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Introduction: Cyberchondria (CYB) represents a poorly characterized syndrome involving the urge-driven tendency to excessively seek health-related information on the Internet. Intended to provide reassurance, the searching results in increased anxiety and distress, uncertainty and reinforcing CYB. CYB may represent a trans-diagnostic digital compulsive syndrome. However, the extent to which CYB contributes to the psychopathology of compulsive psychiatric disorders, such as illness anxiety disorder (hypochondriasis), obsessive-compulsive and related disorders (OCRD) or other online disorders of behavioral addiction, is not understood. Objectives: We describe one of the first reported cases of a treatment-seeking patient with DSM-5 illness anxiety disorder and disabling CYB. We review the available peer-reviewed published knowledge on CYB. Methods: Updated search of PubMed, PsycINFO, Cochrane Library. Search terms: "cyberchondria", "cyberchondriasis". Results: 58 original research studies were found. No consensus definition of CYB was established. Existing studies were exclusively cross-sectional, recruited from general population samples, with no descriptions of CYB in clinical samples. Data on the epidemiology, sociodemographic and clinical characteristics and associated comorbidities were scarce. A scale has been developed to quantify CYB severity in the general population. CYB was variously found to correlate with the presence of health anxiety broadly defined, obsessivecompulsive symptoms, problematic use of the internet, and other psychological constructs. Only cognitive behavioral therapy and psychoeducation were suggested as a possible therapeutic approach. Conclusions: Research on CYB remains in its infancy. Further studies are warranted to understand CYB in terms of definition, clinical features, measurement, relationship with hypochondriasis and other compulsive disorders, and therapeutic interventions. [ABSTRACT FROM AUTHOR]

Introduction: Medication adherence was defined by the WHO as "the extent to which a person's behavior coincides with the medical advice given" (WHO, 2003). Existing literature indicates that approximately 49% of patients with major psychiatric disorders do not fully adhere to their prescribed psychopharmacological therapy (Colom et al, 2002). Non-adherence can lead to partial therapeutic responses or treatment resistance, increased risk of relapse, re-hospitalization, elevated suicide risk, and overall poorer functioning, thereby compromising the patient-doctor therapeutic relationship (Garcìa et al, 2016). Objectives: The aim of the present study was to assess potential differences in terms of clinical features related to adherence to treatment in a large cohort of psychiatric patients of an Italian psychiatric department. Methods: The study included 307 psychiatric patients, of any gender or age, diagnosed with unipolar depression (UD), bipolar depression (BD), anxiety disorders (AD), schizophrenic spectrum disorders (SS) or a primary diagnosis of personality disorders (PD), based on DSM-5 criteria. Patients were consecutively recruited from the Department of Psychiatry at Luigi Sacco University Hospital, in Milan. The patient's adherence to treatment was evaluated using the Clinician Rating Scale (CRS), with a cut-off of ≥ 5 defining adherence subgroups (A+: score ≥ 5; A-: score < 5). Comparative and predictive analysis were performed for the whole sample and the two adherence subgroups. Results: Overall, nearly one-third of the whole sample reported suboptimal medication adherence. Specifically, rates were approximately 35.3% and 32.7% for BD and SS, respectively, followed by 30.8% for PD, 28% for AD and, 20.3% for UD (see Figure 1). Patients with A- showed significantly higher current substance abuse (17.8% vs 4.5%, p<.001), along with a higher rate of lifetime substance abuse, although with a trend towards significance (31.5% vs 20.5%; p=.057). Moreover, the A- group had a significantly higher number of lifetime hospitalizations (1.35 ± 1.8 vs 0.73 ± 1.11; p<.001) and higher rate of previous psychotropic treatment dropouts compared to the A+ group (90% vs. 36.2%; p<.001, see Figure 2). Image: Image 2: Conclusions: Approximately one-third of the whole sample reported a suboptimal medication adherence, with varying rates across different diagnoses. Current and lifetime substance abuse appears to be an unfavorable transdiagnostic factor. Additionally, severe outcomes such as increased hospitalizations and a more acute disease presentation are linked to poorer adherence. Recognizing the characteristics of adherence patterns within specific diagnostic categories is crucial for designing precise interventions to enhance patient outcomes and optimize the overall effectiveness of treatment. Disclosure of Interest: N. Girone: None Declared, B. Benatti Speakers bureau of: Angelini, Lundbeck, Janssen, Rovi., M. Cocchi: None Declared, F. Achilli: None Declared, C. Viganò: None Declared, M. Vismara: None Declared, B. Dell'Osso Grant / Research support from: Angelini, Lundbeck, Janssen, Pfizer, Otzuka, Neuraxpharm, and Livanova, Speakers bureau of: Angelini, Lundbeck, Janssen, Pfizer, Otzuka, Neuraxpharm, and Livanova [ABSTRACT FROM AUTHOR]

We report a case of a woman with a cryptic balanced translocation between chromosomes 5 and 17, suspected during genetic counseling. The woman had a history of previous fetal losses attributed to lissencephaly and intra uterine growth retardation (IUGR) and a daughter with dysmorphic features and mental retardation, previously attributed to a small deletion 5pter, detected years ago by a first generation CGH-array. This peculiar combination of personal and family history suggested the opportunity to carry out a FISH approach, focusing on chromosomes 5 and 17, based on the idea that a malsegregation secondary to a balanced translocation, might have escaped the first CGH array. This approach allowed the identification of a balanced translocation in the mother, FISH in the affected child confirmed the partial 5p deletion predicted by the previous CGH array and identified a new 17p duplication that had not been detected before. The described translocation opens the possibility of alternative imbalances that were probably responsible for previous fetal losses. The imbalances were confirmed by a new high resolution SNP array. We conclude that despite the availability of highly effective and sensitive genomic approaches a careful evaluation of medical history is highly recommended since it can suggest clinical hypothesis that can be confirmed by more classical and molecular cytogenetic based approaches. [ABSTRACT FROM AUTHOR]

Introduction: Clinical staging is based on the concept that psychiatric illnesses progress over time through successive stages marked by symptoms of increased clarity and intensity: from increased risk, asymptomatic to severe illness. A clinical staging model integrating the severity of symptoms and the phase of illness for personalized case management for Obsessive Compulsive Disorder (OCD) patients has been proposed. Aim of the study is the application of this model to a sample of OCD Italian patients. Objectives: Aim of the study is the application of this model to a sample of OCD Italian patients. Methods: 188 patients with OCD were recruited and 32 patients completed a follow-up assessment. Patients were divided in four main stages (Stage 0: YBOCS 0 and family history for OCD; Stage 1: YBOCS 1-13; Stage 2: YBOCS 14-34; Stage 3: YBOCS 35-40) and then on 3 groups: no stage change, improvedstage or worsened stage between T0 and follow up. Results: 53.1% of the followed-up patients showed no changes on their stage, 37.5% improvedtheir stage and 9.4% showed a progression tothe worse stage. All patients with a worsened stage showed at least one psychiatric comorbidity and a significantly higherprevalence of somatic obsessions (p<.05). The age at onset of patients witha worsened stage was earlier compared to the other groups and theduration of untreated illness andduration of illness resulted almost two times higher compared to the other groups Conclusions: Preliminary results confirm the relevance of illness onset and early intervention in OCD. There is an emerging need of more stringent criteria for staging to better characterize OCD patients. [ABSTRACT FROM AUTHOR]

Introduction: During the COVID-19 pandemic, health workers represented a group particularly vulnerable to work-related stress, but prevention and management of psychiatric symptoms are still under evaluation. Neurofeedback is a safe and noninvasive neuromodulation technique with the target of training participants in the self-regulation of neural substrates underlying specific psychiatric disorders. Protocols based on the increase of alpha frequencies, associated with the process of relaxation, are used for the treatment of stress, anxiety and sleep disturbances. Objectives: The aim of the present study was to assess the effectiveness of an alpha-increase NF protocol for the treatment of stress in healthcare workers exposed to the COVID-19 pandemic. Methods: Eighteen medical doctors belonging to the Sacco Hospital were recruited during the COVID-19 health emergency and underwent a 10 sessions NF alpha-increase protocol during two consecutive weeks. The level of stress was assessed at the beginning (T0) and at the end (T1) of the protocol through the following questionnaires: Severity of Acute Symptoms Stress (SASS), Copenhagen Burnout Inventory (CBI), Pittsburgh Sleep Quality Index (PSQI), Brief-COPE. Statistical analyses were performed with Paired Samples t-Test for continuous variables, setting significance at p < 0.05. Results: A significant increase in alpha waves mean values between T0 and T1 was observed. In addition, a significant reduction in the PSQI test score between T0 and T1 was observed. Conclusions: Alpha-increase protocol showed promising results in terms of stress modulation, sleep quality improvement and safety profile in a pilot sample of health-care workers. Larger controlled studies are warranted to confirm present results. [ABSTRACT FROM AUTHOR]