Healthcare services are increasingly confronted with challenges related to old age mental disorders. The survey aimed to provide an overview of existing psychogeriatric services in Albania, Bulgaria, Greece, and North Macedonia.

After identification of psychogeriatric units across the four countries, their head physicians were asked to provide data on their clinical, teaching, and research activity, as well as staff composition. Moreover, the attitudes of head physicians to current needs and future service development were explored.

A total of 15 psychogeriatric units were identified (3 in Bulgaria, 8 in Greece, and 4 in North Macedonia). Results show wide variation regarding the location, team size and composition, service availability, numbers of patients attending, and inpatient treatment length. Most head physicians underscored the urgent need for breakthroughs in the graduate and postgraduate education in psychogeriatrics of medical and nonmedical professionals, as well as in the interconnection of their units with community primary healthcare services and long-term care facilities for seniors via telemedicine. They would welcome the development of national standards for psychogeriatric units, potentially embodying clear pointers for action. A number of head physicians advocated the development of nationwide old age mental health registries.

Regional disparities in resources and services for seniors’ mental health services were unveiled. These data may enrich the dialogue on optimizing psychogeriatric services through planning future cross-border collaborations mainly based on telemedicine services, especially in the era of the novel coronavirus pandemic, and training/education in psychogeriatrics of mental health professionals.

To report a case of status epilepticus in a patient receiving olanzapine, with no previous history of seizure and no confirmed underlying cause for seizure.

A 48-year-old woman with low weight and psychotic disorder not otherwise specified, was admitted because of provoked vomiting and anorexia. She developed generalized tonic-clonic seizures that progressed to status epilepticus during her hospitalization. Two days earlier, treatment switched from mirtazapine 30 mg plus quetiapine to mirtazapine 30 mg plus olanzapine - with quick titration up to 30mg. No other toxic, metabolic, electrolyte or anatomic abnormality was identified. Olanzapine was discontinued and the patient was started on intravenous phenytoin, which was discontinued without complications one month later. The patient remained seizure free.

To our knowledge this is the second case of status epilepticus described that has been associated with the use of olanzapine, in a patient with no other confirmed predisposing factors for seizure. Olanzapine is an atypical antipsychotic that shares many pharmacological properties with clozapine. However, clozapine has been noted to induce dose-dependent seizures in about 10% of patients, whereas manufacturer's trials gave a seizure rate of 0,88% for olanzapine, similar to other antipsychotics. In our patient it is possible that seizures were induced due to the abrupt change in pharmacotherapy and the quick titration to high dose.

Although olanzapine has infrequently been associated with epileptogenic risk, it should be used cautiously especially when other predisposing factors exist.

Deficits in executive functioning in schizophrenia spectrum psychosis have been repeatedly reported. However, their relationship to the duration of disease and its psychopathology remains unclear. The purpose of this study was to compare executive functioning between first episode and chronic psychotic patients. The aim was also to investigate whether positive or negative psychotic symptoms are differentially related to executive functioning. The Stroop Color Word Test (SCWT) was chosen for this purpose, as a representative task of executive function, evaluating shifting ability, concentration and selective attention.

24 patients with one (n=8) or more (n=16) psychotic episodes and 30 sex and age-matched controls were assessed using the SCWT. Patients were also evaluated with the Positive and Negative Syndrome Scale (PANSS).

Patients with one psychotic episode showed significantly higher speed in all subtasks of SCWT compared to patients with more psychotic episodes, but no significant difference in the accuracy between these two groups was proved. Psychotic patients performed worse -in term of accuracy and speed- in SCWT compared to controls. Accuracy but not speed showed correlation with both Positive and Negative symptom dimensions, as well as with the severity of psychopathology (total PANSS).

Deficits in executive functioning in schizophrenia spectrum psychosis, as they are assessed by SCWT, seem to be associated with the duration of the disease and the severity of both negative and positive psychopathology.

Investigating the indexes of alexithymia and psychopathology, as well as their relation to each other, in patients with type II diabetes.

The study was conducted on a random sample of 60 patients with type II diabetes (Group 1), who were outpatients in two Diabetes Centers of Northern Greece, and in 30 healthy controls (Group 2) We used the translated and validated versions of: 1) the international neuropsychiatric interview questionnaire (M.I.N.I. screen/ DSM-IV), 2) the M.M.S.E., 3) the TAS-20 questionnaire for alexithymia, 4) the SCL-90-R symptoms auto-questionnaire, 5) the Beck Depression Inventory (BDI) and 6) a protocol of demographic data.

The statistical analysis of the data has yielded the following results: 1) in Group 1, there seems to be a high or very high statistical correlation between the rates of all 4 factors of alexithymia and all 11 sub-scales of SCL-90-R, 2) where alexithymia is concerned, in both Groups 1 and 2, the findings in all 4 factors are as follows: Total score z(78)=-5.132, p<0.001/ Factor 1 z(78)=-5.553, p<0.001/ Factor 2 z(78)=-3.857, p<0.001/ Factor 3 t(78)=-3.825, p<0.001.

The indexes of alexithymia in chronic patients with type II diabetes have a statistically significant higher frequency compared to healthy controls. The factors of alexithymia, as defined in the TAS-20 questionnaire, correlate in various ways with certain psychopathological conditions, as defined in the SCL-90-R questionnaire

Frontal lobe dysfunction has been considered as a core feature in schizophrenia. To the evaluation of this impairment, time-consuming neuropsychological batteries are needed. Recently, Dubois et al (2000) reported a short battery for assessing frontal lobe function in patients with neurological disorders. To evaluate the clinical efficacy of this frontal assessment battery (FAB) in patients with schizophrenia, we performed both FAB and Stroop Color Word Test (SCWT), which is suggested to be a representative task of executive function.

24 schizophrenic patients and 30 sex and age-matched controls were included. FAB, SCWT and Mini Mental State Examination (MMSE) were performed in both groups. The FAB scores were compared with the performance in SCWT and correlated with education level, age and duration of disease. No difference in the MMSE scores between two groups was found.

The FAB global score was significantly lower in the schizophrenia group compared to controls. In the patients group, the conceptualization and the inhibitory control subscores were negatively correlated with mistakes in color-naming task. The FAB total score, the mental flexibility and the programming subscores were negatively correlated with latencies in color-naming, color-reading and in color-word interference task of SCWT. Negative correlation between the FAB scores and the age and duration of disease was also evident.

The FAB is likely to be a useful and brief battery for assessing frontal lobe function in schizophrenia, as it results from the comparison with SCWT.

Frontal lobe deficits have often been reported in patients with schizophrenia. Recently, Dubois et al (2000) reported a short bedside cognitive and behavioral battery for assessing frontal lobe function in patients with neurological disorders. We hypothesized that cognitive functions of frontal lobe in schizophrenia could be evaluated with this battery.

27 patients with schizophrenia and 30 sex and age-matched controls were included. We performed FAB and Mini Mental State Examination (MMSE) in both groups and we correlated the scores of six subtests and the total FAB score with handedness, education level, age and duration of disease.

The FAB global score was significantly lower in the schizophrenia group compared to controls. There was negative correlation between the FAB scores and their age and duration of disease in the schizophrenia patients. Correlation between FAB scores and MMSE scores was evident in both groups.

The FAB is likely to be a useful and brief battery for assessing frontal lobe function in schizophrenia patients.

Auditory Processing Disorder (APD) is defined as a disorder in recognition, discrimination, separation, grouping, localisation or ordering of sounds.AP evaluation of children with learning disorders has two goals:1) to rule out an auditory processing disorder (APD) as a contributing factor for impaired cognition and 2) to diagnose APD in children with learning disabilities, in order to ensure appropriate remediation.

46 children were evaluated for Auditory Processing Disorders. 40 of them were fully assessed in 2 sessions each. 6 were lost to follow-up. We applied the: a) Peripheral hearing testing: Otoscopy, PTA, Speech audiometry b) AP battery:, Speech in noise, Duration Pattern Sequence (DPS), Pitch Pattern Sequence (PPS), Random GAP. C) Speech in noise: normative data from our lab. D) DPS,PPS, Random GAP: Standardized tests (Auditec, St. Louis). E) Learning Disability battery: WISC-III, Language tests (phonemic synthesis, non-words).

22 (of 40) 55% are diagnosed with Auditory Processing Disorders (at least 1 of the AP tests is pathological.) All 22 children with APD are already receiving appropriate treatment according to their auditory processing deficits and are being followed up for their progress. APD management strategies include: 1. Signal enhancement strategies 2. Specific Auditory Training 3.Linguistic, cognitive, metacognitive and educational strategies

Identification of underlying specific auditory deficits in the heterogeneous group of LD children may indicate what remedial action is appropriate, since appropriate management of the auditory processing deficits may lead to improved auditory as well as reading skills.