Childhood adversities have been associated with long-lasting brain morphological differences and poor psychological outcomes over the lifespan. Evidence with regard to protective factors counteracting the detrimental effect of childhood adversity on neurobiology is scarce.

Therefore, we examined the interplay of childhood adversity with multiple protective factors in relation to brain morphology in a child and an adult cohort.

We analyzed data from two epidemiological longitudinal birth cohorts, the Generation R Study (N=3,008) and the Mannheim Study of Children at Risk (MARS) (N=179). Cumulative exposure to 12 adverse events (such as physical and sexual abuse), and the presence of protective factors, including child temperament, cognition, self-esteem, friendship quality and maternal sensitivity were assessed at different time points during childhood. Anatomical scans were acquired at the ages of 9-11 years in Generation R and at 25 years in MARS.

Childhood adversity was related to smaller global brain volumes in Generation R, with similar effect sizes observed for the cerebellar volume in MARS. While small interaction effects between adversity and protective factors were found on the medial orbitofrontal cortex, the cerebellum and the amygdala in either cohort study, no interactions were consistent across cohorts or survived correction for multiple comparisons.

We found no consistent or strong evidence for interaction effects between multiple protective factors and childhood adversities on brain structure in a child and an adult cohort study. Instead, small interaction effects were found in either children or adults warranting further investigation and more fine-grained analyses.

TB:consultancy for Actelion, Hexal Pharma, Lilly, Lundbeck, Medice, Novartis, Shire; conference support by Lilly, Medice, Novartis, Shire; clinical trials by Shire and Viforpharma; royalties by Hogrefe, Kohlhammer, CIP Medien, Oxford University Press

Experimental data from both clinical and preclinical studies have unequivocally shown positive correlations between stress and depression, stress, depression and epigenetic changes.

The aim of this research is to analyze clinical trials on coping mechanisms and their interaction with epigenetic mechanisms in patients with mood disorders. Generally, we studied the interaction between these two mechanisms and its effects on the onset, recurrence and progression of these disorders.

109 articles were analyzed, of which 37 were considered relevant. 72 studies were excluded based on titles and abstracts. Regarding the coping mechanisms, 10 longitudinal and cross-sectional studies were selected. Longitudinal studies are defined here by a follow-up period longer than 6 months.

There is a consistent association in the literature between the degree of methylation of the NR3C1 gene, stress and affectivity disorders. The analyzed studies showed that methylation of the NR3C1 gene is associated with both stress and mood disorders. FKBP5 influences glucocorticoid receptor sensitivity and stress response. SLC6A4 gene methylation has been systematically associated with stress and affectivity disorders. Higher BDNF methylation has also been found in people who report high levels of stress at work. The data collected suggest that SKA2 methylation may serve as a biomarker for certain features of depression, such as suicidal ideation, and is not directly involved in the etiology of mood disorders.

The results suggest that environmental stress and adversity in early childhood may change biological systems through epigenetic mechanisms and have long-term consequences, increasing the risk for unfavorable prognosis of mood disorders.

No significant relationships.

Antenatal depression and antenatal anxiety adversely affect several obstetric and foetal outcomes, and increase the rate of postnatal mental illness. Thus, to tackle these challenges the need for social support during pregnancy is vital.

This study examined the association between domains of social support and antenatal depressive and anxiety symptoms among Australian women.

Our study used data obtained from the 1973–78 cohort of the Australian Longitudinal Study on Women’s Health (ALSWH), focusing upon women who reported being pregnant (n=493). Depression and anxiety were assessed using the Center for Epidemiological Studies Depression (CES-D-10) scale, and the 9-item Goldberg Anxiety and Depression scale (GADS) respectively. The 19 item-Medical Outcomes Study Social Support index (MOSS) was used to assess social support. A binary logistic regression model was used to examine the associations between domains of social support and antenatal depressive and anxiety symptoms.

After adjusting for potential confounders, our study found that the odds of antenatal depressive symptoms was about four and threefold higher among pregnant women who reported low emotional/informational support (AOR=4.75; 95% CI: 1.45, 15.66; p=0.010) and low social support (overall support) (AOR: 3.26, 95%CI: 1.05, 10.10, p=0.040) respectively compared with their counterpart. In addition, the odds of antenatal anxiety symptoms was seven times higher among pregnant women who reported low affectionate support/positive social interaction (AOR=7.43; 95%CI: 1.75, 31.55; p=0.006).

Low emotional support and low affectionate support have a significant association with antenatal depressive and anxiety symptoms respectively. As such, targeted screening of expectant women for social support is essential.

No significant relationships.

High amounts of Ultra-Processed Foods (UPF) characterized Western type diet and have recently been associated with adverse cardio-metabolic outcomes. The extent to which UPF intakes affect Depressive Symptoms (DepS) in non-Mediterranean countries remains uninvestigated.

We aimed to study whether long-term intake of UPF over adult life 1) is associated with subsequent recurrence of DepS assessed over 13 years of follow-up and 2) contribute to explain the diet quality-DepS associations already established.

Data came from the 4554 participants (mean age=61.0 (SD=5.9) years; 74% men) from the Whitehall II Study who underwent repeated dietary intake assessment (food frequency questionnaire in 1991-1993, 1997-1999 and 2002-2004), and follow-up for recurrence of DepS (CES-D ≥ 16 or use of antidepressants) over 13 years (2002-2004 and 2015-2016). The NOVA classification was used to estimate UPF intakes.

Over 13 years of follow-up, 12.9% of participants reported having recurrence of DepS. Results of logistic regression models adjusted for potential confounders showed that high amounts of UPF intakes (top quintile versus the four last ones) increased the odds of recurrent DepS by 30 % (95%CI 1.05 - 1.61). Additional analyses suggested that UPF intakes did not attenuate much the overall diet quality–DepS association previously reported.

Our study showed that long term exposure to high UPF intakes increased odds of subsequent recurrent DepS. This association was independent of overall diet quality. Further research is needed to understand the underlying mechanisms between food processing and depression physiopathology.

No significant relationships.

Mental illness stigma is the most significant obstacle impeding the wellbeing of individuals with such conditions. Thus, research on determinants of mental illness stigma may be of crucial importance in avoiding these attitudes. Affective temperaments are thought to be present in up to 20% of the healthy general population. However, there are very few studies addressing the relationship between temperament and mental health-related stigma.

Evaluate attitudes and behavioral responses of medical students towards individuals with a mental illness. Explore factors associated with stigma including temperament.

A cross-sectional study was conducted among students in medical universities.

All participants were invited to complete a brief anonymous electronic survey administered on the google forms online platform.

Data were collected using self-administered questionnaires, Stigma Measurement, Mental Illness: Clinicians’ Attitudes (MICA). Students were also asked to complete the TEMPS-A Scale.

The sample consisted of 1028 respondents (9.3% of the total population). Females represented 78,3% of the study sample. A dominant affective temperament was found in 17% of the cases under study, represented mainly by depressive and irritable temperaments. Bivariate correlations performed to assess the association between temperament and mental illness stigma revealed that a positive relationship was identified between the MICA scale and hyperthymic temperament( p=0,04). There were no significant associations between the other type of temperaments and The MICA scale.

Students’ temperament should be considered in developing anti-stigma programs in undergraduate education. Further researches should be undertaken to disentangle the complex relationship among demographic features, personality traits, and attitudes toward people with a mental illness.

No significant relationships.

The high technical barrier to entry in the field of neuroimaging can hinder early insight from promising results and the development of evidence-based clinical practice.

The working group focused on published literature in order to develop a new methodology in the analysis, visualization, and representation of fMRI data in the psychiatric setting.

Three valid and established measures were chosen, in order to achieve dimensionality reduction, stability and explainability of results, namely Regional-Homogeneity; fractional Amplitude of Low-Frequency Fluctuations; Eigenvector-Centrality. Each measure was color coded and individual images per subject compiled, averaging results by functional networks as described the FIND lab of the University of Stanford. 272 individual scans were processed (130 neurotypicals, 50 patients with Schizophrenia, 49 with Bipolar Disorder, 43 with ADHD).

The discriminative power between clinical groups of the novel method was significant both by human eye, and later confirmation by statistical tests, and by computer vision algorithms (Convolutional Neural Networks). The precision-recall Area Under the Curve, dividing by 80/20 proportion between train and test sets, was >84.5% for each group. The group of patients with Bipolar Disorder showed a partial overlap with the group of patients suffering from Schizophrenia – by a dominance of Eigenvector-Centrality and Regional-Homogeneity, as well as a lower prevalence of fractional Amplitude of Low-Frequency Fluctuations, for both in comparison to controls.

The present study offers preliminary evidence for the adoption of i-ECO (integrated-Explainability through Color Coding) in fMRI analyses during rest in the Psychiatric field.

No significant relationships.

White matter abnormalities have been identified in major depressive disorder (MDD). Although several diffusion tensor imaging studies found decreased fractional anisotropy (FA) in MDD, the effect of antidepressants (AD) treatment on white matter integrity has been insufficiently studied.

We sought to examine the effect of AD treatment of MDD on white matter, using DTI, in responders compared to nonresponders.

We included 25 individuals with MDD (HAMD >/=20) without inflammatory, unstable medical/neurological conditions or prolonged duration (> 1 year),or AD or anti-inflammatory treatment >/=1 week preceding first evaluation. Evaluation before treatment and at 16 weeks included depression rating scales, a cognitive battery, inflammatory markers and MRI. Desvenlafaxine was initiated at 50mg with a possible increase to 100mg at 8 weeks.

Changes included: increased volume in responders in the right Inferior Fronto-Occipital fasciculus (p=0.0315) and Superior Longitudinal Fasciculus part 3 (p=0.0050); in remitters in the right Inferior Fronto-Occipital fasciculus (p=0.0359) and Superior Longitudinal Fasciculus part 2 (p<0.05) and 3 (p=0.0481); decreased volume in responders in the left Superior Longitudinal Fasciculus part 1 (p=0.0147) and left Corona Radiata(p<0.05); and in remitters in the left Superior Longitudinal Fasciculus part 1 (p=0.0109) and the Corpus Callosum part 5 (p<0.05); decreased FA in the right Cortico Spinal Tract in remitters (p=0.0175) and responders (p=0.0272), and an increase in FA in the left Uncinate Fasciculus in nonremitters (p=0.0493). These results lose significance following Bonferroni correction.

Overall, AD treatment of MDD was not associated with significant changes in FA, whole brain, or specific tract volume in this study.

This research was funded by Pfizer Canada.

Clinical case about a 62 year old patient, diagnosed with mixed anxiety-depressive disorder. In current treatment with Paroxetine, Clorazepate and Trazodone. She presents low spirits secondary to a neurological process (stroke + amyloid angiopathy+ epilepsy+ cognitive impairment) and difficulties in performing daily activities. Her daughter reports that she is totally dependent, she spends the whole day in bed. On examination we observe a dull mood, without emotional reactivity. Lack of motivation. Psychomotor slowness.Significant cognitive impairment with difficulties in performing daily activities. Mnesic faults.

Clinical case shows radiological and cognitive improvement with vortioxetine

Last diagnoses: August 2020: HSA OF THE FRONTAL AND PARIETAL GROOVES RIGHTS September 2020:SYMPTOMATIC FOCAL EPILEPSY SECONDARY TO LEFT FRONTOPARIETAL INTRAPARENCHIMATOSUS HEMATOMA December 2020:MYELOID ANGIOPATIA February 2021:SUBARACHNOID HEMORRHAGE March 2021:DEPRESSIVE DISORDER SECONDARY TO MEDICAL ILLNESS - MODERATE COGNITIVE IMPAIRMENT

Spectacular improvement in mood and cognitive deficit. The family reports that after 5 days they noticed the change. They find her more lively, she has returned to doing housework and is autonomous for day-to-day life. She has regained her memory and performed calculation exercises on a daily. The patient says that she has returned to being her usual self, “before I felt like a mummy and now I have finally woken up, it seems like a miracle”.

It has improved much with change of antidepressant, from paroxetine to vortioxetine in patient who show in cranial MRI: New-onset lesion in the right frontal lobe attributable and subarachnoid hemorrhage located in convex furrows ,radiological findings in favor of amyloid angiopathy

No significant relationships.

Depression is characterized by a pattern of specific changes in the network organization of brain functioning.

We researched a graph structure specificity in a depressive student sample by analyzing resting-state EEG. All possible combinations of graph metrics, frequency bands, and sensors/sources levels of networks were examined.

We recorded resting-state EEG in fourteen participants with high Beck Depression Inventory score (24.4 ± 9.7; 20.4 ± 1.5 y.o.; 14 females; 1 left-handed) and fourteen participants with a low score (6.8 ± 3.7; 21.3 ± 2.0 y.o.; 8 females; 1 left-handed). We applied weighted phase-lag index (wPLI) to construct functional networks at sensors and sources levels and computed characteristic path length (CPL), clustering coefficient (CC), index of modularity (Q), small-world index (SWI) in 4-8, 8-13, 13-30, and 4-30 Hz frequency bands. We used Mann-Whitney U-test (p < 0.05) to investigate between-group differences in the graph metrics.

The depressive sample was characterized by increased CC and Q in the 4-30 Hz band networks and decreased CPL in the beta-band network (sensors-level for CPL and CC, and sources-level for Q).

Elevated CC and Q may relate to an increase of intramodular connectivity, and CPL reduction reflects the global connectivity increasing. We hypothesize that intramodular hyperconnectivity could explain the rise of global functional connectivity in participants with depressive symptoms. Funding: This research has been supported by the Interdisciplinary Scientific and Educational School of Lomonosov Moscow State University ‘Brain, Cognitive Systems, Artificial Intelligence’.

No significant relationships.

Schizotypy is associated with increased vulnerability to schizophrenia spectrum disorders. Therefore, investigation of its brain correlates seems prominent for better understanding of schizophrenia-spectrum continuum as well as for development of biological treatments for schizotypal personality disorder. Functional alterations of prefrontal cortex (PFC) and their associations with clinical symptoms are well-known to exist in schizophrenia. However, their relevance to schizotypy remains unclear.

The aim of the study was to check for associations between schizotypal traits in a non-clinical sample and whole-brain functional connectivity (FC) of lateral as well as medial PFC (lPFC and mPFC, respectively).

Eighty-two healthy individuals (52 females, mean age 24.8±5.48) filled out the Schizotypal Personality Questionnaire (SPQ-74) and underwent resting-state fMRI (3T). Seeds in lPFC and mPFC were taken from frontoparietal and default mode networks (atlas by Yeo et al., 2011). We analyzed correlations between four schizotypal factors (cognitive/perceptual, paranoid, negative, and disorganization; Stefanis et al., 2004) and whole-brain FC of the seeds (statistical threshold: p<.001 voxelwise; p[FDR]<.05 clusterwise).

Cognitive/perceptual factor (‘Odd beliefs/magical thinking’ and ‘Unusual perceptual experiences’ SPQ-74 subscales) is negatively correlated to FC of bilateral mPFC with a cluster in the right cerebellum (Crus 1, 2).

Prefrontal-cerebellar dysconnectivity may be one of the neurobiological factors underlying positive-symptoms-like schizotypal traits in non-clinical subjects. To some extent, it coincides with the data on associations between functional features of these brain structures and positive symptoms in schizophrenia (Pinheiro et al., 2021; Goghari et al., 2010).

The study was supported by RFBR Grant 20-013-00748.

Brain lesions may induce psychiatric symptoms in some cases. Imaging tests are important to make a differential diagnosis, and therefore initiate an appropriate treatment.

Presentation of a clinical case about a patient with psychiatric symptoms who presented an organic lesion.

Bibliographic review including the latest articles in Pubmed about psychiatric symptoms induced by organic lesions.

We present a 51-year-old male patient, with adequate previous functionality, who attended psychiatric consultations due to changes in his character, with delusional mystical and megalomaniac ideation, verbiage, hypoprosexia, memory loss and insomnia (diagnosed with Bipolar Disorder type II, hypomanic episode). Eventually, a brain computed tomography scan was performed, in which meningioma was visualized. The patient underwent surgery, and he asked to keep a sample of his tumor to always carry it with him on a pendant. Psychiatric symptoms induced by organic lesions are highly variable, depending on the location and size of the lesion, and they may be the first and/or only symptom of a meningioma (up to 21% according to various studies), so it is important to perform imaging tests in some cases. At this time, the patient is under follow-up, he has remained euthymic and stable, and he refuses to take psychopharmacological medication.

Psychiatric symptoms may be the first and/or only manifestation of an organic lesion in some cases. Neuroimaging tests (CT and MR) may be useful in the differential diagnosis. It is important to carry out an indiviualized treatment based on the patient’s pathology, which may include surgery and/or drugs.

No significant relationships.

Uterine cancer is the most common gynecologic malignant neoplasm in developed countries. While depression is up to 3-5 times more common in patients with cancer than in the general population, literature is still limited regarding the relation between Endometrial Cancer and depression.

To analyze Depression among Endometrial Cancer hospitalizations in mainland Portuguese public hospitals (2008-2015).

A retrospective observational study was conducted using administrative data from all hospitalizations in Portuguese mainland public hospitals between 2008-2015. All women’s hospitalizations(≥18 years) with a primary diagnosis of Endometrial Cancer (ICD-9-CM 182.x) were selected. Secondary diagnosis of depression was identified with ICD-9-CM 296.2x, 296.3x and 311x codes. Surgical procedures codes 68.4x, 65.6x, 40.3x, 40.5x, 68.6x, 68.9x and 68.8x were used to divide the hospitalizations into surgical vs non-surgical. Groups were compared with Pearson Chi-square test and crude odds ratio(OR) was used to estimate the association between surgery and depression.

From 10227 hospitalizations with a primary diagnosis of Endometrial Cancer, 533 had a registry of depression(5.2%). Annual depression frequency rose from 2.0% (2008) to 8.3% (2015). Among patients with a record of depression, 73.2% had surgery. Women who had surgery were significantly more likely to have registered depression (p<0.001). The OR for depression in surgical vs non-surgical patients was 1.73 (95%IC:1.42-2.10).

Patients hospitalized due to Endometrial Cancer and submitted to surgery had almost two-fold more risk of having a registry of depression. This trend reinforces the importance of early depression screening of these patients, enabling the implementation of timely therapeutic strategies before and after surgery.

No significant relationships.

individual attitudes and structural inadequacies act as major barriers towards non-utilization of cancer screening and treatment offers in many high-income countries with subsidized public healthcare.

Our interdisciplinary research group at Heidelberg University is studying the underlying individual perceptions, attitudes and experiences of age- and gender-specific barriers against cancer-related medical and psychosocial offers available in Germany.

We designed a mixed-methods, sequential explanatory study using two quantitative instruments to determine the most important age- and gender-specific barriers for non-patients and cancer patients and survivors. In the second phase, semi-structured interviews will be conducted via selective sampling to record participant opinions, experiences and expectations of using cancer-related health services.

We expect to identify and explain important personal barriers and facilitators related to the use of cancer screening and treatment offers. Further interviews with stakeholders in cancer healthcare, such as physicians, nurses and self-help groups will be conducted to complement data from the service-providers’ point of view. The results will be analyzed with behavioral and sociocultural theories to gain a deeper understanding of perceived and experienced barriers in accessing cancer care in Germany and to formulate recommendations for prospective targeted approaches and interventions.

Our findings will be useful for facilitating knowledge transfer and policy dissemination to increase public awareness about cancer offers and improve participation rates. The results will be also used to develop an interprofessional teaching module in the medical curriculum as well as prepare and implement advanced training courses for medical professionals certified by the State Medical Association.

This study is funded by Strube Stiftung Stuttgart.

The cerebellum is often overlooked when evaluating neuropsychiatric disorders. Lately, evidence has increased for the existence of cerebellar connections -generally in relation to vermis and posterior lobe- with cortical areas related to pathophysiology of psychiatric disorders. The cerebellar affective cognitive syndrome, also known as Schmahmann syndrome, has even been described with an evaluation scale.

Case report of a patient suffering a manic episode in context of single right cerebellar metastasis derived from ovarian tumor.

A non-systematic literature review was conducted on PubMed database on cerebellum pathology related to psychiatrics disorders. The clinical case report was prepared through the review of the patient´s clinical record.

The authors introduce the case of a 50-year-old woman, diagnosed with high-grade serous ovarian tumor, with single right cerebellar metastasis of 42mm, who was admitted to oncology due to behavioral alteration, with no prior psychiatric history. The patient showed hyperthymic mood, with speech scanned but fluid, manifesting intense well-being and ideation of mystical-religious and megalomaniac content. Haloperidol up to 7.5mg/8 hours and clonazepam 2 mg/8 hours were prescribed, switching haloperidol to olanzapine up to 25mg/day after several days, since the symptoms did not improve. Valproic acid 500 mg/24 hours was also added. Progressive improvement was seen, without worsening of motor symptoms or instability. The CCAS scale (Cerebellar Cognitive Affective/Schmahmann syndrome) was performed, with a positive result (10/10) being> 3 definitive CCAS.

The relationship between cerebellum and neuropsychiatric disorders is still partly unknown, requiring more research to be able to carry out specific diagnoses and treatments for patients.

No significant relationships.

Refugees are forced migrants but there is a large variation in the distance that refugees cover and there is a knowledge gap on how this may affect refugees’ health and health care needs.

Herein, we investigate the association between long-distance migration and post-traumatic stress disorder (PTSD), a serious psychiatric disorder associated with deteriorating mental and somatic health and highly prevalent in refugees.

Included were 712 adult Syrian refugees and asylum seekers in Lebanon and Denmark arriving no more than 12 months prior to inclusion. The Harvard Trauma Questionnaire was used to assess PTSD and the estimate of association was obtained by multiply imputing missing data and adjusting for confounding by propensity score-weighting with covariates age, sex, socioeconomic status, trauma experience, and WHO-5-score, reporting the bootstrap 95-percentile confidence interval (95% CI). Additionally, a number of sensitivity analysis were carried out.

The prevalence of PTSD was high in both Lebanon (55%) and Denmark (60%) and long-distance migration was associated with a 9 percentage point (95% CI [-1; 19]) increase in the prevalence of PTSD among newly arrived Syrian refugees and asylum-seekers.

In the present study the prevalence of PTSD increased after long-distance migration which may support considering “long-distance migration” in refugee health screenings and in particular when assessing the risk of post-traumatic stress disorder. This is a first step in examining the health effects of migration on refugee health.

No significant relationships.

Emigration is the act of leaving one’s country of nationality or habitual residence to settle in another nation. In Tunisia, this phenomenon is increasing in particular for doctors.

Evaluating the intentionality of emigration among interns and medical residents in Tunisia while studying the factors related to it.

We conducted a cross-sectional, descriptive and analytical study of interns and medical residents who participated in our study through the social network ’Facebook’ by an anonymous self-questionnaire. The level of satisfaction with the different aspects of life were assessed by a 5-point Likert scale, from “not at all satisfied” to “very satisfied”.

The total number of participants was 56 of which 64.3% were medical residents. More than 50% of the participants expressed dissatisfaction with the distribution of tasks and organization of work (66.1%), safety at work (53.6%), comfort (57.2%), time allocated to personal life (53.6%) and salary (69.6%). The political, health and educational situation in the country was considered unsatisfactory by the majority of participants (90% to 95%). Among our participants, 44.6% regretted having chosen the profession of medicine and 53.6% had plans to immigrate to work abroad. The intentionality of immigration was significantly higher among men (p=0.02), those with siblings abroad (p=0.047) and those without dependent relatives (p=0.040).

Young physicians are strongly looking for emigration. This decision could emanate from professional, personal and political factors. Further studies seem to be necessary to explain this emigration phenomenon.

No significant relationships.

Migrations are a source of stress for patients, which can have repercussions on their Mental Health. We present the case of a native Senegalese patient who presented a first psychotic episode.

Presentation of a clinical case of an immigrant patient with a psychotic disorder.

Bibliographic review on migration and psychosis by searching for articles in Pubmed.

We present the case of a patient of 20 years, a native of Senegal, who has been living in Spain for 3 months in a shelter home. He has no family or relations in Spain, and only speaks Wolof, presenting serious difficulties in communication with healthcare workers. He came to Hospital with his social worker because strange behaviors had been observed. He presented delusional ideation of self-referential and mystical-religious content, related to “the prophet” and “the need to fulfill a mission”. He also presented auditory hallucinations that he identified as of divine origin, and ordered him to perform behaviors such as picking hairs from the ground and various rituals. He acknowledges cannabis and alcohol use in the previous days. Paliperidone treatment was started. Throughout the admission, he begins to show concern for the state of his relatives in Senegal and the need to send them money.

Multiple studies indicate that migrants are at higher risk of psychosis, specially those from countries where the majority of population was black, according to some series. The challenge lies in understanding the mechanisms underlying this increased incidence, taking into account psychosocial factors such as social isolation and trauma.

No significant relationships.

Clozapine, the first atypical antipsychotic, is a highly effective medication for patients with treatment-resistant schizophrenia. Robust evidence describes important risk for psychosis in immigrant population(2). Despite this, some studies suggest that immigrant patients are less treated and misdiagnosed due to cultural barriers(3,4). Clozapine and Electroconvulsive therapy tend to be less prescribed in immigrants(3). However, few studies assess differences in clozapine prescription between immigrants and non-immigrant psychotic inpatients.

To describe and compare clozapine prescription between psychotic patients and non-psychotic patients in a sample of Acute and Chronic inpatients.

Patients who have presented, according to DSM-V criteria, one or more non-affective psychotic episodes, were recruited in Acute and Chronic inpatients units leading to a total sample of 198 patients. Immigrant condition was defined as “a person who comes to live permanently in a foreign country”. Demographic characteristics of patients, clinical data and main pharmacological treatment were recorded through a questionnaire. Comparative analysis was performed with IBM SPSS Statistics using Chi-Square Test and t-Student test.

From a total of 198patients clozapine was prescribed to 31(15,7%). From the total immigrant sample only 7,1% had prescribed clozapine compared to 24,2% from the locals(p<0.005). Significant differences in diagnosis associated to clozapine were found between both groups : Schizophrenia(57,1%immigrants, 57,1%locals), Schizoaffective disorder(14,3%immigrants, 41,7%locals) and Non specific psychosis (28,3%immigrants, 8,3%locals).

According to our results, immigrant psychotic inpatients receive less clozapine prescription compared to non-immigrant psychotic patients. There results should be considered to study barriers for clozapine prescription in this population and offer a treatment based in equality.

No significant relationships.

Despite a significant number of studies devoted to the relationship between depression and religiosity, the diagnosis of depression in religious patients is complicated due to the insufficiently studied psychopathology and the peculiarities of the patient’s experiences.

To determine the specific features of psychopathology and phenomenology of depression, masked by a “religious facade”, for timely diagnostics and prevention of suicidal behavior.

One hundred and fifteen religious (orthodox) inpatients (41 male, 74 female) with depression (F31.3, F31.4, F 32.1., F 32.2, F 33.1, F 33.2 according to ICD-10) were examined. Psychopathological method, HAM-D, SIDAS and statistical analysis were applied.

Five types of depression were specified, which differed in psychopathological structure and content of the religious experiences. Overvalued ideas of guilt and sinfulness were predominant in melancholic depressions, ideas of God-forsakenness and the loss of “living” faith - in apathetic. Depressions with overvalued doubts whether the right faith and confession has been chosen accompanied with anxiety, melancholy and apathy. It should be specially mentioned apathetic and melancholic depressions characterized by “spiritual hypochondria” with specific cenesto-hypochondrical symptomatology. Melancholic depressions characterized by high suicidal risk prevailed (65%) over the other depressions.

Depressions masked by a “religious facade” often are not recognized due to specifical content, which results in lack of timely diagnostics and creates a high risk of suicidal behavior.

No significant relationships.

Alexithymia is considered a personality trait characterized by difficulties in identifying and expressing emotions, impoverished fantasy life and tendency toward action-oriented or ‘operational’ Thinking. There are alterations in cognitive processing and regulation of emotions, and tendency to somatization.

The authors examine literature regarding the concept of alexithymia, exploring the current definition and role in the clinic, research findings and proposed management.

A brief non-systematized review is presented, using the literature available on PubMed and Google Scholar.

Alexithymia is not a discrete psychiatric diagnosis. It has been reported in 9-10% of the general population. It is related to numerous psychiatric disorders (substance use disorders, anxiety disorders, depression and eating disorders), but also to somatic illnesses (essential hypertension, functional gastrointestinal disorders, diabetes mellitus, psoriasis, fibromyalgia and cancer pain). Neuroimaging and neurobiological studies found evidence for morphological and functional brain alterations that integrate the classification introduced by Bermond. Affective type I is characterized by the absence of emotional experience and, consequently, by the absence of cognition accompanying the emotion (associated to right unilateral cortical lesions). Cognitive Type II is characterized by a selective deficit of emotional cognition with sparing of emotional experience (associated to a right-to-left unidirectional deficit in interhemispheric transfer).

There is little consensus on the subject. Clarification of the mechanisms underlying alexithymia can improve our management of these individuals. Identification of effective strategies could improve the patients’ capacities for adaptive emotional processing and enhance other aspects of functioning.

No significant relationships.