To develop a toolkit (QuIRC) for assessing the living conditions, care and human rights of people with long term mental illness in psychiatric and social care facilities.

The QuIRC was developed by research partners across ten countries: UK; Germany; Spain; Czech Republic; Bulgaria; Italy; Netherlands; Poland; Greece and Portugal. Its content was informed by triangulation of the evidence on critical components of care collated from: a review of care standards in each country; an international literature review; and Delphi exercises. Its final format was agreed by an international panel of rehabilitation and recovery experts. QuIRC scores were compared against service users’ quality of life, autonomy, experiences of care and markers of recovery to assess whether the QuIRc could provide a proxy-assessment of the unit’s promotion of service users’ autonomy and Recovery.

The finalised tool was used to interview managers from 21 units throughout Germany. One hundred and eighty-eight service users were also interviewed. QuIRC domain ratings were compared by facility type and with service user assessments. The QuIRC’s ability to deliver assessments relevant to Germany’s established systems of change at local, regional and national level will be discussed.

In many countries suicide is one of the leading causes of death among children and adolescents. Identifying young people at risk and offering effective treatment is a major concern of mental health policies.

To look for the presence of suicidal thinking, plans and attempts in adolescents.

Measure the presence of suicidal tendencies having in mind possible correlation with psychological difficulties (measured by SDQ), level of depression, hopelessness and self-esteem of adolescents in one school sample.

The sample of adolescents at school have been offered to fill out CESD, Hopelessness scale for children, Rosenberg self-esteem scale, SDQ questionnaire and four item adopted questions about suicidal tendencies. All data has been analyzed by SPSS 14.0.

In the sample of 768 adolescents (12-20yr, mean Age=17, 52) 22, 1% of them declared suicidal thinking, 3, 9% planed and 2, 2% attempted. About third of them didn’t find any reason for these tendencies. Females showed more suicidal tendencies but significantly only for thinking. Tobacco, alcohol and marihuana users have significantly more suicidality. Youths who declared more test anxiety have significantly more suicidal thinking. Significantly association is found between suicidal tendencies and psychological difficulties (emotional, conduct, hyperactivity and peers problems). Depression and high hopelessness also have significances. Suicidality is significantly higher in youths with normal self-esteem.

Suicidality is much presented in our sample and showed significantly association with substance use, psychological difficulties, hopelessness, depression and normal self-esteem.

In this 15-week, randomized, double-blind, placebo-controlled, parallel study the impact and tolerability of 150 mg b.i.d. n-3 PS were investigated in 200 children (6-13-y) with ADHD. Efficacy was assessed by teachers’ Conners Rating Scale (CRS) and strength and difficulties questionnaires (SDQ) - school version and clinicians who filled Clinical Global Impression of Improvement. Additional measures included parental rating of behavior (CRS and SDQ - home version) and wellbeing (Child Health questionnaire - Parental Form 50), and continuous performance test (Test of Variables of Attention). Safety evaluation included adverse event reports, vital signs, and parents’ Barkley’ side effects rating scale.

The interim results of the first group of children that were randomly assigned in a 2:1 ratio to n-3 PS or placebo will be presented.

n-3 PS impact on ADHD symptoms at school and home as evaluated by teachers, clinicians, and parents will be discussed.

This work was sponsored by Enzymotec LTD.

Behavioral and psychological symptoms in dementia are known to increase caregiver stress and proceed admission to a nursing home. We studied caregiver stress due to the impact of sleep disturbances in different types of mild dementia.

A sample of 151 persons with mild dementia from the Norwegian DEMWEST- cohort and their caregivers. Sleep problems in dementia were studied with the Mayo Sleep Questionnaire and the Neuropsychiatric Inventory. Caregiver stress was studied with the Relative's Stress Scale.

Caring for a person with mild dementia with any sleep disturbance significantly increased caregiver stress as compared to caring for a person with mild dementia without any sleep disturbances. (18.2 vs. 13.0, p=0.017) Caregivers to patients diagnosed as having mild Dementia with Lewybodies with any sleep disturbance reported significantly more stress as compared to caregivers to person with mild Alzheimer's Disease with any sleep disturbance. (14.7 vs. 21.7 p=0.010).

Sleep disturbances in mild dementia significantly impact on caregiver stress, more so in DLB as compared to AD.

Pregnancy represents a critical life stage for its physical and emotional changes. Maternal thoughts are often oriented to the worry to lose control on their body, and to their new physical shape. According to this, literature on eating disorder (ED) highlights how pregnancy is usually associated to a temporary interruption of the dysfunctional eating habits due to the move of concerns about the self and the body toward the caregiving of the baby.

The goal of the present study is to explore the impact of generalized difficulties in emotion regulation (as a stable trait) versus specific difficulties in emotion regulation (as pregnancy-related) in women with pre-pregnancy eating problems.

The sample is made by 15 women previously overweight and recruited during their 3^rd trimester of pregnancy. The following measures were administered: Difficulties in Emotion Regulation Scale (DERS), Eating Attitudes Test (EAT-26), Emotional Difficulties Specific to Pregnancy Scale (EDS), and the Adult Attachment Interview (AAI).

Preliminary findings have shown how higher scores on the DERS Impulse scale as well as higher difficulties in handling emotional states related to pregnancy (e.g. fear of the delivery) are associated to the existence of dysfunctional eating behaviors during the 3rd trimester.

Emotion regulation has emerged as a transversal skill during the life cycle. Difficulties in this area seem to represent a stable trait in the individual functioning, with the risk to affect the eating behaviors, as well as the health of the mother and the baby during pregnancy.

Facebook use among Teenagers has become a very common phenomenon. Its use can resuly in Facebook addiction .

To estimate the prevalence of problematic Facebook use among a sample of school-going adolescents.

This is a cross-sectional and descriptive study carried out among 110 school-going adolescenthe at 2 state colleges in Sidi Bouzid. We used a pre-established self-questionnaire containing 2 parts: a part exploring the socio-demographic data of the adolescent and a psychometric part: Bergen Facebook addiction Scale.

Study participants had a mean age of 14.4 years with extremes of 12 to 17 years. The sex ratio (M / F) (46/64) of the participants was 0.71.In our population, 13 students (11.8%) were smokers. Two students (1.8%) consumed alcohol. Cannabis use was noted in only one student.The majority of students (102), or 92.7%, had been online for more than a year.The daily Facebook connection time was more than 4 hours for 20.9%. Boredom was the number one reason for logging into Facebook for 82 students (74.5%) followed by curiosity for 45 students (40.9%). Fifteen students (13.6%) were addicted to Facebook (score> 10 on the Bergen Addiction Scale.

Facebook can be a useful and interesting tool to maintain and develop a network of relationships and create new ones. Its problematic use or addiction to Facebook has become a new scourge of public health. Faced with the negative impact of this addiction, It would be necessary to rationalize this use.

No significant relationships.

Cerebellar cognitive affective syndrome (CCAS) is a condition that arises from cerebellar lesions. CCAS can easily be overlooked by medical teams; therefore a bibliographic review will facilitate the understanding of symptoms in order to effectively diagnose and provide a holistic early treatment approach.

A case report of a 72-year-old woman with bilateral cerebellar lesions with high pre-morbid function presented with classic symptoms of CCAS. Multidisciplinary workup included medical, psychiatric, neuropsychological assessment (R-BANS (Form 1), Digit Span, Verbal fluency tests, the Hayling Test, the Delis-Kaplan Executive Function System) as well as other investigations (neuroimaging and blood tests) were conducted on the patient to confirm CCAS and exclude other differential diagnoses.

The results from the medical assessments conducted showed symptoms of cerebellar dysfunction. A psychiatry and neuropsychological review revealed aggression, irritability, disinhibition, deterioration in cognitive function and personality changes. A multidisciplinary team was formed to rehabilitate the patient however patient was non-compliant with therapy. The patient was prescribed Seroquel 50 XR and she responded well to the medication.

This case review illustrates the challenges associated with engaging a CCAS patient in rehabilitation activities due to cognitive and mood disorders. The use of psychotropic medications can be an effective method in improving cognition and mood disorders in CCAS patients. Early psychiatry and psychological intervention can significantly improve the overall outcome of a patient diagnosed with CCAS.

Nil.

The author has not supplied his declaration of competing interest.

Major depression is associated with altered neural function in frontal and limbic areas.

The findings have been inconsistent, especially those derived from cerebral blood flow (CBF) measures.

To identify differences in regional CBF between patients and controls using arterial spin labeling (ASL) at rest.

20 patients with major depression and 20 matched healthy controls were scanned in the morning with a pCASL-sequence at a 3 T Siemens scanner. Mean Hamilton Depression Score (21 item version) was 26.2 ± 5.7 for patients, mean Beck Depression Inventory scores were 28.9 ± 8.9. Mean age did not differ between groups (39.6 vs. 44.4 years). Whole brain voxelwise T-Tests were correct for multiple comparisons using a False Discovery Rate of q < 0.05.

Mean global resting CBF was not different between groups (66.1 vs. 63.0 ml/100 mg/min, T = 0.95, p = 0.35). FDR correction at q < 0.05 led to a T-value threshold of 3.71 (p < 0.001) for group comparison. Hypoperfusion in patients was detected in left middle temporal gyrus, left middle frontal gyrus, right precentral gyrus. Hyperperfusion in patients was seen in the right superior temporal gyrus.

ASL revealed frontotemporal hypoperfusion in patients with major depression. This is in line with previous work and the current concept of depression. However, we were unable to replicate hyperperfusion in limibic areas.

The Maudsley Obsessional-Compulsive Inventory (MOCI; Hodgson & Rachman, 1977) continues to be a widely used self-report measure of obsessive-compulsive symptoms. It has been translated into at least seven languages and the respective validations have resulted in good psychometric characteristics. It has not been validated to the Portuguese population yet.

To investigate the psychometric properties and factorial structure of the MOCI Portuguese version.

The process of translation/re-translation followed the required steps. The MOCI was administered to a community sample of 217 first year university students (178 girls; 82.0%). The mean age was 18.50 (± 2.345: range: 17–35). To study the temporal stability 166 (135 girls; 81.3%) respondents answered the questionnaires again after approximately six weeks.

The MOCI Cronbach's a was good (.79). The test-retest coefficient for the total score was high (.79; p < .001). An inspection of the Cattel's Scree plot and also of the item's content led us to select a three factors structure, which explained variance was of 29.17%: Factor (F) 1 “Doubting and Rumination” (VE = 15.43%; a = .72); F2 “Checking” (VE = 7.65%; a = .66) and F3 “Cleaning” (VE = 6.08%; a = .63). Temporal stability of F1, F2 and F3 were high: .67, .65 and .73 (all p < .001), respectively. Pearson correlations between factors were moderate and significant (≥.30).

The MOCI Portuguese version has good psychometric properties and its factorial structure is in accordance with those reported by other groups. It could be very useful to clinical and epidemiological purposes, as well as to transcultural studies.

Giving birth to an infant with very low birth weight (VLBW) is a major life event for a mother. Several studies have shown that mothers of these infants are at greater risk of psychological distress. The aim of this study was to investigate the level of depressive symptoms and to determine the associated factors among mothers who have infants with VLBW.

The sample consisted of 105 subjects; 35 mothers of VLBW infants (< 1500 g), 35 mothers of low birth weight (LBW) infants (1500 – 2500 g), and 35 mothers of healthy term infants (> 2500 g). The Edinburgh Postpartum Depression Scale (EPDS) was used to detect maternal depressive symptoms. Maternal social support was assessed by the Multidimensional Scale of Perceived Social Support (MSPSS).

The mean EPDS score and the number of mothers with high depressive scores (EPDS > 12) were significantly higher in mothers of infants with VLBW than mothers of LBW and term infants. We found that low birth weight (Odds Ratio [OR]: 1.009; p = 0.005; 95% Confidence Interval [CI]: 1.003 – 1.016) and long hospital stay (OR: 1.074; p = 0.01; 95% CI: 1.017 – 1.133) were predictors of PPD.

The birth and subsequent hospitalization of an infant with very low birth weight evokes psychological distress in mothers. Pediatricians should be more careful about depressive symptoms of mothers of infants with VLBW and should refer for counseling when it is necessary.

Given that parental mental diseases affect the whole family system, a family centered support and help system seems appropriate for families with a mentally ill mother/father. However, the majority of mental health services do not integrate interventions for the family system into psychiatric treatment programs.

To introduce a counselling and support service for families with a mentally ill parent (FIPS) that has been established at a psychiatric hospital serving a large catchments area. Preliminary results of a qualitative study that focused on the clients’ family background as well as on their reasons for utilising the service and service satisfaction will be presented.

Factors that impact the family system are considered and brought to a concept for counselling and support service for families with a mentally ill parent. Problem-focused interviews with 14 clients (mentally ill parents and relatives) of the counselling service for families were subjected to content analysis.

Most clients came to the counselling centre because of worries that the parent's mental illness might negatively affect children's well-being. Mentally ill mothers described their daily lives as utterly burdensome and also reported strong feelings of guilt towards their children. The concept of FIPS includes psychoeducation, social therapy, case management and family therapy. Clients assessed the counselling service as helpful and reported some significant changes.

Medication discontinuation in remitted single episode patients after a period of maintenance therapy is a major clinical decision and thus the identification of risk factors controlling for medication status is important.

Following a first/single episode with DSM-IV schizophrenia and related psychoses, remitted patients who had remained well on maintenance medication for at least one year were randomized to receive either maintenance therapy (with quetiapine 400 mg/day), or placebo for 12 months.

178 patients were randomized. Relapse rates were 33.7% (30/89) in maintenance group and 66.3% (59/89) in placebo group. Potential predictors were initially identified in univariate Cox regression models (p<0.1) and were subsequently entered into a multivariate Cox regression model for measuring the relapse risk. Significant predictors included patients on placebo (hazard ratio, 0.41; CI, 0.25 – 0.68; p=0.001); having more pre-morbid schizotypal traits (hazard ratio, 2.32; CI, 1.33 – 4.04; p=0.003); scoring lower in the logical memory test (hazard ratio, 0.94; CI, 0.9 – 0.99; p=0.028); and having more soft neurological signs (disinhibition) (hazard ratio, 1.33; CI, 1.02 – 1.74; p=0.039).

Relapse predictors may help to inform clinical decisions about discontinuation of maintenance therapy specifically for patients with a first/single episode psychosis following at least one year of maintenance therapy.

We are grateful to Dr TJ Yao at the Clinical Trials Center, University of Hong Kong, for statistical advice. The study was supported by investigator initiated trial award from AstraZeneca and the Research Grants Council Hong Kong (Project number: 765505).

Today's, families of individuals with bipolar disorders are actively participating in the care of their relative. Successful management of bipolar disorder in the community relies significantly on family caregivers. The need and experiences of such caregivers have been little studies with respect to bipolar disorder.

The aim of the study was to identify of family caregivers needs of patients with bipolar disorder.

This study is a qualitative research of phenomenological methodology; the family member's caregivers of bipolar disorder in farshchian psychiatric hospital in Hamedan were selected by purposive sampling. By reaching data saturation the number of participant was 12. Data were gathered through in-semi unstructured interviews and analyzed by “Colaizzi” method.

Five groups were identified in this study analysis: illness management, consoling, economical needs, persistent care and social attention & perception.

Identified the need of family member caregiver with bipolar disorder patient for mental health services to be helped and to identify the specific caring interventions that are effective in helping to sustain family caregiving.

Out of hours, there is only one on-site junior doctor. First year psychiatry trainees (CT1s) and GP trainees may have no prior experience in psychiatry. On-call shifts are therefore potentially daunting for new trainees.

Expand the resources available for trainees when on-call.

We issued questionnaires to CT1s asking if they would have appreciated more information about on-call scenarios and in what format.

Based on the questionnaire results we implemented some changes. These were:

• – a printed “pocket-guide” summarising common on-call scenarios;

• – a training video on common on-call scenarios.

The handout was given to new trainees in February 2016 and in August 2016. The video was shown to new trainees in August 2016. Trainees provided feedback on the resources.

Of 24 CT1s, 15 (63%) were “neutral” or “disagreed” that they had felt prepared for on-calls.

CT1s wanted additional resources, especially a paper handout or phone download.

Feedback on the “pocket-guide” from trainees in February 2016 (n = 8) was positive (62.5% reported increased confidence in on-call situations). Feedback is also being collected from trainees who received the guide in August 2016.

Trainees in August 2016 (n = 36) liked the video – no trainees “disagreed” with statements asking if the video had been useful.

The video improved the confidence of trainees about on-call situations by an average of 2.8 points.

We have expanded available resources relating to on-calls and improved confidence. Further improvements would include making resources more easily available in downloadable formats.

The authors have not supplied their declaration of competing interest.

Adverse childhood experiences (ACEs) and exposure to potentially traumatic events (PTEs) during military service are associated with mental health problems. However, knowledge about relative contributions of these factors to non-U.S women combat veterans’ posttraumatic sequalae is sparse.

To examine associations between ACEs, combat exposure, military sexual trauma (MST), potentially morally injurious events (PMIEs), posttraumatic stress disorder (PTSD) and complex PTSD symptoms among women veterans.

A volunteer sample of Israeli women combat veterans (n=885) and non-combat veterans (n=728) responded to self-report questionnaires in a cross-sectional design study.

Combat veterans reported more total average ACEs, were more likely to experience 3 or more ACEs and specific ACEs of physical abuse and emotional neglect, as compared to non-combat veterans. Combat veterans also reported higher levels of combat exposure, PMIEs, higher prevalence of MST and higher levels of PTSD symptoms, but not CPTSD symptoms, as compared to non-combat veterans. Importantly, ACEs, combat exposure, MST-assault and PMIEs of betrayal predicted PTSD symptoms, while only ACEs and PMIEs of betrayal predicted complex PTSD symptoms.

This study emphasized the relatively high exposure to PTEs and PTSD symptoms of women combat veterans as compared to non-combat veterans. Our findings also confirm prior studies demonstrating associations between ACEs, combat exposure, MST and mental health problems. Importantly, we demonstrated the unique contribution of betrayal based PMIEs and the differential associations of PTEs with PTSD and Complex PTSD symptoms among combat veterans.

None Declared

Increase in affective and somatic complaints during pandemic is considered as related to experienced stress (Wang et al., 2020, Roy et al., 2020, Robillard et al., 2020). Expression or suppression of emotions related to pandemic could affect the vulnerability of people to stressful situations (Gross, Thompson, 2007, Roberts et al., 2008).

The aim was to reveal a role of suppression / expression emotions regarding pandemic in the changes in somatic and affective complaints in people without coronavirus during lockdown.

In May 2020 110 people 18-65 years old (61.2% females) without coronavirus appraised their strategy of dealing with different emotions regarding pandemic on the 1-5 scale from emotional expression to hiding and suppression (Cronbach’s alphas) and 26 somatic and emotional symptoms including sleep-related symptoms, daytime functioning, affective symptoms, general physical condition (Cronbach’s alphas .81-.90). In December 2020 they reappraised 26 complaints.

There were no statistically significant changes in somatic and affective complaints during May-December 2020 (p>.20). Increase in sleep-related complaints (β=.23, p<.05, ΔR2=5.0%) and complaints regarding general physical condition (β=.32, p<.05, ΔR2=10.0%) were more pronounced in those reporting higher expression of emotions related to COVID.

People with higher emotional reactivity to pandemic situation tend to report increase in sleep-related problems and general worsening of their physical condition during lockdown. Research is supported by the Russian Foundation for Basic Research, project No. 20-013-00799.

Research is supported by the Russian Foundation for Basic Research, project No. 20-013-00799

Systematic assessment of risks is an essential component of care in psychiatric mother baby units. Self-harm, infant neglect and harm or the vulnerable physical health of both mother and infant may all pose risks.

Development of a risk assessment tool and risk assessment among mother-infant dyads at a MBU in Bangalore, India.

Based on data from 200 admissions, doctors and nurses of the unit developed a 15-item tool for risk assessment. Risk was assessed by both nurses and doctors among 58 consecutive mothers admitted to the unit. Risk domains included risks to self, to infant, related to infant health and feeding and violence faced by mother. Frequencies of various risks were calculated. Nurses’ risk assessments were compared to the residents’ risk assessments.

The mean age of the mothers was 25 (±4) years, age of infant 4 (±4) months and duration of episode was 4 (±14) months. Diagnoses included acute polymorphic psychosis (30%), BPAD (27%) and depression (21%). 47% had high suicidal risk and 28% had made an attempt in the current episode. 22% had expressed ideas of infant harm and 24% had physically harmed the infant. 48% of mothers had been physically violent. Multiple risks were seen in 47%. Doctors were able to identify risks more often than nurses.

Risks for self-harm, infant harm and related to infant health were high. Systematic risk assessment by both nurses and doctors is important in an MBU to ensure adequate care for the mother infant dyad.

The authors have not supplied their declaration of competing interest.

Many well known studies have defined results and tolerability of stimulants used in school children with ADHD in last period. In our follow-up study from August 2007 to January 2009. will present results of once-daily OROS Methylphenidate therapy including break it for holiday.

We are enrolling 32 children in study, 7-14 years old, and all of them were team-diagnosed according DSM IV/psychiatrist, psychologist, neurologist. Children with ADHD symptoms are treating with OROSMPH (18-54mg), with adjustments based on clinical symptoms, and all ADHD symptoms measures, vital signs, EEG and laboratory results also will be included through our study period.

Effects of OROS MPH therapy will be presented only in children who completed the study, looking for adverse events, clinically significant effects on vital sings, EEG, laboratory test parameters, and also, improvement academic functions, before and after breaking therapy.

Besides our expecting on reduction of ADHD symptoms with minimal effects on vital sings,values on growth, tick, laboratory test, it considers too, better academic functioning, social relationship with continual therapy.