Introduction: People with Autism Spectrum Disorders (ASD) have difficulty adapting to changes and new routines, especially in crisis situations such as a pandemic. This provides caregivers with greater responsibility and emotional stress, which can have negative consequences for their mental health. Therefore, it is crucial to create coping and mental health promotion strategies in this population. We aim to reflect on the impact of the pandemic on the mental health of caregivers of people with ASD and identify strategies that can be adopted and preventive measures. Material and Method: a scoping review of the literature published on the topic using PubMed/MEDLINE database. Results: The results highlight the emotional stress experienced by caregivers of people with ASD during the COVID-19 pandemic. The interruption of support in health services, the closure of schools and socio-occupational support institutions and domestic demands were some of the challenges identified. The role of continuity of care for families of people with ASD during the pandemic and the need to implement flexible and timely support programs is highlighted. Telemedicine was one of the most highlighted interventions for the continuity of care and the implementation of support measures for caregivers. Conclusions: The COVID-19 pandemic has negatively affected the mental health of people with ASD and their caregivers. It is important to drive the expansion and development of support programs and adapted interventions. Multidisciplinary work is needed to overcome the challenges imposed by the pandemic, both at the current moment and in the post-pandemic period.

Introduction Mood destabilization and induced manic episodes are well-known phenomenon under antidepressant medications. However, even with a cautious introduction of antidepressants, it’s important to be aware of possible pharmacological interactions. Terbinafine is a known inhibitor of CYP2D6, a major hepatic metabolizer of a full list of antidepressant medications, and so capable of raising their serum levels and potentiating their side effects.ObjectivesWith this case report we aim to emphasize the importance of cautious usage of Terbinafine when combined with antidepressant medications.MethodsWe present a clinical case of an induced first manic episode after the introduction of Terbinafine in a patient under antidepressant medication and a qualitative review on the topic, using PubMed database.ResultsA 66-year-old woman, with an history of Major Depressive Disorder, previously medicated with Venlafaxine 75mg/day and Mirtazapine 30mg/day, was brought to the emergency department because of psychomotor agitation. She also had an history of seasonal fluctuating mood, although never fulfilling the criteria for Bipolar Disorder. At admission, her clinical status was compatible with a manic episode. This episode followed two months after the initiation of Terbinafine for onychomycosis.Conclusions There are few studies that have shown antidepressant toxicity mediated by an interaction with Terbinafine. As far as we know this is the first case of induced mania after the introduction of Terbinafine. Therefore, it is important to remind that Terbinafine is a potential interacting agent when combined with psychotropic medications.

Background: Bipolar disorder is a complex psychiatric disorder where long-term treatment is crucial to maintain stabilization. Although largely well tolerated, lithium has a wide spectrum of adverse effects in different organs and seems to also cause taste and smell disorders, which remain rare and not largely described. We aim to present a rare case of hyposmia and dysgeusia secondary to lithium treatment in a bipolar patient and also conduct a review on these rare lithium adverse effects. Case Presentation:The case is a 43-year-old woman with type I bipolar disorder who became stabilized and fully functional with lithium therapy. After 4 months of treatment, she began to notice progressive hyposmia and dysgeusia. After multiple diagnostic and screening tests, lithium was implicated as the cause of the symptoms, which led to a switch to valproic acid. After 3 months, she was not compensated with valproic acid treatment, returned to lithium therapy despite its adverse effects, and became stabilized again.Conclusions: There are few data on lithium therapy taste and smell adverse effects. Most studies on this topic are likely to be case reports. Lithium therapy may cause dysgeusia and hyposmia, although mechanisms are not fully understood. These adverse effects can interfere negatively in patient's treatment adherence. Therefore, physicians who prescribe lithium should be aware of them. Further structured studies are needed to better understand these lithium rare adverse effects and the appropriate way to assess and monitoring them.

Introduction Since the first outbreak, the Covid-19 pandemic has had and still has several implications worldwide, particularly in severe mentally ill patients, leading to multiple challenges in their management. Objectives We aim to assess the impact and implications of the Covid-19 pandemic on patients with Schizophrenia Spectrum Disorders (SSD) and the treatment recommendations available. Methods We conduct an integrative review using PubMed database. Search terms included: “psychosis” AND “COVID-19 pandemic”, “schizophrenia and COVID-19”, “severe mental illness” AND “COVID-19”. The search period was between 1st January 2020 and 31th July 2021. Results Studies postulated that people with SSD are at a higher risk of COVID-19 infection with a poorer medical and social outcome which is attributed to factors such as higher rates of disadvantageous lifestyle behaviours, medical comorbidities, antipsychotic medication metabolic effects, psychosocial adversities, smaller social networks and poor engagement with general health services. The Covid-19 pandemic also demanded adjustments in treatment guidelines and monitoring, particularly in patients with SSD on Clozapine. Many studies address the importance of psychiatric care and treatment during the pandemic. They emphasize rapid implementation of measures to decrease the risk of COVID-19 transmission and maintain continuity care and research. An individualized and flexible approach is needed to promote safety of SSD patients. Conclusions Particular attention is required by clinicians to help SSD patients face the current pandemic situation. Future epidemiological studies are needed in order to better understand the impact of the COVID-19 pandemic in this population and provide proper care. Disclosure No significant relationships.

No abstract