Immigrants encounter difficulties in adapting to social life due to cultural and socioeconomic differences which consequently causes psychological and physical problems. Previous studies demonstrated that diabetes, high blood pressure, dyslipidemia and obesity are associated with psychological disorders.

This study aimed to investigate the frequency of depression and anxiety and to observe associated sociodemographic among endocrine patients treated at NPZR.

190 Turkish psychiatric patients with at least one endocrine disorder (45.3% were male (n=86) and 54.7% were female (n=104) between the ages of 30-65, who participated in group therapy session at the NPZR, were recruited. Demographics, prevalence of depression and anxiety as well as current psychological conditions of participants were analyzed through Beck Depression Inventory, Hamilton Anxiety Scale, SCL-90-R and Personal Information Form.

The findings of our study demonstrated that prevalence of depression, anxiety and sleep disorders among Turkish immigrant patients with endocrine diseases is high. The mean scores of depression and anxiety were 31.39 and 32.61 respectively. The most common endocrine diseases were hypertension (51.6 %) and obesity (49.6%). Analysis of our research showed that there was no significant gender differences in the anxiety and depression scores. However, there was a significant relationship between income of participants and prevalence of anxiety, depression (p<0.05).

The results of this research suggest that anxiety and depression disorders are highly prevalent among Turkish psychiatric patients with endocrine diseases Using the data of this study, the frequency of endocrine diseases among immigrant psychiatric patients can be analyzed.

No significant relationships.

Despite the growing number of studies focusing on the relationship between appearance evaluation and personality dimension, few is known regarding the role of depressive personality and malignant self-regard regarding this topic. Moreover, there is a lack of studies investigating the potential role of both clarity of self-concept and interpersonal exclusion feelings in this relationship.

To extend the knowledge regarding the relationships between malignant self-regard, depressive personality and appearance evaluation.

We administered to a very large sample of adults a battery of self-report questionnaires including the subscale Appearance evaluation of the Multidimensional Body-Self Relations Questionnaire, the Self Concept Clarity Scale, the Malignant self-regard questionnaire, the Depressive Personality Inventory and the Core Exclusion Schema Questionnaire.

We found that depressive personality negatively predicted positive appearance evaluation whereas the inverse pattern of results was obtained in relation to malignant self-regard. Moreover, we found that both poor self-concept clarity and feelings of exclusion mediate the relationship between malignant self-regard and positive appearance evaluation.

Depressive personality and Malignant self-regard appear to be promising construct to investigate in the field of eating disorders.

No significant relationships.

TRD is a highly disabling condition, often responsible for chronic clinical course, high number of relapses and elevated suicide risk. Intranasal esketamine is currently the only available pharmacological therapy specifically indicated for TRD, as add-on therapy to antidepressant treatment with SSRI or SNRI.

The purpose of the study was to evaluate the safety and efficacy of intranasal esketamine associated with CBT in a complex clinical case of TRD, over a six-month follow-up.

A 67-year-old patient with TRD was selected for treatment with intranasal esketamine+CBT as add-on to antidepressant therapy. Before each treatment session the HAM-D rating scale was administered. The patient underwent weekly CBT sessions throughout the 6 months follow-up. The effect on physical well-being and social functioning was evaluated by means of Short-Form-Health-Survey-36.

After the first two administrations of intranasal esketamine the total score on HAM-D decreased by 10 units (from 26 to 16). After 6 weeks of treatment decreased from 26 to 12 with the disappearance of suicidal ideation present at T0. After 6 months the total HAM-D score decreased from 26 to 8. Treatment was well tolerated, with mild adverse effects, confined to the first two hours post-administration. In particular, mild sedation, dizziness, slight transient blood pressure rise were reported, never required medical intervention and resolved spontaneously during the observation period.

Intranasal esketamine add-on therapy + CBT was an effective and safe treatment allowing to achieve and maintain symptomatic remission in a complex case of TRD, improving quality of life, social functioning, and reducing suicidal ideation over a six-month follow-up.

No significant relationships.

In Denmark, about 14% of patients with depression develops treatment resistant depression (TRD) in the following year after the first hospital contact. Possible explanations for TRD include lack of adequate clinical effect of pharmacological treatment and reluctance to treatment due to unacceptable side effects. Cold water swimming (CWS), also known as winter swimming, describes swimming outdoors - mainly during the winter season in cold to ice-cold water on a regular basis. Many winter swimmers believe that exposure to cold water is beneficial for their health. However, evidence of health effects have been anecdotal or based on results from small sample-size studies. The availably studies report that winter swimming abolishes general tiredness, boosts self-esteem and improves mood and/or general well-being.

To test if it is possible for patients with depression to participate in two weekly sessions of CWS and to measure the effects of CWS on general well-being and depression among the participating patients.

All psychiatric in- and outpatients from the department of psychiatry at Little Belt Hospital, Vejle with a diagnose of depression are eligible for inclusion. CWS-sessions will include a dip in an inlet - and if desired a short swim for a few minutes – depending on individual preferences. The CWS sessions will take place at the local inlet at a recreational area with sauna and changing facilities available.

The study starts in October 2021 and we expect to have results by April 2022.

Conclusion: Awaiting.

No significant relationships.

The study of attitudes towards death in patients of different nosological groups is an urgent task for modern science. It becomes especially relevant when working with adolescents with severe depressive disorder: for many of them, thoughts about death in various forms become the main reason for contacting specialists and the most subjectively painful symptom.

Revealing the characteristics of attitudes towards death in adolescents with severe depressive disorder.

The study involved 135 adolescents (12-17 years old) with depressive disorder, hospitalized in a psychiatric hospital. Participants completed the following methods: Hamilton Rating Scale for Depression, Columbia Suicide Severity Rating Scale, Death Attitude Profile-Revised, Fear of Personal Death Scale, Death Anxiety Scale.

The severity of depressive symptoms is significantly associated with the “death-as-flight” scale (r = 0.639, p = 0.000). The values on the “fear of death” scale are positively associated with the indicators on the scales “death anxiety” (r = 0.432 p = 0.025), “consequences of death for the individual” (r = 0.658, p = 0.000), “transcendental consequences of death” (r = 0.711, p = 0.000), “the consequences of my death for loved ones” (r = 0.496, p = 0.008). Indicators on the “active death search” scale are negatively associated with indicators on the “neutral acceptance of death” scale (r = -0.503, p = 0.007) and positively with the “fear of oblivion” scale (r = 0.432, p = 0.024).

The attitude towards death in adolescents with depressive disorder has a pronounced specificity, which can become one of the targets of psychotherapeutic work.

No significant relationships.

Cardiovascular events (CVE) are infrequent adverse effects in patients receiving electroconvulsive therapy (ECT). Nonetheless, it constitutes a threat for patient’s life and may compromise continuing ECT.

To describe a case of acute-onset atrial fibrillation under combined therapy with ECT and venlafaxine.

We present a 76-year-old man diagnosed of delusional disorder and without any previous CVE, who was hospitalized in our acute psychiatric unit by major depressive episode with psychotic symptoms resistant to pharmacological treatment (valproic-acid 100mg/d, haloperidol 6mg/d, venlafaxine 300mg/d). ECT was initiated presenting atrial fibrillation after first session of ECT, requiring amiodarone and anticoagulant treatment for stabilization. Second session of ECT was delayed for three-weeks, worsening the psychiatric symptoms. Haloperidol was discontinued initiating lurasidone with better cardiovascular profile.

CVE occur in 2% of the patients receiving ECT, being acute arrhythmia the most frequent one. Among them, few cases of atrial fibrillation (AF) under ECT have been reported. It has been hypothesised that initial vagal response followed by catecholamine surge secondary to ECT could facilitate the development of AF. In addition venlafaxine, an antidepressant drug, may also predispose to arrhythmia in high-risk individuals. High doses of venlafaxine (>300mg/d) combined with ECT have been related with an increment of CVE.

Although clinically effective for the treatment of major depression disorder, combined therapy of ECT and venlafaxine could precipitate the start of a CVE in genetically susceptible individuals. Therefore, identify and clarify potential risk factors other than previous history of CVE is critical to reduce morbidity and mortality in these patients.

No significant relationships.

In 2018 Missouri University Psychiatric Center, an inpatient psychiatric hospital established a ketamine infusion team to treat severely depressed and acutely suicidal clients. Over 80 infusions were delivered over three years, with positive outcomes and minimal side effects.

To evaluate outcomes of an inpatient psychiatric intravenous ketamine team to deliver treatment without anesthisia colloabration, which could open the horizon for future intravenous medications in a psychiatric inpatient setting.

A team consisting of a psychiatrist supported by a psychiatric PA, psychiatric pharmacist, and a mental health nurse devloped a protocol including physical and mental health screening, inclusion/exclusion criteria, dosing, and client monitoring. For data collection, the team monitored vital signs and mental status changes for tolerability and depression screening tools for efficacy.

Table 1:

Ketamine Infusion Data

Overall, ketamine infusions were tolerated well with limited adverse drugs reactions reported or observed and were easily addressed by the team without any serious adverse events. Given the rapid improvement of symptoms and overall tolerability, intravenous ketamine infusions conducted solely by a psychiatric-based team advances our field for further treament modalities.

No significant relationships.

Major depressive disorder is present in approximately 7% of the general population. There are some patients that remain treatment-resistant - patients who were treated with two or more different medications and did not demonstrate any improvement in their mental state. These patients can be treated with a new treatment – Esketamine. The recommended Esketamine treatment protocol includes 8-treatment sessions, each session lasts about two hours. In our clinic, we added a therapy group after each treatment. The therapy group is led by two co-therapist and lasts 30 minutes. The patients are invited to share their experiences from the session, their thoughts and emotions.

The study that we will present was conducted in the Esketamine treatment unit at a psychiatric hospital. There were two groups - 1. A group whose treatment included a therapeutic group at the end of each Esketamine treatment (n=30); 2. A group whose treatments did not include a therapeutic group at the end of the Esketamine treatment (n=30).

The current study examines the role of the therapeutic group. It compares between the standard treatment protocol, with and without a therapeutic group. All participants completed three questionnaires, about their emotions, three times during the treatment (before the first session, after 4 sessions and after 8 sessions).

We will present first results as well as vignette to demonstrate.

The expectation is to find a better patient experience and a better insight about the clinical changes following the Esketamine treatment, in the group which participates in the therapy group

No significant relationships.

Depression is known to be associated with changes in the hypothalamic-pituitary-thyroid axis and the brain is a major target organ for thyroid hormone. Overt hypothyroidism can cause symptoms compatible with depression. However, its relationship with subclinical hypothyroidism (SCH) is not well established.

To review the literature regarding the effect of levothyroxine therapy among patients with SCH and coexistent depression.

We conducted a MEDLINE search using depression, subclinical hypothyroidism and levothyroxine as keywords, selecting studies written in English.

SCH is defined as an elevated thyroid stimulating hormone with normal peripheric hormone levels. The association between SCH and depression is controversial. Some studies indicate that SCH had the same propensity with overt hypothyroidism, while others report that major affective symptoms are not associated with SCH, but are likely due to independent psychiatric diagnoses, which are common in the general population and occur with similar frequency in patients with SCH. Individuals with SCH are recommended to initiate levothyroxine replacement therapy only when their TSH level is above 10 mIU/L or if symptoms are present. There is a lack of evidence supporting the use of levothyroxine therapy to improve mental health outcomes and the majority of meta-analysis do not show relief of affective symptoms after levothyroxine therapy, among individuals with SCH.

Routine screening for depressive symptoms among individuals with SCH is important to prevent morbidity. Nevertheless, there is no evidence enduring levothyroxine supplementation in these cases. Further studies, with larger sample sizes and longer follow-up periods are needed to enlighten the potential benefit of this therapy.

No significant relationships.

Postpartum depression (PPD) is an important cause of discomfort and dysfunction that impair the quality of life and the daily functionality not only of the patient but also of her child and her family, in its entirety. New treatment options have been made available for this pathology, but their use is restricted by methodological aspects, like the difficulty of administration, lack of enough data regarding their long-term efficacy, and costs.

To conduct a literature review in order to find the most evidence-based pharmacological interventions for PPD.

A literature review was performed through the main electronic databases (PubMed, CINAHL, SCOPUS, EMBASE) using the search paradigm “postpartum depression” AND “treatment” OR “pharmacological agents”. All papers published between January 2000 and August 2021 were included.

Among the most evidence-based agents for PPD treatment are serotonin selective reuptake inhibitors (SSRIs). As individual agents, sertraline seems to be the most supported antidepressant by evidence from clinical trials, followed by escitalopram/citalopram, and fluoxetine. Other antidepressants supported by clinical data were venlafaxine, desvenlafaxine, nortriptyline, and bupropion. A 6-12 months maintenance treatment is considered optimal after remission, in women with a low risk of recurrence. Brexanolone, zuranolone, and ganaxolone are members of a new class of drugs studied for postpartum depression, but currently, only the first agent is FDA-approved for this indication.

SSRIs are the most supported by evidence treatments for PPD, and brexanolone is a drug with a new mechanism, dedicated to this pathology that provides new hope for recovery.

No significant relationships.

Postpartum depression is a common psychiatric complication after pregnancy, so it is necessary to know the depressive symptoms to be able to carry out early prevention and treatment interventions. It is a health problem with a prevalence that ranges between 10–15% according to the world literature. Behavioral and psychosocial factors favoring postpartum depression are recognized.

-To emphasize multidisciplinary treatment in the combined attention to the mother-baby. -To demostrate decreased risk for baby if early use of antidepressants. -To evaluate of the impact of desvenlafaxine during breastfeeding.

Descriptive-study. Clinical Case. Evolution of postpartum depression. Follow-up of a patient based on coordination with the midwife attending a successful breastfeeding while treatment with desvenlafaxine. Use of Edinburgh Postnatal Depression Scale.

-Use of Desvenlafaxine 50-100mg being compatible with breastfeeding, in adittion to depressive illness improvement *Obstetrics and psychiatry guidelines and safety considerations for lactation and antidepressants).

-Postpartum-depression could be the first episode of depression in a healthy woman. Sometimes there are unnoticed symptoms during pregnancy. -Health-care for puerperal women should be focused on both, biomedical and psychosocial issues, with a coordinated multidisciplinar team. -Due to important early treatment during the puerperium, it is recommended a close medical control of the mother´s psychological state after the birth. -If depression appears, a psychiatric follow-up is kept even after the episode remission. Besides, the role of the midwife is essential during lactation. -Some antidepressants like desvenlafaxine have demonstrated benefits over the risk of the baby´s complications without treatment.

No significant relationships.

Depression is one of the leading causes of psychiatric disability across the globe because of its high prevalence and chronic, treatment resistant and recurrent nature. Erythropoietin (EPO), well known for its effects on blood cells, has also a key role in neuroprotection and cognitive function.

The authors aim to explore the potential of EPO to treat depressive disorders (DD) and related cognitive dysfunction.

A literature research was conducted on PubMed starting from the MeSH terms: “Erythropoietin” and “Depressive Disorders”. The results selected for our analysis corresponded to investigations using EPO based on an adult population with DD.

The research provided 14 results, of which 9 met the defined criteria. Different types of studies with variable samples were considered, including randomized clinical trials (RCTs) and a systematic review. Overall, despite records of reduction in depression symptomatology and increased quality of life, evidence does not demonstrate statistically significant reductions in depression severity through the use of EPO in the treatment of DD. However, several RCTs examined its effect on cognitive performance, founding effective improvements in memory, verbal recall and recognition. The underlying potential mechanisms and the current limitations in the use of EPO, and of the available studies are analysed and discussed.

Although EPO does not appear to be effective treating depression, it may play a role in improvement of deficits in memory and executive function. Larger RCTs evaluating its potential use are needed, in order to move towards better clinical practice, quality of life and functional reintegration of these patients.

No significant relationships.

Acute measles encephalitis is a pathology of the central nervous system. It is most frequent in children but can also be described in adults. Given the rarity of this pathology, we present the case of this patient.

To assess perfectionism and depression and to study the relationship between these two parameters in a population of medical students.

We conducted a descriptive and analytical cross-sectional study among students of the Faculty of Medicine of Sfax during the months of June, July, and August 2020. The data were collected through a self-questionnaire disseminated on the social network “Facebook”.This questionnaire included identification of socio-demographic characteristics as well as the personal history of students. Perfectionism was assessed by the Rheaume scale and depression by the Beck scale.

A total of 206 students participated in the survey. The mean age was 21.49 ± 1.37 years. The majority of students were female (57.2%) with a sex ratio (F/H) of 1.34. Of the participants, 39.8% were enrolled as undergraduates and 60.19% as graduate students. According to their scores on the Rheaume scale, the students were non-perfectionists (NP) in 21.4% of cases; moderately perfectionists (MP) in 70.38% of cases, and highly perfectionists (HP) in 8.25% of cases. Severe depression was objectified in 7.3% of the cases. Students living alone were less perfectionist (p=0.01). Perfectionism score was higher in depressed students (35 ± 6.34) versus (31.428 ± 6.37) with a statistically significant correlation ( p ≤ 0.001).

It is true that perfectionism is an essential element for academic success. However, screening and prevention of depression are deemed necessary given its significant association with perfectionism.

No significant relationships.

There are some patients that remain resistant to treatment for major depressive disorder - who were treated with two or more different medications, and did not demonstrate any improvement in their mental-state. These patients can be treated with a new treatment – Esketamine. The recommended Esketamine treatment protocol includes 8-treatment sessions, each session lasts about two hours. In our clinic, we added a therapy group after each treatment. The therapy group is led by two co-therapist and lasts 30 minutes. The patients are invited to share their experiences from the session.

We will present a case report of a 44 year old man, that suffers from a major-depression for years, with symptoms such as loss of energy, recurrent thoughts of death and a decrease in functioning. He was treated with different medications, but there was no improvement in his mental state.

For the last six months, he was treated with Esketamine and also participated in the therapy group.

According to content that he raised in the sessions of the therapy group and following conversations with him and with his close environment, we observed a clinical improvement in his condition – a positive mood, a decrease of the thoughts of death, an increase in his function at work and at home.

He reported that the improvement is more significant because of the therapy group – he found a peer group, a place to process his treatment experience and to share his feelings and thoughts. We will present vignettes to demonstrate.

No significant relationships.

Hysterical disorders were considered separately in the context of the dynamics of the course of either endogenous affective diseases or schizophrenia, without attention to the conjugation and interaction of issues of hysterical symptoms and affective or psychotic syndromes.

To test the psychopathological structure and provide a typology of the conjugation of hysterical symptoms with other psychopathological syndromes.

120 patients (82 women and 38 men) with schizophrenic and affective disorders with associated hysterical symptoms were examined by a clinical psychopathological method.

Three variants of conjugation were identified. In the group of hysterical disorders associated with affective diseases (37,1%) the structure and dynamics of hysterical symptoms directly influenced the developing affective phase: the low intensity of hysterical symptoms contributed to the development of an apatho-adynamic type of depression, and bright and spontaneous hysterical manifestations formed an anxious-hypochondriac type of depression. Hysterical disorders formed in the structure of the psychotic state (41,4%) influenced the nature, structure, dynamics and content of delusional, hallucinatory and paranoid disorders. “Caste” hysterical symptoms (21,4%) revealed a lack of connection with affective and psychotic states. Hysterical symptoms were characterized by persistence, stability, invariability of manifestations, long-term psychotherapeutic and psychopharmacological resistance.

Clinical and psychopathological analysis of endogenous mental diseases of the affective and schizophrenic spectrum, occurring with hysterical symptoms, showed that the parameter of the conjugation of hysterical symptoms with other psychopathological syndromes is prognostically significant.

No significant relationships.

Approximately 15% of pregnant women suffer from a mental illness, however only half of them accept psychopharmacological treatment. One of the reasons for refusing treatment is the stigma attached to it.An important part of functional recovery is defining identity. This identity is multifactorial and is defined by several variables, one of them being gender.Several studies on motherhood in women with mental illness define the importance of a mothering identity, providing meaning and values. We present the case of a 39-year-old woman, mother of a two-year-old child, undergoing follow-up at a psychiatric clinic for recurrent depressive episodes and a history of two suicide attempts ten years ago. Currently stable in treatment with escitalopram 10 mg and lorazepam 1 mg if necessary.The woman refers the desire to abandon treatment after realizing that she is pregnant again. Therapeutic accompaniment is decided. The social worker from the obstetric service communicates with the psychiatric service to question the woman’s ability to care for a child with her psychiatric history.

Determine the stigma of mental illness, including among healthcare workers.

The woman makes her decision with full judgment. The patient is accompanied during pregnancy without incident, with clinical stability.

After delivery, the patient decides to resume psychopharmacological treatment.

Having a mental illness does not determine a woman’s ability to be a mother. As long as it is agreed with the psychiatrist, patients have the right to make decisions about their treatment.

No significant relationships.

Major depressive disorder (MDD) is a highly prevalent clinical condition with a leading cause of disability worldwide. The currently available therapeutic agents have important limitations regarding side effects, partial or non-responsiveness. Patients are considered to have treatment-resistant depression (TRD) if there is no effect or minimal effectiveness after receiving adequate dose-duration use of antidepressants from two different categories. For this patients, electroconvulsive therapy (ECT) can be a treatment option and new therapies appear to tackle TRD like ketamine, a dissociative anesthetic and analgesic.

The authors elaborate a narrative literature review to understand if ketamine might enhance the antidepressant efficacy of ECT.

PubMed database searched using the terms “Electroconvulsive therapy”, “ketamine” and “treatment-resistant depression”.

ECT is currently recommended as an end-line therapy for TRD. Memory impairment after ECT could be a consequence of indiscriminate activation or saturation of glutamate receptors during the treatment, disrupting hippocampal plasticity involved in memory. Ketamine inhibits N-methyl-d-aspartate (NMDA) receptors, while stimulating glutamate release and was proposed as an ECT adjuvant, might reduce cognitive adverse effects, time until response/ remission and inclusively improve response rates to ECT.

However, response and remission rates of ketamine in ECT showed no significant difference from the comparator groups and was associated with higher rates of psychiatric and cardiovascular adverse events.

The results did not support the use the combination of ketamine and propofol as anesthetic agents for ECT in patients with MDD. However, further studies are needed to investigate the beneficial clinical and cognitive effects of ketamine alone in ECT settings.

No significant relationships.

Psychiatric emergencies in Major Depressive Disorder (MDD) are characterised by multiple types of symptoms including risk of self-harm and suicidal ideation. S-ketamine intranasally (Spravato) has recently been shown to help alleviate symptoms during depressive emergencies. In this case-series, we detail the clinical effects and usability of S-ketamine applied intranasally in a psychiatric emergency setting.

To describe the effects of S-Ketamine on depressive crises associated with suicidality and self-harm in a psychiatric emergency setting.

Patients with MDD in a psychiatric emergency were provided with intranasal S-Ketamine according to clinical indication in routine clinical care in a University inpatient setting. Clinical characteristics were assessed in a standardised manner and symptom measures were applied pre-and posttreatment. Experience with 10 patients is systematically described in this case-series.

Patients had a primary diagnosis of MDD accompanied by a variety of secondary psychiatric comorbidity. Among these 10 patients, the majority were female (70 %) and the mean age was 49.5 yrs (range 26-66). All cases were considered treatment resistant and suffered severe acute suicidal ideation. Across all cases, pre-treatment MADRS was 37 on average (range 20-47) indicating a severe form of MDD. High severity was confirmed in elevated BDI scores (pre-treatment 39). Post-treatment, MADRS scores were reduced to 18 on average, alongside BDI scores (mean 24). S-ketamine administration was well-tolerated and side effects such as dissociation were of short-lived duration.

S-Ketamine intranasally can be safely and effectively administered in an acute psychiatric setting to treat psychiatric emergencies.

BTB received honoraria for consultancy and presentations from AstraZeneca, Bristol-Myers Squibb, Lundbeck, Pfizer, Servier, Wyeth, LivaNova, Janssen, Novartis, Otsuka, Angelini.

Residency training has been reported as being stressful which may lead to different mental disorders.

To study the prevalence and associated factors of anxiety and depression symptoms among psychiatry residents.

A cross-sectional study was conducted through an online survey among psychiatry residents. Participants completed an anonymous self-administered questionnaire and the HADS questionnaire for screening anxiety and depression.

Forty responses were collected.The average age of the sample was 28.08 ± 2.43 and the sex-ratio (F/M) was 0.875. Eleven participants were married. Eight residents were smokers. The prevalence of alcohol use and cannabis use was 22.5 % and 5% respectively. Half of participants were first year residents and near three-quarter of them (72.5%) declared working in poor conditions. A considerable proportion of participants had symptoms of anxiety and depression. The prevalence of anxiety case and depression case was 52.5% and 47.5% respectively. The prevalence of Anxiety symptoms and depression symptoms was significantly higher in female participants (p = 0.017, p=0.034 respectively). Poor conditions of the workplace were significantly associated with depression symptoms (p=0.004).

Training residents in psychiatry showed high rates of anxiety and depression symptoms. Screening and early management of these psychiatric manifestations is necessary. In addition, improving working conditions would upgrade their training and quality of life.

No significant relationships.

To improve the effectiveness of treatment for atypical depression, it is necessary to revise the accumulated experience, taking into account new knowledge and drugs.

Comparative study of the efficacy and safety of therapy for atypical depression (AtD) in the structure of bipolar affective disorder (BAD), recurrent depressive disorder (RDR) and psychogenic depression (PD).

Clinical and clinical follow-up methods examined 77 patients with AtD, of which 35 - with bipolar disorder, 18 - with RDR and 24 - with PD. Patients in all three groups received monotherapy with an antidepressant or a mood stabilizer, or a combination of antidepressant and antipsychotic, antidepressant and mood stabilizer, mood stabilizer and antipsychotic, as well as a combination of antidepressant, antipsychotic and mood stabilizer.

Agomelatine was the most frequently used (27.3%) and effective in reducing MADRS in all groups both in monotherapy and in combination with other drugs. Also in the PD group, escitalopram and vortioxetine were highly effective. Of the antipsychotics, when combined with antidepressants, sulpiride was found to be the most effective. When comparing the tolerance of antidepressants in all groups showed the best results (by the CGI scale), agomelatine and venlafaxine, in the BAR group is also vortioxetine.

The best strategy for effective and safe treatment of atypical depression is the use of modern antidepressant, which does not increase the symptoms of the atypical spectrum and, if necessary, can be supplemented with some antipsychotics.

No significant relationships.