Psychopathological Features Research Articles

Non-intimate Relationships and Psychopathic Interpersonal and Affective Deficits as Risk Factors for Criminal Career: A Comparison Between Sex Offenders and Other Offenders.

Sex-offenders are at risk of criminal recidivism. For the treatment to be truly effective, it must be individualized. For this purpose, an accurate assessment should focus on criminological, psychological, and psychopathological features. The present study compared sex offenders with other offenders on historical experiences (i.e., problems with violence, anti-social behaviors, problems with personal relationships, problems with substance use, traumatic experiences, and parenting style). In addition, given the association between life events and psychopathy, we explored whether the relation between life events and crime type (sexual crime vs. other types of crime) might be moderated by psychopathy traits (interpersonal and affective deficits and antisocial behavior). Eighty-eight sex offenders (76% of whom child molesters) and 102 other offenders were included. The Historical, Clinical and Risk Management - 20 item Version 3 (HCR-20V3) and Psychopathy Checklist-Revised (PCL-R) were administered. The scores of the HCR-20V3 Historical scale items were computed to assess life events. The scores of the PCL-R factors, F1 Interpersonal affective deficits and F2 Antisocial behavior, were recorded. The presence of a history of problems with non-intimate relationships was the only significant risk factor for sexual crime compared with other crimes. Interpersonal and affective deficits provided an increased likelihood of being sex offenders as compared with other offenders when problems with non-intimate relationships were possibly/partially or certainly present.

L’anhédonie musicale : des neurosciences à la psychiatrie

Music has always been part of our culture. Listening to it can convey strong and many emotions in humans. By its capacity to move us, it occupies an important value in the lives of people. There are important differences in the ability to enjoy listening to music. Some people will find music more enjoyable than others. Part of the population is unable to experience pleasure, or has lost the ability to do so. This fact is called “musical anhedonia”. Mas-Herrero et al. have developed a psychometric instrument that studies this sensitivity to musical reward; this is the “Barcelona Music Reward Questionnaire”. Mas-Herrero et al. in 2014, measured the physiological responses of subjects insensitive to music. They found that these people had no changes in their heart rate, temperature or sweat levels when listening to a piece of music, as well as no subjective sensations such as a chill. They thus confirmed the existence of this musical anhedonia. It is to be distinguished from amusia, which concerns the capacities of sensory perception to music. Amusia, that is not associating with the presence of musical anhedonia, is a rare phenomenon, which appears to involve the lower right frontal gyrus and the upper and right middle temporal gyrus. It is most often the consequence of ischemic or hemorrhagic vascular injury and is more frequent and severe in the presence of an injury to the right hemisphere. Several studies highlight the existence of a musical anhedonia in healthy subjects, not depressed, in the absence of amusia, but also in the absence of a loss of pleasure to the presentation of other stimuli, such as money in particular. We speak of “specific” musical anhedonia to describe a loss of pleasure that only concerns musical stimuli. It is a rare phenomenon. There does not seem to be a relationship between a perception deficit and musical anhedonia. In 5% of people, musical anhedonia is congenital. It can also be acquired following focal brain lesions of various locations. In this case, people with it have lost their ability to enjoy listening to music, which they were likely to experience before. Musical reward appears to be processed by the connectivity that exists between the auditory cortical areas, responsible for analyzing musical content and located at the level of the superior temporal gyrus, and areas of the reward system, responsible for assigning a value, such as the nucleus accumbens (at the level of the ventral striatum), the caudate nucleus (at the level of the dorsal striatum) and the limbic system (amygdala and anterior insula). The enjoyment of listening to music varies from individual to individual on a spectrum from musical anhedonia to musicophilia. Thus, some people are more sensitive than others to the emotional stimuli generated by music. The “Barcelona Music Reward Questionnaire” by Mas-Herrero et al. allows individuals to be divided into three classes according to their emotional and sensory experience of music: “anhedonic”, “hedonic” and “highly hedonic” or musicophiles. The context in which a melody is heard for the first time would be crucial. Indeed, there would be an association between a positive or negative emotional experience with music. It also appears that the same neural circuits are activated when listening to sad or happy music, resulting in dopaminergic release. Musical pleasure seems to remain intact in a wide variety of neurological disorders involving impaired cognitive functions, such as Alzheimer's disease, frontotemporal dementia and even Parkinson's disease. Anhedonia is one of the psychopathological features present in many mental disorders such as major depression and schizophrenia. Although anhedonia is a major symptom of depression, the literature on the subject has not yet established the link between musical anhedonia and depression. When it comes to schizophrenia, anhedonia can be considered a negative symptom of the disease. To date, we have not found any studies linking depression and loss of pleasure specific to music.

Risk and protective factors of Internet gaming disorder among Chinese people: A meta-analysis.

Effective prevention and intervention of Internet gaming disorder require the identification of risk and protective factors. This study aims to exhaustively review the risk and protective factors of Internet gaming disorder among Chinese people. We searched for articles published from database inception to February 2020 in MEDLINE, PsycINFO, Embase, PubMed, Web of Science and two Chinese databases, CNKI and Wanfang Data. Studies were included in the meta-analysis if they addressed Internet gaming disorder, sampled people in China, presented correlational factors of Internet gaming disorder and reported the effect sizes for correlations. Reviewers independently selected the studies, assessed their validity and extracted the data. Pooled Pearson's correlations were calculated using the random effects model. In the meta-analysis, 153 studies covering 115,975 subjects were included. We identified 56 risk factors and 28 protective factors. Most risk factors strongly correlated with Internet gaming disorder fell into the category of maladaptive cognitions and motivations. Other factors that showed high effect sizes fell into various categories, including psychopathological characteristics, personality traits, cognition emotion regulation style and gaming-related factors. The only protective factor strongly correlated with Internet gaming disorder was self-control. We found that the factors related to the 'environments' show modest effect sizes compared to those related to the individual. The pooled effect sizes for most factors were not influenced by outliers and publication bias. Factors strongly correlated with Internet gaming disorder, especially maladaptive cognitions and motivations, are more likely to be proximal correlates of Internet gaming disorder and may be considered the focus of interventions. We encourage further empirical and experimental studies to examine the causal pathway and the treatment efficacy.

Early detection of bipolar disorders and treatment recommendations for help-seeking adolescents and young adults: Findings of the Early Detection and Intervention Center Dresden

BackgroundEarly identification and intervention of individuals with risk factors for or subtle prodromal symptoms of bipolar disorders (BD) may improve the illness course and prevent adverse long-term consequences.MethodsWe examined sociodemographic, clinical and psychopathological characteristics of help-seeking adolescents and young adults who consulted the Early Detection and Intervention Center Dresden at the University of Dresden (Germany) and presented with or without pre-defined at-risk criteria for BD. The standardized diagnostic procedure for all help-seeking youth included a comprehensive psychiatric history and a structured clinical interview. When BD at-risk state was suspected, early detection instruments (EPIbipolar, BPSS-FP) were applied. Treatment recommendations were formulated in multi-professional case conferences.ResultsOut of 890 help-seeking persons between 05/2009 and 04/2018, 582 (65%) completed the diagnostic process. Of these, 24 (4%) had manifest BD and 125 (21%) fulfilled at-risk BD criteria (age = 23.9 ± 0.6 years, female = 62%). Of the pre-defined main risk factors, family history for BD was reported in 22% of the at-risk persons, (hypo-)mania risk state in 44%, and increasing cyclothymic mood swings with increased activity in 48%. The most common secondary risk factors were decreased psychosocial functioning (78%), lifetime diagnosis of depressive disorder (67%) and specific sleep/circadian rhythm disturbances (59%). Substance use was very common in subjects at-risk for BD (cannabis = 50%, alcohol = 33%) and highest in patients with BD (cannabis = 75%, alcohol = 40%). Psychiatric treatment history, including psychopharmacological therapy, was similar between the groups, while treatment recommendations differed, with more advice for psychotherapy and antidepressants in the at-risk group with a lifetime diagnosis of depression and more advice for specialized BD treatment including mood stabilizers in patients with BD.ConclusionThis analysis on the phenomenology of different BD at-risk stages suggests that early detection of individuals presenting with suggested risk factors for the development of BD is feasible in help-seeking young people. Future research should further develop/test stage-specific prevention and early targeted intervention approaches that were described in a naturalistic setting.

Psicoterapia e dipendenze. Dal trattamento supportivo alla cura fenomenologica

A subject which is often not given the importance it deserves concerns addiction psychotherapy. Starting from taking into account the complex and problematic characteristics of this peculiar psychopathology, there will be an effort to trace back the fundamental canon of the healing process to supportive treatment. Later on, expanding on the subject, we will take into account the possibility of a phenomenologically oriented treatment, and include it into the number of those psychotherapies which are better suited to respond to the typical aspects of these clinical conditions.

Maternal filicide and mental illness: A descriptive study of 17 women hospitalized in a French secure unit over a 24-year period.

Maternal filicide is defined as the murder of a child by its mother. Many classifications have been elaborated based on underlying motives such as altruism, mental pathology, fatal maltreatment, spousal revenge, or an unwanted child. Pathological filicide refers to cases in which the perpetrator has a major psychiatric illness. Related literature is sparse. The present work proposes to identify the main characteristics of mentally ill filicidal mothers. This study was based on data gathered through a retrospective chart review of all filicidal women admitted to the Henri Colin secure unit (France) between 1996 and 2019 (N=17). Most filicidal mothers had a dysfunctional childhood marked by emotional neglect, intrafamilial violence, or social isolation. They were often married, on average about 32years old. We found a history of attempted filicide in 3 cases, and abuse or neglect in 3 other cases. The victim's average age was 6.2years old, and in several cases, multiple siblings were murdered. Half of the filicidal mothers had a history of psychiatric disorders. Three different diagnoses were found in our study: bipolar or depressive disorders (41.2%); schizophrenia or other psychotic disorders (41.2%); personality disorders (17.6%). We identified two subgroups, as having different motivational profiles. In the first group, filicide is a defensive reaction to a perceived threat: The murder is committed under the influence of hallucinations or delusions. In the second group, filicide is linked to a context of separation, real or imagined. Several forensic and psychopathologic features associated with each profile are detailed.

Clinical phenomenology of anxiety disorders in patients with hypothyroidism

Recently, there has been a significant increase in thyroid pathology worldwide. In most studies of thyroid pathology, it is increasingly common to see an increase in thyroid hypofunction among individuals from different population groups. The aim of the study is to investigate the clinical and psychopathological features of the formation and course of anxiety disorders in patients with primary hypothyroidism. It was examined 74 patients of both sexes, aged 30–55 years with primary hypothyroidism (mild – 26.1% of patients, moderate – 45.2%, severe – 28.7%) who were diagnosed with anxiety disorder of organic nature (F06.4). The following examination methods were used in the study: clinical-neurological, clinical-psychopathological, anamnestic, psychodiagnostic. The most common complaints among the examined patients were constant feelings of anxiety, unmotivated anxiety, mood depression, various fears and intrusive memories, loss of interest in previous activities, general weakness, and rapid physical and intellectual fatigue. According to the study results, clinical picture of anxiety disorders in the examined patients is represented by anxious (38.2% of the examined), panic (36.7%) and anxious-depressive (25.1%) variants of psychopathological symptoms. The analysis of the severity of anxiety manifestations using the State-Trait Anxiety Inventory shows that in hypothyroidism there was an increase in the level of situational and personal anxiety. Analysis of neuropsychiatric stress level in the examined patients showed predominance of extensive (excessive) stress in moderate and severe hypothyroidism and intense (moderate) stress in patients with mild hypothyroidism. The data obtained during study allow to develop diagnostic criteria for anxiety disorders in patients with organic and symptomatic mental illnesses due to primary hypothyroidism. Keywords: thyroid gland, neurotic disorders, anxiety, worry.

INTERCONNECTION OF COGNITIVE DISORDERS AND CLINICAL AND PSYCHOPATOLOGICAL FEATURES IN PROLONGED DEPRESSIVE REACTION

Aim of research. The aim of the study was to determine the relationship between the clinical and psychopathological features of anxiety and depressive manifestations and the features of cognitive dysfunctions in patients with prolonged depressive reaction.
 Materials and methods. The study involved 98 patients with prolonged depressive reactions. The study used an integrated approach, which consisted in the use of clinical-psychopathological, psychometric, psychodiagnostic and statistical research methods.
 Results. According to the research results, a correlation analysis was carried out, which made it possible to determine the combination of clinical and psychopathological symptoms with the features of the cognitive functioning of patients with prolonged depressive reaction. Obsessive thoughts and hypochondriacal ideas have been shown to be associated with marked levels of anxiety; suicidal thoughts - with a protracted onset of depression and a minor depressive episode; mild violations of verbal productivity were associated with a major depressive episode and with a prolonged onset of depression, with 1-2 episodes of depression in anamnesis; a low level of attention switching was associated with an episode duration of up to 2 years, a protracted onset of depression, a major depressive episode, and an increased level of anxiety; average work efficiency correlated with a low level of anxiety, an episode duration of up to a year, 1-2 episodes of depression in anamnesis, a remission duration of more than 24 months; mobilization of mental processes was associated with a remission duration of more than 24 months and a reduced level of anxiety; high selectivity of attention to negative stimuli was combined with the duration of the episode up to 2 years and a pronounced level of anxiety; moderate disturbances in aggressive behavior patterns were associated with an episode duration of up to a year and a moderate level of anxiety.
 Conclusions. The relationship between clinical and psychopathological features of anxiety and depressive manifestations and features of cognitive dysfunction in patients with prolonged depressive reaction were identified. It should be considered in the differential diagnosis and in the development of psychocorrective measures to reduce cognitive impairment in patients with depressive disorders.

A COMPARATIVE STUDY OF PHENOMENOLOGY BETWEEN EARLY ONSET AND LATE ONSET PSYCHOSIS

Introduction: Phenomenology is the study of subjective experience. Psychiatric diagnoses are based on cross-sectional psychopathological features, for example, the presence of rst-rank symptoms in the case of schizophrenia. Phenomenological investigation focuses on the form of experience, i.e. the way in which the content is experienced, while the content itself is of secondary importance. This study was conducted to investigate the subtle differences between early-onset group (onset before 18 years of age) and late onset (onset after age of 40 years). Aim And Objectives: To study the socio-demographic prole and phenomenology of early onset psychosis and late onset psychosis compare them based on the variables studied. It is a cross sectional observational Materials And Methods: study carried out in the Department of Psychiatry, Gauhati Medical College and Hospital during the period of June 2018- May 2019. A semi structured, self designed proforma has been used to collect the socio-demographic data and personal details of the patients and their treatment history. The ICD-10 Classication of Mental and Behavioural Disorders, WHO, 1992, Brief Psychiatric Rating Scale (BPRS) Version 4.0, Modied Kuppuswamy Socio-economic status scale were used along with. All the data that was derived from the study were analyzed by using the software IBM SPSS 21.0. Observations And Results: Mean age of presentation in early onset psychosis is 19.22 years with Standard Deviation ±5.69. Mean age of presentation in early onset psychosis is 54.5 years with Standard Deviation ±11.9. Signicantly higher ratio of male was noted in early onset group and higher ratio of female was noted in that of the late onset group. Somatic concern, anxiety, depression and suspiciousness was signicantly more in late onset psychosis. In comparison to the group of late onset psychosis, self-neglect, blunted affect, emotional withdrawn, motor retardation, motor hyperactivity, mannerisms and posturing were signicantly more in early-onset psychosis. Major distinction was noted in the Conclusion: distribution of delusional disorders and acute and transient psychotic disorders. Age of onset was skewed to late adolescence with more number of male patients. Late onset psychosis group had more uneducated patients with considerable proportion of adults left unmarried in the late onset group. Late onset psychosis group shows predominance of somatic concern, anxiety, depression and suspiciousness in contrast to early onset psychosis group which shows predominance of motor hyperactivity, self-neglect, blunted affect, motor retardation, mannerisms and posturing

Emotional and behavioral problems in pediatric patients with migraine and tension-type headache

ObjectiveThis study aimed to investigate the associations between psychopathological characteristics of children and adolescents with primary headache, as measured by the Strengths and Difficulties Questionnaire (SDQ), and treatment outcomes. MethodsA cohort study was conducted on 124 pediatric patients with primary headache. At the first consultation, the SDQ was completed by the parents. The analysis of treatment efficacy was conducted on 90 patients with a follow-up period of at least one year. Treatment responders were defined as those who showed 50% reduction in the headache frequency. First, an analysis of the SDQ total scores and five subscales, among the migraine and tension-type headache groups, was conducted for 124 participants. Second, the association between the SDQ scores and treatment outcomes in the groups with periods of improvement of less than three months and three months or more were analyzed in 90 patients. ResultsMigraine patients displayed more difficulties than strengths in terms of the total score (p = .004) and in the emotional symptoms subscale (p = .012) compared with tension-type headache patients. Migraine patients who required more than three months to show improvement displayed more peer problems (p = .020), while tension-type headache patients who required more than three months to show improvement displayed fewer conduct problems (p = .007). ConclusionEvaluation of patient characteristics using the SDQ at first consultation can predict the treatment outcome. Moreover, it can help provide appropriate initial treatment and improve outcome of primary headache in children.

ADHD and Bipolar Disorder in Adulthood: Clinical and Treatment Implications.

Attention deficit hyperactivity disorder (ADHD) is a condition that usually has its onset in childhood. Although the disorder persists into adulthood in half of cases, adult ADHD is often not recognized due to different psychopathological characteristics, quite often overlapping with other diagnoses such as mood, anxiety and personality disorders. This is especially true for bipolar disorder (BD), which shares several symptoms with adult ADHD. Moreover, besides an overlapping clinical presentation, BD is often co-occurring in adults with ADHD, with comorbidity figures as high as 20%. This review will focus on the comorbidity between ADHD and BD by exploring the magnitude of the phenomenon and evaluating the clinical and functional characteristics associated with ADHD–BD comorbidity in adults. Finally, the review will address the implications of pharmacologically treating the ADHD–BD comorbidity, providing suggestions in how to treat these complex patients and addressing the issue of treatment-induced manic switch with the use of stimulants and other medications for ADHD.

Comorbidities, Depression Severity, and Circadian Rhythms Disturbances as Clinical Correlates of Duration of Untreated Illness in Affective Disorders.

Background and Objectives: Affective disorders, namely bipolar (BDs) and depressive disorders (DDs) are characterized by high prevalence and functional impairment. From a dimensional point of view, BDs and DDs can be considered as psychopathological entities lying on a continuum. A delay in treatment initiation might increase the burden associated with affective disorders. The aim of this study is to analyze the correlates of a long duration of untreated illness (DUI) in these conditions. Materials and Methods: Subjects with BDs and DDs, both in- and outpatients, were recruited. Long DUI was defined according to previous research criteria as >2 years for BDs or >1 year for DDs. Socio-demographic, clinical and psychopathological characteristics of the recruited subjects were collected. Bivariate analyses were performed to compare subjects with a long and short DUI (p < 0.05). Results: In our sample (n = 61), 34.4% of subjects presented a long DUI. A long DUI was significantly associated with longer overall illness duration (p = 0.022) and a higher rate of psychiatric (p = 0.048) and physical comorbidities (p = 0.023). As for psychopathological features, depressive symptoms were more severe in the long DUI subgroup, as demonstrated by a higher score at the Clinical Global Impression-severity of depression (p = 0.012) item and at the anxiety/depression factor of the Positive and Negative Syndrome Scale (p = 0.041). Furthermore, subjects with a long DUI displayed more severe disruption of circadian rhythms, as evaluated by the Biological Rhythms Interview for Assessment in Neuropsychiatry total (p = 0.044) and social domain (p = 0.005) scores and by the Hamilton Depression Rating Scale diurnal variation items (18a: p = 0.029, 18b: p = 0.047). Conclusions: A long DUI may underpin higher clinical severity, as well as worse illness course and unfavorable prognosis in affective disorders. Intervention strategies targeting comorbidities, depressive symptoms and circadian rhythms may decrease disease burden in subjects with a long DUI.

Depression and Related Factors in Patients with Parkinson's Disease at High Altitude.

PurposeDepression seems to aggravate progression of Parkinson’s disease (PD). Hypoxia stress may be one of the pathogenic factors leading to PD. We investigated the characteristics of PD and factors related to Parkinson’s disease depression (PDD) at high altitude (mean altitude ≥2300 m).Patients and MethodsTotally 221 PD patients of three different nationalities (Han, Hui, and Tibetan) were recruited in a high-altitude hospital. Depression was present in 55.6% of them. Patient data were examined, including demographic information, medical history, disease duration and family history. Psychopathological characteristics and motor signs were assessed by the Hamilton Depression scale (HAMD) and scales for motor and non-motor symptoms in the Unified Parkinson’s Disease Rating Scale (UPDRS). Progression of PD was evaluated by the modified Hoehn and Yahr (H-Y) staging system.ResultsMean age (47.1% men) was 68.25±13.67 years old, with disease duration of 4.18±5.13 years and median H-Y scores 2.07±0.97 points. Among three different nationalities, PD rate was 69.2% in Han nationals, 17.6% in Hui nationals and 13.1% in Tibetans of 221 PD patients. Compared with the non-depressed PD group, female, no-smoking and living alone rates, and dysphagia, pain, H-Y stage, ADL, UPDRS-I, UPDRS-III, HAMA, and PSQI scores were significantly increased in the PDD group, while MMSE scores were significantly decreased (P<0.05 or P<0.01). PD patients of Han and Hui nationalities had increased depression rates compared with Tibetan individuals (P<0.05). Compared with the mild depression group, the moderate and severe depression groups had significantly increased salivation, dysphagia, H-Y stage, UPDRS-I, UPDRS-III, HAMA, and PSQI scores (P<0.05 or P<0.01). Living alone rates and ADL scores were increased in the severe depression group (P<0.05). Logistic regression analysis showed that living alone (OR=19.833, 95% CI: 2.758–142.624, P<0.01), UPDRS-III score (OR=1.079, 95% CI: 1.009–1.153, P<0.05), and PSQI score (OR=1.538, 95% CI: 1.347–1.755, P<0.001) were risk factors for PDD. Male gender (OR=0.292, 95% CI: 0.112–0.763, P<0.05) was a protective factor in PDD.ConclusionPDD is associated with gender, ethnicity, loneliness, non-motor symptoms (NMSs), motor symptoms, and disease severity, and depression severity. Living alone, dyskinesia, and sleep disorder are risk factors for PDD at high altitude. A relative protection against depression was observed in the Tibetan population.

Predictors of long-acting injectable antipsychotic treatment discontinuation in outpatients with schizophrenia: relevance of the Drug Attitude Inventory-10.

Given the importance of patients' subjective experience and attitudes in the management of severe mental illness, the present study evaluated their potential role as predictors of future continuation of long-acting injectable antipsychotic maintenance treatment (LAI-AMT) in clinically stable outpatients with schizophrenia switching from an oral therapy. Retrospective data from 59 subjects receiving LAI-AMT for at least 6 months were collected. Patients who continued LAI treatment (n = 32) were compared to those who discontinued it (n = 27), assessing baseline socio-demographic and clinical characteristics, psychopathological features (Positive And Negative Syndrome Scale, Montgomery-Åsberg Depression Rating Scale and Young Mania Rating Scale) and patient-reported experience of treatment through Drug Attitude Inventory 10-item (DAI-10) and Subjective Well-being under Neuroleptics short form. Binary logistic and Cox regression analyses explored the predictive role of the mentioned variables on treatment discontinuation. The Kaplan-Meier estimator compared dropout from LAI treatment in subsamples with different characteristics. Unemployment and lower baseline DAI-10 scores predicted LAI-AMT discontinuation. No major differences were detected in other socio-demographic, clinical or psychometric indexes. When switching from oral to LAI-AMT, the preliminary assessment of attitude towards drug might be clinically relevant, allowing the identification of patients at risk for treatment discontinuation.

Prevalence of Circadian Rhythm Sleep-Wake Disorder in Outpatients with Schizophrenia and Its Association with Psychopathological Characteristics and Psychosocial Functioning.

The prevalence of circadian rhythm sleep-wake disorder (CRSWD) among patients with schizophrenia is not clear. The effect of comorbid CRSWD on such patients has also not been fully evaluated yet. Outpatients with schizophrenia in the maintenance phase who visited Tokyo Women’s Medical University Hospital between April 2018 and March 2019 participated in this study. The Brief Psychiatric Rating Scale (BPRS), the Clinical Global Impressions–Severity Illness Scale (CGI-S), Global Assessment of Functioning (GAF), World Health Organization Disability Assessment Schedule II, Insomnia Severity Index (ISI), and Morningness–Eveningness Questionnaire (MEQ) were administered, and the patient responses with and without CRSWD were compared. Of the 105 patients with schizophrenia, 19 (18.1%) had CRSWD. There were trends toward higher BPRS and lower GAF scores in the CRSWD group than in the non-CRSWD group, although these did not reach statistical significance following a false discovery rate correction. Among the BPRS subitems, the anxiety scores were significantly higher in the CRSWD group than in the non-CRSWD group (p < 0.01). CRSWD was highly prevalent among patients with schizophrenia in the maintenance phase. Comorbidities of CRSWD may affect psychopathological characteristics and psychosocial functioning.

Religious delusions in adolescence and young adults: Features of psychopathology and clinic

IntroductionReligious delusions is a complex psychopathological phenomenon. The delusional disorders with religious content in young age, the need for an additional detailed study of the conditions of their formation, patterns of the course and outcome of the disease determine the relevance of this study.ObjectivesTo identify the psychopathological features, the conditions of formation, the characteristics of the course of psychosis with religious delusions in young age.Methods95 patients (62 male and 33 female) with religious delusions (delusion of sin - 33,7%, delusion of demonic possession (40,0%), messianic and antagonistic delusion - 18,9%, oneiroid with religious content – 7,4 %) in psychotic episode (F20, F25 according to the ICD-10) at a young age (16-25 years) were included in the study and examined with clinical-psychopathological, clinical-follow-up and psychometric (PSP, SANS) methods. The average duration of follow-up was 7.4 ± 2.3 years.ResultsIn a post-psychotic period it is possible to preserve or form religiosity, as well as a complete reduction of the religious worldview in patients who had been indifferent to religious issues before the first episode of the disease. Though, the formation of residual psychotic symptoms with religious content were noted with greater frequency. The delusions of demon obsession in a psychosis episode is unfavorable prognostic factor.ConclusionsGeneral psychopathological features of psychotic states with religious delusions, according to the specificity of young age, were identified. A role of the previous religiosity, including overvalued religious ideas, was clarified.DisclosureNo significant relationships.

Clinical, psychopathological, and biological predictors of resumption of menses in subjects with anorexia nervosa: A 4-year follow-up study

IntroductionAmenorrhea is one of the most frequent and serious consequences of Anorexia Nervosa (AN). Resumption of menses (ROM) is considered an important goal and is associated with a better outcome.ObjectivesTo investigate the role of age, Body Mass Index (BMI), diagnostic subtype (restrictive vs binge-purging), history of childhood abuse, duration of illness, psychopathology and sex hormones on ROM in AN.Methods52 patients with AN and amenorrhea were enrolled at the start of treatment. Clinical parameters of interest were collected, and questionnaires were administered for the assessment of general (SCL-90-R) and specific (EDE-Q) psychopathology. Blood samples were taken to assess FSH, LH and estradiol levels. All patients were monitored regularly through psychiatric checkups until ROM, for up to four years.ResultsA total of 30 (57.7%) subjects recovered their menstrual cycle in the follow-up period (mean time: 18.7 ± 14.8 months). Recovery was more frequent in the binge-purging subtype than in the restrictive subtype (82.4% vs 48.6%, p=0.019), and was significantly associated with diagnostic crossover (odds ratio=10.0, p=0.032). Multivariate Cox regression showed an increased likelihood of menstrual recovery for binge-purging subtype (p=0.005) and for those reporting a history of childhood abuse (p=0.025). Early ROM was also associated with baseline SCL-90-R scores (p=0.002) and FSH (p=0.011), while a longer duration of illness (p=0.003) and EDE-Q scores (p=0.009) predicted a later recovery.ConclusionsThis study highlights the role of duration of illness, childhood abuse history and psychopathological characteristics in subjects with AN at the start of treatment in predicting ROM.DisclosureNo significant relationships.

Melancholia. Historical evolution through a case report

IntroductionThe diagnosis of psychotic depression has its origin in the millennial term of Melancholia.ObjectivesA case of psychotic depression is presented to highlight its psychopathological characteristics and to make a historical overview of its origins.MethodsWe present the case of a 40-year-old male patient with a history of dysthymic mood who developed a major depressive mood, loss of self-care, decreased apetite, insomnia and repetitive speech with ideas of guilt and ruin of psychotic characteristics.ResultsMelancholy is a term used since the time of Hippocrates, who spoke of it as the state that appears after the prolongation of an intense period of sadness. It was extolled and self-attributed by authors such as Montaigne and branded as selfish by authors such as Cicero in the days when reason and madness formed a whole and distinguishing their limits was a complex task. Esquirol changed his name to Lypemania to get rid of its poetic nuances and framed it within partial insanity. Both he and the rest of the psychopathologists of the XIX century and early XX considered the melancholic as the great tormented, the one who despises himself and blames all ills, who suffers from apathy and above all presents a strong pain of the soul.ConclusionsLater it was Falret and Baillarger who unified melancholy with mania in what they nominate as circular and dual-form insanity. This gave way to the Krapelinian entity of manic-depressive insanity, the direct predecessor of the current Bipolar Disorder, which includes the diagnosis of our clinical case.DisclosureNo significant relationships.

Changes in moral decision-making during the COVID-19 pandemic

IntroductionStress can influence moral decisions.ObjectivesThe aim of the study was to evaluate whether the stress experienced by people during the COVID-19 pandemic can change moral decision making.Methods311 respondents took part in the Internet survey 30.03.20-31.05.20, including SCL-90-R, and a subset of moral dilemmas proposed by Greene J.D (30 dilemmas in Russian), with «footbridge dilemma» among them as a personal dilemma and «trolley dilemma» as impersonal. The relationship of utilitarian personal dilemmas choices with psychopathological characteristics was analyzed. Personal moral dilemma choices were considered separately, in subgroups with a high level of somatization (N=107) and a high level of psychopathological symptoms (N=76).ResultsThe results showed an increase in personal dilemmas choices: 2.84 mean utilitarian choice in March - April and 3.17 in May (Univariate Analysis of Variance, age, gender as Covariates, p&lt;0.01). At the beginning of the study the groups did not differ in the number of utilitarian personal choices, and at the end of the study the number of personal choices increased in the subgroup with a high level of psychopathology (4.7 utilitarian choices in May) and became statistically higher than in other groups (ANOVA with Bonferonni correction). In the subgroup with a high level of somatization, personal choices slightly decreased by the end of the survey (2.68 choices).ConclusionsThe level of stress during the COVID-19 ambiguously affects moral decisions: a higher level of psychopathological symptoms leads to an increase in utilitarian choices and a high level of somatization leads to a decrease in utilitarian choices.DisclosureNo significant relationships.

The end-world delusion with religious content, apocalyptic variant

IntroductionDiagnostics of Apocalyptic variant of end-world Delusion with Religious Content (ADRC) in schizophrenia is related with insufficient exploration and recognizability, despite the severity of the state, social risks and resistance to psychopharmacotherapy.ObjectivesTo define psychopathological and phenomenological features of ADRC in schizophrenia, to identify the clinical dynamics of delusional disorders due to specifics of the delusional behavior, and to develop diagnostic and prognostic criteria.Methods28 patients with ADRC in schizophrenia were examined (ICD-10: F20.0, F20.01, F20.02). Clinical-psychopathological and statistical methods were applied.Results Delusional ideas of end-world, Apocalyptic variant, occurred in the structure of affective-delusional state (acute sensual delusion with fantastic content). Two types of ADRC were identified: with the predominance of acute sensory delusions of perception and with the predominance of visual-figurative delusions of the imagination. These types differed in the severity and depth of psychotic manifestations and in the specifics of a delusion formation, were characterized by the mono- or polythematic delusional disorders.ConclusionsCases of ADRC differ both in the clinical-psychopathological specifics of delusional constructions, and in the socio-behavioral aspect. Among these cases, there is a high risk of delusional destructive behavior, with auto-aggressive, suicidal attempts and hetero-aggressive behavior. In cases with ADRC the strong persistence of delusional pseudo-religious beliefs occurs, with the refusal of any medical and psychological assistance, as well as implication of socially dangerous acts associated with the spread of delusional ideas and their induction of religiously inclined persons, which leads to the emergence of pathological pseudoreligiosity (distortion of traditional canonical religious views).DisclosureNo significant relationships.