COVID-19 has increased the levels of psychological stress experienced by the dental team, and higher level of constant stress negatively impacts mental health.

The study aimed to 1) assess dentists’ level of stress and compare it to normal population data; 2) identify the hierarchy of coping strategies chosen by dentists and their perception of those chosen by team members to manage psychological stress caused by the pandemic; and 3) to ascertain the effects of these coping strategies on dentists’ higher stress level.

Data from an electronic test battery comprising of general demographic and dental-related variables was collected from 182 licenced Hungarian dentists at the outset of the pandemic. Responses to an empirical series of questions regarding their perceived level of stress, choice of interventional coping skills and their perception of those used by team members were recorded.

Dentists’ level of stress was significantly lower than the stress level measured in a Hungarian normal population (t(386)=-2.227, p=0.027), while financial status has a moderating effect (F(3,176)=4.851, p=0.003). The hierarchy of coping strategies chosen by the dentist indicated that physical activity and exercise, particularly in groups settings (M=4.78, SD=0.463), and socialization with family (M=4.72, SD=0.626) were the most effective coping management strategies, superior to financial compensation, shifting work patterns, systems level change, and decisions within the team structure. Inclusionary strategies with family (M=4.64, SD=0.587), participating in individual leisure activities (M=4.49, SD=0.621) and socializing with friends (M=4.44, SD=0.825) were seen by dentists as more important to team members. Regression analysis was used to ascertain whether the use of these coping strategies increased the likelihood of having higher levels of perceived stress. The model was significant (F(4,169)=8.292, p≤0.001) with R2 of 16.4%. Older age (B=-0.179, S.E.=0.050, t=-3.582, p≤0.001), gender (B=4.214, S.E.=1.423, t=2.961, p=0.004), active participation in developing COVID-19 protocols (B=-1.619, S.E.=0.575, t=-2.815, p=0.005) and socialization with family (B=-2.108, S.E.=1.058, t=-1.993, p=0.048) were the most effective coping mechanisms for having lower levels of perceived stress.

Our study provided insights into the value of importance attributed to perceived stress and a series of coping strategies used by the respondents and their perception of value ascribed to the same series by their team members. Active participation both in family life and in professional environment proved to be protective in such a highly stressful time like the COVID-19 pandemic.

None Declared

The COVID-19 pandemic has placed extraordinary mental health burdens on healthcare professionals. For women, it is a major challenge to reconcile the diverse roles of a professional, mother, and wife. The COVID-19 pandemic has exacerbated this, increasing their vulnerability to mental health issues.

The aim of the study was to assess COVID-19-related mental health of healthcare professionals and to investigate whether possible gender differences as well as other parameters are associated with mental health disturbances.

We conducted a nationwide cross-sectional study of healthcare professionals working in hospitals or primary care settings in Greece from April to June 2022. Participants answered a questionnaire that included socio-demographic and other parameters, the Coronavirus Anxiety Scale (CAS), the Coronavirus Reassurance-Seeking Behaviors Scale (CRBS), and the Obsession with COVID-19 scale (OCS).

A total of 464 healthcare professionals participated in the study, 71.2% were females and two-thirds were 31-50 years old. Elevated levels of anxiety, frequent reassurance seeking activities and persistent troubling thoughts related to COVID-19 were found in 5.8%, 3.2% and 6.1%, respectively. However, females reported significant higher mean levels on CAS and CRBS compared to males (2.41 vs 1.60, p=0.015, and 3.36 vs 2.64, p=0.041, respectively). Participants living in smaller areas had increased levels on all three scales (CAS, p < 0.001; CRBS, p = 0.007; OCS, p < 0.001), indicating thus higher coronaphobia, more frequent reassurance-seeking behaviors and disturbed thinking about COVID-19, compared to healthcare workers living in urban regions. Furthermore, lower educational level is also associated with higher values on CAS, CRBS and OCS (p < 0.003; p = 0.017; p < 0.023, respectively). Nurses experience higher anxiety scores (2.96) than physicians (1.92, p=0.013) or other healthcare workers (1.87, p=0.016). No dysfunctional thinking about COVID-19 is observed in medical doctors, whereas nurses and other healthcare workers experience higher levels on OCS.

Our study does not show any worrying increased psychological dysfunction related to COVID-19 pandemic among healthcare workers in general. However, females have increased levels than males. Thus, support and mental health protecting strategies should be applied primarily to female healthcare professionals when necessary.

None Declared

Like many under-resourced settings, there is a large gap between burden of mental illness and availability of services in South Africa. Because South Africa also bears a high burden of adverse childhood events (ACEs) and adult trauma, mental illness is often preceded in individuals by either or both. While studies within South Africa have examined the association between ACEs and distress in adulthood and adult trauma and adult mental distress, there is less knowledge of how these preceding factors interact to affect mental distress together, particularly in clinical populations.

Using path analysis, this study seeks to ascertain the impact that ACEs and adult trauma have on mental illness in urban South Africa. Understanding the perceptions and experiences of people living with mental illness is key not only to expanding biomedical services and ensuring appropriate and effective mental health treatment, but can also help identify ways to prevent mental illness in the future.

This study uses data collected from 309 psychiatric out-patients at two public psychiatric hospitals in Johannesburg. Ethics approval was received and data were collected in-person between January and June of 2022. Patients 18 years and above, of African descent, and willing to provide informed consent were invited to participate. The survey included questions about demographics COVID-19, adverse childhood events, adult traumatic events, depression, anxiety, and stress. Participants were also invited to take part in a brief, semi-structured interview. Data were analyzed via path analysis, using the lavaan package in R, version 4.1.1.

Incidences of both ACEs and adult trauma were significantly associated with three mental illness outcomes – depression, anxiety, and stress. An aggregated adult trauma score was found to partially mediate the association between total ACEs and depression, anxiety, and stress. When analyzed separately, total adult trauma partially mediated the association between ACEs including childhood verbal abuse, sexual abuse, emotional neglect, and mental illness in the household and depression, anxiety, and stress. Total adult trauma also partially mediated the association between childhood physical abuse and depression and anxiety, but not stress.

This study highlights the importance of dis-aggregating adverse childhood events when exploring their effects, while also reinforcing previous findings that ACEs increase the likelihood of experiencing adult trauma and mental illness. Future studies should attempt to pinpoint which ACEs are most impactful, and target those in particular for prevention in childhood and intervention in adulthood, to mitigate their deleterious impacts.

None Declared

Stress related to high expectations towards students, a large amount of knowledge necessary to assimilate in a brief period of time, and peer pressure are an important factor in the deterioration of the mental state of medical students. As a consequence, it can lead to burnout and even the development of mental disorders such as depression. Mechanisms of coping with difficulties play an extremely important role in moderating this risk. For this reason, it was of the interest what strategies medical students adopt in the face of everyday stress and how it affects their well-being and functioning.

The objective was to determine how medical studies impact mental health of students and what coping strategies are used by them to mitigate the negative influence of stress associated with high expectations, peer pressure and overwork.

A cross-sectional study was conducted among students of polish medical faculties using an online questionnaire. Risk of depression was assessed using validated BDI inventory, aggression using STAXI inventory and evaluation of coping strategies was conducted with Brief-COPE inventory.

Study was conducted among 329 participants. The majority of respondents were female (71.4%; n=235) and average age in the whole population equaled 22.46 years (95%CI: 22.1-23.01). There was no statistically significant difference in age between females and males. Average outcome in BDI equaled 13.84 (95%CI: 12.8-14.8) with higher levels among females (13.84 vs. 12 p<0.05). 165 (49.6%) students had a score above threshold for the increased risk of depression while 32 (9.63%) for severe symptoms of it. In case of aggression average outcome of STAXI equaled 24.89 (95%CI: 22.6-27.1). There was a statistically significant correlation between STAXI and BDI (r=0.3; p<0.05). In terms of the coping mechanisms in terms of coping strategies, a clear advantage of approach strategies was observed (65.36% of respondents). In the multiple regression analyses coping strategies did not influence neither STAXI nor BDI outcomes.

What draws attention are the high level of depression among the surveyed students, where over 50% show results above the cut-off point for an increased risk of a depressive episode. The advantage of approach strategies is also interesting, especially in terms of planning strategies and positive reformulation. Interestingly coping strategies in the analysed population did not constitute a significant protective factor in relation to the severity of the depressive symptoms and agression. Meanwhile, the sense of satisfaction and contentment with the chosen direction was a very good protective factor in terms of the severity of depressive symptoms.

None Declared

Antidepressants (AD) are one of the most prescribed pharmacological treatments in developed countries. AD efficacy is well-proven in anxiety, depressive and other mental disorders, but their use is also common in individuals without psychiatric health conditions. Indeed, recent evidence reported an increase in AD prescription over the latest years. Concern has been raised on the overuse of AD in several countries, and societal policies and national guidelines have been developed to regulate their use in the general population.

Several factor might be used to explain this increase, including the more safety profile of new AD classes (i.e. SSRI, or vortioxetine) compared to old AD, a possible overall increase in the incidence of depressive and anxiety disorders, or their inappropriate prescription in mild conditions which could be managed without pharmacological treatment as first-step option in primary care (PC).

Explore AD prescription patterns in relation to mental health diagnoses and identify the most relevant factors involved in PC health systems. Understanding the variables influencing AD prescription would allow designing strategies and guidelines to make appropriate use of this pharmacological group in PC. As part of the PRESTO project (www.prestoclinic.cat), here we investigated the changes in frequency and the variables associated with AD prescription in a population-representative sample of people attending PC between 2010 –2019 in Catalonia, Spain.

We retrieved AD prescription, sociodemographic, and health-related data using individual electronic health records from a population-representative sample (N=947.698) attending PC between 2010-2019. Prescription of AD was calculated using DHD (Defined Daily Doses per 1,000 inhabitants/day). We compared cumulative changes in DHD with cumulative changes in diagnoses with an indication for AD during the study period. We used Poisson regression to examine sociodemographic and health-related variables associated with AD prescription.

Both AD prescription and mental health diagnoses with an indication for AD gradually increased. At the end of the study period, DHD of AD prescriptions and mental health diagnoses with an indication for AD reached cumulative increases of 404% and 49% respectively. Female sex (incidence rate ratio (IRR)= 2.83), older age (IRR = 25.43), and lower socio-economic status (IRR= 1.35) were significantly associated with increased risk of being prescribed an AD.

Our results from a large and representative cohort of patients confirm a steady increase of AD prescriptions that is not explained by a parallel increase in mental health diagnoses with an indication for AD. A trend on AD off-label and over-prescriptions in the PC system in Catalonia can be inferred from this dissociation.

M. Gonzalez: None Declared, G. anmella Grant / Research support from: received CME-related honoraria, or consulting fees from Janssen-Cilag, Lundbeck, Lundbeck/Otsuka, and Angelini, with no financial or other relationship relevant to the subject of this article, E. vieta Grant / Research support from: received research support from or served as consultant, adviser or speaker for AB-Biotics, Abbott, Abbvie, Adamed, Angelini, Biogen, Celon, Dainippon Sumitomo Pharma, Ferrer, Gedeon Richter, GH Research, Glaxo SmithKline, Janssen, Lundbeck, Organon, Otsuka, Rovi, Sage pharmaceuticals, Sanofi-Aventis, Shire, Sunovion, Takeda, and Viatris, out of the submitted work, M. Primé-Tous: None Declared, X. Segú: None Declared, A. Mas: None Declared, D. Hidalgo Grant / Research support from: received CME-related honoraria or adviser from Abbott, Angelini, Janssen-Cilag and Ethypharm with no financial or other relationship relevant to the subject of this article.

Patients with Functional Neurological Disorder have a high return rate to Emergency Rooms.

To assess possible changes in Emergency Room presentation rates in patients with Functional Neurological Disorder following their attendance of specialized long-term multidisciplinary treatment and rehabilitation program.

Seventy-two adult patients with Functional Neurological Disorder were included. These patients were consecutive referrals accepted for ongoing specialist FND treatment.

The total number of Emergency Room presentations in the year prior to program admission was obtained from central health records. Patients were provided ongoing treatment for one year, during which the number of ER presentations was monitored. Patients received one or more of the following treatment modalities: psychoeducation, psychological therapy, psychologically informed physical and occupational rehabilitation and psychopharmacological treatments.

We subsequently compared high and low emergency service users. Low ER users are those with pre-treatment Emergency Room presentations of less than 3 per year. High emergency service users are those who presented to the emergency room 3 or more times per year before the start of their treatment.

The mean emergency room presentation per year in the year leading to patients referral was 2.6 per patient, SD 9.4; dropped to 1.2 emergency room presentations per year, with a standard deviation of 4.4 in the year following the start of treatment. The difference was statistically significant (p= 0.02).

There was a strong positive correlation between the pre and post-treatment number of presentations with a Pearson Correlation Coefficient of 0.976 (95% Confidence Interval 0.962 to 0.985).

The reduction in emergency room presentations in both high and low-emergency service user groups was significant, with a mean difference of 12 ER visits a year in high-frequency emergency service users (p= 0.04) and a mean difference of 0.5 visits a year in low-frequency emergency service users (p < 0.001).

Ongoing specialist treatment and rehabilitation of patients with Functional Neurological Disorder significantly reduce their need for emergency room presentation, regardless of the treatment modality.

None Declared

It is well established that the quality of mental health care and human rights mutually reinforcing. Until now, Georgian psychiatry is highly institutionalized, oriented towards medical treatment and suffers from a lack of recognition of the importance of the human rights concept.

The purpose of the evaluation was to gather information on the current state of human rights and service quality in the inpatient mental health facilities throughout Georgia; pilot the WHO Quality rights toolkit as a major instrument to monitor mental health institutions within the country; develop recommendations for improvement of service care in psychiatric institutions and initiate changes based on the assessment results.

All inpatient mental health facilities operating in the country were selected for the evaluation. The assessment team conducted visits in facilities in March – May, 2019. All visits were planned in advance. All five themes of WHO Quality rights tool were covered. Interviews, observation and documentation reviews were used during the assessment process.

Infrastructure malfunction is linked to the lack of encouraging environment, with scarce of daily and social activities. Comprehensive, patient-oriented individual recovery plan has not been initiated throughout the country. Treatment is focused mainly on medication treatment aimed at reducing / removing psychotic symptoms and timely discharging patients or “calming them down“. Taking into consideration scarcity of community-based service alternatives, the patients frequently have no choice where to get the relevant service. In general, the patients are satisfied with how they are being treated. The challenge is the incidents of violence among the patients and ensuring relevant safety measures. Educational and employment programs for persons with mental disorders are not developed in the country.

Based on the assessment findings recommendations for improvement of service care at mental health policy and institutional level were elaborated.

Despite some improvements in developing community services the assessment revealed gaps in mental health care and lack of understanding of the concept of human rights. The instrument was sensitive to identify poor treatment and violation of rights but less sensitive in determining differences in existing services. It is discussed that an in-depth assessment using the specific theme of the tool can help develop specific recommendations.

None Declared

Physical activity (PA) has multiple health benefits for people with severe mental illness (SMI). People with SMI engage in less exercise and more sedentary behaviour than the general population; this can be further exacerbated by inpatient settings. Staff’s attitudes towards PA may influence patient engagement.

In 2019, a study explored staff’s views on PA for acute psychiatric inpatients. This follow-up study by the same team aimed to establish whether the enablers/barriers to promoting PA have changed and to identify targets for intervention.

In 2022, an online anonymous survey with free text was sent to all multidisciplinary team (MDT) members (n=91) of two acute general adult wards, including nurses, doctors, and allied health professionals (AHPs). A combination of quantitative and qualitative analysis was used to understand participants’ perspectives. Manual thematic analysis was completed to identify discrete themes.

Response rate was significantly lower for the follow-up at 39% as opposed to 63% of the initial study, possibly reflective of post-COVID-19 staffing issues and lack of time for engagement in quality improvement activities. Respondents were nearly unanimous in agreeing that PA was beneficial to physical and mental health. Enablers to PA included higher numbers of staff (24%), more PA resources (22%), more PA-designated staff (19%), more PA-dedicated time (14%), and timetables of available activities (14%). The majority (65%) continued to report that promoting PA was difficult during their shift. Reported barriers included lack of staff (38%), lack of time (27%), and high levels of clinical activity (24%). Noticeably, nurses were much more likely than doctors or AHPs to report short staffing as a barrier to promoting PA (OR=19.8, p < 0.05). Participants described the gym (22%), walking groups (19%), and football (14%) as the most beneficial PA for patients, whilst 14% responded it was “whichever PA patients preferred”. This was mirrored by staff naming “user feedback” as a potential enabler. Reasons for PA being beneficial included “being outside” (24%) and “being inclusive” (11%). Only 45% of MDT members felt they had been provided with PA education/training.

Staff continued to acknowledge the importance of PA for physical and mental health and were aware of multiple enablers and barriers. Post-COVID-19, systemic issues such as staffing levels, lack of time, high levels of clinical activity, and lack of PA education/training remained barriers. Service user preference, enjoying the outdoors and inclusivity were features of activities perceived to be most beneficial. An integrative approach to mental health and wellbeing, providing inclusive activities, educating/training staff, promoting PA in inpatient psychiatric settings, and offering organisational support can contribute to improved PA provision and regular patient engagement.

None Declared

Burnout in the medical profession has garnered a lot of attention over the recent years. While it is reported across all specialties and all stages of medical education; resident physicians in particular are at high risk for burnout throughout their years of training.

This study aimed at evaluating the prevalence and correlates of burnout among resident physicians in Alberta.

Through a descriptive cross-sectional study design, a self-administered questionnaire was used to gather data from resident physicians at two medical schools in Alberta, Canada. Maslach Burnout Inventory was used as an assessment tool. Chi-squared and multivariate binary logistic regression analyses were used.

Overall burnout prevalence among residents was 58.2%. Working more than 80 hours/week (OR= 16.437; 95% CI: 2.059 – 131.225), being dissatisfied (OR= 22.28; 95% CI: 1.75– 283.278) or being neither satisfied nor dissatisfied with a career in medicine [(OR= 23.81; 95% CI: 4.89 – 115.86) were significantly associated with high depersonalization. Dissatisfaction with efficiency and resources (OR= 10.83; CI: 1.66- 70.32) or being neither satisfied nor dissatisfied with a career in medicine (OR= 5.14; CI: 1.33- 19.94)] were significantly associated with high emotional exhaustion. Working more than 80 hours/week (OR= 5.36; CI: 1.08- 26.42) and feeling that the residency program is somewhat having enough strategies aimed at resident well-being in place (OR= 3.70; CI: 1.10- 12.46) were significantly associated with high work exhaustion and interpersonal disengagement. Young age of the residents (≤ 30 years) (OR= 0.044; CI: 0.004- 0.445) was significantly associated with low professional fulfillment.

Burnout is a serious occupational phenomenon that can degenerate to other conditions or disrupts one’s professional performance. Significant correlates were associated with high rates of burnout. Leaders of medical schools and policy makers need to acknowledge, design, and implement various strategies capable of providing continuous effective mental health support to improve the psychological health of the medical resident across Canada.

None Declared

Meta-analyses of functional magnetic resonance imaging (fMRI) studies have been used to elucidate the most reliable neural features associated with various psychiatric disorders. However, it has not been well-established whether each of these neural features is linked to a specific disorder or is transdiagnostic across multiple disorders and disorder categories, including mood, anxiety, and anxiety-related disorders.

This project aims to advance our understanding of the disorder-specific and transdiagnostic neural features associated with mood, anxiety, and anxiety-related disorders as well as to refine the methodology used to compare multiple disorders.

We conducted an exhaustive PubMed literature search followed by double-screening, double-extraction, and cross-checking to identify all whole-brain, case-control fMRI activation studies of mood, anxiety, and anxiety-related disorders in order to construct a large-scale meta-analytic database of primary studies of these disorders. We then employed multilevel kernel density analysis (MKDA) with Monte-Carlo simulations to correct for multiple comparisons as well as ensemble thresholding to reduce cluster size bias to analyze primary fMRI studies of mood, anxiety, and anxiety-related disorders followed by application of triple subtraction techniques and a second-order analysis to elucidate the disorder-specificity of the previously identified neural features.

We found that participants diagnosed with mood, anxiety, and anxiety-related disorders exhibited statistically significant (p < .05 – 0.0001; FWE-corrected) differences in neural activation relative to healthy controls throughout the cerebral cortex, limbic system, and basal ganglia. In addition, each of these psychiatric disorders exhibited a particular profile of neural features that ranged from disorder-specific, to category-specific, to transdiagnostic.

These findings indicate that psychiatric disorders exhibit a complex profile of neural features that vary in their disorder-specificity and can be detected with large-scale fMRI meta-analytic techniques. This approach has potential to fundamentally transform neuroimaging investigations of clinical disorders by providing a novel procedure for establishing disorder-specificity of observed results, which can be then used to advance our understanding of individual disorders as well as broader nosological issues related to diagnosis and classification of psychiatric disorders.

None Declared

There is much evidence of grey matter alterations in subjects at clinical-high risk of psychosis (CHR). Although, to the best of our knowledge, no studies have analyzed both cerebral cortex and amygdala nuclei morphometry alterations in CHR individuals.

The aim of the study was to explore cortical thickness and amygdala nuclei morphometric characteristics in CHR patients.

Nineteen right-handed male patients (17-24 years, mean age 21.1 ± 2.1) fulfilling CHR criteria and 20 matched healthy controls (18-24 years, mean age 21.1 ± 1.8) underwent T1-weighted structural MRI at 3T Philips scanner. Images were processed via FreeSurfer 7.0. Cortical thickness (according to Desikan atlas) and volumes of 9 separate amygdala nuclei bilaterally were compared between groups. The morphometry data, SOPS, HDRS (Hamilton Depression Rating Scale) scores and chlorpromazine equivalents were included in correlation analysis.

Compared to healthy controls, patients showed decreased cortical thickness in the left [F(1, 36) = 10.8, p = 0.002; Cohen’s d = −1.1, 95% CI: −1.8 to −0.4] and right [F(1, 36) = 10.5, p = 0.003; Cohen’s d = −1.0, 95% CI: −1.7 to −0.3] postcentral gyri, and increased cortical thickness in the right posterior cingulate [F(1, 36) = 9.9, p = 0.003; Cohen’s d = 1.0, 95% CI: 0.3 to 1.6] and the right rostral anterior cingulate gyri [F(1, 36) = 12.2, p = 0.001; Cohen’s d = 1.1, 95% CI: 0.4 to 1.8]. No changes in any amygdala nuclei were detected. No correlations between altered cortical thickness, HDRS, SOPS or chlorpromazine equivalents were revealed.

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The current findings suggest that volumetric characteristics of amygdalar complex are unaffected in the CHR state. The results have some inconsistency with our previous findings (Tomyshev et al. Psychiatry Res Neuroimaging. 2019; 289 26-36), which revealed only a decrease in cortical thickness in CHR individuals. However, the cross-sectional design of the current study and the lack of correlations between cortical thickness and clinical symptoms do not allow to conclude definitely whether the revealed higher cortical thickness can represents some resilience mechanisms, which will be elucidated via further research.

This study was supported by RSFBR 22-15-00437

None Declared

Neuroanatomical abnormalities are reported in psychotic disorders compared to healthy controls; nevertheless, less is known about the role of familial liability to psychosis in morphological brain changes.

Using an exploratory voxel-based morphometry (VBM) analyses of the whole brain, we evaluated differences on GMVs across the whole brain among first-episode psychosis (FEP) patients, community-controls, and healthy siblings of patients to interrogate the role of familial liability.

Data were retrieved from a study (STREAM) conducted in Ribeirão Preto/SP Brazil. We included 71 first-episode psychosis patients (67.6% males, mean age±SD: 18.7±10.8), 24 unaffected siblings of patients (37.5% males, mean age±SD 30.8±10), and 36 controls (71.9% males, mean age±SD: 10±10.5). All magnetic resonance imaging (MRI) scans were acquired on a 3T Philips scanner. VBM data were processed using Statistical Parametric Mapping (SPM) software in MATLAB the MNI coordinate system. We performed exploratory voxel-wise comparisons of GMVs among the three groups using an analysis of covariance (ANCOVA) model in SPM. Results were considered significant if they retained significance after family-wise error (FWE) correction for multiple comparisons (p<0.05). All the analyses were adjusted for age, sex, education in years, and total brain GMV.

The whole-brain exploratory analyses revealed no significant findings at the p<0.05 level (FWE-corrected). However, pairwise comparisons revealed significant changes betweeen FEP patients and their unaffected siblings. In particular, FEP patients had decreased volumes in the right side of the following regions (FEW = 0.047): superior temporal cortex, Rolandic operculum, insula, Heschel’s gyrus, supramarginal gyrus, superior temporal pole, hippocampus, parahippocampal gyrus, fusiform gyrus, amydgala, olfactory, inferior frontal operculum, cerebellum, posterior and medial orbital frontal cortex, rectus, medial temporal, medial frontal, and putamen. FEP patients also showed decreased volumes on the left side of the following regions (FWE 0.049): frontal superior medial gyrus, superior frontal gyrus, frontal middle part, caudate, anterior cingulate cortex, thalamus, and pallidum. Patients also showed widespread reduced GMV in various GMVs regions compared to controls at FWE<0.05. However, no difference was found between siblings and controls (FWE: >0.05).

The study of healthy siblings of patients with heritable illnesses could help in the understanding of the contribution of genetic background and environmental factors to illness state and predisposition. Differences between patients and their siblings could be attributed to the disease state, considering that the unaffected sibling group and unrelated healthy control group did not differ. We will next evaluate biological and environmental contributors to the reported differences.

None Declared

Previous findings show that the depressive state is characterized by a peculiar suppression of the resting state functional connectivity (rsFC) anti-correlation between resting-state networks (e.g., Default Mode Network) and task-positive networks (e.g., Sensory-Motor Network) in favor of an abnormal positive rsFC pattern. This suggests a large-scale functional disbalance in adaptively switching the attentional focus from an internal-oriented cognitive modality to an external-oriented processing modality. Yet, according to further evidence, such a functional inversion is primarily driven by the global signal (GS) (i.e., by an abnormal large-scale topographical reconfiguration) in major depressive disorder (MDD). However, it is not clear if similar alterations may affect bipolar disorder (BD) in depressive phase.

Investigation of the global topography of the depressive syndrome as a potential transnosographic endophenotype and evaluation of the GS on generating differences between groups.

We compared large-scale rsFC patterns in a group of healthy controls (HC) (n=70) and a group of patients with BD (n=70) during a depressive episode. In order to investigate the impact of the GS, we further performed all analyses both with and without GS regression (GSR).

Compared to HC, patients with an ongoing major depressive episode exhibit specific resting-state changes that are only observed when analysis is performed without regressing GS. Patients were found to exhibit an (i) abnormally strong GS contribution within an extended cluster comprising regions known to be part of highly interconnected hubs (i.e., transmodal networks) and showing functional relations’ core along the cortical midline and a (ii) diminished influence of the GS in correspondence of frontoparietal and occipitotemporal regions. Notably, no traces of such changes -differentiating the global topography of patients from HC- held when applying GSR.

Our results (i) suggest that rsFC alterations detected stem from a global rather than a local source and (ii) corroborate the impact GS can exert on generating within and between-networks differences. Hence, we underline the necessity that future investigations on groups with expected altered topographical distribution include GS within data-analysis and a proper evaluation of its involvement. Nonetheless, our results are in line with previous evidence of altered global topography in MDD. Hence, we interpreted this finding as a benchmark of a whole-brain functional disbalance toward self-oriented cognition characterizing the transnosographic depressive syndrome.

None Declared

Self-compassion (SC) describes an emotionally positive attitude extended toward ourselves when we suffer, consisting of three main components; self-kindness, common humanity, and mindfulness (Germer & Neff, 2013). SC entails being warm and understanding towards ourselves when encountering pain or personal shortcomings, rather than ignoring them or flagellating ourselves with self-criticism. SC also involves recognizing that suffering and failure are part of the shared human experience rather than isolating. In addition, SC requires taking a mindful approach to one’s feelings and thoughts, without judgment of them.

Self-compassion (SC) involves taking an emotionally positive attitude towards oneself when suffering. Although SC has positive effects on mental well-being as well as a protective role in preventing depression and anxiety in healthy individuals, few studies on white matter (WM) microstructures in neuroimaging studies of SC has been studied.

Magnetic resonance imaging data were acquired from 71 healthy participants with measured levels of SC and its six subscales. Mirroring network as WM regions of interest were analyzed using tract-based spatial statistics (TBSS). After the WM regions associated with SC were extracted, exploratory correlation analysis with the self-forgiveness scale, the coping scale, and the world health organization quality of life scale abbreviated version was performed.

We found that self-compassion scale (SCS) total scores were negatively correlated with the fractional anisotropy (FA) values of the superior longitudinal fasciculus (SLF) in healthy individuals. The self-kindness and mindfulness subscale scores of SCS were also negatively correlated with FA values of the same regions. The FA values of SLF related to SC were found to be negatively correlated with the total scores of self-forgiveness scale, and self-control coping strategy and confrontation coping strategy.

Our findings suggest that levels of SC and its self-kindness and mindfulness components may be negatively associated with DMN-related WM microstructures in healthy individuals. These less WM microstructures may be associated with positive personal attitudes, such as self-forgiveness, self-control and active confrontational strategies.

None Declared

Negative symptoms represent a fundamental aspect of schizophrenia: they have a substantial impact on patients’ real-life functioning and do not respond satisfactorily to currently available treatments. Therefore, a better understanding of the pathophysiological mechanisms underlying these symptoms could favor the development of new treatments.

To date, the most validated pathophysiological hypothesis indicates an association between the Motivational domain (consisting of avolition, anhedonia and asociality) and alterations in the neuronal circuits involved in motivation. The Expressive Deficit domain (consisting of blunted affect and alogia) would be subtended by widespread alterations of cortical connectivity and associated with impaired neurocognition, social cognition, and the presence of neurological soft signs.

The aim of the present study is to examine the neurobiological correlates of the two domains of negative symptoms, starting from the brain areas that have been most commonly found in the literature to be associated with negative symptoms.

Resting-state (rs) fMRI data were acquired in 62 subjects with schizophrenia (SZ) and 46 healthy controls (HC). The two negative symptom domains were assessed using the Brief Negative Symptom Scale. In addition, the following assessment tools were used: the Positive and Negative Syndrome Scale for the assessment of positive symptoms and disorganization, the Calgary Depression Scale for Schizophrenia for depression and the St. Hans Rating Scale for extrapyramidal symptoms. The study of the possible relationships between rs-brain activity and the negative symptoms domains was conducted through partial correlations, checking for possible confounding factors (positive, depressive, extrapyramidal symptoms and disorganization).

The SZ, compared to the HC, showed higher rs-brain activity of the right inferior parietal lobule and of the right temporoparietal junction and lower rs-brain activity of the right dorsolateral prefrontal cortex, bilateral anterior dorsal cingulate cortex, bilateral ventral caudate and bilateral dorsal caudate. Furthermore, in the group of patients, the rs-brain activity of the left ventral caudate showed a moderate negative correlation with the Expressive deficit domain (r = -0.401; p = 0.003), but not with the Motivational domain.

The results of the present study, in line with the literature, demonstrated how the two domains of negative symptomatology are subtended by different pathophysiological mechanisms. Given the role played by the ventral caudate in neurocognitive processes, these results are in line with the hypothesis that Expressive deficit may have a common etiopathogenesis with cognitive deficits. A better understanding of the neurobiology of negative symptoms could foster the development of innovative treatment strategies targeting the two negative symptom domains.

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Childhood family income is a powerful predictor of academic achievement and mental health. Here, we ask whether children living in poverty–those whose family incomes are not sufficient to meet their material needs–who beat the odds by succeeding academically are subsequently either protected from, or more at risk for, internalizing disorders. Prior research indicates that children in poverty with better academic performance and more depressive symptomatology tend to have higher temporal coupling between lateral frontoparietal network (LFPN; supports executive functions) and Default Mode Network (DMN; supports internally-directed thought) than lower-performing children in poverty, in direct contrast to the pattern observed for children above poverty. Thus, an open question is whether this pattern of connectivity adaptive for children in poverty has maladaptive long-term consequences, particularly for mental health.

In this pre-registered study, we analyzed concurrent data from 8,091 children (1,307 in poverty) in the ABCD study at baseline (ages 9-10y). We performed linear mixed effects models to investigate whether both higher LFPN-DMN connectivity and grades are linked to more internalizing symptoms concurrently, and whether this differs for children above and below poverty.

We performed linear mixed effects models to investigate whether both higher LFPN-DMN connectivity and grades are linked to more internalizing symptoms concurrently, and whether this differs for children above and below poverty.

We found that higher grades were associated with fewer internalizing symptoms for both children above and below poverty; this association was stronger for children below poverty. In addition, LFPN-DMN connectivity showed a significant negative correlation with internalizing symptoms at this age. However, when looking at internalizing symptoms separately - that is, anxiety/depression, withdrawal/depression, and somatic symptoms - we found that higher LFPN-DMN connectivity for children below poverty was associated with higher withdrawal/depression symptoms, but fewer somatic symptoms, pointing to a dissociation in what pattern of brain connectivity is most adaptive for the development of internalizing symptoms vs. physical health. These somatic symptoms highlight potential maladaptive consequences of resilience for children growing up in unequal structural conditions.

This research has important implications for supporting children in poverty by illuminating mechanisms for, and potential maladaptive consequences of, their resilience in academic contexts.

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Anhedonia is a loss of pleasure and interest in activities and a core symptom of major depressive disorder (MDD). Diffusion tensor imaging studies show evidence for white matter (WM) alterations in the superior longitudinal fasciculus (SLF) of patients with MDD, already in the early stage of illness. SLF fibers extend from the parietal lobe to prefrontal regions that are important for attention, motivation, decision-making and reward processing.

The present study focuses on the relationship between WM-integrity and anhedonia in patients with MDD. We hypothesize that WM-alterations are present in the SLF of depressed patients with motivational anhedonia.

Thirty-nine patients with MDD and 19 healthy controls matched for age and gender underwent diffusion-weighted magnetic resonance imaging. Voxel-wise statistical analysis of fractional anisotropy (FA) data was performed using FSL-Tract-Based Spatial Statistics (TBSS) software. Whole brain voxel-wise comparison in local coherence (LCOR), a measurement of resting state fMRI connectivity strength between a given voxel and the neighbouring areas in the brain, were compared between patients and healthy controls. We used the sum value of item 1 and 7 of the Hamilton rating Scale for depression (HAM-D) and the CORE non-interactiveness value to assess motivational anhedonia.

TBSS-analyses revealed reduced FA in the left SLF of depressed patients and we found a correlation with motivational anhedonia and LCOR in temporo-parietal regions of depressed patients.

These findings suggest that WM-alterations in the SLF might be associated with motivational aspects of anhedonia and predict motivation of reward in MDD.

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Cloninger divides personality into temperament and character, proposing that temperament is innate and character is shaped by environment. With the development of noninvasive methods for measuring central nervous system activity, there have been many attempts to test personality theories using neuroscientific research methods. Thus, the use of neuroscience to examine existing theories of personality will enable a review of these theories and may lead to the formulation of new theories of personality.

The purpose of this study was to investigate the biological factors underlying temperament and personality development in healthy adults by analyzing neural networks in the brain using resting-state functional magnetic resonance imaging.

The study was conducted after obtaining prior approval from the Ethics Committee of Kanazawa Medical University. Eighty-one healthy subjects who consented to the study after explaining the purpose and methods were imaged with a 3T MRI scanner in the resting state, and statistical image analysis was performed using the CONN toolbox. Personality and temperament were assessed using the temperament personality test based on Cloninger’s 7-dimensional model of personality.

Five types of neural networks were extracted by independent component analysis, including Salience, Default mode, and Language. Regression analysis revealed a significant relationship between the functional connectivity of the networks and temperament/personality traits.

We were able to observe the functional connectivity of representative neural networks from the data of healthy subjects, suggesting that individual differences in the degree of functional connectivity of neural networks may be related to the individual characteristics of temperament and personality of the subjects.

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Psychiatry is often perceived “different” by other medical professionals as well as by the general population. This perception of “difference” may give rise to stigma toward both patients with psychiatric disorders and mental health professionals.

The aim of this study was to investigate the attitudes of non-psychiatric and their perception of psychiatry and mental disorders.

It was a cross-sectional, descriptive and analytical study, conducted among Tunisian undergraduate and graduate non-psychiatric physicians. Data were collected during September and October 2022, through an anonymous online questionnaire, spread throughout social media (Facebook), using the Google Forms® platform. We used the “Attitude toward Psychiatry-30” (ATP-30).

A total of 168 participants completed the questionnaire. Among them, 81 (48,2%) were undergraduate and 87 (51,8%) were graduate doctors. Their mean age was 26,4± 4.4 years, with a sex-ratio (F/M) of 3.4.

Among doctors, 79,2% had overall favorable attitudes toward psychiatry but only 38,2% among the undergraduate considered psychiatry as a potential career choice.

Psychiatry was considered as an unscientific and imprecise specialty by 20,3%; while 35,7% considered it as the least exciting.

The total score ATP-30 increased significantly with age (p= 0.023). It was significantly higher in those with psychiatric history (p=0.01).

Our study showed a dissonance between favorable perception of psychiatry and the choice of psychiatry as a potential career. Therefore, it is crucial to identify factors that potentially account for this dissonance and enhance enthusiasm among undergraduate doctors as the shortage of psychiatrists may influence mental healthcare.

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Worldwide efforts to standardize instruments measuring quality in psychiatric care are rare. The international project “Quality in Psychiatric Care” (QPC) is a large research programme aiming at adapting the versions of the QPC instrument for patients and staff to different international settings.

The aims were to test the psychometric properties and equivalence of dimensionality of the different language versions of QPC and also to describe and compare the quality of psychiatric out-patient, in-patient, forensic in-patient and psychiatric care across different countries.

The QPC is a family of instruments based on a definition of quality of psychiatric care from the patients perspective with adapted versions for staff. In this project, we used different language versions in three areas for patient and staff: psychiatric out-patient (QPC-OP/OPS), in-patient (QPC-IP/IPS), and forensic in-patient (QPC-FIP/FIPS).

Patients in out-patient psychiatric care in Brazil rated the quality of care higher than Swedish patients. Comparisons of forensic in-patient care (QPC-FIP/FIPS) patients were more critical of the care they received while staff were generally more positive on the quality of care provided in both Denmark and Sweden. Quality of in-patient care (QPC-IP/IPS) in Spain show staff rating lower quality of care than patients and lowest in the secure environment, which the Swedish staff rated low as well. In Indonesia the patients rated lower quality than staff and lowest in the discharge dimension, followed by the participation dimension. Generally, staff and patients were similar in their perceptions of the low quality of participation. Several studies in Turkey, Indonesia, Spain, Faroe Islands and Norway is ongoing.

The psychometric test and validations of the instrument QPC in different language and country versions will assist countries to compare quality of care, quality improvement and permits benchmarking. Since there are few standardized instruments for measuring quality of care in the psychiatric care, the QPC is expected to make an important contribution to the development in the field.

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