Contextualization: health professionals’ anguish towards the patient with head and neck cancer (HNC) permeates clinical issues: the location of the tumour, if advanced diagnosis, the psychosocial features of the patient. The perception, coming from patients as undesirable, refers to the conflict of how to deal with one’s own anguishes.

AIM: To explore and interpret how anguish experienced by physicians and nurses are mobilized regarding to the clinical and psychosocial peculiarities of patients with HNC.

Strategies: Clinical-qualitative design; semi-directed interview with open-ended questions in depth. Trigger question: “Tell me about the management of the patient with …”. Ten interviewees (06 nurses and 04 resident doctors) from a university oncology outpatient. Intentional sample. Clinical-Qualitative Content Analysis with psychodynamic concepts. Findings validated by peers at the Laboratory of Clinical-Qualitative Research at the University of Campinas, Brazil.

Topics: the treatment of the speeches resulted in three emerging categories: (1) Cancer is literally on the face: self-perception of peculiarities; (2) An appalling illness: dealing with the ‘deteriorated’; (3) To naturalize without trivializing: handling with their own anguish.

Final considerations: The anguish of health professionals who deals with the HNC patient consists of the feelings, which are not exposed, because they are not organized and neither understood as natural feelings. It is up to them to seek neutrality to minimize the anguish present in the conflict of not manifesting thoughts considered inadequate by the patient, avoiding moral judgments and conflicts. Balint groups are recommended to attend emotional demands of health professionals.

Patients with severe mental illness experience physical health inequities. They are less likely to receive preventative care and adequate treatment for physical illnesses. Physical health screening of patients receiving antipsychotics is usually carried out every six months. This comprises screening bloodwork and ECGs, and the sharing of results with family physicians.

We sought to investigate whether the pandemic affected the receipt of routine physical health screening in patients managed by an Assertive Community Treatment (ACT) Service.

A comprehensive chart review was performed on 62 ACT patients. We compared the receipt of screening bloodwork and ECGs from March—December 2020 to the same period in 2019. Results were analyzed using McNemar’s Chi square test with Yates’ correction.

Patients were less likely to have received an ECG during the pandemic period. 69% received an ECG from March—December 2019 versus 42% from March—December 2020 (χ2= 7.76, p<0.01). Similarly, patients were less likely to have received screening bloodwork during the pandemic period (69% vs. 50%, Χ2= 4.32, p<0.05). Qualitative discussion with ACT staff regarding the 39 patients who had not received an ECG and/or bloodwork during the pandemic period revealed system-related (8%), patient-related (23%), and Covid-related (69%) barriers to screening. Covid-related barriers included transport concerns and lab closures.

ACT patients were less likely to have received routine health screening during the Covid-19 pandemic. Thus, the pandemic may have exacerbated physical health inequities for patients with severe mental illness. Covid-related barriers to screening represent an important target for intervention.

No significant relationships.

There are several sets of skills first set of skills which psychiatrists should acquire before or as early as possible after starting their career. THe first of those are communication skills – including those of listening, speaking clearly and convincingly, negotiating and writing scientific and other types of documents. A second set of skills are those that will enable psychiatrists to understand and use legal documents and materials. The third set of skills that is likely to be useful are skills necessary to function as a physician. These sets of skills combined with the knowledge of the subject of psychiatry should help in building a career in any of the areas open to psychiatrists.. Yet, more important than any of the skills or bits of knowledge that a candidate psychiatrist should have to build a career and be happy with it are the motivation to do psychiatry and the acceptance of a style of work marked by empathy, willing acceptance of ethical principles of medicine and if at all possible infectious optimism. The above array of skills, knowledge style of work are not easily developed and those educating future psychiatrists should be careful in their selection of trainees and resourceful in the provision of training that will create psychiatrists who can advance the health of their patients as well as their discipline and will have a chance to live a rewarding life.

No significant relationships.

Religion belongs among well-documented coping strategies, through which one can understand and deal with stressors.

The aim of this study was to examine religious coping responses face to the outbreak of COVID-19 pandemic among Tunisian people.

The survey was conducted using the online anonymous questionnaires and distributed through social networks from 24 April to 23 May 2020. It included sociodemographic questions, participants’ experience of SARS-CoV-2related stressful events and the frequency of religious practice during the COVID-19 pandemic. The Brief RCOPE was used to assess religious coping.

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 religion of all participants was Islam, and 72.5% of them had religious practices. Participants reported much lower levels of negative religious coping than positive religious coping (5% versus 37.5%). There were no significant differences in religious coping activities as a function of gender (p=0.180, p= 0.192). Significant relationships were found only for demographic variables: level of education with Higher-educated reported more PRC (p=0.002). Having a family member with a suspected or confirmed infection was correlated with PRC (p=0.016).Concern with becoming infected or having a friend with a suspected or confirmed infection did not correlate with any coping strategy (p=0.112; p=0.489). No correlation was found between religious commitment and religious coping (p=0.897; p=0.504) however increasing religious activity during this pandemic was correlated with PRC (p=0.013).

Our findings suggest that lockdown experience is associated with higher use of NRC strategies.

Psychiatrists should be aware of the new challenges and needs that globalization poses.

To highlight the need for a culturally sensitive approach to mental health.

Non-systematic review of “cultural consultation” on PubMed.

Most people assume a direct connection between pathophysiology and clinical symptoms. However, evidence shows that the translation of pathophysiology and psychopathology into specific symptoms is mediated by cognitive processes and social interactions, which reflect models/practices specific to our culture. Patients focus on specific aspects of being sick, reinforced by cultural narratives or to fit expectations. Thus, people from different cultural backgrounds might have trouble communicating; cultural idioms of distress can be misinterpreted. The role of structural violence bestowed upon cultural minorities, which leads to discrimination and social exclusion, has extensively been studied as a risk factor for mental illness. Furthermore, ignoring cultural differences and diversity has been shown to contribute to healthcare disparities, hampering access to care and diminishing the quality of care received. In Canada, the Cultural Consultation Model provides cultural expertise, either by evaluating patients (preferably accompanied by the referring doctor, a translator and cultural mediator) for 1-3 sessions, providing recommendations to the referring doctor; or providing consulting to a referring doctor or organisation, through general guidance or discussion of specific cases.

In an evergrowing globalization process, we will inevitably have more contact with patients from culturally distinct backgrounds. To provide the best care, we must be aware of the ways in which culture can shape symptom expression, and take into account cultural explanations and preferences.

No significant relationships.

SARS-CoV-2 is having an important direct impact, and also due to treatments used such as corticosteroids. Among its effects, we have focused on psychosis.

The objective of this paper is to study, from following case, incidence of steroid-induced psychosis in context of COVID-19.

A bibliographic search was performed from different database (Pubmed, TripDatabase) about psychiatric symptoms associated with use of corticosteroids during pandemic. 64-year-old woman with no psychiatric history, who is hospitalized for pneumonia secondary to SARS-Cov2 and treated with antibiotics, bronchodilators, and corticosteroids. At 4 days she began with injury and nihilistic delusions. The corticosteroids were progressively reduced, adding 2.5 mg Risperidone, resolving after ten days.

Corticosteroids are currently being used to treat the systemic inflammatory response associated with COVID-19, but they can produce other effects such as psychiatric symptoms (3-6%): 75% affective (mainly hypomanic symptoms); and 25% psychotic. Steroid-induced psychosis are characterized by confusion, delusions, and hallucinations, and they usually begin 3-4 days after onset, and resolve within a week. They are associated especially with oral systemic steroids and high doses: 1.3% with 40mg of prednisone, and 18% with 80mg; increased this incidence due to the greater use that is being made to treat COVID-19 and the higher doses used in severe cases (up to 120 mg).

To conclude, we need to know characteristics of these episodes in order to be able to prevent and treat them properly (minimum effective dose and less time), since they will probably occur more frequently at this time.

Schizophrenia is a chronic mental disorder that requires long-term treatment. Non-adherence to antipsychotics is common and associated with poor outcomes.

Our study is aimed to describe the therapeutic adherence and to identify the factors associated with poor adherence among schizophrenic patients.

This was a cross-sectional study conducted at psychiatry consultation of the university medical center of Mahdia, Tunisia. Data collection occurred between the months of January and March 2018, including patients suffering from schizophrenia. The evaluation of adherence was performed using the MARS scale (Medication Adherence Rating Scale).

In our sample of 131 schizophrenic patients, there is a male predominance (76%), as well as unmarried status (58.7%), unemployed (72%). The rate of non compliance treatment was 73%. Low levels of education, poor insight and polytherapy were associated to poor adherence. Although patients aged more than 40 years, who were married and diagnosed with undifferentiated schizophrenia were good compliant to treatment (p<0.05).

We suggest a proper treatment strategy for each patient based on the identification of non adherence risk factors.

Stress has been associated with the onset and progression of neuropsychiatric conditions. The neuroendocrine response to psychosocial stressors is mediated via the hypothalamus-pituitary-adrenal axis, resulting in systemic glucocorticoid secretion. FKBP5 is a co-chaperone of the cortisol-bound glucocorticoid receptor. FKBP5 Single Nucleotide Polymorphisms (SNPs) may indicate stress-response alterations, thus affecting vulnerability or resilience to neuropsychiatric phenotypes.

To investigate the FKBP5 polymorphism rs1360780 and FKBP5 mRNA levels in a well-characterized, drug-naïve sample of First-Episode Psychosis (FEP) individuals and matched controls.

For genotyping rs1360780, whole blood DNA was extracted from FEP individuals and matched controls. The presence of the C (protective)→T (risk) alleles was assessed using TaqMan SNP genotyping assay. Peripheral Blood Mononuclear Cells (PBMCs) were isolated and whole RNA was extracted. FKBP5 mRNA levels were detected with RT-qPCR, using SYBRgreen. Results were normalized against the 18s rRNA reference gene. Statistical analysis was performed in GraphPad Prism 8.

The distribution of C→T alleles of rs1360780 genotyped in FEP (N=44) and controls (N=39) indicate a statistically significant prevalence of the C/C alleles in FEP individuals (*p=0.0432). mRNA FKBP5 data revealed increased levels of FKBP5 in FEP individuals (N=25) compared to controls (N=18), (***p=0.0007).

Our data show increased FKBP5 mRNA levels in FEP individuals compared to matched controls, as well as the presence of the rs1360780 protective (C) allele. Follow up studies include investigation of the translational profile of stress-mediators, in order to pave an individualized approach towards deciphering psychosis onset pathobiology.

No significant relationships.

It is well established that reaction time and IQ test scores are correlated, although the strength of this relationship is a matter of debate (Neisser et al., 1996). It was proposed that processing speed is a component of intelligence (Deary, Penke, & Johnson, 2010; Hunt, 2011). In our previous research we have not revealed the relationship between IQ and reaction time in children (Kiselev et al., 2000). However, it is possible that reaction time can predict intelligence test scores in the developmental perspective.

This study investigated whether visuomotor reaction time in 5 year-old children predicts intelligence test scores in 8 year-old children using the longitudinal approach.

The participants were 35 children (17 males and 18 females) at the age of 5 years (5,34±0,45). We used computerized sensorimotor technique (Kiselev et al., 2009) to investigate visuomotor reaction time in children. Children completed simple, discrimination and choice reaction time tasks. The IQ of 8-year children was assessed by the WISC.

The regression analysis has revealed the significant (p≤0,05) relationships between discrimination and choice reaction time tasks in 5 years-old children and non-verbal IQ performance in these children at 8 years of age. However, we did not find this relationship for simple reaction time task.

In view of obtained results it can be assumed that visuomotor reaction time in preschool children can predict non-verbal intelligence test scores in the developmental perspective. The received data can give new perspective in the understanding the interrelation between reaction time and IQ in children.

N-acetylcysteine (NAC) is a precursor of cysteine and glutathione, widely known as an antidote to paracetamol overdose. Its role as precursor of an antioxidant and modulating agent of glutamatergic, dopaminergic, neurotropic and inflammatory pathways, raised interest in its application in psychiatric disorders. NAC emerges as a promising therapeutic agent in substance use disorders (SUD) and provides a treatment option in a field with limited and suboptimal therapies.

To describe the use of NAC in SUD (tobacco, cocaine, cannabis, methamphetamine and alcohol), its potential mechanisms and clinical application.

The literature was searched using the Pubmed database with the following keywords “N-acetylcysteine”, “Substance use disorders” and “Psychiatry”. Retrieved papers (2011-2018) were selected according to their relevance.

SUD results in disruption of glutamate system, in nucleus accumbens, a critical brain area in the rewarding system. NAC reestablishes glutamate homeostasis restoring function of the cysteine-glutamate exchange in glial cells and reversing the downregulated GLT-1 receptor. Concerning its properties, evidence suggests that NAC is able to decrease drive, craving or compulsion to consume, making it particular useful in relapse prevention after achieving abstinence.

NAC has revealed itself as a promising therapeutic agent in SUD and its safety profile and favourable tolerability, as well as being an over-the-counter medication, adds to its interest. Data is still preliminary for the use of NAC in psychiatry disorders, due to the relatively small number of trials and their heterogeneous methodology. Larger studies are needed to confirm efficacy, optimal doses, long-term tolerability and side effects.

Several studies have mentioned the link between psychotrauma and psychosis. A direct causal link remains to be discussed.

Evaluate the link between sexual abuse and psychosis.

We report the case of a male patient who developed schizophrenia following sodomy rape. We performed a literature review based on a PubMed search with the following keywords: “rape sodomy psychosis”.

Mr. M., 26 years old, with a personal psychiatric history of chronic psychosis evolving for 10 years, consulted us for follow-up of his schizophrenia. When he was 16, the patient was raped by sodomy by a 40-year-old man under stabbing threat. After this incident, the patient did not verbalize this trauma, he isolated himself, became irritable and aggressive and has had olfactory hallucinations. The symptomatology worsened until the age of 24 when the patient presented a delusional syndrome with a theme of persecution, mysticism, bewitchment by a mechanism of interpretation and visual hallucinations. Then,he was hospitalized in psychiatry for psychomotor instability, verbal hetero-aggression. He had been diagnosed with schizophrenia evolving over 9 years. Treatment with an antipsychotic: risperidone and valproic acid was started. The evolution was quickly favorable but the patient currently presents blunted affect, a sexual disinterest and a strong desire for revenge from his rapist. Treatment adjustment and psychotherapy would be considered.

The onset of subsequent rape psychosis and the persistence of symptoms related to the trauma are arguments in favor of a direct causal link between sexual abuse and schizophrenia.

No significant relationships.

Currently, the number of cases of pathological aging of the CNS, represented by a violation of cognitive functions, is increasing. But there is a social request to prolong the physical and mental activity of older people

The study of the dynamics of cognitive aging is timely and relevant. The article contains a report on a cohore non-repeating study of higher brain functions at various age periods

The average age was 45.1 + 5.7 years. Inclusion criteria: 1. Dextral. Non-inclusion criteria: 1. Clinically significant somatic diseases in their medical history. 2. Mental disorders in their medical history. •Applied neuropsychological, statistical research methods. The research tool was the neuropsychological rapid method including the subtests: •“Memorizing 9 words in three presentations (1st, 2nd, 3rd attempts)”, •“Sequential subtraction”, •“Test of Benton’s visual memory”, •“Solving an arithmetic problem”, •“Overlaid images”, •“Specified flow of associations in 1 minute”, • “Figure of 3 geometric figures”, • “Blind hours”, • “Graph-motor test”, “Delay word reproduction”

The first cohort 27–40 years old. The second cohort 41–50 years old.Third cohort 51 years old and older. A significant difference in the performance of the graphomotor test between the subjects of the age subgroup of 27-40 years and the subgroup of 41-50 years was statistically confirmed. In older people revealed a much greater number of errors, interruptions of the test than the representatives of the more “young” subgroup

The deterioration in the performance of the graphomotor test was the most age-specific

No significant relationships.

Current studies indicate the involvement of inflammation in the pathogenesis of chronic non-infectious diseases, and therefore it is of interest to study the role of inflammation markers in non-psychotic mental disorders (NPMD).

To identify a number of inflammatory markers in serum of patients with NPMD.

73 patients with NPMD were examined (F43.2; F06.6). The comparison group consisted of 76 patients with endogenous psychosis (EGP) (F20.0; F25.0). The control group included 80 healthy people. The serum activity of leukocyte elastase (LE), α1-proteinase inhibitor (α1-PI) and the level of autoantibodies (aAb) to neuroantigens were determined.

Three groups of patients with different variants of inflammatory response to the pathological process were identified. In group 1 (23.3%), all indices corresponded to the control values, which indicated the absence of the pathological process in brain. In group 2, there was a significant increase in activity both LE and α1-PI compared to control (p<0.05). This type of immune reaction characterized a balanced inflammatory response. It was found in 52% of patients with NPMD and in all patients with EGP. The aAb level also exceeded the control values (p<0.05). Group 3 (24.7%) showed an increase in α1-PI activity (p<0.05), but not in LE activity compared to control. Insufficient LE activity reflects a decrease in the functional activity of neutrophils.

The immune heterogeneity of NPMD according to the level of inflammatory markers was identified. 52% of patients with NPMD have a pronounced activation of inflammatory reactions accompanied by increased levels of aAb to neuroantigens.

Existing evidence regarding the association between hypertensive disorders of pregnancy (HDP) and the risk of maternal mental illness is inconclusive.

This study aimed (i) to investigate the relationship between HDP (pre-eclampsia and gestational hypertension) and the risk of depressive and anxiety symptoms during pregnancy and in the postpartum period and (ii) to test whether parity moderates the association between HDP and antenatal and postnatal anxiety and depressive symptoms.

The study cohort consisted of more than 8500 mothers who participated in the Avon Longitudinal Study of Parents and Children (ALSPAC), UK. Maternal antenatal and postnatal depressive and anxiety symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS) and the Crown-Crisp Experiential Index (CCEI), respectively. Univariable and multivariable logistic and linear regression analyses were used to examine the associations.

Mothers with pre-eclampsia had a 53% (aOR= 1.53; 95% CI, 1.06-2.23) increased risk of antenatal depressive symptoms compared with those without pre-eclampsia. Having pre-eclampsia and being a nulliparous woman resulted in a 2.75 fold increased risk of antenatal depressive symptoms (p-value for interaction = 0.03). Gestational hypertension was associated with antenatal depressive and anxiety symptoms. We found no associations between pre-eclampsia and/or gestational hypertension and postnatal anxiety and depressive symptoms.

Our study showed that mothers with HDP were at higher risk of antenatal depressive and anxiety symptoms. Nulliparous women with pre-eclampsia are a higher risk group for depression during pregnancy.

No significant relationships.

The sexual abuse of children is well documented in literature. Data on it from Nigeria is rather sparse. The current study examines the prevalence and pattern of sexual abuse with a view to increasing our understanding of it.

To determine the prevalence and pattern of sexual abuse of children at home in Ilorin Nigeria.

A cross sectional survey of secondary school students aged 11-18 years in Ilorin Nigeria using multistage random sampling technique with proportional allocation was done. Respondents completed the ICAST-CH questionnaire which covers child abuse in its several forms including sexual abuse. Prevalence of sexual abuse was computed.

Over a third (586) of participants experienced some form of sexual abuse in the last year. Table 1: prevalence and pattern of sexual abuse at home

Sexual abuse of children occurs commonly in Ilorin Nigeria. There is a need for further research towards understnding it determinants towards strengthening systems of safeguarding children against it.

No significant relationships.

Multiple sclerosis (MS) is a chronic inflammatory, demyelinating, and neurodegenerative disease of the central nervous system. This condition is enhanced by stress. In turn, stress symptoms are a risk factor for the onset and progression of MS. However, knowledge about predictors of stress in patients with MS is scarce.

This preliminary study aimed to verify whether the number of relapses, fatigue, physical disability (MS characteristics), experiential avoidance and self-judgment (emotion regulation processes) predict stress symptoms in patients diagnosed with MS.

A convenience sample of 101 patients diagnosed with MS and without other neurological diseases participated in this study. Participants completed the Depression Scale of the Depression, Anxiety and Stress Scales-21, Analog Fatigue Scale, World Health Organization Disability Assessment Schedule-12, Acceptance and Action Questionnaire-II, and Self-Judgment Subscale of the Self-Compassion Scale.

All predictors initially hypothesized and years of education have significant correlations with stress symptoms. Simple linear regression analyses showed that the variables significantly predicted stress symptoms and were, therefore, included in the multiple linear regression model. This model explained 51.8% of the variance of the stress symptoms and showed that years of education, the number of relapses, fatigue, and experiential avoidance significantly predicted those symptoms.

The promotion of mental health mental in patients with MS must develop functional skills to deal with stress induced by years of education (possibly responsible for the degree of awareness about MS and its consequences), recurrence of relapses and fatigue, and should minimize emotion regulation strategies focused on experiential avoidance.

The reception of a patient in the psychiatric ward is an important step that determines the proper course of care. The welcome is the first stage of the relationship, it is essential to take the measure of the importance of this moment.

Assess psychiatric inpatients’ knowledge of their rights and obligations.

This was a descriptive and cross-sectional study based on a self-administered questionnaire containing about twenty questions (20), which assessed the knowledge of patients hospitalized in the HMPIT psychiatry department about their rights and obligations.

Twenty-five (25) patients agreed to answer the questionnaire and two (2) patients refused. Sixty percent (60%) of the patients were unaware of their rights. Sixty-eight percent (68%) of the patients did not know their duties. Forty-eight percent (48%) of the patients did not know the rules and conditions of hospitalization in psychiatry.

Patients hospitalized in the psychiatric ward have limited knowledge about their rights and duties and about the conditions and rules governing hospitalization. In addition to the poster on patients’ rights and duties, a welcome leaflet will provide all the information on the rules of hospitalization.

During COVID 19 epidemic it has been interesting to observe the gradual transformation of the daily routine into death, sorrow and pain. The moment of transition from life to death was really changed by distressing for survivors who had to face with unexpected ways to live their mourning.

The paper would like to analyze the mounring ritual during COVID 19 epidemic.

During COVID 19 tragedy victims and survivors have been first associated by the infection and then dramatically separated by its effects. It has been necessary to re-relaborate new procedures of separation from deceased, as far for laws prohibitions it was no longer possible to use the traditional ones.

So a leaving “ritual” re-emerged very similar to the “crying ritual” of the Southern Italy folkloric culture. The traditional wailers have been substitued by the windows flash mobs trying to replace the forced absence of “pietas”, with a moment of positive sharing of physical distance between life and death, using sounds, songs, tools that always, in farming culture help to exorcise and take away death.

The relevant starting powerlessness to face the fast disease diffusion, its intrinsic seriousness, inspired surprising capabilities of immediate reaction and active mobilization in response to the attack suffered by Koerper and Leib (in Heidegger sense) which actualized in the research of a new “separation” dimension. In the end, as psychiatrists, we have to notice how this collectivization practice is actually a big distress container and wonder where and how this distress will finally arrive

Shared psychotic disorder or Folie a deux is an unusual mental disorder characterized by the transfer of delusions between two or more people who have a close relationship. An individual (inductor or primary) who suffers from a psychotic disorder, influences one or more individuals (induced or secondary). Delusional disorders or schizophrenia are the most commonly diagnosed disorders in the inductor individual.

The objective of this study is to describe the clinical characteristics of an unusual entity such as shared psychotic disorder.

Description of a clinical case of shared psychotic disorder of a family treated in the emergency room during confinement.

47-year-old woman, goes to the emergency room with her husband. No psychiatric history. Both the patient and her husband verbalize delusions of harm and surveillance from neighbors. They also report that two of their children hold this belief. The mother, unlike the rest of the cohabitants, presents disqualifying auditory hallucinations. Her husband decides to take her to the emergency room because he finds her distressed, “between two realities” and aggressive when she is confronted about hallucinations. We start treatment with oral paliperidone in the mother and a subsequent follow- up, and a total remission of symptoms in all cohabitants.

As in other mental disorders, the correct diagnosis and subsequent referral are essential. The separation of the inductor individual from the induced one is useful for the correct management of this disorder. With timely intervention and a regular follow-up, the Folie a deux has a good prognosis.

No significant relationships.

Substance abuse has traditionally been considered as a disease of men. Women were believed to have some kind of immunity in terms of “social inoculation”. However, due to change in societal norms and beliefs, substance use is currently increasing among women also.

To focus on female substance use in India

In India, traditional use of various substances by women during religious festivals is not unknown. Chewing tobacco is a common practice among many women across the country. Cultural use of alcohol has been known in some tribal populations but gradually the use is increasing. There is major difference in pattern of male and female substance use including initiation, progression, recovery and relapse. Women experience greater medical, physiological and psychological impairment and experience loss of control sooner than males. Teatment needs of female substance users is different and requires a gender specific comprehensive strategy which will require medical services, mental health services, services for family and child and employment opportunities.

Currently, there is no Indian policy for women substance use. However, Government of India has started a convergence program which includes National AIDS Control program (NACP), National rural health mission (NRHM) and reproductive or sexually transmitted infection (RTI/STI) to combat some aspects.

India is in great need of a policy or at least a standard operative protocol for management of female substance use disorder which may include screening for substance use disorder for all females accessing health sector, counselling, referral to addiction services, formation of a treating team and after –care.

No significant relationships.