Welcome to the 22nd WCP Congress Program Scheduling

While HIV/AIDS has become a chronic, manageable illness for people with access to HIV medical care and treatment with antiretrovirals, there is ample evidence of an ongoing pandemic, with 36.9 million persons living with HIV, even though HIV and AIDS are entirely preventable. Symposium presenters are academics from the WPA HIV Psychiatry Section. They will underscore the importance of a comprehensive biopsychosociocultural approach to HIV/AIDS care and psychiatric care. Dr. Pereira will review advancements in HIV treatment and consequent increase in life expectancy. He will review challenges with current HIV treatment, including drug-drug interactions and neuropsychiatric side effects of ARVs. Dr. Sales will describe overlapping features between COVID-19 and HIV pandemic responses. He will review similarities and differences between long COVID syndrome and HIV associated neurocognitive disorder (HAND). He will address HIV stigma, the COVID antivaccination movement, and the risk of moral injury while treating the pandemic of the unvaccinated. Dr. Siste will present her research findings from a cross sectional study in Indonesia showing that lifetime suicidality in persons with HIV was associated with depressive and anxiety symptoms, non-marital status, CD4 count < 500 cells/μl, and efavirenz use. She will discuss relevant suicide prevention strategies. Dr. Thisayakorn will describe the development of an innovative collaborative care model between psychiatry and primary care for persons with HIV in Thailand that could be replicated in underserved areas. This symposium will provide useful guidance for psychiatrists, mental health professionals and trainees as they face ongoing challenges in working with persons with HIV.

Since the horrible lessons of the NS holocaust and its severe first, second and third generation psychological impact, the sequaelae of genocidal actions have also been explored by research in further groups, including Armenians, Bosnians, Yezidi, in Myanmar and other asian countries. A number of genocidal acts, including social, economic, group dynamic and psychological acts have been defined besides killings and forced disappearances by the UN, each with its long term psychological sequels. Transgenerational and transcultural issues of preparation, perpetrator profiles, impact and recovery aspects have been the focus of recent research to be summarised in this state-of-the art symposium, presented by experts from different regions. Acts of persecution affect not only individuals, but the whole group and the social fabric, and approaches for support must be interdisciplinary. Examples and data on the most relevant such acts will be summarised in the symposium with a research plan and teaching model developed by the section.

The dearth of child and adolescent mental health services is a global problem. Integrating these services in primary care has been offered as a solution. We sampled integrated care perspectives from colleagues involved in recent research and practices around the world. From US we will hear the communication of an ongoing publication about experiences of integrated care around the world in countries like Australia, United Kingdom (UK), Spain, Qatar, Singapore, Canada, Brazil, Uruguay, Kenya and Micronesia. From Brazil we will hear about a tele-collaborative care project conducted by two universities 2 thousand kilometers distant from each other. From Greece, representing World Association of National Colleges of Family Medicine (WONCA) Mental Health Working Party, a family doctor will talk about primary care vision for integrated care in child and adolescent, as well as adult patients. We hope these findings will provide insights into training initiatives necessary to build workforce capacity and integrated care research and practice especially for youth. Also, we hope to better understand and address obstacles to this model, specifically funding within complex healthcare systems, limited training mechanisms, and geopolitical/policy issues.

Affective disorders are a major public health challenge across the world. In this symposium, we want to present recent development in the treatment of affective disorders, including treatment of anhedonia, which is a huge challenge, and the current state of the art of lithium treatment that is easily available across the world. Finally, we will present new psychotherapeutic treatments using digital tools that have the potential to considerably improve treatments in most countries.

We propose to discuss novel approaches to imaging that uncover both neuropathological mechanims underlying schizophrenia, and point to paths towards more effective treatment. Furthermore, we will discuss how the neurobiological signatures of psychosis uncovered in the course of these investigations can serve as biomarkers of specific clinical features. Dr. Niznikiewicz will discuss how the use of real-time fMRI based neurofeedback (rt-fMRI-NFB) in schizophrenia patients with auditory hallucinations (AH) helped delineate a cortical nework associated with AH, and how clinically relavant changes in this network, post-NFB, led to AH reductions. The results suggest the involvement of a network of brain regions in AH, and that targetting one brain region belonging to this network resulted in network-wide changes. Dr. Brady will discuss cortical-subcortical sources of AH and the use of transcranial magnetic stimulation (TMS) as a novel way to interrogate the neural basis of dysconnectivity in schizophrenia. The approach involved the identification of dys-connectivity of the cerebellar-thalamo-cortical network, followed by the TMS stimulation (TMS) directed at the cerebellum to ameliorate it, which again resulted in AH reductions. Dr. Borgwardt will discuss thalamo-cortical dysconnectivity and its clinical relevance in psychotic states. He will present recent findings on thalamocortical dysconnectivity, both in schizophrenia and in psychedelic states, suggesting that psychedelic and psychotic states share clinically and functionally relevant dysconnectivity patterns. Implications of these three different approaches to the models of psychosis neuropathology, and for identifying biomarkers of specific clinical features, will be discussed.

The section on Psychiatry and Human Sexuality will address the crucial subject of sex education for the youth and other generations - as well as education of PCPs on sexual disorders viewing the literature and from clinical and practical community experience. The chairs of the section will moderate the session.

This session represents an interface of areas of basic and clinical research in dementia. Speakers will be presenting selected psychiatric clinical and biological research on factors affecting cognitive functions, leading to dementia, commonly with neuropsychiatric symptoms like psychosis. Kasia Gustaw Rothenberg will focus on Lewy body diseases and psychosis in their course. She will discuss clinical, cognitive and genetic correlations of psychosis in Lewy body diseases. Jerzy Leszek will discuss insulin resistance in AD. Recent studies reveal the impact of p53 on expression and processing of several microRNA/miRNA. Additionally, the role of miRNAs in promotion of insulin resistances and in type 2 diabetes have been well documented. Understanding p53/miRNA crosstalk in driving insulin resistance in Alzheimer’s brains could lead to effective diagnostic and therapeutic diagnostic and lead to development of therapy Carlos Augusto de Mendonça Lima will on psychosis in older adults, and underlines which assessments and managements are required at primary care level. He also takes into account the possible impact of the new Diagnostic Classifications on the approach of psychosis in older adults, in particular in what concerns the organization of care and the reduction of all forms of stigma and discrimination against older adults. The Chair and Co-Chair will frame of these findings within translational model of psychiatric disorders and discuss their implication for a personalized medicine approach to treatment

The coexistence of mental and physical disorders- multimorbidity - is a growing global challenge, driven by rapidly changing demographics and lifestyles across the world. Multimorbidity worsens outcomes for both mental and physical health conditions, increasing mortality, morbidity and poverty, and reducing quality of life for people living with multiple conditions. In the past 20 years, an increasing body of research has found that mental disorders are associated with premature mortality, including an almost two-fold higher risk of cardiovascular mortality, with life expectancy shortened by 10-20 years in people with schizophrenia spectrum disorders or bipolar disorders. Specific general medical conditions occur disproportionately within clinical populations with severe mental disorders, through three main pathways: (a) pathogenetic links (e.g., disorders of the metabolic or immune system), (b) changes in lifestyle, and (c) adverse effects of drug treatment, since antipsychotic drugs, lithium and other medicines commonly used to treat severe mental disorders can have important adverse consequences for these patients and contribute to comorbidities. In this symposium, we present three studies relevant to this theme, which between them (i) document the adverse physical health outcomes and poorer access to healthcare for people with severe mental illness, (ii) describe pharmacological interventions for tackling increased metabolic risks associated with antipsychotic use in this population, and (iii) review approaches to study multimorbidity. The symposium showcases a range of methods to study and address mental-physical multimorbidity, which will help to address the unacceptable gap in health and life expectancy for people with mental illness.

Various forms of medico-rehabilitation practice based on the use of visual activity differ in the features of artists accompanying (as participants of art therapy or outsider artists), organization of the environment classes, provide technical equipment, artistic and other materials, attract necessary resources. In some cases, this is the achievement of a certain artistic and creative result, the formation of an original artistic style, the support of "artistic identity", the public recognition of an outsider artist. In others, it`s mainly the achievement of therapeutic and prophylactic effects and social rehabilitation. It`s also obvious that the solution of these problems can be interconnected. As part of the symposium it is important to discuss models of clinical and social art therapy, accompanying patients in the process of their creative classes in inpatient and outpatient settings, as well as inclusive and socio-cultural projects. The symposium involves the following tasks: 1. Joint analysis of the current situation in the field of clinical and social art therapy, social initiatives related to supporting the creativity of people with mental disorders, outsider artists. 2. Formulation of conceptual positions and methodological recommendations related to the support of the creative activity of persons with mental disorders. 3. Discussing the possibilities of building a model of a single and continuous cycle of supporting the creative activity of people with clinical and psychosocial problems. 4. Raising the question of the need for interdisciplinary research of the accumulated artistic material, its institutionalization, legitimation and museumification.

No conclusive data exist concerning the total number of COVID-19 cases and deaths among refugees, asylum seekers, and migrants worldwide. Data from the UNHCR between April, 2020, and February, 2021, indicate a gradual rise in reports of COVID-19 cases among displaced populations. According to the IOM, one of 281 million people worldwide who were more vulnerable than others to contracting SARS-CoV-2 because of personal, social, infrastructural, and health factors. Social effects include a rise in discrimination and villainising of migrants as disease spreaders, more lengthy lockdowns that severely restrict their movement for work, border closures that discouraged those who were otherwise willing to reunite with their families, and slow asylum processes. Health impacts include underlying health conditions that render displaced populations more susceptible to COVID-19, overcrowded camps and detention centres that heighten their risk of exposure to SARS-CoV-2, and lack of accessible information concerning the pandemic. Clinical impacts include barriers to access mental healthcare services, mental health issues, uncertainties around inclusion in vaccination programmes. The first speaker will talk on „Dates and facts from the available literature on the occurrence of Covid-19 among vulnerable populations“, the second on „Covid-19 and its impact on the mental health of migrants, refugees and asylum seekers“, the third will present „The mental health implications of Covid19 in Africa through transcultural psychiatry lenses“ and the last speaker will present „Recommendations to reduce the risk of developing mental health problems of migrants, refugees and asylum seekers“. All presentations will be discussed with the plenum.