European citizens suffering from mental disorders still experience several obstacles in achieving functional recovery. Integration of pharmacotherapy and psychosocial interventions represents an optimal strategy in mental health care, but implementation of psychosocial interventions is rarely available in many European countries. Data from efficacy findings in pharmacological and psychosocial trials to effectiveness in real-world studies will be provided, alongside with a focus on the main barriers and obstacles for implementing psychosocial interventions in clinical practice.

None Declared

Increasingly the collection and use of clinical data is considered as extremely important. These data may allow, among other targets, a better profiling of patients and as such help to develop better and more targeted care-pathways. Often these type of data collections are implemented on large, national levels. Although this already provides an important source of information, often the regional specifics are missed on these larger scales. Within the Antwerp region we developed a program allowing a deeper, smaller grained, level analyses of populations mental health care needs and their regional differences. The aim is to use these data to steer changes in the care pathways as offered by the different locally active care-providers.

None Declared

Non-suicidal self-injury (NSSI) is a significant public health issue, particularly among adolescents with attention-deficit/hyperactivity disorder (ADHD). Characterized by inattention, hyperactivity, and impulsivity, ADHD is strongly linked to emotional dysregulation (ED) and psychiatric comorbidities, exacerbating vulnerability to self-injurious behaviors. This presentation examines the relationship between ADHD, ED, and NSSI, emphasizing clinical strategies for assessment and intervention during adolescence and the transition to adulthood.

Adolescents with ADHD often struggle with heightened emotional sensitivity and impaired emotion regulation, which can lead to NSSI as a maladaptive coping mechanism. ED mediates the connection between ADHD symptoms and NSSI. Evidence suggests that individuals with persistent ADHD and ED are at increased risk of psychiatric comorbidities such as depression, anxiety, and borderline personality disorder—factors independently associated with NSSI and suicidal behaviors (SB). Key findings include:

1. - ED and impulsivity contribute to risk-taking behaviors, poor decision-making, and increased vulnerability to NSSI.

2. - NSSI often begins in early adolescence and can escalate to severe SB, especially in individuals with co-occurring depression or adverse childhood experiences (ACE).

3. - Girls with ADHD show higher rates of NSSI, often mediated by comorbid conditions such as depression and substance use disorders, underscoring the need for gender-specific interventions.

Cheng et al. (2024) demonstrated that ADHD subtypes marked by inattention were more associated with NSSI than hyperactivity/impulsivity, with anxiety as a significant mediator, especially for females. Ojala et al. (2022) found that childhood inattention predicts mid-adolescent NSSI, underscoring the importance of early detection. Balázs et al. (2018) highlighted the mediating roles of affective and psychotic disorders, with alcohol abuse uniquely influencing girls. Thornton et al. (2024) emphasized the role of cognitive disengagement syndrome (CDS) in predicting self-injurious behaviors.

These findings support integrating emotional regulation therapies into ADHD treatment frameworks. Interventions such as Dialectical Behavior Therapy (DBT), emotion-focused therapies, and ADHD medications addressing ED can mitigate risks of NSSI. Early identification and tailored care strategies targeting inattention and comorbid conditions are critical. Clinicians should screen for ADHD in adolescents presenting with NSSI and vice versa to ensure comprehensive treatment.

This presentation highlights the urgent need for developmentally sensitive approaches to mitigate NSSI risks in adolescents with ADHD, particularly during the vulnerable transition to adulthood. Addressing ED offers a promising avenue for reducing self-injury and improving psychosocial outcomes.

None Declared

This presentation examines the complex relationship between Attention-Deficit/Hyperactivity Disorder (ADHD) and bipolar disorder in the context of suicide risk. A comprehensive literature review will first explore existing studies on the interplay between ADHD, bipolar disorder, and suicidal behavior in youth. In addition, a retrospective analysis of clinical data extracted from a large database at Hôtel-Dieu de France Hospital in Beirut will be presented. The ongoing study includes approximately 700 patient files and aims to evaluate the suicide risk over the past three years, specifically assessing the role of ADHD vulnerability and a history of hospitalization for mood disorders. The analysis will explore whether the increased suicide risk in individuals with ADHD is primarily attributed to comorbidity with bipolar disorder or inherent aspects of ADHD itself. The presentation will provide insights into the underlying pathophysiology, offering a deeper understanding of these critical associations, and will discuss implications for clinical risk assessment and intervention strategies.

None Declared

Children and adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD) are at an increased risk of experiencing traumatic events and developing Post-Traumatic Stress Disorder (PTSD). The interplay between ADHD and PTSD presents unique diagnostic and therapeutic challenges, as symptoms such as emotional dysregulation, impulsivity, and attentional difficulties may overlap, complicating early identification and intervention. Notably, the presence of both ADHD and PTSD significantly heightens the risk of suicidal spectrum behaviors, underscoring the need for targeted clinical strategies. This presentation will explore current evidence on the association between ADHD, PTSD, and suicidal behaviors in youth, highlighting the neurobiological, cognitive, and psychosocial mechanisms that contribute to this heightened vulnerability. We will discuss practical approaches for screening PTSD in children and adolescents with ADHD, considering both clinical and psychometric tools tailored to this population. Additionally, we will examine intervention strategies that integrate trauma-focused care within ADHD management, including psychoeducation, cognitive-behavioral therapy (CBT), parent training, and pharmacological considerations.

None Declared

Despite rigorous evidence of the benefits, costs and savings and mentions in treatment guidance, cognitive remediation access is still sparse. Providers are often confused by disagreements about the strength of the benefits evidence, some think it is a game not a treatment and others do not consider that cognition should be a treatment target. These are all issues that were present in the literature at least ten years ago.

To identify the steps to widespread implementation of this beneficial intervention

Drawing on the literature and data from a large UK adaptive randomised control trial, we describe three: (i) the barriers and facilitators for the implementation into first episode services, (ii) cost effectiveness and (iii) training rollout and competency.

(i) Clinicians need to understand the relevance of cognition and be aware of effective interventions, (ii) Despite evidence of efficacy a therapist seems important for engagement and leads to cost effective therapy and (iii) online therapy can improve competencies for delivering cognitive therapy and but commitment to completing therapy is related to management commitment.

All the implementation issues can be overcome but we still need to understand the non-specific effects of cognitive remediation as well as the specific if we are to provide a formulation-based approach. Clinicians need to know that cognitive remediation is not “brain training” but is a holistic therapy that involves an active therapist providing motivation support, and who helps to mitigate the impact of cognitive difficulties through metacognition to develop awareness of cognitive approaches to problems.

T. Wykes Grant / Research support from: NIHR grant 2.2m

While many evidence-based mental health prevention, promotion, and treatment interventions exist, they are poorly and inequitably scaled across populations. Too often, research produces interventions and implementation strategies that are difficult to scale due to misalignment with culture, policy, system, community, provider, and individual realities. This presentation will introduce the Lancet Psychiatry Commission on Transforming Mental Health Implementation Research, which makes five recommendations to transform the research enterprise to produce more actionable evidence and address the mental health implementation gap. These recommendations focus on strategies for integrating research and real-world implementation; centering health equity in mental health intervention and implementation research; using a complexity science lens to study strategies for scaling effective interventions; expanding research designs beyond the traditional randomized clinical trial; and using transdisciplinary approaches. The Commission also made cross-cutting recommendations related to elevating work on mental health systems and policy and the importance of strengthening mental health implementation research globally.

None Declared

Smoking remains a significant cause of mortality and morbidity, with a higher prevalence among those with severe mental illness compared to the general population. Patients with psychotic disorders are the most frequent smokers, which contributes to increased somatic diseases and cardiovascular risk. Existing guidelines for smoking cessation are not well-suited for patients with mental disorders, and these patients often lack confidence in their ability to quit. An effective intervention must therefore be comprehensive and interdisciplinary to increase motivation. As part of the national, Norwegian multicenter project “Preventing Multimorbidity in Severe Mental Disorders with a Multidisciplinary Approach (CVD-MENT), the subproject User-Driven Smoking Cessation Group has been launched. The idea of users’ active participation as co-leaders of a smoking cessation group comes from patients and is based on their experiences with their own smoking cessation attempts.

To investigate whether a new, tailored treatment specifically targeted at patients with severe mental disorders affects smoking behaviour in a patient group known to have a very high risk of cardiovascular disease.

The program for the User-Driven Smoking Cessation Group is based on the existing template for smoking cessation groups described by the Norwegian Directorate of Health, but is adapted to the patient group. The study is conducted at three Norwegian hospitals. International recommendations for smoking cessation counselling describe the approach to unmotivated and ambivalent participants in five R’s, all of which are emphasized in the project:

1. - Relevance - Help the patient reflect on whether tobacco cessation might be relevant

2. - Risks - Discuss personally related health risks

3. - Rewards - Help the patient articulate potential benefits of quitting tobacco

4. - Roadblocks - Identify barriers preventing the patient from attempting to quit

5. - Repetition - Prepare the patient for discussing this again at the next meeting

The project has developed a program for open smoking cessation groups specifically tailored for individuals with severe mental disorders. Patients who have successfully quit smoking actively participate in leading the group alongside healthcare professionals. The content focuses on smoking cessation, but other factors known to impact cardiovascular risk are addressed in the semi-structured teaching over seven sessions. Training is provided for users who are co-leaders.

Experiences from a pilot study and preliminary experiences and results from the first groups will be presented and discussed.

None Declared

people with alcohol- and substance use disorders have disproportionally high levels of tobacco use compared with the general populations. This concerns not only the prevalence of nicotine dependence but also the intensity of their smoking behaviour. Importantly, regarding the negative consequences the combined effects of alcohol and smoking are exponentially. Efforts to include smoking cessation treatment within the treatment programs for AUD and other SUD patients need to be intensified.

None Declared

High-risk studies have shown significant parent-child transmission of bipolar disorders (BPD) and major depressive disorder (MDD), which was stronger when parents had a mood disorder with an early onset. However, less studies have focused on functional outcomes of these offspring across development and most studies have not adjusted for the effect of offspring psychopathology. Our goal was to assess 1) psychosocial functioning in offspring of parents with mood disorders, and 2) the role of emerging mood psychopathology in offspring on the association between the parental mood disorder and psychosocial functioning in offspring.

We have collected clinical information on 32 patients with early-onset BPD (prior to age 21), 54 with later-onset BPD, 23 with early-onset MDD, 51 with later-onset MDD, 74 controls and their 425 offspring assessed for a mean duration of 14.9 (s.d: 5.3) years. Current Global Assessment of Functioning (GAF) scores for offspring were rated by trained interviewers after administering diagnostic interviews. Multilevel models adjusting for intra-familial correlation (several offspring per family) assessed the impact of parental mood disorders on the last rated GAF scores for offspring, with and without adjustment for offspring mood disorders over the follow-up.

An initial model showed an association between early-onset BPD and a trend level association between early-onset MDD in parents with lower GAF scores in offspring. However, these associations disappeared after adjustment for emerging offspring mood disorders.

Our data suggest that the frequently reported lower psychosocial functioning in high-risk offspring is essentially mediated by emerging offspring mood psychopathology.

M. Preisig Grant / Research support from: This research was and is supported by five grants from the Swiss National Foundation (SNF: #3200-040677, #32003B-105969, #32003B-118326, #3200-049746 and #3200-061974), three grants for a National Centers of Competence in Research project “The Synaptic Bases of Mental Diseases” (#125759, #158776, and #51NF40 – 185897) financed by the Swiss National Foundation, one grant from the Swiss State Secretariat for Education, Research and Innovation (SERI #22.00170), one grant from the Foundation Campus Biotech Geneva, and one grant from GlaxoSmithKline Clinical Genetics. The funders had no involvement in any aspect of this study.

Rates of common mental disorders (CMD), such as anxiety and depression, treated in primary care have increased among young adults in the UK. However, it remains unclear whether this increase reflects a greater tendency to seek help for CMD or a rise in CMD symptoms over time. Additionally, it is not clear if these increases are more pronounced in specific sociodemographic groups. This research examined the temporal trends of primary care-recorded CMD and self-reported CMD symptoms in young adults.

We included participants born between 1980 and 2003 in two datasets: UK primary care records from the Clinical Practice Research Datalink, and longitudinal cohort data from Understanding Society. We estimated the annual incidence of primary care-recorded CMD overall and by sex, age, birth cohort, ethnicity, country, region, and deprivation from 2009 to 2019, and explored changes over time using incidence rate ratios. We compared these trends to annual estimates of self-reported CMD symptoms from longitudinal cohort data between 2009-10 and 2019-20, calculating ratios to explore changes in CMD symptoms over time by sociodemographic group.

Between 2009 and 2019, the incidence of recorded CMD increased by 9·90% and CMD symptoms increased by 19·33%. The sharpest increases for both recorded CMD and CMD symptoms were observed in older adolescents (ages 16-19) and those born after 1995. Recorded CMD increased more in males (20·61%, increase) than in females (7·65%), despite similar increases in CMD symptoms. Recorded CMD increased the most in the least deprived areas of England (16·34%) compared to the most deprived areas (3·55%), despite similar increases in CMD symptoms across all levels of deprivation.

Both primary care-recorded CMD and self-reported CMD symptoms in young adults increased between 2009-19, suggesting that the rising rates of CMD treated in primary care may reflect heightened symptoms of CMD. However, differences in the patterns of recorded CMD and CMD symptoms across sociodemographic groups highlight potential misalignment between mental health care provision and underlying population need, suggesting that the groups with the highest burden of CMD symptoms may not be the groups most likely to receive care.

None Declared

Traditionally, the discipline of Epidemiology, regardless of clinical specialty, has tended to focus on public health in community populations, although its study designs are widely applied in more clinically oriented research. The emergence and rapid accumulation of digital health records have resulted in data resources that are both large in sample size and granular in detail presenting unprecedented opportunities for understanding course and outcome in mental health.

Drawing on over 15 years of experience in building and achieving research output from electronic mental health records data in south London, this presentation will consider the role of Epidemiology as a discipline in this field.

There is no fundamental difference between studying disease incidence in community populations and using healthcare data to study disease course and outcome in clinical populations, and there are similar considerations of sample representativeness and cohort cohesion. Psychometrics principles are also strongly applicable to measurement issues in clinical data, although computer science collaborations particularly underpin the natural language processing and m-health advances required to improve information availability in routine data. Clinical Informatics and Epidemiology face common analytic challenges from data density and complexity, as well as in realising novel clinical trials opportunities.

Clinical Informatics does benefit from the public health focus that Epidemiology brings, as well as its methodological frameworks. However, multiple disciplines are key to setting up and maintaining data resources and achieving research output, so it is equally important to flatten hierarchies and enable a genuine cross-cutting team science approach.

R. Stewart Grant / Research support from: GSK, Takeda

Women face a greater incidence of mental health issues than men, stemming from societal expectations, gender stereotypes, organizational structures that prioritize male leadership, and the need to balance work responsibilities with home life. Research indicates that women are twice as likely to suffer from depression, generalized anxiety disorder, and post-traumatic stress disorder (PTSD) compared to men. They are also more likely to battle eating disorders.

The authors will review the current literature on this topic.

43% of female executives experience burnout, compared to 31% of their male counterparts (Mc Kinsey 2024). Research is definitely needed to better understand the pathophysiology and socioeconomic mechanisms that drive sex-specific risk factors of psychological disorders in women. There is also an urgent need for studies that addressed the specific needs of women including insights around: the biological, life stage, socioeconomic, political and cultural factors associated with being female that have a significant impact on women’s mental health.

A mental health reform is necessary to prevent mental illnesses in women, provide specific care to vulnerable women and increase the overall well-being of women living with existing mental health conditions.

None Declared

Cannabis use is highly prevalent among individuals at risk for psychosis, yet its role remains paradoxical—offering both temporary relief and potential harm. In this session, we present preliminary results from a study examining cannabis perception, use patterns, and motivations in cannabis users with and without psychosis. Findings reveal that cannabis users with psychosis consume over three times more THC but do not perceive significantly greater risks. They also exhibit a higher risk of cannabis addiction, which may influence their risk assessment and experience of cannabis effects. Both groups reported similar reasons for use and quitting, though individuals with psychosis were more likely to cite cost as a reason for quitting. These insights suggest that financial concerns could be a target for intervention. Understanding why individuals vulnerable to psychosis turn to substances is crucial for refining treatment strategies, as addressing these underlying motivations may enhance therapeutic outcomes.

None Declared

Obsessive-compulsive symptoms (OCS) are a prevalent and under-recognized complication of clozapine treatment in schizophrenia, with significant implications for clinical practice and patient outcomes. This synthesis of four longitudinal studies explores the interplay between psychosis, clozapine dose, and OCS, emphasizing their phenomenology, prevalence, and impact.

OCS, particularly checking compulsions, affect up to 47% of clozapine-treated patients, with risk factors including psychosis severity, duration of clozapine therapy, and antiserotonergic properties of the drug. A two-phase model of OCS development is proposed: during active psychosis, compulsions emerge as goal-directed responses to hypervigilance, while post-remission, they persist as maladaptive habits mediated by clozapine’s serotonergic effects. While clozapine improves psychotic symptoms, its dose and plasma levels are positively correlated with OCS persistence after psychosis remission, suggesting a dose-dependent effect.

Notably, OCS significantly reduce subjective well-being independently of depressive and psychotic symptoms but do not impair general functioning, highlighting the ego-syntonic nature of compulsions. Screening for and addressing OCS in clinical practice is critical for optimizing therapeutic outcomes.

This integrated perspective advances our understanding of the nuanced relationship between schizophrenia, clozapine treatment, and OCS, with implications for personalized treatment strategies.

E. Fernández-Egea Grant / Research support from: Dr Fernandez-Egea is supported by the 2022 MRC/NIHR CARP award (MR/W029987/1) and this research was supported by the NIHR Cambridge Biomedical Research Centre (BRC-1215-20014). The views expressed are those of the author(s) and not necessarily of the NIHR or the Department of Health and Social Care. , Consultant of: EFE has received consultancy honoraria from Boehringer-Ingelheim (2022), Atheneum (2022) and Rovi (2022-24), speaker fees by Adamed (2022-24), Otsuka (2023) and Viatris (2024) and training and research material from Merz (2020) and editorial honoraria from Spanish Society of Psychiatry and Mental Health (2023-).

Growing evidence suggests that inflammation plays a critical role in the early stages of psychosis, potentially contributing to disease onset and progression. Several studies have identified elevated levels of pro-inflammatory cytokines, such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), in individuals at clinical high risk (CHR) for psychosis and in those with first-episode psychosis (FEP). However, inconsistencies across studies highlight the need for further research to clarify the relationship between immune dysregulation and psychosis onset.

This talk reviews the current literature on inflammatory markers in early psychosis and their potential implications for pathophysiology, early detection, and treatment strategies. Notably, inflammation may serve as a promising biomarker for identifying individuals at risk and monitoring disease progression. Additionally, anti-inflammatory interventions are being explored as potential adjunctive treatments for psychosis.

Beyond the review of existing evidence, we will present original data from the PREGAP study conducted at the Early Intervention \Service (EIS) of Basurto University Hospital. This dataset includes inflammatory marker assessments in CHR and FEP individuals, providing novel insights into immune alterations in early psychosis.

Understanding the role of inflammation in psychosis could open new avenues for personalized medicine, early intervention, and improved treatment outcomes. Future research should focus on large-scale longitudinal studies to confirm the clinical utility of inflammatory markers and identify potential therapeutic targets.

None Declared

The study aims to analyze the mental health conditions of Ukrainian university students during and after the war and to examine the impact of these conditions on their academic productivity.

The research combines methods of cross-sectional surveys and regression analysis. The survey includes a demographic section, a mental health screening, and the “Work Productivity and Activity Impairment: Specific Health Problem” (WPAI: SHP) section, adapted for the study’s purposes. The sample consists of 1,398 respondents.

Among all respondents, 85.8% exhibited symptoms of depression, 66.1% of anxiety disorder, 56.9% of sleep disorders, and 48.1% of post-traumatic stress disorder (PTSD). Econometric modeling results confirm the devastating impact of mental health issues on students’ academic productivity during the war: moderate to severe symptoms of mental disorders, such as depression, anxiety disorder, and sleep disorders, are associated with a decline in students’ productivity by 17.4%, 12.2%, and 11.0%, respectively.

The prevalence of mental health issues among university students during and after the war highlights an urgent need for interventions to support their well-being and academic performance. These efforts are critical for fostering a resilient and capable generation essential for Ukraine’s postwar recovery and future development.

Mental health, mental conditions, war, academic productivity, students.

None Declared

It is important to support the Ukrainian mental health research and practice in time of war and after the war has ended. Norwegian universities engage in this by collaboration in psychiatric research and mental health initiatives.

With a grant from the University of Oslo and in collaboration with the Taras Shevchenko National University Kyiv, the Ukrainian Psychiatric Association, and the Norwegian Psychiatric Association, we launched a research school for young psychiatry and psychology researchers who are based in the Ukraine and who can travel outside the country. The research school and training class was held in Warsaw 2023, Krakow 2023 and in Oslo 2024. It offered scientific lectures, interaction with international researchers, and clinical site visits. The young Ukrainian researchers present their projects from early to completed phase to be openly discussed. Networking and scientific exchange is encouraged. The Oslo university library has opened their doctoral educational programs for Ukrainian doctoral students and the University of Oslo sponsors participation in international conferences.

We now aim for a renewed strategy to help meet the needs of mental health and clinical research in the Ukraine also after the end of the war.

None Declared

This presentation will provide an overview of our original studies focusing on the mental health impact of the ongoing war in Ukraine on adolescents. Our studies address critical areas such as posttraumatic stress disorder (PTSD), anxiety, depression, suicidality, and the prevalence of psychiatric conditions, alongside resilience factors among war-affected youth. By synthesizing findings from the studies , the presentation will hilight the substantial psychological burden of the conflict on Ukrainian adolescents and emphasizes the pressing need for targeted mental health interventions. These studies contribute essential insights into the long-term implications of trauma, resilience, and mental health outcomes in conflict-affected populations, informing both research and clinical practice.

None Declared

Multidisciplinary cooperation is an imperative prerequisite for good clinical practice in general, and for healthcare of gender-variant people in particular. Although self-determination of one’s gender identity is regarded a human right and self-medication in the trans community widespread, gender-affirmative treatment (GAT) with its far-reaching consequences (including reimbursement by social insurances) still is based upon diagnostics – and more importantly – by indication of mental health professionals (MHP). Empathy and affirmative encounter cannot detract from the fact that medical interventions in general cannot be carried out without a diagnosis. It is the assignment and duty of MHPs to make a diagnosis of gender incongruence or gender dysphoria prior to GAT carried out by somatically oriented doctors. This mutual dependency is a constituent of transgender healthcare, not only at the beginning of a transition trajectory but life spanning. Mental and somatic health care are interdependent. Gender affirmative hormonal treatment and its potential side-effects as well as surgical intervention and its potential complications may have large impact on mental health, and vice versa mental health disorders impact medical conditions. MHPs and somatically oriented doctors are socialized and trained in different ways, sometimes complicating understanding. This presentation deals with the needs, peculiarities and obstacles of joint mentoring gender-variant patients from a medical perspective, not only at the beginning of transition but also in times of crisis or in the course of getting older.

None Declared