Sadness, nostalgia, deep discomfort, guilt and feelings of loss, hopelessness are just some of the emotions that overwhelm people who are experiencing the death of a loved one (Franza et al. Psychiatr Danub 2022; 34 (8) 60-63). The unusual mourning process in the time of COVID-19 challenges the usual process of coping with loss. The absence of the funeral rite and coping in time of COVID-19 affects the grieving process. The consequences of “bodiless” bereavement in survivors of people who died during the COVID-19 pandemic may be similar to Post Traumatic Stress Disorder (PTSD) (Spurio. Psychiatr Danub 2021; 33 (Suppl 9) 102-107).

To evaluate the effects of the absence of the funeral rite on anxiety, depression, PTSD and hope in family members of people who have died from COVID-19.

In our observational study, 23 family members (12 females; 11 males; mean age: 48.56 yrs) who experienced a bereavement of a loved one without participation in funeral rites due to COVID-19 restrictions were recruited. They had turned to mental health professionals (psychiatrists and psychologists) as suffering from anxiety and depressive disorders. The subjects interviewed between the months of May 2020 and July 2020 (T0) were administered the following evaluation scales: Beck Hopelessness Scale (BHS), Beck Depression Inventory -2 (BDI-II); Anxiety Zung, and PTSD Checklist for DSM-5 (PCL-5).

The same scales were administered after 1 year (T1) and after two years (T2).

All the relevant data were analysed using EZAnalyze Version 3.0, Microsoft Excel Add-ln. Repeated Measures ANOVA Variables used for analyzing scales scores.

The main results are shown in Table 1. High values of hopelessness, anxiety and depressive symptoms were observed in T0. The score was reduced in the following times. In BHS the ANOVA results indicate that at least two of the repeated measures differed significantly (P – Unadjusted: T0 and T2: .003, T1 and T2: .009; P – Bonferroni: T0 and T1: .009, T1 and T2: 0.28). Similar results were highlighted in the Zung and DBI-II scales. These results indicate high levels of anxiety and depression at the beginning of the observation period (T0). The results for the assessment of PTSD indicate statistically significant differences (P. .000, Eta Squared: .378).

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Our little study evaluated some psychological factors in the emotional process of “normal” and complicated mourning. The loss of a loved one is inevitably an extremely painful event and is accompanied by a series of highly emotional experiential pathways. In the first months after death, family members have high levels of anxiety, depression, and hopelessness. There is a need to deepen the study with a higher number of participants and with a comparison with “normal” bereavement

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On January 7, 2020, the Chinese authorities identified a new type of virus from the Coronaviridae family as the causative agent of an outbreak of pneumonia of unknown etiology, which has been named SARS-CoV-2. The disease caused by this new virus has been named by international consensus COVID-19. The WHO recognized it as a global pandemic on March 11, 2020. The Government of Spain declared the State of Alarm on March 13.

Hospitals have had to reorganize their consultation areas and emergency rooms to carry out security measures and prioritize the care of patients with COVID-19. All this has had repercussions on the closure of Psychiatric Day Hospitals and outpatient consultations, carrying out fundamentally telephone or telematic follow-up.

The objective of the study was to analyze the characteristics of admission during the year after the 2020 pandemic compared to the similar period in 2019.

An observational study of retrospective characteristics of patients admitted to a hospitalization unit during the year 2020 after the pandemic will be carried out compared to the year 2019 of the same period. Demographic and clinical variables are included in the study.

During the period after the 2020 pandemic, a total of 135 patients were admitted, with a mean age of 42.8 years, 65 of them women and 70 men. With a diagnosis at discharge of 48% of Psychotic Disorder, 17% of Bipolar Disorder, 11.1% of other affective disorders (T. depressive, adaptive, dysthymia) 14% of Personality Disorder, and 17% of others. Compared to the same period of the previous year, the number of admissions decreased by 98 patients (42%), including the severity of the clinic, with 36% of the total admissions being psychotic disorders.

It can be concluded that the number of hospitalizations has decreased due to the patients’ fear of being admitted and therefore being subject to infection, and the higher percentage of psychotic and affective pathology because these patients are more serious, making home containment impossible.

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Several studies show a negative impact of mass media contents on adolescents’ mental health, especially on perceived body uneasiness. COVID-19 lockdown determined an increased use of social networks (SN). Psychiatrists highlighted an increase in Eating Disorders’ (ED) diagnoses.

The aim of this study is to assess the pattern of SN use in patients with ED using a self-administered questionnaire.

30 patients with clinical diagnosis of ED (Anorexia nervosa, Bulimia nervosa or Binge eating disorder) admitted to the ED unit, underwent clinical assessment, and filed a questionnaire on SN use. The questionnaire assesses time spent on SN, weight-control apps use, exposure to fitness- or food-related contents and to ED-promoting contents, distractibility, weight changes and feeling of body uneasiness.

Mean age was 20.63 (SD 4.71), mean BMI 20.24 (SD 5.27); 93.3% (28) of patients were females. Eating behaviours were divided into restrictive type (66.7%, 20) or binge/bulimic (33.3%, 10). 16.7% (5) of patients reported self-injury behaviours. In 46.7% (14) of cases, the onset of the ED occurred during COVID-19 pandemic; the remaining 53.3% (16) experienced a relapse of a previous ED during this period. 66.7% (20) of subjects reported an increased use of social media and fitness apps. 90% (27) experienced weight changes during the pandemic, with 76.7% (23) seeking nutritional or psychological interventions. 53.3% (16) perceived an increase in body- or food-related contents on their SN feeds, with 50% declaring of knowing the meaning of the terms pro-ana and pro-mia.

Table 1 displays reported answers to the questionnaire. Table 2 shows mean age of patients according to self-injury behaviours and to the onset time of ED.Table 1.

ED onset during the COVID-19 pandemic and self-injury behaviours appear as pivotal characteristics of younger patients, displaying a greater severity of the disorder in our clinical experience. With a more consistent number of patients, it would be possible to correlate SN use and body- and food-related contents to the onset and the severity of ED, focusing on pandemic periods.

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Insulin is the basic medical therapy to manage type 1 diabetes and is also a cornerstone of treatment of type 2 diabetes as insulinopenia belongs to its natural history. However, insulintherapy is associated with many challenges especially psychological difficulties such as patient’s acceptance and compliance, which may lead to metabolic and psychological disorders.

The aim of our study was to determine the association between insulintherapy and depression.

A cross sectional analytic study was conducted from October 2019 to October 2020 among a group of diabetic patients followed in the Endocrinology Department of Taher Sfar University Hospital in Mahdia, Tunisia. “DSM-V diagnosis criteria for depression screening” and “Hamilton score scale” were used to evaluate the severity of depression.

A total of 260 patients were recruited in our study. The mean age was of 57.36±15.4 years with extremities ranging from 20 to 91 years. The sex ratio M/F was situated at 0.59. The mean diabetes duration was of 10.92 years. The majority of patients had type 2 diabetes (92.3%). The micro vascular long-term complications of diabetes were the most frequent (67.7%): neuropathy (39%), retinopathy (37%) and nephropathy (24%). According to the “DSM-V diagnosis criteria”, 15% of the study population suffered from a Major Depressive disorder (MDD). Hamilton score scale showed that thirty-eight patients had severe depression symptoms (14.6%). Insulintherapy was associated with MDD and depression severity (19.1% vs 10.1% ; p=0,041 and 20% vs 8.4% ; p<10–3).

Diabetic patients treated with insulin seem to be exposed to severe depressive syndromes. Once insulin initiated, doctors should be careful at the psychological aspects and the burden of this decision and use in consequence appropriate tools to screen depressive symptoms and anxiety. The role of family doctor is crucial providing early psychological support and preventing complications associated with depression especially poor glycemic control.

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Parents have significant genetic and environmental influences, which are known as intergenerational effects, on the cognition, behavior, and brain of their offspring. These intergenerational effects are observed in patients with mood disorders, with a particularly strong association of depression between mothers and daughters.

The main purpose of our study was to investigate female-specific intergenerational transmission patterns in the human brain among patients with depression and their never-depressed offspring.

We recruited 78 participants from 34 families, which included remitted parents with a history of depression and their never-depressed biological offspring. We used source-based and surface-based morphometry analyses of magnetic resonance imaging data to examine the degree of associations in brain structure between four types of parent-offspring dyads (i.e. mother-daughter, mother-son, father-daughter, and father-son).

Using independent component analysis, we found a significant positive correlation of gray matter structure between exclusively the mother-daughter dyads within brain regions located in the default mode and central executive networks, such as the bilateral anterior cingulate cortex, posterior cingulate cortex, precuneus, middle frontal gyrus, middle temporal gyrus, superior parietal lobule, and left angular gyrus. These similar observations were not identified in other three parent-offspring dyads.

The current study provides biological evidence for greater vulnerability of daughters, but not sons, in developing depression whose mothers have a history of depression. Our findings extend our knowledge on the pathophysiology of major psychiatric conditions that show sex biases and may contribute to the development of novel interventions targeting high-risk individuals.

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Major depressive disorder (MDD) is a highly prevalent mental illness that frequently originates in early development and is pervasive during adolescence. Despite its high prevalence and early age of onset, our understanding of the potentially unique neural basis of MDD in this age group is still not well understood, and the existing primary literature on the topic includes many new and divergent results. This limited understanding of MDD in youth presents a critical need to further investigate its neural basis in youth and presents an opportunity to also improve clinical treatments that target its neural abnormalities.

The present study aims to advance our understanding of the neural basis of MDD in youth by identifying abnormal functional activation in various brain regions compared with healthy controls.

We conducted a meta-analysis of functional magnetic resonance imaging (fMRI) studies of MDD by using a well-established method, multilevel kernel density analysis (MKDA) with ensemble thresholding, to quantitatively combine all existing whole-brain fMRI studies of MDD in youth compared with healthy controls. This method involves a voxel-wise, whole-brain approach, that compares neural activation of patients with MDD to age-matched healthy controls across variations of task-based conditions, which we subcategorize into affective processing, executive functioning, positive valence, negative valence, and symptom provocation tasks.

Youth with MDD exhibited statistically significant (p<0.05; FWE-corrected) hyperactivation and hypoactivation in multiple brain regions compared with age-matched healthy controls. These results include significant effects that are stable across various tasks as well as some that appear to depend on task conditions.

This study strengthens our understanding of the neural basis of MDD in youth and may also be used to help identify possible similarities and differences between youth and adults with depression. It may also help inform the development of new treatment interventions and tools for predicting unique treatment responses in youth with depression.

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The mechanisms leading to Oxytocin’s differential effects among patients with borderline personality disorder have thus far been elusive.

This study was aimed to explore the differential effect of OT administration among depressive patients with or without comorbid borderline personality disorder, and to explore the mediating role of attachment in these differential patterns.

Patients treated with psychotherapy in an inpatient settings (N=58) were randomized and double-blindly allocated to receive oxytocin or placebo for a period of four weeks. The effect of OT on therapy process and outcome was examined among patients with (n=35) and without (n=23) borderline personality disorder. Moderated mediational models were estimated to explore whether attachment differentially affected the association between oxytocin and treatment outcomes.

patients without BPD showed significantly larger improvements following OT administration (B=-8.32, p=.001) as compared to placebo in OQ-45. On the other hand, patients with BPD showed no significant improvement following OT (B=0.61, p=.76). The same pattern was observed in the HSCL, where patients without BPD demonstrated significantly larger improvements following OT administration (B=-0.29 ,p=.0009) as compared to placebo, while patients with BPD demonstrated no significant improvement (B=-0.04 ,p=.55). Moderated mediational models indicated no significant moderated indirect effect, however, a significant trend of indirect effect only in the BPD group was observed, whereby the no-BPD group showed a stronger direct effect (β=-0.19, t=-1.30, p=.20), whereas the BPD group showed a stronger indirect effect (β=-0.72, SE=0.45, CI= -1,71, -0.00).

Patients with depression and comorbid BPD benefit less from OT administration as compared depressive patients without such comorbidity. It is possible that the involvement of the attachment system may be associated with the attenuation of OT’s effect.

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Insomnia in depression is common and difficult to resolve. Music is commonly used as a sleep aid, and clinical trials pointing to positive effects of music as a sleep aid are increasing adding to the evidence base. There is little knowledge on the effectiveness of music for depression related insomnia.

A recent RCT study conducted in psychiatry at Aalborg University Hospital examined effects of a music intervention for insomnia in depression. The intervention group listened to music at bedtime for four weeks, controls were offered music intervention post-test. Primary outcome measure was Pittsburgh Sleep Quality Index (PSQI). Secondary outcomes included Actigraphy, The Hamilton depression Rating Scale (HAMD-17) and World Health Organisation well-being questionnaires (WHO-5, WHOQOL-BREF).

A two-armed randomized controlled trial (n=112) and a qualitative interview study (n=4)

The RCT study showed signficant improvements for the music intervention group in sleep quality and quality of life at four weeks according to global PSQI scores (effect size= -2.1, 95%CI -3.3; -0.9) and WHO-5 scores (effect size 8.4, 95%CI 2.7; 14.0). Actigraphy measures showed no changes and changes in depression symptoms (HAMD-17) were not detected.

The interview study unfolded examples of the influences of music on sleep and relaxation. Music distracted, affected mood and arousal positively and supported formation of sleep habits.

Results from the trial are discussed and merged with findings from the interview study. The results from the trial suggested moderate effects of music listening for the population while findings from the interview study showed examples of individual and highly varying outcomes.

Music is suggested as a low-cost, side-effect free and safe intervention in supplement to existing treatments improving sleep in depression.

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The role of the interaction between the serotonin-transporter-linked promoter region (5HTTLPR) and stressful condition in determining the vulnerability to depression has been widely investigated. Nevertheless, empirical research provides contrasting findings. Recently, the differential susceptibility to environment model proposed a conceptual shift respect to the classical interpretation of 5-HTTLPR: viewing the short (s) and the long (l) allele not as associated to different traits of vulnerability (respectively vulnerable or not), but determining different plasticity levels (respectively, more and less plasticity) and, thus, different susceptibilities to the environment (respectively, high and low susceptibility).

As 5-HTTLPR is involved in plasticity, the main goal of the present study is to demonstrate that the interaction between the polymorphism and stress emerges when assessing its effects according to temporal factors in a dynamic process perspective.

We explored our hypothesis, exploiting a meta analytic approach. We searched PubMed, PsychoINFO, Scopus and EMBASE databases and 1096 studies were identified and screened, resulting in 22 studies to be included in the meta-analyses. We applied the DerSimonian and Laird random-effects model to estimate crude odds ratios for risk of depression according to 5HTTLPR and we assessed heterogeneity using the I² and Cochran’s Q statistic. We stratified the staties according to (i) stress duration (i.e., chronic vs. acute stress) and (ii) time elapsed between the end of the stressful condition and the assessment of depression (i.e., within one year vs. more than one year).

When stratifying for the duration of stress, the effect of the 5-HTTLPR x stress interaction emerged only in the case of chronic stress (OR 1.43, 95%IC 1.16-1.77, I²= 52%, Q=25.25; Figure 1), with a significant subgroup difference (p=0.004). The stratification according to time interval revealed a significant interaction only for intervals within one year (OR 1.23, 95%IC 1.03-1-46, I²= 67%, Q=39.35), though no difference between subgroups was found. The critical role of time interval clearly emerged when considering only chronic stress: a significant effect of the 5-HTTLPR and stress interaction was confirmed exclusively within one year (OR 1.53, 95%IC 1.17-2.02, I²= 45%, Q=10.94; Figure 2) and a significant subgroup difference was found (p=0.01).

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Our results show that the 5-HTTLPR x stress interaction is a dynamic process, producing different effects at different time-points, and indirectly confirm that s-allele carriers are both at higher risk and more capable to recover from depression. Overall, these findings expand the current view of the interplay between 5-HTTLPR and stress adding the temporal dimension, resulting in a three-way interaction: gene x environment x time.

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Working in intensive care units and in emergencies is a stressful job. Taking care of acute and serious pathologies may cause various psychological diseases.

This study aimed to screen depression among emergency and intensive care caregivers and to determine factors associated with these disorders.

This is an exhaustive, descriptive and analytical cross-sectional study that interested paramedical caregivers working in the emergency and intensive care services from south Tunisia. We used an anonymous questionnaire that included sociodemographic, medical and professional characteristics and the subscale of depression from the Hospital anxiety and depression (HAD) scale.

A total of 240 patients participated in the survey. The prevalence of depression was 30.8%. In the univariate study, depression was associated with the female sex (P=0.006), university level (p=0.04) and anxiety (p<10-3). Three risk factors of depression were found in the multivariate analysis: female gender (OR=2.4 [1.1-7]; P=0.025), and the university school level (OR=5[1.5-16.7]; P =0.009).

Depressive disorders are common among caregivers in emergency and intensive care units. This finding highlights the importance of an early screening of these disorders to improve their management.

None Declared

With the increase of older adult population, late life depression is emerging as a major problem in many countries as it significantly deteriorates function and quality of life in older adults. Late life depression is a multidimensional disease that requires intervention in biopsychosocial perspective. Recent reduction in family size and rapid simplification of generations are making this decrease more dramatic. Thus, single older households are becoming general type of household in late life, emphasizing the importance of social engagement in late life depression

the purpose of this study is to assess the correlation between the frequency of face-to-face and non-face-to-face contact with non-cohabitating adult children and late life depression after the COVID-19 pandemic. Additionally, we hypothesized 10 possible moderators and evaluated the moderation effect of each moderator on the correlation. By identifying groups of older adults that are more affected by contact with their children, the understanding of the relationship between late life depression and family contact in older adults might provide insights to set intervention targets in the community.

Older adults who completed the Living Profiles of Older People Survey in Korea were included. In total, 7,573 participants were analyzed by measuring their contact frequency and depression symptoms. Regression analysis was done adjusting covariates. Process macro was used to verify the moderating effects of variables.

Multivariable logistic regression analysis showed that both infrequent face-to-face (OR=1.87, 95% CI=1.56-2.23) and non-face-to-face contact (OR=1.22, 95% CI=1.03-1.44) with non-cohabitating adult children group was associated with higher risk of late life depression compared to a frequent contact group. Further linear regression analysis, which viewed depressive symptoms as SGDS-K score, indicated consistent results in face-to-face and non-face-to-face contact (estimate=0.468, standard error [SE]=0.091, p<0.001 and estimate=0.262, standard error [SE]=0.079, p<0.001, respectively). Finally, using moderation analysis, association with late life depression and frequency of face-to-face contact was moderated by age, quartiles of household income, number of chronic diseases, frequency of physical activity, existence of spouse, and nutritional status (NSI) whether effect of frequency of non-face-to-face contact on late life depression was increased by participation in social activity, frequent physical activity, and good cognitive function (MMSE-DS score)(p for interaction<0.05).

Frequent contact of non-cohabitating children lowers the risk of later life depression. Several variables were found significant in moderating contact frequency-depression symptoms.

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The risk of suicide may be elevated in the presence of personality pathology. Adults with Obsessive Compulsive Personality Disorder (OCPD) may be vulnerable to depression and suicidal thoughts.

To identify factors associated with suicide in cases of OCPD.

Psychological autopsy procedures were used to gather detailed information about adults who died by suicide and natural causes. A total of 75 deceased adults were evaluated using psychological autopsy procedures. Family members were interviewed about a recently deceased adult, using structured diagnostic interviews (SCID and SIDP-IV). Diagnostic summaries, coroner’s reports and police records were reviewed by a psychiatrist, a psychologist, a social worker, and a neuroscientist until agreement was reached about final diagnosis. The final sample included 40 adults who met criteria for OCPD (18 had died by suicide; 20 had died by natural causes). An additional 40 cases were examined in which evidence of PD was absent (19 had died by suicide; 18 had died by natural causes).

The diagnosis of a Major Depressive Disorder was significantly more common in suicide completers with OCPD compared to suicide completers without OCPD (X2 = 6.74, p < .01) or cases of natural death with OCPD (X2 = 12.70, p < .001). Suicide completers with OCPD displayed many symptoms of depression, more often than suicide completers without OCPD or cases of natural death with OCPD (see Table 1). As compared to the cases of natural death, both groups of suicide completers were more likely to have previously attempted suicide prior to their final act (X2 = 8.52, p < .05).Table 1.Comparison of four groups using psychological autopsy procedures to identify the presence of diagnostic criteria for a Major Depressive Episode at the time of death.

Adults with OCPD appear vulnerable to a Major Depressive episode, and the combination of MDD with OCPD creates a significant risk for death by suicide. It is important to appreciate the influence of personality disorder or depression and suicide risk.

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Premenopausal period is characterized by cognitive and mood disorders in women (Weber et al. J. Steroid Biochem. Mol. Biol. 2014;142:90–98). Resveratrol (3,5,4′-trihydroxy-trans-stilbene) is a phytoestrogen present in the skin of a range of foods including red grapes, blueberries and peanuts. Resveratrol can act through multiple mechanisms, including binding and activation of estrogen receptors (ER), to increase nitric oxide bioavailability and thereby facilitate the endothelium-dependent vasodilatation necessary for adequate cerebral perfusion (Xia et al. Molecules. 2014;19:16102–16121). Some evidences indicate that resveratrol can improve cognitive processes and emotional state (Kodali et al. Sci. Rep. 2015;5:8075).

The aim of the present study was to compare the efficacy the combined treatmnet of SSRIs (vortexine, escitalopram, sertraline and fluoxetine) plus resveratrol (50 mg twice per day) for 6 months therapy on the affective profile of premenopausal woman with clinically confirmed Major Depressive Disorder (MDD)

For the assessment of affective profile in premenopausal women (35-45 years) with clinically confirmed MDD, we used the different tests: Montgomery-Asberg Depression Rating Scale (MADRS) and Shihan Anxiety Scale (ShARS Scale).

After 6 months of SSRIs plus resveratrol therapy, MADRS Scale showed more significant improvement of the depressive symptoms in premenopausal women with clinically confirmed MDD compared to the SSRIs treatment alone (p>0,05). Moreover, these patients demonstrated a significantl low anxiety state using ShARS Scale.

Thus, our pilot clinical study clearly demonstrated that co-treatment with SSRIs plus resveratrol (50 mg twice per day) was able to enhance the therapeutic effects of SSRIs on the affective-related symptoms in premenopausal women. We need to create new approaches to treat the premenopausal women with MDD using a combination of SSRIs with resveratrol.

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Studies have shown that family factors affect the development, maintenance and course of major depressive disorder (MDD).

The present study aimed to prospectively investigate whether dysfunctional family functioning is associated with meaningful clinical outcomes including symptom severity and quality of life (QoL) in patients with MDD.

A total of 114 patients with a clinical diagnosis of MDD (83.3% females, aged 47.25±13.98 years) participated in the study. Participants were recruited from the outpatient clinic, Department of Psychiatry and the mobile mental health unit of the University Hospital of Heraklion in Crete, Greece, and from a Greek online depression peer-support group. Family functioning was assessed in terms of cohesion, flexibility, communication and satisfaction dimensions (FACES IV) at baseline. Depression severity (BDI) and QoL (WHOQOL-BREF) were assessed about 10 months after the baseline assessment (9.56±2.52).

Conceptually, the cohesion dimension contains Balanced Cohesion (central area) with Disengaged (low unbalanced) and Enmeshed (high unbalanced) dimension, and the flexibility dimension contains Balanced Flexibility (central area) with Rigid (low unbalanced) and Chaotic (high unbalanced) dimension. Multivariable analysis adjusting for confounding variables such as patients’ educational level, residence, family structure, pharmacotherapy, psychotherapy, and history of suicide attempts indicated that Balanced Cohesion was positively associated with increased levels of patients’ psychological QoL. Moreover, two out of four unbalanced scales - Enmeshed and Chaotic - were negatively related to lower psychological QoL. The findings also demonstrated that Enmeshed scale was positively associated with higher depressive symptoms. Finally, lower family communication was related to increased depressive symptoms, whereas lower family satisfaction was associated with patients’ lower psychological QoL.

Family environmental factors appear to play an important role in clinical outcomes of MDD. Family interventions targeting dysfunctional family interactions by promoting awareness of family dynamics could improve the emotional well-being of patients with MDD.

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Major depressive disorder (MDD) is the third leading cause of disease burden, accounting for 4.3% of the global burden of disease. Personality traits, as described in the Five-Factor Model, are consistently associated with individual’s well-being and mental health. Early Maladaptive Schemas (EMS) are self-perpetuating dysfunctional cognitive structures that have been linked with psychological health and play a significant role in developing and maintaining psychological distress. Both personality traits and EMS have been extensively studied as contributors to MDD symptoms.

To our knowledge, very few studies have attempted to link personality to EMS in clinical samples. The present study aimed to investigate the association between EMS with personality traits of Five-Factor Model in a clinical sample of patients with MDD in Crete, Greece.

Two hundred and two patients with a clinical diagnosis of MDD (81.7% females, aged 47.75±14.06 years) participated in the study. The Traits Personality Questionnaire was used to measure personality traits in terms of neuroticism, extraversion, openness, agreeableness, and conscientiousness dimensions. The Young Schema Questionnaire-Short Form 3 (YSQ-SF 3) was used to evaluate 18 EMS which are grouped in five domains: disconnection and rejection, impaired autonomy and performance, impaired limits, other-directedness, and overvigilance and inhibition.

Significant associations between EMS and personality traits were found. Specifically, a higher level of all EMS domains was found in patients with MDD scoring higher in neuroticism and lower in extraversion, conscientiousness and agreeableness (apart from the association of agreeableness with other-directedness which was non-significant). Openness was negatively related to other-directedness.

Although causal inferences cannot be made due to the cross-sectional design of the present study, our findings are in accordance with Schema Therapy that affirms a relationship between innate temperament and EMS. Future research should examine whether psychological interventions focusing at healing EMS will contribute to alteration of personality traits.

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In hoarding disorder the patient has a strong tendency to collect and accumulate objects with or without value and great difficulty in destroying them.

In this case, a 58-year-old woman diagnosed with a hoarding disorder 5 years ago, came to a psychiatry clinic due to frequent auditory hallucinations related to episodes of acute stress. She received treatment in an outpatient mental health unit which consisted of psychopharmaceuticals and cognitive behavioural therapy. The patient achieved a partial remission of the hallucinations and a clinical improvement of the accumulation symptoms.

The main objective of this study is to describe the psychiatric and psychological treatment of this patient. We also performed a review of the available literature on comorbidity of the symptoms of Diogenes syndrome and psychotic symptoms.

A close follow-up of the psychopathology of this patient was carried out and we did a database search in PubMed to document the case, with the keywords: “hoarding disorder”, “psychotic disorder”, “comorbidity”, “hallucination”, with the inclusion criteria: In the last ten years, Spanish and English language.

The patient, who was being treated with sertraline 100 mg, started treatment with olanzapine 10 mg and with a psychotherapeutic plan with different objectives: stabilization of symptoms, reduction of hoarding behaviours, letting go of objects, as well as coping with stressful situations. Cognitive behavioural techniques such as psychoeducation, exposure with response prevention and cognitive therapy were included in the psychological treatment.

After one year of treatment the hallucinatory symptoms have remitted and the patient’s daily functioning has improved. The most resistant symptoms are those of accumulation that are slowly decreasing but the patient has stopped collecting objects from the street.

More studies of the treatment of hoarding disorder and more investigation of its possible comorbidities are needed.

None Declared

Although there is sparse evidence about patients with obsessive-compulsive disorder (OCD) that develop dementia, some case reports have suggested an association between these two clinical entities. There have also been descriptions that point to a possible link between late onset OCD and an increased risk or prediction of dementia. Dementia is a common public health problem, exacerbated by the aging of the population, and, without significative improvement in prevention and treatment, its adverse consequences will continue to increase. On the other hand, OCD is a chronic and impairing condition, that typically initiates in adulthood, with variable clinical presentation, impact and prognosis, that can be optimized depending on the therapeutical approach.

We propose to review, select and schematize the existing evidence about the association between OCD and dementia. Information about this correlation is considered useful to improve clinical practice in both entities.

We will analyze the existing literature linking OCD and dementia, considering the articles available in PubMed, published since 2010.

A recent study showed that patients with OCD had increased risk of developing dementia, including Alzheimer’s disease and vascular dementia, compared with control. However, another study on the theme concluded that OCD had no impact in Alzheimer’s disease onset or cognitive impairment. A different study correlated late onset OCD with dementia with Levy bodies, highlighting the importance of testing secondary causes of late onset OCD. There is also a study that correlates OCD with progressive supranuclear palsy, suggesting that dysfunction of the fronto-caudate-thalamus-cerebellum circuit may be involved. Obsessive-compulsive behaviors are also documented symptoms in frontotemporal dementia, existing studies of this overlapping that may elucidate about its neural networks.

Important questions remain unanswered and, to establish an effective correlation between OCD and dementia, clinical investigation in this area should be amplified, mainly with longitudinal studies. Research on the pathogenic and molecular mechanisms potentially common to OCD and dementia may lead to the development of promising therapeutics. Moreover, given its clinical relevance, we consider it pertinent to study the impact of treating properly OCD in reducing the risk of dementia or attenuate its symptoms and progression.

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Obsessive-compulsive disorder (OCD) is a heterogeneous and debilitating neuropsychiatric disorder. First-line antidepressants with Selective Serotonin Reuptake Inhibitors (SSRIs) and Clomipramine (a tricyclic antidepressant) are unresponsive or partially responsive in 40% of treated patients. Preclinical studies have shown that cannabidiol (CBD) can reduce compulsive behavior in animals, and considering that the release of glutamate in the action of CBD can inhibit terminal axons of neurons in the corticostriatal-thalamo-cortical circuit, we chosefor testing CBD, a drug with few side effects and low toxicity, as an adjuvant in treating OCD.

To evaluate the clinical effects of CBD add-on to the usual pharmacological treatment of outpatients diagnosed with OCD.

Methods: This is an open-label study in which patients received CBD 300mg-day for 30 days in addition to their usual treatments and CBD 600mg-day for an additional 30 days if they have not reduced at least 25% of symptoms compared to the baseline evaluated by the Yale-brown obsessive-compulsive scale (Y-BOCS). Psychometric scales were used to assess the effects of CBD: Y-BOCS, General Anxiety Disorder 7 (GAD-7), Clinical Overall Impressions-Severity (CGI-S), Clinical Global Impressions-Improvement (CGI-I), Patient Health Questionnaire-9 (PHQ-9), Epworth Sleepiness Scale and Udvalg Scale for Kliniske Undersogelser (UKU) scale.

Participants: We initially assessed 33 participants in the study. So far, 19 patients have completed the study. Eleven did not complete the study, and 03 patients are still in the study trial.

Mean (SD) Y-BOCS scores decreased from 28.0 (4.8) at baseline to 13.8 (8.6) at week 8, corresponding to a - 50.7% reduction (P<.0001). Anxiety symptoms (GAD-7 scale) (P=0.001) and CGI-Severity scales scores (P<0.001) improved significantly.

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We concluded that there was an important reduction in the psychometric scales used with statistical significance. This is a partial analysis of the results as the study progresses. We believe that in the future we will be able to complete this study and have a better analysis of the results that are promising. At the end of the study, other psychometric scales such as CGI-I, epworth scale and UKU will be analyzed.

None Declared

Obsessive-compulsive symptoms and Obsessive-Compulsive Disorder (OCD) have been reported by clinicians in Parkinson’s disease (PD) due to the involvement of a shared circuitry. In DSM-5, OCD related disorders include Trichotillomania, Hoarding Disorder, Skin Picking Disorder, and Body Dysmorphic Disorder. However, there is no prevalence information about Obsessive Compulsive and Related Disorders in PD.

The aim of this study is to evaluate patients with Idiopathic Parkinson’s Disease (IPD) in terms of obsessive-compulsive symptoms, OCD and Related Disorders, compare with a matched control group, and determine the relationship between the two phenomena.

80 patients between 52-82 years of age, diagnoised IPD and 80 healthy controls between 52-80 years of age were included in this study. Structured Clinical Interview for DSM-5 Disorders, a Structured sociodemographic and clinical form, The Unified Parkinson’s Disease Rating Scale, Frontal Assessment Battery (FAB), Parkinson’s Disease Questionnaire-39 (PDQ-39) and Yale-Brown Obsessive-Compulsive Scale were applied to the participants. The relationship between PD and OCD and related disorders and obsessive-compulsive symptoms was evaluated.

Contamination obsession was found in 21.3% of patients and 16.3% of the control group; cleaning compulsion was found in 13.8% of patients and 8.8% of the control group. Two groups were compared in terms of obsessions (p=0.215) and compulsions (p=0.361); no statistically significant difference was found between the groups.The presence of obsessions (p=0.027) and compulsions (p=0.007) in patients with a family history of Parkinson’s disease was found to be significantly higher. A statistically significant correlation was found between FAB scores and PDQ-6 (cognition item) in the Parkinson’s group (r= -0.359, p=0.001). Compared to the control group (mean 15,08; SD: 1,84), FAB scores were found to be significantly lower in the Parkinson’s group (mean 13,95; SD: 2,23) .(p=0.001). The presence of any obsession (p=0.003) or any compulsion (p<0.001) was found to be significantly higher in patients with hoarding in the Parkinson’s group. The presence of any obsession (p<0.001) or any compulsion (p<0.001) was found to be significantly higher in patients with Skin Picking Disorder in the Parkinson group. The scores obtained from the PDQ emotional well-being (p=0.027) and bodily discomfort (p=0.001) items in the Parkinson group with Skin Picking Disorder were significantly higher than the Parkinson group without Skin Picking Disorder.

PD is characterized by dysfunction in frontobasal ganglia circuits. A similar circuit is also important in OCD. Obsessions and compulsions, Hoarding Disorder, Skin Picking and Trichotillomania may accompany PD. Family history increases any obsession and compulsion in PD.

None Declared

The physiopathology of patients with treatment-resistant obsessive-compulsive disorder (OCD) may differ from that of treatment-responsive patients. Cognitive evoked potentials may be one of the ways to detect these differences. The error-related negativity (ERN) is an electrophysiological correlate of error detection during the execution of a motor task, which is larger in patients with OCD than in typical people. According to the literature, the ERN could vary according the patients’ treatment-resistance.

The main goal of this study was to assess whether the ERN, which begins 20 ms before the motor response and reaches its maximum 80 ms later, was different between non-resistant and highly resistant OCD patients.

Forty-seven OCD patients and their age- and gender-matched controls were asked to perform a flanker task while the potentials evoked by their motor responses were recorded. For each participant, the difficulty of the task was adjusted to get an error rate of about 20%. Treatment-resistance was evaluated using Pallanti and Quercioli’s (Prog Neuropsychopharmacol Biol Psychiatry 2006; 30 400-412) resistance scales.

In all participants, response errors evoked an ERN at fronto-central electrodes [Fz, FCz, red and green lines on the figure], whereas the negativity was absent or smaller for correct responses (black and blue lines on the figure, both ps < .01). As expected, the ERN of OCD patients was consistently larger and of longer duration than that of control participants (compare the green and blue lines with the red and black ones, respectively). Interestingly, the amplitude of the potentials evoked by correct responses at central and centro-parietal electrodes on the left side of the brain [C5, C3, CP5] was significantly less negative in treatment-resistant patients (all ps < .05). In control participants, the ERN recorded at fronto-central electrodes were followed by a positive wave which reached its maximum between 170 and 270 ms after the response, and was larger after errors than after correct response. In OCD patients in contrast, this positive wave was absent whether the response was correct or not.

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The significant correlation observed between OCD patients’ treatment resistance and the potential evoked by correct responses on the left side of the brain suggest that this potential could be used as a marker of treatment-resistance. The absence in OCD patients of the positive wave that follows the ERN in control participants suggests that OCD patients were not fully aware of whether or not their response was correct.

None Declared