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Abstract Background Italy can be viewed as a laboratory to assess the quality of mental healthcare delivered in a community-oriented system, especially for severe mental disorders, such as personality disorders. Although initiatives based on clinical indicators for assessing the quality of mental healthcare have been developed by transnational-organisations, there is still no widespread practice of measuring the quality of care pathways delivered to patients with severe mental disorders in a community-oriented system, especially using administrative healthcare databases. The aim of the study is to evaluate the quality of care delivered to patients with personality disorders taken-in-care by mental health services of four Italian regions (Lombardy, Emilia-Romagna, Lazio, Sicily). Methods A set of thirty-three clinical indicators, concerning accessibility, appropriateness, continuity, and safety of care, was implemented using regional healthcare utilization databases, containing data on mental health treatments and diagnosis, hospital admissions, outpatient interventions and exams and drug prescriptions. RESULTS 31,688 prevalent patients with personality disorders treated in 2015 were identified, of whom 2,331 newly taken-in-care. One-in-10 patients received a standardized assessment, the treatment discontinuity affected half of the cases. 12.7% of prevalent patients received at least one hospitalization, 10.6% in the newly taken-in-care cohort. 6-out-of-10 patients had contact with community-services within 14 days from hospital discharge. Access to psychotherapy and psychoeducational treatments was low and delivered with a low intensity. The median of psychosocial interventions per person-year was 19.1 and 9.4, respectively, in prevalent and newly taken-in-care cases. Nearly 50% of patients received pharmacological treatments. Conclusions Healthcare utilization databases were used to systematically evaluate and assess service delivery across regional mental health systems; suggesting that in Italy the public mental health services provide to individuals with personality disorders suboptimal treatment paths.

Abstract Background Mental health (MH) care often exhibits uneven quality and poor coordination of physical and MH needs, especially for patients with severe mental disorders. This study tests a Population Health Management (PHM) approach to identify patients with severe mental disorders using administrative health databases in Italy and evaluate, manage and monitor care pathways and costs. A second objective explores the feasibility of changing the payment system from fee-for-service to a value-based system (e.g., increased care integration, bundled payments) to introduce performance measures and guide improvement in outcomes. Methods Since diagnosis alone may poorly predict condition severity and needs, we conducted a retrospective observational study on a 9,019-patient cohort assessed in 2018 (30.5% of 29,570 patients with SMDs from three Italian regions) using the Mental Health Clustering Tool (MHCT), developed in the United Kingdom, to stratify patients according to severity and needs, providing a basis for payment for episode of care. Patients were linked (blinded) with retrospective (2014–2017) physical and MH databases to map resource use, care pathways, and assess costs globally and by cluster. Two regions (3,525 patients) provided data for generalized linear model regression to explore determinants of cost variation among clusters and regions. Results Substantial heterogeneity was observed in care organization, resource use and costs across and within 3 Italian regions and 20 clusters. Annual mean costs per patient across regions was €3,925, ranging from €3,101 to €6,501 in the three regions. Some 70% of total costs were for MH services and medications, 37% incurred in dedicated mental health facilities, 33% for MH services and medications noted in physical healthcare databases, and 30% for other conditions. Regression analysis showed comorbidities, resident psychiatric services, and consumption noted in physical health databases have considerable impact on total costs. Conclusions The current MH care system in Italy lacks evidence of coordination of physical and mental health and matching services to patient needs, with high variation between regions. Using available assessment tools and administrative data, implementation of an episodic approach to funding MH could account for differences in disease phase and physical health for patients with SMDs and introduce performance measurement to improve outcomes and provide oversight.

Abstract Background The assessment of the quality of care pathways delivered to people with severe mental disorders in a community-based system remains uncommon, especially using healthcare utilization databases. The aim of the study was to evaluate the quality of care provided to people with bipolar disorders taken-in-care by mental health services of four Italian areas (Lombardy, Emilia-Romagna, Lazio, province of Palermo). Methods Thirty-six quality indicators were implemented to assess quality of mental health care for patients with bipolar disorders, according to three dimensions (accessibility and appropriateness, continuity, and safety). Data were retrieved from healthcare utilization (HCU) databases, which contain data on mental health treatments, hospital admissions, outpatient interventions, laboratory tests and drug prescriptions. Results 29,242 prevalent and 752 incident cases taken-in-care by regional mental health services with a diagnosis of bipolar disorder in 2015 were identified. Age-standardized treated prevalence rate was 16.2 (per 10,000 adult residents) and treated incidence rate 1.3. In the year of evaluation, 97% of prevalent cases had ≥ 1 outpatient/day-care contacts and 88% had ≥ 1 psychiatric visits. The median of outpatient/day-care contacts was 9.3 interventions per-year. Psychoeducation was provided to 3.5% of patients and psychotherapy to 11.5%, with low intensity. 63% prevalent cases were treated with antipsychotics, 71.5% with mood stabilizers, 46.6% with antidepressants. Appropriate laboratory tests were conducted in less than one-third of prevalent patients with a prescription of antipsychotics; three quarters of those with a prescription of lithium. Lower proportions were observed for incident patients. In prevalent patients, the Standardized Mortality Ratio was 1.35 (95% CI: 1.26–1.44): 1.18 (1.07–1.29) in females, 1.60 (1.45–1.77) in males. Heterogeneity across areas was considerable in both cohorts. Conclusions We found a meaningful treatment gap in bipolar disorders in Italian mental health services, suggesting that the fact they are entirely community-based does not assure sufficient coverage by itself. Continuity of contacts was sufficient, but intensity of care was low, suggesting the risk of suboptimal treatment and low effectiveness. Care pathways were monitored and evaluated using administrative healthcare databases, adding evidence that such data may contribute to assess the quality of clinical pathways in mental health.

Objetivo: Estimar a prevalência das infecções pelo HIV, Hepatites B e C, e da Sífilis em moradores em situação de rua no município de Santos. Métodos: Estudo transversal em amostra com 192 indivíduos representativos da população estimada de moradores em situação de rua do município de Santos. Critério de Inclusão: todos indivíduos, independente de gênero ou idade, que ao chegarem ao acaso no albergue noturno mantido pelo município apresentavam condições clínico-intelectuais e concordavam com o termo de consentimento livre e esclarecido, assim como responder à questionário sociodemográfico e comportamental, e permitir coleta de sangue na polpa digital para pesquisa sorológica de Sífilis, Hepatite B e C, e HIV. Os testes rápidos foram fornecidos pelo Ministério da Saúde. Todos os indivíduos com testagem positiva foram tratados em Ambulatório de IST da Prefeitura de Santos. O estudo é trabalho de campo de tese do primeiro autor e apresentador. Resultados: Resultados preliminares são de 119 indivíduos já estudados. Predomina idade de 30-60 anos (46,2%), com 78/119 do sexo masculino. Vivendo há menos de um ano na rua são 42,9% deles. Procedentes da Baixada Santista são 55/119 (49,5%) sendo 32,0% (38/55) de Santos; 18/119 procedentes da região metropolitana de São Paulo e 20/119 do interior do estado de São Paulo; Nascidos em outros estados brasileiros são 19,3%. A positividade para Sífilis foi de 22,7% (27/119) sendo que 14 destes já foram tratados anteriormente. Houve nulidade de prevalência para Hepatite B. Cinco dos indivíduos pesquisados foram positivos para Hepatite C (4,2%) sendo três do sexo feminino. Cinco indivíduos pesquisados foram positivos para HIV (4,2%), sendo que três já sabiam e não estavam em tratamento. Quanto aos fatores de risco: 72/119 (60,5%) relataram ter relações sexuais na rua; 84/119 (70,6%) relataram fazer uso de drogas ilícitas; 14/119 disseram já ter recebido transfusão de sangue durante a vida, e somente 68/119 cortam cabelo e unhas no albergue. Conclusões: 1) A alta prevalência de Sífilis, HIV e Hepatite C nessa comunidade de moradores em situação de rua sugere a necessidade de reforços nos programas de redução de danos. 2) O Município de Santos, em que somente 32% dos indivíduos dessa comunidade serem cidadãos nascidos e procedentes do município, arca com pesado ônus social e econômico sugerindo a necessidade de programas assistenciais e resolutivos mais extensos nas demais esferas institucionais federativas.

Introduction The 1978 Italian reform of psychiatric services initiated the closure of psychiatric hospitals encouraging the development of community mental health. However, there is wide variability across regions in the amount of resources devoted to community-based psychiatric care, and the range of services provided still is cause of concern. Objectives To evaluate the quality of mental health care delivered to patients with schizophrenia and related disorders taken-in-care by mental health services in four Italian regions (Lombardy, Emilia-Romagna, Lazio, Sicily). Methods Thirty-one clinical indicators concerning accessibility, appropriateness, continuity, and safety were defined and estimated using healthcare utilization (HCU) databases, containing data on mental health treatments, hospital admissions, outpatient interventions, lab tests and drug prescriptions. Results A total of 70,586 prevalent patients with schizophrenia treated in 2015 were identified, of whom 1,752 were newly taken-in-care. For most patients community care was accessible and moderately intensive. However, care pathways were not implemented based on a structured assessment and only half of the patients received psychosocial treatments. One patient out of ten had access to psychological interventions and psychoeducation. Activities specifically addressed to families involved a third of prevalent patients and less than half of new patients. One patient out of six was admitted to a community residential facility, and one out of ten to a general hospital psychiatric ward (GHPW); higher values were identified in new cases. In general hospitals, one-fifth of the admissions were followed by readmission within 30 days of discharge. For two- thirds of patients continuity of community care was met, and six times out of ten a discharge from a GHPW was followed by an outpatient contact within two weeks. For cases newly taken-in-care the continuity of community care was uncommon, while the readiness of outpatient contacts after discharge was slightly more frequent. Most of the patients received antipsychotic medication, but their adherence to long-term treatment was low. Antipsychotic polytherapy was frequent and the control of metabolic side effects was poor. The variability between regions was high and consistent. Conclusions The Italian mental health system could be improved by increasing the accessibility to psychosocial interventions, improving the quality of care for newly taken-in-care patients, focusing on somatic health and mortality, and reducing regional variability. Clinical indicators demonstrate the strengths and weaknesses of the mental health system in these regions, and, as HCU databases, they could be useful tools in the routine assessment of mental healthcare quality at regional and national levels. Disclosure of Interest None Declared

Introduction The evaluation of healthcare pathways must be considered of fundamental importance. The quality of care provided to patients with severe mental disorders (SMD) does not correspond to the standards set by the recommendations. Therefore, measures such as the real coverage rate of psychiatric patients’ needs (contact coverage), by comparing epidemiological prevalence rates and the number of patients receiving adequate care, could be a valuable resource for implementing the transition to community mental health. However, simple assessment and reporting of rates of contact with mental healthcare potentially overestimate the full expected health benefits of services. Therefore, in addition to monitor the coverage rate achieved by the services, the evaluation of the effectiveness of the care provided (effective coverage) [De Silva et al. Int J Epidemiol 2014;43(2):341–53] is also of relevant importance. Objectives To measure the gap between contact and effective coverage of mental healthcare, i.e., the effectiveness of interventions provided by services for the treatment of SMD in preventing an exacerbation of psychiatric symptoms. Methods Data were retrieved from Healthcare Utilization databases of four Italian Regions (Lombardy, Emilia-Romagna, Lazio, Sicily). 45,761 newly taken-in-care cases of depression, schizophrenia, bipolar, and personality disorder were included. A variant of the self-controlled case series method was used to estimate the incidence rate ratio (IRR) for the relationship between exposure (use of different types of mental healthcare such as pharmacotherapy, generic contacts with the outpatient service, psychosocial interventions, and psychotherapies) and relapse episodes (mental illness emergency hospital admissions). Results 11,500 relapses occurred. Relapse risk was reduced (Figure) during periods covered by (i) psychotherapy for patients with depression (IRR 0.67; 95% CI, 0.49 to 0.91) and bipolar disorder (0.64; 0.29 to 0.99); (ii) psychosocial interventions for those with depression (0.74; 0.56 to 0.98), schizophrenia (0.83; 0.68 to 0.99) and bipolar disorder (0.55; 0.36 to 0.84), (iii) pharmacotherapy for those with schizophrenia (0.58; 0.49 to 0.69), and bipolar disorder (0.59; 0.44 to 0.78). Coverage with generic mental healthcare, in the absence of psychosocial/psychotherapeutic interventions, did not affect the risk of relapse. Image: Conclusions Psychosocial interventions, psychotherapies and specific pharmacotherapies can be considered particularly effective in treating patients with bipolar, depressive, and schizophrenic disorders. This study ascertained the gap between utilization of mental healthcare and effective coverage, showing that real-world data can represent a useful resource to monitor mental healthcare paths and to assess the effectiveness of a mental health system. Disclosure of InterestNone Declared

(1) Background: Recently, we found that adenosine A2A receptor (A2AR) stimulation results in an increase in STEP phosphatase activity. In order to delve into the mechanism through which A2AR stimulation induced STEP activation, we investigated the involvement of mGlu5R since it is well documented that A2AR and mGlu5R physically and functionally interact in several brain areas. (2) Methods: In a neuroblastoma cell line (SH-SY5Y) and in mouse hippocampal slices, we evaluated the enzymatic activity of STEP by using a para-nitrophenyl phosphate colorimetric assay. A co-immunoprecipitation assay and a Western blot analysis were used to evaluate STEP/mGlu5R binding. (3) Results: We found that the A2AR-dependent activation of STEP was mediated by the mGlu5R. Indeed, the A2AR agonist CGS 21680 significantly increased STEP activity, and this effect was prevented not only by the A2AR antagonist ZM 241385, as expected, but also by the mGlu5R antagonist MPEP. In addition, we found that mGlu5R agonist DHPG-induced STEP activation was reversed not only by the mGlu5R antagonist MPEP but also by ZM 241385. Finally, via co-immunoprecipitation experiments, we found that mGlu5R and STEP physically interact when both receptors are activated (4) Conclusions: These results demonstrated a close functional interaction between mGlu5 and A2A receptors in the modulation of STEP activity.

This study with 198 urban Chinese adolescents (M age = 16.0, SD = 1.46) and their parents investigated the impact of parental control over personal issues in the context of everyday conflicts and adolescent self-reports of internalizing disorders as measured by the Brief Symptom Inventory (BSI). Adolescents and parents completed the Parental Authority Index (PAI) assessing perceptions of parental control over personal, prudential-conventional, and overlapping issues. Adolescents recorded daily conflicts with parents over 2 weeks on private blogs through an online platform. Significant relationships were found between adolescent BSI scores for internalizing disorders (anxiety, somatization, interpersonal sensitivity) and their scores on the PAI for perceptions of parental control over personal issues as well as actions that overlapped personal with conventional and prudential considerations. Blog data revealed that two thirds of these urban Chinese parent--adolescent conflicts were about regulation of adolescent daily activities and issues directly impacting adolescent personal choice. Adolescents considered the majority of these conflicts as personal issues, and those who reported perceiving a higher level of parental control over their personal issues had significantly more daily conflicts with their parents. In addition, significant associations were found between reported actual daily conflicts and adolescent internalizing disorders: The greater the intensity of conflicts as experienced by the adolescents, the higher adolescents scored on the BSI subscale for depression; the less fair adolescents rated the conflict resolution and the less positively they felt about the process that led to the outcome, the higher they scored on the BSI subscales for interpersonal sensitivity and depression.

ObjectivesTo measure the gap between contact and effective coverage of mental healthcare (MHC).Materials and methods45,761 newly referred cases of depression, schizophrenia, bipolar disorder, and personality disorder from four Italian regions were included. A variant of the self-controlled case series method was adopted to estimate the incidence rate ratio (IRR) for the relationship between exposure (i.e., use of different types of MHC such as pharmacotherapy, generic contact with the outpatient services, psychosocial intervention, and psychotherapy) and relapse (emergency hospital admissions for mental illness).Results11,500 relapses occurred. Relapse risk was reduced during periods covered by (i) psychotherapy for patients with depression (IRR 0.67; 95% CI: 0.49 to 0.91) and bipolar disorder (0.64; 0.29 to 0.99); (ii) psychosocial interventions for those with depression (0.74; 0.56 to 0.98), schizophrenia (0.83; 0.68 to 0.99), and bipolar disorder (0.55; 0.36 to 0.84), (iii) pharmacotherapy for patients with schizophrenia (0.58; 0.49 to 0.69), and bipolar disorder (0.59; 0.44 to 0.78). Coverage with generic care, in absence of psychosocial/psychotherapeutic interventions, did not affect risk of relapse.ConclusionThis study ascertained the gap between contact and effective coverage of MHC and showed that administrative data can usefully contribute to assess the effectiveness of a mental health system.

In this blended ethnography, combining fieldwork with campus conservative organizations/figures and digital ethnography of their social media, we explore how capitalism, Christianity, and conservatism are brought together and branded for youth. We argue that campus conservative organizations like Turning Point USA are important sites for mainstreaming, branding, and circulating an assemblage of conservative, Christian, and racialized discourses aligned with Christian nationalism and against the left. We analyze how this 'friend enemy distinction' occurs through gendered social media practices, constructing female 'cuteservatives', influencers who sell friendship and t-shirts, and masculine heroes who battle a socialist enemy. We explore how these discourses are produced, marketed, and circulated. And finally, through Turning Point's celebration of Kyle Rittenhouse, we show the dangerous potential consequences of this violent rhetoric. [ABSTRACT FROM AUTHOR]

Background: Before the Affordable Care Act (ACA), the financing landscape for fee-for-service health care lacked broad structure and incentives to provide palliative care outside hospitals. Since the ACA, several payers have taken the opportunity to offer home-based palliative care (HBPC) to their members. Objective: To evaluate the impact of outreach efforts by a physician champion among a cohort of primary care physicians (PCPs) to introduce a new HBPC program and benefit, obtain buy-in, and motivate referrals for Blue Shield patients. Design: Secondary qualitative analysis of detailed field notes from a HBPC physician champion from in-person meetings with a cohort of PCPs and their office staff. Subjects: PCPs were from a physicians group in northern California that met with the physician champion during a 12-month study period. Results: During the 12-month study period, the physician champion met with clinicians at 27 distinct primary care offices. Qualitative analyses revealed three independent themes relating to receptivity and perception of the new HBPC program: (1) physician-level factors (overburdened, lack of palliative care knowledge, misconceptions around palliative care, and patient control), (2) practice-level factors (practice structure and role/integration of advance practice providers), and (3) first impression of the HBPC program (receptivity, ?dirty data,? and communication). Conclusion: Results hold important implications for practice and new approaches to engaging PCPs in HBPC, obtaining buy-in, and generating patient referrals. PCPs need better support in caring for patients with serious illness and HBPC can likely fill that role if PCPs are willing to refer and HBPC programs adapt.

ABSTRACT: This study aimed to elucidate the sedative effect and physiological changes associated with the intramuscular injection of detomidine combined with morphine in horses. Six healthy crossbred horses, aged 2 to 10 years, were included. A crossover experimental design was used to compare the effects of intramuscular injection of 30 µg/kg of detomidine alone (IMD) and intramuscular administration of 30 µg/kg of detomidine and 0.1 mg/kg of morphine (IMDM). The degree of sedation, height of head above ground, were assessed at the time points before and 5, 10, 20, 30, 40, 50, 60, 75, 90, 105, and 120 minutes after drug administration, and heart rate, respiratory rate, systolic blood pressure, rectum temperature and intestinal motility were assessed at the time points before and 10, 20, 30, 40, 50, 60, 75, 90, 105, and 120 minutes after drug administration. The physiological parameters were analyzed using the Kruskal-Wallis test with Dunn’s post-hoc test and analysis of variance with t-test for independent samples and the sedation scores using the Friedman test and Mann Whitney U-test. P-values

O objetivo do presente estudo foi simular o efeito sedativo da administração de detomidina nas doses de 80ug/kg e 30 ug/kg por via intravenosa e intramuscular em equinos. Foi realizado um modelamento farmacocinético/farmacodinâmico (PK/PD) com a curva sigmoide de concentração plasmática, obtidas por Mama e colaboradores, em função do efeito na posição da cabeça mediante a equação de Hill. Seguidamente foi realizada uma simulação do efeito sedativo das doses de 80ug/kg via intravenosa (IV) e intramuscular (IM) por meio da equação de Hill. As concentrações plasmáticas maiores e mais prolongadas obtidas após as administrações de 80ug/kg, quando comparadas às administrações de 30ug/kg resultaram em efeitos superior e mais duradouros. A simulação do efeito de detomidina após a administração de 80ug/kg via IV determinou efeitos na posição da cabeça superiores a 90%, 75% e 50% até 2, 4 e 6 horas após administração. Enquanto que a simulação do efeito de detomidina após a administração de 80ug/kg via IM determinou efeitos na posição da cabeça superiores a 90%, 75% e 50% até 3, 4 e 6 horas após administração. A presente simulação demostrou que os efeitos da posição da cabeça após a administração de 80ug/kg de detomidina por via IV e IM em equinos são superiores e mais duradouros que administrações de 30ug/kg. Porem, estudos in vivo devem ser realizados a fim de verificar os potenciais efeitos adversos dessas dosagens em equinos.

The popularity of digital media has spurred what has been called a “crisis of authority”. How do female evangelical microcelebrities figure in this crisis? Many of these women belong to churches led by male pastors, have amassed a large following online, and are sought-after speakers and teachers. This paper analyses how gender, religious authority, and the digital sphere collide through the rise of female evangelical microcelebrities. Bringing together ethnographic data, textual analysis, and social media analysis of six prominent women, I emphasize the power of representation to impact religious practices and religious meaning. This article examines how evangelical women are performing and negotiating their legitimacy as the Internet and fluid geographical boundaries challenge local models of religious authority. Moving away from a binary perspective of “having” or “not having” authority, this paper considers the various spheres of authority that evangelical microcelebrities occupy, including normative womanhood, prosperity theology, and politics. Finally, by examining the social media content put forth by female evangelical microcelebrities, I interrogate the political stakes of evangelical women’s authority.

Background: The assessment of the quality of care pathways delivered to people with severe mental disorders in a community-based system remains uncommon, especially using healthcare utilization databases. The aim of the study was to evaluate the quality of care provided to people with bipolar disorders taken-in-care by mental health services of four Italian areas (Lombardy, Emilia-Romagna, Lazio, province of Palermo). Methods: Thirty-six quality indicators were implemented to assess quality of mental health care for patients with bipolar disorders, according to three dimensions (accessibility and appropriateness, continuity, and safety). Data were retrieved from healthcare utilization (HCU) databases, which contain data on mental health treatments, hospital admissions, outpatient interventions, laboratory tests and drug prescriptions. Results: 29,242 prevalent and 752 incident cases taken-in-care by regional mental health services with a diagnosis of bipolar disorder in 2015 were identified. Age-standardized treated prevalence rate was 16.2 (per 10,000 adult residents) and treated incidence rate 1.3. In the year of evaluation, 97% of prevalent cases had ≥ 1 outpatient/day-care contacts and 88% had ≥ 1 psychiatric visits. The median of outpatient/day-care contacts was 9.3 interventions per-year. Psychoeducation was provided to 3.5% of patients and psychotherapy to 11.5%, with low intensity. 63% prevalent cases were treated with antipsychotics, 71.5% with mood stabilizers, 46.6% with antidepressants. Appropriate laboratory tests were conducted in less than one-third of prevalent patients with a prescription of antipsychotics; three quarters of those with a prescription of lithium. Lower proportions were observed for incident patients. In prevalent patients, the Standardized Mortality Ratio was 1.35 (95% CI: 1.26–1.44): 1.18 (1.07–1.29) in females, 1.60 (1.45–1.77) in males. Heterogeneity across areas was considerable in both cohorts. Conclusions: We found a meaningful treatment gap in bipolar disorders in Italian mental health services, suggesting that the fact they are entirely community-based does not assure sufficient coverage by itself. Continuity of contacts was sufficient, but intensity of care was low, suggesting the risk of suboptimal treatment and low effectiveness. Care pathways were monitored and evaluated using administrative healthcare databases, adding evidence that such data may contribute to assess the quality of clinical pathways in mental health. [ABSTRACT FROM AUTHOR]

(1) Background: Recently, we found that adenosine A2A receptor (A2AR) stimulation results in an increase in STEP phosphatase activity. In order to delve into the mechanism through which A2AR stimulation induced STEP activation, we investigated the involvement of mGlu5R since it is well documented that A2AR and mGlu5R physically and functionally interact in several brain areas. (2) Methods: In a neuroblastoma cell line (SH-SY5Y) and in mouse hippocampal slices, we evaluated the enzymatic activity of STEP by using a para-nitrophenyl phosphate colorimetric assay. A co-immunoprecipitation assay and a Western blot analysis were used to evaluate STEP/mGlu5R binding. (3) Results: We found that the A2AR-dependent activation of STEP was mediated by the mGlu5R. Indeed, the A2AR agonist CGS 21680 significantly increased STEP activity, and this effect was prevented not only by the A2AR antagonist ZM 241385, as expected, but also by the mGlu5R antagonist MPEP. In addition, we found that mGlu5R agonist DHPG-induced STEP activation was reversed not only by the mGlu5R antagonist MPEP but also by ZM 241385. Finally, via co-immunoprecipitation experiments, we found that mGlu5R and STEP physically interact when both receptors are activated (4) Conclusions: These results demonstrated a close functional interaction between mGlu5 and A2A receptors in the modulation of STEP activity. [ABSTRACT FROM AUTHOR]