Non-mental health professionals play an important role in the diagnosis and treatment of Eating Disorders (EDs).

This study aimed to explore attitudes toward EDs and knowledge of diagnosis, aethiology, and management of EDs among health professionals.

A new questionnaire was validated and administered to residents and consultants working in disciplines involved in the management of EDs. Health professionals were grouped in the following areas: internal medicine, general practitioners, psychiatric area, psychological area, and surgical area. One-way ANCOVA and chi-square tests were employed to compare knowledge and attitudes among the study groups.

For all health professionals, the most deficient area was the aetiopathogenesis, while the best one was the management of physical complications. A gap in the knowledge of diagnosis, aetiopathogenesis and treatment emerged in nonmental health professionals. Psychotherapy effectiveness and the role of family members in the therapeutic process were not sufficiently acknowledged, and general psychological factors contributing to the onset of EDs were not recognized. Stigma was found primarily among surgeons, although all nonmental health professionals often considered those patients responsible for their ED.

Inadequate knowledge and impaired attitudes toward EDs occurr among health professionals. This type of stigma may impair early diagnosis and treatment of EDs. Educational programs should provide continuous education to update and improve the knowledge of EDs among non-mental health professionals.

None Declared

Binge-Eating Disorder (BED) is characterized by frequent episodes of consuming excessive amounts of food, leading to both psychological and physical symptoms. Treatment typically involves a combination of psychotherapy and antidepressants. The disorder is often associated with dysfunctions in the dopamine and norepinephrine systems and to address these dysfunctions, lisdexamfetamine dimesylate (LDX) may offer potential benefits by targeting impulse control and reward pathways, thereby addressing these underlying issues.

This study aims to evaluate the efficacy, safety, and tolerability of LDX compared to placebo in adults with BED through a systematic review and meta-analysis.

We systematically searched PubMed, Embase, and Cochrane Central for randomized controlled trials (RCTs) comparing LDX versus placebo in patients with BED. Primary outcome was binge eating days per week (BEDW) and secondary outcomes were Yale–Brown Obsessive–Compulsive Scale modified for binge eating (YBOCS-BE), Clinical global impressions-improvement scale (CGI-I), weight reduction (WR) and specific occurrence of treatment-emergent adverse event (TEAEs), like dry-mouth and insomnia. Mean differences (MDs), standardized mean differences (SMDs) and risk ratio (RR) were used for all outcomes. p<0.05 presented significant statistical results, while I²>40% represented a high heterogeneity.

A total of 5 RCTs were included, involving a total of 963 patients, of whom 517 patients received LDX. BEDW (MD: -1.29; 95% CI [-1.65, -0.93]; p<0.01; I²=60%; Figure 1A) was significantly reduced when comparing LDX with placebo. YBOCS-BE (MD: -6.16; 95% CI [-8.35, -3.97]; p<0.01; I²=66%; Figure 1B) has shown an indication of reduction of obsessive-compulsive behaviors (OCB) in patients using LDX. CGI-I (RR: 1.72; 95% CI [1.12, 2.63]; p=0.032; I²=71%; Figure 2A), WR (SMD: -1.31; 95% CI [-1.55, -1.07]; p<0.01; I²=59%; Figure 2B). The use of LDX exhibit an increase on dry-mouth (RR: 5.08; 95% CI [3.39, 7.61]; p=0.001; I²=0%; Figure 3A) and insomnia (RR: 3.00; 95% CI [1.52, 5.94]; p=0.014; I²=0%; Figure 3B) when compared with placebo.

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Our study has shown significant improvements in the use of LDX in BED. Patients presented a reduction in OCB, CGI-I, WR, and BEDW. Although some TEAEs were observed, LDX treatment in BED shows a greater benefit.

None Declared

The adverse social impact of parental alcoholism on children’s development is well known and is primarily associated with difficulties in social adaptation, a higher risk of anxiety, depression, personality disorders, etc. At the same time, in the genesis of neuropsychiatric disorders in such children, parental alcoholism can be both a socio-psychological and biological factor, through its impact on germ cells, the developing fetus, and postnatal development. The dates of birth of the studied cohort of patients fell in the period of the late 1970s - first half of the 1980s - years of steady growth in alcohol consumption in the late Soviet Union, when, according to the USSR State Statistics Committee, the average resident of the USSR consumed (excluding production by the population, primarily moonshine) an average of 10.7 liters of pure alcohol per capita. Soviet tradition prescribed the mandatory presence of alcoholic beverages on the holiday table. At the same time, the longest and most widespread alcohol consumption in the USSR occurred on summer vacations and official state holidays, for which extraordinary non-working days were established. Along with traditional summer holidays (July and August), such periods were, the second half of February – the first half of March (passing from one to another, the celebration of February 23 (Soviet Army Day and March 8), the end of December/the non-working first half of January (a ten-day celebration of the New Year), the celebration of Revolution Day (the first half of October).

To investigate the possible role of increased alcohol abuse during the periods of conception of children who will later suffer from nervous anorexia and bulimia.

The approximate dates of conception (considering the terms of full-term pregnancy and the date of birth) of patients (N=191) with eating disorders (AN and NB) born before 1991 were analyzed in relation to the periods of traditional mass alcohol consumption in the late USSR.

The frequency of conception of future patients with eating disorders in the study group during periods of traditionally stable growth in alcohol consumption was 1.4–1.7 times higher (p < 0.01) than in other periods. A clear pattern emerged from the analyses. That is, eating disorders, like other chronic psychiatric diseases, are the product of multiple factors, however, alcohol abuse during conception clearly increases the risk of having daughters with AN and BN.

In conclusion, periconceptional alcohol consumption appears to significantly elevate the risk of offspring developing eating disorders, specifically anorexia nervosa and bulimia nervosa. The study reveals a marked increase in conception during peak alcohol consumption periods, suggesting alcohol’s potential role in the etiology of these disorders.

None Declared

Eating disorders (EDs) are characterized by intrusive thoughts about food, weight loss, and body image, often accompanied by compulsive behaviors related to weight control. Obsessive-compulsive behavior is frequently observed in individuals with EDs. The relationship between obsessive-compulsive disorder (OCD) and EDs is complex due to overlapping symptoms. Research indicates that individuals with both OCD and EDs are prone to depression and anxiety, which may manifest as secondary responses to stress. Symptoms of OCD can significantly impair functioning, leading to maladjustment. Some studies have noted a correlation between increased body mass index (BMI) and reduced depressive symptoms in patients suffering from anorexia nervosa.

This research aimed to investigate the severity of anxiety-depressive and obsessive-compulsive symptoms in relation to changes in BMI among patients with eating disorders.

The study was conducted at the Center for Eating Disorder Research in collaboration with the Department of Psychiatry and Medical Psychology at the Peoples’ Friendship University of Russia. A sample was created from patients undergoing inpatient treatment with diagnoses according to ICD-10 (F50.0, F50.1). Clinical interviews were conducted during the first and fourth weeks using PHQ-9 (for depression), GAD-7 (for anxiety), and the Yale-Brown Obsessive Compulsive Scale. Statistical analysis was performed using Jamovi 2.3.28.

Thirty female patients participated in the study. All received psychopharmacotherapy. The average age was M=14.4, SD=1.5. The mean BMI at the start was M=13.3, SD=1.69, increasing by M=1.20, SD=0.612 by the second assessment. Depressive symptoms were observed in 28 (93.33%) during week one and in 25 (83.33%) during week four. Elevated anxiety levels were noted in 24 (79.99%) during week one and in 25 (83.33%) during week four. Significant OCD symptoms were present in 25 (83.33%) during week one and in 21 (70%) during week four. Correlation analysis revealed no significant relationships (p > 0.01) between BMI levels and OCD symptoms on the Yale-Brown scale (r = 0.099), depressive symptoms on the PHQ-9 scale (r = 0.28), or anxiety levels on the GAD-7 scale (r = 0.369).

Findings indicate certain relationships between BMI and psycho-emotional states among patients with eating disorders; however, statistically significant correlations were not identified (p > 0.01). This underscores the need for further research to deepen understanding of these relationships, especially since none of the respondents achieved normal BMI values (18.5). Future studies should involve larger sample sizes and extended time frames for more reliable data.

None Declared

Bulimic behavior has been increasingly recognized in patients with bipolar disorder (BD). Even during euthymic phases, individuals with BD may remain vulnerable to disordered eating patterns such as bulimia and binge eating.

This study aims to examine the occurrence of bulimic behavior in euthymic patients with BD and identify associated clinical and sociodemographic factors.

We conducted a cross-sectional, descriptive, and analytical study of 93 patients followed for bipolar disorder at the psychiatry outpatient unit at the Hedi Chaker University Hospital in Sfax. The questionnaire included sociodemographic data, medical and psychiatric history, and anthropometric characteristics. Bulimic behavior was assessed using the Bulimic Investigatory Test Edinburgh (BITE).

The mean age of the participants was 41.49±12.33 years, with a M/F sex ratio of 2.58. Among the patients, 58.1% were married, 45.2% had secondary education, and 47.3% were unemployed. Personal somatic history was reported by 35.5%, while 11.8% had psychiatric comorbidities in addition to bipolar disorder.

The mean body mass index (BMI) was 27.4 kg/m² (SD=5.96), with 29% of patients being overweight and 31.2% classified as obese.

Eight patients (8.6%) had BITE scores above the threshold of 20, indicating bulimic behavior.

Significant associations were found between elevated BITE scores and female gender (p=0.012), comorbid medical conditions (p=0.005), family history of schizophrenia (p=0.024), weight (p<10⁻³), BMI (p<10⁻³), hypomanic residual symptoms (p<10⁻³), irregular follow-up (p=0.027), and delayed management of BD (p=0.04).

Our results highlight the importance of early identification and comprehensive management of disordered eating in bipolar patients, even during periods of mood stability, to optimize overall health and psychiatric outcomes.

None Declared

Bipolar disorder is a chronic mood disorder that often coexists with a range of psychiatric and physical comorbidities. Among these, eating disorders (ED) have emerged as a significant concern due to their impact on the course and prognosis of BD.

This study aims to investigate the prevalence of ED in stabilized bipolar patients and identify clinical and demographic factors associated with this comorbidity.

We conducted a cross-sectional, descriptive, and analytical study of patients followed for bipolar disorder at the psychiatry outpatient unit at the Hedi Chaker University Hospital in Sfax. The questionnaire included sociodemographic data, medical and psychiatric history, and anthropometric characteristics. Eating disorders were assessed using the Eating Attitude Test 40 (EAT-40).

Our study included 93 patients. The mean age was 41.49±12.33 years, with a M/F sex ratio of 2.58. Among the patients, 58.1% were married, 45.2% had secondary education, and 47.3% were unemployed. Personal somatic history was reported by 35.5% of participants, and 11.8% had psychiatric comorbidities alongside bipolar disorder.

The mean body mass index (BMI) was 27.4 kg/m² (SD=5.96). Of the patients, 29% were overweight, and 31.2% were obese. The prevalence of eating disorders was 18.3%.

EAT-40 scores were significantly associated with age (p=0.018), female gender (p<10⁻³), living alone (p=0.031), lack of formal education (p=0.009), history of medical comorbidities (p<10⁻³), weight (p=0.05), and BMI (p=0.003).

The significant associations between EAT-40 scores and sociodemographic factors underscore the need for targeted screening and interventions in this population. Early detection and management of eating disorders in bipolar patients are crucial to improving clinical outcomes and overall quality of life.

None Declared

Depression is a serious CNS-related disease that may require long-term treatment. Postpartum depression is a critical medical condition that affects the mother, as well as has a short and long-term impact on the growth of the infant. There is an urgent medical need to develop new treatments for these diseases. GABAA receptor is a cell membrane receptor in the brain that responds to the neurotransmitter gamma-aminobutyric acid (GABA). It is a ligand-gated ion channel and help maintain the balance between excitation and inhibition in the central nervous system, by reducing the likelihood of neuronal firing. It is proven that positive allosteric modulation of GABAA receptor has the potential to treat postpartum depression and major depression disorder.

To discover a pre-clinical compound that meets our targeted product profile, i.e., good potency, orally bioavailable, in vivo efficacy in animal disease models, a good safety profile, etc. The compound was to be advanced into clinical development.

With the help of CADD and AIDD, we have discovered lead molecules that bound to GABAA receptor. Structural optimization of these molecules led to the discovery of a potent GABAA receptor positive allosteric modulator as our pre-clinical candidate (PCC) compound with excellent pharmacokinetic properties and efficacy in a variety of animal models. Safety studies showed that the compound has a good safety profile.

We have discovered a positive allosteric GABAA modulator, KH607, with high potency against all three subtypes of GABAA receptors, especially the α5β3γ2 subtype. PK studies showed that the compound had high oral bioavailability in mice, rats, dogs, and monkeys, ranging from 60% to 125%. KH607 effectively penetrates the blood-brain barrier. In anxiety and depression animal modes, KH607 showed anti-anxiety and antidepressant efficacy through oral administration at a dosage of 0.3 mg/Kg to 1.0 mg/Kg. The phase 1 clinical trial up to 40 mg qd dosage orally in human showed that KH607 was well-tolerated with no severe adverse events (AEs) and low discontinuation rate. The PK result demonstrated good pharmacokinetic characteristics and a linear correlation between dosage and exposure.

PPD and MDD are serious CNS-related diseases that need new treatments. Our newly discovered compound, KH607 is a potent GABAA receptor positive allosteric modulator. Pre-clinical studies showed significant efficacy to improve anxiety and depression-like behaviors in a variety of animal models. The compound has an acceptable safety profile for the development as an anti-depressive drug. Therefore, it was advanced to human clinical studies. A phase 1 clinical trial in human was completed. Phase II clinical studies are currently ongoing. We expect that the compound to be developed as a new treatment to address the unmet medical needs for PPD and MDD patients.

None Declared

One year after COVID-19’s emergence, studies show healthcare workers (HCWs) face significant depression risk linked to pandemic stressors. While the pandemic impacted social and economic factors, the link between depression and social support/financial hardship in HCWs remained unclear.

This study leaded in France investigates depression prevalence and its association with these factors among HCWs one year after the onset of the COVID-19 pandemic.

Data collection was conducted in 2021 where participants completed an online questionnaire to assess probable major depressive disorders (MDD) using the 9-item Patient Health Questionnaire (PHQ-9).

Among the 655 respondents, 21.1% had probable MDD. Using log-binomial regression, we found an association between perceived loneliness, lack of psychosocial support at work and deterioration of one’s financial situation with probable depression. Further adjustment on mental health comorbidities revealed an association between both a deterioration of financial situation and living alone with probable depression.

This study shown an association between social support and financial conditions and depressive symptoms among HCWs, regardless of level of education, pandemic and work-related factors and mental health comorbidities. This emphasises the need to improve working conditions for HCWs, combat their loneliness, increase wages and provide support for HCWs at high risk of depression.

None Declared

In the ESCAPE-TRD study, esketamine nasal spray (ESK-NS) significantly increased chance of remission at Week 8 versus (vs) quetiapine extended release (Q-XR) in patients (pts) with treatment resistant depression (TRD; Reif et al. NEJM 2023; 389:1298–309). Changes in disability and functional impairment due to depressive symptoms assessed with the Sheehan Disability Scale (SDS) are reported.

To assess the effect of ESK-NS vs Q-XR on pts’ daily functioning using SDS, considering their symptom evolution.

ESCAPE‑TRD was a randomised phase IIIb trial comparing the efficacy of ESK-NS vs Q-XR, both alongside an ongoing selective serotonin/serotonin-norepinephrine reuptake inhibitor, in pts with TRD. Clinical response (CRes) was defined as ≥50% improvement in Montgomery-Åsberg Depression Rating Scale (MADRS) score from baseline or total score ≤10, clinical remission (CRem) was defined as total MADRS score of ≤10, and functional remission (FRem) was defined as SDS total score ≤6. The Kaplan-Meier method was used for time to event analyses, and hazard ratios (HRs) were estimated using Cox regression models. Time in each state was estimated by treatment arm and compared between arms using analysis of covariance.

336 and 340 pts were randomised to ESK-NS and Q-XR, respectively. Significantly more ESK-NS treated pts achieved CRes, CRem and FRem (HRs: 1.848, 1.711 and 1.819, respectively; all p<0.001), and achieved these faster, compared to Q-XR (Figure 1). In each arm and at each time point, more pts reached CRes than CRem, and more reached CRem than FRem, illustrating that FRem is more difficult to achieve (Figure 1). Total time in CRes was 5.4 weeks greater for ESK-NS compared with Q-XR; total time in CRem was 3.7 weeks greater and in FRem 2.0 weeks greater for ESK-NS vs Q-XR, respectively (Table 1).

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These data support a temporal cascade of events from CRes to CRem to FRem; ESK-NS improved time to, and in, each outcome vs Q-XR. Treatments that reduce clinical symptoms better and faster provide the best chance of improving functional impairment.

None Declared

Depression in older adults may present itself as a recurring disorder originating from earlier life, as a new onset depression (late-onset depression, LOD), or as a depression due to organic diseases (e.g., vascular depression). An estimated 30% of all cases of depression in older adults are represented by LOD. Low tolerability due to the changes of the pharmacodynamic and pharmacokinetic profile (e.g., lower volume of distribution, reduction of renal clearence, longer half-time, different receptoral sensitivity and density), as well as low efficacy of antidepressants and high risk of completed suicide, have been reported in this population.

To explore the current state of evidence for the pharmacological treatment of LOD through a narrative literature review.

This review included three databases (Web of Science/Clarivate, PubMed, and Cochrane), explored from their inception to June 2024, for papers published in English using the keywords “late-onset depression,” “geriatric depression,” “old age depression,” and “antidepressants” or “treatment.”

Based on the results of 27 selected primary and secondary reports, selective serotonin reuptake inhibitors (SSRIs), especially escitalopram and sertraline, are considered the first line of treatment for LOD, with >50% rate of responsiveness being reported. SSRIs are followed by serotonin-norepinephrine reuptake inhibitors (SNRIs), and other new-generation antidepressants, mainly mirtazapine, vortioxetine, and bupropion. The therapeutic guidelines recommend the correct treatment of comorbid neurocognitive disorders; however, the available evidence shows that antidepressants have very limited efficacy in the presence of dementia. The number needed to treat (NNT) for LOD was between 6.7 and 14.4 (Alexopoulos Transl Psychiatry 2019;188 9). For treatment-refractory LOD (TRLOD), augmentation with lithium, aripiprazole, memantine, or methylphenidate, as well as switching to phenelzine, nortriptyline, desipramine, or a combination of antidepressants, such as bupropion and nortriptyline have been suggested as potential solutions, but the evidence to support such recommendations has low quality. Regarding the tolerability of antidepressants in this specific population, electrolyte imbalance, worsening of cognitive dysfunction, increased coagulation time, and falls should be considered.

SSRIs are the first-line pharmacological approach in LOD, with SNRIs and other new-generation antidepressants as the second-line. The pharmacological recommendations for TRLOD are based on low-quality data. Due to the tolerability and safety-specific aspects, special care should be given when monitoring these patients during the pharmacological treatment.

None Declared

Migraine is strongly associated with depressive and anxiety disorders, as migraine patients have over a twofold higher risk of major depressive disorder and nearly a threefold higher risk of anxiety disorders compared to non-migraine individuals.

This study investigates the 13-year trajectories in individuals with a depression or anxiety disorder with and without comorbid migraine. Additionally, the time to recovery of the depressive or anxiety disorder was compared.

The NESDA cohort consists of participants with an affective disorder at baseline, according to the Composite International Diagnostic Interview (CIDI). Depressive symptoms were measured using the Inventory of Depressive Symptomatology (IDS) and anxiety symptoms with the Beck Anxiety Inventory (BAI). The participants were divided at baseline into three subgroups: migraine, non-migrainous headache and non-headache. The individual symptom trajectories were evaluated over 13 years with linear mixed models. Additionally, the time to recovery of the affective disorders with or without migraine were compared with a Cox-proportional hazard analysis.

In total 1,448 participants had either a depressive or anxiety disorder or a combination of both at baseline, 327(23%) had additional comorbid migraine, 518(36%) non-migrainous headache. Participants with comorbid migraine consistently reported higher severity of depressive and anxiety symptoms than non-headache participants over the 13-year follow-up, with an estimated higher IDS sum score of 0.22 (p<0.001) and a higher BAI sum score of 0.28 (p<0.001) (see Figure 1 and 2). The time to recovery of an affective disorder was similar for migraine and non-headache individuals (HR: 1.13 (p=0.17)).

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In this cohort, individuals with comorbid migraine showed consistently higher severity of depressive and anxiety symptoms than non-headache individuals over 13 years. Recovery time from an affective disorder was similar for migraine and non-headache individuals.

N. Van Veelen: None Declared, N. Pelzer Grant / Research support from: Independent support from the European Community, Dutch Heart Foundation, Dutch Research Council, Dutch Brain Foundation, Dioraphte, and the Clayco foundation, Consultant of: Consultancy support from Abbvie/Allergan, Lilly, Lundbeck, Novartis, Pfizer, Teva, B. Penninx: None Declared, G. Terwindt Grant / Research support from: Independent support from the European Community, Dutch Heart Foundation, Dutch Research Council, Dutch Brain Foundation, Dioraphte, and the Clayco foundation, Consultant of: Consultancy support from Abbvie/Allergan, Lilly, Lundbeck, Novartis, Pfizer, Teva, E. Giltay: None Declared

Craniocerebral injuries are serious traumatic situations with negative effects in the overall health and also in sports performace and health

Aim of this study is to present cases of deppresive disorders after mild craniocerebral injuries in professional athletes

6 cases are presented. Range of age between 20 and 30 years old. All of them reported depressive disorders during the post traumatic period after craniocerebral injuries mainly during professional athletic activities

All of them they receive appropriate neurological, psychiatric, psycological and rehabilitation support and treatment. They managed to have a good outcome after 24 months follow up.

The development of depressive disorders after such traumatic events remains a strong predictor of a variety of difunctions (social, personal, work etc). The emergence of depressive disorders in many cases remains unexplored and poorly understood. The effect into the the overall health remains a very important factor to investigate. The combination and collaboration of the various medical disciplines is essential in order to help young people and mainly professional athletes.

None Declared

Cranial and cervical spine injuries are serious traumatic situations with negative effects in the overall health and also in sports performace and health

Aim of this study is to present cases of deppresive disorders after combination of cranial and cervical spine injuries in amateur athletes

8 cases are presented. Range of age between 25 and 45 years old. All of them reported depressive disorders during the post traumatic period after combination of cranial and cervical spine injuries mainly during amateur athletic activities

All of them they receive appropriate neurological, psychiatric, psycological and rehabilitation support and treatment. They managed to have a good outcome after 36 months follow up.

The development of depressive disorders after such traumatic events remains a strong predictor of a variety of difunctions (social, personal, work etc). The emergence of depressive disorders in many cases remains unexplored and poorly understood. The effect into the the overall health remains a very important factor to investigate. The combination and collaboration of the various medical disciplines is essential in order to help young people.

None Declared

Cervical spine injuries are serious traumatic situations with negative effects in the overall health and also in sports performace and health

Aim of this study is to present cases of deppresive disorders after cervical spine injurie in amateur athletes

12 cases are presented. Range of age between 30 and 40 years old. All of them reported depressive disorders during the post traumatic period after cervical spine injuries mainly during amateur athletic activities

All of them they receive appropriate neurological, psychiatric, psycological and rehabilitation support and treatment. They managed to have a good outcome after 24 months follow up.

The development of depressive disorders after such traumatic events remains a strong predictor of a variety of difunctions (social, personal, work etc). The emergence of depressive disorders in many cases remains unexplored and poorly understood. The effect into the the overall health remains a very important factor to investigate. The combination and collaboration of the various medical disciplines is essential in order to help young people.

None Declared

Major Depressive Disorder (MDD) affects up to 20 million people worldwide over their lifetime. 30% will not attain lasting symptom relief even after multiple treatment attempts. Mindfulness-based interventions (MBIs) have recently been added as adjunctive therapy for MDD. However, their efficacy as adjunctive therapy for difficult-to-treat depression (DTD) remains unclear.

This systematic review and meta-analysis sought to evaluate the efficacy of MBIs in treating DTD.

We conducted a search of MEDLINE, Embase, Web of Science, PsycINFO, Cochrane Central Register of Controlled Trials, the World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov. No restrictions on language or publication date were enforced. We included randomized controlled trials that compared MBIs with usual care or other treatments for unipolar DTD. In this context, DTD refers to the inability to achieve full remission of depressive symptoms despite receiving an adequate course of antidepressant medication. When a sufficient number of studies were available for the outcome analysis, we employed a random-effects model to address the variability between interventions. For outcomes based on a smaller number of studies, we used a fixed-effects model. Additionally, we performed influential and subgroup analyses to investigate the data further. To assess the risk of bias, we utilized the Risk of Bias 2 tool.

Eight studies met our inclusion criteria, comprising 449 participants (mean age = 42.6, predominantly female). The MBIs evaluated included mindfulness-based cognitive therapy, breathing-based meditation, and dialectical behavior therapy with mindfulness components. We found that adjunctive MBIs significantly reduced depressive symptom severity, with an effect size of g = -0.80 (95% CI [-1.32, -0.27], p = 0.0004). Additionally, MBIs caused significant improvements in anxiety (g = -0.57, 95% CI [-0.94, -0.20], p = 0.002) in four studies (n = 126), mindfulness (g = 0.32, 95% CI [0.06, 0.57], p = 0.02) in three studies (n = 243), and psychological well-being (g = 0.66, 95% CI [0.25, 1.07], p = 0.002) in three studies (n = 97).

MBIs demonstrate a substantial benefit for patients with DTD, with a large effect size in reducing depressive symptoms, a medium effect size in improving anxiety and psychological well-being, and a smaller effect size in enhancing mindfulness. Their ability to significantly alleviate depressive symptoms and improve overall mental health supports their integration into treatment plans for DTD. However, this review was limited by the small number of eligible studies, small sample sizes, and high heterogeneity between studies. To better understand the effectiveness of MBIs for DTD, larger clinical studies are needed.

I. Borja De Oliveira: None Declared, L. Robles Rafael: None Declared, M. Kraide Piedade de Abreu: None Declared, A. Stephany: None Declared, D. Soler Lopes: None Declared, M. Geremias: None Declared, F. Wagner: None Declared, A. de Vasconcelos: None Declared, M. Carbajal Tamez: None Declared, J. Quevedo Shareolder of: Instituto de Neurociencias Dr. Joao Quevedo, Grant / Research support from: LivaNova; and receives copyrights from Artmed Editora, Artmed Panamericana, and Elsevier/Academic Press, Consultant of: EMS, Libbs, and Eurofarma, Speakers bureau of: Myriad Neuroscience and AbbVie., M. Teranishi: None Declared

Knowledge of the prenatal predictors of postpartum depressive symptoms is of fundamental importance in preventing them.

This study aimed to examine whether first trimester maternal hair cortisol influenced maternal postpartum depressive symptoms.

The women (N = 75) were tested twice: in the first trimester of pregnancy and within three months after delivery. In the first trimester, they had hair samples taken and were examined using a sociodemographic survey and questionnaires: the Edinburgh Postnatal Depression Scale (EPDS), the Perceived Stress Scale (PSS-10), and the Zimbardo Time Perspective Inventory (ZTPI). After delivery, women completed a survey about the course of delivery and their child’s health, EPDS, PSS-10, and ZTPI.

A multiple hierarchical regression analysis was conducted to identify the predictors of postpartum depressive symptoms. In the first step, presence of maternal chronic illness and birth length were added, since these variables were associated with postpartum stress in our study. In the second step, we added the scores on depressive symptoms (EPDS) and stress (PSS-10) in the first trimester. After including hair cortisol concentration in the third step, depressive symptoms, stress, and hair cortisol concentration in the first trimester turned out to be predictors of postpartum depressive symptoms. The results showed that higher levels of depressive symptoms and stress and a lower level of hair cortisol concentration in the first trimester were associated with higher levels of postpartum depressive symptoms. We conducted mediation analyses to test time perspective as a mediator in the relationship of hair cortisol concentration in the first trimester to postpartum depressive symptoms.The results suggested that fatalistic time perspective mediated the relationship between hair cortisol concentration in the first trimester and postpartum depressive symptoms. In other words, women with lower hair cortisol concentration in the first trimester were more likely to develop postpartum depressive symptoms, and this relationship was explained by fatalistic time perspective.

The results of our study indicate that women with very low hair cortisol concentration in the first trimester are at greater risk for postpartum depression. These are the first data to show that low level of cortisol in the first trimester can be a predictor of maternal postpartum depressive symptoms. The results of our study suggest that examining hair samples in the first trimester of pregnancy may be a valuable method for identifying women at risk of developing postpartum depression.

None Declared

A systems approach to understanding late-onset depression points to its association with cardiovascular disease, cerebrovascular disease, tissue and organ trophic disorders, cognitive impairment, anergy, and decreased lifespan. These features are consistent with progressive aging

literature analysis

general scientific method

Cellular senescence is characterized by irreversible cell growth arrest. Characteristic features of senescent cells include increased cell size, accumulation of β-galactosidase and lipofuscin in the cytoplasm, accumulation of DNA damage foci, condensed heterochromatin regions, shortened telomeres, and increased expression of cell cycle regulatory markers. Telomere attrition has been linked to depression. Individuals with MDD have shorter white blood cell length compared to subjects without a history of depression. Telomere attrition is also associated with more unstable IL-6 levels and oxidative stress markers in major depressive disorder. Postmortem studies of the brain have revealed that severe depression leads to depletion of various areas of the cerebral cortex and oligodendrocytes. According to the authors, there is a link between severe depressive disorders and cellular aging of the brain. Mitochondrial dysfunction. Mitochondrial dysfunction in depression and aging includes genomic instability, defects in biogenesis, electron transport chain and mitochondrial scavenging, nutrient regulation mechanisms, proteostasis. In late depression, the number of mitochondrial DNA copies decreases. Increased production of ROS is a marker of mitochondrial dysfunction. In contrast, depressed individuals have elevated lipid peroxidation markers and an imbalance between oxidative stress and antioxidant stress markers. MtDNA oxidation and fragmentation are consequences of elevated OS, with high levels of fragmented mtDNA being associated with more severe depressive episodes and also a biomarker of aging and tissue damage. In patients with late-onset depression, ccf mtDNA has been found to correlate with chronic levels of IL-6, a master regulator of inflammation and a major component of SASP.

Total scores assess indicators of mitochondrial dysfunction, telomere length, cognitive tests, and structural changes on MRI in women with late depression higher than in elderly men.

None Declared

Affective disorders, including but not limited to major depressive disorder, bipolar disorder, and persistent depressive disorder, comprise a group of disorders characterized by clinically significant mood disturbances. Depression, which makes the most important contribution to the DALY index among all mental disorders, was the primary focus of this study. Physical activity, regardless of changes in body weight, has been shown to reduce symptoms of depression and the likelihood of a new episode of the disease.

This qualitative study aimed to explore the barriers to motivation for physical activity in patients with affective disorders.

This study comprised a qualitative investigation using semi-structured interviews with thematic analysis. Following ethical approval, a convenience sample of 10 participants with affective disorders was drawn: all of the sample were female, aged 18 years or older, with 69% falling into the 27–35 years age bracket. Diagnostic and clinical information were collected, and barriers to engagement in physical activity were explored. All interviews were recorded and transcribed verbatim.

Ten face-to-face qualitative interviews were completed and lasted between 30 and 60 min. The findings were summarized under the key thematic areas of Anhedonia, Fatigue, Lack of time, Fear of condemnation, and Embarrassment, illustrated by texts. The key thematic areas were further grouped under the overarching themes of 1. Personal characteristics and the influence of low mood: anhedonia and fatigue; 2. External factors: need more time; 3. Social factors: embarrassment and fear of condemnation. Then, the following barriers were identified: “Lack of Strength” barrier, “Lack of Time” barrier, and “Rejection of physical characteristics” (or self-stigma) barrier.

While small and exploratory, the study provides significant insights into the barriers to motivation for physical activity in patients with affective disorders. Although these findings are not generalizable to other populations or males with affective disorders, they offer valuable considerations for future research and interventions in this field. This study’s findings have profound implications for future psychosocial interventions for patients with affective disorders. By identifying and understanding the barriers to motivation for physical activity, it paves the way for more effective, individualized interventions, including those aimed at reducing self-stigma.

None Declared

Healthcare workers are exposed to many psychological constraints, making them vulnerable to mental health issues, like depression. However, these constraints, in addition to other organizational and environmental exposures, vary between specialties and wards.

The aim of this study is to compare depression score in anesthesia technicians (AT) and radiology technicians (RT).

We conducted a cross-sectional study among AT and RT in both University Hospitals in Sfax, Tunisia, between January and July 2024 during periodic health assessment visits. Sociodemographic and professional data were collected. The Patient-Health-Questionnaire-9 (PHQ-9) was used to assess signs of depression.

A total of 79 technicians participated in the study, with 60 AT and 19 RT. Their mean age was 46.4±7.6 years and six of them were males. Ten participants (12.7%) had a known psychiatric history. The mean seniority was 22.2±7.7 years. Sixty-two percent of the population had night shift work. The median PHQ-9 score was 7 interquartile range IQR [4;12]. Moderate to severe signs of depression were found in 32.9% of the population. Depression scores were significantly higher among RT with a median of 10 IQR [6;15] compared to a median of 7 IQR [2;11] among AT (p=0.04). PHQ-9 was not associated with age (p=0.15), sex (p=0.9) or seniority (p=0.06).

Both AT and RT presented signs of depression. The difference of scores between the two groups stirs interests about the explaining factors. Further studies detailing different occupational constraints and exposure are needed.

None Declared

Exposure to anesthetic agents (AA) has long been a subject of concern, both for patients and healthcare workers. Recent studies highlighted potential associations between a prolonged exposure and healthcare concerns, including psychological effects such as depression.

The aim of this study was to assess signs of depression among anesthetic technicians (AT) and evaluate its associated factors.

We conducted a cross-sectional study among AT in two University Hospitals in Sfax, Tunisia, between January and July 2024 during periodic health assessment visits. Sociodemographic and professional data were collected. The Patient-Health-Questionnaire-9 (PHQ-9) was used to assess signs of depression.

Our population consisted of 60 AT with a mean age of 47.9±7.1 years. Two participants (3.3%) were males. Nine participants (15%) had a known psychiatric history. The mean seniority was 24±7.5 years in healthcare and 10.4±8.1 years in the current ward. The mean duration of exposure to anesthetic gases was 18.3±10.7 years. Sevoflurane was the most utilized AA, used by 75% of the population. Ninety-five percent of the population had shift work.

The median PHQ-9 score was 7 interquartile range IQR [2;11]. Moderate to severe signs of depression were found in 26.7% of the population. Duration of exposure to anesthetic gases was significantly lower among those presenting moderate to severe signs of depression (11 IQR [5;21]) compared to those presenting no or mild signs of depression (20 IQR [11;28]) (p=0.02).

Long professional exposure to AA showed lower depression scores among AT. Comprehensive studies are needed to evaluate the broader mental health and cognitive effects of these agents. Understanding these dynamics is essential for ensuring the safety of healthcare professionals.

None Declared