The present review addresses major depressive disorder (MDD) and the implications of antidepressant treatment in the field of brain neuroplasticity, an effect initially considered adjacent but currently passed as central in the process of remission of MDD. Both in experimental animal studies and in human studies in subjects with mood disorders, neuroplasticity is considered the fundamental mechanism of neural defense against stress. Stress is the mediator between neurofunctional, neuroendocrine, neurobiological and neuroimmune disorders and depressive pathology of various intensities. Neurons have a high potential to adapt to the influences of internal and external factors. We are talking about neuroplasticity at different levels: structural neuroplasticity involving adult neurogenesis (such as plastic changes, dendritic reconstruction, when the morphology of the spine is affected); synaptic functional neuroplasticity and molecular and cellular mechanisms involved. These two major dimensions explain the pathophysiology of depression, as well as the convergence of the mechanisms involved in stress, major depressive decompensations, and the concept of neuroplasticity as the present target for new effective and potent antidepressant treatments.

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IntroductionThe Covid-19 pandemic has restructured the entire health care system. As systems of care were overwhelmed, many health professionals in related professional areas became increasingly involved in providing medical aid. We highlight a comparative analysis between two psychiatric wards of the same hospital, with qualified medical staff, with similar levels of competence, one of the wards caring for patients exclusively with major psychiatric pathologies, and the other patients with associated SARS-COV2 infection.ObjectivesConsidering that motivation at work depends on a multitude of factors, in our case, stress related to contamination, situational anxiety generated by psychiatric patients who arepartially inside on COVID infection, can decrease the motivation to perform a quality psychiatric medical act. Resilience and organizational civic behavior are instead variables with the role of maintaining professional motivation at an optimal level and enhancing dedication.MethodsWe applied questionnaires aimed at motivation at work in relation to the dependent variables: stress, anxiety, resilience and civic organizational behavior in two different departmentsof the psychiatric hospital, a ward where patients were admitted positively confirmed COVID 19, versus a ward with non-COVID psychiatric patients.ResultsPsychiatric medical staff are trained to treat predominantly psychomotor agitation, violent behavioral syndromes, suicide attempts, psychotic illnesses. 95% of the employees of theCOVID support department stated that they prefer to take care of 10 agitated patients, than one patient with COVID. The stress came in most cases from: insufficient supportequipment, insufficient doctor to coordinate nurses, lack of experience with somatic patients, fear of contamination generated by non-compliance with protective measures by psychiatric patients.ConclusionsResilience and civic organizational behavior kept staff motivation at an optimal level, but lower than would have been appropriate. Also, motivation at work was lower compared tothe non-COVID psychiatric ward.Disclosure of InterestNone Declared

The current paper aims to describe and exemplify the pathology that is increasingly common in contemporary society, compared to the Freudian period in which repression was dominating. Dissociative disorders are usually associated with overwhelming stress, which can be generated by traumatic life events, accidents or disasters experienced directly or witnessed by the individual, or unbearable inner conflicts, which force the mind to separate incompatible or unacceptable pieces of information and feelings.