Attention Deficit and Hiperactivity Disorder (ADHD) is a neurobiological disorder, affecting executive functions and defined by hyperactivity, attention deficit and/or impulsivity symptoms. This neurodevelopmental disorder affect up to 7% of children. It is observed as a chronic pathology appearing on childhood with other comorbid diseases. Often, remarkable symptoms use to change with the age, however a real improvement is also related with other -external- factors, as social environment.

-To highlight variability of ADHD symptoms and complexity of available treatments in childhood. -To analize influence of personal and familiar factors, which affect to evolution of ADHD and the response to treatment.

Comparative-study. Retrospective selection of 8 patients with treatment for ADHD and currently stable. A 12-months ADHD confirmed diagnosis in Child and Adolescent Mental Health Unit and follow-up after diagnosis. They are compared by aged-pairs (females and males) at the different development school-stages (preschool 3-6 years, primary school 7-12 years and adolescence 13-16 years). *Pairs of study: male-5 years/female-6 years; male-7 years/female-8 years; female-10 years/male-11 years; female-13 years/male-15 years

-Evolution of ADHD highlights the influence of age-factor about remarkable symptoms mainly (from hiperactivity to inattentiveness). -Comorbid disorders seems related with sex-factor (impulsivity-eating disorders on females and irritability-mood disorders on males). -Children social environment, specially family support, is an important external factor for all these patients (low self-steem or somatization disorders).

1. ADHD as a chronic disorder whose evolution depends on the age, sex and social factors 2. Genetic component or familiar support are also considered as influencers factors 3.Multidisciplinary approach to objectives: motivation, organization and maturity 4. Treatment is consider according to side effects and comorbidity

The most recent legal regulations in the Republic of Croatia govern the process of criminal procedure for persons in pre-trial detention who have a temporary mental disturbance for which psychiatric treatment is needed. The Prison Director is in this case obliged to seek psychiatric treatment for such persons who are then hospitalized in a psychiatric institution instead of a prison hospital or prison that meets the requirements prescribed by law for the accommodation of pre-trial detainees. Forensic departments of the five psychiatric hospitals in Croatia accept mentally incapable persons subject to court order, but not persons in custody, i.e. in pre-trial detention. Pre-trial detention is a measure imposed in the previous proceedings to ensure that the person to whom the measure is imposed is present during the pre-trial stage and the hearing stage, i.e. after the final judgment has been rendered until it becomes final. According to Croatian laws, a person who has been sentenced to pre-trial detention and who has mental disorders is entitled to a range of rights that must be respected, and at the same time, there are strict restrictions in exercising those same rights for the reason of sentencing to pre-trial detention.

The article points to several problems that have arisen in practice due to the under-regulation of pre-trial detention measures.

Perspective, opinion, and commentary article.

Perspective, opinion, and commentary article.

The authors discuss legal, medical, and ethical issues, but also the financial framework of such a process.

There is a significant relation between old-age depression and subsequent dementia in patients aged 50. This supports the hypothesis of old-age depression being a predictor, and possibly a causal factor, of subsequent dementia. The number of people aged 60 years and over has tripled since 1950, reaching 16% in 2050, leading to new medical challenges. Depression is the most common mental disorder in older adults, affecting 7% of the older population. Dementia is the second most common with about 5% prevalence worldwide, but it is the first leading cause of disease burden.

Early detection and treatment is essential in promoting remission, preventing relapse, and reducing emotional burden. Speech is a well established early indicator of cognitive deficits. Speech processing methods offer great potential to fully automatically screen for prototypic indicators of both dementia and depressive disorders.

We present two different methods to detect pathological speech with artificial neural networks. We use both deep architectures, as well as more traditional machine learning approaches.

The models developed using a two-stage deep architecture achieved 59% classification accuracy on the test set from DementiaBank. Our CNN system achieved the best classification accuracy of 63.6% for dementia, but reaching 70% for depressive disorders on the test set from Distress Analysis Interview Corpus.

These methods offer a promising classification accuracy ranging from 63% to 70%, applicable in an innovative speech-based screening system.

The main feature of body dysmorphic disorder (BDD) is impairing preoccupation with a physical defect that appears slight or non-existent to others.

To draw an overview of BDD through a clinical case of a patient with BDD and autolytic ideation, which improved after an adequate diagnosis and an early pharmacological and psychotherapeutic approach.

Bibliographic review of the treatment and diagnosis of BDD, from articles published in the last 5 years in Pubmed.

18-year-old woman diagnosed with depression and obsessive ideation, which started at the age of 11, after a comment at school. The patient believes that she has intenseunder-eye bags or dark circles, this has caused her to abandon all activity and self-isolate at home. Symptoms included recurring obsessive and intruding thoughts related to the supposed defect, ritualized behaviors of hours of duration aiming toit through makeup, and autolytic ideation. Therapeutic approach combined psychopharmacological and psychotherapeutic treatments, obtaining gradual improvement of symptomatology and disappearance of the autolytic ideation.

The disorder is severe, which is reflected in high rates of suicide attempts. Differential diagnosis between obsessive and delirious dysmorphophobia is essential for improving outcomes; the egodystonic nature of the symptom, awareness of illness and obsessive personality traits facilitate the diagnosis. A multidisciplinary approach involving psychiatrists and clinical psychologists is necessary for a correct diagnosis and early treatment of this pathology, as well as recognition by dermatologists, surgeons and medical aesthetic professionals, where these patients go with the aim of finding solutions to their problem.

No significant relationships.

The Adolescent Brain and Cognitive Development (ABCD) study, a US population-based sample of 10 year-olds, offers a unique opportunity to examine the neural correlates of manic-like symptoms presenting in children about to enter adolescence.

The study will avail of the rich dataset of over 11,000 children aged 9-10 years at enrolment using data from the baseline and 2-year follow-up assessment. The analyses aim to track the evolution of manic-like symptoms between the two follow-up waves and test their sensitivity of their association with brain correlates.

Data analyses are ongoing and will focus on changes in manic-like symptoms, focusing on youth with remitting, persistent and emerging symptoms and examine their associations with brain structure and resting-state functional connectivity.

The results will inform about the early trajectory of manic-like symptoms and offer new insights into their brain-related correlates.

No significant relationships.

The immediate antidepressant effect of Ketamine has become a breakthrough in the treatment of depression. Cytochrome CYP3A4 and 2B6 primarily metabolize Ketamine.

The present study explores potential pharmacokinetic and pharmacodynamic interactions of Lamotrigine and Ketamine.

A literature search was conducted using (“ketamine” OR “Lamotrigine” AND Interactions in PubMed, Embase, and PsycINFO. Our literature search resulted in 72 hits and result in qualified five studies.

We found five studies: one RCT study, a RCT, a crossover design, Two case reports, and one murine model study. In the first RCT conducted on 16 healthy normal volunteer subjects. lamotrigine significantly decreased ketamine-induced perceptual abnormalities (P < 0.001), positive (P < 0.001) and negative symptoms (P < 0.05), and learning and memory impairment (P < 0.05) which shows the counter effect of ketamine. Another study revealed Ketamine evoked increases in all the BPRS subscale scores, and all scores were lower after lamotrigine pretreatment. A case report from 2014 reports the failure of ketamine anesthesia in a patient with lamotrigine overdose. Another case report mentions that Lamotrigine reduced the craving in a patient with ketamine use disorder. A murine model study with lamotrigine showed improved PPI (Prepulse inhibition) ketamine-induced disruption. These results suggest that Lamotrigine may exert this effect via a glutamatergic system.

The literature review suggests that Lamotrigine interferes with glutamatergic neurotransmission reducing the effect of Ketamine. It is not clear how this may impact Ketamine’s antidepressant action. Future large scale and well-designed RCTs are required to confirm these findings.

No significant relationships.

Eye movement deficits in psychiatric patients have often been investigated with linear models, which fail to fully capture the complex dynamics characterizing eye movements.

The present work aims to investigate the deficits in fixational eye movements in psychiatric patients according as non-linear chaotic dynamic.

We recruited 191 patients (91 males, average age 45 years) diagnosed with schizophrenia, bipolar disorder, depression and personality disorder. The control sample consisted of 22 healthy subjects (12 males, mean age 41 years). Fixational eye movements were recorded with the Eytribe infrared system and off-line analyzed using Matlab. The dynamics of fixation eye movements were investigated using a phase space graph, which refers to chaotic system analysis. This analysis allows to evaluate how the changes in space during fixation as a function of their speed.

A major difference emerged: psychiatric patients showed larger and faster eye movements gravitating around a single point of density, while control subjects exhibited slower and smaller eye movements with multiple drifts and microtremors.

In conclusion, the dynamics of fixational eye movements in psychiatric patients seemed to be characterized by poorer efficiency in space exploration. These differences could be attributed to a worse coordination between the perceptual and the oculomotor system.

No significant relationships.

The ongoing COVID-19 pandemic is inducing fear, and a timely understanding of mental health status is urgently needed for society. Previous research has revealed a profound and wide range of psychosocial impacts on people at the individual, community, and international levels. On an individual level, people are likely to experience fear of falling sick or dying themselves, feelings of helplessness, and stigma. Currently, there is little understanding of mental well-being assessment under scenarios of pandemics that oblige to social isolation and quarantine.

This study aims to: a) establish the prevalence of psychiatric symptoms; b) identify risk and protective factors contributing to psychological stress; and c) identify coping strategies to promote better adjustment during and after the pandemic crisis.

We will adopt a mixed-method approach, firstly with a cross-sectional survey design (in both Portugal and Swiss context) to assess the higher education student’s psychosocial response during and after the pandemic, by using an anonymous online questionnaire. In a 2nd phase, and in order to gain more insight into the psychological stress faced by the students as a result of pandemic, a qualitative approach was chosen, focusing on the experiences of the participants.

This study has received ethical approval from both international and local institutional review boards. Data collection will start in November 2020 and will be completed at February 2021.

The findings of this study will provide important data to assist government agencies and healthcare professionals in safeguarding the psychosocial wellbeing of the community in the face of COVID-19 outbreak expansion.

Delirium is characterized by fluctuating disturbance of consciousness, inattention, reduced awareness, hallucinations or delusions, occurring in 20% of hospital admissions. Central nervous system symptoms are the main form of neurologic injury in patients with COVID-19 and a significant portion of these patients presents with delirium. COVID-19 infection’s course and symptoms, as well as patient comorbidities can facilitate its onset, which is exacerbated by the frequent need for higher doses of sedation to suppress severe cough.

To summarize the most recent practices for management of delirium in COVID-19 infected patients, with emphasis on the psychopharmacology approach.

Selective literature review via PubMed search, using the terms “delirium, neurological disorders, psychopharmacology and COVID-19”.

COVID-19 associated delirium can be presented in its hyperactive type with exuberant agitation, but also with additional clinical features such as rigidity, akinetic mutism, abulia and alogia. Psychopharmacological approaches may be needed for patients with agitation when there’s intractable stress or risk to self or others. In this group of patients, melatonin, alfa-2 agonists and low potency antipsychotics have been used as first line treatment. Trazodone, valproate, dopamine agonists, amantadine can be used. Other approaches such as correction of vitamin deficiencies and remdesivir can also play a role.

Delirium remains frequently unrecognized. In the pandemic context of COVID-19 it is important to consider this infection as a cause of delirium and mind the misdiagnosis as a psychiatric condition. One should look for atypical features and be more thoughtful about the psychopharmacological approach.

Recovery is much broader than experiencing remission of symptoms. It is understood as the experience of a subjectively significant and satisfying life, even if some symptoms of mental illness persist. The recovery process from borderline personality disorder (BPD) is complex and includes recognizing the need for change and developing greater self-acceptance.

Provide an overview of personal recovery from BPD.

The authors did a non-systematic review in pubmed with the words: “borderline personality disorder” and “Recovery”.

BPD is a serious mental disorder characterized by a pattern of instability in interpersonal relationships, self-image and affections, marked by impulsiveness and (para) suicidal behaviors. Unemployment and difficulties in obtaining and maintaining employment are highly prevalent on BPD and add social exclusion and deterioration of physical and mental health. Recent long-term follow-up studies offer a optimistic scenario, indicating high rates of clinical remission (not equivalent to full recovery). Most psychotherapies, such as dialectical behavioral therapy (DBT) or mentalization-based therapy, have proven their effectiveness in treating emotional dysregulation, impulsivity and interpersonal difficulties. Teams working with people with BPD should develop comprehensive multidisciplinary care plans. The care plan should identify long-term goals that should be realistic, and linked to the short-term treatment aims and develop a crisis plan that identifies potential triggers that could lead to a crisis.

Cognitive rehabilitation and psychoeducational interventions can be effective in individuals with BPD. These interventions can be easily implemented in mental health settings and offer benefits for improving overall functioning, which often remains affected after clinical remission in long-term follow-up.

The study of effects of long-term antipsychotic therapy in patients with schizophrenia is relevant.

To study effects of long-term antipsychotic therapy on parameters of immunity and cytokine levels in patients with schizophrenia.

We examined 20 schizophrenic patients, who received quetiapine (group 1) and 17 - olanzapine (group 2) for more than 6 months before admission in the hospital as the main anti-recurrence therapy. Persons aged 20-63 years with length of the follow-up of the disease ≥1 year were included. The investigations included: phenotyping of immunocompetent cells into CD differentiation clusters by flow cytometry; mitogen-induced, spontaneous production of cytokines (IL2, IFN-γ, IL-4, TNF-α) were identified with use of kits for enzyme-linked immunosorbent assay (ELISA).

It was shown that patients of group 1 in comparison with group 2 were characterized by lower values of СD3- lymphocytes (p=0.049), higher values of the spontaneous production of IFN-γ (p=0.01), mitogen-induced production of IL-2 (p=0.043) and IL-4 (p=0.059). In all examined low level of mitogen-induced of IFN-γ (p=0.0001) and TNFα (p=0.002; p=0.0001), high level of spontaneous production of TNFα (p=0.001) were revealed in relation to control.

It was found that the acute period of schizophrenia after prolonged treatment with atypical antipsychotics is accompanied by immunological imbalance and dysregulation of the cytokine system. More severe immune disorders when hospitalized during the exacerbation period were revealed in patients who had been receiving antipsychotic therapy with the atypical antipsychotic quetiapine for a long time. This can be associated with the features of the mechanism of action of atypical antipsychotics.

No significant relationships.

For young people, just as in the general population, COVID-19 caused many changes in their lives. The literature review has shown an increased risk for mental illness symptoms as a consequence of the pandemic.

With this study, we aimed to evaluate the impact of COVID-19 pandemic in university students’ anxiety and depression symptoms.

This study is part of a larger longitudinal research on university students’ mental health with the Portuguese version of The Patient Health Questionnaire (PHQ-9) and the Portuguese version of the Generalised Anxiety Disorder (GAD-7) data with evaluations on January, May and October 2019 and June 2020, as well as socio-demographic information.

341 university students (257 females and 84 males) were included in this study, with a mean age of 19.91 (SD=1.58). In June 2020, the mean for perceived well-being loss was 60.47% (SD=26.56) and 59.54% (SD=28.95) for mental health loss. In the PHQ-9, the proportion of students with scores equal or above 15 ranged between 22.6% and 25.5% in 2019, however, in June 2020, the proportion was significantly higher (37.0%). The proportion of GAD-7 scores above the cut-off 10 ranged between 46.0% and 47.8% in 2019, and, in 2020, 64.5% of the students scored 10 or above. Compared with preceding trends, PHQ-9 scores were 3.11 (CI=2.40-3.83) higher than expected, and GAD-7 scores were 3.56 (CI=2.75-5.37) higher.

COVID-19 had a negative impact on depressive and anxiety symptoms in university students, in line with the literature and confirming the vulnerability of young people in such uncertain times.

Indomethacin, a non-steroidal anti-inflammatory treatment used in various inflammatory diseases, is one of the drugs that has been related to the appearance of psychotic symptoms as a side effect.

Point out the importance of knowing the possible psychiatric symptoms that some drugs can cause as a side effect.

Description of a clinical case and bibliography review.

We present the case of a 71-year-old woman, with no previous mental health history, who is referred by her primary care physician due to the presence of auditory hallucinations and self-referential ideas. As a somatic history, the patient presented Rheumatoid Arthritis under control by rheumatology and acoustic neuroma, under control by neurosurgery. Treatment with Risperidone was started, up to 2 mg, which helped control her symptoms. After an exhaustive study of her situation, the possibility that her symptoms were a side effect of her usual treatment was raised. It was evidenced that the patient had taken a higher dose of Indomethacin than prescribed by the rheumatologist, reason why its daily intake was suspended, and subsequently an improvement and even suppression of symptoms was seen. Later, due to a misunderstanding, the drug was reintroduced, and symptoms appeared again.

The appearance of psychotic symptoms has been related to the intake of various drugs, including Indomethacin. It is essential to carry out a differential diagnosis if psychotic symptoms appear in the subject.

No significant relationships.

Alzheimer’s disease is common among the modern population. Emotional support for caregivers and a stable social role contribute to the maintenance of cognitive resources in Alzheimer’s.

To investigate the protective mechanisms that protect the brain from premature aging

Clinical, sociological

Violations of the higher cerebral functions of speech, gnosis, praxis are the neuropsychological basis for the development of psychological symptoms of dementia. Speech disorders, gnosis disorders contribute to the formation of painful ideas, perception disorders, eating disorders and affective symptoms. The level of functional activity is low and does not depend on the state of severe microsocial dementia, total aphasia and apraxia. The social, work, family and marital status of caregivers for patients with moderate to severe dementia is declining. An increase in the degree of dementia can reduce the functional activity of the caregiver. Caregivers often suffer from neurotic, affective and other mental disorders. A person with dementia plays a subordinate role in the family. Changing roles in the family occurs when the patient has delusion, agitation / aggression, anxiety, unstable mood / irritability. In these cases, the interpersonal distance in the “care-patient” pair increases. Caregivers have a high level of emotional involvement in the care process. A change in the role of the family, a change in place of residence, and a high level of “expressive” emotions of the guardian negatively affect the formation of psychosis, anxiety and aberrant behavior in patients with dementia. Microsocial factors influence cognitive retention in dementia

Protective psychosocial factors strengthen the cognitive reserve

No significant relationships.

At Coombe Wood Mother and Baby unit (MBU) there are daily multi-disciplinary team (MDT) handover meetings and a weekly MDT ward round attended by 7-8 team members. There are concerns that the handover is too time consuming, utilising time which could be spent on other clinical duties, and concerns regarding the relevance of information that is handed over.

To perform a service evaluation to determine the efficiency and quality of MDT handover meetings in an MBU setting.

Data was collected from September to October 2020. A checklist was designed listing information felt to be relevant to handover and contained the following data points – ‘current situation’, ‘mental health’, ‘level of observations’, ‘risk’, ‘physical health’, ‘baby care’, ‘baby supervision levels’ and ‘tasks and responsibilities’. The start and stop times of each MDT handover meeting were noted and a record was made as to whether these topics were discussed.

Mean meeting duration was 32.2 minutes (range: 13 – 45 minutes) and amounted to 2.68 hours spent in MDT handover over a 5-day working week. This equates to 21.4 person-hours (based on 8 staff) a week. 928 data points were generated. 50.7% (468) data points were recorded and commonly omitted data points were – ‘tasks and responsibilities’, ‘risk’, ‘level of observations’ and ‘physical health’. On all occasions, ‘current situation’, ‘mental health’ and ‘baby care’ were handed over.

The results of this service evaluation provide compelling evidence for a wider improvement project. Involving MDT staff in designing interventions will make handover meetings more meaningful.

Teenagers’ Internet addiction can be supported by a wide variety of Internet content.

To study the structure of the content consumed by Siberian adolescents with Internet addiction.

200 (69 boys and 131 girls) Internet addicted adolescents aged 11-18 years and living in the urban area of Central Siberia (Krasnoyarsk) were surveyed. Content consumption was studied using Game Addiction Scale for Adolescents and The Social Media Disorder Scale.

19.0% of adolescents were addicted to Internet games, 22.5% of adolescents were addicted to social media. A combination of both types of addictions was found in 23.5% of adolescents. Other types of content addiction was found in 35% of adolescents. Boys prefer Internet games (62.3% of boys vs. 32.1% of girls), while girls prefer communication on social media (55.0% of girls vs. 29.0% of boys), p <0.001. Combined addiction is observed equally in both sexes (23.2% and 23.7% respectively). For older adolescents, there is observed a decrease in the interest to Internet games (from 48.4% at 11-14 y.o. to 37.6% at 15-18 y.o.) and to social media (from 49.5% to 43.1%). At the same time, interest to other types of content is growing (from 27.5% to 41.3%).

Boys with internet addiction are more likely to be addicted to internet games, while girls are more likely to get engaged in social media. Older adolescents show a decrease in the interest both to Internet games and social media, while their interest to other types of content increases. The study was funded by RFBR project № 18-29-2203218.

The study was funded by RFBR project № 18-29-2203218.

Binge-eating disorder (BED) is a difficult-to-manage clinical entity, that may associate both organic (e.g., obesity, metabolic syndrome) and psychiatric (e.g., anxiety, mood, or substance use disorders) co-morbidity. Psychotherapeutic and pharmacological approaches are usually combined in order to reach the best outcome for these patients, but the disorder seems to have prolonged evolution even under appropriate therapeutic managment.

To evaluate the most evidence-based therapies focused on BED.

A literature review was conducted through main electronic databases, and papers published between January 2000 and August 2020 were included in the analysis.

Cognitive-behavioral therapy (CBT) is supported by multiple trials, and it led to decreased number of binge episodes and increased rates of remission. Behavioral activation may improve certain symptoms of BED (depressive mood, anxiety), but not the binge episodes frequency. Interpersonal group therapy (IPT) may be helpful for BED patients with an external locus of control and significant interpersonal dificulties. Dialectical behavior therapy (DBT) has been applied in BED patients, but the results have been inconclusive. Lisdexamfetamine dimesylate is the only FDA approved drug for this indication, as dasotraline was rejected by FDA and its research discontinued by the manufacturer. Fluoxetine, sertraline, escitalopram, duloxetine, bupropion, atomoxetine, reboxetine, armodafinil, disulfiram, baclofen, zonisamide, lamotrigine, topiramate, samidorphan, liraglutid, and orlistat need more trials in order to validate their efficacy, especially on long term.

There is only one drug currently FDA approved for this indication, lisdexamfetamine, and a number of psychotherapies, with CBT and IPT being the most supported by evidence.

Although several authors have investigated the relationship between demoralization, insight, and suicide risk, the role of these factors in determining suicide risk in patients with psychiatric disorders is still unclear [Berardelli et al., 2019; Costanza et al., 2020].

The main aim of this study was therefore to determine whether suicide risk was associated with better insight and worse demoralization in a sample of 100 adult psychiatric inpatients.

The study was performed on 100 psychiatric hospitalized adult patients consecutively enrolled between January 2019 and April 2020 at psychiatric units of Sant’Andrea Medical Center, Sapienza University of Rome. The Columbia Suicide Severity Rating Scale (C-SSRS) was used to assess suicide risk, Demoralization was assessed using the Demoralization Scale (DS) [Kissane et al., 2004] and for the assessment of insight we used the The Insight Scale (IS).

Only age was significantly associated with higher suicide risk (χ2=9.07, p<0.01). The variable mood disorder was significantly associated with higher suicide risk (χ22=7.50, p<0.05). Non-suicidal self-harm behaviors in the last 3 months (χ2=5.89, p<0.05) and lifetime suicide attempts (χ2=21.80, p<0.001) were significantly associated with higher suicide risk. Only the insight-high dimension (χ2=8.01, p<0.01) and lifetime suicide attempts (χ2=12.33, p<0.001) were significantly associated with higher suicide risk.

Our results don’t confirm the role of demoralization in suicide risk. In our sample of patients, only high insigth of illness and other psychological variables are involved in suicide risk.

No significant relationships.

Epilepsy is associated with a wide range of psychiatric manifestations. Forced normalization occurs when the establishment of improved seizure control in a patient with previous uncontrolled epilepsy leads to the emergence of psychiatric symptoms, which include, among others, psychotic phenomena.

We aim to review the literature regarding the phenomenon of forced normalization and its association with psychosis.

We performed an updated review in the PubMed database using the terms “forced normalization” and “psychosis”. The included articles were selected by title and abstract.

Psychosis is the most common behavioural disturbance in forced normalization, usually manifested as delusions and hallucinations. Forced normalization is more frequent in young female patients with drug‐resistant focal epilepsy. Antiepileptic drug treatment and epilepsy surgery are the most common triggers. Institution of antipsychotics and management of antiepileptic drugs are part of the treatment. Prognosis seems to be better in women, children and patients with generalized epilepsy, among other factors.

Forced normalization is an overlooked entity, the pathophysiology of which remains largely uncertain. The recognition of forced normalization by psychiatrists is crucial for adequate patient treatment including pharmacological management and consultation with a neurologist

After the first case of Covid-19 was emerged in Turkey on March 11, 2020, schools were closed distance education began. On March 21, curfew was declared for people who under the age of 20. Subsequently, the date of the nationwide university exam was changed twice.

This study has two aims. The first goal was to investigate the factors that affect the test anxiety of individuals who will enter the university exam during the Covid-19 outbreak. The second aim was to investigate whether the test anxiety levels of the participants vary according to the level of cognitive flexibility and self-regulation.

The study consists of 420 (284 women, 131 men and 5 others). The age range of the participants was between 18 and 21, with the mean of 18.33. Exam Anxiety Scale, Adolescent Self-Regulation Skills Scale and Cognitive Flexibility Scale were used to collect data.

The findings indicated that women’s level of test anxiety was higher than men. Those who do have concentration issues in distance education have high level of test anxiety. Test anxiety was higher for students whose household income decreased because of the pandemic. MANOVA results revealed that individuals with low test anxiety have higher ‘self-regulation successful’ scores and lower ‘self-regulation unsuccessful’ scores. Moreover, it was yielded that people with low test anxiety have higher level of cognitive flexibility.

Protective factors such as cognitive flexibility and self-regulation play an important role in individuals’ management of test anxiety.

No significant relationships.