Anhedonia is a transdiagnostic psychopathological phenomenon, which is assessed as «core» for several diseases, first of all - schizophrenic and affective spectrum disorders. The problem of clinical features differentiation and identification of anhedonia’s neurobiological mechanisms in the structure of the affective and schizophrenic spectrum disorders is still topical and far from being resolved.

The aim of the study was comparative research of the relationship between the features of neurocognitive functioning and the manifestations of anhedonia among patients with disorders of the schizophrenic and affective spectra.

The sample consisted of 40 patients, 17 patients with schizophrenic spectrum disorders and 23 patients with affective spectrum disorders were examined. We used next psychometric techniques to research anhedonia: Revised Social Anhedonia Scale (RSAS), The Temporal Experience of Pleasure Scale (TEPS), Physical Anhedonia Scale (PAS). We used following methods to study neuropsychological features: Dynamic praxis; Color interference test; Arithmetic Tasks; Plot picture; Number of skips and impulsive errors; Reverse and straight rows; Verbal fluency; Number of repetitions; Rey-Osterritz figure.

Patients with schizophrenia spectrum disorders show lower scores of pleasure anticipation ability and ability to experience pleasure in the social sphere. Neuropsychological indicators of prefrontal cortex dysfunction demonstrate a positive relationship (p = 0.035) with the severity of social anhedonia and a negative relationship with the ability to anticipate pleasure. Thalamus and forehead dysfunction indicators mainly show a negative relationship with the ability to directly experience pleasure. Indicators of dysfunction of the parietal, occipital and temporal lobes have single connections with different parameters of anhedonia.

Manifestations of different parameters of anhedonia demonstrate their heterogeneity among patients with schizophrenic and affective spectrum disorders. Patients with schizophrenic spectrum disorders have greater difficulty with anticipation of pleasure and the ability to experience pleasure in the social sphere. The ability to anticipate pleasure is more strongly related to prefrontal brain function, whereas the ability to experience pleasure directly is related to subcortical brain function.

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Perceived stress in the case of health professionals in general and, more specifically, nurses is a frequent phenomenon and occurs when the demands of the clinical environment exceed the available resources in order for nurses to manage the problems that arise.

The objective of our study was to investigate the relationship between social support and psychological empowerment with perceived stress of nurses working in psychiatric acute units.

Our study sample consisted of 153 nurses working in psychiatric acute units, located in Athens area. Participants completed a questionnaire that included a) demographic characteristics, b) the Perceived Stress Scale, c) the Psychological empowerment scale, and d) the Social Support Questionnaire Short Form (SSQ-6).

The majority of our sample were female (62.7%), graduates of Technological Education (47%), married (60.8%), permanent employees (81.7%), working in psychiatric units for over than twenty-one years (34.6%), with an average age of 45.3±6.7 years. The 64.7% of our sample considered the night shift as the most aggravating. The 3 main reasons that caused nurses the greatest stress were (a) lack of staff, (b) dangerousness and (c) workload. Psychological empowerment was positively correlated with social support (r=0.39). When nurses perceived greater social support, were more psychologically empowered as well. Women (b=1.43) compared to men, as well as those who had more years of service in a psychiatric ward (b=0.6), compared to younger employees exhibited a statistically significant higher level of subjective stress. Nurses who considered that night shifts were the most aggravating exhibited more stress (b=1.45). Female nurses (b=3.35), compared to males and those who were scheduled to work more day shifts (b=0.25) exhibited higher levels of psychological empowerment. Married nurses reported higher levels of social support (b=5.66). In contrast, older nurses (b=-0.44), as well as nurses who were scheduled to work more night shifts (b=-1.28), reported statistically significant lower social support.

It is necessary to capture the levels of perceived stress of nurses working in psychiatric acute units and the development of strategies by utilizing the parameters that contribute to reducing stress and act protectively in the workplace, as well as family and wider social environment.

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The study discusses the possibility of assessing postmorbid adaptation in depressed patients who had SARS-CoV-2 infection, within the framework of a multimorbidity model. This model takes into account not only mental, but also somatic clusters and allows to identify non-randomly occurring, related conditions and their impact on the ability to recover.

The aim of the study is evaluation of the impact of psychosomatic and anxiety symptoms of depression on the formation of postmorbid adaptation in a group of patients who underwent outpatient SARS-CoV-2 infection.

The data of 54 patients aged 25-55 years with a current depressive episode who underwent outpatient SARS-CoV-2 infection were analyzed. We used the Hamilton depression rating scale (HDRS); the somatic condition was assessed using a general assessment of the patient’s function limitation at the stage of convalescence. A linear regression analysis was performed to assess the association of psychosomatic and anxiety symptoms with somatic condition in SARS-CoV-2 infection, regardless of other factors.

An association was established in patients with SARS-CoV-2 infection showing signs of psychosomatic and anxiety symptoms of depression. Patterns of somatic and anxiety symptoms were independently associated with impaired postmorbid adaptation, other manifestations of depression did not show such association. This fact raises the question of whether depression syndrome is really associated with an impaired postmorbid adaptation in the postcovid period, or only certain specific symptoms of somatic anxiety explain the low readaptation capacity in this group of patients.

Identification of clusters of symptoms associated with an impact on the full recovery possibilities in the SARS-CoV-2-postmorbid period can significantly help in providing high-quality and targeted psychopharmacological care.

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Pathologic grooming disorders can lead to clinically significant distress and functional impairment. Various psychopharmacological and nonpharmacological treatments have been used to ameliorate the symptoms of these disorders. N-Acetylcysteine (NAC) is a newer modality in the treatment of these disorders and has shown promise in treatment of obsessive-compulsive and related disorders.

To determine whether NAC is useful in the treatment of body-focused repetitive behavior disorders.

A literature review was carried out in PubMed using the descriptors: “body-focused repetitive behaviour disorders” “grooming disorders” AND “N-Acetylcysteine”.

Six results were obtained when using the time limit of 5 years. We selected two of them for their relevance to the PICO question. Subsequently, the search was repeated using the same descriptors and the time limit in the Cochrane Library, Epistemokinos and Tripdatabase, in which no additional results were found.

Overall, thirty-three articles were included in these systematic reviews that we studied, which consisted of 23 case reports, one case series, and seven randomized controlled trials. Dosing of oral NAC ranged from 450 to 3,000 mg per day, and treatment periods lasted from 1 to 8 months. Side effects were uncommon, mild, and usually gastrointestinal in nature, with severe aggression reported in one child. Two randomized controlled trials showed a significant improvement in trichotillomania and excoriation disorder in adults. The other two were performed in pediatric population, showing no statistical difference. Two randomized controlled trials and six case reports studying the effects of NAC in patients suffering from trichotillomania (one performed in adults and the other one in infants) were included. Only the one performed in adults showed improvement when adding NAC to the treatment using the Massachusetts General Hospital, Hairpulling Scale (MGH-HPS). Four case reports and two randomized controlled trials included patients with excoriation disorder showed statistical differences in all of them. Three case reports and one randomized controlled trial in patients with onicotylomania showed a difference that wasn’t consistent after two months of treatment.

There are multiple case reports an several clinical trials supporting both the safety and efficacy of NAC in the treatment of body-focused repetitive behavior disorders. Based on these positive preliminary results and the absence of serious adverse effects, carrying out a therapeutical trial with NAC is a plausible option in the management of this pathology, especially in those in which other therapeutic options have not been effective. Further studies are needed to develop a treatment algorithm and elucidate the difference in the efficacy of NAC between children and adults with this disorder.

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Subclinical or subthreshold social anxiety (SSA) is associated with significant burden. Up to 20% of general population report subclinical social anxiety symptoms, which can change individual social, work functioning.

However, neural mechanisms of SSA have not been fully investigated in healthy individual yet. This study aimed to examine the relationship between gray matter volumes (GMVs) and SSA.

We enrolled a total of 57 healthy individuals with SSA. The General Anxiety Disorder-7 (GAD-7), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), and Albany Panic and Phobia Scale (APPQ) were evaluated. Freesurfer was applied to investigated the relationship between SSA and GMVs. Multiple regression models with age, sex, and total intracranial volume as covariates were performed. Pearson correlation analyses also investigated the exploratory correlations between the GMVs of the SSA-related regions and other psychological characteristics among healthy individuals.

Freesurfer voxel-wise correlational analyses showed a significant negative correlation between the SA scores of APPQ and gray matter volumes (GMVs) in the fusiform gyrus (FG). In addition, the GMVs in the FG were significantly negatively associated with the total GAD-7, BDI-II, BAI, and APPQ scores. Performance anxiety was significantly correlated with posterior cingulate gyrus, parahippocampal gyrus and fusiform gyrus.

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Our findings suggest that healthy individuals with SSA showed decreased GMVs in the FG and the GMVs of FG were associated with general anxiety and depression symptomatology.

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This study establishes research priorities for Medically Not Yet Explained Symptoms (MNYES). A significant number of patients suffer from these symptoms, also known as MUS, that are likely to cause work disability and impact on quality of life. Research into MNYES in general has been poorly funded over the years, has been primarily researcher-led, and was sometimes controversial.

To identify research priorities from the perspective of patients, caregivers and clinicians, following the James Lind Alliance (JLA) priority setting partnership (PSP) method.

The PSP Steering Group termed these symptoms Medically Not Yet Explained Symptoms (MNYES). This was an operational definition not intended to add to or replace other definitions already in use, that was constructed to embrace the views of all stakeholders. The nomenclature MNYES was chosen to indicate our incomplete understanding of these conditions. This could pertain to biological, psychological and social factors, as well as factors involving the trajectory of patients through various healthcare settings.

The study involved five key stages: defining the appropriate term for the conditions under study by the PSP Steering Group; gathering questions on MNYES from patients, caregivers and clinicians in a publicly accessible survey; checking these research questions against existing evidence; interim prioritisation in a second survey; and a final multi-stakeholder consensus meeting to determine the top 10 unanswered research questions using the modified nominal group methodology.

Over 700 responses from UK patients, caregivers and clinicians were identified in two surveys from a broad range of medical specialities and primary care. Patients prioritised research questions regarding diagnosis and aetiology; clinicians and caregivers prioritised outcomes and treatment, relatively.

The top 10 unanswered research questions cover the domains of: treatment; the role of clinicians; symptoms and outcomes; and recovery.

This JLA PSP may well be the first attempt at capturing the thoughts of a wide group of medical professionals, patients and caregivers in one place with the aim eventually of standardising care and reducing unhelpful variability in the management of MNYES. Following the JLA approach is a strength of the study. The choice of the term MNYES conveys a message of hope, which responds to a need identified by patients, carers and clinicians alike for vigorous research in this domain. The research priorities are expected to generate much-needed, relevant and impactful research into MNYES. Better funding possibilities for MNYES are urgently needed.

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Panic attacks(PA) or episodic paroxysmal anxiety are attacks of severe anxiety (panic) or fear (most often - fear of death, less often - fear of losing consciousness, loss of control, helplessness or fear of “going crazy”), accompanied by a rapid heartbeat and a feeling of “suffocation” , “lack of air.” Sometimes there are additional symptoms such as increased blood pressure, a feeling of “internal trembling”, trembling in the limbs, a feeling of “hot flashes” of heat or cold, numbness of the extremities, increased sweating, a feeling of “unstability” or dizziness, nausea, derealization or depersonalization.

It was revealed that many patients with cervical and spinal pain suffer from PA. Psychotherapy and traditional psychopharmacology treatment often not effective. The goal of our study was analysis of radical anti-oxidative therapy for the PA patients in addition to traditional to traditional psychoparmacology and psychotherapy techniques.

12 patients with cervical and 31 with lumbar pain experienced panic attacks during outbreaks of panic attacks. 6 cervical pain patient and 17 patients with lumbar pain were treated by antipsychotic medications also by cognitive behavioral therapy, hypno-suggestive therapy and autogenic training. Other patients also receive hyperbaric oxidation therapy (HBO) in addition to psychopharmacology and psychotherapy.

It was revealed that patients with PA comorbid with vertebral pathology had much better effects in terms of evading of psychopathologic outcomes. PA became much more rarely and finally disappeared at all. The anti-oxidative treatment was also very beneficial for neurologic symptoms cause by vertebral pain.

Anti-oxidative therapy showed very marked effect. In this regard, new anti-oxidative treatment seems to be promisable for management of such conditions.

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The flood in Fort McMurray (FMM) which occurred between April 26 and May 2, 2020, is known to have displaced an estimated population of 1,500 people, and destroyed or damaged about 1,230 buildings. In all, it is estimated to have caused about $228 million in losses.

This study aims to identify the determinants of likely Generalized Anxiety disorder (GAD) among respondents 12 months after the 2020 flooding

Data for the study were collected through a cross-sectional survey sent through REDCap and hosted online from the 24th of April to the 2nd of June 2021. The self-administered questionnaire was emailed to respondents using community, government, school, and occupational platforms. Demographic, flooding-related variables and clinical data were collected. A validated instrument, the GAD-7 was used to collect information on likely GAD. Consent was implied by completing the survey forms, and the University of Alberta Health Research Ethics Committee approved the study.

Of the 249 residents surveyed, 74.7% (186) respondents completed the online survey, 81.6% (80) were above 40 years, 71% (132) were in a relationship, 85.5% (159) were females, and 94.1% (175) were employed. The prevalence of likely GAD was 42.5% in our study. Predictors of likely GAD among respondents included positive employment status (OR = 30.70; 95% C.I. 2.183–423.093), prior diagnosis of depression (OR = 3.30; 95% C.I. 1.157–9.43), and the perceived need to have mental health counseling (OR = 6.28; 95% C.I. 2.553–15.45).

This study showed that there was an increased magnitude of moderate to high anxiety symptoms among respondents following the natural disaster, particularly the flood in 2020. The predictors of likely GAD include positive employment status, a history of depression diagnosis, and the need to have mental health counseling. Policy formulators may reduce the risk of anxiety after flooding in vulnerable areas by addressing these factors.

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T1D is the most common chronic endocrine pathology in children. The management of type 1 diabetes requires strong diet, physical activity, lifelong insulin therapy, and proper self-monitoring of blood glucose and is usually complicated and, therefore may result in a psychosocial problem for the whole family. Metabolic control of the disease is determined by glycated haemoglobin (HbA1c), the main criterion for diabetes compensation. It is assumed that anxiety and depression symptoms negatively affect glycemic control. A correlation was observed between anxiety and depression level and glycaemic control, as well as a three-way interaction among HbA1c, frequency of blood glucose monitoring, and diabetes-related stress (Buchberger et al., 2016). Parental psychological distress was associated with higher child self-report of stress and depressive symptoms, and it had negative effects on diabetes management.

To evaluate the relationship between parental depression and anxiety and metabolic control of their adolescents with T1DM.

The cross-sectional study recruited adolescents with T1D (N=251) and their parents (N=251). The 7-item Generalized Anxiety Disorder (GAD-7) scale measured anxiety level. The Patient Health Questionnaire – 9 (PHQ-9) detected depressive symptoms. Glycaemic control of patients was assessed using the last glycated haemoglobin (HbA1c) values. GLM mediation analysis was performed to determine the potential mediating effect of parent’ mental health depression and anxiety on the relationship between depression and anxiety of child on the level of HbA1c.

502 respondents were eligible for screening. Mediation analysis was performed to assess the mediating role of parent GAD-7 on the linkage between HbA1c and child GAD-7 and child PHQ-9. the results relevated that the total effect of child GAD-7 on HbA1c was significant but the total effect of child PHQ-9 was not significant. With the inclusion of the mediating variable (parent GAD-7) (Figure 1), the impact of child GAD-7 and child PHQ-9 was founding insignificant (p ≥ 0.05) but the indirect effect of child GAD-7 and child PHQ-9 on HbA1c though parent GAD-7 was found significant (p ≤ 0,01) (Table 1). This indicates that the relationship between HbA1c and child GAD-7 and PHQ-9 is fully mediated by parent GAD-7.

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Glycated haemoglobin in adolescents with Type 1 diabetes is related to adolescents’ mental health via parents’ anxiety. It means that parents’ anxiety plays more significant role in the level of glycated haemoglobin in adolescents than depression and anxiety of the adolescent.

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Facebook Instagram, tik tok are popular platforms for interacting with others to build or maintain relationships. Compared to other interpersonal exchanges, these social networks do not require face-to-face interactions. Therefore, they may represent an important social sphere for people with social anxiety disorder (SAD). This study investigated the relationship between social anxiety symptoms and different patterns of social media use. We also looked at the role of brooding, a known risk factor for Social Anxiety Disorder.

establish the relationship between the misuse of social media and the symptoms of social anxiety

This is an analytical cross-sectional study conducted through the distribution of a self-questionnaire, which was published online, through different platforms. The questionnaire in the 1st part includes socio-demographic data and general questions about social networks. And a Social Phobia Scale (SPS) which has 20 items in a second part.

preliminary results showed that greater social anxiety symptoms were associated with spending more time on social media and using passively (i.e. viewing other people’s profiles without interacting). .

Social anxiety is a fear associated with certain social activities or performance situations where the person might feel observed, embarrassed, humiliated, rejected or concerned about the judgment of others.

In people with social anxiety, however, these fears become excessive, persistent and pervasive. The affected person may panic and attempt to avoid situations or conditions that remind them of the object of their fear. While the use of social networks especially among adolescents can create a virtual space in which users can act and react freely without coming into direct contact with people, which increases the signs of social anxiety in this type of user.

the relationship between social media use and social anxiety symptoms highlights the need for further research on this topic. Future research should use experimental manipulations and replicate current findings in clinical samples.

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Panic disorders (PD) are associated with suicidality. The link between PD and suicide has been suggested to be depression; however, this remains controversial. Comprehensive research on the history of suicide attempts (SAs) in patients with PD is scarce.

This study investigated the characteristics and pharmacological short- and long-term treatment responses of patients with PD, with or without SAs. Moreover, a network analysis was conducted to investigate the central symptoms and their connection to suicidality among SA-related variables with and without SAs.

We investigated the characteristics of SAs in patients with PD using PD-related scales, magnetic resonance imaging, and network approaches. A total of 1151 subjects were enrolled, including 755 patients with PD (97 with SA and 658 without SA) and 396 healthy controls. Suicide and PD-related scales were also administered.

Our results revealed that the scores of all symptom severities were significantly higher in the PD+SA group than in the PD-SA group. Multiple linear regression analysis revealed that short- and long-term pharmacological treatment responses were significantly poor in the PD+SA group. Network analysis showed that fear of cognitive dyscontrol (FCD) was the strongest central symptom among strength, expected influence (1 and 2 step), randomized shortest path betweenness, and eigenvector centrality measures in PD+SA, whereas depression was the central symptom in PD-SA.Table 1.Results of multiple regression analysis to predict treatment response for patients with panic disorder.

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Our results suggest that SA history could be associated with high symptom severity and poor pharmacological treatment response in patients with PD and that FCD is the central symptom in the PD+SA network.

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The high recurrence rate and diagnostic stability are current problems in treating panic disorder. Because anxiety symptoms are often temporary, it is hard to evaluate anxiety behaviors objectively. In evaluating anxiety behavior, virtual reality is suitable tools that can help bridge the gap between where the symptoms are and where the treatment is given.

This study aims to develop VRABES, an anxiety behavior evaluation system for objectively assessing an individual’s anxious behavior, and to evaluate the feasibility of VRABES.

Patients with panic disorder (ANX group) and healthy controls (CON group) matched for sex, age, and marital status were recruited through outpatient clinics and public advertisements. VRABES consists of four modules; Baseline evaluation (module 0), Daily environment exposure (module 1), Relaxation (module 2), and Interoceptive exposure (module 3). Except for the Baseline evaluation module, the other three modules consisted of three steps, including 1) pre-evaluation, 2) virtual environment 1, and 3) virtual environment 2. In VRABES, subjective anxiety experience (AS) were collected for three times (pre, during, post) for module 1, 2, and 3. we conducted a repeated-measures analysis of covariance (ANCOVA) to explore any significant differences in self-rating anxiety scores among groups and repetition for each module controlling for age, sex, smoking usage, alcohol usage, and depression. Additionally, partial correlation coefficients were calculated on the relationships between measures in VRABES and Panic disorder Severity Scale (PDSS) in the ANX group to eliminate the effects of demographic variables (age, sex, smoking usage, alcohol usage), and other psychological assessment scores [Liebowitz Social Anxiety Scale: Self-Report Version (LSAS-SR), Generalized Anxiety Disorder Scale (GAD-7), and Hospital Anxiety and Depression Scale (HADS)].

Table presents the significant results of repeated-meausre ANCOVA. Figure shows the significant results among the paired t-tests for each group conducted as a post-hoc test for the interaction effect shown in Module 1 and Module 2.Table.Results of repeated-measured ANCOVA for self-rating anxiety scores in the two groups (ANX and CON) and different time (pre, during, and post) concerning each module.

There are no significant results found in partial correlation analysis between PDSS scores and self-rating anxiety scores from VRABES.

The results showed that the VRABES is a reliable and valid research tool.

None Declared

The dental surgeon may be the cause of a psychological trauma - without necessarily knowing it - as well as being confronted with patients who have undergone a trauma as a result of dental care or with patients who have undergone some kind of trauma and that the dental practice exacerbates their anxieties. In this case, the treatment becomes difficult or even inaccessible or a cause of treatment failure.

Study the events that can cause trauma and the different approaches to psychological trauma in dental care.

How to explore the traumatic event in a patient and propose its erasure?

Study the events that can cause trauma and the different approaches to psychological trauma in dental care. How to explore the traumatic event in a patient and propose its erasure?

This is a descriptive and analytical cross-sectional study based on a hetero questionnaire filled in by patients who consulted a dental surgeon.

41% are men, 76% are aged between 30 and 50 years, for the marital status: 43% are single, 38% are married, 72% have an average socioeconomic level, 36% of patients have a personal history of a psychiatric disorder, 21% personal history of a medical disease, 32% have a disorder related to the use of psychoactive substances,

For the reason of consultation: 28%: dental square, 42%: oral malformations, 17%: gingival problem, 8% dental extraction. Medication used: 65% of patients used anti-inflammatory drugs, 77% used antibiotics, 13% used paracetamol. Duration of treatment: 86% one year

41% are men, 76% are aged between 30 and 50 years, for the marital status: 43% are single, 38% are married, 72% have an average socioeconomic level, 36% of patients have a personal history of a psychiatric disorder, 21% personal history of a medical disease, 32% have a disorder related to the use of psychoactive substances, For the reason of consultation: 28%: dental square, 42%: oral malformations, 17%: gingival problem, 8% dental extraction. Medication used: 65% of patients used anti-inflammatory drugs, 77% used antibiotics, 13% used paracetamol. Duration of treatment: 86% one year .

He should be careful, attentive and open to the principles of the psychology of communication in his psychological approach, in order to adapt the level of difficulties of care to the capacity of comprehension, so as to take care of the patient in his globality and avoid any traumatic act. He should not hesitate to send his patient to a psychiatrist if necessary.

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A phobia is a type of anxiety disorder that causes an individual to experience extreme, irrational fear about a situation, living creature, place, or object. The most common in the treatment of phobic disorders are in vivo exposures (IVEs) consisting of confrontation with feared stimulus until distress has decreased. Virtual reality exposure therapy (VRET) is a modern alternative to IVEs where patients are exposed to virtual anxiety-provoking environments, and its effectiveness has already been demonstrated in the treatment of most phobias (Freitas et al. Psychiatr q. 2021; 92(4):1685–1710).

This paper aims to present a complex virtual city developed for VRET in different types of phobia. The VRET system is composed of several interactive environments (a skyscraper, a subway, a cinema, and a hospital) that can be combined in form of different scenarios targeting various phobias, allowing controlled and gradual exposure. Selected virtual environments will be presented in case studies of agoraphobic patients (F40 by ICD-10).

The number of VRET sessions is individual, based on the need of each patient, starting with an introductory session including stimulus mapping and VR control explanation. Each session lasts about 30 minutes. During exposure, Subjective Units of Discomfort (SUDS) are assessed at various points. The scenarios for agoraphobia are typically composed of an elevator or subway ride, open spaces (city streets, the roof), or crowded interiors (the cinema). Environments allow various effects, elevator trembling, getting stuck situations and adjusting the number of people. All the scenes contain authentic ambient sounds.

We present a case of a 33-year-old male patient experiencing intense fear of getting stuck or locked, turning into panic attacks. During 10 VRET sessions, the patient was exposed to different environments (subway, underground parking, elevator, cinema) focusing primarily on elevator rides, sometimes in combination with IVE, consisting of locking the door in the experimental room. Another case is a 59-year-old female patient with a fear of open spaces and crowd situations. This patient had 5 VRET sessions combining exposure to open spaces with subway rides. In addition, the patient was instructed to watch short 360° videos of crowd situations. The last case is a 20-year-old female patient with an intense fear of subway tunnels and sounds, enclosed spaces, and heights. During 4 VRET sessions, we mainly focused on the subway with additional IVEs in a real elevator.

Subjective evaluations during exposures indicate a reduction of anxiety across sessions. Based on the patient’s feedback we can conclude on a good acceptance of the technology and an improvement in real-life situations. These case studies demonstrate the valuable use of variable combinations of virtual scenarios in the treatment of agoraphobia.

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Bipolar disorder (BD) is higher in developing countries. Childhood trauma exposure is a common environmental risk factor in Colombia and might be associated with a more severe course of bipolar disorder in Low-Middle Income-Countries. We carried out the first case-control study (114 BD patients and 191 controls) in Colombia using a structural clinical interview and the Childhood Trauma Questionnaire-Short Form (CTQ-SF) to describe the prevalence and association between trauma exposure during childhood with a severe course of illness in a sample of BD patients.

to describe the prevalence and association between trauma exposure during childhood with a severe course of illness in a sample of BD patients.

A case-control study (114 controls versus 191 controls) that assessed outpatients between 18 and 65 years old, at a teaching hospital in Barranquilla, Colombia was carried-out. All participants were assessed with the SCID-5-CV, the Young Mania Rating Scale (YMRS), and the Bipolar Depression Rating Scale (BDRS). Additionally, exposure to childhood trauma was assessed using The Childhood Trauma Questionnaire-Short Form (CTQ-SF). The CTQ-SF is a brevity 28-item Likert-type, with a five-factor structure: emotional abuse EA, physical abuse PA, sexual abuse SA, physical neglect PN, and emotional neglect EN, self-administered instrument in order to assess multiple types of trauma during childhood.

We generate an outcome variable named severe bipolar disorder defined by course severe of bipolar disorder as the presence of any clinical indicator of severity, previously delimited by the research team (early-onset, rapid cycling, ideation or suicide attempt, or 3 or more hospitalizations per year). Also, we carried out bivariate and regression analyses with each clinical indicator of severity as an outcome.

Cases included 61.4% BD type I and 38.6% BD type II. The median age was 31.5 years (IQR, 75-24) for BD patients and 31 years old (IQR, 38-24) for healthy controls. A higher prevalence of childhood trauma was evidenced in cases compared to controls.

Multivariate logistic regression model in severe bipolar disorder

This is the first association study between childhood trauma exposure as a higher risk for a severe course of illness in BD patients in Colombian. Our findings highlight the importance of screening and evaluating childhood trauma exposure during the course of BD patients.

None Declared

Bipolar disorder (BD) is a severe psychotic disease repeats depression, hypomania or mania. Using mobile applications to record emotions can help BD patients to self-manage and reduce emotional symptoms. Gamification applied in health-manage applications can improve the using frequency and satisfaction. Nurturing and horticultural therapy could increase the using frequency and alleviate the depression and anxiety.

This study chose plants-nurturing to add to a self-management application, and explored the users’ experiences.

A one-group pretest-posttest design with qualitative interview was used. Analysis included the frequency of usage, emotional changes, and users’ feedback of the plants-nurturing in the first three months and after three months.。

A total of 26 participants were included. In the frequency of usage, the times and ratio of days were increased but no significant difference. The emotional symptoms were no significant difference. Positive experiences were novelty and interesting, while negative experiences were the slow rate of growth.Table 1.Demographics (N=26)

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There was a preliminary increase when adding plants-nurturing to the self-manage application, whereas the effect should be examined by further research. The more delicate elements of gamification could be included in self-manage application, considered the users’ other sensory perception in the future. Meanwhile, to improve the frequency of usage and self-management in BD patients, the subjective experiences should be explored in-depth.

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Sleep disturbances are frequently reported in patients with Bipolar Disorder (BD), parallel, patients with BD report significantly higher rates of exposure to major lifetime traumatic events than the general population with a high risk of developing PTSD.

The aim of this study was to compare sleep parameters subjectively and objectively measured, in patients with BD with or without PTSD with respect to healthy control subjects.

73 patients with BD (26 BD+ PTSD and 46 BDw/oPTSD) and 88 HC were evaluated through actigraphic monitoring to explore sleep and circadian parameters, scales exploring sleep quality (Pittsburgh Sleep Quality Index -PSQI-) and chronotype (reduced Morningness-Eveningness Questionnaire –rMEQ-) and the Trauma and Loss Spectrum Self Report (TALS-SR), for lifetime trauma and loss spectrum symptoms.

Compared to age-matched HC, patients with BD reported lower sleep quality, lower rMEQ scores suggestive of delayed chronotype, longer total sleep time, higher waking after sleep onset, lower interdaily stability and lower sleep health. Patients with BD+PTSD reported significantly higher PSQI scores than BDw/oPTSD; significant correlations between the PSQI total scores and TALS-SR symptomatic domains emerged in the BD+PTSD group only.

Our results suggest a strong correlation between sleep disturbances, particularly evaluated by subjective measures, and PTSD symptoms in patients with BD.

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Circadian rhythms, defined as endogenous oscillations that regulate metabolism, physiology and behaviour, may be frequently disrupted in mood disorders, influencing their clinical presentation and course (Srinivasan V. et al. World J Biol Psychiatry. 2006;7(3):138-151).

To characterise circadian rhythm disruptions in a population of patients with mood disorders, analysing clinical and course differences in subjects with and without clinically significant circadian rhythm alterations

Patients selected for this cross-sectional study were assessed with CGI-BP, HAM-D, MRS, and PANSS. Circadian rhythm disturbances were evaluated with BRIAN. Patients with clinically relevant circadian rhythm disturbances were defined as BRIAN > 36 (Mondin TC et al. J Psychiatr Res. 2017;84:98-104). Bivariate analyses were subsequently performed to compare subgroups of patients.

In our study, 61 subjects with DD or DB were enrolled. The overall mean BRIAN test score was 40.08 ± 10.26. When comparing the BRIAN test scores, both total and subscales, between subjects with DB and DD, social rhythms were significantly more altered in subjects with DB (8.63 ± 2.90 VS 6.80 ± 2.11, p=0.034). Subjects with disruption of circadian rhythms displayed greater severity of depressive symptoms (mean total HAM-D test score 16.06±8.61 VS 8.94±5.85; p<0.003, mean CGI-BP severity of depression test score 3.14±1.68 VS 1.88±1.11; p<0.010) and with a longer duration of untreated illness (6.14±8.64 VS 2.53±6.28; p= 0.040).

Alterations in circadian rhythms should be routinely investigated in all individuals with mood disorders, especially BD, and may represent a transdiagnostic psychopathological construct that defines a more severe disease phenotype.

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Vitamin B12, folic acid and homocysteine play a key role in cellular functioning as part of “one-carbon metabolism”, a biochemical pathway involved in many essential biological processes, such as DNA synthesis. Therefore, imbalance involving these micronutrients might impair neurological functioning as well. Vitamin B12 has been implicated in the onset of a wide range of neuropsychiatric symptoms/disorders, like mood disorders, anxiety, hallucinations and delirium. Altered levels have been reported in mood disorders (MDs), but available literature particularly focuses on major depression (MDD), while the information in bipolar disorders (BDs) is still limited.

The present study aimed at assessing vitamin B12, homocysteine and folic acid in bipolar inpatients and detecting any relationship with clinical features or outcome measures.

A total sample of 69 inpatients was selected. Diagnoses of bipolar disorder I (BDI), II (BDII), schizoaffective disorders, and MDD, were assessed according to DSM-5 criteria. The Mini International Neuropsychiatric Interview (MINI), Hamilton Rating Scale for Depression (HRSD), Young Mania Rating Scale (YMRS) and Clinical Global Impression-Severity (CGI) scales were used to complete the psychopathological evaluation. The blood parameters were measured according to common clinical-chemical methods.

About 50 % of bipolar patients (34) showed significantly lower vitamin B12, and 14 higher homocysteine levels than normative values. No differences were noted between genders, except for a slightly higher rate of women showing lower homocysteine, phase of illness, intake of psychotropic drugs, or dietary habits. Folic acid levels were normal in most of the sample. Patients with a family history of suicide showed significantly lower levels of vitamin B12.

These results suggest that implementing the assessment of vitamin B12, homocysteine and folic acid in patients with BD in routine clinical practice could be a useful as well as simple, non-invasive and cheap tool. Although other studies are necessary, the present findings that lower levels of vitamin B12 seem typical of patients with a family history of suicide independently from the phase of illness, suggests that they might constitute a possible predictor of this tragic outcome.

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Treatment adherence in patients living with Bipolar Disorders can influence prognosis and quality of life. It is associated with an increased morbidity and healthcare costs.

The aim of our study was to evaluate treatment adherence in a sample of patients living with Bipolar disorders and to determine factors associated with poor adherence.

We conducted a cross sectional study where we included bipolar patients being treated in psychiatry department A. We developed a survey containing sociodemographic and clinical features. We used the medical adherence rating scale to evaluate treatment adherence.

Our sample consisted of 100 patients with a mean age of 47,5 years old. Sixty seven patients were being treated for bipolar disorder type 1. Medication adherence rate was 64%.

Factors associated with poor medication adherence were being single, an early age of onset, comorbid substance abuse disorder, severe treatment side effects and poor insight.

Poor medication adherence is a major issue for people living with Bipolar Disorders. Clinicians should pay more attention to sociodemographic and clinical factors to predict and enhance treatment adherence.

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