Individuals with major depressive disorder (MDD) can experience reduced motivation and cognitive function, leading to challenges with goal-directed behavior. When selecting goals, people maximize ‘expected value’ by selecting actions that maximize potential reward while minimizing associated costs, including effort ‘costs’ and the opportunity cost of time. In MDD, differential weighing of costs and benefits are theorized mechanisms underlying changes in goal-directed cognition and may contribute to symptom heterogeneity.

We used the Effort Foraging Task to quantify cognitive and physical effort costs, and patch leaving thresholds in low effort conditions (reflecting perceived opportunity cost of time) and investigated their shared versus distinct relationships to clinical features in participants with MDD (N = 52, 43 in-episode) and comparisons (N = 27).

Contrary to our predictions, none of the decision-making measures differed with MDD diagnosis. However, each of the measures was related to symptom severity, over and above effects of ability (i.e. performance). Greater anxiety symptoms were selectively associated with lower cognitive effort cost (i.e. greater willingness to exert effort). Anhedonia and behavioral apathy were associated with increased physical effort costs. Finally, greater overall depression was related to decreased patch leaving thresholds.

Markers of effort-based decision-making may inform understanding of MDD heterogeneity. Increased willingness to exert cognitive effort may contribute to anxiety symptoms such as worry. Decreased leaving threshold associations with symptom severity are consistent with reward rate-based accounts of reduced vigor in MDD. Future research should address subtypes of depression with or without anxiety, which may relate differentially to cognitive effort decisions.

Stigma describes prejudicial attitudes, negative stereotypes, and discrimination targeting a subgroup. Various forms of stigma have been identified in the literature, including self-stigma. Self-stigma or internalized stigma occurs when stigmatized individuals become aware of the negative stereotypes and apply these to themselves. Self-stigma may be a barrier to career development and employment in individuals with Autism Spectrum Disorder (ASD). However, there are few data available on the presence of self-stigma among young adults with ASD in Chile to inform local interventions and policies.

To analyze self-stigma and its relation with career development and employment in young adults with ASD in Chile.

A mixed-method observational study was conducted to analyze self-stigma and its association with career development and employment among young adults with ASD in two regions of Chile. For the quantitative analysis, self-stigma was assessed using the Internalized Stigma of Mental Illness (ISMI) scale, and employment information was collected. For the qualitative analysis, in-depth interviews were conducted. Data from the interviews were digitalized and transcribed, and the analysis was conducted using ATLAs.ti following the principles of Glaser and Strauss’s Grounded Theory. All participants provided written informed consent, and the study was approved by the local Institutional Review Board.

Overall, 356 participants were included in the quantitative analysis (mean age: 27.8 [SD 6.2] years, 44.7% women, 14.8% with regular employment). The mean ISMI for the total sample was 2.34 (SD = 0.62). By triangulating this information with the qualitative analysis (n=27), it was observed that young adults with ASD frequently experience self-stigma attitudes. Through the in-depth interviews, we identified barriers and facilitators for the development of self-stigma. Also, we identified that negative self-perceptions among young adults with ASD may be a barrier to seeking career development opportunities and employment in this population.

The current study shows self-stigma is present in young adults with ASD in Chile, and this may impact negatively their career development and employment.

None Declared

Manic episodes have a multifactorial etiology, with frequent association with genetic factors, comorbidities such as systemic diseases or secondary to infectious diseases, and environmental exposure factors. The prevalence of bipolar disorder is markedly higher in patients with autoimmune disease. The risk of developing bipolar disorder in some studies has been seen to be higher among patients with rheumatoid arthritis, therefore chronic inflammation would be a potential mechanism and could be a modifiable risk factor for bipolar disorder. Growing evidence indicates that Sars-CoV-2 may also trigger the acute onset of mood disorders or psychotic symptoms.

We present the case of a patient who presents symptoms compatible with an acute manic episode after an outbreak of rheumatoid arthritis and comorbid COVID infection.

52-year-old patient. She went to the hospital emergency room presenting affective symptoms compatible with a manic episode and psychomotor agitation. Personal medical history: rheumatoid arthritis, antiphospholipid syndrome. Psychiatric personal history: Depressive disorder under follow-up by a private psychiatrist under treatment with antidepressants. During the interview, the patient presented accelerated speech, with great emotional incontinence. Saltigrade thought and tachypsychia. She verbalizes delusional ideas of megalomaniacal and mystical and religious characteristics. She verbalizes that she is the reincarnation of the holy spirit, that God has taken her body and speaks through her. In the emergency room, a Sars-CoV-2 infection that the patient was unaware of was diagnosed. She is admitted to the hospital in the mental health unit, in the first interviews the patient maintains speech with delusional ideas “I notice the stigmata of Christ on my body”.

The patient recovers after treatment for the COVID infection, remaining asymptomatic. It was decided to start lithium to stabilize mood and the patient presented good tolerance and treatment with antipsychotics. The patient presented a favorable response, remitting the psychotic symptoms of which she was critical and stabilizing the affective symptoms. The patient is diagnosed with Severe Manic Episode with Psychotic Symptoms, as the main diagnosis and we could conclude the diagnosis of Bipolar Disorder since she has presented 2 depressive episodes in the past that have required treatment and follow-up by psychiatry.

Manic episodes have a multifactorial etiology and require an individualized approach, and comorbid medical conditions must always be assessed in order to establish a therapeutic plan with patients.

None Declared

Previous functional neuroimaging studies have demonstrated a brain network responsible of time discrimination (TD) processes, which may play a significant mediating role in other cognitive processes, such as change detection and cognitive control. The study of TD and its dysfunction in psychosis has become a matter of growing interest. We hypothesize that the impairment of the TD network is involved both in the mechanisms of psychosis and in the cognitive deficit presented by patients.

1. 1. To delimit the brain regions involved in TD.

2. 2. To examine the dysfunction in TD brain network in patients diagnosed with psychosis.

3. 3. To sudy the integrity of brain white matter pathways in psychosis.

4. 4. To verify whether the neuroimaging findings and TD test performance predict the neurocognitive profile of the patients.

Participants included 20 patients with psychosis (PSY group) and 13 healthy controls (HC group). PSY group participants met remission criteria for 6 months prior to the study. Participants were interviewed for sociodemographic information and clinical assessments. They underwent a detailed cognitive assesment using the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB). Neuroimaging study was performed on a 3 Tesla MRI scanner. We designed an experimental task including a test tool to assess TD and Oddbal detection (OD) paradigms with a cognitive control component. The task was conducted under functional magentic resonance imaging (fMRI). We used the general linear model analysis of the individual data of the fMRI images and the random effects model for group inference. Group differences in DTI were tested using tract-based spatial statistics (TBSS).

We find statistically significant differences (fMRI) in the activity related to TD (in HC), with greater activity in frontal cortical regions, the insular cortex and the cerebellum. In the PSY group, differences in the functionality and activation pattern of brain networks responsible for TD are observed, although voxel clustering does not reach the cluster significance limit when compared to HC. Compared to the HC, the PSY group has a significant deficit of fractional anisotropy (DTI) in the whole brain and in 21 specific brain regions. The PSY group has significantly lower scores in six of the seven cognitive domains than the control group, as well as in the overall composite. We correlated FA values in the groups of interest with MCCB scores.

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We have defined the TD network, its relationship with other brain networks and cognitive processes of more complexity. The inclusion of participants with stable psychosis allowed us to analyze de TD disfunction in the PSY group. We compared the integrity of TD related brain pathways and correlated the findings with various clinical characteristics and the cognitive impairment present in psychotic patients.

None Declared

Burnout syndrome or professional exhaustion is defined as feeling burned out, exhausted, overloaded, exhausted. It is a syndrome characterized by emotional exhaustion, depersonalization and low personal fulfillment. This clinical syndrome was first described in 1974 by Herbert Freudenberger, a psychiatrist, who defined burnout as “the depletion of energy experienced by professionals when they feel overwhelmed by the problems of others.” Mental Health is one of the specialties with the greatest emotional exposure due to all the circumstances that surround these professions, to maintain health in its 3 axes: physical, mental and social well-being as defined by the WHO

The objective of the study is to determine the presence of Burnout Syndrome in Mental Health professionals through the Maslach Burnout Inventory (MBI) questionnaire.

An observational, descriptive and cross-sectional study is carried out. The people included in the study were the health personnel of the Mental Health Clinical Management Unit (psychiatrists, administrative personnel, nursing assistants, nursing personnel, social workers and psychologists, and training personnel) who wanted to participate in the study. Carrying out the MBI questionnaire and sociodemographic data.

In our study we have a sample of 59 people. Regarding the sociodemographic data, we have 45 women and 14 men. Regarding the results after correcting the MBI questionnaire, we found that 4 professionals presented Burnout Syndrome (a psychiatrist and a 4th year psychiatry resident intern of psychiatry), 35 professionals presented tendency to suffer from Burnout since one of the three areas measured by the questionnaire was affected and 15 did not suffer from Burnout. Regarding the domains, we obtain that emotional exhaustion is the area, together with low personal achievement, that is most affected in the professionals of the community mental health unit, 23 and 22 professionals, respectively. Depersonalization is present at 12. Professionals with temporary contracts presented greater emotional exhaustion and low personal accomplishment. Professionals with permanent contracts show greater emotional exhaustion. Among the professionals in training, low personal achievement and depersonalization stand out. The 4 professionals who present burnout syndrome are married women and 3 of them with temporary contracts.

The results obtained show the presence of Burnout Syndrome and a high tendency to develop it among the professionals of the Mental Health Unit. In relation to the data, we must reassess the care systems for professionals and prevent the causes that can lead professionals who are starting their professional career to develop burnout in normal situations that can lead to collapse in extraordinary circumstances such as the COVID-19 pandemic.

None Declared

Previous studies suggest that adults with mental disorders (MD) or Autism Spectrum Disorder (ASD) are more likely to be unemployed than those without MD. However, it is unclear whether working adults with MD or ASD perceive the same effort-reward balance as their counterparts without MD or ASD.

To analyze labor conditions and to identify factors associated with effort-reward imbalance among young adults with ASD, MD and those from the general population (GP).

A qualitative and quantitative study design is being conducted to analyze the rates of employment among young adults with ASD, and to identify factors associated with employment rates (Fondecyt ID11201028.). As part of this study, we conducted a quantitative analysis in young adults 16 to 30 years of age in two regions of Chile between August and October, 2022. Young adults with MD and ASD were compared with adults of similar age recruited from the GP. We applied a questionnaire to collect data on participant’s sociodemographic information, autonomy level and employment status. We applied the short Spanish version of the effort–reward imbalance (ERI) and overcommitment (OC) questionnaire, which has been widely used in Latin American countries.

Chi-square test was used and the Kruskal Wallis H Test was applied to compare among groups. The statistical significance was set at P<0.05.

Overall, 422 participants were included in the analysis (mean age 22±3.2, 64.2% women, 65.2% students, and 4.4% unemployed). Of the total respondents, 22% of young adults from GP, 17.8% with MD, and 4.8% with ASD were working at the moment of the survey. Regarding autonomy level, a higher proportion of participants with ASD needed support (36.4%), compared with 9.7% and 0.8% of young adults with MD and GP, respectively. Of the population who reported working (n=125), about 56.0% have a permanent job, and 44% a seasonal or occasional job. The median value for the effort–reward ratio was 0.96 (range 0.4–1.8), with no significant differences between the groups. Of those participants working, 44.3% showed an ERI ratio higher than 1, which was higher in participants with ASD (60%). ERI-esteem was significantly different (P=0.01) among ASD (7.0; range 5-8), MD (6.0; range 2-8) and PG (6.0; range 2-8). In the OC questionnaire, young adults with ASD were more likely to think about work (P=0.01) and having trouble sleeping at night due to work issues (P=0.03) than GP and MD groups.

The ASD group showed higher overcommitment and a considerable proportion of subjects at risk of effort-reward imbalance at work, were more likely to think about work at home, and had trouble sleeping thinking about work. Our preliminary results highlight the importance of considering the working conditions of young adults diagnosed with ASD and the need to provide them with enough support to promote labor inclusion.

None Declared

Stigma is a complex process and a universal phenomenon that is part of all social groups and that is maintained by its functions related to the establishment of one’s own identity and the facilitation of socialization processes. The stigma of the patient is important to evaluate since it is a subjective experience that can have negative correlations in relation to self-esteem, empowerment and recovery orientation of the patient with mental illness. Hospitalization in mental health takes place at times of mental illness decompensation and is an intervention closely related to the stigma towards mental illness.

The objective of the study is to evaluate the stigma perceived by patients with mental illness hospitalized in an acute mental health unit.

Observational study with 53 patients hospitalized in an acute mental health unit.

Variables collected: Sociodemographic variables (age, sex), clinical diagnosis and stigma is evaluated with the Illness Self-stigma Scale (ISMI).

Sample of 53 patients, 55% women and 44% men, the most frequent diagnoses among those admitted are psychosis spectrum 26.42%, depressive disorders 24.53%, personality disorders 22.64% and bipolar disorders 11.33%. The average age is 41.96 years, between 18 and 72 years. The self-stigma according to the scale (ISMI) we obtain as a total score the patient with the highest stigma scores 100 points and the one with the least scores 44 points. Regarding diagnoses, depressive disorders score 33-72 points, while psychotic disorders score 36-85 points. The highest scores in self-stigma in our study are in personality disorders 49-100 and borderline personality disorder stands out (100 points). In the 5 subscales such as alienation, self-stigma, perceived discrimination, social isolation and resistance to stigma. Higher scores in alienation stand out in all patients.

Patients with personality disorders, especially borderline personality disorder, followed by psychotic disorders, present greater perceived self-stigma in our study than the rest of the patients; it is a very important factor that can affect the evolution of the clinical picture. This factor is important to establish the therapeutic plan and the different interventions, it would be recommended to assess the stigma together with the measures to reduce symptoms.

None Declared

To present a clinical case that reflects the causal relationship between the administration of high-dose corticosteroids and the appearance of maniform-type psychopathology.

Descriptive study of a case report and literature review on the subject.

32-year-old woman with alcohol abuse detected, added Antabus 250 mg / day to her treatment.

After 2 months of treatment, she was admitted to the Digestive Service due to acute hepatitis. After a liver biopsy and autoimmunity study was diagnosed as Autoimmune Hepatitis. Treatment with Antabus was withdrawn, and Prednisone 60 mg/day was prescribed. Seven days after starting treatment with corticosteroids, she presented maniform symptoms (psychomotor restlessness, expansive mood, dysphoria, megalomanic delusions, alteration of biological rhythms with decreased need for sleep and risk behaviors), and she was admitted in a psychiatric hospitalization unit. After considering various differential diagnoses she is diagnosed with Substance-Induced (corticosteroids) Mood Disorder with manic features. Psychiatry agrees with the Digestive Service to start treatment with Paliperidone and progressively lower the dose of corticosteroids until suspending it and prescribe an immunosuppressant. Finally, the maniform symptoms that led to admission remitted completely and control and outpatient treatment were continued.

Its important to always keep in mind the great risk of the appearance of psychiatric disorders that treatment with high doses of corticosteroids entails, especially in susceptible patients or with a psychiatric history or genetic susceptibility. It is necessary to know the possible appearance of these neuropsychiatric adverse effects in order to prevent them, and if it appear, to assess, if possible, the suspension or reduction of corticosteroid treatment.

None Declared

The Persistent Depression and Self-Management Study is a mixed-methods pragmatic randomized controlled trial that evaluated the “Patient and Partner Education Program for All Chronic Illnesses” (PPEP4All) in patients with persistent depressive disorder (PDD) compared to care as usual (CAU). PPEP4All is a brief, structured self-management program that focuses on functional recovery and involves the partner/caregiver in the program. The latter may improve patient outcomes and reduce caregiver psychosocial burden related to PDD.

In addition to evaluating the cost- and clinical-effectiveness of PPEP4All, we conducted a nested qualitative study to deepen our understanding of how patients with PDD and their caregivers cope with chronic depression. Additionally we identify areas in which they require care and learn how they could benefit from a self-management program like PPEP4All.

In the nested qualitative study, 28 patients (16 from PPEP4All, 12 from CAU) and 9 partners/caregivers agreed to participate. The in-depth semi-structured interviews took place at participant’s home, the main research location, or over telephone. For each interview, we used a topic list, which was initially evaluated in a pilot study of patients with PDD. All interviews were audio recorded, with consent from the participant, and transcribed verbatim. Data were analyzed using Grounded Theory, with a constant comparative analysis method, using Atlas.ti version 9 software.

Qualitative data are currently being analyzed. We expect to identify important themes relevant to the patient’s and caregiver’s personal experience and learn how they use and implement self-management in their lives.

PPEP4All may help patients with PDD and caregivers learn important self-management techniques to effectively cope with chronic depression and its consequences, and thus, it may help them meet their needs for care.

None Declared

Both women and men experience potentially stressful events during their reproductive periods and both are at risk of developing peripartum depression. Men have a reproductive period that is difficult to define, and research on their mental health has rarely considered the effects of paternity. A prevalence of postpartum depressive symptomatology of 10.4% has been described worldwide (Paulson J et al. 2010). Paternal depression is also a risk factor for peripartum maternal depression (Escribá et al, 2011; Paulson et al., 2016). Among the risk factors for developing postpartum depression in men are identified: personal history of depression, conflictive relationship, lack of family and social support, unemployment, older age, lower educational level, and the father’s ability to support his new role as a father (Morse et al., 2000).

Screening to investigate and identify early objective biomarkers in recent fathers of early depression.

An anonymous survey is carried out through GoogleForms, to 57 men, fathers, with children born alive under 1 year of age, which includes biopsychosocial aspects and a questionnaire for depression: PHQ9.

Of the total of 57 parents, the average age is 36 years. 4 of them are unemployed, 1 is a student, the rest have active work or parent´s licency. Only 10% refer to present economic problems. 36% reported that their partner had a risky pregnancy and 22% had a peripartum complication. 9% describe an unsatisfactory or very unsatisfactory relationship with the mother of their child(ren). 51% have a personal and/or family history of depression and/or anxiety. 57% are overwhelmed in their role as fathers. 33% feel they have little or no social/emotional support. 5% have increased the consumption of alcohol/psychotropic medication and 94% report that their sleep pattern has been affected. 3.5% refer self-injurious thoughts or that they would be better off dead. 14% have considered requesting/consulting with a psychiatrist/psychologist since the arrival of the baby.

In relation to PHQ 9, 5% present moderate/severe depression.

In conclusion, it seems relevant to think about a screening to investigate and identify early objective biomarkers and rapid intervention, not only in mothers but also in fathers and thus take a first step to broaden the view from the mother-child dyad to the triad, thus understanding that mental health does not exist in isolation, it is a contextual and relational phenomenon and also reduce the negative impact of this problem, such as: dysfunction and family well-being, marital satisfaction, growth and development of your child/ren . In this context, primary care health professionals (midwives and primary care doctors) could play a fundamental role in recognizing the importance of incorporating parents as relevant figures in health .

None Declared

The COVID-19 pandemic and social and mobility restriction measures have had a negative impact on the mental health of the population.

The objective is to demonstrate the impact of the pandemic on mental disorders.

64-year-old man who is taken to the emergency room after a suicide attempt, by hanging with a belt out of concern and measuring the contagion of the COVID-19 virus in the context of long-standing delirious ideas of contamination and hypochondriacal neurosis. Adaptive disorder in relation to previous divorce. Psychopathologically, the patient is anxious and restless, conscious, inattentive and poorly oriented in space and time. Accelerated language with monothematic discourse about the possibility of contagion that has caused isolation behavior to the point of shredding organic waste and throwing it down the toilet so as not to have to go out to throw it out for fear of contagion. Faced with a neighbor’s wake-up call due to a blocked pipe, he suffers a crisis of guilt and anxiety and attempts to commit suicide. COVID-19 PCR=negative. Beck’s Depression Inventory 24=moderate depression. IPDE accentuated obsessive and avoidant personality traits.

Diagnosis: Moderate depressive episode with psychotic symptoms. Hypochondriacal disorder. Ananchastic personality disorder. Treatment: Paliperidone 3mg/24h. Sertraline 100mg/24h

In obsessive personalities and hypochondriacal neuroses, the COVID-19 pandemic has posed an increased risk of decompensation for affective disorders and even suicide attempts. Isolation, lack of treatment and prior monitoring, as well as the difficulty of identifying vital stressors, must be taken into account if an early intervention is to be carried out.

No significant relationships.

Patients with mild cognitive impairment may present deficits in naming, speech production, oral comprehension and written comprehension. In the differential diagnosis, cerebrovascular disease that can lead to cognitive impairment must also be differentiated from endogenous depressive disorder or language impairment.

The aim is to highlight the importance of differential diagnosis in cognitive disorders in relation to a case.

A 68-year-old female patient attended a psychiatric consultation derived from neurology when presenting a language disorder. The husband who accompanies her and the patient indicate that she has problems finding words and substitutes other expressions for them or sometimes does not answer or does so with something different from the topic that is being asked. She refers that she presents repetitive language with memory problems, alteration in the evocation of memories. The patient reports mood swings and irritability and crying with a low tolerance for frustration since she cannot express herself. Cranial MRI: cortical and central involutional changes. Periventricular leukoaraiosis and ischemic gliosis-like lesions in the white matter of both hemispheres. Psychopathological exploration: Conscious, oriented. She smiles at the questions but doesn’t answer them. Repetitive language. Alteration in the articulation of language. Depressed mood reactive to current situation. Some irritability Alteration in recent memory and evocation.

She was diagnosed with organic mental disorder compatible with mild cognitive impairment. Treatment with rehabilitation of the language disorder of vascular etiology is established.

Imaging and neuropsychological tests should always be performed in a patient with language, memory, and mood disorders to study its etiology.

No significant relationships.

Obsessive compulsive disorder (OCD) is a pathology represented by thoughts, images, impulses or feelings that generate great anxiety and discomfort, as well as the development of compulsive acts and rituals that cause great dysfunction.

The comorbidity of different psychiatric disorders with OCD is known, such as impulse control disorder and tic disorder.

The objective of this study is to describe the clinical characteristics, comorbidities and the treatment used in a patient with an OCD diagnosis and motor tics.

Description of a clinical case of motor tics associated with OCD in an adult patient.

A 29-year-old man begins mental health follow-up for presenting, as a result of a choking episode, obsessive thoughts with significant emotional and behavioral repercussions, to the point of restricting his diet and losing several kilos of weight. He also manifested checks and rituals in order to avoid possible choking.Treatment with sertraline and clonazepam was started, without evidence of improvement in symptoms. Months later, bucolingual and guttural tics, difficult to control by the patient and which caused bite lesions in the mouth and tongue, were added to the described clinic. Oral aripiprazole was associated to the treatment and then prolonged- release intramuscular administration was used, achieving improvement in obsessive symptoms and motor tics.

The usefulness of adjuvant treatment with atypical antipsychotics has been demonstrated in adults with OCD who present an insufficient response to an SSRI. Injectable prolonged-release antipsychotics can help improve long-term prognosis by ensuring adherence.

No significant relationships.

People spend a large part of our lives in the workplace. Stress at work, desmotivation and mental exhaustation are consequences derived from stressful situations that can be generated at work.

Detection in hospitals of those workers susceptible to exhaustion, work stress or personal demotivation to avoid a problem in the worker’s mental health, allowing early intervention and health strategies.

A cross-sectional study was carried out that included 84 healthcare workers from Spain in October 2021, through an anonymous, voluntary and multiple response type online survey which included questions about sociodemographic aspects and the Maslach burnout inventory

62% were doctors and 29% were nurses, 3 workers were nursing assistants, 2 orderlies, 1 psychologist and 1 physiotherapist. 13% of workers report having received / thought about requesting care from a mental health team (psychologist / psychiatrist) in the last year. 8% admit to having had suicidal ideas in the last year. 30.6% report being emotionally exhausted from their work always and almost always. 15.3% report that working with patients every day is stressful for them.29.4% report feeling “burned” by work. Only 28.2% say that they are always or almost always with a lot of vitality. 20.2% feel that they are at the limit of their possibilities.

Detection in hospitals of those people susceptible to exhaustion, work stress or personal demotivation to avoid a problem in the worker’s mental health, allowing early intervention and health strategies.

No significant relationships.

The coronavirus disease 2019 (COVID-19) pandemic has caused major sanitary crisis worldwide. Frontline healthcare workers face many difficulties, such as: direct exposure to patients with high viral load, physical exhaustion, reorganization of workspaces, face the unusually high number of deaths among patients, colleagues or relatives and ethical issues in a tense health system.

Provide up-to-date information of Burnout syndrome associated with exposure of healthcare workers to the COVID-19 pandemic, after almost 20 months of the declaration of pandemic by the World Health Organization.

A cross-sectional study was carried out that included 84 healthcare workers from Spain in October 2021, through an anonymous, voluntary and multiple response type online survey which included questions about sociodemographic aspects and the Maslach burnout inventory

62% were doctors and 29% were nurses. 70% work on the front line of Covid-19. 38% report not having been able to enjoy their vacations when they wanted. 8% admit to having had suicidal ideas. Almost 52% admit low personal fulfillment, 38.6% admit a high depersonalization count, and 45% report high emotional exhaustion. Of the total sample, 17 respondents have burnout syndrome.

It is necessary create strategies to promote mental well-being in health professionals exposed to COVID-19 after 20 months of active work. Protecting and identifying health care professionals who could be at high risk for developing a mental health pathology or detecting Burnout syndrome in them should be the priority of public health post pandemic.

No significant relationships.

Patients with anti-N-methyl-d-aspartate (NMDA) receptor encephalitis (ANMDARE) show a wide range of behavioral abnormalities and are often mistaken for primary psychiatric presentations. We aimed to determine the behavioral hallmarks of ANMDARE with the use of systematic neuropsychiatric and cognitive assessments.

A prospective study was conducted, with 160 patients admitted to the National Institute of Neurology and Neurosurgery of Mexico, who fulfilled criteria for possible autoimmune encephalitis and/or red flags along a time window of seven years. Cerebrospinal fluid (CSF) antibodies against the NR1 subunit of the NMDAR were processed with rat brain immunohistochemistry and cell-based assays with NMDA expressing cells. Systematic cognitive, neuropsychiatric, and functional assessments were conducted before knowing NMDAR antibodies results. A multivariate analysis was used to compare patients with and without definite ANMDARE according to antibodies in CSF.

After obtaining the CSF antibodies results in 160 consecutive cases, 100 patients were positive and classified as having definite ANMDARE. The most frequent neuropsychiatric patterns were psychosis (81%), delirium (75%), catatonia (69%), anxiety-depression (65%), and mania (27%). Cognition was significantly impaired. A total of 34% of the patients had a predominantly neuropsychiatric presentation without seizures. After multivariate analysis, the clinical hallmarks of ANMDARE consisted of a catatonia–delirium comorbidity, tonic-clonic seizures, and orolingual dyskinesia.

Our study supports the notion of a neurobehavioral phenotype of ANMDARE characterized by a fluctuating course with psychotic and affective symptoms, catatonic signs, and global cognitive dysfunction, often accompanied by seizures and dyskinesia. The catatonia–delirium comorbidity could be a distinctive neurobehavioral phenotype of ANMDARE.