The authors have not supplied their declaration of competing interest.

The purpose of this study was to test the impact of foot reflexology (FR) on sleep architecture in patients suffering from sleeping disorders.

Try to improve sleep quality in patients with sleep disorders using the foot reflexology.

A controlled interventional study in which volunteers (n = 10) were their own control. Each subject received one 20 min FR session during their three nights in the sleep laboratory. Randomly, FR was performed during night 2 or night 3. A polygraph was used to measure these changes in sleep architecture throughout the night and a visual analogue scale (VAS) completed the measurements, in the morning, to subjectively determine the sleep quality.

The sleep architecture measured by polygraphy showed no statistically significant difference in percentage between nights with and without FR. However, a tendency to increase sleep latency and duration of nocturnal awakening was recorded insignificantly. The VAS sleep quality increased highly significantly with FR (p = 0.0059).

According to the patients′ feelings, FR induced an improved sleep quality, while the polygraph measures showed no change. This suggests that FR stimulates endogenous factors causing a feeling of well-being and comfort in those patients.

Antipsychotic combination treatment without clozapine is common in the treatment of schizophrenia patients worldwide, despite clinical guidelines generally do not recommend such practice. This is potentially due to a high rate of non-response to monotherapies and a low-frequent adoption of Clozapine.

This presentation briefly summarizes rational combination strategies without second generation antipsychotics other than clozapine and presents new results of a multi-center randomized, double-blind controlled trial comparing monotherapy of oral amisulpride (400-800 mg/day), or olanzapine (10-20 mg/day) with amisulpride-olanzapine combination treatment.

Positive findings with small to medium effect sizes in favor of combination treatment with amisulpride and olanzapin have to be weight against a higher propensity to side effects since reduced sexual functions, weight gain and gain in waist circumference are higher in patients with combination treatment and olanzapine monotherapy than in patients with amisulpride monotherapy. Overall evidence in favor of combination treatment without clozapine is not strong when regarding its highly-frequent adoption in clinically practice. The strategy of combination treatment with amisulpride and olanzapine may be an alternative in certain clinical situations but should be carefully monitored and justified according to guideline recommendations for resistance to pharmacotherapy.

The adoption of clozapine should be considered, before other antipsychotic combination treatment is indicated in clinical non-response to various monotherapies. Other factors that may lead to non-response or therapy resistance such as non-adherence, substance-abuse or high metabolization have to be excluded, before such strategy is appropiate.

No significant relationships.

The role of psychological factors in the development and maintenance of encopresis is controversial.

Assessment of the psychosocial profile of encopretic children and their caregivers in relation to parenting style compared to controls.

The current cross sectional study comprised 90 Egyptian children classified into three groups: group I (encopresis without constipation and overflow incontinence), group II (encopresis with constipation and overflow incontinence), and group III (clinically healthy controls); each group included 30 children. Thorough clinical evaluation and psychometric assessment were carried out for all enrolled children while caregivers were evaluated for their parenting styles, anxiety, depression, and introversion scores.

Hardness, undue blaming, and indecisive parenting styles were significantly more prevalent among caregivers of group I. Encopretic children of group I & II had poorer self-esteem and higher prevalence of clinically manifest depression compared to healthy controls. Furthermore, there was a higher prevalence of clinically manifest paternal anxiety, depression, and introversion and maternal depression among caregivers of group II and higher prevalence of clinically manifest paternal anxiety and depression among fathers of group I.

The approach of toilet training, not the time of its initiation, seems to be the factor that really matters in predisposing to and perpetuating encopresis. Further exploration is needed to determine if the documented association of psychological disorders of enrolled encopretic children and their caregivers was causal or being just the impact of the child's encopresis.

The authors have not supplied their declaration of competing interest.

The interest have focused in the effects of COVID-19 in mental symptoms. However, the pandemic and restrictions such as the lockdown decreed in Spain limited access to resources and lead to a change in assistance organization.

to compare the incidence and characteristics of psychiatric emergencies during the Spanish 2020 Lockdown with the same period in 2019

All the emergencies attended the the emergency room (Hospital El Bierzo) From 01/02/2019 to 30/06/2019 and those from 01/02/2020 to 30/06/2020 were analysed by two senior psychiatrists. Cases were selected if attended by any psychiatric reason. The cases were evalueated identifying ICD-10 diagnosis (according to clinical records and best criteria matching), sociodemographics, factors associated to the emergency and resolution.

23360 cases were attended in 2019 (799 psychiatric), 14907 (578) in 2020. That means a 36.19% of reduction in general emergencies and 27.66% in psychiatric emergencies (psychiatric emergencies proportion increased form 3.42% to 4.03%). The reduction started the week just before the lockdown declaration, minimal records coincided with the highest COVID-19 incidence and the recovery starts in early june for psychiatric and late June for general emergencies (figure 1). A decrease of 62.79% of anxiety cases and 45.9% of depresion was observed with no incresaes in any diagnosis. A slight increase in suicide attempts (two cases) was observed.

The lockdown seem to decrease psychiatric emergency care. Only suicidability was maintained/increased during the period. Psychiatry services must be aware of the risk of unattended inicidence that may cause an increase of cases after the lockdown.

No significant relationships.

Handwriting disorders (HDs) are prevalent in elementary school children, but their nature is poorly understood. Moreover, the diagnosis of dysgraphia is often too quickly concluded on a single assessment.

In the present study, we aimed to use a transdisciplinary assessment approach. We looked for to provide objective data to better understand the nature and aetiology of HDs.

27 school aged children with HDs aged 6-11 years were included in the study and were compared to typically developing children. They performed a normed prescriptural task of copying cycloid loops. Postural and gestural inter-segmental coordination of arm movements were recorded with two video cameras allowing 2D reconstruction of the gesture. Spatial/temporal kinetic and kinematic measures were recorded with a digital pen. All children underwent normed and standardized clinical assessments of neuropsychomotor, neuropsychological and oculomotor functions. The handwriting test (BKK) were used.

Handwriting disorders seem very heterogeneous. However, there is a significantly poorer gestural of inter-segmental coordination and of kinetic/kinematic performances of the tracings in HDs. Furthermore, it was possible to highlight three levels of HDs: mild HD not detected by the BHK test (26% of children), moderate HD with the BHK (33%), dysgraphia identified by the BHK (41% of children). The mild nature of HDs not dectected by the BHK seems to occur to a relatively low frequency with associated disorders identified during clinical assessments. On the contrary, dysgraphia appears linked to a high frequency of the associated disorders with a majority of oculomotor disorders (55% of children) leading to visual-perceptual difficulties (44%).

HDs appear to be multifactorial but have a common characteristics of immaturity of gestural synergy of the arm, associated with poorer spatio-temporal kinetic and kinematic parameters. Dysgraphia occurs with more severe disorders as oculomotor and visual perception impairments. Our findings highlight the importance to identified a nosography of HDs with a transdisciplinary evaluation to better understand the nature and aetiology of the disorders in order to better clinical decision-making processes for handwriting remediations.

None Declared

With an increasingly growing population in Europe, cognitive impairment is a major social and health issue. According to the World Alzheimer Report (WHO, 2014), dementia, including Alzheimer's disease is one of the biggest global public health challenges our generation is facing. There are many efforts at European level to promote active and healthy ageing. This three-year project has the ambition to provide new services for integrated care with breakthrough research and radical innovation by employing user-friendly Information and Communication Technology (ICT) tools, ultimately increasing patients’ quality-of-life and autonomy at home.

ICT4Life proposes an innovative platform for integrated care by the use of sensor-based analytics for human behaviour. Novel ICT services are used to determine the relation between cognitive decline, related psychopathological symptoms and the quality-of-life of the patients, and to assess how these affect patients’ and caregivers’ daily living. ICT4Life platform uses advanced sensor-based analytics; to maximize elderly empowerment and self-care abilities thanks to a properly designed and reconfigurable recommendation system that will be able to exploit user-generated data; and to improve decision-making processes in care professionals’ daily activities. All solutions are developed following a user-centred methodology and tested in real-life scenarios.

The study design and the preliminary results of the ICT4Life project are presented on the poster.

ICT4Life programme develops a solution for individuals with early stage cognitive impairment that will permit doctors and caregivers to extract useful information about patients, while contributing in a user-friendly way to extending their independence.

COI: This project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement N° 690090. Tamas Tenyi and Sandor Fekete are supported by the National Brain Research Program Grant N° NAP KTIA NAP-A-II/12.

Many forms of mental disorders, especially psychotic disorders are characterized also by a worsening of sexual functioning. Sexual dysfunction has been shown to significantly correlate with a longer duration of untreated psychosis and with heavier psychotic symptomatology.

The aim of this study is to validate the Italian version of the Arizona Sexual Experience (ASEX), a very handy and reliable tool to assess sexual dysfunction, in a population of people suffering from psychotic spectrum disorders.

Seventy-three psychiatric patients were recruited and assessed for mental illness and sexual functioning. We administered the Italian version of ASEX, adequately translated by two expert bilinguals. After 15 days we administered once again the test for test-retest reliability.

Validation of ASEX revealed Cronbach’s coefficients >0.70 in both single items as in the total score. In addition, the test-retest reliability revealed Pearson’s coefficients >0.50 in the various domains. Confirmatory factor analysis revealed good fit indexes for the two factors model of ASEX (SRMR=0.54; CFI=0.974; RMSEA=0.135).

This study represents the first validation in the Italian psychiatric context of a very useful specific tool for the sexual assessment in people suffering from mental illness. Our analysis revealed good psychometric characteristics in terms of confirmatory factor analysis, internal consistency, and test-retest reliability.

No significant relationships.

The ability to tolerate uncertainty or ambiguity was first identified as a stable personality variable by Budner (1962) who defined it as an individual's propensity to view ambiguous situation as either threatening or desirable.

We tried to measure ambiguity tolerance of medical students and compare the scale according to age, major and medical speciality preference.

By a questionnaire designed by Budner(Budner Ambiguity Scale), we measured the ambiguity tolerance of 240students entering medical school.

Analysis of data showed significant difference between men and women (60.81, 63.24). We found no difference of ambiguity tolerance according to the other variables. Conclusion: These data show the higher degree of ambiguity intolerance among Iranian students compared to the levels reported by Budner (44–48). Proper education could lead to better understanding of own potentiality in the students. Ambiguity tolerance may be an important variable to assess and train so that students are better prepared for unstructured situations that promote thinking and parallel the complexities of the applied world.

No significant relationships.

Mental health care is considered to be one of the main sources of mental illness stigmatization. Detailed information about these stigmatization experiences is needed to reduce stigma in mental health practices.

The study aimed i) to identify the most relevant stigmatizing situations in mental health care encountered by users and families, ii) to characterize the relative importance of these situations in terms of frequency, experienced stigmatization and suffering, and iii) to identify individual and contextual factors associated with these experiences.

In a focus group, users were asked to select the 15 most relevant stigmatization situations among those they elicited and those that were taken from the literature. An online survey was then conducted among users and family members to characterize these situations and identify predictors.

A total of 235 participants were included: 59 participants with schizophrenia diagnosis, 96 with other psychiatric diagnoses and 80 family members. The results revealed 15 situations with different levels of frequency, stigmatization and suffering. Participants with a diagnosis of schizophrenia experienced more situations of stigmatization and with a higher frequency. Moreover, factors such as recovery-oriented practices and measures without consent were the best predictors of experienced stigmatization.

These original stigmatization situations could be targeted to reduce stigmatization and associated suffering in mental health practices. Results strongly suggest that recovery-oriented practice should be fostered to fight stigma in mental health care.

No significant relationships.

There are sufficient amount data on the immune cells and their biologically active products leading role in the pathogenesis of depression, which allows viewing modulated immune cells as model objects for developing new approaches to depression immunotherapy.

We first demonstrated the ability of immune cells modulated outside the body by caffeine to edit depression-like behavior and showed the central cytokines-mediated mechanisms of this effect. Considering theimportant role of the peripheral immune system in the pathogenesis of depression, we investigated the main parameters of its functional activity after transplantation of modulated immunocytes.

(CBAxC57Bl/6) F1 depressive-like male mice, developed under the long-term social stress, were undergoing the transplantation of syngeneic immune cells with in vitro caffeine-modulated functional activity. Recipient’s behavior and immune systems functional activity parameters were studied.

We showed earlier significant positive psychoneuromodulatory effect of caffeine-treated immune cells in depressive-like recipients which manifests itself in the behavioral editing (anhedonia reduction, stimulation of exploratory behavior and activity in forced swimming test); hippocampal neurogenesis stimulation against the background of increased BDN and modulation of brain cell’s cytokines production. Transplantation of caffeine-modulated immune cells in syngeneic depressive-like recipients also leads to positive changes in the immune system functional activity as evidenced by enhanced immune response, splenocytes proliferation stimulation on the background of modulation of cell’s cytokines production and decreased tryptophan catabolism, reducing systemic inflammation.

Results demonstrated that in vitro caffeine-modulated immune cells caused positive psychoneuroimmunomodulating effect in depressive-like recipients. So, its may be considered as a potential therapeutic agent in the treatment of depression.

No significant relationships.

The main objective was to examine agreement between the internet based Development and Well-Being Assessment (DAWBA) generated diagnoses and clinical diagnoses. Second, we aimed to explore how disclosure of the DAWBA-diagnosis before clinical decision making influenced the clinicians diagnosis. Third, whether there were differences of influence for different categories of disorders. Last, we examined how the use of DAWBA information affected identification of co-morbidities.

315 patients from outpatient clinics were randomised into two groups. In 177 cases the clinician was informed about DAWBA diagnosis, in 155 cases the clinican was blind to DAWBA information. DAWBA is an internet based package of questionnaires and rating techniques designed to generate psychiatric ICD10 or DSM IV diagnoses for 5- 17 year old children and adolescents. Information from parents, teachers and self-reports are brought together by a computer programme that predicts likely diagnoses. An expert rater decides on the diagnosis by synopsis of these different inputs.

DAWBA diagnoses and clinical diagnosis without information from DAWBA showed acceptable agreement with Cohens kappa 0,26 for emotional disorders, kappa of 0,29 for hyperactive disorders and kappa of 0.31 for disruptive disorders.

There was a significant effect on clinical diagnoses for emotional disorders for disclosure of DAWBA (kappa of 0.26 without DAWBA information versus kappa of 0,52 with information, Fishers z of p< 0,05)

There was no significant effect of information about DAWBA-diagnosis considering comorbidities.

DAWBA showed the most pronounced effect on clinical diagnoses for emotional disorders in children and adolescents.

Prevalence of psychiatric comorbidities in alcohol dependence syndrome and association of severity of alcohol dependence, personality dimensions, motivation and short delay relapses.

A prospective study in 91 male alcoholic patients for 2 months.

Two groups not relapsed (NR = 48) and Relapsed (R = 43) were comparable in age, SADQ severity score, average units of alcohol consumption and years of alcohol use. Average consumption was 17 units/day (500 mL spirits), age of onset before 25 years 87%, mean age 40 and severe alcohol dependence was in 57% of study population. Co-morbid nicotine use was 80.2% and in equal numbers in the relapsers and non-relapsers group.

Bipolar disorder was the most prevalent (19.8%) in the study population. About 53.8% had alcohol dependence as the primary diagnosis with no associated psychiatric comorbidities. Anxiety disorders (12%) and personality disorders (19.7%) were found more in the relapsers group. Anxiety symptoms seemed to be a risk factor for relapsing compared to other comorbidities in bivariate analysis (Pearson Chi2 5.998, P = 0.014). Psychoticism among relapsers were high (Pearson Chi2 4.901, P value 0.027, OR: 3.782, 95% CI: 1.103–12.958). Co-morbidities were not statistically significant in multivariate (Pearson Chi2 1.765, P = 0.184, OR: 1.755, 95% CI: 0.763–4.037). Severity of alcohol dependence in relapsers was not significant (Pearson Chi2 0.650, P = 0.722). Motivation levels of 62.8% of relapsers were low, 32.6% medium and only 4.7% reported high motivation (Pearson Chi2 11.846, P = 0.003). Poor motivation proved to be a risk factor for future relapse (P = 0.008, 95% CI: 1.266–4.648, SE.332).

The authors have not supplied their declaration of competing interest.

Depression is known to be associated with low serum Brain-Derived Neurotrophic Factor (BDNF) and elevated levels of cortisol. Yoga has been shown to be associated with significant antidepressant effect as well as increase in serum BDNF levels and reduction in serum cortisol levels in these patients.

We examined the association between serum cortisol and BDNF levels in patients with depression who were on treatment with antidepressants, yoga therapy, and both in combination.

Fifty-one consenting drug-naive outpatients (29 males) aged between 18-55 years, diagnosed with Major Depression received antidepressant medication alone (n=15), yoga therapy with (n=18), or without (n=18) concurrent antidepressants. Subjects in the yoga groups practiced a specific Yoga module for three months. Depression was assessed using the Hamilton Depression Rating Scale (HDRS). Serum BDNF & cortisol levels were obtained before and after three months using sandwich ELISA method. The group differences were analyzed using one-way ANOVA. Correlations between Serum BDNF & cortisol levels were analyzed using Pearson's correlation.

Significant negative correlations were observed between baseline BDNF & cortisol levels in the Yoga+Medication group (r=0.569*; P=0.01), and between change in BDNF and cortisol level in the Yoga alone group (r=0.582*; P=0.01). No other significant correlations were found.

There is a significant association between serum cortisol and BDNF levels in patients with depression who underwent Yoga with or without antidepressants. This suggests that Yoga may have stress reduction and neuroplastic effects alone or in combination with medications in depressed patients.

The Assertive Community Treatment (ACT) was developed by Leonard Stein and Mary Ann. The objective is the treatment of serious Mental Disorders in an integral way and in the community.

The Assertive Community Treatment (ACT) was developed by Leonard Stein and Mary Ann. The objective is the treatment of serious Mental Disorders in an integral way and in the community.

This is a retrospective study with a total of 69 patients whose main diagnosis is Schizophrenia undergoing CT follow-up in 2018-2019. The data obtained have been analyzed by the SPSS statistical program.

Our sample is mainly composed of men (60.9%) with an average age of 48 years (+ - 11.56). The main diagnosis is schizophrenia (62.3%) and the most commonly used long-term injectable treatment is paliperidone palmitate with a dose range of 150mg. Of the total number of patients, 29% of the cases did not maintain active use of any toxic, and the most commonly used toxic is tobacco (49.3% of cases).

The inclusion of patients in a ACT program requires a diagnosis of severe Mental Disorder and poor therapeutic adherence. After analyzing our data, we observed that most of them also have active toxic consumption and high doses of psychotropic drugs.

No significant relationships.