There is a high degree of comorbidity between serious mental illness (SMI) and substance use disorders (SUD) and cardiovascular disorders. Other life-style related disorders are also common in patients with SMI and SUD. Consequently, comorbidity with somatic diseases contributes to a dramatic reduction in life-expectancy for these patient groups. Physical training has been shown to have positive effects also for mental health, but there has been little systematic use of physical training as part of the treatment for patients suffering from SMI and SUD in Norwegian health care.

To present a new project on physical training for patients suffering from SMI and SUD.

We briefly describe a project in a major Norwegian hospital, where physical exercise will be offered as part of the treatment for patients suffering from SMI and SUD.

The Division for Substance Use and Mental Health now offers an exercise room for inpatients at the main clinic in Tromsø, Norway. The exercise room contains various equipment including treadmills and equipment for strength training. This facility has recently been made available and is currently being used by a selection of patients. A study of user experiences is forthcoming and a systematic study of effects of physical exercise for patients suffering from SMI and SUD is being planned.

Physical exercise has been shown to have positive effects also on mental health. In one major Norwegian hospital, facilities are now offered for inpatients suffering from SMI or SUD. The effects of physical exercise on patients with SMI and SUD will be examined.

No significant relationships.

The Eye Movement Desensitization and Reprocessing (EMDR) therapy has shown to be useful in the treatment of PTSD, general anxiety, stress and burnout. Nonetheless, assessing therapy progress has been limited to subjective appreciations of the patient and therapist, which compromise therapy efficacy, and the continuum of care (clinic and at home) and scalability that digitized approaches can offer.

The aim of the present study was to validate the potential of a smartphone-based biofeedback digitized approach for EMDR usage in burnout therapy, as a means to provide quantitative progress assessment and personalized therapy optimization.

A digitized burnout status assessment app based on Maslach Burnout Inventory was first implemented and tested. Then, an EMDR app was developed by making use of adjustable audiovisual stimuli (e.g. different velocity and horizontal/vertical visual stimuli; and different pitch and left-right surround sound effects) and also of the smartphone’s camera photoplethysmography finger recordings from which heart rate, heart rate variability and breathing rate are derived and used for modulating stimuli (biofeedback). Finally, interviews with several EMDR experts were conducted to assess the potential of the app as a therapeutic adjuvant.

The preliminary interview results showed that the app can be useful for online therapy, to optimize the stimuli presentation, and to quantify the therapy experience and outcomes. The interviews also validated the technical specifications and usability of the tool.

Results so far have shown a promising receptivity and interest from EMDR experts. As such, patient testing is currently on-going.

The work of the present abstract is the basis of the research conducted at the Faculty of Sciences of the University of Lisbon, co-lead with NEVARO, a spin-off company of the same Faculty.

Antipsychotics have been classically considered the treatment of choice for delusional disorder (DD) and antidepressant medications have been restricted to patients with comorbid depression.

Our aim is to describe the case of a patient with DD with delusions of parasitosis, who responded to paroxetine as monotherapy. We also aimed to review the recent literature on the potential use of antidepressants as the main treatment for somatic type DD.

After the case report, we present a narrative review on the use of antidepressants in DD, somatic type (DSM-criteria) by using PubMed database from inception until 2020.

Case: 74 year-old woman without previous psychiatric diagnosis who suffered from long-term cutaneous and vulvar pruritus. She was referred to psychiatry from dermatology to assess thought content and sensoperceptive disturbances. In the past, she had received unsuccessful treatment with antihistamines. The patient brought a collection of “the identified parasite” (matchbox sign) to our first appointment. On assessment, she was diagnosed with DD with delusions of parasitosis. Risperidone 1mg/day was poorly tolerated (excessive sedation). She refused further antipsychotic treatment, so we started paroxetine up to 20mg/day. The patient went into total remission of her pruritus and delusions of parasitosis. Review. In line with our case, 6 studies reported on the successful use of antidepressants as monotherapy for DD, somatic type. Most of studies report the successful use of an antipsychotic/antidepressant combination (case-series, case reports).

Although antipsychotics are the treatment of choice, antidepressant medications may be an effective alternative in somatic type DD when patients refuse antipsychotics.

The reform of the Moscow psychiatric service began in 2011 and was aimed at its optimization, reducing the inpatient level, actively introducing psychosocial rehabilitation, multidisciplinary teams of specialists and developing community-based forms of care. In 2016, the number of beds in day care hospitals in Moscow had doubled to rich 3500.

Analyze the dynamics of characteristics of day hospital patients and propose measures to improve the quality of medical rehabilitation care provided.

Clinical and psychopathological, clinical and statistical, psychological, statistical of 337 schizophrenia patients discharged in 2010 and 2016.

A comparative analysis of the results obtained in 2010 and 2016 indicates a change in the clinical, socio-demographic and psychological characteristics of patients treated in the day hospital. In 2016, the proportion of early stage disease patients with endogenous mental disorders (F20-F29, according to ICD-10) increased; the age of patients and the proportion of patients with disabilities decreased; the proportion of patients with preserved working capacity increased, demonstrating low rates of compliance and motivation for treatment, but higher rates of neuro-cognitive functioning. In 2016, only a fifth of patients received complex psychosocial therapy.

The modernization of the psychiatric service has improved the continuity between its inpatient and out-of-hospital units. To improve the quality of care in the day hospital and to prevent relapses of the disease, it is necessary to combine pharmacotherapy with complex psychosocial treatment followed by a long-term personalized management of patients with the patient’s families involvement.

Impulsivity is not a classical psychiatric diagnosis like schizophrenia, depression, bipolar or borderline personality disorder. It is a symptom that could occur in almost all psychiatric disorders and in some neurological or systemic diseases.

In this study we examine the influence of bipolar disorder’s (BD) treatment on the impulsivity.

We performed a cross sectional study on 30 patients diagnosed with BD and consulting at the Psychiatric department of HediChaker Hospital. Patients were euthymic during the time of the study confirmed by administration Young Mania Rating Scale (YMRS) and Montgomery Depression Rating Scale (MDRS). The socio-demographic data and treatment models were obtained. Impulsivity was evaluated using the Barratt Impulsiveness Scale (BIS-11).

The study sample consisted of 30 patients (10 men and 20 women). The mean age of the sample was 45.83 years (SD= 11. 63). Seventeen patients (56.7%) were married. Half of the participants were using an association of mood stabilizer (MS) and an antipsychotic (AP), 36.7% and 13.3% were receiving respectively only mood stabilizer or an antipsychotic. The mean BIS11 score was 75. 60 (SD=5.51) and 76.7% had a high level of impulsivity. No correlation was found between the level of impulsivity (BIS-11 scores) and using MS, AP or MS+AP (p=0.199; p=0.933; p=0.195).

Further studies should be realized to identify pharmacological treatment of impulsivity among people with BD.

Today cocaine use is very frequently associated with adolescents with maladaptive personality traits and impulse control disorder. It requires a multidisciplinary approach and individualized treatments to improve the clinic and achieve the abandonment of consumption.

1. To assess the efficacy of monthly injectable paliperidone palmitate treatment in controlling impulsivity. 2. Determine the consumption of toxins after treatment.

Sample: Adolescents, 14-17 years old, with a diagnosis of Personality Limit T and cocaine consumption who start treatment with Paliperidone Palmitate LD IM (50-100mg / month) in monotherapy, with Diazepam 5mg if significant anxiety. Retrospective data collection. Plutchik impulsivity scale (IE) before starting treatment and at 3 months. Statistical analysis SPSS 20.0

Twelve adolescents who met the inclusion criteria were included and 12 adolescents, 83% male, 16% female, completed the questionnaires. After its application and correction through non-parametric tests (N <30), scores in the EI questionnaire of a mean of 37.42 points in the pretest were observed, corresponding to a severe level of impulsivity; and a mean of 26.28 points in the post-test, compatible with a mild-moderate degree of impulsive symptoms. A decrease in the consumption of toxins was observed in 65% of the cases.

In our experience, the management of toxic consumption in adolescent population with severe impulsivity symptoms has great limitations due to the scarce resources available. The Palpitate of Paliperidone long-term treatment has been useful in the approach of serious registered cases, being associated with symptomatic improvement and decrease in consumption.

Schizophrenia (SKZ) is a chronic, disabling and incapacitating psychiatric disorder. In addition to the traditional symptomes of schizophrenia, the suffering of this patients can be expressed through a set of cognitive complaints

To determe the factors associated with subjective cognitive complaints in schizophrenia

We conducted a cross-sectional descriptive and analytical study among a sample of of 72 patients followed in psychiatric outpatient of Hefi chaker university hospital in sfax. We used the SSTIC scale to determine subjectif complains ans the PANSS to evalue positif and negatif symptomes

The mean age of our popularion was 46.83± 11.6 years. The patients had a low socio-economic level in 70.1%. They were unemployed in 46.9%, consumed alcohol in 23.6% and consumed tobacco in 58,6% of the cases. the total score on the PANSS scale was 46, distributed as follows: 9 for positive symptoms, 17 for negative symptoms and 22 for total psychopathological assessment. They had an average score of 25 on the total SSTICS score Factors significantly correlated with subjective cognitive complaints were: low socio-economic level (p=0.04), lack of occupation (p=0.001), alcoholism (p=0.001), smoking (p=0.01) and presence of negative symptoms (p=0.00).

This study demonstrates that socio-demographic characteristics and the predominance of negative signs may increase the subjectif cognitif complains in schizophrenia. The recognition of these associations by the psychiatrist can have an important implication in the therapeutic management.

Intellectual disability is a condition of cognitive impairment and deficit in adaptive skills. Mental illness is frequent in people with intellectual disability. As a result antipsychotics are often prescribed to treat not only mental illness but also problem behaviors.

Perform a literature search about intellectual disability and antipsychotics.

A non-systematic literature review was performed on PubMed using the keywords “intellectual disability” and “antipsychotics”. All papers published between 2015 and 2020 were evaluated.

A review of the literature reveals that antipsychotics are the most frequently prescribed psychotropic drugs in people with intellectual disability. However, results from the studies are ambiguous. Several studies showed that antipsychotics are effective in improving problem behaviours, nevertheless some recent studies showed no significant difference in the outcomes between antipsychotics and placebo

Even though antipsychotics are prescribed in people with intellectual disability, evidence to support their use is lacking. In consequence, clinicians should consider the pharmacological approach as a part of an integrative treatment. Assessing adverse events, drug effects and the possibility of decreasing dose of antipsychotics is crucial.

Concerns have been raised about ecological momentary assessment (EMA) acceptability among patients with schizophrenia spectrum disorders (SSD), which is of major relevance during the e-Mental health-focused COVID-19 pandemic.

To investigate i) the levels of adherence to a passive smartphone-based EMA tool, the Evidence-Based Behavior (eB2), among SSD patients; and ii) putative predictors of this.

Sample: SSD (F20-29-ICD10) outpatients, age 18-64, without financial incentives, recruited over 17/06/2019-11/03/2020 at the Hospital Universitario Fundación Jiménez Díaz (Madrid, Spain). Those who accepted the eB2 installation -users- and those who did not -non-users- were compared in sociodemographic, clinical, premorbid adjustment, neurocognitive, psychopathological, insight and metacognitive variables by a multivariable binary logistic regression model.

Sample (N=77): n=41 males; age: 47.69±9.76 years, n=24 users (31.2%). n=14 users (70%) had the eB2 installed at follow-up (median=14.50 weeks).

X2=25.296,df=6,p<0.001. Nagelkerke-R2=44.7%. Correctly classified: 76.9%, users:54.5%, non-users:88.4%.

Acceptability of a smartphone-based EMA application among SSD patients was low. Age (young) and good premorbid adjustment predicted acceptability. e-Mental Health methods need to be tailored for patients with SSD. Otherwise, these highly vulnerable individuals may be neglected by e-health-based services in the post-COVID-19 years ahead.

Associations between childhood trauma (CT), social support (SS), brain functions and major depressive disorder (MDD) is unknown.

This study aimed to investigate whether brain functions mediated associations between CT, SS, and MDD.

164 MDD and 98 healthy controls (HC) were recruited and measured by HAMD-24 and HAMA. Some completed CT questionnaire (CTQ) and social support rating scale (SSRS). We examined amplitude of low-frequency fluctuation (ALFF) between the two groups and correlations between HAMD-24, HAMA and ALFF in MDD. Then, the peak voxels of the ALFF changed regions were used as seeds to analyze whole-brain functional connectivity (FC). Next, correlations between FC and clinical variables of MDD were performed. Last, mediation analysis was used to further determine whether ALFF or FC could mediate the associations between CT, SS, and different clinical variables in MDD patients.

Compared to HC, MDD showed decreased ALFF in right posterior cingulate (PCC_R), left postcentral gyrus, right precentral gyrus, and left thalamus (THA_L), but increased ALFF in right medial frontal gyrus, left subgenual anterior cingulate, and left middle occipital gyrus as well as decreased FC in bilateral PCC and THA_R. HAMD-24 had negative correlation with ALFF of THA_L, while positive with sexual abuse (SA) score in MDD. Mediation analysis revealed that FC of PCC_R mediated association between SA and baseline HAMD-24, and itself or together with SS mediated association between CT and onset age of MDD.

CT may influence the depression severity and onset age of MDD by moderating FC of PCC_R only or together with SS.

The intentional use of drugs before or during sexual intercourse (chemsex) is a phenomenon of special importance in the MSM (men who have sex with men) population due to its impact on mental, physical and sexual health. Sexual health issues related to chemsex practice have been described such as difficulties in achieving sober sex, erectile dysfunction or problems with sexual desire.

To describe the sexual health interventions (including sexual counselling and sexual therapy) for patients with chemsex practices in the NGO Apoyo Positivo in Madrid. We describe the main sexual problems.

Descriptive analysis.

The main sexual problems were dissatisfaction in sexual intercourse without substance and difficulties with sexual desire activation (70%); compulsive sexual behaviour (70%), difficulties with sexual orientation and non normative gender expression, difficulties in erection (34%), premature ejaculation (7%) and delayed ejaculation (10%).

Chemsex is a phenomenon that needs a multidisciplinary approach and mental and sexual health must be taken into account. “Sexo, Drogas y Tu” is a model of collaborative approach which is a pioneering intervention developed by an NGO in Spain.

The literature shows a high prevalence of psychopathological problems, anxiety and depression among university students because of academic expectations, uncertain future plans, staying away from their family, economic issues and peer relationships. Although these problems show high prevalence among university students, providing them a professional care is limited so most of problems remain untreated. Nowadays the students use digital technologies commonly therefore web based and computer delivered interventions may be useful for them to improve resilience and coping strategies.

The intent of the study was to review systematically the impacts of web based and computer delivered interventions regarding stress management among university students.

Several databases were searched with using key words such as university students, online interventions, web based interventions and stress management. Randomised controlled studies were reviewed.

We found 284 article with the key words. Only four of them met the including criterias. All results of reviewed articles show that web based online interventions have an impact to reduce depression, stress and anxiety level among students. According to the results students improved coping skills against stress after web based online sessions.

The findings show that web based and computed delivered interventions can be effective to improve resilience and reduce students` depression, anxiety and stress symptoms when compared non-interactive and inactive controls. In addition online interventions regarding stress management may provide us to reach out large group of university students.

No significant relationships.

Over the past decades, immunotherapy treatments have been a revolution to many chronic diseases with encouraging results in clinical outcomes and quality of life. The use of monoclonal antibodies has yielded a great variability in terms of clinical efficacy and tolerability although it’s believed the incidence of psychotic symptoms is low (0,1-0,4%).

To review the effects of monoclonal antibodies on psychosis.

Review of literature using PubMed database. A total of 16 studies were included.

The targeted molecules by monoclonal antibodies may determine the risk of psychosis. While those who target TNF-alfa seem to have a reduced risk of psychosis (such as Infliximab, Adalimumab, Certolizumab and Golimumab), monoclonal antibodies who modulate lymphocytes may have a greater risk of psychosis namely Natalizumab, Belimumab, Basiliximab and Daclizumab, which seems to correlate to evidence of alterations in lymphocyte subsets in groups of patients with first psychotic episode and schizophrenia. Some seem to have positive correlation with psychosis namely monoclonal antibodies who have a supressing effect on the immune system, especially those who target adaptative immunity and those who are used in autoimmune diseases (vs oncologic conditions). It is unknown if delusions prevail over hallucinations or vice-versa. Despite the paucity of evidence, these findings corroborate the variability regarding the psychiatric effects of immunotherapy.

The available literature reports a low prevalence of psychotic symptoms associated with the use of monoclonal antibodies but it highlights the importance in knowing the immune mechanisms involved in psychotic disorders. Greater research is needed to correctly assess that risk.

Important changes have been done in economic status of residents in 2018. The impact of these measures in changing opinion was checked.

The prioritization exercises of main factors related with psychiatric residents’ decision to emigrate could be a starting point of elaboration of a strategy of reforms.

The study was cross sectional evaluation at national level on a randomized selected sample of Romanian psychiatric residents’ opinion on factors which influence decision of migration in EU countries in two time points: 2015 and 2020.

38% of residents intend to work abroad comparing with 78% before the economic changes (25.84% versus 71.66% for a limited period of time and 15.73% versus 28.33% intend to emigrate) and 2% versus 5% intend to leave the speciality. The most important factors for decision to emigrate changed from “Better working conditions” (15.73 versus 37.31% residents) to “Better training” 20.25% residents and the factor “respect and appreciation by colleagues” remained important for 19.10% versus 17.91%. “Lack of working place for partner” was considered by 26.96% of responders as an important disadvantage of working abroad. “Being far from family members” which was considered 5 years ago by 64.18% of responders as an important disadvantage of working abroad, nowadays concerns only 6.74%, probably because it seems easier to go abroad together with the family members.

The factors (better training in psychiatry and psychotherapy, better supervision, more involvement in research) which influence the residents’ decision to emigrate represent the starting points on futures reforms in educational and medical system in psychiatry.

No significant relationships.

The generalist assistance at the Primary Attention is fundamental to face the increase of type 2 diabetes mellitus cases through the relationship physician-patient. This sets the therapeutic plan and its continuous review. Therapeutic Plan could be affected by the same psychocultural phenomena related to the increasing cases numbers of DM2. Therefore, new trends in Medical Psychology have been promoted during medical undergraduate course. These incorporate methods and concepts of Liberal Arts to develop specific psychosocial management skills to DM2 clinic.

AIM: To understand the experience of medical students in the simulated care of DM2 cases in two different moments: 1) to diagnose and start treatment; 2) start insulinization.

METHOD: Clinical-Qualitative design; data collected through an semidirected interview of open-end questions in depth; thematic analysis generated categories discussed in light of Medical Psychology of psychodynamic framework.

RESULTS: Ten clinical clerkship students attended as clinicians two cases of Standard Patients of DM2. They reported their reflections toward the role they should sustain: being doctor in front of the patient and their colleagues; difficulty to play the leading and show skills and knowledge in a scenario full of surprises and fantasies; an existential and professional gains in simulation activity; and considerations about responsible in conduct so impacting situations to patients.

FINAL CONSIDERATONS: The themes translate moments during their simulated attending experience in which they have not sustained their semblance – the intended rule. These could be enriched though group reflecting, supervisor discussion, and patient dialog in the process of developing Medical Psychology skills.

No significant relationships.

Fear of evaluation and a negative view of the self are the key characteristics of social anxiety, which is one the most prevalent anxiety problem. Self-esteem refers to views of oneself, including individual’s personal feelings towards self, whereas self-compassion refers to caring attitude toward oneself. Both constructs are two distinct positive views of the self, and were found to be related to each other, well-being and good mental health. To date, however, little is known, how they interplay in people with predominantly negative view of themselves, that is in socially anxious individuals.

The current research aims at evaluating how social anxiety interacts with self-esteem and self-compassion and to assess whether self-compassion, mediates the relationship between social anxiety and self-esteem.

In this research, 388 adult participants with elevated social anxiety level (LSAS score M = 81.47, SD = 21.20) were recruited via open calls posted on the Internet and completed measures of social anxiety, self-compassion, and self-esteem.

In accordance with the view that individuals with social anxiety tend to have negative mental representation of the self, we found that both self-esteem and self-compassion correlated negatively with social anxiety, and positively with one another. More importantly, self-compassion partially mediates the relationship between self-esteem and social anxiety.

These findings suggest that self-compassion may play an important role in buffering against social anxiety and suggest that enhancing self-compassion might be beneficial for reducing symptoms of social anxiety

No significant relationships.

Neuropsychiatric drugs account for 16% of drugs that can lead to hepatotoxicity and psychiatric patients can have multiple comorbidities that can increase the incidence of liver disorders such as alcoholism, drug abuse and polymedication. The continuous use of atypical antipsychotic drugs (AAD) has raised questions over their tolerability over endocrine, metabolic and cardiovascular systems. They are also associated with mild elevation of aminotransferases and occasionally cause idiosyncratic liver injury with varying phenotypes. Hepatotoxicity is defined based on biological parameters such as elevation of alkaline phosphatase enzyme, SGPT, SGOT and GGT or clinical abnormalities (jaundice and hepatitis).

This work reviewed the current available evidence on the hepatic damage produced by AAD.

Non-systematic review of the literature with selection of scientific articles published in the past 10 years; by searching Pubmed and Medscape databases using the combination of MeSH descriptors. The following MeSH terms were used: atypical antipsychotic drugs; hepatotoxicity; hepatic; Olanzapine; Clozapine; Risperidone; Aripiprazol; Paliperidone.

Atypical Antipsychotic Drugs are generally well tolerated and hepatic alterations are in general very low or rare. The cases published were observed with Clozapine, Olanzapine and Risperidone. Atypical Antipsychotic drugs have a better profile than Chlorpromazine.

In conclusion, the hepatic injury generally occurs within the first weeks of treatment and is usually reversible with drug withdrawal. Hepatic check-ups may be relevant, especially in the beginning of treatment.

No significant relationships.

The medical novelty of COVID-19 requires a comprehensive study of its impact on various areas of human health, including mental health.

To study the spectrum and severity of psychopathological disorders in previously healthy patients of different age groups who have had moderate and severe COVID-19 pneumonia.

Immediately after stabilization of the physical condition, patients completed the Symptom Checklist-90-R, designed to assess 11 parameters: somatization (SOM), obsessive-compulsive (OS), interpersonal sensitivity (INT), depression (DEP), anxiety (ANX), hostility (HOS), phobic anxiety (PHOB), paranoid ideas (PAR), psychoticism (PSY). Patients with cognitive impairment were excluded.

The study involved 148 patients aged from 26 to 84 years. In the general sample, psychopathological symptoms were detected mainly on the SOM, DEP, ANX, HOS scales. To a lesser extent - on the INT and PAR scales; were practically not determined on the PSY and PHOB scales. Most of the symptoms are significantly more intense in patients over 46 years old (n = 129) compared with the younger population (<46 years old, n = 19). Older patients according to SOM revealed 1.23 points (IQR 0.5) versus 0.85 (IQR 0.7) among young people, DEP - 0.88 (IQR 0.44) vs. 0.47 (IQR 0.44), ANX - 0.66 (IQR 0.44) vs. 0.43 (IQR 0.29), OS - 0.55 (IQR 0.5) vs. 0.31 (IQR 0.25) and HOS - 0.46 (IQR 0.34) vs. 0.29 (IQR 0.09).

Patients recovering from severe COVID-19 pneumonia require psychiatric evaluation and subsequent differentiated psychotherapeutic rehabilitation, especially for the age group over 46.

No significant relationships.

Smart care in offices and industrials approach has the best way for the results of staying healthy in the transmission chain and this issue is not only a moral necessity but also it can be a successful plan where personal care centers start keeping the patients, employees, and experts of healthcare ward healthy by digital industries. In this project, the environment along with the individual`s body scan and accessing his /her biomarkers, the environment mechanism will be approached to the welfare level to disappear the disease, then change the air by antiseptic materials for air conditioning desirably.

Designing the self-care environment by accessing the smart elements decreases the pathogenic factors in the environment, by scanning the individual`s case and inquiring from health base, the features of the environmental elements will be optimized to normal situation.

Content analysis of environmental components of space and categorizing of sensors. Determining the basic model for programming Designing the architectural environment in accordance with the standards set in the previous section, preparation of the model with thermal, biological, biochemical,.sensors.

Designing the self-care environment by accessing the smart elements decreases the pathogenic factors in the environment, by scanning the individual`s case and inquiring from health base, the features of the environmental elements will be optimized to normal situation.

By a positive design in architectural changes in care units in the field of public spaces, offices and industrial parts, we can easily control individual behaviors in the face of pandemic diseases and decline their psychic side effects.

Our work experience requires investment to run on a real scale

General-population studies investigating the biological correlates of anhedonia/amotivation might be informative for treatment breakthroughs for a number of clinical conditions. Reduced gut-microbial diversity might lead to an anhedonic/amotivational syndrome (“sickness behaviour”). However, how gut-microbial diversity contribute to this clinical phenotype is a key gap in knowledge. We hypothesised the endocannabinoid system would be at play.

We tested the hypothesis that the endocannabinoid system mediates the association between gut-microbial diversity and anhedonia/amotivation

Secondary data analysis on 786 volunteer twins (TwinsUK). Measures of gut-microbiome, faecal endocannabinoid metabolites, and anhedonia/amotivation were collected over five years. To test our hypothesis we used a multilevel mediation model using alpha diversity as predictor, faecal levels of the endocannabinoid palmitoylethanolamide (PEA) as mediator, and anhedonia/amotivation as outcome. Analyses were adjusted for obesity, diet, antidepressants, and sociodemographic covariates.

Mean age was 65.2±7.6; 27% were obese and 4.7% were on antidepressants. Alpha diversity was significantly associated with anhedonia/amotivation (β=-0.37; 95%CI: -0.71 to -0.03; P=0.03). Faecal PEA levels mediated this association: the indirect effect was significant (β=-0.13; 95%CI: -0.24 to -0.01; P=0.03), as was the total effect (β=-0.38; 95%CI: -0.72 to -0.04; P=0.03). The direct effect of alpha diversity on anhedonia/amotivation was attenuated fully

We provided the first evidence showing that the association between gut-microbial features and anhedonia/amotivation is mediated by the endocannabinoid system. These findings shed light on a new therapeutic target in an area of unmet clinical need.

No significant relationships.