were assessed in serum using Enzyme-Linked Immunosorbent Assay (ELISA). After comparing between groups, the association between OS markers and OCD characteristics, psychiatric medication and psychiatric comorbidities was assessed among patients with OCD. All analyses were adjusted for BMI, smoking and presence of physical comorbidities.

The six OS markers were similar between patients with OCD and controls. Among patients with OCD, patients with more obsessive and depressive symptoms had lower concentrations of 8-OHdG, although this correlation may be sensitive to extreme values. Also, those who were on higher doses of antidepressants had lower concentrations of SOD. The remaining OS markers were not associated with OCD characteristics, psychiatric medication, or comorbidities.

Our results suggest that OS markers in blood do not seem to be a good biomarker of disease in symptomatic adult patients with OCD, and that OCD characteristics and comorbidities do not seem to have a clear impact on OS profile. Several factors contribute to the robustness of our findings, namely the sample size, the adjustment for confounding factors, and the assessment of a representative panel of OS markers using strict experimental methods. Future studies should always control for confounding factors when assessing OS markers and study OS profile in more specific samples, such as children or treatment-naïve patients.

None Declared

A moderate sport activity is considered beneficial for both physical and mental health. On the contrary, different studies have shown that professional players may be more vulnerable to suffer from psychological and/or psychiatric disorders.

Given the limited information available, the present study aimed to investigate the possible presence of depressive and obsessive-compulsive symptoms or disorders in a group of professional tennis players.

Twenty-five current or former professional tennis players (18 men and 7 women; mean age ± SD: 42.32 ± 13.45 years), were recruited within the Italian Tennis Federation during an international competition and during a master meeting of coaches. They were compared with a control group, recruited from university students, doctors and nurses. All of them underwent a psychiatric interview with a structured scale and a psychopathological assessment carried out with the Mini-International Neuropsychiatric Interview (MINI), the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Self Assessment Scale for Depression (SAD).

The Y-BOCS total and subscale scores were significantly higher in both current and past athletes than controls. Current athletes showed higher scores at Y-BOCS total, subscales and some items. The majority of the current athletes also showed superstitions and magical thinking.

The present study demonstrated that professional tennis players show a relevant increase of obsessive-compulsive symptoms and supertistions than controls. Interestingly, current athletes resulted more severe than past ones. Taken together, our findings support the notion that agonistic sport activities of high level require intensive training and compliance to strict daily routines that might represent a sort of vulnerability toward the onset of full-blown obsessive-compulsive disorder (as well as other disorders) in more fragile individuals. Not suprisingly, sport psychological support experts are increasingly needed.

None Declared

Obsessive-compulsive disorders are complex pathologies causing a major psychosocial handicap. However, their association with a disabling somatic pathology such as rheumatoid arthritis makes management more difficult.

To investigate through a case analysis and a review of literature the association between obsessive-compulsive disorder (OCD) and rheumatological disorders.

We reported a case of a woman with a long history of obsessive compulsive disorder who presented rheumatoid arthritis and we conducted a review of literature through search on Pub-Med/MEDLINE following the terms “obsessive-compulsive disorder”, “rheumatoid arthritis”, “association”, “inflammation”.

Case presentation: A 62-years old woman who had been followed at the psychiatric consultation for 20 years for OCD. She had been stabilised on clomipramin at a dose of 100 mg per day until 2012 and since then she had been lost to follow-up with the notion of poor compliance with the treatment. She re-consulted in August 2022 for worsening psychiatric symptoms such as phobic obsessions with delusional beliefs, verification compulsions, sleep disorders and multiple somatic complaints including diffuse arthralgia and chronic arthritis evolving for 6 months.

The patient was put on risperidone 2mg with anxiolytic without improvement. She was referred to the rheumatology consultation where the diagnosis of very active rheumatoid arthritis was retained, hence she was put on 20mg of prednisolone per day with methotrexate.

The evolution was marked by the accentuation of obsessions and compulsions with the appearance of depressive elements, hence the introduction of fluoxetine 40 mg per day, the increase in the dose of risperidone to 4 mg with the anxiolytic with an improvement on the somatic and psychiatric symptoms.

Literature had shown that patients with this OCD usually suffer from inflammatory or rheumatological comorbidities. This association could complicate the management of these patients.

None Declared

Obsessive–Compulsive Disorder (OCD) is a disabling and chronic illness defined by the presence of obsessions and/or compulsions. Recently it has been proposed that the perinatal period may act as a trigger in this disorder, leading to its onset or exacerbation.

Variations in pregnancy-related hormones are believed to be one of the main etiological theories for the development of perinatal OCD (pOCD). Perhaps for that reason research has been almost exclusively focused on the development of this disorder in mothers. We aim to investigate pOCD in fathers.

A non-systematic review was conducted via electronic searches of PubMed. The keywords used were “Perinatal”, “Father”, “OCD”, “Obsessive-compulsive disorder”.

Unwanted intrusive thoughts are experienced with a similar prevalence in mothers and fathers. The same seems to be true regarding compulsions. However, it does appear that mothers are more distressed by these symptoms, which tend to be baby-related, usually concerning themes of suffocation, accidents or contamination. It is hypothesized that this seemingly different impact is related to the fact that mothers are more often the primary caregivers than fathers, thus feeling more distress because they are imbued with a greater responsibility. Accordingly, pOCD symptoms tend to be more severe in fathers who consider their baby-related obsessions meaningful, often confusing them as a desire to carry out such thoughts. These findings are consistent with the Cognitive-Behavioral Theory of OCD, highlighting that purely biological theories for the development of pOCD might not suffice.

Research indicates a similar presence of OCD symptoms in postnatal mothers and fathers, although it seems that mothers may experience more distress. Underlying dysfunctional beliefs seem to be responsible for the negative appraisal of these symptoms, predicting the development of the disorder in question. Further research of pOCD should seek to better characterize the onset or exacerbation of this disorder in fathers.

None Declared

Obsessive-compulsive disorder (OCD) is a mental disorder in which patients who suffer from it have repetitive and undesirable thoughts, feelings, ideas, sensations (obsessions) and behaviors that drive them to do something over and over again (compulsions).

Often the person tries to get rid of the obsessive thoughts through compulsions, but this only provides short-term relief. Not carrying out the obsessive rituals can cause enormous anxiety and suffering.

To describe a 23-year-old male patient, who suffers from anxiety and mood symptoms, reacts to ego-dystonic obsessive ideas and sexual content, of months of evolution, and who manages to calm down through compulsive masturbation or watching sexual videos on the internet. All this clinic negatively interferes with their quality of life, asking the patient for medical help to calm these ideas.

We carried out a review in Pubmed with the terms Antiandrogens and TOC, in order to make a better description of the clinical case.

After several treatment attempts (Sertraline, Paroxetine, Clomipramine, Clomipramine + SSRI), reaching maximum doses according to clinical guidelines, and with poor therapeutic response, it was decided to discuss the case with the endocrinology department of our hospital, deciding to start treatment with antiandrogens, in order to alleviate the persistent intrusive ideas of a sexual nature. The administration of antiandrogens in men can cause a decrease or increase in the development or involution of secondary sexual characteristics in men, reducing the activity or function of accessory sexual organs, and hyposexuality, with decreased sexual desire or libido.

After several weeks, there was improvement in the obsessive symptoms with a decrease in compulsive rituals. However, after the 3rd mo, some symptoms reappeared, but not with the same severity and intensity as before treatment. In addition, we cannot ignore the adverse effects that have occurred, such as involution of secondary sexual characteristics. However, and taking into account the negative repercussion that this clinic had on the patient’s quality of life, the benefit obtained exceeded the risk, having noted clear improvement with this therapy, and maintaining evolutionary controls by both psychiatry and endocrinology.

Patients suffering from obsessive-compulsive disorder can be effectively treated with anti-androgenic pharmacological agents with various modes of action. The most effective group of such agents is the long-acting analogues of the gonadotropin-releasing hormone. The objective of this review is to elucidate the possibility of using such powerful anti-androgenic agents in the treatment of obsessive-compulsive disorder.

None Declared

While bipolar disorder–obsessive compulsive disorder overlap is quite common, sexuality remains a largely unexplored area of this clinical entity.

Illustrate through a clinical vignette the case of a patient with diagnosed homosexual obsessive –compulsive disorder (OCD) comorbid with bipolar disorder (BD).

The clinical case report was prepared through the review of the patient´s clinical record.

We report a rare case of a 22 year-old man who was diagnosed with Homosexual Obsessive–compulsive Disorder comorbid with Bipolar Disorder, admitted to our department for a suicide attempt. He came from a religious and conservative background and suffered from intrusive, unwanted mental images of homosexual behaviour since the age of 17. He presented periods of remission from his obsessive thoughts, while showing signs of elevated mood, talkativeness, restlessness, agitation and hyperactivity that would last for a few days, with recrudescence of obsessive and depressive symptoms again afterwards. The present case showed a significant reduction in depressive symptoms and in the impact of his obsessive intrusive thoughts after prescription of Risperidone and Sodium Valproate along with Exposure and Response Prevention Therapy conducted over a period of 6 weeks.

The homosexual OCD comorbid with bipolar disorder can cause important distress and impairment and severely impact a person’s life in multifaceted ways. Correct diagnosis, adequate medication and psychotherapy provide the effective treatment.

None Declared

Only 40%–70% of patients have an adequate response to the first-line treatment of OCD with SSRIs. Antipsychotic augmentation is effective in the management of both obsessions and compulsions and these drugs are currently the first-line pharmacological augmenting agents for OCD. (Jaisoorya T, Thamby A. Antipsychotic augmentation in the treatment of obsessive-compulsive disorder. Indian Journal of Psychiatry. 2019;61(7):51)

We present the cases of a 31-year-old man and a 21- year-old girl. A 31 -year old man experienced hygienic obsessive and compulsive symptoms with excessive showering for one year (YBCOS 20). First, he was treated with 100 mg of fluvoxamine daily which helped him gain partial remission of symptoms. After a stressful period at work and his showering compulsions got worse. Our female patient suffered from compulsive hand washing and disinfection with fear of getting contaminated by other people (YBCOS 24). She was also treated for anorexia nervosa. At the moment of referral to our outpatient clinic, she had already been taking 2 mg of risperidone daily, but still, her compulsions persisted.

Both patients were included in outpatient service treatment. They were followed up weekly, psychotherapeutically supported and their psychopharmacotherapy was titrated. In the case of our male patient, risperidone of 1 mg/day was added to the ongoing fluvoxamine of 100 mg/day. Our female patient was given fluvoxamine 50 mg/a day and gradually increased to 100 mg/day with an ongoing 2 mg/day of risperidone.

After two weeks, the hygiene compulsions of the 31-year-old-man completely remitted (YBCOS 6). He stopped excessive showering and became fully functional at work and in family relations. Our female patient also continued to take risperidone in augmentation with fluvoxamine as recommended. Her compulsions improved, and she returned to her hobbies and her college lectures (YBCOS 8). They have both been advised to continue outpatient psychiatric treatment and to regularly use pharmacotherapy.

The condition of both of our patients improved after adding an augmentative agent to the therapy. In the first case, it was risperidone as a fluvoxamine augmentation, and in the second, fluvoxamine was added as a risperidone augmentation. The combination of these two drugs, rather than each other being used on its own, proved to be a powerful therapeutic tool in the treatment of OCD. Further clinical studies are required for a better understanding of the underlying neurobiological mechanism of this effective combination.

None Declared

Up to 30% of individuals with obsessive-compulsive disorder (OCD) present with a current or past history of tics. Simultaneously, OCD is one of the most frequent psychiatric comorbidities in patients with primary tic disorders (TD), such as Tourette syndrome.

We present a literature review about the relationship between OCD and movement disorders, including its potential implications.

A literature review is performed on PUBMED, using the next keywords: "obsessive-compulsive disorder”, “comorbidity”, “movement disorders” and “tic disorders” We focused on data from systematic reviews, clinical trials and meta-analysis published in English on last 10 years.

Goal-directed behaviour, such as compulsions, is orchestrated by the basal ganglia, through parallel but interconnected frontal–striatal circuits. Dysfunction of these circuits is known to play a role in the pathogenesis of TD and may also underlie OCD.

The most common movement disorders comorbid with obsessive-compulsive disorder (OCD) are indeed TD, with obsessive-compulsive symptoms (OCS) occurring in up to 90% of Tourette syndrome cases. OCD comorbid with TD associates with higher frequencies of hoarding, counting rituals, intrusive violent and sexual thoughts/images, somatic obsessions and repetitive movement compulsions. It also associates with earlier age of onset, higher frequency of sensory phenomena, higher male prevalence and familial aggregation.

However, OCD and OCS are also highly prevalent in choreatic movement disorders, such as Huntington’s disease and rheumatic fever with Sydenham’s chorea. There is also evidence for a correlation between streptococcal infections, autoimmunity, tic disorders and OCD, as seen in Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS).

Current evidence shows OCD and movement disorders may share dysfunctional brain circuits, resulting in a neuropsychiatric obsessive–compulsive phenotype, which may differ in terms of clinical characteristics and management.

None Declared

Obsessive compulsive symptoms may occur at any age. It was studied extensively in the youth contratry to the elderly that usually suffer for other health issues leading to misdiagnosis.

We aim through this study to discover the particularities of OCD in elderly .

Our literature review was based on the PubMed interface and adapted for 2 databases: Science Direct and Google Scholar using the following combination ( obsessive compulsive disorder [MeSH terms]) OR (OCD [MeSH terms]) AND (elderly [MeSH terms]) OR (dementia [MeSH terms]).

Our review revealed 39 articles from which we selected 4 articles.

We found that in aged adults over than 50 years experience mostly somatic symptoms, religiosity, and moral scrupulosity as obsessive thoughts.

We also found that OCD can occur as a primary disorder in older women, whereas in men it either persists from, younger years or arises in the context of another psychiatric or medical disorder

The relationship between Obsessional illness, brain mechanisms and Cognitive disorders are not fully understood.

Indeed, we noted a relative Impairment in executive function in older adults with OCD stressing the link with cognitive impairment. Moreover, Obessive compulsive symptoms may worsen cognitive functioning .

Obsessive compulsive disorder presence in the elderly may be described as a primary health condition or be related to organic mental health issues in particular dementia. The physiopathology remains unclear therefore further studies are needed for better understanding and management.

None Declared

Although not the most prevalent clinical presentation, obsessive compulsive (OC) symptoms have been reported after TBI. Post-TBI OC disorder (OCD) cases are rare, so that OC symptoms in this setting are frequently described as OC personality disorders (OCPD).

Generally, the clinical features of post-TBI OCD are thought to be similar to those observed in idiopathic OCD, assuming the probable involvement of structures such as the orbitofrontal cortex, basal ganglia, limbic and thalamic systems in its pathophysiology, although no anatomical location clearly associated with post-TBI OCD being recognized.

Brief systematic review of OCD post-TBI and case report.

Bibliographic research using Pubmed. Clinical interviews and file consultation, with patient informed consent.

We present a case of a 63-year-old patient referred to the Psychiatry Consultation due to obsessive thoughts of dirt and contamination, accompanied by compulsive cleaning and sanitizing behaviors with at least 3 years of evolution with a history of TBI and right frontopolar hemorrhage 5 years ago. These behaviors significantly impaired his functionality (cleaning objects on average 300 to 700 times a day, spending hours in the shower). The patient had insight for the excessive behaviors and its daily impairment.

Psychopathology in the post-TBI context is not infrequent, however reported cases of post-TBI OCD are described as rare in the current literature. The short description of this phenomenon implies the need for more studies focused on the study of the phenomenology of post-TBI OCD. For example, while OCD and obsessive-compulsive symptoms tend to be recognizable psychiatric phenomena, neurobehavioral sequelae in a post-TBI context can present multiple manifestations and resemble OC phenomena, without actually constituting OCD.

None Declared