Schizophrenia is a mental disorder characterized by social problems and disorders of thought, behaviour and cognitive functions. These impaired cognitive functions may be associated with alterations in resting state functional connectivity in schizophrenia. Therefore, the present study has been carried out to determine the resting state functional brain connectivity changes associated with schizophrenia in all the resting state networks (RSNs) using independent component analysis approach (ICA) and dual-regression based approach.

The objective of this study was to investigate the aberrant resting-state functional connectivity patterns in schizophrenia patients as compared to healthy controls.

35 schizophrenia patients and 31 healthy controls were recruited for the study and scanned by using resting state functional magnetic resonance (rsfMRI). Pre-processing and post-processing of the resting state functional data were performed using the FMRI Expert Analysis Tool (FEAT), which is a part of FSL (FMRIB's Software Library, www.fmrib. ox.ac.uk/fsl).

Our results showed significantly decreased functional connectivity in the regions of left fronto-parietal network, lateral visual network, medial visual network, motor network and default mode network (DMN) in schizophrenia patients as compared with healthy controls.

The overall findings suggest that the alterations in these resting state network connectivity may, in part, contribute to the impairments in cognitive functions associated with schizophrenia. These findings also suggest that aberrant resting state network connectivity contributes to regional functional pathology in schizophrenia and bears significance for core symptoms.

Needs assessment has been highlighted as a crucial factor in the development, organisation and evaluation of mental health services. Moreover, meeting self-reported needs is of prime importance for ensuring quality of life and reducing social disability for people with severe mental disorders.

Service evaluation based on patients’ need assessments has never taken place in Greece. Furthermore there are no standardized needs assessment instruments. Given the underfunding of psychiatric services due to the current economic crisis, systematic need assessment is expected to contribute to the efficient use of their limited resources.

To examine the concurrent validity, inter-rater and test-retest reliability of the Greek research version of the Camberwell Assessment of Need (CAN-R).

Fifty-three schizophrenia patient–staff pairs were interviewed twice to test the inter-rater and test-retest reliability of the CAN-R (Greek version). The WHOQOL-BREF and WHODAS 2.0 were administered to the patients to examine concurrent validity.

The inter-rater and test-retest reliability of patient and staff interviews for the 22 individual items and the eight summary scores of the instrument's four sections were good to excellent. Significant correlations emerged between CAN scores and the WHOQOL-BREF and WHODAS 2.0 domains for patient and staff ratings, indicating good concurrent validity.

Our results suggest that the Greek version of the CAN-R is a reliable instrument for assessing mental health patients’ needs. This is the first CAN-R validity study with satisfactory results using WHOQOL-BREF and WHODAS 2.0 as criterion variables.

COVID-19 outbreak has significantly affected the mental health of people worldwide. The first wave of the pandemic began during the beginning of March 2020, and included significant preventative measures. Previous research on mental health differences between the genders has found that women were more likely to exhibit symptoms of anxiety during the COVID-19 outbreak.

The aim of our study was to assess the differences between the genders in depression, anxiety, and stress.

An online survey designed for the purposes of this study was distributed using the snowballing method during April and May of 2020. The survey consisted of two parts: sociodemographic and clinical data, and COVID-19 related data. Participants also filled out the Depression, Anxiety and Stress Scale (DASS-21) - a well validated, self-questionnaire instrument. T-test for independent samples was used to evaluate the differences between the genders.

Out of the initially sent 563 surveys, a total of 161 were included in further analyses (28.6% response rate). Mean age of the sample was 42.2±10.2 and 65.2% of the participants were female. Mean scores on DASS-21 were as follows: 8.78±6.66 on depression, 9.78±7.39 on anxiety and 7.76±7.14 on stress. Females scored significantly higher on depression (t=-2.25, p=0.029), anxiety (t=-2.25, p=0.028), stress (t=-2.44, p=0.017), and total DASS-21 score (t=-2.44, p=0.016).

The results of our study imply that female participants exhibit higher levels of depression, anxiety, and stress during the COVID-19 pandemic. Larger, population-based studies could provide a mroe in-depth answer to the importance of these differences for the general population.

The recent reforms of mental health legislation occurred in most European countries, together with the continuous advances of technologies and the development of research in all the domains of psychiatry have deeply modified the role of mental health professionals with consequent changes in training needs for early career psychiatrists. The competencies required to psychiatrists today include not only the knowledge of the advances in neuroscience, psychopharmacology, psychotherapy and social psychiatry, but also the ability to understand the different clinical and social needs of the patients. Young psychiatrists report a gap between their knowledge and the skills required during the first years of their job.

The European Psychiatric Association-Early Career Psychiatrists Committee, in cooperation with the European Federation of Psychiatric Trainees, conducted a survey among European young psychiatrists and psychiatric trainees, aimed at evaluating difficulties and perspectives related to psychiatric training residency.

86 respondents completed the Psychiatric Training Questionnaire, a multiple-choice and self-reported questionnaire, which evaluates: 1) satisfaction with training received; 2) self-confidence in theoretical and practical skills included in psychiatric training curriculum; 3) educational opportunities received during training.

Respondents were almost equally split between trainees (54%) and young psychiatrists (46%). Seventy per cent of them were completely or partially satisfied with training received. Early Career Psychiatrists reported higher levels of self-confidence in clinical psychiatry (98%), psychopharmacology (69%) and emergency psychiatry (61%), whereas the most problematic areas were forensic psychiatry (64%) psychotherapy (61%) and child and adolescent psychiatry (57%). 41% of respondents was not assigned a tutor for clinical activities, 73% of them could not rely on a dedicated supervisor for training in psychotherapy and 58% had not the possibility to use a log-book to record the competencies acquired during training. Only 37% participated in exchange programs; all early career psychiatrists who had this opportunity found this experience very useful for their professional growth.

Standards of training in psychiatry in Europe are generally satisfactory. However, our results highlight the need to:

1. 1) upgrade training in some areas, such as psychotherapy, forensic psychiatry and child and adolescent psychiatry;

2. 2) guarantee an adequate clinical supervision;

3. 3) spread the use of log-book;

4. 4) improve the opportunities for exchange programs.

For developing suicide prevention interventions, epidemiologic, socio-economic and demographic factors influencing suicide rates are of high interest. One considerable factor in this respect is gender, as in most countries male suicide rates are much higher than female suicide rates with a global average male/female ratio of 3.6:1. The present study seeks to contribute to the clarification of the question what underlies the different suicide rates of men and women by analyzing gender-specific lethality of suicide methods.

Data on completed (fatal) and attempted (non-fatal) suicides from 2000 to 2004 were collected in two cities in the region of Bavaria, Germany. This data sample offers the opportunity to compare data of suicidal acts including completed as well as attempted suicides of the same region during the same time. The lethality for each suicide method was estimated by dividing the number of fatal episodes by the total episodes and then related to gender and age.

Lethality per method was higher for men than for women; significant differences could be shown for the majority of methods. Regarding age, lethality rising with age could be shown. Still, in higher age groups, differences in lethality between men and women were significant.

Results stress the importance of gender-specific suicide prevention. Male-specific suicide-prevention should be concerned with improving access to and treatment of men under risk for suicidal behaviour. Addressing the problem through multifaceted programs therefore is a promising approach.

First psychosis programs have been developed during the past 30 years to influence the prognosis of a first psychotic episode by early integrative biopsychosocial interventions, with a focus on the processes that contribute to relapse. In the process of recovery, Navigate program emphasis on enabling a connection to what is important to the person (work, studies, relationships, intimacy), thus strengthening resiliency and quality of life and reducing self-stigma. Medication is part of any intervention program, however, there is a lot of ambivalence amongst the young person and family about its continuation and many will stop the medication altogether. Moreover, although evidence for the benefits of antipsychotic medication in short-term treatment is well established, there is an ongoing debate in the professional medical literature about the need and benefit of routine prophylactic long-term antipsychotics after first psychotic episode. There is also a significant uncertainty concerning the proportion of patients that will maintain remission without antipsychotics.

In this lecture, we will present some of the lessons that we have learned and are still learning from our clients, together with case examples.

In our Navigate Program, we have developed strategies based on literature and experience that enables the person/family to be part of the decision-making process, which at times presents dilemmas and risks but also promotes the potential for growth and transformation.

How do we talk about the medication issue? Who can continue without medication or with very low dosage? How can we taper antipsychotic treatment?

Are we willing to take the risk?

No significant relationships.

No significant relationships.

Bipolar Disorder (BD) is a disorder in which cognitive function is relatively preserved but social functioning is markedly impaired. Interestingly, studies on BD show that the patients have a strong desire for social rewards. Hypersensitivity to social rewards in BD has not yet been sufficiently examined through experimental methods, although recent studies have pointed out that their reward hypersensitivity is the cause of symptoms and dysfunction.

The purpose of this study was to investigate whether patients with BD are hypersensitive to social rewards using the social value capture task.

Groups of 25 BD and healthy control (HC) each completed the social value attention capture task. This task consists of a practice phase in which associative learning of social rewards with specific stimuli occurs, and a test phase in which the stimuli associated with rewards appear as distractors during the participants performing a selective attention task. We also recorded event-related potential (ERP) in the practice phase in order to investigate BDs’ cortical activity for social reward.

showed significantly decreased accuracy rate and increased reaction time in the high social reward-associated distractor trials of the test phase in the BD compared to the HC. As a result of analysis in ERP components, P3 amplitude for social reward was significantly greater in the BD than the HC.

BD patients exhibit behavioral and physiological hypersensitivity to social rewards that might contribute to social dysfunction.

No significant relationships.

Acute angle-closure glaucoma (AACG) is an ophthalmic emergency, accompanied with severe eye pain, headache, and visual changes because of acute intraocular pressure elevation. Among psychotropic drugs, several antidepressants, typical antipsychotics with strong anticholinergic effects, and topiramate have been known to increase a possibility of AACG. Benzodiazepines have been used widely in the treatment of mental and physical illnesses regardless of age or indication. Since benzodiazepines have some anticholinergic properties and affect pupillae muscles, their use could be theoretically a risk factor for AACG. However, it is unclear whether benzodiazepines actually increase the risk of AACG. To our knowledge, there was no population-based study on the risk of benzodiazepines to the occurrence of AACG.

To know whether benzodiazepines increase the risk of AACG in a geriatric population.

We will perform a case-control study using a geriatric cohort from the National Health Insurance database. Case subjects will be defined as cases diagnosed with AACG confirmed by the claim data of laser iridotomy, which is the definitive treatment of AACG. The controls, which were not diagnosed with AACG, will be matched with case subjects according to similar age, sex, and the scores of the Charlson comorbidity index.

The data handling and statistical analyses will be executed in autumn and winter 2016.

Any preliminary findings of this study will be presented at the EPA 2017. We will discuss the importance of a pharmaco-epidemiological study in the geriatric research.

The authors have not supplied their declaration of competing interest.

Antisocial disorder is characterised by difficulty to adapt to social norms that normally rule different aspects of the person’s conduct in adolescence and adulthood. According to DSM-V, this disorder’s prevalence stands between 0.2% and 3%, and is more frequent in men.

Numerous studies have been made about the influence between the environment and genetics for the development of this disorder, finding in several patients a punctual mutation of the monoamine oxidase gen (MAOA); although impulsive behaviour has also been associated to the 5-HT tranporte gene (5-HTT), and the protein coding gene for Tryptophan Hydroxylase TPH1

The hospital admission for these patients must be made when there’s autoregressive or hetero aggressive behaviour, suicide attempts, psychotic symptoms, or symptoms that generate important repercussions in the person’s normal functions. Nevertheless, is important to identify during the hospitalization the improvement possibilities of these patients in order to make drug or psychotherapy adjustments; in the case that we don’t observe treatment benefits, the patient will be released from the hospitalization

The main treatment is psychotherapy.

There’s not much evidence of drug use in this disorder, however, mood stabilizers, antidepressants, atypical antipshychotics and benzodiazepines are used for rage control, impulsiveness, anxiety and aggressiveness.

No significant relationships.

Little is known about how young medical professionals view euthanasia (EUT) and assisted death activities. The aim of this study is to investigate and to compare Greek final year medical students and medical trainees' attitudes towards EUT and physician-assisted suicide (PAS).

To assess attitudes towards EUT and PAS we translated, adapted and modified, in a short version, the questionnaire developed by Ganzini et al (1996). The Greek version of the questionnaire consisted of 26 items. 251 final year medical students and 274 medical trainees completed the questionnaire. The survey was anonymous.

52% of medical students and 64% of medical trainees were for the acceptance of EUT. The view that PAS may be morally acceptable under some circumstances was endorsed by 76% of the students and by 79% of the trainees. 80% of the students and 81% of the trainees believed that withdrawing life sustaining medical treatments in terminally ill patients should be permitted. 54% and 38% of the students and trainees, respectively, believed that prescribing drugs to relieve pain in doses that may hasten death should be permitted.

A high percentage of the medical students and medical trainees were for the acceptance of EUT and PAS. Given the progress of legalization of EUT in many countries, the need for special education regarding many aspects of EUT is demonstrated.

Adolescents and young adults are a vulnerable population to both alcohol use disorders and depressive major disorder. Use of cognitive-behavioral therapy (CBT) could help in diminishing depressive symptoms severity as well as alcohol dependence severity.

To evaluate CBT efficacy in young adults diagnosed with major depressive disorder and alcohol dependence.

A number of 12 patients, age 23–35, 7 male and 5 female, outpatients, diagnosed with alcohol dependence and major depressive disorder, moderate or mild episodes, according to ICD-10 criteria, were included in a 3 months CBT oriented program. All subjects were evaluated using a Visual Analogic Scale (VAS) for self-evaluation of alcohol problems severity (score ranging from 0 – absent to 10 – extremely severe), AUDIT scale, Hamilton Depression Rating Scale (HDRS) – 17 items, and Global Assessment of Functioning (GAF). Patients participated in 30 minutes individual CBT sessions, twice per week, for 12 weeks. Cognitive restructuring based on patients’ diary, coping skills training, and activation techniques have been applied in the CBT sessions.

After 12 weeks all patients reported decreases on VAS and AUDIT scores, with mean percentages of 55 and 50, while GAF increased with 45%. HDRS scores decreased with 65%. These changes were considered significant when compared to initial values (P = 0.007 for VAS, P = 0.009 for AUDIT, P = 0.012 for GAF and P < 0.001 for HDRS), according to dependent samples t-test P < 0.05, bivariate.

Cognitive-behavioral therapy, focused on cognitive restructuring, coping skills training, and activating techniques is an efficacious intervention in young patients with comorbid depressive and alcohol dependence.

The presenting author was speaker for Astra Zeneca, Bristol-Myers Squibb, CSC Pharmaceuticals, Eli Lilly, Janssen-Cilag, Lundbeck, Organon, Pfizer, Servier, Sanofi Aventis and participated in clinical research funded by Janssen-Cilag, Astra Zeneca, Eli Lilly, Sanofi Aventis, Schering Plough, Organon, Bioline Rx, Forenap, Wyeth, Otsuka Pharmaceuticals, Dainippon Sumitomo, Servier.

The other author has not supplied his/her declaration of competing interest.

Psoriasis is a chronic inflammatory skin disease that affects approximately 2% of the population. It seems to have a multifactorial aetiology and it can be considered as a psychosomatic disorder.

To determine risk factors for anxiety and depression in psoriasis

Case-control study including 44 subjects with psoriasis and 50 controls without psoriasis. All participants answered the Hospital Anxiety and Depression Scale (HADS) to measure the severity of anxiety and depression

Descriptive study: We solicited 44 patients and the average age was 45.8 years. The majority of patients were married (70.5%), unemployed (40.5%), without medical heredity (84,6%). Psoriasis was in plaque (65.9%), guttate (20.5%), pustular (13.6.5%).Its severity, assessed by BSA, was mild to moderate in 72.7% of cases and associated arthropathy was noted in 29.5% of patients.the prevalences of anxiety and depression estimated at 29.54% and 18.18% respectively. Analytical study: Subjects with psoriasis, as opposed to controls, showed higher levels of anxiety (29,54% vs 15,9%) and depression (18,18% vs 4,54%) but there was no significant difference (p=0,335, p=0,573) Depression was significantly more important for single (p=0.043), for patients with associated arthropathy (=0.005) and for guttate form (p=0.015) According to the severity of the disease: patients with mild disease are more anxious and patients with severe disease are more depressed

Higher scores in anxiety and depression is common in psoriasis. Dermatologists should give special attention to this subgroup of persons with psoriasis in order to prevent future psychopathology.

During the COVID 19 epidemic, the isolation helped virtual psychoterapy sessions, not to break up therapeutic relationship in critical moments.

This paper points out the traditional setting modification and how the interpersonal relationship can affect the therapeutic dynamics.

The experience could support the possibility to design adequate plans to test possible relational potentiality/prospect to respond to the pandemic emergency. The computer screen represents a very important new and rich element as “Skype” seems to have been the most used remote support. The screen plays a filter and separation function but physically represents the related presence in a shared timeframe. It is also a “mutual mirror”, reflecting the exclusive duality and resending to “different” space and time where the therapeutic relationship acts.

In this way the “analysis room” loses its physical feature to move towards a new dimension where the subjective experience are communicated/lived/re-elaborated by the mean of shared visual, modifyng the codified space of a traditional setting.

The screen is not only a mere vehicle of verbal communication, but fully gets in “hic et nunc” in space relationship assuming however an allegoric value, that, in the individual subjective, could go really beyond its “simple” and usual technological function.

Life expectancy of people with schizophrenia is reduced by 10-20 years compared to the general population. The excess mortality is part due to an increased prevalence of cardiovascular disease, prediabetes and obesity, which are in part due to antipsychotic treatment. Gaining weight is associated with reduced quality of life and also among the most frequently reported reasons for the discontinuation of treatment. Lifestyle changes have a time limited effect, and therefore, interest has focused on Glucagon-Like Peptide 1 receptor agonist treatment. Semaglutide, currently used to treat type 2-diabetes in doses up to 1.0 mg once-weekly, has shown promising results regarding weight loss in doses up to 2.4 mg once-weekly. It may also be able to reduce the risk of developing diabetes and cardiovascular disease.

The HISTORI Trial aims to reduce risk of developing diabetes and cardiovascular disease in people with schizophrenia, prediabetes and overweight and to investigate for an indirect effect of Semaglutide on psychotic symptoms and quality of life through a weight loss.

A 30 weeks randomized, placebo-controlled, double-blinded study with once-weekly injections of Semaglutide 1.0 mg. Primary inclusion criteria are age 18-40 years, schizophrenia, prediabetes, overweight and treatment with antipsychotics. Questionnaires and interviews regarding psychotic symptoms, quality of life, medication adherence and physical activity will be applied either monthly or every third month.

will not be ready for the congress. A poster outlining the feasibility challenges will be presented.

Perspective: Through weight loss, Semaglutide may indirectly be able to improve quality of life, medication adherence and psychotic symptoms.

No significant relationships.

ADHD is often unrecognised and untreated, particularly in Europe. There is a need for improved understanding of ADHD in adults and its impact on patients across the lifespan. Registries allow for multiple real-world comparisons based on assessment of patients that are typically excluded from clinical studies. Data describing the cost, burden and consequences of ADHD are essential to inform clinicians, regulatory agencies, payers and patients about the condition.

To address the gaps in our current understanding of the care and cost of treating adult patients with ADHD by documenting real-life experiences.

A prospective, longitudinal, observational study of adults > 18 years with ADHD, designed to follow 2500 patients in the USA, UK, Germany, The Netherlands and Canada for a minimum of 5 years.

In year one, patients will be asked questions regarding:

the impact of childhood diagnosis and/or treatment on adult ADHD, long- and short-term treatment patterns and their consequences, differences between ADHD treatments, the relationship between disease severity and compliance with treatment, increased tendency to risk behaviour/substance abuse, costs.

In subsequent years, topics may be expanded to include the transition into adulthood and healthcare access for young adults.

Ten sites are currently recruiting, with 45 patients enrolled up to 7 October 2010. Challenges associated with initiating a global registry in North America and Europe will be discussed.

Data generated from CLEAR will help improve the global understanding of the longitudinal impact of ADHD.

Supported by Shire Development, Inc.

UK healthcare policy has highlighted a shift in mental health services from hospital to community, stressing the importance of training for professions not traditionally associated with healthcare. Recommendations have been made to introduce training for the police force designed with experts. Similarly, the value of further training for ambulance clinicians in assessing mental health, capacity, and understanding legislation has been highlighted.

To investigate the effect of simulation training on the confidence, knowledge, and human factors skills of police and ambulance service personnel in working with people experiencing mental health conditions.

On completion of data collection from 14 training courses, approximately 90 police and 90 ambulance personnel (n = 180) will have completed the human factors skills for healthcare instrument, confidence and knowledge self-report measures, and post-course qualitative evaluation forms. A version of the hfshi for non-clinical professions will hopefully be validated following data collection. Results will also be compared by profession.

Analyses have not been fully completed, although preliminary statistical analyses demonstrate promising findings, with increases post-course for human factors skills, confidence and knowledge. Furthermore, qualitative feedback initially illustrates valuable learning outcomes and interesting findings from comparisons by professions.

Mental health simulation training appears to have a promising impact on the confidence, knowledge, and human factors skills of police and ambulance personnel for working with people experiencing mental health conditions.

The authors have not supplied their declaration of competing interest.

Amygdala subregion-based network dysfunction has been determined to be centrally implicated in major depressive disorder (MDD). Little is known about whether ketamine modulates amygdala subarea-related networks. We aimed to investigate the relationships between changes in the resting-state functional connectivity (RSFC) of amygdala subregions and ketamine treatment and to identify important neuroimaging predictors of treatment outcomes.

Thirty-nine MDD patients received six doses of ketamine (0.5 mg/kg). Depressive symptoms were assessed, and magnetic resonance imaging (MRI) scans were performed before and after treatment. Forty-five healthy controls underwent one MRI scan. Seed-to-voxel RSFC analyses were performed on the amygdala subregions, including the centromedial amygdala (CMA), laterobasal amygdala (LBA), and superficial amygdala subregions.

Abnormal RSFC between the left LBA and the left precuneus in MDD patients is related to the therapeutic efficacy of ketamine. There were significant differences in changes in bilateral CMA RSFC with the left orbital part superior frontal gyrus and in changes in the left LBA with the right middle frontal gyrus between responders and nonresponders following ketamine treatment. Moreover, there was a difference in the RSFC of left LBA and the right superior temporal gyrus/middle temporal gyrus (STG/MTG) between responders and nonresponders at baseline, which could predict the antidepressant effect of ketamine on Day 13.

The mechanism by which ketamine improves depressive symptoms may be related to its regulation of RSFC in the amygdala subregion. The RSFC between the left LBA and right STG/MTG may predict the response to the antidepressant effect of ketamine.