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Introduction: In recent years, a global debate has emerged regarding the protection of Internet users from exposure to harmful content. Content moderation is defined as the organized practice of filtering user-generated content posted on internet, social networks, and media to determine the appropriateness of the content for a site, locality, or jurisdiction. The growing volume of this content along with the psychological impact of this activity have promoted the application of automated approaches based on artificial intelligence and machine-learning. However, the changing characteristics of content, as well as the cultural differences that influence its appropriateness, mean that human moderation of Internet content currently continues to exist. Psychological effects of this activity such as symptoms of post-traumatic stress disorder (PTSD) could represent an example of secondary trauma. Objectives: Our aim is to describe a clinical case of post-traumatic stress disorder presenting with specific traumatic exposure idiosyncrasy that could lead to a better consequence characterization of a recent social phenomena such as internet content moderation. Methods: We expose the clinical case of a woman with emotional distress who was reffered to our outpatient psychiatric unit in Barcelona in 2022 after five years working as an internet content moderator. Results: We describe the case of a 35-year-old woman without relevant medical, toxicologic or psychiatric record that presents to our out-patient psychiatric clinic with post-traumatic stress disorder after five years of working as an internet content moderator and being exposed to visual traumatic content such as sexual assault and paedophilia. The clinical presentation consisted with one year of recurrent daily panic attacks, intrusive images about the traumatic exposure, intrusive thoughts, insomnia, vivid nightmares, avoidance of exposure to her son, distrust of the environment and intense fear for her son security. The disorder interfered in her capacity to work. The patient received psychological treatment and ISRS (Sertraline) was prescribed, however only partial response was reached with persistence of the majority of symptoms. Conclusions: The presented case suggests a temporal and symptom content relationship between the described work exposure and the appearance of emotional distress in a patient without PTSD history. Although previous evidence of secondary trauma in people exposed to indirect traumatic experiences has been reported, for example in healthcare professionals, the exposure to alien trauma through digital exposure as a workactivity is yet to be specifically examined. It is necessary to expand knowledge on the clinical expression of this phenomenon due to the observed recurrence of anxious and depressive symptomatology related to repeated exposure to traumatic content. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: Schizophrenia is associated with a reduced life expectancy, not only because of suicide, but also medical causes such as cancer. Standardized mortality for cancer is higher in patients with schizophrenia, specially for lung, breast and colorectal locations (Ni et al, 2019). Other less frequent tumor locations have not been deeply studied. Thir mortality gap could be related to a delayed diagnosis due to several reasons, such as lower inclusion in screening programs (Solmi et al, 2019). Since cervical cancer has a very efficient screening technique, women with schizophrenia and cervical cancer could have a worse prognosis because of a delayed diagnosis. However, there is a lack of research in this tumor location. Objectives: To analyze clinical differences in women with cervical cancer with and without a diagnosis of schizophrenia. Methods: We carried out a retrospective cohort analysis with adult patients from the cancer registry of Hospital del Mar diagnosed between 1997 and 2021. The information was crossed with the Minimum Basic Data Set (MBDS) to identify those cancer patients with a diagnosis of schizophrenia using International Classification of Diseases (ICD) 9 codes 295*. The sociodemographic variables were age and sex. The clinical oncological variables included tumor location, place of first conultation, stage, first treatment intention, vital status and place of decease. We used t-student for continuous data and Chi-squared test for categorical variables. We performed a post-hoc analysis using Bonferroni correction for multiple comparisons to identify specifically which categories were significantly different between groups. Results: We identified 13 women with schizophrenia and cervical cancer, and 1354 women with cervical cancer without schizophrenia. The proportion of this location was higher in the schizophrenia group (8% of all cancers vs. 4.4%; p=0.03). The proportion of diagnoses through screening programm was significantly lower (7.7% vs 14.6%; p=0.04). There was a trend of fewer diagnoses in situ in patients with schizophrenia (30.8% vs 55.6%) and less radical intention as first treatment option (15.4% vs 3.5%) but without statistical significance in both cases. There was a higher proportion of deceased patients in the group with schizophrenia (46.2% vs 15% p=0.002), and also a higher proportion of deaths outside hospital facilities (30.8% vs 6.6%; p=0.003). Image: Conclusions: Women with schizophrenia receive less diagnoses of cervical cancer through screening programs and more in emergency facilities, which could lead to more advanced stages and fewer indication of radical treatments. This ultimately leads to a higher proportion of deaths, and more frequently outside of hospital facilities. Our data supports the idea that the increased mortality for cancer is related to a delayed diagnosis. Women with schizophrenia need special care to ensure their inclusion in early detection programs for cancer. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: Due to the global humanitarian crisis, there has been a significant increase in global immigration.(1) The migration process typically involves multiple trauma exposures that are sustained over time(2), which may result in an impact on the mental health of these individuals(3), such as posttraumatic stress disorder(3). A recent meta-analysis estimated that 25% of migrants had PTSD(15), which is significantly higher than the 0.2% to 3.8 percent prevalence data found for the general population(4). In addition, a number of meta-analyses indicate an increased risk of psychosis among immigrants(5). Despite this rise, there is a gap in trauma research in non-refugee immigrants, particularly those with psychotic disorders. Objectives: To describe and compare PTSD diagnosis between immigrants and locals recruited from mental health services in Barcelona. Methods: Patients who have presented, according to DSM-V criteria, one or more non-affective psychotic episodes, were recruited in Acute and Chronic inpatients units at Hospital del Mar (Barcelona) from November 2019 to June 2021, leading to a total sample of 199 patients. Demographic characteristics of patients, clinical data and main pharmacological treatment were recorded through a questionnaire. Database information was completed with electronic medical records. Global Assessment of Posttraumatic Stress Questionnaire (EGEP-5) was used as an instrument to assess PTSD diagnosis, main trauma nature and PTSD symptoms. Comparative analysis was performed with IBM SPSS Statistics (Chicago INC) using Chi-Square Test for qualitative variables and t-Student test for continuous variables. Covariate adjustment with demographic and clinical variables was performed by ANOVA test. Study received local ethics committee approval "CEIC" (No. 2019/8398/I). Results: From the total sample of 199 individuals, 98 were immigrants and 98 locals. From the total sample 39 individuals (19.69%) presented PTSD. 32.3% of the immigrants with psychotic disorders presented PTSD compared to 7.1% of the locals with psychotic disorders (F1=19.9, p=0.00). Most traumatic events related to PTSD in immigrants were: "murder of relatives" (33.1%), Physical violence (21.9%) and Terrorism (15.6%) in locals were: "physical violence" (28.6%). Immigrants and locals with psychotic disorders showed similar averages of symptoms, except for avoidance symptoms where locals showed a mean of 5.1 compared to a mean of 3.5 in the immigrant group. Finally, immigrants showed one more functionality affected area by PTSD (5.1) when compared to locals (4) (F7=3.9, p=0.05). Conclusions: According to our results there are important differences in PTSD prevalence between immigrants and locals with psychotic disorders. These findings ought to be taken into consideration for programs that are both clinically and sociopolitically tailored to improve assessment and treatment for this population. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: Hiccups are repetitive and involuntary contractions of the diaphragm and intercostal muscles. Acute hiccups normally. last between 4 and 60 minutes, and sometimes can be stopped by physical manoeuvres. Persistent hiccups can continue for days and months, and lead to important stress and discomfort. Persistent hiccups can be caused by several organic conditions, including causes that affect the central nervous system or the peripheral nervous system, but also toxic metabolic and pharmacologic causes as part of a myoclonic syndrome. Objectives: To illustrate the clinical features of this symptom and to investigate the possible relation with antidepressant treatments. Methods: We present a case-report and literature research of the topic. Results: We present a clinical case of a 58-year-old male patient, who started presenting persistent hiccups for 5 months while starting taking venlafaxine as a treatment for a depressive disorder. Several blood tests and thorax and neck computerized tomographies were performed to dismiss the more frequent causes. With the progressive switch from venlafaxine to mirtazapine, the patient stopped having hiccups. In a recent systematic review, drug-induced myoclonus was reported in relation to selective serotonin-reuptake inhibitors (SSRI) (n=44) and tricyclic antidepressants (n=55), but not to serotonine-norepinephrine reuptake inhibitors (SNRI) (n=1). Conclusions: When assessing the etiology of hiccups and myoclonus, psychopharmacological agents must be taken into account. Although it is a very strange condition, SNRI can present this side effect. In this situation, switching the treatment should be considered. [ABSTRACT FROM AUTHOR]

Introduction: Opsoclonus-Myoclonus syndrome (OMS), also known as Kinsbourne syndrome, is a paraneoplasic pediatric condition characterized by erratic eye movements and generalized myoclonus. Previous studies have described a wide range of psychiatric comorbidities in children with this syndrome. Cognitive impairment (especially intellectual capacity and language), affective symptoms (irritability, poor mood regulation) and behavioral problems are the most frequent presentations (1). However, there is a lack of literature describing the progression of this symptoms when the patient reaches the adulthood. Objectives: To illustrate the psychiatric comorbidity of an adult patient with Opsoclonus-Myoclonus syndrome. Methods: We present one case-report and literature research of the topic. Results: We present a 18 year old girl diagnosed with OMS and Graves-Basedow hyperthyroidism. During her childhood she started presenting attention and comprehension difficulties. She was diagnosed with an Attention Deficit Hyperactivity Disorder (ADHD) and started treatment with methylphenidate. She completed elementary and secondary education. During the adulthood, the main psychiatric comorbidity was related to affective symptoms. We observed an impaired mood regulation, hypothymia, anhedonia, and frequent episodes of irritability, which persisted after the thyroid regulation. This caused incremented anxious symptoms and insomnia that were treated with mirtazapine and lormetazepam. After some weeks, she fulfilled criteria of a depressive episode and we started antidepressant treatment with vortioxetine. Conclusions: - Adult patients diagnosed with OMS during childhood can persist presenting ADHD as a comorbidity. - Affective symptoms, and even a major depressive episode, should be considered during the follow-up of this population. Insight of the cognitive limitations could be a risk factor for a depression. [ABSTRACT FROM AUTHOR]

Introduction: Psychiatric liaison services are important providers of diagnosis and treatment for hospital patients with mental comorbidities and medically ill. Several studies have observed that patients with psychiatric comorbidities had a longer length of stay. However, further research is needed to study the association between psychiatric diagnosis and complications during the hospitalization. Objectives: The aim of this study is to describe the presence of somatic complications in hospitalized patients with psychiatric comorbidity in a General Hospital in Barcelona. Methods: Consecutive consultations to a Liaison Psychiatry Service of a General Hospital (Hospital del Mar, Barcelona) were registered from January 2018 to December 2018 with a total sample of 373. Demographic characteristics of patients, clinical data and main pharmacological treatment were recorded through an "ad hoc" questionnaire. Database information was completed with electronic medical records. Comparative analysis was performed with IBM SPSS Statistics (Chicago INC) using Chi-Square Test for qualitative variables and t-Student test for continuous variables. Results: From a total of 373 consultations, the most frequent diagnosis were: adjustment disorder with depressedmood (21.6%), acute confusional syndrome (17.6%), normal stress reaction (9,8%) and adjustment disorder with mixed symptomes (9,8%). The psychiatric diagnosis most related to somatic complications were adjustment disorder with anxiety and adjustment disorder with mixed symptomes. Significant differences were found between the consultation services and the presence of somatic complications. Conclusions: We must consider to perform specific programms and protocols in patients with psychiatric comorbidities in order to decrease the somatic burden on these patients. [ABSTRACT FROM AUTHOR]

Introduction: Physicians in general hospitals are frequently faced with decisions regarding the psychopharmacologic management of medically ill patients, yet receive limited psychiatric training and leading to interruption of psychiatric treatment. Literature demonstrate high rates of relapse when medications are discontinued in patients suffering from schizophrenia, mood and anxiety disorders. Objectives: The aim of this study is to compare interruption of psychopharmacologic treatment in a general hospital between surgery department and Internal medicine department. Methods: 373 consecutive consultations to a Liaison Psychiatry Service of a General Hospital (Barcelona) were registered during 1year. Consultations from Surgery and Internal Medicine departments were selected with a total sample of 56. Demographic characteristics of patients, clinical data and main pharmacological treatment were recorded through an "ad hoc" questionnaire. Database information was completed with electronic medical records. Comparative analysis was performed with SPSS using Chi-Square Test for qualitative variables and t-Student test for continuous variables Results: From a total of 373 consultations, 30%(8.0%) were from Internal medicine department and were from 26(7%) general surgery. The diagnosis found were similar in both departments. Interruption of treatment was detected in 17.24% of the Internal Medicine consultations and 18.18% of the Surgery consultations. The treatment most interrupted were antidepressants(55.5% from total interrupted treatments). Conclusions: According to our results there are differences in treatment interruption between psychotropic drugs and internal Medicine and surgery admissions. It is important to apply specific programs and adjust protocols in each department, involving Psychiatry Liaison service to help physician making complex psychopharmacologic decisions and to improve mental health patient's treatment. [ABSTRACT FROM AUTHOR]

Introduction: In general hospitals the presence of mental health disorders in hospitalized patients is a common problem. Patients with comorbid mental illnesses display increased morbidity and mortal and thus leads to an increased risk of prolonged and repeated hospital stays. Objectives: The aim of this study is to describe in a general hospital which departments request Psychiatry Liaison service consultation and sociodemographic and clinical characteristics of the assessed patients. Methods: Consecutive consultations to a Liaison Psychiatry Service of a General Hospital (Hospital del Mar, Barcelona) were registered from August 2018 to August 2019 with a total sample of 373. Demographic characteristics of patients, clinical data and main pharmacological treatment were recorded through an "ad hoc" questionnaire. Database information was completed with electronic medical records. Comparative analysis was performed with IBM SPSS Statistics (Chicago INC) using Chi-Square Test for qualitative variables and t-Student test for continuous variables. Results: From a total of 373 consultations, 30(8.0%) were from Internal medicine department, 26(7%) general surgery, 27(7.2%) Pneumology, 58(15.5%) Emergency department, 29(7.8%) Nephrology, 19(5.1%) Cardiology, 18(4.8%) Oncology, 15(4.0%) Intensive care unit, 17(4.6%) Anaesthesiology, 16(4.3%) Neurology, 15(4.0%) Infectious disease, among others. The most diagnosis treated was adjustment disorder(21.2%) and acute confusional syndrome (17.3%) with significant differences between services. Conclusions: According to our results there are differences in mental health diagnosis depending of consultant department in our general hospital. Thus, it is important to apply specific programs and adjust protocols in each department to improve mental health patient's assessment. [ABSTRACT FROM AUTHOR]

Purpose: To compare social, clinical, and migration-related factors between male and female immigrants with psychotic disorders and to determine the association between these variables and stress in the last year., Methods: We administered the Holmes and Rahe Social Readjustment Scale to evaluate psychological stress in 99 non-refugee immigrants (26 women, 73 men) who presented ≥ one psychotic episode (ICD-10 criteria). We compared the two groups in terms of sociodemographic, clinical, cultural, and migration-related variables. A multivariable analysis using a linear regression model (stepwise method) was performed to evaluate potential associations between these variables and stress., Results: Women were more likely to be married and divorced, had less access to welfare payments, and lower unemployment and homeless rates than men. The most common psychiatric diagnosis was psychosis not otherwise specified with more women being affected (61.5% in women vs. 45.2% in men), but the diagnosis of schizophrenia was more common in men (38.4% vs 15.4%). Both groups exhibited very high levels of stress in the past year (mean total distress score > 300). In women, stress was significantly associated with age at first migration and be a racialized person. By contrast, among men stress was significantly associated with language barrier and comorbidity with a physical disorder., Conclusions: The results of this study reveal important differences between men and women immigrants. These findings underscore the importance of understanding how gender-specific roles and social expectations intersect with the timing and nature of migration to influence stress levels differently in immigrant women and men with psychotic disorders., (© 2024. The Author(s).)

Schizophrenia is associated with higher cancer-related mortality, perhaps due to delayed diagnosis and limited access to treatment. The study aimed to compare patients diagnosed with cancer with and without schizophrenia to determine whether these groups differ in terms of oncological variables and survival outcomes. This was a retrospective, observational cohort study that included 30.990 patients diagnosed with cancer between 1997 and 2021. We performed univariate and bivariate analyses for the sociodemographic and clinical variables, and constructed Kaplan-Meier survival curves and used the log-rank test to perform the comparisons. All variables were compared for each cancer type. One hundred and sixty-two (0.52 %) patients had a confirmed diagnosis of schizophrenia (ICD-9 criteria). The mean age at diagnosis was significantly lower in the schizophrenia group. A significantly higher proportion of the schizophrenia group was diagnosed with cancer through the emergency department and a lower percentage through scheduled appointments. A smaller percentage of patients in the schizophrenia group received radical treatment for cancer. The mortality rate was higher in the schizophrenia group and median survival was lower. These findings suggest that cancer patients with schizophrenia have worse outcomes than patients without schizophrenia in terms of oncological variables and survival., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: More than half of women with psychosis take care of their children despite the difficulties caused by the disease. Additionally, these kids have a higher risk of developing a mental health disorder. However, no interventions have been developed to meet these needs. Metacognitive Training (MCT) is a psychological intervention that has demonstrated its efficacy in improving cognitive insight, symptom management and social cognition in people with first-episode psychosis (FEP). Additionally, MCT has shown better results in women than men with FEP. This study aims to adapt and evaluate the efficacy of MCT-F in mothers and adolescent children in an online group context with the main purpose of improving family relationships, cognitive awareness and symptoms in women with psychosis and increase their children's knowledge of the disease and their functioning. As secondary objectives, it also aims to evaluate improvements in metacognition, social cognition, symptoms, protective factors and self-perception of stigma., Materials and Methods: A quasi-experimental design with participants acting as their own control will be carried out. Forty-eight mothers with psychosis and their adolescent children (between 12 and 20 years old) recruited from a total of 11 adult mental health care centers will receive MCT-F. Participants will be evaluated 11 weeks before the intervention (T1), at baseline (T2), and post-intervention (T3) with a cognitive insight scale, as a primary outcome. Measures of metacognitive and social cognition, symptoms, cognitive functioning, family and social functioning, protective factors (self-esteem, resilience, and coping strategies) and self-perceived stigma will be addressed as secondary outcomes. Assessment will also address trauma and attachment in mothers and, lastly, the feasibility and acceptability of MCT-F in both participant groups., Discussion: This will be the first investigation of the efficacy, acceptability, and viability of the implementation of MCT-F. The results of this study may have clinical implications, contributing to improving mothers' with psychosis and adolescents' functioning and better understanding of the disease, in addition to the possible protective and preventive effect in adolescents, who are known to be at higher risk of developing severe mental disorders. Clinical trial registration: https://clinicaltrials.gov/, identifier [NCT05358457]., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Ochoa, Espinosa, López-Carrilero, Martinez, Barrera, Birulés, Barajas, Pélaez, Díaz-Cutraro, Coromina, González-Rodríguez, Verdaguer-Rodríguez, Gutiérrez-Zotes, Palma-Sevillano, Montes, Gallego, Paya, Casanovas, Roldán, Noval, Varela Casals, Salas-Sender, Aznar, Ayesa-Arriola, Pousa, Canal-Rivero, Garrido-Torres, Montserrat, Muñoz-Lorenzo and Crosas.)

Little is known about genetic predisposition to relapse. Previous studies have linked cognitive and psychopathological (mainly schizophrenia and bipolar disorder) polygenic risk scores (PRS) with clinical manifestations of the disease. This study aims to explore the potential role of PRS from major mental disorders and cognition on schizophrenia relapse. 114 patients recruited in the 2EPs Project were included (56 patients who had not experienced relapse after 3 years of enrollment and 58 patients who relapsed during the 3-year follow-up). PRS for schizophrenia (PRS-SZ), bipolar disorder (PRS-BD), education attainment (PRS-EA) and cognitive performance (PRS-CP) were used to assess the genetic risk of schizophrenia relapse.Patients with higher PRS-EA, showed both a lower risk (OR=0.29, 95% CI [0.11-0.73]) and a later onset of relapse (30.96± 1.74 vs. 23.12± 1.14 months, p=0.007. Our study provides evidence that the genetic burden of neurocognitive function is a potentially predictors of relapse that could be incorporated into future risk prediction models. Moreover, appropriate treatments for cognitive symptoms appear to be important for improving the long-term clinical outcome of relapse., Competing Interests: Conflict of interest A. Ibáñez has received research support from or served as speaker or advisor for Janssen-Cilag, Lundbeck and Otsuka. A. Gonzalez-Pinto has received grants and served as consultant, advisor or CME speaker for the following entities: Janssen-Cilag, Lundbeck, Otsuka, Pfizer, Sanofi-Aventis, Exeltis, the Spanish Ministry of Science and Innovation (CIBERSAM), the Ministry of Science (Carlos III Institute), and the Basque Government, J. Saiz-Ruiz has been as speaker for and on the advisory boards of Adamed, Lundbeck, Servier, Medtronic, Casen Recordati, Neurofarmagen, Otsuka, Indivior, Lilly, Schwabe, Janssen and Pfizer, outside the submitted work. M. Bernardo has been a consultant for, received grant/research support and honoraria from, and been on the speakers/advisory board of ABBiotics, Adamed, Angelini, Casen Recordati, Janssen-Cilag, Menarini, Rovi and Takeda, Pilar A. Saiz has been a consultant to and/or has received honoraria or grants from Adamed, CIBERSAM, European Comission, Government of the Principality of Asturias, Instituto de Salud Carlos III, Janssen-Cilag, Lundbeck, Otsuka, Pfizer, Plan Nacional Sobre Drogas and Servier. R. Rodriguez-Jimenez has been a consultant for, spoken in activities of, or received  grants from: Instituto de Salud Carlos III,  Fondo de Investigación Sanitaria (FIS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid Regional Government (S2010/ BMD-2422 AGES; S2017/BMD-3740), JanssenCilag, Lundbeck, Otsuka, Pfizer, Ferrer, Juste, Takeda, Exeltis, Casen-Recordati, Angelini. The rest of the authors reported no biomedical financial interests or potential conflicts of interest., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)

Circulating white blood cells (leucocytes), which form the peripheral immune system, are crucial in inflammatory processes but their role in brain structural change in schizophrenia has been scarcely studied. With this study we want to determine how and which type of white blood cells are associated with hippocampal volume (as a key structure in schi- zophrenia etiopathology) in first episode psychosis (FEP) patients. Moreover, to determine the association between white blood cells and clinical symptomatology, including positive and negative symptoms, cognition and depression. For this purpose fifty drug-naïve FEP were included in this study. All patients underwent an assessment at baseline and at 1 year follow-up, including sociodemographic and clinical variables (substance use, DUP, PANSS, GAF and CDSS). Fasting blood samples were obtained before administering any medication at baseline. Structural T1 MRI was performed at baseline and brain volumes were quantified. In the present study, higher lymphocyte count was associated with larger right hippocampal volume at baseline in FEP drug-naive patients. Higher lymphocyte count was associated with lower depressive symptomatology measured with CDSS and Marder depressive factor from PANSS at baseline and 1-year follow -up. These results suggest that lymphocytes may have a protective effect in hippocampal volume at baseli- ne in antipsychotic naïve FEP and also, are associated with a better depressive course over follow up. These results open the door to identify new biomarkers and therapeutic targets for patients with schizophrenia., Competing Interests: Declaration of Competing Interest A. Mané and D. Bergé have received financial support to attend meetings, travel support, and served as a speaker from Otsuka and Janssen Cilag. The other authors of this manuscript do not have any conflicts of interest., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background: Women with schizophrenia or other psychotic disorders differ from male patients in many respects, including psychopathology, prognosis, disease course, and substance use comorbidities. Most studies performed to date to investigate the association between drug use and psychosis have not evaluated gender differences, although this has started to change in recent years., Methods: We briefly summarize the available evidence on gender differences in drug use and substance use disorders (SUD) in psychotic patients during the early phases of the psychotic illness and during the course of schizophrenia., Results: Substance use and SUD are both less prevalent in women, both in the general population and at all phases of the psychotic spectrum. Some studies suggest that SUD may be under diagnosed in female patients, in part due to their more vulnerable profile. Substance use, especially cannabis, may more negatively impact females, especially on the disease course and prognosis. The available data suggest that it may be more difficult to treat SUD in female patients with schizophrenia, which could negatively impact prognosis., Conclusion: Women with concomitant psychotic illness and SUD comprise a highly vulnerable subgroup. This should be considered when selecting the treatment approach, especially in the early phases of the illness, to ensure better outcomes., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

The COVID-19 pandemic has affected the mental health of people around the world. However, its impact on first-episode psychosis (FEP) remains unclear. The aim of this study was to determine the incidence rate (IR) and the clinical and sociodemographic characteristics of patients who developed FEP during the nine-month period following the COVID-19 outbreak in Spain and to compare these data to the corresponding period in the previous year. We included all patients (n = 220) treated for the first time during these two time periods at three FEP programs in Spain. The IR was 0.42/100,000 person-years during the pandemic vs. 0.54/100,000 in the prior year (p = 0.057). Compared to prior year, women accounted for a significantly higher proportion of FEP patients (46.3% vs. 28%; p = 0.005) during the COVID-19 period. This association was significant on the logistic regression analysis (odds ratio, female: 2.12 [confidence interval 1.17-3.82]; p = 0.014). These data reveal a non-significant trend towards a lower incidence of FEP during the pandemic period. Female sex was associated with a greater risk of developing FEP during the pandemic period, perhaps due to differences between males and females in the susceptibility and expression of psychosis. The findings of this study contribute to a better understanding of stress-related disorders., (© 2022. The Author(s).)

Objective: To describe clinical and epidemiological features of influenza A H1N1 2009 diagnosed patients in the Emergency Department of 4 hospitals., Material and Methods: Prospective multicentre study conducted from july to december 2009. The patients diagnosed by Real-Time PCR of influenza A H1N1 2009 in the emergency department were included. The test was requested according to the protocols established throughout the epidemic. Epidemiological, clinical, laboratory variables and outcomes were evaluated., Results: A total of 456 cases were included, with a median age of 6.5years (PC(25-75) 3-10.6). There were risk factors of complications In 266 patients (59.4%) due to the influenza, mainly: respiratory (47%), cardiovascular (17%), neurological (14%) and immunosuppression (11%). The most frequent symptoms were fever (96%), (88%) cough, (72%) rhinorrhoea, muscle aches or asthenia and breathing difficulties and, less common, gastrointestinal and neurological symptoms. Chest X-ray was performed on 224 cases (49%), with lobar (31%) and interstitial (15%) infiltrates. One hundred and forty patients (31%) were hospitalised and 3.2% required Intensive Care Unit (median stay 4 and 3.5days, respectively). The most frequent complications were pneumonias and bronchospasms. Three patients died (a previously healthy patient with myocarditis and 2 patients with encephalopathy due to respiratory failure). Another case of myocarditis recovered with sequelae., Conclusions: The profile of patient with influenza A 2009 diagnosed in the emergency department was a school child, with risk factors of complications, presenting with respiratory symptoms and fever over a short time, and who can be discharged. It is important to emphasise myocarditis, as well as the usual respiratory complications of influenza virus., (Copyright © 2010 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.)