People with personality disorders (PD) share some impairments in personality functioning (e.g. identity, intimacy, empathy) that are also associated with inner or interpersonal conflicts, and sometimes also with different strategies of moral disengagement (MD). It is unclear whether MD strategies are related to individuals with/without PD and their willingness to have social contacts with representatives of otherness (like minorities, physically handicapped, etc.).

Comparison of the differences in MD strategies and social distance to the otherness of healthy controls and people with PD, and the influence of personality functioning.

Moral Disengagement Scale which measures eight MD strategies, the Semi-Structured Interview for Personality Functioning DSM-5 assessing the Self and Interpersonal functioning, and Bogardus Social Distance Scale measuring perceived social distance toward various representatives of otherness are applied in two samples (general population and personality disorders).

People with PD showed a significantly higher propensity to use various MD strategies than healthy controls with moderate effect size (.34–.49). Moral disengagement is facilitated by different aspects of personality functioning in both samples, sharing the impairments in maintaining close relationships. Both samples differed in MD strategies connected with higher social distancing.

People with PD are more prone to moral disengagement than healthy adults. MD appears to be facilitated by different aspects of personality functioning in both samples. Some representants of otherness are more related to specific MD strategies. We hypothesize that understanding of specific MD strategies used by people with PD can provide insight and explain some of their behavior.

Bipolar disorder (BD) is frequently underdiagnosed and due to poor screening, the average time between onset of symptoms and diagnosis is more than 7-years (Mantere et al., 2004). Improper diagnosis has serious consequences in intervention (Ghaemi et al., 2001), and previous assessment instruments are now considered insufficient to detect intervention changes, and to provide a more functional and integrated view of BD.

Our study aims to develop a new DSM-5 based Clinical Interview for Bipolar Disorder (CIBD), providing criteria to diagnose BD, but also the individual’s perceptions dealing with BD symptoms. This interview follows the same structure of CIPD (Martins et al., 2015), which has shown acceptability by the participants and experts.

CIBD was developed by a multidisciplinary team considering the DSM-5 criteria for Bipolar Disorders. There was a thorough research regarding assessment and evaluation of BD, and several suggestions from an international task force of specialist working with BD patients were considered, when writing the questions for the interview. A detailed description of CIBD development is presented. The authors of the interview have extended experience in the management and assessment of BD patients, and CIBD is now being assessed by a wider non-related panel, regarding pertinence and clarity.

Preliminary assessment and qualitative feedback from participants that were interviewed is shown, with an overall positive feedback.

CIBD assesses both the diagnosis/presence of mood episodes (hypo/mania, and depressive) and symptoms’ psychosocial correlates. CIBD detects subtle changes caused by intervention adding a much needed recovery focused perspective.

No significant relationships.

People with psychosis are commonly socially isolated, both due to their condition, and the stigma towards them. Remote volunteering over smart-phone can be a way to overcome social isolation and physical distance, promoting social inclusion. This talk will present the qualitative findings from a feasibility study – the Phone Pal – which connected in the United Kingdom patients with psychosis with community volunteers, to communicate with each other for up to 12 weeks via smart-phone (through texts, WhatsApp messages, e-mails, audio or video calls). Participants described at the end of the study their experiences of communicating with their match over the smart-phone in terms of frequency, duration and timing of communication, their communication method, content and style, and the changes of communication over time. Several participants reported a positive impact of being connected with someone, meeting a new person, feeling supported and feeling better, and a few described challenges, such as disappointment, guilt and burden. These interview findings show that some matches were able to develop a positive and friendly relationship, and were willing to continue to be in contact with each other beyond the study duration. It is hoped that this talk will generate a lively discussion, gathering further understanding about the potential benefits and challenges of remote volunteering over smart-phone for patients and volunteers, and its potential usefulness in the current pandemic times.

No significant relationships.

The presence of acquired speech disorders of varying evidence can cause maladjustment and job loss. Often there is no adequate psychological and psychotherapeutic assistance for these patients, which hinders the process of recovery and reintegration into the social environment.

To study the level of anxiety and depression in patients with dysarthria who have undergone various types of cerebrovascular accidents. To give practical recommendations regarding the correction of these conditions.

To assess the level of anxiety and depression, the Hospital Anxiety and Depression Scale (HADS) was used as the most convenient for application in clinical practice.

The study involved 42 people in the age group 45-60 years old with the consequences of cerebrovascular accident in the form of various types of dysarthria and without severe movement disorders. All participants had a university degree and a confirmed stroke of anamnesis. According to the data obtained, 45% of patients had symptoms of depression, 52% – anxiety. It should be clarified that specific weight of men with manifestations of depression and anxiety was higher (65% and 56%, respectively). The beginning of active antidepressant therapy in a hospital setting showed a positive subjective effect from such influences – in 38% of patients.

The use of modern methods for assessing the level of anxiety and depression in patients with speech disorders should become an obligatory stage of diagnostic measures. Psychological assistance and pharmacological correction not only helps patients to adapt to new social conditions, but also promotes prevention the progression of depressive manifestations.

No significant relationships.

Children with conduct problems (CP) exhibit problematic externalizing behaviors that violate the rights of others and/or societal norms, are likely to present with comorbid psychological problems, engage in high-risk behaviours during adolescence and in turn, display poorer prospective health in adulthood. However, little known about their adolescent quotidian behaviors, such as their sleep behaviours, which may contribute to these poorer outcomes.

Using a sample designed to assess the longitudinal consequences of CP, the current study examines how histories of CP and comorbidity with depressive symptoms and/or attention-hyperactivity problems are associated with sleep difficulties during adolescence.

744 participants from an ongoing longitudinal study in Québec, Canada were assessed for CP and comorbidities when they were 6 to 10-years-old. They were classified as without CP, CP only, CP and depressive symptoms, CP and attention-hyperactivity problems, or CP, depressive symptoms and attention-hyperactivity problems based on parent and teacher-reported indices. Sleep difficulties were assessed 7 years later, using self and parent-reported indices. Regression analyses controlling for sex, age, family income, maternal education and medications were conducted.

demonstrated that youth and parents from all CP groups reported more sleep difficulties than youth without histories of CP. Participants from the CP, depressive symptoms and attention-hyperactivity problem group reported more sleep difficulty than all other groups, while their parents did not.

These findings suggest that histories of CP, regardless of comorbidity, predispose youth to future sleep difficulties and highlight the importance of incorporating self and parental indices of sleep as well as examining the effect of comorbidity.

In First Episode Psychosis (FEP), Suicidal Behaviours (SB), Violent Behaviours (VB) and substance use are frequent respectively 10% to 30%, 34.5% and 50% (Pompili et al., 2011), (Tournier et al., 2013). The role of substance use in facilitating SB and VB is described (Large et al., 2011).

We aim to evaluate the impact of substance use in FEP patients. Our hypothesis is that substance use is associated with more SB or VB before first admission.

First admission files of 45 patients diagnosed ICD10 F20 to F29 during the 2013-2018 period were retrospectively studied. SB, VB and substance use (Cannabis, alcohol and opiate/cocaine) before admission were collected. Correlation between SB and VB were tested with cannabis, alcohol, opiate/cocaine use with chi2 Pearson independance test.

The frequencies of suicidal behaviours and violent behaviours were 25 % and 22.7 %. The frequencies of cannabis use, alcohol use, opiate/cocaine use were 56.1 %, 10 % and 16.3 %. A strong significant correlation was found between opiate/cocaine use and violent behaviour, p = 0.011 Chi2 was 6.471 DF 1. No other significant correlations were found.

Suicidal behaviours and violent behaviours are known to be more frequent in psychotic patients with addictive comorbidity. Our french rural hospital retrospective study confirms that violent behaviours in first admission psychotic patients are strongly associated with opiate/cocaine substance use comorbidity.

The pharmacological management of women with bipolar disorder in the perinatal period is challenging. This population has a high recurrence rate, but some medications can be a concern in pregnancy and breastfeeding. Little is known about prescribing practices in perinatal services, and the impact of medication on recurrence rates.

To describe 1. the use of medication in women with bipolar disorder in the perinatal period and 2. the impact of medication on the rate of recurrence.

Clinical data was collected from pregnant women with diagnosis of bipolar disorder in the nine participating centres and who were not experiencing an episode of illness entering the postpartum period. Data were analysed for association using χ2 tests and logistic regression.

In this sample of 167 women, 55% were taking medication at delivery: 37% antipsychotics, 15% mood stabilisers, 25% antidepressants. In 12 cases medication was reduced before delivery. 42% experienced a recurrence, with 30% being a manic/psychotic episode. There was no significant association between taking medication and recurrence c2(1)=0.72, p=0.79. There continued to be no association when adjusted for severity (previous admissions, age at first treatment, bipolar subtype) and type of medication OR 0.57 95%CI [0.08; 4.29], p=0.59.

A high number of bipolar women are taking medication before delivery and in the majority antipsychotics are prescribed. The postnatal recurrence rate in both medicated and unmedicated women is high. Further work is needed in larger samples to provide clinical guidance for women and their clinicians.

No significant relationships.

Delusional Syndrome of Possession in schizophrenia (DSPS) is insufficiently explored. Although it characterized by significant severity of clinical state and resistance to psychopharmacotherapy, and may be accompanied by high social risks.

To carry out clinical and psychopathological differentiation of DSPS and to define its personalized diagnostic and prognostic criteria.

66 patients with DSPS were observed (F20.0, F20.01, F20.02 according to ICD-10) by psychopathological, psychometrical and statistical methods.

Persistent delusional conviction of patient in invasion of certain «spiritual being» (demonic or divine) inside of the body and soul is the specific core of DSPS. The psychotic episode with DSPS has similar pattern with paranoid syndrome of Kandinsky–Clérambault. Although, the structure of the syndrome is varying, and characterized by predominance of hallucinatory or delusion symptoms. According to these varieties two different types of DSPS were identified, which were observed in continuous or paroxysmal course of disease. The forms of destructive delusional behavior were also different for both of these types.

Delusional Syndrome of Possession in schizophrenia (DSPS) is complex and diverse phenomenon, due to religious content of delusional disorders, which occurs in specific psychopathological structure of psychotic state. This fact may cause controversy both in psychiatric practice and in religious communities. So, the obtained data could be important for social and treatment predicting, as well as for pastoral counseling.

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.

A 15-year-old man who comes to the consultation referred from neurology for a poorly progressive tic disorder that is resistant to treatment. This is a patient with no relevant medical history. He has good academic performance, without symptoms of inattention, hyperactivity or impulsivity. He does not present buccophonatory tics

To Show guanfacine as a efficient treatment fot tics disorder

Case report

He has presented complex motor tics as cervical contractions that have had to receive physiotherapeutic treatment. He also presents simple ocular tics. The patient at our evaluation is on a 4 mg dose of pimozide without response. He was previously on risperidone. It was decided to start treatment with guanfacine up to 5 mg with reduction of pimozide, to 1 mg. The patient with this dose adjustment shows a notable improvement in the frequency and intensity of the tics, both cervical and ocular. The patient also refers to a feeling of being calmer and being able to face stressful situations such as being exposed to social relationships, intervening more in class without increasing their anxiety levels.

Guanfacine is a selective alpha-2a adrenergic receptor agonist that has an indication for attention deficit hyperactivity disorder. Like its precursor, clonidine, there is more and more literature that proposes this medication and others for ADHD as useful drugs in pathologies such as tic disorder. It has a safe use profile, which with progressive adjustment and hardly any side effects is placed as a treatment to take into account in this pathology.

No significant relationships.

Acute marital psychosis is an acute psychotic episode occurring in a particular context which is marriage. In fact, marriage represents an event with a very important emotional load especially in the Arab-Muslim culture. This event can, in some people, induce a relapse of certain psychiatric disorders, particularly psychotic ones. We propose in this work to report two clinical observations concerning two brothers who both presented, a few years apart, an acute nuptial psychosis with two different evolutions.

Studing the characteristics of nuptial psychotic episode in a one family and the different evolution of each one.

Reporting two clinical cases of two brothers who represented both acute psychotic episode in a nuptial context with different evolution.

The two patients are brothers with common psychiatric background which is their mother treated for chronic psychotic disorder. They were hospitalized in our psychiatric service for acute psychotic episode occuring in a nuptial context with chronic evolution for the first one and a partial recovery for the second one.

Marriage represents an event with a very important emotional load especially in the Arab-Muslim culture. In thiscontext, acute psychotic episode can occur with different evolution for patients predisposed. Studing socio-cultral circumstances related to psychotic episode can help mental health professional to improve the quality of health care service.

Objective laws of emotional disorder formation, their frequency along with clinic and psychopathological structure have been poorly studied until now.3 groups of patients have been observed: 200 people with alcohol addiction, 180 people with opioid addiction, and 90 people with psychostimulant addiction.

All these have influenced our research which goal is to study patients’ emotional state at the stages of psychosocial rehabilitation.

Signs of psychological and physical addiction, specific personality disorders and decrease in social functioning level have been found for all of the observed patients. Psychodiagnostic research (performed according to Hamilton, Spielberger and Hanin, Buss-Durkee methods) has shown significant increase of depression and anxiety parameters, as well as aggression level for all the patients.

Psychosocial rehabilitation system has been formed and created according to the results of the research. It is built based on a stepwise multimodal principle, including social deprivation, individual and group psychotherapy, craft therapy with an outcome to self-organizing psychotherapeutic groups.

Emotional sphere state normalization occurred during the process of participation in the system. According to catamnesis data of 1 to 2 years, the developed system efficiency is: 72.00 % for patients with alcohol addiction, 64.00 % for patients with opioid addiction, 51.00 % for patients with psychostimulant addiction.

No significant relationships.

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 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.

Young people, regarded as less susceptible to the virus, may differently perceive the situation associated with the COVID-19 outbreak.

To determine the differences in perception of COVID-19 and preventive actions taken against it by domestic and international university students under the spreading threat of COVID-19 illness.

During the outbreak of COVID-19, 224 domestic and 312 international students of Russian universities responded via on-line to the self-constructed Attitude towards COVID-19 Questionnaire.

The showings of the international students were surely higher than those of domestic students in seriousness of their evaluation of the COVID-19-related situation in the world (p=.0006), in the country (p=.0096), and in the region (p=.0390); in the evaluation of the virus-related risks for aged and chronic patients (p=.0075), in adequacy of measures taken by the government against COVID-19 (p=.0114), in degree of disturbing their customary way of life (p=.0363), and ruining their plans for the future (p=.0161). The international students, who live mostly not at their homes and have a higher stress level (p=.0227), showed higher interest to COVID-19-related news (p=.0001), they were stricter in taking preventive measures: in wearing a mask, washing hands, keeping the distance in order to reduce the risk of the virus infection (p=.0009).

During the COVID-19 outbreak, both the international and domestic students are calm in perceiving the threat to their health and life. At the same time, with a higher stress level, the international students are more watchful concerning the situation of COVID-19 spread, and they more strictly obey the restrictive measures.

Psychiatric emergency care visits have been associated to several climate variables. However, the influence of precipitation has been understudied

To study the association between precipitation and number of emergency care psychiatric visits.

Daily urgency visits were extracted from electronic medical records of Hospital Universitario La Paz from 1st January 2019 to 31th December 2019. Precipitation data (measured as accumulated litres per square meter) was obtained from a local climate station. Spearman correlation was estimated.

The Spearman correlation coefficient was -0.02(p = 0.80).

Precipitation was not associated to number of emergency visits.

No significant relationships.

The demand for mental health care is increasing globally as a result of societal challenges such as automation, increased economic competition, unemployment and the growing impact of climate change. The direct and indirect economic costs of mental health problems are substantial, totalling over € 600 billion yearly across the EU (OECD 2018). The COVID-19 crisis has led to an additional increase in demand and has changed the way care is delivered. Since March 2020 there has been a significant increase in the use of e-mental health (eMH), telemental health in particular. eMH can contribute to keeping services, accessible, affordable and patient focused. The eMEN project (funded by the EU Interreg North-West-Europe programme) is promoting the latter through a European cooperation platform for eMH development, research and implementation. This platform focuses on high quality and professional ‘blended care’, which combines face-to-face and online treatment. The implementation of eMH has been slow and varies considerably between EU countries, even though this technology has been on the market for over 20 years. The reasons for this are related to quality problems (e.g. validation, usability), resistance from clinicians, lack of blended care treatment protocols, digital skills, reimbursement systems and policies and other barriers. Many service providers and public health authorities are increasing their efforts to overcome these barriers. This presentation will give a short overview of how the eMEN project is trying to overcome these barriers and accelerate the eMH implementation process.

No significant relationships.

The patterns and clinical correlates related to antidepressant drugs (ADs) prescription for BD remain poorly understood.

This study aimed to compare socio-demographic and clinical features of BD patients treated vs. not treated with ADs.

The sample consists of 287 currently euthymic bipolar patients. Among participants (mean age=51.9±15.02), 157 (40.1%) were receiving ADs.

Based on the main findings, subjects given ADs were older and more frequently retired than those without receiving ADs. Moreover, patients given ADs were more likely to have had a first major depressive episode and present with psychotic symptoms at illness onset. Lifetime substance abuse/dependence history was less frequently reported among patients given ADs. Furthermore, ADs given patients have a higher number of affective episodes, and longer duration of their illness. Additionally, subjects treated with ADs reported higher hopelessness levels, and lower positive reinterpretations than those who were not treated with ADs. Factors associated with ADs-use by multivariate modeling were reduced personal autonomy (OR=.070), and hopelessness levels (OR=1.391).

These results may help clinicians to better understand the clinical correlates of BD subtypes and improve their differential management. Additional studies are needed to replicate these findings, and facilitate the differential trajectories of BD patients based on socio-demographic/clinical profile.

No significant relationships.

Internet is an important sphere of activity in children 7-11 years old (Finkelhor et al., 2014; Li et al., 2015; Nasi, Koivusilta, 2013) creating a sphere of possible mental health risks (Livingstone et al., 2011). Neurocognitive deficiency could increase these risks online due to control and change replies and activities online.

The aim was to study relationship between neurocognitive functioning in children 7-11 years old and their self-appraisals online and offline.

50 children 7-11 years old (primary school in Russia, 25 males and 25 females) participated in neuropsychological observation (Akhutina, 2016) and filled Dembo-Rubinstein scales of self-appraisals both for Internet and offline (used descriptors: healthy, happy, clever, kind, confident, independent, Cronbach’s alpha=.63-.65).

Difficulties in the functions of programming and control, serial organization, auditory-speech processing are related to better self-appraisals online (r=.30-.35, p<.01) but not offline. Difficulties in functions of the right hemisphere are more strongly related to online self-appraisals (r=.51) than to offline self-appraisals (r=.31). Adjusting for offline self-appraisals, serial organization, auditory-speech processing and functions of the right hemisphere predict difference in offline and online self-appraisals (ΔR²=6.6-13.0%, p<.05).

Neurocognitive deficiency in children 7-11 years old could lead to unrealistic appraisals of themselves online but not offline increasing probability of problem behavior in the Internet. Study is supported by the Russian Foundation for Basic Research, project 19-29-14181mk.

Study was supported by the Russian Foundation for Basic Research, project 19-29-14181mk. There are no other significant relationships.

The COVID-19 pandemic led to changes in how healthcare was accessed and delivered. It was suggested that COVID-19 will lead to an increased delirium burden in its acute phase, with variable effect on mental health in the longer term. Despite this, there are limited data on the direct effects of the pandemic on psychiatric care.

1) describe the mental health presentations of a diverse acute inpatient population, 2) compare findings with the same period in 2019, 3) characterise the SARS-CoV-2 positive cohort of patients.

We present a descriptive summary of the referrals to a UK psychiatric liaison department during the exponential phase of the pandemic, and compare this to the same period in 2019.

show a 40.3% reduction in the number of referrals in 2020, with an increase in the proportion of referrals for delirium and psychosis. One third (28%) of referred patients tested positive for COVID-19 during their admission, with 39.7% of these presenting with delirium as a consequence of their COVID-19 illness. Our data indicate decreased clinical activity for our service during the pandemic’s peak. There was a marked increase in delirium, though in no other psychiatric presentations.

In preparation for further exponential rises in COVID-19 cases, we would expect seamless integration of liaison psychiatry teams in general hospital wards to optimise delirium management in patients with COVID-19. Further consideration should be given to adequate staffing of community and crisis mental health teams to safely manage the potentially increasing number of people reluctant to visit the emergency department.