The prevalence of medical illnesses is high among patients with psychiatric disorders. The current study aimed to investigate multi-comorbidity in patients with psychiatric disorders in comparison to the general population. Secondary aims were to investigate factors associated with metabolic syndrome and treatment appropriateness of mental disorders.

The sample included 54,826 subjects (64.73% females; 34.15% males; 1.11% nonbinary gender) from 40 countries (COMET-G study). The analysis was based on the registration of previous history that could serve as a fair approximation for the lifetime prevalence of various medical conditions.

About 24.5% reported a history of somatic and 26.14% of mental disorders. Mental disorders were by far the most prevalent group of medical conditions. Comorbidity of any somatic with any mental disorder was reported by 8.21%. One-third to almost two-thirds of somatic patients were also suffering from a mental disorder depending on the severity and multicomorbidity. Bipolar and psychotic patients and to a lesser extent depressives, manifested an earlier (15–20 years) manifestation of somatic multicomorbidity, severe disability, and probably earlier death. The overwhelming majority of patients with mental disorders were not receiving treatment or were being treated in a way that was not recommended. Antipsychotics and antidepressants were not related to the development of metabolic syndrome.

The finding that one-third to almost two-thirds of somatic patients also suffered from a mental disorder strongly suggests that psychiatry is the field with the most trans-specialty and interdisciplinary value and application points to the importance of teaching psychiatry and mental health in medical schools and also to the need for more technocratically oriented training of psychiatric residents.

Prevention of Post-traumatic stress disorder (PTSD) is a major public health interestand one of the concerns of any emergency physician.

The purpose of this study was to evaluate the efficacy and safety of a herbal supplement in preventing the occurrence of PTSD in high-risk patients.

: It is a randomized, double-blind, prospective, interventional study including patients exposed to a traumatic event meeting DSM-V Criterion A and having a Peri-traumatic Distress Inventory score and/or Peri-traumatic Dissociative Experience Questionnaire (PDEQ) and/or immediate stress score (L.Crocq score) higher than the thresholds between day 1 and day 3. A total of two hundred patients were included and they were randomly assigned into two groups: Aleozen group and placebo group. Patients included in the aleozen group received Aleozen® for 10 days while patients in the placebo group received a Placebo. A CAPS-5 assessment was performed for all patients at different moments. The main objective was to assess the efficacy of Aleozen® after day 90 of exposure to traumatic events according to PTSD. The secondary objectives were to evaluate the safety of Aleozen® at 10 and 30 days after its administration and to assess PTSD in the involved population after one year.

No statistical differences were noted between the two groups in terms of baseline characteristics, including age, sex, and ISS score. After day 90 of follow-up, and according to the CAPS-5 scale, 85 patients (42.5%) had PTSD. Concerning the primary endpoint, less PTSD was observed in the intervention group compared to the placebo group (38.8% versus 61.2%, respectively; p<0.001). No adverse events were noted during the study

The results of this study suggest the potential preventive effects of an herbal supplement on PTSD for traumatic patients in the emergency department. Further confirmatory studies are required

None Declared

The current SARS cov 2 virus disease pandemic presents a threatening physical danger as well as its impact on mental health. It seems important to screen any patient who has experienced covid 19 for its psychological impact.

Therefore the aim of our study was to highlight the impact of COVID-19 infection on mental health by screening them for depression

This is a cross-sectional, single-center study, conducted at the Sahloul Emergency Department, over a period of 5 months (January to May 2021). Patients are collected from a database of ouremergencydepartment COVID-19 unit.We included patients whose age is greater than or equal to 18 years old; who has been infected with SARS-COV-2 according to the results of the PCR test. All patients lost to follow-up, refusing to participate in this study, having a psychiatric illness or having taken a psychotropic medication before randomization or non-cooperating (unable to respond to the evaluation test) were excluded.A telephone follow-up was done after 30 days from admission to calculate the HAMILTON score after a positif HAD D scale.

200 patients were included. For the 20 patients (10%) with depressive symptomatology (doubtful and certain) according to the HAD D scale, their responses to the Hamilton scale were analysed in order to determine the severity of the depressive symptomatology. Note that 30% of patients had mild to moderate signs of depression and 70% had severe depression.The majority of patients in whom the presence of depressive symptoms was noted had an average age of 40 years; those who presented with severe depression had an average age of 51.3 years with a female majority of 72%. No difference was noted in relation to pathological history, half had been hospitalized for treatment of COVID-19(57%). Patients with severe depression symptom resolution lasted an average of 14 days.

According to the results of this study, interventions may be carried out to minimize the pandemic’s negative psychological consequences.

None Declared

The actual pandemic of COVID 19 is a very unusual yet real situation we are facing. It has affected people in both physical and psychological way. In fact,in such particular circumstances, so many people experience stress, anxiety and depression.Objective

The goal of our study is to emphasize theanxiety among patients who were tested positive with COVID 19 , using the HAD scale.

It is a retrospective study single-centerstudyPatients are collected from a database of the Sahloul emergency COVID unit. We include patients whose age is greater than or equal to 18 years old who has been infected with SARS-COV-2 according to the results of the PCR test. All patients lost to follow-up, refusing to participate in this study, having a psychiatric illness or having taken a psychotropic medication before randomization or non-cooperating (unable to respond to the evaluation test) were excluded. At 30 days follow up, anxiety was evaluated by HAD scale.

200 patients were included in this study.In our study, 98 patients had symptoms of anxiety (49%) after one month of their consultation in the emergency room; i.e. 39% have a doubtful symptomatology of anxiety and 10% have a certain symptomatology. Half (51%) of the patients had no signs of anxiety depression. The average age of the patients in whom the presence of definite anxiety symptoms was noted was 56.2 years; 63.7% of these patients were female. No difference was noted in relation to the pathological history. Patients in whom the symptoms of anxiety were certain presented a persistence of clinical signs for 10.7 days in average as opposed to 7.1 days in patients without anxious symptoms (p<0.001).

Anxiety is so common among COVID 19 patients and it has a huge influence on the evolution of their health state . This is why all health workers have to fight against COVID and its effects on both physical and mental health . Highlighting the fact that a psychological assistance is highly recommended in the management ofCOVID19 patients in order to improve their prognosis

None Declared

Alteration of GABergic neurotransmission is accused to be sharing in the cognitive impairment in schizophrenia. Exploring the relation between the neuronal expression of GABergic genes and cognitive impairment in living patients through modeling of schizophrenia is an important step to know more about the core of the pathophysiology of this disorder

Altered genetic expression of GAD 67 may have an important role in the pathophysiology of cognitive impairment in schizophrenia

. Reprogramming of human fibroblasts into human induced pluripotent stem cells (hIPSc) then neuronal differentiation was performed in 20 patients presenting with schizophrenia and 20 matched controls. Real time Polymerase chain reaction was done for measurement of genetic expression of GAD 65, GAD 67 and GABA beta 2. The Digit Symbol task, block design, block design task and similarities tasks from the Wechsler Adult Intelligence Scale., Trail A and Trail B making tests in addition to Rey-Osterrieth Complex Figure Test (ROCF) were applied to measure cognitive functions .

There were lower means of GAD65, GAD67 and GABA beta2genetic expression in the patients group with significant statistical difference between the 2 groups. The down regulation of GAD 67 in patients presenting with schizophrenia is positively correlated with impairment in executive functions.

GAD 67 gene expression had the most significant correlations with the cognitive assessment in both patients and controls. The presence of those statistically significant correlations in both groups points to the possible role of GAD 67 gene functioning in the pathophysiology of cognitive impairment in schizophrenia

No significant relationships.

ASPD has a prevalence of 2-3% in the general population but rates in prison have been reported as 50% to 75%. ASPD is associated with significant psychiatric and medical comorbidity, high offending rates, poor psychosocial adaptation and premature death. Outcomes are poor. There is little consensus regarding the most effective intervention for the condition.

To conduct systematic literature reviews to identify randomised controlled trials for either pharmacological or psychological interventions for ASPD.

Systematic literature reviews (Cochrane reviews).

For the review on psychological interventions only 11 studies could be included with a total of 411 participants, but only five reported data separately for the subgroup of ASPD. Nine of the studies looked at participants with substance misuse problems who also suffered from ASPD. Only three types of interventions were effective (contingency management, CBT and a specific programme for those convicted for driving whilst intoxicated). These interventions showed positive results for substance misuse related outcomes but not for any others behaviours or symptoms. For the pharmacological review 10 studies were identified, anticonvulsants were the most commonly used drugs with some evidence of effectiveness on aggression, however, study quality was poor.

Despite the considerable personal and societal consequences of ASPD, very little research is carried out with regards to interventions in this patient group and subsequently the evidence base to support any interventions is extremely limited.

Among the 10 categories of personality disorders (PDs), interventions for antisocial and borderline personality disorder are best studied. However, the remaining PDs also pose major problems in everyday health care settings. People affected often additionally present with Axis-I disorders such as substance-related, mood or anxiety disorders, and are among those most difficult to treat. Cluster A PDs (paranoid, schizoid, schizotypal) are of particular significance as some authors argue that they may be part of a continuum of mental disorders and be considered as sub-syndrome of schizophrenia

In the context of Cochrane Collaboration reviews for Cluster A, B and C PDs, exhaustive literature searches were completed to identify the current RCT evidence for PD treatments. Retrievals were assessed and evaluated by two reviewers independently and trials for Cluster A PD were identified.

Only very few (under five) RCTs specifically for Cluster A PDs were identified. Some studies reported on mixed PD samples but it was not always possible to extract data specifically for Cluster A disorders. Participants mostly also suffered from Axis-I disorders. Reported outcomes also focus on Axis-I disorder outcomes or general measures such as overall functioning rather than specific PD symptoms.

The current evidence for psychpathological treatment of Cluster A PD is sparse and does not allow for distinct treatment recommendations. Symptom-driven treatment regimes as suggested by several guidelines are not supported by current evidence.