While pregnancy itself is a risk factor in the development of anxiety disorders, the COVID-19 pandemic has brought additional pressure on expecting women. Despite these two independent factors, no study regarding their cumulative effect on anxiety in soon-to-be Romanian mothers exists.

This study intends to address this deficiency by measuring the level of anxiety in a sample of pregnant women from the public healthcare sector in Romania.

Sociodemographic data and Zung Self-reported Anxiety Scores (SAS) were used to look at 121 pregnant women to get a fuller picture of anxiety in pregnant women during the pandemic.

Some of the main findings of the study are as follows: anxiety symptoms are more intense during the first trimester of pregnancy, especially in the psychological domain of the scale, as opposed to the third one. High BMI was weakly correlated with lower Zung Scale scores, while marital status and having other children were moderately correlated with less anxiety symptoms. While no association could be found between history of infection, vaccination and anxiety, surprisingly, unvaccinated women showed less psychological distress than vaccinated ones (moderate correlation), suggesting that less anxiety prone women are also less likely to get adequate protection. Getting one’s information from official sources also proved to be weakly correlated with higher Zung Scale scores.

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In conclusions, the findings of this study can serve as a start for further inquiry regarding the impact of the COVID pandemic on the mental health of pregnant women.

None Declared

While a growing corpus of literature regarding the stress suffered by caretakers for people living with dementia (PLWD) already exists, very little data is available regarding this subject among Romanian caretakers.

This cross-sectional study aims to compensate for this by assessing a small (N=72) sample of caretakers through the use of self-reporting questionnaires for subjective feelings of stress and burden.

Responders filled and online survey containing miscellaneous socio-demographic questions and the Kingston Caregiver Stress Scale (KCSS) along with the Caregiver Health Assessment Self Questionnaire (CHASQ). Results were collected and analysed in SPSS for subsequent correlations.

The majority (77%) of caretakers are women and 86% of responders are offering their care at home, emphasizing pervasive gender roles and lack of availability or accessibility of social services for the PLWD in Romanian society. Three thirds of caregivers were children of PLDW. More than half of responders (51%) had KCSS scores that suggested severe stress while less than 9% related only mild stress. Most responders (52%) related social aspects of their lives as most affected by their caregiver status.

While in line with most other findings and limited in scope and means by its methodology, this study offers a quick snapshot on the subjective levels of stress affecting caretakers of Romanian PLWD and can lead towards further points of inquiry on the matter in the Romanian population.

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Cannabis consumption among Romanian youth has seen a steady increase in the last couple of decades.

This work attempts to fill the void left by the relative dearth of in-depth research on the subject of cannabis misuse in Romania, which is particularly concerning given the significant connection that exists between anxiety, depression, and cannabis usage.

An epidemiological overview of cannabis misuse, mental comorbidities, and other socio-demographic characteristics was outlined through the use of validated self-reported scales on a small sample size (N=125) that was analyzed throughout this research. The purpose of this research was to outline this overview.

By applying the Cannabis Use Disorder Identification Test – Revised (CUDIT-R), Alcohol Use Disorder Identification Scale (AUDIT), Fagerstrom Test for Nicotine Dependence (FTND) and Hospital Anxiety and Depression Scale (HADS), the study’s results are as follows: although 48% of participants have tried cannabis, about a third (32%) have used it in the last 6 months. Among this sub-group, 40% presented scores that suggest Cannabis Use Disorder according to the DSM-V definition. Almost half (47%) percent of cannabis users had clinically significant scores for depression and anxiety, as opposed to 21% of non-users. Consumption of cannabis was more likely to be associated with alcohol abuse (63%) and nicotine dependence (85%). While students were equally represented among users and non-users; male gender and the unemployed were overly-represented. Interestingly, there was no correlation between relationship status and cannabis consumption.

In conclusion, this study’s results are in line with most epidemiological literature regarding cannabis and can serve as a starting point for deeper, more analytical investigations of cannabis use in Romania.

None Declared

Despite the literature regarding the impact of the COVID-19 pandemic on education, there is little research that specifically targets medical students and their relationship with online courses in regards to engagement and feelings of inadequacy.

This cross-sectional study aims to explore such questions by evaluating a small (N=169) sample of Romanian medical students and applying self-reporting questionnaires in order to quantify subjective levels of burnout and imposter phenomenon

Responders filled an online survey with question regarding miscellaneous socio-demographic factors, alont with the Academic Burnout Scale (ABS), Clarence Imposter Phenomenon Scale (CIPS) and Ohio Resilience Scale (ORS). Results were collected and analysed for subsequent correlations.

Predictably, respondents already in favour with online courses showed less signs of burnout and higher levels of resilience. While higher-year students preferred online courses, particularly final year students, it was lower-year students who showed higher level of resilience and lower burnout and imposter phenomenon levels, possibly suggesting a more profound impact of online education on students in clinical rotations, as opposed to pre-clinical ones. No statistically significant correlations were found between socio-demographic factors and the self-reported ratings, showing that feelings of burnout and imposter phenomenon were equally distributed among genders.

The results of this study present a snapshot into the opinions of future Romanian medical professionals on their own education and, in spite of its methodological limitations, can function as a starting point for deeper and more exhaustive inquiry regarding medical education during COVID-19 times.

None Declared

In Romania, the first case of COVID-19 was detected on 26 February 2020 and the number of cases has been rising afterward.

The goal of this study was to assess anxiety and resilience regarding the COVID-19 pandemic and to analyse possible protective measures and risk factors.

This is a cross-sectional study and data were collected March and April 2021. Participants filled in the Zung Self-Rating Anxiety Scale and the Connor-Davidson Resilience Scale.

The sample consisted of 440 participants who presented to the general practitioner (female-65.7%) and the most representative age group was 35-64 years old; 18.4% of the participants stated that they were infected; 56.6% reported that they do not know anyone in their entourage who was infected/ has died of COVID-19 (group A), 32.9% knowing people with an infection in their close social environment (group B) and 10.5% had close people who died (group C). Almost half of the respondents (49,3%) scored above the cut-off point of the anxiety index (mild 38.6%, moderate 9.9%, severe 0.8%). As we expected, there is a strong negative correlation between anxiety levels and resilience (Pearson Correlation=-.551, p<0.01). If groups A and B had similarities regarding anxiety levels (44.97 and 44.23), those knowing someone who died of COVID-19 (group C) had a higher anxiety level (47.81%) (p<0.05).

The recent COVID-19 pandemic has caused an understandable surge in anxiety among the general population. Low level of resilience is predictive of the phenomenon of having high anxiety in the face of the death of others.

No significant relationships.

Facing the COVID-19 pandemic, individuals are experiencing severe mental distress. Following social distancing and economic insecurity, significant increases in mental health concerns have developed.

The aims of this study was to report the levels of depressive and anxiety within active population in Romania, and to identify possible risk and protective factors for mental health.

Data collection occurred between February-March 2021. The online survey included questions regarding socio-demographic characteristics and Hospital Anxiety and Depression Scale (HADS). 620 responses were validated (331 students and 289 workers).

Among active population, risk of anxiety symptoms is lower in those who already were infected with SARS-Cov2 (p=0.026, df=2, Phi=0.109), while positive screening for anxiety or depression in this study was statistically significant associated with younger age (p=0.026, df=4, Phi=0.134) and female gender (p=<0.001, df=2, Phi=0.166). Even though anxiety and depression scores are similar among students and employees, there are different aspects regarding symptomatology between these two groups. Students have experienced more frequently tendency to worry and sudden feelings of panic (p=0.004, df=3, Phi=0.146). Also, their ability to laugh and see the funny side of things is affected (p=0.019, df=3, Phi=0.127) and they feel less enthusiasm about future (p=0.001, df=3, Phi=0.159). Participants living with someone else scored lower on anxiety and depression subscales and those are not influenced by the person with whom they are cohabitating or residing (p=0.020, df=3, Phi=0.138).

Findings from the current study offer initial insights into the rates of anxiety and depression within active population in Romania, one year after the onset of the COVID-19 pandemic.

No significant relationships.

The COVID-19 (Coronavirus Disease 2019) pandemic is associated with several stressful factors that can negatively affect peoples’ sleep quality and mental health.

The aim of the current study was to prospectively identify decreased sleep quality and associated risk factors in general population during COVID-19 pandemic.

We conducted a prospective, observational online study on a Romanian sample of 667 respondents aged >18 years. Sleep quality and quantity was evaluated with Athens Insomnia scale (AIS) and the main concerns associated with the pandemic context were evaluated through a multiple-choice question.

The data collected identified important evidence regarding the prevalence and intensity of insomnia. The average score for AIS was 6.13 (cut-off point for was set at 8). However, it is worth noting that 179 respondents (26.8%) meet the criteria for insomnia. Of the 8 self-assessment items, daytime sleepiness was the criterion evaluated with the highest average score (1.01), all other items getting subunit values. A low quality of sleep was linearly related with fear of illness/death (p=0.053), fear of illness/death of close people (p=0.032), social isolation (p<0.001), economic impact (p=0.003), losing the job (p<0.001) and social stigma associated with COVID-19 infection (p=0.009).

More than a qurter of respondes scored above the threshold of 8 at the insomnia scale, while losing the job, social stigma associated with COVID-19 infection and social isolation are the main risk factors for a low quality and quantity of sleep.

No significant relationships.

Timely and accurate information is foundational to moderating and curing the COVID-19 for both the public and the scientific community, while repeated media exposure to crisis-related information raises stress and anxiety among general population.

The main goal of the current study was to evaluate the associations between the COVID-19-related information sources and anxiety levels.

An online web-survey recruited participants who were ≥18 years old and lived in Romanian through an online campaign in May 2021. Participants were asked whether they received COVID-19-related information frequently from the following sources: the Internet, traditional media, medical staff in health care settings or from friends, co-workers, or family members. We also assessed participants’ level of anxiety with Zung Self-Rating Anxiety Scale (SAS) and the cut-off point for anxiety index was set at 45. The associations of each information source with anxiety were examined using multiple regression analyses to control for sex, age, education and other demographic characteristics.

In total, the data of 1559 respondents (1224 female; mean age = 37.03 years and standard deviation (SD)=12.90 years) were analysed. The mean index score for SAS were 44.28 (SD=10.6). The major source of information on COVID-19 was the Internet (59.20%) and medical stuff (58.27%), almost in equal measure, followed by traditional media (48.17%) and friends, co-workers, and family members (30.72%).

Receiving COVID-19 information from the Internet and traditional media was positively correlated with anxiety level (p=0.01), while receiving COVID-19 information from medical-stuff was associated with low levels of anxiety (p=0.03).

No significant relationships.

Compulsory admission procedures of patients with mental disorders vary between countries in Europe. The Ethics Committee of the European Psychiatric Association (EPA) launched a survey on involuntary admission procedures of patients with mental disorders in 40 countries to gather information from all National Psychiatric Associations that are members of the EPA to develop recommendations for improving involuntary admission processes and promote voluntary care.

The survey focused on legislation of involuntary admissions and key actors involved in the admission procedure as well as most common reasons for involuntary admissions.

We analyzed the survey categorical data in themes, which highlight that both medical and legal actors are involved in involuntary admission procedures.

We conclude that legal reasons for compulsory admission should be reworded in order to remove stigmatization of the patient, that raising awareness about involuntary admission procedures and patient rights with both patients and family advocacy groups is paramount, that communication about procedures should be widely available in lay-language for the general population, and that training sessions and guidance should be available for legal and medical practitioners. Finally, people working in the field need to be constantly aware about the ethical challenges surrounding compulsory admissions.

chronic neurological diseases such as multiple sclerosis (MS) and Parkinson's disease (PD) determines highly social impact through direct and indirect cost burden, so that management of quality of life(QoL) of these patients is often difficult.

to assess whether the relantionship between depression and chronic neurological diseases is relevant in quantifying QoL.

to proove that associated depression in patients with serious neurological diseases should not be minimized.

we followed up 20 patients (10 with MS-mean age 39.1, mainly women and 10 with PD-mean age 55.8, mainly men) during one year after diagnosis of depression; the mean time of disease evolution was 7.83 years for MS patients and 6.33 for PD patients; we compared them with a lot o patients matching as age and sex diagnosed with depression, without other comorbidities. Both lots were assessed every 3 month by Beck Depression Inventory, Fatigue Impact Scale and QoL Short form-36 scores. Time of positive diagnosis was over one year, even if symptoms were present for at least double time.

patients with chronic neurological diseases had a less favourable outcome, especially young women, than control group, revealing more problems especially in somatization field and in accepting psychiatric help; there were also more drug interactions that led to patient compliance difficulties.

even if there is resistance in accepting psychiatric diagnosis and treatment, we must do all efforts to persuade patients to undergo specialized treatment and supportive psychotherapy in order to improve their's quality of life.

frontotemporal dementia (FTD) is marked by progressive changes in behavior, personality, variable degrees of language impairment and preservation in other cognitive domains.

neuropsychological assessments must be more attentive performed, as FTD is the third cause of neurodegenerative dementia, in younger ages, being often misdiagnosed.

During one year we followed up every 3 months, 4 women, mean age 53.5 years admitted in Psychiatry Clinic. They all presented for depressive symptoms, started for about 4 years before, for which a series of antidepressants were used without any clinical improvement. Clinical, psychiatric and psychological evaluations were performed every 3 months, showing slowed verbal rhythm, difficulties in expressing themselves and finding right words, repetitive speech, lack of spontaneity and initiative. No perceptual disturbances or memory impairment were found. Systematically neurologic examination was normal except for bradykinesia and bradypsychia. MRI showed evidence of frontal and temporal involvement.

According to DSM 5, criteria for probable neurocognitive frontotemporal disorder were fulfilled, as there were a prominent decline in language ability, in the form of speech production with relative sparing of learning and memory.

Because of the nature of the symptoms and the fact that a patient is often 'too young' for dementia to be considered, FTD is often initially misdiagnosed. Especially when present in midlife, it can be a significant clinical challenge to distinguish it from primary psychiatric disorders like major depression, bipolar illness or even late-onset schizophrenia. A correct diagnosis may help us improve patient's quality of life and social restoration.

Depression leads to substantial suffering for the patients, their families and becomes an economic burden for system [1,2]. Patients and clinicians tend to rate the remission differently [3].

We investigate if clinicians and patients rate different the treatment response. This study assed the evolution of major depressive episode (MDE) in patients treated with Agomelatine, in Romania. It was designed as a multicentre, observational study that included 1213 adult patients evaluated in 75 sites in 2014. The design included 3 visits (baseline (V1); visit at 2/3 weeks (V2); visit 6/8 weeks (V3)). The scales used were: MADRS, SHAPS, CGI-I, CGI-S, PGI-I, PGI-S.

The MDE improvement was significant (P < 0.001) for all aspects evaluated. At baseline, more clinicians vs. patients considered the moderately or markedly ill as best descriptors of the state. The difference between the two assessments was even higher for V2 and V3. During V2 clinicians reported “minimally improvement” while patients reported “much improvement” in higher percentage. During V3, both, clinicians and patients reported a “very much improved” clinical status. Of the patients 42.60% reported at V3 “normal”, not at all ill’ in comparison to 34.81% of clinicians who reported the same (P < 0.001).

This could mean that patients are not aware of the severity of their disease. This data could be interpreted in the way that patients are more prone to rate higher the improvements as response to treatment and the clinicians to rate as response a more than 50% decrease of symptomatology.

References not available.

The authors have not supplied their declaration of competing interest.

Multiple sclerosis (MS) is the most common chronic neurologic disease affecting young people. Cognitive dysfunction is an important part of disability, interfering with quality of life (QoL). Disease modifying therapies (DMT) are gold standard of long-term treatment in MS.

Assessment of DMT impact on evolution of cognitive dysfunction.

To analyze the cognitive status in a lot of 74 patients with MS, with a mean age of 40.4 years, treated with different DMT in the National Health Program.

Testing patients during 2014–2015 for cognitive dysfunction, by applying MMSE, Sunderland Clock Test, Beck Depression Inventory, Fatigue Impact Scale and QoL Short form-36 scores every 6 months; analyzing demographic, clinical and magnetic resonance imagery (MRI) data.

Thirty-six percent of lot showed memory and concentration changes (12 patients with secondary progressive MS, 15 with relapsing-remitting MS); mean age of these patients was 46.29 years, with a mean period of evolution of the disease of 9.8 years before starting DMT; cortical atrophy was present on MRI in 37% of these patients. Mean age of those who didn’t present cognitive disturbances was 37.01 years, with a mean period of evolution of 6.2 years before starting DMT. Disturbances appeared independently of the presence of cortical atrophy, as this marker appeared in 5% of patients with no cognitive dysfunction.

When starting DMT, age and time of evolution of the disease are essential for further developing of cognitive dysfunction. Mood and anxiety disturbances can be a prodromal marker of neurocognitive troubles. DMT have neuroprotective outcome in MS.

The authors have not supplied their declaration of competing interest.