A large number of studies have suggested that longer duration of untreated psychosis (DUP) is associated with poor clinical and functioning outcomes.

The aim of this study is to explore the association of duration of untreated psychosis and functional and clinical outcomes at short term (3 months) in first episode patients.

This is a study of all patients admitted to the EI Service of University Hospital Marqués de Valdecilla in Spain, from January 2020 to July 2024, residents in the area (310,000 habitants), aged from 17 to 65, who experiencing a first episode of psychosis. We set the DUP cut-off point at 6 months to compare both groups, short-duration and long-duration psychosis. The response to treatment was assessed at 3 months with standardized scales: the PANSS scale was used to measure clinical response and the GAF scale to asses functional outcomes.

A total of 207 first episode patients were referred to the Early intervention Service (EIS). The mean age was 37 years-old. 54% were woman (n=111). 21% were living alone. 32% were unemployed. Forty percent (n=82) have a psychiatric family history. 63% required hospital admission and forty-nine percent were involuntary.

The mean GAF at the initial assessment was 34.8 (SD: 12.08). The mean duration of untreated psychosis (DUP) was 15 months (SEM ±2.63) and the median was 3 months (SD: 37.87). A total of 67 patients had DUP longer than 6 months.

We did not found significant differences in sex (51.4% women in the short-DUP and 58.2% women in the long-DUP; χ2 = 0.84; p = 0.36) or age (36 years old in the short-DUP vs 37 years old in the long-DUP; p = 0.52) between groups.

A greater number of people in the long-DUP group were unemployed (χ2 = 18,136, p = 0.02) compared to the short-DUP group. A&E visits were significantly higher in short-DUP group (71.8% vs 28.2%, χ2 = 8.82; p = 0.003). No significant differences were found between groups in terms of hospital admission or duration of stay.

The rate of responders using the PANSS remission criteria proposed by Andreasen was 82.7% at 3 months. Non-responders were 15.9% in the short-DUP vs 20.8% in the long-DUP (p = 0.43). Non-significant differences were found.

At 3 months, the rate of patients who scored more than 70 points on the EEAG scale was 71.5%. Non-significant differences were found (70% short-DUP vs 74% long-DUP; p = 0.49) between both groups.

We observed that the percentage of non-responders at 3 months is higher in the group with a larger DUP. At 3 months, patients within the early intervention program showed a high level of functioning regardless of the duration of untreated psychosis.

None Declared

Individuals at Clinical High Risk of Psychosis (CHR-P) show increased risk for developing psychotic disorders. The relationship between the risk of developing psychosis and urbanicity has been previously described; however, there are divergent results regarding the relationship between positive psychotic symptoms and urbanicity.

The present study aims to analyze the clinical and sociodemographic differences between an urban and a rural population of youth with CHR-P.

The characteristics of the CHR-P program at La Fe Hospital (Valencia) are described and compared for the two populations in the study: a rural area comprising 10 towns with populations ranging from 200 to 29,000 inhabitants each, with an average of 12,600 inhabitants, and an urban area corresponding to the northern metropolitan area of Valencia. An analysis and comparison of the sociodemographic and clinical characteristics of the general population in both areas is also conducted.

Preliminary results are provided: The sample consists of 46 patients, 21 from the rural area and 25 from the urban area. The average follow-up for both groups was 8 months, with a transition rate to psychosis during this period of 19% (n=4) for the rural area group compared to 0% for the urban area group (p=0.04). Patients in the rural area group exhibited greater severity of positive psychotic symptoms with a higher positive PANSS score (14.19 ± 4.32) compared to the urban area group (11.12 ± 3.67), and this difference was significant (p=0.032). No statistically significant differences were found between the two groups for the rest of the variables.

The preliminary results of our study show greater symptom severity in individuals from rural areas. Demographic factors, resource provision, or delays in care might be related to this finding.

None Declared

The relationship between childhood adversity and psychosis has been the focus of extensive research in recent years. Studies suggest that individuals who experience significant adversity during childhood,such as abuse,neglect,or trauma, hava an increased risk of developing psychotic disorderser later in life.

Enviromental factor have been shown to play a signitficant role in the development of psychosis,often interacting with genetic predispositions.Nevertheless the relation between childhood trauma and social vulnerability in adulthood in patients with a first episode of psychosis (FEP) patients has not been studied.

The aim of this work is to study social factors in patients with childhood trauma and their impact on the development of a FEP.

The sample was divided into 3 groups, controls,first episode psychosis patients with childhood trauma (FEP with CT) and first episode psychosis patients without childhood trauma (FEP without CT). 135 controls and 190 patients with FEP (58.42% with CT) were assesed through questionnaires on traumatic experiences, life stress events and a socio-demographic interviews. The likelihood of experiencing life stress events in the past year, social vulnerability,affective issues and substance use were examined using logistic regression models.

Four covariates demonstrated a significant association with the clinical group with CT: being without a partner (p < .01), unemployment (p < .01), a history of psychiatric conditions (p < .01), and migration status (p < .01). However, stressful events in adulthodd were not found to be significant.

While childhood trauma does not seem to directly trigger re-traumatization in adulthood, it may contribute to place FEP patients in socially vulnerable circumstances that could lead to the development of psychotic symptoms.

None Declared

Ekbom Syndrome or delusional parasitosis is a, usually monosymptomatic, somatic type of delusional disorder in which the patients are convinced they are being infested with animal parasites while no objective evidence exists to support this belief (Mumcuoglu KY, Leibovici V, Reuveni I, Bonne O. Isr Med Assoc J. 2018 Jul;20(7):456-460). It has also been described as a hypochondriacal psychosis that causes great suffering for the patient and those around them. (Campbell EH, Elston DM, Hawthorne JD, Beckert DR. J Am Acad Dermatol. 2019 May;80(5):1428-1434.)

To study this syndrome in depth and learn more about these patients.

The Pubmed database was used to collect the available information about Ekbom syndrome since 2006. Using the search term “delusional parasitosis”. We also present the following clinical case:

A 66-year-old woman, with no history of mental health or substance abuse, came to the dermatology department for multiple pruritic wounds all over her body. She reports that when she scratches herself there is a “small ball that crackles, like a living thing”, she has tried to bring samples but has not been able to collect them, according to her. She is convinced that she is infested by parasites. In addition, in the last few weeks she has suffered significant hair loss. On physical examination she presents multiple scabby plaques on the thorax, back, face and scalp. On the scalp she presents frontal alopecia and madarosis.

The patient was referred to Psychiatry.

On psychopathological examination the patient presented moderate ideational and somatic anxiety, reactive to hair loss and feeling of infestation, also admits difficulty in falling asleep. No affective symptoms were observed or described, nor were there any other accompanying psychotic symptoms (self-referentiality, delusions of harm, persecution, etc.).

We started treatment with Olanzapine 5mg before going to bed, plus a rescue tablet if needed due to anxiety.

In the following reviews, the delirious clinic persists, although a notable reduction of the anxiety and improvement of the night rest is observed.

When it comes to treatment, one of the main difficulties we find is that the patient accepts to be evaluated by psychiatry, so it is important to establish a good therapeutic relationship with the patient, since this will determine the patient’s therapeutic adherence to the treatment.

Treatment usually consists of antipuriginous and antipsychotic agents. In our case we selected Olanzapine for its sedative effect, with which we observed a significant reduction of symptoms. However, the available literature usually recommends starting treatment with risperidone. Even so, there is little evidence on its efficacy in Eckbom’s Syndrome.

Treatment studies are scarce and the evolution varies from one case to another.

None Declared

Negative symptoms are one of the core symptom groups of schizophrenia. These symptoms are highly prevalent and are proven to have a strong correlation with mental health-related quality of life. Evaluating negative symptoms using the Brief Negative Symptoms Score (BNSS), a semi-structured interview, is recommended. BNSS can be supplemented with the Self-assessment of Negative Symptoms (SNS), a self-assessment scale. It is unclear whether a semi-structured interview or a self-assessment scale is more related to the mental health-related quality of life.

To evaluate whether scores BNSS or SNS are more strongly correlated with the mental health-related quality of life.

We performed a cross-sectional study in an inpatient clinic of a university hospital in Lithuania. Inclusion criteria were a diagnosis of schizophrenia spectrum disorder according to ICD-10, age between 18 and 65. Exclusion criteria were acute and/or severe comorbid psychiatric or somatic disorders. BNSS and SNS were used to evaluate negative symptoms. The 36-item Short Form survey (SF-36) was used to evaluate quality of life. Three independent psychiatrists evaluated the participants of the study. The first psychiatrist evaluated the negative symptoms with BNSS. The second psychiatrist handed out, collected, and scored SNS. The third psychiatrist handed out, collected, and scored SF-36. Afterward, the statistical correlation analysis was performed. Only the energy/fatigue and mental health subscores of SF-36 were included in the study to limit the correlation analysis to only the mental health-related quality of life.

The study included 93 participants. We found that SNS scores significantly correlated with mental health-related quality of life compared. SNS had higher correlation indexes with the energy/fatigue subscore than the mental health subscore of SF-36. The strongest correlation was seen between the total score of SNS and the energy/fatigue subscore of SF-36 (r=-0,508, p<0,001). BNSS had no statistically significant correlations with either the energy/fatigue or the mental health subscore of SF-36. All of the correlation coefficients can be seen in Table 1.

Table 1. Correlation coefficients of SNS and SF-36 scores. MH – SF-36 mental health subscore; EF- SF-36 energy/fatigue subscore; SNS SI – SNS social isolation subscore, SNS A- SNS alogia subscore; SNS AV – SNS avolition subscore; SNS AN – SNS anhedonia subscore; SNS total score.

SNS, a self-evaluation scale, was more strongly correlated to mental health-related quality of life than scores of BNSS.

None Declared

Negative symptoms of schizophrenia include abulia, anhedonia, alogia, blunted affect, and social isolation. These symptoms strongly correlate with health-related quality of life and treatment outcomes. (Azaiez et al., 2018; Galderisi et al., 2018; Kirkpatrick et al., 2006). According to current negative symptoms diagnosis and treatment guidelines, the Brief Negative Symptom Scale (BNSS) is the instrument of choice for the psychometric evaluation of negative symptoms (Galderisi et al., 2021). Unfortunately, BNSS was not available in Lithuania.

To validate the Lithuanian version of the BNSS in a Lithuanian-speaking sample.

We performed a double translation from English to Lithuanian and then back to English. The final version of the Lithuanian BNSS (Lit-BNSS) was finalized according to comments from two native Lithuanian-speaking experts, who evaluated the forward translation, and the representatives of the authors of the BNSS, who evaluated the back translation. We performed a validation study in an inpatient setting in a university hospital in Lithuania and asked patients diagnosed with schizophrenia spectrum diagnosis according to ICD-10 to participate in the study. We evaluated the included patients with the Positive and Negative Symptoms Scale (PANSS), Montgomery Asberg Depression Rating Scale (MADRS), Self-Evaluation of Negative Symptoms Scale (SNS), and Calgary Depression Scale for Schizophrenia (CDSS). PANSS Marder factors were calculated for more accurate PANSS scores. We check the convergent validity with the Marder negative symptoms factor, the total score of SNS, and the discriminant validity with the Marder positive symptoms factor, MADRS, and CDSS total scores.

The study included 122 patients. The Lit-BNSS showed great internal consistency for the 13 items (α=0,944) and good consistency for six subscores (α=0,874). Convergent validity was good, with the total score of Lit-BNSS having a strong positive correlation with the Marder negative symptoms factor and a weaker correlation with the SNS total score. Discriminant validity was adequate because there were insignificant correlations with MADRS and CDSS subscores and the Marder positive symptoms factor. Correlation scores can be seen in Table 1.Table 1.

BNSS TS correlation with other scores. MARDER-NEG – PANSS Marder negative symptoms factor; SNS-TS- SNS total score; MARDER-POZ- PANSS Marder positive symptoms factor; MADRS – MADRS total score; CDSS-TS- CDSS total score

The Lit-BNSS is a valid and effective psychometric tool for evaluating negative symptoms in a Lithuanian-speaking sample.

None Declared

Negative symptoms, such as avolition, blunted affect, or alogia, contribute to functional disability and reduced quality of life in schizophrenia. Patients with predominant negative symptoms and minimal positive symptoms represent a distinct subgroup requiring tailored therapeutic strategies. Sleep disturbances, particularly reduced sleep efficiency, are commonly reported in this population and may exacerbate the severity of negative symptoms. Understanding the differential impact of specific negative symptoms on sleep efficiency could inform individualized approaches for improving otucomes.

To explore associations between distinct dimensions of negative symptoms and sleep efficiency in schizophrenia patients with predominant negative symptoms and low positive symptoms.

This analysis used baseline data from a randomized, sham-controlled trial on the efficacy of transcranial magnetic stimulation in schizophrenia, conducted between 2000 and 2023. The study included patients with PANSS negative subscale score > 24 and PANSS positive subscale score < 20. The outcome variable was the sleep efficiency subscale of the Pittsburgh Sleep Quality Index. Independent variables were the five SANS dimensions: blunted affect, alogia, avolition(/apathy, anhedonia/asociality, and attention impairment. Quantile regression was used to assess associations, and robust standard errors were applied.

We included 76 patients (median age 36 years, 33% women). Alogia was positively associated with sleep efficiency (β = 4.41, p = 0.040), while avolition (β = -3.61, p = 0.014) and attention impairment (β = -4.12, p = 0.041) were negatively associated. Blunted affect and anhedonia/asociality were not significantly associated with sleep efficiency.

Distinct negative symptom dimensions show differential associations with sleep efficiency in schizophrenia patients with predominant negative symptoms. Alogia’s association with better sleep efficiency may reflect reduced mental arousal and fewer ruminative thoughts before sleep. Conversely, avolition and impaired attention may worsen sleep through increased inactivity and fragmented sleep patterns. These findings suggest that targeted therapeutic interventions may be necessary to optimize sleep and overall clinical management in this subgroup of patients. Further studies are needed to explore underlying mechanisms and clinical implications of the presented associations.

None Declared

Patients with predominant negative symptoms of schizophrenia experience severe functional impairment and limited response to pharmacological treatments. Transcranial magnetic stimulation (TMS) has shown potential for treating negative symptoms, but its impact on long-term outcomes, such as time to relapse, remains underexplored.

This study aimed to determine whether TMS with an H7-coil prolongs time to first relapse compared to sham stimulation in patients with low positive symptomatology and predominant negative symptoms.

This study was a randomized, sham-controlled trial at the Psychiatric Clinic Sveti Ivan, Zagreb, Croatia. The target population were patients with PANSS negative symptoms score > 24 and PANSS positive symptoms score < 20, on stable pharmacotherapy for at least three months The intervention group received high-frequency TMS with an H7-coil, while the control group received sham stimulation, both applied once daily for 20 sessions over four weeks. The outcome was time to first psychiatric relapse, defined as psychiatric rehospitalization. Kaplan-Meier survival curves, log-rank tests, and Cox proportional hazards models were used for statistical comparisons.

A total of 76 outpatients with schizophrenia, aged 18-55 were included; 33% were women. Over the 12-month follow-up, 29% in the H7 group and 24% in the sham group experienced a relapse. The median time to relapse was not reached in either group. The hazard ratio (HR) for relapse in the H7 group relative to sham was 0.82 (95% CI 0.34; 1.97), suggesting no significant effect of TMS on delaying relapse. Adjusted Cox regression model for age, gender, baseline severity of negative and positive symptoms, pharmacotherapy, and number of prior hospitalizations showed similar results (HR = 0.85, 95% CI 0.30; 2.46, p = 0.769). Significant predictors of relapse were baseline severity of negative symptoms (HR = 0.88, 95% CI 0.79; 0.99, p = 0.026) and the number of prior hospitalizations (HR = 1.81, 95% CI 1.16; 2.82, p = 0.009).

No significant effect of H7-coil TMS on delaying relapse was observed in patients with schizophrenia and predominant negative symptoms. Median survival was not reached in either group, suggesting the need for longer follow-up to fully evaluate potential benefits. Baseline severity of negative symptoms and prior hospitalizations should be considered when assessing relapse risk in this patient population.

None Declared

Schizophrenia is one of the most disabling mental disorders, affecting around 1% of the population. Although most patients respond to antipsychotic treatment, one third have a limited response to antipsychotic medication, being considered treatment resistant schizophrenia (TRS). Clozapine is the only effective medication for TRS, but 30-40% of TRS patients do not respond to it. Patients with schizophrenia who do not respond to clozapine experience more severe disability, persistent symptoms, a lower quality of life and incur higher economic costs compared to those who respond to treatment.

The aim of the present study is to review evidence for therapeutic strategies for patients with treatment-resistant schizophrenia not responding to clozapine.

Review of the literature regarding treatment-resistant schizophrenia not responding to clozapine. The research was carried out through the PubMed® database, using the terms “treatment resistant schizophrenia”, “schizophrenia resistant to clozapine” and “clozapine augmentation”.

For patients with treatment-resistant schizophrenia who do not respond to clozapine, several therapeutic strategies have been explored. These include pharmacological approaches, non-pharmacological interventions and brain stimulation procedures [Electroconvulsive Therapy (ECT) and Transcranial Magnetic Stimulation (TMS)]. However, the evidence is weak and the reported benefits were modest.

The current evidence is weak for efficacy of pharmacological augmentation strategies to clozapine. There are contradictory data regarding ECT and clozapine augmentation. More studies are necessary to clarify the potential of these strategies in order to manage these complex patients.

None Declared

Psychotic disorders with acute onset and remitting course have been described by 19th and 20th-century European psychiatrists under various terms, such as “amentia,” “cycloid psychosis,” “bouffée délirante”. In modern taxonomy, brief psychotic episodes are classified as “acute and transient psychotic disorder” (ATPD) in ICD-11 and “brief psychotic disorder” in DSM-5. The lack of continuity between earlier nosological concepts and current descriptive categories, along with frequent changes in definitions across DSM and ICD versions, has hindered empirical research, limiting our understanding of these conditions. As a result, ATPDs have been marginalized in textbooks and training programs, leading to a lack of evidence-based treatments, despite their clinical relevance. Our work aims to renew interest in these “forgotten” disorders.

To examine the epidemiological and clinical aspects of ATPDs through the description of clinical cases.

We selected a convenience sample of 8 patients with a first diagnosis of ATPD (F23, ICD-10), currently or previously treated at Unidade Local de Saúde Amadora/Sintra. Data was collected from electronic health records, including demographic information, clinical presentation, treatment, and disease course. Additionally, we conducted a non-systematic literature review.

The sample consisted of 6 females and 2 males, with a median age at diagnosis of 44.5 years (min=24, max=64). Fifty percent (n=4) were migrants, with 25% (n=2) coming from lower-middle- and low-income countries. Sixty-two point five percent (n=5) received inpatient care (mean stay of 8.6 days). Most patients (87.5%, n=7) were treated with dopamine D2 receptor antagonists/partial agonists, risperidone being the most common (n=4); one patient achieved spontaneous remission. All patients had a sudden onset of symptoms; the clinical picture was primarily marked by delusions, hallucinations, confusion, psychomotor abnormalities (including catatonia signs) and mood disturbances (mainly anxiety). The mean duration of the episode was 23.2 days. All patients fully remitted and returned to their premorbid functional status. Sixty-two point five percent (n=5) experienced a second episode after a mean of 33.2 months, and 25% (n=2) had a change in diagnosis (bipolar disorder and unspecified psychosis).

Despite the small sample and follow-up variability, our findings highlight ATPDs’ clinical heterogeneity and high recurrence rates. A renewed research effort is necessary to refine diagnostic criteria and investigate treatment responses, risk factors, and long-term prognosis of this disorder, in order to improve therapeutic strategies and patient outcomes in clinical practice.

None Declared

Ekbom’s syndrome is a clinical term for delusional parasitosis, a condition characterized by the belief that one’s skin is infested by invisible parasites. Delusional infestation is a rare psychiatric disorder, is more common in the elderly, particularly in postmenopausal females. Psychiatric interventions are usually rejected by these patients and long-term treatments are frequently abandoned, they usually seek care from dermatologists. It is advocated to form a liaison between dermatology and psychiatry to ensure a full range of differential diagnoses, in order to form the most suitable management plan.

The objetive of this case is to illustrate the severity of Ekbom’s syndrome, providing detailed clinical information and highlighting the challenges in treatment.

The following patient will be presented, doing a thorough systematic bibliography review.

A 54-year-old female patient describes a clinical history of three years of visual hallucinations and generalized pruritus since a family weekend at a countryside house. She reported that, for the past three years, she has experienced itching all over her body and has occasionally seen “bugs” on her body that she believes to be fleas. She mentioned having been diagnosed with “scabies” and “seborrheic dermatitis”.Despite these diagnoses, her father noted that for the past year, the patient has been extremely anxious, spending hours examining her hair and skin, washing repeatedly, and searching for “bugs.” In recent weeks, she refused to eat.Throughout her stay in the unit attended therapy regularly, and participated actively. A psychopharmacological adjustment was made, starting with Abilify at 15 mg/day, which was well-tolerated and effective. A dermatology consult ruled out dermatological pathology. Over the days, a reduction in anxiety and partial improvement in somatic complaints were observed. As the patient’s condition improved, she committed to continuing with the treatment and attending mental health team consultations with her referring psychiatrist.

Delusional infestation is a serious and uncommon disorder that endangers the patients and the people around them, and can be complicated with secondary somatic complications, often requiring involvement of different medical specialists.The treatment is long and complicated, the effectiveness of pimozide, aripiprazol or risperidone for the Ekbom syndrome has been documented in the literature. In our case, we decided to introduce aripiprazol. The management of these patients requires a multidisciplinary approach between dermatologists and psychiatrists, as they often refuse treatment. Consultation and collaboration between both specialties are essential to ensure timely referral. Additionally, it is crucial for general physicians to have greater awareness of these conditions, perform early recognition, maintain good rapport with patients, and provide empathetic treatment.

None Declared

Many patients suffering from schizophrenia have symptoms suggesting depression during the course of their illness. It can appear both in the prodrome of a psychotic decompensation and in the acute phase, as well as after its resolution. But is it part of the disease itself? Is it an experiential reaction to the assumption of the sickness or is it an independent entity? Can it be produced or exacerbated by antipsychotics?

This case study aims to analyze the clinical presentation of depressive symptoms in a patient with schizophrenia.

A review of the literature on affective symptomatology which may occur in psychosis.

A 34-year-old male with a history in Mental Health since the age of 16, with diagnosis of paranoid schizophrenia. He has presented at least 5 depressive episodes and several severe self-harming attempts. He is on treatment with olanzapine, clonazepam, quetiapine and aripiprazole.

During a follow-up, he reports intensification of low mood in the last few weeks due to sentimental break-up, clinophilia and social isolation. He spends the day in his room with the curtains lowered, he has neglected his personal hygiene, and verbalizes thoughts of death. He shows poor functioning, slowed thinking and lack of energy.

His mother reports that he has had self-aggressive behaviors, such as hitting his face and eating his faeces. Sensory and perceptual disturbances are not excluded. Given the current depressive affective state and risk of commiting suicide, it is decided to admit him to the hospital and to start treatment with fluoxetine.

A few weeks after hospital discharge, he continues with poor functioning and isolation, but his mood is better and his thoughts of death have disappeared.

Although clear differentiation between depressive and psychotic symptomatology has been classically described, both symptoms are often associated. Affective symptoms can be part of different stages of the disease, secondary to medication, due to insight phenomena or part of schizoaffective disorder and psychotic depressions.

Depressive symptomatology can also be confused with the presentation of negative symptoms. They both share clinical manifestations such as anergy, social isolation and lack of interest; but while in depression there is a sad mood, in negative symptons there is emotional flattering. Also, positive symptomatology can simulate social withdrawal, usually seen in depression.

Depression in an acute phase has historically been related to a better prognosis, although several studies indicate that depression in a chronic phase causes a higher risk of suicide and relapses. Therefore, early diagnosis and treatment are essential.

In our case, the patient suffers from major affective symptoms regarding his life situation, which may be overlapped by isolation due to a likely positive symptomatology, without dismissing possible negative symptomatology as a result of many years of evolution of his disease.

None Declared

Obesity and weight gain are major clinical problems for people with severe mental illness (SMI), such as schizophrenia and bipolar disorder. While psychopharmacological treatment, particularly with atypical antipsychotics and mood stabilisers, is the ‘core’ of treatment for these disorders, it can increase the risk of overweight/obesity, metabolic and cardiovascular disease. Most guidelines on how to manage overweight and obesity in these patients share an initial conservative approach. These guidelines include diet, physical activity, lifestyle coaching and behaviour modification. Only then are pharmacological or, eventually, surgical treatments added.

This study evaluated the effectiveness of a group behavioural weight management program in a real Italian outpatient setting.

100 patients diagnosed with schizophrenia or bipolar disorder who participated in a group weight management program were followed up for 12 months. The intervention consisted of 8-week training in which patients received nutritional and lifestyle coaching in groups of 10. Weight, BMI, waist circumference, blood glucose and blood pressure were measured at 0, 6 and 12 months.

Mean body weight (kg) decreased from 98.01±18.30 at baseline to 93.29±17.36 at 6 months (p>0.001) and to 90.35±17.90 at 12 months. There were also statistically significant reductions in BMI, waist circumference, blood glucose and systolic blood pressure. There was no significant reduction in diastolic blood pressure. After segmenting the patients at baseline according to their initial body weight (normal weight, overweight and obese according to the World Health Organisation), a statistically significant difference in weight only occurred between baseline and the first 6 months of follow-up, suggesting that the programme was successful in the short term and that the results were maintained over the following 6 months.

Despite the study’s limitations, the intervention demonstrated feasibility in an outpatient setting, a high retention rate with no drop-outs during the programme, and significant weight loss in the first six months, followed by long-term maintenance at the end of the study. Current NICE recommendations suggest that people with SMI, particularly those receiving antipsychotic treatment, should receive integrated diet and exercise programmes. Future research should focus on the cost-effectiveness of this type of intervention and its reliability in the medium and long-term in different health care settings.

None Declared

A person with “high-risk mental status (HRMS)” indicates that the person, usually young people between the ages of 14 and 25, is more likely to develop psychosis. These people have attenuated psychotic symptoms without reaching the intensity or frequency of a frank psychotic episode. It is suggested that psychological trauma could favor neurochemical and psychopathological changes in a vulnerable individual. It would be interesting to study the role of psychotherapeutic interventions in the course of high-risk mental states and their possible evolution to a psychotic disorder.

We present the case of an 18-year-old adolescent whose diagnosis was high risk of psychosis.

This work has several objectives. On the one hand review current information on high-risk mental status (EMAR). On the other hand, develop a discussion about whether the EMAR category should be a diagnostic entity or just a condition.

A bibliographic search has been carried out in the main sources of medical information such as Pubmed, Uptodate as well as in national and international journals. Likewise, the knowledge and clinical experience of the team has been reviewed in order to expose its own experience in this field, defining specific interventions as well as results.

The case presented is of an 18-year-old female patient. She states that the main reason for consultation is something that happened last Sunday, at which time he had “an identity crisis” in which he did not know if he was a girl or a boy. The reasoning behind this fact is that “as Pablo Alborán likes him, perhaps he is a boy”. Given the bizarreness of the explanation and the patient’s particular contact, I explore a previous psychopathological situation. She says that since last year she feels more insecure, with diffuse fear that it is difficult to specify or nominate something specific: “in class and that is very difficult for me, public presentations”, she says that “everything scares me”, she says that she has a non-specific fear that has been maintained even increasing over the months and that has led him to have greater anguish. Even though the patient dates the beginning of the picture on Sunday, it is noteworthy that the previous Thursday she had requested a consultation with psychology in the private circuit that although she does not know how to specify the reason “because of fears” it seems that the anguish resulting from this fear had been increasing, having greater difficulties for the presentations in class. The contact is psychotic and the situation that the patient describes is typical of a “treme” situation, cataloged in the current literature as a High-Risk Mental State.

High-risk mental states are not a diagnostic category according to current classifications, although it is necessary to reach a consensus on what the diagnosis implies and what would be the way to proceed when a patient presents these symptoms.

None Declared

Aripiprazole, a novel antipsychotic drug with partial agonist activity at dopamine D2 and serotonin 5-HT1A receptors, as well as antagonist activity at 5-HT2A receptor, has demonstrated fewer side effects, including extrapyramidal symptoms, hyperprolactinemia, and metabolic disturbances, compared to other antipsychotic drugs.

The aim of this study was to examine the dose-dependent impact of aripiprazole on sexual dysfunction and prolactin levels in patients with schizophrenia. Patients with schizophrenia under aripiprazole monotherapy were recruited into this study.

Patients with schizophrenia under aripiprazole monotherapy were recruited into this study. Psychopathology and sexual dysfunction were evaluated using the Positive and Negative Syndrome Scale and the Arizona Sexual Experiences Scale (ASEX), respectively. Fasting blood samples were analyzed to measure metabolic parameters and prolactin levels.

We recruited 128 patients with schizophrenia, comprising 86 females and 42 males. The prevalence of hyperprolactinemia, hypoprolactinemia, sexual dysfunction, and metabolic syndrome was 12.5%, 47.6%, 39.1%, and 36.7%, respectively. Patients with sexual dysfunction exhibited higher prolactin levels and a higher prevalence of hyperprolactinemia compared to those without sexual dysfunction. The ASEX scores showed a positive correlation with prolactin levels and a negative correlation with aripiprazole dose. Multivariate analysis revealed that prolactin levels and age were associated with ASEX scores. Prolactin levels were negatively correlated with aripiprazole dose and metabolic parameters. Multivariate regression analysis indicated that aripiprazole dose was associated with prolactin levels.

Aripiprazole exhibited inverse dose-dependent effects on prolactin levels and ASEX scores in patients with schizophrenia. Regular monitoring of prolactin levels and sexual function is recommended for patients with schizophrenia receiving aripiprazole treatment.

None Declared

Background and aims: There is a lack of research regarding the topic of childhood sexual abuse trauma on men population. Childhood experiences and traumas can have a great impact on various life domains, including mental state and addictions.

This study examines the impact of childhood sexual abuse on men diagnosed with schizophrenia – regarding the age of the disease’s appearance, the appearance of additional PTSD diagnosis and substance use throughout life.

This study can contribute to the development of more effective treatment and prevention strategies for men who have experienced childhood sexual abuse and are diagnosed with schizophrenia.

Participants: 60 Male patients hospitalized in the closed wards for men, aged 18-50 at ‘Merhavim’ - Mental Health Center.

Data Collection: A one-time meeting with the research team, which included completing several questionnaires regarding their current state and childhood experiences.

The influence of childhood sexual abuse was significant in all subjects we examined. Patients of suffered from sexual abuse in their childhood were more likely to develop PTSD or develop schizophrenia at a much younger age. Also, they were more likely to suffer from substance abuse throughout their life.

- Childhood sexual abuse has a significant impact on the onset of schizophrenia symptoms (age of first hospitalization), PTSD symptoms and substance abuse throughout life.

- Traumatic childhood experiences have a significant impact on mental symptoms that appear in adulthood as well as on various behaviors throughout life.

None Declared

Schizophrenia remains a complex psychiatric disorder characterized by varying symptoms and levels of insight. The Frankfurt Complaint Scale (FBS) and the “My thoughts and feelings” questionnaire provide quantitative measures of symptom severity and insight, respectively. Previous literature has emphasized the importance of these tools in both clinical assessment and therapeutic planning.

Exploring the Relationship Between Schizophrenia Symptom Severity and Insight based on the Frankfurt Scale and the “My thoughts and feelings” Questionnaire.

The study utilized data extracted from an Excel dataset comprising demographic information and specific scores from the FBS and the Insight questionnaire. The sample was divided into four subgroups based on their FBS scores, and the average Insight score for each subgroup was calculated.

The study found the following average Insight scores across FBS-defined subgroups: Mild symptoms: 9.67, Moderate symptoms: 8.25, Severe symptoms: 8.22, Very severe symptoms: 9.29. The correlation analysis revealed a weak and non-significant correlation between FBS scores and Insight scores (r = -0.017, p = 0.925). The demographic analysis showed a prevalence of male patients (n=20), with the most common age group being 36-45 (n=11). Most participants resided in large cities (n=16), with the highest educational attainment being a Bachelor’s/Master’s degree (n=12), and the majority were single (n=21). The study group displayed diverse demographic characteristics,

with a significant male predominance and a concentration in urban environments. This demographic distribution may influence the generalizability of the findings and provides a context for interpreting the varied experiences and perceptions of illness within the group.

This study underscores the complexity of schizophrenia, where symptom severity does not straightforwardly correlate with insight into the illness. It highlights the importance of using a range of assessment tools to fully capture the multifaceted nature of patient experiences. Future studies should explore these relationships further to refine the tools used for assessments and to tailor intervention strategies effectively.

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Symptoms of schizophrenia are associated with dysregulation of the dopaminergic systems of the central nervous system. Negative symptoms, including those related to emotions and mood, result from reduced activity in the mesocortical system, while positive symptoms result from increased activity of the mesolimbic system. Disorders in the reward system, composed of dopaminergic neurons, play an important role in the pathogenesis of addiction development. Nicotine activates the presynaptic parts of the neurons that make up the system to secrete dopamine, which translates into a feeling of pleasure and stimulates the development of addiction.

The aim of the study was to demonstrate the relationship between the degree of development of nicotine and the severity of symptoms related to emotions and mood with patients suffering from schizophrenia.

The study involved 75 patients diagnosed with schizophrenia (F.20 according to ICD-10). The study was conducted from October 2023 to September 2024 in CZPiLU in Gliwice. During the study, the Frankfurter-Bejindlichkeits-Skala was used to assess the appearance and severity of symptoms related to emotions and mood. The analysis of the development of addiction was made possible by the Fagerström Test for Nicotine Dependence.

Based on statistical analysis, a significant relationship was noted between the severity of addiction to nicotine and the presence or absence of symptoms related to well-being. In addition, a correlation (p<0,001) was noted between the degree of nicotine and the severity of symptoms related to emotions and mood. Patients with strong negative symptoms of schizophrenia developed a high level of addiction to nicotine (p=0,001), while those with mild (p=0,001) or moderate symptoms (p=0,005) related to well-being achieved lower scores on individual addiction scales. All patients included in the study had at least a mild level of addiction to nicotine.

The presence of schizophrenia symptoms related to well-being has a significant impact on the initiation of addiction development to nicotine. Furthermore, the level of advancement of symptoms related to emotions and mood translates into the severity of nicotine, especially in the group of patients in whom strong negative symptoms translate into a high level of addiction advancement. Patients suffering from schizophrenia require psychological and psychiatric care and diagnostics for addictions and appropriate prevention before their development.

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The cognitive model of psychosis suggests that psychotic symptoms may arise due to biases in information processing. Cognitive biases such as jumping to conclusions (JTC), belief inflexibility (BI), selective attention to threat (AT), and external attribution (EA) are dysfunctional ways of thinking in which distortions are observed in data collection, processing and interpretation. Cognitive biases are known to be associated with the occurrence of positive psychotic symptoms, but evidence for the influence of other cognitive processes on this relationship remains lacking.

This study aimed to examine the relationship between cognitive biases and psychotic symptoms in schizophrenia spectrum disorders and the cognitive factors hypothesized to influence this relationship, such as intolerance of uncertainty and insight.

65 patients with schizophrenia spectrum disorder were included. Sociodemographic data form, Davos Assessment of Cognitive Biases Scale (DACOBS), Intolerance of Uncertainty Scale (IUS) Anxiety Sensitivity Index-3 (ASI-3), and Beck Cognitive Insight Scale (BCIS) Positive and Negative Syndrome Scale (PANSS) and Beck Anxiety Inventory were applied. Ethics committee approval was obtained (no: 2023-40). Statistical analysis was performed with SPSS 25.

The mean age of the participants was 39.27 ± 12.21 years. 63.1% were male (n: 41) and 36.9% (n: 24) were female. Disease duration was 16.95 ± 12.80 years. Hierarchical regression analysis determined that PANNS positive scores were predicted by DACOBS external attribution subscale and IUS, ASI-3 and BCIS scores had a moderator effect (F: 3.51 p<0.001).

Our results showed that external attribution bias is the only cognitive bias associated with positive psychotic symptoms. Intolerance of uncertainty and anxiety sensitivity also play a role in the prediction of positive psychotic symptoms. Targeting intolerance of uncertainty and anxiety sensitivity with cognitive interventions may be useful in the treatment of positive psychotic symptoms in schizophrenia spectrum disorders.

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Comprehending metabolic syndrome (MetS) risk factors in schizophrenia patients is pivotal for devising effective treatment strategies.

This study aims to explore the relationship between MetS and psychological resilience in schizophrenia patients.

A total of 140 schizophrenia patients with no hospital admissions or treatment changes in the last 6 months were enrolled in the study. For metabolic syndrome screening, patients’ blood pressure, height, weight, waist circumference, and hip circumference measurements were taken; these data, along with blood lipid levels and fasting glucose, were recorded on the sociodemographic and clinical data form. Patients were categorized into two groups based on the presence or absence of MetS. The Positive and Negative Syndrome Scale (PANSS) and the Resilience Scale for Adults were applied cross-sectionally.

MetS was identified in 33.6% of the included patients, with 88.6% exhibiting abdominal obesity. There were no statistically significant differences between groups in terms of gender, marital status, education level, employment status, type of antipsychotic, and use of single or multiple antipsychotics. In the MetS group, PANSS negative symptom scores were significantly higher. No significant differences were observed in psychological resilience between the groups.

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The demonstration of the relationship between the presence of MetS and the severity of negative symptoms is one of the significant outcomes of our study. These outcomes may contribute to formulating personalized treatment approaches.

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