The identification of potential biomarkers is crucial to improve the management and treatment of mood disorders. Glycogen synthase kinase-3 (GSK-3) is a multifunctional enzyme with an important role in the etiology of mood disorders. Recent findings suggested GSK-3 as a putative biomarker in mood disorders.

The aims of the study are: - to evaluate GSK3 as potential biomarker for differential diagnosis (MDD and BD); - to analyze the regulation of GSK3 by psychopharmacological treatments.

Patients included fulfill the following criteria: (a) principal diagnosis of MDD or BD (DSM-5); (b) age ≥ 18 years; (c) drug-free for at least 4 weeks before the inclusion. For each patient included a healthy control is enrolled, matched by gender and age. All included subjects at the study entry point (t0) are assessed through: - semistructured clinical interview and clinical rating scales (Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale; Young Mania Rating Scale, Clinical Global Impression) - blood draw, to measure GSK-3 levels Patients with MDD or BD are assessed again after 1 week (T1) and after 2 month (T2) of specific pharmacological treatment.

So far, we enrolled 16 patients and 16 healthy controls. The enrollment is still ongoing.

We expect to find GSK-3 levels differently expressed between healthy controls, patients with DDM and patients with BD. This finding would be crucial as it could contribute to the improvement of differential diagnosis. Moreover, we expect to observe a change in GSK-3 levels after psychopharmacological treatments.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by frequent comorbidity including mood, anxiety and psychotic disorders. Psychiatric comorbidity in ASD has been associated with poor prognosis.

To summarize clinical data regarding the relationship between autism spectrum disorder and psychosis comorbidity, namely its epidemiology, diagnosis, treatment and prognosis.

We conducted a non-systematic review of the literature relevant to the topic published in the PubMed database. Articles were selected based on title and abstract review.

Epidemiological studies report significant rates of comorbidity between ASD and psychosis. According to a recent systematic review, prevalence of non-affective psychosis in ASD has been estimated at 9,56%, despite heterogeneity across included studies.

The differential diagnosis of psychosis in a patient with ASD is frequently a challenge and depends on the severity of intellectual and language impairment, medical comorbidities (including epilepsy and associated pharmacological iatrogenic factors), psychiatric comorbidities and substance use. Conversely, establishing the diagnosis of ASD in a patient presenting with psychosis is not always clear, and clinicians must rely on collecting a detailed developmental history.

There are no large controlled studies regarding the treatment of psychosis in this specific patient group, but risperidone and aripiprazole have been used based on efficacy in primary psychotic disorders, as well as efficacy and safety profile in other symptomatic clusters of ASD, namely irritability.

ASD and psychosis comorbidity has been associated with lower response rates to antipsychotic treatment and negative long-term prognosis.

Psychosis is a common and serious comorbidity of ASD, with limited data regarding treatment options. Further research is needed to improve global outcomes.

None Declared

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.

Serum BDNF levels are decreased in major depressive disorder (MDD) and tend to normalize under antidepressant treatment, serving as a treatment outcome predictor. BDNF is initially synthetized as precursor protein proBDNF and is cleaved to mature BDNF (mBDNF) while only the latter exerts neurotrophic activity.

The aim was to explore if a specific enzyme-linked immunosorbent assay (ELISA) kit for mBDNF in serum would be superior to the unspecific assessment of total serum BDNF in predicting treatment response in MDD.

Twenty-five patients with MDD underwent standardized treatment with duloxetine. Severity of depression was measured by Hamilton Depression Rating Scale (HDRS) at baseline (BL), after one (W1), two (W2) and six weeks (W6) of treatment. Treatment response was defined as a HDRS ≥ 50% reduction of BL score at W6. mBDNF and total BDNF serum levels were determined at BL, W1 and W2.

A high and stable correlation was found between mBDNF and total BDNF serum levels over all measurements. The predictive value of mBDNF BL levels and mBDNFΔW1 to response was similar to that of total BDNF BL and total BDNFΔW1. The assessment of serum mBDNF was not superior to total BDNF in prediction of treatment outcome.

Not only baseline total BDNF but also mBDNF is predictive to treatment outcome. The later might represent the main player in this respect, which supports the idea of a functional link between neuroplasticity and MDD.

The authors have not supplied their declaration of competing interest.

Treatment adherence in patients living with Bipolar Disorders can influence prognosis and quality of life. It is associated with an increased morbidity and healthcare costs.

The aim of our study was to evaluate treatment adherence in a sample of patients living with Bipolar disorders and to determine factors associated with poor adherence.

We conducted a cross sectional study where we included bipolar patients being treated in psychiatry department A. We developed a survey containing sociodemographic and clinical features. We used the medical adherence rating scale to evaluate treatment adherence.

Our sample consisted of 100 patients with a mean age of 47,5 years old. Sixty seven patients were being treated for bipolar disorder type 1. Medication adherence rate was 64%.

Factors associated with poor medication adherence were being single, an early age of onset, comorbid substance abuse disorder, severe treatment side effects and poor insight.

Poor medication adherence is a major issue for people living with Bipolar Disorders. Clinicians should pay more attention to sociodemographic and clinical factors to predict and enhance treatment adherence.

None Declared

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.

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.

E-cigarette use has increased over the last years. Many studies have examined teenagers’ attitudes towards smoking, but did not examine adolescents’ attitudes towards e-cigarettes.

The aim of this study was to examine high school students’ attitudes regarding e-cigarette safety, addictive properties and social norms and to compare e-cigarettes perceptions among e-cigarette users and non-users in Tunisia.

A survey was conducted with a sample of 234 students in Mohamed Ali high school in Sfax, a town in South of Tunisia, in February 2020. Socio-demographic data and questions about vaping and attitudes towards e-cigarettes were used to evaluate students’ perceptions towards e-cigarettes.

Among high school students aged 15 to 20, 58,8% have ever used e-cigarette, 38,3% had done so within the previous 30 days and 20,5 % were regular users of vapes. 53.8% of students believed that e-cigarettes are harmful. 78.4% of them thought they were less harmful than regular cigarettes and 50.5% thought they could be addictive, 45.4% of students believed e-cigarette smoking decreased anxiety and a third thought it made them sociable (33.3%) and confident (30.6%).Adolescents who used e-cigarettes had significantly more favorable e-cigarette attitudes than non-users: they believed they were less harmful than tobacco (p=0,019), they were not addictive (p=0,005), they decreased anxiety (p=0,001) and they made the user sociable (p<0,001) and confident (p=0,01).

Our results suggest the need to provide teenagers with the correct information about e-cigarettes risks, and the balance risk-benefit of their use.

No significant relationships.

The H2020/PERISCOPE project, including 32 partners from European universities & agencies, began 1st November 2020 and will last 36 months. The overarching objectives of PERISCOPE are to map and analyse the unintended impacts of the COVID-19 outbreak; develop solutions and guidance for policymakers and health authorities on how to mitigate the impact of the outbreak; enhance Europe’s preparedness for future similar events; and reflect on the future multi-level governance in the health as well as other domains affected by the outbreak. During this session we will report about early lessons learnt from the mapping and assessments of the impacts of the COVID-19 outbreak on mental health at national and subnational level in the EU with respect to individuals, communities and societies. Further, we will comment on their comparability. The aim is to explore differences between countries regarding the occurrence of mental ill health, and especially the impact on vulnerable groups, and how this is related to exposure to SARS-CoV-2, differences in policies over time, and effects on the economy. We will reflect on the short- and long-term consequences on mental health and health inequalities, report on the ongoing development of holistic policy guidelines for health authorities & other authorities, and from the analysis of multilevel governance, at local, regional and national level, memberstate – EU-level, and EU - global governance level. PERISCOPE will continue collecting data and updating a common data ”Atlas”, which would lead the consortium to engage in modelling and experiments to provide “continuous nowcasting” of the outbreak.

No significant relationships.

Joint hypermobility syndrome/Ehlers Danlos III (JHS/EDS III) is a common, connective tissue condition. This group is over-represented in panic/anxiety disorders and exhibits autonomic abnormalities and heightened interoceptive sensibility. Previous neuroimaging in healthy volunteers with hypermobility has observed differences in key emotional brain regions, notably amygdala and insula.

Aims and objective To explore, in a clinical population, the structural brain correlates underpinning the association between JHS/EDS III and anxiety.

Seventy participants were divided into four experimental groups: (2 × 2 factor design: presence/absence of hypermobility; presence/absence of anxiety). Hypermobility was assessed using Brighton Criteria. All participants underwent brief tests of autonomic function and interoception. Structural images were obtained using a 1.5 T MRI scanner. Results are reported at whole brain uncorrected significance threshold of P < 0.001.

Comparison of grey matter volume revealed increased insular volume in anxious patients with JHS/EDS-III compared to anxious patients without (Fig. 1A, B), correlating with initial peak heart rate on standing. Additionally, amygdala volume correlated with hypermobility score in anxious patients, but not in non-anxious individuals (Fig. 1C, D). Amygdala volume correlated with interoceptive accuracy.

This data implicates amygdala and insula as likely neural substrates mediating clinical relationships between hypermobility syndrome and anxiety, demonstrating the relevance of autonomic and interoceptive influences on this relationship. Further work hopes to explore functional and structural connectivity between these regions in JHS/EDS-III.

The authors have not supplied their declaration of competing interest.

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.

The growing concern about cannabis use, the most used illicit drug worldwide, has led to an increase in the number of cannabis studies using neuroimaging techniques to determine its effect on brain structure and function.

We conducted a systematic review to assess the evidence of the impact of chronic cannabis use on brain structure and function in adults and adolescents.

Papers published until August 2012 were included from EMBASE, Medline, PubMed and LILACS databases following a comprehensive search strategy and pre-determined set of criteria for article selection. Only neuroimaging studies involving chronic cannabis users with a matched control group were considered.

One hundred and forty-two studies were identified, of which 43 met the established criteria. Eight studies were in adolescent population. Neuroimaging studies provide evidence of morphological brain alterations in both population groups, particularly in the medial temporal and frontal cortices, as well as the cerebellum. These effects may be related to the amount of cannabis exposure. Functional neuroimaging studies suggest different patterns of resting global and brain activity during the performance of several cognitive tasks also in both groups, which may indicate compensatory effects in response to chronic cannabis exposure. The results pointed out methodological limitations among studies and high heterogeneity in the findings.

Chronic cannabis use may alter brain structure and function in adult and adolescent population. Further studies should consider the use of convergent and multimodal methodology, prospective large samples involving adolescent to adulthood subjects, and data-sharing initiatives. Grants: PNSD/2011/050, PNSD2006/101, SGR2009/1435.

Researches has shown that a subset of the autism spectrum disorder (ASD) population presents with immune dysregulation. Based upon the immunological abnormalities, various treatment modalities have been applied to children with ASD. One immunomodulatory treatment that has been studied in ASD is intravenous immunoglobulins (IVIG).

This report is based upon two hypotheses: autism etiology may be closely related to neuroinflammation; and, an effective treatment should restore the individual’s comminication skills. In this report, we present two cases who were diagnosed with ASD and received IVIG treatment.

Case A is a 5-year-old female patient who was diagnosed with ASD at the age of 3. The second case, B is a 9 -year-old male patient who is a 7th grade student and was also diagnosed with ASD at the age of 3. The first patient’s autism symptoms was noticed by her family at the age of 2. Although she had the ability to coordinate eye contact, understood simple commands, she was observed to lose all her acquired developmental skills one by one at around 18-24 months. Towards the age of 3, stereotypical movements such as turning around and flapping wings, started. Similarly, the second patient’s acquired skills were lost around at the age of 2-3, after having recurrent infections. Based on deficits in social‐emotional reciprocity, deficits in nonverbal communicative behaviors used for social interaction and restricted/repetitive patterns of behavior, both patients were diagnosed with ASD. Considering that autoimmune mechanisms may have been affected in ASD, IVIG treatment was initiated at 1 g/kg/month. Case A received IVIG once in a month, total 5 infusions had been applied. Case B received total 12 infusions with the same protocol. Treatment response was assessed with the Childhood Autism Rating Scale (CARS).

In these two ASD cases which were treated with IVIG ,a subjective partial reduction in autism symptoms and an objective decrease in CARS scores were detected. Current evidence suggests that there are various factors contributing to the development of autism and different combinations of these aspects give rise to different variations of some ASD subtypes. Recent studies in this field indicate a possible connection between the immune system impairments and ASD. This report, therefore, provide support for the notion that at least a subset of children with ASD might have immune abnormalities and may respond to the immune modulating effect of IVIG therapy.

Although, autoimmune or inflammatory etiologies may not explain the majority of cases of autism, it might at least be useful to understand some. Further studies with larger number of patients should be conducted about the use of IVIG in selected patients with ASD.

None Declared

Repetitive transcranial magnetic stimulation (rTMS) is a new treatment, used for different psychotic disorders mainly depression.

Assessing knowledge and attitude toward rTMS among psychiatrists in Saudi Arabia, and determining factors affecting that.

To ensure that psychiatrists have sufficient knowledge regarding rTMS. A good knowledge will most likely have a positive impact on their attitude.

Cross-sectional study was conducted through an online survey. The study population is all psychiatrists in Saudi Arabia. A new valid and reliable questionnaire was developed.

Sample of 96 psychiatrists enrolled in the study, 81% were males. Participant's mean age was 37 years. Half of participants were consultants. The sample mainly consists of general psychiatrists (65%). The study showed that 80% of psychiatrists have an efficient knowledge about rTMS. Consultants have higher knowledge than residents do. Abroad training has no association with the level of knowledge or attitude. Seventy-nine percent of psychiatrists have a positive attitude toward rTMS. Only 53% of psychiatrists agreed to receive (rTMS) in case they were in a psychotic depressive condition. Minority (7%) of psychiatrists would not refer their patients for rTMS.

Most of psychiatrists have a good knowledge and a positive attitude toward rTMS. Those who have high level of training and experience show higher level of knowledge. Articles are found to be a better source for updating knowledge. Having an rTMS treated person in the family or relatives will positively affect the psychiatrist's attitude.

The authors have not supplied their declaration of competing interest.

While alcohol-induced psychotic disorder (AIPD) is a well-recognised clinical disorder, relativery little is known about aspects such as epidemiology, course and treatment of the condition. Current evidence suggests AIPD can be clinically distinguised from alcohol-withdrawal delirium and schizophrenia. AIPD is associated with high comorbidity with other psychiatric disorders, high re-hospitalization and mortality rate, namely suicidal behaviour.

The objetive of the study was to examine the correlates, clinical features, psycopathology, and short-term response in an inpatient sample with alcohol-induced psychotic disorder, predominant hallucinations (ICD-10 F10.52) admitted to Centro Hospitalar Psiquiátrico de Lisboa.

We collected retrospectively data from all admitted patients to our Alcohol Unit between January 2010 and January 2020 with the diagnosis of AIPD. The exclusion criteria were: presence of preexisting psychotic disorder, delirium, or other substance use disorders. We characterized our sample in Demographic categories, Clinical categories, Treatment and Short-term course.

A total of 113 subjects were included in the study. The prevalance of alcoholic hallucinosis was found to be 1.3% of all patients who received inpatient treatment. Most individuals reported auditory hallucinations, that iniciated when they decrease their alcohol intake, and 1 in 4 had past episodes of AIPD.

There are specific challenges in studiyng AIPD, such as the relatively rarity of the disorder, its often transient nature and high levels of comorbidity. A high degree of recurrence and morbidity indicates a need to prevent, and intervene early with an abstinent-oriented management goal.

No significant relationships.

Various social problems, financial difficulties and academic factors contribute to the fact that more and more students around the world experience mental health problems (Chen et al., 2013; Gotlib et al., 2019). On the other hand, all the sides of students’ lives – from education to family relationships – are mediated by information communication technologies, that may have broad and ambiguous influence on students mental health. What is undoubtedly that youth mental health can no longer be considered without touching on the digitalization, including in education.

The current study aims to point up positive and negative examples of intersection of education digitalization and mental health of modern youth.

Theoretical analysis of research publications and conceptualization of practical applications in education mediated by digital technologies.

A striking example of the negative impact of total digitalization of education was the sharp deterioration in mental health in the context of the transition to fully distant learning in conditions of the spread of coronavirus infection. Positive education as teaching form for both traditional skills and positive functioning and happiness provides a broad opportunities to combine the concepts of positive psychology with cutting-edge high-tech education approaches.

Digitalization of modern education can be accompanied by both mental health risks and new opportunities. Mental health support can be based on finding information about good functioning, learning and participating in community activities that are provided through websites and mobile applications. The reported study was funded by the Russian Foundation for Basic Research, project number 18-29-22049.

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.

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.

This study is about the clinical uses of three antidepressants( escitalopram, desvenlafaxine, vortioxetine) in the treatment of anxioun depression.

The purpose of this study was to compare the efficacy and safety of escitalopram, desvenlafaxine, vortioxetine, and aripiprazole augmentation with escitalopram in the acute treatment of anxious depression.

Patients (n=189) with DSM5 major depression and high levels of anxiety were evenly randomized to escitalopram, desvenlafaxine, vortioxetine, and aripiprazole augmentation with escitalopram in a six-week, randomized, rater-blinded, head to head comparative trial. Changes in overall depressive and anxiety symptoms were assessed.

Patients demonstrated similar baseline-to-endpoint improvement in HAMD and HAMA total scores. Patients also demonstrated similar response rate and remission rate in HAMD and HAMA. In analysis of individual HAMD and HAMA items, desvenlafaxine had greatly reduced scores for anxiety somatic (p=0.013), hypochondriasis (p=0.014), cardiovascular symptoms (p=0.005), respiratory symptoms (p=0.013) compared to escitalopram or vortioxetine. Each treatment were well tolerated with no significant differences.

These results showed no significant differences in efficacy and tolerability of escitalopram, desvenlafaxine, vortioxetine, and aripiprazole augmentation with escitalopram in this subtype of patients with anxious depression during the acute phase treatment.

No significant relationships.