Local characteristics of populations have been associated with COVID-19 outcomes. We analyze the Municipality-level factors associated with a high COVID-19 mortality rate of in Mexico.

We retrieved information from cumulative confirmed symptomatic cases and deaths of COVID-19 as of June 20th, 2020 and data from most recent census and surveys of Mexico. A negative binomial regression model was adjusted, dependent variable was the COVID-19 deaths and the independent variables were the quintiles of the distribution of sociodemographic and health characteristics among the 2,457 Municipalities of Mexico.

Factors associated with high MR of COVID-19, relative to Quintile 1 were; diabetes and obesity prevalence, diabetes mortality rate, indigenous population, economically active population, density of economic units that operate essential activities and population density. Among factors inversely associated with lower MR of COVID-19 were; high hypertension prevalence and houses without drainage. We identified 1,351 municipalities without confirmed COVID-19 deaths, of which, 202 had high and 82 very high expected COVID-19 mortality (Means=8 and 13.8 deaths per 100,000 respectively).

This study identified Municipalities of Mexico that could lead to a high mortality scenario later in the epidemic and warns against premature easing of mobility restrictions and to reinforce strategies of prevention and control of outbreaks in communities vulnerable to COVID-19.

Cognitive restructuring is one of the most complex application procedures in psychotherapy. It is widely used by psychologists from different orientations. However, the guidelines on how to apply it do not usually have empirical evidence and there is a lack of knowledge about the mechanisms of change that explain it.

The analysis of verbalizations that therapists emit during the Socratic method could help to better understand the functioning and strategies of effective debates.

In this study, specific verbal interaction sequences were analysed using observational methodology. The sample consisted of 113 Socratic questioning fragments belonging to 18 clinical cases, treated by behavioural therapists.

Among other findings, it was found that using questioning together with certain previous verbalizations directed the client’s response more effectively and those successful debates were characterized by using the aversive component in a frequent and contingent way.

This study shows the most effective way to establish such an interaction in the Socratic method (following a style closer to Ellis’s argumentative debate), which entails relevant practical applications in therapy.

La schizophrénie reste une pathologie invalidante malgré une prise en charge médicamenteuse efficace. Il importe de développer d’autres stratégies adjuvantes efficaces sur les symptômes de la maladie en limitant les effets secondaires des traitements pharmacologiques. L’efficacité des activités physiques dans le traitement de la schizophrénie n’est pas démontrée mais des travaux soulignent des bénéfices sur les symptômes négatifs et dépressifs [1,2].

Nous souhaitons évaluer l’impact clinique d’un programme d’activité physique sur une population de sujets atteints de schizophrénie.

Un programme d’activités physiques supervisé par deux moniteurs a été élaboré. Il comprend une heure de multi-activités, 2 fois par semaine, pendant 12 semaines. L’intensité minimale de chaque séance était fixée à 50 % de la fréquence cardiaque de réserve. Des mesures comprenant les échelles PANSS, SANS, SAPS, CDSS, S-QoL, un bilan anthropométrique et biologique ont été réalisés à S 0, S 6, S 12 et S 16.

Deux groupes de 5 patients (n = 10) ont réalisé le programme. Une amélioration clinique est retrouvée sur l’ensemble des échelles utilisées entre S 0 et S 16. Les changements observés ne sont pas en faveur d’une amélioration du syndrome métabolique et nous notons une prise de poids des sujets sur la période de l’étude. Le traitement statistique des données présente des résultats non significatifs (p > 0,05).

In Spain, consumption of psychotropic drugs is high and benzodiazepines represent 74% of the total. His prescription in primary care is very common and their use continues to grow. They are safe and effective drugs, but patients with prolonged use are elaborating the most adverse effects, particularly the dependency.

Descriptive ans cross-sectional.

Primary Health Care.

We seleted 202 patients treated with benzodiazepines, consecutive sample, belonging to the health center Los Barrio who were seen in consultation during 2009.

We conducted through a questionnaire that cointained the treatment and demographic characteristics.

We detect a frequency of use of benzodiazepines 9% (95% CI 4,7-12,1%). The profile of the consumer responds to middle-aged woman, with primary and housewives. Somatic diseases were associated in 72.6% (CI 67,2-77,5%) and had mental pathology at 59.7% (CI 53,9-65,3%). 35% (95% 29,6-40,6%) of prescribed benzodiazepines were clorazape dipotassium. Consumption was constant for over a year. The prescription from primary care represents 81% (95% 76,3-85,4%) and in 65% (CI 59,3-70,3%) is associated with other psychoactive drug.

In our area, highlights the prescription of benzodiazepines from primary care on demand and consumption during prolonged time. Interventions should be conducted on the prescription of benzodiazepines in medical and other interventions for patient support.

Sexuality is a crucial area of human life. A proper examination to assess and detect problems in this field, it seems imperative to intervene when transsexual patients. Therefore accurately known, the sexual practices of these patients, allows us to work directly on possible alterations in the functioning of sexual life during the therapeutic process.

Describe patterns of sexual behavior in patients diagnosed with transsexualism

Gender and Identity Disorder Unit (GIDU)

Selected by consecutive sampling, 200 transsexuals treated at GIDU Malaga, aged between 20 and 40 years and who agreed to participate in the study. Comprising 142 transgender male-to-woman (MtW) and 58 women-to-man (WtM).

Was conducted through a heterocompleted questionnaire that included questions about sexuality, personality traits and demographic characteristics. These were filled in the consultation and were anonymous.

11.6% of MtW transsexuals have never had sex. 26.8% of the MtW and 29% of WtM are more than 3 months without masturbating. 54.1% of the MtW avoid having sex due to the rejection of his genitals, lack of sexual desire and previous traumatic experience. Transgender respondents had secondary education, stable jobs and they were single.

It is vital that we explore the sex lives of transsexual patients. This information must be integrated in a systematic and rigorous evaluation process. According to the results presented, the hyposexuality would be the most significant feature that describes sexuality for this population.

Drug substance abuse has been related with chronic insomnia and other sleep disorders that are thought to interfere in detoxification treatment and relapse induction. These disorders can persist after drug detoxification.

To describe sleep disorders refered by drug dependents patients in an inpatient detoxification unit.

We prospectively studied drug dependents patients admitted to our Detoxification Unit from January 2005 to March 2009. The first night, patients were asked to complete an 11-item questionnaire measure designed to assess the relationship between sleep disorders and drug use. Responses ranged from 1 to 7. The questionnaire measured the following:

1. a) insomnia before hospitalization;

2. b) patients’ beliefs about the relationship between insomnia and drug use;

3. c) insomnia in previous detoxifications;

4. d) patients’ worry about insomnia;

5. e) treatment of sleep disorder with benzodiazepines.

The study sample included 150 patients (75.3% men). 39% of the patients suffered from alcohol abuse, 34.67% from cocaine abuse, 22.67% from opiod abuse, 21% from cannabis abuse, 18% from benzodiazepine abuse, and 12.67% of patients were polydrug users.Lifetime prevalence of sleep disorders was 68.1%. 64% had suffered insomnia the months previous to detoxification. 80.1% of patients’ refered sleep disorders in relationship with substance abuse. 69.4% were worried about insomnia during detoxification. 75.4% of patients took benzodiazepines without prescription.

Sleep disorders in patients with drug abuse are frequent. A high prevalence of patients having worries about insomnia during the detoxification treatment and believing in a relationship between their sleep disorders and the drug abuse was found.

Sharing personal experiences and survival mechanisms about challenging conditions such as Autism on YouTube may be useful to other parents, educators, psychologists, and policy makers.

This study aimed at analysing YouTube videos of parents sharing their experiences about Autism and text comments posted by viewers.

During the period from 15 November to 15 December, 2012. YouTube was researched by three assessors for videos covering parents sharing their experiences about Autism. Only relevant videos in the English language were identified. For each video, the following information were collected: title, authors, duration, number of viewers, and total number of days on YouTube. Using criteria comprising content, technical authority and pedagogy parameters, videos were rated independently by three assessors and grouped into educationally useful and non-useful videos. A critical thematic analysis of comments posted on was conducted.

A total of 834 videos were screened and only 128 were found to be relevant to parents sharing their experience. Further analysis revealed that 105 (82.1%) provided useful information; scoring (mean ± SD, 15.5 ± 0.94). The other videos 23 (17.9%) were not useful educationally, scoring (11.9 ±2.87). The differences between these two categories were significant; p <0.001. An aggregate of 2393 text comments was posted to useful videos and 951 to non-useful videos.

Despite the variability in the quality of YouTube videos, there are good videos covering parents’ experiences about Autism that can be used by other parents, publics, and professional bodies. The comments made by viewers reflect the importance of the emerging social media tools such as YouTube in sharing experiences.

Poor insight is a distinctive feature of the psychotic spectrum disorders. One of the theories of the etiology of awareness is the neuropsychological view which suggests that there is an association of awareness, cognition and brain changes in psychosis. But the relationship of cognitive reserve, insight and drug use is still an unexplored field in the psychosis literature.

The aim of this research is to analyze the possible moderator effect of cannabis use in the relation between cognitive reserve and insight in psychosis.

A longitudinal study was held with 65 patients with FEP from 3 main hospitals in the Basque Country (Spain). All patients underwent clinical and functional evaluations at base line and longitudinally at one year follow up. Insight was measured using the insight and judgement item (G12) from the Positive and Negative Syndrome Scale (PANSS). The cognitive reserve was measured using the Vocabulary sub-scale from WAIS-III and educational level. Drug use was assessed during the clinical interview.

One year follow-up data were available for 35 patients. Significant relation between the cognitive reserve and G12 item (β = −9.58; p < .05) was found as long as the cannabis use is included as a moderator (β = −9.34; p < .05).

As it is a complex multidimensional concept, a more complete explanatory model of the insight recognizing the functions of the cognitive reserve and others covariates as drug use, defines the role of each variable of the illness and facilitates the objects of treatment definitions.

Basque Government(2008111010), EITB-Maratoia(BIO 09/EM/015).

The objective of the present study was to examine the predictive value of clinical and cognitive -including the cognitive reserve (CR) - variables on the severity of the patient's illness at one year of follow-up.

A study was held with 45 patients with first episode psychosis (FEP) from 3 main hospitals in the Basque Country (Spain). All patients underwent cognitive, clinical, and functional assessments at baseline and at 6 months follow-up. The cognitive measures included were: the Stroop test, Vocabulary sub-test from WAIS-III, the WCST, and Trail Making Test. The clinical and functional measures included were: Positive and Negative Syndrome Scale (PANSS), Young Mania Scale, Montgomery-Asberg Depression scale, and CGI (Clinical Global Impression).

Six-months follow-up data were available for 29 patients. Regression analysis was performed with the 6-month follow-up CGI measure as a dependent variable. Results showed that after controlling for CGI at baseline, -PANSS Negative Symptoms Scale (B = 0.47, p ≤ .05) and the CR measure -Vocabulary from WAIS-III- (B = 0.36, p ≤ .05) were the only two which significantly predicted severity of illness after 6 months (R2 = 0.44) and remained significant when CGI at base line was controlled in the regression analysis. The rest variables did not reach statistical significance.

These findings emphasize that CR have a role on outcome in first episode psychosis, and enhance that exist a relation between cognition and clinical measures in psychosis.

Basque Government, Health Department (2008111010); EITB-Maratoia (BIO 09/EM/015).

Endocannabinoid system has been highlighted as one of the most relevant research topics by neurobiologists, pharmacists, basic scientists and clinicians. The association between endocannabinoids and its congeners and mood disorders is relatively recent. However, evidence from both clinical and preclinical studies is increasing and many researchers point out endocannabinoid system and particularly endocannabinoids and congeners as promising pharmacological targets.

The main objective of this study is to compare the plasma concentrations of endocannabinoids and congeners between a sample of patients with depression and a sample of control subjects, and the influence of variables such as age, body mass index, gender, severity of symptoms, and antidepressant medication.

Plasma concentrations of endocannabinoids and congeners will be analyzed in 69 patients with depression from primary care and 47 controls using mass spectrometry analysis.

Statistically significant differences in 2-arachidonoylglycerol and monoacylglycerols were found between both samples. Somatic symptoms of depression seems to be more related to these compounds that to cognitive-affective symptoms. In addition, differences between mildly and moderately depressed patients were found in concentrations of AEA, LEA, DGLEA and POEA. Patients with antidepressant medication showed higher levels of 2-AG, DGLEA and OEA.

The results of this study provide evidence supporting the hypothesis that in depression there is a dysregulation of the inflammatory signaling and, consequently the immune system. The results of this study could also support the realization of translational research to better understand the mechanisms of this widely distributed system.

The authors have not supplied their declaration of competing interest.

Only 21% of patients included in the South of Granada's First Episodes Program in the year 2014 were women. Studies do not use to focus on sex differences at first-episode samples and it can be masking some relevant variables in this population.

In this exploratory study, we aim to focus on gynaecological consultations during the period of untreated psychosis (DUP) at first episodes of psychosis in women.

A retrospective clinical-cases review of medical histories was made searching for sociodemographic variables, consultations during DUP and psychotic prodromal outcomes.

The average age of the sample was 23 years. The average of DUP was one to three months. Sixty percent of referees to mental health services were from primary care and 20% from emergency services. The main symptom was persecutory or prejudice delusions. Thirty-six percent of them were related to sexuality or pregnancy. In most cases, the demands were not bizarre. When a wide history was made and they were properly explored, a delusional theme was appreciated and the reason for consultation was not justified. Eg. Postcoital pill order for not taking precautions, in a telepathic relationship. Forty percent of claims were made in primary care. Half of them were assessed by a gynecologyst. Sixty percent were treated in the emergency room.

We conclude that these data are relevant for specialists. Both for efficient resource management and for early detection of incipient psychosis. Gynecological abnormal demands are common in consultations to health services for specific malaise during the period of untreated psychosis.

The authors have not supplied their declaration of competing interest.

Endocannabinoid System (ECS) has been highlighted as one of the most relevant research topics by neurobiologists, pharmacists, basic scientists and clinicians (Skaper and Di Marzo, 2012). Recent work has associated major depressive disorder with the ECS (Ashton and Moore, 2011). Despite the close relationship between depression and bipolar disorders, as far as we know, there is no characterization of ECS and congeners in a sample of patients with bipolar disorders.

The objective of this work is to characterize the plasma levels of endocannabinoids and congeners in a sample of patients with bipolar disorders.

The clinical group was composed by 19 patients with a diagnosis of bipolar disorders using SCID-IV (First et al., 1999). The control group was formed by 18 relatives of first- or second-degree of the patients.

The following endocannabinoids and congeners were quantified: N-palmitoleoylethanolamide (POEA), N-palmitolylethanolamide (PEA), N-oleoylethanolamide (OEA), N-stearoylethanolamide (SEA), N-arachidonoylethanolamide (AEA), N-dihomo-γ-linolenoylethanolamide (DGLEA), N-docosatetraenoylethanolamide (DEA), N-linoleoylethanolamide (LEA), N-docosahexaenoylethanolamide (DHEA), 2-arachidonoylglycerol (2-AG), 2-linoleoylglycerol (2-LG), and 2-oleoylglycerol (2-OG).

The result showed statistically significant lower levels of AEA, DEA and DHEA in clinical sample. Previous research also identified lower levels of AEA in depressed women (Hill et al., 2008, 2009). Until date, it is unknown if DEA and DHEA have some effect on EC receptors, and whether they have some direct effects on endocannabinoids.

It would be necessary to carry our other research with a larger sample, which could allow the control of potential confounding variables.

The authors have not supplied their declaration of competing interest.

The Early Psychosis Intervention Programme (EPIP) in South Granada serves a population with a first psychotic episode. In 2014, 16 patients entered the program, 6 of whom were North Africans.

It is justified by clinical and health care needs to adapt and contextualize care plans and interventions to the specific necessities of this population: considering its suffering meaning and interpretation.

A descriptive study of the data obtained in this population with the Scale of Positive and Negative Syndrome of Schizophrenia (PANSS) arises.

In the positive scale, the 6 subjects score in the low range (between 6–25th percentile).

On the negative 2 score in the low range and 4 in the middle (between 26–74th percentile).

In the compound scale in 3 cases, the predominance of negative symptoms is in the low range scale, the rest is in the middle range.

Finally, in general psychopathology scale, 2 subjects scored in the low range, the same who scored in the same range in the negative scale. Two subjects scored in the midrange and 2 in the high.

According to data, positive symptoms do not stand out among this group of patients. As for negative symptoms, if the range is low, so is the measure of general psychopathology. If the range is average, general psychopathology is medium-high. Also, when the range is average in negative symptoms, means the compound profile reflects predominance of negative syndrome. This reveals the importance of emphasizing a negative symptoms approach and its relationship with general psychopathology.

The authors have not supplied their declaration of competing interest.

Comorbidity between two or more mental disorders is highly frequent. Depression is one of the diseases that more often accompanies other conditions.

The objective of this study is to establish the prevalence of depression in patients with delusional disorder and describe the treatment used in these cases.

The aim is to provide useful information regarding this frequent, often disregarded, comorbidity.

Our results proceed from the Andalusian delusional disorder case register. We reviewed 1927 clinical histories of patients diagnosed of delusional disorder. Upon having verified the diagnosis, following DSM-V criteria, we recollected several data, including sociodemographic factors, depression comorbidity and antidepressive treatment.

One thousand four hundred and fifty-two patients matched DSM-V delusional disorder criteria. 49,8% of our sample were women. Average following period was 9 years and 1 month, with an average of 0,84 hospitalizations. The prevalence of depression in patients with delusional disorders was 31,9%. 67,5% of them received some kind of antidepressive treatment. The antidepressive drugs most frequently used were selective serotonin reuptake inhibitors.

Depression is a highly prevalent condition among patients with delusional disorder. Most of them are on antidepressive treatment, the most employed of which is based on selective serotonin reuptake inhibitors. Comorbid depression can have an important impact on the course of delusional disorder. A correct diagnosis and treatment should be made to help improve the prognosis and life quality of these patients.

The authors have not supplied their declaration of competing interest.

Several recent epidemiological studies have reported during the last few years that the prevalence of psychotic symptoms in the community is bigger than the previously thought.

Estimate the prevalence in our influence area, as there are no previous studies focused on this measure and its correlated factors in Andalusia population.

Literature review was made about the prevalence reported in all continents as well as the found correlation. Then, a cross-sectional epidemiological study was designed (Granada). We present data from 809 Andalusian individuals taken from the Unified Data Base of the Andalusian Health System.

This poster presents a brief but updated systematic literature review of psychotic symptoms in the general population (i.e. delusions and hallucinations). We present also data from 809 individuals from our clinical catchment area. Prevalence of psychotic symptoms in Granada was of 10.3%. Hallucinations were reported in 6.1% and 7.4% reported delusions.

The prevalence found was similar to other studies in the Spanish population such as the EsEMED Study performed in Catalonia where 11.2% of psychotic symptoms were reported, and similar to European studies like the BNS in Great Britain with a 10.9% of psychotic symptoms. Differences obtained in percentages could be due to different measure scales (PSQ, MINI, CIDI…) used in other studies made in the North American population such as the National Comorbidity Survey with a 28% of prevalence reported. inter-interviewer differences and the potential risk factors for psychotic symptoms in each population seem to be the causes of such differences and similarities.

The authors have not supplied their declaration of competing interest.

Duration of untreated illness (DUI) has been considered as a relevant variable used to measure the degree of disabilities that are associated with psychotic disorders. In this paper we describe a cluster of patients with a DUI superior to 1 year according to their symptoms and sociofamiliar functioning.

We compare a group with a DUI superior to 1 year (n = 7) against a group with a DUI inferior to 1 year (n = 17).

The group with a DUI superior to 1 year showed an average age of 4 years younger (21) as the duration of untreated psychosis (DUP) of 1 to 3 months in the 80% of cases and higher percentage of unemployed or without occupation. The 60% were derived from primary care, compared to the 17% of the other group. Although the consumption of toxic substances was similar in both groups, no toxic psychosis were found in comparison with the 35% present in the group with a DUI inferior to 1 year. PANSS’ profile scored more positive and less negative symptoms. Both have similar general psychopathology. There were group differences in the Social Functioning Scale (SFS) with lower scores in the superior to 1 year DUI, in the following scales: Prosocial, Autonomy, Execution and Employment. The Global Assessment of Functioning (GAF) gives an average of almost 8 points higher.

While the SFS shows significant differences in several areas of social functioning, both PANSS’ profile and the family questionnaire do not support greater deterioration, as evidenced in the GAF's average score.

The authors have not supplied their declaration of competing interest.

The Integrated Care Process of Anxiety, Depression and Somatization (ICP-ADS) lays out the cooperation between primary care (PC) and mental health (MH) as basic premises. Showing this model improves patient detection, inadequate patient referrals, adherence and response to medical treatment.

The Therapeutic Program (TP) established in PC includes low intensity psychological and psychosocial interventions, pharmacological treatment, and use of collaborative space with MH combining consultations, case tracking and educational activities. Our rotation as MH residents in the Community Mental Health Unit (CMHU) has focused on this framework, encouraging the use of a collaborative space.

Three training sessions were used to deal with the process as a whole. PC professionals were given self-help handbooks for low intensity interventions and clinical practice handbooks for psychopharmacological treatment. The referral space was established afterwards, where we took part in the TP founded by the PC doctor. In case the demand would continue, we opened consultation one day a week for co-therapy. With brief interventions of 3–4 sessions we continued the work with self-help guides, which also optimized psychopharmacotherapy.

Referrals were sufficient in many cases. Sixteen procedures were completed in co-therapy, half of which required referrals to encourage adherence. Only a referral to MH had to be done. Three months later, a follow-up showed that no patient in co-therapy had to be referred to specialized care.

The amount of referrals was reduced in comparison to previous months, adherence to interventions of low intensity was improved and was useful in both detection and prevention of new cases.

The authors have not supplied their declaration of competing interest.