Conversion Disorder is a condition defined by the sudden appearance of neurologic symptoms without an identifiable organic cause, often thought to be associated with psychological triggers. This disorder can lead to severe distress and loss of functionality which, without appropriate treatment, can be made permanent.

To raise awareness for this unexplained and often misunderstood disorder using a clinical case as background.

Clinical history, organic evaluation, psychological evaluation and literature review.

28-year-old female, single, with two children, working from home as a call-centre operator. Previously followed and medicated for depression. Presents to the ER due to sudden loss of consciousness while working, after which her speech became hindered by stuttering. Neurologic evaluation was unremarkable and she was referred for Psychiatric assessment, resulting in a diagnosis of Conversion Disorder. Speech was at first understandable but in the following weeks became progressively worse and eventually led to aphonia, while written communication remained normal and was the patient’s method of choice.

Once a favourite of Psychiatrists, little is yet known about the underlying mechanisms behind this disorder. Experts disagree on whether to classify it as a dissociative disorder, a somatoform disorder, or its own category. Patients presenting with this condition are often mistaken for malingering and thus subject to unhelpful or outright discriminatory practices. Broadened awareness is required to ensure patients get early access to the best possible care and thus improve their quality of life.

Medication is primary tactics in schizophrenia treatment. First and second generation antipsychotics (FGA and SGA respectively) affect on core symptoms. Unfortunately, it causes side effects. Metabolic syndrome one of them and includes large number of affections like body mass index changes, lipidemias, hypertension and others.

To study the role of polymorphic variants FTO gene in metabolic syndrome in schizophrenia patients.

We were investigated 480 patients. Main criteria for inclusion in study was using antipsychotics, verified diagnosis of schizophrenia and metabolic syndrome. Mean age was 42,1±1,4 years. The metabolic syndrome was assessment based on clinical data. Standard phenol-chloroform protocol for DNA isolation was used. Genotyping was carried out on six SNP’s of FTO gene with real-time PCR. Statistical analysis was carried out with R 3.6.2 with basic functions and SNPassoc package.

The distribution of genotypes for variants rs7185735 and rs9939609 was not in according to Hardy-Weinberg equilibrium (a p-value less than 0.05) and excluded from further analysis. Patients with schizophrenia were divided into two groups: patients with metabolic syndrome and patients without it. We did not identify any statistically significant associations between genotypes and alleles of FTO gene and metabolic syndrome.

We did not find any associations of alleles and genotypes of FTO gene with metabolic syndrome in schizophrenia patients from Siberia region. Metabolic syndrome needs more further studies with larger number of samples and different populations. Conflict of interest. The authors declare no conflict of interests. Supported by Grant of RSF 19-75-10012.

The coronavirus crisis has had an impact on the mental health of children and adolescents

Determine how it has affected this population and what mental pathologies are occurring

Literature bibliographic review

School closures and lockdown have been seen to have produced higher levels of anxiety, anger, and sleep and appetite disruption. On the one hand, the children had more anxiety and regressive behaviors, and the adolescents had more isolation, depressive symptoms and even autolytic ideation. The economic crisis and lockdown have affected the family environment, having reported greater situations of domestic violence and substance use among parents. Studies show a prevalence up to 28-34% of post-traumatic stress symptoms among adolescents. In Spain it has been determined that ¼ children present anxiety and / or depression. Their parents noticed in them greater irritability, less concentration and greater feelings of loneliness There has been an increase in addiction to new technologies. This is partly a method of maintaining social relationships, but prolonged use is associated with higher levels of anxiety and depression. Regarding to patients with mental pathology, they have presented greater tantrums, especially ADHD and ASD, due to the loss of structure and routine.

Confinement and fear of COVID have affected mental health of children and adolescents, with anxiety and depression occurring more frequently. Is highlighted the presence of feelings of loneliness among adolescents and the increase in the use of screens. Finally close to 80% of patients who had mental health conditions referred that this crisis had worsed their symtponms

Current definitions for delusional disorder (DD) state that no cognitive or functional impairment is present. However, this assumption lacks empirical validation and has been questioned by numerous authors over the years. Through systematic search we collected articles that compare patients with DD with either healthy controls or patients with schizophrenia on the basis of their cognitive symptoms and their functional outcomes.

Our aim is to draw conclusions from the available evidence on neurocognitive and functional affectation of DD.

Systematic electronic search was performed using Pubmed and Embase databases. Inclusion criteria included that selected articles must be original studies, must be published in peer-reviewed journals, must contain a sample of DD patients that is compared with a sample of healthy controls and/or patients with schizophrenia and that samples must be compared on the basis of cognitive and/or functionality parameters. A qualitative synthesis was performed due to heterogeneity in data.

According to the information collected through our systematic review, DD patients tend to perform worse than healthy control in tests assessing cognitive functions. Results are not as conclusive regarding comparison between DD and schizophrenia, with mixed outcomes. When it comes to functionality, results are not conclusive either, with some degree of evidence pointing towards a better functioning in patients with DD in comparison to patients with schizophrenia.

Results agree with many authors who consider both conditions as part of a psychosis spectrum. Cognitive interventions, such as cognitive remediation, must be studied for their potential role in the treatment of patients with DD.

Since ancient philosophy extraordinary creativity is associated with mental disorders, emotional and cognitive destabilization, and melancholia. We here summarize the results of empirical and narrative studies and analyze most prominent cases of highly creative persons who suffered from depression, bipolar and schizotypic disorders, drug- and alcohol addiction. Hereby, we focus on the interaction of creative processes with “bipolar” personality traits. Finally, we offer an interdisciplinary interpretation of the creative dialectics between order and chaos.

An interdisciplinary concept of the relationship between creativity and psychopathology is shown to be essential for reasonable psychopharmacological and psychotherapeutic treatment of creative individuals.

On the basis of empirical-statistical and biographical studies we offer a comprehensive concept of the interaction between creativity and psychopathology.

The exemplary cases of J. W. v. Goethe and Robert Schumann show a complex interaction of mood swings with creative achievements. Dysthymic and mild depressive phases were associated with creative efforts whereas severe depressive episodes inhibited their creativity. Mild mood swings and “bipolar personality traits” interacted constructively with their creative striving. With respect to the relationship of alcohol- and drug-abuse, we show on behalf of a detailed analysis of the life and work of prominent Pop-Icons that addiction mostly leads to psycho-social disintegration and destruction of creativity.

An interplay between cognitive coherence and incoherence, emotional stability and instability, order and chaos accompanies many creative processes. The interdisciplinary approach shows that psychopathology can motivate creative efforts. However, if expressed severely, mental disorders inhibit or even destroy creativity.

No significant relationships.

Impairment of conventional perception is one of the key dysfunction in patients with schizophrenia even in absence of psychotic symptoms.

Possibility of improvement of conventional perception by add-on treatment with ipidacrine in patients with schizophrenia in long-term remission.

26 (13 females) patients, mean age 40.4 (SD 11.7) with episodic schizophrenia in remission more than one year, receiving stable antipsychotic therapy were included into the open label study. As add-on treatment ipidacrine was administered once per day in dosage 20 mg for two months. Positive and Negative Symptoms Scale (PANSS) was used to assess clinical symptoms and projective psychological method (Rorschach Test) was used to assess conventional perception.

The study showed that ipidacrine in a low dosage, added to standard antipsychotic treatment, was effective in relation to negative symptoms (PANSS negative subscale score before 22,4 (SD4,7) and after beginning of the study 19,7 (4,5), p=0, 001). Of all the indicators of the Rorschach test, there was significant improvement in the index X+%, which is responsible for the degree of conventionality in reality recognition. The decrease in conventionality was associated with both high individualism and perceptual disorders. The value of of X+ % did not reach the standard one (70%) to the end of the study, but the improvement showed the switching from severe (52,4 (SD 12,2) to moderate (60,6 (SD10,4) impairment level (p=0,039).

Ipidacrine in a low dosage as add-on treatment has positive effect on conventional perception of stable patients with schizophrenia even in short-term trial.

The curious effect of an increase of the placebo effect across year of publication has been shown for depression, schizophrenia, obsessive-compulsive disorder, as well as for some medical conditions like hypertension and pain.

We aimed to observe how randomised clinical trials with a placebo control behave at this respect in panic disorder trials.

We searched the PubMed database using the strategy: (panic disorder OR panic attack disorder) AND placebo, which on 3 November 2020 produced 779 records. Inclusion criteria were the above stated, excluded were all studies focusing on the same patients as others and those not providing intelligible data. In our selection we used the PRISMA statement and reached agreement with Delphi rounds.

We identified through other sources further 3 studies. The finally eligible studies were 82, excluded were 700 studies, mainly consisting of reviews (176), challenge studies (173), not dealing with panic disorder (67), studies with unsuitable designs to detect placebo effect (53), studies using same populations as others (36), those with misfocused outcomes (57), those lumping diagnoses and not allowing to separate data for panic disorder (22), and those not using placebo at all (21). Mean response to placebo in included panic disorder studies was 36.01±19.812, ranging from 0 to 76.19%; the correlation with year of publication was positive and significant (Pearson’s r= 0.246; p=0.026).

The effect of placebo in randomised control trials has increased across the years, but this field of research appears to be idle in recent years.

No significant relationships.

People from the general population often tend to believe that psychiatric patients may be incurable, dangerous, and unpredictable. Stigma represents a critical issue which should be defeated. In spite of the interest of research, little is known about the relationship between personality traits and level of stigma toward people with mental illness.

To evaluate whether certain personality traits can influence the level of stigma towards mental illness in a population of university students.

A web-survey was spread on social networks between March and June 2020 through Google Forms. Eligibility criteria for inclusion were:1) Being 18 years of age or older; 2) Attending a degree course in an Italian University; 3) Provide informed consent. Socio-demographic characteristics of the participants were collected. Stigma was measured using the Attribution Questionnaire (AQ-27), personality traits were evaluated through the Big Five Inventory (BFI) and the Mental Health Knowledge Schedule (MAKS-i) investigated the knowledge about mental illness. Statistical analyses were performed using SPSS 24.0.

We computed a multiple linear regression to calculate potential predictors of stigma, adjusted on the basis of the knowledge of mental illness. Results showed that age and faculty class were not related to stigma. Agreeableness (A) and Openness to experience (O) were associated with less stigmatizing attitudes. Conversely, Neuroticism (N) and Conscientiousness (C) seemed to predict higher levels of stigma.

Our results suggest an interesting relationship between personality traits and stigmatizing attitudes, which deserves to be further studied. They also confirm the importance of implementing appropriate strategies against the stigma of mental illness.

No significant relationships.

Evaluate the impact of the initial health assessment service for asylum seekers provided by the Asylum Practice Service.

Examine the inputs of Asylum practice service to asylum seekers. Investigate the activities and outputs of the Asylum practice service. Identify the outcomes of Asylum practice service to asylum seekers. Assess the impact of Asylum practice service to asylum seekers.

The conceptual framework for measuring impact at the asylum practice service was based on a Logic Model to engage stakeholders and service users in order to evaluate the impact of services provided by the service. Also the Refugee Health Screener – 15 (RHS15) was used to screen the emotional distress/trauma to identify those individuals who would benefit from further mental health evaluation and treatment. Both quantitative and qualitative data were used to articulate and evidence social value performance and to tell the story of change created.

The study shows that newly arrived asylum seekers benefit from the services of asylum practice, even though the impact could be marginal in some cases.

There is a need to revisit the current Initial Health Assessment tool, as in its current form, vital information on the causes of trauma such as rape, torture, human trafficking, and witnessing the death of parents, child, and close relatives which may underpin mental health problems, may not be captured, thus preventing access to appropriate interventions.

No significant relationships.

Usually, Plato is not considered a philosopher that comprehensively treated the matter of suicide. By studying Plato’s work (especially Crito, Phaedo, the Republic and the Laws), we observe that Plato was concerned with the problem of suicide and that he gave an elaborate answer regarding the problem of suicide, laws against its practice as well as exceptions from them, customs and punishments.

This paper, in the light of a trial to overcome the monistic approaches of the matter of suicide, proposes the modest but fundamental goal to point out the resemblance between Plato’s position (especially from the Laws and the Republic) regarding the matter of suicide and the nowadays reasons invoked by the patients requesting assisted suicide.

Looking at the patients from the United States of America which requested assisted suicide, by analyzing the available annual reports (at the time of writing this abstract, only 6 out of 9 states that have a legal status that permits assisted suicide are publishing annual reports regarding the patients and their assisted suicide requests), we compare them with Plato’s attitude towards suicide.

We observe that the most invoked reasons (concerns and underlying illnesses), by the patients wich request assisted suicide, are also the cases in which Plato permitted suicide.

This comparison and insight into Plato’s philosophy does not resolve any particular issues of the medical praxis but is binging out the utility of a multidisciplinary, especially philosophical and ethical, approach to the practice of assisted suicide.

Several changes to the classification of schizophrenia and other psychotic disorders have been made to increase the reliability, clinical use and validity of the diagnostic classification which are considered here. A diagnosis of schizoaffective disorder would only be made in ICD-11 when the definitional requirement of schizophrenia is met concurrently with mood symptoms that meet the definitional requirements of a moderate or severe depressive episode, a manic episode, or a mixed episode. This requirement is more restrictive compared to ICD-10, which just required the presence of symptoms of schizophrenia and mood disorder. The total duration requirement would be 4 weeks. A cross-sectional approach was maintained in the ICD-11 for schizoaffective disorders as there is no evidence on how a longitudinal “lifetime” criterion impacts cross-sectional inter-rater reliability, and the reliability of lifetime symptoms’ report by patients and retrospective assessment by clinicians remains unknown.

No significant relationships.

Treatment representation is an important factor of motivation and well-being during treatment (Horne, 2002).

The aim was to reveal the relationship between treatment representation and well-being in oncological patients first referred to chemotherapy.

40 oncological patients (10 males, 20-72 years old, mean age 50.49±13.75 years old, localizations included gastrointestinal tract and genitourinary system) first referred to chemotherapy filled Satisfaction with Life Scale (Diener et al., 1985), Scale for Positive and Negative Experiences (Diener et al., 2009), Hospital Anxiety and Depression Scale (Zigmond, Snaith, 1983) and Beliefs about Medication Questionnaire (Horne, 2002) that was slightly modified for the situation of chemotherapy. Disturbance of functioning was assessed in the interview as an opportunity to cope with job, home responsibilities or self-care (1-5-point Likert scale).

Cronbach’s alphas for Necessity and Concern scales were .69 and .76. Despite high appraisals of necessity of chemotherapy (mean 4.24±.53 on 1-5 Likert scale), concern about it was rather high (2.83±.82). Hierarchical regression analyses revealed that, after adjusting for disturbances in social functioning, concern about chemotherapy (but not its subjective necessity) predicted more severe negative emotions (β=.32, p<.05, ΔR2=10.0%). After control for general level of anxiety and depression, this relationship became weaker but marginally significant (β=.32, p<.10, ΔR2=8.4%).

Concern about chemotherapy in patients first referred to this treatment could be important predictor of well-being demanding for interventions aimed at stabilization of emotional reaction to chemotherapy regardless belief in its necessity.

Nonhuman primates (NHPs) are critical for translational research due to their close genetic, physiological, and behavioral similarity to humans. In particular, higher brain functions depend on brain regions and neural circuits that evolved differently between primates and rodents. Thus, NHPs are a strong translational model system to investigate the pathophysiology and relevant biological correlates of mental disorders. This talk will focus on translational approaches leveraging NHP models to advance our understanding of environmentally induced epigenetic changes in post-traumatic stress disorder (PTSD). Environmental factors including early life stress significantly contribute to risk and resilience for psychiatric disorders including PTSD. However, human studies are often confounded, and it remains challenging to identify robust epigenetic signals in clinical populations even in large studies. We investigate the natural spectrum of behavioral phenotypes in rhesus macaques to complement human studies with a focus on stress and fear. This talk will present data on epigenetic signatures of fear and the effects of early life stress in rhesus monkeys and their relationship to human studies.

No significant relationships.

In clinical practice, differentiating Bipolar Disorder (BD) from unipolar depression is challenging due to the depressive symptoms, which are the core presentations of both disorders. Patients with BD are often misdiagnosed during depressive episodes resulting in a delay in proper treatment and a poor management of their condition.

The aim of the present study is to discriminate between unipolar depression and BD using a panel of RNA edited blood biomarkers.

Depressed patients were classified according to clinical scores in MADRS and IDSC-30 depression scales. After blood collection and RNA extraction, we used whole-transcriptome sequencing to identify differential A-to-I editing events, and Targeted Next Generation Sequencing to validate those biomarkers.

We discovered 646 variants differentially edited between depressed patients and control in a discovery cohort of 57 participants. After using stringent criteria and biological pathway analysis, 6 biomarker candidates were singled out and tested in a validation cohort of 160 patients suffering from unipolar depression and 95 BD patients in a depressive episode, which allowed a differential diagnosis of BD with an AUC of 0.935 and high specificity (Sp=84.6%) and sensitivity (Se=90.9%).

We have shown that a combination of 6 blood RNA editing-related biomarkers allows to discriminate unipolar and bipolar depression This 6 BMKs panel may be crucial to improve BD diagnosis and orientate the treatment therefore addressing the needs of millions of patients suffering from misdiagnosis and incorrect treatment for their diseases. This will change the game for the management of patients.

No significant relationships.

Neurosciences evolved very rapidly in last few years and helped the establishment of Liaison Psychiatry as a fundamental part of the general hospitals functioning. However, the use of this department by the other specialties still needs to be refined, as it is common to find wrong assessments in the referral of the patients.

We aim to study the concordance between the referral motives and the assessment by the psychiatry team.

Data was collected through the informatic registry. Contains patient data observed by a liaison psychiatrist in the period between 1st of July and 30th of September of 2020. In this period there were 80 requests, of which, 6 were refused for various reasons. We decided to study the concordance when one of these symptoms were in the request: anxious symptoms, depressive symptoms, psychotic symptoms and psychomotor agitation. 46 requests met this criteria.

The mean age was 63,3yo and 46% were older than 65yo. Most were women (54%) and 68% had history of psychiatry disorder. About 50% were requests from the Medicine wards. The concordance between the medical request and the psychiatry assessment was higher for psychomotor agitation (n=11; 64%) and depressive symptoms (n=23; 57%), but it was lower in anxious symptoms (n=3; 33%) and in psychotic symptoms (n=9; 33%). Most common diagnosis was delirium.

Non-psychiatrist doctors appear to have more difficulty when assessing anxious and psychotic symptoms. Those concordance percentages are in line with recent research. Actions should be taken to improve this, like academic training and standardization of referral.

No significant relationships.

Suicide in adolescents represents a major public health concern. To date, a growing number of suicide preventive strategies based on the use of new technologies are emerging.

The purpose of the present paper is to provide an overview of the present literature on the use of new technologies in adolescent suicide prevention.

A systematic electronic search was run using the following keywords: Technology OR Technologies OR APP OR Application OR mobile application) AND (Adolescent OR youth OR puberty) AND (Suicid* OR Self-harm OR self-destruction).

We found 12 studies on the use of telemedicine, 7 on mobile applications, and 3 on language detection. Heterogeneity regarding the study design was found: 3 Randomized Controlled Trial (RCT), 13 are Open-label single group trials, 2 Randomized studies, and 1 Cross-sectional study. Telemedicine was the most adopted tool, especially web-based approaches. Mobile applications mostly focused on screening of depressive symptoms and suicidal ideation, and for clinical monitoring through the use of text messages.

Despite telepsychiatry and mobile applications can provide a fast and safe tool, only a few studies demonstrated efficacy in preventing suicide among adolescents through the use of these interventions. Some studies suggested sophisticated algorithms able to recognize people at risk for suicide from language detection on social media posts. To date, only a few data support the use of such interventions in clinical practice and preventive strategies. Further studies are needed to test their efficacy in suicide prevention among adolescents and young adults.

Major depression (MD) is associated with cognitive and behavioral alterations in many domains. It is not well clear what cortical structures and functional alterations characterize MD patients during resting state, a condition during which mind wandering process is prevailing.

In MD patients with severe levels of depression we expected, during resting state, an altered asymmetry of cortical activity in the EEG bands that generally mark neurological impairment, i.e. Delta and Theta EEG bands.

30 MD patients under pharmacological treatment and 32 matched controls underwent an EEG recording (38 scalp sites) during 5 min resting state with open eyes. Eye movements were corrected by ICA modeling and the 5 min recording was divided in 2 sec epochs from which Delta and Theta spectral powers were extracted.

Spectral analysis of the 5 min resting state revealed a significant difference between the two groups at the level of left temporal lobe. MD patients showed larger Delta and Theta spectral power in the left superior temporal gyrus at the level of Brodmann’s Areas 22 and 42.

Results evidenced a cortical inhibition (greater EEG Delta and Theta activity) in left temporal linguistic areas in severe depression, a result pointing to a different mind wandering process and thought architecture in MD patients during resting state.

There is a considerable association between major depressive disorder (MDD) and cardiovascular disease, most possibly relying on abnormalities in the autonomic nervous system (ANS)-related cardiac reactivity, although the exact underlying pathophysiological pathway is unclear.

This study tends to shed some additional light on this background by investigating ANS reactivity in MDD with respect to previous depression history through an objective stress challenge paradigm.

The study assessed the effects of an overnight hypothalamus-pituitary-adrenal (HPA) axis stimulation with metyrapone (MET) on baseline ANS activity through linear and non-linear heart rate variability (HRV) measures in the morning of two continuous days in a group of 14 physically healthy, antidepressant-free patients with clinical, non-psychotic MDD, to investigate differences in autonomic reactivity with respect to prior MDD history.

The main findings of this study include statistically significant time x group interactions with respect to several HRV measures, suggesting substantial differences on autonomic reactivity between patients with and without depression history. Hereby, recurrent-episode MDD patients showed lower vagal activity, while first-episode MDD patients increased PNS activity after HPA axis stimulation.

These findings indicate that HPA axis stimulation in MDD patients leads to inverse vagal response according to MDD history. We suggest that chronic stress system overactivation, as found in MDD, might lead to a progressive inversion of the original stress response through HPA axis and ANS divergence over the course of a recurrent illness. HRV could, thus, represent a significant biomarker in MDD with temporal sensitivity.

Major depressive disorder is highly prevalent worldwide and has been affecting an increasing number of people each year. Current first line antidepressants show merely 37% remission, and physicians are forced to use a trial-and-error approach when choosing a single antidepressant out of dozens of available medications.

We sought to identify a method of testing that would provide patient-specific information on whether a patient will respond to a medication using in vitro modeling.

Patient-derived lymphoblastoid cell lines from the STAR*D study were used to rapidly generate cortical neurons and screen them for bupropion effects, for which the donor patients showed remission or non-remission.

We provide evidence for biomarkers specific for bupropion response, including synaptic connectivity and morphology changes as well as specific gene expression alterations.

These biomarkers support the concept of personalized antidepressant treatment based on in vitro platforms and could be utilized as predictors to patient response in the clinic.

This work was funded by Genetika+ Ltd, Jerusalem, Israel. YA, DK, EN, DL and TCS are employees of Genetika+ Ltd and received salary and/or stock options for the submitted work.

Since COVID19 pandemic emergence, containment measure have been taken by the Tunisian government imposing a new lifestyle resulting in psychological repercussions and a change in behavior.

Highlighting changes of behavior and lifestyle of the general public secondary to the COVID19 pandemic and to confinement and to assess their levels of psychological.

This is a qualitative, descriptive and analytical cross-sectional study realized between April and May 2020 with the general public using an anonymous online questionnaire covering: socio-demographic data; behavior during confinement; epidemic psychological impact; Mental health status was measured using Depression, Anxiety and Stress Scale(DASS-21). Anger level was assessed by STAXI-10 items.

132 responses were received: 68.2% were women; the average age 32.01(±11.10); half were single; 77.3% were at higher education level; 41.7% were healthcare professionnels. Consumption increased by 26.5% in coffee, 8.3% tobacco and 1.5% alcohol. 33.3% of participants increased their religious practice. 56.1% experienced sleep disorder mostly women(p<0.05). 91.7% followed COVID19 evolution through media essentially Facebook. Partners relationship was deteriorated in1.7% and improved in 25%. Child abuse increased by 13.7%. During confinement: 15.9%depression (0.8%severe depression), 12.9%anxiety (0.8%severe anxiety), 5.3% stress and 27.3%feelings of anger. Depression, anxiety and anger were related to younger age(p<0.05). Stress wasn’t age related. Depression was observed in participants without children (p<0.05). No association founded between psychological impact and gender, profession and civil status.

The COVID19 pandemic and the containment had consequences on individuals behavior and mental health. A psychological listening unit was launched during the period of confinement to overcome psychological impact.