Since the outbreak of Coronavirus Disease 2019 (COVID-19) pandemic, sleep and mental health of the population have been disrupted worldwide. Predisposing, precipitating, and perpetuating factors of insomnia may signify shared mechanisms that relate insomnia symptoms to psychiatric disorders during stressful periods like pandemic. However, long term repercussions of COVID-19 pandemic on sleep features such as insomnia, and psychological health remains poorly elucidated even after the alleviation of the pandemic measures.

The current study aims to identify the longitudinal trajectory of insomnia, in terms of prevalence and associated risk factors, during and post COVID-19 pandemic era among the general population of Singapore.

Current study consists of longitudinal online and in person surveys involving two-point assessments-Phase1 (during pandemic) from May 2020-June 2021 and Phase2 (post pandemic) from October 2023-August 2024. Singapore residents aged 21 years and above, fluent in English, Chinese or Malay language participated in the study. Participants answered an interviewer-administered questionnaire across both timepoints, including Socio-Demographic information, Insomnia Severity Index, Generalised Anxiety Disorder-7, Physical Health Questionnaire, Depression Anxiety Stress Scales and Covid-19 related stressors-Exposure to Covid-19, current and future perceived risk of infection.

597 participants completed both assessments at phase1 and phase2. The prevalence of insomnia increased from 8.83% in phase2 as compared to 8.24% in phase1 (p<0.00). Those aged 50 years and above (vs 21-34 years) (p<0.02), highest educational attainment of primary school (vs University) (p<0.05), being economically inactive (vs employed) (p< 0.01), having mild levels of anxiety (p<0.007) and having severe levels of depression, anxiety or, stress (p<0.005) was seen to be significantly associated with insomnia.

Insomnia prevalence rose from 8.24% in phase1 to 8.83% in phase2 and was significantly associated with anxiety disorder, psychological distress, and perceived stress among Singapore residents in both phases. These findings could be ascribed to the failure in re-establishment of pre-COVID-19 pandemic norms, social situations and working dynamics that might have led to sleep curtailment and insomnia. Study findings can be utilised to design effective targeted interventions like cognitive behavioural therapy, therapist assisted relaxation and meditation programs to improve sleep and reduce psychological distress. Mentioned interventions can be delivered via smartphone applications enabling easy access, monitoring, delivery, and utilization by the vulnerable groups.

None Declared

Remote interaction offers new opportunities for medical-psychological rehabilitation, providing access when in-person consultations are limited. The proactive model of psychosomatic medicine, focusing on prevention and can to enable continuous monitoring and active patient engagement, crucial for those affected by post-COVID syndrome and war.

Analyze the effectiveness of a medical-psychological rehabilitation program for anxiety and depressive post-COVID disorders, as well as post-traumatic symptoms resulting from war, in the context of remote interaction.

The study sample consisted of 240 individuals with anxiety and depressive post-COVID disorders. The tools used in the study included the PHQ-9, GAD-7, and PCL-5.

By day 63, according to the PHQ-9, depression in the study group decreased to 6.942±5.073, while in the control group it remained at 15.567±6.540 (p < 0.001; t = 11.437). According to the GAD-7, anxiety reduced to 3.991±3.589 in the study group, whereas in the control group it remained higher at 12.966±3.980 (p < 0.001; t = 18.355). According to the PCL-5, PTSD symptoms decreased to 13.295±8.727 in the study group, while in the control group they remained high at 29.177±13.541 (p < 0.001; t = 10.836).

The study results indicate that the medical-psychological rehabilitation program, delivered through remote interaction, effectively reduces symptoms of depression, anxiety, and post-traumatic stress in individuals with post-COVID disorders amid wartime conditions.

None Declared

Conspiracy thinking refers to the tendency to accept explanations about reality that are different from those that are most rational or best proven. This trend became a significant threat during the COVID-19 pandemic, as belief in false information about COVID-19 was an important factor inhibiting preventive actions. The tendency to think conspiratorially has also been associated with the severity of some psychopathological symptoms, such as anxiety and depressive symptoms.

The aim of the study was to assess the differences in general and COVID-19 conspiracy thinking between Polish and Spanish respondents, as well as the relationship between conspiracy thinking and the severity of anxiety and depression symptoms.

192 Polish citizens (average age of 39.7 ± 8.61 years; women: 151, men: 41) and 190 Spanish citizens (average age of 48.3 ± 10.03 years; women: 139, men: 51) were recruted. The GCBS (Brotheron, et al.), the COVID-19 CBS (Dębski, et al.) and the HADS (Zigmond & Snaith) tools were used. The Shapiro-Wilk test, the Mann-Whitney U test and Spearman’s correlation coefficient were implemented.

In Spain, the highest average score in terms of conspiracy thinking about COVID-19 was obtained by the statement: “Governments deliberately spread false information about COVID-19 in order to conceal the actual state of the pandemic” (mean = 2.784), while in Poland this statement was: “SARS-CoV-2 tests are unreliable, they may be positive in the case of infection with another virus” (mean = 2.912). Spanish citizens obtained significantly higher scores than Poles on the Malevolent global conspiracies scale (median 9 vs 8, p=0.024), as well as in two false beliefs about COVID-19: “Wearing face masks causes oxygen deficiency…” (median 3 vs 2, p=0.000) and “There is a drug that can effectively cure COVID-19 patients, but information about it is confidential…” (median 3 vs 1.5, p =0.026). Among Polish citizens, the belief: “Health workers receive financial benefits for diagnosing COVID-19…” was higher (median 2 vs. 1, p=0.000). In the Spanish group, most of the GCBS subscales correlated positively with the anxiety and depression symptoms. COVID-19 CBS also correlated with anxiety. In the Polish group positive correlations were noted between two GCBS scales and the severity of depression symptoms. There were no significant associations between GCBS and COVID-19 CBS with the anxiety symptoms in that group.

The group studied in Spain showed a significantly higher intensity of conspiracy beliefs in more issues than the group studied in Poland. At the same time, conspiracy thinking in the Spanish group showed more pronounced relationships with the severity of anxiety and depression symptoms than in the Polish group.

None Declared

Mainstream literature classifies SARS-CoV-2 positive-sensed single-stranded RNA (ssRNA), and only a few literature mentioned the method being Reverse Transcription–Polymerase Chain Reaction -- one limited to ssRNA studies without method improvement of RNA interference (Wang et al. BMC Bio 2018; 18). Studies found the 3’-to-5’ exoribonuclease activity within CoV nonstructural protein 14 (NSP14) critical for CoV high-fidelity replication (Smith & Denison, PLoS Pathog 2013; 9 e1003760), and NSP15 a distinctive endoribonuclease able to cleave both ss- and double-stranded RNA (dsRNA) effectively (Frazier et al. NA Res 2022; 50 8290-8301). While MERS-CoV inhibit oligoadenylate synthetase–ribonuclease L, protein kinase R, and interferon (IFN), CoV-2 activates the former two and induces minimal levels of IFN (Li et al. PNAS 2021; 118 e2022643118), corroborating with S2 protein’s homogeneity with HIV gp41 (Zhang & Yap JMS: THEOCHEM 2004; 677 73-76) with differentiated impacts on macrophage activities via interleukin 6 (Ascierto et al. JIC 2021; 9). Image 1 indicates the post-vaccination pericarditis is caused by negative charge interference during depolarization in NCT05711810.

Primary objective of advancing treatment designs followed the fixed effect metaanalysis model and gathered relevant data (Nikolakopoulou et al. EBMH 2014; 17 64). Secondary objective is to compare effects between presynaptic and postsynaptic treatment efficacies in order to determine infection depth for post-COVID-19-vaccination neuropathic pain to appear, and adverse events (AEs) are collected for random effects metaanalysis. Tertiary objective is to weigh the evidences whether COVID-19 is ssRNA or dsRNA.

With the framework and paradigm of sebaceous immunobiology, the pathway bypassing blood-brain barrier is found with steroidogenesis (Pachankis JP 2023; 26 615; Pachankis GJMR 2023; 23C 5-11). NCT05839236 and NCT06357104 trials’ metaanalysis are illustrated in image 2 with the observational protocol NCT06107348 in image 3.

Sebaceous (purpura and ecchymoses) AEs appeared with postsynaptic treatments with valproate, and comparatively, presynaptic treatments with gabapentin afterwards attenuated them. Presynaptic treatments of gabapentin shows superiority by the equivalence tests on neuropathic pains’ attenuation in duration and intensities. The considerations of Ca2+ channel inhibition by the adoption of gabapentin in the proton-coupled electron transport chain are consistent with the electrocardiogram indications of negative charge interference on cardiac activities.

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Image 2:

Image 3:

Migraine AEs in NCT05711810 trial is the neuropathic pain resulted from immune activation with initial treatment. Infection depth of neuropathic pains from COVID-19 post-vaccination symptoms is extendable to the presynaptic vesicles with impacts to macrophage activities. Indirect evidences support that SARS-CoV-2 is negative-sensed dsRNA (Pachankis JCMI 2023; 6 1-4).

None Declared

Since October 2004, antidepressants have had a black-box warning indicating that they are associated with an increased risk of suicidal thinking, feeling, and behavior in children and adolescents. On 2nd May 2007, the United States Food and Drug Administration ordered that all antidepressant medications carry an expanded black-box warning stating an increased risk of suicidal symptoms in young adults aged 18 – 24.

The initiation of antidepressants in the young adult population present unique patient safety considerations and medicolegal risks for physicians. Unlike the triadic doctor-parent-patient relationship in a child or adolescent patient, the doctor-patient realtionship in a young adult is a dyadic one. Hence, enlisting the help of a trusted adult to supervise the young person who has been newly initiated on antidepressants is more challenging.

In this poster, we explore the unique ethical considerations in initiating antidepressants in the young adult population and the steps clinicians may take to mitigate their medicolegal risk in treating this population. The ethical considerations of autonomy, beneficence and non-maleficence are analysed. The measures an individual clinician may take in clinical decision-making and follow-up to mitigate medicolegal risk are also discussed.

A literature search was conducted to determine the clinical considerations and prescription patterns in prescribing antidepressants to young adults. The legislation surrounding medication prescription in major jurisdictions were explored. Current literature on medicolegal risk management was studied to come up with recommendations on mitigating medicolegal risk when initiating antidepresants in young adults.

Initiating antidepressants in a young adult is a collaboratively undertaken medical decision. A thorough evaluation is required to determine if antidepressant initiation is warranted. Young adults initiated on antidepressants must be closely monitored for increased suicidality. The clinician should offer to psychoeducate a member of the young adult’s support network on his diagnosis and treatment, and apprise this person of the black box warning. . If there are imminent grave risks to the young person or others, confidentiality may have to be broken. Clear detailed documentation of the clinical considerations and discussion with the young person is essential.

Initiating antidepressants in young adults presents clinicians with unique patient safety and medicoleagl risk concerns. Steps in clinical decision-making and follow-up may be undertaken by clinicians to mitigate this risk.

None Declared

In research, recruitment challenges are common and lead to delays and reduce sample size and power. People with schizophrenia are often described as hard to reach and retain in research, and in particular, studies targeting people with chronic comorbidities such as diabetes, meet difficulties related to recruitment.

This study aims to describe challenges and strategies to recruitment of Danish adults with schizophrenia and type 2 diabetes to a cross-sectional survey study about psychosocial health and support.

The recruitment process was tracked in a register where all relevant information was synthesized systematically. This included information on how eligible participants were identified and invited for the study and reasons for declining. Two recruitment strategies were applied for recruiting participants to complete a questionnaire: 1) Through mental health professionals in psychiatric outpatient clinics in Region Zealand, Denmark, and 2) Through phone calls to eligible participants. Descriptive analyses of the recruitment data were conducted.

Three types of challenges were found and described: 1) Identifying eligible participants, 2) Challenges with having mental health professionals to recruit, and 3) Participants’ lack of ability to complete a questionnaire. The challenges were met by several practical approaches: 1) Identifying eligible participants though electronic health records and medication types, 2) Inviting participants through phone calls, and 3) Letting participants receiving help for completing the questionnaire from a care coordinator, family/friend or researcher when needed. Approximately 15% of all eligible participants declined to take part, which indicate high willingness to participate.

Exploring different types of challenges was important for understanding the actual difficulties in recruitment, for using approaches to meet the challenges, and for detecting the high willingness to take part.

None Declared

Euthanasia is an ancient theme that, especially since individual autonomy became the health paradigm in contemporary societies, has sparked profound reflections and declared dissensions between different socio-ideological quadrants. The experience of the countries where it is decriminalised shows a tendency to broaden the clinical, age and legal assumptions for its access. Older adults with psychiatric disease, a clinically and socially idiosyncratic group, where physiological weaknesses and social losses accumulate, and the chronological proximity to death becomes progressively more self-aware, are a group of particular concern.

Our research aimed to reflect on the Constitutional feasibility of Euthanasia in Portugal, make available a validated psychometric instrument to assess attitudes towards euthanasia and do a multidimensional study of the attitudes towards euthanasia of older adult patients with mixed anxiety-depressive disorder.

The field research study applied a paper questionnaire composed of a sociodemographic section and a battery of scales (to assess depression, anxiety, cognitive performance, suicide risk, therapeutic adhesion, functionality, loneliness, attitude towards euthanasia, decision pattern, personality, empathy and health status) in the Psychogeriatric Unity of Senhora da Oliveira Hospital in Portugal. The sample was collected by convenience. The multidimensional study included 114 patients and 25 controls of the same age. Six months later, a reassessment was conducted. Patients and controls were compared using descriptive statistics and a multiple-regression model.

The Constitution of the Portuguese Republic does not prohibit medically assisted death. The results support the validated scale’s usefulness and validity. Eighty-one point six per cent of patients had four or fewer years of schooling. Contrary to controls, they presented mild depressive and anxiety symptoms, loneliness feelings, worse cognitive performance, a more fragile personality, higher personal distress and a poorer health state. No statistically significant differences were found between controls and patients regarding their attitudes towards euthanasia. Patients more favourable to euthanasia had higher empathic concern, conscientiousness and fantasy and lower personal distress.

When addressing euthanasia in older adult patients with mixed anxiety and depressive disorder, it is crucial to ensure they are fully self-determinate and that all the necessary treatment and support are available. It may not be the case when the educational level is low and mild disease persists, significantly affecting their well-being and cognitive performance.

None Declared

Psychiatric diagnosis plays a key rol in the mental health care. One of the critical factors that influence the diagnostic process is inter-rater reliability, the degree to which different raters agree on the diagnosis when assessing the same patient. Despite the availability of standardized diagnostic manuals, variability in psychiatric diagnoses persists. The assessment of inter-rater reliability involves calculating statistical measures which quantify the level of agreement between raters beyond what would be expected by chance. Improving inter-rater reliability in psychiatric diagnoses is necessary for optimizing both patient care and research quality in mental health.

Assess inter-rater reliability across main psychiatric disorders and identify the sources of variability.

This study was performed according to the PRISMA guidelines and a total of ninety-three studies were included. Regarding inclusion criteria, (1) the articles had to focus on inter-rater reliability, (2) study participants had to have an average age greater than 18 years, and (3) the reported diagnoses had to refer to a diagnostic manual. Quality scores were assessed for all included studies (Armijo-Olivo S et al. J Eval Clin Pract. 2012; 18 12-8). Seven different meta-analysis were conducted, one for each psychiatric diagnosis detected. The heterogeneity between studies was quantified using Cochran’s Q and I2. Funnel plots was analyzed to assess the possible influence of publication and location biases (Higgins&Green. BMJ. 2011;343). To account for publication bias, the Eggers’ test and the Fail-Safe Number31 was applied.

Psychotic disorder: (k=0.70; 95% CI: 0.66-0.75) (I²=97%).

Anxiety Disorders: (k=0.65; 95% CI: 0.60-0.70) (I²=91%).

Obsessive-Compulsive Disorder (OCD): (k=0.73; 95% CI: 0.64-0.82) (I²=76%)

PTSD: (k=0.60; 95% CI: 0.52-0.66) (I² =84%).

DCA: (k=0.73; 95% CI: 0.67-0.79) (I² =76%).

two different meta-analysis were conducted because many studies used Intraclass Correlation Coefficient (ICC) as a value to express inter-rater agreement. [k=0.65 (95% CI: 0.59, 0.7)] (I2= 96%) (ICC=0.85; 95% CI: 0.82-0.87) (I² = 66%).

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The lower Kappa for schizoaffective disorder (Kappa < 0.7) compared to other psychiatric disorders underscores the diagnostic challenges posed by this category, given its overlapping symptoms with both mood and psychotic disorders. As regards personality disorder, antisocial and borderline PD showed highest agreement potentially due to its well-defined diagnostic criteria. The lowest agreement (k=0.60) of PTSD emphasizes the variability of his clinical presentation. In conclusion, studies show variability across disorders, highlighting the need for further research to improve diagnostic accurac (Regier et al. Am J Psychiatry. 2009;166 645-50) thereby enhancing clinical and research outcomes.

None Declared

Psychiatric patients, especially those with psychotic disorders, face an increased metabolic and cardiovascular risk, which ultimately leads to higher mortality from cardiovascular disease and reduced life expectancy. This is due to a multitude of risk factors, including those related to the course of the mental illness, lifestyle, socioeconomic and cultural circumstances, and the use of certain medications, such as atypical antipsychotics. This underscores the need for structured interventions during hospitalization to identify and manage these risks. Non-pharmacological interventions, such as physical activity and dietary education, have shown to be beneficial in managing weight and improving cardiovascular health. Pharmacological treatments, particularly the use of metformin and aripiprazol, have demonstrated efficacy in reducing metabolic disturbances such as weight gain, dyslipidemia, and hyperglycemia. The implementation of structured protocols to mitigate metabolic risk in psychiatric inpatients is recommended.

The main goal of the protocol is to guide the assessment, diagnosis, and therapeutic management of metabolic and cardiovascular risk factors in psychiatric inpatients. It also aims to guide the follow-up of these patients after discharge and coordination with other medical specialties.

The protocol was developed in an interdisciplinary manner, involving the specialties of Psychiatry, Endocrinology, and Internal Medicine, and is based on recent guidelines and recommendations from other countries on this matter. The protocol was also adapted to the current conditions of the psychiatric inpatient setting.

The protocol involves a thorough clinical evaluation, including medical history, physical examination, and extensive laboratory analysis to identify comorbidities. Cardiovascular risk is calculated using the SCORE2, PRIMROSE and QRISK3 models. Non-pharmacological interventions include physical activity programs and nutritional counseling, while pharmacological interventions involve adjusting antipsychotic medications, selecting antipsychotics with more favourable metabolic profiles, and the adjuvant use of medications like metformin, aripiprazol, and topiramate. These evaluations are conducted at regular intervals, including post-discharge, to assess the efficacy of these interventions.

Psychiatric inpatients, especially those on atypical antipsychotics, face significant metabolic and cardiovascular risks. A comprehensive assessment of risk factors and early intervention during hospitalization, combining lifestyle modifications and pharmacological treatments, can significantly reduce these risks and improve patient outcomes. Continued monitoring and coordination with outpatient services post-discharge are essential for sustained management of these health risks.

None Declared

Given the increasing rates of antipsychotic use in multiple psychiatric conditions, greater attention to the assessment, monitoring and documentation of their side effects is warranted. While significant attention has been provided to metabolic side effect monitoring, comparatively little is known about how clinicians screen for, document and monitor their motor side effects (i.e. parkinsonism, akathisia, dystonia and tardive dyskinesia (TD), collectively “extrapyramidal symptoms” or EPS).

This review aims to systematically assess the literature for insights into current trends in EPS monitoring practices within various mental health settings globally.

In line with our preregistered protocol (PROSPERO: CRD42023482372), we systematically searched the OVID Medline, PubMed, Embase, CINAHL and PsycINFO databases for studies published from 1998 to present day. Figure 1 shows a detailed flowchart of the selection process. Included studies were assessed for quality using a modified version of the Quality Improvement Minimum Criteria Set (QI-MQCS) and findings summarized using narrative synthesis. All stages of the review process are reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.

A total of 22 studies met our inclusion criteria. Studies occurred in varied settings and employed a range of study designs. The APA and NICE guidelines were most commonly used to guide practice. Baseline monitoring rates in adult settings ranged from 0 to 54%, and 3.7 to 100% in child & adolescent settings. In studies reassessing EPS monitoring rates following practice improvement initiatives, virtually all demonstrated benefits. Screening processes and instruments varied, ranging from standardized rating scales (such as the AIMS for TD screening) to locally developed tools. In some studies, no structured tool was identified. Monitoring rates were higher when structured processes and tools were used.

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This review demonstrates significant heterogeneity in clinical practice for the screening, documentation, and monitoring of EPS in patients prescribed antipsychotic medication in mental health settings globally. Adherence to existing guidelines was found to be poor in most settings, with practice improvements observed in virtually all settings where quality improvement initiatives were implemented. The best improvements were seen to occur after services introduced structured EPS screening tools with regular education on their use.

R. Aubry: None Declared, T. Hastings: None Declared, M. Morgan: None Declared, J. Hastings: None Declared, M. Bolton: None Declared, M. Grummell: None Declared, R. Shorr: None Declared, S. Killeen: None Declared, C. Coyne: None Declared, M. Solmi Consultant of: MS has received honoraria/has been a consultant for AbbVie, Angelini, Lundbeck, Otsuka.

The 3-dimensional (3D) marker-less motion capturing (MoCap) systems are an emerging technique in movement analysis. Recent studies have shown that such MoCap assessment have great potential for accurate and objective assessment of motor alterations in psychiatric patients. Gait as a fundamental gross motor function is the final motor outputs of a complex network integrating sensorimotor systems, cognitive and affective stimuli. Understanding gait alterations in catatonia patients can provide insights into their sensorimotor dysfunction and help in diagnosis and treatment in future.

The primary objective of this study is identifying gait alterations using a 3D optical marker-less MoCap system in catatonia patients (CAT) compared to non-catatonia controls (Non-CAT). We hypothesize that there will be significant reduction in the spatiotemporal parameters of gait, such as speed, stride width, stride length, step length, and cadence as well as increased gait instability in CAT group. Moreover, these alterations will be correlated with general psychomotor slowing.

In this cross-sectional study, we examined a total of 61 patients with and without catatonia diagnosis (CAT; n=22, Non-CAT; n=39) according to ICD-11. Participants were assessed with the Positive and Negative Syndrome Scale (PANSS), Northoff Catatonia Rating Scale (NCRS), the Brief Psychiatric Rating Scale (BPRS), Global Assessment of Functioning (GAF). We conducted clinical psychomotor examination with the Heidelberger Neurological Soft Sign Scale (NSS), Salpêtrière Retardation Rating Scale (SRRS) and Unified Parkinson Disease Rating Scale (UPDRS). Gait analysis were performed using a marker-less MoCap system with 8 cameras (Qualisys, Goeteborg, Sweden). Participants walked on a marked path (18 m) with a self-selected tempo during the experiment. The spatiotemporal parameters (STP) of gait were obtained automatically through Theia Software.

The two groups did not differ in age, sex, or BMI. The CAT group showed higher scores in PANNS, BPRS, NCRS and GAF (p< 0,05). We found a statistically significant difference in clinical psychomotor parameters in NSS, SAS and UPDRS between the two groups (p <0,05) and more specifically in gait subdomain of each scale. No differences were found in any of STP of gait or gait instability measurements after controlling for covariates (age, sex, BMI and medication).

Image 1:

This study exhibit a significant difference between the results of clinical psychomotor assessments and objective gait analysis through marker-less MoCap. This discrepancy suggests a potential overestimation of gait alterations in clinical evaluations. The findings underscore the importance of integrating advanced 3D MoCap technologies into the psychiatric assessment to enhance our understanding of gait alterations in mental disorders.

None Declared

Early diagnosis of ASD a very important factor in improving the quality of life of people on the spectrum. Isolated reports that analyse the effect of age of diagnosis on the comorbidity indicate a statistically significant relationship between these parameters. However, the literature on this subject is very poor and does not take into account the risk of self-aggression and suicide in this context.

In this two-stage study we have aimed to analyse the risk of comorbidity, specific diagnoses, and the risk of autoagression and suicidality depending on the age of diagnosis of ASD as well as we have tried to answer the question of what factors affect the age of diagnosis in Poland.

First stage of the study was carried out in the form of a retrospective analysis of the documentation and, in total, included the documentation of 328 people who comprised all patients with ASD diagnosis hospitalised in inpatient and diagnosed in outpatient clinic of our Department in 2021 and 2022. Subsequently in the second stage 77 children were randomly recruited among the patients with the diagnosis of ASD who came to local mental health clinic at the Child and Family Health Center in Sosnowiec for the more detailed analysis.

In the first stage the mean age of diagnosis of ASD in the overall group was 11.28 years. The late diagnosis of ASD was also statistically significantly associated with the risk of psychiatric comorbidity. Furthermore in the logistic regression analysis, each subsequent year of diagnosis delay was statistically significantly associated with the risk of suicidal ideation with OR=1.29 (95%CI: 1.17-1.42; p<0.000001). Statistically significant parameters shaping the time of ASD diagnosis were: mutual communication, the ability to establish peer relationships and the appearance of atypical social behaviours. In the second stage of the study the mean age of the first enrollment in the mental health clinic was 9.09 years for girls and 6.42 for the boys. The age of the first visit to mental health clinic was correlated only with the total score of the ADOS-2 study (rho = -0.32; p = 0.0092) and the ADOS-2 social affect subscale (rho = -0.29; p = 0.012). Meanwhile, the time it took for a specialist to diagnose ASD depended on the TAS-20 score (rho = -0.30; p = 0.0049).

The results of the study indicate that the diagnosis of ASD is still a significant problem both in Poland and in the world. The long time needed to obtain the correct diagnosis is a common problem. Furthermore delaying the correct diagnosis has a significant negative impact on function, health and prognosis in patients with ASD in many contexts. Inter allia in the analysed group it was responsible for a significant increase in risk of suicidal ideations.

None Declared

In the past decade, techno-referentiality has increasingly influenced daily life, illustrating how technology can disrupt human relationships. A notable example of this phenomenon is “phubbing”—a combination of “phone” and “snubbing”—which refers to the act of ignoring someone in favor of engaging with a mobile phone, leading to diminished eye contact and interest during face-to-face interactions. Recent research has highlighted “parental phubbing,” suggesting it may adversely affect parent-child relationships and contribute to developmental and mental health issues in children and adolescents.

This study seeks to investigate the potential effects of parental phubbing on the mental health and development of children.

We conducted a systematic review and meta-analysis using Nested Knowledge software, adhering to PRISMA guidelines. Our search encompassed five databases: PubMed, Scopus, PsycINFO, Web of Science, and EBSCO. The inclusion criteria for studies were:

• • Cross-sectional or longitudinal design.

• • Quantitative data on parental phubbing and its potential impact on children’s mental health symptoms and developmental disorders.

• • Studies involving children aged 0 to 18-21 years.

• • Publications in peer-reviewed English-language journals.

The methodological quality and risk of bias in the included studies were assessed using the JBI Critical Appraisal Checklist. Publication bias was evaluated through funnel plot analysis and Egger’s regression intercept. Meta-analyses were performed using Jamovi with the MAJOR module, applying the Fisher r-to-z transformation for correlation coefficients. A random-effects model was used, and heterogeneity was estimated with the restricted maximum-likelihood estimator. Sensitivity analyses were conducted to ensure the robustness of the findings.

Our search identified 26 studies involving 22833 children and 2125 parents. We developed a unified theoretical model of the direct and mediating effects of parental phubbing on child mental health. The meta-analysis revealed that parental phubbing was significantly associated with:

• • Increased affective symptoms in children (k=10; r=0.319; 95% CI [0.269, 0.370]).

• • Higher levels of aggression or deviant behavior (k=3; r=0.260; 95% CI [0.134, 0.386]).

• • Greater internalizing problems (k=4; r=0.242; 95% CI [0.166, 0.319]).

• • More externalizing problems (k=4; r=0.158; 95% CI [0.081, 0.234]).

Additionally, parental phubbing was negatively correlated with children’s self-esteem (r=-0.233; 95% CI [-0.315, -0.150]).

This meta-analysis underscores the significant harm that parental phubbing can inflict on children’s emotional and social well-being. To safeguard and enhance children’s development, it is crucial to implement strategies that promote more mindful technology use and foster stronger, more engaged parent-child relationships.

None Declared

School-based sexual education aims to provide children and adolescents with the knowledge and values necessary for a positive view of their sexuality within their emotional and social development. However, sexual health education in Tunisian schools remains controversial, particularly among parents.

To assess parents’ perceptions of school-based sexual education and identify challenges related to sexual health education in Tunisia.

This descriptive study, conducted from September to October 2021, involved 154 parents from various Tunisian governorates. Participants completed a self-administered questionnaire in classical Arabic distributed via online groups. The survey explored perceptions of sexual education and identified key challenges.

Of the participants, 55.8% (n=86) were aware of the national sexual education program, but only 13.6% (n=21) knew its content. A majority (81.8%; n=126) supported school-based sexual education. Key topics for discussion included the human body and its development (77.3%), moral values, rights, and culture (68.8%), and violence and safety (68.2%). Most parents preferred discussions to start in middle school (46.1%; n=71) or primary school (30.5%; n=47), with only 6.5% (n=10) advocating for earlier education.

Parents, healthcare professionals, and teachers were seen as primary educators (68.2%; n=105; 64.3%; n=99; 63%; n=97). While 55.8% recognized sexual rights as part of human rights, only 39.53% (n=34) were knowledgeable about these rights. Only 29.1% of parents (n=46) regularly discussed sexuality with their children. Despite the general value placed on sexual education and minimized concerns about negative consequences, some parents worried about risks such as early sexual activity. On a scale of 1 to 10, half of the participants (50%; n=77) rated the importance of sexual education at 8/10 or higher.

The study highlights the need for sexual education programs tailored to Tunisia’s cultural context. Despite strong parental support (81.8%) and acknowledgment of essential topics like human development and moral values, only 13.6% are familiar with the program content. Challenges include concerns about cultural fit and potential negative impacts. Engaging parents, educators, and health professionals is crucial for overcoming these challenges. Further research should explore these cultural dynamics and assess.

None Declared

Specific Learning Disorder (SLD) is a significant comorbidity in children with Attention Deficit Hyperactivity Disorder (ADHD). Both ADHD and SLD are neurodevelopmental conditions that share common characteristics, such as deficits in executive functions. Identifying SLD in patients with ADHD is crucial because targeted educational interventions are the primary treatment for SLD.

This study aimed to evaluate the utility of the Stroop Test (ST) in differentiating SLD from ADHD.

79 patients (42 with ADHD and 37 with both ADHD and SLD) participated in the study. Sociodemographic information and ST performance metrics (completion time, omission errors, and commission errors) were collected by a child and adolescent psychiatrist. Additionally, parents completed the Turgay DSM-IV ADHD Rating Scale to assess the severity of ADHD symptoms.

There were no significant differences between the ADHD and ADHD+SLD groups regarding age, gender, or ADHD symptom severity. The ADHD+SLD group exhibited longer completion times across all sections of the ST. Omission errors in the fourth and fifth sections were significantly higher in the ADHD+SLD group. After adjusting for age, gender, and ADHD symptom severity, the completion time in the fifth section and omission errors in the fourth and fifth sections remained significant. Receiver Operating Characteristic (ROC) analysis identified cut-off scores for the fifth section’s completion time (42 seconds; Sensitivity: 0.62, Specificity: 0.66) and omission errors (1 error; Sensitivity: 0.64, Specificity: 0.61). Moreover, omission errors in the fifth section predicted being in the ADHD+SLD group (p= .006, Odds Ratio [OR]= 1.527, 95% CI= 1.127–2.068).

The findings suggest that the ST may be a valuable tool for diagnosing SLD in patients with ADHD. In particular, the completion time and omission errors in the fifth section of the ST may serve as practical diagnostic indicators. Further research with larger sample sizes is necessary to confirm these results.

None Declared

Children with Attention Deficit Hyperactivity Disorder (ADHD) may experience impairments in memory functions and visuospatial skills. Despite this, research exploring the relationship between ADHD subtypes, psychiatric comorbidities, and these neurocognitive functions is limited. This study focused on cognitive disengagement syndrome (CDS) and anxiety as comorbid conditions, both of which independently impact neurocognitive functions. However, the combined effects of these conditions with ADHD remain poorly understood. Moreover, investigating how CDS influences neurocognitive domains is essential for a comprehensive understanding of the syndrome’s cognitive aspects. Therefore, identifying the factors that impact memory functions and visuospatial skills in children with ADHD is expected to facilitate the recognition of cases at risk.

This study aimed to investigate the relationship between ADHD subtypes, psychiatric comorbidities, and memory functions and visual spatial skills in children with ADHD.

The study recruited 120 children with ADHD aged 6-12 years. ADHD subtypes, anxiety, and CDS symptoms were assessed using standardized scales and DSM-5-based psychiatric evaluations. The participants were then administered the Visual Reproduction Subtest of the Wechsler Memory Scale, Oktem Verbal Memory Processes Test, Block Design Subtest of the WISC-IV, Judgment of Line Orientation Test and Benton Visual Recognition Test to measure visuospatial skills and working memory functions.

The results showed that 28% of the sample group was diagnosed with inattentive type ADHD (ADHD-IN), while 72% were diagnosed with combined type ADHD. Additionally, 33.33% of participants had CDS+ADHD. When comparing children with CDS + ADHD to those with ADHD alone in terms of visual-spatial and organizational processing abilities, it was found that those with CDS + ADHD were impaired. Children with ADHD-IN also scored lower on a verbal memory test compared to those with combined-type ADHD. On the other hand, anxiety scores were found to be positively correlated with memory functions.

The study found that ADHD subtypes, the presence of CDS symptoms, and anxiety impact the neurocognitive profile of children with ADHD. Further research is needed to understand the various areas of cognitive function that may be affected. The authors declare that they have no conflicts of interest.

None Declared

Early life adversity (ELA) such as physical and emotional abuse has been recognized as an important risk factor for depression in adults. Past research has shown that ELA was associated with alteration in the hippocampus, a key region involved in stress sensitivity, emotional learning and memory. However, relatively little is known about the role of the hippocampus in the relationship between ELA and depression in adolescents.

This study aimed to investigate whether the hippocampal volume and hippocampus resting-state functional connectivity (RSFC) moderated the relationship between ELA and depressive symptom severity in adolescents with major depressive disorder (MDD).

This study included 73 adolescents with MDD (age M (SD) = 15.0 (1.5) years, 51 girls). The participants completed the Early Trauma Inventory and Children’s Depression Rating Scale to assess ELA and depressive symptom severity, respectively. Resting–state functional and structural T1 images were collected using a Siemens 3T MR scanner and preprocessed using AFNI and FreeSurfer routines. The average BOLD time-series was extracted from our regions-of-interest (ROIs), the bilateral hippocampus and dorsolateral prefrontal cortex (DLPFC). An ROI-to-ROI RSFC analysis was conducted to calculate Pearson correlation coefficients between the hippocampus and DLPFC ROIs. The correlation coefficients were transformed to Fisher’s z. We performed correlation and moderation analyses to test our moderation model (Figure 1) after controlling for age and sex.

Emotional abuse, one form of ELA, was significantly correlated with depressive symptoms in adolescents with MDD (r = 0.25, p < .05). Bilateral hippocampus – left DLPFC RSFCs moderated the association between emotional abuse and depressive symptoms in adolescents with MDD (ps < .01). The association between emotional abuse and depressive symptoms was stronger when bilateral hippocampus – left DLPFC RSFCs were lower (left hippocampus – left DLPFC RSFC, -1D: b = 3.72, SE = 1.06, p < .001; right hippocampus – left DLPFC RSFC, -1D: b = 4.15, SE = 1.04, p < .001) than when they were greater (left hippocampus – left DLPFC RSFC, +1D: b = -0.09, SE = 1.05, p = .93; right hippocampus – left DLPFC RSFC, +1D: b = -0.10, SE = 0.98, p = .69) (Figure 2). Hippocampal volumes also moderated the relationship between emotional abuse and depressive symptoms, but the results did not remain significant after correcting for multiple comparisons.

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Image 2:

Our findings suggest the important role of hippocampus RSFC with the DLPFC in the relationship between emotional abuse and depressive symptoms in adolescents with MDD.

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Despite the identification of several risk factors, an understanding of the role of specific psychopathological profiles in predicting adolescent suicidal behaviours remains a key challenge in public health research.

The current study aimed to identify psychopathological profiles in suicidal adolescents and to analyse their association with suicide-related outcomes.

A total of 285 adolescents aged 12 to 17 years [mean age (SD)=14.98 (1.51); females: 249 (87.40%)] were recruited from different hospitals in Spain. Latent profile analysis was performed to classify subgroups with similar patterns based on self-report Strengths and Difficulties Questionnaire. Logistic regression and generalised linear modelling were applied to examine the relationship between profile membership and suicidal behaviours.

Three psychopathological profiles were identified: internalizing symptom profile (52.63%), externalizing symptom profile (24.21%), and low symptom profile (25.58%). The predominantly female internalizing symptom profile members were more likely to report higher levels of psychopathological symptoms, including number of psychiatric diagnoses, depressive symptoms, and trauma (except sexual abuse). Additionally, they had more non-suicidal self-injury (NSSI) and suicidal thoughts and behaviours. Likewise, greater ideation intensity was associated with the internalizing symptom profile compared to other groups, while greater number of previous suicide attempts correlated with an increase in suicidal behaviours. Finally, higher levels of motor impulsivity were associated with a lower probability of suicidal behaviours.

Identifying symptom profiles among adolescents who have attempted suicide allows us to establish reliable predictors for suicide prevention as well as personalised interventions, indicating the domains where these interventions are needed.

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Bullying is a persistent aggressive behavior characterized by a power imbalance and driven by the intent to cause harm. Examining the connection between past experiences of victimization and current bullying behaviors is essential for a comprehensive understanding of this phenomenon..

This study aims to assess the prevalence of bullying and cyberbullying among Tunisian adolescents and to explore the relationship between current bullying behaviors and a history of childhood victimization.

This cross-sectional study was conducted via a survey among adolescents attending middle and high schools during the 2023-2024 school year. Participants provided written consent and completed a demographic information sheet, the Adolescents and Peer Relations Instrument (APRI), and the Adverse Childhood Experience-International Questionnaire (ACE-IQ).

The study population consisted of 1,005 adolescents, with a sex ratio of 0.73 and a mean age of 14.62 years. We find that 92.1% of adolescents experienced traditional bullying within the year, with 54.9% exposed to school bullying more than once a month. The most prevalent form was verbal bullying (88%), followed by relational bullying (77.3%) and physical bullying (73.9%). Among the participants, 38.5% had no history of past bullying but were currently victimized, 53.7% had experienced bullying in the past and continued to be victimized, 1.3% had been victimized in the past but no longer experienced bullying, and 6.5% had never been bullied, either in the past or present.

We identified a significant association between peer violence and bullying victimization, with a p-value <0.001 and an odds ratio (OR) of 4.11 (95% CI: 2.5-6.66). There was also a significant correlation between peer violence and the APRI scale (p < 0.001). Further analysis showed a strong correlation between peer violence and verbal bullying victimization (p < 0.001, OR = 3.75 [2.53-5.56]), relational bullying victimization (p < 0.001, OR = 2.8 [2.1-3.8]), and physical bullying victimization (p < 0.001, OR = 2.64 [1.97-3.53]). The risk of being victimized by all three forms of bullying was tripled (p < 0.001, OR = 2.75 [2.1-3.6]).

This study highlights the alarmingly high prevalence of bullying among Tunisian adolescents and emphasizes the significant link between past victimization and current bullying experiences. These findings underscore the need for targeted interventions that address the underlying trauma from past experiences to promote positive youth development.

None Declared

With the increased exposure to social media and the widespread use of technological tools, adolescents are at higher risk of engaging in cyberbullying. Cyberbullying is a specific form of bullying, characterized by persistent aggressive behavior, an imbalance of power, and an intent to cause harm. It occurs through electronic communication, including social media platforms, messaging apps, and other online spaces. In Tunisia, limited data exists on the extent and characteristics of cyberbullying, particularly in the of Sousse.

Our study aims to assess the prevalence of cyberbullying among middle school students in the Sousse region and identify the factors associated with this phenomenon.

This is a cross-sectional, descriptive, and analytical study based on a survey conducted among adolescents attending two middle schools in the governorate of Sousse during the 2020/2021 school year. The participants completed a demographic information sheet, the “Cyberbullying Screening Test,” and the “Resilience Factors Inventory (IFR-40) “

Our population consisted of 238 adolescents, with 63.6% girls and 36.4% boys, giving a sex ratio of 0.57. The average age of participants was between 13 and 15 years old. Our results showed that 38.2% of adolescents used their phones or computers for more than three hours per day, and 32.4% used social media for over three hours daily. The prevalence of cyber victimization was 51.3% within our population. Familial protective factors were present in 80.6% of the sample, individual protective factors in 76.5%, and social protective factors in 68.7%. Our analysis revealed that repeating a grade was statistically associated with cyberbullying (p-value = 0.002). Furthermore, familial protective factors and individual protective factors were significantly correlated with cyberbullying, with p-values of 0.007 and 0.019, respectively. However, no significant association was found with social protective factors (p-value = 0.3).

Our study confirms the concerning extent of cyberbullying among Tunisian adolescents and highlights the need to develop appropriate prevention and intervention strategies to improve youth well-being. Enhancing family and individual resilience appears to be a promising approach for preventing cyberbullying and supporting affected adolescents.

None Declared