In recent years, Tunisia has observed a notable decrease in marriage rates, with a 36% drop in marriage contracts. This decline has been linked to post-independence reforms, modernization, the influence of tourism, media, foreign languages, rapid communication, and international migration, which have transformed values and behaviors related to marriage and family. However, it remains to be determined if the reluctance of women toward marriage is the primary cause of the decrease in marriage rates, or if other factors, such as socioeconomic conditions and male migration, are also contributing to this decline.

To determine if women are reluctant to marry.

A cross-sectional study was conducted with Tunisian women using a questionnaire distributed via Google Forms and social media.

The study included 138 women with 121 women being not married at the time of the study. Only not married women were part of the study. The age range of the participants was from 20 to 40 years with a majority in the age range between 20 and 25 years. The majority of the participants had a university-level education (88%), came from an urban background, were active(99%); 64% were employed, 28% were university students and 7% were high school students. Interest in a serious relationship and openness to marriage was expressed by 65% of the women. 30% of women who are open to marry, reported that they are unable to find a suitable partner. Among the cases, 1.3% women were homosexual, and the lack of same-sex marriage legislation in our country was the reason they had not yet married. Additionally, 1.3% of the women admitted to having a disability or deformity, which they perceived as a challenge for a potential partner. In 16% of cases, the women expressed that economic difficulties are the reason, as they and their partners are unable to cover the costs of the wedding ceremony. However, 31% of these women reported that they are not affected by social pressure regarding marriage.

The study indicates that reluctance to marry among Tunisian women is influenced by multiple factors rather than being a single cause. While 65% of participants expressed interest in serious relationships or marriage, challenges such as difficulty finding a suitable partner, economic constraints, lack of same-sex marriage legislation and personal disabilities or deformities contribute to the observed decrease in marriage rates. However, some women remain unaffected by social pressure. This suggests that the decline in marriage rates is a multifaceted issue, involving a combination of personal, economic, and legislative factors rather than a singular reluctance to marry.

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Currently, we see an increase in the identification and diagnosis of girls with Autism Spectrum Disorder (ASD) over the years, but where are these girls, now adult women, in the Brazilian population? There are barriers that delay and prevent early diagnosis and intervention in women with ASD, such as active attempts to camouflage or mask the signs of ASD in challenges related to social situations. It is known that people with ASD have high rates of depression, self-harm, and suicidal thoughts, which are exacerbated by difficulties in accessing treatment, professional, and family support. In this sense, obtaining the correct diagnosis and treatment for women with ASD is a challenge, as the measures developed and validated are primarily based on male samples and may not be sensitive to the female autism phenotype. With this in mind, the use of screening protocols is a tool that could minimize these impacts, improve quality of life, and drastically change the referral pathways for adult women with ASD.

To present the results of the use of the Girls Questionnaire for Autism Spectrum Condition (GQ-ASC) protocol.

The screening questionnaire, Girls Questionnaire for Autism Spectrum Condition (GQ-ASC), developed by Brown et al., 2020, was used. In this study, a freely translated version was used, as there is no cross-cultural adaptation to Brazilian Portuguese. The questionnaire was sent via an online form, where participants who accepted the Informed Consent Form had access to the GQ-ASC. The study was approved by the Research Ethics Committee under protocol 65890317.9.0000.0065. The questionnaire consists of 21 items, assessed on a 4-point Likert scale (1=Strongly Disagree, 2=Disagree, 3=Agree, 4=Strongly Agree) that evaluate specific clinical characteristics of ASD presentation in adult females across five dimensions: imagination and play, camouflage, sensory sensitivity, socialization, and interests. At the end, the scores are summed, with a total score above 56 indicating a high level of autistic traits, with 80% sensitivity in the author’s studies.

31 women with self-reported ASD diagnoses responded to the questionnaire. The average age was 24.09 years, 80.64% identified as white, 61.29% reported incomplete higher education, and 22.58% postgraduate education, 25.80% identified as bisexual, and 25.80% as heterosexual. For the GQ-ASC questionnaire, 83.87% of the participants scored above 56, with an average final score of 64.12 and a standard deviation of 7.95.

The results of the pilot study demonstrated that the final score of the GQ-ASC corroborates the self-reported diagnosis of ASD in adult women. The GQ-ASC can be considered a screening tool for this population, requiring cross-cultural adaptation to Brazilian Portuguese and validation so that more research and refinement of this tool can improve the quality of life for these women.

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Perinatal grief is the process that occurs after the loss of a baby, either during pregnancy or during the period immediately before or after childbirth (up to a year). In recent years, the increase in specific training and development of programs focused on perinatal mental health has facilitated the creation of specific action protocols. The case of a 38-year-old woman who suffers a gestational loss during the third month of pregnancy is explored. The presence of personal and family antecedents that suppose risk factors for the adequate elaboration of the duel, raise doubts about the handling of the case.

This work has several objectives, including reviewing the published literature on perinatal bereavement in an emergency situation and, on the other hand, presenting a case.

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.

On evaluation, the patient was conscious and oriented to person, time, and space. Approachable and cooperative. Overall calm, although with intermittent crying. Low mood reactive to vital situation, without apathy, apathy, or anhedonia. No previous episodes of hypomania or mania. Not another major affective clinic. Fluid and coherent speech, formally well constructed without glimpse alterations in the course or content of thought. She denied sensory- perceptual alterations, without showing a listening attitude, or suspicion or any other psychotic or dissociative symptoms.

She denied ideas of self-harm, death or self-harm, presenting an adequate request for help and coherent and realistic future plans. Altered biological rhythms with insomnia of three days of mixed pattern evolution, preserved appetite. Judgment of reality preserved.

The grief reaction is an experience that must be normalized after the loss of a loved one. However, given the risk factors presented by the patient, preventive management is established in the face of possible complicated perinatal grief. A new appointment is established in less than 10 days to reassess the case with the perinatal mental health team.

Perinatal mental health is an area of knowledge that could provide assistance to mothers, fathers and family systems plunged into a crisis of perinatal grief.

Prevention in situations of possible complicated perinatal mourning is no less important than treatment when the disorder is already established.

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Research on transgender issues has significantly advanced in recent years, yet transgender individuals in correctional facilities (CF) remain an overlooked and vulnerable population. Transgender inmates (TGI) within CF face intersectional and systemic challenges, particularly concerning housing placement, access to gender-affirming treatments, and mental health support.

This systematic review of qualitative studies aims to explore the experience of TGI in CF.

Medline, Embase, Scopus, PsychInfo, and CINAHL were searched for studies on TGI in CF published until 31 December 2023. Qualitative studies capturing the voices of TGI detained in CF at the time of data collection were eligible for inclusion. Two independent reviewers extracted key constructs (researcher interpretations) and narratives (participant voices), categorizing them into labels and analytical themes. Intensity (I) and frequency (F) were calculated for each theme as the proportion of labels and studies associated with that theme, respectively. Following a socio-constructivist approach, a meta-synthesis was performed to create a new conceptual framework capturing the subjective experiences of TGI in CF. The study was registered with PROSPERO, CRD42023456340.

From 641 studies initially identified, 33 full texts were analyzed, leading to a selection of 13 qualitative studies of TGI in CF. Ten main themes emerged, based on 537 coded labels: (1) feelings and identity (F:92.3%, I:29.1%); (2) mental and physical violence (F:84.6%, I:12.5%); (3) social issues and connections (F:76.9%, I:11.0%); (4) housing (F:76.9%, I:10.2%); (5) mental and physical health (F:61.5%, I:8.8%); (6) discrimination (F:53.8%; I:6.9%); (7) therapy (F:46.1%, I:6.2%); (8) definition and language (F:38.4%, I:11.6%); (9) coming out (F:38.4%, I:2.6%); (10) expectations (F:15.3%, I:1.3%). These findings inform the proposed Safety Model, a new framework for understanding TGI experiences in CF.

CF, as a total institution, with binary and heteronormative characteristics, often fails to ensure the safety of TGI. This review underscores incarceration as a significant social determinant of health for TGI. A comprehensive policy reform and targeted staff training should be promoted to foster inclusive and supportive correctional environments and improve the safety and health of TGI.

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Patients with postpartum depression may have an increased risk of developing schizophrenia or bipolar affective psychosis. Conversely, women with schizophrenia may have a higher risk of developing depression during the perinatal period, which could be screened using the EPDS. The presence of cutoff effects complicates the statistical analysis of the Edinburgh Postnatal Depression Scale (EPDS). Sensitivity and specificity, two key parameters, cannot be treated as independent variables in such cases. To improve the precision of EPDS evaluations across different populations, versions with multiple cutoff points are preferable. While linear regression correlations may produce statistically significant results, they can be misleading when nonlinear relationships are present. In these instances, alternative statistical methods are recommended, such as hierarchical (Bayesian) models, bivariate (random effects) models assuming normal distribution, and joint modeling of sensitivity and specificity. Additionally, models with multiple cutoff values for sensitivity and specificity are particularly useful.

This study aims to review the literature and assess the validity of the EPDS in its various language versions and across different psychotic states.

The literature data on the EPDS, across different language versions and psychotic states, was statistically analyzed, focusing on specificity, sensitivity, and the influence of cutoff thresholds.

The analysis of 42 pairs of sensitivity and specificity data using linear regression showed a statistically significant moderate negative correlation (Pearson’s r =−0.4342, p = 0.0018). Visual aids such as the histogram and Q-Q plot indicated the absence of normal distribution, confirmed by formal normality tests. The normality test results were as follows: Kolmogorov-Smirnov: D(84) = 0.135, p<0.001; Shapiro-Wilk: W = 0.817, p<0.001.

The Kruskal–Wallis one-way ANOVA test revealed statistically significant differences among the three variables (sensitivity, specificity, and cutoff threshold), with a test statistic of H(2) = 79.647, p<0.001. The Receiver Operating Characteristic (ROC) curve is widely regarded as the most reliable tool for representing the relationship between sensitivity, specificity, and cutoff thresholds across different language versions of the EPDS. These variations account for cultural and national characteristics, which play a significant role in the scale’s overall validity.

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Limited research has been done regarding antidepressant use during pregnancy. Current insights show that a higher daily-dose equivalent of maternal SRI during pregnancy is associated with lower birthweight. Additionally, also large-scale registry studies show that prenatal antidepressant exposure is associated with small decreases of pregnancy duration and birthweight, and a higher risk for preterm birth, decreased birthweight, neonatal hospitalization and postnatal neonatal withdrawal symptoms. In these studies, no differences were found regarding PPHN (Persistent Pulmonary Hypertension of the Newborn) and congenital abnormalities. Thus far, research has been done on a general population level. This study is aimed at a specific high risk population group, which makes this study much more relevant for clinical practice.

Gain insight into the effects of antidepressants during pregnancy and how they are prescribed. Specifically, the effects on birthweight and pregnancy duration, and whether the antidepressants are prescribed according to the daily-dose equivalent and are prescribed on-label.

This is a retrospective clinical cohort consisting of women who between 2006 and 2018 gave birth in the Erasmus MC University Hospital, because of a medical or psychiatric referral. All women were treated by the multidisciplinary pregnancy and psychiatry outpatient clinic in the Erasmus MC, were diagnosed with a DMS diagnosis, and for this specific study were selected for antidepressant use. Birth weights were categorized against the Dutch Perined birth registry. We estimated the association of pregnancy duration with the daily-dose equivalent.

Of the 1372 births from mothers with a DSM diagnosis, 323 unique births were selected for antidepressant use during pregnancy. No effects were found regarding birthweight and pregnancy duration. There was a non-significant effect on birthweight: Kruskall-Wallis test statistic (3): 0,962, with a p-value of 0,810. And a non-significant effect on pregnancy duration using linear regression: standardized beta: -0,028, with a p-value of 0,654. The antidepressants, which included SSRIs, SNRIs, and TCAs, were described off-label in 26% of the cases. As a whole, the antidepressants were prescribed lower than the daily-dose equivalent, with a total average of 0.69.

The fact that no effects were found on the use of antidepressants in women with a DSM-diagnosis on birthweight and pregnancy duration, is a reassuring finding. Certainly when taking into account the previous studies, that showed lower birthweights and higher risk for pre-term birth when using antidepressants during pregnancy. This might affect how antidepressants will be prescribed for pregnant women in the future. It is however remarkable, that antidepressants aren’t always prescribed on-label, and not always according to the recommended daily-dose.

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Transgender healthcare has increasingly gained importance, particularly in understanding how individuals align with their affirmed gender in various physiological and sociological aspects. Transfemales, individuals assigned male at birth who transition to female, represent a group that is less studied in gender research. There remains uncertainty regarding the degree of similarity transfemales exhibit to cisgender males or females post-transition. This study aims to address this by using a binary logistic regression model to compare transfemales with gender-affirming males and females.

The primary objective of this study is to determine whether transfemales are more similar to gender-affirming males or gender-affirming females. Using a binary logistic regression model previously validated on a cohort of transmales, we aim to categorize transfemales based on personality traits.

A binary logistic regression model, initially developed to distinguish between gender-affirming males and females, was applied to a dataset that included transfemales. The model was trained using characteristics of cisgender males, females and transgender participants. The dataset included 108 gender-affirming males, 260 gender-affirming females, 142 transmales and 20 transfemales, ages 15-25, from Europe. The primary outcome was the classification of transfemales into the male or female categories according to personality trait assessment, using the regression function trained on the gender-affirming cohort.

The binary logistic regression model categorized the vast majority of transfemales as females, with a classification accuracy close to that of gender-affirming females being categorized as female. Specifically, 85% of transfemales were classified as female, which is slightly lower than the 93% classification accuracy for gender-affirming females but significantly higher than the 34% classification accuracy for gender-affirming males being categorized as female. Detailed results are presented in the attached table.

The results suggest that transfemales are more similar to gender-affirming females than to gender-affirming males in their personality traits based on the binary logistic regression model. However, caution must be exercised when interpreting these findings due to the limited sample size of transfemales (n = 20). Furthermore, the predictive accuracy of the model was modest, highlighting the need for further research with larger and more diverse datasets. These findings contribute to the understanding of gender identity and its alignment with personality traits, yet emphasize the complexity of such classifications in transgender populations.

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Panic disorder and depression during pregnancy are significant mental health concerns that can adversely affect both maternal and fetal well-being. Prompt recognition and management of these conditions through early screening are essential, not only for maternal health but also for the neuropsychological development of the child.

This study aims to assess anxiety and depression in pregnant women diagnosed with panic disorder, utilizing both objective and subjective measurement tools while integrating patient perspectives.

The study included pregnant women with a confirmed diagnosis of panic disorder, evaluated in an outpatient setting (N=40). The participants were divided into three groups: (1) those with panic disorder (42.5%), (2) panic disorder with agoraphobia (20.0%), and (3) panic disorder with depression (37.5%). Objective measures such as the Hamilton Depression Rating Scale (HAM-D) and the Hamilton Anxiety Rating Scale (HAM-A) were used, along with self-reported scales, including the Hospital Anxiety and Depression Scale (HADS-A/HADS-D). Statistical methods, including descriptive analyses, the Student’s t-test, One-way ANOVA, and multiple linear regression, were employed. Ethical approval was obtained for the study.

Most participants were in their first pregnancy (77.5%) and had no prior psychiatric history (75%). Depression scores, measured by HADS-D (F(2, 37) = 6.05, p = .005, ω = .20) and HAM-D (F(2, 37) = 5.71, p = .007, ω = .19), were significantly higher in patients with depression compared to those with panic disorder, with or without agoraphobia. Higher gestational age was also associated with increased self-reported depression (p = .002, R² = .324, F(6) = 2.632, p = .034). Anxiety, as measured by the HADS-A scale, was significantly higher in the panic disorder group (F(2, 37) = 71.12, p < .01, ω = .78) than in the agoraphobia and depression groups. No significant differences were found between the groups on the HAM-A scale (p > .05).

Proper identification of anxiety and depression during pregnancy is essential, as these conditions can negatively affect maternal functioning and quality of life. Moreover, they may hinder the mother’s ability to care for her infant postnatally. Utilizing both objective and subjective tools to assess anxiety and depression can improve diagnostic accuracy. Recognizing depression as a distinct domain in cases of anxiety disorder during pregnancy is also crucial for targeted intervention.

I. Kamenova Ilieva Grant / Research support from: This study was supported by the National Scientific Program “Young Scientists and Postdocs,” funded by the Medical University of Sofia and the Ministry of Education and Science, Bulgaria., R. Vladimirova: None Declared

Six clinical cases of patients with premenstrual dysphoric syndrome treated in Mental Health with SSRIs are presented.

The aim is to briefly review the pharmacological approach to premenstrual dysphoric syndrome through the presentation of a series of cases.

Six cases of female patients are presented, with a mean age of 35.4 years, two of whom were nulliparous. All of them had no history of mental health problems. They had regular cycles and had no relevant medical or gynecological history. They reported that for the last three years they had been more irritable, emotionally labile, feeling apathetic and sad, with difficulties in concentration and a feeling of loss of self-control, which made interpersonal relationships difficult, especially at work.

The patients denied that they had previously experienced these symptoms throughout their lives.

Analyses were carried out, with estrogen and progesterone levels, without obtaining significant alterations.

The MADRS and HAMILTON scales were administered to all of them on the 14th day of the cycle, as well as on the 5th day of the cycle. A mean of 9.2 was obtained on the MADRS on the 5th day of the cycle, compared to 15.6 on the 14th day, while the HAMILTON obtained a score of null-mild anxiety on the 5th day and moderate anxiety on the 14th day.

After this comparison, treatment with fluoxetine at a dose of 20mg DMD was started only from the day of ovulation to menstruation, withdrawing this treatment for the rest of the cycle. Again, both scales were compared and the results obtained were more similar on the 5th and 14th day of the cycle.

To avoid hormonal treatment and thus the moderate side effects it presents, premenstrual dysphoric syndrome can be treated by taking SSRIs at low doses, only for 15 days of the cycle.

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The perinatal period is a vulnerable time for women, with specific risk factors for mental health issues. Puerperal psychosis typically presents within the first month postpartum, although the perinatal period extends through the first year after delivery. This condition is understudied, and its nature and pathophysiology remain subjects of debate.

To describe a case of late-onset puerperal psychosis, highlighting the challenges in decision-making regarding medical approach.

A clinical case report and a non-systematic review of the literature.

A 39-year-old woman was brought to the Emergency Unit by her relatives due to paranoid delusions that her partner and in-laws were attempting to poison her. She had previously sought mental health care only once, as an adolescent, for anxiety symptoms following her parents’ divorce. She is the mother of a 5-year-old child and a 10-month-old infant, with no reported complications during pregnancy or delivery.

The patient reported experiencing strange occurrences over the preceding 10 days, beginning during a family vacation when she became suspicious of the food and the organization of meals. She believed her in-laws were poisoning her and expressed concern about transmitting poison to her infant through breast milk. Upon returning home, these fears intensified, extending to suspicions that her husband, mother, and sister were involved. She had drastically reduced her food intake the prior days before consulting, her appearance was malnourished and disheveled.

Further psychopathological exploration revealed delusional beliefs centered on being poisoned and potentially poisoning her baby through breastfeeding. These delusions were accompanied by confusion, perplexity, and heightened anxiety. She denied experiencing hallucinations and had no thoughts of harm toward herself or others.

Low-dose olanzapine treatment was initiated and outpatient management was initially chosen to minimize disruption to her role as a mother, in accordance with the patient’s preference and the presence of family support. However, hospitalization ultimately became necessary, resulting in complete resolution of psychotic symptoms after 14 days, with olanzapine titrated to a higher dose (20 mg per day).

Puerperal psychosis is a complex condition with potentially severe consequences for both maternal and infant health, including disruptions in mother-child bonding. This case underscores the need for further research and resource allocation in this area. Specifically, the development of more psychiatric mother-baby units could help prevent unnecessary separations, promote bonding, and provide opportunities for early parenting interventions.

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Postpartum (or puerperal) psychosis is a severe mental health condition about which there is little literature, which recommends measures to prevent separation between mother and baby in the acute crises, such as home treatment. However, there is a lack of published experiences on the subject. Here we present the case of a 36-years-old woman with this diagnosis successfully treated under a home treatment, and with history of one previous hospital admission in a conventional inpatient psychiatric care unit for the same diagnosis.

To show the specific advantages of home treatment over conventional hospitalization in acute conditions that are particularly difficult for the family environment, like the postpartum psychosis.

A case report is presented alongside a qualitative analysis of the perceived experience, based on a brief semi-structured interview with the patient.

The patient’s own comparative experience shows less interference in the development of mother-child care and greater satisfaction under the home treatment model.

This case helps to support home treatment as a better way of acute management of postpartum psychosis, compared to conventional hospitalization, and invites to further research on the topic.

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Infertility is a significant source of emotional stress for couples worldwide. In Tunisia, it affects approximately 15 to 20% of couples of reproductive age. Studies indicate that women experience higher rates of depression (35% vs. 15%) and anxiety (52% vs. 28%) compared to men, largely due to cultural pressures. For these reasons, understanding these gender differences in coping mechanisms is essential.

To analyze the coping styles of infertile couples and identify gender differences in coping mechanisms to inform tailored psychological support.

We conducted a cross-sectional study involving couples undergoing infertility treatment at a specialized Assisted Reproductive Technology center inTunis. The participants provided information related to socio-demographic data. Coping strategies were assessed using the Brief Cope scale administred in the Tunisian dialect. These strategies were classified into three categories: problem-focused, emotion-focused, and avoidant coping.

A total of 60 infertile couples participated in the study. The average age of men was 41.1±6 years, while the average age of women was 35.07±4 years. Among them, 68% resided in urban areas, and 73% were from a middle socioeconomic background. Educationally, 47% of women held a university degree, compared to 17% of men. Approximately half of the women were unemployed, while 52% of men were employed.

Problem-focused coping emerged as the most frequently utilized strategy (5.93±1.02), followed by emotion-focused coping (5.32±0.82) and avoidant coping (3.95±0.70).

Women significantly employed problem-focused and emotion-focused strategies more than men (p=0.017; p<0.01). They also scored higher in emotional support, expression of feelings, active coping, planning, and religious coping (p<0.05; p=0.01). Conversely, men displayed a greater inclination towards acceptance, distraction, and substance use.

In conclusion, addressing gender-specific coping strategies is essential for providing effective psychological support to infertile couples. Healthcare professionals should promote problem-focused coping to help couples actively manage their challenges.

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Domestic violence is a scourge that continues to spread, destroying family ties and increasing the prevalence of divorce in our Arab-Muslim societies. In our culture, women often find it hard to disclose domestic violence in general, but what about sexual violence? It’s the most under-reported form of violence in Tunisia. However, few studies have focused on sexual violence in the Tunisian context, or on the psychological repercussions of this form of violence.

To determine the prevalence and describe the different forms of sexual violence perpetrated by husbands against their wives and to evaluate marital satisfaction and its relation with sexual violence.

This is a descriptive and analytical cross-sectional study of 122 married women who consulted for medical expertise following domestic violence.

An anonymous survey was asked to these ladies. It included a section for collecting socio-demographic and clinical data on the woman and her partner, and a section for assessing the various forms of sexual violence.

We used the Azrin scale to evaluate marital satisfaction.

One hundred and twenty-two women victims of domestic violence were included in our study. Their average age was 35.66 years, it oscillates between 18 and 64 years. A family history of domestic violence was found in 32.8% of women (N=40). The battered family member was the mother in 41.5% of cases.

A history of childhood sexual abuse was found in 14.8% of women (N=18).

Half of the women (53.3%; n=65) were victims of sexual violence. Different types of sexual violence were reported with decreasing prevalence: forced intercourse (36.1%), unwanted intercourse (15.6%), unusual type of intercourse (31.1%) and pain during intercourse (4.9%).

Seventy-one percent (N=87) had poor marital satisfaction. On multivariate analysis using binary logistic regression, we found that sexual violence: an unusual type of relationship (p=0.04; OR=4.62) and the presence of psychological distress (p=0.04; OR=2.63) were independent factors associated with poor marital satisfaction.

Our study suggests that more attention should be provided to women victims of domestic violence in order to detect any form of sexual violence and provide them with the necessary psychological support.

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We can learn a great deal about the power of writing to vanquish the worst forms of psychological trauma by looking closely at Mary Wollstonecraft in the second half of the eighteenth century. Mary Wollstonecraft wrote a Vindication of the Rights of Woman (1792), which is considered by many to be the most important work in feminist thought. Her literary impact went far beyond this foundational work. With the publication of Wollstonecraft’s first semi-fictional autobiography, Mary: A Fiction (1787), we can see how her personal life did not follow conventional rules either. Her dedication to individual freedom and social progress was not limited to women. Her own personal life history significantly shaped her influential stance on women’s equality. She was a pioneering advocate for women’s equal treatment to men.

This presentation aims to explore how ‘the author,’ Mary, coped with her own life traumas by going beyond the era of her time. By examining her real-life reflections of her fictional characteristics through the lens of psychoanalytic formulations, we seek to gain deeper insights into her inner self and coping mechanisms.

We critically analyzed Mary: A Fiction from a psychoanalytical and literary perspective. By connecting each real-life trauma with its fictional retelling, we uncover Mary’s liberation.

Self-analysis refers to Freud’s exploration and examination of his own psyche, emotions, thoughts, and behaviors in order to gain insight into the unconscious processes that influenced his behavior. In Mary: A Fiction, Mary Wollstonecraft wrote her autobiography as a way of her ‘self-analysis’ in order to erase her family’s repression of her ego. In this work, she explores a solitary and challenging self-analytical journey to address the erasure of her identity enforced by her family’s adherence to her mother’s martyrdom to the role of women. Through this process, she constructs a narrative of anger and righteousness to replace the previously “unspeakable” narrative of submission. In his Memoirs of Mary Wollstonecraft, Mary’s husband, William Godwin, locates the sadomasochism of her parents’, Elizabeth and Edward John’s patriarchal marriage, as foundational. In response to this trauma, Mary kills off her brother, mother, and father in the first seven chapters of Mary: A Fiction. Once her family is erased, so is their erasure of her. Mary can cast off her guilt and give herself the tools to “work through” the traumas of : her tyrannical, abusive, favored brother; the blows of her alcoholic father, and her family’s adherence to her mother’s martyrdom. These were the traumatic cornerstones for Mary’s pain and repressed rage.

Writing a fictional biography based on one’s own life story is a remarkable example of how unresolved conflicts in real life can be reprocessed and lead to eventual healing, similar to the work done in psychoanalysis.

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Several studies have reported that high fruit and vegetable consumption is associated with increased life expectancy. In migrant populations, lifestyle habits are modified in the process of acculturation.

Our aim was to review the diversity/functional compounds of food groups in Latin American, African, Asian and European cultures. In a second step, we aimed to review the dietary patterns for migrant women with schizophrenia.

A two-stage systematic review was conducted using the PubMed and ClinicalTrials.gov databases (2004-2024). The first part included studies reporting information on food and nutrients in adult populations from the nationalities with the highest prevalence of women with schizophrenia attending the Mútua Terrassa Functional Unit for Women with Schizophrenia (Dominican Republic, Venezuela, Ecuador, Morocco, Senegal, Romania and Pakistan). In a second part papers focused on food consumption among migrant women with schizophrenia.

A total of 87 studies were included from a total of 21,306 records screened. First part: (1) Latin America (n=32). Outcomes:food choice trajectories for dietary acculturation, barriers and facilitators for fruit and vegetable consumption (antioxidant effects of polyphenols), fruit/tubers/legumes traditionally consumed. (2) Africa (n=25). Regular consumption of oils, changes in medications during the holy month of Ramadan, anti-inflammatory effects of species. (3) Europe (n=17). Antioxidant properties of phenolics in mushrooms, and polyphenols in berries. (4) Asia (n=13). Women more vegetables, fruit and fish. Second part: Dietary intake of vitamin C, niacin, and folate reduced in schizophrenia. Few studies in women with schizophrenia.

Nutritional intervention programmes for migrant women with schizophrenia should pay attention to biocultural heritage and traditional antioxidant/anti-inflammatory foods.

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Consensual non-monogamous relationships (CNM) are characterized by a diversity of approaches to intimate relationships, diverging from the traditional monogamous model and exploring new possibilities. CNM relationships include forms such as polyamory, open relationships, and swinging. There are no official and systematic epidemiological data on CNM relationships in Italy; however, these relationships have recently gained more visibility due to social media, support groups, and open discussions about relationship diversity that are slowly emerging in a country whose culture is traditionally influenced by Catholicism and conservative social norms.

Most research focuses on discrimination against individuals involved in CNM, while the factors underlying people’s engagement in such relationships are overlooked. This study aims to investigate predictors of willingness to engage and actual engagement in CNM among Italian emerging adults. Specifically, based on the Theory of Planned Behavior (Ajzen, 1991), we examined the role of perceived social norms and perceived behavioral control, as well as other predictors already tested in previous research.

Participants completed an online questionnaire examining factors such as gender, sexual orientation, willingness to engage in CNM relationships (WECNM; Moors et al., 2015; 6 items), avoidant and anxious attachment style (ECR-S; Wei et al., 2007; 12 items), erotophilia (ATP; Johnson et al., 2015; 5 items), social norms (PSN; custom scale, 4 items), perceived behavioral control in CNM relationships (PBC; custom scale, 2 items). Data were analyzed using SPSS, applying multiple linear regression.

The sample consists of 667 emerging adults (Mage = 23.29; age range: 18 – 30) with diverse sexual orientations and gender identities. Of these, 535 participants are involved in monogamous relationships, 65 in polyamorous, and 67 in open relationships. In line with our hypotheses, results show that social norms, perceived behavioral control, non-heterosexual orientation, and cisgender male identity are significant predictors of both the willingness to engage in and the commitment to consensual non-monogamous relationships. Avoidant attachment style, as well as erotophilia, predict the predisposition but not the actual commitment to CNM.

The results contribute to a deeper understanding of CNM relationships in the Italian context by identifying some individual and social factors related to openness and involvement in CNM relationships. This provides preliminary evidence of the utility of the Theory of Planned Behavior in understanding this type of relationship. Moreover, the significant number of individuals involved or interested underscores the importance of considering relationship diversity in future research and social policies, with the aim of promoting greater acceptance and inclusion.

None Declared

In recent years, there has been an increase in alcohol consumption among women. Given that a significant percentage (1 in 3) of pregnancies are unplanned, fetal exposure to alcohol is inevitable in some.

The main objective of this work is to present a review of the current state of the art regarding the impact of alcohol use during pregnancy.

Evidence-based review, using a search on PubMed and selection of the most relevant studies on this topic, published in the last decade.

Although the international consensus recommends total abstinence from alcohol consumption during pregnancy, its global prevalence is 9,8%, with the highest percentage found in Europe (25,2%), which constitutes an important public health problem. Contrary to expectations, a recent study highlights that women who continue to consume alcohol during pregnancy were more likely to be older and have a higher socioeconomic status and educational level. Alcohol consumption during pregnancy is associated with high rates of maternal and child morbidity and mortality, with serious social, personal and family consequences. Prenatal alcohol exposure is the leading preventable cause of birth defects and neurodevelopmental disorders. The psychopharmacological treatment of alcohol use disorder during pregnancy is a challenge, given the limited evidence.

The main guidelines recommend total alcohol abstinence as no safe amount to consume has been identified. Stopping alcohol consumption during pregnancy is the only effective way to eliminate the risk of complications associated with this substance. A focus on early prevention and identification is essential, as well as, when necessary, referral for specialized treatment.

None Declared

Eating disorders (EDS) have become in recent decades an important focus of interest for basic and clinical research due to the increase in prevalence and incidence observed and, therefore, the evident need to prevent and provide a therapeutic response to situations that affect important sectors of the population. Normal eating behavior and its pathological deviations can only be understood if they are studied under the biopsychosocial approach, since, attending only to the eating aspect, we are ignoring a series of determining factors in the development of this process. Within these factors, important changes have been observed in recent times in relation to the demographic profile, going from being a disease studied predominantly in women, to extending to men and non-binary people or with other sexual and/or gender options.

The aim of this study is to propose a new model for the representation of Eating Disorders (EDS) using nursing care languages, which allows us to approach the description of people affected by this pathology and their environment, implementing the perspective of gender, and that facilitates the realization of better diagnoses.

A systematic bibliographic review on EDS was carried out using databases from the different areas involved. The information was ordered and summarized in tables and concept maps. Next, a comparison was made between the traditional EDS model, described using medical language, and the new model proposed by the nursing discipline, where all the information previously obtained is codified in languages proposed by the North American Nursing Diagnosis Association (NANDA) and the Nursing Development Foundation (FUDEN) in the manual on Standardized Nursing Knowledge (CENES).

The results obtained indicate that, after coding and organizing the existing information through nursing languages, the diagnostic view can be broadened by incorporating a greater number of variables to carry out a more complete approach to EDs. This would make it possible to propose a new conceptual model of these disorders, addressing them not only as a disease, but as a product of the failure of a healthy individualization that leads people who suffer from them to not carry out their self-care adequately, exerting on their person a act of anti-self care.

The energetic representation of care, characteristic of nursing, could be useful in care practice, so that the description of the phenomenology of care for each individual could be established, and it would also provide a series of action algorithms that would favor its implementation for health prevention.

None Declared

Psychological well-being of women during the first years of their maternity is essential for both them and their families. However in the same time mothers of infants and toddlers face a lot of challenges in fulfilling their role so their well-being should be closely monitored.

The research aimed to study the basic markers of the psychological well-being of mothers with little children, such as depressive tendencies, anxiety, optimism and aggression.

To measure depressive tendencies the Beck Depression Inventory (as adapted by N.V. Tarabrina) was used. Anxiety levels were assessed using the State-Trait Anxiety Inventory by C. Spielberger (as adapted by Yu.L. Khanin). Life Orientation Test (as adapted by T.O. Gordeeva et al) was used to assess respondents’ optimism levels and Bass-Perry Aggression Questionnaire was used to assess the aggression factors (as adapted by S.N. Enikolopov and Tsybul’skii N.P.). Spearman’s rank correlation coefficient was used for data analysis. The research was conducted from September 2023 to August 2024. The sample consisted of 253 mothers and 31 fathers (as the control group) with children of three years old and less.

Our sample demonstrated comparably high levels of anxiety and average levels the aggression factors and optimism for women as set out in the table below (mean scores shown) (table 1).

Table 1. Comparative analysis of psychological well-being in women and men.

Results of 73 women (29%) show expressive depressive tendencies and results of 67 women (27%) show severe depression tendencies (using the cut-off points proposed by Andriushchenko A.V. and his colleagues (Andriushchenko et al. Zh Nev rol Psikhiatr Im S S Korsakova 2003; 103(5) 11–18 ), being 12 points for the expressed depressive tendencies and 20 points for the severe depressive tendencies). Only results of 2 men from the control group (7%) show expressive depressive tendencies and results of 3 men (10%) show severe depression tendencies.

Negative correlations of the optimism levels of mothers to the depressive tendencies (r=-0.342, p=0.003) and hostility (r=-0.259, p=0.027) levels were discovered.

Thus, the results of our study indicate that the depression and anxiety levels of mothers of infants and toddlers are comparably high, while the aggression and optimism indicators stay on average levels. The study also shows negative correlations of the optimism level of mothers with the depression tendencies and the hostility level.

None Declared

Postpartum depression (PPD) is one of the most prevalent mental disorders, with the potential to precipitate complications in childbearing. The estimated prevalence of PPD ranges from 7% to 13% in developed countries and exceeds 20% in underdeveloped countries. Near 20% of women presenting with symptoms of PPD experience suicidal ideation. Prompt detection and management of this patient group is of particular importance. The use of esketamine has shown to reduce the incidence of PPD in previous studies, but its widespread use has been hampered by its side effects and the need for hospitalisation.

We aimed to review the available literature on the efficacy and safety of peripartum esketamine use.

A narrative literature review was carried out in the PubMed, Cochrane and Embase databases, selecting only the articles published in the last 10 years, using the following keywords: pregnancy, esketamine, postpartum depression.

After childbirth 6 week is a high-risk period for PPD, specially the first week. The incidence of PPD is higher in C/S than in normal births. Compared with pregnant women who underwent C/S without the use of esketamine, those who used esketamine in the perioperative period had a 48% reduced risk of developing postpartum depression and a 1.43 point reduction in the Edinburgh Postnatal Depression Scale (EPDS). The optimal dose of esketamine for PPD is unknown; most studies consider high doses above 0.5 mg/kg and low doses inferior. These favourable effects were observed at both short and long-term follow-up and in low and high doses. Compared to intranasal esketamine, intravenous esketamine has a higher bioavailability and is more convenient to dose control. Route of administration and dose of esketamine did not affect the prophylactic effect of esketamine on PPD, but they differ in their adverse effect profiles. The incidence of immediate adverse reactions to intraoperative pumped esketamine is extremely high, particularly during the intraoperative period when more patients receiving esketamine developed neurological or psychiatric symptoms (97.7%). Other common immediate intraoperative maternal adverse events were nausea and vomiting, dizziness and hallucinations, but had no significant effect on postoperative adverse. Adverse reactions to esketamine are usually transient and are more common when single intravenous injection is used (continuous infusion is preferable), with faster and higher doses.

PPD has potentially serious consequences for mothers and their children, and there is an urgent need for safe, effective and accessible treatments. As the use of esketamine has progressed, concerns have arisen about adverse effects, particularly long-term efficacy, addiction and suicide risk. Current evidence suggests that although it may have a good preventive effect, a long research trail is needed to prove and confirm the efficacy and safety of esketamine.

None Declared