The role of the brain-derived neurotrophic factor (BDNF) in the pathophysiology of depression is well established, with decreased BDNF levels being associated with the emergence of depressive symptoms. More recent studies have reported that the precursor protein – proBDNF – might also be involved in the pathogenesis of depression since both particles are biologically active and elicit opposing effects: mature BDNF promotes the proliferation of neurons and synaptogenesis, while proBDNF evokes neuronal death. The BDNF/proBDNF ratio has been suggested as a possible biomarker of depression state and treatment response among adults with depression. However, no study has analyzed BDNF/proBDNF serum ratio levels in adolescent depressed patients.

We aimed to verify the changes in serum BDNF/proBDNF ratio levels during the course of treatment in adolescents with depression in relation to healthy control. We also aimed to investigate whether this parameter could predict the antidepressant treatment outcome.

Thirty female inpatients, aged 11-17, diagnosed with a first-lifetime depressive episode were assessed at two time-points: before (t0) and after (t1) the minimum six-week period of the first-line antidepressant treatment and compared with thirty age-matched healthy girls. The assessment at t0 and t1 involved the analysis of BDNF and proBDNF serum levels (ELISA method) and clinical symptoms evaluation using standardized depressive symptoms scales: Children’s Depression Inventory (CDI-2) and Hamilton Depression Rating Scale (HDRS). Patients with at least 50% symptom reduction in CDI-2 and HDRS or HDRS<7 were classified as ‘responders.’ The control group underwent one-time BDNF and proBDNF evaluation. The BDNF/proBDNF ratio has been calculated.

The BDNF/proBDNF serum ratio did not significantly differ between the studied and control groups. We proved no significant differences in BDNF/proBDNF serum ratio before and after the antidepressant treatment, regardless of the treatment outcome. However, responders had a significantly higher pretreatment BDNF/proBDNF ratio when compared with non-responders (Figure 1). The ROC analysis revealed that the BDNF/proBDNF ratio at t0 could predict the remission status at t1 with a sensitivity of 66.67% and a specificity of 81.25% (Figure 2).

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Pretreatment BDNF/proBDNF ratio could be considered a possible biomarker predictive of antidepressant treatment response in adolescent girls.

None Declared

Depression is one of the most common mental health disorders in children and adolescents. In India, many parents resist psychotropic medication for children due to potential side effects, highlighting the need for non-pharmacological interventions like yoga.

The current study investigates the impact of additional yoga therapy on depressive symptoms, global functioning, and parental stress among children and adolescents diagnosed with Major Depressive Disorder (MDD) on children seeking treatment at the Department of Psychiatry of a tertiary care medical institute in India.

This study included 80 participants aged 6 to 17 years. After taking written informed consent from the parents and assents from the adolescents, they were randomized into two groups: one receiving yoga Therapy alongside treatment as usual (TAU) and the other a waitlist control group receiving only TAU. Assessments were done on both children and their parents, and the instruments included were Centre for Epidemiological Studies Depression Scale for Children (CES-DC), the Children’s Global Assessment Scale (CGAS), the Clinical Global Impression scale (CGI), and the Depression Anxiety and Stress Scale (DASS) for parents. Follow-up assessments occurred at 6 and 12 weeks.

In the experimental group, CES-DC scores showed significant improvements, with p value < 0.01 at 6 weeks and < 0.01 at 12 weeks. Global functioning scores also improved, recording p values of < 0.01 at 6 weeks and < 0.01 at 12 weeks. The control group also exhibited results, with CES-DC p values of < 0.01 at 6 weeks and < 0.01 at 12 weeks. Global functioning scores revealed p values of < 0.01 at 6 weeks and < 0.01 at 12 weeks. However, there were no significant differences in the improvement in CES-DC score and functioning in the experimental and control group at the end of 6 weeks and 12 weeks. At the baseline, at end of 6 weeks and at the end of 12 weeks, there were no significant differences in parental depression, anxiety, and stress score.

Yoga therapy was beneficial for the children and adolescents with major depressive disorder. However, there were no significant differences in the improvement in depression and functioning in the experimental and control group.

B. Patra Grant / Research support from: The Department of Science & Technology, Govt of India under its scheme “SATYAM”, R. Sagar: None Declared, G. Sharma: None Declared

Adolescents face significant stress, which can undermine their subjective health, often manifesting as psychosomatic symptoms. Perceived self-efficacy is a critical resource for resilience, potentially buffering the impact of stress on subjective health. While action self-efficacy indicates one’s perceived ability to set goals and take initiative, coping self-efficacy refers to one’s ability to achieve the goals. By investigating both components, researchers and mental-health professionals can better understand how different aspects of self-efficacy influence the stress-symptom relationship, providing a more nuanced view of coping mechanisms.

The aim of this study is to determine how these key components of self-efficacy - action self-efficacy and coping self-efficacy - moderate the relationship between stress and psychosomatic symptoms.

The analyses were based on the Hungarian contribution to the representative international Health Behaviour in School-aged Children (HBSC) survey, collected in 2021/2022. The study population comprised self-report data from high-school students (N = 3,410; mean age = 16.77 years). We examined the main effects of self-efficacy dimensions and perceived stress, and their interactions in explaining psychosomatic complaints, using linear regression analysis with Hayes’ PROCESS macro (Model 1) in SPSS. Age and gender were controlled for as covariates.

Coping self-efficacy: The overall model explained 33% of the variance in psychosomatic symptoms (R² = 0.33, F(5, 3404) = 330.96, p < .001). The results showed that stress (b = 1.93, p < .001), coping self-efficacy (b = 2.18, p = .02), and their interaction (b = -0.33, p = .002) were significant explanatory variables. This suggests that the relationship between stress and psychosomatic symptoms is weaker among adolescents who reported stronger coping self-efficacy. Action self-efficacy: In contrast, the interaction between stress and action self-efficacy was not significant (p = .16), implicating that the ability to set goals did not mitigate the effect of stress on symptoms.

The findings imply that coping self-efficacy significantly reduces the relationship between stress and psychosomatic symptoms. Adolescents with stronger coping skills are better equipped to mitigate the adverse effects of stress. However, action self-efficacy did not show a significant moderating effect, highlighting the distinct roles different self-efficacy components play in stress management. These results emphasize the importance of enhancing coping skills, such as cognitive reappraisal, in primary prevention interventions to reduce stress-induced psychosomatic symptoms.

adolescents, HBSC, psychosomatic symptoms, self-efficacy, stress

This study was supported by the Hungarian National Research, Development, and Innovation Office (K139265 and K143764).

None Declared

The Lancet Commission noted severe mental health service disparities in low- and middle-income countries facing crises. Regarding this, the World Health Organization (WHO) developed the early adolescent skills for emotions (EASE), an experimental group-based intervention delivered by non-specialists, to offer evidence-based psychological support for adolescents with mental distress.

This systematic review and meta-analysis assesses EASE’s effectiveness in alleviating post-traumatic stress disorder (PTSD) compared with enhanced treatment as usual (ETAU).

We systematically searched PubMed, Cochrane, and Scopus for randomized controlled trials (RCTs) comparing EASE with ETAU. Our outcomes included the overall improvement in post-traumatic and depressive symptoms, measured by the Children’s Revised Impact of Event Scale (CRIES-13) and the Patient Health Questionnaire-Adolescent version (PHQ-A) scores respectively. We pooled mean differences (MD) with 95% confidence intervals (CI) in RStudio using a random-effects model. Heterogeneity was assessed with I² statistics.

Six RCTs were included with 1,417 patients, of whom 642 (45.3%) received EASE treatment. In 67% of the studies, Syria was the main location of RCT’s. A total of 688(49%) were female. CRIES-13 (MD = -0.18, 95% CI [-1.88, 1.52], p = 0.84, I² = 0%; Figure 1) and PHQ-A (MD = -0.69, 95% CI [-1.47, 0.09], p = 0.08, I² = 15%; Figure 2) scores in the EASE intervention group compared to the ETAU group showed no significant difference. In both outcomes the heterogeneity was low.

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The benefit of EASE in improving mental distress in adolescents is uncertain. Additional trials will provide new evidence for EASE potential therapeutic benefits.

None Declared

Pathological anxiety in social anxiety disorder (SAD) is characterized by dysregulated arousal and altered cardiac autonomic responses, with lower heart rate variability (HRV) potentially indicating emotional dysregulation.

This study aimed to explore the relationship between peripheral and central autonomic nervous system activity during emotional processing in patients with SAD.

Thirty-two patients with SAD and 41 healthy controls participated in a passive viewing task that alternated between neutral and angry faces. We analyzed correlations between brain activation during emotional processing and root mean square of successive differences (RMSSD) in HRV during both resting state and task conditions.

Unlike the controls, the SAD group showed a trend toward significant correlations between baseline RMSSD and left anterior insula activity during neutral face processing (R2 = 0.118, β = -0.003, F= 3.886, p = .058) and significant correlations with both left anterior insula and right amygdala activities during angry face processing (R2 = 0.157, β = -0.003, F= 5.415, p = .027 and R2 = 0.135, β = -0.002, F= 4.360, p = .046, respectively). In the control group, task RMSSD was significantly correlated with right amygdala and right dorsomedial prefrontal cortex activities during neutral face processing (R2 = 0.160, β = -0.003, F=6.284, p = .017 and R2 = 0.222, β = -0.009, F=9.443, p = .004, respectively), while in the SAD group, correlations were found with the right parahippocampal gyrus (R2 = 0.148, β = -0.002, F=4.5, p = .044). Additionally, only in the control group, RMSSD during neutral face trials was significantly correlated with neural activation during angry faces processing (R² = 0.132, β = -0.002, F=4.856, p = .035).

This study identifies distinct patterns of autonomic and neural responses to emotional stimuli in SAD patients, highlighting heightened autonomic readiness and reduced flexibility when processing social threats.

None Declared

Opioid use disorder (OUD) is a national public health concern. Craving is a diagnostic criterion and is also implicated in the risk of relapse to opioids. Although sleep impairment is believed to relate with OUD, little research to date has examined the relationship between sleep components and craving in individuals with OUD as well as the moderators in the relationship.

This cross-sectional study was designed to address the relationship between sleep disturbance and OUD.

Individuals with current OUD (n=51) were enrolled. Each participant completed validated scales, including the Pittsburgh Sleep Quality Index for sleep, and Barratt Impulsiveness Scale for impulsivity, and the Opioid Craving Scale for cravings. Correlation and moderation analyses were performed using SPSS, v29.

Total scores of the PSQI were significantly associated with cravings (r=0.44, p=0.006). Among sleep components, sleep quality, sleep efficiency, and sleep disturbance were significantly associated with cravings, while four other sleep components were not. Impulsivity moderated the relationship between sleep impairment measured using total score of the PSQI and cravings for participants (b=0.15, p<.05).

Although preliminary, the findings add to literature on craving, impulsivity, and sleep among individuals with OUD. Sleep impairment and impulsivity may be important targets of a comprehensive, long-term treatment plan for some patients with OUD.

None Declared

ASD is a neurodevelopmental disorder with 1% prevalence among children and adolescents, with high comorbidity with Intellectual Disability. ASD imposes a significant disease burden and is a leading cause of disability among children and adolescents. Its aetiology is multifactorial, including both genetic and environmental factors. Although prior studies have explored the incidence, comorbidities and several prenatal risk factors, research especifically focusing on ASD categorization by ID is limited.

The aim of this study was to report the incidence and cumulative incidence of overall ASD, and HF and LF-ASD categorization, utilizing several national registers.

This study consisted of all singltone born in Finland between 1998 and 2015 (N=1,044,102), who were diagnosed with ASD from age 3 to 20. We devided study sample into four cohorts by birth year: 1998-2002, 2003-2007, 2008-2011 and 2012-2015. We also categorized ASD into LF-ASD and HF-ASD, based on their comorbidity with ID (ICD 10 codes: F70-F79). All cases (n=10,171) were matched with Controls (n=49,391) on the age, gender and place of birth. We limited our study of other psychiatric disorders comorbidities to the oldest birth cohort, born in 1998-2002. The association between sociodemographic risk factors and ASD cases and separately for HF-ASD and LF-ASD was analysed using Conditional logistic regression.

The incidence of ASD increased with age, specifically among girls. Among the birth cohorts, the cumulative incidence of HF-ASD increased from 0.52 (95% CI 0.49-0.54) to 0.89 (95% CI 0.84- 0.94), by age 10, while in the cumulative incidence of LF-ASD remained stable at 0.17 (95% CI 0.16-0.19). Several socio-demographic risk factors were associated with both HF-ASD and LF-ASD, except for parental immigration, which was only associated with LF-ASD. A total of 58.99% cases had at least one comorbid diagnosis, 35.91% of HF-ASD and 31.86% of LF-ASD. The most common comorbid diagnoses among HF-ASD cases were ADHD (33.9%), depressive disorder (25.4%) and anxiety disorder (23.9%). Among LF-ASD cases were ADHD (17.2%), anxiety disorder (10.5%) and Schizophrenia (5.2%).

The incidence of diagnosed ASD increased with age from 1998-2018, especifically HF-ASD. This result could indicate a real increase in incidence or is due to improved access to mental health services and enhanced awareness of ASD among population and professionals. The rise in ASD incidence underscores the need for specialized mental health services and social support. The association between immigration and the risk of ASD highlights the importance of ensuring mental health services are accessible to immigrants.

None Declared

Tobacco smoke exposure(TSE) is a significant public health issue, children and adolescents, who are often involuntarily exposed through secondhand or thirdhand smoke.This exposure has been linked to a range of neuropsychiatric conditions and can negatively impact mental and physical well-being. In the U.S., TSE is prevalent among certain sociodemographic groups, including those with lower income and specific racial backgrounds.The goal of this study was to evaluate the prevalence of TSE and its association with neuropsychiatric comorbidities.

Assess TSE prevalence among U.S. children and adolescents

Examine sociodemographic factors influencing TSE

Analyze the link between TSE and neuropsychiatric conditions’ prevalence and severity

This cross-sectional study used data from the 2020-2021 National Survey of Children’s Health (NSCH), a survey conducted by the U.S. Census Bureau.Parent-proxy responses were collected in English and Spanish through mail and web-based surveys.A total of 91,404 children aged 0-17 were included for the analysis of TSE prevalence, while 79,182 children aged 3-17 were analyzed for neuropsychiatric comorbidities.The primary measures were TSE, assessed through household smoking behavior, and the presence of neuropsychiatric conditions. Statistical analyses included t-tests, Chi-Square tests, and multivariate regression models to identify associations between TSE, socio-demographic factors, and neuropsychiatric comorbidities, providing adjusted odds ratios and confidence intervals. Statistical analyses were carried out using Stata version 17.

TSE was identified in 12.9% of the sample population. The likelihood of TSE was higher among males and adolescents aged 11-17 years. Children from lower-income households and American Indian/Alaska Native backgrounds had a greater risk of TSE. Among children exposed to tobacco smoke, 36.4% had at least one neuropsychiatric comorbidity, with anxiety (15.7%), ADHD (15.5%), and conduct problems (13.7%) being the most common. Females had lower odds of anxiety and autism spectrum disorder(ASD)compared to males, and Asian children exhibited lower odds of ADHD and other conditions. TSE was associated with increased severity of neuropsychiatric conditions. Figure 1.

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TSE is a significant concern among U.S. children and adolescents, particularly affecting males and those from lower-income families. Exposure to tobacco smoke notably elevates the risk and severity of neuropsychiatric conditions, with ADHD, behavioral and conduct problems, and learning disabilities being the most common co-occurring issues. These findings highlight the importance of early screening and intervention for youth exposed to tobacco smoke. Addressing sociodemographic disparities in exposure and implementing prevention strategies could play a critical role in reducing these negative health outcomes.

None Declared

Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder that significantly affects children’s behaviour, attention, and academic performance. While the impact of maternal smoking during pregnancy on ADHD risk is well-established, emerging research suggests that paternal smoking may also contribute to this risk. However, the relationship between paternal tobacco use and ADHD remains underexplored, with existing studies presenting mixed results.

This systematic review and meta-analysis aim to clarify the extent of this association and provide a comprehensive assessment of the evidence available.

All relevant studies in CINAHL, Embase, PsycINFO, PubMed, Scopus, and Web of Science databases were searched from inception until 15 March 2024. Both conventional and cumulative meta-analyses were conducted. Pooled odds ratios with 95% confidence intervals (CIs) were calculated using a random-effects model. The heterogeneity among studies was assessed using the I2 test, and the presence of small study effects was evaluated using funnel plots and Egger’s test. Sensitivity and subgroup analyses were also performed.

Twenty observational studies involving over 294, 236 study participants from 16 different countries were included. We found that paternal smoking was associated with a 22% increased risk of ADHD in children (RR=1.22, 95% CI: 1.12, 1.33). The observed association has remained stable since 2014, with minimal fluctuations in effect sizes and their corresponding 95% CIs. Our subgroup analysis revealed that this association is only evident among studies that did not account for maternal smoking (OR=1.23, 95% CI: 1.10, 1.38, n=8), while no increased risk of ADHD was found in studies that adjusted for maternal smoking (OR=1.14, 95% CI: 0.98, 1.33), suggesting that maternal smoking may confound the observed association.

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Paternal smoking may increase the risk of ADHD in children. Future studies should focus on maternal and paternal comparisons to disentangle the independent and combined effects of parental smoking on ADHD risk in children.

None Declared

Body dissatisfaction is becoming more common among adolescents and is a putative risk factor for adverse mental (e.g., eating disorder and depressive symptoms) and physical health outcomes (e.g., excessive weight gain), both of which have also been increasing. Targeting body dissatisfaction through preventative interventions might improve these outcomes, however robust evidence of causal associations is limited.

To investigate the association between body dissatisfaction at age 16 and eating disorder symptoms at age 21, as well as depressive symptoms and BMI at ages 21 and 26 using a co-twin control design.

We used data from the Twins Early Development Study (TEDS) and validated self-report measures. We fitted univariable and multivariable linear mixed effect models adjusting for a comprehensive list of confounding factors (Figure 1) to investigate the association between body dissatisfaction, eating disorder and depressive symptoms, and BMI in the full twin sample. We then repeated these analyses using a co-twin control design, which allows to fully and partially control for genetic confounding in monozygotic (MZ) and dizygotic (DZ) twins, respectively, and for any shared measured and unmeasured environmental factors. We conducted primary analyses in imputed datasets for participants with complete exposure data.

The analytical sample included 2,183 twins (60.2% females, 61.7% DZ twins). In the full twin sample, one unit increase in body dissatisfaction at age 16 was associated with: (i) a 1.80-point increase in eating disorder symptoms at age 21 (95%CI: 1.49 to 2.11), (ii) a 0.59-point increase in depressive symptoms (95%CI: 0.46 to 0.72), and (iii) a 0.20-point BMI increase (95%CI: 0.08 to 0.32) across age 21 and 26 years. In co-twin control analyses, the association between body dissatisfaction and eating disorder symptoms was larger in DZ twins (N=661; 1.72, 95%CI: 1.11 to 2.33) than in MZ twins (N=414, 0.96, 95%CI: 0.15 to 1.77), whereas effect sizes for depressive symptoms were comparable [DZ: (0.56, 95%CI: 0.33 to 0.78); MZ: (0.50, 95%CI: 0.15 to 0.85)]. Associations with BMI were smaller in DZ (0.20, 95%CI: 0.00 to 0.40), and null in MZ twins (0.07, 95%CI: -0.21 to 0.35).

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Our findings suggest that greater body dissatisfaction might be a causal risk factor for eating disorders and depression in young people, as associations seen in the full sample persisted in co-twin control analyses. This indicates that body dissatisfaction could be a modifiable target to reduce the risk of these mental health problems in adolescents and young adults. Evidence of associations between body dissatisfaction and increased BMI was weaker in co-twin control analyses than in the full sample. This might be due to larger proportions of shared genetic risk and thus require larger sample sizes to detect.

None Declared

The association between prenatal acetaminophen exposure and the development of Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) remains a subject of considerable debate. Despite extensive research, the evidence regarding this relationship is conflicting.

To perform a systematic review and meta-analysis of studies comparing the incidence of ADHD and ASD in patients that were either exposed or not exposed to acetaminophen prenatally.

We systematically searched Pubmed, Embase and Cochrane Central for eligible studies up until August 2024. Only studies which included participants with a medical diagnosis of ADHD/ASD and reported acetaminophen exposure as a binary measure were included. Available summary data was extracted from published reports and pooled with a random-effects model using odds ratios (OR) with 95% confidence intervals (CI). Hazard ratios (HR) adjusted for potential confounding factors were used for sensitivity analyses. All statistical analyses were conducted utilizing Review Manager 5.4.1. PROSPERO iD:CRD42024587662.

We included five studies with a total of 2,647,536 patients with ADHD (150,741) / ASD (63,726), of whom 271,126 were exposed to acetaminophen prenatally and 2,376,410 were not exposed. Prenatal acetaminophen exposure was associated with an increased risk of developing ADHD (OR 1.30; 95% CI 1.17 to 1.45; p<0.01; I2 = 73%; Figure 1) and ASD (OR 1.17; 95% CI 1.14 - 1.20; p<0.01; I2 = 0%; Figure 2). Sensitivity analyses revealed that acetaminophen exposure during the third trimester of pregnancy was associated with an increased risk of ADHD (HR 1.26; 95% CI 1.07 to 1.47; p<0.01; I2 = 0%; Figure 3), but not during first (HR 1.10; 95% CI 0.97 to 1.26; p=0.13; I2 = 0%; Figure 3) and second (HR 1.07; 95% CI 0.95 to 1.19; p=0.26; I2 = 0%; Figure 3) trimesters.

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In this systematic review and meta-analysis, prenatal acetaminophen exposure was significantly associated with risk of developing ADHD and ASD, especially if exposure occurs in the third trimester of pregnancy.

None Declared

Autism Spectrum Disorder (ASD) affects approximately 3% of children and adolescents in the U.S. This condition is increasingly prevalent worldwide and presents significant treatment challenges. Preliminary evidence suggests that cannabidiol (CBD) cannabis extracts may help manage ASD symptoms, but their efficacy and potential harms have not yet been systematically investigated.

To systematically review and meta-analyze the evidence from clinical trials investigating the efficacy and safety of CBD cannabis extracts in alleviating symptoms of ASD in children and adolescents.

We conducted a comprehensive search in MEDLINE, Embase, PsycINFO, and the Cochrane Central Register of Controlled Trials using MeSH terms including “Autism Spectrum Disorder,” “Cannabidiol,” “Cannabis,” “Child,” and “Adolescents.” No language or publication date restrictions were applied. The search was last updated on September 8, 2024. We included randomized, placebo-controlled trials on the efficacy or safety of CBD cannabis extracts in children and adolescents with ASD. For outcomes with limited study data, we used a fixed-effects model. The risk of bias in the included studies was evaluated using the Risk of Bias 2 tool.

Three studies met our criteria, comprising 276 participants (78.3% male; mean age 10.5 years, range 5 to 21). Interventions included orally administered CBD cannabis extracts, with tetrahydrocannabinol (THC) present in minimal amounts or in ratios of 9:1 to 20:1 CBD to THC. Dosages of CBD started at 1 mg/kg per day and were titrated up to 10 mg/kg per day. CBD cannabis extracts significantly enhanced social responsiveness (SMD = -0.75 [-1.08, -0.43], p < 0.01, I² = 17%), reduced disruptive behavior (SMD = -0.36 [-0.67, -0.06], p = 0.02, I² = 0%), and alleviated anxiety (SMD = -0.33 [-0.63, -0.03], p = 0.03, I² = 59%). CBD cannabis extracts also improved sleep quality, without reaching statistical significance (SMD = -0.19 [-0.49, 0.11], p = 0.21, I² = 0%). There was no significant difference in adverse effects between interventions and placebo (odds ratio = 2.11 [1.00, 4.46], p = 0.05, I² = 38%).

CBD cannabis extracts appear to provide meaningful benefits for children and adolescents with ASD, showing moderate improvements in social responsiveness and small yet notable reductions in disruptive behaviors and anxiety. They do not seem to significantly increase adverse effects compared to placebo, suggesting a favorable safety profile. These findings support the potential consideration of CBD cannabis extracts in ASD treatment plans. However, the review’s limitations include a small number of studies, limited sample sizes, and significant heterogeneity. Future research with larger, robust trials is needed to clarify the efficacy and safety of CBD cannabis extracts in managing ASD.

None Declared

Tobacco use among adolescents remains a significant public health concern, particularly in the Middle East region.

This study compared the effectiveness of two interventions aimed at preventing tobacco use among Omani adolescents: the home use of photoaging app and a school-based educational module.

In this randomized controlled trial, 188 adolescents were assigned to either the photoaging app or the educational module group.

The use of photoaging app demonstrated superior efficacy in enhancing perceptions of tobacco’s harmful effects, with 78.5% of participants recognizing tobacco as definitely harmful compared to 27.1% in the educational module group (p<0.001). Additionally, the app group showed greater resistance to peer pressure, with 95.7% stating they would “definitely” refuse tobacco if offered by a friend, versus 83.5% in the module group (p=0.031). However, the educational module was more effective in promoting support for smoking bans in public places. While not statistically significant, the photoaging app group showed a trend towards lower susceptibility to tobacco use.

These findings suggest that integrating technology-driven interventions like photoaging apps with comprehensive educational programs could enhance tobacco prevention efforts among adolescents. Future interventions should consider a hybrid approach to leverage the strengths of both methods in combating youth tobacco use.

None Declared

Prementrual disorders (PMD) affect millions of women in reproductive age worldwide. Understanding the potential link between PMD and its comorbidities, including autoimmune disease (AD), is crucial for ultimately improving women’s health. Although hormonal fluctuations seem involved in the development of PMD and some AD, the relationship between PMD and AD remains unclear.

Hence, we aimed to investigate the bidirectional association between PMD and AD.

Leveraging Swedish nationwide and regional registers, we conducted a nested-case control study and a matched-cohort study. Among 3,630,028 eligible women of reproductive ages during 2001-2022, we identified 104,972 incident PMD, their unaffected full sisters, and 10 unaffected matched women per case. We extracted 41 types of AD diagnosis recorded in the registers. Using conditional logistic regression and Cox regression models, we estimated the odds ratio (OR) and hazard ratio (HR) with 95% confidence interval (CI).

Women with AD had a 12% increased risk of subsequent PMD (95% CI 1.10-1.15) compared to unaffected women, and a 6% increased risk compared to their unaffected full sisters (95% CI 1.01-1.11). Women with PMD had 23% (95% CI 1.20-1.26) and 17% (95% CI 1.10-1.24) elevated risks of subsequent AD compared to unaffected women and full sisters, respectively. Among parous women, a stronger bidirectional association was observed for those both exposed to PMD and perinatal depression (nested case-control OR:1.46, 95%CI 1.38-1.54; matched cohort HR:1.49, 95%CI 1.34-1.66) compared to only PMD (nested case-control OR:1.04, 95%CI 1.00-1.07; matched-cohort HR:1.14, 95%CI 1.07-1.21). The strongest bidirectional association with PMD was found for autoimmune thyroid disease and celiac disease.

Our findings illustrate a bidirectional association between PMD and AD, in particular among parous women with a history of perinatal depression. If confirmed in future studies, healthcare professionals need to be vigilant about the risk of AD in women with PMD and vice versa.

None Declared

Trans women can encounter various struggles throughout their gender-affirmation. There is a need for further understanding of trans women’s experiences to gain deeper insights into how they cope throughout this process. The development of psychosocial support services that are adapted to their personal needs is crucial to enhancing their coping strategies.

The current study aimed to examine the coping experiences of trans women throughout their gender-affirmation.

This qualitative descriptive study utilized in-person, semi-structured interviews with 12 trans women to gather in-depth data on their coping experiences. Content analysis was employed to analyze the data.

The experiences of trans women emerged in five themes. Four themes correspond to four distinct phases: “self-discovery,” “self-acceptance,” “coming out to others,” and “after coming out to others,” each characterized by its own coping mechanisms. The fifth theme was labeled “to facilitate coping…”. Trans women have a heightened need for support during the periods “when they confront the possibility that their situation will not change,” “when they accept themselves but attempt to decide how they can move forward in life,” and “when they first come out to people around them.” The study indicates the critical role of addressing family and social stigma in trans women’s coping throughout their gender-affirmation. Furthermore, the study unveils a striking finding that efforts to facilitate trans women’s coping throughout their gender-affirmation extend beyond the purview of mental health professionals. It reveals that these efforts have dimensions that concern the entire healthcare system, the legal system, social security, labor, and working conditions.

The study highlights the importance of psychosocial support and improved access to these services to bolster trans women’s coping mechanisms throughout their gender-affirmation, with particular emphasis on the specific periods identified above. The psychosocial support for trans women should encompass not only them but also extend to their families, significant others, and the community in which they live, adopting a holistic approach.

None Declared

Antipsychotic (AP) medications are increasingly prescribed, with indications ranging from psychotic illness to mood disorders. Many patients and clinicians are concerned about long-term consequences of drug exposure in the neurodevelopmentally critical prenatal window. Yet maternal mental illness itself is also associated with significant changes to the prenatal environment.

To systematically review the literature on the short- and long-term behavioral, socioemotional, psychomotor, and neurocognitive outcomes in children prenatally exposed to AP medication.

We included original studies assessing cognitive, motor, behavioral, social, and psychiatric. Searches were performed in MEDLINE, Cochrane, Embase, and PsycINFO for studies up to March 15, 2024. Quality and risk of bias were assessed using the Newcastle Ottawa Scale (NOS). Studies were eligible for inclusion if they were original, peer-reviewed research which assessed human offspring of any age, prenatally exposed to any antipsychotic medication, regardless of maternal indication for use.

We identified 1,315 studies, and reviewed 53 in full-text screening. The final synthesis included 16 studies (6 cohort and 10 register-based studies) with the number of prenatally exposed individuals ranging from 17 to >15,000.Eleven studies included a control group with maternal mental illness in at least one of their analyses. These groups varied with some including any maternal mental illness, while others used an antipsychotic discontinuation control, and still others used non-antipsychotic psychiatric medication use as a control. Five studies included only a general or healthy maternal population control. Eight studies assessed motor development, ranging from newborn assessments up to 14 years of follow-up. These studies observed early motor delays following prenatal exposure to AP medication, which did not persist into later childhood. Five studies investigated risk for neurodevelopmental diagnoses and three studies explored school performance following prenatal AP exposure. No significant associations were found after adjustment for confounding. The quality of the evidence ranged from moderate to high.

While the majority of studies did not identify differences between exposed and unexposed groups, some differences emerged early in infancy or when looking at neurodevelopmental disorders. However, our findings suggest that the observed neurodevelopmental differences are likely due to confounding by indication rather than exposure to antipsychotics themselves. More rigorous research is needed to clarify the neurodevelopmental effects of AP use during pregnancy.

None Declared

Motherhood represents a challenge for all women, but it’s even more complex for those suffering from serious psychiatric illnesses such as Bipolar Disorder, Schizophrenia and Schizoaffective Disorder. The treatment of these women requires special care during the preconception, prenatal and postnatal phases, taking into account the risk of decompensation, the psychosocial factors involved and the difficult balance between the potential harm to the foetus and/or infant and the risks associated with not treating the mother. With the scarcity of randomised clinical trials and limited evidence, clinical practice guidelines become essential to determine the best therapeutic approaches to adopt.

To systematise the best evidence of care for pregnant and/or postpartum women with a history of psychotic illness.

Systematic literature review.

Mental health management in women with severe psychiatric illness who want to become pregnant should involve shared decision-making and multidisciplinary counselling. In women of childbearing age who are diagnosed with such conditions, adequate awareness of the illness and the need for family planning is the first step towards effective and safe long-term treatment. In the prenatal period, it’s essential to monitor early signs of relapse, to psychoeducate about the need to stop comorbid consumption and to carry out additional foetal ultrasounds at specific times to rule out malformations in foetuses exposed to antipsychotics and lithium. In the postnatal period, the risk of relapse is especially high. Careful monitoring in the first month after birth and regular review thereafter are essential. When necessary, hospitalisation in mother-baby units is the gold standard treatment. Pharmacological treatment of pregnant and breastfeeding women should weigh up the risks associated with non-intervention and the potential adverse effects on the foetus and lactating infant. The choice of psychotropic drugs should taking into account the varying safety profiles; for example, typical antipsychotics can cause extrapyramidal symptoms or withdrawal syndrome in the newborn and atypical antipsychotics metabolic syndrome. Nevertheless, despite the quality of the evidence, antipsychotics appear to be generally safe in pregnancy and breastfeeding.

The management of mental health care for this subpopulation must ensure that decisions are shared, follow-up is multidisciplinary, pre- and post-natal monitoring is individualised and pharmacological treatment is chosen based on the best balance between the needs of the mother and the safety of the foetus/infant.

None Declared

This study examines the intersection of mental health services and gender-based violence (GBV) in Moldova, identifying knowledge gaps and assessing service capacity through a mixed-methods approach, including focus groups and a national KAP survey. The findings highlight the urgent need for specialized training and evidence-based interventions to improve mental health outcomes and GBV responses.

The study aimed to develop targeted interventions and training programs to enhance the capacity of mental health professionals in Moldova to address mental health challenges and gender-based violence (GBV) by identifying knowledge gaps, assessing practices, and providing actionable insights for improved service delivery and outcomes.

The study used a mixed-methods design, combining quantitative surveys and qualitative focus groups to assess knowledge gaps and training needs among mental health professionals in Moldova. A cross-sectional survey gathered quantitative data on perceptions of knowledge gaps, confidence, and training needs from a representative sample of professionals, including CCSM coordinators. Focus group discussions, held on the same day, provided qualitative insights into their challenges and suggestions for service improvement. This approach offered both breadth and depth, leading to evidence-based recommendations for addressing the identified gaps in knowledge and training.

The study uncovered major knowledge gaps among mental health professionals in Moldova, particularly in psychopharmacology, child and geriatric psychiatry, and gender-based violence (GBV) management. These gaps, identified via surveys and focus groups, reflected a lack of confidence in applying modern protocols and navigating legal aspects. There was a strong call for continuous professional development, especially through structured training in underserved regions. Inadequate training negatively affected the quality of care, particularly in GBV cases, though professionals were eager to improve their skills despite regional disparities in resources. The findings underscore the need for targeted training and better resource allocation.

The study concluded that mental health professionals in Moldova face significant knowledge gaps, particularly in psychopharmacology, child and geriatric psychiatry, and managing gender-based violence (GBV). These gaps, along with insufficient training, negatively impact care quality, especially for GBV cases. Despite motivation to improve, professionals face challenges like limited access to updated training and regional disparities in resources, highlighting the need for structured, continuous training and equitable resource distribution to improve mental health services nationwide.

None Declared

Postpartum depression (PPD) impacts millions of new mothers worldwide, and the challenge of treatment resistance (TR) further hampers recovery prospects. The occurrence of TR in women with PPD and the risk factors for TR remain less studied. Identifying these factors is critical for the precise prediction of treatment responses, enabling tailored interventions and effective management of PPD.

This study aimed to determine the prevalence of TR and assess risk factors associated with TR in women with PPD in a nationwide population-based setting.

We conducted a nationwide register-based cohort study of all women who gave birth during 2006-2021 in Sweden and were diagnosed with PPD up to 12 months postpartum. TR is defined as having ≥3 distinct antidepressant drugs, add-on medications, electroconvulsive therapy, or repetitive transcranial magnetic stimulation in one year after PPD diagnosis. Information on demographics, pregnancy characteristics and outcomes, comorbidities, and treatments were obtained from national registers. Potential risk factors in relation to TR were assessed using multivariable Poisson regression.

Out of 58 618 women with PPD (mean age 30.8, SD 5.3), 4 933 (8.5%) occurred treatment resistance. Younger age (<20 vs. 25-29y: risk ratio (RR) 1.28, 95% CI 1.07-1.52), lower educational level (<9 vs. >12y: 1.52, 1.39-1.67), lower family income level (lowest 20% vs. top 20%: 1.28, 1.16-1.40), smoking at early pregnancy (≥10 cigarettes/day vs. no smoking: 1.39, 1.19-1.62), prior physical comorbidities (Charlson comorbidity index ≥2 vs. 0: 1.40, 1.18-1.65), prior psychiatric disorders (RRs for specific types range: 1.54-6.04) were significantly associated with treatment resistance. In contrast, non-primiparous patients had a reduced risk of treatment resistance (vs. primiparous women, RRs for 2 parities: 0.74, 0.69-0.79; ≥3 parities: 0.87, 0.80-0.95). Maternal body mass index, snuff use, delivery method, pregnancy outcomes, and hypertensive or diabetic disorders did not predict treatment resistance.

Treatment resistance in women with PD is common and is notably associated with specific demographic and clinical profiles. These findings highlight the need for personalized management strategies, particularly for identified high-risk groups.

None Declared

Previous studies show the aggregation of major psychiatric disorders (MPDs; a combined category of schizophrenia, bipolar disorder, depression, and anxiety) among siblings. However, few studies have examined whether MPDs in childhood and early adulthood are associated with siblings’ future socioeconomic status (SES).

To assess subsequent SES outcomes among siblings of individuals with an MPD diagnosed at age 5–25.

This cohort study included 54,742 full siblings, 4,490 paternal, and 4,858 maternal half siblings of individuals born in Finland between 1975–1985 with MPDs diagnosed at ages 5–25 (affected probands). We defined the reference groups as identical types of siblings of individuals without any MPD diagnosis (matched unaffected probands). The siblings of both the affected and the unaffected probands were followed from the diagnosis date of affected probands until December 31, 2020. MPD diagnoses were obtained from the Finnish Care Register. SES was measured through employment status, annual disposable income (measured in EUR), and educational achievement derived from the FOLK module of Statistic Finland. Conditional logistic regression, median regression, and Generalized Estimating Equations (GEE) models were applied to estimate the adjusted associations.

The median age (interquartile range, IQR) at baseline was 20 years (16–24) for full siblings, 17 years (12–26) for maternal half-siblings, and 18 years (12–26) for paternal half-siblings of the affected and unaffected probands. Compared to siblings of the unaffected probands, the odds of unemployment were 50% higher (95% CI: 1.46-1.55) in full siblings of affected probands with any MPD; this association was particularly pronounced in full siblings of an affected proband diagnosed before age 15 (aOR: 1.68, 95% CI 1.49-1.90). Full siblings of the affected probands were more likely not to attain a university degree (aOR: 1.37, 95% CI 1.33-1.41). The median annual disposable income was 1,518.3 EUR lower (95% CI: -1647.4, -1389.3) in full siblings of affected probands. Similar but weaker associations were observed in maternal and paternal half-siblings. For example, compared with the half siblings of the unaffected probands, the odds of unemployment were 29% (95%CI 1.16-1.44) and 23% (95%CI 1.10-1.38) higher in maternal and paternal half-siblings of affected probands with any MPD, respectively.

Our findings suggest that the unfavorable socioeconomic consequences of MPDs might extend to siblings.

None Declared