Data on the differences between young and elderly patients with bipolar disorder and between elderly patients with early and late age of onset are limited.

to study the clinical differencies between bipolar patients with an onset in old age and other bipolar patients.

This is a retrospective study of 420 bipolar patients. In this study, patients with onset after age 60 (n=37) were compared to other patients with early-onset bipolar (EOB) (<>50 years; n=383).

In the year before recruitment, older patients more frequently reported a rapid course of the illness, but fewer suicide attempts , more often a single psychotropic medication and had less severe manic and psychotic symptoms, atypical antipsychotics were administered less frequently. but no difference in depressive symptomatology was observed.

Elderly bipolar patients differ from younger bipolar patients in course and treatment. Medication use and the occurrence of rapid cycling in elderly bipolar patients deserve careful investigation.

None Declared

Despite the projected growth of the geriatric population, there is currently no clear treatment framework for these patients. This treatment requires specific training for psychiatrists in the field of geriatric psychiatry.

to evaluate the attitudes of psychiatric residents in Tunisia with regard to gerontopsychiatry.

All psychiatry residents at Razi Hospital in Tunis in April 2022 were asked to complete an anonymous online survey with questions related to previous experience with the elderly, exposure to geriatric psychiatry patients during medical school, future career plans and interest in pursuing a geriatric psychiatry rotation, and factors involved in their decision.

55 of 72 (76%) residents responded, of whom 63 (n=34)% were in their second year of residency. 69% (n=38) of residents reported no exposure to geriatric psychiatry patients during medical school, but of those who had, 70% (n=24) had a positive experience. Only four residents (7%) reported considering a career in geriatric psychiatry. With respect to the geriatric psychiatry curriculum, all residents felt that changes were needed in geriatric psychiatry education and career path.

Residents’ interest in further training in geriatric psychiatry is low. The most common reason is the perception of a poor prognosis for this patient population. Future studies are needed to develop strategies to increase interest in this field.

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Psychiatric admissions of elderly subjects with mental disorders is a difficulty in management and treatment. This problem is essentially related to somatic comorbidities of this population.

To compare the demographic characteristics, comorbid conditions and functional status of younger and older individuals with major mental illnesses admitted to psychiatry.

Using the records of patients admitted between 2015 and 2020 to the psychiatric department "G" of Razi Hospital, we collected the demographic characteristics, comorbid conditions and functional impairments for patients admitted to psychiatry and aged over 65 years. We compared these characteristics to those collected in the total population of admitted patients.

The study population consisted of 75 elderly patients. Compared to the youngest patients there was a greater male majority, a higher rate of severe cognitive impairment, higher rates of chronic medical illnesses, such as congestive heart failure.

Our findings suggest an urgent need for integrated psychiatric and medical care for elderly subjects with major mental illness. Future research is needed to adapt evidence-based integrated models of collaborative mental health care.

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Delusion of pregnancy (DP) is a heterogeneous symptom that can emerge from different neuropsychiatric syndromes, including schizophrenia, bipolar disorders, but also major neurocognitive disorder (MND). According to the Diagnostic and Statistical Manuel of Mental Disorders-5 (DSM-5), DP is an unspecified type of delusional disorder present in the spectrum of schizophrenia and other psychotic disorders This type of delusion, which can affect both sexes, may have numerous determinants to its genesis and may last decades to resolve.

We aim to present a case and review of DP and its association with dementia/MND, hyperprolactinemia and galactorrhea.

Non-systematic literature review and case report, based on the search for titles and/or abstracts of articles that address both DP and dementia, and DP and hyperprolactinemia/galactorrhea, including articles published between 2010 and 2022 in English.

A 71-year-old female patient was admitted to the Psychiatric unit due to a change in usual behavior in the past 6 months: insomnia, anterograde amnesia, delusions of ruin and persecutory and, for the past month, the belief of being pregnant with twins, supported by the galactorrhea she presented after starting Risperidone prescribed by her Family Doctor weeks prior. Shortly after admission, the patient also revealed hearing her fetuses’ voices. DP vanished briefly after admission due to the combination between the change of Risperidone to Aripiprazole (a prolactin-sparing antipsychotic) and psychotherapy to help deconstruct the patient’s cognitive misinterpretations. She was furthermore diagnosed with Alzheimer’s disease and Memantine was started.

This patient, according to Bera et al. (Bera et.al. Indian J Psychol Med 2015;37:131-7) is part of the 28.6% of patients more than 50 years of age who present DP, 6.0% that report having twins and 8.3% that report hearing voices of their fetuses. No data was found correlating DP and MND directly. Hyperprolactinemia and its consequent galactorrhea represent one of the many explanations behind DP, especially in suggestible demented patients that easily misinterpret somatic sensations, in which delusional thoughts are frequent and contribute to the morbidity.

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The prescription of psychotropic drugs is a major health problem , especially in the elderly. In fact, many studies highlight the misuse of psychotropic drugs and in particular the over-prescription of antipsychotics in the elderly which would be deleterious and not indicated.

To evaluate the prescription of antipsychotics in hospitalized elderly people in a psychiatric environment and to compare them with data from the literature.

This is a retrospective descriptive study of patients aged over 65, hospitalized in the psychiatry department between January 2017 and December 2021 and who received first- or second-generation antipsychotic treatment during their hospitalization.

Our sample consisted of 20 patients. More than half of our sample (55%, N=11) had at least one somatic history. More than 20% of subjects, was polymedicated; and for only one patient, the ECG showed an elongation of the space QT counter indicating the use of antipsychotics. The most common diagnosis found was schizophrenia with a rate of 35%,followed by paranoia (20%), and chronic hallucinatory psychosis (15%). More than a quarter of our sample (30%, N=6) received antipsychotic treatment of first generation (AP1G), 10 patients (50%) received antipsychotic treatment of second generation(AP2G) and three patients (15%) received a combination of AP1G and AP2G. More than a quarter of our patients (30%, N=6) reported adverse effects due to neuroleptic treatment.

The results of our study highlighted different indications for which an antipsychotic treatment was prescribed for an elderly person despite a ground often flawed, polymedicated and where the undesirable effects are superimposed.

None Declared

Delirious mania is a potentially fatal neuropsychiatric syndrome of unknown etiology often characterized by the acute onset of delirium, symptoms of mania, and psychosis. The presentation is often punctuated by catatonia.

Delirious mania may constitute up to 15% of all acute mania cases. When delirious mania is unrecognized or improperly treated, it can progress rapidly in severity and can become life-threatening.

Despite being relatively prevalent, literature on delirious mania is sparse, and there are no formal diagnostic criteria or treatment guidelines.

Review delirious mania as an entity, its symptoms, type of patient and treatment.

Presentation of a patient’s case and review of existing literature regarding delirious mania and its characteristics.

In delirious mania symptoms present abruptly, within hours. Symptomatology varies from psychotic (hallucinations, delusions…), maniac (agitation, dysphoria…) and altered sensorium (desorientation, fluctuation of symptoms…). A differential diagnosis has to be done, as well as discarding an organic origin, which in the end, as illustrated in this case, was the etiology of the symptomatology in this patient.

Delirious mania is a clinical entity very underdiagnosed given that patients exhibit an array of different symptoms, making diagnosis very challenging for professionals. It should always be considered in differential diagnosis when these symptoms are present, especially in elderly people, given that early treatment is key. However, discarding an orgnanic origin should always be the first thing to do in clinical practice.

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Dementia with Lewy bodies(DLB) and Parkinson’s disease dementia(PDD) make up for about 20% of dementia cases, with a significant overlap of clinical features. They are described as separate entities in the DSM-5 with an arbitrary delimitation based on the onset of cognitive decline in relation to parkinsonism.Visual hallucinations are a common clinical feature. Treatment consists of low dose antipsychotics, generally quetiapine or clozapine being used.

Case presentation and reflection on pharmacological treatment

Review of the clinical file of a patient with DLB

A 76 year old female was referred to our clinic with a recent history of complex visual hallucinations and delusional thoughts. The onset of parkinsonism was made 8 months prior to admission and treatment with IMAO-B Rasagiline and a combination of Levodopa was initiated. The patient had no psychiatric hospitalization history. Her comorbidities include hypertension, dyslipidemia and osteoporosis, for which she received specific treatment. The onset of complex visual hallucinations was one month prior to admission. A trial with small dose clozapine was initiated in an out-patient setting and dropped out due to intolerance.

During the hospitalization she was describing recurrent complex visual hallucinations in the form of people engaging in sexual activities in front of her and suspected her husband of involvement in these acts. She was also experiencing tactile and proprioceptive hallucinations, interpreting them as harmful laser beams resulting in skin marks (age spots were present). Sun downing syndrome was present, consisting of fluctuating cognition, worsening of temporo-spatial orientation, marked anxiety as the visual hallucinations became more vivid. CT scan showed moderate atrophy and psychological testing indicated moderate cognitive decline.

Treatment with Rasagiline was interrupted as it can worsen psychotic features, by raising dopamine levels. Levodopa was reduced to the minimum efficient dose for parkinsonism as it can cause agitation and worsening of visual hallucinations. Treatment with small dose quetiapine (100 mg per day) was initiated, the patient experiencing severe hypotension due to neuroleptic sensitivity. Quetiapine was continued for about 3 months, with the aggravation of the visual hallucinations and encapsulated delusional thinking. Small dose Clozapine (25 mg per day) was rechallenged, with favorable outcome. Some visual disturbances were still present but less bothersome. Lorazepam was used for the management of insomnia and psychomotor agitation and the cholinesterase inhibitor Rivastigmine for managing the behavioral symptoms and cognitive decline.

Visual hallucinations are often a bothersome clinical feature in DLB. Treatment and diagnosis is often challenging. Clozapine is a good option for managing visual hallucinations in DLB.

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Population aging is accompanied by an increase in mental disorders of late age, cognitive impairment and dementia, which makes research on their diagnosis, prevention and therapy particularly relevant.

In order to improve the diagnosis of cognitive disorders in elderly patients, a comparative characteristic of the MMSE and MoCA psychometric scales is presented. Due to the lack of differentiation of results in the MoCA - test according to the severity of cognitive disorders, ranking was carried out to determine the scoring levels of cognitive decline.

On the clinical basis of the scientific department of gerontopsychiatry of the Moscow Research Institute of Psychiatry - branch of the V. Serbsky National Medical Research Center for Psychiatry and Narcology, 46 people over 60 years old were examined. The identified mental disorders were coded under the ICD-10 F00-F09 rubric “Organic, including symptomatic mental disorders”. Cognitive status assessment was carried out by psychometric scales MMSE and MoCA. Psychometric and statistical research methods were used. To compare MoCA and MMSE scores, an equal-percentage alignment method was used

In patients examined by MMSE and MoCA, different point values were determined in assessing cognitive functions. In most observations, the MoCA- test indicators were lower than the MMSE values. The following correspondences of the score values of the scales were revealed: MOCA 23-30 - MMSE 28-30 points; MOCA 22-18 - MMSE 27-25; MOCA 17-12 – MMSE 23-20; MOCA 12-0 – MMSE 19-0.

Such features of the MMSE scale as insufficient sensitivity in assessing memory impairment and differentiation of non-dementia levels of cognitive impairment, regulatory functions of programming and goal-setting, lexical fluency were revealed. The advantages of the MoCA - test were the ability to assess visual-constructive and executive skills, praxis, a more accurate assessment of memory impairments, mobility of mental processes and the ability to switch, logical thinking, the possibility of topical diagnosis of brain damage. The disadvantages of the MoCA - test were the duration of its implementation, the fatigue of patients, the lack of tasks for assessing written speech and motor praxis.

The MoCA - test is a more sensitive method for detecting and differentiating cognitive impairment compared to the MMSE scale, which makes it possible to recommend it for widespread introduction into psychiatric practice. Relevant in further studies are the determination of indicators of moderate cognitive impairment as a threshold value between mild cognitive impairment (MCI) and incipient dementia, clarification of the point values of different levels of dementia.

None Declared

The diagnosis of depression in the elderly patient presents peculiarities that should be taken into account. Studies point out the importance of an adequate screening of suspected cases of depression in older adults by physical therapists and other non-mental health professionals (Ramos Vieira et al., 2014). In this study, we intend to find out which are the most used diagnostic methods in Mental Health research on geriatric patient.

To analyze the diagnostic methods most used in research on the geriatric patient, specifically in articles that analyze the patient with cognitive impairment.

A bibliographic search of all articles analyzing depression in patients with cognitive impairment between 2000 and 2020 was carried out. The diagnostic method of depression in each of them has been collected.

A total of 38 studies were analyzed. The most common diagnostic method continues to be the use of diagnostic criteria (ICD or DSM), which is used in 34.2% of the studies, while the Center for Epidemiologic Studies Depression Scale (CES-D) is the most commonly used test, appearing in 23.7% of the studies. The remaining tests (CIDI, GDS, HAM17, PHQ, SCID, SCL-90, SGDS) do not reach 10% each.

The diagnosis of depression continues to be made primarily using diagnostic criteria. It is striking that the most commonly used test is the CES-D, given that the Geriatric Depression Scale (GDS) is usually the most popular scale for screening for late-life depression (Gana et al., 2017), which may be due to the fact that the studies analyzed have a more research than clinical purpose.

Gana, K., Bailly, N., Broc, G., Cazauvieilh, C., & Boudouda, N. E. (2017). The Geriatric Depression Scale: does it measure depressive mood, depressive affect, or both?. International journal of geriatric psychiatry, 32(10), 1150–1157.

Vieira, E. R., Brown, E., & Raue, P. (2014). Depression in older adults: screening and referral. Journal of geriatric physical therapy (2001), 37(1), 24–30.

None Declared

Traumatic stress is a major determinant of decreasing global mental health (Schnyder, 2013). Traumatic stress is a global public health issue, with the majority (70.4% and 88.7%) of the general population experiencing a traumatic event at least once in their lifetime (Schnyder, 2013, Kessler et al., 2017, de Vries and Olff, 2009, Ribeiro et al., 2013), which may result in Posttraumatic Stress Disorder (PTSD) (Iqbal et al., 2022, Riedl et al., 2019). People with a diagnosis of PTSD have been found to be at increased risk of developing dementia (hazard ratio (HR) of 1.61)(Gunak et al., 2021). Studies on the comorbidity of PTSD in dementia are sparse, probably, because of the lack of a valid diagnostic tool (Havermans et al., 2022). As subjects with dementia are often unable to give a valid report of their life history, in particular a delayed-onset PTSD may be easily missed. Preliminary findings reported a comorbidity rate of PTSD in veterans with dementia between 4.7- 7.8% (Sobczak et al., 2021).

We will investigate a) clinical manifestation and b) diagnostic challenges of PTSD in dementia.

a) A structured review with a PRISMA design, b) a qualitative case-study will be used.

a) 13 papers were included. Only 1% of included cases fulfilled the DSM-5 criteria of PTSD.

Most commonly described PTSD symptoms were: irritability and anger (9%), persistent negative emotional state ( 9%), and sleep disturbances (8%). In 93% of the cases reports, other symptoms were described, e.g. screaming (33.3%). B) Diagnostic challenges are: attributing symptoms to the past traumatic event, overlap in symptoms between PTSD and personality disorders and interference of other neuropsychiatric symptoms.

Mondial the number of people with dementia are sky rocketing and number of subjects with comorbid PTSD is substantial and will increase steadily in the coming years. PTSD and dementia are both known for their impact on the quality of life of those affected. In clinical practice, we see that the combination of both causes significant psychological suffering. And that while it is precisely in people with dementia that the experiences of these violent events often revive.

As the clinical manifestation of PTSD in dementia may differ and expertise on PTSD is often missing in geriatric wards, diagnosis of PTSD is easily missed. Hence, related behavior is often described as ‘unexplained’ or ‘problem’ while it can better be seen as ‘signal’ behavior (van Dongen et al., 2022). Adding observational research to the diagnostic process in people with dementia can give insight into underlying causes of neuropsychiatric symptoms. The TRADE-interview can be helpful in diagnosing PTSD. The value of using validated tests is emphasized.

None Declared

With the rapid ageing of societies in Europe and worldwide, the issues of social functioning and mental well-being of older adults gain importance and call for effective care solutions. Among the non-pharmacological options, modern technologies are a promising direction. The use of humanoid social robots, at least in selected areas of care for community-dwelling older people, is one of the possibilities to cope with both their mental problems and the increasing shortage of qualified caregivers.

We thus investigated which prospective areas of care are scored best by older subjects and their professional caregivers.

Opinions of older people (60+; no severe cognitive impairment), living in the community, and their professional caregivers about a robot in care for older adults were collected using the mixed-methodology Users’ Needs, Requirements and Abilities Questionnaire (UNRAQ), after a 90-150 minute interaction with the TIAGo robot (PAL Robotics, Spain).

The robot as a companion of an older person was scored better by older adults than caregivers (p<0.01). Similar results were obtained for the statements The robot could decrease the sense of loneliness and improve the mood of the elderly person (p<0.01), The robot should detect the owner’s mood (p<0.05), and The robot should accompany the owner in everyday activities (p<0.01).

Our results, reflecting the opinions and preferences of various stakeholders, indicate a high general acceptance of a robot in care for older people. The indication of best-scored areas provides clues for the robot’s designers as well as those involved in the implementation of robotic solutions in care and their introduction into the lives of older adults.

None Declared

Antipsychotics are frequently used to treat certain delusional, psychotic and behavioral symptoms in the elderly. However, the data in the literature show a great variability in the practices of different teams as well as numerous misuses in the use of this therapeutic class.

The aims of this work were to evaluate the prescription of antipsychotics in the elderly admitted in a psychiatric department and to compare them with the Information in the literature.

This was a retrospective and descriptive study carried out in the Psychiatry Department at Mahdia Hospital. We included all patients aged 65 years and older, admitted between January 2016 and December 2021 and having received antipsychotic treatment.

Our sample consisted of 53 patients with a mean age of 69.8 years with a standard deviation of 4.2. The sex ratio (M/W) was 2.7. The most common diagnoses in our sample were schizophrenia and dementia with rates of 31.8% and 27.3% of cases respectively. Regarding antipsychotic treatment, 34.1% received first generation oral antipsychotic treatment (AP1G), 31.8% received second-generation oral antipsychotic treatment (AP2G), 27.3% received a combination of AP1G and AP2G and 6.8% received a long-acting injectable antipsychotic. More than a quarter of our patients (34.1%) reported adverse events due to antipsychotic treatment.

The results of our study highlighted various indications for which an antipsychotic treatment was prescribed in an elderly person despite an often poor and multi-medicated health status, to which side effects were added.

None Declared

Improving health-related quality of life (HRQL) is the main goal of palliative care. It requires consensual management strategies and specific measures targeting modifiable factors that could affect the quality of life.

The aim of this study was to identify factors influencing the quality of life of patients with metastatic prostate cancer in a limited resources country.

This is a retrospective and analytical study enrolling all patients with metastatic prostate cancer who were managed at medical oncology and urology consultations of two Tunisian teaching hospital. HRQL was measured using UCLA prostate cancer index and SF-36 SCALE. The influence of demographic and medical characteristics on HRQL was determined using t tests and analysis of variance, with Tukey’s correction for multiple comparisons.

Multivariate linear regression was used to determine independent predictor

This study enrolled 244 patients. The mean age was 72 years. The strongest determinants of overall HRQL after univariate analysis were: increased age (p = 0.006), lower income (p = 0.009), sexual function problems (p = 0.004), urinary function problems (p = 0.002) and symptoms such as pain (p = 0.001) and asthenia (p = 0.001).

Age, income, sexual and urinary functions are important determinants of HRQL in patients with metastatic prostate cancer that may require specific interventions.

None Declared

The assessment of quality of life is an essential complement to medical care. Some studies have shown that young women are more vulnerable to the disease impact and have a greater worsening of their quality of life.

The aim of our study was to assess the quality of life of patients with breast cancer.

Cross-sectional descriptive study including patients followed for breast cancer at the outpatient medical oncology consultation of Hadj Ali Soua regional hospital from January to March 2021. We applied the 36-Item Short Form Survey SF-36.

Fifteen patients were included with a mean age of 49.87 ± 8.48 years and a mean age at diagnosis of 46.73 ± 7.55 years. At the TNM classification, 66.6% of the patients had a T1 or T2 at the time of diagnosis and 80% had an N0. All patients received a surgical intervention, which was conservative in 53.3% of cases. No patient underwent breast reconstruction. Chemotherapy and hormone therapy were prescribed in 86.7% of patients. There was unequal impairment of different areas of the SF-36 questionnaire. The physical component was the most affected with a mean physical score (PCS) of 62.64; the RP score (limitations due to physical condition) was the lowest with a mean of 45 and the score of the item “Life and relations with others” was the best with a mean of 77.5.

The quality of life in relation to breast cancer in our population was at the medium rating, with moderately high scores. Sustainable improvement of the quality of life of women with breast cancer is a priority issue among the treatment objectives. Further studies are needed to assess the impact on the spouse, which is inseparable from the couple.

None Declared

Neoplastic disease affects all aspects of life. People with cancer may experience a variety of emotions and reactions to their new reality that may be mild or intense, transitory or permanent.

The aim of our study was to assess the psychological distress of patients with breast cancer.

Cross-sectional descriptive study including patients followed for breast cancer at the outpatient medical oncology consultation of Hadj Ali Soua regional hospital from January to March 2021. We used the “Hospital Anxiety and Depression Scale (HAD-S)” for the assessment of anxiety and depression.

Fifteen patients were included with a mean age of 49.87 ± 8.48 years and a mean age at diagnosis of 46.73 ± 7.55 years. At the TNM classification, 66.6% of the patients had a T1 or T2 at the time of diagnosis and 80% had an N0. All patients received a surgical intervention which was conservative in 53.3% of cases. No patient underwent breast reconstruction. Chemotherapy and hormone therapy were prescribed in 86.7% of patients. The mean anxiety and depression scores according to the HAD-S were 9.53 and 4.93, respectively. The majority of our patients had no depressive symptoms (80%) against only 2 patients (13.33%) with depressive symptoms. On the other hand, most of our patients were anxious: 6 patients (40%) showed probably clinically relevant levels of anxiety (score of 11 or higher) and 5 patients showed possibly clinically relevant levels of anxiety (scores of 8 or higher) (33,33%).

Our study revealed a high prevalence of psychological distress. The presence of clinical psychologists in the medical oncology department and the training of nursing staff in psycho-oncology are essential for the overall care of patients with cancer.

None Declared

Breast cancer is the leading cancer in women in developed and developing countries. Treatment strategies can affect sexuality in the short or long term.

The aim of our study was to assess sexuality and martial satisfaction in patients followed for breast cancer.

Cross-sectional descriptive study including patients followed for breast cancer at the outpatient medical oncology consultation of Hadj Ali Soua regional hospital from January to March 2021. We passed the Female Sexual Function Index (FSFI) and the martial adjustment test (MAT).

Fifteen patients were included with a mean age of 49.87 ± 8.48 years and a mean age at diagnosis of 46.73 ± 7.55 years. At the TNM classification, 66.6% of the patients had a T1 or T2 at the time of diagnosis and 80% had an N0. All patients received a surgical intervention, which was conservative in 53.3% of cases. No patient underwent breast reconstruction. Chemotherapy and hormone therapy were prescribed in 86.7% of patients. Radiotherapy and targeted therapy were prescribed in 12 and 2 case, respectively. Amenorrhea, hot flushes and vaginal dryness were noted in 98.7%, 26.7% and 7.6% of patients, respectively. Sexual disorders were found in 53.3% of cases, which settled in a chronic mode in 75% of cases and progressed in a continuous mode in half of cases. The assessment of physical and erotic life was revealed to be neat in 73.3% of the patients. The mean score of the FSFI questionnaire was 17.25 [2.6-31.9]. Eleven patients (73.3%) had sexual dysfunction. A low marital satisfaction was found in 34% of cases.

The medical consultation to identify sexuality disorders in correlation with the martial dissatisfaction in women followed for new breast cancer is crucial allowing a better management of this pathology.

None Declared

Delirium is an important mental disorder, especially in intensive care units, which negatively affects the morbidity and mortality. Subjective clinical assessment of patients by non-psychiatric health professionals in intensive care units is insufficient to detect and measure delirium. Therefore, different scoring scales have been developed to assess delirium. A brief examination cannot entirely differentiate between a delirium, especially of organic origin, versus a psychotic break. Measurement scales for delirium are not routinely used. However, evidence shows that objective assessment of delirium contributes to its early detection in intensive care and the initiation of appropriate treatment.

To show the importance of using validated scales in delirium patients.

A case report.

A 63-year-old male patient was admitted to our psychiatry ward after being evaluated by the local internal medicine specialist for confusion and suicidal ideation. He wrote a suicide note and had a positive family history for mental disorder (the brother has schizophrenia). During the initial mental state examination, the patient showed general disorientation, thought dissociation and defunct reality testing. A profound laboratory testing did not show any meaningful changes. A CT-scan was conducted that showed no pathologic alteration. Firstly, the patient was treated as a psychotic case, with haloperidol and diazepam parenterally. After no evident improvement of his mental state the Delirium Detection Scale (DDS) was used. Eliciting a highly positive result, the patient was re-evaluated as an (somatic) delirium. Therefore, a neurologist was consulted and a lumbar puncture performed. The cerebrospinal fluid (CSF) was indicative for a viral meningitis. So, the patient was admitted to the Infectious Disease Unit. As no treatment showed results an additional CSF panel for paraneoplastic antibodies. This came back very positive for AntiHu – a marker for small-cell lung carcinoma. Next day’s thoracic CT scan revealed a massive carcinoma with no proliferation. At last, the patient was transferred to the pneumo-oncological unit where he received pulse therapy with methylprednisolone. After which, his mental state recovered fully and the patient started chemotherapy.

Delirium is a complex medical situation. It is an emergency which is classified in the ICD as a mental disorder. However, it demands medical and non-psychiatric therapy swiftly. Only, a swift and precise diagnosis can be a leading light here. The use of diagnostic scales should be encouraged as shown in this case report.

None Declared

Religiosity and spirituality are resources, frequently used by patients as a strategy against chronic diseases. Islam is the fastest growing monotheistic religion whose belief is based on the unity of God and devotion to God’s will, gratitude, and satisfaction with God’s provision. Despite many researches have proven mostly positive correlation between religion and health, there is a lack of them directed to a single religion.

To provide an overview of the most recent researches that have examined the role of Islam religion in cancer treatment.

PubMed database was screened using the keywords, “Islam, religion, cancer, treatment”.

Patients expressed a lack of religiosity/spirituality support and it is connected to a significantly lower quality of life compared to those who adequately addressed their spiritual needs. The study which included 800 Muslim cancer patients showed that cancer patients (82.8%) prayed more than non-cancer individuals (72.5%). Many Muslim patients do not consider disease as a penance, but rather, as a redemption of sins, because they have trust and faith in God’s will. There are studies postulating the positive effects of fasting on cancer treatment.

Muslim cancer patients are more religious and spiritual than the non-cancer Muslim population, and they are in need of spiritual support with the aim to reduce depression, anxiety, and stress. Health care professionals may encourage the patients to use their religious beliefs to cope with the challenges of therapy.

None Declared

The diagnosis of leukemia in a child is a difficult moment for the therapist and for the parents. Nevertheless, this moment is crucial and determining in the course of care and the therapeutic relationship.

Determine the quality of diagnosis announcement among mothers of children with leukemia.

A cross-sectional study was conducted at Aziza Othmana hospital department of haematology in Tunisia between June and July 2021.

We have questioned the mothers about the announcement of the diagnosis: the space frame, the time provided and the availability of the doctor.

We included 31 mothers, their middle age was 41 years old. Acute lymphoblastic leukemia is the most frequent type of cancer in our sample (94%).

According to 4 mothers (13.3%), the diagnosis of leukemia was not announced before the start of treatment.

The quality of the diagnostic announcement was judged to be good in 40% of cases (n=12), average in 12.7% (n=8) and mediocre in 20% of mothers (n=6).

The space frame of the announcement was perceived as appropriate with respecting confidentiality in 18 mothers (69.2%).

The time provided for the announcement was considered sufficient for 17 mothers (65.4%).

The doctor who announced the diagnosis was described as available by 69.2% of the mothers and unavailable by 30.8% of the mothers.

The quality of the diagnosis announcement amoung mothers of children with leukemia in our context is not optimal. Oncologists must be trained in diagnostic announcement and must be aware of the importance of this moment in the subsequent therapeutic relationship.

None Declared

The incidence of psychological disorders in patients with cancer is very high (30–60%), with approximately 29–43% fulfilling the diagnostic criteria for psychiatric disorders. The most commonly encountered mental problems encompass depressive symptoms associated with mixed anxiety and adjustment disorder or depressive mood or major depression.

The aim of this research is to highlight the characteristics of psychiatric manifestations in patients with cancer and to analyse the risk factors that influence the occurrence of these psychiatric manifestations.

Α bibliographical review was performed using the PubMED platform. All relevant articles were found using the keywords: cancer, psychiatric manifestations, risk factors.

Sleep problems, irritability, tendency to cry easily, sadness, and pain were among the leading symptoms at baseline. Women reported sleep problems, tendency to cry easily, irritability, pre-occupation with the illness, and sadness as the first five most frequent issues, and men reported sleep problems, irritability, pain (usually incompatible with their medical conditions), sadness, and tendency to cry easily as the most frequent problems.

Significant risk factors that increased the mood disorders were recurrence, presence of secondary cancer, other chronic medical illnesses, history of psychiatric disorder, low income level, poor social support, and being single or divorced.

None Declared