A person who has gender dysphoria can experience some difficulties in his/her/their life (as we can see even in language). These difficulties are mostly because of the binary gender system. Especially in countries like Turkey, homophobia is very common. Because of that, a homosexual person can think that he/she/they is a transgender.

At this point, group psychotherapies are worthwhile, especially for differantial diagnosis. These individuals can share their experiences about the process. On this way, they can also explore themselves.

We have a monthly group psychotherapy for transgender and gender nonconforming adults in our clinic. We accept the individuals who have problems about gender identity. All trans adults who apply to us and are considered to be suitable are directed to the support group.

An individual, aged 20, who defines herself as a FtM trans has joined to the group for 4-5 months. She was in hurry and had decided to go under surgery for gender transition. She was referred to surgery by another clinic which didn’t have a group psychotherapy. So she applied to our clinic. During the group psychotherapy, she realized that she was homosexual and gived up gender transition.

Group psychotherapy is helpful for trans individuals to reduce psychological distress and manage their process. This study shows that it is not the only benefit of group support psychotherapy. It also helps the individuals to explore themselves, like our case. Its benefit can be as major as saving themselves from an irreversible step and its consequences.

Ayahusca has potential therapeutic beneffits.

Expose the potential beneffits of ayahuasca from neuropharmacology and clinical existing evidence.

A literature review was carried out in the databases pubmed, clinical key and texts of scientific dissemination.

There´s scientific literature about the potential therapeutic use of ayahuasca in dependencies, anxiety symtoms and depression, near death experiences and terminal illnesses. Possible benefit is postulated in impulsivity and personality disorders. It induces an introspective state, triggered by thoughts, emotions and autobiographical memories, which promotes reflection on personal issues, allowing new perspectives on certain life issues. It is common for users to describe it as analogous to a psychotherapeutic intervention. 5HTA2 agonists stimulate the expression of genes that encode transcription factors such as c-fos, egr 1, egr 2 and brain-derived neurotrophic factor (BDNF), which influence neuronal plasticity and are associated with cognitive aspects such as memory and attention. MAOIs and 5HT2A agonism have anxiolytic and antidepressant effects. Sigma -1 agonism promotes neuroplasticity. Decrease and remission in the consumption of alcohol and cocaine has been reported in patients with abuse and dependence. There has been significant decrease in depressive symptomatology, in observational studies, cases and controls and double blind compared with placebo. Improvement in different domains measured with mindfulness scales, similar to those observed in meditators, suggests an association between mindfulness techniques and experiences with ayahuasca.

There is existing evidence about potential therapeutical uses of ayahuasca. More studies are needed with biger samples, to establish it´s clinical use.

No significant relationships.

Studies on fear conditioning have made important contributions to the understanding of affective learning mechanisms as well as its applications (e.g., anxiety disorders, post-traumatic stress disorder). However, central mechanisms of sleep related consolidation of fear memory in humans have been almost neglected by previous studies.

In the current study we aimed to test effects of sleep and a period wakefulness on fear conditioned responses.

In our experiment in a group 18 healthy volunteers event-related brain potentials (ERP), heart rate variability (HRV) and behavioral responses were recorded during a fear conditioning procedure presented twice, before daytime sleep (2h) or control intervention (a period of wakefulness) and after. The conditioning procedure involved pairing of a neutral tone (CS+) with a highly unpleasant sound (UCS+).

Differential conditioning manifested itself in the contingent negative variance (CNV)-like slow ERP component. Both period of sleep and wakefulness resulted in an increased amplitude of the CNV to CS+. But we did not find an interaction effect of Time (Pre-Post) by Intervention (Sleep-Wake), suggesting that sleep did not affect the conditioned response differently as compared to a period of wakefulness. An apparent increase in HRV after a period of wakefulness did not affect fear conditioned responses (CNV and valence ratings).

To summarize, the data indicate that fear memories are consolidated with the course of time with no beneficial effect of sleep; relearning of fear causes stronger differential responses as measured by slow wave amplitude but not behavior; increase of HRV does not affect fear learning.

Social withdrawal, or hikikomori, is one of Japan’s most serious psychosocial issues. The concept gained international attention around 2010 and widespread psychiatric epidemiological studies have since been conducted.

With an understanding of the extensive range of hikikomori circumstances as a spectrum, we aimed to quantitatively measure the severity of hikikomori in adolescent subjects, an age group considered particularly susceptible to the condition, and to identify factors associated with its severity.

We selected population demographics, socioeconomic data, and psycho-behavioral characteristics as factors related to hikikomori and explored their associations with hikikomori severity using cross-sectional analysis. Subjects were a patient group of middle school students examined as outpatients at a psychiatric clinic during adolescence for a chief complaint of hikikomori and a control group of middle school students matched for sex and age. Subjects’ parents completed a questionnaire pertaining to their child’s hikikomori symptoms and living environment along with the Child Behavior Checklist (CBCL). The data collected was then statistically analyzed.

T-test results demonstrated that scores for all CBCL syndrome scales were significantly higher in the patient group, but no scores fell within the clinical range. Multiple regression analysis revealed that being anxious/depressed, somatic complaints, lack of communication between parents, and overuse of the Internet were statistical predictors of hikikomori severity.

It may be possible to prevent hikikomori from becoming severe if the above predictors are used to identify high-risk individuals requiring active intervention while hikikomori is at an early stage.

No significant relationships.

COVID-related situation has produced multiple challenges in the field of implementation of the restrictions.

Russian media, NGOs and sociological institutions collected and processed data on following the COVID-related guidelines in Moscow and in other regions. According to these data, different social groups behave differently in respect to the restrictions.

The following methods were used: analysis of information in media, interviews with child psychologists and pedagogues, personal involved and non-involved observation.

The COVID-related restrictions are often violated in all the Russian provinces. Observation and interviews demonstrate similar results. Young people aged 13–20 transgress the regulations most often. The reasons for that are not only the insufficient information, but also neurotic reactions and respective behavior: suppression, reaction formations, reactions of denial. Moreover, new behavioral norms (e.g. wearing masks) are insufficiently shaped yet, which makes following the new rules even more difficult. Furthermore, during the introduction of those regulations, their possible pathopsychological consequences were not taken into consideration, e.g. consequences of isolation, maintaining social distance, communication while wearing masks, fears, stress, paranoic reactions.

The pathopsychological consequences of introduced measures should be taken into consideration. Moreover, the phrasing of regulations needs reshaping and implementation of techniques of mental hygiene to prevent the development of mental disorders. Efficient shaping of respective skills might help to increase the percent of people following the guidelines too. However, all those issues require additional research.

Suicide is an international public health problem and a leading cause of death for youth and adults, worldwide. Prevention efforts in health care systems create opportunities for identifying medical patients with occult suicidality. Detecting suicide risk among patients in medical settings can be a challenge, but successful suicide risk screening programs have been demonstrated in hospital settings.

This presentation will discuss how a suicide risk screening tool that was developed for the pediatric emergency department was tested and then implemented in other medical settings in order to leverage healthcare providers as partners in combating the public health crisis of youth suicide..

Implementation and quality improvement projects in various medical settings that have adapted the ASQ will be described. Effective management of pediatric patients that screen positive for suicide risk and how mental health clinicians can best be utilized in efficient ways will also be discussed.

Average time to administer the ASQ was 20 seconds. Positive screen rates across ED, inpatient and outpatient settings ranging from 2-14% equating to one additional psychiatric consultation per week. The ASQ Toolkit was developed to help medical providers implement screening including scripts for nurses, flyers for parents and a brief suicide safety assessment (ASQ BSSA) to operationalize next steps for patients at risk.

The medical setting is a key venue for youth suicide risk detection and linking patients with effective interventions. Mental health clinicians have a role in guiding non-mental health providers in the identification and management of patients found to be at risk.

No significant relationships.

We present the case of an 82-year-old patient who was treated by our liaison psychiatry unit after a suicide attempt through prescription-drug overdose. The patient had been diagnosed with Parkinson’s disease (PD) ten years prior to his admittance and was being treated with carbidopa/levodopa and non-ergot dopamine agonists.

Impulse control disorders and depression are the most prevalent neuropsychiatric manifestation of PD. According to several sources, this symptomatology is underdiagnosed and undertreated, causing helplessness and distress to patients and their caregivers. Likewise, the accumulated evidence suggests that certain drugs can contribute to the appearance of the aforementioned symptoms.

A case report is presented alongside a review of the relevant literature regarding the neuropsychiatric manifestations in the context of PD and the diagnosis and treatment of these symptoms.

During his treatment, ropinirole was removed while quetiapine was progressively administered (up to 150mg/day). Carbidopa/levodopa regime was increased causing visual hallucinations and delusional jealousy. A careful balance between antiparkinsonian and antipsychotic medication needed to be achieved before discharge.

Neuropsychiatric manifestations in the context of PD are more prevalent than what was thought in the past. Certain medications, particularly non-ergot dopamine agonists could potentially contribute to the onset of these symptoms. Moreover, these manifestations can be underdiagnosed due to the stigma or social burden imposed upon family and / or caregivers. It is important that recent advances in the understanding of non-motor symptomatology of PD could permeate clinical practice to achieve an adequate identification and treatment of these symptoms.

Few studies have examined the course of eating disorders and the respective treatments based on insurance data, even though they provide representative information.

To assess the epidemiology, treatments, duration of illness, costs of treatment in a data set of a public health insurance.

Data provided by a German health insurance (data from 4.2 million members from 2005-2010). A matched control group based on age and gender without an eating disorder diagnosis was used for comparisons.

2.734 cases with the diagnoses of an eating disorder (anorexia nervosa AN, bulimia nervosa BN or combination ANBN) were identified. More than 92% of the patients were female. The relative risk for personality disorders, depressive disorders, alcohol abuse and obsessive-compulsive disorders was highly increased. Most of the patients with BN (53.04%) or AN (41.57%) were treated in out-patient care, and many were only treated for three months, whereas most of the patients with ANBN were treated for a longer time. 3-19% with BN, AN or ANBN were treated only in in-patient care. The in-patient costs of treatment for the year of the diagnosis were 5471.15€ for BN, 9080.26€ for AN, 10809.16€ for ANBN and 339.37€ for the control group.

Our findings suggest that patients with ANBN diagnosis have a severe and longer course of treatment. Furthermore, contrary to national guidelines for eating disorders, there is a considerable proportion of patients with BN or AN that are treated only in in-patient care.

No significant relationships.

Clozapine is the most effective antipsychotic for treatment resistant schizophrenia. In patients treated with clozapine, COVID-19 infection may result in complications including an increased risk of pneumonia, clozapine toxicity, and disruption to clozapine treatment by COVID-19 induced lymphopenia.

We report 5 cases of elevated clozapine levels occurring in patients with COVID-19 infection who had been previously managed for several years on stable doses.

Subjects: 48 admitted patients to a long-stay psychiatric unit. COVID-19 infection confirmed by positive nasopharyngeal swab for viral ribonucleic acid of SARS-CoV-2. Hematological controls between March and April 2020.

16 patients (33%) treated with clozapine.18 patients (37’5%) had COVID-19 infection, of which 5 (10’4%) were treated with clozapine. Results are presented in table 1. Increases in plasma clozapine levels were observed in all cases (49’38 to 307.5%). We don’t have the clozapine levels of a patient who presented a pneumonia requiring admission and treatment in the general hospital. Two cases of neutropenia were observed, of which one had to discontinue treatment with clozapine. In the other three patients the dose of clozapine was reduced and they did not present haematological or intoxication complications that required further adjustments.

Covid-19 infection is associated with increased serum clozapine levels by probably multifactorial mechanisms (systemic infection, reduced smoking). Importance of full clinical assessment of suspected COVID-19 infection in clozapine treated patients, including assessment clozapine level, and full blood count. The general recommendation is to reduce the dose of clozapine in this patients.

Galactorrhea wiht antidepressants SSRIs or SNRI is a rarely adverse effect. Some authors believe that the risk of galactorrhea in women who use SSRIs is 8 times higher than in patients treated with other types of drugs. Serotonin is believed to be a potent physiological stimulator of prolactin release.Prolactin stimulates the growth of the mammary glands and the galactorrhea. The SSRIs would activate the serotonergic pathways, these in turn would stimulate the release of prolactin directly in the pituitary and in the hypothalamus, inhibiting the release of dopamine and increasing the release of stimulating factors. The main inhibitor of prolactin secretion is dopamine.

The objective is to reveal this rare complication through the report of a clinical case

A 45-year-old woman with a diagnosis of mixed anxiety-depressive disorder. Treatment with 20 mg of escitalopram was started, with a good therapeutic response, but with breast pain and swelling. She was switched to duloxetine 60 mg, with a good response and adequate tolerance. At 6 months of treatment, she begins to present breast pain and yellow-green breast discharge, with elevated prolactin levels and normal cranial MRI.

She was diagnosed with functional hyperprolactinemia, and treatment with vortioxetine was started. Finally, the Prolactin levels normalize.

Galactorrhea is a very rare and annoying side effect that can lead to discontinuation of treatment and requires a change in the therapeutic strategy.

No significant relationships.

Digital Mental Health holds strategic potential in fulfilling populations’ mental healthcare unmet needs, enabling convenient and equitable access to mental healthcare. However, despite strong evidence of efficacy, uptake by mental healthcare providers remains low and little is known about factors influencing adoption and its interrelationship throughout the Digital Mental Health adoption process.

This study aimed at gaining in-depth understanding of factors influencing adoption and mapping its interrelationship along different stages of the Digital Mental Health adoption process.

This work adopted a qualitative approach consisting of in-depth semi-structured interviews with 13 mental healthcare professionals, including both psychologists and psychiatrists. The interviews were transcribed and analysed thematically, following Braun and Clarke’s method.

In this communication, we will describe how digital technology is currently used by clinicians to deliver mental healthcare. We identify potential factors influencing Digital Mental Health adoption and characterize the different identified stages inherent to this appropriation process: i) Pondering appropriate use; ii) Contractualizing the therapeutic relationship; iii) Performing online psychological assessment; iv) Adapting and/or developing interventions; v) Delivering Digital Mental Health interventions; and vi) Identifying training unmet needs. A discussion on how different factors and its interrelationship impact the adoption process will also be performed.

By characterizing mental healthcare providers journey throughout the Digital Mental Health adoption process, we intend to inform ecosystem stakeholders, such as researchers, policy makers, societies and industry, on key factors influencing adoption, so policies, programs and interventions are developed in compliance with this knowledge and technology is more easily integrated in clinical practice.

The COVID-19 pandemic represents a stressful event for humanity. The spread of this disease mainly affects health professionals and interests them closely.

Identify the impact of the COVID-19 pandemic on the mental health of healthcare personnels and associated factors exposing them to increased psychological fragility.

The current article is a narrative review of the existing literature. A search on electronic database like PubMed was undertaken using the search terms “coronavirus mental health healthcare workers”. 20 articles were included in this review.

Studies revealed that health care workers have prensented considerable psychiatric symptoms such as anxiety, depression, PTSD, stress, insomnia, somatization, mental and physical exhaustion, addiction and obssessive compulsive symptoms. The prevalence of these symptoms varies from study to another with almost a more notable prevalence of anxiety and depressive symptoms. The following factors that predispose to developing mental distress were noted: being a frontline health worker, having direct contact with infected patients, working in a city with a high infection rate, female sex, isolation, being a suspected case, stigmatization, change of organization, lack of materials, lack of information, lack of communication, lack of support, fear of contamination or of contaminating loved ones, having an organic pathology.

This notable impact of the pandemic on the mental health of healthcare workers alerts us as colleagues and civil society to the ultimate need for an urgent adequate and up-to-date intervention to alleviate this distress.

Positive psychiatry is the science and practice of psychiatry seeking to promote overall well-being and understand the “positive” aspects of the patient’s life, such as resilience, social connections, and meaning and values in life. While positive psychiatry research has recently blossomed, the field lacks practical ways to integrate these overarching principles into clinical practice. Life review interventions are commonly used in palliative care, spiritual care, and geriatrics, and involve a healthcare team member interviewing a patient about their life.

Our objective is to describe the implementation of a positive psychiatry-informed life story review initiative into medical education, with the goal of creating a structure for medical trainees to see the larger context of patients’ health, understand how past experiences influence current values, and improve patients’ overall well-being.

First- and third-year students at Alpert Medical School of Brown University are required to participate in at least one strengths-based life review with a patient in the community or inpatient setting, transcribe the story, and integrate the story into the electronic health record.

Preliminary results demonstrate high acceptability and perceived development of patient-centered competencies, such as understanding patients as more complete human beings. While this is a low cost and sustainable intervention, barriers include buy-in from medical educators, hospital administrators, and trainees.

To our knowledge, this is one of the first positive psychiatry-informed interventions to be implemented into the required medical curricula. Life story reviews may allow providers to understand the “positive” aspects of patients’ lives and understand their patients better as people.

Psychodermatologic disorders are conditions involving an interaction between the mind and the skin. Dermatitis artefacta (DA), also known as factitial dermatitis, is a frequently unrecognized psychocutaneous illness, in which the patient creates skin lesions to satisfy the unconscious need to presume a sick role. It is more common in women and in patients with a diagnosis of psychiatric illness. This is an exclusion diagnosis and organic causes should be ruled out. Treatment of DA can be challenging and it needs to involve a multidisciplinary approach consisting of dermatologists and mental health professionals.

From a case report the authors intend to present a literature review of dermatitis artefacta.

Observation the patient and review the clinical file. Consultation published and referenced scientific articles on PubMed.

60 year old man, diagnosed with Bipolar Disorder, was admitted for manic decompensation of his pathology. During physical examination he had sparse erythematous lesions, more exuberant in the neck, scalp, belly and upper limbs. The diagnosis of artifact dermatitis was made after excluding other possible causes.

Treatment of DA can be challenging and it needs to involve a multidisciplinary approach. Dermatitis artefacta is a long-term disorder, and patients need regular follow up with a dermatologist and a psychiatrist because relapses are common. These doctors must be aware of this possible pathology in order to make a correct diagnosis and treatment of psychiatric disorders that sometimes coexist with skin lesions. The prognosis for most patients is poor leading to self-injury, scarring and poor cosmesis.

No significant relationships.

Lockdown due to coronavirus pandemic has been a stressful experience especially to mothers. Juggling work from home and childcare has led to maternal burn out and depression.

The aim of the present study was to assess maternal burn-out rate during lockdown and its eventual relationship with depression and associated factors

156 Tunisian mothers responded to online questionnaire posted on social network after 1 month of lockdown. The questionnaire evaluated burnout and depression as measured by the Maslach Burnout Inventory (MBI) and depression and anxiety symptoms (HADS) respectively.

The participants were aged between 24 and 64 years and 61.5% had more than one child. Mean score on the BMS10 was 4.11 out of 7 maximum score with 71.8% of participants fulfilling criteria for maternal burn-out. Among them, 30.1% had high level of burn out and 9.6% extreme burn out. The main factors associated with maternal burn out were age of children, financial difficulties and lack of leisure activities. Mother’s age, perceived husband support, medical or psychiatric history haven’t been associated with maternal burn out. HADS questionnaire indicated that 38.5% of mothers had moderate to severe anxiety disorder and 35,9% had moderate to severe depressive disorder. A postive correlation was found between burnout and anxiety (r=0.634, p<0.001) and burn out and depression (r=0.515, p<0.001).

The prevalence of maternal burn out during lockdown was significantly high resulting in higher rate of depression than ususal. However, severe forms of burnout may share several characteristics with depression raising the question of overlap of these two entities.

Sleep disorders are the most common health problem among the health care staff, mainly those who perform night shifts.

To assess the prevalence of sleep disorders among health care workers in emergency department and to determine its associated factors.

It was a cross-sectional study, including health care workers assigned to emergency ward and intensive care unit of Hedi Chaker and Habib Bourguiba hospitals in Sfax and regional hospital of Kebili, during the first six months of 2017. We used an anonymous and confidential self-administered questionnaire. We used hospital anxiety and depression scale (HAD) to assess anxiety and depression. Sleep quality was assessed by the Pittsburgh Sleep Quality Index and day time sleepiness by the Epworth Sleepiness Scale.

240 nurses were included. Mean age was 37 years-old, 59.2% were female and 64.2% were married and 79.2% assured night shifts. The prevalence of sleep disorders was 70.4%. Sleep difficulties were significantly correlated with anxiety (p=0.001) and depression (p=0.02). In multivariate study, sleep disorders were related to the absence of leisure activity (OR=0.42 [0.19-0.94]; p=0.035) and anxiety (OR=3 [1.4-6.1]; p=0.002). 40.8% of nurses experienced drowsiness. Sleepiness was significantly correlated with the absence of leisure activities (p=0.04) and with psychiatric family history (p=0.02). In the multivariate study, sleep disorders were correlated with female gender (OR=0.43 [0.19-0.9]; p=0.042) and with no leisure activity (OR=2.6 [1.2-5.6]; p=0.01).

Sleep disorders were common among emergency nurses, in order of that; working conditions should be improved to provide less stressful conditions for nurses.

No significant relationships.

Lockdown due to the management of infectious diseases such as corona virus disease affect mental health. We would think that with the end of the lockdown due to the corona virus pandemic, the feeling of regaining freedom and movement would be good for our morale.

Through this servery, we examine the prevalence of anxiety symptoms in the Tunisian population face to the end of lockdown.

The survey was conducted using the online anonymous questionnaires and distributed through social networks from 24 April to 23 May 2020(which was considered the end of the lockdown in Tunisia). It included socio-demographic questions and participants’ experience of SARS-CoV-2related stressful events (A member of your family was suspected of having Corona virus /someone you know had Corona virus‘s symptoms /You were quarantined). Anxiety symptoms were evaluated with the Hospital anxiety and depression scale-anxiety (HADS-A)

Our study included 80 participants: 71.3% female and 42.5% married. The mean age of the participants was 29.30 years (SD = 8.72). The mean HADS-A score was 8.03 (SD=2.938) (maximum=16 minimum=1). Two-thirds of the participants exhibited anxiety symptoms (66.3%) with 1.3 % reported moderate severe anxiety symptoms. Anxiety was correlated with age and gender (p=0.013, p=0.027).

Our results suggest that in this early phase of the COVID-19 lockdown resolution we can already observe its fundamental impact on anxiety.

In atypical anorexia nervosa, one of the causes of restrictive eating behavior is prolonged vomitophobia, which leads to a pronounced degree of alimentary exhaustion.

To study the existence and prevalence of vomitorium atypical anorexia nervosa

Psychopathological, anamnestic, psychological

It was found that in atypical anorexia nervosa, vomitophobia is observed in 30% of cases. The initial stage is a psychotraumatic situation unrelated to eating behavior. In the future, the pathological fear of vomiting is fixed, which is due to the presence of personal deviations and anxiety disorders. The initial stage of an eating disorder is a psychotraumatic situation that is not directly related to eating behavior. However, after Psychotrauma, there is anxiety with its subsequent somatization and vegetative dysfunction of the gastrointestinal tract. In the future, the pathological fear of nausea and vomiting is fixed, which is due to the presence of significant personal characteristics and persesting of anxiety disorders. Dysmorphophobic experiences appear as you lose weight and have an inverted character-discontent with thinness, exhaustion.

The presence of massive vomitorium leads to restrictive eating behavior. Therefore, there is a need to differentiate this pathology from typical anorexia nervosa with vomiting and from hypochondriac disorders. Against the background of adequate complex therapy with food rehabilitation, anti-anxiety medication, psychotherapy, atypical anorexia nervosa with vomitophobia undergoes a fairly rapid reverse dynamics with the appearance of a critical attitude to the existing pathological eating behavior. The prognosis in these cases is quite favorable.

No significant relationships.

In 2005 Elizabeth Parker and fellow researchers described the first case of Hyperthymestic Syndrome, a woman going by initials AJ. Thereafter, a handful more of such cases have emerged. Older descriptions of extraordinary memory in medical literature mainly considered semantic and working memories. Jorge Luis Borges in his 1930s short story ‘Funes, his Memory’ writes about his, presumably fictitious, encounter with a man named Ireno Funes who possessed an extraordinary memory and a knack for keeping track of briefest of passing moment. Among many qualities that Funes and AJ share are their extraordinary memories, obsession for keeping track of time, and their problems with abstraction. After describing his extraordinary memory, Borges says of Funes, ‘I suspect nevertheless, that he was not very good at thinking. To think is to ignore (or forget) differences, to generalize, to abstract.’ Similarly, AJ has been described to have impaired abstraction, hypothesis formation and conceptual shifting. Moreover, both Funes and AJ see their capability as a burden rather than a gift. “My memory, sir, is like a garbage heap.” Says Funes.

A brief exploration of Jorge Luis Borges’ works in the context of autobiographical memory.

The comparisons between Borges’ description of his character’s autobiographical memory and findings of modern research techniques will be done qualitatively.

Effort is made to undersatnd Borges philosophy in context of mordern memory research.

An in depth look into Borges’ philosohies linking perception of time, coding of memory, abstration and language can inform further line of research regarding autobiographical memory.

No significant relationships.

Cluster B personality disorders are characterized by a higher prevalence of suicidal ideation and behavior than others, and Narcissistic Personality Disorder is no different. Very intense feelings of shame, intolerable for the individual, are often found in patients with Narcissistic Personality Disorder and may have a role in suicidal behavior.

To offer preliminary empirical evidences concerning the relationship between narcissism, shame and suicide ideation.

We administered Pathological Narcissism Inventory (PNI), Test of Self Conscious Affects (TOSCA) and Beck Scale for Suicidal Ideation (BSI) to a sample of individuals with Suicide ideation (n= 65) and a sample of community participants (n=65).

Controlling for age and gender, in the merged sample we found that BSI scores correlated significantly with the vulnerable dimension of narcissism and with TOSCA Interpersonal Shame subscale. In the clinical sample, Interpersonal shame partially mediates the relationship between vulnerable narcissism and suicidal ideation.

Shame seems to play a key role in the relationship between the vulnerable facet of narcissism and suicidal ideation, although the profound mechanism by which it works remains to be understood. Future directions and clinical implications are discussed.