Storytelling could be considered as one of the ecological way to study the pragmatic function of speech in schizophrenia. It demands the ability to create narrative (text) that would be appropriate to particular context. Neuropsychological basis of text-context relation impairment in schizophrenia needs clarification.

To study neuropsychological correlates of pragmatic text-context impairment revealed during storytelling in patients with schizophrenia.

Participants were 14 inpatients with schizophrenia and 18 students without mental disorders. Neuropsychological functioning was measured in both groups according to Luria’s method. Pragmatics assessed by storytelling on images which simultaneously depicts some narrative that should be correctly decoded and after expressed to investigator. The images were taken from Luria’s neuropsychological album and Bidstrup’s drawings.

Stories of patients with schizophrenia were different from control stories in two ways. Some patients produced stories which predominantly characterized by incompleteness that don’t give an opportunity to understand their narratives as connected whole because of its lacunarity. In other cases, stories predominantly characterized by distortion of the storyline which became not realistic and don’t match with the original picture. Incompleteness errors primarily correlates with neuropsychological dysfunction of left frontal lobe (p<0,001). Distortion errors also mainly correlates with dysfunction of frontal lobes (p<0,01), but qualitative analysis reveals right hemisphere involvement.

Impairment of the pragmatic function of speech during storytelling in schizophrenia could manifest itself in at least two different ways. Preliminary results show that it could be connected with different neuropsychological mechanisms and worth considered with left-right frontal lobes opposition.

The reported study was funded by RFBR, project number 20-013-00772

Anxiety are among the most common (Huang, Zhao, 2020, Rajkumar, 2020, Roy et al., 2020) and stable (Wang et al., 2020) mental complaints in a pandemic situation. Based on cognitive approach (Beck, Emery, Greenberg, 2005) one should differentiate unrealistic (dysfunctional) anxiety as well as different types of anxiety (Roy et al., 2020).

The aim was to reveal relationship of different types of anxiety with the search for information about coronavirus and protective behavior.

In April 2020 (2-3 weeks of self-isolation regimen) 409 respondents not infected by coronavirus (186 men, 223 women) aged 18 to 64 years appraised their anxiety of infection and pandemic consequences (Cronbach’s alphas .77-.82), the degree to which anxiety disturbs their usual activities, the frequency of tracking information about the coronavirus (.75) and various protective actions against the coronavirus (.76).

17.1% reported that anxiety disturbed their activities. Anxiety of pandemic negative consequences was more prominent than anxiety of infection and was unrelated to age and gender. Anxiety of infection was higher in females (t=-5.48, p<.01, η=.26) and elder people (r=.20, p<.01). Both anxiety of infection and of pandemic consequences was equally related to information tracking and protective behavior (r=.25-.36, p<.01). Dysfunctional anxiety was unrelated to adherence to self-isolation (r=.08) but was related to information tracking (r=.21, p<.01).

Dysfunctional anxiety is unrelated to self-isolation and should be differentiated from realistic anxiety in studies of pandemic. Research is supported by the Russian Foundation for Basic Research, project No. 20-04-60072.

One of the most perplexing and characteristic symptoms of the schizophrenia (SZ) patients is hallucination. The occurrence of hallucinations to be associated with altered activity in the auditory and visual cortex but is not well understood from the brain functional network dynamics in SZ.

To explore the brain abnormal basis of hallucinations in SZ with the dynamic functional connectivity (dFC).

Using magnetic resonance imaging for 83 SZ patients and 83 matched healthy controls and independent component analysis, 52 independent components (ICs) were identified as nodes and assigned into eight intrinsic connectivity networks (Figure 1A). Subsequently, we established dFC matrices and clustered them into four discrete states (Figure 1B) and three state transition metrics were obtained. To further explore the changes in the centrality of each component, eigenvector centrality (EC) was calculated and its time-varying was evaluated.

Compared to controls with FDR correction, we found that patients had more mean dwell times and fractional time in state 1 (P=0.0081 and P=0.0018), mainly with hypoconnectivity between auditory and visual network and other networks and hyperconnectivity between language and default-mode network (DMN). While, patients had less dwell times and fractional time in state 3 (P=0.0018 and P=0.0009), and decreased FC between visual network and executive control network (ECN) and increased FC between ECN and DMN than controls (Figure 2).

EC statistics showed that SZs displayed increased temporal dynamics in visual-related regions (Figure 3).

SZ was mainly manifested as altered dFC and temporal variability of nodal centrality in auditory and visual networks.

No significant relationships.

Non-suicidal self-injury (NSSI) is a clinical condition defined as intentional, self-inflicted act causing pain or superficial damage without suicidal intents (12-35% of the adolescent community). Several findings show a high correlation between NSSI and impairments in the impulsivity control.

The goal of our study is to evaluate the role of impulsivity in NSSI adolescents, relatively to the inhibitory control, in order to investigate if it can represent a neurocognitive risk factor underlying maladaptive behaviours and which psychopathological dimensions can be associated with this neurobiological process.

30 NNSI inpatients (age range: 12 to 18 years), drug-free, were compared with an age-matched control group, using two behavioural paradigms for the study of inhibitory control: the Stop Signal task and the emotive go/Nogo. Psychopathological traits were evaluated by self-report questionnaires for impulsivity dimensions, suicidality and self-injurious acts. Statistical analyses were performed with SPSS program (p =0.05).

NSSI patients did not present impairments in the global inhibitory control but they had longer movement times in both paradigms and faster reaction times in the Go/no-go behavioural paradigm. Therefore, NSSI patients tended to be impulsive at an early stage of movement (rapid TR) and have to slow down in a second phase (TM slow) in order to have time to rework the cognitive processes underlying movement.

The impulsivity dimension is a complex construct that involves multiple interconnected factors. The study of neuro-cognitive and psychopathological aspects and how they are interconnected is necessary to draw new perspectives on the etiopathogenesis of NNSI.

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

Perform a literature search about intellectual disability and antipsychotics.

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

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

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

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.

Levetirazetam is an antiepileptic drug with psychiatric adverse reactions. It includes psychosis, paranoia or hallucinations. The frequency is less than 1%.

To describe and study a case of Psychosis produced by Levetirazetam

Retrospective review of clinical records and complementary test, including psychiatry, electrophysiology and neurology. Diagnosis schales such as Salamanca Questionnaire were used as suport.

A 42-year-old woman diagnosed with tuberous sclerosis and undergoing treatment with levetirazetam acudes to the emergency department for behavioral disorders. She has presented an episode of aggression against a relative threatening him with a kitchen knife. The family reports that since the change in antiepilepticus 1 month ago, the patient has presented strange behaviors. Te Patient is conscious, uncooperative. Barely Approachable. Suspicious of her surroundings, with psychomotor restlessness, self-reference ideas and sparse speech. Auditory hallucinations seem to be present, as well as depressed and irritable mood. Psychic and somatic anxiety is found. Levetirazetam is discontinued, being replaced by valproic acid. Risperidone is started at a 3 mg dose. Treatment is well tolerated, and clinical stability is achived. Cluster A personality traits are found. Complementary test Blood and Urine simples, Imaging tests (CT and MRI), electroencephalogram and Electrocardiogram show no alterations

Levetirazetam can cause psychiatric adverse effects. it is important to make a proper diagnosis before a first psychotic outbreak in later life. Drugs that can produce psychiatric side effects should be identified and patients should be inform.

No significant relationships.

Psychological problems are common among the pediatric population suffering from a chronic illness, especially compared to the normal population. Stressful life events, such as social distancing measures implemented to counter the COVID-19 pandemic emergency, can strongly influence their epidemiology.

The aim of this study was to assess the prevalence rate of depressive and anxiety symptoms among an Italian pediatric population affected by chronic illness and already under a Children Hospital psychological follow-up program during COVID-19 lockdown.

We conducted a cross-sectional study among 54 Italian children and adolescents affected by chronic illness (mean age: 15y; range: 8.9-18y) during the COVID-19 epidemic period. We assessed depressive and anxiety symptoms with the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorders (GAD-7) questionnaire during scheduled follow-up checks or teleconsulting.

Preliminary results showed an elevated prevalence of depressive and anxiety symptoms (51% and 48% respectively) among chronically ill children during the COVID-19 outbreak. When compared with a non-ill pediatric population (Zhou et al. 2020), rates are + 7.3% higher for depression and + 10.6% for anxiety.

Chronic ill pediatric patients are a vulnerable group and require careful consideration. For this reason, the healthcare system should be able to implement and guarantee adequate mental health support programs and continuity of care. Further research is necessary since the COVID-19 outbreak could be repeated.

Coprophagia is a relatively rare phenomenon characterized by the ingestion of feces, and it is usually classified as a rare form of pica. It has been associated with multiple organic causes or mental disorders such as brain tumors, alcoholism, mental retardation, dementia, schizophrenia, depressive disorders or fetishism.

Case report and reflection on its etiology

A Pubmed search was performed with the MeSH terms “Coprophagy” and “pica”. Relevant articles obtained from the respective bibliographic references were also consulted.

A 56-year-old man with a history of psychiatric follow-up with a diagnosis of schizophrenia and cognitive impairment, assessed for behavioral changes such as cat feces intake. After possible organic causes were excluded, treatment with supportive psychotherapy and pharmacologically began with a selective serotonin reuptake inhibitor, fluoxetine, along with treatment for schizophrenia.

According to literature, coprophagia often occurs associated with other medical or neuropsychiatric conditions. Although the etiology, pathophysiology and management remains unclear, several pharmacologic treatments have been attempted with some degree of success. We describe a case of unusual behavior, coprophagia, associated with cognitive impairment and schizophrenia that responded favorably to fluoxetine although without complete remission, in order to contribute to a future nosological redefinition.

No significant relationships.

Altered fear learning processes could be mechanistically linked to the development and/or maintenance of obsessive-compulsive disorder (OCD). From a clinical perspective, the first-line psychological treatment for OCD is cognitive-behavioral therapy (CBT), which is based on the principles of fear learning. However, no previous functional magnetic resonance imaging (fMRI) studies have evaluated the predictive capacity of regional brain activations during fear learning on CBT response in patients with OCD.

We aimed at exploring whether brain activation during fear learning in patients with OCD are associated with CBT outcome.

We assessed 18 patients with OCD and 18 healthy participants during a 2-day experimental protocol where brain activation and skin conductance responses (SCR) where assessed during fear conditioning, extinction learning, and extinction recall within the fMRI scanner. Following the protocol, patients with OCD received CBT.

We found non-significant between-group differences in SCR during fear learning. Patients with OCD showed significantly diminished activation of the dorsal anterior cingulate cortex and the right insula during fear conditioning. Importantly, our analyses revealed a significant negative association between clinical improvement after CBT and activity at the right insula during fear conditioning (x = 39, y = 12, z = -11; t = 5.64; p<0.001; k = 928). This finding is displayed in Figure 1 below.

Patients with OCD may require less fear-conditioned brain responses to achieve the same level of psychophysiological fear conditioning as healthy participants. Interestingly, insula activations during fear-conditioned responses may represent a potential predictor biomarker of response to CBT for OCD.

No significant relationships.

Many children with autism spectrum disorder (ASD) experience high levels of anxiety. However, inconsistencies between parent and child reports may complicate the assessment of anxiety in this population.

The aim of this study is to investigate discrepancies between parent and self-reported anxiety among children with high functioning ASD.

Children aged between 8 and16 years with high functioning ASD, followed in the outpatient unite of child psychiatry at the University Hospital of Monastir, Tunisia and their parents, were invited to complete the Arabic version of the Anxiety Scale for Children with Autism Spectrum Disorder (ASC-ASD). The ASC-ASD is a 24-item questionnaire with six sub-scales, designed specifically for the assessment of anxiety symptomatology in children with ASD. A total score of ≥ 20 indicate significant levels of anxiety.

We recruited 66 children and their parents. The mean age was 10 years old. High rates of anxiety were found: children’s reports revealed that 70% of them present anxiety and 60 % were coated anxious by parent’s reports. Performance Anxiety, Uncertainty and Social Anxiety were the most frequent types of anxiety reported by both parents and children. We did not find a significant difference between the parents and children rating of anxiety except for the apprehension subscale.

This is one of the first studies to compare between parent and self-reported anxiety among children with ASD using an autism-specific measure of anxiety. No discrepancies have been found between parents and children report, however others studies are needed to investigate discrepancies in children with severe ASD.

Treatment of accompanying somatic disorders in patients with schizophrenia is a crucial issue, as those people die about 25 years earlier, compared with the general population. Moreover, premature death in this group of patients is more often caused by comorbidities than by suicide. It is worth emphasizing that cardiovascular disease itself in people with schizophrenia accounts for as much as 23% of causes of death, followed by suicides and drug toxicity. The paper presents a description of a 65-year-old patient diagnosed with schizophrenia, alcohol addiction, metabolic syndrome, and cardiac arrhythmia.

To determine the impact of cooperation between medical specialists and a psychiatric patient on the treatment effect.

A case of a patient treated in a day ward is described. A literature search was made in the PubMed database.

A patient after exacerbations of mental illness, often preceded by a return to alcohol use, tends to discontinue both psychiatric drugs and those prescribed for somatic diseases. Due to the diagnosed atrial fibrillation, sudden discontinuation of cardiac medications significantly increases the risk of life-threatening somatic complications, including stroke.

Diagnostic and therapeutic management in the treatment of psychiatric and somatic diseases with concurrent addiction to psychoactive substances requires interdisciplinary cooperation of medical specialists with the patient to achieve a successful outcome. Summarizing, in treatment, we must always look at the patient as a whole. Aside from caring for the mental state, the physical condition along with the possibility of cooperation on the part of the patient remains essential.

No significant relationships.

The Perinatal Anxiety Screening Scale was translated and validated for European Portuguese (PASS-29; Pereira et al. 2019), from the original PASS (composed of 31 items; Somerville et al. 2014) to allow epidemiological and correlational research and early detection, which is an health policy imperative. This need also applies to Brazil, where a specific instrument to measure perinatal anxiety is not available.

To study the psychometric properties of the PASS Brazilian version factor structure using confirmatory factor analysis (CFA), internal consistency and pattern of correlations with mood states.

350 women (Mean age: 30.01±5.452) in the second trimester of pregnancy (Mean weeks =25.17±±6.55) completed the PASS and the Brazilian version of Profile of Mood States (POMS-25; Barros et al. 2021). SPSS and AMOS software were used.

After deleting two items (1 and 2) and some errors correlated, CFA indicated a good fit for the second-order model (X2/df=2.987; CFI=.903; TLI=.889; GFI=.797, RMSEA=.075; p[rmsea≤0.01]<0.001). The Cronbach alpha was α=.937, and for the four dimensions (general anxiety and specific fear, perfectionism and control, social anxiety and adjustment disorder, acute anxiety and trauma.), were all α>.800. PASS total and dimensional scores significantly (p<.01) and moderately correlated with Profile of Mood States dimensions: negative affect (.471), Depression (.294), Anxiety (.548), Fatigue (.438) and Vigour (-.288).

Similarly, to what has been found for Portuguese version, the Brazilian PASS resulted in a 29-items-and-four-factors version, with good construct and convergent validity and reliability. In the near future we will determine the PASS cut-offs to screen for anxiety disorders in pregnancy and postpartum.

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

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

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

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

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

No significant relationships.

Paranoia querulans is a type of persistent delusional disorder of the persecutory subtype, recognized under ICD-10 and DSM-IV. Being a classically described entity, evidence is lacking from its conceptualization as a nosological entity to diagnosis and treatment. Furthermore, controversy still exists regarding its interplay between the judicial and mental health systems.

To summarize current evidence and knowledge regarding Paranoia querulans on its conceptualization, ethiopathological explanations, therapeutical management and interface between psychiatry and the law.

A systematic review was undertaken between June and October 2020 in the PubMed, Web of Science and Scopus databases according to PRISMA directive. Key-terms: ((querul* OR vexatious) AND (paranoia OR delusio* OR neuros* OR behavi* OR complai*) OR litig*) AND psychiatry. No language or time restrictions were established.

A total of 1648 studies were initially identified (PubMed: 679; WOS: 945; Scopus: 24; other: 0); after duplicates were removed, n=1381 studies remained. After screening title and abstract, 56 studies were included. Their main content was categorized into: 1. Conceptualization (n=26): Neurosis (n=5), psychosis (n=9), behavioral disorder (n=5); no psychiatric diagnosis (n=7). 2. Descriptive psychopathology (n=8) 3. Etiopathogenesis (n=9): Social or personality basis (n=3), culture (n=4), trauma (n=1), cognitive decline (n=1) 4. Management (n=1) 5. Psychiatry and Law: same object, different objectives (n=12)

There is controversy regarding the nosological entity of querulousness, from psychosis to neurosis or behavioral disorders. Some authors consider this behavior to not be a psychiatric diagnosis. Furthermore, most papers dealt with a social or nurture-based origin. There is a dearth of information regarding treatment.

JPE has received CME-related fees from Lundbeck.

Sleep-related complaints are among the most common during pandemic, along with anxiety and depression (Huang, Zhao 2020, Rajkumar 2020). Their prevalence is associated with anxiety about the pandemic (Roy et al., 2020), online information search (Moghanibashi-Mansourieh, 2020, Wang et al., 2020).

The aim was to reveal relationship between the type anxiety and coping during pandemic and sleep-related complaints after 3-4 weeks of lockdown.

203 adults aged 18 to 59 years filled situational version COPE (Carver et al., 1989) and scales measuring anxiety of infection and pandemic consequences (Tkhostov, Rasskazova, 2020) in the mid-April 2020 after 2-3 weeks of lockdown in Russia. After 3-4 weeks, they filled in a modified insomnia severity index (Morin, 1991) appraising how much worse their sleep and daytime functioning during this period (Cronbach’s alpha .62-.73).

Prevalence of sleep and day functioning related complaints during lockdown varied 19.3%-30.5%. Complaints were associated with anxiety only if it reaches dysfunctional level (interfering with daily activities, r = .17-.34, p <.05) and coping strategy of mental disengagement (r = .15-.19, p <.05). Sleep complaints were related to substance use to cope with lockdown problems while complaints on daytime functioning correlated were more common among young respondents (r = -0.22, p <0.01).

Complaints about poor sleep during a pandemic are not related to the general severity of pandemic anxiety, but to the dysfunctional level of anxiety and attempts to avoid it. Research is supported by the Russian Foundation for Basic Research, project No. 20-013-00740.

Research is supported by the Russian Foundation for Basic Research, project No. 20-013-00740.

COVID-19 is a disease with insufficiently studied diagnosis, therapy, and prevention that causes anxiety disorders in population.

To evaluate prevalence and correlates of COVID-19-related anxiety in university students during the period of their distant learning due to COVID-19 pandemic.

The on-line survey of May 2020 covered 327 Russian university students aged 17-40. The questions concerned evaluation of threats, risks and acute problems faced by the students and their closest people in the situation of COVID-19 spread. We determined the anxiety level of the students by the degree of their concern about high risk of COVID-19 infection.

We established that 17.1% of the students had maximal level of COVID-19-related anxiety that correlated with older age (r=.13), better academic performance (r=.12), expectation of higher COVID-19-related threat to their life (r=.57), to the closest people’s health (r=.44), to the aged people’s lives (r=.16). It correlated with a more serious approach to evaluating the COVID-19-related situation and dangers in the world (r=.19), in the country (r=.24), and in the region of their residence (r=.37). Students with a high anxiety level often saw in pandemic a threat to their way of life (r=.12), material wellbeing (r=.12), and plans for the future (r=.11). They more strictly obeyed the restrictions (r=.13) and they did not exclude a recurrence of COVID-19 type pandemics in the future (r=.17).

COVID-19 related anxiety is present in every sixth student and it correlates with older age and better academic performance. These students may have a high risk for depressive disorders.

PsychED Up is an extra-curricular course for 3rd year medical students at King’s College London delivered by psychiatry trainees, senior students and actors. It focuses on the hidden medical curriculum, exploration of holistic care and communication skills.

Develop a responsive and sustainable template for course evaluation Obtain rich and specific feedback across multiple domains which can be translated into course improvements Work collaboratively with former students Empower current students with the knowledge that their input is valuable

Embedded evaluation in start of term course development sessions to engage faculty in evaluation processes Faculty survey to determine what student feedback would be most useful Questionnaire finalised Collaborative design and refinement of questions, confirmed sub-sections and scope

Revised questionnaire: - Included rationale at the start - Questions tailored to faculty development needs - Greater quantity of prompted questions - Specific questions for large group presentation, small group teaching, actors’ performances and students’ reflections - Quantitative ratings and open-space questions thoughtfully paired Reduced time between sessions and obtainment of feedback Quality and quantity of feedback: - High response rates: 32/30 (2 duplicates) mid-term, 29/30 end-of-term - High-quality filling of open-space feedback allowed consolidation of themes to improve the course

Co-designed questionnaire brought focus and organisation to questions leading to richer, more personalised responses for faculty More detailed reflections were attributed to better student understanding of the questionnaire rationale, and knowledge that they would aid course improvement Created a robust system for collecting long-term feedback for PsychED Up and will continue making iterative amendments

The evaluation of the crime of impetus poses problems in seeking clinical elements that configure the total or partial defect of mind. Even in the presence of acute psychotic syndromes it is difficult to identify a psychopathological picture that almost overlaps with the times and methods of the crime itself.

From a longitudinal perspective, this contribution intends to propose a method of integrating data derived from psychopathological, criminological and forensic psychiatric analyzes, in order to identify the link between them and the criminal act that qualifies or excludes the mental defect.

In the analysis of a criminal event generated during an acute psychotic episode, it’s described the logic and methodology of integrating criminological, psychopathological and psychiatric forensic data for which it was possible to identify the pathological nature of the event.

The psychopathological analysis allowed the identification of psychotic manifestations before and after the crime. The criminological analysis included the decision to commit the crime, within a framework of alteration of the reality examination and recognized the delusional purpose in the same methods of carrying out the crime. So, the forensic psychiatric analysis clarified the continuity of the psychopathological manifestations in the time frame in which the crime was planned, organized and committed and to codify such manifestations as an acute psychotic episode.

Although it’s not sufficient to circumscribe the criminal act between two pathologically relevant moments, this contribution shows how integrating different methods of analysis makes it possible to identify the quality of the behavior intended as a crime.

After discharge from forensic psychiatric hospital, rates of violent reoffending are reported to range from 2% to 8% per year in high income countries. Risk assessment informs decisions around admission to and discharge from secure psychiatric hospital and contributes to treatment and supervision Current approaches to assess violence risk in secure hospitals are resource intensive, limited by accuracy and authorship bias. Forensic Violence Oxford (FoVOx) was developed using all forensic psychiatric patients in Sweden, based on the largest forensic psychiatric sample to date, and has the advantage of using routinely available data, which are less liable to bias than interview-based measures.

Literature review on the Forensic Psychiatry and Violence Oxford (FoVOx) tool.

Pubmed and Google Scholar search

The 12 items within the FoVOx tool are sex, age, previous violent crime, previous serious violent crime, primary discharge diagnosis, drug use disorder at point of hospitalization or discharge, any lifetime drug use disorder, alcohol use disorder at point of hospitalization or discharge, personality disorder at discharge, employment at admission, five or more prior inpatient episodes, and whether current length of stay has exceeded one year.

The FoVOx tool is scalable, quick, free to use and available online. Its use could enable clinicians to provide a reasonably accurate risk assessment in a brief and cost-effective way, and free up time to focus on clinical care and risk management rather than risk assessment.