Over the past two decades, public health research has increasingly informed decision-making, but more evidence is needed on implementing interventions in real-life conditions. The COVID-19 pandemic highlighted these challenges, particularly in mental health. A study in Spain (RESPOND-HCWs) adapted and implemented psychological interventions for healthcare workers during the pandemic, showing significant reductions in anxiety and depression symptoms. This process evaluation aims to guide the practical implementation of these interventions in crisis settings.

This study provides a process evaluation of a successful stepped-care program involving eHealth interventions (Doing What Matters in Times of Stress [DWM] and Problem Management Plus [PM+]) designed for healthcare workers experiencing psychological distress (REsponding to Psychological distress among HCWs [RESPOND-HCWs] trial) conducted in Spain. The aim is to analyze program delivery context, assess implementation outcomes, and explore mechanisms of action.

We utilized mixed methods, gathering quantitative data through routine RCT monitoring and structured observation, complemented by qualitative insights from semi-structured interviews with trial participants (n = 12) and decision-makers (n = 7), and a focus group discussion involving intervention providers (n = 7). Quantitative data were analyzed descriptively using R Software. Qualitative data underwent thematic analysis with NVivo.

Context analysis identified implementation barriers, such as DWM visual design, confidentiality, time to practice, stigma, unrealistic expectations about stepped-care programme, DWM phone calls, trust in the health system, internet literacy and intervention provider profile; and enabling factors, such as flexibility in schedules, remote delivery and mental health awareness initiatives. The implementation of the interventions was feasible, appropriate, and had minimal protocol deviations, with good participant acceptance. Mechanisms of action included confidence in intervention effects, a strong therapeutic relationship, and specific intervention components.

The results serve as a complement to outcome evaluation and can guide wider implementation in similar settings. Recommendations include raising awareness about mental health and reducing stigma, providing brief orientation sessions, offering flexible schedules, and encouraging peer support.

None Declared

The integration of Artificial Intelligence (AI) in education and mental health fields represents an innovative path to optimize diagnostic, intervention, and monitoring processes, although it poses ethical and technical challenges that must be carefully assessed. Understanding how professionals in these areas perceive this technology is essential to support its informed and effective adoption.

This study aimed to explore and compare perceptions and attitudes towards AI among professionals in education and mental health by examining key dimensions such as efficiency, personalization, diagnosis, monitoring, privacy, and validation.

A cross-sectional pilot study was conducted with a sample of 17 professionals divided into two groups: five from the educational sector and 12 from the clinical-mental health sector. An online structured questionnaire, designed ad hoc, was used, comprising ten dimensions addressing diagnosis, monitoring, efficiency, data analysis, quality, ethics, dependency, validation, ease of use, and AI acceptance. All participants provided written informed consent to participate in this study.

The findings are as follows:

• - High agreement in perceived efficiency across both sectors (>80%).

• - Greater optimism in personalization within the educational sector (80% vs. 58.3% in mental health).

• - General concern about the validation of AI systems (94.1% consider it insufficiently rigorous).

• - Significant resistance to AI implementation (82.4%).

• - Key perceived barriers: Data privacy (85%) and risk of dehumanization (76%).

While AI’s potential to enhance efficiency is acknowledged in both areas, reservations persist concerning the validity and safety of these systems, particularly regarding data privacy and the integrity of professional-patient or student relationships. These findings suggest the need to develop comprehensive validation programs and specific protocols that facilitate the ethical and technically sound implementation of AI in these fields.

None Declared

Artificial intelligence (AI) is emerging as a disruptive tool in medicine and healthcare, especially in Mental Health. Its ability to process large volumes of data and detect complex patterns has opened up new possibilities for the diagnosis, treatment, and monitoring of mental disorders, providing opportunities to improve the clinical accuracy and personalisation of therapeutic intervention. However, the use of AI in Mental Health poses critical challenges involving ethical, privacy, and inherent issues regarding the quality and validity of the models employed.

The aim of this review is to critically analyse the strengths and limitations of the use of AI in Mental Health, offering a balanced perspective on the potential benefits and associated risks.

A narrative review of the current scientific literature was conducted on the main applications of AI in the diagnosis, treatment, and monitoring of mental disorders as well as the barriers to its effective implementation.

The main strengths identified were the ability of AI to provide more accurate and personalised diagnoses, continuous monitoring of patients’ well-being, increased efficiency in the delivery of Mental Health services, and the possibility of analysing large volumes of data in reduced times, thus improving the ability to detect and track symptoms. However, regarding limitations, the scientific literature highlights the lack of transparency in many of the studies conducted, problems of methodological quality, risks regarding the perpetuation of pre-existing biases, concerns about the privacy of sensitive data, and the potential risk of dehumanisation of care by prioritising automated systems over human contact. In addition, the need for rigorous validation and a clear regulatory framework are key issues in ensuring the ethical and safe use of these technologies.

In conclusion, AI represents a resource with immense potential for transforming clinical practice in Mental Health care, providing more accurate diagnoses, personalised interventions, and real-time monitoring. However, its implementation must be accompanied by rigorous scientific and regulatory scrutiny to mitigate ethical risks and ensure the protection of patients’ privacy and dignity. It is necessary to ensure that technological advances go hand in hand with a humanised approach, where technology complements, but does not replace, the essential therapeutic connection in Mental Health care.

None Declared

Tele-rehabilitation (Tele-TR) has emerged as a promising alternative to traditional, in-person cardiac rehabilitation (Conventional-CR), offering accessible and convenient rehabilitation options for patients who may face logistical or health-related barriers to attending conventional programs. Advances in digital health technologies, coupled with the increasing demand for remote healthcare solutions, have led to the widespread adoption of Tele-TR, particularly for patients recovering from cardiac events or undergoing surgery. However, there is a need for a comprehensive evaluation of the comparative effectiveness of Tele-TR versus Conventional-CR, especially in terms of clinical outcomes. Given the rise in mental health concerns among patients undergoing cardiac rehabilitation, the impact of these rehabilitation modalities on psychological well-being, particularly depressive symptoms, has become an important area of focus.

This meta-analysis aims to evaluate the efficacy of Tele-TR in comparison to Conventional-CR, specifically assessing their effects on depressive symptoms. The primary objective is to determine the mean differences in health assessment scores, such as the PHQ-9, across studies that compare Tele-TR and Conventional-CR. By synthesizing the findings from multiple randomized controlled trials (RCTs), this analysis will provide insights into the relative effectiveness of these two rehabilitation approaches, with a particular emphasis on mental health outcomes and their implications for patient recovery and quality of life.

Three studies were included, comparing Tele-TR with Conventional-CR. Outcomes were assessed based on mean differences (MDs) and 95% confidence intervals (CIs) for continuous data. Heterogeneity among studies was quantified using Tau² and I² statistics, and a random-effects model was employed to account for variability across studies.

The analysis of post-treatment improvement in PHQ-9 scores across included studies demonstrated an overall mean difference of -1.94 (95% CI [-4.02; 0.15]), suggesting a trend favoring Tele-TR over Conventional-CR. However, this improvement did not reach statistical significance (Z = -1.82, P = 0.07). High heterogeneity was noted (Tau² = 3.36, I² = 100%, P < 0.01), indicating substantial variability in treatment effects among studies.

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While Tele-TR showed a trend toward improvement over Conventional-CR, the findings did not achieve statistical significance. High heterogeneity suggests differences in study design and patient populations, warranting further research to clarify the potential benefits of Tele-TR and identify the contexts where it may offer the most significant advantages.

None Declared

Current global societal challenges pose significant threats to the mental well-being of European citizens. The ‘RECONNECTED’ project, supported by the EU/Horizon Europe program, aims to tackle mental health issues experienced by vulnerable populations in Europe, including those in Kosovo, particularly individuals with low socioeconomic status.

The objective is to present key pillars of project and outline some key findings that will inform the consortium toward finalizing the conceptual framework of RECONNECTED which draws inspiration from the Urban Mental Health (UMH) framework, with a focus on particular aspects related to Kosovo.

It’s a mixed-methods study design. We have reviewed the literature related to three key pillars of project: social prescribing, mental health literacy and personalized micro-interventions in Kosovo, and analysed preliminary some recent cross-sectional samples focusing on sociodemographic and psychosocial variables. Data processing was done with SPSS 27.0 and Microsoft Excel 2019.

The literature review in internet does not find information about the implementation of social prescription and personalized micro-interventions in Kosovo so far. However, we can see that similar fragmented activities of social prescription have been implemented in Kosovo in various unstructured and informal designs. There is also information about the individual use of various applications by young people. Furthermore, no study is found regarding mental health literacy in Kosovo, and we have found that there are no mental health promotion programs. Recent cross-sectional samples analysis highlights the association between gender, dysfunctional coping style, social support and low socio-economic status with mental health indicators like anxiety, depression and suicidal ideation among young individuals.

These findings highlight how key mental health challenges could impact the implementation and use of a digital support system like RECONNECTED within a community care model. Addressing these factors during the co-creation process between researchers, stakeholders and end-users is crucial for ensuring the success of this innovative scientific approach in Kosovo, a low-middle-income country.

N. Fanaj Grant / Research support from: Principal Researcher for Kosovo in Project RECONNECTED, S. Mustafa Grant / Research support from: Researcher Officer for Kosovo in Project RECONNECTED, E. Krasniqi Grant / Research support from: Researcher Officer for Kosovo in Project RECONNECTED, A. Cerga Pashoja Grant / Research support from: Principal Researcher for UK in Project RECONNECTED

Nowadays, the use of the Internet has become a very popular practice. However, excessive use can lead to serious problems such as cyberaddiction. This phenomenon has repercussions on several levels, including academic performance.

This study aimed to explore the prevalence of cyberaddiction and its associated factors among nursing students at the Higher Institute of Nursing

Professions and Health Techniques of Oujda in Morocco.

A cross-sectional study was carried out among undergraduate nursing students in the city of Oujda, Morocco. The data were collected through a self-administered questionnaire that was directly distributed to all of the targeted students, exploring their demographic and academic profiles. Young scale was used to identify the levels of cyberaddiction among participants.

The average student’s daily connection time was 5.3+/- 3.2 hours. 26.3% of the participants were identified as cyber-dependent, and 1.4% were suffering serious issues linked to cyberaddiction. Internet addiction was significantly associated with academic failure.

These results should lead to preventive measures in order to protect nursing students from the potential harmful effects of internet excessive use.

None Declared

Perinatal loss is a prevalent health concern worldwide, with one in four pregnancies ending in loss. Spontaneous perinatal loss (i.e., miscarriage, stillbirth, and neonatal death) is an excruciating experience that becomes part of parental identity and represents a unique form of grief. Online interventions offer a cost-effective and feasible option for reducing symptoms of depression, anxiety, and grief in cases of perinatal loss. Involving stakeholders during the early stages of content design and development results in interventions that are more relevant and effective.

This study aims to co-design evidence-based online content for offering psychological support in the early stages after perinatal loss and to integrate this content into the e-Perinatal app (mHealth application for the prevention of Perinatal Mental Health Disorders). It involves collaboration with local stakeholders, including bereaved women, non-birthing partners, and health professionals, to ensure that the intervention meets the population’s needs and aligns with the local sociocultural context. This is a secondary study of the ERC Starting Grant ePerinatal project (101042139), funded by Banco Sabadell Foundation.

This study employed a qualitative design to conduct a multi-stage co-design and development process (pre-design, generative and evaluative phases). Two online focus groups were conducted: 1) bereaved women and non-birthing partners (n = 9), and 2) healthcare professionals with experience in perinatal loss care (n = 12). Following the presentation of the app prototype, participants were asked to provide feedback on both the evidence-based content (micro-intervention contents and information provided) and the app design features. The qualitative data were analysed using thematic analysis with NVivo software, while sociodemographic data were analysed through descriptive analysis. All data were coded by two researchers.

The analysis process is ongoing, and the emerging themes and subthemes are being categorized into: 1) user-related (e.g., health status, previous experience with the public health system, social support), 2) program-related (e.g., intervention content, formal and informal social connectedness), 3) user experience (e.g., information architecture [length], content strategy [wording]), and 4) professional-related (e.g., factors influencing healthcare professionals’ recommendations of the app).

The content developed for perinatal loss will be designed to align with local stakeholders’ expectations and be integrated into the e-Perinatal app. By offering accessible support for women and their partners, the app will aim to help manage the psychological reactions often experienced during this vulnerable period, including grief, stigma, and an increased risk to mental health, as it is implemented in routine maternal care.

None Declared

Recent advancements in large language models (LLMs) demonstrate their ability to perform verbal generalization and simulate agency, opening new possibilities for innovative applications in psychotherapy. One promising avenue is the integration of LLMs into Eric Berne’s Transactional Analysis, a psychotherapeutic approach that conceptualizes human personality through three distinct ego-states: Parent, Adult, and Child.

To investigate the potential of LLMs in Transactional Analysis.

LLM capabilities described in the literature were compared with demands derived from the theory.

By examining the interactions among ego-states in Transactional Analysis, individuals can become aware of their behavior patterns and modify ineffective ones, fostering healthier relationships and improving social adaptation. Incorporating LLMs into Transactional Analysis offers a novel tool for psychotherapeutic interventions. Therapists could utilize AI to help clients recognize emotional experiences and identify maladaptive interaction patterns. By simulating the Parent, Adult, and Child ego-states, an LLM could engage in dialogues that reflect these internal states, allowing the client to explore and better understand their emotional reactions and needs. This interaction would enable clients to actively engage with different parts of their personality, promoting self-awareness and providing valuable insights into the causes of relational difficulties. While the potential benefits are clear, further research is needed to assess the practical effectiveness of integrating LLMs into Transactional Analysis. Empirical studies should investigate the degree to which LLMs can accurately simulate ego-states and contribute to positive therapeutic outcomes. Additionally, ethical considerations must be addressed to ensure that the application of AI in psychotherapy is both responsible and beneficial for clients.

The proposed approach fosters a deeper understanding of internal conflicts and provides a structured, controlled environment where clients can work through problematic situations.

None Declared

The growing need for effective solutions to bridge the mental health treatment gap is particularly critical in countries where economic and political crises have exacerbated existing mental health challenges. In this context, the urgency for scalable and accessible interventions is evident. Step-by-Step (SbS), a guided digital self-help program developed by the World Health Organization (WHO), has been implemented as a promising approach to alleviate depressive symptoms and improve functionality in vulnerable populations.

This meta-analysis aims to evaluate the findings of studies that examined the efficacy of SbS, compared with enhanced care as usual (ECAU), in reducing depressive symptoms and functional impairment.

We systematically searched PubMed, Cochrane, and Scopus for randomized controlled trials (RCTs) comparing SbS with ECAU. The pooled outcomes were the overall improvement in depressive symptoms, measured by the Patient Health Questionnaire (PHQ-9), as well as functional impairment measured by the WHO Disability Assessment Schedule-12 (WHODAS). We calculated the mean difference (MD) for the outcomes, with 95% confidence intervals (CIs). Statistical analysis was performed using Review Manager (RevMan) 8.1.1 with a fixed-effect model. Heterogeneity was assessed using the I² statistic.

Three RCTs were included, encompassing 604 patients, of whom 263 (43.5%) participated in SbS. The population consisted of 35.1% males and 64.9% females. The mean age was 28.8 years, with a standard deviation of 8.7. SbS reduced PHQ-9 scores (MD = -3.48; 95% CI [-4.44, -2.52]; P < 0.00001; I² = 3%; Figure 1) and WHODAS scores (MD = -3.37; 95% CI [-4.84, -1.90]; P < 0.00001; I² = 0%; Figure 2) compared with ECAU.

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This meta-analysis of RCTs suggests that SbS has a positive effect in reducing depressive symptoms and functional impairment compared with ECAU.

None Declared

Hospital suicide rates vary according to study from 100 to 550 per 100,000 admissions. This is 10 to 30 times the rate of suicide rate in the general population. In prison, there is an average of one death every two or three days, Most of them by suicide. Sensors and Artificial Intelligence to avoid and/or interrupt suicide in the inpatients population. Preliminary explorations will determine weather this kind of device might be acceptable for care providers and patients.

Determine weather careproviders (doctors, nurses) consider the SPIN system as usable in a routine hospilat care setting

Determine weather careproviders (doctors, nurses) consider the SPIN system as acceptable

Establish the technical feasability of the SPIN sytem includin hadware (sensors) and softwar (algorithm) in an invitro setting.

A full presentation of the spin device was presented to the careproviders in a in vitro setting and via a video tutorial of the data capture procédure.

Participants were interviewed during a personal meeting.

Evaluation criteria were : Score to the SUS usablity scale, score the net promoter score and Analysis of the qualitative contents of the interviews.

Qualitative analysis of the interviews contents showed a good

The Spin system will enable earlier intervention in cases where risk factors associated with increased suicidal risk are identified, as well as adjustment of therapies associated with the management of suicidal risk. It can also be used to adjust hospitalization conditions for patients at risk of suicide. transfer knowledge to the prison environment, for example, or to the home of a patient identified as being at high risk (repeat patient).

According to participants, the SPIN device will:

• - alleviate the mental workload of caregivers whose job it is to supervise high-risk patients (risk of falling, risk of agitation, risk of suicide, etc.).

• - admit patients under better conditions (less frequent searches on admission, less frequent room visits, more human-centred care).

This type of system will free us from the logistical constraints associated with the proximity of surveillance rooms and treatment rooms, or even their availability. In this way, patients in intensive care units (monitoring rooms with a view of the nurses’ station) can benefit from more flexible hospital conditions (accommodation), thanks to a remote monitoring system.

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Overall, our study showed a good acceptance of the in vitro setting of the SPIN device in the careproviders population. The newt step of our study will decribe the acceptance in a patient populations and the efficiency on suicidal outcomes in routine population.

None Declared

Objectives: Tele-mental health services can play an important role in overcoming barriers in mental health services in the Eastern Mediterranean Region. However, despite its potential, tele-mental health has not been widely adopted in Oman.

This study is an exploratory investigation into the experiences of therapists and their clients in utilizing video-based tele-mental health care during the COVID-19 pandemic.

A total of 19 semistructured qualitative interviews were individually conducted, it included 13 adult clients with mental health conditions who received video-based tele-mental health care and six clinical psychologists who provided video-based tele-mental health care during the COVID-19 pandemic.

The clients reported favorable experiences using tele-mental health, with the primary benefits being convenience, easy accessibility to subspecialized care, reduced absenteeism from work with commuting costs, and alleviated mental health stigma. The therapists also expressed experiencing benefits from tele-mental health, such as reduced risk of intrahospital infection, reduced healthcare costs, and the achievement of work-life balance. Primary concerns were related to the lack of public tele-mental health services, lack of specified tele-mental health guidelines, shortage of trained therapists, limited access to high-speed Internet, electronic devices, privacy, and concerns toward the security of telehealth systems in general.

Clients and therapists report that tele-mental health offers new opportunities to improve the quality of mental healthcare services in Oman, and that the challenges could be resolved by establishing governmental tele-mental health services along with developing tele-mental health guidelines and implementing local postgraduate clinical psychology programs in universities in Oman.

None Declared

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition characterized by persistent patterns of inattention, hyperactivity, and impulsivity. Cognitive Behavioral Therapy (CBT) is a well-established intervention for ADHD, helping individuals manage symptoms by targeting dysfunctional thought patterns and behaviors. In recent years, the accessibility of digital CBT apps has expanded, providing a potential alternative to traditional therapy. This systematic review aims to assess the efficacy of digital CBT apps for symptom management in individuals with ADHD.

This review seeks to (1) evaluate the effectiveness of digital CBT apps in reducing ADHD-related symptoms such as inattention and impulsivity, (2) assess the adherence and usability of these apps, and (3) identify gaps in the literature to guide future research on digital interventions for ADHD.

A systematic search was conducted using PubMed and Google Scholar to identify peer-reviewed studies published within the last 5 years (2019–2024). The search terms used included “ADHD,” “digital CBT,” “mobile apps,” and “cognitive behavioral therapy.” Inclusion criteria were studies that focused on the use of digital CBT interventions specifically for ADHD symptom management in both children and adults. Studies that assessed the effectiveness of these interventions using standardized symptom rating scales were prioritized. Articles that involved non-CBT digital interventions, case reports, or review articles were excluded.

Six studies met the inclusion criteria. The results showed promising outcomes for ADHD symptom reduction, particularly in reducing inattention and impulsivity. Lenhard et al. (2018) demonstrated significant improvement in ADHD symptoms in children using digital CBT programs. Nigg et al. (2020) found similar improvements in adults. Sibley et al. (2021) observed enhanced executive functioning with high adherence to app-based interventions. In Torous et al. (2020), digital CBT apps improved patient engagement and accessibility to care. Hirvikoski et al. (2017) reported moderate effectiveness in symptom control but emphasized the need for continued monitoring of user adherence. Russell et al. (2021) highlighted the potential for personalization in digital therapies, although further research is needed to optimize these interventions.

The review suggests that digital CBT apps offer a promising approach for ADHD symptom management, particularly in increasing accessibility and adherence to therapy. While these interventions show moderate to significant effectiveness in reducing core symptoms like inattention and impulsivity, further research is needed to address personalization and long-term efficacy. This highlights the growing potential for digital mental health interventions to complement traditional ADHD treatments.

None Declared

Altered brain functional connectivity (FC) of patients with anorexia nervosa (AN) has been observed in the acute phase of the disorder, but it remains unclear to what extent these alterations recover during weight normalization.

In this study, we used resting-state functional imaging data collected during hospitalization and six months post-treatment to investigate longitudinal changes in FC patterns in patients with AN during weight normalization. Since a core feature of AN is the disconnect between body signals and the brain, we aimed to elucidate whether treatment led to changes in the FC of the anterior cingulate cortex (ACC), a part of the brain’s limbic system that plays a crucial role in integrating visceral, attentional, and emotional information.

Seventeen women with restricting type AN underwent MRI scans and assessments to measure BMI and eating disorder symptomatology (Eating Disorder Inventory- EDI) upon hospital admission and six months after discharge. Functional imaging data were processed using seed-based connectivity analysis with ACC as a seed.

Longitudinal analyses showed a significant (p<0.05 FDR corrected) increased FC post-treatment between the ACC and the precuneus, specifically Brodmann area 7. Participants demonstrated significant BMI increases, although no significant changes were observed in clinical symptomatology assessed by EDI.

The findings indicate greater FC between the ACC and the precuneus as patients with AN complete treatment and undergo weight normalization. The precuneus is integral to one’s sense of self, perceived information integration, and reaction to cues. Therefore, increased FC between the ACC and precuneus might improve proprioception, body awareness, and frequency of body image disturbances—all abnormalities central to AN.

None Declared

Eating disorders (EDs) are an important and highly prevalent class of disorders worldwide, with the global lifetime prevalence reaching more than 8% in females and 2% in males. Also, EDs associate high rates of mortality, comorbidity, organic and psychiatric complications, and years lived with disability (YLD), low quality of life and increased healthcare costs. Yet, the pharmacological armamentarium available to treat EDs is quite reduced, a phenomenon that creates difficult challenges for the case management of these patients.

To review the existing literature in order to find new targets explored for the treatment of EDs.

A literature review was conducted in four electronic databases (PubMed, EMBASE, Cochrane, and Clarivate/Web of Science) and the US National Library of Medicine database for clinical trials (www.clinicaltrials.gov) to find clinical studies published between January 2000 and September 2024. The keywords used were “eating disorders”, “feeding disorders”, “anorexia nervosa”, “bulimia nervosa”, “binge eating disorder”, “drugs in pipeline”, and “pharmacological treatment”. Only adult participants were included, and only sources published in English were selected.

The following data are based on 33 sources found during the literature search. Lisdexampheatmine and vortioxetine are explored for in BED, with the first agent receiving FDA approval for moderate and severe binge eating disorder (BED) in adults. Olanzapine is explored in patients with anorexia nervosa (AN), chromium picolinate for BED, methylphenidate + CBT also for BED, and antibiotics for bulimia nervosa (BN). Psychedelics, e.g., psilocybin and MDMA, are explored for AN and BED, but there is a limited number of trials dedicated to these agents that reach only phase 2a. Therapeutic guidelines dedicated to EDs have very few level A recommendations, i.e., fluoxetine and topiramate for BED, lisdexamphetamine for BED, and olanzapine for AN, with several cautionary notes regarding adverse events and restricted availability for some of these drugs.

There is a dearth of good-quality data regarding the efficacy and tolerability of newer pharmacological agents for treating EDs. Therapeutic guidelines dedicated to this type of disorders have only scarce recommendations regarding pharmacotherapy, and there is an urgent need to find more agents that could improve the prognosis of patients with ED.

None Declared

The Preoperative Psychological Assessment of Bariatric Surgery and Metabolic (PP-BSM) aims to detect psychopathologies before the procedure, facilitating interventions and lifestyle changes.

Describing and analyzing the psychological aspects and tools used for pre-bariatric surgery psychological evaluation in the Brazilian Public Health System.

Descriptive cross-sectional study. The convenience sample was composed by psychologists of the bariatric surgery and metabolic teams in the public health system in a region in the South of Brazil. Data were collected through an electronic questionnaire administered via telephone survey, focusing on PP-BSM.

There was consensus regarding the areas to be assessed: cognition, emotion, social support, and psychiatric comorbidities. Variation was found in the protocols and instruments used for PP-BSM, with each hospital using its own protocol. Semi-structured clinical interviews, along with self-reported scales and questionnaires, were used by most psychologists.

Although the psychological aspects assessed are aligned with current Brazilian guidelines, there is a lack of either standardized protocols among services or specific instruments for bariatric surgery candidates. Providing adequate tools and training professionals in their use may contribute to increasing safety and long-term positive surgical outcomes.

None Declared

Eating disorders, such as anorexa nervosa, bulimia nervosa and binge eating disorder, are complex conditions that affect both a person’s physical and mental health. Although biological and psychological factors have been extensively studied, sociocultural factors play a fundamental role in the developmental and maintenance of these disorders.

This poster explores how peer pressure, beauty standards, the influence of the media and social media, along with aspects such as gender, social class and culture, contribute to the emergence of eating disorders, especially among teenagers and young women.

Literature review

Patterns are identified that show a significant correlation between the idealization of thinness and increased body dissatisfaction. The impact of patriarchy, diet culture and social media consumption are discussed, and how these influences are amplified in different sociocultural contexts. Additionally, differences in the prevalence of eating disorders by gender and ethnicity are discussed, as well as implications for treatment prevention.

Intervention strategies that address sociocultural factors and promote a more inclusive and healthy view of the body are needed, with the aim of reducing the impact of these factors on the appearance of eating disorders. The research highlights the need for public policies that regulate media content and promote educational programs on physical and mental health.

None Declared

Eating disorders have some of the highest mortality rates among mental health conditions, particularly when co-occurring with diabetes. In such cases, the risk of complications like recurrent diabetic ketoacidosis and premature mortality significantly increases. Diabulimia, characterized by intentional insulin restriction in individuals with type 1 diabetes to lose weight, remains unrecognized as a distinct diagnosis in psychiatric classification systems, limiting effective treatment options.

To examine the unique clinical challenges of managing diabulimia and address the diagnostic limitations in current psychiatric frameworks

A comprehensive case report was conducted, which included a review of the patient’s clinical history, treatment responses, and psychosocial interventions. Additionally, a literature review was performed using multiple databases, including PubMed, PsycINFO, and Scopus, to evaluate current research on the co-occurrence of eating disorders and diabetes, with particular emphasis on diabulimia. This review helped contextualize the case findings within the broader clinical understanding of diabulimia and its management.

The patient, a 22-year-old woman, has a long history of type 1 diabetes and struggles with diabulimia. She is aware of the severe risks associated with insulin omission, but her desire for weight control leads her to intentionally restrict insulin, particularly during periods of emotional distress. She has a concurrent psychiatric history of depression and anxiety, which exacerbate her difficulties with diabetes management. The patient’s adherence to insulin therapy has been inconsistent, with cycles of brief compliance followed by relapse, particularly during times of heightened stress and body image dissatisfaction. Despite treatment with fluoxetine and ongoing cognitive-behavioral therapy (CBT), she continues to face significant challenges in managing both her diabetes and eating disorder. Recent interventions, including a structured fitness program and targeted psychotherapy, have yielded partial improvements, helping her develop healthier coping mechanisms and improve self-management. However, sustaining these gains remains difficult, and she continues to experience frequent hospitalizations due to metabolic decompensation.

Diabulimia presents unique diagnostic and therapeutic challenges, primarily due to its lack of recognition as a distinct disorder within current psychiatric classification systems. This case highlights the complex interplay between eating disorders, mental health, and diabetes management, highlighting the need for an integrated, multidisciplinary approach to treatment. There is a critical need for increased awareness, the development of specific diagnostic criteria, and tailored therapeutic interventions to improve outcomes for individuals affected by this often-overlooked condition.

None Declared

Eating disorders (EDs) can significantly worsen one’s physical and psychological well-being. In the professional environment, EDs may have serious consequences on the psychological and physical health of workers.

Our study aims to screen EDs and psychological health among workers.

We conducted a descriptive, analytical, cross-sectional survey among workers from an electricity company. We collected sociodemographic and professional characteristics. We screened EDs using the SCOFF questionnaire (Sick, Control, One stone, Fat, Food). Psychological health of our participants was assessed using the Hospital anxiety and depression scale (HADS).

Our study included 497 workers with an average age of 42.2 ± 11.1 years. Among them, 381 were male (76.7%) and 72.2% were married. Two hundred twenty-two participants engaged in physical activity, and 44.1% were smokers. The average job tenure was 15.2 ± 10.8 years. According to the SCOFF questionnaire, 35.6% of participants showed signs of possible eating disorders (EDs). Additionally, 12.5% of participants were found to be anxious, and 13.9% were depressed. The likelihood of EDs was higher among those with depression. Factors associated with an increased probability of EDs included feeling slowed down, experiencing anxiety symptoms like ‘butterflies’ in the stomach, and losing interest in personal appearance.

Eating disorders are common among workers, with notable rates of anxiety and depression also observed. It is essential to raise awareness about the importance of a healthy, balanced diet to support mental well-being and, in turn, improve workplace productivity.

None Declared

Orthorexia Nervosa (ON) is an eating disorder, characterized by rigid and irrational rules about nutrition and food preparation. Although it is not officially recognized by the DSM-5 as a mental disorder, individuals with ON exhibit compulsive and obsessive behaviors related to their diets, with an interest that starts moderate but gradually becomes excessive and potentially pathological.

To assess individuals facing eating disorders, with an emphasis on Orthorexia Nervosa (ON) and Obsessive-Compulsive Disorder (OCD).

This is an integrative literature review, with analyses conducted on the National Library of Medicine (PUBMED) using the descriptors and boolean operators: (Orthorexia Nervosa) AND (Eating Disorders) AND (Obsessive-Compulsive Disorder) AND (obsessive compulsive). Filters applied included: articles published in the last 10 years and available in full text. All articles were analyzed a priori based on the information in the title, followed by reading the abstract, and subsequently, reading the full article.

Seventeen studies were found. According to the data, the age range between 23 and 26 years is at the highest risk for ON, while the risk is lower in individuals between 16 and 19 years. Orthorexic tendencies are more prevalent among Hispanics/Latinos and individuals with overweight or obesity. ON is frequently associated with patients who have body distortions, dissatisfaction with body image, excessive desire for thinness, and eating disorders such as anorexia and bulimia nervosa. Additionally, ON is linked to compulsive behaviors, obesity, strict diets, perfectionism. In individuals on diets, behaviors and problems similar to those seen in eating disorders are often observed, including orthorexic tendencies and obsession with adhering to strict dietary rules. Perfectionism is a common trait among these patients, who often begin with the desire to improve their diet and adopt a healthier lifestyle. However, this pursuit can become excessive, leading to behaviors such as social isolation, high spending on food, and nutritional deficiencies. Various tests conducted in the analyzed studies showed effects in identifying patients with ON, indicating the need for further research to better understand risk factors in different populations and to develop effective strategies for diagnosis, prevention, and treatment.

While a careful diet is not pathological in itself, severe dietary restrictions and social problems should raise the possibility of ON. Improving the identification of risk factors and behaviors may contribute to a better understanding, prevention, and management of ON.

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Refeeding syndrome is a severe metabolic condition seen in psychiatric patients, particularly those with anorexia nervosa or other eating disorders, after rapid nutrient reintroduction. It involves disturbances such as hypophosphatemia, hypokalemia, and hypomagnesemia, creating challenges in psychiatric and medical settings. Early identification and management are critical to prevent complications like cardiac and respiratory failure (1,2,3).

This study analyzes the pathophysiological mechanisms of refeeding syndrome, focusing on key metabolic, psychiatric and electrolyte disturbances during the refeeding process in malnourished patients. It also discusses prevention strategies and clinical management, emphasizing the role of multidisciplinary teams in early diagnosis and treatment (1,2,3).

A literature review was conducted using Scielo, PubMed, Cochrane, and BMJ, focusing on studies about the pathophysiology, risks, and interventions related to refeeding syndrome. From 40 articles analyzed, 12 published between 2000 and 2023 were selected, focusing on clinical management and treatment guidelines for malnourished patients.

The review highlights that refeeding syndrome (RS) is a serious metabolic condition in malnourished patients, especially those with psychiatric disorders like anorexia nervosa. Rapid nutrient intake can cause metabolic issues, such as hypophosphatemia and hypokalemia, alongside significant psychiatric stress. Anxiety and treatment resistance may increase, especially in patients fearing weight gain, raising the risk of relapse.

Physical discomfort from refeeding, such as fluid retention, can worsen anxiety and complicate treatment. This may lead to extended hospitalization and poor treatment adherence. In psychiatric settings, inadequate management of RS can lead to agitation or self-harm. Preventive measures like controlled carbohydrate intake, thiamine supplementation, and electrolyte monitoring are crucial.

Multidisciplinary teams, including psychiatrists, psychologists, and nutritionists, are key to managing RS. Guidelines like those from NICE recommend gradual refeeding to reduce both metabolic and psychiatric stress.

Refeeding syndrome is a preventable yet potentially fatal condition. Early identification of at-risk patients and careful nutritional strategies are essential to reduce morbidity and mortality. Multidisciplinary teams play a crucial role in managing and educating patients, while further research is needed to inform clinical practices (6-7).

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