Network analysis has been used to explore the interplay between psychopathology and functioning in psychosis, but no study has used dedicated statistical techniques to focus on the bridge symptoms connecting these domains.

The current study aims to estimate the network of depressive, negative, and positive symptoms, general psychopathology, and real-world functioning in people with first-episode schizophrenia or schizophreniform disorder, focusing on bridge nodes.

Baseline data from the OPTiMiSE trial were analysed. The sample included 446 participants (age 40.0±10.9 years, 70% males). The network was estimated with a Gaussian graphical model (GGM), using scores on individual items of the Positive and Negative Syndrome Scale (PANSS), the Calgary Depression Scale for Schizophrenia (CDSS), and the Personal and Social Performance (PSP) scale. Stability, strength centrality, expected influence (EI), predictability, and bridge centrality statistics were computed. The top 20% scoring nodes on bridge strength were selected as bridge nodes.

Nodes from different rating scales assessing similar psychopathological and functioning constructs tended to cluster together in the estimated network (Fig. 1). The most central nodes (EI) were Delusions, Emotional Withdrawal, Depression, and Depressed Mood. Bridge nodes included Depression, Conceptual Disorganisation, Active Social Avoidance, Delusions, Stereotyped Thinking, Poor Impulse Control, Guilty Feelings, Unusual Thought Content, and Hostility. Most of the bridge nodes belonged to the general psychopathology subscale of the PANSS. Depression (G6) was the bridge node with the highest value.

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The current study provides novel insights for understanding the complex phenotype of psychotic disorders and the mechanisms underlying the development and maintenance of comorbidity and functional impairment after psychosis onset.

None Declared

PTSD is a chronic, debilitating condition with limited treatment efficacy. Accessing traumatic memories often leads to overwhelming distress, impacting treatment process. Current approved pharmacological treatments have exhibited small to moderate effects when compared with placebo. Evidence suggests 3,4,-methylene-dioxymethamphetamine(MDMA)-assisted psychotherapy as a viable option for refractory PTSD.

Comprehensive review of early clinical research, proposed mechanisms, safety and emerging therapeutic models.

Eligible studies will be identified through strategic search of MEDLINE.

Pre-clinical and imaging studies suggest memory reconsolidation and fear extinction as candidate psychological and neurological mechanisms, involving MDMA’s combined effects of increasing serotonergic activity, as well the release of oxytocin and brain-derived neurotrophic factor in key memory and emotional circuits. Resulting reduction in amygdala and insula activation and increasing connectivity between the amygdala and hippocampus may create a “tolerance window” of neuroplasticity for emotional engagement and reprocessing of traumatic memories during psychotherapy. Early clinical trials report impressive and durable reduction in PTSD symptoms, with a safety profile comparable to that of SSRIs. A recently completed randomized, double-blind, placebo-controlled phase 3 trial reported full remission of PTSD symptoms in 67% of patients at 2 months, with no increase in suicidality, cardiovascular events or abuse behavior. Emerging treatment models underline the importance of unmedicated therapeutic sessions for preparation for the experience and subsequent integration as essential for full benefit and safety of the clinical context.

The psychological impact associated with the COVID-19 pandemic is an reminder of the emotional and economic burden associated with PTSD. MDMA-assisted therapy may be a breakthrough approach meriting further multidisciplinary investment and clinical research.

No significant relationships.

Nowadays we know that autism spectrum disorders (ASD) and Schizophrenic spectrum (SS) are different types of disorders in their etiology, symptoms and prognosis, but the clinical distinction is often difficult to make due to comorbidity and similar symptoms.

With this project, the authors intend to explore the differential diagnosis between ASD and SS specially when we talk about critical ages of onset.

An analysis of articles searched on Pubmed (articles between 2010-2020) with the key words “adult autism”, “childhood onset schizophrenia”, “childhood psychosis”.

Early-onset schizophrenia (EOS) is defined as occurring before age 18 years. The condition share key diagnostic symptoms with adult-onset schizophrenia (AOS) but his prognoses and comorbidities differ. Autism spectrum disorder (ASD) is a common neurodevelopmental disorder characterized by difficulties since early childhood across reciprocal social communication and restricted interests and behaviors. ASD is a lifelong neurodevelopmental disorder, however there is a lack of answers and research for adults with ASD. There are shared aspects of odd thinking, rigid behaviors and impaired socialization in schizophrenia and ASD and COS seems to have a strong relationship with ASD, being comorbid in up to 50% of cases.

Usually the evaluation of the developmental history of the person, prodrome and onset, its course and the presence of positive symptoms of schizophrenia is enough to help us find a diagnosis. Unfortunately, in some ages the conclusion is not so easy to find. However is essential to determine whether the clinical manifestations belong to the autistic spectrum, the schizophrenic or result from comorbidity.

There are minimal data directly comparing plasma neurofilament light (NfL) and glial fibrillary acidic protein (GFAP) in aging and neurodegenerative disease research. We evaluated associations of plasma NfL and plasma GFAP with brain volume and cognition in two independent cohorts of older adults diagnosed as clinically normal (CN), mild cognitive impairment (MCI), or Alzheimer’s dementia.

We studied 121 total participants (Cohort 1: n = 50, age 71.6 ± 6.9 years, 78% CN, 22% MCI; Cohort 2: n = 71, age 72.2 ± 9.2 years, 45% CN, 25% MCI, 30% dementia). Gray and white matter volumes were obtained for total brain and broad subregions of interest (ROIs). Neuropsychological testing evaluated memory, executive functioning, language, and visuospatial abilities. Plasma samples were analyzed in duplicate for NfL and GFAP using single molecule array assays (Quanterix Simoa). Linear regression models with structural MRI and cognitive outcomes included plasma NfL and GFAP simultaneously along with relevant covariates.

Higher plasma GFAP was associated with lower white matter volume in both cohorts for temporal (Cohort 1: β = −0.33, p = .002; Cohort 2: β = −0.36, p = .03) and parietal ROIs (Cohort 1: β = −0.31, p = .01; Cohort 2: β = −0.35, p = .04). No consistent findings emerged for gray matter volumes. Higher plasma GFAP was associated with lower executive function scores (Cohort 1: β = −0.38, p = .01; Cohort 2: β = −0.36, p = .007). Plasma NfL was not associated with gray or white matter volumes, or cognition after adjusting for plasma GFAP.

Plasma GFAP may be more sensitive to white matter and cognitive changes than plasma NfL. Biomarkers reflecting astroglial pathophysiology may capture complex dynamics of aging and neurodegenerative disease.

A clear distinction between schizophrenia and some clusters of dementia is sometimes difficult to do in clinical practice.

A 38-years-old-male patient, with history of alcohol dependence, was admitted in our unit for generalized tremor, sweating, agitation, auditive, visual and cenestesic hallucinations, thought broadcasting and persecutory delusion. Agitation and the vegetative symptoms gradually subsided within 48 hours. Lab work showed no clinically significant changes. EEG and EKG were normal. MRI showed augmented cortical encephalic sulci. 5 days after the admission 10 mg of olanzapine was prescribed due to psychotic symptoms persistence. Haloperidol was stopped. A gradually improvement occurred and 26 days after the admission the patient was discharged home asymptomatic. Neuropsychological testing revealed severe fronto-temporal cognitive defect suggestive of alcoholic dementia.

The difficulty to clearly distinct schizophrenia from some dementias may be because, as Kraepelin stated in the 19th century, schizophrenia is itself a form of early dementia. His concept of dementia praecox is supported nowadays by the knowledge acquired from several neuropsychological and neuroimaging tests that a progressive cognitive deterioration appears to occur in schizophrenic patients.

Behavioral and personality changes are the core symptoms of frontotemporal dementia. Suicide and suicide attempts have been reported in demented patients.

We present a case of an 80 years-old-male patient, with a suicide attempt at the age of 76 as the presentation symptom of FTD.

There are few studies of suicide or selfharm in frontotemporal dementia where such behavior might be expected to be more common. We are conducting a clinical study in FTD patients about the relation between FTD and suicide. The results of such study will be presented and discussed.

To our knowledge, there are no reliable data or reports about suicide in FTD patients. Also, we didn’t find any case report of a suicide attempt as the first presentation symptom of FTD. We discuss the known data about this issue considering our clinical study and report.

Personal and familiar spiritual and religious beliefs are important factors to be considered when prescribing an antipsychotic drug to a schizophrenic patient.

A case report of a 29 years old male patient with a schizoaffective disorder is presented. in this case the border between what was delusion and what was the result of the patient personal and familiar spiritual beliefs was impossible to made. Only after the medication precribed has produced its effect this distinction has become clearer.

A literature revision about this issue was made.

Spiritual beliefs are important factors that influence therapeuticall adhesion. A clear distinction between them and delusion symptomatology is very difficult to made, mainly in an acute psychotic state. after medication, the delusion symptomatology disappears and personal spiritual beliefs persist.

The term depressive pseudodementia has proved to be a popular clinical concept. Little is known about the long-term outcome of this syndrome.

To compare depressed elderly patients with reversible cognitive impairment and cognitively intact depressed elderly patients.

All patients suffering from moderate or severe depression admitted to St Margaret's Hospital, UK as inpatients or day hospital outpatients between January 1, 1997 and December 31, 1999 (n=182) were screened for entry into the study. Eligible patients were divided into those presenting with pseudodementia and those who were cognitively intact and followed up for 5 to 7 years.

Seventy one percent point four percent of those suffering from pseudodementia had converted into dementia at follow up compared to only 18.2% in the cognitively intact group. The relative risk was 3.929 (95% CI: 1.985 to 7.775) and the ‘number needed to harm’ 1.88.

Reversible cognitive impairment in late-life moderate to severe depression appears to be a strong predictor of dementia. Patients with pseudodementia should probably have a full dementia screening, comprehensive cognitive testing and ongoing monitoring of their cognitive function.

Perfectionism and perseverative negative thinking/PNT are both associatedwith eating disorders symptoms. PNT is a prime candidate when investigating the pathway that links perfectionism to psychopathology.

To investigate if PNT mediates the relationshipbetween perfectionismcognitions and ED symptoms.

114 young women(mean age=23.78±6.340; mean BMI=21.59±3.127; 49.4% students) fill in the Portuguese validated versions of Eating Attitudes Test/EAT-25 (to evaluateBulimic behaviors, Diet and Social pressure to eat), MultidimensionalPerfectionism Cognitions Inventory (Concern over mistakes/CM, Personal standards/PS,Pursuit of Perfection) and Perseverative Thinking Questionnaire/PTQ-15(Repetitive Thought/RT, Cognitive interference and unproductiveness). Onlyvariables significantly correlated with the outcomes (EAT-25_Total and itsdimensions) were entered in the multiple regression models. Mediation analysesusing Preacher and Hayes bootstrapping methodology were performed.

Significantpredictors of EAT_Total were CM (b=.180)and RT (b=.169)(both p<.05). RT partially mediatedthe relationship between EAT_Total and CM. (95%CI=.0671-.0290).

Bulimicbehaviors were predicted by the same variables (b=.359;b=.154;p<.05) and RT also partially mediated the relationship between Bulimic behaviorsand CM (95%CI=.0071-.0190). Diet and Social Pressure to Eat were only predictedby PS (b=.154;b=.257,respectively; p<.05).

Although PNT mediates the relationship between perfectionist cognitions andbulimic behavior, the effect of the perfectionism on other disordered eatingdimensions, such as diet and SPE, seems to be independent of the PNT levels. Aspreviously reported in other studies with community samples, disordered eatingbehaviors are associated to negative perfectionism dimensions, but also todimensions that have been considered not entirely maladaptive.

Different psychoeducational and family-based interventions have been shown to improve chronic physical diseases, such as asthma. There is an increasing consistency of therapeutic effects in these programmes, across the literature. However, scientific validation of the benefits of each programme and what is the best model/method are required.

To evaluate the effects of Multifamily/MG and Psychoeducational/PG interventions for asthma on psychological, biological and morbidity outcomes.

A sample with 299 outpatients with asthma diagnosis from a University Hospital was recruited consecutively. Patients with moderate/severe asthma were included in a five-month randomized controlled study with simple occultation. There was a balanced inclusion of 141 patients allocated to three groups: MG, PG and control group/CG. All patients continued usual pharmacological treatment. Anxiety (SAS/STAIY), depression (BDI), coping mechanisms (WCAEL), quality of life (MiniAQLQ), asthma control (ACQ), lung function (FEV1/PEF), airway inflammation (FeNO), asthma severity and morbidity were assessed at the beginning and the end of the study.

Both MG and PG improved asthma control. The overall quality of life score increased in MG (0.5 U) and PG (0.8 U), but not in the CG. A significant decrease was also found in the use of oral steroids in MG and in the hospitalization in PG. The behavioural changes improved psychological parameters (anxiety, depression, coping), and lung function.

Multidisciplinary group interventions seem to improve physical/psychological parameters in asthma, and assessment of efficacy is necessary after a longer follow-up period, as is identification of patients’ clusters which benefit the most from each intervention.

New psychoactive substances (NPS) are substances that have recently appeared on the market and are not under international control. NPS use is experiencing an unprecedented increase. DiPT, 4-HO-DiPT and 4-AcO-DiPT are new psychoactive tryptamines and their effects may differ from those of other psychoactive tryptamines.

To explore the presence of DiPT, 4-HO-DiPT and 4-AcO-DiPT from samples delivered to and analyzed by Spanish harm reduction service Energy Control.

All samples analyzed from 2009 to 2014 delivered as DiPT, 4-HO-DiPT and 4-AcO-DPT or containing these substances. Analysis was performed by gas chromatography–mass spectrometry.

From 17,432 samples, 4-HO-DiPT was found in 16, delivered as 4-HO-DiPT (6); 4-AcO-DiPT (7); DiPT (1); 4-AcO-DMT (1) and cocaine (1). 4-AcO-DiPT was found in 16, delivered as 4-AcO-DiPT (12); 5-MeO-DMT (1); 5-MeO-DiPT (1); 4-AcO-DMT (1) and cocaine (1). Only 4 samples contained DiPT, all presented as DiPT. Nine samples contained both 4-AcO-DiPT and 4-HO-DiPT. During the years of study, 4-HO-DiPT deliverance was increasing (4 samples in 2014) while deliverance of 4-AcO-DiPT and DiPT was decreasing (1 sample in 2014).

Increasing 4-HO-DiPT presence could translate a progressive replacement of 4-AcO-DiPT and DiPT recreational use. Clinical relevance comes from its growing use and the absence of scientific evidence on humans, therefore relying on users subjective experience to predict the effects.

The authors declare that they have no competing interest.