Premature ovarian failure (POF) is manifested by menstrual troubles and menopause symptoms including psychiatric burdens such as depression, anxiety, and decreased perceived psychosocial support. POF predisposes to many health risks, including decreased bone density and early progression of cardiovascular disease. Hormono-therapy of replacement of ovarian sex steroids is indicated until the normal age of natural menopause.

The aim of our work was to study the benefits of increased physical activity and regular exercise in POF women and to show how exercise produces positive biological effects on their psychiatric health through the contribution of the exerkines network.

We conducted a comprehensive review of the scientific literature with the following keywords: Premature ovarian failure (POF), exerkines and psychiatric health.

Increased physical activity and regular exercise are accompanied by the discharge of exerkines that represent an intricate network of signaling molecules or kines released into the systemic circulation during and after exercises. These molecules derived from various tissues (myokines, batokines, etc…) and organs (organokines) such as skeletal muscle, white and brown fats, liver, bones, nervous system, heart, etc…) act in different ways on the body: autocrine, paracrine or endocrine manners. Their roles in metabolic regulation, neuroprotection, and muscle adaptation highlight the importance of physical activity in maintaining health and preventing disease. Generally, it is shown that exercise can positively affect hormonal balance, homeostasis and overall health. It is also reported that physical activities promote stress reduction and hormonal regulation. Consistency and moderation are key to reaping the benefits of exercise for ovarian health. We found no human studies reporting the action of exerkines and myokines in women with POF. Some studies reporting the effects of physical exercise without further details on exerkines were found in women during and before menopause. The relationship between ovarian function and exercise, as well as exerkines levels and proteomics, was non-existent in humans and rare in animal models. Other research indicates that exercise has a positive impact on mental health, improving mood, self-esteem, and reducing stress and anxiety levels, through the improvement of the production of endorphins and neurotransmitters, the mitochondrial function and the hypophyso-hypothalamo–adrenal axis regulation interaction response to stress.

We conclude that human scientific studies in women with ovarian deficiency should now be carried out to investigate the types of exercise to be recommended in these women to improve their mental health. These studies should benefit from next-generation technologies such as proteomics and interactomics.

None Declared

Burnout is a prolonged response to chronic emotional and interpersonal stressors on the job and is defined by the three dimensions of exhaustion, cynicism, and inefficacy. Burnout has a major impact on employees’ health and the economy through absenteeism.

• - To describe the socio-professional characteristics of patients suffering from burnout

• - To Specify the impact of burnout on the medical fitness for work.

Retrospective descriptive study of patients with burnout who consulted the occupational pathology and fitness for work department, during the period from 17 August 2022 to 14 September 2023, as part of a medical examination for long-term absence.

Of the 669 patients who presented for medical control, 222 (33.2%) suffered from burnout. The average age was 45.51±10.69 years. They were predominantly female, with a sex ratio (M/F) of 0.43. They belonged to the health (78.8%) and service (21.2%) sectors. The most common occupations were nurses (32.9%), manual workers (19.4%), and administrative staff (7.4%). The average length of time off work was 60.5±32.6 days. Medical decisions were to justify sick leave (73%) and return to work (24.8%).

Burnout is responsible for absenteeism, which is a major source of expense. Prevention based on collaboration between the occupational physician and the psychologist is essential.

None Declared

Job satisfaction is undoubtedly one of the concerns that has given rise to the most research since the middle of the 20th century. It is one of the particularly important concepts in the study of ‘health at work’ determinants. Its evaluation may appear to be necessary in order to set up relevant preventive actions. However, in Tunisian hospitals, job satisfaction remains poorly assessed. It is therefore crucial to assess it and study its factors in order to promote a balanced work environment.

Assess the overall job satisfaction of health care workers (HCW) at Charles Nicole Hospital using a validated questionnaire in French and Arabic.

This was a cross-sectional study of consenting HCW at Charles Nicole Hospital during the period from 1st September to 31st October 2024. Data were collected by means of a 63-item questionnaire, which assessed participants’ well-being and satisfaction on several aspects using a four-point Likert scale with six dimensions: Perceived superior support at work, affective commitment, emotional exhaustion, work/family conflict, extrinsic efforts and job satisfaction. The questionnaire had good internal consistency and was validated in French and Arabic. The questionnaire was self-administered to the HCW who went to the occupational health department for a medical check-up.

A total of 30 participants were enrolled. The mean age was 45.37 ± 10.3 years, with a sex ratio of 2.3 (F/H). Eighty-six percent were married and had at least one child. The most common occupational category was senior technician (34%). The average length of service was 17.27 ± 10.1 years. Laboratory departments and surgical departments were the most represented in 32% and 26% of cases respectively. Eighty percent of HCW worked full-time. Teamwork was reported in 53% of cases. The number of staff in the work team was less than 10 in 83.4% of cases. Perceived support from a superior was found in 40% of cases. Nearly 20% of cases showed emotional exhaustion secondary to their work and 34% showed extrinsic strain. Affective commitment was present in 36.7% of cases. Only 14.3% of cases showed work/family conflict. Overall, 73.3% of HCW were satisfied with their work.

This study highlights the importance of working conditions and organisational support in the well-being of HCW. Job satisfaction, although mainly present, is put to the test by a mismatch between professional and personal life, extrinsic efforts and a lack of hierarchical support. Emotional exhaustion is a major warning sign, showing that better care and support could improve both emotional commitment and job satisfaction.

None Declared

Systemic lupus erythematosus (SLE) is a chronic, multisystemic disease that can significantly impact the quality of life (QoL) and self-esteem of lupus patients.

To study the quality of life of female patients with SLE and its relationship with self-esteem.

A descriptive and analytical cross-sectional study was conducted on 50 female patients with SLE followed at the Department of Internal Medicine at Hédi Chaker Hospital, Sfax, Tunisia, from September to November 2023. We used:

• - A socio-demographic and clinical data sheet and the Lupus QoL questionnaire to assess the quality of life of lupus patients

• - The Rosenberg Self-Esteem Scale

• - The mean age of patients was 43.46 ± 11 years. 56% had a medical or surgical history.

• - The mean age of SLE diagnosis was 33.54 years with a mean number of flares of 2.94 years ± 2.473

• - According to the Lupus QoL questionnaire: the mean global score was 59.76± 23.496 [8.8-91.98]. The mean scores in the different domains were: physical health = 58.35 ± 32.571 [0-97], pain = 53.013 ± 33.896 [0-100], planning= 69.33 ± 32.741 [0-100], feeling of being a burden = 71.36 ± 32.694 [0-100], emotional health = 57.71 ± 26.67 [0-95.83], body image = 72.9 ± 24.6 [10-100], fatigue = 40.93 ± 24.462 [0-87.5].

• - According to the Rosenberg Scale: a mean global score of 28.28 ± 8.572 [2-40]. Very low to low self-esteem was found in 50% of patients.

• - Statistically significant correlations between low scores in the domains of quality of life and low to very low self-esteem were found:

  • - Physical health: P = 0.000

  • - Planning: P = 0.042

  • - Pain: P = 0.002

  • - Emotional health: P = 0.004

  • - Fatigue: P = 0.017

  • - Body image: P = 0.007

  • - Global Lupus QoL: P = 0.001

Our results indicate that SLE can impair the QoL of lupus patients in various domains. The same is true for self-esteem. The positive relationship between the two parameters encourages a better understanding of the factors associated with each and highlights the importance of a global approach to improve the management of female lupus patients.

None Declared

Humanitarian love, a concept grounded in compassion, emotional support, and empathy, plays a pivotal role in mental health care, where patients often confront profound emotional and psychological challenges. This compassionate approach strengthens patient-centered care by fostering deeper therapeutic relationships between mental health professionals and patients. However, balancing this emotional engagement with professional responsibilities can give rise to complex ethical dilemmas.

This literature review aims to: a) examine how humanitarian love influences mental health practice, and b) explore the ethical tensions between respecting patient autonomy and ensuring beneficence.

A literature review of scientific articles was conducted using databases such as PubMed, Scopus, and Cochrane, with a focus on recent research exploring the role of humanitarian love in mental health care.

The findings suggest that humanitarian love enhances the quality of mental health care by promoting empathy, trust, and greater patient engagement. However, significant challenges arise when mental health professionals must navigate the balance between compassion and their ethical and legal obligations. The assessment of a patient’s decision-making capacity is inherently subjective, which can potentially lead to bias or burnout among mental health professionals. Furthermore, cultural factors often add complexity to mental health care, particularly in global or cross-cultural contexts. In such situations, well-intentioned humanitarian interventions may inadvertently conflict with local traditions and human values.

While humanitarian love is essential in mental health care, it frequently comes into conflict with the ethical principles of autonomy and beneficence. The subjective nature of assessing a patient’s decision-making capacity, combined with cultural influences, requires mental health professionals to adopt a sensitive and nuanced approach to ensure balanced and high-quality healthcare services.

None Declared

Although there is good empirical data on factors that predict harmful outcomes, and standardised approaches to risk assessment have been developed, there remains a disconnect between the academic study of risk and routine clinical practice. This is exemplified by (i) the outstanding uncertainty about how to use predictive models for everyday clinical decision-making, and (ii) the use of predictive methodology to test tools that eschew prediction. The disconnect is, in part, a consequence of the varied use of the notion of ‘risk’ within and between academia and clinical practice.

To derive a more nuanced understanding of the meaning of ‘risk’ in clinical practice.

After reading clinical vignettes, participants (all practising clinicians, n=18) took part in semi-structured interviews regarding clinical decision-making. The interview transcripts were subject to thematic analysis using a novel approach to the analysis of ideas in expressed language (in this case the idea of ‘risk’) which draws on philosophical and intellectual history methodologies (derived from the work of Wittgenstein, and Skinner respectively).

The use of risk by participants varied according to the extent and type of its spatial location (figure 1).

In many cases, ‘risk’ was used in a disembodied (i.e., dislocated) way (e.g., ‘what is the risk,’ ‘risk will increase’).

When locatable, it was evident that participants located risk in:

1. a) the patient (e.g., ‘the patient’s risk’) which was sometimes qualified by the type of harm envisaged (e.g., ‘his risk involved hurting staff’);

2. b) clinical activity (e.g., risk assessment, positive risk-taking, risk management);

3. c) the clinician (e.g., risk tolerances and thresholds); and

4. d) the system (e.g., ‘our system is… quite risk averse,’ ‘who holds the risk’).

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This study demonstrates the varied use of ‘risk’ in practice. By empirically delineating the different expressed forms ‘risk’ takes in clinicians’ language (and thinking), the findings of this study can inform (i) the development of risk study methodologies that are more applicable to practice, and (ii) improvements in clinical practice by clarifying how risk can be understood and spoken about.

None Declared

The level of functioning, in patients with schizophrenia, is an essential aspect in assesing and improving their quality of life. Schizophrenia is a major contributor to severe disability in adults, as it impacts patients’ capacity to live independently, engage in social activities and pursue work or education. It is important to focus not only on reducing patients’ symptoms, but also on improving their overall functioning. There are some factors, that can improve the functional capacity of these patients, such as: family support, level of education, being employed, treatment adherence.

A 64 years old man, was diagnosed with Schizophrenia at the age of 20 years old ( 44 years ago) and he has had several hospitalizations in the Psychiatry Clinic. He is living with his 90 years old mother, has never been married and doesn’t have any children. The patient finished high school, but he doesn’t have additional studies and he has never had a job. Outside the hospitalization periods, the patient has never been compliant to the amtipsychotic treatment. The mental state exam is dominated by: complex visual and auditory hallucinations; delusional ideas of interpretation and persecution; soliloquy, stereotyped speech; bizarre, desorganized behavior; diminished self-care and self-management abilities; recent and long-term memory loss.

A 65 years old man, was diagnosed with Schizophrenia at the age of 31 years old ( 34 years ago) and has had several hospitalizations in the Psychiatry Clinic. He lives with his wife, he has 3 children and 2 grandchildren. The patient finished high school and has post-secondary studies. He worked as an electrician until the age of 53 years old and then he retired due to his medical condition. The patient was compliant to the treatment for the majority of the time. The mental state exam of the patient, was dominated by: complex imperative auditory pseudohallucinations, complex visual pseudohallucinations and hallucinations, cenesthetic hallucinations; delusional ideas of persecution and interpretation, tangentiality and circumstantiality; emotional blunting, with an improvement of the symptoms over time.

The GAF scale was applied for both patients ( in 2024), and the difference between the two of them was significant, with the first patient scoring only 27 points, indicating a notable deterioration in his functionality. The second patient scored 58 points, indicating a much better level of functionality. The SQLS scale was also applied for both patients, the first one achieved a higher score, meaning a poor quality of life, whereas the second one obtained a lower score, meaning a better quality of life.

The socio-educational factors play a significant importance in the quality of life, in patients with schizophrenia Mental health professionals should be aware of this factors for helping their patients to improve their functionality.

None Declared

The transition from childhood to adulthood is a complex process and an important developmental task with many opportunities and risks. Despite the fact that almost three-quarters of psychiatric disorders begin before the age of twenty-four, adolescents and young adults are poorly represented in psychiatric research, and the data used to guide diagnosis and treatment in this group rely mainly on studies in adult populations. The mental health system in Germany is also not organized to meet the needs of this age group, and as a result, the treatment outcomes for young adults in inpatient or day-care units of adult psychiatric centers are mostly unsatisfactory. For this reason, it is crucial to implement mental health care concepts that are tailored to the needs of young adults.

Here we present a milieu-therapeutic inpatient care concept, ‘House of the Future,’ which integrates different therapeutic approaches to provide holistic and targeted support for young adults in need of psychiatric care.

An innovative inpatient psychiatric care concept for young adults from a psychiatric training hospital in Lower Saxony, Germany, will be presented in detail.

The concept of the ward incorporates a variety of therapeutic approaches, including milieu therapy, systemic family therapy, and psychodynamic therapy. Additionally, it incorporates safe-wards elements and numerous non-verbal, innovative techniques such as art therapy, occupational therapy, music therapy, and sports therapy adapted for this age group. We provide a structured and needs-based environment for young adults, enabling them to engage with their experiences without being defined by their disorder or solely integrated into psychiatric systems. Our holistic approach aims not only to treat symptoms but also to promote sustainable personal development and a healthy lifestyle that empowers young adults. Young adults represent the future, and the development of their future is contingent upon the efficacy of the social support system, which is itself a significant challenge. Consequently, social work and pedagogical support are among the most essential elements of the concept. In addition to the comprehensive presentation of the concept, opportunities for networking with integration support institutions, day clinics, and specific outpatient units will be provided.

Adolescence and young adulthood are distinct developmental stages with unique needs. To reach optimal outcomes and to build our future on a safe base, it is fundamental to implement tailored care models in psychiatric settings that are in harmony with the specific requirements of this age group. Project ‘House of the Future’ aims to be a best practice example to address these needs.

None Declared

Workplace harassment is one of the main psychosocial risks, leading to suffering at work or a lack of well-being. It can compromise one’s sense of safety and dignity and leave lasting scars on mental health.

Determine the prevalence of workplace harassment in healthcare environments and evaluate its impact on mental health.

This is across-sectional study conducted among health professionals at an University Hospital in Tunisia. Data was collected using a pre-established synoptic form on the social and professional characteristics of the participants. Workplace harassment was assessed using the LIPT questionnaire.

Of the 500 healthcare workers included in this study period, 362 respended to the questionnaire representing a response rate of 72.4%. The average age of the participants was 37.3±8.71 years, with women predominating (59.4%). The majority of participants were paramedical staff (54.4%). Of the participants, 101 (27.9%) had at least one comorbidity. The most common medical conditions were hypertension (10.5%). As for psychiatric history, which was present in 21.8% of participants, depression was the most common pathology (53.1%). The prevalence of harassment was 19.9%. Both men and women were harassed in 47.9% of cases, 66.7% by their hierarchical superior, and 72.2% by their colleagues. Our results show that 27.4% of subjects reporting palpitations were harassed, compared with 14.8% in the group without palpitations (p=0.003). Similarly, the frequency of harassment was significantly higher in participants with a lump in the throat. Subjects with fatigue were also significantly more harassed than subjects without this complaint (25.5% vs. 12%, p=0.002). Anxiety and competition problems were 4.27 (CI95%(2.3-7.91), p<0.001) and 4.41 (CI95%(2.32-8.39), p<0.001) times more frequent in people suffering harassment.

The prevalence of harassment among health professionals is not negligible, and the repercussions of this phenomenon are frequent. Given the extent of this emerging concept, preventive measures must be proposed and studied in order to put an end to its harmful effects.

None Declared

Stress is one of the biggest problems facing teachers today. The increasingly demanding nature of their job has also increased pressure levels dramatically. Research shows that teachers are now facing greater day-to-day problems with occupational stress than most other employees.

Determine the prevalence and the caracteristics of the occupational stress among teachers.

This is an exhaustive cross-sectional study carried out among the teachers of a private teaching group in the city of Sousse in Tunisia between October and December 2022. The data were collected using an anonymous questionnaire in electronic format ‘Microsoft Forms’ distributed by e-mail. The questionnaire included socio-professional and medical data. Ocuupational stress was assessed using the Karasek questionnaire.

A total of 241 questionnaires were included, representing a response rate of 90.14%. The mean age of the teachers in this study was 39.98 ± 9.14 years, with a predominance of females (56.8%) and a sex ratio (M/F) of 0.75. In this private teaching group, there were 181 higer education teachers (75.1%) and 60 school teachers (24.9%).The average seniorty in this educational group was 3.49 ± 2.95 years. Participants worked an average of 4.88 ± 1.49 hours per day and 16.92 ± 7.39 hours per week. The majority of respondents had no medical (82.6%) or surgical (71.8%) co-morbidities. Only 10 (4.1%) teachers were anaemic, 6 (2.5%) were hypertensive and 4 (1.7%) were diabetic. More than half (55.6%) of the teachers had a BMI above the normal range: 102 participants were overweight (42.3%) and 32 (13.3%) were obese. As for lifestyle habits, 12.9% of teachers were smokers, 9.5% drank alcohol and 34.4% practised a sporting activity. Referring to Karasek’s two-dimensional model, 59 (24.5%) of the 241 teachers were classified in a situation of <<Jobstrain>>associating: low latitude and high professional demands. By completing this model with the third dimension of social support at work, 35 (14.5%) of the 241 teachers were classified in a situation of <<Isostrain>> combining low latitude, high professional demands and low social support.

Action to improve work organisation and support for teachers would be necessary to prevent the occupational stress.

None Declared

The ACT team consists of mental health professionals with a wide range of expertise, including psychiatrists, psychologists, nurses, social workers, and peer specialists. The goal of ACT is to help patients achieve and maintain stability in the community, and to reduce the need for hospitalization and other forms of institutional care and reduce the barriers to care by bringing the care to the Patient.

Upon discharge from the Psychiatric Hospital Patients are often sent home with more than one antipsychotic oral medication and are at times on two long-acting intramuscular preparations.

This is an example of polypharmacy which refers to the concurrent use of multiple medications to treat a single patient, polypharmacy is often used to manage patients with complex mental health conditions who may require multiple medications to address their symptoms.

The AIM of the study is to determine the number of patients followed by the ACT team in the Bronx who are on 2 or more antipsychotics as compared to those on monotherapy who were re-hospitalized within 1 year of discharge.

This is a retrospective study on patients who are followed by Bronx ACT team affiliated with the Institute for Community Living (ICL) in NYC from February 2022 to February 2023. The study compared the number of re- hospitalizations of patients on 2 or more Antipsychotics as compared to those on Monotherapy from February 2022- February 2023. were a thorough review of charts of the 68 Clients being followed by the ACT team was done.

Out of 68 patients being followed by the ACT team; 9 Patients were on 2 antipsychotics/ LAI (Long Acting Injectable) of which 5 patients were on 2 oral antipsychotics, 1 Patient on 3 oral antipsychotics, and 3 Patients on two long-acting intramuscular depot preparations of which five 5(3 for psychiatric related issues and 2 for medical reasons) out of 9 (55.55%) of this population were hospitalized in the 12-month reporting period of February 2022 to February 2023. As compared to 27 (45.7%) patients on monotherapy who were also hospitalized in the last 12-month reporting period.

All remaining 32 (54.2%) clients on monotherapy had no hospitalizations in the 12 months reporting period.

Patients who warrant the need to be followed by The ACT are majorly those who require intensive follow-up in the community and are mostly non-adherent with their medications and prescribing multiple antipsychotics that usually not taken should be carefully considered.

Due to the nature of the study no definite conclusion could be drawn regarding causality between APP and hospitalizations within the 12- month reporting period.

None Declared

The follow-up of patients with severe mental disorders and disruptive behaviors poses a significant challenge, particularly when there is a history of high impulsivity and risk of escape. Effective coordination among mental health teams, support institutions, and families is essential to provide a safe therapeutic environment and facilitate rehabilitation. This case illustrates the complexity of managing a patient with conduct disorder and borderline intellectual functioning following a prolonged escape from a long-term psychiatric care center.

To describe the clinical and outpatient management of a patient who escaped from a long-term psychiatric care facility. To evaluate the importance of multidisciplinary and inter-institutional coordination in the planning and follow-up of treatment to optimize the clinical and functional stability of the patient.

We present the case of a 26-year-old male with a history of conduct disorder and borderline intellectual functioning (IQ=60), problematic cannabis use, and gambling addiction. The patient was admitted to a Long-term Psychiatric Care Unit (UCPP) due to impulsive behaviors, aggression, and threats towards family members. The patient escaped and remained missing for 8 months. After being located and returning to the clinic, an outpatient intervention was initiated in coordination with the Madrid Agency for Support to People with Disabilities (AMAPAD) and the Regional Office of Mental Health and Addictions (ORSMA), assessing his readiness for re-admission and the adequacy of the treatment plan.

Upon re-admission, the patient initially appeared cooperative, minimizing the behaviors that led to his previous admission. As the intervention progressed, signs of irritability and hostility emerged, with overvalued/delusional ideas of persecution from family and UCPP staff, and limited introspective capacity. Intensive treatment at the UCPP led to better acceptance of limits and reduced impulsivity, although deficiencies in awareness of his limitations persisted. A transfer to another long-term care unit, the recently inaugurated Recovery and Community Reintegration Unit (URCC), was planned, with intensive rehabilitation goals tailored to the patient’s needs.

Proper coordination among institutions and flexibility in the therapeutic approach are essential for managing patients with severe mental disorders and high-risk behaviors. This case underscores the importance of a multimodal approach and adapting therapeutic strategies to the patient’s clinical evolution, always prioritizing the safety and well-being of both the individual and their family environment.

None Declared

Genetic testing has become an essential tool in managing psychiatric conditions among individuals with intellectual and developmental disabilities (IDD). The frequent presence of genetic syndromes within this population underscores the value of genetic insights for guiding personalized treatment. By integrating pharmacogenetics into care, clinicians enhance medication efficacy and reducing the likelihood of adverse effects.

This study aims to elucidate the role of genetic testing in identifying specific syndromes and psychiatric comorbidities in IDD, explore the application of pharmacogenetic insights to optimize psychiatric medication management, and highlight case examples that demonstrate how genetic insights influence treatment decisions.

A targeted literature review identified relevant studies on genetic syndromes linked to IDD, the impact of genetic testing in psychiatric care, and the application of pharmacogenetic data in guiding medication management. Key studies examined the pharmacogenetic profiles of individuals with IDD and their effects on treatment outcomes, focusing on findings that can inform personalized treatment strategies.

Fragile X syndrome (FXS), a prevalent genetic disorder among IDD populations, is associated with high rates of anxiety, ADHD, and autism spectrum disorder (ASD). Research shows that stimulant medications commonly used for ADHD may worsen agitation in individuals with FXS, making non-stimulant options or behavioral therapies preferable. Pharmacogenetic findings, such as variations in serotonin-related gene polymorphisms, have been linked to increased aggression and stereotypic behaviors in males with FXS, guiding clinicians toward selective serotonin reuptake inhibitors (SSRIs) or alternative behavioral approaches. In cases of DiGeorge syndrome (22q11.2 deletion syndrome), genetic testing identifies an increased risk for psychotic disorders, and genetic variants may affect drug metabolism. Findings from the IMPACT study, a Centre for Addiction and Mental Health (CAMH) project, highlight the benefits of tailoring medications based on genetic markers, such as CYP2D6 and CYP2C19 enzyme activity. These insights improve outcomes by reducing side effects like sedation and enhancing therapeutic efficacy, especially for IDD patients who may respond unpredictably to psychiatric medications.

Genetic testing is invaluable in the psychiatric management of individuals with IDD, offering insights that enable more personalized and effective treatment approaches. By identifying genetic syndromes and incorporating pharmacogenetic data into medication planning, clinicians can minimize adverse effects, tailor therapies, and improve patient outcomes. Ongoing research and broader access to pharmacogenetic testing are essential to further refine treatment protocols for the IDD population.

None Declared

Adults with intellectual and developmental disabilities (IDD) often struggle to access suitable psychiatric care due to cognitive and communication challenges. Traditional mental health services are not always well-equipped for these needs, highlighting a critical need for evidence-based, IDD-specific guidelines. Expanding research, especially randomized controlled trials (RCTs), is essential to develop personalized, effective treatments for this population.

This poster aims to outline current gaps in psychiatric care for adults with IDD, propose strategies for treatment adaptation, and emphasize research priorities to advance evidence-based care for this underserved group.

A literature review assessed studies on treatment adaptations for IDD, focusing on the effectiveness of current interventions and limitations in existing research. Priority was given to innovative care approaches and adaptations in standard mental health treatments.

Psychiatric care for adults with IDD often involves adapting treatments like cognitive-behavioral therapy (CBT) and pharmacotherapy with simplified, patient-centered methods. For example, CBT adaptations may include breaking techniques into smaller steps, using visual aids, and shorter sessions, which accommodate cognitive limitations. Personalized care is essential due to varying abilities within this population. Pharmacological treatments also require careful titration and close monitoring, as the risk of side effects is higher among those with IDD. However, few RCTs assess the efficacy and safety of treatments for severe psychiatric disorders in the IDD population, underscoring the need for more rigorous research to support clinical guidelines. To overcome recruitment and follow-up barriers in RCTs, studies suggest alternative methods such as targeted outreach through day centers, provider organizations, and one-on-one approaches, which have been effective in reducing dropout rates. Furthermore, bipolar disorder treatment in IDD is particularly under-researched, despite its significant impact on quality of life, highlighting a need for focused studies in this area.

Enhancing psychiatric care for adults with IDD will require systemic changes, including increased research funding, IDD-specific clinical guidelines, and improved provider training. RCTs focused on adapted therapies and pharmacological interventions are crucial to build a strong evidence base. By promoting individualized, evidence-based approaches, the field can better meet the unique needs of adults with IDD, ultimately improving mental health outcomes and quality of life.

None Declared

Adults with intellectual and developmental disabilities (IDD) are more likely than the general population to experience psychiatric disorders, with prevalence rates estimated at 33-40%. These individuals often display atypical symptoms, complicating diagnosis. Primary care providers are often the first to encounter these patients but face challenges due to limited training and “diagnostic overshadowing”—the misattribution of psychiatric symptoms to the IDD itself rather than recognizing comorbid mental health conditions.

This study aims to: (1) highlight the prevalence and unique presentations of psychiatric disorders in adults with IDD, (2) discuss diagnostic challenges, particularly diagnostic overshadowing, in primary care, and (3) advocate for collaborative care models to improve diagnostic accuracy and outcomes.

A literature review across PubMed, Medline, and PsycINFO focused on studies addressing psychiatric prevalence in IDD, diagnostic barriers, and the efficacy of collaborative care models in managing complex cases in primary care.

Adults with IDD show high rates of mood disorders, anxiety, ADHD, and psychotic disorders, often presenting atypically. For example, ADHD may show as prolonged attentional and behavioral difficulties, impacting social and functional skills. Anxiety may present as agitation or sensitivity to routine changes, often misinterpreted as behavioral issues. Mood disorders, especially depression, tend to appear as irritability or somatic complaints, which are frequently attributed to the IDD itself. Psychotic disorders are also prevalent, particularly among individuals with certain genetic syndromes, and complicate diagnosis due to overlapping symptoms.

Diagnostic overshadowing significantly impacts accurate psychiatric diagnosis in adults with IDD, as primary care providers often attribute psychiatric symptoms to the disability itself. Limited IDD-specific training in primary care compounds this issue. Collaborative care models, where primary care providers collaborate with mental health specialists familiar with IDD, show promise in addressing these diagnostic and treatment challenges, especially for complex cases.

Effective psychiatric care for adults with IDD requires specialized provider training, comprehensive evaluations sensitive to atypical presentations, and collaborative care models. Addressing diagnostic overshadowing through improved training and integrated care can enhance psychiatric outcomes for this underserved population. Further research, particularly randomized controlled trials, is needed to develop evidence-based guidelines for tailored care in adults with IDD.

None Declared

Adults with intellectual and developmental disabilities (IDD) have higher rates of psychiatric disorders, such as depression, anxiety, and bipolar disorder, compared to the general population. Unique challenges, like cognitive impairments and communication barriers, require tailored treatments. This poster reviews strategies for managing these conditions in adults with IDD, focusing on adaptations in psychopharmacology and psychotherapy.

To outline treatment approaches for depression, anxiety, and bipolar disorder in adults with IDD, highlight limitations and necessary adaptations, and advocate for collaborative treatment models involving healthcare providers and caregivers.

A literature review identified studies and guidelines on psychopharmacologic and psychotherapeutic interventions tailored to adults with IDD, examining the effectiveness of pharmacological agents, cognitive behavioral therapy (CBT), and other adaptations.

Current treatments for depression, anxiety, and bipolar disorder in adults with intellectual and developmental disabilities (IDD) often deviate from standard protocols, requiring modifications in both pharmacological and therapeutic approaches. Depression management in IDD typically relies on selective serotonin reuptake inhibitors (SSRIs), adapted with gradual dose escalation and close monitoring due to limited data on their specific effects in this population. Psychotherapy, particularly group cognitive behavioral therapy (CBT), has shown notable efficacy, with studies reporting significant symptom reduction in treated groups. For anxiety disorders, low-dose SSRIs remain the primary pharmacological option, with cautious titration to minimize adverse effects, while benzodiazepines are generally avoided to prevent paradoxical responses and disinhibition. CBT-based interventions, including graduated exposure therapy customized for specific phobias or triggers, show promise, though further randomized trials are warranted. Managing bipolar disorder in IDD is particularly challenging due to the heightened risk of severe functional impairment and symptom overlap, with mood stabilizers like lithium and antipsychotics administered sparingly given potential metabolic and neurological side effects. Given limited research, clinical strategies often rely on individualized treatment plans informed by provider expertise and patient-specific needs.

Treatment for psychiatric disorders in adults with IDD requires significant adaptation, with careful dosing and monitoring of medications to minimize adverse effects. Evidence supports CBT as an effective option, yet there is a critical need for more research, especially randomized trials, to develop more robust guidelines specific to this population. Close collaboration between healthcare providers and caregivers is essential for successful outcomes.

None Declared

Autism Spectrum Disorder (ASD) is characterized by social interaction challenges, repetitive behaviors, and behavioral issues such as irritability, aggression, and hyperactivity. These symptoms lead to significant functional impairments, placing emotional and financial burdens on caregivers. Current treatment options include second-generation antipsychotics (SGAs) and selective serotonin reuptake inhibitors (SSRIs), but direct comparisons of their efficacy in managing ASD-related behaviors are limited.

This review aims to compare the efficacy and safety of SGAs and SSRIs in reducing behavioral symptoms in children and adolescents with ASD.

A comprehensive systematic review by Lamy et al. (2020) evaluated over 50 studies on pharmacotherapy for ASD, including randomized clinical trials (RCTs) of SGAs like risperidone and aripiprazole. Other studies focused on specific SSRIs, such as citalopram, in ASD populations. Additionally, two notable trials were included: Ghanizadeh et al. (2014), which compared aripiprazole and risperidone, and King et al. (2009), a placebo-controlled study on citalopram.

Lamy et al. reported that SGAs, particularly risperidone and aripiprazole, significantly reduced irritability scores on the Aberrant Behavior Checklist (ABC) and Clinical Global Impression (CGI) scales (p<0.05), aligning with their FDA approval for ASD treatment. Ghanizadeh et al. (2014) also found that aripiprazole and risperidone reduced ABC scores (12.6 points for aripiprazole and 9 points for risperidone), though both were associated with side effects, such as increased appetite (34.5% for aripiprazole and 40% for risperidone) and drooling.

In contrast, King et al. (2009) found no significant improvement with citalopram over placebo (CGI-I improvement: 32.9% for citalopram vs. 34.2% for placebo) and noted more adverse effects in the SSRI group, including impulsiveness and insomnia. The review highlighted limitations, including methodological heterogeneity, lack of direct comparisons between SGAs and SSRIs, and variability in treatment duration.

In conclusion, SGAs appear more effective than SSRIs in managing ASD-related behavioral symptoms, particularly irritability. Despite limitations, SGAs show consistent benefits with a manageable safety profile. Future research should prioritize direct SGA vs. SSRI trials and longer treatment durations to inform clinical decision-making in ASD pharmacotherapy.

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The behavioral disorders of individuals with dementia, as well as the attitudes and behaviors of people with intellectual disabilities, create challenges both in their home environment and for the nursing staff responsible for their care in Social Welfare Centers. This phenomenon is widely examined in both international and Greek literature; however, it remains a complex and multifactorial issue, not only in defining behavioral disorders but also in identifying the factors that cause them.

This qualitative study aims to explore how nurses at Social Welfare Centers perceive behavioral disorders, the factors they associate with them, and their emotional reactions. The goal is to gain an in-depth understanding of the phenomenon, highlight its significance, and bring forward the nurses’ perspectives.

A qualitative approach was adopted to explore the relationship between nurses and beneficiaries due to behavioral disorders. A relational perceptual framework was used. Eight semi-structured interviews were conducted with permanent nursing staff from Social Welfare Centers. This was followed by a literature review of behavioral disorders, focusing on both nurses and beneficiaries.

The qualitative data analysis revealed three key themes: the role of the nurse and their relationship with beneficiaries in Social Welfare Centers, the behavioral disorders and emotional reactions of nurses based on their experiences, and the need for nursing staff education, along with the importance of an interdisciplinary team.

The onset, worsening, reduction, or elimination of behavioral disorders depends on the complex interaction between nurses and patients with dementia or intellectual disabilities. The need to focus on factors that increase the occurrence of such behaviors is emphasized, to assist nurses working in long-term care facilities in managing them without compromising the quality of care provided to the beneficiaries. More studies are required to provide guidelines for better management of behavioral disorders.

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Fragile X Syndrome (FXS) is a hereditary disease, linked to the X chromosome. FXS is the most common form of inherited intellectual disability and monogenic cause of Autism Spectrum Disorder (Protic et al. Developmental medicine and child neurology 2024; 66,7 863-871). Other clinical features includes speech and language delay, deficits in executive functioning, attention deficit hyperactivity disorder, sensory hyperarousal, social anxiety and aggressive behaviour. Cardiac abnormalities, musculoskeletal and gastrointestinal symptoms are also present.

The aim of the case is providing a review of multidisciplinar strategy in Fragil X Syndrome.

Clinical case description and literature review on the subject.

We report a clinical case of a 25 year old man was diagnosed with autism spectrum disorder, moderate intellectual disability, associated with Fragile X Syndrome. The patient is followed up in a Psychiatry (neurodevelopment) consultation. The present clinical condition causes multiple difficulties in managing his daily life, requiring supervision to carry out most of the tasks assigned to him, resulting in dependence on a third person. Furthermore, the patient has permanent total incapacity for any employment activity. Despite the diagnosis presented, as a result of investment on the part of the clinical, school, social action teams and especially his parents, the patient does not present behavioral changes that justify, at the moment, the use of any psychotropic drug. However, it is important to have access to all non-pharmacological therapies, otherwise the patient will lose the benefits achieved to date. The patient is currently stable, taking a course to become an administrative assistant at an institution. He participates in dance groups, speech therapy and hydrotherapy.

The best approach involves a targeted intervention to control symptoms and improving the quality of life. The management includes non-pharmacological strategies, such as individualized educational support, applied behavior analysis, physical, occupation and speech-language therapy. A pharmacologic strategies that includes, for exemple, SSRIs and/or antipsychotics is often helpful. FXS has a major impact on the individual’s social and family environment, which requires an appropriate multidisciplinary strategy that includes occupational, physical therapists, teachers, psychologists and psychiatrists. (Protic et al. International journal of molecular sciences 2022; 23 1935).

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Prader-Willi syndrome (PWS) is a rare neurodevelopmental and multisystemic disorder. This syndrome is most often caused by paternal deletion or a maternal disomy of chromosome 15. PWS is characterized by hypotonia, hypogonadism, and hyperphagia. Intellectual disability, impaired social skills, emotional regulation, sleep disorders and behavioral problems (tantrums, temper outbursts, obsessive–compulsive symptoms, skin picking) are also present. Autism spectrum disorder, mood disorders, anxiety, and psychosis are common in these individuals. (Bos-Roubos et al. Frontiers in psychiatry 2022; 13 897138).

The aim of the case is providing a review of psychiartric and behavioral problems in PWS.

Clinical case description and literature review on the subject.

We report a clinical case of a 23 year old man who was diagnosed with PWS. Clinical features includes intellectual disability, obesity, scoliosis bracing, probable hypoventilation-obesity syndrome [using non-invasive ventilation], hypercholesterolemia and hypogonadism. He took 3 doses of testosterone in 2017, which had to be suspended due to serious changes in behavior. Behavioral sporadic problems, reactive to the environment, are also present such as impulsiveness, stubbornness, aggressive outbursts, oppositional behavior, self-injuring behavior (placement of foreign bodies in the ear canal), card obsession and suspicious posture. This clinical condition has an impact on PWS relatives and at social level. He was medicated with Paliperidone 9mg; Topiramate 50mg; Clozapine 25mg; Escitalopram 10mg; and Haloperidol 2mg/ml (SOS). Currently, the patient is stable, with little weight gain and sporadic episodes of greater impulsivity without clinical relevance. He has participating in integrated activities at the institution.

The main limitations in adolescence/adulthood are psychiatric and behavioral comorbidities, in association with hyperphagia and intellectual disability, which become more prominent with age. However, these symptoms are highly variable among individuals of different ages. Antipsychotics have been used for management of psychiatric and/or behavioral comorbidities. Other medications have also been used such as antidepressants (SSRI), antiepileptics, mood stabilizers and the response may vary depending on the individual. Weight gain, due to atypical antipsychotics, can be mitigated when food has controlled access. PWS has a major impact on the individual’s social and family environment, which requires an appropriate multidisciplinary strategy. A safe and constant environment as well as behavioral management programs must be ensured. (Butler et al. Current pediatric reviews 2019; 15 207-244).

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