In bipolar patients cognitive deficits are an important feature. Persisting neurocognitive impairment is associated with low psychosocial functioning.

The aim of this presentation is to discuss potential cognitive, clinical and treatment-dependent predictors for functional impairment in bipolar patients.

In a first study (1) at the Medical University of Vienna 43 remitted bipolar patients and 40 healthy controls were assessed testing specifically attention, memory, verbal fluency and executive functions. In a randomized controlled trial, patients were assigned to two treatment conditions as add-on to state-of-the-art pharmacotherapy: cognitive psychoeducational group therapy over 14 weeks or treatment-as-usual. At 12 months after therapy, functional impairment and severity of symptoms were assessed. In a second, ongoing study, in-patients from a defined catchment area in Vienna (12th, 13th and 23rd district) were assessed via SCIP (Purdon S. 2005. The screen for cognitive impairment in psychiatry: Administration and psychometric properties. Edmonton, Alberta, Canada: PNL Inc.). The SCIP was performed before and after cognitive remediation. The effects of treatment on functioning were measured with the clinical Global Impression Scale (CGI).

Compared to controls, bipolar patients showed lower performance in executive function, sustained attention, verbal learning and verbal fluency. Cognitive psychoeducational group therapy and attention predicted occupational functioning. In the second study, SCIP and CGI values showed improvement after treatment.

Our data support the idea that cognition affects outcome. Bipolar patients benefit from cognitive psychoeducational group therapy in the domain of occupational life. (1) Sachs G et al. Front. Psychiatry, 23 November 2020 | https://doi.org/10.3389/fpsyt.2020.530026

No significant relationships.

Risperidone is a benzisoxazole derivative and is an antipsychotic drug that is frequently used in psychiatric disorders with high binding to 5HT-2A, D2, α1-adrenergic and α2-adrenergic receptors. It is a second generation antipsychotic and the most common side effects are known as extrapyramidal symptoms, weight gain, sedation, hyperprolactinemia, dizziness, insomnia, anxiety and nausea. Edema has been reported in a few cases as a side effect of risperidone in the literature.

In this case report, we aimed to present a case of peripheral edema developed in a patient using escitalopram combined with risperidone and to review the literature on this subject.

A 48-year-old male presented to the outpatient psychiatry clinic with symptoms of difficulty in controlling his irritability and anger, damaging the things around him, depression, loss of interest and desire, sleep disturbance, fatigue, and feelings of worthlessness. The patient also applied to the psychiatry outpatient clinic with similar symptoms 5 months ago, and had been on sertraline 50 mg/day and quetiapine 25 mg/day since then. But it was learned that he did not benefit, so his treatment was adjusted as escitalopram 10 mg/day and risperidone 1 mg/day. The patient, who came to the outpatient clinic control after 1 month and did not describe a similar complaint before, described peripheral edema that developed approximately 2 weeks after he started using psychiatric medication. On examination, 3+ pretibial peripheral edema was detected. Since the patient had a previous history of escitalopram use, it was recommended to continue escitalopram 10 mg/day treatment, and risperidone 1 mg/day was discontinued and he was called for control.

It was observed that the edema completely resolved within 2 weeks following the discontinuation of risperidone treatment.

In conclusion, risperidone is an antipsychotic frequently used in clinical practice, and edema is a rare but important side effect and can be encountered even at low doses. Despite the low incidence, this side effect should be considered by clinicians. There is a need for controlled studies that explain the relationship between risperidone and edema, elucidate the mechanism of edema and investigate its incidence.

None Declared

Eight hundred and forty-two parents completed our risk and associated features screening questionnaire. Out of these, 494 answered the question regarding handedness (209 had children diagnosed with ASD). This asked the parents to state how they perceived their child's handedness. An ADOS assessment has been conducted for 170 of the children whose parents were included in the study, based on clinical relevance for the case. The data were analysed using Excel and SPSS 22.0. For the comparisons, Chi2 and the Kruskal–Wallis test were used.

Children with ASD had more left-handedness (χ2(2) = 12.54, P = 0.002). There were no differences between boys and girls in terms of perceived handedness in any of the groups. There were no differences in the ADOS scores according to the perceived hand laterality (χ2(2) = 0.58, P = 0.74).

Rightward-asymmetry in regions of corpus callosum has been reported to correlate with symptoms severity in ASD. The finding of different perceived handedness in children with ASD versus children with other psychiatric pathologies is useful for designing appropriate, individualized training programs for motor therapy.

The authors have not supplied their declaration of competing interest.

The worldwide pandemic exacerbated the new role of the media.If previously the discussion was on whether new or traditional media had primacy in popularity and exposure, nowadays the question is whether communicating health issues through social and traditional media leads to understanding their content better and to more trust in both types of media.

We set the following objectives for this study:(1) to examine trust in the traditional and new media among university students,(2) according to the level of media trust to compose a psychological portrait,establish the most prevalent coping strategies,and emotional reactions to the pandemic.

213 university students (55.9% women,Mage=19 years) were tested from December 2020-March 2021.We examined the attitude towards information on coronavirus presented in the media and to investigate the level of severity of neurotic states,the level of psychological stress,and basic coping strategies used by respondents.

showed that although students generally prefer to use Internet news, trust in traditional media increased during the pandemic. We examined a general psychological portrait of young people derived from trust in the media. In the group of students who trust media information, we found indifference (39% of respondents) and helplessness (24.4%). In the group convinced that the media are hiding the actual state of affairs, anger prevailed (32.4%). The third group, confident that the media exaggerate everything, experienced indifference and anger (38.5% and 32.7%, respectively).

We may conclude that desire to learn more accurate and unbiased information firsthand indicates students’ attitude towards traditional media as more reliable sources of information.

No significant relationships.

Parkinson's disease is one of the most disabling neurological diseases; however much progress has been made in the treatment of drug resistant patients through electrode implantation and stimulation of the subthalamic nucleus (STN). This new neurosurgical method may lead to some neuropsychological side effects in patients. The main aim of this study was to evaluate the neuropsychiatric effects of this treatment.

This case-control study was designed to compare two groups of patients with Parkinson's disease. Thirty patients who underwent electrode implantation and deep brain stimulation were compared with 60 patients treated with antiparkinson drugs. These two groups were matched for age, sex, duration and severity of Parkinson's disease.

The UPDRS was used to assess the severity of Parkinson's disease. The Beck Depression Inventory questionnaire and the Hamilton Anxiety Rating Scale were used to evaluate depression and anxiety as a consequence of DBS. The Mini Mental Status Examination and Clock Drawing Test (CDT) were used to evaluate the cognitive and executive function.

Thirty months after STN stimulation, a lower level of anxiety and depression were seen in the DBS patients compared with drug treated subjects, but the differences were not significant. However, cognitive status deteriorated to a greater extent in study subjects compared to the control group. The MMSE results were not significantly different, but the differences in CDT scores were significant.

Patients who have undergone DBS surgery must be followed up for neuropsychiatric symptoms, particularly for subcortical cognitive deterioration in the long term.

Burnout is known to be higher in doctors than in the general population and is associated with adverse patient outcomes. By identifying factors that can lead to burnout, interventions can be implemented to support the health of the workforce and improve patient care.

The aim of this study is to (1) look at whether psychiatric trainees differ from medical trainees in the work−related stress they experience and the social support they perceive, within and outside the workplace. It also aims to (2) look at whether social support can mediate the stressor-burnout relationship in trainees.

The sample consisted of 184 London based trainees. Participants were administered the Maslach Burnout Inventory (strain), the Specialist Doctors’ Stress Inventory (stressors) and the House and Wells social support scale. To explore the pathways and potential mediating effect of social support within the stressor-burnout relationship structural equation modeling was applied to the data.

42% of all doctors exhibited high levels of emotional exhaustion and depersonalization. Medical trainees were significantly more burnt out than psychiatric trainees (p < .01). Occupational stressors were significantly correlated with the core burnout dimensions. Family, consultant and top management support demonstrated significant correlations with burnout dimensions whereas co-worker support failed to reach significance. Direct, indirect and mediational pathways between study variables were found.

Psychological distress is still prevalent amongst our junior workforce. Medical trainees appear to exhibit more severe levels of burnout and suggestions to improve psychological wellbeing are discussed.

The increased interest in the phenomenology, etiology, and treatment of Obsessive-Compulsive Disorder (OCD) follows the recognition that OCD is a more pervasive and serious problem that was previously thought. Family studies indicate a modest tendency for OCD to occur among biological family members. Studies on twin and family-genetic analysis show that non-heritable factors present as great and possibly greater risk to the development of OCD. Psychological and familial issues are also implicated in the development and maintenance of OCD.

This study explored the relationship between parental style and OCD among a clinical sample of children and adults in Tehran, Iran.

Subjects consisted of 190 patients who had sought treatment for OCD during the period from 2002 to 2009. Designation of parenting style was based on interviews using Baumrind typology. Two clinical psychologists assigned each subject to one of the four family styles: authoritative, authoritarian, permissive and neglectful.

The data replicate previous findings in relation to gender differences, the age of onset, family history of OCD and comorbid disorders. Patients who had experienced authoritarian, permissive, and neglectful parenting styles were significantly more likely to experience OCD. A hitherto unreported finding is the positive relationship between a mixed parenting style and OCD.

The present study indicates that the positive relationship between parenting styles and OCD extends beyond cultural boundaries. The psycho-social and cognitive dynamics of family-styles in relation to development and maintenance of OCD and treatment implications are discussed.

The number of novel psychoactive substances (NPS) available is increasing. Synthetic cannabinoids (SC) are one of many NPS sold. SC aim to emulate the effects of natural cannabis by acting on cannabinoid receptors. Despite much research into pharmacology, there is limited data on the user experience of SC.

It is useful for psychiatrists, to understand what experiences people have whilst on illicit substances. The aim of this qualitative study is to gain an initial understanding of what characterizes the experiences of those who use SC.

Fourty anonymously written online reports were collected from the “Erowid experience vaults” and analysed using the Empirical Phenomenological Psychological Method.

The analysis yielded 488 meaning units (MU). These were grouped into 36 categories revealing 5 broad themes: (1) physical affects; (2) sensory distortions and distortions of perception; (3) emotional and psychological effects; (4) re-dosing, addiction and comedown effects; (5) similarities to other substances.

Synthetic cannabinoids have a mixed effect on users with a myriad of experiences reported. Some experienced positive results from their usage such as euphoria and relaxation, however these were counter balanced by those who experienced some serious negative emotional and physical side effects such as anxiety, paranoia, palpitations and convulsions. SC appear to often emulate that of their natural counterpart, yet there is an unpredictability to them which can end with serious consequences. Online forum content gives us a strong base understanding of users experiences of SC. Further research is required to elucidate a more nuanced understanding.

The authors have not supplied their declaration of competing interest.

Patients who remain unresponsive to two different antipsychotics should be given clozapine. However, some of the schizophrenic patients had presented an unsatisfactory benefit under clozapine monotherapy or clozapine cannot be used because of toxicity or patient refusal. Finding an efficient therapy represents a tough challenge in this situation, other drugs or drug combinations can be tried.

To choose a therapeutic scheme that improves acute psychotic symptoms and has a good tolerability. Olanzapine has antagonist activity at dopamine, serotonin, muscarinic, α1-adrenergic and histamine receptors. Zuclopenthixol has high affinity for both dopamine D1 and D2 receptors, high affinity for α1-adrenergic and 5-HT2 receptors, a weaker histamine H1 receptor blocking activity, and even lower affinity for muscarinic cholinergic and α2-adrenergic receptors.

2 schizophrenic females patients, hospitalized for an active phase episode. Both patient had perssistent hallucinations during the course of their illness despite the antipsychotic treatment and the good compliance. In the past they followed multiple therapeutic schemes. Antipsychotic medication was adjusted following the clinical outcome. Instruments: PANSS, CGI, weight, glycemia, lipide profile, blood pressure, heart rate, full blood count, hepatic enzymes, EKG, adverse events and relapse (follow-up 6 months).

Olanzapine and zuclopenthixol combined therapy led to psychotic symptoms remission.

In this case olanzapine and zuclopenthixol may represent an option for treatment of refractory schizophrenia. No new side effects have been observed or any unfavorable drug interactions. These results have maintained untill the end of the follow-up period.

There is strong evidence that oxygen free radicals may play an important role in the pathophysiology of major mental illnesses such as schizophrenia and bipolar disorders.

To detect the difference in the level of total glutathione mainly in serum sample of schizophrenic patients compared to bipolar patients and healthy control.

A case-control cross sectional study, the sample included thirty schizophrenic patients, 30 patients with bipolar I disorder (manic, depressive, mixed episode) compared to 30 healthy controls well matched for age, sex, educational level and marital state.

Young Mania Rating Scale, Hamilton Depression Rating scale, Positive and Negative Syndrome Scale ., Serum sample for level of glutathione.

There are statistically significant differences between the level of glutathione in group of schizophrenia, and group of bipolar1 disorder in comparison to control group, but no significant differences between two patients groups. There is positive significant correlation between smoking and glutathione in control group. There is significant negative correlation between glutathione and both of negative symptoms and number of hospital admissions in schizophrenia. There is significant negative correlation between glutathione and duration of illness, significant negative correlation between glutathione and aging, significant positive correlation between glutathione and (manic-mixed episode) in bipolar group.

Decrease plasma level of glutathione in both schizophrenic and bipolar patients that indicates the role of total glutathione in pathophysiology of these disorders and it is considered as indirect bio markers for the oxidative stress theory in these patients.

Treatment resistance to clozapine is estimated at 40–70% of the treated population. Several clozapine potentiation strategies have come into clinical practice although often without evidence-based support.

The aim of our work was to identify the potentiation strategies in ultra-resistant schizophrenia depending on the subtype of schizophrenia.

This is a prospective study conducted on patients with the diagnosis of schizophrenia, based on DSM-IV-TR criteria, and hospitalized in the psychiatric department of the university hospital in Mahdia, Tunisia. The study sample consisted of patients meeting the resistant schizophrenia criteria as defined by national institute for clinical excellence (NICE), and the prescription of clozapine for 6 to 8 weeks was shown without significant improvement.

we have collected 10 patients. The mean serum level of clozapine was 462.25 mg/L. The potentiation strategies were different depending on the subtype of schizophrenia. For the undifferentiated schizophrenia, we have chosen ECT sessions. For the disorganized schizophrenia, we opted for amisulpiride and aripiprazole. For the paranoid forms, we have chosen the association of risperidone and ECT. A psychometric improvement was noted in BPRS ranging from 34 to 40%.

Every potentiation strategy entails a cost, whether it is an additional monetary cost, adverse effects or greater stress to caregivers. The cost/benefit equation should be thoroughly evaluated and discussed before commencing a strategy.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Non-suicidal self-injury (NSSI) has been proposed as diagnostic entity and was added in the section 3 of the DSM 5. However, little is known about the long-term course of the disorder: NSSI and suicide attempt (SA) often lie on a continuum of self-harm, but it’s still unclear if they represent two different nosografical entities. Both these groups are commonly enclosed in the term of Deliberate self-harm (DSH), also including self-harm with suicidal intent conditions.

This study aims to explore differences between two clinical samples (NSSI and SA) to highlight the possible connection between these two categories, to better understand the risk of progression from NNSI into suicidal intent conditions.

102 inpatients with DSH (62 NNSI; 40 SA; age range: 12 to 18 years) were assessed by self-report questionnaires: the Deliberate Self-Harm Inventory (DSHI) and the Repetitive Non-suicidal Self-Injury Questionnaire (R-NSSI-Q) to explore the severity and repetitiveness of self-injurious behaviors and by the Beck Hopelessness Scale (BHS) and Multi-Attitude Suicide Tendency scale (MAST), as indirect measures of suicidal risk.

Preliminary results showed that inpatients with NSSI (62) presented high scores of indirect suicide risk, similar to SA sample (40).

This result highlights the possibility to consider NSSI and SA in a continuum of psychopathology and that repetitive self-harm even in the absence of clear suicidal intentions represent a significant risk factor in the development of suicidality in adolescence.

No significant relationships.

One of the most difficult aspects of unexplained infertility treatments are feelings of uncertainty and the perception that infertility is beyond one's personal control, both of which make the infertility situation more threatening and stressful.

The aim of this study was to explore the correlation between general self-efficacy and infertility specific well-being and distress among women with unexplained infertility.

The sample consisted of 97 women with unexplained infertility aged between 22 and 46 years old (mean age: 33.58), who were recruited from the obstetrics and gynecology clinic “National front”. Mean duration of conception attempts was 3.10 years. The General Self-Efficacy Scale and the Infertility Specific Well-Being and Distress Scales were applied in the study.

The mean score on the General Self-Efficacy Scale was 32.77 (SD = 4.624), on the Well-Being scale 3.22 (SD = 0.984) and on the Distress scale 1.94 (SD = 0.754). There was a positive correlation between intensity of infertility specific well-being and general self-efficacy (r = 0.502; P < 0.01) and a negative correlation between infertility specific distress and general self-efficacy (r = −0.265; P < 0.01). Women with unexplained infertility with higher self-efficacy expressed higher levels of well-being and lower levels of distress.

The results of our study indicate that women with unexplained infertility who perceive their problems as being beyond their control express higher levels of stress and lower levels of well-being. Psychological treatment of women with unexplained infertility should focus on the aspects that can be influenced through psychotherapy.

The authors have not supplied their declaration of competing interest.

The author has not supplied his declaration of competing interest.