Valproic acid (VPA) is considered a well-tolerated antiepileptic drug used in Bipolar Disorder as a mood stabilizer. Nevertheless, VPA has been related to several adverse effects. Neutropenia is included as a potential adverse effect, although in clinical practice it is not often measured with regularity.

To report a case of a patient with Bipolar Disorder type 2 and Personality Disorder Cluster B treated with VPA with a neutropenia caused by VPA.

A 61-year-old woman assists to the outpatient psychiatric unit in order to a pharmacological treatment adjustment. A blood test is performed showing a decrease in the levels of neutrophiles in comparison with previous tests. Psychiatric history is revised finding and association between the prescription of VPA and the reduction of neutrophile levels. When this drug was removed, neutrophile levels had increased again up to normal levels.

Due to the relationship between neutropenia and VPA treatment, we decided to discontinue this drug. At the beginning the patient doesn’t agree with the withdrawal of VPA treatment due to its effectiveness in her mood stabilization. Psychoeducation sessions are performed in order to explain risk and benefits of potentials treatment alternatives versus maintaining the same prescription. Finally the patient accepts the switch of the mood stabilizer treatment to oxcarbazepine with a good tolerability and effectiveness.

Periodical blood test monitoring is needed in order to study adverse effects as neutropenia in patients with VPA treatment.

The author has received support from Janssen-Cilag, Otsuka-Lundbeck, Italfármaco, Angelini Pharma and Casen Recordati; and declares no support related to the subject of this article.

The trans-3;4-dichloro-N-(2-(dimethylamine) cyclohexyl) labelled as U-47700 has a high affinity with the selective receptor, considered to have 7.5 times the binding affinity of morphine; as a result, it is sold as a recreational drug because of its analgesic and euphoric effects. Several toxicity cases and some fatalities have been reported during 2016.

To describe the presence of trans-3;4-dichloro-N-(2-(dimethylamine) cyclohexyl) in samples delivered to Energy Control during 2016 in Barcelona.

From January 2016 to October 2016, 4031 samples were delivered and only those samples containing trans-3;4-dichloro-N-(2-(dimethylamine) cyclohexyl) were studied, 6 of them were analysed as U-47700 (0.148%). Samples were analysed by energy control, a Spanish harm-reduction NGO that offers users the possibility of analysing the substances they intend to consume. Analysis was done by gas chromatography–mass spectrometry.

From the 6 samples that were analysed as trans-3;4-dichloro-N-(2-(dimethylamine) cyclohexyl), the presentation of 4 of them was white powder and the rest were not described. The procedence of the samples was Canada (2), USA (1), Sweden (1), Holland (1) and the remaining sample was not described. All samples were received during 2016.

The use of trans-3;4-dichloro-N-(2-(dimethylamine)cyclohexyl) is progressively increasing in Barcelona. Its harmful effects are being reported in recent medical literature and consumption represents an emerging issue, gaining popularity among recreational opioid users. It is potentially lethal when mixed with depressants like alcohol or benzodiazepines and overdose risk is higher compared to other opioids. This drug is not being detected by routine in medical test.

The authors have not supplied their declaration of competing interest.

Serotonin syndrome is a potentially life-threatening condition that is precipitated by the use of serotonergic medications, Selective Serotonin Reuptake Inhibitors (SSRIs) and Monoamine Oxidase Inhibitors (MAOIs). It usually occurs when high doses of serotonergic drugs are prescribed. It is a medical emergency that requires prompt recognition, cessation of offending drugs and supportive therapy.

We present a case of serotonin syndrome that occurred in a patient who was prescribed a low dose of sertraline, and aim to highlight the importance of early detection of this severe condition.

Details of the case were described. Information was gathered based on medical records.

Patient M was a 29-year-old Malay male with a history of major depressive disorder, who was previously trialed on fluvoxamine 100mg every night but subsequently switched to and maintained on sertraline 75mg every night in 2020. He then defaulted follow up appointments. In 2023, he presented to the emergency services for a suicide attempt and was diagnosed with major depressive disorder with psychotic features. He was restarted on sertraline 50mg every night and risperidone 0.5mg every night was newly started. Two days later, sertraline was increased to 100mg every night. Two days following this increase, he was noted to have altered mental state, fever of 39.3-degree celcius, tachycardia of 120 beats per minute, ocular clonus and generalized hyperreflexia. Sertraline and risperidone were immediately stopped. Blood tests including creatine kinase, lumbar puncture and magnetic resonance imaging (MRI) of the brain did not show any abnormalities. After stopping of the medications, the patient’s symptoms resolved within 24 hours. Based on clinical symptoms and a normal creatine kinase level, neuroleptic malignant syndrome (NMS) was ruled out. Subsequently, he was restarted on risperidone 0.5mg and mirtazapine 7.5mg every night. He developed symptoms of serotonin syndrome with a low dose of sertraline. Symptoms resolved after the discontinuation of the SSRI.

In this case, differential diagnoses of serotonin syndrome were also considered, such as NMS, encephalitis, meningitis and thyroid storm. NMS was less likely due to the rapid onset of onset and resolution of symptoms. Encephalitis and meningitis were unlikely in view of normal MRI brain and lumbar puncture findings.

There have been case reports of serotonin syndrome developing with lower doses of an SSRI in the pediatric population. There is, however, a lack of literature describing serotonin syndrome with low doses of SSRI in the adult population. To avoid a missed diagnosis, clinicians should monitor closely for SSRI toxicity, including serotonin syndrome, even when low doses of serotonergic drugs are used.

None Declared

The presentation considers the peculiarities of late adulthood, different views on the periodization of older ages (World health organization, I. Burnside, H.S. Pryazhnikov).

The research is aimed at studying the peculiarities of late adulthood.

The method of work is a bibliographic analysis.

Reveals the structure of psychological age (concept by L.S.Vygotsky), the specificity of the development in late adulthood and features of the social situation of development. Reveals modern ideas of ageing as a process not only of involution and loss, but also a process of continued development. The greatest attention is paid to the peculiarities of development tasks at older ages and the difficulties faced by older people trying to cope with them. There are the brief overview of the positions of C.G.Jung, A.Adler, E.Erikson, R.Peck, G.M.Bryugman, A.G.Liders, N.S.Pryazhnikov, E.E.Sapogova, I.V.Shapovalenko, V.I.Slobodchikov, G.A.Zuckerman, etc. regarding the development tasks in late adulthood. The comparison of the development tasks of early and late age periods by G.M. Bryugman, which shows that the tasks of aging worse defined, at least sequentially ordered, and the results of solution of development tasks is less predictable than in earlier ages.

We can say that in old age is important not only the task of adjusting to different changes of pace of life, quality of life, social circle, etc., and overcome the negative aspects of aging but also issues of self-development. As the primary development task in late adulthood is considered an achievement of his own integrity and finding the meaning of life.

No significant relationships.

Persons receiving care in forensic settings face unique challenges. Long hospital stay combined with other factors such as reduced physical activity, unhealthy diets, smoking, serious mental illness, antipsychotic medications, all add up to increase their risk of acquiring metabolic syndrome, thereby increasing morbidity and mortality.

Practice of monitoring for metabolic effects of an atypical antipsychotic- Clozapine was audited with the Maudsley Guideline as standard in 2 medium secure wards with 25 patients. It was conducted in 2011.

We checked whether blood lipids and body weight were monitored at baseline, at 3 months and then yearly; whether blood glucose and blood pressure were checked at baseline, at 4–6 months and then yearly.

Various sources of information were used including: paper medical records, electronic clinical entries, physical observation charts, medication prescription charts, Clozapine charts and acute hospital laboratory results

24 patients (96%) were on antipsychotic medication. Of these, 23 patients were on atypicals. Of the latter, 8 persons were on Clozapine. No patient on Clozapine achieved a 100% monitoring on indices. Baseline monitoring for cholesterol, weight, blood glucose and blood pressure were 88%, 50%, 75% and 88% respectively. At midterm they were 50%, 100%, 38%, and 25% respectively. There were variable compliance with other indices at stipulated times. Lack of supporting infrastructure to facilitate compliance was identified.

There was a need to adhere to existing guidelines which were also embodied in Trust policy to help manage metabolic syndrome.

Lack of insight in schizophrenia is frequently associated with deficits in self-assessment of cognitive and functional abilities, as well as quality of life outcomes.

The aim of this analysis was to evaluate the impact of treatment-related improvement in illness awareness on changes in cognition and functional outcomes in a double-blind, controlled study.

Clinically unstable patients with schizophrenia (N=488) were randomized to once-daily, fixed dose treatment with lurasidone 80 mg (LUR 80), lurasidone 160 mg (LUR 160), quetiapine XR 600 mg (QXR) or placebo (PBO), followed by a 12-month, double-blind extension. Impairment of insight (G12 ‘lack of judgment and insight’), cognitive performance, quality of well-being (QWB scale), and UPSA-B were assessed at baseline, week-6 and month-6 of extension (32 weeks). Mixed effects model was applied.

PANSS insight scores were significantly improved for all treatment groups compared to placebo after 6 weeks. Improvement in insight at week-32 was significantly greater in subjects treated with lurasidone compared with quetiapine XR. Improved insight at week-6 was a significant mediator for the effect of LUR160 (vs. placebo) on neurocognitive composite score (p<0.05), UPSA-B total score (p<0.05), and QWB (p<0.05) at week-6. Improved insight was significantly associated with increase in UPSA-B score and health-related quality of life at weeks 19 and 32.

Improvement in insight at week-32 was significantly greater in subjects treated with lurasidone compared with quetiapine XR. Our findings suggest treatment-related improvement in illness awareness had significant impact on cognition and functional outcomes in a doubleblind, controlled study.

IGA MZ CR NT 11047-4/2010

A comparison between Pyridoxine (vitamin B6) and a placebo for the treatment of premenstrual syndrome (PMS).

A double blind randomized clinical trial was performed on 160 university students who were suffering from PMS (according to the retrospective diagnostic criteria which had been recorded during the last 3 menstrual cycles). Then the patients were randomly assigned into two groups, and finally 94 patients who had finished the study were statistically analyzed.

In the Pyridoxine group (46 patients) vitamin B6 was prescribed at a dose of 40 mg twice daily (total 80 mg), and in the placebo group (48 patients) a tablet similar to vitamin B6 tablets in size, smell, shape and taste was prescribed 1 tablet twice daily. In both groups the tablets were started from the first day of the fourth menstrual cycle and continued for the next two cycles, and during these two cycles the symptoms were recorded.

The severity of PMS in the second cycle of the treatment (in both groups) showed a statistically significant decrease (p <0.05, Pair T test) and the comparison between the two groups showed that the severity of PMS in the Pyridoxine group decreased more than the placebo group, which was statistically significant (p < 0.05, Student T Test) and this was because of the reduction in the psychiatric rather than somatic symptoms of PMS.

Regarding the effect of Pyridoxine in reducing the severity of PMS, it can be suggested as a treatment for PMS.

Parricide is murder of parents by their children. This kind of murder is rare, approximately 2 % of all homicides. It is associated with severe mental disorders which makes this phenomena interesting for psychiatric and forensic exploration.

The aim of the study was to describe sociodemographic and psychopathological characteristics of committers and victims and to investigate the act itself.

All homicide autopsy records from1991-2005, performed on Institute of Forensic Medicine, Medical School, University of Belgrade, were examined (948 cases). Only cases of parricide (33) were included in further analyses. Study was retrospective and descriptive statistic was used.

In the region of Belgrade, rate of parricide in all homicides was 3.5% (0-9 cases per year). In average, parricide committers were: 31.2±11.9 years old, 87.8% male, 60.6% with psychiatric symptoms (most common schizophrenia, alcohol dependence, personality disorder etc), while victims were: 63.7±11.9 years old, 54.5% male, 21.2% with diagnosis of mental illness. Most used tools were: 48.5% edgeless object, 30.3% weapon, 15.2% knife. Although clear motives were difficult to obtain, we recorded possible motives: in 42.4% parental abuse, 30.3% child abuse; 9.1% benefit and 18.2% unknown.

Subjects with severe mental illness are more likely to be parricide committers. Specific features of their psychopathology, differences in the course of the illness, compliance and many other risk factors should be explored further on in order to recognize and prevent fatal outcome.

To assess efficacy and safety of tenoten for children (TC, ultra-low doses of antibodies to S100 protein) in ADHD patients.

In a double-blind placebo-controlled study 50 children (6-12 years) met DSM-IV criteria, mild/moderate CGI-ADHD-Severity and ADHDRS-IV-Parent:Inv > 22 points were enrolled. Patients were randomized to receive either TC (2 tablets BID, n=25) or placebo (n=25) for 12 weeks. ADHD symptoms were assessed by ADHDRS-IV-Parent:Inv, CPRS-R:S and CGI-ADHD-Severity.

According to both parents and investigators assessment TC decreased ADHD symptoms: ADHDRS-IV total score reduced by 13.5 points, hyperactivity by 6.7 points, inattention by 6.8 points (5.4, 2.3 and 3.2 in placebo); CPRS-R:S total score reduced by 12.8 points, hyperactivity by 3.6 points, inattention by 6.1 points (4.8, 1.8 and 1.7 in placebo). ADHD severity reduced in 9 patients received TC and 3 patients received placebo. No adverse effects were reported in both groups.

The study demonstrated good clinical efficacy and safety of TC in children with ADHD.

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

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

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

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

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

No significant relationships.

Abdominal obesity is currently a growing problem in public health and has a high comorbidity with depressive and anxiety disorders. Obesity significantly decreases life quality, causes disability and decreases life expectancy.

The objective of this study was to examine anxiety and depressive symptoms among women, who received individual or group psychotherapy sessions due to obesity control.

577 women aging from 18 to 65 were examined. Height and weight were measured, Body mass index (BDI) was calculated based on received data. Depressive symptoms were determined with the PHQ-9 questionnaire [Kroenke K, Spitzer RL, Williams JB]. Anxiety symptoms were determined with the GAD-7 questionnaire. The level of social adaptation was examined.

The prevalence of mild depression in our sample of women with obesity was 31.5%, 19.1% - moderate depression, 1% - severe depression, 48.4% had no depression symptoms. Anxiety symptoms were found in 38.2% of examined women, 61.8% showed no anxiety symptoms. Furthermore, when patients were divided into subgroups accordingly to BMI, anxiety was mostly registered among ones with normal BMI. An average correlation between indicators of anxiety and depressive symptoms was identified (r=0,62, p<0,05). Average correlation between indicators of anxiety and depression and the level of social adaptation (r=0,59 and r=0,48 relatively, p<0,05). Anxiety and depressive symptoms’ dependency on BMI was not established.

The received data showed that anxiety and depression have high prevalence among women with obesity. The study will help medical specialists draw attention to high comorbidity between abdominal obesity and anxiety-depressive disorders.

There is an urgent need for sustainable thinking and practices in healthcare systems to meet the challenge of climate change (Charlesworth & Jamieson, 2019; Corvalan et al., 2020; Luykx & Voetterl, 2022; Madden et al., 2020). This need is accelerated by the recent energy crisis. According to an international NGO policy paper (Karliner et al., 2019) healthcare institutions are large energy consumers and major emitters. The (mental) health sectors of the Netherlands and Flanders, the northern part of Belgium, also greatly contribute to the global climate crisis. Both regions have per capita emissions (between the 0.50t and 1t) that fall just below the world’s healthcare top emitters.

To evaluate the state of sustainability in Dutch and Flemish mental health institutions (including psychiatric hospitals, rehabilitation centers, and community mental health centers) and assess whether certain differences can be found in the climate policies of these institutions between both regions.

Board members of mental health institutions were asked to complete a 20-item online survey in which concrete actions, objectives and ambitions in the field of sustainability were questioned. Frequencies and percentages were calculated for each question. For certain topics chi-squared tests were performed to test differences in sustainability issues addressed in the questionnaire between Dutch and Flemish mental healthcare institutions.

Survey response rates for Dutch and Flemish mental health institutions were 38% and 20%, respectively. Ninety-five percent and 38% of respectively the Dutch and Flemish institutions fully agreed that sustainability is a very important theme (χ2(1)=2,25, p=0,13). Key focus areas in both regions included sustainable energy transition (with half of the mental health institutions sourcing at least half of their energy via renewable energy resources and technologies) and recycling (almost 80% of the institutions). Statistically significant differences were found between both regions with regard to monitoring the environmental impact (Flanders 24% vs. The Netherlands 60%, χ2(1)=6,41, p=0,01) and fostering more sustainable commutes (Flanders 72% vs. The Netherlands 15%, χ2(1)=17,35, p<0,0001). The climate impact of medicines and food, as well as investments in sustainable projects, received little attention.

Although a substantial part of Dutch and Flemish mental health institutions consider sustainability (very) important, a systemic ‘transformation’ will be necessary to make them climate neutral, as tenets of practicing mental healthcare sustainably include more than sustainable energy transition and recycling (Monsell et al., 2021). Moreover, a lack of sufficient investment opportunities, partly due to a lack of financial resources, seems to be the main barrier for many mental healthcare institutions for quickly reaching sustainability goals.

None Declared

Polycystic ovary syndrome(Pcos) disease significantly decreased quality of life for women. Mental health is one of the components affecting the quality of life of these patients that attention to it is necessary to improve their quality of life.

The present study was conducted to determine The effect of Motivational Interview Based on WhatsApp on the Psychological Domains of Quality of Life in Infertile Women with PCOS.

This randomized controlled clinical trial enrolled 60 Infertile Women with PCOS from the city of Sari-Iran in 2020. Participants were assigned to MI and control groups using block randomization. The intervention group received 5 weekly of MI online via WhatsApp. While the control group received only routine care. The psychological Domains score of quality of life in these individuals was measured using the quality of life questionnaire of polycystic ovary syndrome(MPCOSQ) before and after the intervention. Then, the data were entered into the SPSS software, version 25 and were analyzed using descriptive statistics, chi-square test, t-test, and repeated measures analysis of variance.

No significant difference was observed between the two groups before the intervention mean The Psychological Domains scores (p>0.05). After the intervention, mean (SD) of The Psychological Domains score was 34.8 (11.8) in the intervention group and 30.7 (11.6) in the control.No significant Increasing in the mean between the two groups. The effect size(0.35) was calculated.

The results of the study showed that motivational interviewing is effective in improving the quality of life of women with pcos.

No significant relationships.

Mood destabilization and induced manic episodes are well-known phenomenon under antidepressant medications. However, even with a cautious introduction of antidepressants, it’s important to be aware of possible pharmacological interactions. Terbinafine is a known inhibitor of CYP2D6, a major hepatic metabolizer of a full list of antidepressant medications, and so capable of raising their serum levels and potentiating their side effects.

With this case report we aim to emphasize the importance of cautious usage of Terbinafine when combined with antidepressant medications.

We present a clinical case of an induced first manic episode after the introduction of Terbinafine in a patient under antidepressant medication and a qualitative review on the topic, using PubMed database.

A 66-year-old woman, with an history of Major Depressive Disorder, previously medicated with Venlafaxine 75mg/day and Mirtazapine 30mg/day, was brought to the emergency department because of psychomotor agitation. She also had an history of seasonal fluctuating mood, although never fulfilling the criteria for Bipolar Disorder. At admission, her clinical status was compatible with a manic episode. This episode followed two months after the initiation of Terbinafine for onychomycosis.

There are few studies that have shown antidepressant toxicity mediated by an interaction with Terbinafine. As far as we know this is the first case of induced mania after the introduction of Terbinafine. Therefore, it is important to remind that Terbinafine is a potential interacting agent when combined with psychotropic medications.

Obsessive-compulsive symptoms (OCS) have been described in many neurological disorders, including dementia. A meta-analysis by the authors (2021) reported a prevalence of OCS in dementia of approx. 35.8%, and a higher percentage in frontotemporal dementia (FTD) (46.7%). The literature also points that obsessive-compulsive disorder with late-life onset is rare, but those cases are frequently associated with neurologic injury, and some authors suggest a role of cognitive disfunction.

Our main goal was to describe the neurobiologic and cognitive underpinnings of OCS in patients with dementia.

MEDLINE, CENTRAL and PsycNet databases were searched for articles about obsessive-compulsive symptoms in dementia. Search terms included “obsessive”, “compulsive”, “OCD”, “cognitive decline”, “cognitive dysfunction” and “dementia”. Titles, abstracts and full texts were screened independently by 2 reviewers.

Correlations between dysfunction / lesions in various circuits in the context of dementia and OCS were found, such as (1) frontal regions (specially the orbitofrontal cortex) and anterior cingulate cortex (2) fronto-striatal-thalamic circuits (3) temporal structures; (4) cerebellar structures; (5) serotoninergic, dopaminergic, and cholinergic neurotransmission. A high proportion of studies concerned FTD. Regarding cognitive mechanisms, there is a focus on the importance subjective concerns about cognitive functioning, which could exacerbate obsessional beliefs and maladaptive responses to intrusions.

The main brain circuits implicated in dementia, specially FTD, and OCS are those involving frontal regions and the fronto-striatal-thalamic circuits, with areas such as the temporal and cerebellar structures algo being studied. The correlation between dysfunctional circuits in dementia and OCS could give us new hints about OCD and its treatment.

No significant relationships.

The purpose of our study is to survey the habits of teenagers concerning the use of internet and furthermore to investigate the frequency of internet addiction and its predisposing factors.

We investigated the habits of high school students (n = 154) in the county of Mureş using questionnaires (Internet Addiction Test).

Young people spend daily an average of 3 hours and 38 minutes in front of a computer. 45% of the boys spend daily more than two hours with computer games while 74, 53% of the girls chat daily. 3, 41% of the adolescents think that they spend a lot of time on the net and their learning and school problems are a result of this. 9,3% of the teenage boys spend daily more than 4 hours 20 minutes in front of a computer (weekly 30 hours), what is qualified as dependence according to the American specialists. There is a strong correlation between internet addiction and parents divorce.

The rate of young people addicted to internet gains considerable importance. Moreover this addiction is associated with other addictions so there would be a serious need for health education programs already in high schools.

There is a complex relationship between smoking, mental health and diabetes. On one side, there is a bidirectional relationship between tobacco and depression: smokers are more at risk to suffer from depression compared with non-smokers and smoking cessation is associated with mood improvement. Moreover, persons with depressive disorders may be particularly vulnerable to nicotine addiction and are less likely to quit smoking. On the other side, a strong association is observed between depression and diabetes. Gender and sex have also been described as influencing the associations between these different pathologies.

Our aim was to determine if and how this relationship exist in a population with diabetes and to assess the impact of smoking reduction on depressive, anxiety symptoms and a health assessment score. We tried also to highlight the potential differences that we find between men and women.

Data were collected from a randomized controlled trial evaluating the 1-year efficacy of smoking cessation interventions in a population of smokers with type 2 diabetes. PHQ-9, GAD-7 and SF12 scores were used to assess depressive, anxiety symptoms and health assessment. We used STATA to perform data analysis.

48 participants were recruited in this study. Women represent 60,4% of the population and men 39,6%. The mean age was 61,9 years old (SD 9.93). The mean depression, anxiety and health assessment scores were 4.1 (SD 4.55), 3.4 (SD 4.83) and 3.0 (SD 0.69) respectively. There were no significant differences between women and men scores. Women tended to have higher depression and anxiety scores, whether they reduced their consumption or not. Men who decreased their smoking consumption (reducers) tended to have better mental health scores than women at baseline. In both genders, we found a trend toward improvement in depressive, anxiety and health assessment scores of participants that reduced their tobacco consumption. We assessed a loss of 1.8 (SD 2.58, p-value= 0.424 ) and 1.7 (SD 3.20, p-value=0.448 ) points to their depressive and anxiety scores respectively while non-reducers only lost 0.6 (SD 4.03*) and 0.7 (SD 2.88**) points respectively.

Our study suggests that differences between genders exist and that there are improvement differences in scores of people who reduced their tobacco consumption compared to people who didn’t reduce their consumption. However, none of our results were significant. A study with a greater number of participants and with more strength should be done to confirm our hypotheses.

None Declared

The author has not supplied his declaration of competing interest.