Depressive Anxiety Symptoms Research Articles

Multisystemic Resilience and Anxious-Depressed Symptoms in Black Youth Exposed to Maternal Syndemics: A Mixed-Method Study.

We explored associations between multisystemic resilience and anxious-depressed symptoms in Black families experiencing maternal syndemics (i.e., co-occurring epidemics of substance abuse, violence, HIV/AIDS), using a sequential explanatory study design. Hierarchical regression was used to analyze data from 171 Black youth (57% girls; Mage=12.13, SD = 2.90). Girls (β=-0.17, p = .02) with higher inter/intrapersonal skills (β = - 0.28, p = .004) and more open familial communication (β = - 0.40, p < .001) reported fewer anxious-depressed symptoms, F(12, 147) = 5.68; p < .001, Adj R2 = 26.1%. Qualitative results from a subsample of 10 Black youth-mother dyads explored inter/intrapersonal factors (i.e., emotion regulation strategies, goal setting, persistence and perseverance, problem-solving skills) and open communication factors (i.e., comfortable environment to talk, solving problems, processing feelings, showing affection, benefiting from open communication) that support Black youth resilience. Findings highlight key resilience factors that could be bolstered in future interventions to reduce anxious-depressed symptoms among Black youth exposed to maternal syndemics.

Cognitive outcomes and psychological symptoms in an Italian cohort with post-acute COVID-19 condition (PACC)

BackgroundWe aim to investigate the proportion of patients (pts) with long-term cognitive outcomes (CO) of PACC and identify associated features. MethodsWe assessed participants through a neuropsychological assessment. The chi-square test was used for comparisons according with time of NPA (within or beyond 6 months since COVID19) and with previously hospitalization status (hospitalized patients, PH; not hospitalized patients, nPH). Results520 participants: mean age 54 years (SD 12), 53 % female, 14 years of education (SD 3.4), 35 % with >1 comorbidity, 48 % previously hospitalized. Overall, we found CO in 89 % of pts, in particular 88 % evaluated in w6M and 89 % in b6M (p = 0.801) while 90 % and 87 % in nPH and PH, respectively (p = 0.239). By fitting multivariable analysis, PH for COVID19 and female gender were associated with an increased risk of an altered PSQI [Odd Ratio, OR 2.48, 95 % CI 1.54 to 3.99, p < 0.001 and OR 2.59, 95 % CI 1.60 to 4.17, p < 0.001, respectively) and BAI [F vs M: OR 1.67, 95 % CI 1.16 to 2.40, p = 0.005). ConclusionsWe show a substantial proportion of PACC-CO; hospitalization leads to impaired memory, anxiety and sleep disorders. Women seem to be at higher risk for anxious-depressive symptoms and worse sleep quality than men.

Insomnia Catastrophizing and Affective Temperaments in Major Depressive Disorder

Background and Objective We aim to assess the role of affective temperaments, insomnia severity, sleep quality, and depressive anxiety symptoms in predicting catastrophizing insomnia in patients with major depressive disorder (MDD).Methods Our study employed a case-control design, involving 90 drug-free MDD patients and 90 healthy controls (HCs) with identical sociodemographic characteristics. Participants completed a comprehensive set of assessments, including the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), Insomnia Catastrophizing Scale (ICS), and Temperament Evaluation of Memphis, Pisa, Paris, San Diego Autoquestionnaire (TEMPS-A).Results Among the 90 MDD patients, 80% were female (n = 72), with a mean age of 32.2 ± 13.6 years. The MDD group exhibited significantly higher scores on the BDI, BAI, ISI, PSQI, ICS night, ICS daytime, and ICS total scores, along with depressive, cyclothymic, irritable, and anxious temperament scores, compared to the HCs (p &lt; 0.001). Notably, the hyperthymic temperament showed no correlation with insomnia catastrophizing in either group. Our findings revealed that the ISI score was a predictive factor for the ICS night; age and ISI were predictive factors for the ICS daytime; and age, anxious temperament, and ISI were predictive factors for the ICS total in the MDD group.Conclusions The severity of insomnia, young age, and an anxious temperament were identified as positive predictors of insomnia catastrophizing.

Facial and Emotion Recognition Deficits in Myasthenia Gravis.

Myasthenia gravis (MG) is a neuromuscular disease of autoimmune etiology and chronic evolution. In addition to the muscle weakness and fatigue that characterize MG, in some studies patients show an inferior performance in cognitive tasks and difficulties in recognizing basic emotions from facial expressions. However, it remains unclear if these difficulties are due to anxious-depressive symptoms that these patients present or related to cognitive abilities, such as facial recognition. This study had a descriptive cross-sectional design with a sample of 92 participants, 52 patients with MG and 40 healthy controls. The data collection protocol included measures to assess recognition of facial expressions (BRFT), facial emotional expression (FEEL), and levels of anxiety and depression (HADS). The MG group had worse performance than the control group in recognizing "fear" (p = 0.001; r = 0.344), "happiness" (p = 0.000; r = 0.580), "disgust" (p = 0.000; r = 0.399), "surprise" (p = 0.000; r = 0.602), and "anger" (p = 0.007; r = 0.284). Likewise, the MG group also underperformed in facial recognition (p = 0.001; r = 0.338). These difficulties were not related to their levels of anxiety and depression. Alterations were observed both in the recognition of facial emotions and in facial recognition, without being mediated by emotional variables. These difficulties can influence the interpersonal interaction of patients with MG.

Alpha oscillation mediates the interaction between suicide risk and symptom severity in Major Depressive Disorder.

The aim of our study was to explore the relationship between changes in neural oscillatory power in the EEG, the severity of depressive-anxiety symptoms, and the risk of suicide in MDD. 350 MDD patients' demographic and clinical data were collected, and their depressive and anxious symptoms were evaluated using HDRS-17 and HAMA-14, along with a suicide risk assessment using the Nurses' Global Assessment of Suicide Risk (NGASR). EEG data were captured, processed, and analyzed to study brain activity patterns related to MDD. The participants were divided based on suicide risk levels, and statistical analyses, including chi-square, t-tests, Pearson's correlations were used to explore the associations between brain activity, symptom severity, and suicide risk. Closely related variables were identified and ultimately the optimal model was screened using stepwise regression analysis with a forward strategy, and mediation effects were further used to determine the possible interactions between the variables in the regression model. The regression model showed a significant effect of HDRS-17 and alpha power of Medial Occipital Cortex (MOC) on suicide risk, with elevated HDRS-17 increasing suicide risk and elevated alpha power decreasing suicide risk. Mediation effect analyses showed that MOC alpha power partially mediated the effect of depression level on suicide risk, and that an increase in depression severity may lead to a decrease in MOC alpha power, while a decrease in MOC alpha power may lead to an increase in suicide risk. The severity of depression directly increases suicide risk, whereas higher alpha power in the MOC serves as a protective factor, reducing this risk. Notably, MOC alpha power not only directly impacts suicide risk but also mediates the effects of both depression severity and anxiety levels on this risk. The relatively small sample size of this study may limit the representativeness of the overall MDD patient population and the detailed analysis of different subgroups. This study did not delve into the relationship between the severity of cognitive symptoms in MDD patients and suicide risk.

Early stress in maternal deprivation affects the expression of OX1R in the limbic system of the brain and contributes to the development of anxiety-depressive symptoms in rats

BACKGROUND: Depressive states are becoming an increasingly common mental disorder and a serious social problem that places a heavy economic burden on society. Increasing data from preclinical and clinical studies indicate that orexins (neuropeptides, also known as hypocretins) and their receptors are involved in the pathogenesis of depression. The orexinergic system regulates disrupted functions in depressive states, such as sleep, reward system, eating behavior, stress response, and monoaminergic regulation. However, the exact role of orexins in behavioral and neurophysiological disorders in depression is still unclear. AIM: This study aimed to examine the effect of early postnatal stress on the expression of OX1R orexin in the limbic system and the development of anxiety-depressive symptoms in rats. MATERIALS AND METHODS: Maternal deprivation was used as a model of early postnatal stress (postpartum days 2–12). The animals were divided into the control (n = 20) and maternal deprivation (n = 20) groups. On day 90 of life, the influence of early postnatal stress on the development of anxiety-depressive symptoms in adult rats was analyzed using a package of behavioral tests, namely, raised cruciform maze, forced swimming Porsolt test, and two-bottle test. After the experiments, the animals were killed by decapitation, the brain was extracted and placed in the cold, and brain structures (hypothalamus and amygdala) were isolated, immediately frozen in liquid nitrogen, and stored at a temperature of −80°C for polymerase chain reaction analysis. RESULTS: In the “raised cruciform maze,” the maternal deprivation group spent less time in the open arms of the maze, and the time spent in the closed sleeves increased relative to the control, which can be assessed as an increase in anxiety levels. In the Porsolt test, the maternal deprivation group had increased immobilization time relative to the control group. In the two-bottle sucrose preference test, the maternal deprivation group demonstrated a decreased preference for sucrose solution, which indicates the development of anhedonia. In the hypothalamus, the mRNA expression level of OX1R significantly decreased in the experimental group compared with that in the control group. A twofold decrease in the mRNA expression level of OX1R was also observed in the amygdala of the experimental group compared with that of the control group. CONCLUSIONS: Early stress caused by maternal deprivation resulted in a decrease in OX1R orexin expression in the hypothalamus and amygdala and contributed to the development of anxiety-depressive symptoms in rats.

Clinical high risk for psychosis and service disengagement: Incidence and predictors across 2 years of follow-up.

Since there are few studies on this topic, the goals of this examination were: (1) to calculate service disengagement rates in a CHR-P sample along 2-years of follow-up; and (2) to examine the most relevant predictive factors of disengagement at baseline. All young CHR-P participants were enrolled within the 'Parma At-Risk Mental States' (PARMS) protocol. At entry, the Global Assessment of Functioning (GAF) scale and the positive and negative syndrome scale (PANSS) were completed. Cox regression analyses were used. Hundred and eighty CHR-P subjects were recruited in this examination. During the follow-up, a 2-year service disengagement prevalence rate of 15% was observed. A statistically robust predictive factor of service disengagement was a lower prescription of antidepressant drug at entry. Other relevant baseline predictive factors were migrant status, higher GAF score, lower levels of anxious-depressive symptoms and a lower acceptance of psychosocial interventions. Baseline presence of anxious-depressive features in CHR-P individuals could favour engagement to specialized EIP services. However, implementing strategies to improve patients' motivation and involvement in care are needed.

Severity of depressive and anxious symptoms and its association with birth outcomes among pregnant women during the COVID-19 pandemic: a prospective case-control study

Aim Comparing the anxiety and depression severity and their impact on subsequent birth outcomes in pregnant women before and during Omicron wave in Shanghai in 2022. Methods The depression-anxiety symptoms networks were compared between the pregnant women during the outbreak period (outbreak group; n = 783) and a matched control group of pregnant women before the outbreak (pre-outbreak group; n = 783). The impact of baseline mental state on follow-up pregnancy and neonatal outcomes was also explored by logistic regression. Findings Levels of depression and anxiety between the two groups were not significant different. Network analysis showed that central symptom "trouble relaxing" and bridge symptom "depressed mood" shared by both groups. Different symptom associations in different periods of the pandemic. Total scores and sub-symptom scores of prenatal depressive and anxious severities increased the odds ratios of maternal and neonatal syndromes. The influence of mental state on gestational and neonatal outcomes differed across different pandemic periods. Conclusion The Omicron wave did not have a significant negative impact on the depressive and anxious mood in pregnant women. Targeting central and bridge symptoms intervention may be effective in reducing their adverse effects on co-occurring of anxious and depressive mood and birth outcomes.

A nonrandomised trial of a five-week brief mindfulness-based intervention for emerging adults experiencing anxious and depressive symptoms

ABSTRACT Objective We tested the effectiveness of a brief mindfulness-based intervention (bMBI) for emerging adults (EAs) experiencing anxious and depressive symptoms. Specifically, we examined: (1) whether there are improvements in mental health outcomes among participants at post-intervention and in a one-month follow-up, and (2) whether initial health variables predict overall mental health improvement over the intervention. Method Forty-five undergraduate students who were experiencing mood and/or anxiety symptoms participated in a five-session, in-person mindfulness group. Data on anxious symptoms (Generalised Anxiety Disorder-7), depressive symptoms (Patient Health Questionnaire–9), mental well-being (Warwick-Edinburgh Mental Well-Being Scale), perceived stress (10-item Perceived Stress Scale), and self-compassion (12-item Self-Compassion Scale – Short Form) were collected at baseline, immediately prior to the beginning of the intervention, at the beginning of session three, immediately following the intervention and at one-month follow-up. Results The preliminary analysis indicated that this five-session bMBI for EAs was: (1) effective in decreasing psychological distress and increasing well-being, with improvements continuing at the follow-up; and (2) that pre-bMBI self-compassion moderated anxious, depressive and well-being scores at mid-bMBI, post-bMBI, and one-month follow-up. Discussion The current findings lend support for an effective intervention for EAs and provide direction for increased services and preventative strategies for EAs in post-secondary education. This study is one of the few studies on such therapeutic interventions for mood and anxiety within EA research.

Prevalence and Impact of Psychiatric Co-Morbidity in Patients with Spinal Pathology in Basrah, Iraq

Background and objective: to minimize complications by proper selection of patients for surgery and to evaluate what is the impact of psychiatric co-morbidity in patients admitted to a spinal surgical unit in Basrah, Iraq. Patients and Methods: A multi-center cross-sectional prospective cohort study was conducted on 247 patients. In Basrah province. During admission complete history was taken in form of identity, complaint, past medical and surgical history, drug history, type of previous and the coming surgery and lastly special emphasis on the questioner to assess patient psychological status using the Patient Health Questioner. Somatic Anxiety Depressive Symptoms (PHQ.SADS) After one week and one-month the same questions were addressed to the patient to check the general condition,and any complications or readmission. Results: Out of the 247 patients: Eight patients refuse to be part of this study, thirty-one patients lost follow up, three patients excluded from the study due to exclusion criteria, five patients their surgery postponded because they were psychologically unstable and advised for psychiatrist consultation. 111 patients (55.5%) of the sample size were male patients. A 90 (45%) patients were at age of 38-57 years, 111 (55.5%) of the sample were male 82 patients (41%) were of moderate degree using the PHQ.SADS. 62 patients (31%) were within the severe scale PHQ.SADS.132 patients (66%) complained from radiculopathy with or without backache,192 (96%) patients discharged safely postoperatively. 41(39.4%) patients were diagnosed with lumber canal stenosis belongs to the severe group. Psychological break down occurs in 10 (5%) patients, 9 (90%) of those patients belong to severe grade category of PHQ.SADS. Conclusion: There was a strong association between pre-operative psychological conditions and post-operative complications in form of repeated visit after surgery and persistence of pain and disability.

Pre-Pandemic Predictivity of Anxious-Depressive Symptoms in Post-Surgical Traumatic Distress in Hysterectomy for Benign Disease and COVID-19 Outbreak: A Case-Control Study.

Background: The severe acute respiratory syndrome coronavirus (SARS-CoV-2) pandemic led to several needed containment measures that conditioned the onset of depressive, anxiety, and post-traumatic stress symptoms in the population. These symptoms, especially if not diagnosed and treated, can also occur in patients undergoing medical care or surgery, with a high impact on people's lives and causing low adherence to treatment. The study evaluates whether the spread of the coronavirus disease 2019 (COVID-19) worsened the onset of post-surgical distress and symptoms of anxiety and depression in a population undergoing hysterectomy for benign disease during the pandemic era, comparing it with a population with the same characteristics but recruited before COVID-19. Methods: The sample was evaluated before surgery (T1), post-operatively (T2), and 3 months after surgery (T3) through a sociodemographic questionnaire and through the HADS (Hospital Anxiety and Depression Scale) to evaluate anxious-depressive symptoms and the PCL-5 (Post-traumatic Stress Disorder Checklist for DSM-5) to assess the onset of post-surgical distress. Results: Patients treated after the COVID-19 pandemic showed a higher depressive symptoms rate compared with those treated before (p-value = 0.02); conversely, pre-COVID-19 patients were more prone to develop post-traumatic stress disorder (PTSD) (p-value = 0.04). A significant association between the occurrence of PTSD and anxiety-depressive symptoms registered at T2 (p-value = 0.007) and T3 (p-value < 0.0001) emerged. In the end, the COVID-19 pandemic has exerted a detrimental influence on the mental well-being of the patients under investigation, with a notable exacerbation of their mood disturbances. Conclusions: The findings advocate for the implementation of psychometric and psychodiagnostic assessments to promptly detect high-risk scenarios that could lead to PTSD, compromising treatment compliance and exacerbating the overall outcome, resulting in substantial direct and indirect burdens.

N-3 PUFA supplementation alleviates anxiety symptoms by manipulating erythrocyte fatty acid levels in depression.

Major depressive disorder (MDD) is frequently accompanied by the symptoms of clinical anxiety. Since our previous research has found that n-3 PUFA supplementation alleviates anxiety in MDD, this study was aimed to further explore whether n-3 PUFA supplementation improves anxiety symptoms in depression by directly manipulating fatty acid levels. A secondary analysis of biomarker data (erythrocyte fatty acid composition) collected as part of the randomized clinical trial which investigated the adjunctive effect of n-3 PUFAs was conducted on 72 venlafaxine-treated outpatients with first-diagnosed, drug-naïve depression. All participants with longitudinal biomarker data were included in the association analysis to determine how n-3 PUFA supplementation influences fatty acid composition and alleviates anxiety symptoms in depression. Decreases of the C20:3n6 were found in all participants at both follow-up time points (χ2 = 96.36, p = 0.000). The n-3 index (χ2 = 10.59, p = 0.001), EPA (χ2 = 24.31, p = 0.000), and C22:5n3/C20:5n3 ratio (χ2 = 10.71, p = 0.001) were increased, while C22:4n6 (χ2 = 7.703, p = 0.006) was decreased in n-3 PUFA group compared to the placebo group. The improvement in anxiety symptoms positively correlates with the extent of reduction of C16:0, C18:0, and total fatty acid levels as well as D5 desaturase activity (p < 0.05). These data suggest that the anxiolytic effect exerted by n-3 PUFAs in first-diagnosed, drug-naïve depression is manipulated by erythrocyte fatty acid levels. Saturated fatty acid levels have an important role in predicting the severity of anxiety symptoms.

The presence of meaning in life and character strengths as protective factors of anxious-depressive symptoms in adolescents from Spain and Russia during the COVID-19 pandemic

ABSTRACT The presence of meaning in life (MiL) and character strengths (CS) are protective factors for adolescents’ mental health. The main objective of the present study was to explore transculturally the relationship between MiL and CS with anxiety and depression in the context of the COVID-19 pandemic among adolescents. Adolescents (N = 577) aged 14 to 18 (319 Russians and 258 Spaniards) completed online questionnaires during the pandemic. The results showed that in both samples, zest, gratitude, and love were the most robust predictors of depression symptoms; zest, hope, and love in girls, and self-regulation, hope, and presence of MiL in boys more robustly predicted anxiety symptoms. The findings provide data on the resilience function of CS and the presence of MiL during the COVID-19 pandemic and have important preventive practical implications.

Supportive care needs and anxious-depressive symptoms in cancer patients: An interaction effect between emotional competence and the COVID-19 pandemic?

The main objective was to assess the link between emotional competence (EC) and adjustment outcomes such as supportive care needs (SCN) and anxious-depressive symptoms in cancer patients starting chemotherapy. The second objective was to assess the interaction effect between EC and the COVID-19 pandemic (i.e. patients included before or during the pandemic) on these outcomes. At the beginning of care, 255 patients with digestive or hematological cancer, recruited before the pandemic began (n = 156, 61.2%) or during the pandemic (n = 99, 38.8%), completed the Short Profile of Emotional Competence, the Hospital Anxiety and Depression Scale, and the Supportive Care Needs Survey Short Form. Partial correlations and multiple regressions were used. Intrapersonal EC showed negative significant correlations with psychological unmet SCN (r = -.32, p < .001), anxiety (r = -.37, p < .001), and depression (r = -.46, p < .001). Interpersonal EC showed only significant interaction effects (p < .05): it was only associated with fewer unmet physical and daily SCN (p < .002) and fewer depressive symptoms (p < .004) during pandemic. Results show significant associations between intrapersonal EC and better adjustment of cancer patients from the early stage of care. Interpersonal EC seems to be a significant resource to deal with illness only in difficult contexts such as the COVID-19 pandemic.

Electric and magnetic field pollution in near substations and investigation of anxiety and depressive effects on adult individuals living in this area

ABSTRACT Exposure to electromagnetic fields causes a variety of health problems in living systems. We investigated EMF pollution in Şanlıurfa city center and also investigated anxiety-depression symptoms in individuals (18–40 years old) exposed to this pollution. For this purpose, electric field and magnetic field measurements were taken at Electricity Distribution Center and 44 substations (for each transformer), at 0 points, 1 meter away, 2 meters away and the house/office closest to the transformer. The experimental group was individuals living in electricity distribution center residences and individuals living near transformers (n = 55). The control group was selected from individuals who lived outside the city center of Şanlıurfa, did not have transformers or high transmission lines near their homes, and did not have any chronic diseases that could cause stress (n = 50). Anxiety and depression symptoms of the groups were measured using the Beck Anxiety Inventory Scale (BAI) and Beck Depression Inventory Scale (BDI). The relationship between EMF pollution and anxiety-depression was evaluated statistically. Maximum MF and EF values were recorded as 0.22 mT and 65.9 kV/m, respectively. All measured MF values were below standards, but EF values were above standards at some points. In conclusion, there is no statistically convincing evidence of a relationship between EMF exposure and anxiety-depression (p > 0.05). This result shows that there may be more meaningful results in places with higher EMF levels. We interpreted the fact that exposure to electromagnetic fields does not cause anxiety and depression in individuals, as the measured values are below the limit values.

Psychosocial resources and psychopathology among persons with neuromuscular disorders during the COVID-19 pandemic.

The COVID-19 pandemic substantially affected the lives of persons with inherited neuromuscular disorders (INMD), causing disruption in clinical and support services. While several studies have investigated mental health, distress and psychosocial resources in the general population during the pandemic, little is known about the experience of persons with INMD. This study was aimed to fill this gap by jointly investigating both psychopathological symptoms and psychosocial resources - specifically, resilience and perceived social support - among persons with INMD during the pandemic, taking into account demographic and clinical factors. Between April and December 2020, 59 participants with INMD (aged 15-59, 71.2% M) completed a questionnaire collecting demographic and clinical data, the Multidimensional Scale of Perceived Social Support, the Resilience Scale for Adults, and the Achenbach System of Empirically Based Assessment. Overall, participants showed good levels of resilience and perceived social support. A minority of participants reported clinically relevant psychopathological symptoms, 28.81% for anxiety and depression. Most psychopathological symptoms were negatively correlated with resilience (-0.347 < r < - .420), but not significantly associated with social support. Consistent with previous studies, regression analyses highlighted that participants with Duchenne muscular dystrophy were more prone to report anxious and depressive symptoms (B = 1.748, p = .028, OR = 5.744), and participants with myotonic dystrophy, attention problems (B = 2.339, p = .006, OR = 10.376). Resilience emerged as a potential predictor of lower anxious-depressive symptoms (B=-1.264, p = .012, OR = 0.283). The findings suggest the importance to investigate psychosocial resources in addition to psychopathology among persons with INMD, and to design interventions supporting resilience as a protective factor for mental health promotion.

Anxious-depressive symptoms after a first episode of schizophrenia: Response to treatment and psychopathological considerations from a 2-year follow-up study in Italy

IntroductionDepression is common in schizophrenia and is correlated with suicide risk and poor long-term outcomes. However, the presence of depressive symptoms is often underestimated in both research and treatment, particularly at the illness onset.ObjectivesThe goals of this study were: (a) to longitudinally observe anxious-depressive symptom levels in patients with First Episode Schizophrenia (FES) during a 24 months of follow-up period, and (b) to examine their associations with other psychopathology and the intervention patients received in an “Early Intervention in Psychosis” (EIP) program during the follow-up period.MethodsThe Global Assessment of Functioning (GAF) and the Positive And Negative Syndrome Scale (PANSS) were completed by 159 FES patients both at baseline and across the follow-up. Data were analyzed by linear regression analysis and Spearman’s coefficients.ResultsAnxious-depressive symptoms had significant longitudinal associations with GAF deterioration and PANSS “Positive Symptoms”, “Negative Symptoms” and “Disorganization” subscores. During the follow-up period, FES participants significantly improved the level of anxious-depressive symptoms. This was significantly associated with the number of case management and individual psychotherapy meetings the patient engaged in, as well as with lower antipsychotic doses prescribed during the follow-up period.ConclusionsIn conclusion, anxious-depressive symptoms are prominent in FES and at the initial entry into EIP programs. Anxious-depressive symptom severity tends to diminish overtime, especially with the provision of specialized EIP treatments. However, since we did not have a control population studied in parallel, we cannot say whether these results are specific to the protocols of EIP programs or just to the intensity of engagement in care.Disclosure of InterestNone Declared

From adjustment disorder to schizotypal personality disorder

IntroductionIndividuals with schizotypal personality disorder are characterized by tendencies to magical thinking, unusual perceptions, discomfort in social situations, and restricted affect. It is frecuent that they have social anxiety and have difficulty in understanding the motivations and thoughts of others.ObjectivesPresentation of a case of a patient who was first diagnosed with adjustment disorder, but on a closer study, was discovered to have a schizotypal personality disorder.MethodsWe conducted a bibliographic review by searching for articles about schizotypal personality disorder and theory of mind in Pubmed.ResultsWe present the case of a 39-year-old woman, diagnosed with adjustment disorder after a conflict at work with a colleague that caused her anxiety-depressive symptoms. In consultations, the patient shows verbiage without expansiveness or euphoria, with rambling speech. She expresses feelings of indignation and injustice, she is irritable, with contained anger. She refers that she prefers to be distrustful of others because she does not understand their intentions. Her thoughts are very rigid, which leads her to have avoidant and phobic attitudes, having no relationships of friendship throughout her life.A neuropsychological evaluation is carried out, resulting in a surprising WAIS with a TIC of 128. However, the Mayer‐Salovey‐Caruso Emotional Intelligence Test (MSCEIT) shows difficulties in Perception, Comprehension and Emotional ManagementConsidering the patient’s symptomatology as a whole, it is noteworthy:–Sustained social isolation throughout their life history–Superficiality of interpersonal relationships–Distrust and slight self-referentiality. Deficit in inferring the feelings and thoughts of others–Peculiar speech with ideas of magical content, superstitions and rituals…Which together supported a diagnosis of schizotypal personality disorder and generalized anxiety disorder. From this point we started to work on her self-esteem, modification of irrational beliefs and cognitive distortions, interpersonal communication and metacognitive therapy, with good results.Conclusions The type of schizotypal patients who come to consultations most frequently are the actively isolated/timorous profile due to their intense social anxiety and difficulties in understanding and adapting to the social world around them. Initial therapy should be empathic support. The theory of mind is the ability to infer the other’s mental states and therefore predict their behavior, this ability being diminished in the schizotypal patient. Mentalization tasks, metacognitive therapy, cognitive flexibility training, social skills training, and promoting self-worth are useful. On some occasions it may be necessary to start psychopharmacological treatment to control anxiety and unusual perceptions when they cause discomfort.Disclosure of InterestNone Declared

Impulse phobias during pregnancy: a case report of a 37 year-old woman pregnant of her first child

IntroductionPregnancy and puerperium are two critical stages for women’s mental health due to the biological stress of pregnancy itself, as well as the emotional stress that surrounds this vital moment. (1) Debut and aggravation of psychiatric symptoms may occur, as well as relapse in women previously diagnosed with Severe Mental Disorder (SMD).Symptoms of the anxious spectrum are the most frequent within the perinatal mental pathology, being impulse phobias an entity that appears in about 25% of women previously diagnosed with OCD and up to 10-15% of women without previous psychopathology (2)ObjectivesExposing the importance of Perinatal Mental Health from the presentation of a clinical case.MethodsReview of the literature available in PubMed. Presentation of the pathobiography and evolution of the patient.ResultsOur case is about a 37-year-old woman, 30 weeks pregnant with her first child and history of having required admission to Psychiatry with subsequent follow-up in Mental Health for anxious-depressive symptoms with the presence of self-injurious ideas who, after two weeks with multiple life stressors, came to the Emergency Department for the presence of impulse phobias focused on pregnancy with significant internal anguish and ideas of death as a resolution to it, which is why it was decided to hospitalize her. During admission, and taking into account the patient’s gestational state, treatment was started with diluted Mirtazapine and Aripiprazole solution at minimal doses, which in this case were sufficient for symptom control.The latest guidelines addressing psychopharmacology during pregnancy and lactation point to sertraline among the antidepressants and Lorazepam among the benzodiazepines as the safest drugs during pregnancy (3).Conclusions-The exacerbation of anxious symptomatology and the presence of gestation-focused impulse phobias are frequent during pregnancy and their intensity increases as the time of delivery approaches.-Sertraline, Lorazepam, Mirtazapine and Aripiprazole are safe drugs during pregnancy.-In these women, a close and multidisciplinary follow-up by Psychiatry and Gynecology is advisable.Disclosure of InterestNone Declared

Liquor for breakfast, fighting against alcohol consumption

IntroductionThe harmful consumption of alcohol is known for how tortuous its management can be in mental health, encouraging introspection of it as a serious problem is perhaps the main key to starting to battle against its damaging influence on the development of a functional and full life.ObjectivesTo describe a clinical case showing an unpredictible complication in an alcohol detoxification process.Methods54-year-old man, native of Cádiz, widowed for half a decade, without children. He resides with his parents in the family home. Currently unemployed for approximately a year. He has previously worked in the IT sector. As a notable somatic history, we found long-established arterial hypertension and a total hip replacement. He has been under irregular follow-up with a mental health team for anxiety-depressive symptoms in the context of grief. He goes to the emergency service brought by his family to begin the detoxification process in the hospital setting. He acknowledges ethanol consumption since he was widowed, which began when he awakes; quantities that ranged between one or up to three bottles of distilled liquor per day, generally consumption is in the home environment. A little less than a year ago, he began to isolate himself in his room and abandon his self-care, eating increasingly insufficient food intake, refusing to receive professional care to quit the habit, mainly because he did not recognize it as disruptive.The patient was admitted to hospital with symptoms suggestive of withdrawal, making it extremely difficult to control blood pressure levels. On the third day of admission to the acute care unit, fever peaks, blood pressure levels well below normal parameters, and compromised level of consciousness began to be evident.ResultsBlood tests were performed that, together with the clinical picture, suggested imminent septic shock, so critical care was contacted for transfer and stabilization. A germ of probable urinary etiology sensitive to a broad spectrum of antibiotics was isolated in blood cultures, and the medication of the detoxification process was progressively optimized. Once clinical stability was achieved at all levels, an inpatient cessation resource was managed, which the patient accepted and considered suitable for his complete recovery.ConclusionsA holistic approach to the alcoholic patient is important, since serious problems of an organic nature often arise. This is why a multidisciplinary intervention is necessary, as well as a holistic approach to care, involving both classic pharmacology and assiduous long-term psychotherapeutic intervention.Disclosure of InterestNone Declared