Clozapine is a second-generation antipsychotic indicated in treatment-resistant schizophrenia. Patients taking clozapine are likely to experience an increase in salivation or sialorrhea. Clozapine‐induced sialorrhea (CIS) may lead to sleep disturbances or aspiration pneumonia. Treatment options include locally administered anticholinergic medication with atropine ophthalmic drops applied sublingually.

To review the current evidence for the effectiveness, safety, side effects and dosage of sublingual application of atropine in reducing or resolving of CIS.

Systematic review. Data were obtained from PubMed/Medline, EMBASE, PsycINFO, Cochrane Plus, Trip Database, Science Direct and Scopus searches of English-language articles, without restriction for date of publication and study design, reporting the sublingual use of atropine in the treatment of CIS. Large clinical studies with appropriate statistical methods and recruited adults were preferred.

12 selected articles (of 458 references) consisted entirely of case reports and case series. A total of 29 patients with CIS were reported, of whom 24 responded favorably to sublingually administered atropine drops 1% (1-2 drops a day). One limitation of its utilization is the dose-related dry mouth, which can be addressed by lowering the number of drops administered. CIS can occur at different clozapine doses, in various stages of treatment.

The reviewed articles suggest that the use of sublingual atropine is a promising local treatment for CIS. Oral anticholinergic and alpha-2 agonist medications have been used to treat CIS with variable efficacy, but can cause systemic anticholinergic side effects. Further experimental research is needed.

No significant relationships.

Suicidal behavior has a great impact on world public health. The literature describes the possible existence of an association between neurobiological, clinical and cognitive factors in suicidal behavior.

To determine the possible relationship between clinical variables (history of abuse/maltreatment in childhood), psychopathology (impulsivity traits) and cognitive (decision-making) with a history of suicide attempt and/or current suicidal idea in patients with major depressive disorder.

Cross-sectional study in a sample of adult patients with major depressive disorder in which two types of comparisons are made. In the first case, two groups were compared based on the presence or absence of history of suicide attempt. In the second case, two groups were compared based on the presence or absence of suicidal ideation in the same sample of patients. Finally, sociodemographic, clinical and cognitive variables were evaluated in that population sample.

When the joint influence of sociodemographic, clinical and cognitive characteristics are present, it can be said that being single/divorced/separated, a history of sexual abuse in childhood and an alteration in decision-making, specifically a lower number of choices of deck D in the IGT test, are associated with a higher probability of a personal history of suicide attempt. While a higher score on the Barrat impulsivity scale is associated with a greater probability of presenting current suicidal ideation once the influence of sociodemographic, clinical and cognitive variables has been taken into account.

Different sociodemographic, clinical and cognitive factors are associated with the presence of a history of suicide attempt and/or current suicidal ideation.

No significant relationships.

Postpartum depression (PPD) is the commonest postpartum psychiatric condition, with prevalence rates around 20%1. PPD is associated with a range of adverse outcomes for both the mother and infant2. Therefore, identifying modifiable risk factors for perinatal depression is an important public health issue3.

To explore the role of dysfunctional attitudes towards motherhood in postpartum depressive symptoms and disorder.

247 women were evaluated in the third (12.08±4.25 weeks) and sixth months (31.52± 7.16 weeks) postpartum with the Attitudes Towards Motherhood Scale4, the Postpartum Depression Screening Scale5 and the Diagnostic Interview for Psychological Distress-Postpartum6. Correlation analysis was performed followed by linear/logistic regression analysis when the coefficients proved significant (p<.05), using SPSS.

Dysfunctional beliefs towards motherhood concerning judgement by others and maternal responsibility positively correlated with depressive symptoms at the third (.528; .406) and the sixth months (.506; .492) postpartum. Those dysfunctional beliefs were predictors of depressive symptoms at the third (ß=.440; ß=.151) and sixth months (ß=.322; ß.241) explaining 29.4% and 30.2% of its variance, respectively. Having dysfunctional beliefs at the third month significantly increase the likelihood of being diagnosed with Major Depression (DSM5) both in the third (Wald=9.992, OR=1.169; Wald=16.729, OR=1.231) and sixth months (Wald=5.638, OR=1.203; Wald=7.638, OR=1.301) (all p<.01).

Cognitive distortions should be included in the assessment of risk factors for PPD. Early identification of women presenting motherhood-specific cognitive biases may be crucial for implementing preventive interventions favoring a more positive and healthier motherhood experience.

No significant relationships.

Pharmaceutical treatment and psychotherapy constitute the most common treatment methods for depression and anxiety. Physical training has been shown to have comparable effect to cognitive behavioral therapy in treatment of mild to moderate depression and anxiety. Physically active individuals also show lower risks to develop depression and relapse in depression.

The objectives are to evaluate how physical activity can affect depressive and anxiety symptoms, by examining biomarkers in the blood and from the gut and also by measuring cognitive functions. Hopefully, this can lead to new treatment strategies for patients with depression and anxiety.

102 patients are randomized to two groups and undergo 12 weeks intervention as add-on to standard outpatient psychiatric treatment. The first group will participate in physical training three times per week and the other group will receive relaxation therapy on a weekly basis. Daily activity intensity will be measured before and at the last week of intervention with an accelerometer. Blood and faeces sample collection, symptom grading by clinician together with self-rating scales and cognitive screening will be performed at baseline, week 12 and one year of follow-up. The cognitive screenings are performed digitally in cooperation with Mindmore.

The RCT is currently recruiting patients at the Department of Psychiatry of Örebro University Hospital.

The project aims to be holistic in its approach, combining the defining clinical psychiatric symptoms in patients who have both depression and anxiety with the finding and evaluation of new biomarkers from blood and gut to improve cognitive functions.

No significant relationships.

Tunisian revolution has been a major upheavel in the tunisian history and has brought many political, social and economic changes. Little were found about the revolution’s potential impact on the psychiatric demand.

Compare the clinical profile of all the new consultants in the out ward psychiatry department before and after the revolution.

The study had a retrospective descriptive design including all the new consultants in the outpatient psychiatry department in the general hospital Fattouma Bourguiba in Monastir, Tunisia before (during 2007) and after (during 2016) the revolution. We used a pre-established questionnaire including sociodemographic and clinical data.

After the revolution, an increase in the number of new patients (p<10-3) 438 to 451 were found. In 2016, there were more unemployed consultants(p=0.004), having criminal record (p=0.01) and having a problematic substance use (p<10-3). An increase also concerned patients consulting for anxiety(p=0.002) and suicidal ideation (p=0.022). Considering the clinical diagnosis, there were also a significant increase regarding anxiety disorders (p=0.001) and mood disorders (p=0.011) essentially major depressive disorder (p=0.002). Although a significant decrease concerned somatoform disorder (p<10-3).

Our study showed a change in the profile of consultants after the Tunisian revolution. A study in the general population could find specific etiological factors. Thus highlight the importance of implementing preventive measures in general population in crisis’ times.

No significant relationships.

The functional approach to the study of stress resistance allows us to distinguish two blocks of resources – the “active” one, which includes the analysis of the content, conditions, subject and means of labor, and the “personal” one, which considers values, motivation and the expressiveness of personal qualities that contribute to the stress resistance (Granek, Buchman, 2020; Cross, 2019; Powell et al., 2020; Hernández-Marrero, Fradique, 2019).

The objective of our work was to study the relationship between the personal and motivational characteristics of hospice employees with the different symptoms of professional burnout as an indicator of a reduced stress resistance.

62 hospice medical employees with an average work experience of 4,5 years took part in the survey. They were asked to fill out questionnaires to diagnose the burnout symptoms, a motivational personality profile and to assess themselves by the personal semantic differential.

By the means of the procedure for determining the extreme groups (M ± σ), two groups of respondents were identified, which are characterized by different degrees of burnout symptoms. The results of the comparative analysis showed that the less advantaged respondents from the burnout perspective are focused on the life support, comfort, social status, which indicates a certain rationality in the choice of this job.

The portrait of a professionally successful hospice employee includes an orientation towards communication, social and creative activity, which is complemented with independence, confidence and decisiveness – the features that allow carrying out their work in stressful conditions and mainly in uncertain situations.

No significant relationships.

In schizophrenia, there are disorders in all sensory modalities, but the regularities of their occurrence, their pathogenesis and attitude towards cognitive functions are not sufficiently studied.

Examine the interrelation between the dysfunctions in different analysers (olfactory and visual) and their dependence on the duration of the disease and the severity of psychotic symptoms and cognitive deficit in schizophrenic patients (F20 according to ICD 10 criteria).

All subjects were determined the threshold of olfactory sensitivity to n-butanol, the ability to discriminate against odors and the amount of error in comparing the same sections. Cognitive functions were evaluated using the BACS scale.

The inverse correlation between the value of the visual assessment error and the reduction of the threshold of olfactory sensitivity (r=- 0.56; p < 0.05) and the inverse correlation between the value of the visual assessment error and the ability to discriminate smells (0.64; p < 0.05) were revealed. There are no significant correlations between the duration of the disease and sensory disturbances. Olfactory and visual disturbances in schizophrenic patients were connected with cognitive functions ((r=-0,62; p< 0,05 and r=-0,84, p< 0,001 accordingly).

The data confirm that sensory impairments have a common pathogenesis and are closely related to cognitive deficits. Sensory and cognitive deficits in schizophrenia may be the result of top-down regulation failure.

No significant relationships.

Previous research has suggested that offspring of parents with mental health problems, including depression and anxiety, are at an increased risk of developing anxiety disorders. Few studies have investigated this relationship in young adults.

To investigate the risk of anxiety symptoms in young adult offspring of parents with mental health problems

We used data from the 1989-1991 cohort of the Western Australian Pregnancy (Raine) Study, which is a multi-generational birth cohort study following mothers and their offspring from pregnancy to 28 years of age. The Depression, Anxiety, and Stress Scale (DASS) was used to assess maternal anxiety and depression whereas a self-reported questionnaire was used to assess paternal emotional problems. Anxiety symptoms among offspring at age 20 were measured by using the short form of the Depression, Anxiety, and Stress Scale (DASS 21). A multivariable negative binomial regression model was used to quantify the associations.

After adjustment, maternal anxiety [RR 1.60 (95% CI 1.11-2.32)] and paternal emotional problems [RR 1.32 (95%CI 1.03-1.68)] were associated with an increased risk of anxiety in offspring at age 20 years. Conversely, maternal depressive symptoms [RR 1.04 (95%CI 0.84-1.32)] were not associated with an increased risk of anxiety in offspring.

The present study suggests that maternal anxiety and paternal emotional problems were associated with an increased risk of anxiety in young adult offspring. However, maternal depressive symptoms were not associated with an increased risk of anxiety in the offspring. The findings suggest the potential for targeted screening and intervention of anxiety problems in the offspring.

No significant relationships.

Nowadays we know that autism spectrum disorders (ASD) and Schizophrenic spectrum (SS) are different types of disorders in their etiology, symptoms and prognosis, but the clinical distinction is often difficult to make due to comorbidity and similar symptoms.

With this project, the authors intend to explore the differential diagnosis between ASD and SS specially when we talk about critical ages of onset.

An analysis of articles searched on Pubmed (articles between 2010-2020) with the key words “adult autism”, “childhood onset schizophrenia”, “childhood psychosis”.

Early-onset schizophrenia (EOS) is defined as occurring before age 18 years. The condition share key diagnostic symptoms with adult-onset schizophrenia (AOS) but his prognoses and comorbidities differ. Autism spectrum disorder (ASD) is a common neurodevelopmental disorder characterized by difficulties since early childhood across reciprocal social communication and restricted interests and behaviors. ASD is a lifelong neurodevelopmental disorder, however there is a lack of answers and research for adults with ASD. There are shared aspects of odd thinking, rigid behaviors and impaired socialization in schizophrenia and ASD and COS seems to have a strong relationship with ASD, being comorbid in up to 50% of cases.

Usually the evaluation of the developmental history of the person, prodrome and onset, its course and the presence of positive symptoms of schizophrenia is enough to help us find a diagnosis. Unfortunately, in some ages the conclusion is not so easy to find. However is essential to determine whether the clinical manifestations belong to the autistic spectrum, the schizophrenic or result from comorbidity.

No significant relationships.

Horticultural therapy is used as alternative treatment option in rehabilitation programs for patients suffering from chronic mental disorders. In Greece, the Psychiatric Hospital of Thessaloniki was the first that organized a organized Rehabilitation Program approved by the Greek Ministry of Health, the “Green Unit - Monada Prasinou”.

The purpose of this study was to investigate the effect of horticultural intervention on the functionality of patients employed in the Green Unit of the Psychiatric Hospital of Thessaloniki.

The Mini-ICF-APP Social Functioning Scale was used to evaluate the functionality of the patients. Horticulture therapy included actual gardening and other agricultural activities. The sample consisted of two groups, 22 inpatient of the Green Unit and 22 patients of outpatient units as a control group. The majority of the patients suffered from Schizophrenia spectrum disorders. Both patients’ groups were evaluated over 12 months (May 2018- May 2019).

At baseline evaluation, the patients of the Green Unit patients presented higher scores only in the mobility and endurance subscale. A year later there was a statistically significant difference in all thirteen subscales. Shortly, the patients were rated as more consistent, organizational, social, flexible, responsible, more confident and enterprising, more adaptable and more able to take care of themselves.

The results suggest that horticulture as a therapeutic method had beneficial effects in all dimensions of patient functionality confirming the hypothesis that such programs should be a priority in the effort of psychosocial reintegration of patients suffering from chronic mental disorders.

Social PSYCHIATRY is essential for solutions of RH-conflicts leading to immense psychic&medical problems-[2a-e,3]. Millions tenants in Europe: Germany-54.3%/Austria-30.2%/France-25.3%/GB-24.1%/Italy-12.9%/Slovenia-4.5%. German journals reflect catastrophic situation of tenant-lessor conflicts-[3].

REFERENCES: [1a]-Luetge,Ch et-al(ed): Experimental Ethics, Basingstoke:Palgrave-Macmillan,2014. [1b]-Pegoraro,R (Chancellor Academy/Vatican-City) «Arzt und Christ» 38:3-55,1992; EACME-2017-Barcelona AB:p.129-130. [2]-Michailov,M.Ch, Neu,E, Welscher,U et-al: [2a]-Psychology: EFPA-2019-Moscow AB:p.1529,1530,1549. IUPsyS-2008-Berlin Int.J.Psychol. 43/3-4 p.154,248,615,799. [2b]-Psychiatry: EPA-2020-virtual/Madrid, Eur.Psychiatry 63S:EPP0834/5+EPV0581/1470; EPA-2019-Warsaw 56S:S689; EPA-2018-Nice 48/S1:S623&567&662. WPA-2019-Lisbon, E-Poster WCP19-2137/-1822/-1839: 2018-Mexico-City, Abs.-Book WCP18-0584/-0625/-0643/-0654. 2011-Buenos-Aires, AB:PO1.200. [2c]-Philosophy&Law: IVR-2019-Lucerne Progr.Book:p.114-116. FISP-2018-Peking Abstr.Book(AB)1348-50,1373-4,1420; -2013-Athens AB464-5/503-4/766. EACME-2017-Barcelona/MedEthics) AB73-74/125-126. [2d]-Psychosomatics: ICPM-2017-Peking AB:ID: 648493/648895/647749/648878; -2005-Kobe, JPsychosomRes 58: 85-86. [2e]-Physiology: DPG-2019 (German-Austrian-Suisse Soc.) Acta-Physiol., 227/S719, A03-3,A03-4,A03-9,A04-4,A05-1. IUPS-2017-Rio-de-Janeiro, AB:ID977; IUPS-2009-Kyoto, J.Physiol.Sci. Proc-IUPS-Vol.XXII/Springer,p.249. [3]-German-journals-“tz”-München, 14.02.2019, 15.02.17, 06.12.16/p.10, 18.10.16/p.10. Süddt.Zeitung-no172/p.30, 2017. Bild-14.12.2018/p.12. Mü.-Merkur-14./15.12.2019/no289/p.33.

Psychological-medical-social observations-[2a,e].

Complex interaction of social-natural factors (micro-ecology/apartments) are demonstrated by conflicts tenants-lessors (RH-Munich). Conflicts conc. high-rents, luxurious repair, cause dangerous psychoneurological diseases: anxiety-neurosis-insomnia-depression,etc., esp. in patients/seniors with cardio-vascular pathology. Defect-doors&radiators&windows (air-currents) induce respiratory-diseases, defect-illumination causes accidents (neuro-orthopaedic diseases: commotio-cerebri,etc.). Examples for impossible situation in German-RH: After 47years annihilation of RH-contract (tenant-woman 74years); over 4.5years lessor tries to eliminate 2scientists from RH, living-working 40/50years (one invalid, other 86years, both with complex pathology) by justice-terror; RH-contracts of tenants 90years with dementia&blind-senior (90years) are annihilated. RH-conflict leads to lethal consequences of 73 year tenant-[3].

SOCIAL PSYCHIATRY could help millions of tenants injured by RH-conflicts-[2a-c,1a,b] by (a)-psychotherapy&education considering “total symptoms of mind-body, acc. to Emperor AKIHITO during ICPM-2005-Kobe-[2d], (b)-education of RH-administrators incl. philosophical/psychological/psychiatric-examination, (c)-foundation of „house-councils“ for „RH-industry“ counteracting psychopathological/-somatic diseases. This way will be supported UNO-Agenda21 for better health/education/ecology on global-level.

No significant relationships.

The prevalence of mental disorders (MD) is greater in children; however, they are the population with less help-seeking and access to mental health-care services (MHS).

To explore the characteristics of help-seeking and access to specialized MHS in children with MD.

A cross-sectional study was carried out from 2018 to 2019, in the Children’s Psychiatric Hospital and National Institute of Psychiatry in Mexico City. Sample 397 children and 397 caregivers. The project was approved by the Ethics Committee of both institutions. The patient’s family member was questioned on sociodemographic data and help-seeking to MHS. Sample’s descriptive statistics applying measures of central tendency, Inferential statistics with t-test for differences in means between groups (diagnosis), and one-way ANOVA to variables associated with the help-seeking to MHS.

Children´s sample: 37% female, average age 12 years (SD± 3.6), 51% had diagnosis of hyperkinetic disorder (HD), 34% depressive disorder (DD). The children´s age at the time of seeking healthcare was different according to the diagnosis: DD 10.1 (SD ± 4.5) and HD 6.95 (SD ± 3.4), (T = -3.18, p = 0.000); and by sex: girls 10.9 (SD ± 4.5), boys 7.85 (SD ± 4.0); (T = -3.07, p = 0.000). The mother was the first person to notice the symptoms.

The search for MHS differs by sex, diagnosis and family history; it is necessary to design mental health interventions considering gender-based differences, namely, to integrate a gender perspective.

No significant relationships.

Some of the most vulnerable psychiatry patients are children under 18, as they can’t protect themselves and their rights from unethical behaviour of mental health professionals. There is a gap between theoretical knowledge and application of ethics at the workplace. Continuous education in ethics is necessary to address this gap.

The objective of the study was to compare various forms of education in ethics and develop training for mental health practitioners.

The study had 2 groups (356 participants, aged 23 to 67, average age – 41.3) – staff of the main and oldest children’s mental health clinic in Moscow, Russia. The control group (124 participants) of mental health professionals received written materials on ethics (such as ethical codes and ethical decision-making protocols). The test group (232 people) participated in a several trainings on ethics. The trainings included 3 parts – discussing the code of ethics, creating examples of potential ethical challenges and role-plays. Participants reported that the topics on the quality of care, common ethical dilemmas and relationships between the practitioners, young patients and legal guardians, were the most helpful for them.

The survey was conducted to evaluate the results. 70.8% of staff members that participated in training shared that they feel confident about applying the Code and the decision-making protocols in unclear cases. Only 32.6% from the control group reported the same level of confidence.

Hands-on training in ethics for continuing education has shown to be more beneficial, as compared to theoretical instructions

Although there are very effective treatment approaches for Attention Deficit Hyperactivity Disorder (ADHD) available, the clinical management has its limits making new treatment modalities a necessity. Evidence suggests that low frequency repetitive transcranial magnetic stimulation (rTMS), improves hyperactivity, impulsivity, and attention deficit of individuals with ADHD.

The aim of this case study is to present the effectiveness of rTMS on hyperactivity, impulsivity, and attention deficit of an individual with ADHD.

This is a case study of a 22 year old male diagnosed with ADHD. The protocol applied was 2 weeks of daily rTMS sessions. This involved repetitive TMS to the right dorsomedial prefrontal cortex (10 Hz, 3.000 pulses, 120% motor threshold) to treat attention deficit, hyperactivity and impulsivity. Assessments were conducted using Adult ADHD Questionnaires, the Jasper and Goldberg questionnaire and WHO self- reported scale at baseline, 1 month and up to 3 months follow up.

The patient showed overall improvement in scores in both ADHD scales with scores dropping more than 50 % in both scales from pre treatment to 3 months follow up. No side effects were recorded during therapy

Our findings suggest that the use of rTMS therapy in individuals with ADHD, is an efficacious and safe therapeutic treatment option.

Acute and transient psychotic disorders are a rare condition entity as the sudden appearance of affective, confusional symptoms and paranoia triggered by some psychological trauma. The current pandemic caused by COVID-19 is an important psychological stressor that could favor the appearance of acute psychotic disorders. Several studies have been recently published proposing that the multifactorial stress associated with lockdown could function as a catalyst for acute psychotic disorders.

To present a case of a brief psychotic disorder during the national lockdown in Spain and to review the literature about the relationship between the current pandemic and psychosis.

We will present a case report and a literature review.

We report a case of a 27-year-old woman, with no previous psychiatric history. Three weeks after the start of Spain lockdown sudden symptoms appeared with psychomotor restlessness, confused speech, emotional lability, thought blocking and persecutory and referential delusions. Physical exam, blood analysis and cerebral CT scan with no alterations. Treatment was performed with aripiprazole 10 mg and lorazepam 1 mg daily with clinical improvement in one weeks. She was diagnosed of Acute transient psychotic disorder.

Stressful life events that can trigger psychosis in vulnerable individuals and the current pandemic and lockdown context could favor the appearance of acute psychotic disorders. The case reported here is in line with other current studies that show a preliminary intuition of this trend.

Posttraumatic stress disorder (PTSD) is common in survivors of acute life-threatening illness, but little is known about the burden of PTSD in survivors of stroke attack.

This study estimated the prevalence of PTSD in post-stroke in the elderly and to look for the factors which are correlated with it.

Participants were outpatients of Psychiatry B department in Hedi chaker University Hospital Center in Tunisia, over the age of 65, hospitalized in psychiatry for a major depressive episode, recruted between 2000 and 2015. The data was collected using a pre-established sheet containing socio-demographic information, the clinical and evolutionary characteristics of the depressive episode and the therapeutic data concerning the depressive episode.

30 patients were included in this study with an average age (69 Y) and sex ratio (0.66). More than half (53.3%, 16 patients) had a history of chronic somatic disease. The average length of hospitalization was 26 days. The most frequent reason for hospitalization is sadness of mood (43.3%) with cognitive impairment as the predominant clinical symptomatology (40%). 93.3% of the population received as treatment an antidepressant mainly Fluoxetine (50%).

clinicians should be mindful that PTSD can be a devastating mental health condition and should consider screening for PTSD in stroke survivors.

No significant relationships.

On the basis of complex clinical anamnestic, clinical psychopatological, pathopsychological research, data were obtained about reasons and conditions of formation, abnormal clinical psychopathological structure, syndrome peculiarities of emotional disfunctions for patients with episodic paroxismal disorders, generalized anxiety disorders and mixed anxiously depressed disorders.To realize the aim and tasks of the research, 145 patients were examined with anxiety disorders, that passed the stationary course of treatment.

The purpose of the research was to discover emotional disturbance peculiarities for anxiety disorder patients with different origins of pathological syndromes.

The basic method was a group psychotherapy with the elements of rational, positive, suggestive and family psychotherapy. In relation to disfunctions of emotional sphere, cognitive-behavioral therapy (CBT) was used for the phobic-depressive and anxious-depressed disorders.

Decrease in general level of anxiety and internal anxiety was obtained for most patients. No spontaneous emergence of fear was practically observed. While active interviewing, patients stated that their former worries and fears have lost actuality and apparent emotional colouring, somatic-vegetative correlates of anxious states disappeared. Up to the end of the therapy course, a sense of calmness was attained as a base-line for the background emotional state. Considerable reduction of symptomatic of the depressed circle also took place. Patients’ mood increased, their interests broadened, patients started to feel joy and optimism.

To correct emotional disfunction of patients with episodic paroxismal disorders, generalized anxiety disorders and mixed anxiously depressed disorders, psychotherapeutic correction system is optimal to use, which is built based on stepwise and multimodal principles.

Epidemics lead to an increase in occupational stress and psychological strain among medical staff (cf. Mulfinger et al. 2020). However, there are no validated questionnaires to measure stress caused by an epidemic such as Covid-19, instead self-constructed questions are used frequently.

The aim was to develop items for the assessment of specific workload in epidemics which can be used to obtain longitudinal data.

A sample of N=8078 persons working in the health care sector in Germany participated in the VOICE, EviPan online survey addressing the burden of Covid-19 pandemic during the 2nd quarter of 2020. We used 15 self-constructed items to examine whether these items can represent Covid-19 specific topics. A total of N=7549 (24% males) had complete data to run a confirmatory factor analysis using SEM procedure in Stata 14.2.

Five factors were identified a priory: Factor (F) 1: Workload due to Covid-19 pandemic (4 items; Cronbachs’ alpha (α))=0.740); F 2: Fear, uncertainty of SarsCoV-2infection (self and others) (3 items; α= 0.741); F 3: Patient safety (3 items; α=0.533; F 4: Perception of protection concepts (2 items; α=0.590); F 5: Dysfunctional coping strategies (3 items; α=0.447). Fit-Indices: χ²(73)= 1373.849, p<.001, CFI=.946, TLI=.923, RMSEA=.0049, SRMR=.037)

We identified 5 factors associated with problems occurring during the Covid-19 pandemic with acceptable to good internal consistency. Most of the constructed items could therefore be used in further surveys to monitor stress, as a basis for recommendations in the area of stress prevention and interventions for medical staff during epidemics.