Goffman defined stigma as an “attribute that is deeply discrediting” and in the last two decades research on this subject grew substantially.Opioids were ranked as the second most common form of illicit drug used worldwide and there is consensus in the literature that opioid substitution therapy (OST), methadone or buprenorphine, are the most effective treatments, although remain underutilized. People with an history of substance use disorders (SUD) are widely stigmatized, a significant barrier to detection and treatment efforts. Care workers were cited as the second most common source of stigma.

The aim is to do a review of the literature of stigma as a significant barrier to OST and present several potential strategies to reduce stigma.

Non-systematic review of the literature with selection of scientific articles published in the last 5 years; by searching the Pubmed and Medscape databases using the combination of MeSH descriptors. The following MeSH terms were used: Opioid Use Disorder; Stigma; Opioid Substitution Therapy

OST providers should actively bring up the topic of stigma in clinic appointments to determine whether the patient is experiencing stigma, and if so, whether it is adversely affecting their ability to continue in the treatment. More active measures need to be taken to help reducing the stigma through public awareness campaigns at local levels, continuing education of health care providers regarding substance OST, and greater incorporation of family members into the program.

In conclusion, further research is required to understand and address this issue.

No significant relationships.

Electroconvulsive therapy (ECT) is considered a gold-standart treatment of severe and treatment-resistant depression. Lack of response to ECT often causes distress in psychiatrists regarding the next therapeutic decisions.

To present a case report of a patient with psychotic depression with partial response to ECT.

Clinical interviews and review of literature using the Pubmed platform.

The authors present a case of a 60 year-old woman admitted for severe depressive episode with psychotic symptoms. Due to lack of response to multiple antidepressive and antipsychotic treatments, 15 sessions of ECT were performed with improvement of behavioral and psychotic symptoms. However, endogenous depressive symptoms with functional impairment persisted. It was then initiated Bupropion 300mg/day resulting in vast improvements on drive, energy and activity levels with restored functionality. Previously to ECT, Bupropion was not considered a valid option due to the psychomotor restlessness that was present. This case exposes the limitations of ECT and the therapeutic conundrums that arise when there is partial response. The symptoms expressed in the patient after ECT course correlate with deficits in noradrenergic and dopaminergic pathways that are involved in endogenous depression. The use of Bupropion, with its effect on noradrenaline and dopamine receptors, may offer a therapeutic lifeline in these cases.

ECT still stands as a gold-standart for severe depressive disorder, especially when several psychopharmacological therapies have failed. In cases of partial response to ECT, the neurobiological correlates of clinical presentation can guide the therapeutic management towards improved outcomes.

No significant relationships.

In depression (MDD) treatment there is a clear need for novel treatments, biomarkers and individualized treatment approaches. One of the most promising and most widely investigated biomarkers for antidepressant treatments is the EEG. Most EEG biomarkers however, still lack robustness and reproducibility and suffer significant publication bias as highlighted in a recent meta-analysis (Widge et al., 2018). Therefore, large controlled validation studies are needed with a focus on robustness, replication and clinical relevance. In this presentation results will be presented from the largest EEG Biomarker study to date, the international Study to Predict Optimized Treatment in Depression (iSPOT-D), where 1008 MDD patients were randomized to Escitalopram, Sertraline and Venlafaxine. Drug-class specific (Arns et al., 2016) and drug-specific (Arns, Gordon & Boutros, 2015) biomarkers will be highlighted as well as preliminary data from a prospective feasibility trial. Furthermore, data will be presented on repetitive Transcranial Magnetic Stimulation (rTMS) treatment in MDD on EEG and clinical predictors (Krepel et al., 2018; 2019) and a new method called Neuro-Cardiac-Guided TMS (NCG TMS), that exploits network connectivity in the frontal vagal pathway, as a target engagement approach (Iseger et al., 2019). Finally, clinical implications and implementations will be discussed from a ‘treatment stratification’ perspective, which might be a more realistic goal relative to ‘personalized medicine’ perspective.

MA is unpaid research director of the Brainclinics Foundation, a minority shareholder in neuroCare Group (Munich, Germany), and a co-inventor on 4 patent applications related to EEG, neuromodulation and psychophysiology, but receives no royalties related

Although OCD is believed to have a chronic course, little research has been conducted on this, and there are discrepant findings. Studies over the last years have found that a significant proportion of patients with OCD shows symptomatic remission over long term, however there are significant variations in sampling, clinical characteristics, follow-up, and outcome assessments.

The present prospective study aims to examine rates of OCD remission after 20 years of follow up and to explore demographic and clinical predictors of remission.

The study sample consists of adult patients with a principal OCD diagnosis and Y-BOCS total score ≥16, who have been referred to the Department of Neuroscience, University of Turin (Italy). OCD symptoms were assessed every 5 years over the 20-year follow-up period. Course data were examined using standard survival analysis methods; Cox proportional hazards regression was used to estimate relative hazards for predictors of remission.

There were 360 participants in the study. At year 20, the 28.7 % of the total sample showed OCD remission. Predictor of remission were female gender, lower Y-BOCS mean scores at study entry, longer duration of illness and comorbidity with major depressive disorder. No specific predictors of full remission were found. Lower Y-BOCS mean scores and comorbid bipolar disorder predicted partial remission.

This study suggests that a significant proportion of patients with OCD shows remission. Future studies are needed to clearly identify predictors of remission.

No significant relationships.

The challenges posed by the COVID-19 pandemic were many and daunting. Almost overnight, the lives of millions of people all over Europe was disrupted and people had to adapt to a completely new situation. Healthcare personal were amongst the ones most affected by it, whether by changes in their everyday work routine or by being the people directly in charge of responding to the demands of the pandemic. Trainees are an indispensable part of healthcare personal and, as a result, they were vastly affected by the pandemic.

Discussing the role of National Trainees Associations (NTAs) in pandemic times, including how they dealt with the new challenges, their successes and hardships, and their steps going forward.

Gathering of institutional information about the work of the Portuguese, Irish and Turkish NTAs during the COVID-19 pandemic. Critical appraisal of each of their contributions and projects.

There were impacts to trainees’ clinical work, formative activities and even personal lives. Amidst this turmoil, NTAs were precious institutions. Their objective is to represent the trainees of each country, looking for formative opportunities and linking trainees. During the pandemic, the work developed by the NTAs increase in importance, serving as a beacon of important information and as intermediaries in a number of discussions. They also aimed to minimize the impact on formative activities, whether by providing recommendations or by organizing some form of educational activity.

We provide some national examples – Portugal, Ireland and Turkey – and draw comparisons and lessons from each one.

No significant relationships.

Approximately, 15- 26% of patients with first-episode psychosis, including schizophrenia, are likely to have attempted suicide by their first treatment contact. Studies of suicidal behavior outside of schizophrenia have indicated grey matter volume loss in the prefrontal and orbitofrontal cortex, and aberrant brain activity in relation to emotional recognition and dysfunction.

This study aimed to investigate the functional neural correlates of suicidal behavior in early schizophrenia.

fMRI faces task was conducted (fearful face versus neutral face) in 8 participants with first-episode schizophrenia together with standardised scales including PANSS and SBQ-R. fMRI activation was compared using a two-sample t-test in participants with low and high suicidal behavior. Extent threshold is 0 voxels and significance level p<0.001 (FWE corrected). Processing of images was carried out using SPM12 and Matlab.

8 participants were recruited; 5 males and 3 females, mean age of 26.5. Results suggest that participants with higher suicidal behaviour showed reduced activation on the anterior-cingulate gyrus and medial frontal gyrus, which are parts of PFC, (p= .005). There was also a significant difference in task response accuracy, where, participants with high suicidal behaviour made more accurate responses compared to low group (t (3) = 3.65, p = .035).

This is an exploratory study, investigated the differences in brain activity in patients with schizophrenia who are at risk of completed suicide and, therefore might provide new insights into the underlying mechanisms. Further work should address how PFC activity changes with risk over time and its potential utility as a biomarker in suicide.

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.

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.

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.

Emotion regulation is a key world to understand many human behaviors. Preschool children can exhibite disturbing behaviors that could interfeer with their integration, development and learning abilities. One way to understand these behaviors is their “immature” emotional regulation process. Helping children acquiring this ability can help to solve these disturbances’, which can lead to mental health problems.

To experiment with a new acceptance and committment therapy protocol in preschool children

It is a qualitative interventional study that relies on issues to enable the recognition and regulation of emotions. a protocol was implemented which consists of activities and techniques useful to help children recognize, regulate and accept their emotions, with the support of the educator.

All six selected children accepted to undergo the therapy till the end of the eight sessions. at fisrt, they were enable to recognise some emtions. it was the most difficult for them to recognise body expression of emotion. they had also difficulties find the different worlds to express them and to enact them.Throw different activities, we tried to help children visualize their emotions, imagine them under different faces and play with them. Children were introduced to mindfulness and emotional regulation technics. After One month of the intervention, children were still able to recognize emotions and to propose technics to regulate them. their score on the CBCL were below 70 one month after the intervention.

Even at an early age of 4 years, ACT seems to be possible and helpful for children.

Personality traits like neuroticism and trait-anxiety, as well as the predisposition to a greater sensitivity to pain, are risk factors for dental anxiety. Although perfectionism has been associated with both anxiety and pain, particularly when mediated by repetitive negative thinking/RNT (Macedo et al. 2015; Albuquerque et al. 2013), its role in dental anxiety has not yet been studied.

To analyze the role of perfectionism and RNT in dental anxiety.

A community sample of 552 adults (68.2% women; mean age=35.15±15.79 years) completed the Portuguese versions of:Hewit and Flett Multidimensional Perfectionism Scale–13, State-Trait Anxiety Inventory, Sensitivity to Pain Traumatization/SPT Scale, Fear of Dental Pain/FDP Questionnaire, Perseverative Thinking Questionnaire and Dental Fear Survey/DFS.

Trait-anxiety (r=.225), socially prescribed perfectionism/SPP (r=.177), SPT (r=.286), FDP (r=.509) and RNT (r=.274) were significantly (p<.01) correlated with dental anxiety (DFS total score). Serial mediation analysis using the PROCESS-macro 3.5 for SPSS (Hayes, 2020; Model 6) showed that even controlling for trait-anxiety and gender (as SPT, FDP and RNT mean scores were significantly higher in women, p<.01) SPP plays a significant indirect effect through SDT, FDP and RNT on dental anxiety, which are (isolated or sequentially) full mediators of this relationship (Total effect: .553, p<.001).

This study shows for the first time that negative perfectionism is a predictor of dental anxiety; its influence operates through the increase in levels of sensitivity to pain, DPA and RNT. We suggest that when intervening in this health problem it is important to evaluate perfectionism and try to mitigate its negative impact, namely diminishing RNT and the focus on pain and fear.

Although some philosophers recognize in the loneliness an evolutionary existential process, a 2019 declaration of World Health Organization underlines the major health problem in the worldwide is the perception of state of loneliness. The feeling of loneliness linked to the social isolation (SI) or a lack of social opportunity activate a stressful condition associated to an increase of social dependence. This ‘learned social helplessness’ can be dangerous so that it is associated with an increased prevalence of suicides (Cacioppo and Cacioppo, 2018; Bzdok and Dunbar, 2020). Considering the impact of loneliness on the mental health we can assume that the COVID-19 forced SI affects the state of health and psychosocial well-being.

To evaluate the psychosocial impact of the SI in Italy.

An ad hoc survey have been sent from May to June 2020.

These results refer to the Italian survey of a multicenter investigation with partnership of Spain and Portugal universities. The investigation is in progress being a longitudinal study. Of the total 292 subjects investigated (age xM: 34; sD14.13), 118 (40,41%) had been in SI. Subjects forced into SI report more interference in the life satisfaction (p=0.003) though no more anxiety, depression and hostility we found in the SI group.

During the phase 2 of Italian COVID-19 diffusion, we found an impact on the life satisfaction more than psychopathology. We can assume that the impact of mental health it may occur as the reduction in life satisfaction associated with forced SI continues.

Attention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder, with an estimated prevalence of 2.8% in adults. It is frequently comorbid with other mental disorders and may significantly affect global functioning, leading to stigma and social discrimination. Despite its widespread occurrence in adults, many general psychiatrists do not feel well prepared to diagnose and manage this disorder. Psychiatry training curricula rarely include rotations in specialized ADHD clinics for adults or specialized courses during residency, and in many European countries such specialized clinics for adults or the most recommended medications, are not even available. It makes the recognition and treatment of ADHD often overlooked, unless it has been diagnosed in childhood. Dr. Gondek will demonstrate the diagnostic process of ADHD in adults and main directions for differential diagnosis in cases of a complex clinical picture.

No significant relationships.

Lithium is the most effective maintenance drug in Bipolar Disorder (BD), although it has a narrow therapeutic index, between 0.6 and 1.5 mEq/L; recommended doses for maintenance are 0.6-1.2 mEq/L.

To describe a clinical case of lithium intoxication and discuss relevant literature.

Clinical examination of a patient and her medical records; non-systematic PubMed review on “lithium intoxication”.

A 73-year-old woman, diagnosed with BD, stabilized on lithium monotherapy for twenty-five years, was admitted to the Emergency Room (ER) with nausea, lethargy, drowsiness, confusion, cough, and fever. A respiratory tract infection is diagnosed, based on clinical presentation, x-ray and blood analysis. Blood tests also revealed a serum lithium concentration of 2.4 mEq/L and impairment of renal function, indicating lithium intoxication; hemodialysis was initiated, with lithium discontinuation. Over weeks, renal function and general state improved, and BD treatment was reinitiated, this time with valproic acid 800mg/day. Two weeks after discharge, she was admitted again at the ER, for an episode starting in the week prior, compatible with a manic episode; olanzapine 10mg was added to the prescription. A week after, the patient is admitted again in the ER, still in a manic episode.

There are no clear indications in the literature about reinitiating lithium on someone who had an intoxication. Given that lithium brings an unparalelled quality of life to BD patients, careful consideration about reintroduction, with close monitoring, should be made, but there is a critical need of more studies and guidelines to orient clinical practice.

No significant relationships.

Treatment-resistant schizophrenia (TRS) represents a major clinical issue, characterized by worse psychopathological outcome, a more disrupted neurobiological substrate and higher healthcare costs. Cognitive impairment is a core feature of schizophrenia, strongly associated with patients’ functional outcome. Different studies showed that TRS patients exhibit poorer neurocognitive performance, particularly on verbal domains. To date Cognitive Remediation Therapy (CRT) represents the best available tool for treating cognitive deficits in schizophrenia. However, CRT outcomes are highly heterogeneous and significant treatment predictors are still lacking.

To investigate possible differences of CRT outcome among patients with schizophrenia, stratified according to antipsychotic response (TRSs vs. first-line responders - FLRs).

150 patients with schizophrenia, (95 FLRs, 55 TRSs) were assessed for neurocognition with BACS and WCST at baseline and after CRT. General Linear Models (GLMs) were performed to investigate possible differences between groups on basal cognition and CRT outcome (Cohen’s d Effect Size).

At baseline, GLMs showed significant differences in Verbal Memory (F=4,66; p=0,03) and WCST–executive functions (F=5,59; p=0,02), both worse in TRS group. Effecr Sizes of CRT outcome resulted significantly different in domains of Verbal Memory (F=4,68; p=0,03) and WCST–executive functions (F=4,62; p=0,03), with greater improvements among TRS patients.

This is the first study to indicate treatment-resistance as a possible predictor of CRT outcome in schizophrenia. Moreover, we observed that CRT resulted able to fill the cognitive gap between treatment groups. Thus, these results further highlight the importance of early cognitive interventions in order to reduce the neuropsychological and functional burden associated with the disease, especially for TRS patients.

No significant relationships.

Commitment to sports is especially important for well-being in people with disabilities (Malm et al., 2019), although mental health problems are common among Paralympic athletes (Hunt et al., 2019). Importance of representations of and regulation in sport situations was supported for different kind of sports (Moran, 1993, Suinn R., 1982, Hardy et al., 1996) but Paralympic ones.

The aim was to reveal aspects of psychological regulation important for achievement and longer commitment to Paralympic sports comparing to non-Paralympic sports.

51 athletes from Paralympic sports (49.1% candidates and masters of sports) filled Questionnaire of Image Representations of Professional Activity of Athletes (Leonov et al., 2020) measuring general importance and self-appraisals of different aspects of image representation and regulation in sport activities: control of temporal, spatial, informational, technical and tactical, energetic aspects, game intelligence, motivational, emotional and social aspects (Cronbach’s alphas .61-.89). Data were compared to 399 athletes without disabilities (48.4% candidates and masters of sports).

Comparing to athletes without disabilities, Paralympic athletes higher appraise general importance and their capacities for emotion regulation during sport situation (t=2.26-3.35, p<.01). High-level Paralympic atheletes report marginally better emotion regulation (t=1.74, p<.10). Longer experience in sport in Paralympic athletes is associated with better representations of spatial and social aspects of sport situations and better emotion regulation (r=.25-.29, p<.05).

Data suggest that improvement of emotion regulation in sport situation in Paralympic athletes could be helpful for longer participation and better achievement. Research is supported by the Russian Science Foundation, project No. 19-78-10134.

Research is supported by the Russian Science Foundation, project No. 19-78-10134

The relationship between epilepsy and depression has been recognized for a long time. In fact, the presence of depression could worsen the disease outcome.

we aimed to study the prevalence of depression in patients with epilepsy and to assess the determinant factors of its genesis.

54 patients with epilepsy, aged more than 18 years, attending the neurology department of Habib Bourguiba Hospital, Sfax, Tunisia, were enrolled for the study. All patients were administered Mini-International Neuropsychiatric Interview (MINI) for evalution of psychiatric comorbid disorders especially depression. Socio-demographic and clinical data were collected.

A total of 54 patients were included, of whom 63% (n =34) were men. Mean duration of epilepsy was 20.13 years. The most frequent type of seizure was generalized 72.7%. Depression was present in 7.3 % of patients. Alcoholism (p=0.027) was significantly associated with occurrence of depression. Drug resistence (p = 0.03) and longer duration of epilepsy (p = 0.046) were significantly associated with occurrence of depression. No significant association was found between type of seizure, seizure frequency, medication compliance and depression. Depression wasn’t associated with anti-epileptic drug. We didn’t find any association between depression and other psychiatric comorbidities.

Depression wasn’t frequent in our study contrary to literature. The possible explanations are the reduced simple size and the sensitivity of the used tool to assess depression in epilepsy. Pursuant to literature, we found significant association between Alcoholism, drug resistance and long duration of epilepsy.