Maternal psychological stress during pregnancy has been associated with the risk for mood disorders in offspring, although there is no consensus about the influence of the timing of the stress on outcomes. We examined the relationship of prenatal stress at specific times in pregnancy to the incidence of mood disorders in offspring using data from a large birth cohort.

We linked data on 90,079 offspring born in Jerusalem in 1964–76 to Israel's psychiatric registry. We used proportional hazards models to evaluate the link between discharge diagnoses and gestational age during the Arab-Israeli war of June, 1967.

Those in their first trimester of fetal development during the war were significantly more likely to be admitted to hospitals for any mood disorders (RR = 3.01, 1.68–5.39, p = .0002), and the subgroups of bipolar disorder (2.44; 1.0–5.99; p = .054) and “other” mood disorders (3.61; 1.68–7.80; p = .001). Mood disorders were substantially increased in offspring whose mothers had been in the third month of pregnancy in June, 1967 (5.54, 2.73–11.24, p < .0001).

These findings suggest that acute maternal stress in early pregnancy may contribute to the etiology of mood disorders in offspring. They point to the third month of fetal development as a moment of special vulnerability.

Little is known about the excess mortality associated with use of some illicit substances. In particular, this concerns the risks associated with injection drug use and psychiatric disorders.

This study estimated mortality following substance abuse treatment among primary users of cannabis, cocaine, amphetamine, MDMA, and opioids. The risks associated with injection drug use and psychiatric comorbidity were assessed.

A register of individuals in treatment for illicit substance disorders was linked with registers on psychiatric treatment and mortality. The study population consisted of 20581 individuals who received treatment in Denmark between 1996 and 2006. There were 1441 deaths recorded over 111445 person-years of follow-up.

Standardized Mortality Ratios (SMRs) for primary users of specific substances were: Cannabis: 4.9, cocaine: 6.4, amphetamine: 6.0, heroin: 9.1, and other opioids 7.7. For MDMA the crude mortality rate was 1.75/1000 person-years, and the SMR was not significantly elevated. Sharing of syringes was associated with increased mortality in both primary users of opioids (hazard ratio (HR): 1.58 [95% CI 1.22–1.99], p < .001) and cocaine/amphetamine (HR: 9.52 (95% CI 3.94–23.02, p < .001). Overall, psychiatric comorbidity was associated with modestly increased mortality (HR: 1.15 [95% CI 1.03–1.29], p = .012) and in particular for primary users of cocaine/amphetamine (HR: 2.74 [95% CI 1.56–4.80], p < .001).

High SMRs were found among individuals who had received treatment for cannabis, cocaine, amphetamine, and opioid use disorders. Injection drug use was clearly associated with excess mortality, while the impact of psychiatric comorbidity was generally modest.

Depression accompanied acute psychosis in 70% of cases and remitted in line with the psychosis; 36% developed PPD without a concomitant increase in psychotic symptoms. PPD occurs without concomitant change in positive or negative symptoms.

We try to evaluate efficacy of Fluvoxamine, versus efficacy of mirtazapine and venlafaxine in PPD.

25 patients (17 men, 8 female), aged 18-45 years, diagnosed with schizophrenia and PPD by DSM IV criteria. All patients received a second generation of antipsychotic (SGA) .We divided in 3 groups - A (9 patients) treated with SGA + Fluvoxamine (100 mg/day), group B (8 patients) treated with SGA + mirtazapine (30-45mg/day) and group C (8 patients) treated with SGA + venlafaxine (150- 225mg/day). We use BPRS, HAMD, and CGI for severity. Period of study 2 month, with visit at every week. We evaluate efficacy in group A versus efficacy in group B and C.

in group A: 2 drop-out, 6 responders, 1 non-responders; in group B: 1 drop- out, 6 responders, 1 non- responders, in group C: 1 drop- out, 7 responders. The response was faster in group C. The treatment was well tolerated.

The results were similar in all groups, but the most responders were found in patients with family support, in first 3 years of evolution of schizophrenia, with family history of affective disorders, absence of negative symptoms. The response was better at patients who don't have traumatic stress in there children or adolescent period.

Chronic tics and Tourette syndrome (TS) can be comorbid with several neuropsychiatric conditions and may add to the complexity of children's clinical presentation and need for inpatient input.

To review the clinical notes of all children admitted to a National Children's Inpatient Unit (aged up to 12 years) over a 5-year period and analyse their demographic and clinical characteristics including the presence of chronic tics/TS.

To assess the clinical correlates of comorbid chronic tics/TS in an inpatient preadolescent population.

A retrospective naturalistic study of all patients admitted to our unit from 2009 to 2014 was conducted. Children with and without chronic tics/TS were compared in terms of age, gender, family history of mental illness, history of neurodevelopmental problems in siblings, medication on admission and at discharge, length of admission and functional outcomes using Chi2 and t-tests for categorical and continuous data respectively.

A total of 133 children (mean age = 11.2 years) were included. Twenty-five (18.8%) were diagnosed with chronic tics/TS. Autism spectrum disorder was the most commonly comorbid diagnosis (84%), with the second most common being an anxiety disorder/OCD (52%). Statistically significant higher percentages of learning disability, neurodevelopmental problems in siblings, medication at discharge and longer inpatient admissions were identified in children with tics compared with the rest of the sample. No other differences were found.

The prevalence of chronic tics/TS in children needing inpatient treatment is significant. In our sample, chronic tics/TS seem to represent a marker of increased neurodevelopmental deviance and overall symptom severity.

The authors have not supplied their declaration of competing interest.

Audit of ADHD caseload identified an open case prevalence of ADHD as 0.2% and 0.6% in Specialist Tier 2 and 3 CAMHS across 2 metropolitan boroughs of Greater Manchester, as opposed to national prevalence of 1–3%.

We carried out a survey of CAMHS clinicians to identify and address any internal factors that could contribute towards such an under-representation.

A Survey questionnaire was designed to look at staff perceptions, knowledge and training needs in identification and management of ADHD.

Questionnaires were distributed to 50 CAMHS professionals working across these two Specialist CAMHS, which were completed anonymously and returned yielding a response rate of 84%.

1 in 10 CAMHS clinicians did not believe in giving children and young people diagnosis of ADHD and a third believed ADHD was medicalization of behavioural problems rather than neurobiological disorder. Only half of CAMHS clinicians were aware of co-morbidities such as conduct disorder and other developmental disorders.

Although ADHD is a professionally well established condition, scepticism amongst significant number of CAMHS clinicians about the validity of diagnosis, relative risks and benefits of diagnosis continues to exist. This may result in under diagnosis of children who are referred to CAMHS with behavioural difficulties. This has an impact on quality and appropriateness of service provided.

Specific training on ADHD is especially important among CAMHS teams, with clinicians from a multidisciplinary background and differing attitudes towards ADHD.

We anticipate this will help identify missed ADHD cases and improve the quality of care.

Text analysis can significantly enrich ideas about the functioning of the psyche in mental illness.

The purpose of this study was to identify the linguistic features of texts written by people with schizophrenia spectrum disorders and to study the relationship between them and the personality traits and indicators of the standard of living of patients.

Twenty-nine patients with schizophrenia spectrum disorders (F20, F21, F23, F25 according to ICD-10) and 37 without mental disorders participated. All participants wrote a text on a given topic and filled in psychodiagnostic methods: a short version of the Big Five method (TIPI-RU), Q-Les-Q, and MOS SF-36. The text was analyzed using the phpMorphy morphological analysis library.

A comparative analysis showed that in the speech of patients, there are fewer adjectives and more verbs than in the speech of healthy subjects (p<0.05) and that the volume of speech production in patients is significantly reduced (<0.001). The results of correlations of such data with the volume of words were contradictory. A statistically significant inverse relationship was found between the verbality index and the factors of extraversion and openness to experience in the clinical group. As for the indicators of quality of life, expectedly positive correlations between the use of adjectives and negative correlations of the use of verbs with the quality of life were revealed.

Studying the linguistic features of the speech of patients with mental disorders is essential. These indicators can be helpful in the diagnosis and treatment of the disease.

None Declared

Anorexia nervosa (AN) is characterized eating behaviors and body image disturbances. Given poor treatment outcomes are available for AN, treatment innovations are urgently needed. Recently, non-invasive neuromodulation tools have suggested having potential for reducing AN symptomatology targeting brain alterations.

The objective was to verify whether an excitatory transcranial direct current stimulation (tDCS) over the left prefrontal cortex may aid in altering/resetting inter-hemispheric balance in AN patients, re-establishing control over eating behaviors.

Research is aimed to evaluate the potential of tDCS treatment in determining a more rapid improvement compared to classical treatments in adolescents with AN.

Twenty-two adolescents with AN, underwent the treatment as usual (AU) plus the tDCS treatment (TDCS + AU: n = 8, age M 13.7 ± 1.9 years) or a family therapy (FT + AU: n = 14, age M 15.1 ± 1.75 years), for six weeks. Psychopathological scales (EDI-III, EAT 26, BUT, MASC, CDI) and anthropometric indicator of nutritional status (BMI) were assessed before and after treatment.

BMI improved only in the TDCS + AU group (P < 0.01). Mean BMI percentage of improvement was 14.43% + 10.8 in the TDCS + AU and 4.83% ± 5.4 in the FT + AU. Both groups improved in the total scores of the EDI, EAT-26, MASC and CDI scales (all P < 0.01).

tDCS treatment improved BMI values more than classical treatment and determined comparable to the classical treatment improvement in the psychopathological scales. This results may be an important starting point to further explore the beneficial effect of brain based treatments for AN.

The authors have not supplied their declaration of competing interest.

The COVID-19 pandemic caused employment related challenges worldwide. Adults diagnosed with Autism Spectrum Disorders (ASD) are especially vulnerable, due to pre-existing employment challenges, intolerance to changes and uncertainty and high levels of related anxiety.

To examine COVID-19 related changes in work experiences and mental health of employees with ASD who held a steady job before the COVID-19 outbreak.

Data were collected from 23 participants diagnosed with ASD (4 females), aged 20–49, who answered an online administered survey at two timepoints: prior to the COVID-19 outbreak, and during the outbreak. Self-reports included measures of background and employment status; mental health (General Health Questionnaire-12); job satisfaction (Minnesota Satisfaction Questionnaire); and satisfaction of psychological needs at work (Psychological Need Satisfaction and Frustration – Work domain).

Participants who continued to physically attend work maintained pre-COVID-19 levels on all assessed variables. Participants who transitioned to remote work from home preserved their salary levels and job satisfaction, but showed a marginally significant deterioration in mental health and a significant decrease in the satisfaction of their needs for competence and autonomy at work. Unemployed participants showed a significant decrease in mental health.

Results highlight employment as a protective factor from the potential negative implications of COVID-19 on mental-health of employees with ASD. Employees who transition to working from home require personalized work-support plans due to the possible negative effects of this transition on mental health. Maintaining the routine of physically reporting to work should be preferred, when possible.

Migratory mourning has specific features and migration is itself a risk factor for mental health. Basic grieving relate to seven areas: family and friends, language, culture, land, social status, contact with the national group and physical risks, as well as general mourning the failure of the migration project.

We intend to trace the process of acculturation seeking to distinguish its symptoms from those of most common psychiatric disorders.

We conducted a literature review using the National Library of Medicine and PubMed search system.

Adaptation process traces a U-shaped curve. In the second stage called crisis stage may appear rejection or isolation, sadness, crying, sleeplessness, irritability, distrust, recurrent and intrusive thoughts, psychosomatic symptoms (headaches, fatigue, musculoskeletal pain), dissociative and somatoform symptoms. Stress reactions can occur with cognitive fatigue, role and personal shocks.

Ulysses syndrome has features in common with acute stress disorder or adjustment disorder. Differential aspects regarding DSM-IV are: multiple identifiable stressors of high intensity, long duration, cultural interpretations and association of dissociative and somatoform symptoms.

Main observed pathologies are: PTSD, schizophrenia and paranoia, somatization and affective disorders, whose clinical expression is primarily determined by cultural factors.

Professionals should know the different manifestations of mental illness in immigrant population to distinguish them from experiential reactions and to avoid upset psychiatrization and therapeutic nihilism. Ulysses syndrome seems closer to preventive health and psychosocial support areas.

Fear of pain motivates defence and protection from events that are perceived as threatening. When defence and protection are not efficient, fear may lead to aggressive acts against the perceived source of threat.

This study tested the link between fear of pain and hostility in adults.

The aim was to investigate the relationship between fear of pain and hostility.

595 community individuals participated to the present study (164 men - 431 women, mean age 34, SD = 12, ranged 18–75). The measures used were: a) the Fear of Pain Questionnaire - III (FPQ-III), b) the Pain Anxiety Symptoms Scale-20 (PASS-20) c) the Hostility and Direction of Hostility Questionnaire (HDHQ) and d) the Aggression subscale of The Symptom Checklist-90-R (SCL-90-R).

Women predicted significantly more aggression (t = −1.9, p = .05), while for hostility no differences with sex were observed (t = −.2, p = .80). Hostility was significantly correlated with the amount of fear of pain (r = .27, p = .001) and pain anxiety symptoms (r = .23, p = .001). Significantly correlations were also found with aggression and fear of pain (r = .27, p = .001) and pain anxiety symptoms (r = .31, p = .001). Hierarchical linear regression models revealed that, pain anxiety had a significant independent link with hostile attitude (β = .176, p = .001) and fear of pain make independent contributions to predicting aggressive behaviour (β = .090, p = .006).

The need for health professionals to assess hostility and aggression in fear of pain behaviors and apply relevant information to the therapeutic regimen was apparent.

As a result of long-term heroin abuse we can see impairment of cerebral structures that leads to specific deficits in cognitive and conative area. Reaction time(RT) is an interval between reception of the certain stimulus and movement execution, as a response to received stimulus. It includes unharmed perceptive functions, attention, concentra- tion and psychomotor coordination. The aim of this study was to evaluate the effect of heroin abuse on RT.

90 heroin addicts, divided in tree groups, regarding to abuse duration, were included in study. Reaction time was estimated by specially designed computer program, based on the modified Donders's model of reaction time.

Averige RT increase in corelation to duration of heroin addiction

Results have shown that heroin abuse is connected with the prolongation of simple and choice reaction time, in both visual and auditory modality. Also, there is significant relation between prolongation of choice reaction time and duration of heroin abuse.

Heroin abuse duration is related to decrease of psychomotor speed and impairment of psychomotor coordination.